The Hanen Program® – The beauty of the ‘4 S’

ByLondon Speech and Feeding
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Image by freepik

One of my favourite pieces of advice I give to parents is the ‘4 S’, a strategy coined by the Hanen Program® which I teach, particularly the ‘More than Words’ programme which is designed for and aimed at parents of children with Social Communication Difficulties or Autism. It is honestly one of those golden nuggets that I use myself in my practice and I highly recommend it to all my parents. There is something about terms like the ‘4 S’ that is easy to recall and therefore use.

Introduction

The ‘4 S’ is a strategy that helps to clarify the words we use with our children so that they can notice us, hear us and understand what we are saying.

Research shows that we use on average 120-200 words per minute during everyday conversation. That’s a lot! And our children who are still learning to communicate are often bombarded with endless speech coming at them all day long. If we take into account that many of our students are Gestalt Language Processors, we can see that picking out relevant chunks of what we are saying is not at all easy, and this contributes to our children’s delays.

So let’s look at the ‘4 S’

1. The first one is SAY LESS

This means we should use shorter, simpler sentences with good grammar, for example, something like: ‘let’s get ready, time to put our shoes on’ instead of what we might be saying: ‘come on then darling, let’s put your shoes on we need to get going it’s dark outside’ or similar.

Good grammar helps to give clues about what words mean and how they are used in sentences. So, instead of ‘shoes on’ say ‘let’s put our shoes on’.

2. The second one is STRESS

I hear you think ‘I am stressed!‘. – NO! here it means ‘highlight’. We use our voice to highlight the important words in our sentence or phrase. For example, when you say ‘this banana is so yummy’ you can stress the word ‘yummy’ by saying it a bit louder and you can make a gesture, like rubbing your tummy as you say it.

3. The third one is GO SLOW

This means to speak a bit slower than you normally would and add pauses. By slowing down the pace of our speaking we give our child time to think and understand what we are saying. When we allow for pauses after we have spoken, we are inviting our child to say something in response.

4. The last one is SHOW

Always remember to show actions, gestures, objects, and point to pictures while speaking to help support your child’s understanding. We can show our child what words mean by pointing to things or holding up objects whilst describing or talking about them.

At this point I would also like to recommend the use of Core Boards, and particularly Electronic AAC devices, such as LAMP Words for Life or PODD. I have written about this in other blogs but can always be persuaded to say a bit more on the matter… 😊 It is such a big help to have an AAC talker available for both the child and the adult so we can find words and pictures to help support the words we are saying.

For example, today when reading a book like The Hungry Caterpillar (so good!) I used my LAMP AAC talker to make comments as we were looking at the pages together with my student. Example: ‘Look! He is eating more cake he is very hungry’ using my AAC talker I was able to supplement my speech and at the same time I was inviting my minimally speaking child to press a button or two and reply with ‘cake!’ which they would not have said with their mouth otherwise.

5. It does say ‘4 S’ but really it should be ‘5’ except the fifth is not an ‘S’

The fifth is REPEAT.

Repeat words and phrases often throughout the day. When learning a language we all need to hear words and phrases several times and in different situations before we can understand, remember, and then eventually use them. Our children are ‘new language learners’ and so we can apply the same principles that we would when learning a new foreign language ourselves.

Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

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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    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    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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    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
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    • Choose earlier, quieter times for trick-or-treating.
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    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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    If you can think of any other alternatives on holiday and would like to tell me about them, I would love to see your comments below. We can never have too many holiday games!!

    If you are at home over the summer and you do have some games in the cupboard you might want to dust these ones down or buy one or two new ones (if you want to).

    Most games have multiple uses, and it’s always best to adapt a game to match your child’s interests and what motivates them.

