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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The power of containment: A therapeutic approach for autistic children
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The power of containment: A therapeutic approach for autistic children

Photo by lemonlenz

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

Understanding sensory processing and autism

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

Photo by lemonlenz

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

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

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

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

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

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

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice


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

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The role of spinning and swinging in Speech and Language Therapy
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The role of spinning and swinging in speech and language therapy

Sonja with a child on a swinging with a stuffed monkey

Spinning and swinging are often observed behaviours in autistic children. While these actions might seem repetitive or unusual to some, they serve crucial functions for these children. Understanding the underlying reasons for spinning and swinging can provide valuable insights into how to support autistic children and incorporate these activities into therapeutic settings.

Why do children spin?

Spinning is a common sensory-seeking activity in autistic children. Sensory seeking means that the child actively looks for sensory input to regulate their nervous system. Here’s why spinning can be beneficial:

  • Vestibular input: Spinning stimulates the vestibular system, which is located in the inner ear and is responsible for balance and spatial orientation. For children with sensory processing difficulties, spinning can provide essential sensory input.
  • Calming effect: For some children, spinning can be a self-regulating strategy. The rhythmic motion can help to calm the nervous system and reduce anxiety.
  • Sensory exploration: Spinning allows children to explore their sensory experiences. It can help them understand their bodies and how they move in space.

The allure of swinging

The rhythmic back-and-forth motion of a swing offers several benefits:

  • Vestibular input: Like spinning, swinging stimulates the vestibular system, helping to improve balance and coordination.
  • Proprioceptive input: Swinging provides proprioceptive input, which is the sense of where your body is in space. This information is crucial for motor planning and coordination.
  • Calming and organising: The rhythmic motion of swinging can have a calming effect on the nervous system, helping to regulate emotions and improve focus.
  • Social interaction: Swinging can be a shared experience, fostering social interaction and communication.
  • Facilitating communication: While swinging, children are so much more relaxed and open to communication. The rhythmic motion can also help facilitate singing, humming, listening to my singing, non-verbal communication for sure but also more verbal and mouth words can be heard from children on my swing. If nothing else, it is so fun and helps build trust and rapport between my child and me.

Therapeutic Activities Combining Spinning, Swinging, and Speech and Language Therapy

Here are some therapeutic techniques that I use at London Speech and Feeding to combine movement with speech and language development:

  • Swinging with verbal prompts: While the child is swinging, I provide simple verbal prompts such as ‘up’, ‘down’, ‘fast’, and ‘slow.’ This helps to develop receptive language skills and improve auditory processing.
  • Sensory-motor play: I like to combine swinging with tactile activities like playing with textured balls or bean bags. This can facilitate language development through descriptive language, words and scripts like: ‘that’s so soft’, ‘oooh tickle tickle tickle!’
  • Storytelling on the swing: Often I manage to create a story while the child is swinging. This can improve narrative skills, vocabulary, and imagination. Recently I did the ‘Tiger who came to tea’ story and each time the swing stopped the tiger came and ‘ate some more cakes’ and ‘tickled their tummy’ whilst eating. It may make not much sense but my child loved it and we had ‘more tiger eat more’.
  • Song and rhyme time: Often I sing the ‘rumble in the jungle’ song while swinging my child to enhance phonological awareness, rhythm, and timing.
  • Visual supports always help: I use LAMP Words for Life AAC support during swinging and show core words such as: ‘go’ / ‘stop’/ ‘more’ / ‘tickle tickle’ etc. #lampwordsforlife #aac
  • Movement-based activities: We can incorporate activities that require sequencing, such as imitating animal movements or following simple commands while swinging. This can improve motor planning and language comprehension.

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

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice


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

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A day in my life as a speech and language therapist

A day in my life as an Independent Speech and Language Therapist

During the pandemic I wrote a blog on what my working day looked like. Now a good year has passed since coming back to some sort of normality and I thought I would update this ‘day in the life of an SLT’ as my working life has changed of course to reflect the ‘new normal’.

