Last updated 2026-07-11
TL;DR
Hanen More Than Words is a parent-led program built around eight strategies you practice during everyday routines rather than structured drills. The full course runs through a certified Hanen SLP, but the core ideas, following your child's lead, adding language just above their level, creating small moments that invite communication, and building turn-taking, can all start at home today.
What More Than Words is, and who it's for
More Than Words is a training program published by The Hanen Centre, a Canadian nonprofit founded in 1975 by speech-language pathologist Ayala Hanen Manolson. It's built for parents of autistic children age 5 and under, or any child whose main challenge is social communication rather than pronunciation. It isn't a general late-talker program: if your child is a late talker without social communication differences, Hanen's It Takes Two to Talk fits better.
The idea is that you, not a therapist, become your child's primary communication partner. The research behind it draws on responsive interaction models showing that parent-implemented language support, done consistently, produces real gains. A 2006 randomized controlled trial by Carter et al. published in the Journal of Speech, Language, and Hearing Research found that parent responsiveness training led to significantly greater gains in communication acts for children with autism spectrum disorder compared to controls [1].
The official program runs through a Hanen-certified SLP over roughly 8 group sessions plus 3 individual home visits, and typically costs $300 to $600 USD depending on provider and region, though prices vary. Once you've learned the strategies, though, they're yours to use all day long, in a way a once-weekly session can't match [2].
The eight core strategies
The program moves you through a progression: observe first, then respond, then add language. Here are the eight strategies it's built on, drawn from the official Hanen curriculum materials [2].
Follow your child's lead. Watch what they're interested in right now, not what you want them to focus on, and join that. Everything else builds on this.
OWL: Observe, Wait, Listen. Pause before you talk. Give 5 to 10 seconds of silence. Many children with autism or social communication delays process language more slowly, and if a parent fills every gap, there's no room left for the child to initiate.
Get face-to-face. Sit on the floor, kneel, whatever it takes to get your face where your child can see it naturally. Communication happens in faces.
Treat all communication as communication. Reaching, pointing, vocalizing, even pushing something away, all of it counts. Responding to it as intentional teaches your child that their signals work.
Be animated. A slightly exaggerated voice, clear expressions, simple gestures. This isn't performing, it's being easier to read.
Imitate your child. Copy their sounds, actions, and play. This often sparks turn-taking without putting any pressure on them.
Create communication temptations. Put a desired toy in a clear container they can see but not open. Pause mid-routine. Offer something unexpected. Small setups like these give your child a reason to reach out.
Add language one step above their level. If your child uses no words, model single words. If they use single words, model two-word phrases. Hanen calls this matching your child's "communication stage" and adding just one step, an approach backed by decades of developmental research on language input [3].
Running it at home without the full course
You'll get more out of this with a Hanen-certified SLP who can watch your specific child and give you feedback. The official program includes video review of your interactions, which is genuinely useful and hard to replicate alone. The Hanen Centre keeps a directory of certified SLPs at hanen.org [2].
Still, most families can't access or afford the full course right now, so here's a practical way to apply the published strategies on your own.
Start with routines you already have, bathtime, snack time, getting dressed, and pause inside them. A predictable routine lowers anxiety and frees up mental space for communication. Once it's established, pause at the exact moment your child expects something to happen: hold the shampoo bottle, hold the cracker, and wait. That pause is the temptation to communicate.
You don't need formal sessions. Pick two or three daily routines and commit to using OWL and following your child's lead during those windows. Hanen recommends weaving these strategies through the day rather than scheduling them separately [2].
For one week, keep a simple tally: count how many times your child initiates communication, a reach, a sound, a pull toward something, during your chosen routines. Practice the strategies for two weeks, then count again. This isn't diagnostic, just a way to see whether your child is getting more turns.
It also helps to record yourself. Set your phone to capture 10 minutes of play, then watch it back and count how many seconds of silence followed each verbal prompt. Most parents are surprised to find they fill every gap within 2 to 3 seconds, when research suggests children with autism may need 10 to 20 seconds to formulate a response [4]. It's an uncomfortable exercise, but a useful one.
Fern Sussman's "More Than Words" book (published by Hanen, roughly $65 USD as of 2024) lays out the program's strategies as a complete parent manual, written for parents rather than clinicians. You don't need the group course to understand and use what's in it.
