Autism Therapy

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

    ByLondon Speech and Feeding

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

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

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

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

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

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

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

    Learning the system first

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

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

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

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

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

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

    And I am completely comfortable with that at the beginning.

    Why start so explicitly?

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

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

    You might manage to find a few obvious words.

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

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

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

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

    We can practise it more than once.

    We can repeat it.

    And gradually, the route to that word becomes familiar.

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

    From structured practice to everyday life

    And this is where the useful transfer can happen.

    Take the word OFF.

    In our sticker activity, we may practise:

    ‘OFFS

    ‘OFFS

    ‘OFF’

    We take the sticker off.

    We find the button again.

    We use the word again.

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

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

    Suddenly:

    ‘OFF!’

    And they know exactly where to find it.

    The same thing might happen with ON.

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

    ‘Shoes ON.’

    ‘Lights ON.’

    ‘Music ON.’

    ‘Hat ON.’

    ‘Tap ON.’

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

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

    Natural modelling is still the goal

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

    Quite the opposite.

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

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

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

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

    And that’s okay.

    It is not about making the child press the button

    There is another important distinction here.

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

    I am not interested in turning AAC into a test.

    I am not continually asking:

    ‘Where’s HORSE?’

    ‘Find SHEEP.’

    ‘Show me CHICK.’

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

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

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

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

    This is what I love about AAC.

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

    It becomes part of the child’s own life.

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

    That is the direction I want families to move towards:

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

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

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

    Parents don’t have to get it perfect

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

    You do not have to become an AAC expert overnight.

    You are learning too.

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

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

    Any questions please contact me via my contact form.

    Sonja McGeachie

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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    Unlocking connection: Why the Hanen ‘More Than Words®’ approach works (BEST online!!)

    ByLondon Speech and Feeding

    As a Speech and Language Therapist, one of the most rewarding parts of my job isn’t just working on speech sounds or vocabulary lists. It’s helping parents truly connect with their autistic children.

    Recently, I had a 1-hour initial online session with the parent of a 7-year-old boy. In just 75 minutes, we achieved a massive breakthrough in perspective, all without parents setting foot into my traditional clinic setting or me visiting them at home.

    I had been sent some video footage of their child along with detailed parent questionnaire and both gave me so much information from which I then worked online with the parent.

    Here is a glimpse into what the Hanen More Than Words® approach is, how I structure my initial sessions, and why doing this work online with parents is often far more powerful than traditional therapy.

    What is the Hanen More Than Words® approach?

    The Hanen More Than Words® programme is an evidence-based framework designed specifically for parents of autistic children or children with social communication difficulties. Rather than treating communication as a clinical ‘lesson’ taught by a therapist, Hanen empowers parents to become their child’s primary communication partner. It focuses on turning everyday interactions, routines, and play into natural opportunities for a child to build connection, express themselves, and initiate communication at their own pace.

    How I structure the first session: Reframing expectations

    When parents first come to speech therapy, they often arrive with understandable anxiety and big, sometimes overwhelming, expectations. My primary goal in session one is to take those expectations, reframe them into realistic, hopeful goals, and establish a clear baseline of where we are right now.

    To do this, I use the Hanen Social Communication Checklist.

    In my session with any parent this tool is always a game-changer. Today, for example, it allowed us to celebrate every single achievement our child has already made, while highlighting the specific micro-skills we want to consolidate next. Instead of focusing on ‘fixing’ speech, our baseline focused on three functional social goals:

    • Responding to comments from others.
    • Initiating his own comments, requests, or questions (in whatever way he can).
    • Taking a single, natural conversational turn, even if that turn takes time to come.

    Why online therapy for Hanen works so well

    People often ask me: ‘Can speech therapy really be effective over Zoom?’

    My answer is an emphatic yes. And for Hanen, online is often superior to a clinic.

