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.
As a Speech and Language Therapist with a specialism in paediatric feeding, I’m constantly looking for ways to support families in developing their little ones’ oral motor skills and fostering a positive relationship with food. While Baby-Led Weaning (BLW) has revolutionised how many families introduce solids, (see my previous blog in July 25) a concept that often sparks discussion and curiosity is the use of ‘hard munchables.’
The term ‘hard munchables’ refers to specific types of firm non-digestible food items that are offered to babies for oral exploration and skill development, not for nutrition. These are typically foods that babies cannot bite off or swallow in large pieces due to their texture, but which provide resistance for chewing practice.
The phrase was coined by Marsha Dunn Klein, M.Ed., OTR/L, Occupational Therapist and feeding therapist. Well known for her work in paediatric feeding she introduced and advocated for the concept of hard munchables as part of a therapeutic feeding approach, particularly for infants learning to manage textures and develop crucial oral motor skills.
Common examples of hard munchables include:
Large, raw carrot sticks: Too hard to bite through, but great for gnawing.
Celery sticks: Like carrots, offering firm resistance.
Large, raw apple slices (peeled chunks): A firm, slightly sweet option.
A firm, uncut pear core: With the seeds removed.
Dried mango cheeks (hard, unsweetened varieties): These offer a fibrous texture.
A large, fully cooked but firm piece of meat (like a steak bone with some meat attached): The meat provides flavour and a bit of shreddable texture, while the bone is for gnawing.
Hard crusts of bread or breadsticks (very firm, without soft inner crumb): These can soften slightly with saliva but offer significant resistance.
Image by Freepik
It’s crucial to emphasise that hard munchables are not for consumption or nutrition. They are tools for oral motor development and should always be offered under strict, active supervision.
How do hard munchables fit into weaning?
While weaning (traditional or Baby-Led Weaning) introduces solid foods that a baby can eventually bite and swallow, hard munchables are complementary to the weaning phase. They enhance that phase by helping a child to develop hand dexterity, hand to mouth movement, and oral development.
It’s important to differentiate: Weaning provides the digestible food for eating, while hard munchables provide the tool for skill practice. They are not substitutes for each other but can be used together under careful guidance.
Pros and cons from a speech therapy perspective
As an SLT, I see both the potential benefits and the necessary precautions when incorporating hard munchables.
Pros:
Enhanced oral motor development: Hard munchables provide excellent resistance training for the jaw, helping to develop the strength, endurance, and coordination needed for efficient chewing. This is foundational for moving beyond purées and very soft textures.
Promotes lateralisation of the tongue: The act of moving the hard item from side to side in the mouth encourages the tongue to move independently of the jaw, a crucial skill for managing food and for speech sound production.
Preparation for more complex textures: By strengthening the oral musculature and refining chewing patterns, hard munchables can help babies transition more smoothly to lumpy and mixed textures.
Sensory exploration: They offer rich sensory input (tactile, proprioceptive) that can be beneficial for oral mapping and awareness, especially for babies who might be orally sensitive.
Cons:
Choking risk: While the intention is for the baby not to bite off pieces, there is always a risk. Small pieces can break off, or a baby might accidentally bite off a larger chunk than he or she can manage. Active, vigilant supervision is non-negotiable.
Not a replacement for digestible solids: It’s vital to remember that hard munchables are for practice, not nutrition. They should complement, not replace, the introduction of varied, digestible solid foods.
Not suitable for all babies: Babies with certain developmental delays, oral motor deficits, or medical conditions might not be appropriate candidates for hard munchables without highly specialised guidance. For instance, babies with an exaggerated gag reflex might find them overwhelming.
Key Considerations for Parents
Here are my top recommendations:
Consult with a professional: Always discuss this with your Paediatric Feeding SLT first before you introduce hard munchables. We can assess your baby’s individual readiness and guide you on safe practices.
Strict supervision: Never leave your baby unsupervised with a hard munchable, even for a second. Your full attention is required.
Appropriate size: Ensure the item is large enough that the baby cannot fit the whole thing in their mouth. It should extend well beyond their fist.