I have become truly busy, perhaps busier than I have ever been to be honest. It’s probably mostly due to the fact that I do most of the aspects of my work myself — though I want to mention two invaluable people here without whom I could not function as well as I do: the excellent Nathalie Mahieu () helps me with my SEO, Insta posts and blog uploading and the wonderful Sue Bainbridge () makes sure that my accounts don’t get into trouble with His Majesty’s tax office.

Attached to our role as Speech and Language Therapists is an arguably enormous amount of administration/paperwork and preparation required for each and every client. This needs to be factored in when deciding how many families I can realistically see each working day. For me it works out as typically 3–5 clients a day, Monday to Friday.

So how does my day typically look? Each day varies a lot depending on what type of client I have, but on average it looks a bit like this:

First thing in the morning — after having a coffee and a quick check-in with my besties on WhatsApp — I do my Buddhist chanting for about an hour. My Buddhist prayers are the base of all I do and get me connected to my higher purpose and how to create value with each activity and each person I see that day. It sets me up for the day, I keep in mind who is going to come and see me and how I can best help them.

Next up, I do the daily ‘spring-clean’ of my therapy room (on all fours! no joke ???? those kids see every speck!), vacuum the floors, wipe down the toys with flash-wipes and tidy up all my boxes, making sure that the battery toys are working, and everything else is in place. On to the guest toilet, the hallway needs to be rid of all the men’s shoes and trainers and coats… It’s endless what needs tidying when you are living with three men… This takes about 45 minutes.

An articulation activity – packaging practice into a little game

Then I prep for all my clients that day. I have now got so much quicker about selecting therapy materials. For one thing I have purchased so many toys and materials over the past five years that I can literally now open a shop and need to consider building an extension! ???? The upside is that it is now very easy for me to select a good handful of toys or games for any one child, even at a minute’s notice. Though, on average, I spend about 30 minutes per child preparing activities.

Hurrah, it’s 11 am and my first client of the day arrives and the fun begins.

When they leave around an hour later, the cleaning and wiping down starts again, this time less extensively. I write up my notes and send homework whilst enjoying a cuppa.

The next client comes at 12.30 pm and once they have left, floor cleaned, toys wiped, notes written it is time for a quick lunch. No more than half an hour usually.

Afternoon clients tend to be one more little one (nursery age) at 2.15 pm and thereafter I see mostly older school children for a variety of reasons (mainly speech production but also some language-based activities). I tend to say farewell to my last client of the day around 6 pm. I spend another hour, sometimes more, on writing up notes, answering new enquiries, blogging and phone calls to keep my service fresh, inspirational and exciting.

And then dinner and the rest of the day rushes by. I tend to finish my day with some more Buddhist chanting, not a lot, perhaps 10–20 minutes to reflect on what has gone well and what could have been better — re-determine to improve or make better as needed.

Tele therapy activity using online materials plus a coreboard

In terms of where I provide a service, I still do a good mix of online clients (tele-therapy) and in-person clients in my clinic, which I love. Occasionally, I visit children in their nursery or at home but this service is now only available for long-standing clients.

Each client is hand-picked to make sure that we are a good fit: no one client gets the same treatment as another; each client is unique, we get to know one another well over the time we work together and they are always highly valued. That takes time and, in reality, each client gets about two hours of my time. That is the actual session plus all the preparation and aftercare, i.e., bespoke hand holding, tweaks, problem solving and reassurance in between sessions.

I absolutely love this way of working and would not ever want to do anything else. Nearly three decades of working both in the NHS and in private practice, countless courses (continual professional development) have enabled me to flourish as a therapist and I know that I offer something special and very valuable to my clients.

My unique way of working affords all my lovely clients the help they need to support their children to make progress; and it gives me the right balance of job satisfaction and work life balance for now. My lovely reviews and testimonials tell me that my clients appreciate my service and this at the end of the day is the most important.

If you are interested in exploring Buddhism/buddhist chanting then check out this link (https://sgi-uk.org/), and feel free to contact me about that specifically, regardless of whether you want speech therapy. I am always happy to chat about Buddhism, it has been so enriching for the last 43 years of my life.

If you need help with your child, please do not hesitate to contact me.


