Speech sound disorders

ByLondon Speech and Feeding
Kids Speech Therapist London
Speech Sound Disorders

Treatment Approaches – A Typical Session

There are various great ways to treat speech sound disorders and I use all the approaches available selectively; I decide what works with each individual child and I also vary the approach depending on the child’s frame of mind at any given time during my session.

Some of the approaches are more “drill-based” and require a child to be able to pay attention and really participate actively in the therapy, and this is what I am showing you today with this video clip.

My little student here has been working with me for some time and from only saying a handful of words which were not very easy to understand he has come a long way. He does have some features of Verbal Dyspraxia which I shall briefly outline here:

  • Making sounds in general is a struggle, especially when asked to copy certain sounds, example: ‘can you say: a ee ou oo?”
  • Repeating sound sequences or words sequences is hard, for example: “say p-t-k in sequence” or “say fish chips fish chips fish chips
  • When saying the same word again and again, different mistakes can be heard
  • Intonation difficulties: speech sounds monotonous
  • Vocabulary is very limited

Some therapy approaches are more play based, for example the Core Word method: here we pick a few words at a time which are very significant to the child and therefore highly motivating to try and say. These could be characters of Pokemon or Minecraft for example, or simple words like “GO!”

When you watch the video you will see that I use a lot of visual prompting, such as showing him where the tongue is moving to or from. I do this with my index finger and this approach is called Tactile Cueing or “Cued Articulation”. Part of the approach is to give a visual prompt and then reduce the prompt as the learner is more able to produce the correct sounds. Once he can produce the sound on its own, we quickly move to the sound within a word.

I do mix and match my approaches and in fact here I am drilling but I also use the Core Word which for him (YELLOW) — it’s his favourite colour and I happen to have quite a few good games where a YELLOW something or other can be asked for….. WHO KNEW!? 🙂

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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    A bite-sized guide to Speech and Language Therapy: feeding and swallowing

    ByLondon Speech and Feeding

    What is a Speech and Language – Feeding Therapist?

    You’ve probably heard of speech therapists helping people who stutter or struggle to pronounce words. But did you know that they also work with children and adults who have problems with eating and swallowing? This specialised area is called Speech and Language Therapy: Feeding and Swallowing, or Dysphagia Therapy.

    Why does a Speech Therapist help with eating and swallowing?

    The mouth, tongue, and throat are all involved in both speech and swallowing. When there’s a problem with any of these parts, it can affect both your ability to talk and to eat. For example:

    • Weak tongue muscles: Can make it hard to chew food and to form sounds.
    • Difficulty coordinating swallowing: Can lead to choking or aspiration (when food or liquid goes into the lungs).
    • Sensory issues: Can make certain textures or tastes feel unpleasant or overwhelming.
    • Communication: If we are not able to express ourselves we are likely to have difficulties during daily mealtimes: how do we ask for ‘more’ of something, how do we say we have had enough or we don’t like a particular food?

    How does a Speech and Language Therapist help?

    Our work involves a combination of assessment and therapy. We carefully observe how your child feeds, eats and swallows, and we look into your child’s mouth to help us see what the cause of the difficulties are: could be a very highly-arched palate, it could be a very flaccid/low tone tongue, it could be poor dentition. Then, we create a personalised treatment plan to address your specific needs.

    Here are some of the things we might do:

    • Teach swallowing techniques: We can help your child learn strategies to improve or facilitate a safe swallow.
    • Recommend dietary modifications: We may suggest changes to your child’s diet to make it easier to eat and swallow.
    • Provide sensory therapy: If your child has sensory needs we can help your child become more comfortable with different textures, tastes, and smells.
    • Work on oral motor skills: We can help to encourage more effective chewing, or drinking skills, or we can help your child to close his/her mouth more during chewing or drinking from a straw.
    • Collaborate with other professionals: We often work closely with doctors, nurses, occupational therapists, and dietitians to provide comprehensive care.

    What kinds of problems do Speech and Language Therapists help with?

