Explore how to improve communication skills for a Gestalt Language Processor

ByLondon Speech and Feeding
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Let’s break it down into steps to make these complicated words easier to understand. Once you have a deeper understanding, you will then be able to support your child or young person develop their communication skills in the best way as a Gestalt Language Processor. Remember not every child will be a Gestalt Language Processor; if your child uses echolalia and/or has a diagnosis of autism then your child’s way of processing language is most likely different to the classic way children typically learn language.

Let’s start with understanding what each of these words “Gestalt Language Processors” mean.

Gestalt: “the way a thing has been placed or put together”

Language: “a system of human communication”

Processors: “responds to and processes basic instruction”

So, let’s put those meanings together. “Gestalt Language Processors are children who process early language in strings of sounds or chunks.” They tend not to process single words.

It is important to understand this way of processing communication because between 75-90% of children with Autistic Spectrum Conditions process language in this way (Blanc, 2012). We know that it’s important for young people to have their voice heard and to be able to express themselves. So, it’s vital that they move from echolalia to self-generated communication to be able to do this. This means that our children’s communication partners play a vital role in supporting their child’s language. We can support our children by modelling phrases until the child has learnt the process themselves.

Speech Therpaist in London

Let’s explore an example together

X (who is a gestalt language processor) and his family love to feed the ducks in their spare time; this is an activity that takes place regularly. Let’s look at how you, as the adults, could support X in his communication. Look at the phrases that are used. They are meaningful to the activity with repetition used throughout.

Top tip: You could think of an activity you and your child or young person take part in on a regular basis and brainstorm some key phrases that you could use.

Need a boost in confidence to support your child’s gestalt language processing?

Contact me.

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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  • ·

    Correcting a lisp

    ByLondon Speech and Feeding
    Correcting A Lisp

    This is a surprisingly common speech error and it can be corrected really well in my experience. I have helped lots of children of all ages learn how to control their tongue movements and produce clear, sharp /S/ sounds and good /SH/ sounds.

    Initial consideration

    There are some factors which need to be considered before we can dive into therapy proper and these are they, in a nutshell:

    1. The student is not currently displaying negative oral habits such as thumb sucking or excessive sucking on clothing. This is because thumb sucking exerts pressure on the teeth and therefore can, over time, push teeth out of their natural order/position.
    2. The student does not have a restricted lingual frenulum or tongue tie which can cause at times restricted movements of the tongue (pending on how tight the frenulum is attaching the tongue to the base of the oral cavity); equally a labial frenulum or lip-tie can restrict lip movement and therefore physically restrict good speech sound production.
    3. The student does not have enlarged tonsils as they can sometimes push a tongue forward and also cause open mouth posture and open mouth breathing.
    4. The student’s motivation to change their speech pattern is high. (this is an important factor though with younger students I can get round this with a lot of fun games and good parental involvement!)

    When I do an Oral Assessment of my student these are the first factors I want to look at and consider. Often I will refer to other agencies such as Orthodontists, dentists or ENT specialists to advise and help with some of these factors before we can get going. However, there are strategies that we can work on almost straight away.

    Most of my Lisp students present with an open mouth posture: that is where the student has their mouth always slightly open for breathing. Over time the tongue starts to fall forward and rests on the front teeth or the bottom lip instead of finding a comfortable resting place either at the alveolar ridge (the bumpy spot behind the upper front teeth) or, alternatively, resting at the bottom of the mouth behind the lower front teeth.

    Another common problem is that the tongue is not moving independently from the jaw and so is reluctant to pull back or lift up inside the mouth as the tongue is guided in movement by the jaw.

    Combine those two factors and your tongue is not pulling back, or lifting up or doing very much at all without the jaw moving as well. This makes for unclear speech sounds, especially all the sounds we make at the front with our tongue or with our lips: /B/ /P/ /L/ /N/ and of course /S/ and /SH/ are particularly hard to make. We often also struggle with the /Y/ sound so ‘LELLOW’ instead of ‘yellow’.