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

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How do we play with our Gestalt Language Processors?
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How do we play with our Gestalt Language Processors?

Image by Freepik

Child-led therapy

When working with Gestalt Language Processors, it is always advisable to use child-led therapy. What does that mean? Child led therapy involves following a child’s interests and allowing her/him to lead the play activity throughout the speech and language therapy session. In other words, instead of having my own ideas of what we might want to play with or what activities I might try and use, I provide a range of toys I know the child likes or has played well with before; then I wait for the child to pick what she/he enjoys doing.

Play can be very repetitive and we can often see our child cycling back to the same one or two toys throughout the session. But this is what she/he needs to do at that time and it means that we have focused attention and engagement. This in turn is very helpful for the therapeutic process, which is to offer great scripts and phrases/words alongside what she/he is playing with.

Monotropic minds

Often the mind of autistic children is more strongly pulled towards a smaller number of interests or hobbies as I like to call them. Dr Dinah Murray, Dr Winn Lawson and Mike Lesser have found in 2005 that autistic people have ‘monotropic’ minds. They explain that autistic children focus their energy on a narrow range of activities as the energy required to switch between several toys is much higher than we would see in the neuro-typical population.

Gestalt Language Processors are often also Gestalt Cognitive Processors. This is when experiences are retained as episodic events and memories. An event is remembered by specific parts of the same event. And, therefore, these specific parts should always be part of that event, when the event is repeated.

Should any of the specifics be changed or are missing, then this can cause great upset to Gestalt Cognitive Processors. So, for example, if the last two times in speech therapy we had the train set out and this was played with happily, then this becomes a specific part of the whole session. If, I then don’t offer the train set the third time a child comes to see me, this could be very upsetting.

This is why I tend to try this out and see what happens. Usually in the 3rd or 4th session: I might not bring out the car run that has hitherto been super successful to see if we are able to transition well to other toys. If yes, then we can have new experiences but if not then I will re-offer the car run/or whatever toy pretty quickly so as not to cause complete dysregulation.

A few pointers below which help with child-led play:

Introduce a few new toys and see what happens

Parents are encouraged to bring some familiar toys their child likes to the session. We can then introduce a couple of different toys to see how we go. Try offering a new toy alongside the familiar one; try offering new toys without the familiar one present, but be prepared to re-offer the “old” toy should our child get upset.

Rotate toys and don’t offer out too many toys

I find that children can get overwhelmed and overstimulated by too many items out all at once. I always talk to parents about toy rotation at home and I encourage storage and ‘tidy up’ of toys so that we can increase attention focus, and also maintain freshness and new interest in older toys.

Some children are not yet ready to play with toys

Here I suggest people games: these are games where the adult becomes part of a more motor-based activity. Some call it ‘rough and tumble play’ but it can be nursery rhymes such as sleeping bunnies/row row the boat or peek-a-boo for the younger ones.

Copy/Imitation is so important – try getting two identical or similar play items

When we are copying our child, it is often not desirable to ‘take turns’ with their toys/blogs/cars etc as our child may not be ready to let us take a turn. Instead, if we have the exact same toy that our child is having then we can play alongside our child and copy them perfectly without interrupting their play.

References:

Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism9(2), 139-156.

If you need help with your child, please do not hesitate to contact me.


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

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Developing Joint Attention
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Developing Joint Attention

Image by Freepik

Joint attention skills what are they and how can we facilitate those?

Most of us want to make friends, connect with others and bond with a friend or be part of a community. To do so we need to develop an important social skill which is: initiating, responding to, and maintaining ‘shared/joint attention’ with another. When we can do this, we are able to focus on the same thing with another person or a group of people: music, hobbies, sport, art, books, toys, games or memories: remember when we did x y z…

Many children who struggle with speech and language development are not able to share or hold attention with another person very easily. My latest blog is all about what we can do to help our children develop Joint Attention.

So to re-cap, joint or shared attention happens when one person gets the other’s attention by either words, or gestures like pointing to something and saying ‘OMG look over there!’ – both people look at that same thing.

What does it take to have or develop this skill?

