Speech Sound Challenges: A focus on /L/ and /Y/

ByLondon Speech and Feeding
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Have you ever thought about how difficult it can be to produce certain speech sounds? Some sounds are definitely trickier than others. This is especially true for children with speech sound disorders like Childhood Apraxia of Speech (CAS).

My student with CAS has been working hard on producing the /L/ sound especially when it was followed by an /O/ or /OO/ like, ‘log’ or ‘look’. We’ve practised lots and now that he’s got a good handle on /L/, he’s started replacing another difficult sound, /Y/, with it. So, ‘yes’ becomes ‘less’ and ‘yuck’ becomes ‘luck.’

This is a common pattern in speech development. Once a child masters a new sound, they may start using it in place of other sounds they find even more challenging.

Minimal Pair therapy

I use different evidence-based methods to help my students. And I often like to start out with phonemic awareness and then I move to contrasting the error sound with another sound to make completely different words. This approach is called ‘minimal pair’ therapy: both words are the same except for the initial/final sound which has the error sound, and this is contrasted with the correct sound.

Below is an example of this:

After we have worked on sound awareness, listening and becoming aware of small units of sound matter, then we can move to working on tongue placement and movement.

Tongue placement and movement to produce correct /L/ and /Y/ sounds

To produce these sounds correctly, the tongue needs to be in specific positions and make specific movements.

  • /L/ sound:
    • Tip of the tongue touches the alveolar ridge (the bony ridge behind your upper teeth)
    • Sides of the tongue are raised to the sides of the upper teeth
    • Airflow escapes through the sides of the tongue
  • /Y/ sound:
    • Tip of the tongue touches the roof of the mouth behind the alveolar ridge
    • Sides of the tongue are raised to the sides of the upper teeth
    • Airflow escapes through the centre of the mouth

I also use:

  • Auditory bombardment: Auditory bombardment is a technique that involves repeatedly listening to a target sound. This can help children to develop a better understanding of the sound and how to produce it.
  • Visual cues: Visual cues can be helpful for children who are having difficulty producing a particular sound. Here I use the image of a ‘standing tongue’ versus a ‘sitting tongue’.
  • Physical cues: I use my hands to show a ‘standing tongue’ for the /L/ versus a ‘sitting tongue’ for the /Y/. But what worked even better and sadly I don’t have the video clip for it:
  • Semantic cues: For example a picture of an ‘EAR’ to make the sound /Y/ so we shape the sound /EA/ to /Y/.
  • Parent involvement: Parents play an important role in their child’s speech sound development by providing opportunities for them to practise their speech sounds at home. This can be done through activities such as reading books, singing songs, and playing games.
  • Reinforcement: It is important to praise children for their efforts, even if they are not perfect. This will help them to feel motivated to keep practising. Important here for speech correction is concrete reinforcement: I feed back to my student what exactly they were doing correctly with their tongue or lips. Rather than saying ‘well done’, I mention what my student has just done with the tongue to change the sound: ‘I saw you lowered your tongue! That made a good /Y/’.

Another great way of reinforcing positively is to ask the student how they feel they have done? For the older ones I often ask them to self-rate their sound production out of 10. Then we can work towards the next incremental number upwards. This is very effective and gives the student control over their own work.

Please contact me if your child has speech sound difficulties.

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

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    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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    Many parents are surprised when I bring AAC into a session, especially if they’ve come to see me primarily for speech sound work.

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    Pretend Play using Speech and AAC in my clinic room

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    Using AAC to support speech practice

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    One of the biggest myths I hear is: ‘My child isn’t ready for AAC yet.’

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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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      Are the Gestalts I model easy to mix and match later on?

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      Image by bearfotos on Freepik

      Here are some examples of great phrases and Gestalts that we could use:

      • Let’s get a banana / Let’s go out / Let’s play lego / Let’s go see daddy
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      • How about a biscuit / How about a cuddle / How about watching tv
      • We love bananas / We love a monkey / We love a cuddle

      Why or how could these examples be mixed and matched?

      You can see I have given several examples for each, that is how later a child can take one chunk (let’s) and add another (go out) or (need) + (go out).

      What about our own grammar? Should we be using grammatical phrases?

      In general for NLA 1 (Natural Language Acquisition stage 1) we want to use short phrases and keep them quite generic, something like:

      ‘Let’s go’ or ‘let’s play’ and pick 2-3 phrases per communicative function (see next point below).

      And if we are going to say longer sentences, for example: ‘let’s go and feed the ducks now’, then we should do so with good grammar and really varied intonation. It sometimes helps me to make up a little song/jingle on the spot that has a lot of intonation, more than I would perhaps use just by speaking.

      How many varied communicative functions do we cover with our modelling?