    So let’s start…

    1. Pop up pirate: pop a sword into the barrel and watch the pirate pop up randomly. Practise social skills, speech sounds, expressive language (e.g., put a sword on a picture, say the word/sentence then pick up the sword and push it into the barrel).
    2. Word games such as ‘ISpy’, ‘I went to the shop and I bought…’, ‘describe a person and guess who they are’: perfect for when you’re on the move, whether travelling or walking. You can play this anywhere and still support speech, language and communication. You could play ISpy using your child’s special sound, or ‘I went to the shop and bought all things beginning with [insert special sound here]’.
    3. Shopping list: Orchard game is a game to practise categorising. We explain the analogy of the brain being like a filing cabinet. If information is all in the correct place, it’s easier to find, retrieve and use. You can also practise specific speech sounds in this activity. You could also put the words in a sentence to add more of an expressive language element.
    4. Wiggly worms: this Orchard game is all about phonological (awareness of sounds) awareness. Matching a letter with the word. You can also practise the sounds in the words (e.g, g-o-l-d = gold; m-a-ke = make). Talk about the elements, e.g., ‘g-o-l-d’ has 4 sounds, 1 syllable; ‘m-a-ke has 3 sounds, one syllable. You can talk about what words rhyme with the different words and what makes a rhyming word (i.e., the middle and end sounds remain the same).
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    9. Simon says: a game that can be played indoors or outdoors. Parents can take turns being “Simon” and give various commands that your child must follow. This means that your child can practise their receptive (understanding of) language as well as their expressive language, speech sounds and social skills (such as turn-taking and initiating).
    10. Ker-plunk: this is perfect for practising your child’s special sound. Repetition is very important, but also can be monotonous, so finding a game that they enjoy is vital. Take turns to pull out a stick. Next, your child can either say their special sound or word (depending on what stage they are at) or hear a good model from other players.

    Do you still have questions? Contact Sonja for support.

    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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  • Could mouth breathing be affecting your child’s speech, sleep and development?

    ByLondon Speech and Feeding
    Could mouth breathing be affecting your child's speech, sleep and development?

    Understanding Orofacial Myofunctional Disorders (OMDs)

    Many parents contact me at London Speech and Feeding because they are worried about their child’s speech. Perhaps their child is difficult to understand, has a persistent lisp, struggles with feeding, snores at night, or always seems to have their mouth open.

    What many families don’t realise is that these concerns may all be connected.

    Increasingly, research and clinical experience are highlighting the important role of Orofacial Myofunctional Health, the way the muscles of the face, mouth, tongue and airway work together to support breathing, eating, sleeping and communication.

    When these muscles are not functioning optimally, children may develop what are known as Orofacial Myofunctional Disorders (OMDs).

    What Is Orofacial Myofunctional Health?

    Orofacial Myofunctional Health refers to the healthy function and coordination of the:

    • lips
    • tongue
    • jaw
    • cheeks
    • facial muscles
    • airway.

    These structures play a vital role in:

    • breathing
    • swallowing
    • chewing
    • speaking
    • facial growth
    • dental development
    • sleep quality.

    When everything is working well, the lips remain gently closed at rest, breathing occurs through the nose, and the tongue rests against the roof of the mouth.

    This seemingly simple posture has a profound influence on how a child’s face, teeth and airway develop.

    What is an Orofacial Myofunctional Disorder?

    An Orofacial Myofunctional Disorder occurs when there is an abnormal pattern of muscle function involving the face, mouth, tongue or airway.

    Children with OMDs may experience difficulties with:

    • speech
    • feeding
    • swallowing
    • sleep
    • breathing
    • dental development
    • facial growth.

    In many cases, these difficulties are linked to chronic mouth breathing.

    Signs your child may have an Orofacial Myofunctional Disorder

    Breathing and sleep signs

    • mouth open at rest
    • mouth breathing during the day
    • snoring
    • noisy breathing
    • restless sleep
    • frequent waking
    • dark circles under the eyes
    • chronic congestion
    • fatigue despite a full night’s sleep.

    Speech signs

    • lisping
    • unclear speech
    • distorted speech sounds
    • difficulty producing certain sounds
    • persistent articulation difficulties
    • reduced speech intelligibility.

    Feeding and swallowing signs

    • picky eating
    • messy eating
    • food remaining in the cheeks
    • gagging easily
    • difficulty chewing
    • long mealtimes
    • tongue thrust swallowing.

    Facial and dental signs

    • narrow palate
    • crowded teeth
    • open bite
    • overbite
    • underbite
    • long face appearance
    • receding chin
    • poor lip seal.

    If several of these signs sound familiar, a comprehensive assessment may be worthwhile.

    Why does mouth breathing matter?