    We see a wide range of feeding and swallowing difficulties, including:

    • Delayed feeding: Children who are slow to develop feeding skills or who have difficulty transitioning to solid foods.
    • Tongue-ties: Babies can have significant difficulties with feeding when the tongue is very tightly tethered to the floor of the mouth.
    • Refusal to eat: Children who refuse to eat certain foods or textures.
    • Aspiration: When food or liquid goes into the lungs, which can lead to pneumonia and other serious complications.
    • Chewing difficulties: Problems with chewing food, such as difficulty breaking down food or keeping food in the mouth.
    • Swallowing difficulties: Problems with swallowing, such as feeling like food is stuck or choking.
    • Neurological conditions: Conditions like cerebral palsy, down syndrome or other genetic syndromes can affect feeding and swallowing.
    • Developmental delays: Children with developmental delays may have difficulties with feeding and swallowing.

    Is there hope?

    If your child is struggling with feeding or swallowing, know that there is help available. Speech and Language Therapy can make a significant difference in your and your child’s quality of life. We’re here to support you every step of the way.

    Remember, you don’t have to suffer in silence. If you’re concerned about your child feeding or swallowing, please reach out. You can find a Speech and Language Therapist with a Feeding/dysphagia qualification near you via www.asltip.co.uk or contact me.

    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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    What Is Echolalia And Does It Have A Function? How Can Speech Therapy Help With Echolalia?

    ByLondon Speech and Feeding
    What Is Echolalia And Does It Have A Function? How Can Speech Therapy Help With Echolalia?

    Echolalia is a term used when assessing or treating children with Autism. The term refers to the repetition or echoing of utterances, either our own or others’. It can also be echoing phrases heard on television, advertising jingles or catchy repeat phrases used in tv programmes or nursery rhymes and songs. Whilst we all use echolalia occasionally and it can be observed in typically developing children, we tend not to see/hear it beyond the age of 2.5 years old. Children with ASD, however, do use echolalia often into late childhood.

    There are generally two types of Echolalia:

    Immediate echolalia

    Here the repeated phrases or words are produced immediately after someone has spoken the original words or within two conversational turns of the original utterance.

    Delayed echolalia

    The repeat echoing of the original utterance occurs sometime later, more than two conversational turns or with a much longer time delay. Due to the delay it can be hard to interpret the meaning of the echolalic utterance as it may refer to something that happened long ago and in a different context to the originally utterance.

    (Stiegler, 2015, Fay 1967, Blanc 2014)

    There are other unconventional speech behaviours which include:

    • Perseveration of Speech – persistent repetition of speech
    • Repetitive questioning – persisting even though answers were given
    • Vocalisations such as: humming, whistling, clicking, squealing etc.

    Much research has gone into the meaning and treatment of Echolalia and the following list consists of possible functions that have been identified:

    • Information sharing
    • Responding to answers
    • Labelling
    • Drawing attention to self
    • Protesting
    • Requesting
    • Giving instructions
    • Self-regulation, calming

    (Stiegler 2015, Prizant 1983)

    Echolalia does have a function and is part of the Gestalt Learning Process (where longer units of speech are memorised and then used as a whole without the individual words being meaningful).

    As a Speech and Language Therapist I promote sound and proven Intervention based on the Hanen Programme which helps provide a highly facilitative Interaction Style and I will tell you a bit more in my next blog how the “More Than Words” approach can help children with echolalia move through their Gestalt Learning into more analytic processing of language, grammar and meaning.

    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.

  • ·

    Explore the world of speech sound therapy for young children

    ByLondon Speech and Feeding

    Many parents who come to the clinic voice with the concerns about their child’s “speech”. On assessment we discover that actually besides the words not being clear what we most often don’t see is “language” (putting words together to request something for example). And we don’t see “social communication” (waving bye with a smile for example). So what is perceived as “speech” is much more than just not saying the speech sounds correctly. It might be that we need to increase the child’s vocabulary and language so that we can target specific speech sound patterns.

    We’ll guide you through some of the most frequently asked questions.

    What is the difference between speech and language?

