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.
Before reading this blog, it’s important to understand what we mean by ‘social communication’ and ‘imitation’. Social communication is more complex than it first appears. It refers to many aspects of communication such as body language, voice, conversational skills, social ‘rules’ (such as being polite and using manners), interpersonal skills (such as developing friendships), and emotional literacy (such as appropriacy and developing self-awareness). Imitation refers to the simple act of copying.
You may have noticed that your child has difficulties in some of the areas mentioned above. They might be less responsive to you and appear to be quite happy in their own world. Whilst we do not want to change their unique characteristics, we do need to prepare them for future experiences, and what is socially acceptable.
How will copying my child develop their social communication?
If your child is already engaged with a certain activity, they are already interested and motivated. You’re not competing for their attention.
Both yours and your child’s attention is on the same activity which makes imitating for you (as the parent) easier.
Studies have demonstrated that when a parent imitates a child, they are more likely to look at the adult.
Imitation not only supports eye contact but supports facial expressions (such as smiling), may increase vocalisations, and encourages your child to sit closer to you.
Children learn through trial and error. They may start to try to perform new actions to gain their parents attention. Let your child lead the play!!
How do I start imitating my child?
Start with observing them. Take the time just to watch. You don’t need to make notes. Sit back and observe their actions, movements, and sounds they make.
Wait for your child’s reaction when they realise you are copying their actions. Remember they may not notice, you don’t need to remind them, simply copy them again.
Having the same set up as your child allows them to feel in control. So, you may have two sets of the same activity rather than copying using their set of toys.
This may sound daunting, but it doesn’t have to be. Start with a ten-minute time frame where you choose to copy your child. This is where you can practise your imitation strategy. Ten minutes a day is far more effective than an hour every two weeks. You may feel self-conscious but trust the process. Build your confidence, whilst exposing your child’s to increased language and communication, enabling them to develop vital social communication skills.
Look at the video above to watch the strategy in action!
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.
Your Speech Therapist might have been advising you to introduce words to your child with the help of a CORE BOARD. What on earth is she talking about and why would we want to do this, I hear you think – and in fact this is what I get asked a lot, as I often do recommend using Core Boards.
Core boards belong to the category of Augmentative and Alternative Communication (AAC ) and they can be really useful for:
Children or adults who cannot speak at all or who are very hard to understand.
Children who are slow to speak and have difficulty expressing themselves verbally, due to genetic conditions as Down Syndrome, Verbal dyspraxia, Autism or any other learning difficulty that means a child is slow to develop speech.
Here is what a Core board might look like, in fact this is one that I love to use. It is made by Beautiful Speech Life, there are a ton of similar boards out there for free. I have also made my own, you can check it out on my Instagram feed.
What is Core Vocabulary/ Core words?
Core vocabulary consists of the most common words used by children throughout a day. In 2003 Banajee and Dicarlo et al found that 50 % of pre-schoolers in their project used nine words consistently across their daily play and meal routines. These words are Core words and are typically the ones you can see on a board, like the one above.
How To Use It
Adults always first need to consistently model and show their child how to use a board. This is key! For example: Adult can point to “YOU” “WANT” ‘MORE” and then point to the cup of Water on the counter. Child could then reply either by shaking his/her head and/or pointing to “NOT” which also stands for “NO”. Then adult can point to “NOT” “MORE” and do an OK sign as well. Eventually Child can initiate a request and point to “I” “ WANT” “MORE” and then point to the cup on the counter.
This is not as cumbersome or limited as it first sounds or appears. Here’s why: As adult you can talk normally and, of course, many words you are using will not be on this board. But some will be, and you will be surprised how many you can find when you start using it. So you could say quite normally: Hey lovely (name of your child) would YOU LIKE some MORE water? The words in capital are on the board which you can point to as you speak normally. Basically, you are showing/saying to your child: “We can speak and these are the pictures we can use to help us; We call this TOTAL COMMUNICATION, as communication is so much more than just words! Great communication can be silent, where we use our facial expression, our smile, our eyes, our hand gestures, body movements and yes, of course, words. But when words fail us, these boards are so helpful.
This still does not answer your original question of: why would I want to do this, I want my child to talk!? You are a SPEECH Therapist, please help my child TALK, not point to pictures, that is not what I had in mind.