    Many parents assume mouth breathing is simply a habit.

    In reality, mouth breathing is often a symptom that something is preventing efficient nasal breathing.

    Common causes include:

    • enlarged tonsils
    • enlarged adenoids
    • allergies
    • chronic nasal congestion
    • recurrent infections
    • structural airway differences
    • tongue tie
    • prolonged dummy use
    • thumb sucking
    • poor oral posture.

    When nasal breathing becomes difficult, children naturally begin breathing through their mouths.

    Over time, this can affect how the face, jaws and airway develop.

    What does healthy oral posture look like?

    Healthy oral posture is surprisingly simple:

    • lips
      • gently closed
    • tongue
      • resting against the roof of the mouth
    • teeth
      • slightly apart
    • breathing
      • through the nose.

    This posture helps guide healthy jaw growth, facial development and airway formation.

    Think of the tongue as a natural orthodontic support system. When it rests in the correct position, it helps shape the upper jaw and supports healthy facial growth.

    The consequences of chronic mouth breathing

    1. Speech difficulties

    Children who breathe through their mouths often have altered tongue posture and reduced oral stability.

    This can contribute to:

    • lisping
    • distorted sounds
    • reduced speech clarity
    • difficulty learning new speech sounds.

    2. Feeding and swallowing difficulties

    A low tongue posture may affect:

    • chewing efficiency
    • swallowing patterns
    • food management
    • oral motor coordination.

    Many children develop a tongue thrust swallow, where the tongue pushes forward instead of moving efficiently during swallowing.

    3. Poor sleep quality

    Mouth breathing can contribute to:

    • snoring
    • restless sleep
    • frequent waking
    • daytime fatigue
    • reduced concentration.

    Poor sleep can have a significant impact on learning, behaviour and emotional regulation.

    4. Changes to facial growth

    Over time, chronic mouth breathing may influence:

    • jaw development
    • facial proportions
    • dental alignment
    • airway size.

    This can result in:

    • narrow palates
    • crowded teeth
    • long facial appearance
    • increased orthodontic needs.

    5. Oral health concerns

    The nose acts as a natural filter and humidifier.

    When children breathe through their mouths:

    • The mouth becomes dry.
    • Saliva protection is reduced.
    • Risk of tooth decay increases.
    • Gum health may be affected.

    Why this matters for speech therapy

    Speech does not develop in isolation.

    The tongue, lips, jaw and airway work together to support clear communication.

    At London Speech and Feeding, we look beyond speech sounds alone.

    A child who presents with:

    • persistent speech difficulties
    • lisping
    • feeding challenges
    • open mouth posture
    • snoring
    • poor sleep

    may benefit from an assessment that explores underlying orofacial myofunctional factors.

    Addressing these foundations can often support more effective progress in speech and feeding therapy.

    How London Speech and Feeding can help

    A comprehensive assessment may include observation of:

    • breathing patterns
    • lip posture
    • tongue posture
    • swallowing function
    • feeding skills
    • speech sound development
    • sleep concerns
    • oral structures.

    Where appropriate, recommendations may include:

    • orofacial myofunctional therapy
    • speech therapy
    • feeding therapy
    • home programmes
    • ENT referral
    • orthodontic referral
    • collaborative multidisciplinary support.

    The good news

    Orofacial Myofunctional Disorders are often highly treatable when identified early.

    Supporting healthy breathing, tongue posture and oral muscle function can positively influence:

    If your child regularly breathes through their mouth, snores, struggles with speech clarity or has feeding difficulties, a specialist assessment may help identify the underlying cause.

    • speech clarity
    • feeding skills
    • sleep quality
    • facial growth
    • dental development
    • overall wellbeing.

    At London Speech and Feeding, we are passionate about looking beyond symptoms and understanding the whole child. Contact me!

    Sometimes the key to clearer speech starts with a simple question:

    ‘Is my child breathing through their nose?’

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Frequently Asked Questions

    Can mouth breathing cause speech problems?

    Yes. Mouth breathing can alter tongue posture, lip strength and oral stability, which may contribute to articulation difficulties and lisps.

    Should I be worried if my child snores?

    Regular snoring is not considered normal in children and may indicate airway obstruction or sleep-disordered breathing.

