How to model AAC with our minimally speaking students?

ByLondon Speech and Feeding December 4, 2023December 4, 2023

Autism Therapy | Speech and Language Therapy

How should we start? Should we use prompts? What kind of prompts? hand-over-hand or just pointing? Should we wait, and, if so, how long? Introducing an alternative communication system (AAC) to our child is for many of us a confusing and sometimes scary prospect, but it needn’t be! Let me reassure you and share some tricks of my practice in this area.

Once we have decided to try for a picture based communication system, I usually start with a paper-based single page with between 48–88 core-words. I choose the number of words depending on where the child is developmentally and also verbally.

If a child does have a small handful of words already, I might start with the 88-cell board below. If, on the other hand, my student is completely non-speaking and still quite little then I might go for the 48-cell below here or I might have even less cells to start with. Again, sometimes I start with an electronic device in my clinic just to trial and introduce the idea and to see if, or how, a student responds.

Below are some samples: a 49-cell board which I made for a child in a nursery setting

Below a Saltillo WordPower board that can be downloaded from the Saltillo website:

Example of a slightly more advanced board, again from the Saltillo Website

And here below one example of a board I made for a specific activity for a child who loves water and sand play:

It is perfectly possible to be very flexible and create a suitable board for any student, starting with as few as 2–5 cells and working up to over a 100 (very small ones) on a sheet of A4 or A3 paper.

So once we have a good board for our child, what now? How do we start introducing this into our daily life?

We can start by showing/pointing to the word GO within a play activity. For example:

a car run,
or a marble run,
or a spinner activity,
a wind-up toy,
anything that can be stopped and started easily.

How to start?

I will talk us through each of the steps using the example for the word ‘GO’.

First phase

The first phase is a TEACHING/ LEARNING PHASE. In this phase we do not expect our student to do anything, to copy us or to point to the board. If they do that it is of course a huge bonus and we will celebrate it.

Our job is to simply MODEL/SHOW/GIVE EXAMPLES of how we can use the board, by steadily and regularly pointing to the chosen word or words. We do so across the day and across settings:

play
meal time
getting dressed/undressed
bath time
going to the car/shops
etc

Once we can be sure that our student has been submerged and SOAKED in seeing the coreboard being used, say after some 3–4 weeks of using it consistently…

Second phase

We can begin to move into the second phase which is the PRACTICE PHASE. By now the student has seen the boards and he or she has seen the word GO (as a example) modelled many times.

Now we can start to see if we can tempt our student into trying this out for themselves.

What sort of TEMPTING are we talking about? Take a look at the Prompt Hierarchy below, which shows us what to do to get our student to be independently communicating as soon as possible.

The PROMPT HIERARCHY: what sort of prompting should we do, should we expect something from our student or how should we view this stage?

TEMPT AND PAUSE

I have the AAC near to the toy and each time the child starts another round of the activity I say clearly ‘GO’ and I point to the picture as do so. I then pause and wait to see what happens. NOTHING? Then…

USE SIGNS AND BODY LANGUAGE

Next time the child starts another round I might be very animated and do a Makaton sign for GO as I say ‘GO’ and I make a very over point to the picture again. Then I wait. STILL NOTHING? OK then…

OPEN-ENDED QUESTION

Now I might say ‘GO’ and follow with: ‘OOH I WONDER IF THERE IS A PICTURE TO POINT TO…’

‘OH LOOK HERE IS GO!’ I then point to GO.

STILL NO RESPONSE?

ASK FOR A RESPONSE

I might say ‘GO’ followed by ‘LOOK! LET’S POINT TO GO HERE ON THE PICTURE.’

STILL NO RESPONSE?

PHYSICAL TOUCH

Next time I say ‘GO’ I will try and take the student’s hand, help isolate their finger and help him or her to point to the actual picture.

REMEMBER: Prompting serves a very important function in scaffolding learning for students BUT if we are constantly prompting kids, then we are teaching them to only communicate when someone tells them to. We want our student to become as independent in speaking and using words as possible.

