Unlocking communication: My daily life with the Saltillo 88 Core Board
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Unlocking communication: My daily life with the Saltillo 88 Core Board

ByLondon Speech and Feeding

Introduction

As an AAC speech and language therapist who uses the Saltillo 88 Core board every day, I can tell you it’s more than just a communication tool. It’s a doorway to independence, connection, and expressing my students’ unique voice.

What is the Saltillo 88 and why do I use this one?

In this blog post, I want to share practical, real-world examples of how I integrate the Saltillo 88 into various daily activities, empowering my students and parents to learn to communicate.

There are literally hundreds of core boards out there and I have tried many different ones over the years. Which one should I use with this particular client? Should I make up my own? (I have made up tons!) or should I use a ready-made one like the one below which is what this blog is about.

For me the best ones are boards with a good number of core words (at least 60) so that the board is versatile and can be used across a range of activities. The board needs to have a range of pronouns, verbs, descriptors, prepositions and question words to be useful and to stimulate not just requesting but commenting and asking questions. Another consideration is: can the board easily be transferred to a more robust AAC system. Once my student is used to the symbols and where they are could we move to an electronic talker/device. And if this answer is ’yes’ then we have a great board to get started with.

Below is a picture of the Saltillo 88.

Saltillo 88 Core Board
Saltillo 88 Core Board

It has 88 words and I find it really does suit most activities. The same board and design is also then found on the TOUCHCHAT AAC device which can be a seamless transition for our learner.

Let me dive into how core words/board or AAC can be used daily:

1.  Getting dressed

Whilst choosing clothes for your little one and getting them ready for the day you can use the following words: want, like, get, finish. Always pack the words into little phrases you can speak naturally when using a board. I have tried to show you phrases that you could use below.

The words in bold are the core words on the board and the other words are just words you say whilst pointing to the core word.

  • Goal: Express choices, needs, and preferences about clothing.
  • Ideas:
    • ‘I want this one [specific item of clothing: ‘shirt’, ‘pants’]’
    • ‘I like that one [colour/type of clothing]’
    • ‘Help me [put/get it on/take off]’
    • ‘let’s get your socks now’
    • ‘finished let’s go’ (when dressed)

2. Having a shower/bath

  • Goal: Bath time tends to happen daily and so it lends itself to using the same useful phrases and words to chat about temperature preferences, to ask for toys or for washing routines.
  • Ideas:
    • ‘let’s go have a bath/shower’
    • ‘let’s turn on the tap/water’
    • ‘now turn it off’
    • ‘let’s get/have more toys/water/bubbles/tickles’
    • ‘all gone, what’s next?’
    • ‘how about washing your hands/feet’
    • ‘let’s do that again’
    • ‘need some help?’
    • ‘Stop it now, let’s do something different’

3. Mealtimes

  • Goal: Mealtimes can be (or should be) enjoyable and motivating to ask for specific things we like, and commenting about our eating experiences.
  • Ideas:
    • ‘I want/give me [food item: ‘apple’, ‘bread’]/[drink item: ‘water’, ‘juice’]’
    • ‘More foods/drinks/snacks’
    • ‘All done’
    • ‘that’s messy we like that (not)’
    • ‘Like’/‘Don’t like’
    • ‘Big’/‘Little’
    • ‘this is so nice!’

4. Playing

  • Goal: This is where it’s at for children of course and we can use our core words to chat and engage with our little learners.
  • Ideas:
    • ‘I want play’
    • ‘Go’/‘Stop’
    • ‘More/again’
    • ‘not it’s my My turn’/’it’s Your turn’
    • ‘that’s a Big one!’/‘let’s do Little bubbles’ (describing toys)
    • ‘let me Open it for you’ (for boxes, doors in play)
    • ‘I See it’ (to draw attention)
    • ‘Help me’ (with a tricky toy)

5. Opening boxes/doors/etc

  • Goal: Most kids love opening boxes, doors and cabinets to see what there is to play with. Help your child to ask for what they want.
  • Ideas:
    • ‘let’s Open that box/bag/zip/door’
    • ‘get me a (toy) out of here’
    • ‘Let’s Take it out and see what it is?’
    • ‘finished’ (when finished with the task)
    • ‘I want [what’s inside]’
    • ‘What’s next? Let’s see’

Tips for using AAC effectively

  • Consistency is key: Emphasise using it regularly, even for small things.
  • Modelling: this is crucial, the adults need to use the board for all situations first and foremost before we can expect our child to be interested.
  • Patience: Communication takes time and practice.
  • Celebrate successes: Acknowledge every communicative attempt.
  • Make it accessible: Keep the board within easy reach at all times.

Conclusion

If you’re considering the Saltillo 88, or TouchChat, or are already using it, I hope these examples inspire you. It’s a journey of discovery, and every word communicated is a step towards a more connected and independent life. What are your favourite ways to use the Saltillo 88 or which core board do you love using? I would love to hear your comments and stories.

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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Seeing sounds: How visual gestures boost speech sound learning
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Seeing sounds: How visual gestures boost speech sound learning

ByLondon Speech and Feeding

Learning to produce new speech sounds can be a complex process for young children, especially those facing challenges with speech sound disorders or motor planning difficulties. It’s not just about knowing what a sound ‘should’ sound like; it’s about figuring out where to put your tongue, how to shape your lips, and how much air to push out. This is where the power of visual gestures comes in – literally helping children see how to make sounds.