    In a clinic, a child is in an unfamiliar environment with a new adult, which can feel demanding or artificial. Online, the child stays in their safe, natural home environment. I get to coach the parent directly in real time, giving them immediate tools they can use every single day. In just one hour online today with one parent, for example, we got a massive amount of foundational work done without causing a single moment of stress for the child.

    Key takeaways: The power of silence, OWL, and agenda-free fun

    If you are looking to support an autistic child’s social communication at home, here are the core principles we put into home practice after our first session:

    1. Embrace the power of O.W.L. (Observe, Wait, Listen)

    We live in a fast-paced world where adults feel compelled to fill every quiet moment with questions (‘What’s that?’, ‘What colour is the car?’). Hanen flips this script.

    • Observe: Step back and see what truly captures your child’s interest.
    • Wait: Be comfortable with silence. Give your child the extra time they need to process their thoughts and formulate a response.
    • Listen: Pay attention to every sound, gesture, or attempt at communication.

    2. Become a buddy, not a teacher

    Try to play alongside your child the way another 5-to-7-year-old peer would. A peer doesn’t quiz, direct, or lecture; they do their own thing nearby, make occasional fun comments, and signal that they simply enjoy being together. Shift your role from communication director to play buddy.

    3. Comment naturally. Don’t ‘state the obvious’

    Once you master silence, narration should feel natural, spontaneous, and genuine.

    • Avoid: Pointing out things they already know just to test them (e.g., ‘That’s a blue car!’).
    • Try: Generic, enthusiastic reactions that invite connection without demanding a answer (e.g., ‘Whoa, look at that!’, ‘Goodness!’, ‘Hey, that’s cool!’).

    4. Have fun with no agenda

    School and daily routines carry a lot of demands for a 7-year-old. Take time every day to simply join your child’s world and have fun with zero clinical agenda. Laughter and genuine connection are the ultimate foundations for all communication.

    Interested in learning how the Hanen programme can support your family? Get in touch today to learn more about our online parent coaching sessions.

    Sonja McGeachie

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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    Beyond the teddy bear picnic: Why language development doesn’t always need imaginative play

    ByLondon Speech and Feeding

    As Speech and Language Therapists (SLTs), we are taught from day one that developmental milestones follow a predictable, linear path: first comes functional play, then symbolic and imaginative play (like pretending to feed a teddy bear or talking on a toy phone), and then comes conversational speech.

    But when working with language delayed children, I have seen something that completely contradicts those textbook charts.

    Many of my students have absolutely no interest in doll play, tea parties, or imaginary scenarios. Yet, as they mature, they still manage to develop robust, meaningful, and conversational language.

    How is this possible? And what does it mean for how we approach therapy?

    Redefining the ‘rules’ of play and language

    The idea that imaginative play is a strict prerequisite for language was built entirely on neurotypical developmental data. But neurodivergent brains don’t follow neurotypical roadmaps. That is not a deficit; it’s simply a different processing style.

    When Gestalt Language Processors bypass traditional imaginative play, they aren’t ‘missing’ a step. They are often using entirely different cognitive vehicles to build their language skills.

    The power of monotropic deep interests

    Video clip 2 lining up dinosaurs

    Many autistic individuals have a monotropic cognitive style, meaning they process the world through deep, single-focused passions (think trains, space, dinosaurs or ocean creatures).

    While a neurotypical child might practise social roles by pretending a doll is going to school, a neuro-diverse child practises language by categorising, analysing, and sharing facts about their deep interest. Their language is anchored in the concrete, fascinating reality of their passion, rather than fictional symbolic play.

    Gestalt Language Processing (GLP)

    A significant number of neuro-diverse children learn language in large ‘chunks’ or ‘gestalts’ (such as movie scripts, songs, or favourite phrases) rather than building sentences word-by-word.

    When a child scripts or uses echolalia, they are storing and mapping vast amounts of conversational data. They don’t need to pretend-feed a teddy bear to practise dialogue; they are actively processing the rhythm, intonation, and structural rules of speech through the media and phrases they love. As they grow, they learn to break these scripts apart to form original sentences.

