Baby-led weaning: Empowering little eaters from the start
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Baby-led weaning: Empowering little eaters from the start

I had a mum ask me about Baby Led Weaning the other day. So I thought I would write a blog on all the useful questions she had and what we discussed as it may help lots of mums and dads out there.

As a Paediatric Feeding SLT, one of the exciting developments in recent years is the growing interest in baby-led weaning (BLW). This approach to introducing solids has gained significant traction, and for good reason. It empowers infants to take the lead in their feeding journey, fostering a positive relationship with food and supporting important developmental milestones.

What exactly is baby-led weaning?

At its core, baby-led weaning is about offering your baby appropriately sized and textured solid foods from the very beginning, allowing him or her to self-feed. Instead of spoon-feeding purées, you present whole, soft foods that your baby can grasp, bring to his or her mouth, and explore at his or her own pace. This means no mashing, no blending, and no forcing spoons into reluctant mouths. It’s a fun, messy, and intuitive process that is led by your baby’s natural instincts.

The genesis of baby-led weaning

‘Baby-led weaning’ was popularised by British health visitor Gill Rapley. In the early 2000s, Rapley observed that babies naturally develop the skills needed to self-feed and that traditional spoon-feeding might actually hinder this development. Her work, particularly her book Baby-Led Weaning: The Essential Guide to Introducing Solid Foods (co-authored with Tracey Murkett), published in 2008, brought BLW into the mainstream and provided a structured framework for parents. Her research and observations highlighted the benefits of trusting a baby’s innate ability to regulate his or her intake and explore different textures.

What’s the deal?

Implementing BLW is simpler than you might think, though it does require a shift in mindset. Here’s a breakdown of what it typically involves:

  • Readiness is key: The golden rule of BLW is to wait until your baby shows clear signs of readiness. This isn’t about age alone, but rather developmental milestones. Your baby should be at least six months old, able to sit unassisted, have good head and neck control, show an interest in food (e.g., reaching for yours), and have lost his or her tongue-thrust reflex (which pushes solids out of his or her mouth).
  • Offer finger foods: Start with soft, easily graspable foods cut into finger-sized sticks or spears. Think cooked sweet potato fries, steamed broccoli florets (soft enough to mash with gentle pressure), banana sticks, or avocado slices. The goal is for babies to be able to pick it up and get some into their mouth.
  • Embrace the mess: BLW is inherently messy, especially in the beginning. Food will be squished, dropped, and smeared. This is a crucial part of the learning process as babies explore textures, smells, and the properties of food. A wipeable mat under the highchair and a good bib are your best friends!
  • Observe, don’t interfere: Allow your baby to lead. He or she will decide what to eat, how much, and how quickly. Avoid putting food into his or her mouth or pressuring him or her to eat more. This respects his or her hunger and fullness cues, laying the foundation for healthy eating habits.
  • Continue breastmilk or formula: Until your baby is well-established on solids, breastmilk or formula remains his or her primary source of nutrition. Solids are for exploration, taste, and developing skills, gradually increasing in quantity over time.

The benefits of baby-led weaning

The advantages of BLW extend far beyond simply getting food into your baby. From a speech and feeding perspective, the benefits are compelling:

  • Develops oral motor skills: Chewing, gnawing, and manipulating various food textures are crucial for developing the muscles in the mouth, jaw, and tongue. This strengthens the oral motor skills necessary for speech development.
  • Enhances fine motor skills and hand-eye coordination: The act of grasping food, bringing it to the mouth, and coordinating these movements significantly refines fine motor skills and hand-eye coordination.
  • Promotes self-regulation and intuitive eating: By allowing babies to control their intake, BLW helps them tune into their own hunger and fullness cues, fostering a healthy relationship with food and reducing the likelihood of overeating.
  • Encourages adventurous eating: Exposure to a wide variety of tastes and textures from the outset can lead to less picky eating later. Babies are more likely to accept new foods when they have been in control of their exploration.
  • Facilitates family mealtimes: BLW integrates babies into family mealtimes from an early age, promoting social interaction and making mealtime a shared, enjoyable experience.