So once I have done Physical Prompting I will try and phase back down to number 1 where all I need to do is point to the picture or look at the board with the aim that the student will then point to the picture.

Take away points:

Keep the learning phase pressure-free and model without expecting our student to jump in. In other words, let’s model first without expectation. Later we can have a little bit of expectation.
After they’ve been exposed to and have been ‘soaked’ in plenty of AAC input, then, YES, we can create an opportunity to help them say or point to the word on their own.
We can model BOTH with and without expectation.
Only after LOTS of exposure, use the least to most prompting hierarchy and start creating opportunities for a student to become an independent communicator.

Do get in touch if you have any questions or comments or if you would like some practical help.

I am always pleased to hear from you.

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

Ages and Stages · Speech and Language Therapy · Top tips

Understanding phonological processes in 3–7-year-olds: What’s typical and when to seek help
ByLondon Speech and Feeding February 18, 2026February 13, 2026
As a speech and language therapist, one of the most common questions I hear from parents is:

‘They can talk, but their speech still sounds immature. Is this normal?’

Many children between the ages of three and seven use speech patterns that make their words sound different from adult speech. These patterns are known as phonological processes, and for younger children, they are a normal part of speech development.

However, when these processes persist beyond the expected age, they can start to affect clarity, confidence and learning, especially once children enter school.

This blog will help you understand:
- what phonological processes are
- which patterns are typical at different ages
- and when it might be time to seek speech therapy support
What are phonological processes?

Phonological processes are patterns of sound simplification that children use while their speech system is developing.

Instead of learning each sound one by one, children initially organise sounds into patterns that make speech easier to produce. This is a normal and efficient strategy for a developing brain.

For example:
- saying ‘tar’ instead of ‘car’
- saying ‘poon’ instead of ‘spoon’
- saying ‘bud’ instead of ‘bus’
These are not ‘bad habits’. They are part of how speech develops.

The key question is how long these patterns last.

Common phonological processes (and when they usually disappear)

Below are some of the most common processes parents notice in 3–7-year-olds.

1. Final consonant deletion

Leaving off the last sound in a word
- ‘ca’ for cat, ‘da’ for dog
- Typically resolved by 3–3½ years
2. Fronting

Replacing back sounds (k, g) with front sounds (t, d)
- ‘tar’ for car, ‘do’ for go
- Typically resolved by 3½–4 years
3. Cluster reduction

Omitting one sound in a consonant cluster
- ‘poon’ for spoon, ‘top’ for stop
- Typically resolves by 4–5 years (some clusters slightly later)
4. Gliding

Replacing /R/ or /L/ with /W/ or /Y/
- ‘wabbit’ for rabbit, ‘yion’ for lion
- Can be typical up to 5–6 years
5. Weak syllable deletion

Leaving out unstressed syllables
- ‘nana’ for banana
- Usually resolved by 4 years
If these patterns continue past the expected age, speech can remain difficult to understand particularly for unfamiliar listeners such as teachers, peers, and also Auntie Karen or grandparents who visit once in a while.

Why phonological processes matter in school-age children

By the time children reach reception and Year 1, speech clarity becomes increasingly important.

Persistent phonological difficulties can affect:
- being understood by teachers and peers
- phonics and early reading
- spelling
- confidence in speaking
- willingness to participate in class
Some children become aware that they ‘sound different’ and may speak less, avoid longer words, or become frustrated when misunderstood.

What’s the difference between a delay and a disorder?