    Structural play is learning play

    Just because a child is lining up dinosaurs or cars, stacking blocks, or spinning wheels instead of making them ‘talk’ doesn’t mean they aren’t learning. This functional and structural play builds crucial foundational skills like pattern recognition, cause-and-effect, and spatial awareness, all of which directly support cognitive and language development.

    Shifting Our Goals

    Meeting our children on their home turf: if that’s dinosaurs, let’s be creative with dinosaurs!

    If imaginative play isn’t the engine driving language, forcing it in the therapy room can quickly turn into an exercise in compliance rather than connection. Instead of trying to pull a child out of their world and into a neurotypical play model, we can meet them exactly where they are!

    Here are three affirming ways to turn deep interests into conversations:

    • Swap questions for comments (declarative language): Instead of interrogating a child about their play (‘What colour is that train? Where is it going?’) make pressure-free observations (‘Wow, that train is moving fast. Look at those wheels spin.’). This lowers conversational anxiety and models natural communication.
    • Bridge and expand: Use their favourite topic to introduce new ideas and concepts. If we love dinosaurs let’s see if dinos can climb up a ladder, slide down a half pipe into some water, then need drying before making footprints across a piece of paper…
    • Validate any scripts or echolalia and find out the EMOTION underlying it: If your child uses a quote from a favourite cartoon clip, let’s try and figure out in what context this phrase was said in the movie; what is the emotion in the movie when the character says this line? Is it upset? Is it joyful? Is it big surprise or a shock? Don’t dismiss it as meaningless. Acknowledge the emotion behind the script ‘You feel worried right now.’ This way we are showing our child that their unique way of communicating is heard and valued.

    So, to sum up:

    Imaginative play is just one way to learn language, not the only way.

    Let’s stop viewing a lack of pretend play as a barrier to communication, and free ourselves to see our children’s true strengths. By embracing their deep passions, we don’t just help them find their voice. We build a real connection that makes communication possible.

    Are you looking for neurodiversity-affirming speech and language support? Contact my clinic today to learn more about how I tailor my therapy to your child’s unique strengths.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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    Why pretend play is the perfect therapy vehicle for children with dyspraxia

    ByLondon Speech and Feeding

    Picture this. A small dinosaur is stomping across a wooden floor. A tiny teacup is being filled with imaginary juice. Someone, probably you, has just been told very firmly that you are the baby and you must go to sleep now.

    To the outside world, this is just play. Joyful, chaotic, completely ordinary toddler play.

    But for a child with Childhood Apraxia of Speech (CAS), also known as verbal dyspraxia, what is happening inside a well-designed pretend play session is anything but ordinary. It is, in fact, some of the most powerful motor speech therapy we have.

    Let me explain why.

    First, a quick reminder: what is dyspraxia?

    Childhood Apraxia of Speech is a motor speech disorder. The difficulty does not lie in the muscles of the mouth, those are perfectly capable. The difficulty lies in the brain’s ability to plan and sequence the precise movements needed to produce speech sounds consistently and accurately.

    A child with CAS knows what they want to say. The message is there. But somewhere between the intention and the execution, the plan breaks down. Words come out differently each time, or not at all. It is effortful, unpredictable, and for many children, deeply frustrating.

    What this means for therapy is important: CAS requires motor learning, not just language stimulation. And motor learning has very specific conditions under which it thrives.

    Repetition is the medicine and pretend play delivers it without the child noticing

    One of the most well-established principles of motor learning is that new movement patterns need to be practised many, many times before they become reliable. Think of learning to ride a bike, or to touch-type. Repetition is how the motor system builds consistency.

    For speech, this means a child needs many opportunities to attempt a target word or phrase within a single session. In a formal drilling exercise, this quickly becomes tedious and dysregulating, especially for young children. After five attempts at ‘go’, most three-year-olds have mentally left the building.

