When you have a child who uses Gestalts it is often difficult to think and adapt clinic activities into those to use at home. More importantly, you find that individualising your activities for your child who uses Gestalt are time-consuming. But you value its importance for their communication development.
You feel so busy, you are taking them to other appointments, or trying to get through your daily activities, all whilst still ensuring your child’s emotional needs are met. You know life should not get in the way of your child’s therapy activities at home, but it does. We know your spare time is precious and limited, so let us achieve your child’s or young person’s goals in the allotted time you have which meets their way of learning (using Gestalts).
We wanted to support you by exploring items which you may have at home, and we will give you some key phrases which you can start to model with your child. Whereas our last blog introduced the idea of gestalt language processors, we are now developing ideas to give you the tools to implement activities at home. We recognise how overwhelming it may feel, and this is one of the reasons to make activities as straight forward as possible. Therapy does not need to be complicated; it just needs to be carried out on a regular basis.
Explore the samples I’ve created to give you an idea of how this might look but please consult with a Speech and Language Therapist who knows about Gestalt Language Processing so that you can work together to develop great home activities for your child.
Want to learn more about gestalt language processing?
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.
‘What kind of speech difficulty does my child have?’
It’s a very understandable question. We often hear different terms such as phonological delay, articulation difficulties, or Childhood Apraxia of Speech (CAS), and it can be confusing.
The reality is that many children don’t fit neatly into one single category.
In fact, quite often I see children whose speech profile includes a mixture of difficulties. They might have some phonological patterns (where they substitute one sound for another) alongside challenges with motor speech planning, where coordinating the movements needed for speech is harder.
When this happens, therapy needs to be flexible, responsive, and tailored to the child sitting in front of us.
Example
Recently I filmed a short clip from one of my therapy sessions which shows exactly how this works in practice.
The child I was working with has difficulties with several speech sounds. Part of the challenge relates to a phonological pattern called fronting.
Fronting is when sounds that should be made further back in the mouth (like /K/ or /G/) are produced further forward instead.
At the same time, this child also shows signs of motor speech planning difficulty, which means the brain has to work harder to organise and sequence the movements of the tongue, lips and jaw for speech.
This type of profile can sometimes overlap with characteristics seen in Childhood Apraxia of Speech (CAS).
When difficulties overlap like this, therapy cannot rely on a single approach. Instead, it needs to draw on multiple evidence-based strategies.
That is exactly what you see happening in the clip. We started out generalising the /K/ sound which until recently had been replaced by a /T/ sound. Whilst looking at a sound loaded picture of /K/ sounds we somehow got talking about a ‘dent’ (I don’t recall how we got there!) but the ‘dent’ was a ‘det’ and I decided to tackle this there and then because there are other great words that end in ‘nt’ like : ‘count’ ‘giant’ ‘point’ or ‘paint’.
Using visual cues to support motor planning
Speech is incredibly complex. For children with motor speech difficulties, the challenge is not only knowing what sound they want to say, but also how to move their mouth to produce it.
This is where visual cues can be incredibly helpful.
In the clip, you can see me using a whiteboard with pictures and simple visual prompts. These help to:
Focus attention on the target sound
Understand where the sound occurs in the word
Remember the sequence of sounds needed
Visual supports can act almost like a map for the mouth, guiding children as they practise new speech movements.
For children with motor planning difficulties, this type of cueing can make a huge difference.
Why repetition of a single word (massed practice) is so important
Another key feature you will notice in the clip is lots of repetition.
This is very deliberate.
When we are supporting children with motor speech challenges, the brain needs repeated opportunities to practise the correct movement patterns. Just like learning a musical instrument or a new sport, repetition helps the brain build stronger and more efficient pathways.
In therapy we call this massed practice.
Rather than saying a word only once or twice, we practise it many times in a structured way, helping the child stabilise the new speech pattern.
But repetition alone is not enough. The child also needs to understand why the sound matters.
Showing children that sounds change meaning
This is where another powerful therapy approach comes in: minimal pairs.
Minimal pairs are word pairs that differ by only one sound. For example:
debt
dent
In the clip, I use these two words to help the child realise that the /N/ sound makes a meaningful difference.