When is baby-led weaning appropriate, and when not?

While BLW offers numerous benefits, it’s not a one-size-fits-all approach.

When BLW is appropriate:

  • When your baby meets all the developmental readiness signs: This is paramount for safety and success.
  • When you are comfortable with the mess and the learning curve: It requires patience and a relaxed attitude.
  • When you are committed to offering a variety of safe, appropriate foods.
  • When you are willing to learn about and practise safe food preparation to minimise choking hazards.

When BLW might not be appropriate (or requires extra caution and professional guidance):

  • If your baby has a history of prematurity or significant developmental delays: His or her oral motor skills might not be sufficiently developed.
  • If your baby has certain medical conditions or anatomical differences (e.g., cleft palate, severe reflux, swallowing difficulties): These may necessitate a modified approach to feeding.
  • If there are significant feeding difficulties, aversion, or a history of choking incidents.
  • If you feel overly anxious about choking: While BLW, when done correctly, is not associated with a higher choking risk than traditional weaning, parental anxiety can impact the feeding experience. Education and consultation with a professional can help alleviate these concerns.

A note on safety: Choking hazards

It’s crucial to understand the difference between gagging and choking. Gagging is a natural reflex that helps prevent choking and is very common in BLW as babies learn to manage food in their mouths. Choking is silent and serious. To minimise choking risks:

  • Always supervise your baby closely during mealtimes.
  • Offer appropriately sized and textured foods. Avoid small, round, hard foods like whole grapes, nuts, popcorn, and large chunks of meat.
  • Ensure your baby is sitting upright and calm.
  • Educate yourself on infant CPR.

Final thoughts

Baby-led weaning is a wonderfully empowering approach that celebrates a baby’s natural abilities and fosters a positive and independent relationship with food. As Speech and Language Therapists we often see the positive impact it has on oral motor development, self-regulation, and overall feeding confidence. By understanding what it entails, when it’s appropriate, and prioritising safety, you can embark on this exciting journey with your little one, helping him or her become a confident and capable eater from the very first bite.

If you would like help and support with weaning your baby whilst continuing to breastfeed then please get in touch!

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 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

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

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

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

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

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

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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Unlocking language and thinking skills: The power of sequencing
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Unlocking language and thinking skills: The power of sequencing

Sonja demonstrates the power of sequencing

As speech and language therapists, we often use a variety of techniques to help children develop their communication and cognitive skills. One incredibly valuable tool in our toolkit is the use of sequencing activities. But what exactly is sequencing, and why is it so beneficial?

What is sequencing?

Sequencing, at its core, involves arranging items, events, or actions in a specific order. This could involve putting pictures in the correct order to tell a story, following the steps in a recipe, or understanding the order of daily routines like brushing teeth or getting dressed.

The link between sequencing and language

Sequencing is fundamental to language development and is quintessential to executive functioning skills in several ways:

  • Narrative skills: Storytelling, whether oral or written, relies heavily on sequencing. A child needs to understand the order of events (beginning, middle, end) to construct a coherent narrative.
  • Explanations and instructions: Providing clear explanations or instructions requires the ability to sequence information logically. For example, explaining how to play a game or how to get from one place to another. In the video clip below we are working on ‘how do make a sandwich’.
  • Vocabulary development: Sequencing helps children understand temporal words and phrases like ‘first,’ ‘then,’ ‘next,’ ‘before,’ and ‘after’.
  • Sentence structure: Constructing grammatically correct sentences often involves sequencing words in a specific order (e.g., subject-verb-object).

Beyond language, sequencing plays a crucial role in developing executive functioning skills. These are higher-level cognitive skills that help us plan, organise, and manage our time and actions.

Sequencing activities can help children improve in the following areas:

  • Planning and organisation: Sequencing tasks require children to think ahead, plan the steps involved, and organise them in a logical order.
  • Problem-solving: When they are faced with a problem, sequencing helps children break it down into smaller, more manageable steps.
  • Working memory: Holding information in mind and manipulating it, such as remembering the steps in a multi-step direction, is supported by sequencing skills.
  • Cognitive flexibility: Being able to adjust to changes in a sequence or think of alternative sequences promotes cognitive flexibility.