No biting off: The goal is gnawing and scraping, not biting off pieces. If your baby is consistently breaking off chunks, stop using them.
Focus on skill, not consumption: Reiterate to yourself that this is for practice, not for eating.
In conclusion, hard munchables, when used appropriately and under guidance, can be a very valuable tool to support oral motor development during the weaning journey. However, always be safe and consult with a specialist to ensure your little one develops his or her feeding skills effectively and joyfully.
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.
First up try and get down at eye level or Face-to-Face with your child
Try to sit so that your child can see you easily, i. e. your child does not have to look up to make eye contact with you. We call that Face to Face: try and sit opposite your child. This makes it easier for you to see facial expressions and therefore pick up nonverbal /pre-verbal communication. Now you can connect and share the moment with your child.
OWL (Observe, Wait and Listen)
Never skip this step as it prepares us for what happens next !
Observe
First, try and simply watch your child quietly and listen and observe what he/she says or does; you need to know what your little one is interested in. For example with this toy (pictured below) we could observe that your child loves the actual spinning of the marble, perhaps more than that noisy click-clacking down the run. Or perhaps he loves collecting the marble at the end and feeling it in his hand.
You could start off with showing once how the marble goes down and say:“ look it goes round and round !” Then hold back and observe, without speaking, so that your child has time to explore the toy.
Wait
Just sit and avoid telling or showing your child what he or she could do with the toy. This gives your child an opportunity to explore and experiment.
Listen
Listen to what your child says, or look at your child’s non-verbal communication without interrupting. Your child will now feel and know that you are really present and that what they have to say is important. It’s best to avoid questions like, “What are you doing or “What’s this?” as that might be a lot of pressure when they don’t know what to say about that yet.
Respond immediately by showing interest
Once you have all the information from OWLing you can respond in the right way, for example: if she catches the marble at the end of the run and looks up with a smile or a sound you could respond with: you’ve got it! One marble in your hand! Nice playing!
Now how to join in the play:
First you can copy what your child is doing
If your child puts the first marble at the top of the run you can take a turn and do exactly the same once his marble is done. Ideally you might have another marble run, perhaps a similar one, it does not have to be exactly the same! Once your child has put the first marble in you can do the exact same with your own marble on your run. Your child is likely to look at what you are doing and you might well see a smile on their face or perhaps she might say: look at mine!
Next you can build on that
You can respond with simple comments like: “Wow! Yes I am looking at yours now! It’s spinning on the red one lots! I love the noise!” Now wait once more to see what your child says or does.
To summarise
We are signalling to our child that we are really interested in what they are doing and saying so we can “collect” our child, i.e. bring him/her back into a joint interaction.
Important
We want to try and not direct our child but respond with interest and fun! This creates a lovely stage for interaction and joint play! And this leads in turn to practising conversation and ever more opportunities for great speech and language skills to emerge.
Great activities we use in Speech and Language Therapy:
Any cause and effect toys like this Marble Run
Creative activities, such as mark making with crayons
Train tracks (building and running the trains)
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.
This particular student has a mild motor planning difficulty and six weeks ago he came to me with a very strong lisp. In addition to the lisp he is struggling to produce a number of sounds, SH and L on its own and all the clusters (FL/BL/KL/PL) but also CH together with some vowel difficulties.
Here I use the ‘Flat Tyre’ Sound, to offer as an image for a new S sound and the ‘Tick Tock’ Sound for a new image of the T sound. Both cards are from the Bjorem Speech Sound Deck, which I love and use almost daily.
Gestural Cues
I like to use all the ‘cued articulation’ hand cues by Jane Passy for consonants and fricatives. Here we use our fingers and hand to illustrate what our tongue does, and we also show whether a sound is voiced or voiceless. When I use one finger it is voiceless (k/f/s/p) and when I use two fingers for the same cue it means that the voice needs to be turned on: (g/v/z/b/n/m). For vowels I like to use Pam Marshalla’s cue system.
Simultaneous production
We say the word together.
Direct imitation
I say the word and my student copies me directly.
Imitation after a delay
I say the word and then after a little wait my student says the word.