As speech and language therapists, we frequently use visual cues and hand gestures to teach articulation. These techniques are incredibly effective, particularly when a child is struggling with the motor planning aspect of speech production.

In the video clip above you see me teaching

  • the /SH/ sound: the hand makes a C-shape and moves forward showing both how the lips are positioned and the air flowing forward
  • the /S/ sound: the index finger shows a snake like movement going forward- also showing the air flow again
  • the /W/ sound: my right hand moves forward and fingers splay out showing that the lips open up at the end of the sound
  • the /K/ sound: my finger points to the back of my throat where the tongue needs to raise.

An overview of motor planning for speech – what do we mean by that?

Think about learning to ride a bike or play a musical instrument. You don’t just know how to do it instantly. You have to plan the movements, practise them, and make adjustments. Speaking is similar! Our brains must:

  1. Plan the sequence of movements needed for each sound and word (e.g., /B/ requires lips together, then release, while /T/ requires the tongue tip behind the top teeth, then release).
  2. Execute those plans rapidly and precisely.

For some children, especially those with conditions like Childhood Apraxia of Speech (CAS) or other severe articulation disorders, this motor planning process is disrupted. They know what they want to say, but their brain struggles to send the correct, consistent messages to their articulators (lips, tongue, jaw, velum). This can make speech sound learning incredibly frustrating.

Why use visual gestures?

Visual gestures provide an additional, powerful sensory input that can help bridge the gap between knowing a sound and producing it. Here’s how and why they are so beneficial:

1.      Providing a visual map:

  • How it helps: Many speech sounds are ‘hidden’ inside the mouth. It’s hard for a child to see where their tongue needs to go for a /K/ sound (back of the tongue to the roof of the mouth) or a /T/ sound (tongue tip behind teeth). A simple hand gesture can visually represent this mouth movement. For example, a hand gesture for /K/ might involve sweeping the hand back towards the throat, while for /T/, it might be a tap on the chin.
  • Why it works: Children are highly visual learners. Seeing a physical representation of an abstract mouth movement gives them a concrete ‘map’ to follow, making the process less mysterious and more manageable.

2.      Enhancing motor planning and memory:

  • How it helps: When a child simultaneously moves their hand (the visual gesture) and attempts to make the sound, they are engaging multiple sensory systems (visual, tactile, proprioceptive – body awareness). This multi-sensory input strengthens the neural pathways associated with that speech sound.
  • Why it works: This multi-modal learning helps to solidify the motor plan for the sound in the brain. It’s like having more ‘hooks’ to hang the information on, making the sound easier to recall and produce consistently. The gesture becomes a built-in reminder.

3.      Reducing cognitive load:

  • How it helps: Instead of just hearing the sound and trying to figure out the complex motor sequence, the child has a visual cue to guide them. This reduces the mental effort required to decode the sound production.
  • Why it works: When cognitive load is lower, the child can focus more effectively on the specific motor execution of the sound, leading to faster progress and less frustration.

4.      Increasing engagement and success:

  • How it helps: Gestures can make therapy more interactive and fun! When a child successfully produces a sound with the help of a gesture, it’s a tangible victory.
  • Why it works: Success is a powerful motivator. When children experience success, they are more likely to stay engaged, participate actively, and feel more confident in their ability to learn new sounds.

5.      Supporting self-correction:

  • How it helps: Once a child learns the gesture associated with a sound, he or she can use it as a self-monitoring tool. If he or she makes an error, he or she can use the gesture to remind himself or herself of the correct mouth position or movement.
  • Why it works: This promotes independent learning and reduces reliance on constant adult prompting.

Conclusion

The journey of speech development can be challenging, but visual gestures offer a powerful and effective tool for teaching new sounds, especially when motor planning is a factor. By providing a clear visual map, strengthening motor memory, reducing cognitive load, and fostering engagement, these gestures pave the way for clearer communication and greater confidence. If your child is struggling with speech sounds, consider talking to a Speech and Language Therapist to get guidance on how visual gestures might be incorporated into the therapy plan. Because sometimes, seeing truly is believing (and speaking!).

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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The quiet power: Why silence and responsiveness boost communication in children with delays
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The quiet power: Why silence and responsiveness boost communication in children with delays

ByLondon Speech and Feeding
The quiet power: Why silence and responsiveness boost communication in children with delays
Supplied by Sonja McGeachie, Practice Owner

As parents and caregivers, our natural instinct when interacting with a child, especially one who struggles with communication, is often to fill every silence. We might ask lots of questions, offer constant commentary, or try to prompt him or her to speak. Our hearts are in the right place. We want to help him or her communicate! However, for children with language delays or those on the autism spectrum, this well-intentioned approach can sometimes inadvertently create more pressure and fewer opportunities for them to truly initiate and develop their own communication skills.

What if I told you that one of the most powerful tools in your communication toolkit is often silence? And that responding to your child, rather than always initiating, can unlock incredible potential?

Let’s explore why these seemingly simple strategies are so profoundly beneficial.