Examples of sequencing activities

Here are some practical examples of sequencing activities you can do with your child:

  • Picture sequencing: Use a set of picture cards to tell a short story or illustrate a process (e.g., making a sandwich, going to the park). Ask your child to arrange the cards in the correct order.
  • Story retelling: After reading a story, have your child retell it, focusing on the order of events.
  • Following instructions: Give your child multi-step instructions to follow (e.g., ‘First, get your shoes. Then, put on your coat. Next, go to the door.’).
  • Sequencing during play: Integrate sequencing into everyday play. For example, while building with blocks, talk about the steps: ‘First, we put this block here. Next, we add this one…’
  • Daily routines: Create visual schedules for daily routines, like getting ready for school or bedtime, to help children understand the sequence of events.
  • In the video clip below I am using an on-line language activity which is often fun for children as they can use their finger to swipe the pictures effortlessly into the right place and, if we realise at the end of the story that we have made a little error, we can then easily re-jig the pictures into their correct place.

In conclusion

Sequencing activities offer a powerful way to support children’s language development and enhance their executive functioning skills. By helping children understand and create order, we equip them with essential tools for communicating, learning, and navigating the world around them.

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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The power of babble: Why your baby's ‘talk’ matters
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The power of babble: Why your baby’s ‘talk’ matters

That adorable string of ‘ba-ba-ga-ga-ma-ma’ might sound like baby gibberish, but it’s actually a crucial milestone in your little one’s language development. Babbling or babble, as we call it, is far more than just cute baby noises. It’s a sequence of sounds that lays the foundation for future communication.

Image by freepik

What is babbling?

Babbling typically begins around six months of age, though the timing can vary slightly from baby to baby. It involves your baby experimenting with different sounds, stringing together consonants and vowels. You might hear them repeating sounds like:

  • ‘Ba-ba’
  • ‘Da-da’
  • ‘Ma-ma’
  • ‘Ga-ga’

As they progress, the babbling becomes more complex, with variations in pitch, rhythm, and intonation. It might even sound like they’re having a conversation with you!

Why is babbling so important?

  1. Laying the groundwork for speech: Babbling is like a vocal workout for your baby. By practising these sounds, they’re strengthening the muscles in their mouth, tongue, and vocal cords that are essential for speech.
  2. Developing phonological skills: Through babbling, babies begin to understand the sound patterns of their native language. They’re learning which sounds go together and how they’re used.
  3. Enhancing social interaction: Babbling is a social activity. Babies often babble back and forth with their caregivers, which helps them learn about the give-and-take of communication.
  4. Cognitive development: The act of babbling requires babies to use their brains in new ways. They’re learning to control their vocalisations, pay attention to the sounds they’re making, and connect those sounds to the responses they receive from others.

How can you encourage babbling?

  • Talk to your baby: Even though they can’t understand your words yet, talking to your baby exposes them to language and encourages them to respond with their own vocalisations.
  • Imitate their sounds: When your baby babbles, imitate them! This shows them that you’re paying attention and encourages them to keep ‘talking.’
  • Respond to their babbling: Treat your baby’s babbling as if it’s a real conversation. Respond with words, smiles, and gestures.
  • Play sound games: Make different sounds for your baby and encourage them to imitate you. This could include animal sounds, silly noises, or simple words.
  • Read to your baby: Even before they can understand the words, reading to your baby exposes them to the rhythm and sounds of language.
  • Sing songs: Singing is a fun and engaging way to introduce your baby to new sounds and words.
  • Use mirrors: Babies often enjoy watching themselves make sounds in a mirror.
  • Tactile stimulation: Gentle massage around the mouth and face can increase oral awareness and encourage vocalisations.
  • Vary textures: Offer different textured teethers.
  • Read books with sound effects: Choose books with animal sounds or other engaging noises.
  • Blow bubbles: The act of blowing and popping bubbles can encourage vocalisations.
  • Use visual aids: Show pictures of objects and say their names, emphasising the consonant sounds.
  • Use exaggerated facial expressions: When you make sounds, exaggerate your mouth movements to help your baby see how sounds are made.
  • Increase joint attention: Follow the child’s gaze and point to objects that they are looking at and say the name of the object.