Spontaneous production
My student has now learned to say the word by him/herself.
Offering feedback
It sounds like… I just heard… I didn’t hear the first sound there? Can you try again?
Letting the student reflect
By just shaking my head or by looking quizzical so that my student realises something didn’t quite go right.
Postitive reinforcement
‘Yes that was it, do it again, nice one…’
Cognitive reframing
This is a technique where we identify different semantic cues and metaphors or imagery cues, so instead of teaching or focusing on a sound we try out viewing each syllable from a different point of view.
For example: ‘yellow’. I have had great success with this one: we start with just saying ‘yeah yeah yeah’. I might make a little joke and say something like ‘imagine your mum says tidy your bedroom, what do you say or what do you think?’ Answer: ‘yeah yeah yeah’. Then we practice ‘low’ together, I might blow some bubbles high and low and we talk about ‘low’. And then we put ‘Yeah’ and ‘Low’ together and now we have YELLOW!! It might at first still sound a bit odd, like ‘yea-low’ but we soon shape that up and have the real word.
Each student is different and having a great rapport is crucial to our success.
Then a little game break after some 7–10 or so repetitions and always trying to finish on a positive note.
What game breaks do I use:
Very quick ones! Students can post something, place a counter in a game, take out a Jenga block from the tower, pop in a counter for ‘connect 4’, stick a sword into the Pop the Pirate barrel or add a couple of Lego blocks to something they are building.
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.
When children find talking hard, parents often face a difficult question: ‘Should we wait and keep encouraging speech? Or introduce something like AAC?’
AAC (Augmentative and Alternative Communication) can sound intimidating, but it simply means any way we support or replace spoken words, from simple gestures and picture boards to high-tech speech-generating devices. Far from ‘giving up on speech,’ AAC often becomes the bridge that helps children find their voice, in whatever form that takes.
💡 What is AAC, really?
AAC is a spectrum of tools and strategies that help people express themselves when speaking is difficult. It might include:
Low-tech supports: Gestures, key word signs (like Makaton), picture symbols, or printed boards
High-tech systems: Apps on tablets that speak aloud when pictures or words are tapped
AAC is not just for children who will never talk. It’s for anyone whose speech isn’t meeting their communication needs right now.
🤔 When to introduce AAC
There’s a common myth that you should only try AAC after ‘exhausting’ other speech therapy options. In fact, AAC can be introduced at any stage, even alongside speech development.
Here are some helpful signs that AAC might support your child:
Your child understands much more than they can say.
They rely on gestures, sounds, or behaviour to communicate.
They become frustrated trying to express themselves.
You find yourself ‘reading their mind’ to interpret needs.
Speech progress feels slow or inconsistent.
If you recognise these patterns, AAC isn’t a ‘last resort’. It’s a communication support, not a replacement for speech.
Recent research consistently shows that AAC does not stop children from talking. In fact, it can encourage speech to develop. A 2024 systematic review and meta-analysis published in the Journal of Autism and Developmental Disorders found that children who received interventions combining naturalistic developmental behavioural approaches with aided AAC showed improved language outcomes, and that AAC ‘does not negatively impact speech development and may even facilitate spoken language growth’ (Smith et al., 2024).
🌉 How AAC supports speech development
Speech and AAC aren’t competing paths: they’re parallel tracks that often feed each other.
Here’s how AAC helps speech grow:
Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
Encourages turn-taking and social connection: AAC lets children join conversations even before speech is fluent, giving them more practice in real communication.
AAC is not ‘giving up on speech’. It’s giving a child more ways to succeed while speech continues to develop.
🧩 How to introduce AAC gently and effectively
Start small and meaningful: Begin with a few key messages your child wants to say, not just what adults want to hear. Think ‘I want’, ‘stop’, ‘help’, ‘more’, ‘all done’, ‘no’, ‘again’. These are powerful words for real interaction and autonomy.
Model, model, model: The most important part of AAC success is modelling—using the system yourself as you talk. For example: ‘You want banana 🍌’ and you tap the ‘want’ and ‘banana’ symbols. Children need to see and hear AAC used naturally before they try it themselves.