Let Me Explain
When speech is difficult for a child it doesn’t mean that there is nothing to talk about! Of course, we want all our children and all people to speak because it is the easiest and most effective way of communicating, no doubt! However, sometimes this is very hard for some children and whilst we are always working towards speech where possible, we also want to make sure that whilst figuring out how to speak, your child has a MEANS TO COMMUNICATE. Using a board like this might well be a temporary strategy but whilst you are using it and working on their speech you will find a reduction in tantrums and frustration as you child is able to express themselves more effectively.
Often we find that as soon as we offer a CORE VOCABULARY like the above sample a child who has had no or very few words suddenly blossoms and starts to point to new words on the board and starts to PRACTICE USING THESE WORDS!! Practice makes perfect, right? Yes it totally does! There is lots of evidence that tells us that using Core Vocabulary Boards ENHANCE AND SUPPORT SPEECH PRODUCTION AND NOT HINDER IT. Using a board like this will only ever be helpful to your child and will never make your child “lazy” – too lazy to speak? NO SUCH THING!
Here is what one of my parents says about the core board we use with her little boy:
“the board has been a game changer, my son is a visual learner so it really helps to have the board as he associates communication so much easier this way. We have incorporated his twin sister who models it’s use and have definitely seen improvement in speech through its support and his frustration around being unable to verbally communicate at times has definitely lessened”
K Connolly, Mother of Tom (aged 3.5 years).
Reading and hearing this makes me so happy!
In addition to general core board above I also sometimes use a Core Board that is specific to an activity, such as for example BLOWING BUBBLES. Below is an example of such a board, which you can use very nicely during a bubble blowing activity and sometimes it is a nice place to start for newcomers, this can be an easy introduction. You can download this and many similar boards on www.widgit.com for free!
There is so much more to say about AAC and using Coreboards, visit my Instagram you can find a bit more information on how I use them.
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.
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.
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.
As speech and language therapists, some of the most effective moments in therapy don’t come from flashcards, worksheets, or even drilling sounds (though to be fair I do drill quite a lot too! needs must…😊).
By and large they happen in natural interaction — during shared attention, laughter, storytelling, and connection.
This short video clip captures that.
In under two minutes, while simply reading a book together with a three-year-old child, we naturally work on:
Speech sounds
Vowel production
Early phonological patterns
Motor planning
Signing and total communication
Visual cueing
Repetition and practice
Confidence building
And engagement through play
To many people, it may just look like ‘reading a book’.
But underneath that moment are years of specialist training, clinical decision-making, preparation, and therapeutic skill.
Therapy hidden inside play
One of the most important parts of paediatric speech therapy is knowing how to embed targets into meaningful interaction.
Books are one of my favourite therapy tools! Why: because as speech therapists we need to prepare for our child and our sessions. And having a book gives me the structure to know beforehand what kind of sounds or words might be coming up. Then I can be prepared for providing extra support for them. As you can see in this clip, I had the sound cards just there because I had anticipated what might be coming up!
A single story can provide opportunities for:
Speech sound practice
Vocabulary development
Sentence building
Turn-taking
Symbolic understanding
Attention and listening
Gesture and signing
Motor speech cueing
And social communication
In this clip, I follow my little one’s interests while carefully weaving in her individual therapy targets.
It looks relaxed and spontaneous — and it is — but it is also highly intentional.
Catching opportunities in the moment
One lovely example in the clip is when she says ‘yes’.
She is now starting to say the final /S/ sound, so I immediately model and draw attention to it using the ‘snake sound’ visual cue, giving her positive feedback that she can now also try using this sound at the start of words.
My gently shaping the word ‘yeSSSS.’ gives her:
Auditory feedback
Visual support
And an achievable opportunity to try again
A few seconds later, we naturally practise it again.
That’s responsive therapy.
Speech therapists are constantly listening, analysing, adapting, and deciding:
When should I model?
When should I pause?
When should I repeat?
When should I let it go?
How can I keep confidence high while still targeting speech?
These decisions happen in seconds.
Working on speech without ‘stopping the play’
Another moment in the clip focuses on the word ‘out’, where the vowel sound is one of her speech targets.
