Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

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Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

Holiday meals are meant to be joyful and something we all look forward to. But for many children and their families, these occasions can be overwhelming and be the cause of dread and worry. The combination of new smells, unfamiliar foods, loud environments, social expectations, and allergy anxieties can quickly turn what should be a festive time into a stressful one.

For parents of children with sensory processing differences, selective eating challenges, or food allergies, holiday gatherings often require careful planning and a big dose of tolerance and compassion. The good news is that with awareness and a few gentle strategies, you can support your child to feel safe, regulated, and included during festive meals without pressure, tears, or discomfort.

Let’s explore how to make holiday mealtimes calmer, safer, and more connected this season.

🎄 Why holiday meals feel so overwhelming

Holiday gatherings usually combine several sensory triggers all at once:

  • Noisy, chaotic rooms
  • Strong smells from a mix of foods we don’t normally cook
  • Multiple conversations happening at once
  • Bright lights, Christmas décor, flickering candles
  • Unfamiliar foods with unexpected textures
  • Expectations to ‘try everything’ or ‘enjoy it’s sooo good!’
  • New environments, seating arrangements, or routines

For children with sensory sensitivities, this can feel like a tidal wave of input. Research shows that children who are sensory-sensitive often have heightened responses to smell, taste, and texture, which may lead to avoidance or distress at mealtimes (Cermak, Curtin, & Bandini, 2010).

Add food allergies into the picture and anxiety increases even further for both children and parents. A 2020 study by DunnGalvin et al. found that children with food allergies experience significantly higher stress in shared eating environments, especially when food preparation or contamination risk is hard to control.

So, if your child becomes tearful, shuts down, or refuses to sit at the festive table, it isn’t ‘bad behaviour.’ It’s sensory overload, heightened vigilance, or discomfort communicating through their body.

🌟 Preparing your child for a calmer festive meal

Preparation is especially important for sensory-sensitive or allergy-aware children. Here’s how to set them up for success:

1. Offer predictability through previewing

Before the event, show your child pictures of:

  • where you’re going
  • who will be there
  • the types of foods that might be served
  • where they might sit

A visual schedule or social story can help reduce anxiety and give your child a sense of control.

2. Pack safe foods without apology

If your child has allergies or selective eating, bring:

  • ‘Safe foods’ you know they will eat
  • Backup snacks
  • A separate (their own) plate, if needed
  • Emergency medication

Announce clear, firm boundaries such as:

‘Ok people, these are Jamie’s safe foods — we’ll stick with these today.’ This will help relatives understand without pressure or judgement.

3. Choose seating that supports sensory regulation

If possible, seat your child:

  • at the end of the table
  • near a familiar adult
  • away from the kitchen (strong smells)
  • away from noise clusters
  • give them their favourite toy or fidget whilst waiting

Let them take breaks when needed. This isn’t ‘rude,’ it’s self-regulation.

🍽️ Supporting children during the meal

1. Focus on connection, not consumption

The holidays are not the time to expand your child’s food range. Keeping mealtimes low-pressure actually supports long-term progress.

In fact, the research is clear: pressuring children to eat decreases acceptance and increases refusal (Galloway et al., 2006).

So instead of ‘Just try it!’ try:

  • ‘You don’t have to eat it, you can look at it.’
  • ‘You’re in charge of what goes in your mouth.’
  • ‘You can keep your safe foods on your plate.’

2. Protect your child’s allergy safety

Holiday meals often include:

  • cross-contamination risks
  • shared utensils
  • buffets
  • homemade dishes without ingredient lists

Use gentle but firm scripts:

  • ‘Because of Ellie’s allergies, we’ll keep her plate separate.’
  • ‘We’ll serve her food ourselves to make sure she stays safe.’

Confidence in your boundary helps others respect it.

