Last updated 2026-07-11
TL;DR
Hanen More Than Words is a parent-led program built around 8 strategies you practice during everyday routines, not structured drills. The full program runs through a certified Hanen SLP, but the core techniques, following your child's lead, adding language just above their level, creating communication temptations, and building turn-taking, can all be practiced at home starting today.
What is Hanen More Than Words and who is it 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 was designed specifically for parents of autistic children ages 5 and under, or any child whose primary challenge is social communication rather than articulation. It is not a general late-talker program. If your child is a late talker without social communication differences, Hanen's It Takes Two to Talk is the closer fit.
The program teaches parents to be their child's primary communication facilitator, not a separate therapist. Research behind the program draws on responsive interaction models showing that parent-implemented language support, when done with good fidelity, 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 is delivered by a Hanen-certified SLP over roughly 8 group sessions plus 3 individual home visits. That full course typically costs $300 to $600 USD depending on the provider and region, though prices vary widely. But the strategies themselves, once a parent learns them, belong to you permanently and can be used all day, every day, in ways a once-weekly therapy session simply cannot replicate [2].
What are the 8 core strategies in More Than Words?
The program organizes its teaching around a progression. You start by observing, then responding, then adding language. Here are the eight main strategies the program builds on, drawn from the official Hanen curriculum materials [2].
1. Follow your child's lead. Watch what your child is interested in right now, not what you want them to focus on, and join that activity. This is the foundation everything else builds on.
2. OWL: Observe, Wait, Listen. Before you talk, pause. Give your child 5 to 10 seconds of silence. Many children with autism or social communication delays process language more slowly, and parent talk that fills every gap leaves no room for the child to initiate.
3. Face-to-face positioning. Get at eye level. Sit on the floor, kneel, or move so your face is where your child can see it naturally. Communication happens in faces.
4. Interpret and respond to all communication. Reaching, pointing, vocalizing, and even pushing things away are communication. Treating every behavior as intentional and responding to it teaches your child that they have communicative power.
5. Animation and affect. Use a slightly exaggerated voice, clear facial expressions, and simple gestures. This makes communication easier to read. It does not mean performing. It means being readable.
6. Imitate your child. Copy what your child does and says, including sounds, actions, and play behaviors. This often sparks turn-taking without any pressure on the child.
7. Set up communication temptations. Place a desired toy in a clear container they can see but cannot open. Pause mid-routine and wait. Offer something unexpected. These situations give your child a reason to communicate.
8. Add language just one step above your child's level. If your child uses no words, you model single words. If they use single words, you model two-word phrases. The Hanen program calls this being at your child's "communication stage" and adding just one step. This is backed by decades of developmental research on optimal language input [3].
How do you actually run More Than Words at home without the full course?
The honest answer is that you get more out of the program if you take it with a Hanen-certified SLP who can watch your specific child and give you personalized feedback. Video review of your interactions, which the official program includes, is genuinely useful and hard to replicate on your own. The Hanen Centre maintains a directory of certified SLPs at hanen.org [2].
That said, most families cannot access or afford the full course right now. Here is a practical home approach based on the published strategies.
Build routines and then pause inside them. Bathtime, snack time, getting dressed: these are your practice arenas. The routine gives your child predictability, which reduces anxiety and frees up cognitive resources for communication. Once the routine is established, pause at the moment your child expects something to happen. Hold the shampoo bottle and wait. Hold the cracker and wait. The pause is the communication temptation.
Track 30 minutes a day. You do not need to run structured sessions. Pick two or three daily routines and commit to using OWL and following your child's lead for that window. Hanen recommends embedding these strategies throughout the day rather than scheduling them as separate activities [2].
Keep a simple tally. For one week, count how many times your child initiates any communication, a reach, a sound, a pull toward something, during your chosen routines. Then practice the strategies for two weeks and count again. This is not a diagnostic tool. It is a way to see whether your child is getting more turns.
Record yourself. Set up your phone to record 10 minutes of play. Watch it back and count how many seconds of silence you gave after each verbal prompt. Most parents, when they first watch themselves, discover they are filling every silence within 2 to 3 seconds. The research suggests children with autism may need 10 to 20 seconds to formulate a response [4]. Recording yourself is uncomfortable and genuinely useful.