    Do not fear!

    But no fear, these problems can be treated over time for sure! We often start with lip, tongue, and jaw exercises that help to move the tongue independently from the Jaw, our student learns that the tongue is a muscle and can be trained to do amazing acrobatic things in the mouth! WOW! It can actually pull back, lift up, and come down again all on its own!

    We work on breathing, holding our breath for a bit then pushing it out and then holding it again.

    And when it comes to the actual /S/ sound I often try and go a NEW route bypassing the Snake-Sound route if that is what had previously been tried and failed so that we can create completely new sound patterns in our brain and think about our sounds in a completely new way.

    We then work on producing the sound /S/ on its own for a bit, at the end of words, then on either side of complimentary sounds, for instance : ‘EASY” – the sound patterns here are EEE-S–EE : the /EEE/ sound is complimentary to the /S/ sound as the tongue is at the right hight for the /S/ already once you have it in place for /EEE/ -……see?! EASY!

    And gradually we work towards saying the /S/ sound clearly at the front of short words, then phrases and then sentences.

    The process takes some time and it depends on how ready the student is. This varies of course hugely so I can never promise the exact number of sessions we will take to get that Lisp fixed. A lot depends on home practice in between sessions, and this is of course crucial to all therapy! Every day 15-20 mins practice is a good average time to aim for and when this is done it shortens the therapy block drastically.

    I always give plenty of home work so there is never a chance of it getting boring or there being “nothing to do”!

    Do contact me. I really enjoy working with this type of student and get a great kick out of FIXING THAT LISP!

    Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

  • · ·

    The power of containment: A therapeutic approach for autistic children

    ByLondon Speech and Feeding
    Photo by lemonlenz

    The practice of wrapping or swaddling children, often referred to as ‘containment,’ has been used for centuries to soothe and comfort infants. I use this therapeutic approach with autistic children at the London Speech and Feeding Practice. While it might seem counterintuitive, the act of being tightly wrapped can provide significant benefits for children who struggle with sensory processing, emotional regulation, and communication.

    Understanding sensory processing and autism

    Autistic persons often experience challenges with sensory processing, which is their brain’s ability to interpret and respond to sensory information. This can lead to sensory overload or under-responsivity. Containment can be a valuable tool in helping children regulate their sensory input.

    Photo by lemonlenz

    To summarise, here are some of the benefits of containment:

    • Sensory Regulation:
      • Provides deep pressure input: The tight, enveloping sensation of being wrapped can provide deep pressure input, which is calming and organising for many children.
      • Reduces sensory overload: By creating a controlled sensory environment, containment can help to reduce overstimulation and promote a sense of safety.
    • Emotional Regulation:
      • Containment creates a sense of security: Being wrapped tightly can mimic the feeling of being in the womb, providing a sense of security and comfort.
      • Facilitates calming: The deep pressure input can help to calm the nervous system and reduce anxiety.
    • Improved Body Awareness:
      • Enhances proprioception: Containment can improve the child’s awareness of their body in space, which is essential for motor development and sensory integration. I often provide extra pressure on a child’s arms and legs sticking out of the yoga mat; this helps my child understand where their limbs are in space: I can feel my legs and I can feel my arms and I can feel where they are right now, i.e. they are under Sonja’s hand, I can feel them.
    • Facilitates Communication – and this is obviously where I come in as a Speech and Language Therapist:
      • Swaddling creates a safe space: When a child feels calm and secure, they are more likely to engage in communication.
      • Enhances joint attention: The shared experience of being wrapped can foster joint attention, which is essential for language development. You can see this one in my highlights where I swaddle my student in the yoga mat (picture above). She absolutely loves it, and what is more she is calm and steady when usually this child likes to be on the move constantly. Here we have a wonderful moment of joint engagement. She looks at me, she can listen to what I say or sing, and she can tell me in her own way to carry on rolling her or to carry on singing or providing calming pressure to her legs and arms or to stop.

