Holiday disruptions & New Year routines: How to support your child’s feeding, communication and regulation over the festive season

ByLondon Speech and Feeding
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Holiday disruptions & New Year routines

The festive season is a wonderful time for many families, but for children with feeding challenges, sensory differences, or autism traits, December can feel overwhelming. Changes in routine, busier environments, travel, new foods, disrupted sleep, and well-meaning relatives giving ‘advice’ can all affect a child’s feeding, communication and overall regulation.

As a speech and language therapist specialising in Early Years, I see the same pattern each year: children often make progress during the term, only to struggle in late December when everything becomes unpredictable. The good news? With a bit of preparation, children can not only cope better, but they can actually make significant developmental gains during the holidays.

This blog will help you feel confident, supported and prepared for the transition from ‘festive mode’ to a smoother, regulated start in January.

1. Why routines matter so much. Especially now

Young children thrive on predictability. For neurodivergent children or those with sensory, feeding or communication needs, routine isn’t just helpful: it’s the backbone of emotional regulation.

In December, typical patterns change:

  • Mealtimes shift or become irregular
  • Bedtime slides
  • New foods appear
  • Loud social gatherings overwhelm
  • Travel disrupts naps and comfort routines
  • Therapies pause
  • Childcare closes

Any one of these can lead to feeding refusals, more meltdowns, increased stimming, reduced communication attempts or regression in speech sounds.

It’s simply the nervous system responding to too much change.

2. Protecting feeding progress during holiday mealtimes

My last blog and insta post have a nice social story on festive meals. They are often the trickiest part of the season for families I support. Children with sensory-based feeding challenges, or ARFID traits may find holiday foods completely unfamiliar and challenging.

What helps:

  • Offer one ‘safe food’ at every meal
  • Keep portion sizes tiny
  • Use the ‘buffet rule’
  • Rehearse tricky moments

3. Supporting communication when routines are disrupted

Holiday time actually offers more opportunities for communication, just in different ways.

Strategies:

  • Slow down and follow your child’s lead
  • Use everyday routines as language opportunities
  • Keep AAC going even if casually

4. Understanding holiday ‘regressions’ and know they’re temporary

This is almost always due to nervous system overload. Children don’t truly ‘lose’ skills; they temporarily prioritise regulation over learning.

5. A gentle January reset: How to start the New Year smoothly

  • Re-establish predictability early
  • Return to preferred foods
  • Book early support if needed
  • Focus on regulation first

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.

Reference:

Bronson, M. (2000). Self-regulation in early childhood. Guilford Press.

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    The purpose and nature of a speech and language therapy assessment

    ByLondon Speech and Feeding

    If you have ever wondered what happens when you bring your child to a speech and language therapy assessment, then this blog will shed light on the ins and outs of it for you.

    At its heart, a speech and language therapy assessment is a systematic and thorough evaluation of your child’s communication or eating/swallowing abilities. It’s more than just asking a few questions. It is a carefully constructed process designed to identify strengths, pinpoint challenges, and ultimately pave the way for effective intervention.

    Establishing a detailed profile – a few bullet points:

    • Identification of communication and swallowing difficulties: I aim to determine if a communication or swallowing disorder exists. I will establish if the difficulty is a delay or a more complex disorder.
    • Diagnosis of the specific disorder/autism: The assessment delves deeper to pinpoint the specific type and nature of the difficulty. For instance, is your child’s language delay due to a specific learning disability, a developmental delay, or another underlying condition?
    • Knowing the aetiology or what is causing a difficulty is crucial for targeted intervention. And whilst we are on the topic let’s talk about an autism assessment: I am trained and experienced in assessing and diagnosing autism. However, when it comes to the diagnosis of autism I provide a preliminary ‘working hypothesis’ rather than giving a definite final diagnosis. The reason for this is that it is considered the ‘gold standard’ and ‘best practice’ to diagnose autism in a multi-disciplinary setting and context. Since I work on my own, I always refer to highly recommended multi-disciplinary clinics for the ultimate diagnostic assessment.
    • Determination of severity: Understanding the severity of the difficulty is essential for prioritising intervention and measuring progress. Is your child’s difficulty mild, moderate, or severe? This helps me choose a particular approach and then tailor it to suit each individual child.
    • Identification of underlying strengths and weaknesses: An assessment doesn’t just focus on what’s wrong. It also highlights your child’s strengths and areas of relative ease. This information is invaluable for building upon existing skills during therapy. Understanding weaknesses provides specific targets for intervention.
    • Guiding intervention planning: The assessment provides the crucial information I need to develop an individualised intervention plan. The findings directly inform the selection of therapy goals, strategies, and techniques. Without a thorough assessment, therapy would be a shot in the dark.