      We want to model a variety of Gestalts other than just requesting for example. In general, we are looking at our child having one or two Gestalts in the following areas before they are ready to move on into stage 2.

      These are the most common ones I see in my practice:

      • Requesting ‘want a banana/biscuit’ ‘Wanna play ball’
      • Transitioning: ‘what now?’ ‘what next?’
      • Ask for help: ‘need help’ ‘help me’ ‘mummy help’
      • Commenting: ‘it’s big’ ‘it’s red’ ‘it’s fast’ ‘too loud’
      • Speak up for self: ‘not that one’ ‘go now’ ‘stop it’

      Is the Gestalt I am modelling meaningful to my child?

      We don’t use all available Gestalts for every child. It has to be meaningful to the individual and has to match their interests. If our child is a big fan of feeding the ducks in the park then we can think about Gestalts like:

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      • They’re over there
      • Let’s feed them?
      • Let’s get some seeds
      • They’re coming!
      • They want food / They wanna eat!
      • That’s a big one
      • It’s so hungry
      • It loves the seeds!
      • No more! All done! Finished! Let’s go home

      What is my child actually trying to tell me?

      We have to be become word/phrase detectives! Is the phrase/script/Gestalt they are using right now actually meaning what they said or does it mean something else, and if so, what?

      Here is an example from my own personal experience in my practice:

      The little boy I was working/playing with was building a tall tower with blocks. When it finally fell with a great big bang he said in a sing-song voice ‘ring-a-ring-a roses’ … then he began to collect the blocks again to make a fresh tower. I sat there and thought: why ‘ring-a-ring-a roses’? What does that mean in this context? I then sang the song (silently) to myself with my detective hat on and realised as I came to the end that it finishes with ‘we all fall down’! it was a real AHA!!! moment for me as I saw right there what the meaning of his Gestalt was. He sang the first line of the song to say ‘all fall down!’

      So realising this I waited for the next tower to fall, and there it was again, he sang the first line of the song. I replied thus, copying him at first:

      ‘RING-A-RING-A ROSES – WE ALL FALL DOWN!…

      FALL DOWN

      WE LOVE IT FALLING DOWN.’

      The process to find what we should say is not always straight forward or easy at all, and often we don’t quite know in the moment what our child is trying to say. But we can try and get to know their interests and then gradually we do know more and more what the meaning behind the Gestalt is or could be.

      What pronouns should we use?

      This can be a tricky one.

      We don’t want to use language that uses the pronouns ‘you’ or ‘you’re’. The reason is that our child will likely copy us exactly as we have said it. Therefore, using pronouns ‘you’ and ‘you’re’ will then sound wrong.

      Always try to model language that is from the child’s perspective or in other words how they would say it if they could.

      Alternatively, you can model using WE or US. For example, if the child is tired, rather than saying ‘you are so tired’ model language from his or her point of view: ‘I’m tired’ or ‘let’s go have a lie down’.

      There is so much more to talk about. Stay tuned for a blog on NLA stage 2 coming soon.

      If you need help with your child, please do not hesitate to contact me.

      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.

      0
    • · ·

      Baby-led weaning: Empowering little eaters from the start

      ByLondon Speech and Feeding

      I had a mum ask me about Baby Led Weaning the other day. So I thought I would write a blog on all the useful questions she had and what we discussed as it may help lots of mums and dads out there.

      Image by Freepik

      As a Paediatric Feeding SLT, one of the exciting developments in recent years is the growing interest in baby-led weaning (BLW). This approach to introducing solids has gained significant traction, and for good reason. It empowers infants to take the lead in their feeding journey, fostering a positive relationship with food and supporting important developmental milestones.

      What exactly is baby-led weaning?

      At its core, baby-led weaning is about offering your baby appropriately sized and textured solid foods from the very beginning, allowing him or her to self-feed. Instead of spoon-feeding purées, you present whole, soft foods that your baby can grasp, bring to his or her mouth, and explore at his or her own pace. This means no mashing, no blending, and no forcing spoons into reluctant mouths. It’s a fun, messy, and intuitive process that is led by your baby’s natural instincts.

      The genesis of baby-led weaning

      ‘Baby-led weaning’ was popularised by British health visitor Gill Rapley. In the early 2000s, Rapley observed that babies naturally develop the skills needed to self-feed and that traditional spoon-feeding might actually hinder this development. Her work, particularly her book Baby-Led Weaning: The Essential Guide to Introducing Solid Foods (co-authored with Tracey Murkett), published in 2008, brought BLW into the mainstream and provided a structured framework for parents. Her research and observations highlighted the benefits of trusting a baby’s innate ability to regulate his or her intake and explore different textures.