When to seek help

If you notice that your baby is not babbling by eight months, it’s a good idea to talk to your speech and language therapist. You might also notice a lack of variation in tone when your child is making sounds, is your baby sounding a little ‘flat’ or monotonous? While every child develops at their own pace, a lack of babbling can sometimes indicate a developmental delay or hearing issue.

Remember, babbling is a gift. So, enjoy those precious moments of ‘baby talk’ and take comfort in knowing that your little one is on the path to becoming a chatterbox!

Do get in touch via my contact form if you are concerned about your child’s development or if you simply want some reassurance that your baby is developing well. We will be delighted to arrange a screening appointment for you and give you support and reassurance.

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.

1
Explaining pronoun reversal: A window into gestalt language processing
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Explaining pronoun reversal: A window into gestalt language processing

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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Why pointing matters: Unpacking the power of this simple gesture
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Why pointing matters: Unpacking the power of this simple gesture

As a speech and language therapist, I’m often asked about the significance of seemingly simple gestures in child development. One question that comes up frequently is, ‘Why is pointing so important?’ It might seem like a trivial action, but pointing is a powerful communication tool and a critical milestone in a child’s development.

Why is pointing so important?

Let’s delve into the theory behind why pointing matters:

1. Pointing as pre verbal communication:

Before children can use words, they use gestures to communicate their needs and interests. Pointing is one of the earliest and most important gestures. It allows children to:

  • Request: ‘I want that!’
  • Protest: ‘No, not that!’
  • Direct attention: ‘Look at that!’
  • Share interest: ‘Wow, cool!’

2. Pointing and language development:

Pointing is not just about communicating in the here and now; it also plays a crucial role in language development. Research shows that:

  • Early pointing predicts later language skills: Children who point more often tend to have larger vocabularies and better grammar later on.
  • Pointing helps children learn new words: When children point at something, adults tend to label it, providing valuable language input.
  • Pointing supports joint attention: Joint attention, or the shared focus of two individuals on an object or event, is essential for language learning. Pointing helps establish joint attention, creating opportunities for communication and learning.

3. Pointing and social-emotional development:

Pointing is not just about language; it’s also about social interaction. It allows children to:

  • Engage with others: Pointing invites others to share their focus and participate in their world.
  • Express emotions: Pointing can convey excitement, curiosity, or concern.
  • Develop social understanding: By observing how others respond to their pointing, children learn about social cues and communication.

4. Pointing and cognitive development:

Pointing is linked to cognitive skills, such as:

  • Understanding object permanence: The ability to know that objects exist even when they are out of sight.
  • Categorisation: The ability to group similar objects together.
  • Problem-solving: Pointing can be used to ask for help or to indicate a problem.

5. Types of Pointing:

It’s important to note that there are different types of pointing, each with its own significance:

  • Imperative pointing: To request something.
  • Declarative pointing: To share interest or direct attention.
  • Informative pointing: To provide information.

If you have concerns about your child’s pointing or overall communication development, don’t hesitate to seek professional guidance from a speech-language therapist. Early intervention can make a significant difference in supporting your child’s communication journey.

How can we create opportunities for pointing?

  • ‘Where’s the…?’ games:
    • Play games like ‘Where’s the doggy?’ or ‘Where’s the ball?’ and encourage your toddler to point to the object.
    • Start with familiar objects and gradually introduce new ones.
  • Reading together:
    • When reading picture books, ask your toddler to point to specific objects or characters on the page.
    • Use phrases like, ‘Can you point to the puppy?’
  • Everyday activities:
    • During daily routines, ask your toddler to point to things they want or need.
    • For example, ‘Do you want the apple or the banana?’
    • When walking outside say ‘LOOK’ and encourage pointing.
  • Use of toys:
    • Use toys that have buttons or points of interest that when pressed make a noise. Encourage your toddler to point to the area that makes the noise.
    • Use toys that have many different parts, and ask the toddler to point to a specific part.