Without the /N/, the word becomes something else entirely.
This approach helps children recognise that speech sounds are not random: they carry meaning. If a sound is missing or substituted, the message may change.
Helping children notice these differences can be a very motivating moment in therapy. Suddenly the sound is no longer just an abstract exercise; it becomes part of real communication.
Blending approaches for the best outcomes
In this short therapy moment, I am combining:
• Visual cueing
• Motor speech practice
• High repetition (massed practice)
• Minimal pair contrasts
• Listening and awareness of sound differences
Each element supports a different part of the speech system.
Some strategies help with motor planning, others support phonological awareness, and others build accuracy and consistency.
Together they create a therapy session that is both structured and responsive.
Every child’s speech journey is unique
One of the most important things I want to convey is that speech development is not always straightforward.
Two children may both struggle with speech sounds, yet the underlying reasons may be very different.
This is why careful assessment is essential, and why therapy needs to stay flexible as we learn more about how a child’s speech system works.
Sometimes a child needs more motor-based work.
Sometimes the focus shifts towards phonological contrasts.
Often, as in this example, the most effective therapy uses both.
Small steps lead to big progress
Every session helps us understand a little more about how a child’s speech system works and what support will help them move forward.
And when the pieces start to come together, when a child realises that one tiny sound can change a whole word, that is when the real progress begins.
If you are concerned about your child’s speech sounds, clarity of speech, or possible motor speech difficulties, early support can make a significant difference. A detailed assessment can help identify the nature of the difficulty and guide a therapy approach tailored to your child’s individual needs.
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.
As parents and therapists, we all want to help our children communicate. But sometimes, the process can feel like ‘work’. If I had a penny for every parent saying ‘I find it so boring!’… Ok hang in… what if I told you the most effective therapy happens when it doesn’t look like therapy at all?
My approach centres on connection, enthusiasm, and multi-sensory engagement. We don’t just teach words; we teach the joy of using them. These strategies can be used whether your child is speaking, using a core board, or communicating in his or her own unique way.
Some of my favourite strategies
Today I want to share a few of my favourite strategies to turn everyday interactions into powerful communication opportunities regardless of why or how big a delay your child is having.
Facial expressions & exaggeration: Use an exaggerated facial expression to show surprise (wide eyes!), excitement (big smile!), or confusion (a crinkled brow!). Your face is a powerful teaching tool. I am always talking like a clown in my sessions. I can announce that I have also a normal speaking voice outside my clinic room! 😊
Using your voice with intonation: Your voice is music! Use a singsong or ‘tuneful’ repeat to make words stand out. For example, ‘It’s a BIIIG ball!’ or ‘Let’s GO-O-O!’. Again think: clown!!
Hands and body to show: Use gestures, hands, and body movements to demonstrate. Say ‘OPEN’ while pulling your hands apart, or ‘UP’ while raising the toy high above your head.
Elongating our words: Stretching out key sounds or words gives them emphasis and more time for your child to process. ‘Criiiinkley’ ‘tiiickleyyyy’
Core board & language modelling:
Model the core board with joy: Don’t just point: point with energy!
Model the core board repeatedly throughout the activity, showing genuine excitement. This demonstrates the board is a joyful tool, not homework.
Pointing to the core board: When you say a core word, point to the corresponding symbol. You are showing your child, ‘My words live here, and your words can too’.
Describing it for your child: Help your child build his or her vocabulary by providing rich sensory language. ‘It’s squishy’, ‘It’s very noisy’, or ‘It’s so smooth’.
Catchy phrases: Repetitive, positive phrases create a sense of shared fun. Use them consistently: ‘Oh, that’s a nice one!’ or ‘We like that!’
Following your child’s Interest: Put down your agenda and follow your child’s lead. If they pick up a block, talk about the block. This ensures they are engaged and ready to learn.
Allowing for pauses: This is critical! After you made a comment, allow for a significant pause (count to five in your head) for your child to fill. The silence creates a powerful opportunity for them to initiate communication.
Copying your child’s sounds: If he or she makes a sound (‘buh!’), you make the sound back! Copying your child’s sounds shows him or her ‘I hear you, and your communication is important’.