    Language is how we put words together (e.g., the cat ran up a tree). For non-verbal children this might be how gestures and symbols are put together. Both will put these into a meaningful context. Language needs to use either speech and/or gestures or signs or pointing to symbols in order to come into being. It needs words, either spoken or written, put into grammatical order so that thoughts can be expressed adequately: about the here and now, about what he had for breakfast this morning or what we are going to do this coming weekend. We put words together to express our feelings and thoughts. Speech is one aspect of this very complex process.

    Speech is the specific sounds that make up a word (e.g., the sounds in fish are /f-i-sh/).

    Some children are delayed in their speech but will catch up with their peers’ development with time. Others may be using disordered speech sound patterns. If you’re unsure, contact your Speech and Language Therapist as early intervention is vital. It might be that you’re given activities to carry out at home. Or a direct therapeutic intervention may be required, along with regular practice at home. The approach depends on your child and how they learn best.

    When might your Speech and Language Therapist recommend direct Speech and Language Therapy?

    There are several reasons why your child may need intervention to support their communication. Some of these include:

    • When they produce vowels incorrectly
    • When a child has significantly fewer consonants than they should have by their age
    • Error patterns that are not following a typical process
    • Fewer word approximations
    • When a child is ready for speech therapy. That is to say, when we can target speech production through interactive play but most often speech is targeted through repeated activities which focus on a few sounds or words at a time. For this to work ideally a child does need to be able to sit at a table and take part in the activities and games.

    How can I work on speech and language targets at the same time?

    You’ll want your child to be engaged in activities. It’ll need to be in short bursts to keep their attention. Let’s say you’re focusing on the /p/ sound. You may get a bag with objects and items with /p/ in them. Speak to your child’s Speech and Language Therapist about what position in the word they are targeting now.

    Sing the ‘what’s in the bag’ song. Pull out each item in turn and emphasise the sound that you are working on such as “it’s a fox, ffffox”. You can then comment on what the fox is doing, or what they look like (e.g., look at this fffurry fffox. It’s very fffriendly. Oh, the fffox is running).

    This activity gives you the opportunity not only to build vocabulary but also to expose your little one to a good model of speech sounds.

    “I’m concerned my child won’t sit through the assessment”

    This is a common concern. Don’t worry. If your child is not able to sit through an assessment then we usually offer play-based assessment. This means it is activity focused and can be wherever your child feels most comfortable; this is usually on the floor. It is often best to see children in their own homes or even nursery places where they can roam more freely and where they feel most comfortable. On reading the filled-out parent questionnaire we can decide whether a home visit/nursery visit or a clinic visit might work best for your child.

    You will be guided all the way through from assessment to intervention and beyond. So, you’ll leave feeling empowered and confident to get started!

    Contact Sonja for support with your child’s speech.

    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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    Discover seven activities to support young children with word-finding difficulties

    ByLondon Speech and Feeding
    Speech Therpaist in London
    Discover seven activities to support young children with word-finding difficulties

    You watch your child struggle to find the right words in conversation. You’ve noticed that they describe what they mean (e.g., it lives in the trees outside, has wings to fly and squawks) but cannot think of the correct word to use (i.e., bird). You see the frustration on their face as they search for that never-ending missing word. You know that as your young person becomes older, they are likely to face an increasing frustration. You recognise the importance of putting strategies into place for their word-finding difficulties. It’s vital that this diagnosis has come from a Speech and Language Therapist, as different activities will target different needs.

    Ensure activities are interesting and fun. Be creative and use the activities your young person relates to. Use words that interest them. Remember, the words we use matter.