Model pointing:

  • Point yourself:
    • When you see something interesting, point to it and say the name of the object.
    • For example, ‘Look! A bird!’
  • Point to show choices:
    • When offering choices, point to each item as you name it.
    • For example, ‘Do you want the blue cup or the red cup?’ (Point to each cup).
  • Point to indicate direction:
    • When giving directions, point in the direction you want your toddler to go.
    • For example, ‘Let’s go that way!’ (Point).

Make it rewarding:

  • Respond to pointing:
    • When your toddler points, immediately respond to their communication.
    • Give them the object they want, or acknowledge what they are pointing at.
  • Use positive reinforcement:
    • Praise and encourage your toddler when they point.
    • Say things like, ‘Good pointing!’ or ‘You showed me the car!’
  • Show excitement:
    • When they point to something, show excitement, this will encourage them to point again.

Use specific techniques:

  • Use gestures and verbal cues:
    • Combine pointing with verbal cues and other gestures.
    • For example, say ‘Look!’ while pointing and nodding your head.
  • Simplify the environment:
    • Reduce distractions to help your toddler focus on the object you want them to point to.
  • Use exaggerated movements:
    • Use large, exaggerated pointing movements to draw your toddler’s attention.

Consider developmental factors:

  • Age-appropriate expectations:
    • Remember that pointing develops at different rates for different children.
    • Be patient and supportive.
  • Underlying issues:
    • If your toddler is not pointing by 18 months, or if you have any concerns about their development, consult with a speech and language therapist.
    • There may be underlying sensory or motor issues.

Key points:

  • Consistency is key. Practise these strategies regularly.
  • Make it fun and engaging for your toddler.
  • Celebrate every success, no matter how small.
  • If you have any concerns about your child’s development, contact your local health services.

Great toys and items for pointing

1. Interactive books:

  • Touch-and-feel books: Books with different textures, flaps to lift, and sounds encourage interaction and pointing. ‘Where’s the…?’ questions prompt pointing to specific features.
  • Books with simple pictures: Clear, uncluttered pictures make it easier for toddlers to focus and point to objects or characters.

2. Cause-and-effect toys:

  • Activity cubes: These often have buttons, dials, and levers that produce sounds or actions when manipulated, prompting pointing and exploration.
  • Pop-up toys: Toys where figures pop up or things happen when a button is pressed encourage anticipation and pointing to the action.
  • Simple musical instruments: A toy piano, drum, or xylophone encourages pointing to the keys/surfaces to make sounds.

3. Toys with parts to manipulate:

  • Shape sorters: Encourage pointing to the shapes and the matching holes.
  • Stacking cups or rings: Nesting cups or stacking rings invite pointing to select the correct size or order.
  • Puzzles with knobs: Simple puzzles with large knobs are easier for toddlers to grasp and point to the pieces.

4. Toys that encourage joint attention:

  • Bubbles: Blowing bubbles and following them with your eyes and pointing encourages joint attention (shared focus).
  • Balls: Rolling a ball back and forth and pointing to where it’s going can promote joint attention and turn-taking.
  • Wind-Up Toys: Wind-up toys that move across the floor can be exciting to follow with pointing.

5. Pretend play toys:

  • Toy telephones: Encourage pointing to the buttons and pretending to dial.
  • Dolls and stuffed animals: Pointing to the doll’s eyes, nose, mouth, etc., or asking the child to point to these features on themselves.
  • Toy food and dishes: Pretend play with food and dishes can involve pointing to request items or indicate actions (e.g., ‘Can I have the apple?’).

Tips for using toys to encourage pointing:

  • Get involved: Play alongside your toddler, modelling pointing and using language to describe what you’re doing.
  • Follow their lead: Observe what your child is interested in and use that to encourage pointing.
  • Limit distractions: Reduce background noise and visual clutter to help your child focus.
  • Use gestures and words: Combine pointing with words and other gestures (e.g., ‘Look!’ while pointing).
  • Be patient and positive: Celebrate all attempts at pointing and provide lots of encouragement.