    But inside a pretend play scenario? The word ‘go’ appears naturally and meaningfully dozens of times. The car goes. The train goes. Ready, steady, go. Go to sleep. Go there doggie. Every repetition is embedded in a moment that makes sense to the child, which means they are motivated to keep going, and the practice is accumulating without any sense of effort or demand.

    A relaxed brain learns better

    There is a reason I tend not to sit a dyspraxic child at a table with flashcards and ask them to repeat after me. It is not because I lack structure. Every session I run has clear targets and intentional design. It is because we know that anxiety and pressure actively interfere with motor learning.

    When a child feels observed, corrected, or under pressure to perform, the cognitive load increases and the very motor planning system we are trying to support becomes less accessible. The errors increase. The frustration escalates. The session unravels.

    Pretend play, by contrast, creates a state of engaged, relaxed absorption. The child is leading. They are safe. They are having fun. In this state, the brain is far more receptive to new motor patterns being laid down. I am not asking the child to perform speech. I am simply being present, following their lead, and slipping in carefully chosen models at exactly the right moments.

    Child-led play gives us the child’s own words to target

    Another reason pretend play works so beautifully for children with dyspraxia is that it tells us exactly which words matter most to this particular child, right now, today. When a child reaches for the toy telephone and hands it to me with enormous expectation, I know that ‘hello’ is a word worth targeting in this moment. When they are clearly trying to tell me that the baby needs feeding, ‘more’ and ‘eat’ have instant, genuine relevance.

    Targeting words a child is already motivated to say means the communication attempt is coming from them. And a self-initiated attempt, even an approximation, is neurologically far more valuable than a prompted imitation.

    What this looks like in practice

    In the short video clip below you can see this dynamic in action. Notice how the session looks relaxed and playful on the surface. The child is absorbed in the pretend play scenario we have created together.

    Notice, though, what is happening underneath:

    • the consistent, gentle modelling of target words
    • the use of Makaton signs alongside speech to provide an additional sensory pathway
    • the visual mouth cues that give the child a roadmap for how a sound is shaped
    • and running through all of it, the repetition. The same words, again and again, wrapped in play.

    This is not therapy disguised as play. It is therapy that is play, because for a child with dyspraxia, those two things are not in opposition. They are, in fact, perfectly aligned.

    If you are concerned about your child’s speech and wondering whether verbal dyspraxia might be a factor, please do not hesitate to get in touch. I would love to help you find some answers.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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    How we can help shape smooth consonant blends

    ByLondon Speech and Feeding

    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.
    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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    When speech difficulties overlap: Helping children with phonological delay and childhood apraxia of speech

    ByLondon Speech and Feeding

    One of the questions parents often ask is:

    ‘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.

    Feel free to contact me on www.londonspeechandfeeding.co.uk

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

    Reference

    McNeill, B. C., Gillon, G. T., & Dodd, B. (2009). Effectiveness of an integrated phonological awareness approach for children with childhood apraxia of speech (CAS). Child Language Teaching and Therapy, 25(3), 341-366.

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    Your child’s communication journey

    ByLondon Speech and Feeding

    Understanding our neurodiversity-affirming, child-led approach

    Welcome to a different kind of therapy!

    Your child’s communication journey

    The start of a new year often brings fresh hope, and sometimes fresh worries, for parents supporting their child’s communication. I am always genuinely excited to begin a new journey with children and their families, and I know that, for many parents, this kind of therapy may look very different from what they were expecting.

    Parents (and children!) are often surprised to discover that our sessions are playful, joyful, and intentionally low-pressure. You won’t see demands for eye contact, sitting still, or being told to ‘do it this way’ or ‘put the red square there’. Instead, you’ll see your child being met exactly where they are.

    For families who have previously experienced more adult-led or behaviour-based approaches including Applied Behaviour Therapy, this difference can feel unfamiliar at first. Because of that, I want to take a moment to prepare you for what child-led, neurodiversity-affirming therapy looks like, so you can feel confident, comfortable, and reassured from day one.