This is an important distinction.
- A phonological delay means a child is following the normal pattern of development, just more slowly.
- A phonological disorder means the child is using atypical patterns, or continuing age-expected patterns well beyond when they should have resolved.
A speech and language assessment helps identify:
- which processes are present
- how many are affecting speech
- how consistent the errors are
- and whether intervention is needed
Signs it may be time to seek speech therapy

You may want to seek professional advice if your child:
- is 3½ years or older and still hard to understand
- is understood well by family but not by others
- becomes frustrated or avoids talking
- has difficulty with phonics or spelling
- uses several phonological processes at once
- has not made progress despite time and encouragement
Early support does not mean something is ‘wrong’. It simply helps speech development move forward more efficiently.Research consistently shows that unresolved phonological processes beyond the expected age can impact intelligibility, literacy and confidence (Dodd, 2014; Bowen, 2015).

How speech therapy helps phonological development

Phonological therapy is not about drilling individual sounds endlessly.

Instead, therapy focuses on:
- helping children recognise sound patterns
- building awareness of contrasts (e.g. ‘tar’ vs ‘car’)
- practising speech in meaningful, playful ways
- supporting generalisation so progress carries into everyday speech
For school-aged children, therapy is usually structured, motivating and highly targeted and progress can be very encouraging.

A final reassurance

Many children with phonological difficulties go on to develop clear, confident speech with the right support.

If you’re unsure whether your child’s speech is ‘just a phase’ or something that needs attention, a professional assessment can give clarity and peace of mind.

If you’d like support or advice, please contact me and I can help guide the next steps.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Research references
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Autism Therapy · Neurodiversity · Speech and Language Therapy · Top tips

The quiet power: Why silence and responsiveness boost communication in children with delays
ByLondon Speech and Feeding June 9, 2025June 9, 2025
Supplied by Sonja McGeachie, Practice Owner

As parents and caregivers, our natural instinct when interacting with a child, especially one who struggles with communication, is often to fill every silence. We might ask lots of questions, offer constant commentary, or try to prompt him or her to speak. Our hearts are in the right place. We want to help him or her communicate! However, for children with language delays or those on the autism spectrum, this well-intentioned approach can sometimes inadvertently create more pressure and fewer opportunities for them to truly initiate and develop their own communication skills.

What if I told you that one of the most powerful tools in your communication toolkit is often silence? And that responding to your child, rather than always initiating, can unlock incredible potential?

Let’s explore why these seemingly simple strategies are so profoundly beneficial.

The unspoken benefits of silence

In our fast-paced world, silence can feel awkward, but for a child who is processing language differently, it’s a gift:
1. Time to process: Children with language delays often need more time to process what they hear and to formulate their own thoughts or responses. When we bombard them with words, we don’t give their brains the crucial milliseconds they need to catch up. A pause of 5–10 seconds can make all the difference.
2. Reduces pressure: Constant questioning or prompting can feel like a test. Silence removes this pressure, creating a more relaxed environment where the child feels safe to communicate without fear of being ‘wrong’ or rushed.
3. Creates opportunity to initiate: If you’re always talking, when does your child get a turn to start the conversation? Silence opens up a space for him or her to initiate, whether it’s through a sound, a gesture, eye contact, or a word. This is vital for developing spontaneous communication.
4. Encourages independent thinking: When a child is given space, he or she is more likely to try to figure things out himself or herself. This fosters problem-solving skills and reduces reliance on adult prompts.
5. Prevents overwhelm (especially for ASD): Many children on the autism spectrum can be sensitive to auditory input. A constant stream of language can be overwhelming, leading to withdrawal or challenging behaviours. Strategic pauses can help them regulate and engage more effectively.
The power of responding (not just initiating)