Lots of repetition: Hearing a word many times in meaningful contexts is how we learn! Repeat key phrases and core words throughout the activity. Repetition is the key to retention.
Getting turns: Explicitly teach and celebrate getting turns in a game. ‘My turn! Your turn!’ This is a foundational social and communication skill.
Using tidy up as a teaching activity: Turn cleanup into a fun game! It’s a goldmine for core words like PUT IN, ALL DONE, HELP, and MORE. For example, ‘Let’s PUT IN the red block! Yay!’
Using exaggerated repeats: When your child tries a sound or word, give it back with exaggerated, tuneful repeats.
Try out all or even just a few of these strategies, and I can promise you, you’re not just encouraging language; you’re building a joyful, reciprocal relationship based on genuine communication!
Which strategy are you excited to try first? Let me know in the comments!
If I can help you with any of the above, if you want to practise these a bit more, I would love to help you!
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of 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.
My baby isn’t babbling and developing speech – what can I do to support?
While every baby develops at their own pace, if your child isn’t babbling by nine months, it’s worth seeking help from an Early Intervention Health Professional, such as a doctor and a speech therapist. Don’t panic! There are many reasons for delayed babbling, and early intervention is key.
In the meantime, it is highly recommended that we talk, sing, and read to our baby often. Exaggerate sounds and expressions, and respond to their coos and smiles. This playful interaction helps stimulate their communication skills.
Below are some tips and tricks from my experience of working with babies and toddlers who need a little bit of help and support to develop.
The benefits of imitating your baby
Copying your baby’s sounds and gestures isn’t just silly fun, it’s a powerful learning tool! By mimicking their babbles and actions, you activate “mirror neurons” in their brain that help them connect sounds with meaning. This playful back-and-forth teaches turn-taking, a foundation for conversation. Plus, it encourages them to copy you, building their own language skills and social interaction abilities.
This is a nice clip on youtube showing how copying/imitating your baby looks like:
Here are some fun ways to imitate your baby:
Matchmaker: Grab two of the same, or two similar toys your child loves, like rainmakers or shakers. Give one to your baby and keep the other for yourself. When your child plays with his/her toy, mirror his/her actions with yours! This creates a fun, interactive game.
Face Time: Get down to your baby’s level, sitting opposite him/her on the floor or kneeling. This makes eye contact easy and encourages him/her to look at you during your playful imitation.
Be the Funniest You: Go all out with silly faces, exaggerated sounds, and big gestures. The goal is to capture your baby’s attention and make you irresistible to watch. This playful energy encourages him/her to interact and potentially imitate you back!
By incorporating these tips, you can turn imitation into a fun and engaging way to boost your baby’s communication skills. I have seen this happen numerous times over the past decades. It is very powerful, go ahead and try it! You cannot be silly and goofy enough!
Did you know that speech and language development starts with how we talk to our babies?
Adults naturally use a special way of speaking called motherese. It involves a higher pitch, slower pace, and exaggerated sounds compared to regular conversation. Sentences are simpler, with shorter words and repetition. This grabs babies’ attention, helps them distinguish sounds, and reinforces word meaning.
Imitation is a key part of motherese. We wait for our baby to make a sound or gesture, then playfully imitate it with exaggeration. Babies notice this right away and often respond with more vocalisations, creating a mini conversation. This back-and-forth teaches turn-taking, a foundation for future conversations.
By responding warmly and engaging in these playful interactions, we encourage our babies to keep exploring the world of communication. Talking, singing, reading and, of course, imitating, these simple actions can have a big impact on a baby’s language development.
Once your conversation is underway then try and keep it going for as long as possible. It’s a beautiful dance of turn-taking, even without words!
A last word on oxytocin
There’s evidence suggesting early non-verbal communication with your baby can increase a mother’s oxytocin levels, often called the ‘love hormone’. This hormone plays a key role in bonding and social connection. Positive interactions, touch, and stress reduction all contribute to oxytocin release, strengthening the mother–baby bond.
For parents of babies with extra needs
The stress of caring for a child with medical needs or developmental delays can be difficult. Stress can lower oxytocin levels, creating a cycle of sadness for both parent and child.