    A multi-faceted approach

    A speech and language therapy assessment is not a ‘one-size-fits-all’ procedure. The specific tools and techniques used will vary depending on a child’s age, the nature of the suspected difficulty, and other relevant factors. However, most comprehensive assessments incorporate several key components:

    • Case history: This involves gathering information about your child’s developmental, medical, social, and educational background. We will go through all the relevant milestones and throughout the process I will make notes which will help bring all the puzzle pieces together.
    • Observation: I will observe how parent and child play together and we also look at how the child plays by themselves. Additionally of interest is how a child plays with me, the therapist. Through discussion I will also endeavour to find out how your child plays with other children, be it at the nursery or within the family.
    • Standardised assessments: These are commercially available tests with specific administration and scoring procedures. They provide norm-referenced data, allowing to compare the individual child’s performance to that of his or her peers. Examples include articulation tests, language comprehension and production tests, and fluency assessments. I tend not to use these assessments a lot.
    • Instead, I use non-standardised assessments: These are more flexible and allow to probe specific areas of concern in more detail. This might include language samples (analysing spontaneous speech), dynamic assessment (testing and teaching to identify learning potential), and informal observation of play or interaction.
    • Immediate feedback and report writing: During and thenfollowing the assessment, I will bring all the gathered information together and I will discuss with the parents what my findings are and what my recommendations in the short term are. Parents always go home with a good handful of useful strategies that they can implement at home right away. In addition, I provide a comprehensive report outlining the findings, diagnosis (if applicable), severity, strengths and weaknesses, and recommendations for intervention.

    In conclusion, a speech and language therapy assessment is a dynamic and essential process. It is a journey of discovery, aiming to understand a child and the child’s family and his or her unique communication or feeding profile. The assessment is usually the start of our wonderful learning journey together.

    Below is a short video clip of an assessment where you see me in action explaining a particular therapy approach to a set of parents. It perhaps shows a tiny bit of how relaxed we are in our sessions and that assessment is not at all daunting, but a hugely informative event overall which will leave you feeling empowered and hopeful.

    What happens after an assessment?

    Please feel free to get in touch with me via my contact form if you wish to have an assessment for your child’s communication difficulties or feeding difficulties.

    An assessment is always a stand-alone event and does not mean you need to automatically book follow up sessions at all. It will give a lot of information and based on this you can decide if you would like more therapy or follow up for you and your child. Many times ongoing therapy is not needed! I only recommend a course of therapy if it is really needed and where it would be immediately beneficial for your child.

    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
  • ·

    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.

  • ·

    How can I incorporate AAC into my speech therapy sessions?

    ByLondon Speech and Feeding

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

    They might wonder: ‘If we’re working on pronunciation, why are we using a communication device?’

    The simple answer is this: speech therapy is about communication first, and speech sounds second. Supporting a child’s ability to express themselves clearly and confidently is always the priority, and AAC can be a powerful tool alongside spoken speech.

    What do we mean by AAC?

    AAC stands for Augmentative and Alternative Communication.

    This can include:

    • A speech-generating device (such as LAMP Words for Life or GRID as I used in the photo below)
    • A communication app on a tablet
    • A symbol board or communication book
    • Gestures, signs, or visual supports

    AAC does not replace speech. Instead, it supports language development, reduces frustration, and builds communication success while speech skills are developing.

    Pretend Play using Speech and AAC in my clinic room

    But I mainly work on speech sounds… So how does AAC fit?