The unspoken benefits of silence

In our fast-paced world, silence can feel awkward, but for a child who is processing language differently, it’s a gift:

  1. Time to process: Children with language delays often need more time to process what they hear and to formulate their own thoughts or responses. When we bombard them with words, we don’t give their brains the crucial milliseconds they need to catch up. A pause of 5–10 seconds can make all the difference.
  2. Reduces pressure: Constant questioning or prompting can feel like a test. Silence removes this pressure, creating a more relaxed environment where the child feels safe to communicate without fear of being ‘wrong’ or rushed.
  3. Creates opportunity to initiate: If you’re always talking, when does your child get a turn to start the conversation? Silence opens up a space for him or her to initiate, whether it’s through a sound, a gesture, eye contact, or a word. This is vital for developing spontaneous communication.
  4. Encourages independent thinking: When a child is given space, he or she is more likely to try to figure things out himself or herself. This fosters problem-solving skills and reduces reliance on adult prompts.
  5. Prevents overwhelm (especially for ASD): Many children on the autism spectrum can be sensitive to auditory input. A constant stream of language can be overwhelming, leading to withdrawal or challenging behaviours. Strategic pauses can help them regulate and engage more effectively.

The power of responding (not just initiating)

Think of a tennis match: if only one person serves, it’s not a game. Communication is a rally, a back-and-forth exchange. When you primarily respond to your child’s communication attempts, you’re teaching him or her the rhythm of conversation:

  1. Follow the child’s lead: This is a cornerstone of effective language intervention, famously championed by programs like Hanen’s ‘It Takes Two to Talk’. When you respond to what your child is already interested in or doing, the interaction becomes immediately relevant and motivating for him or her.
  2. Validates his or her attempts: Every sound, gesture, glance, or partial word your child offers is a communication attempt. By responding to it, you’re telling him or her, ‘I see you. I hear you. Your communication matters.’ This builds immense confidence and encourages him or her to try again.
  3. Builds confidence and motivation: When a child feels understood and successful in his or her communication, he or she are more likely to communicate more often. It’s a positive feedback loop.
  4. Teaches turn-taking naturally: By taking your turn after his or hers, you model the natural flow of conversation. He or she learns that communication is a shared activity, not a one-sided lecture.
  5. Makes interactions meaningful: When you respond to his or her interests, you’re talking about things that are inherently motivating to him or her. This makes the language you use more easily understood and remembered.

Practical strategies for parents: Observe, Wait, Listen (OWL)

The Hanen Centre’s ‘Observe, Wait, Listen’ (OWL) strategy perfectly encapsulates these principles:

  • Observe: Watch your child closely. What is he or she looking at? What is he or she doing? What sounds is he or she making? What gestures is he or she using?
  • Wait: After you’ve observed, wait. Give him or her time. Resist the urge to jump in with a question or comment immediately. Count to five (or even ten) in your head. This silence is an invitation for him or her to communicate.
  • Listen: When he or she does communicate (in any way!), listen intently. Try to understand his or her message or intent.

Beyond OWL – More tips:

  • Reduce questions, increase comments: Instead of ‘What’s that?’ try ‘Oh, a big red ball!’ or ‘The car is going fast!’ Comments provide language models without demanding a verbal response.
  • Expand, don’t just prompt: If your child says ‘Car’, you could respond with ‘Yes, That’s a big car!’ or ‘It’s really fast!’ You’re building on his or her communication with a slightly richer language model.
  • Create opportunities for communication: Place desired items slightly out of reach. This creates a natural reason for your child to communicate his or her wants (e.g., reaching, pointing, vocalising).
  • Respond to all communication: Don’t just wait for words. If your child points, look where he or she is pointing and comment. If he or she makes a sound, imitate it or respond with a related word.

In summary

Embracing silence and prioritising responsiveness might feel counterintuitive at first, especially when you’re eager for your child to talk. However, these powerful strategies create a nurturing, low-pressure environment that encourages spontaneous communication, builds confidence, and truly meets your child where he or she is. By giving your child the space and the meaningful responses he or she needs, you’re laying a strong foundation for his or her communication journey.

Try incorporating these ‘quiet powers’ into your daily interactions and watch your child’s communication blossom.

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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The purpose and nature of a speech and language therapy assessment
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The purpose and nature of a speech and language therapy assessment

ByLondon Speech and Feeding

If you have ever wondered what happens when you bring your child to a speech and language therapy assessment, then this blog will shed light on the ins and outs of it for you.

At its heart, a speech and language therapy assessment is a systematic and thorough evaluation of your child’s communication or eating/swallowing abilities. It’s more than just asking a few questions. It is a carefully constructed process designed to identify strengths, pinpoint challenges, and ultimately pave the way for effective intervention.