    Can enlarged tonsils affect speech?

    Yes. Enlarged tonsils may affect resonance, tongue positioning, swallowing and breathing patterns.

    What age can children be assessed?

    Children of all ages can be assessed if parents have concerns about speech, feeding, breathing or oral development.

    What is Orofacial Myofunctional Therapy?

    Orofacial Myofunctional Therapy focuses on improving breathing patterns, tongue posture, lip seal and oral muscle function to support overall health and development.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    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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  • · ·

    The power of babble: Why your baby’s ‘talk’ matters

    ByLondon Speech and Feeding

    That adorable string of ‘ba-ba-ga-ga-ma-ma’ might sound like baby gibberish, but it’s actually a crucial milestone in your little one’s language development. Babbling or babble, as we call it, is far more than just cute baby noises. It’s a sequence of sounds that lays the foundation for future communication.

    Image by freepik

    What is babbling?

    Babbling typically begins around six months of age, though the timing can vary slightly from baby to baby. It involves your baby experimenting with different sounds, stringing together consonants and vowels. You might hear them repeating sounds like:

    • ‘Ba-ba’
    • ‘Da-da’
    • ‘Ma-ma’
    • ‘Ga-ga’

    As they progress, the babbling becomes more complex, with variations in pitch, rhythm, and intonation. It might even sound like they’re having a conversation with you!

    Why is babbling so important?

    1. Laying the groundwork for speech: Babbling is like a vocal workout for your baby. By practising these sounds, they’re strengthening the muscles in their mouth, tongue, and vocal cords that are essential for speech.
    2. Developing phonological skills: Through babbling, babies begin to understand the sound patterns of their native language. They’re learning which sounds go together and how they’re used.
    3. Enhancing social interaction: Babbling is a social activity. Babies often babble back and forth with their caregivers, which helps them learn about the give-and-take of communication.
    4. Cognitive development: The act of babbling requires babies to use their brains in new ways. They’re learning to control their vocalisations, pay attention to the sounds they’re making, and connect those sounds to the responses they receive from others.

    How can you encourage babbling?

    • Talk to your baby: Even though they can’t understand your words yet, talking to your baby exposes them to language and encourages them to respond with their own vocalisations.
    • Imitate their sounds: When your baby babbles, imitate them! This shows them that you’re paying attention and encourages them to keep ‘talking.’
    • Respond to their babbling: Treat your baby’s babbling as if it’s a real conversation. Respond with words, smiles, and gestures.
    • Play sound games: Make different sounds for your baby and encourage them to imitate you. This could include animal sounds, silly noises, or simple words.
    • Read to your baby: Even before they can understand the words, reading to your baby exposes them to the rhythm and sounds of language.
    • Sing songs: Singing is a fun and engaging way to introduce your baby to new sounds and words.
    • Use mirrors: Babies often enjoy watching themselves make sounds in a mirror.
    • Tactile stimulation: Gentle massage around the mouth and face can increase oral awareness and encourage vocalisations.
    • Vary textures: Offer different textured teethers.
    • Read books with sound effects: Choose books with animal sounds or other engaging noises.
    • Blow bubbles: The act of blowing and popping bubbles can encourage vocalisations.
    • Use visual aids: Show pictures of objects and say their names, emphasising the consonant sounds.
    • Use exaggerated facial expressions: When you make sounds, exaggerate your mouth movements to help your baby see how sounds are made.
    • Increase joint attention: Follow the child’s gaze and point to objects that they are looking at and say the name of the object.

    When to seek help

    If you notice that your baby is not babbling by eight months, it’s a good idea to talk to your speech and language therapist. You might also notice a lack of variation in tone when your child is making sounds, is your baby sounding a little ‘flat’ or monotonous? While every child develops at their own pace, a lack of babbling can sometimes indicate a developmental delay or hearing issue.

    Remember, babbling is a gift. So, enjoy those precious moments of ‘baby talk’ and take comfort in knowing that your little one is on the path to becoming a chatterbox!

    Do get in touch via my contact form if you are concerned about your child’s development or if you simply want some reassurance that your baby is developing well. We will be delighted to arrange a screening appointment for you and give you support and reassurance.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    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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