Use it throughout the day: AAC isn’t a therapy tool to take out once a week. It’s a living part of communication. Model a few words during mealtimes, play, and routines. The more consistently it’s embedded, the more fluent both you and your child will become.
Keep it accessible: If using a device or picture board, make sure it’s always nearby. If it’s in a bag or drawer, it can’t be used in real moments.
Celebrate all communication: If your child points, signs, uses a sound, or taps a symbol, it all counts. Respond warmly and naturally to reinforce communication in any form.
🧠 What parents often worry about
‘Won’t AAC stop them from talking?’: No. Research shows AAC use either has no negative effect on speech or leads to increased spoken output (Smith et al., 2024). When children feel understood, their motivation to communicate grows.
‘What if I model it wrong?’: There’s no perfect way to start. Your effort and consistency matter far more than accuracy.
‘Will they get ‘stuck’ using pictures?’: Some children do continue using AAC long-term; others move naturally toward more spoken language. The goal is always functional communication, not replacing one form with another.
🪞 Bringing AAC into daily life
Here are a few simple, parent-friendly ideas:
Create visual spaces: Post symbols or core words on the fridge, mirror, or play area.
Narrate routines: Use AAC during toothbrushing, dressing, or mealtimes; consistent contexts build understanding.
Pair speech and touch: Always say the word aloud when you point to or tap a symbol.
Involve siblings and friends: Model how they can respond to AAC too. ‘Oh, you said go! Let’s go fast!’
Use shared books and songs: Pause and model key words in stories or songs.
🌱 The takeaway
AAC doesn’t mean giving up on speech; it means opening more doors to communication. When words don’t come easily, AAC gives children a way to connect, share, and be heard.
It helps parents move from guessing to understanding, and gives children the power to express themselves on their own terms.
If you’re unsure where to start, reach out to a speech and language therapist experienced in AAC. Together, you can find a system that fits your child’s strengths, build confidence in modelling, and help every word (spoken or tapped) feel like a step forward.
Because when communication is possible, everything else begins to grow.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
📚 Reference
Smith, K., et al. (2024). The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta‑Analysis. Journal of Autism and Developmental Disorders, 55, 3078–3099. https://doi.org/10.1007/s10803-024-06382-7
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.
There’s often this idea that autistic children have extensive vocabulary and knowledge, but this is not always the case. In fact, 30% of autistic children have language regression.
Goldberg (2003) suggested that speech and language regression refers to the decline in a young child’s speech and communication abilities. We know that regression in speech, language and communication skills often occur before the age of two years. 25% of autistic children develop language at word level between 12 and 18 months of age before losing this language they have learned. As you’re probably aware this regression in communication is a diagnostic indicator of Autism.
We understand that you want your child to progress, and you struggle to watch as their frustration grows as you feel helpless. I want to provide you with tips so that you can feel empowered to support your autistic child and reduce the impact their communication skills have on the family.
Reduce frustration by providing visuals to support their communication
Praise the ability to communicate. Focus on what they say not how they say it. E.g., good listening, nice talking.
Provide your child with choices (using real objects to represent your choices). E.g., do you want an apple or banana?
Your child must be motivated and have a purpose to communicate. So, ensure you use highly motivating objects for conversations
Provide them with opportunities to communicate. We need to teach children that if they want something, there’s a process that you need to have the opportunity to ask for it. We find that if parents understand what their child wants (without them asking), the object is given to them, and so there’s no reason for your child to ask.
There’s this idea that we need to teach children eye contact. This is not always the case. Your child is unique, we do not want to take their unique skills away.
Model words which are concrete. E.g., words such as ‘finished’, ‘more’. You can model these several times within the day. You can use a gesture to make the word more visual (see the images below). We know that autistic children are often visual learners.
Remember that if your child has speech, language and communication regression, it doesn’t mean your child will stay static.
It’s vital that you seek support from a qualified Speech and Language Therapist. We can tell you at what point in the communication development that your child is at. And we can support you through the process. We can provide you with an individualised plan specifically for your child to ensure you maximise their potential.
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.