3. Manage sensory load in real time

Offer:

  • headphones
  • a small chew or fidget toy
  • a designated ‘calm corner’
  • time outside for fresh air
  • a predictable signal for breaks (e.g., a hand squeeze or card)

Remember, sensory regulation is healthcare, not ‘giving in.’

4. Model calm eating

Children learn most from watching.

Slow, happy bites and relaxed facial expressions tell the nervous system: ‘This environment is safe’.

💛 What to say to well-meaning relatives

Families often have big feelings about food. You can prepare nice phrases like:

  • ‘We’re focusing on helping him feel safe around food today.’
  • ‘She has allergies, so we’re sticking to our plan.’
  • ‘We’re avoiding pressure because it helps him eat better long term.’
  • ‘We’re celebrating together, eating is not the goal today.’

Setting expectations ahead of time can reduce awkward moments later.

🎁 The bigger picture: It’s about safety, not ‘picky eating’

Children with allergies, sensory differences, or feeding challenges aren’t trying to be difficult. They are trying to stay safe, regulated, and comfortable.

Your calm presence, gentle boundaries, and preparation create the conditions for a holiday that feels peaceful, not pressured.

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.

📚Research References

Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–246.

DunnGalvin, A. et al. (2020). APPEAL-2: A pan-European qualitative study to explore the burden of peanut-allergic children, teenagers and their caregivers. Clinical & Experimental Allergy, 50(11), 1238–1248.

Galloway, A. T., Fiorito, L. M., Francis, L. A., & Birch, L. L. (2006). ‘Finish your soup!’ Counterproductive effects of pressuring children to eat on intake and affect. Appetite, 46(3), 318–323.

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    The great air debate: How different swallowing patterns impact breastfeeding and reflux

    The great air debate

    As a Speech and Language Therapist specialising in infant feeding, I often hear from worried mums describing their breastfed baby’s fussiness. ‘My baby is so burpy and gassy,’ ‘might it be reflux?’ or ‘she just seems uncomfortable after every feed’. While these concerns are incredibly valid and distressing for both baby and mum (and dads!), the underlying cause isn’t always what you might think. Often, the culprit isn’t primarily a digestive issue, but rather a mechanical one: how effectively your baby is managing air during feeding.

    Many parents are told their baby has ‘colic’ or ‘reflux’ and are offered solutions that don’t quite hit the mark because they overlook a fundamental aspect of feeding: the suck-swallow-breathe sequence. Understanding this intricate dance can be the key to unlocking a calmer, happier feeding experience for your baby and you.

    Understanding the suck-swallow-breathe sequence

    Your baby’s mouth, tongue, jaw, and throat muscles work together in a precise rhythm like a beautifully orchestrated symphony. First your baby draws milk, then swallows it, and then takes a breath, all without interruption. This is the ideal suck-swallow-breathe (SSB) sequence.

    When the SSB sequence functions optimally, a baby latches deeply, creates good suction, draws milk, swallows efficiently, and then pauses just long enough to take a gentle breath before the next suck. This smooth, coordinated process minimises the amount of air swallowed.

    However, for various reasons (it could be a shallow latch, oral motor challenges, an uncoordinated suck, or even an overly fast milk flow) this sequence can get a bit out of sync. Instead of a smooth rhythm, you might see:

    • Suck-suck-swallow-gasp!: Too much air pulled in with the swallow.
    • Rapid, shallow sucking followed by gulping: Inefficient milk transfer and air intake.
    • Clicking noises during feeding: Loss of suction, indicating air entry.
    • Frequent detaching and re-latching: Often to ‘catch a breath’ or because of discomfort.

    Each of these patterns can lead to increased air intake.

    The root cause: Air trapping leading to a gassy breastfed baby

    When a baby swallows too much air during a feed, that air must go somewhere. It builds up in the stomach, causing bloating, discomfort, and often leads to the familiar reflux-like symptoms parents describe: arching, spitting up, burping excessively, or simply appearing distressed.