    A few pointers for when you try this at home: How to practise containment safely and effectively

    • Create a safe environment: Ensure the wrapping material is soft, breathable, and free from any hazards.
    • Observe your child’s cues: Pay attention to your child’s body language and verbal cues to determine their comfort level.
    • Respect your child’s boundaries: If your child shows signs of distress, stop the containment immediately – this might seem obvious but sometimes we adults get so carried away with some ‘great idea’ that we have seen work elsewhere. And so we can be a little too ‘determined’ sometimes to ‘make it happen’… perhaps this rings a bell with some of my readers.
    • MAKE IT FUN: Start carefully and take it step by step. See if the student is having a nice time. It is all about trust and therefore it might not work the very first time you do it.

    It’s important to remember that containment is not a one-size-fits-all approach. Some children may respond better to other sensory-based interventions. However, for many autistic children containment can be a valuable tool in their journey towards improved communication and emotional regulation.

    For more information follow me on Instagram, Facebook or LinkedIn.

    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
  • · ·

    Chaining: A powerful tool for phonological development

    ByLondon Speech and Feeding

    Understanding chaining

    Chaining is a therapeutic technique I like to use in my speech therapy work with children who have Childhood Apraxia of Speech (CAS) or phonological speech sound difficulties. It helps to break down a complex target behaviour into smaller, more manageable steps. By systematically teaching and reinforcing each step, I can help my students achieve their communication goals.

    There are two types of chaining: Forward and backward chaining

    Today I am going to show and talk about backward chaining. This technique involves starting with the last step and working backward to the first. This approach can be particularly effective for children with persistent speech sound difficulties where combining consonants into clusters, such as /BL/ or /FR/ or /SHR/ is very difficult.

    Backward chaining allows my student to experience immediate success and build his confidence.

    In my video I show you how I applied backward chaining to the words ‘Shriek’, ‘Shrub’, ‘Shrimp’ etc

    My student struggles with both the /SH/ and the /R/ sounds and we have been working on both sounds for some weeks now. He has mild Childhood Apraxia of Speech and he has difficulties with coordinating his tongue movements, breathing and using his jaw effectively to make words. His sound repertoire has grown a lot since we started working together last year. Today in this session I show you how we pulled both the sound /SH/ together with /REEK/ to make ‘SHRIEK’. I love using the pictures and therapy materials from Adventures in Speech Pathology.

    This is also part of the Complexity approach which I will explain in a separate blog post.

    • Step 1 (not shown in the video): I explain what the word means; I find that when my student understands what a word means he is much better at saying it. It increases his confidence and motivation to say a word that he knows the meaning of. Often this student does not tell me that he does not know what a word means, so I always remind myself to check that out first.
    • Step 2 (not shown in the video): We do a little rhyming game and think about what any one word rhymes with: ‘Shriek’ – ‘meek’, ‘weak’, ‘seek’.
    • Step 3: I show my student that there are two parts to this word /reek/ and the sound /SH/.
    • Step 3: We practise the easier part: /reek/ /reek/ /reek/.
    • Step 4: We add the /SH/ sound and pull it together to make our target word ‘Shriek’.

    /REEK/ /REEK/ /REEK/ + /SH/ = ‘SHRIEK’
    /RUB/ /RUB/ /RUB/ + /SH/ = ‘SHRUB’
    /RUG/ /RUG/ /RUG/ + /SH/ = ‘SHRUG’

    By breaking down the word into smaller, manageable steps, my student can focus on each syllable individually, get that right and then gradually build up to the full word. This approach can help to reduce frustration and increase motivation.