Establishing a detailed profile – a few bullet points:

  • Identification of communication and swallowing difficulties: I aim to determine if a communication or swallowing disorder exists. I will establish if the difficulty is a delay or a more complex disorder.
  • Diagnosis of the specific disorder/autism: The assessment delves deeper to pinpoint the specific type and nature of the difficulty. For instance, is your child’s language delay due to a specific learning disability, a developmental delay, or another underlying condition?
  • Knowing the aetiology or what is causing a difficulty is crucial for targeted intervention. And whilst we are on the topic let’s talk about an autism assessment: I am trained and experienced in assessing and diagnosing autism. However, when it comes to the diagnosis of autism I provide a preliminary ‘working hypothesis’ rather than giving a definite final diagnosis. The reason for this is that it is considered the ‘gold standard’ and ‘best practice’ to diagnose autism in a multi-disciplinary setting and context. Since I work on my own, I always refer to highly recommended multi-disciplinary clinics for the ultimate diagnostic assessment.
  • Determination of severity: Understanding the severity of the difficulty is essential for prioritising intervention and measuring progress. Is your child’s difficulty mild, moderate, or severe? This helps me choose a particular approach and then tailor it to suit each individual child.
  • Identification of underlying strengths and weaknesses: An assessment doesn’t just focus on what’s wrong. It also highlights your child’s strengths and areas of relative ease. This information is invaluable for building upon existing skills during therapy. Understanding weaknesses provides specific targets for intervention.
  • Guiding intervention planning: The assessment provides the crucial information I need to develop an individualised intervention plan. The findings directly inform the selection of therapy goals, strategies, and techniques. Without a thorough assessment, therapy would be a shot in the dark.

A multi-faceted approach

A speech and language therapy assessment is not a ‘one-size-fits-all’ procedure. The specific tools and techniques used will vary depending on a child’s age, the nature of the suspected difficulty, and other relevant factors. However, most comprehensive assessments incorporate several key components:

  • Case history: This involves gathering information about your child’s developmental, medical, social, and educational background. We will go through all the relevant milestones and throughout the process I will make notes which will help bring all the puzzle pieces together.
  • Observation: I will observe how parent and child play together and we also look at how the child plays by themselves. Additionally of interest is how a child plays with me, the therapist. Through discussion I will also endeavour to find out how your child plays with other children, be it at the nursery or within the family.
  • Standardised assessments: These are commercially available tests with specific administration and scoring procedures. They provide norm-referenced data, allowing to compare the individual child’s performance to that of his or her peers. Examples include articulation tests, language comprehension and production tests, and fluency assessments. I tend not to use these assessments a lot.
  • Instead, I use non-standardised assessments: These are more flexible and allow to probe specific areas of concern in more detail. This might include language samples (analysing spontaneous speech), dynamic assessment (testing and teaching to identify learning potential), and informal observation of play or interaction.
  • Immediate feedback and report writing: During and thenfollowing the assessment, I will bring all the gathered information together and I will discuss with the parents what my findings are and what my recommendations in the short term are. Parents always go home with a good handful of useful strategies that they can implement at home right away. In addition, I provide a comprehensive report outlining the findings, diagnosis (if applicable), severity, strengths and weaknesses, and recommendations for intervention.

In conclusion, a speech and language therapy assessment is a dynamic and essential process. It is a journey of discovery, aiming to understand a child and the child’s family and his or her unique communication or feeding profile. The assessment is usually the start of our wonderful learning journey together.

Below is a short video clip of an assessment where you see me in action explaining a particular therapy approach to a set of parents. It perhaps shows a tiny bit of how relaxed we are in our sessions and that assessment is not at all daunting, but a hugely informative event overall which will leave you feeling empowered and hopeful.

What happens after an assessment?

Please feel free to get in touch with me via my contact form if you wish to have an assessment for your child’s communication difficulties or feeding difficulties.

An assessment is always a stand-alone event and does not mean you need to automatically book follow up sessions at all. It will give a lot of information and based on this you can decide if you would like more therapy or follow up for you and your child. Many times ongoing therapy is not needed! I only recommend a course of therapy if it is really needed and where it would be immediately beneficial for your child.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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 power of imitation in supporting children with autism
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The power of imitation in supporting children with autism

ByLondon Speech and Feeding
Image by Freepik

Imitation, the act of mirroring someone else’s actions, gestures, sounds, or words, is a fundamental skill that plays a crucial role in human development. It’s how babies learn to wave ‘bye-bye’, how toddlers pick up new words, and how children acquire social skills. But for children with autism imitation can be a significant challenge and understanding why it’s important and how to foster it becomes a key focus for parents, educators, and speech and language therapists.

Why is imitation important?

Imitation is a building block for a wide range of developmental skills:

  • Social interaction: Imitation is the foundation of social reciprocity. When a child imitates, he or she is engaging in a shared experience, connecting with another person, and learning to take turns in social exchanges.
  • Communication development: Imitation is closely linked to language acquisition. Children often imitate sounds and words before they can produce them independently. Imitation also helps them understand the meaning of gestures and facial expressions, which are vital for nonverbal communication.
  • Cognitive development: Imitation plays a role in problem-solving, learning new skills, and understanding cause and effect. By imitating actions, children explore their environment and learn how things work.
  • Emotional development: Imitation helps children understand and share emotions. When a child imitates a smile, he or she may begin to understand the feeling of happiness.

Imitation challenges in autism

Many children with autism face challenges with imitation, which can affect their development in these key areas. These challenges can manifest in different ways:

  • Difficulty imitating motor actions: Children with autism may struggle to imitate simple motor movements, such as clapping hands, waving, or playing ‘peek-a-boo’.
  • Limited vocal imitation: Imitating sounds, words, and phrases can be difficult for some children with autism, which can impact their speech development.
  • Challenges with social imitation: Imitating social cues, such as facial expressions, gestures, and body language, can be particularly challenging for children with autism, affecting their ability to engage in social interactions.