Think of a tennis match: if only one person serves, it’s not a game. Communication is a rally, a back-and-forth exchange. When you primarily respond to your child’s communication attempts, you’re teaching him or her the rhythm of conversation:
1. Follow the child’s lead: This is a cornerstone of effective language intervention, famously championed by programs like Hanen’s ‘It Takes Two to Talk’. When you respond to what your child is already interested in or doing, the interaction becomes immediately relevant and motivating for him or her.
2. Validates his or her attempts: Every sound, gesture, glance, or partial word your child offers is a communication attempt. By responding to it, you’re telling him or her, ‘I see you. I hear you. Your communication matters.’ This builds immense confidence and encourages him or her to try again.
3. Builds confidence and motivation: When a child feels understood and successful in his or her communication, he or she are more likely to communicate more often. It’s a positive feedback loop.
4. Teaches turn-taking naturally: By taking your turn after his or hers, you model the natural flow of conversation. He or she learns that communication is a shared activity, not a one-sided lecture.
5. Makes interactions meaningful: When you respond to his or her interests, you’re talking about things that are inherently motivating to him or her. This makes the language you use more easily understood and remembered.
Practical strategies for parents: Observe, Wait, Listen (OWL)

The Hanen Centre’s ‘Observe, Wait, Listen’ (OWL) strategy perfectly encapsulates these principles:
- Observe: Watch your child closely. What is he or she looking at? What is he or she doing? What sounds is he or she making? What gestures is he or she using?
- Wait: After you’ve observed, wait. Give him or her time. Resist the urge to jump in with a question or comment immediately. Count to five (or even ten) in your head. This silence is an invitation for him or her to communicate.
- Listen: When he or she does communicate (in any way!), listen intently. Try to understand his or her message or intent.
Beyond OWL – More tips:
- Reduce questions, increase comments: Instead of ‘What’s that?’ try ‘Oh, a big red ball!’ or ‘The car is going fast!’ Comments provide language models without demanding a verbal response.
- Expand, don’t just prompt: If your child says ‘Car’, you could respond with ‘Yes, That’s a big car!’ or ‘It’s really fast!’ You’re building on his or her communication with a slightly richer language model.
- Create opportunities for communication: Place desired items slightly out of reach. This creates a natural reason for your child to communicate his or her wants (e.g., reaching, pointing, vocalising).
- Respond to all communication: Don’t just wait for words. If your child points, look where he or she is pointing and comment. If he or she makes a sound, imitate it or respond with a related word.
In summary

Embracing silence and prioritising responsiveness might feel counterintuitive at first, especially when you’re eager for your child to talk. However, these powerful strategies create a nurturing, low-pressure environment that encourages spontaneous communication, builds confidence, and truly meets your child where he or she is. By giving your child the space and the meaningful responses he or she needs, you’re laying a strong foundation for his or her communication journey.

Try incorporating these ‘quiet powers’ into your daily interactions and watch your child’s communication blossom.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Lisp · Speech and Language Therapy

Tongue training: Why tongue placement matters for clear speech
ByLondon Speech and Feeding February 12, 2025February 3, 2025
As speech and Language therapists (SLTs), we know that where your tongue goes, so goes your sound. This blog post will explore why tongue placement is so vital for speech correction and how we use tools and techniques to help our clients find their ‘sweet spot’ for sound production.

Let me show you here a little video clip where I am using my dentist’s mouth/teeth model to help my clients navigate their tongue movements.

The tongue: A tiny muscle with a big job

The tongue is a small but mighty muscle. It’s incredibly versatile, playing a key role in eating, swallowing, and, of course, speaking. For each speech sound, the tongue, along with the lips and jaw, needs to move to a very specific spot. Think of it like a dance: every part of your mouth has a choreographed movement to produce the correct sound. If the tongue is out of sync, the sound comes out muffled, distorted, or just plain wrong.

The trouble with our tongue movements is that most of us never think about how the tongue has to move and what it does to: swallow, chew, drink, suck and speak. Most parents when asked to think about their own tongue placement for say the /S/ sound are completely lost as to what their tongue is doing. Yet, of course, they produce a perfect /S/ and perfect speech in general. The same goes for swallowing. When did you last think about what happens in your mouth when you swallow? I bet you have not thought about it. We ‘just do it’, right?

Why is tongue placement so important?