    It’s a common misconception that all gassiness or reflux symptoms in a breastfed baby are due to something in the mother’s diet or a genuine digestive disorder. While these can be factors, as an SLT, we first look at the mechanics of the feed. If a baby is constantly struggling to maintain a seal, sucking inefficiently, or having to gulp to keep up with flow, he or she is inevitably swallowing air. This air then creates pressure, which can push milk back up (silent reflux) or out (visible reflux).

    Think of it like trying to drink through a straw with a hole in it. You’re sucking, but you’re also pulling in air, making it harder to get the liquid and leaving you with more bubbles in your stomach.

    Why mechanical speech therapy assessment is key

    This is where the distinction between a medical diagnosis (true gastro oesophageal reflux disease or GORD) and a functional feeding challenge becomes critical. A paediatrician will assess for medical causes and may prescribe medication to reduce stomach acid. This can be appropriate for severe cases of GORD.

    However, if the primary issue is air being trapped due to a suboptimal suck-swallow pattern, medication only treats the symptom (acid burning) and not the root cause (air intake). This is precisely where a Speech and Language Therapist specialising in infant feeding comes in.

    My role is to meticulously observe and assess your baby’s oral motor skills, latch, tongue function, and the efficiency of their SSB sequence. I look for subtle signs of inefficiency that contribute to excessive air swallowing.

    • Is the tongue elevating correctly to create suction?
    • Is the jaw stable, or is it excessively moving?
    • Is the latch deep enough to prevent air leaks?
    • Can the baby coordinate suck, swallow, and breathe without gasping?

    By identifying these mechanical challenges, I can then implement targeted strategies to improve feeding efficiency and reduce air intake, often leading to a significant reduction in reflux-like symptoms and overall discomfort.

    Strategies to optimise air management during breastfeeding

    The good news is that many babies can learn to feed more efficiently with the right support. Here are some general strategies we might explore:

    1. Optimise latch and position: A deep, asymmetric latch is crucial. Experiment with different positions that allow for a deeper latch and better head/neck alignment, such as laid-back feeding or upright positions.
    2. Paced feeding (even at the breast): If your milk flow is very fast, consider removing your baby from the breast briefly if you hear excessive gulping or see him or her struggling to breathe. This allows him or her to catch up and manage the flow.
    3. Support the jaw and cheeks: Sometimes, gentle support to the baby’s jaw or cheeks can help them maintain a more stable, efficient suck. I can demonstrate specific techniques for this.
    4. Burping effectively: While burping won’t get rid of all swallowed air, upright burping positions and gentle back rubs can help release some of it.
    5. Pre-feed oral preparation: Gentle oral massage or stretches before a feed can sometimes ‘wake up’ the oral muscles and improve coordination.

    Addressing the ‘Great Air Debate’ isn’t about blaming anyone; it’s about empowering parents with a deeper understanding of their baby’s feeding mechanics. By focusing on the how, not just the what, we can often resolve persistent feeding challenges, reduce discomfort, and make breastfeeding a more joyful, peaceful experience for both you and your little one.

    If you suspect your baby’s gassiness or reflux symptoms are related to how they are managing air during feeds, don’t hesitate to reach out for a specialist assessment.

    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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  • ·

    Bilingualism – should I speak only English with my speech delayed child?

    Introduction

    Bilingualism is a beautiful aspect of our diverse world. Growing up in a bi- or multi-lingual household is a wonderful gift, allowing children to communicate with a broader range of people and access many cultures.

    My own two children grew up in a bilingual German-English speaking household. They have both been so enriched by this experience, not only language- and learning-wise but of course also culturally: their world has always been so open and colourful. Growing up in inner London and having their German family and mum’s friends as well, this has been a wonderful experience. Both my boys speak German well (not quite like native speakers but like very good second language speakers) and both have very easily learned 3rd and 4th languages additionally when in secondary school.

    Whilst bilingualism has untold benefits, it’s not uncommon for bilingual children to take slightly longer to reach certain speech milestones. This should not be automatically mistaken for speech disorders but rather seen as a natural part of bilingual language development.