We need to first of all find something of interest that captivates our own attention. This part is usually not difficult for most people or children.

Then, crucially, we need to direct our focus away from what we find interesting, for long enough to get another person’s attention onto the same topic. This could be just seconds or it could be longer if we are very determined and good at embracing others into our experience. But if we are not then it must not take longer than seconds!

Let me give an example: if someone is in the room with me whilst I see something strange out the window, I would take that second to draw their attention to it. However, I might not be bothered to run upstairs and find someone only to show them something odd outside in the road. If I am very bored, I might do! But as I am rarely bored it is unlikely. So, unless someone else is right here with me, they are not going to be part of that particular experience, I would not share it.

Back to our child: if we make it difficult for a child who is not naturally inclined to share an interest then it is not going to happen. We must be ready, and right there for our child to have that fleeting second to look at us before returning to their hobby/interest.

This skill ‘to share a moment’ tends to develop around 12 months of age and starts with a child pointing to things. Prior to that, our child might give us something or come to show us a thing. Joint attention underpins language skills and is strong predictors of later language development (Law et al, 2017).

What are the signs that my child is struggling with Joint Attention?

  • Tunes out or does not respond when I call their name
  • Cannot follow my suggestions for games or toys/play activities
  • Does not point to anything of interest, like a truck passing by, or an aeroplane in the sky
  • Ignores or does not respond to what I say, does not follow instructions, only when he/she wants to

What can I do to help with this?

Here are some ideas you can follow in no particular order – see which one sticks:

  1. Get down to your child’s eye/face level, we call it ‘face to face’. It does not require your child to make eye contact with you but they might just do so more easily if you are ‘just there’ and don’t have to crook their neck to look up at you. When reading a book with your child, instead of sitting behind try sitting opposite him/her.
  2. Mirror play – making funny faces together in a mirror can be fun.
  3. COPY your child: top tip!! Imitate your child’s vocalisations and actions. Even if these are repetitive, just enjoy the ride.
  4. Follow your child and let your child take the lead in the play activity. What does that look like? The adult has no agenda, does not want to teach, to ask questions (see point number 9) does not want to direct or show the child how to ‘do it better/differently’ – instead accept that the child is the boss when it comes to their play and take their lead in how a toy should be played with.
  5. Hold up objects to your face or at eye level so that your child can see your face and the item at the same time.
  6. Be the ‘funniest thing’ in the room; be hugely entertaining, watchable and offer the ‘irresistible invitation’ to look at you or play with you.
  7. Offer PEOPLE TOYS (any toy where another person is needed to have fun) so: wind-up toys, bubbles, anything that needs opening or holding or doing which is tricky for the child to do alone. I always try and hide the buttons that make something ‘go’ so that my child needs to come back to me for ‘more/again’.
  8. Do PEOPLE GAMES – as above really but games that do not need a toy, that need another person to have fun: being swung round, row row the boat, being pushed on a swing etc.
  9. REDUCE ASKING QUESTIONS – this is my favourite top tip!!! Instead of asking lots of questions try and make simple statements/comments on what is happening so there is absolutely no pressure on your child to ‘perform’. Equally, silence is actually golden sometimes! An odd bit of advice from a speech therapist? Try sitting with your child, next to them or opposite and just don’t talk but simply BE… yes easier said than done, I do know this. Turn off your phone (OMG did I just say that!?) yes, please turn it off and just be with your child for a little while, just like a comfy buddy who is just enjoying their company with no agenda. You might be very surprised how your child suddenly seeks you out!

I will write about more ideas on this in my next blog so look out for more play ideas to encourage Joint Attention.

Most important, try and have fun with your child. Think about what is fun for her or him. And make it EASY for your child, remember unless you are ‘right there’ it might not happen so easily.

Happy New Year!

If you need help with your child, please do not hesitate to contact me.


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

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Are the Gestalts I model easy to mix and match later on?
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Are the Gestalts I model easy to mix and match later on?