Accurate tongue placement is the foundation of clear articulation. When a child struggles with a particular sound, it’s often because his or her tongue isn’t quite reaching the right spot or moving in the correct way. For example, the /S/ sound requires the tongue to be slightly raised and positioned behind the top teeth, creating a narrow channel for air to flow through. If the tongue is too far forward, you might get a /TH/ sound instead. If it’s too far back, the /S/ can sound muffled.

Visual aids: Our secret weapon

We SLTs love our visual aids! They’re incredibly helpful for showing clients exactly where their tongue needs to be. Here are some of our favourite tools:
- Mirrors: Mirrors provide instant feedback. Clients can see their tongue’s position and make adjustments in real-time. We often use hand mirrors or even the mirror on a compact for quick checks.
- Tongue depressors: These simple tools can gently guide the tongue to the correct position. We might use them to show where the tongue tip should rest for the /L/ sound or how the sides of the tongue should touch the molars for the /K/ and /G/ sounds.
- Diagrams and models: Pictures and models of the mouth can help clients visualise the tongue’s movements. We might use a cross-section diagram of the mouth to show how the tongue forms different sounds.
Beyond the tongue: The jaw’s role

While the tongue takes centre stage, the jaw plays a supporting role. It provides a stable base for the tongue and helps control the opening and closing of the mouth. Sometimes, jaw stability is an issue, and we might use techniques to help clients find a comfortable and stable jaw position.

Making it fun and engaging

Learning correct tongue placement can be challenging, but we make it fun! We use games, stories, and playful activities to keep clients motivated. For younger children, we might use silly voices or pretend to be animals. For older children, we might incorporate their interests, like using a car analogy for tongue movements.

The takeaway

Correct tongue placement is essential for clear speech. By using visual aids, interactive techniques, and a bit of creativity, we can help our clients master their speech sounds and communicate with confidence.

If you have any concerns about your child’s speech, don’t hesitate to reach out to a qualified speech and language therapist, we are here to help! Contact me via my contact form.

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Autism Therapy · Neurodiversity · Speech and Language Therapy

Stage 2 NLA
ByLondon Speech and Feeding February 23, 2024February 15, 2024
Image by Freepik

Last time we asked: is our child ready tp move to Stage 2 NLA (Natural Language Acquisition stage 2) and we looked at how we can know. Now we know: he/she is ready, they are mixing and matching those scripts quite liberally! Hurrah!

So for example we hear phrases like:
- ‘let’s go’+ ‘downstairs’
- ‘it’s’ + ‘downstairs’
- ‘I see it’ + ‘downstairs‘
- ‘I want to’ + ‘shoes downstairs’ (I want to put my shoes on downstairs)
To recap, it’s important to listen out to a variety of contexts because if we only hear the single version of a gestalt —this is so great, hurrah!— but that’s not yet Stage 2.

What we can now do on a daily basis to help and support at this time:

1. We need to offer more ‘mix and match’ phrases to help our child establish this new way of communicating.

Good phrases:
- It’s … raining / cooking / eating / washing / brushing
- That’s … great / cool / amazing / wow / so good
- Let’s … see / look / go / run / chase
- How’bout … some food / playing / I’ll chase / sleeping / we read a book
- I see a … bird / large car / fire engine
- I wanna … have a biscuit / have a book / have a snuggle
- We’re … going out / going home / going in the car / going upstairs
Here in my video clip of train play I use:
- Let’s go
- It’s going up the hill
- It’s coming down
- Ooops it falls!
- It’s stopping
- Let’s put on another parcel
- Ready steady go
- Off we go
- It’s come off!
- Let’s fix it
- I can do it
- I don’t need help
You can offer these gestalts either with an AAC as you can see me do in the video clip or you can just verbally offer these.

2. Watch out for Pronoun confusion or reversal:

Gestalt kids repeat gestalts, so we don’t want to create ‘pronoun reversal’.

Instead model from a:
- first person perspective: ‘I’ / ‘Our’ / ‘Us’
- joint perspective: ‘We’ / ‘Let’s’ or a
- neutral perspective: ‘It’
You can turn almost any sentence into a good language model once you get used to it. And you can avoid ‘you’ and ‘your’ at the same time!