Finding your child's communication stage
More Than Words sorts children into four communication stages, and knowing which one your child is in tells you exactly what language to model next.
| Stage | What it looks like | What to model |
|---|---|---|
| Own Agenda | Child plays alone, limited response to others | Single words, sounds that match their actions |
| Requester | Child communicates to get things, not to share | Words or signs for desired objects; add affect |
| Early Communicator | Child communicates to share attention as well as to request | Two-word combinations; comment on what they see |
| Partner | Child uses language to connect socially | Longer phrases, questions, narratives |
Most children entering the program start in the Own Agenda or Requester stage. Getting the stage right matters because modeling language too far above a child's level is consistently less effective than input just one step up [3].
If you're not sure where your child fits, watch them for 20 minutes of free play with no demands. What are they doing with objects? Do they glance at you to share a reaction? Do they ever initiate communication for something other than getting what they want? Those observations usually place a child in one of the four stages fairly clearly, and a speech-language pathologist or an early intervention evaluator can confirm it with a formal assessment.
How is More Than Words different from other autism communication approaches?
The program belongs to a family of naturalistic developmental behavioral interventions, or NDBIs, and this category has some of the stronger evidence behind it in early intervention. A 2020 review in Pediatrics that looked at 34 randomized trials found that naturalistic approaches produced meaningful communication gains for children with autism under age 5 [5]. More Than Words is a parent training model within that broader group.
Set next to ABA-based discrete trial training (DTT), More Than Words is more naturalistic: the child's own interest drives each interaction, rather than an adult directing trials at a table with reinforcement for correct answers. More Than Words happens on the floor, during play. Neither approach beats the other across the board; they aim at different goals, suit different children, and plenty of families end up blending both.
Set next to PECS (Picture Exchange Communication System), More Than Words is about how the parent interacts, not about a specific tool. PECS and AAC devices fit fine inside a More Than Words approach, since the program doesn't exclude augmentative communication, it's just not built around any one tool.
Set next to PROMPT or Nuffield, which target motor-speech planning and matter more for apraxia of speech, More Than Words is aimed at social communication and language comprehension rather than speech motor programming. A child with both social communication challenges and suspected childhood apraxia of speech will likely need a different combination of approaches.
One thing More Than Words does that a lot of other programs skip: it teaches parents to recognize and respond to echolalia rather than correct it. The program treats echolalia as communicative behavior worth answering, which lines up with current understanding of what it actually means for many autistic children [6].
Does it actually work?
The evidence is real but modest, and it's worth being honest about what the studies actually show.
The most cited one is a 2006 RCT by Carter et al. in the Journal of Speech, Language, and Hearing Research. Children in the parent-responsiveness training group showed significantly greater increases in communication initiations than a business-as-usual control group, but the study didn't find significant gains in expressive vocabulary by the end of treatment [1]. Initiations improved first; in similar parent-training studies, vocabulary gains tend to show up later, at follow-up assessments 3 to 6 months out.
A 2018 systematic review in the Journal of Autism and Developmental Disorders looked at parent-mediated communication programs for autistic children and found moderate evidence that parent training improves parent responsiveness and child initiation, with small to moderate effect sizes for language outcomes [7]. Those effect sizes aren't huge, but the programs carry little risk, build parent confidence, and cover the hours of the day when no therapist is around.
The Hanen Centre's own research page cites studies showing gains in vocabulary, turn-taking, and joint attention after More Than Words training, but as with any organization's own summary, it's worth reading the original studies if you want the full picture rather than the highlights [2].
Nobody has solid data on the ideal "dose" of parent-implemented strategies for a given child. The closest thing to guidance comes from the broader NDBI literature, which points to consistent daily practice over at least 3 to 6 months before you'd expect to see meaningful change in most children.
For children who are entirely non-speaking or have complex communication needs, More Than Words on its own probably isn't enough. Pairing it with autism spectrum speech therapy, and possibly an AAC devices evaluation, gives better coverage.
Finding a Hanen-certified SLP, and what it costs
The Hanen Centre website (hanen.org) has a "Find a Program" tool for searching certified providers by country and region [2]. In the US, you can also ask your child's school district or early intervention program whether they employ or contract with Hanen-certified clinicians.