Image by bearfotos on Freepik

Here are some examples of great phrases and Gestalts that we could use:

  • Let’s get a banana / Let’s go out / Let’s play lego / Let’s go see daddy
  • That’s nice! / That’s really good! / That’s a green one / That’s a submarine
  • Need more help / Need a wee wee / Need that / Need to run
  • How about a biscuit / How about a cuddle / How about watching tv
  • We love bananas / We love a monkey / We love a cuddle

Why or how could these examples be mixed and matched?

You can see I have given several examples for each, that is how later a child can take one chunk (let’s) and add another (go out) or (need) + (go out).

What about our own grammar? Should we be using grammatical phrases?

In general for NLA 1 (Natural Language Acquisition stage 1) we want to use short phrases and keep them quite generic, something like:

‘Let’s go’ or ‘let’s play’ and pick 2-3 phrases per communicative function (see next point below).

And if we are going to say longer sentences, for example: ‘let’s go and feed the ducks now’, then we should do so with good grammar and really varied intonation. It sometimes helps me to make up a little song/jingle on the spot that has a lot of intonation, more than I would perhaps use just by speaking.

How many varied communicative functions do we cover with our modelling?

We want to model a variety of Gestalts other than just requesting for example. In general, we are looking at our child having one or two Gestalts in the following areas before they are ready to move on into stage 2.

These are the most common ones I see in my practice:

  • Requesting ‘want a banana/biscuit’ ‘Wanna play ball’
  • Transitioning: ‘what now?’ ‘what next?’
  • Ask for help: ‘need help’ ‘help me’ ‘mummy help’
  • Commenting: ‘it’s big’ ‘it’s red’ ‘it’s fast’ ‘too loud’
  • Speak up for self: ‘not that one’ ‘go now’ ‘stop it’

Is the Gestalt I am modelling meaningful to my child?

We don’t use all available Gestalts for every child. It has to be meaningful to the individual and has to match their interests. If our child is a big fan of feeding the ducks in the park then we can think about Gestalts like:

  • I see ducks!
  • They’re over there
  • Let’s feed them?
  • Let’s get some seeds
  • They’re coming!
  • They want food / They wanna eat!
  • That’s a big one
  • It’s so hungry
  • It loves the seeds!
  • No more! All done! Finished! Let’s go home

What is my child actually trying to tell me?

We have to be become word/phrase detectives! Is the phrase/script/Gestalt they are using right now actually meaning what they said or does it mean something else, and if so, what?

Here is an example from my own personal experience in my practice:

The little boy I was working/playing with was building a tall tower with blocks. When it finally fell with a great big bang he said in a sing-song voice ‘ring-a-ring-a roses’ … then he began to collect the blocks again to make a fresh tower. I sat there and thought: why ‘ring-a-ring-a roses’? What does that mean in this context? I then sang the song (silently) to myself with my detective hat on and realised as I came to the end that it finishes with ‘we all fall down’! it was a real AHA!!! moment for me as I saw right there what the meaning of his Gestalt was. He sang the first line of the song to say ‘all fall down!’

So realising this I waited for the next tower to fall, and there it was again, he sang the first line of the song. I replied thus, copying him at first:

‘RING-A-RING-A ROSES – WE ALL FALL DOWN!…

FALL DOWN

WE LOVE IT FALLING DOWN.’

The process to find what we should say is not always straight forward or easy at all, and often we don’t quite know in the moment what our child is trying to say. But we can try and get to know their interests and then gradually we do know more and more what the meaning behind the Gestalt is or could be.

What pronouns should we use?

This can be a tricky one.

We don’t want to use language that uses the pronouns ‘you’ or ‘you’re’. The reason is that our child will likely copy us exactly as we have said it. Therefore, using pronouns ‘you’ and ‘you’re’ will then sound wrong.

Always try to model language that is from the child’s perspective or in other words how they would say it if they could.

Alternatively, you can model using WE or US. For example, if the child is tired, rather than saying ‘you are so tired’ model language from his or her point of view: ‘I’m tired’ or ‘let’s go have a lie down’.

There is so much more to talk about. Stay tuned for a blog on NLA stage 2 coming soon.

If you need help with your child, please do not hesitate to contact me.


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

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