    1. Read, read, and read some more!

    • Read books that rhyme, or those that talk about opposites
    • Read about the semantic classes in the book such as occupations, the equipment they might use, or names of related words
    • Talk about books that involve animals and their young, and the names of the animal genders (i.e., Horses have foals; horse; mare, stallion, filly, colt)
    • Use books that have repetition of the same word or ones that have a silly rhyme

    2. Play word-games

    You could play games which transform one part of speech to another

    • Today I am riding, yesterday I … (rode)
    • Today I am driving, yesterday I … (drove)

    You could name the odd word out from a list of items

    • e.g., cat, dog, sheep, red

    Why not read out a list of words and your child must guess which two go together

    • e.g., television, sofa, apple, banana

    Play a game of complete the sentence

    • e.g., “A house is a place to live. An office is a place to …”

    Play a word game involving synonyms or antonyms

    • e.g., Can you think of another word for “small”? Can you think of another word for “sleepy”?
    • e.g., “The opposite of hot is …” or use a question-and-answer format e.g., “What is the opposite of hot?”

    Play a word game involving similarities and/or differences

    • e.g., “what is the same as a car and a bus?”
    • e.g., “what is the difference between a car and a bus?”

    3. Use story telling

    Sing rhymes or songs, and allow children to complete the sentence

    • e.g., ‘Little Jack Horner sat in a …’ (corner)

    4.Tell jokes

    Why not tell knock-knock jokes, or riddles? These need accurate word-retrieval otherwise they wouldn’t be funny.

    5. Make up words in rhymes

    Use rhymes and make up words

    • e.g., “Humpty Dumpty had a great… grandmother”

    6. Play word category games

    These games might include ones (e.g., “see how many boys’ names you can think of in one minute”. Time yourself while you do it. Categories may include tools, games, girls’ names, drinks, films, toys, animals, makes of cars, clothes, sports, items that you find in school, colours, names of places beginning with ‘B’). You could also play this in reverse, so name items in the category and your conversation partner guesses the category.

    7. Play “what comes next?”

    • e.g., ABCDE…
    • e.g., First, second, third…
    • e.g., Monday, Tuesday, Wednesday…

    Knowing that you’re helping your child with their word finding is a weight off your mind. It helps you to relax knowing that you’re supporting their word-finding difficulties. Watch your child develop strategies as their word knowledge grows.

    Credit: Caroline Bowen

    All information in this blog originates from:

    Bowen, C. (1998). Information for Families: Helping Children Who have Word Retrieval Difficulties. Retrieved from http://www.speech-language-therapy.com/index.php?option=com_content&view=article&id=100 on [15.11.2022]

    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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  • · ·

    Support your autistic child’s communication by learning the stages of Gestalt Language Processing

    ByLondon Speech and Feeding

    If your child is using echolalia and/or has a diagnosis of autism, then your child’s way of processing language is most likely different to the classic way children typically learn language. We call this process Natural Language Acquisition or Gestalt Language Processing.

    Speech Therpaist in London
    Step by Step guide to Gestalt Learning

    Let’s explore the following stages of Gestalt Processing:

    Stage 1: communicative use of whole language gestalts

    (e.g., “let’s get out of here”)

    Children and young people in this stage use echolalia. They need to hear more gestalts or scripts. So, your job is to model, model, model and to use functional language that your child can repeat back.

    Stage 2: mitigated into chunks and re-combining these chunks

    (e.g., “let’s get” + “some more”) and (e.g., “let’s get” + “out of here”)

    This is when you take parts of gestalts or phrases and then combine it with other parts.

    Stage 3: further mitigation (single words recombining words, formulating two-word phrases)

    (e.g., “get…more”)

    They are going beyond their gestalts. Furthermore, they may begin to label different objects.

    Stage 4: formulating first sentences

    (e.g., “let’s get more toys”)

    You may see more grammatical errors during this phase as they are creating unique sentences. Please don’t worry about this, it means they are playing and experimenting with language. As communication partners, you could model the correct form of the sentence.

    Stages 5 & 6: formulating more complex sentences

    (e.g., “how long do you want to play inside for?”)

    You can see that language learning is a process, that is trialled and tested, used in different contexts for children to be able to learn and use language appropriately.

    My next blog will give you activities ideas and how you might use them specifically with a Gestalt Language Processor.

    Remember early intervention is vital. So, if you have any concerns, please seek the advice of a Speech and Language Therapist.

    Contact me, Specialist Speech and Language Therapist Sonja here.

    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.

  • · ·

    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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