Breaking the cycle:
Knowledge is Power: Understanding the importance of communication can empower parents.
Seek Support: Speech therapists and other healthcare professionals can provide valuable guidance on communication strategies.
Start Small, Celebrate Big: Even small interactions can boost oxytocin. Focus on playful imitation and positive reinforcement. Remember, friends, family and healthcare professionals are there to encourage you.
This approach can help reverse the negative cycle and create a more positive and connected relationship between parent and child.
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.
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.
For many children, especially those navigating Childhood Apraxia of Speech (CAS), the challenge isn’t just making individual sounds. It’s the ‘speech gymnastics’ required to move smoothly from one sound to the next.
You might notice that instead of saying ‘Train’, your child says ‘Ter-ain’, or for ‘Frog’, you hear ‘Fer-og’. That sneaky little ‘uh’ sound in the middle is what we call a schwa vowel. In the world of speech science, this is known as epenthesis. It’s essentially a ‘repair strategy’ the brain uses to break up a difficult cluster of sounds into two easier pieces.
While it might seem like a small detail, that tiny vowel makes a big difference in how fluent and clear a child’s speech sounds. In today’s post (and the video below), I am working with my student on ironing out that schwa by focusing on co-articulation—the art of getting the mouth ready for the second sound while still finishing the first.
The ‘best friends’ strategy
To help my student understand this complex movement, I use visual cues and a story. There are many ways to portray two sounds living closely together, but for this session, I used the ‘Best Friends’ story.
In our story, the /T/ and the /R/ are older brother best friends who want to play together. The ‘schwa’ sound is represented by a little sister who keeps trying to jump in the middle of their game! Because my student has a younger sister, this scenario was instantly familiar and helped him visualise why we needed to ‘close the gap’ between those two sounds.
Alternative methods I often use:
Beyond stories, I often use other visual and tactile methods to show the closeness of two sounds:
The sliding finger: I draw two dots on a paper—one for /T/ and one for /R/. We slide a finger quickly from one to the other. I might say, ‘Don’t let the ‘uh’ monster jump in the gap!’
The rubber band: We stretch a rubber band as we speak. I tell my student that the word is one long, smooth stretch, rather than two separate ‘pops’.
Visual cues for ‘quiet’ sounds: I often put my finger to my lips or tap my throat to remind a child to keep the first sound voiceless. If the voice stays ‘off’ during the /T/, it’s much harder for that schwa vowel to creep in.
The importance of ‘pure’ modelling
A major hurdle in clearing up these blends is how we, as adults, model sounds. Often, when teaching the alphabet, we say ‘Kuh’, ‘Puh’ or ‘Tuh’. But if you listen closely, you’re actually adding a vowel! If a child learns that /K/ says ‘Kuh’, it’s only natural they will say ‘Kuh-R’ for /KR/.
To give your child a cleaner blueprint, try modeling ‘pure’ sounds. Think of whispering rather than talking:
The /K/ sound: A short, sharp burst of air from the back of the throat. No voice! (A quiet /K/ click).
The /P/ sound: Just a ‘pop’ of air from the lips. If your throat vibrates, the vowel has snuck in.
The /T/ sound: A tiny tap of the tongue behind the teeth.
Why is this important?
You might ask, ‘If I can still understand them, does it really matter if they say “ter-ain”?’
The goal of speech therapy isn’t just functional communication; it’s building phonological awareness. When a child adds extra vowels, it can eventually impact their literacy. If they hear ‘ter-ain,’ they are much more likely to eventually spell it as ‘terain’ or ‘traint’.
By helping them master these clusters through co-articulation now, we are setting them up for success in reading and writing. And we are giving them the confidence to speak with ease.
Feel free to contact me if your child needs help with clusters or other difficulties either aligned with Childhood Apraxia of Speech or other articulation difficulties.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
References
Hall, N. (2011). Vowel Epenthesis. In The Blackwell Companion to Phonology (eds M. Oostendorp, C.J. Ewen, E. Hume and K. Rice). In this work, epenthesis is defined as the insertion of a vowel to break up complex consonant clusters into simpler, more manageable syllables. This is often viewed as a ‘repair strategy’ used by the brain when a transition between sounds is too complex to execute quickly.