    Bilingualism and speech delays

    Sometimes, of course, we do see speech delays or disorders where a child’s speech development lags significantly behind their peers. We often see a delay in both languages equally, making it extra hard for to communicate effectively. BUT PLEASE KNOW the family speaking in multi-lingual languages never caused the delay/disorder!

    If there is a delay or a disorder any number of other reasons could have caused it, such as:

    • hearing impairments,
    • reduced phonological awareness,
    • sensory processing issues,
    • reduced attention and reduced joint attention,
    • neuro-developmental delays or difficulties,
    • general or specific learning difficulties
    • or sometimes other genetic factors.

    So, to say that the difficulty is due to a child being exposed to several languages is a red herring. (no offence to herrings!)

    Speech therapy

    Speech therapy can be powerful to help bilingual /multilingual children with speech delays unlock their full linguistic potential. By providing individualised assessments, targeted interventions, and involving families, speech therapy can bridge the gap between speech delays and bilingualism. It’s essential for the therapist and parents to work together to support the children in their unique linguistic journeys, helping them communicate effectively and thrive in both of their languages.

    Happy Islamic family sitting on the floor
    Image by Freepik

    Speak your home language at home

    Many parents report that they worry about speaking their home language at home and instead they have been focusing on just speaking English at home. They now rarely use their home language with their child. They fear that speaking a language other than English with their child will cause further delay and hinder their progress. All parents want the best for their child and often parents fear that their child won’t fit in or will be seen as ‘different’. So we can understand why parents feel that the English language is the only one worth having.

    But the opposite is the case: it is crucial to speak in both languages freely, both at home and outside the home! Both languages will benefit your child, no matter what the delay or difficulty is. Acquiring a ‘mother tongue’ or native language is absolutely vital for children to have a good, solid linguistic grounding on which to build other languages. Bilingual children may mix languages during speaking and parents may equally mix their languages. This does not hinder language development and is a natural part of linguistic development.

    Speak freely and naturally

    What is far more important than the question: ‘which language should I say this in?’ Instead think: ‘let me speak freely and naturally, let me respond naturally, in good intonation and let communication flow freely to the child.’

    Speech therapy can be a crucial resource for bilingual or multilingual children and their families.

    We work on targeted interventions to address speech and language difficulties, helping your child develop essential communication skills. For home practice between therapy sessions, we can recommend tailored treatment plans to help you help your child in daily life. Our input could be focusing on articulation, phonological awareness, attention and listening, vocabulary development and grammar.

    Family support is crucial in speech therapy. We like to work closely with parents to provide guidance and strategies for fostering language development in both languages at home.

    If you have any worries about your child being delayed in a bilingual or multilingual household do get in touch and we will be happy to support you in your journey.


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  • Attention Autism Therapy

    Sonja is kneeling on a multicoloured carpet holding a bucket in one hand and a toy in the other
    Sonja

    Attention Autism” is an Early Years Intervention designed by Gina Davies, Specialist Speech and Language Therapist. Gina created this amazing therapy approach based on her many years of working with children on the autism spectrum. It aims to develop natural and spontaneous communication through the use of highly motivating activities. These activities offer your child an IRRESISTABLE INVITATION to engage and attend to.

    I love using this approach and have trained in all of the stages including the Curiosity Stage which is for another blog. I use it frequently with all children who have trouble attending, listening, sitting or waiting regardless of whether they are neuro-diverse or neuro-typical, this activity and method is so great for all children!!

    Why is it important for our children to attend and listen?

    It is commonly assumed that, as our child has passed their hearing tests he/she will be able to listen and respond to being called, being questioned or asked to do something. However, all children I see in my practice have reduced joint attention skills, which means that whilst their hearing is often good, even brilliant to the point that they can often hear a faint noise somewhere outside the house like a distant train rushing by – but strangely they can’t seem to hear their name being called. Parents often ask me why this is the case, why can my child not turn round when I call him?