So instead of saying, ‘Do you want to go to the park?’

You could say:
- We wanna go to the park?
- Let’s go out?
- Shall we go out / to the park?
3. Start providing ‘variation’ in your language modelling:

Instead of just modelling something one way, start thinking about offering a pattern in a couple of other ways, in a couple of different situations, then several ways in several different situations.

Example: once you hear your child saying: ‘it’s raining’ and you know it’s a mitigation, because you don’t often say ‘it’s raining’, or haven’t said it in a while and you know your child says other ‘it’s’ phrases.

Repeat: ‘it’s raining!’

Then: ‘it’s’ + ‘raining hard’ / ‘it’s wet out there’ / ‘It’s’ + ‘raining lot’s’.

Then later think of other combinations for ‘it’s’ + ‘something’:
- (rice) ‘It’s’ + ‘cooking’
- (water/tap) ‘It’s’ + ‘running’
- (radio) ‘It’s’ + ‘singing
- (dog) ‘It’s’ + ‘peeing’ / ‘it’s’ + ‘running’ / ‘it’s’ + ‘jumping’
In my train video clip:
- Let’s go
- It’s going
- Let’s make it go
- Ready steady go
- Oops its gone
4. Use natural intonation that shows you really mean what you’re saying.

You can be animated or try for musical if your child prefers that / doesn’t mind you singing —they might not like it if their hearing is pitch perfect and your singing is off key…—
- ‘I’m’ + ‘trying to find you!’ (animated, goofy face)
- ‘I’m’ +’ getting tired!’ (exaggerated stretch and yawn)
- ‘I’m’ + ‘catching up with you!’ (animated goofy)
- ‘I’m’ + ‘gonna get you!’ (animated goofy)
- ‘I’m’ + ‘sad right now’ (exaggerated face and tone of voice)
5. USE SILENCE!

Important, I might not have said this before but we need to hold back sometimes (hard I know) and not constantly offer models. Let our child sit in a bit of silence with us there just observing and waiting for their own offers. This is a very important point. Silence is golden sometimes. Try it out. I am not talking about the silence that comes with a person scrolling on their phone though, we do need to be present and receptive.

You will see this works wonders!

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

You can also check my friend’s lovely handmade jewelry on her website.

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Ages and Stages · Speech and Language Therapy · Top tips

My child is hard to understand at school age. Should I be concerned?
ByLondon Speech and Feeding March 30, 2026March 25, 2026
Many parents notice speech errors when their children are toddlers. At that stage it often feels quite normal. Young children are still learning the sounds of their language, and those early mispronunciations can be very endearing.

But as children grow older, parents sometimes begin to wonder:

‘Should my child still be speaking like this?’

A common concern I hear from families is that their child is still difficult to understand even after starting school. Sometimes it is a parent who notices it first. Other times it is a teacher who gently mentions that classmates occasionally struggle to understand what a child is saying.

When this happens, parents naturally wonder whether it is something their child will grow out of, or whether some extra support might help.

When should children’s speech be clear?

Children learn speech sounds gradually over several years. Some sounds develop earlier, while others take longer to master.

By the time children reach five to six years of age, most of their speech should be clear enough for unfamiliar adults to understand. There may still be a few tricky sounds developing (such as /R/ or /TH/), but overall speech should be fairly easy to follow.

If a child is frequently difficult to understand at school age, it can sometimes indicate that a speech sound difficulty has persisted beyond the stage when it would normally resolve on its own.

Why some children remain hard to understand

There are several reasons why speech clarity may still be developing in older children.

Phonological patterns

Some children continue to use speech patterns that are typical of younger children. For example:
- saying ‘tat’ instead of ‘cat’
- saying ‘doe’ instead of ‘go’
- leaving sounds out of words
These patterns are called phonological processes. They are a normal part of early speech development, but when they persist into the school years they can make speech difficult for others to understand.