Get the book. Fern Sussman's "More Than Words" book (published by Hanen, roughly $65 USD as of 2024) is a complete parent manual for the program's strategies. It is written for parents, not clinicians. You do not need the group course to understand and apply what's in it.
What communication stages does the program cover, and how do you know which one your child is in?
More Than Words organizes children into four communication stages. Knowing your child's stage tells you exactly what language to model and what to expect 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 are in the Own Agenda or Requester stage. The staging matters because it stops parents from modeling language that is too far above the child's level, which research consistently shows is less effective than input one step up [3].
If you are uncertain which stage your child is in, watch them for 20 minutes in free play with no demands. What are they doing with objects? Are they glancing at you to share a reaction? Are they initiating communication for any purpose besides getting something they want? Those observations will usually place them in one of the four categories fairly clearly. A speech therapy speech therapist or a early intervention evaluator can confirm the staging with a formal assessment.
How is More Than Words different from other autism communication approaches?
The program sits within a family of naturalistic developmental behavioral interventions, sometimes called NDBIs. The research base for NDBIs in autism is among the stronger bodies of evidence in early intervention. A 2020 review in Pediatrics examining 34 randomized trials found that naturalistic intervention approaches produced meaningful gains in communication outcomes for children with autism under age 5 [5]. More Than Words is specifically a parent training model within that broader category.
Compared to ABA-based discrete trial training (DTT), More Than Words takes a more naturalistic approach where the child's interest drives each interaction. DTT typically involves adult-directed trials at a table with reinforcement for correct responses. More Than Words happens on the floor during play. Neither approach is universally superior; they address different goals and work for different children. Many families use elements of both.
Compared to PECS (Picture Exchange Communication System), More Than Words focuses on the parent's interaction style rather than on a specific communication tool. PECS and aac devices can absolutely be incorporated into a More Than Words approach. The program does not exclude augmentative communication. It just is not organized around a specific tool.
Compared to PROMPT or Nuffield (which target motor-speech planning and are more relevant for apraxia of speech), More Than Words targets social communication and language comprehension, not speech motor programming. If your child has both social communication challenges and suspected childhood apraxia of speech, they may need a different mix of approaches.
One thing More Than Words does that many other programs do not: it explicitly teaches parents to recognize and respond to unconventional communication like echolalia. The program frames echolalia as communicative behavior worth responding to, not correcting, which matches current understanding of what echolalia actually means for many autistic children [6].
Does More Than Words actually work? What does the research say?
The evidence base is real but not enormous, and it is worth being honest about what the studies show.
The most cited study is a 2006 RCT by Carter et al. in the Journal of Speech, Language, and Hearing Research. It found that children in the parent-responsiveness training group showed significantly greater increases in communication acts (initiations) compared to a business-as-usual control. However, the study did not find significant gains in expressive vocabulary by the post-treatment time point [1]. Gains in initiations came first. Vocabulary gains in similar parent-training studies often emerge at follow-up assessments 3 to 6 months later.
A 2018 systematic review in the Journal of Autism and Developmental Disorders examined parent-mediated communication programs for autistic children and found moderate evidence that parent training improves parent responsiveness and child communication initiation, with small to moderate effect sizes for child language outcomes [7]. The effect sizes are honest, they are not huge, but the programs are low-risk, build parent confidence, and work across all the hours of the day that a therapist cannot be present.
The Hanen Centre's own research page cites several studies showing gains in vocabulary, turn-taking, and joint attention following More Than Words training, but as with any organization-published summaries, reading the original studies rather than the summaries is worth doing if you want the full picture [2].
Nobody has good data on the optimal "dose" of parent-implemented strategies for a given child profile. The closest guidance is from the broader NDBI literature, which suggests consistent daily implementation over at least 3 to 6 months is needed to see meaningful communication change in most children.
For children who are entirely non-speaking or who have complex communication needs, More Than Words alone is likely insufficient. Pairing it with autism spectrum speech therapy and potentially an aac devices evaluation gives the best coverage.
How do you find a Hanen-certified SLP and what does the program cost?
The Hanen Centre website at hanen.org has a "Find a Program" tool that lets you search by country and region for certified providers [2]. In the United States, you can also ask your child's school district or early intervention program whether they employ or contract with Hanen-certified clinicians.