    Forward chaining

    Forward chaining is the same process but in reverse: we start with the front sound or syllable and work forward towards the next/last part of the word:

    /SH/ + /REEK/ = ‘SHRIEK’
    /SH/ + /RUB/ = ‘SHRUB’
    /SH/ + /RUG/ = ‘SHRUG’

    Benefits of chaining

    • Increased motivation: By starting with the last step, my student experiences success, which boosts his motivation to continue trying to say the word and trying other words.
    • Reduced frustration: Breaking down the target behaviour into smaller steps can make the task less overwhelming, reducing frustration and anxiety.
    • Improved confidence: As the little learner masters each of the step, his confidence and self-esteem increases. Again, this leads to increased motivation.
    • Faster learning: By focusing on the final step first, and practising lots of chaining (forward and backward), a student can quickly learn to generalise to other words.

    Backward chaining (and forward chaining) is a really great tool for teaching complex speech sounds and words to children with phonological disorders.

    Watch out for my next blog which is all about the complexity approach in Phonology.

    Do get in touch if your child has a speech sound disorder, I would love to help.

    Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

    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
  • · · ·

    The joy of container play: Exploring play development and understanding of how things work

    ByLondon Speech and Feeding
    The joy of container play
    Designed by Freepik

    Have you heard the term ‘Container play’? I use this very often with children in my sessions as it is so versatile and an enjoyable activity that can be done in parallel with a child or together. Container play is a powerful tool for fostering development in young children, especially those with developmental delays. This seemingly mundane activity provides a rich environment for sensory exploration, motor skill development, and cognitive growth.

    What is container play?

    Container play involves children interacting with various containers—boxes, buckets, bowls, cups, various bags, etc.—and filling, emptying, and transferring objects within and between them. Objects can include literally anything: small beads, bead chains, table tennis balls, wooden pegs, dinosaurs or any other little person toy, blocks of varying sizes, sand, water, or any other safe material. Larger containers obviously take larger items: socks, stuffed animals, bigger balls, bigger blocks etc really the choices are endless.

    Benefits for children with developmental delays:

    Sensory exploration:

    • Touch: Children explore different textures and temperatures of containers and objects.
    • Sight: They observe how objects look inside and outside the containers, how light reflects off them, and how colours change.
    • Sound: They listen to the sounds of objects clinking, rattling, and splashing.
    • Proprioception: Filling and emptying containers helps develop body awareness and spatial awareness.

    For neurodivergent children who might have sensory regulation difficulties, consider the following adaptions to accommodate your child’s sensory needs:

    • Over-stimulation: For children who are easily overstimulated, start with simple setups using a limited number of containers and objects. Gradually increase the complexity as they tolerate it.
    • Under-stimulation: For children who seek sensory input, provide a variety of textures and materials, such as sand, water, slime, or beans.
    • Temperature: Offer a variety of temperature options. Some children may enjoy warm water or cool sand.
    • Lighting: Adjust the lighting to create a calming or stimulating environment.
    • Focus on one sense at a time: Initially, focus on one sensory aspect, such as the feel of sand or the sound of water.
    • Weighted containers: Use heavy containers filled with rice or beans to provide deep pressure input.
    • Fidget toys: Incorporate fidget toys into the activity to provide sensory input and help with self-regulation.
    • Tactile exploration: Encourage exploration of different textures using objects with varying surfaces.

    Fine motor skill development:

    • Hand-eye coordination: Scooping, pouring, and transferring objects require precise hand-eye coordination.
    • Pincer grasp: Picking up small objects helps develop fine motor skills like the pincer grasp.
    • Strength and dexterity: Manipulating containers and objects strengthens hand muscles and improves dexterity. Opening and closing containers can be a huge area of interest; how does the top screw back on, or off?

    Cognitive development:

    • Cause and effect: Children learn that their actions (e.g., pouring water or sand) have consequences (e.g., the water spills).
    • Spatial awareness: They develop an understanding of concepts like inside, outside, full, empty, and over/under; also how big is the vessel and how much goes in before it’s full or spills over. How small is the vessel opening and what do I need to do to get the beads into the container.
    • Problem-solving: Children learn to solve problems, such as how to get an object out of a narrow container or how to transfer water without spilling.