    Most of the children I see are working on:

    • Articulation difficulties
    • Phonological delay
    • Motor planning challenges (including apraxia/dyspraxia)
    • Unclear speech affecting confidence

    For these children, AAC isn’t a separate therapy. It’s simply woven naturally into what we are already doing.

    If a child brings their device to sessions, I actively include it. If they don’t yet use AAC but could benefit from visual or symbolic support, I may introduce simple options within activities.

    Using AAC to support speech practice

    Let’s say we are working on early speech targets like: ‘GO’.

    We might practise:

    • Saying the word verbally
    • Listening for the target sound
    • Using play (TOY TRAIN GOING ROUND A TRACK)

    Now we can extend this using AAC.

    On the device or communication board, we might model: ‘LET’S GO’ or ‘IT’s GOING up the hill’.

    This allows the child to:

    • Practise their speech sound target
    • Build a simple sentence
    • Experience successful communication even if speech is not fully clear yet

    All responses are valid and supported.

    AAC helps children communicate more than they can say

    Many children can understand and think in longer phrases than they can physically say.

    For example:

    • A child who verbally says single words may build longer phrases on AAC.
    • A child who struggles to plan speech movements may use AAC to communicate smoothly while still practising verbal attempts.
    • A child who becomes frustrated when misunderstood gains a reliable backup system.

    Rather than slowing speech progress, AAC often:

    • Reduces communication pressure
    • Increases participation in therapy
    • Encourages more attempts at speech
    • Supports language growth

    When children feel understood, they usually become more motivated to try speaking.

    There are no ‘prerequisites’ for AAC

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

    In reality, children do not need to:

    • Reach a certain speech level
    • Use pictures first
    • Prove they understand everything
    • Show immediate interest

    Instead, we presume competence and introduce AAC in meaningful, playful ways.

    That means:

    • Modelling words while blowing bubbles
    • Commenting during playdough activities
    • Choosing words during games
    • Building simple phrases in shared reading

    AAC should never feel like extra ‘work’. It’s simply another way to join in communication.

    My goal is always the same: to help each child communicate as clearly, confidently, and successfully as possible, using every helpful tool available.

    If your child uses AAC (or might benefit from it)

     Please feel free to:

    • Bring the device to sessions
    • Show me how your child currently uses it
    • Share advice from school or other therapists

    I am very happy to incorporate AAC into our work together so that speech practice, language development, and real communication all move forward hand-in-hand. Because ultimately, therapy isn’t just about producing perfect sounds. It’s about helping your child be heard and understood.

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

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

      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
    • · ·

      The hidden impact of mouth breathing and open mouth posture on speech and feeding

      ByLondon Speech and Feeding

      When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

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

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

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

      💨 Why we’re designed to breathe through our nose

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

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

      Children who breathe through their mouths most of the time may develop:

      • A longer face and narrower palate
      • Forward head posture
      • Slightly open lips and low tongue position at rest
      • A tendency toward drooling or noisy breathing
      • A dry mouth and consequently bad breath
      • At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)

      These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

      🗣 How mouth breathing affects speech

      Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.

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

      🥄 How mouth breathing affects feeding and chewing

      Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.

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

      Common signs to watch for

      Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:

      • Lips habitually open at rest
      • Drooling after the toddler years
      • Snoring or noisy breathing during sleep
      • Preference for soft foods or grazing eating habits
      • Dark circles under the eyes due to allergies
      • Frequent colds, congestion, or mouth odour
      • Speech that sounds slushy or unclear despite good effort

      If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

      👩‍⚕️ What can help

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

      🌱 A gentle note on change

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

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

      💡 The takeaway

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

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

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

      Sonja McGeachie

      Highly Specialist Speech and Language Therapist

      Owner of The London Speech and Feeding Practice.

      References

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

      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.

      2

    • The tricky /R/: Mastering tongue placement for clear speech

      ByLondon Speech and Feeding

      The /R/ sound is notoriously challenging for many children (and even some adults!). It’s one of the most complex sounds in the English language, with various pronunciations depending on its position in a word. If your child is struggling with their /R/s, you’re not alone. As Speech and Language Therapists (SLTs), we frequently work on this sound, and a key component of our therapy is focusing on proper tongue placement.