      What’s the deal?

      Implementing BLW is simpler than you might think, though it does require a shift in mindset. Here’s a breakdown of what it typically involves:

      • Readiness is key: The golden rule of BLW is to wait until your baby shows clear signs of readiness. This isn’t about age alone, but rather developmental milestones. Your baby should be at least six months old, able to sit unassisted, have good head and neck control, show an interest in food (e.g., reaching for yours), and have lost his or her tongue-thrust reflex (which pushes solids out of his or her mouth).
      • Offer finger foods: Start with soft, easily graspable foods cut into finger-sized sticks or spears. Think cooked sweet potato fries, steamed broccoli florets (soft enough to mash with gentle pressure), banana sticks, or avocado slices. The goal is for babies to be able to pick it up and get some into their mouth.
      • Embrace the mess: BLW is inherently messy, especially in the beginning. Food will be squished, dropped, and smeared. This is a crucial part of the learning process as babies explore textures, smells, and the properties of food. A wipeable mat under the highchair and a good bib are your best friends!
      • Observe, don’t interfere: Allow your baby to lead. He or she will decide what to eat, how much, and how quickly. Avoid putting food into his or her mouth or pressuring him or her to eat more. This respects his or her hunger and fullness cues, laying the foundation for healthy eating habits.
      • Continue breastmilk or formula: Until your baby is well-established on solids, breastmilk or formula remains his or her primary source of nutrition. Solids are for exploration, taste, and developing skills, gradually increasing in quantity over time.

      The benefits of baby-led weaning

      The advantages of BLW extend far beyond simply getting food into your baby. From a speech and feeding perspective, the benefits are compelling:

      • Develops oral motor skills: Chewing, gnawing, and manipulating various food textures are crucial for developing the muscles in the mouth, jaw, and tongue. This strengthens the oral motor skills necessary for speech development.
      • Enhances fine motor skills and hand-eye coordination: The act of grasping food, bringing it to the mouth, and coordinating these movements significantly refines fine motor skills and hand-eye coordination.
      • Promotes self-regulation and intuitive eating: By allowing babies to control their intake, BLW helps them tune into their own hunger and fullness cues, fostering a healthy relationship with food and reducing the likelihood of overeating.
      • Encourages adventurous eating: Exposure to a wide variety of tastes and textures from the outset can lead to less picky eating later. Babies are more likely to accept new foods when they have been in control of their exploration.
      • Facilitates family mealtimes: BLW integrates babies into family mealtimes from an early age, promoting social interaction and making mealtime a shared, enjoyable experience.

      When is baby-led weaning appropriate, and when not?

      While BLW offers numerous benefits, it’s not a one-size-fits-all approach.

      When BLW is appropriate:

      • When your baby meets all the developmental readiness signs: This is paramount for safety and success.
      • When you are comfortable with the mess and the learning curve: It requires patience and a relaxed attitude.
      • When you are committed to offering a variety of safe, appropriate foods.
      • When you are willing to learn about and practise safe food preparation to minimise choking hazards.

      When BLW might not be appropriate (or requires extra caution and professional guidance):

      • If your baby has a history of prematurity or significant developmental delays: His or her oral motor skills might not be sufficiently developed.
      • If your baby has certain medical conditions or anatomical differences (e.g., cleft palate, severe reflux, swallowing difficulties): These may necessitate a modified approach to feeding.
      • If there are significant feeding difficulties, aversion, or a history of choking incidents.
      • If you feel overly anxious about choking: While BLW, when done correctly, is not associated with a higher choking risk than traditional weaning, parental anxiety can impact the feeding experience. Education and consultation with a professional can help alleviate these concerns.

      A note on safety: Choking hazards

      It’s crucial to understand the difference between gagging and choking. Gagging is a natural reflex that helps prevent choking and is very common in BLW as babies learn to manage food in their mouths. Choking is silent and serious. To minimise choking risks:

      • Always supervise your baby closely during mealtimes.
      • Offer appropriately sized and textured foods. Avoid small, round, hard foods like whole grapes, nuts, popcorn, and large chunks of meat.
      • Ensure your baby is sitting upright and calm.
      • Educate yourself on infant CPR.

      Final thoughts

      Baby-led weaning is a wonderfully empowering approach that celebrates a baby’s natural abilities and fosters a positive and independent relationship with food. As Speech and Language Therapists we often see the positive impact it has on oral motor development, self-regulation, and overall feeding confidence. By understanding what it entails, when it’s appropriate, and prioritising safety, you can embark on this exciting journey with your little one, helping him or her become a confident and capable eater from the very first bite.

      If you would like help and support with weaning your baby whilst continuing to breastfeed then please get in touch!

      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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