Why do children with autism struggle with imitation?

The exact reasons for imitation difficulties in autism are complex and not fully understood. However, several factors may contribute:

  • Neurological differences: Research suggests that differences in brain structure and function, particularly in areas involved in social perception and motor control, may play a role.
  • Sensory processing differences: Some children with autism may have sensory differences that make it difficult to attend to and process the movements or sounds they are expected to imitate.
  • Attention and motivation: Challenges with attention, focus, and social motivation can also affect a child’s ability to engage in imitation.

How to foster imitation in children with autism

Fortunately, imitation skills can be developed and improved through targeted interventions and strategies. Here are some approaches that I use in my practice as a speech and language therapist working with autistic children and their families:

  • Create a playful and engaging environment: Children are more likely to imitate when they are having fun and feel motivated. I use toys, games, and activities that the child enjoys.
  • Start with simple imitation: Begin by imitating simple motor movements that the child is already capable of and gradually introduce more complex actions.
  • Imitate the child first: As the Hanen Program emphasises, imitating the child’s actions, sounds, and words can encourage him or her to interact and communicate more.
  • Use visual supports: Visual aids, such as pictures, photos or videos, can help children with autism understand what is expected of them and make imitation easier.
  • Break down complex actions: Divide complex actions into smaller, more manageable steps. For example, to teach a child to brush their teeth, break it down into steps like ‘pick up toothbrush’, ‘put toothpaste on brush’, and ‘move brush on teeth’.
  • Reinforce imitation attempts: Provide positive reinforcement, such as praise, smiles, or preferred activities, when the child attempts to imitate, even if the imitation is not perfect.
  • Integrate imitation into daily routines: Incorporate imitation into everyday activities, such as imitating sounds during playtime, imitating gestures during songs, or imitating actions during self-care routines.

The role of speech therapy

Speech-language therapists play a crucial role in helping children with autism develop imitation skills, particularly in the areas of vocal and verbal imitation. As part of my therapeutic role, I offer the following:

  • Assessing a child’s imitation abilities.
  • Developing individualised therapy plans to target specific imitation goals.
  • Using a variety of techniques to encourage vocal imitation.
  • Working with parents and caregivers to provide strategies and support for promoting imitation at home.

Summary

Imitation is a fundamental skill that is essential for social, communication, cognitive, and emotional development. While children with autism may face challenges with imitation, it is a skill that can be developed and improved with targeted interventions and support. By understanding the importance of imitation and using effective strategies to foster it, parents, educators, and therapists can make a significant difference in the lives of children with autism, helping them to connect with others, learn new skills, and reach their full potential.

Do get in touch via my contact form if you have any question or need help with supporting your little one.

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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Understanding Angelman Syndrome: A guide for parents
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Understanding Angelman Syndrome: A guide for parents

ByLondon Speech and Feeding

Angelman Syndrome (AS) is a complex neurological disorder that affects development. It’s caused by a missing or functionally incorrect gene (UBE3A) on chromosome 15. While AS is rare, understanding its characteristics is crucial for parents and caregivers.

What are the key characteristics of Angelman Syndrome?

Children with AS typically exhibit a range of unique characteristics, which can include:

  • Developmental delay: Significant delays in reaching developmental milestones, such as sitting, crawling, and walking.
  • Speech impairment: Limited or absent speech. Individuals with AS may use few or no words.
  • Movement and balance issues: Difficulties with coordination, balance, and movement, sometimes causing a jerky or unsteady gait.
  • Happy demeanour: Frequent smiling, laughter, and a generally happy, excitable personality.
  • Intellectual disability: Varying degrees of intellectual disability.
  • Seizures: Seizures are common and often begin in early childhood.
  • Sleep difficulties: Disrupted sleep patterns and difficulty falling asleep.

The role of Speech and Language Therapy

Speech development and social communication is significantly affected in Angelman Syndrome, and therefore, Speech and Language Therapy plays a vital role in helping individuals with AS to communicate. As Speech and Language Therapists (SLT) we can work with the child and family support any of the following:

  • Assess communication skills: We evaluate the child’s current communication abilities, including any vocalisations, gestures, or signs they may use. With younger children we do this through play and playful social games as well as observation of a child playing and interacting with their siblings or caregivers.
  • Develop alternative communication strategies: Since spoken language may be limited, SLTs can help the child learn other ways to communicate, such as nonverbal communication, e.g
    • Gestures: use of pointing, waving and miming certain activities.
    • More formal sign language: Teaching basic signs to express needs and wants.
    • Core boards: Using pictures and symbols to represent everyday common words, actions, and feelings.
    • Augmentative and Alternative Communication (AAC) devices: Providing electronic devices that can produce speech.
  • Encourage vocalisations: When words don’t readily develop, SLTs can encourage the child to make vocalisations and sounds, as these can be a form of communication.
  • Support language development: SLTs can work on understanding of language, even if expressive language is limited.
  • Educate and support families: SLTs provide families with strategies and techniques to support their child’s communication at home.