Cost varies widely. Through early intervention (for children under 3 in the US, governed by IDEA Part C), parent training services may be provided at no cost if they are included in the child's Individualized Family Service Plan (IFSP) [8]. IDEA Part C requires that early intervention services be provided 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 under IDEA and can be written into an IEP, though whether a district offers Hanen-specific training varies by location [8].
Private-pay options through outpatient SLP clinics range roughly from $300 to $600 for the group course plus individual sessions, though some clinics charge more in high-cost metros. Many private health insurance plans cover speech-language pathology services but may not cover the group training portion specifically. Call your insurer and ask specifically whether "parent training for communication" is covered under your SLP benefit.
If the full course is out of reach, the More Than Words book by Fern Sussman (ISBN 978-0921145219) is the most practical standalone resource. Online speech therapy providers have increasingly offered parent coaching sessions based on Hanen-compatible strategies, which may be more accessible geographically and financially.
What daily routines work best for practicing these strategies?
Any routine your child already participates in is the right routine. The goal is not to add new activities. It is to turn existing activities into communication opportunities.
Mealtimes. Offer one cracker at a time and wait. Put the juice out of reach and wait. Name what you are eating in single words or short phrases. Do not ask "do you want more?" every time. Instead, hold the food visible and pause. The pause is the invitation.
Bath time. Fill the tub and then wait with the toy in your hand before you put it in. Pour water and comment: "pour, pour, pour." Imitate any sound your child makes and wait for another. Bath time has a natural sequence your child will learn, and pausing inside that sequence creates the expectation that communication will happen here.
Getting dressed. Hold the shirt and wait. Put one sock on and then stop. "One sock... " and pause. This is one of the best contexts for early requesting because your child physically needs your help to finish the task.
Play. Follow your child into whatever they are doing. If they are lining up cars, you line up cars next to them. Do not redirect to a "better" activity. Imitate. Wait. Comment with one word. This is OWL in its simplest form.
Reading books. The most effective approach for language learning at this stage is not reading the text but pointing at pictures, labeling, and waiting for your child to point or vocalize. Let your child flip pages out of order. Follow them. Comment on what they stop at.
American Speech-Language-Hearing Association (ASHA) guidance on family-centered practice emphasizes that embedding communication support into naturally occurring activities produces better generalization than clinic-based drills alone [9]. That is the reasoning behind all of these suggestions.
If you want a digital tool to help 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 should you do if your child seems stuck after trying these strategies?
First, give it more time than feels comfortable. Most families see their child become more communicative within 4 to 8 weeks of consistent strategy use, but for some children it takes longer, and the gains can feel invisible until suddenly they are not. Keep the tally. Even one additional communication initiation per routine per day is real progress.
If you have been implementing these strategies consistently for three months and see no change at all in how often your child initiates, that is a clear signal to seek a formal evaluation if you have not already. ASHA recommends that children who do not meet language milestones be referred promptly for a speech-language evaluation [9]. The American Academy of Pediatrics (AAP) has specific developmental surveillance guidelines in its Bright Futures materials: by 18 months a child should have at least 10 words; by 24 months, at least 50 words and two-word combinations [10].
Some children have underlying factors that parent-implemented language strategies cannot fully address on their own. Motor-speech disorders like apraxia of speech require hands-on work from an SLP trained in motor-speech. Significant hearing loss changes the strategies you need to use. Severe anxiety can make the wait-and-see routines feel very threatening to certain children.
A speech-language evaluation will look at receptive language (what your child understands), expressive language (what they produce), pragmatics (how they use communication socially), and oral motor function. That profile will tell you whether More Than Words-style strategies are the right primary approach or whether your child needs additional or different support.
You do not have to choose between using these strategies at home and pursuing formal therapy. They are complementary. The strongest outcomes in early intervention research come from children who receive 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 does not prescribe a specific communication modality. It teaches parents how to be responsive communication partners, and that responsiveness matters equally 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 to emerge before using AAC delays access to communication for no good reason. The American Speech-Language-Hearing Association's position on AAC is clear that there is no evidence AAC use suppresses speech development, and substantial evidence that it supports it [9]. The More Than Words strategies of OWL, following your child's lead, and responding to all communication map directly onto effective AAC facilitation.
In practical terms: if your child uses a device or a picture board, you follow the same More Than Words principles. Observe what they are interested in. Model language on the device one level above theirs (if they point to single pictures, you model two-picture combinations). Wait after you model. Respond with real enthusiasm to any intentional communication act.