    Why doesn’t child-led therapy look like ‘traditional’ therapy?

    Many people picture speech and language therapy as sitting at a table, using flashcards, or practising words through repetition. While those approaches can work well for some children, they are often not effective or appropriate for many neurodivergent children—including children with autistic profiles, ADHD, or demand-sensitive nervous systems.

    Our approach is grounded in a simple and powerful truth:

    Children learn best when they feel safe, motivated, and emotionally connected.

    When a child’s nervous system feels calm and secure, learning becomes possible. When a child feels pressured or controlled, communication often shuts down, even if they can speak.

    🎯 Our purpose: Communication through connection

    Our goal is not simply to help your child say more words. Our goals go deeper and are built on strong foundations:

    • Trust and regulation: We focus on building a trusting relationship where your child feels safe, understood, and emotionally regulated. A calm nervous system is the starting point for all communication.
    • Motivation: We follow your child’s intrinsic motivation, the things they naturally enjoy to make communication meaningful, joyful, and purposeful.
    • Spontaneous communication: We create opportunities for your child to communicate because they want to, not because they are asked or instructed to.

    🧸 What to expect in a session

    Our sessions are intentionally child-led and often look very much like play.

    FeatureWhat it looks likeWhy we do this
    Minimal toysWe usually offer just 3–4 carefully chosen activities (such as bubbles, blocks, or sensory play).Less is more. Fewer choices reduce overwhelm and help children focus on what genuinely interests them.
    Child choosesYour child decides what to play with and how to engage.This immediately establishes us as a safe, non-demanding partner and increases motivation.
    The therapist’s roleWe join your child’s play, observing closely and responding naturally.We model language, share attention, and reflect your child’s experiences in a way that feels natural and supportive.
    No pressure or demandsThere are no ‘must-do’ tasks. If your child wants to spin, crash, line up toys, or repeat an activity, we follow.Reducing demands lowers anxiety and supports communication, particularly for children with demand-sensitive profiles.

    Is this really effective?

    It’s completely natural to wonder, ‘Are they just playing?’ The answer is yes, and very intentionally so.

    Our sessions are guided by nearly 30 years of speech and language therapy experience, alongside clear, achievable goals tailored to each individual child. Play is a child’s natural language and their most powerful learning tool.

    Within play, we are constantly creating opportunities to:

    • Build joint attention (sharing focus and interest)
    • Model language at the right level
    • Encourage back-and-forth communication
    • Develop a deep, authentic connection

    If your child has struggled to engage or communicate in more structured or demand-heavy settings, this child-led approach is often the key to unlocking their potential.

    💛 What this might look like at home

    You may notice that when pressure is reduced:

    • Your child begins communicating more during everyday routines
    • Language emerges through play, movement, or shared enjoyment
    • Communication feels more natural and less forced

    Small moments could be a shared smile, a look, a sound, a gesture. All matter. These are the building blocks of meaningful communication.

    📚 Resources for parents

    If you’d like to explore these ideas further, you may find the following helpful:

    I look forward to meeting you and your child. Please bring any questions, uncertainties, or curiosities to our first session, there is no such thing as a silly question. This is a journey we take together. Contact me via my contact form.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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

    ByLondon Speech and Feeding
    Holiday disruptions & New Year routines

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

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

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

    1. Why routines matter so much. Especially now

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

    In December, typical patterns change:

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

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

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

    2. Protecting feeding progress during holiday mealtimes

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

    What helps:

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

    3. Supporting communication when routines are disrupted

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

    Strategies:

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

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

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

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

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

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

    Reference:

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

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    Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

    ByLondon Speech and Feeding
    Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

    Holiday meals are meant to be joyful and something we all look forward to. But for many children and their families, these occasions can be overwhelming and be the cause of dread and worry. The combination of new smells, unfamiliar foods, loud environments, social expectations, and allergy anxieties can quickly turn what should be a festive time into a stressful one.