The importance of a multidisciplinary approach

Caring for a child with Angelman Syndrome requires a team effort. A multidisciplinary approach, involving various healthcare professionals, is essential to address the diverse needs of the individual. This team may include:

  • Paediatrician: Provides overall medical care and monitors the child’s health.
  • Physiotherapist: Helps with movement, balance, and coordination.
  • Occupational therapist: Works on daily living skills, such as feeding, dressing, and self-care.
  • Speech and Language Therapist: Addresses communication and language needs.

By working together, we can provide comprehensive care, address the unique challenges of Angelman Syndrome, and help the child reach their full potential.

Conclusion

Angelman Syndrome presents unique challenges and opportunities. With early diagnosis, appropriate interventions, and a strong multidisciplinary team, children with AS can make good progress and live fulfilling, joyful lives. As Speech Therapists we delight in supporting parents in their role in advocating for their child.

Do get in touch via my contact form if you are concerned about your child’s development.

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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Explaining pronoun reversal: A window into gestalt language processing
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Explaining pronoun reversal: A window into gestalt language processing

ByLondon Speech and Feeding
Explaining pronoun reversal: A window into gestalt language processing

Have you noticed your child referring to themselves as ‘you’, or calling you ‘me’? This seemingly confusing mix-up of pronouns, known as pronoun reversal, often raises concerns for parents. Below I outline why your child does this and want to reassure you that it is to do with his or her unique language learning style.

Gestalt language processing: Learning in chunks

Many children, particularly those on the autism spectrum, use a gestalt language processing approach. Unlike analytic language processors who learn individual words and build sentences, gestalt language processors learn language in whole ‘chunks’ or ‘gestalts’. Think of these gestalts as pre-packaged scripts they pick up from their environment — phrases, sentences, even snippets of songs or movie lines.

As Marge Blanc, author of Natural language acquisition on the autism spectrum, explains, ‘When a child picks up an entire gestalt (script), he’s got the pronoun of the original speaker. So ‘pronoun reversal’ is nothing more than that.’

So your child is simply repeating what they’ve heard, without yet understanding the individual word meanings or grammatical functions.

Imagine your child hearing ‘You want a rice cake?’ repeated frequently. They might then use this phrase to express their own desire for a rice cake, even though it doesn’t grammatically fit. So they are thinking and saying ‘You want a rice cake?’ and the meaning of this phrase is: ‘I want a rice cake’. This isn’t a sign of confusion, but a natural step in their language development. They’re working with the tools they have: the scripts they’ve acquired.

How can we support their natural language journey

Instead of trying to ‘correct’ pronoun usage, our role as caregivers and speech therapists is to support the child’s natural language progression. Here’s how we can do this:

  1. Learn about their gestalt stage and run with it: In the early stages (1–3) of gestalt language development, correcting pronouns can be counterproductive. These children are still processing language as whole units, not individual words. Direct corrections can lead to frustration and hinder their natural language exploration.
  2. Patience and trust: Gestalt language processing follows a predictable, albeit sometimes non-linear, path. By understanding their current stage, we can provide targeted support. Language sampling and scoring, guided by the Natural Language Acquisition framework, help us pinpoint their stage and tailor our approach.
  3. Model language strategically: In the early stages, avoid using pronouns like ‘you’ and ‘you’re’. Instead, model language from the child’s perspective or use joint perspectives. For example, instead of ‘Are you thirsty?’, try ‘I’m thirsty!’ or ‘Let’s get some water’,

The big picture: Language unfolds naturally

Pronoun reversal is a stepping stone, not a stumbling block. As gestalt language processors progress, they begin to break down these gestalts into smaller units and develop their own self-generated language. This is when their understanding and use of pronouns naturally emerge.

By shifting our perspective from ‘error correction’ to ‘developmental support’, we create a nurturing environment for these children to thrive. We empower them to navigate their unique language journey, ultimately leading to more meaningful and independent communication.

So, to summarise:

  • Pronoun reversal is a typical characteristic of early-stage gestalt language processing.
  • Focus on modelling language from the child’s perspective or a joint perspective.
  • Avoid correcting pronouns in the early stages.
  • Trust the process and support the child’s natural language development.

Let’s celebrate the diverse ways our children learn to communicate and empower them to find their unique voice!

If you have any questions or would like some help with understanding your little gestalt language learner, please get in touch with 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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The joy of container play: Exploring play development and understanding of how things work
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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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Speech Sound Challenges: A focus on /L/ and /Y/
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Speech Sound Challenges: A focus on /L/ and /Y/

ByLondon Speech and Feeding

Have you ever thought about how difficult it can be to produce certain speech sounds? Some sounds are definitely trickier than others. This is especially true for children with speech sound disorders like Childhood Apraxia of Speech (CAS).

My student with CAS has been working hard on producing the /L/ sound especially when it was followed by an /O/ or /OO/ like, ‘log’ or ‘look’. We’ve practised lots and now that he’s got a good handle on /L/, he’s started replacing another difficult sound, /Y/, with it. So, ‘yes’ becomes ‘less’ and ‘yuck’ becomes ‘luck.’