      Why is the /R/ so difficult?

      The /R/ sound requires precise coordination of the tongue, jaw, and lips. Unlike sounds like /P/ or /B/ that involve simple lip movements, the /R/ involves intricate tongue movements and tension. There are also different ways to produce the /R/ sound, which adds to the complexity:

      • Retroflex /R/: The tongue tip curls up and back towards the roof of the mouth.
      • Bunched /R/: The body of the tongue bunches up towards the roof of the mouth, while the tongue tip remains down.

      The importance of tongue placement

      Regardless of which /R/ variation is being targeted, accurate tongue placement is crucial. Even a slight deviation can result in a distorted or inaccurate sound. That’s why SLTs dedicate significant time to teaching and practising tongue positioning.

      Speech therapy techniques: Focusing on the tongue

      Here’s a glimpse into how I address /R/ sound difficulties, with a focus on tongue placement:

      • Visual aids:
        • Mirrors: I use a mirror to help children see their tongue movements and make adjustments.
        • Tongue diagrams and models: These visual tools provide a clear representation of where the tongue should be positioned.
      • Tactile cues:
        • Tongue depressors: These can be used to gently guide the tongue into the correct position.
        • Food-grade tools: Sometimes, I use flavoured tongue depressors or other tools to provide tactile feedback and increase awareness of tongue placement.
      • Auditory discrimination:
        • I help children distinguish between correct and incorrect /R/ sounds.
        • I use auditory cues and verbal feedback to reinforce proper pronunciation.
      • Exercises and drills:
        • Tongue strengthening exercises: Strengthening the tongue muscles can improve control and coordination.
        • Tongue placement drills: We practise positioning the tongue in the desired location and holding it there.
        • Sound approximation techniques: Sometimes we use other sounds to help approximate the /R/ sound. For example, I use the /L/ sound, to help achieve the correct tongue placement. Once my child has found the /L/ sound it is then a matter of pulling back just slightly to get a good /R/.
      • Contextual practice:
        • Once the child can produce the /R/ sound in isolation, we gradually introduce it into syllables, words, phrases, and sentences.
        • We also practise the /R/ sound in different contexts, such as at the beginning, middle, and end of words.

      Tips for Parents:

      • Be patient and supportive: Learning the /R/ sound takes time and practice.
      • Practise regularly: Short, frequent practice sessions are more effective than long, infrequent ones.
      • Make it fun! Use games, stories, and other engaging activities to keep your child motivated.
      • Work with an SLT: A qualified SLT can provide personalised guidance and support.

      In conclusion:

      The /R/ sound can be challenging, but with targeted speech therapy and a focus on tongue placement, most children can achieve clear and accurate pronunciation.

      I hope this blog post is helpful!

      Get in touch with me via my contact form if you need support

      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.

      1
    • · ·

      When AAC modelling doesn’t feel natural yet: Helping parents learn to use their chosen AAC system

      ByLondon Speech and Feeding

      One of the most common pieces of advice parents hear when their child starts using AAC is: ‘Just model the words naturally.’

      And, yes, natural modelling is an important part of AAC support.

      But there is something we don’t always talk about: How on earth is a parent supposed to model a word naturally when they are still trying to work out where the word is themselves?

      Using a robust AAC system such as LAMP Words for Life can feel a little like learning a new language.

      The parent is learning the language at the same time as the child they are hoping to teach it to.

      So, although I absolutely want AAC to become part of everyday life, I often begin with something much more structured.

      And I have found that this can make the transition to natural, everyday modelling much easier for families.

      Learning the system first

      In my first video clip, I am using a very simple farm animal sticker activity with LAMP Words for Life.

      The activity gives us the opportunity to practise some useful, functional words:

      • OFF: taking the sticker off
      • FARM ANIMALS: finding the animal category
      • HORSE
      • SHEEP
      • CHICK
      • ON: putting the sticker onto the book

      At first, I am quite explicit about what I am doing.