    The reason lies in the difference between hearing and listening. Listening is a skill that needs to be learned and practiced. As a child develops, their hearing tunes into (listening) the sounds and noises they hear on a daily basis. This is how a child develops understanding of the speech sounds they hear every day (which then form the basis of their native language); they also get to know “their door bell, dog barking next door, daddy coming up the stairs” and so on. They tune into those common every day sounds and noises and gradually start to copy speech sounds to form words. So listening is tuning our ears to the sounds that surround us. In contrast, many of us have to work in large office spaces or noisy environment, perhaps even a café, etc, where we are able to tune out those environmental noises and sounds that surround us, for otherwise we will not get that report/piece of work done in time! Our focus means that we become single-minded and single-channelled concentrating on our work and so we do not hear people chat and clutter all around us.

    Tuning in and out is a skill that we learn and some of us are better than it that others, it comes largely with practice but also with motivation – I go back to the report that needs doing by end of the day – my motivation is strong and I can now focus and blend out all around me so that I get the work done. Other times when I am not so motivated I might doodle and tune into what is being said at the table next to me, because my focus is not that strongly dedicated to my work.

    Many children who are delayed in their development and especially children on the neuro-diverse continuum have difficulty with tuning in. By contrast, they are very good at being single-minded, single focused on what it is they are wanting/needing to do at any one point. And so they cannot listen to sounds, speech, noises around them very easily at all. They are fully absorbed in their activity and are not able to look and listen to mum/dad calling their name. Once we understand this we can start helping our children to practise tuning in a bit more bit by bit and day by day.

    Enter the Attention Autism approach!

    There are 4 stages to this method:

    Stage 1: The Bucket to Focus Attention

    The first stage involves filling a bucket with visually engaging toys that aim to help children learn how to focus their attention. Three toys will be presented to the child/group one at a time and the therapist will make simple comments about each toy to help introduce them to the children and expand their vocabulary.

    Important to know: the Attention Autism approach does not require the child to look at the adult, or to sustain eye-gaze on the objects. Instead engagement may be indicated by non-verbal signals such as seeming alert and interested, and looking frequently at the object.

    Stage 2: The Attention Builder

    At this stage the child/group is introduced to visually stimulating activities. This stage aims to build and sustain attention for a longer period of time. Activities may include ideas such as:

    • Flour castles which can be built like sandcastles, using flour, a bowl and moulds
    • Erupting volcano activity
    • Wriggly worms foam – pile shaving foam onto an upside down plastic flower pot with the holes taped over; then slowly press down another plastic flower pot over the shaving foam and the foam will come through the top holes looking like wriggly worms, especially if you have dropped a bit of food colouring on top of the foam

    Important: children are not required to make eye contact or sit still during these activities. The focus is on engagement, in whatever way the child demonstrates this.

    Stage 3: The Interactive Game – Turn-Taking and Shifting Attention

    The therapist demonstrates a simple engaging activity and invites children up to have a turn. This may be the same activity from stage 2 or something new. The aim is for children to learn to shift their attention from the group/sitting experience to doing something and then going back to sitting again.

    Stage 4: Individual Activity

    In the final stage of Attention Autism, the adult models an activity, and then each child is given the same equipment to use themselves. They do not have to copy exactly what the adult modelled. The aim is for the child watching to have a go independently with confidence, and then to take their materials back to the leading adult at the end. The activity should be engaging and enjoyable for the children. The Attention Autism approach aims to foster an interest in learning new things and to inspire communication in whatever form works for the child.

    Ideally this should be practised 4-5 times a week aside from the therapy session. But I have seen it work with just 2-3 practice repeats per week. It can be tough in the beginning until your child gets used to the “no touch just look” rule but with a little bit of practice usually children do sit well for the first part of the Bucket activity within about 10 sessions and after that you are on a roll!