Difficulty producing specific sounds

Other children may have difficulty producing certain individual sounds clearly. This might include sounds such as:
- /S/
- /SH/
- /R/
- /TH/
These difficulties are called articulation difficulties.

A child might understand exactly what they want to say but find it hard to produce the sound accurately with their tongue, lips or airflow.

Motor speech planning challenges

For some children, the difficulty lies in the planning and coordination of the movements needed for speech.

Speech requires very precise timing between the tongue, lips, jaw and breath. If the brain finds it difficult to organise these movements consistently, speech can sound unclear or inconsistent.

In some cases this may relate to Childhood Apraxia of Speech, although only a full assessment can determine this.

Why clarity matters for school-age children

Speech clarity becomes particularly important once children start school.

At this stage, children are:
- Answering questions in class
- Talking with friends
- Reading aloud
- Developing confidence in communication
When speech is difficult to understand, children sometimes become more hesitant to speak, particularly in group situations.

This can affect confidence and participation, even when the child has lots of ideas they would like to share.

The good news: speech can improve

The encouraging news is that speech sound difficulties can often improve significantly with the right support.

Speech therapy focuses on helping children:
- Learn how sounds are produced
- Practise accurate speech movements
- Understand how sounds change meaning in words
- Build consistency through structured practice
Different children benefit from different therapy approaches. Some need support with phonological patterns, while others benefit from more motor-based practice that strengthens speech coordination.

Often therapy combines several strategies to support the child’s individual speech profile.

When to seek advice

If your child is already at school and you find that people outside the family often struggle to understand them, it can be helpful to seek advice from a speech and language therapist.

A detailed assessment can help identify:
- Which sounds are causing difficulty
- Whether patterns such as fronting or sound substitutions are present
- Whether motor planning challenges may be contributing
- Which therapy approach is likely to be most effective
Early support can help children develop clearer speech and greater confidence in communication.

Every child’s speech journey is different

Speech development is not the same for every child. Some children master speech sounds quickly, while others need a little more guidance along the way.

The important thing is that support is available when children need it.

With the right strategies and practice, many children make excellent progress and develop speech that is clearer, more confident and easier for others to understand. If you are concerned about your child’s speech clarity or ongoing speech sound errors, a speech and language assessment can help identify the underlying difficulty and guide the most appropriate support.

Feel free to contact me on my contact page.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Feeding · Neurodiversity · Speech and Language Therapy

The hidden impact of mouth breathing and open mouth posture on speech and feeding
ByLondon Speech and Feeding November 17, 2025November 17, 2025
When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

Mouth breathing and open mouth resting posture can quietly influence everything from how a child’s face grows to how clearly they speak, to how confidently they chew and swallow. It’s something many parents never think about, until they start noticing the subtle signs.

Let’s explore why this happens, what to look for, and how to gently support better breathing and oral posture.

Recent research supports this link between mouth breathing and speech difficulties. For example, a 2022 study by Alhazmi et al., published in the Journal of Pharmacy and Bioallied Sciences, found that 81.7% of children aged 9–17 who breathed primarily through their mouths presented with speech sound disorders. The study highlights how mouth breathing can significantly influence orofacial development and articulation patterns.

💨 Why we’re designed to breathe through our nose

Our bodies are made for nasal breathing. When we breathe through the nose, the air is filtered, warmed, and humidified before reaching the lungs. The tongue naturally rests against the roof of the mouth, the lips close gently, and the jaw stays relaxed, all of which encourage healthy oral development.

In contrast, mouth breathing often means the tongue rests low in the mouth and the lips stay apart. Over time, this posture can subtly reshape how the muscles and bones of the face grow.