Then we move into practising the word ‘open’, a word she has previously found difficult.
Within this one word, we can support:
Sequencing
Motor planning
Lip shape
Vowel production
And speech sound accuracy
We also briefly practise the /K/ sound — a sound produced at the back of the mouth which can be particularly tricky to produce.
Instead of explaining it verbally (which is often too abstract for young children), I use:
Visual demonstration
Exaggerated mouth movements
Gesture/sign support
And playful modelling
Children learn through seeing, hearing, doing, and experiencing.
That is why Speech Therapists use multiple layers of cueing simultaneously.
Why I use signs alongside speech
Throughout the clip, I also use signs such as ‘book’ and ‘pig’.
Using signs does not stop children talking.
In fact, for many children, signs:
Reduce frustration
Support understanding
Increase participation
Reinforce vocabulary
And help bridge the gap while speech is developing
Communication always comes first.
Speech is only one part of communication.
When children feel successful communicating, they are far more likely to keep trying.
The skill behind ‘natural’ therapy
One thing I often hear from parents is:
‘You make it look so easy.’
That is actually one of the biggest compliments a therapist can receive. (Though we also often feel we need to justify our very existence with these thoughts because we don’t just play/just read but we know it can look like that!) 😊 this is the reason for this blog…
High-quality paediatric therapy should feel warm, playful, responsive, and natural.
But underneath that natural interaction is:
Clinical knowledge
Phonological analysis
Motor speech understanding
Language development expertise
Sensory awareness
Relationship-building
And careful session planning
Before this session even began, I already knew:
Which speech patterns to target
Which words would likely appear in the book
What visual cues might help
Which signs to model
And how to adapt depending on the child’s responses
That preparation allows therapy to stay child-led without losing therapeutic focus.
Following the child while leading the therapy
The best therapy is rarely rigid.
Children do not learn communication through pressure or endless correction. They learn through interaction.
That is exactly what this short clip demonstrates.
One book. One conversation. Hundreds of tiny therapeutic decisions.
And all within a joyful moment shared together.
Because good speech therapy should never feel like hard work for a child.
It should feel like connection, confidence, success — and fun.
If you’re concerned about your child’s speech and language or wondering whether they might benefit from speech therapy, feel free to get in touch.
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.
It feels like the Christmas festivities start earlier and earlier every year. This makes it harder for your child with communication difficulties to process what is happening. Whilst you can’t do anything about the events that happen around your child, you can start to put into practice strategies which may support them and allow them to regulate their emotions.
Six ways to prepare your child for the Christmas festivities
Explore six ideas here:
1. Print off or buy a blank calendar to use at home
You can start to write in activities out of the usual routine and add a picture to allow your child to understand what it’s about. You can also use it as a countdown to Christmas Day to try to prevent ‘how long’ questions.
2. Make use of visual timetables
These are useful in everyday settings and activities but also when change occurs.
3. Be aware of any non-uniform days
Days like ‘Christmas Jumper Day’ can make your child feel uncomfortable and may affect their behaviour. By giving yourself time, you can have conversations with your child’s teacher to find a more suitable alternative. For example, they can wear a Christmas t-shirt that they find more comfortable.
4. Think about what will benefit your child
Do they like being surrounded by people or do they prefer a quiet space on a 1:1 basis? Christmas activities often involve lots of group work in school (e.g., rehearsing for carol concerts or plays). They might prefer to pre-record their part in the Christmas play or create pieces of art which can be used. At home, they may prefer one guest visiting at a time, rather than all at once.
5. Explore how your child is feeling
It’s important to find out how your young person is feeling and how these impact on the activities of that day. It might be that your child doesn’t like surprises and the intensity of opening gifts is too much for them. They may prefer gifts to be left unwrapped and given throughout the day, rather than all at once.
6. Consider sensory needs
Ensure your young person has everything they need to meet their sensory needs. This can be e.g. noise cancelling headphones, fidget toys, or comforting items. These will particularly be helpful with routines changing, often with little notice. If at home, you may wish to not put lights on the Christmas tree if visual stimuli become too much.
Remember clear communication between home, school and other family members is vital during this time. By having clear communication and expectations, your young person will feel more secure. And you can have a Christmas that is right for you and your family.
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.