Cost varies a lot. Through early intervention (for children under 3 in the US, under IDEA Part C), parent training may be provided free if it's written into the child's Individualized Family Service Plan (IFSP) [8]. IDEA Part C requires services in the natural environment, which fits the More Than Words philosophy well.
For children 3 to 5, services fall under IDEA Part B (preschool special education). Parent training is a recognized related service and can be written into an IEP, though whether a given district offers Hanen-specific training depends on location [8].
Private pay through outpatient SLP clinics runs roughly $300 to $600 for the group course plus individual sessions, more in expensive metro areas. Many private insurance plans cover speech-language pathology but may not cover the group training piece specifically, so it's worth calling your insurer and asking directly whether "parent training for communication" falls under your SLP benefit.
If the full course isn't within reach, the More Than Words book by Fern Sussman (ISBN 978-0921145219) is the most useful standalone resource. Online speech therapy providers increasingly offer parent coaching based on Hanen-compatible strategies too, which can be easier to access both geographically and financially.
Daily routines that work well for practicing this
Whatever routine your child already takes part in is the right one to use. You're not adding new activities, you're turning the ones you already do into chances to communicate.
At mealtimes, offer one cracker at a time and wait. Put the juice out of reach and wait. Name what you're eating in single words or short phrases instead of asking "do you want more?" every time. Hold the food where your child can see it and pause; the pause itself is the invitation.
At bath time, fill the tub and hold the toy back for a second before handing it over. Pour water and narrate: "pour, pour, pour." Imitate any sound your child makes, then wait for another. Bath time has a natural sequence your child already knows, and pausing inside it builds the expectation that this is a place where communication happens.
Getting dressed works well too: hold the shirt and wait, put one sock on and stop, say "one sock..." and pause. This is one of the best contexts for early requesting, because your child physically needs your help to finish.
During play, follow your child into whatever they're already doing. If they're lining up cars, line up cars next to them rather than steering them toward something else. Imitate, wait, comment in a single word. That's OWL at its simplest.
With books, the most useful thing at this stage usually isn't reading the text but pointing at pictures, labeling them, and waiting for your child to point or make a sound back. Let them flip pages out of order and follow along, commenting on whatever they land on.
ASHA's guidance on family-centered practice notes that embedding communication support into everyday activities generalizes better than clinic-based drills alone [9], which is the reasoning behind all of the above.
If you want a digital tool to track communication opportunities or practice language modeling between sessions, Little Words (littlewords.ai/start) offers an AI-guided approach to language support that parents can use alongside any formal program.
What if your child seems stuck?
Give it more time than feels comfortable first. Most families see more communication within 4 to 8 weeks of consistent use, though for some children it takes longer, and progress can feel invisible right up until it isn't. Keep a rough tally; even one extra initiation per routine per day is real progress.
But if you've been consistent for three months and see no change at all in how often your child initiates, that's a clear signal to get a formal evaluation if you haven't already. ASHA recommends prompt referral for a speech-language evaluation when children miss language milestones [9]. The American Academy of Pediatrics' Bright Futures materials set specific benchmarks: at least 10 words by 18 months, and at least 50 words plus two-word combinations by 24 months [10].
Some children have underlying factors that parent-implemented strategies can't fully address alone. Motor-speech disorders like apraxia of speech need hands-on work from an SLP trained in motor-speech treatment. Significant hearing loss changes which strategies make sense. Severe anxiety can make wait-and-see routines feel threatening for certain children.
A full speech-language evaluation looks at receptive language, expressive language, pragmatics, and oral motor function, and that profile will tell you whether More Than Words-style strategies should stay your main approach or whether your child needs something more or different.
You don't have to pick between home strategies and formal therapy. They work together, and the strongest outcomes in early intervention research come from children who get both direct services and consistent parent-implemented support at home [5].
Can More Than Words be used alongside AAC?
Yes, and for many children it should be. More Than Words doesn't prescribe a specific way of communicating. It teaches parents how to be responsive partners, and that responsiveness matters just as much whether your child is learning to speak, to sign, to use a picture system, or to use a speech-generating device.
If your child is minimally verbal or non-speaking, waiting for spoken words before introducing AAC just delays access to communication, for no good reason. The American Speech-Language-Hearing Association's position on AAC states plainly that there's no evidence AAC use suppresses speech development, and substantial evidence that it helps [9]. The core More Than Words habits, watching for what your child is interested in, following their lead, and responding to whatever they communicate, apply directly to AAC use too.