Aichert, I., & Ziegler, W. (2004)Brain and Language 88(1):148-59. Syllable frequency and syllable structure in apraxia of speech. This research highlights that children with Apraxia often struggle specifically with word-onset clusters, leading to distortions like the schwa.
Browman, C. P., & Goldstein, L. (1992)Phonetica 1992;49(3-4):155-80. Articulatory Phonology: An Overview. This paper explains that fluent speech requires ‘gestural overlap,’ where the movements for two different sounds happen simultaneously. This supports the ‘Best Friends’ method of keeping sounds close together.
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.
For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.
1. Individual Pacing:
Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.
2. Neurodevelopmental Complexity:
The human brain is a remarkable entity, with a bewildering array of interconnected processes that lead to us achieving our developmental milestones. Autistic children often have variations in “neural wiring”, which can impact the balance between gross motor skills (crawling, walking) and fine motor skills. Speech and language acquisition falls under fine motor skills and may be momentarily disrupted due to the divergent neurological pathways at play in autism.
2. Sensory Processing Differences:
One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.
3. Visual-Spatial Abilities:
Autistic children and adults frequently display excellent visual-spatial abilities. This strength might lead some children to focus more on activities that engage these skills, potentially delaying their engagement with activities like walking or talking. As they navigate their environment and process information visually, they might naturally invest more time in activities that stimulate this particular cognitive ability and strength.
4. Communication Challenges:
For many autistic children, speaking can be a really complex and difficult endeavour. Communication delays are a common feature of autism. This can affect both receptive and expressive language development. While some children might be physically capable of crawling or walking, they may not yet have the tools to communicate their desires and intentions. This leads to a temporary focus on non-speaking forms of expression. This does not mean that they do not communicate at all. But autistic individuals often start out using jargoning or echolalia as a form of communication as well as behaviours and physical forms of communication.
5. Executive Functioning and Motor Skills:
Executive functioning, or abilities for planning, organising, and carrying out tasks, can vary in autistic children. These skills are crucial for activities like crawling, walking, and talking, which need coordination and planning. About 40% of autistic persons have a motor planning difficulty.
6. Intense Interests and Routines:
Autistic children often develop intense interests in specific subjects, sometimes to the exclusion of other activities. These interests might become their primary mode of engagement. They might side-line milestones like crawling, walking, or talking. The mostly rigid adherence to routines and preferences might cause them to allocate more time to their preferred activities. This delays their engagement with other developmental tasks.
How can Speech and Language Therapy help:
Support and Intervention:
Early intervention and regular Speech and Language Therapy play a pivotal role in the developmental journey of autistic children. Therapies tailored to individual needs can aid in bridging the gaps between milestones. Occupational therapy, for example, can help address sensory sensitivities and motor skill challenges that might impact crawling and walking. Speech therapy can help communication development, gradually bridging the gap between non-verbal expressions and spoken language.
For example, we now know that echolalia or jargoning of longer phrases with intonation, repeating scripts from favourite tv shows or songs have many meanings and communicative functions. For example, a child who utters long strings of echolalic utterances, often difficult to understand, might want to do any one of the following:
Comment
greet
ask a question
make a request
express surprise
negate something.
We now understand that the way to support a child with echolalia is to acknowledge all utterances and try and find out what the meaning is behind these scripts. This is very supportive. Over time it will lead a child to move on to understanding and saying more clear and self-generated language. For more information about this Natural Language Acquisition here are some other great websites for you to look at:
In conclusion, the journey of an autistic child’s development is a testament to the uniqueness and complexity of the human mind. The delays or differences in achieving milestones like crawling, walking, and talking can be attributed to a range of factors, including
neurodevelopmental intricacies,
sensory processing variations,
and communication challenges.
It’s crucial to recognise that these delays are not indicative of a lack of potential, but rather a manifestation of the intricate interplay between an autistic child’s strengths and challenges. By embracing these differences and providing tailored support, we can help each autistic child unfold their potential at their own pace.
Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive
Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive
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.