      I might draw attention to the relevant button, help the child navigate to it, talk through what we are looking for and practise finding the word several times.

      This is more didactic and structured than the idealised picture some people have of AAC modelling.

      And I am completely comfortable with that at the beginning.

      Why start so explicitly?

      Imagine that you are given a brand-new device containing hundreds or thousands of words.

      Someone tells you: ‘Don’t worry. Just use it naturally.’

      You might manage to find a few obvious words.

      But when you are suddenly standing in the kitchen taking your child’s coat off and want to say ‘OFFS, you may have absolutely no idea where to look.

      That is exactly why I think parents sometimes need permission to learn the system in a supported way.

      The structured activity creates a safe environment where we can stop and think:

      • Where is that word?
      • How do I get there?
      • What does this word do?
      • What happens when I press it?

      We can practise it more than once.

      We can repeat it.

      And gradually, the route to that word becomes familiar.

      AAC systems are not simply devices that children need to learn. Communication partners need to learn them too. All the AAC research highlights partner training as an important part of AAC intervention and notes that intervention initially includes helping the individual and their family or carers develop operational competence with the system.

      From structured practice to everyday life

      And this is where the useful transfer can happen.

      Take the word OFF.

      In our sticker activity, we may practise:

      ‘OFFS

      ‘OFFS

      ‘OFF’

      We take the sticker off.

      We find the button again.

      We use the word again.

      After several opportunities, the parent has not only seen their child use the word, the parent now knows where the word lives too.

      Then later that day, they are taking their child’s coat off.

      Suddenly:

      ‘OFF!’

      And they know exactly where to find it.

      The same thing might happen with ON.

      Once the parent has practised finding ON several times during play, it becomes much easier to spot opportunities for it during the day:

      ‘Shoes ON.’

      ‘Lights ON.’

      ‘Music ON.’

      ‘Hat ON.’

      ‘Tap ON.’

      This is one of the reasons I like structured AAC activities. They are not necessarily the final goal.

      They can be the rehearsal space that gives parents and children enough confidence to use AAC in real life.

      Natural modelling is still the goal

      This doesn’t mean that I want parents spending their whole day sitting beside their child and directing them towards buttons.

      Quite the opposite.

      The aim is to gradually move towards a much more natural style of AAC use.

      Once parents know their way around the system, they can begin to model words spontaneously as they occur in everyday interactions.

      Research into aided AAC modelling describes adults using AAC alongside speech within meaningful activities, and evidence supports the use of aided input as part of AAC intervention.

      But getting there may take teaching, repetition, practice and coaching.

      And that’s okay.

      It is not about making the child press the button

      There is another important distinction here.

      When I say that I may initially be more explicit or ‘direct’ during an activity, I do not mean that I am trying to make a child perform the correct response.

      I am not interested in turning AAC into a test.

      I am not continually asking:

      ‘Where’s HORSE?’

      ‘Find SHEEP.’

      ‘Show me CHICK.’

      Instead, I am helping the child and parent become familiar with the system.

      I might point, gesture, navigate, model the word and repeat it within a meaningful activity.

      As confidence grows, the support can be reduced so that the child has increasing opportunity to locate and use the language themselves.

      My second video clip shows a child using their own LAMP Words for Life system at home, accessing a category they have chosen which is FOOD.

      This is what I love about AAC.

      The device isn’t just being used in the therapy room.

      It becomes part of the child’s own life.

      And the child is using it around their own interests and choices.

      That is the direction I want families to move towards:

      From ‘I don’t know where anything is!’ to ‘I know where some useful words are.’

      Then ‘I can use those words during our everyday routines.’

      And eventually: ‘This is my communication system, and I can use it to tell you what I think, want, notice, enjoy, reject and choose.’

      Parents don’t have to get it perfect

      This is perhaps the biggest message I would like parents to take away.

      You do not have to become an AAC expert overnight.

      You are learning too.

      It is completely reasonable for a parent to need time to become familiar with the layout, vocabulary and navigation of their child’s system.

      Learn it. Practise it. Model it. Then take it into real life.

      Any questions please contact me via my contact form.

      Sonja McGeachie

      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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