This is a common pattern in speech development. Once a child masters a new sound, they may start using it in place of other sounds they find even more challenging.

Minimal Pair therapy

I use different evidence-based methods to help my students. And I often like to start out with phonemic awareness and then I move to contrasting the error sound with another sound to make completely different words. This approach is called ‘minimal pair’ therapy: both words are the same except for the initial/final sound which has the error sound, and this is contrasted with the correct sound.

Below is an example of this:

After we have worked on sound awareness, listening and becoming aware of small units of sound matter, then we can move to working on tongue placement and movement.

Tongue placement and movement to produce correct /L/ and /Y/ sounds

To produce these sounds correctly, the tongue needs to be in specific positions and make specific movements.

  • /L/ sound:
    • Tip of the tongue touches the alveolar ridge (the bony ridge behind your upper teeth)
    • Sides of the tongue are raised to the sides of the upper teeth
    • Airflow escapes through the sides of the tongue
  • /Y/ sound:
    • Tip of the tongue touches the roof of the mouth behind the alveolar ridge
    • Sides of the tongue are raised to the sides of the upper teeth
    • Airflow escapes through the centre of the mouth

I also use:

  • Auditory bombardment: Auditory bombardment is a technique that involves repeatedly listening to a target sound. This can help children to develop a better understanding of the sound and how to produce it.
  • Visual cues: Visual cues can be helpful for children who are having difficulty producing a particular sound. Here I use the image of a ‘standing tongue’ versus a ‘sitting tongue’.
  • Physical cues: I use my hands to show a ‘standing tongue’ for the /L/ versus a ‘sitting tongue’ for the /Y/. But what worked even better and sadly I don’t have the video clip for it:
  • Semantic cues: For example a picture of an ‘EAR’ to make the sound /Y/ so we shape the sound /EA/ to /Y/.
  • Parent involvement: Parents play an important role in their child’s speech sound development by providing opportunities for them to practise their speech sounds at home. This can be done through activities such as reading books, singing songs, and playing games.
  • Reinforcement: It is important to praise children for their efforts, even if they are not perfect. This will help them to feel motivated to keep practising. Important here for speech correction is concrete reinforcement: I feed back to my student what exactly they were doing correctly with their tongue or lips. Rather than saying ‘well done’, I mention what my student has just done with the tongue to change the sound: ‘I saw you lowered your tongue! That made a good /Y/’.

Another great way of reinforcing positively is to ask the student how they feel they have done? For the older ones I often ask them to self-rate their sound production out of 10. Then we can work towards the next incremental number upwards. This is very effective and gives the student control over their own work.

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.

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A helpful addition in my toolbox for lisp correction: Meet the MUPPY – a vestibular orthodontic plate
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A helpful addition in my toolbox for lisp correction

ByLondon Speech and Feeding

Meet the MUPPY – a vestibular orthodontic plate

I have become very well versed in Lisp Correction because so many children come to me with this problem! And I absolutely love lisp correction and Articulation Therapy! Please take a look at my blog on tips and tricks for correcting a lisp.

The MUPPY

Over the years I have created my unique style of remediating an Interdental Lisp and as part of my treatment I sometimes use an Orthodontic Tool, called the ‘MUPPY’, which I purchase directly from Germany. I first discovered it some years ago when working with a child with Down Syndrome. Back then I was searching for additional support with my student’s jaw grading and mouth closure difficulties and that’s when I first came across this little tool as recommended by one of my colleagues, a specialist orthodontist in Germany.

I was a bit sceptical at first but I have used it now many times for three years on a variety of clients with varying degrees of lisps. I find it really helps together and in addition to all my other techniques which are language and motor based.

How do I use it?

The MUPPY is a custom-made mouth plate that gently repositions the tongue, encouraging correct tongue placement for clearer speech. It sits comfortably between the lips and teeth; a thin wire sits right behind the teeth, inside the oral cavity.

The plate I like to use for lisp correction has a pearl in the middle. As soon as it is in situ the tongue starts fishing for the pearl and thereby keeps on moving up towards the correct place on the hard palate, just behind the front teeth. This is the place where the tongue tip needs to be for all the alveolar sounds our students find so hard to make.

How does this help reduce a lisp?

A lisp results mainly from incorrect tongue placement during sound production – though at times atypical dentition also contributes to the problem. Specifically, an interdental lisp occurs when the tongue protrudes between the teeth during the production of sounds like /S/ and /Z/. The tongue is often described by parents as ‘thrusting forward’ but I find that is rarely the case. Most often the tongue simply protrudes forward, which is different to tongue thrusting, a more forceful and involuntary movement. Most often I see a habitual tongue protrusion not only for /S/ and /Z/ but also for /T/, /D/, /L/ and /N/. Often /SH/ and ZH/ are also affected.

To visualise this:

  1. A correct /S/ sound looks like this: The tongue tip is raised and touches the alveolar ridge (the bony, slightly uneven ridge behind the upper teeth). The sides of the tongue touch the upper molars.
  2. Interdental lisp: The tongue tip protrudes between the front teeth, creating a /TH/ sound.
  3. Lateral lisp: Here the mechanics of the tongue are different. But using the MUPPY can help here too. To visualise a lateral lisp, the sides of the tongue are not raised high enough, allowing air to escape over the sides. This results in a ‘slushy’ or ‘wet’ sound.