    Do get in touch with me if you would like to find out more about this approach! Here is a great link to Gina Davis’s Autism Centre facebook site for more inspiration: https://facebook.com/ginadaviesautism/.


    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 imitation in supporting children with autism

    Image by Freepik

    Imitation, the act of mirroring someone else’s actions, gestures, sounds, or words, is a fundamental skill that plays a crucial role in human development. It’s how babies learn to wave ‘bye-bye’, how toddlers pick up new words, and how children acquire social skills. But for children with autism imitation can be a significant challenge and understanding why it’s important and how to foster it becomes a key focus for parents, educators, and speech and language therapists.

    Why is imitation important?

    Imitation is a building block for a wide range of developmental skills:

    • Social interaction: Imitation is the foundation of social reciprocity. When a child imitates, he or she is engaging in a shared experience, connecting with another person, and learning to take turns in social exchanges.
    • Communication development: Imitation is closely linked to language acquisition. Children often imitate sounds and words before they can produce them independently. Imitation also helps them understand the meaning of gestures and facial expressions, which are vital for nonverbal communication.
    • Cognitive development: Imitation plays a role in problem-solving, learning new skills, and understanding cause and effect. By imitating actions, children explore their environment and learn how things work.
    • Emotional development: Imitation helps children understand and share emotions. When a child imitates a smile, he or she may begin to understand the feeling of happiness.

    Imitation challenges in autism

    Many children with autism face challenges with imitation, which can affect their development in these key areas. These challenges can manifest in different ways:

    • Difficulty imitating motor actions: Children with autism may struggle to imitate simple motor movements, such as clapping hands, waving, or playing ‘peek-a-boo’.
    • Limited vocal imitation: Imitating sounds, words, and phrases can be difficult for some children with autism, which can impact their speech development.
    • Challenges with social imitation: Imitating social cues, such as facial expressions, gestures, and body language, can be particularly challenging for children with autism, affecting their ability to engage in social interactions.

    Why do children with autism struggle with imitation?

    The exact reasons for imitation difficulties in autism are complex and not fully understood. However, several factors may contribute:

    • Neurological differences: Research suggests that differences in brain structure and function, particularly in areas involved in social perception and motor control, may play a role.
    • Sensory processing differences: Some children with autism may have sensory differences that make it difficult to attend to and process the movements or sounds they are expected to imitate.
    • Attention and motivation: Challenges with attention, focus, and social motivation can also affect a child’s ability to engage in imitation.

    How to foster imitation in children with autism

    Fortunately, imitation skills can be developed and improved through targeted interventions and strategies. Here are some approaches that I use in my practice as a speech and language therapist working with autistic children and their families:

    • Create a playful and engaging environment: Children are more likely to imitate when they are having fun and feel motivated. I use toys, games, and activities that the child enjoys.
    • Start with simple imitation: Begin by imitating simple motor movements that the child is already capable of and gradually introduce more complex actions.
    • Imitate the child first: As the Hanen Program emphasises, imitating the child’s actions, sounds, and words can encourage him or her to interact and communicate more.
    • Use visual supports: Visual aids, such as pictures, photos or videos, can help children with autism understand what is expected of them and make imitation easier.
    • Break down complex actions: Divide complex actions into smaller, more manageable steps. For example, to teach a child to brush their teeth, break it down into steps like ‘pick up toothbrush’, ‘put toothpaste on brush’, and ‘move brush on teeth’.
    • Reinforce imitation attempts: Provide positive reinforcement, such as praise, smiles, or preferred activities, when the child attempts to imitate, even if the imitation is not perfect.
    • Integrate imitation into daily routines: Incorporate imitation into everyday activities, such as imitating sounds during playtime, imitating gestures during songs, or imitating actions during self-care routines.