    For parents of children with sensory processing differences, selective eating challenges, or food allergies, holiday gatherings often require careful planning and a big dose of tolerance and compassion. The good news is that with awareness and a few gentle strategies, you can support your child to feel safe, regulated, and included during festive meals without pressure, tears, or discomfort.

    Let’s explore how to make holiday mealtimes calmer, safer, and more connected this season.

    🎄 Why holiday meals feel so overwhelming

    Holiday gatherings usually combine several sensory triggers all at once:

    • Noisy, chaotic rooms
    • Strong smells from a mix of foods we don’t normally cook
    • Multiple conversations happening at once
    • Bright lights, Christmas décor, flickering candles
    • Unfamiliar foods with unexpected textures
    • Expectations to ‘try everything’ or ‘enjoy it’s sooo good!’
    • New environments, seating arrangements, or routines

    For children with sensory sensitivities, this can feel like a tidal wave of input. Research shows that children who are sensory-sensitive often have heightened responses to smell, taste, and texture, which may lead to avoidance or distress at mealtimes (Cermak, Curtin, & Bandini, 2010).

    Add food allergies into the picture and anxiety increases even further for both children and parents. A 2020 study by DunnGalvin et al. found that children with food allergies experience significantly higher stress in shared eating environments, especially when food preparation or contamination risk is hard to control.

    So, if your child becomes tearful, shuts down, or refuses to sit at the festive table, it isn’t ‘bad behaviour.’ It’s sensory overload, heightened vigilance, or discomfort communicating through their body.

    🌟 Preparing your child for a calmer festive meal

    Preparation is especially important for sensory-sensitive or allergy-aware children. Here’s how to set them up for success:

    1. Offer predictability through previewing

    Before the event, show your child pictures of:

    • where you’re going
    • who will be there
    • the types of foods that might be served
    • where they might sit

    A visual schedule or social story can help reduce anxiety and give your child a sense of control.

    2. Pack safe foods without apology

    If your child has allergies or selective eating, bring:

    • ‘Safe foods’ you know they will eat
    • Backup snacks
    • A separate (their own) plate, if needed
    • Emergency medication

    Announce clear, firm boundaries such as:

    ‘Ok people, these are Jamie’s safe foods — we’ll stick with these today.’ This will help relatives understand without pressure or judgement.

    3. Choose seating that supports sensory regulation

    If possible, seat your child:

    • at the end of the table
    • near a familiar adult
    • away from the kitchen (strong smells)
    • away from noise clusters
    • give them their favourite toy or fidget whilst waiting

    Let them take breaks when needed. This isn’t ‘rude,’ it’s self-regulation.

    🍽️ Supporting children during the meal

    1. Focus on connection, not consumption

    The holidays are not the time to expand your child’s food range. Keeping mealtimes low-pressure actually supports long-term progress.

    In fact, the research is clear: pressuring children to eat decreases acceptance and increases refusal (Galloway et al., 2006).

    So instead of ‘Just try it!’ try:

    • ‘You don’t have to eat it, you can look at it.’
    • ‘You’re in charge of what goes in your mouth.’
    • ‘You can keep your safe foods on your plate.’

    2. Protect your child’s allergy safety

    Holiday meals often include:

    • cross-contamination risks
    • shared utensils
    • buffets
    • homemade dishes without ingredient lists

    Use gentle but firm scripts:

    • ‘Because of Ellie’s allergies, we’ll keep her plate separate.’
    • ‘We’ll serve her food ourselves to make sure she stays safe.’

    Confidence in your boundary helps others respect it.

    3. Manage sensory load in real time

    Offer:

    • headphones
    • a small chew or fidget toy
    • a designated ‘calm corner’
    • time outside for fresh air
    • a predictable signal for breaks (e.g., a hand squeeze or card)

    Remember, sensory regulation is healthcare, not ‘giving in.’

    4. Model calm eating

    Children learn most from watching.

    Slow, happy bites and relaxed facial expressions tell the nervous system: ‘This environment is safe’.