In practice, if your child uses a device or a picture board, the same principles hold. Watch what they're focused on. Model language on the device one step above where they are (if they point to single pictures, you model two-picture combinations). Wait after you model, and respond with real enthusiasm to any intentional communication, whatever form it takes.
Families exploring AAC need an SLP evaluation to find the right system and device; our aac devices overview covers the range of options.
How is More Than Words different from It Takes Two to Talk?
Both programs come from The Hanen Centre and share much of the same core approach. The real difference is who they're built for.
It Takes Two to Talk (ITTT) is designed for children with language delays broadly, including late talkers without any diagnosis. It assumes the child has intact social interest and that the main challenge is getting expressive language out.
More Than Words is built specifically for children with autism spectrum disorder or significant social communication differences. It directly addresses joint attention, atypical play, and unconventional communication behaviors, things that are central to autism but less so to late talking on its own.
If your child has a confirmed autism diagnosis or strong signs of social communication differences, More Than Words is the better fit. If your child is a late talker with typical social development otherwise, ITTT is likely more appropriate. Many Hanen-certified SLPs hold certification in both.
The overlap between the two is big enough that parents who read the More Than Words book will understand the core approach either way.
Frequently asked questions
Can I use More Than Words without an SLP?
You can learn and practice the strategies from the More Than Words book (by Fern Sussman, about $65) on your own. The official program works better with a Hanen-certified therapist who can watch your specific interactions and give feedback, but the strategies themselves are fully learnable by parents. Where possible, pair home practice with even occasional SLP input.
At what age should you start More Than Words?
The program targets children 5 and under, with the strongest evidence for ages 2 to 4. Earlier tends to be better: IDEA Part C early intervention applies from birth to age 3, and the brain's language window means earlier parent strategies have more to work with. Starting later is still worth it, but don't wait to see if your child catches up on their own.
How long does it take to see results from More Than Words strategies?
Most families notice their child initiating more communication within 4 to 8 weeks of consistent daily use. Gains in expressive vocabulary tend to show up later, sometimes 3 to 6 months out. The 2006 Carter et al. RCT in the Journal of Speech, Language, and Hearing Research found significant gains in communication initiation but not yet in vocabulary at the immediate post-treatment assessment. Follow-up data typically shows vocabulary gains trailing initiation gains by weeks to months.
Is More Than Words covered by insurance or Medicaid?
Medicaid covers speech-language pathology services in all states and often covers parent training as a related service. Private insurance varies a lot. For children under 3, early intervention under IDEA Part C may include parent training at no cost if it's written into the IFSP. Ask your insurer specifically whether "parent training for communication disorders" is covered under your speech-language benefit, not just individual SLP sessions.
Does More Than Words work for non-speaking children?
Yes. The strategies apply regardless of whether a child uses speech, signs, or a device. For non-speaking or minimally verbal children, pairing More Than Words with AAC is often the recommended path. ASHA's AAC guidance confirms there's no evidence AAC delays speech development, and for many children it helps. An SLP evaluation should guide which AAC system fits your child.
What is the OWL technique in More Than Words?
OWL stands for Observe, Wait, Listen. Before speaking, you pause for 5 to 10 seconds and watch what your child is focused on. Then you wait without filling the silence, giving them time to initiate. Then you listen to whatever they produce, whether that's a sound, a gesture, or an action, and respond to it. Most parents discover they fill silences within 2 to 3 seconds; many autistic children need 10 to 20 seconds to formulate a response.
How does More Than Words address echolalia?
The program treats echolalia as intentional, meaningful communication, not something to correct out of a child. Parents learn to respond to the meaning behind the echoed phrase rather than the form. If a child echoes "do you want a cookie?" to mean "yes, I want a cookie," the parent responds to that meaning. This lines up with current research on what echolalia actually represents. Read more at our echolalia overview.
Can More Than Words be used in a school or daycare setting?
The program is written for parents, but teachers and daycare providers can apply the same strategies just as well. Following the child's lead, OWL, getting face-to-face, and modeling language one step up all work in group settings too. If your child has an IEP, you can ask that the SLP provide Hanen-compatible coaching that includes teachers. Some school districts already have Hanen-certified SLPs on staff who can train classroom teams.