Children who breathe through their mouths most of the time may develop:
- A longer face and narrower palate
- Forward head posture
- Slightly open lips and low tongue position at rest
- A tendency toward drooling or noisy breathing
- A dry mouth and consequently bad breath
- At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)
These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

🗣 How mouth breathing affects speech

Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.
1. Reduced tongue strength and placement, i.e. the tongue rests low in the mouth (as it does in mouth breathing), it’s harder for children to lift it efficiently for sounds like /T/, /D/, /N/, /L/, and /S/. This can lead to speech that sounds slightly slushy or unclear, or a frontal lisp.
2. Open mouth posture and resonance: An open mouth at rest may affect how air vibrates in the oral and nasal cavities. Children might have speech that sounds a bit ‘muffled’ or lacks crispness because the lips and jaw aren’t fully supporting articulation.
3. Fatigue and breath control: Mouth breathing can lead to drier mouths and less efficient breath support. That can make longer sentences or conversations feel tiring, especially in noisy environments.
🥄 How mouth breathing affects feeding and chewing

Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.
1. Chewing efficiency: Children who habitually keep their mouths open often have low tongue tone and reduced jaw stability. They may prefer softer foods, chew slowly, or struggle with mixed textures.
2. Swallowing pattern: A tongue that rests low may push forward when swallowing. This ‘tongue-thrust swallow’ can interfere with efficient chewing and even affect dental alignment over time.
3. Breathing while eating: Since it’s hard to chew, swallow, and breathe through the mouth simultaneously, children who can’t comfortably nasal breathe may rush bites or pause to catch their breath. This can contribute to coughing, choking, or food refusal.
Common signs to watch for

Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:
- Lips habitually open at rest
- Drooling after the toddler years
- Snoring or noisy breathing during sleep
- Preference for soft foods or grazing eating habits
- Dark circles under the eyes due to allergies
- Frequent colds, congestion, or mouth odour
- Speech that sounds slushy or unclear despite good effort
If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

👩‍⚕️ What can help
1. Address the underlying cause: If nasal blockage, allergies, or enlarged adenoids are making nasal breathing difficult, a medical assessment is the first step. ENT specialists can rule out or treat physical causes.
2. Encourage closed mouth rest: Gentle reminders like ‘Lips together, tongue up, breathe through your nose’ can help older children become aware of their resting posture. For younger ones, visual cues (stickers or mirrors) can make it a game.
3. Build oral-motor strength and awareness: Speech therapists can design activities to strengthen the tongue and lips, improve jaw stability, and encourage balanced breathing. This might include blowing games, tongue-tip lifts, use of dental-palatal devices or oral-motor exercises disguised as play.
4. Support good posture: Sometimes mouth breathing goes hand-in-hand with forward-head posture. Encouraging upright sitting during meals and screen time helps keep the airway open and supports better breathing habits.
5. Make nasal breathing part of daily routines: Gentle nose-breathing practice during calm times (reading, bedtime, car rides) helps normalise it. Avoid making it a battle: calm, consistent reminders work best.
🌱 A gentle note on change

Patterns of mouth breathing develop over time, and change doesn’t happen overnight. It’s important to approach this with curiosity, not criticism. The aim isn’t ‘perfect breathing,’ but to give your child the tools and awareness to breathe comfortably and efficiently.

Small improvements in nasal breathing and resting posture can lead to big gains in speech clarity, eating confidence, and even sleep quality.

💡 The takeaway

Breathing seems automatic, and it is! but how we breathe matters. Mouth breathing and open-mouth posture can quietly shape how a child speaks, eats, and grows.

By noticing early signs, addressing underlying causes, and building supportive habits, you can help your child move toward stronger, clearer speech and more comfortable mealtimes.

Just like every area of development, progress starts with connection, patience, and gentle consistency, one calm breath at a time.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

References

Alhazmi, A., Alshamrani, A., Alhussain, A., et al. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Study. Journal of Pharmacy and Bioallied Sciences 14(5):911. https://www.researchgate.net/publication/361978128_Mouth_breathing_and_speech_disorders_A_multidisciplinary_evaluation_based_on_the_etiology

Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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