For families exploring AAC options, an SLP evaluation is needed to identify the right system and device. Read more about the range of options in our aac devices overview.
How is More Than Words different from It Takes Two to Talk?
Both programs come from The Hanen Centre and share many of the same core strategies. The difference is population and focus.
It Takes Two to Talk (ITTT) is designed for children with language delays broadly, including late talkers without a diagnosis. Its framework assumes the child has intact social interest and the main challenge is expressive language output.
More Than Words is designed specifically for children with autism spectrum disorder or significant social communication differences. It explicitly addresses the challenges of joint attention, atypical play, and unconventional communication behaviors that are central to autism but less central to late talking.
If your child has a confirmed autism diagnosis or strong signs of social communication differences, More Than Words is the right choice. If your child is a late talker with typical social development, ITTT is likely more appropriate. Many SLPs who are Hanen-certified hold certification in both programs.
The strategies in both programs overlap enough that parents who read the More Than Words book will understand the core approach regardless of which program they technically "need."
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) without an SLP present. The official program works better with a Hanen-certified therapist who can watch your specific interactions and give feedback, but the core strategies are fully learnable by parents. If at all possible, combine 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 children 2 to 4. Earlier is generally better: IDEA Part C early intervention services apply from birth to age 3, and the brain's language development window means earlier parent-implemented strategies have more to work with. Starting the strategies at any age is still worthwhile, but do not 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 may take longer, sometimes 3 to 6 months. 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 lagging behind initiation gains by several 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 widely. For children under 3, early intervention services under IDEA Part C may include parent training at no cost if written into the IFSP. Ask your insurer specifically whether 'parent training for communication disorders' is covered under your speech-language benefit, more than individual SLP sessions.
Does More Than Words work for non-speaking children?
Yes. The program's strategies apply regardless of whether a child uses speech, signs, or a device. For non-speaking or minimally verbal children, combining More Than Words strategies with AAC is often recommended. ASHA's AAC guidance confirms there is no evidence that using AAC delays speech development, and for many children it supports it. 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, to give them time to initiate. Then you listen to whatever communication they produce, including sounds, gestures, or actions, and respond. 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 frames echolalia as intentional, meaningful communication, not a behavior to extinguish. Parents are taught to respond to the communicative function behind the echoed phrase rather than correcting the form. For example, if a child echoes 'do you want a cookie?' to mean 'yes I want a cookie,' the parent responds to the meaning. This matches current research on what echolalia represents. Read more at our echolalia overview.
Can More Than Words be used in a school or daycare setting?
The program is designed for parents, but teachers and daycare providers can absolutely apply the same strategies. Following the child's lead, OWL, positioning face-to-face, and modeling language one step up all work in group settings. If your child has an IEP, you can request that the SLP provide Hanen-compatible parent coaching that includes teachers. Some school districts 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 engineer to give your child a reason to communicate. Examples: put a desired toy in a clear container they cannot open; start a favorite song and then stop mid-verse; give them crackers but forget to give them a drink; put the wrong shoe on first and pause. The child now has something to communicate about. The key is that you wait after the setup and do not rescue them immediately.
How is the More Than Words program structured in a typical course?
The official program runs over approximately 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 allow personalized feedback on how you specifically are implementing them. The whole course spans roughly 3 to 4 months. Home visit video review is considered the most valuable component by many participants.
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 parent-implemented communication strategies. The two approaches are compatible but target different things. An SLP can assess whether motor-speech differences are present and design a plan that covers both. More Than Words strategies still apply for the social communication piece 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 primarily available in English. Some Hanen-certified SLPs work in Spanish and can deliver the program in Spanish. If you need Spanish-language delivery, ask potential providers directly whether they can conduct sessions in Spanish. The Hanen Centre website at hanen.org lists certified providers and you can filter or inquire about language availability.
How do you track your child's progress while using More Than Words at home?
The program uses video review as its main progress tool. At home, a practical alternative is a simple tally: count how many times your child initiates any communication during a single 30-minute routine, once a week. Note what forms of communication they use (gaze, reach, sound, word, device). Over 6 to 8 weeks, most families see the number of initiations increase and the range of forms expand. Record 10-minute play sessions monthly and 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.