    Social and emotional development:

    • Communication: Container play can encourage communication as children interact with others, sharing toys and commenting on their actions. Asking for help to open and close a container is often a great opportunity to practise ‘help me’ or ‘open it’
    • Turn-taking: Sharing containers and materials helps children learn to take turns and cooperate.
    • Sensory regulation: For children with sensory sensitivities, container play can be a calming and self-regulating activity.

    Tips for engaging children in container play:

    • Create a safe and inviting environment. A shower curtain on the floor makes things easier for tidy up afterwards. And it allows for spillages.
    • Provide a variety of containers: Use different sizes, shapes, and materials. Use containers that are visually interesting and pleasing, perhaps a festive biscuit tin, or a tin that looks like train engine. Use see-through containers at first which make the filling and emptying more obvious. This is important for children who have no previous experience with this type of play and need to ‘warm up’ to it. Once a child loves and is used to container play you can go wild with all types of containers.
    • Offer a variety of objects: Include balls, blocks, sand, water, and other age-appropriate materials.
    • Join in the fun! Start off the process, show your child what the joy of the activity is for yourself, how fun it is to fill and empty containers, provide enough containers for your child to start playing alongside you, and comment on their actions.
    • Follow your child’s lead: Allow them to explore and experiment at their own pace.
    • Adapt activities: Adjust the level of challenge based on your child’s abilities and interests.

    Container play is a simple yet powerful tool that can support the overall development of young children, especially those with developmental delays. By providing a rich and engaging sensory experience, container play can help children build essential skills in motor, cognitive, social, and emotional domains.

    If you have any questions or would like to have more in-depths demonstration of this or other play styles for your child please contact me.

    I look forward to hearing from you.

    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.

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  • A Day In The Life Of An Independent Speech And Language Therapist

    ByLondon Speech and Feeding
    A Day In The Life Of An Independent Speech And Language Therapist

    A Day In The Life Of An Independent Speech And Language Therapist

    I often get asked how many clients/children I see per working day or what my working day/life looks like. I always reply that every day is different, which is true, but there is a sort of average working day which looks a bit like this:

    I usually start preparing for my first client of the day at around 9.30 am: I clean the room, wipe down all the toys and materials (that’s if they are coming to my clinic room) and then it takes me about 30 minutes to select and sometimes make suitable materials, games and activities for the child’s therapy programme. Client arrives at 10.30 am and the fun begins. They leave around 11.30am, and the cleaning and wiping down starts again – yes it’s the pandemic but to be fair I would do this anyway. I quickly write up my notes and send home work to the client via email. Now it’s 12 noon and I start preparing for the next client at 12.30 pm. This might be online parent-child interaction coaching and so I need different materials and activities that are suitable for teletherapy. We finish around 1.30 pm and I will write up my notes before having some lunch.

    Lunch tends to not be around 30 minutes. Around 2.00 pm I start prepping again for the next client: selecting activities, going over their last session, making sure I have everything I need to start at 2.45pm – we finish at 3.45pm, I write up my notes and then have a cuppa. The next client might be more on-line coaching or a child coming to see me: room cleaned and tidy, materials and activities prepared: client arrives at 4.30 pm and we finish at 5.30 pm. I clean the toys again, write up my notes and it is 6.00 pm ready for dinner. So that was four clients between 9 am and 6pm allowing for preparation, aftercare, cleaning and coffee and lunch.

    Other days I might see three clients and do more admin like ordering toys or books or teletherapy activities, or making materials (we therapist make tons of materials, we’d put Blue Peter to shame!) Sometimes I do two home visits, one in the morning and one in the afternoon – the travelling/parking in London is so time consuming that it really reduces the number of clients I can see which is why I don’t do many of those.

    I hand pick my clients to make sure that we are a good fit, and my service is bespoke: no one client gets the same treatment as another; each client is unique, usually very well-known and always highly valued. That takes time and means that in reality each client gets about 2 hours of my time, that is the actual session plus all the preparation and aftercare.