    💛 What to say to well-meaning relatives

    Families often have big feelings about food. You can prepare nice phrases like:

    • ‘We’re focusing on helping him feel safe around food today.’
    • ‘She has allergies, so we’re sticking to our plan.’
    • ‘We’re avoiding pressure because it helps him eat better long term.’
    • ‘We’re celebrating together, eating is not the goal today.’

    Setting expectations ahead of time can reduce awkward moments later.

    🎁 The bigger picture: It’s about safety, not ‘picky eating’

    Children with allergies, sensory differences, or feeding challenges aren’t trying to be difficult. They are trying to stay safe, regulated, and comfortable.

    Your calm presence, gentle boundaries, and preparation create the conditions for a holiday that feels peaceful, not pressured.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

    📚Research References

    Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–246.

    DunnGalvin, A. et al. (2020). APPEAL-2: A pan-European qualitative study to explore the burden of peanut-allergic children, teenagers and their caregivers. Clinical & Experimental Allergy, 50(11), 1238–1248.

    Galloway, A. T., Fiorito, L. M., Francis, L. A., & Birch, L. L. (2006). ‘Finish your soup!’ Counterproductive effects of pressuring children to eat on intake and affect. Appetite, 46(3), 318–323.

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    Let’s ditch the ‘Fix-It’ approach to autistic play and stimming

    ByLondon Speech and Feeding
    Let’s ditch the 'Fix-It' approach to autistic play and stimming

    December is often presented as a time of perfect, reciprocal play. Children are supposed to be unwrapping toys, sharing, and engaging in imaginative scenarios with family. But for parents of young autistic children, this high-pressure, socially demanding period can often feel like a battleground.

    If you’ve been told to interrupt your child’s stimming, push for eye contact, or force them to play ‘functionally’ with toys, it’s time to take a deep breath. Those traditional approaches are not only stressful—they often miss the point of your child’s communication.

    As a neurodiversity-affirming Speech and Language Therapist, I want to encourage you this December: You are allowed to follow your child’s lead, validate his or her unique interests, and trust that his or her play and movement are profoundly meaningful.

    1. Stimming: not a distraction, but a regulator 💡

    Stimming is short for self-stimulatory behaviour and includes repetitive movements or sounds like hand flapping, humming, rocking, finger flicking, or repeating phrases (called echolalia).

    For years, parents were incorrectly advised to block or eliminate these behaviours. The neurodiversity-affirming view tells us the exact opposite: Stimming is a vital and essential tool for your child’s self-regulation.

    Think of stimming as an internal volume dial:

    • Too loud/overwhelmed: Your child may stim to reduce incoming sensory input (e.g., rocking to ground himself or herself in a busy room).
    • Too quiet/under-stimulated: Your child may stim to increase sensory input and focus (e.g., running back and forth to maintain alertness).

    The shift: validate, don’t block

    Instead of saying, ‘Stop flapping your hands’, try to understand the message behind the movement.

    • Observe: When does the stimming happen? Is it before a meltdown? When your child excited? When your child is bored?
    • Validate: Name the need, not just the behaviour. You might say, ‘I see your body needs to move fast right now. That helps you calm down!’
    • Co-regulate: If the stim is unsafe (e.g., head-banging), help your child find a safer, alternative stim that meets the same sensory need (e.g., pushing hard against a wall, squeezing a stress ball).

    By validating your child’s need to regulate, you are building trust, reducing anxiety, and teaching him or her critical self-awareness.

    2. Autistic play: Meaningful, even if it’s monologue

    The traditional idea of ‘good play’ often involves turn-taking, pretending, and specific toy functions (e.g., pushing a train around a track). When an autistic child spends 30 minutes lining up cars, spinning their wheels, or scripting whole scenes from a favourite movie, it can often be dismissed as non-functional or repetitive.

    In neurodiversity-affirming practice, we recognise that autistic play is authentic play. These activities are crucial for learning, deep focus, and imaginative development.