Remember, the most important factor is the interaction you have with your child while playing. Use these toys as tools to create opportunities for communication and joint attention, and your toddler will be well on their way to mastering pointing!

Get in touch with me via my contact form if you need support

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 picky eater's plate: Introducing solids to toddlers with ARFID
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The picky eater’s plate: Introducing solids to toddlers with ARFID

Designed by Freepik

Mealtimes can be a battleground for parents of picky eaters, especially toddlers with Avoidant/Restrictive Food Intake Disorder (ARFID). I see a great number of toddlers with Autism traits and many of my clients are picky eaters from mild to severe. Take a look at my blog for an outline of what the issues are and how to try and help.

ARFID goes beyond typical ‘picky eating’ and can significantly impact a child’s growth, nutrition, and social-emotional well-being. If your toddler is resistant to trying new foods or has a very limited diet, here are some strategies to navigate the introduction of solids:

1. Understand ARFID:

ARFID is a diagnosable eating disorder characterised by:

  • Limited food variety: Eating only a small range of foods, often with specific textures or colours.
  • Fear of new foods: Intense anxiety or aversion to trying unfamiliar foods.
  • Sensory sensitivities: Heightened sensitivity to taste, smell, texture, or appearance of food.
  • Lack of interest in eating: May show little interest in food or mealtimes.

2. Seek professional guidance:

  • Paediatrician and/or gastroenterologist: Rule out any underlying medical conditions.
  • Registered dietitian: Assess nutritional needs and create a balanced meal plan.
  • Speech and language therapist (SLT): If oral-motor skills or sensory sensitivities are contributing to feeding difficulties.
  • Occupational therapist (OT): If sensory processing challenges are affecting mealtime behaviours.
  • Child psychologist: If anxiety or emotional factors are contributing to ARFID.

3. Strategies for introducing solids:

  • Start small: Introduce one new food at a time, in small amounts, alongside familiar favourites.
  • Patience is key: It can take multiple exposures (up to 10–15 times!) for a child to accept a new food. Don’t give up!
  • Positive reinforcement: Praise and encouragement for any interaction with the new food, even just touching or smelling it.
  • No pressure: Avoid forcing or pressuring the child to eat. This can create negative associations with food.
  • Make it fun: Present food in playful ways, use cookie cutters for fun shapes, or involve the child in food preparation.
  • Sensory exploration: Encourage exploration of food through touch, smell, and sight before tasting.
  • Role modelling: Show the child that you enjoy eating a variety of foods.
  • Use fun utensils: your child might like characters from ‘Frozen’ or ‘Dinosaurs’ or ‘Diggers’ there are a host of character-based cutlery and cups/plates to be had. Also, I really rate these two items very highly they are so good so I want to share these with you. Both are available online. But warning: the cup is outrageously expensive as it comes from the United States and is sold by a small scale company. But I feel this is cup very worth trying, I have had good results with this.
  • Gradual desensitisation: Start with foods that are similar in texture or taste to accepted foods, then gradually introduce more challenging options.
  • Food chaining: Introduce new foods that are similar in taste, texture, or appearance to accepted foods.

4. Mealtime Environment:

  • Positive and relaxed: Create a calm and enjoyable mealtime atmosphere.
  • No distractions: Minimise distractions like TV or toys.
  • Consistent schedule: Offer meals and snacks at regular times.
  • Child-sized portions: Offer small, manageable portions to avoid overwhelming the child.
  • Involve the child: Let the child choose their utensils, plate, or cup.

5. Remember:

  • Every child is different: What works for one child may not work for another.
  • Progress takes time: Be patient and celebrate small victories.
  • Focus on the positive: Praise any positive interaction with food.
  • Seek support: Connect with other parents or support groups.

Introducing solids to toddlers with ARFID can be challenging, but with patience, persistence, and professional guidance, you can help your child develop a healthier relationship with food.

Get in touch with me via my contact form if you need support

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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