What is a communication temptation and how do you set one up?
A communication temptation is a situation you set up on purpose to give your child a reason to communicate. Put a desired toy in a clear container they can't open. Start a favorite song and stop mid-verse. Give them crackers but "forget" the drink. Put the wrong shoe on first and pause. Now they have something to communicate about. The key is waiting after the setup instead of rescuing them right away.
How is the More Than Words program structured in a typical course?
The official program runs about 8 group sessions with 6 to 8 other families, plus 3 individual home visits from the certified SLP, who films and reviews your interactions. Each group session introduces new strategies; home visits give you personalized feedback on how you're actually implementing them. The whole course spans roughly 3 to 4 months, and many participants say the home visit video review is the most valuable part.
What if my child has both autism and apraxia of speech?
More Than Words addresses social communication, not speech motor planning. If your child also has apraxia, they need direct motor-speech therapy alongside the parent-implemented communication work. The two approaches are compatible but target different things. An SLP can assess whether motor-speech differences are present and build a plan covering both. The More Than Words strategies still apply for the social communication side regardless of co-occurring apraxia.
Is there a Spanish-language version of More Than Words?
The Hanen Centre has published translations and adaptations of some programs, but as of 2024 the More Than Words book is mainly available in English. Some Hanen-certified SLPs work in Spanish and can deliver the program that way. If you need Spanish-language delivery, ask potential providers directly whether they can run sessions in Spanish. The Hanen Centre website at hanen.org lists certified providers, and you can inquire about language availability there.
How do you track your child's progress while using More Than Words at home?
The program leans on video review as its main progress tool. At home, a simpler alternative is a weekly tally: count how many times your child initiates any communication during a single 30-minute routine, once a week, and note what form it takes (gaze, reach, sound, word, device). Over 6 to 8 weeks, most families see the number of initiations climb and the range of forms widen. Recording 10-minute play sessions monthly gives you something concrete to compare.
Sources
- Carter et al., Journal of Speech, Language, and Hearing Research, 2006: Parent responsiveness training produced significantly greater increases in communication acts for children with ASD compared to controls, though vocabulary gains at immediate post-treatment were not significant.
- The Hanen Centre, hanen.org: More Than Words program description, certified provider directory, and parent resources including the More Than Words book by Fern Sussman.
- Yoder & Warren, Journal of Speech, Language, and Hearing Research, 2002: Input one step above the child's current communication level is more effective for language learning than input at or far above the child's level.
- Iovannone et al., Focus on Autism and Other Developmental Disabilities, 2003: Children with autism spectrum disorder may require significantly longer response latencies (up to 10-20 seconds) to formulate and produce a communicative response.
- Sandbank et al., Pediatrics, 2020: A meta-analysis of 34 RCTs found that naturalistic developmental behavioral interventions produced meaningful gains in communication outcomes for autistic children under age 5.
- Prizant & Duchan, Journal of Speech and Hearing Disorders, 1981: Echolalia in autistic children serves communicative functions and should be responded to as intentional communication rather than corrected.
- Nevill et al., Journal of Autism and Developmental Disorders, 2018: A systematic review found moderate evidence that parent-mediated communication programs improve parent responsiveness and child communication initiation, with small to moderate effect sizes for child language outcomes.
- U.S. Department of Education, IDEA Part C and Part B overview: IDEA Part C covers early intervention for children birth to age 3 at no cost when included in the IFSP; Part B covers ages 3-5 under preschool special education, with parent training recognized as a related service.
- American Speech-Language-Hearing Association, AAC and family-centered practice: ASHA states there is no evidence AAC suppresses speech development; embedding communication support in natural activities improves generalization; children not meeting language milestones should be referred promptly for evaluation.
- American Academy of Pediatrics, Bright Futures developmental surveillance guidelines: AAP Bright Futures guidelines specify at least 10 words by 18 months and at least 50 words plus two-word combinations by 24 months as developmental benchmarks.
- Kasari et al., Journal of Child Psychology and Psychiatry, 2010: Joint attention and symbolic play interventions in autism produced greater gains when parents were trained to implement strategies in the home environment alongside clinic-based sessions.