    I love this way of working and would not ever want to return to seeing tons of clients each day, not knowing any of them really well, due to high caseload numbers, staff shortages and an overload of administration.

    My way of working affords all my lovely clients the help they need to be able to feel empowered and to then support their children to make progress; when working with children they make the best progress they can make, fulfilling their potential. My lovely reviews and testimonials tell me that my clients appreciate the extra attention.

    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.

  • · ·

    Speech sounds practice at home

    ByLondon Speech and Feeding

    Speech therapists use a variety of tools to help children master specific sounds, and then the students are sent home with some practice sheets to use daily. Parents are able to observe what we do in the session, but I know that back at home three days later they can’t quite remember what it was all about and how to do the practice.

    Here I explain the importance of visual cues, finger shapes, pictures, and semantic prompts (fancy speech therapy term for word clues!). By understanding these tools, you can turn practice time into a fun and engaging experience for both of you.

    Why Visual Cues matter?

    Imagine learning a new language just by listening. It’s tough, right? Young children learning new speech sounds face a similar challenge. Visual cues act like flashcards for their minds, giving them a clear picture of how to position their mouth and tongue.

    • Mirrors: Encourage your child to watch your face (and theirs) in the mirror as you make the sound together. This helps them see the tongue placement and lip movements required.
    • Mouth pictures: Speech therapy sheets often have pictures of mouths making specific sounds. Point to the picture and explain how the tongue and lips look, then have your child try to imitate it.
    • Your face is the best cue! Don’t underestimate the power of your own face. Over-enunciate the sound and let your child observe your mouth movements. Watch this little video clip where I am teaching the /SH/ sound to my little student. You cannot see him but we are both sitting on the floor opposite one another so that he can see me easily.

    Finger fun: making sounds with our hands

    Finger shapes are another powerful tool in my speech therapy arsenal. Think of them as fun reminders of how to position the tongue.

    • ‘Open Wide’ fingers: For sounds like /AH/ and /OH/, hold your fingers wide apart, mimicking an open mouth.
    • ‘Tongue Up’ fingers: For sounds like /T/ and /D/, touch the tip of your thumb to your other fingers, creating a little ‘wall’ like the tongue tip touches the teeth ridge.
    • ‘Snake Tongue’ fingers: For the /S/ sound, wiggle your pinky finger to represent the snake-like tongue tip.
    • In this little video clip I am demonstrating the C-shape moving forward which I had taught my child, showing how the windy sound (/SH/) travels forward with lips open and slightly pursed.

    Bringing sounds to life with pictures

    Pictures serve as visual prompts to connect the sound with a familiar word.

    • Video clip: I am using the WINDY SOUND picture and the FLAT TYRE sound picture to represent /SH/ and /S/ respectively
    • Point and Say: Point to each picture and say the word clearly, emphasising the target sound. Encourage your child to repeat.

    Unlocking sounds with semantic prompts

    Semantic prompts are fancy words for clues that help your child guess the target sound. They can be simple questions or descriptive words.

    • ‘Can you feel the wind whooshing?’ (/SH/)
    • Think of tyre going flat, or a balloon losing air, or a train coming to a slow halt (/S/)

    Practice makes progress, but fun makes it funnier!

    Remember, the key is to keep practice sessions light and engaging. Here are some extra tips:

    • Short and sweet: Stick to short practice times (5-10 minutes) to avoid frustration.
    • Make it a routine: Integrate practice time into your daily routine, like after breakfast or before bedtime.
    • Positive reinforcement: Celebrate your child’s efforts with praise and high fives!
    • Make it multisensory: Incorporate sensory activities like blowing bubbles for /F/ or feeling the wind for /SH/.

    Parents you’re a vital part of your child’s speech development, and together we can make huge progress quickly.

    Please contact me if your child has speech sound difficulties.

    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