Understanding the specific type of lisp is crucial for targeted therapy and successful correction.

The Vestibular Plate (Muppy) HELPS to guide the tongue towards the right place from where we shape the NEW SOUND.

Methods

Most important to my articulation work re lisping are the motor- and language-based techniques I use, as broadly described below:

  • A thorough oral examination, tongue movements, lip closure, dentition, jaw grading, breath coordination, cheek tonicity, palatal form
  • Discussion on awareness and motivation of child to work on their speech
  • Contrasting sounds at the beginning and end of words: sing vs thing / sink vs think / mess vs mesh etc to raise awareness that it matters what sounds we use in speech and that just one sound can change the meaning of a word completely
  • Mirror work, pulling faces, moving our tongue voluntarily
  • Exploring the oral cavity and thinking about all the parts of the tongue and the palate
  • Finding the alveolar ridge and placing the tongue there at rest
  • Then working towards a good baseline of the other alveolar sounds: /T/ /D/ /L/ /N/ and from there we work towards our NEW /S/ SOUND.

I use a variety of picture clues depending on what is most meaningful for my student:

The child likes a train set, I use the TIRED TRAIN SOUND.

The child knows about bike or car tyres, I use the FLAT TYRE SOUND.

With a student who loves a balloon I might use the FLAT BALLOON SOUND.

And we work our way from correct tongue placement to these long /SSSSSSSSS/ sounds with the help of these visual cues, but also gestural and hand cues such as Jane Passy’s Cued Articulation sound for /S/.

I really love helping children correct their speech sound, be it an articulatory difficulty like the lisp or a phonological difficulty such as ‘fronting’ or ‘gliding’ and I also love working with motor-based speech difficulties we see in Childhood Apraxia of Speech. Feel invited to get in touch if your child needs help in these areas.

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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Chaining
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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.

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The Hanen Program® – The beauty of the ‘4 S’
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The Hanen Program® – The beauty of the ‘4 S’

ByLondon Speech and Feeding
Image by freepik

One of my favourite pieces of advice I give to parents is the ‘4 S’, a strategy coined by the Hanen Program® which I teach, particularly the ‘More than Words’ programme which is designed for and aimed at parents of children with Social Communication Difficulties or Autism. It is honestly one of those golden nuggets that I use myself in my practice and I highly recommend it to all my parents. There is something about terms like the ‘4 S’ that is easy to recall and therefore use.

Introduction

The ‘4 S’ is a strategy that helps to clarify the words we use with our children so that they can notice us, hear us and understand what we are saying.

Research shows that we use on average 120-200 words per minute during everyday conversation. That’s a lot! And our children who are still learning to communicate are often bombarded with endless speech coming at them all day long. If we take into account that many of our students are Gestalt Language Processors, we can see that picking out relevant chunks of what we are saying is not at all easy, and this contributes to our children’s delays.

So let’s look at the ‘4 S’

1. The first one is SAY LESS

This means we should use shorter, simpler sentences with good grammar, for example, something like: ‘let’s get ready, time to put our shoes on’ instead of what we might be saying: ‘come on then darling, let’s put your shoes on we need to get going it’s dark outside’ or similar.

Good grammar helps to give clues about what words mean and how they are used in sentences. So, instead of ‘shoes on’ say ‘let’s put our shoes on’.

2. The second one is STRESS

I hear you think ‘I am stressed!‘. – NO! here it means ‘highlight’. We use our voice to highlight the important words in our sentence or phrase. For example, when you say ‘this banana is so yummy’ you can stress the word ‘yummy’ by saying it a bit louder and you can make a gesture, like rubbing your tummy as you say it.

3. The third one is GO SLOW

This means to speak a bit slower than you normally would and add pauses. By slowing down the pace of our speaking we give our child time to think and understand what we are saying. When we allow for pauses after we have spoken, we are inviting our child to say something in response.

4. The last one is SHOW

Always remember to show actions, gestures, objects, and point to pictures while speaking to help support your child’s understanding. We can show our child what words mean by pointing to things or holding up objects whilst describing or talking about them.

At this point I would also like to recommend the use of Core Boards, and particularly Electronic AAC devices, such as LAMP Words for Life or PODD. I have written about this in other blogs but can always be persuaded to say a bit more on the matter… 😊 It is such a big help to have an AAC talker available for both the child and the adult so we can find words and pictures to help support the words we are saying.

For example, today when reading a book like The Hungry Caterpillar (so good!) I used my LAMP AAC talker to make comments as we were looking at the pages together with my student. Example: ‘Look! He is eating more cake he is very hungry’ using my AAC talker I was able to supplement my speech and at the same time I was inviting my minimally speaking child to press a button or two and reply with ‘cake!’ which they would not have said with their mouth otherwise.

5. It does say ‘4 S’ but really it should be ‘5’ except the fifth is not an ‘S’

The fifth is REPEAT.

Repeat words and phrases often throughout the day. When learning a language we all need to hear words and phrases several times and in different situations before we can understand, remember, and then eventually use them. Our children are ‘new language learners’ and so we can apply the same principles that we would when learning a new foreign language ourselves.

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.

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