    • Lining up toys may be an exploration of patterns, visual organisation, and order.
    • Spinning wheels may be a deep interest in cause-and-effect and visual sensory input.
    • Scripting is often a way to process language, regulate emotions, and practise complex social situations in a safe, controlled way.

    Make a change: Join your child’s world, don’t drag them to yours.

    Stop trying to force the ‘right’ way to play. Instead, try these neuro-affirming strategies:

    1. Be a co-regulator, not a director: If your child is lining up cars, sit down next to him or her. Instead of moving a car, try handing him or her another car to line up. Focus on the shared interest rather than forcing interaction.
    2. Narrate (don’t question): Avoid constantly asking, ‘What are you doing?’ or ‘What does this car say?’ This puts pressure on your child to perform. Instead, narrate your observations using his or her interest: ‘I see you made a long, straight line of red cars. Look at all the wheels spinning!’
    3. Validate the interest: Show genuine appreciation for your child’s focus. ‘Wow, you know so much about how magnets stick together! That’s incredible.’

    3. The communication revolution: Honouring gestalt language processing 

    Many young autistic children communicate in ways that don’t fit the traditional model of building language word-by-word. Many use Gestalt Language Processing (GLP).

    A gestalt language processor learns language in chunks or scripts (e.g., ‘what’s-in-there?’ or ‘ready-go!’). These chunks (or gestalts) are not random; they are often tied to an emotional memory or meaning. Over time, the child breaks down these big chunks into individual words then learns to recombine those words creatively.

    If your child repeats movie phrases or whole sentences that seem unrelated, he or she is likely a gestalt language processor!

    Affirm the script, then model something useful.

    1. Affirm the script: When your child says a script, respond to the meaning or emotion behind it, not the literal words. If he or she says, ‘We’re going to need a bigger boat’, and he or she is looking at a messy toy pile, he or she may be trying to express overwhelm or a need for help. You can affirm: ‘That pile is too big! I can help you move it.’
    2. Model new ‘mix and match’ scripts: To help your child move from whole scripts to single words, you can model shorter, slightly changed versions of the script, also called ‘mitigated gestalts’. If they say, ‘I want to go home now’, you might model, ‘Let’s go home, now’ or ‘I wanna go home’.

    By honouring your child’s communication style, you validate his or her experience and naturally support his or her path to language development—a core part of neurodiversity-affirming SLT.

    Your December gift to your little one:

    This December, stop trying to make your child fit into a neurotypical box. Instead, make your home a safe space where he or she can be his or her authentic selves.

    Prioritise regulation and connection over compliance.

    Trust that when your child is regulated, his or her communication, learning, and engagement will flourish naturally. This is the true gift of neurodiversity-affirming practice.

    Download and print my neuro-affirming quick reference guide and keep this guide handy on your fridge and/or in your child’s play area for a quick reminder to prioritise connection over conformity.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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    What to do when words don’t come fast enough

    ByLondon Speech and Feeding
    What to do when words don’t come fast enough

    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:

    1. Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
    2. Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
    3. Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
    4. 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

    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. 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.

    And download and print my one page summary.

    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

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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    The joyful language toolkit: Strategies for connecting with your child through play

    ByLondon Speech and Feeding

    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.

    1. 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! 😊
    2. 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!!
    3. 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.
    4. Elongating our words: Stretching out key sounds or words gives them emphasis and more time for your child to process. ‘Criiiinkley’ ‘tiiickleyyyy’
    5. 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’.
    6. 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’.
    7. Catchy phrases: Repetitive, positive phrases create a sense of shared fun. Use them consistently: ‘Oh, that’s a nice one!’ or ‘We like that!’
    8. 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.
    9. 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.
    10. 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’.
    11. 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.
    12. Getting turns: Explicitly teach and celebrate getting turns in a game. ‘My turn! Your turn!’ This is a foundational social and communication skill.
    13. 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!’
    14. 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.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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