    The role of speech therapy

    Speech-language therapists play a crucial role in helping children with autism develop imitation skills, particularly in the areas of vocal and verbal imitation. As part of my therapeutic role, I offer the following:

    • Assessing a child’s imitation abilities.
    • Developing individualised therapy plans to target specific imitation goals.
    • Using a variety of techniques to encourage vocal imitation.
    • Working with parents and caregivers to provide strategies and support for promoting imitation at home.

    Summary

    Imitation is a fundamental skill that is essential for social, communication, cognitive, and emotional development. While children with autism may face challenges with imitation, it is a skill that can be developed and improved with targeted interventions and support. By understanding the importance of imitation and using effective strategies to foster it, parents, educators, and therapists can make a significant difference in the lives of children with autism, helping them to connect with others, learn new skills, and reach their full potential.

    Do get in touch via my contact form if you have any question or need help with supporting your little one.

    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.

    1
  • Getting down on their level: Why face-to-face play is a speech therapy superpower

    As parents, we spend a massive portion of our days multi-tasking. We are talking to our toddlers while washing dishes, shouting encouraging words from across the living room while folding laundry, or answering their questions from a few feet above them while walking through the supermarket. It is a completely natural dynamic, after all, the adult world happens up here, and their world happens down there.

    But when it comes to actively boosting your child’s speech and language development, one of the simplest, most profound changes you can make costs absolutely nothing and requires no special training.

    It is simply this: Get down on the floor, sit cross-legged, and get face-to-face.

    At London Speech and Feeding I call this physical positioning ‘face to face’. It is also one of the major ‘Hanen Programme’ Strategies. It completely reshapes how your child interacts with you, transforms how they process language, and turns ordinary playtime into an instant communication opportunity.

    Our mouth is the magic: Visual cueing and speech imitation

    When a child is learning to talk, they aren’t just listening to the sounds you make; they are watching how you make them.

    Speech is an incredibly complex motor skill. To say a single word, the brain must coordinate the lips, tongue, teeth, jaw, and vocal cords in a fraction of a second. When you speak to your child from a standing or even a seated chair position while they are on the floor, your mouth is entirely out of their direct line of sight. They miss the visual roadmap of speech.

    When you sit right in front of them at eye level:

    • They see mouth shapes: They can see how your lips round for an /OO/ sound, how your teeth touch your lip for an /F/ sound, or how wide your mouth opens for an /AH/.
    • They read facial expressions: Emotions give context to words. Seeing your eyes widen with excitement or your eyebrows lift in surprise helps them map meaning onto the vocabulary you are using.
    • They mimic naturally: By putting your face directly in your child’s field of vision, you make it infinitely easier for her or him to try and copy your oral movements.

    If you are working on a specific word like ‘pop’ while blowing bubbles or ‘more’ during snack time getting your face just a foot or two away from your child gives her or him the front-row seat she or he needs to learn the mechanics of that word.

    Unlocking joint attention: The foundation of all languages

    Before a child can say their first words, they need to master a milestone called joint attention.

    What is joint attention?

    It is the magic moment when a child looks at an object (like a toy train), looks up at you to share their excitement, and then looks back at the object. It is a three-way loop of shared experience.

    Without joint attention, communication cannot thrive. If a child is entirely hyper-focused on a toy and ignoring your presence, or if you are commenting on a book they aren’t looking at, true communication isn’t happening.

    When you get down on the floor on a play mat, you naturally insert yourself into their bubble. You aren’t a distant narrator anymore; you are a co-player. Being at their level makes it incredibly easy for their eyes to flick from the toy straight to your face. This shared gaze is the exact moment language takes root. It signals to the child, ‘We are experiencing this together, and this thing we are doing has a name.’

    The ‘wait and see’ technique

    Once you are down on the floor, the temptation is often to take over by pointing at everything, asking a million questions like ‘What’s that?’, ‘Is that a blue train?’, or somehow driving the play.

    Instead, the most powerful thing you can do at eye level is to practise the ‘Wait and See’ technique.

    In the video clip you can see this exact dynamic in action. Look at how I am sitting cross-legged on the mat, at eye level with the toddler. Notice how my hands are on the toy container, but my eyes are locked on the child. I am not forcing the interaction; instead, I am waiting.

    Here is how you can use this strategy at home:

    1. Set the stage: Get down on their level with a high-interest toy that requires help (like a wind-up toy, bubbles, or a tight-lidded box with toys inside).
    2. Create anticipation: Hold the object near your face or place your hands on it, but don’t open or activate it right away.
    3. Lean in and wait: Lean slightly forward, open your eyes wide, adopt an expectant facial expression, and completely pause. Count to five or ten in your head. Do not say anything.
    4. Capture the gaze: Wait for the exact moment your child looks up from the toy to meet your eyes, as if to say, ‘Well? Are you going to open it?’
    5. Reward the eye contact: The instant they make eye contact, deliver the language reward! Model a simple, functional word like ‘Open!’, ‘Go!’, or ‘Look!’ as you immediately do the action.

    By pausing and waiting at eye level, you create a ‘communication temptation’. The child learns that looking at you and engaging with your face is the key that unlocks the fun.

    Making it a daily habit

    You don’t need to spend hours a day sitting on the floor to see a difference. Start small by dedicating just 10 to 15 minutes of undivided, face-to-face play time each day. Turn off the television, put your phone in another room, get down on their level, and let them lead the play while you focus on being their visual communication partner.

    Whether you’re opening a little toy briefcase, pushing a plastic train along a track, or stacking blocks, remember: your face is the best toy in the room.

    Are you wondering if your toddler’s speech and language milestones are on track? At London Speech and Feeding I love helping families navigate early communication. Feel free to explore my services page and reach out directly to schedule a consultation.

    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.

    3
  • Explore 12 questions to determine whether your child may be Autistic

    A young boy is in the foreground and has turned his head away from the woman sitting next to him.
    May your child be autistic?

    As professionals, when diagnosing young children with an Autistic Spectrum Condition, it is vital we work as a multi-disciplinary team, so you will likely see many professionals. This may include Educational Psychologist, Dietician, General Practitioner, Occupational Therapist, Paediatrician, Special Educational Needs Coordinator, Speech and Language Therapist and Social worker. Once the evidence is collated, then a diagnosis may be made.

    You may be wondering what are some of the early signs of social communication difficulties? Whilst no autistic child is the same and we know Autism is very much a very wide spectrum of abilities and needs there are some autistic spectrum characteristics we do typically see in the early years of childhood. You may wish to think about these areas or presentations to help you prepare for the Speech and Language Therapy appointment.

    Twelve questions

    1. Does your child respond to their name?
    2. Are they fixated with watching their hands?
    3. Do they have sensory processing difficulties such as bright lights, food textures, or loud noises?
    4. Are they meeting their milestones or are they delayed?
    5. Do they flap their arms or legs when excited?
    6. Have you noticed any rocking back and forth?
    7. Do they blink excessively or display any facial tics?
    8. Do they play with a particular sort of toy e.g. spinning toys?
    9. Have you noticed that they lack interest in toys?
    10. Have they regressed in their language? Perhaps you’ve noticed they are not using words that they have previously learnt.
    11. Do they use gestures to communicate their needs? How do they communicate their wants and needs?
    12. Do they appear to be in their own world?

    You are not alone

    These questions are by no means exhaustive and there are many more factors to consider. But it is important to trust your instincts as you are the expert on your child and know your child the best. Regardless of whether you see all of the above points or none, do not hesitate to have an assessment if you are concerned as, even if it turns out to be nothing to worry about, there is always at least one or two great pieces of advice I can offer you on the way and you will leave feeling hopeful and empowered. It’s always best to seek early intervention with communication difficulties. This allows strategies and support to be put in place. Never feel alone, always speak out.

    Find communication support here from me, Sonja, (Specialist Speech and Language Therapist)


    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.