Communication Strategies

Ages and Stages · Speech and Language Therapy · Top tips

My child is hard to understand at school age. Should I be concerned?
ByLondon Speech and Feeding March 30, 2026March 25, 2026
Many parents notice speech errors when their children are toddlers. At that stage it often feels quite normal. Young children are still learning the sounds of their language, and those early mispronunciations can be very endearing.

But as children grow older, parents sometimes begin to wonder:

‘Should my child still be speaking like this?’

A common concern I hear from families is that their child is still difficult to understand even after starting school. Sometimes it is a parent who notices it first. Other times it is a teacher who gently mentions that classmates occasionally struggle to understand what a child is saying.

When this happens, parents naturally wonder whether it is something their child will grow out of, or whether some extra support might help.

When should children’s speech be clear?

Children learn speech sounds gradually over several years. Some sounds develop earlier, while others take longer to master.

By the time children reach five to six years of age, most of their speech should be clear enough for unfamiliar adults to understand. There may still be a few tricky sounds developing (such as /R/ or /TH/), but overall speech should be fairly easy to follow.

If a child is frequently difficult to understand at school age, it can sometimes indicate that a speech sound difficulty has persisted beyond the stage when it would normally resolve on its own.

Why some children remain hard to understand

There are several reasons why speech clarity may still be developing in older children.

Phonological patterns

Some children continue to use speech patterns that are typical of younger children. For example:
- saying ‘tat’ instead of ‘cat’
- saying ‘doe’ instead of ‘go’
- leaving sounds out of words
These patterns are called phonological processes. They are a normal part of early speech development, but when they persist into the school years they can make speech difficult for others to understand.

Difficulty producing specific sounds

Other children may have difficulty producing certain individual sounds clearly. This might include sounds such as:
- /S/
- /SH/
- /R/
- /TH/
These difficulties are called articulation difficulties.

A child might understand exactly what they want to say but find it hard to produce the sound accurately with their tongue, lips or airflow.

Motor speech planning challenges

For some children, the difficulty lies in the planning and coordination of the movements needed for speech.

Speech requires very precise timing between the tongue, lips, jaw and breath. If the brain finds it difficult to organise these movements consistently, speech can sound unclear or inconsistent.

In some cases this may relate to Childhood Apraxia of Speech, although only a full assessment can determine this.

Why clarity matters for school-age children

Speech clarity becomes particularly important once children start school.

At this stage, children are:
- Answering questions in class
- Talking with friends
- Reading aloud
- Developing confidence in communication
When speech is difficult to understand, children sometimes become more hesitant to speak, particularly in group situations.

This can affect confidence and participation, even when the child has lots of ideas they would like to share.

The good news: speech can improve

The encouraging news is that speech sound difficulties can often improve significantly with the right support.

Speech therapy focuses on helping children:
- Learn how sounds are produced
- Practise accurate speech movements
- Understand how sounds change meaning in words
- Build consistency through structured practice
Different children benefit from different therapy approaches. Some need support with phonological patterns, while others benefit from more motor-based practice that strengthens speech coordination.

Often therapy combines several strategies to support the child’s individual speech profile.

When to seek advice

If your child is already at school and you find that people outside the family often struggle to understand them, it can be helpful to seek advice from a speech and language therapist.

A detailed assessment can help identify:
- Which sounds are causing difficulty
- Whether patterns such as fronting or sound substitutions are present
- Whether motor planning challenges may be contributing
- Which therapy approach is likely to be most effective
Early support can help children develop clearer speech and greater confidence in communication.

Every child’s speech journey is different

Speech development is not the same for every child. Some children master speech sounds quickly, while others need a little more guidance along the way.

The important thing is that support is available when children need it.

With the right strategies and practice, many children make excellent progress and develop speech that is clearer, more confident and easier for others to understand. If you are concerned about your child’s speech clarity or ongoing speech sound errors, a speech and language assessment can help identify the underlying difficulty and guide the most appropriate support.

Feel free to contact me on my contact page.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of 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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Autism Therapy · Neurodiversity · Speech and Language Therapy

When speech difficulties overlap: Helping children with phonological delay and childhood apraxia of speech
ByLondon Speech and Feeding March 18, 2026March 18, 2026
One of the questions parents often ask is:

‘What kind of speech difficulty does my child have?’

It’s a very understandable question. We often hear different terms such as phonological delay, articulation difficulties, or Childhood Apraxia of Speech (CAS), and it can be confusing.

The reality is that many children don’t fit neatly into one single category.

In fact, quite often I see children whose speech profile includes a mixture of difficulties. They might have some phonological patterns (where they substitute one sound for another) alongside challenges with motor speech planning, where coordinating the movements needed for speech is harder.

When this happens, therapy needs to be flexible, responsive, and tailored to the child sitting in front of us.

Example

Recently I filmed a short clip from one of my therapy sessions which shows exactly how this works in practice.

The child I was working with has difficulties with several speech sounds. Part of the challenge relates to a phonological pattern called fronting.

Fronting is when sounds that should be made further back in the mouth (like /K/ or /G/) are produced further forward instead.

At the same time, this child also shows signs of motor speech planning difficulty, which means the brain has to work harder to organise and sequence the movements of the tongue, lips and jaw for speech.

This type of profile can sometimes overlap with characteristics seen in Childhood Apraxia of Speech (CAS).

When difficulties overlap like this, therapy cannot rely on a single approach. Instead, it needs to draw on multiple evidence-based strategies.

That is exactly what you see happening in the clip. We started out generalising the /K/ sound which until recently had been replaced by a /T/ sound. Whilst looking at a sound loaded picture of /K/ sounds we somehow got talking about a ‘dent’ (I don’t recall how we got there!) but the ‘dent’ was a ‘det’ and I decided to tackle this there and then because there are other great words that end in ‘nt’ like : ‘count’ ‘giant’ ‘point’ or ‘paint’.

Using visual cues to support motor planning

Speech is incredibly complex. For children with motor speech difficulties, the challenge is not only knowing what sound they want to say, but also how to move their mouth to produce it.

This is where visual cues can be incredibly helpful.

In the clip, you can see me using a whiteboard with pictures and simple visual prompts. These help to:
- Focus attention on the target sound
- Understand where the sound occurs in the word
- Remember the sequence of sounds needed
Visual supports can act almost like a map for the mouth, guiding children as they practise new speech movements.

For children with motor planning difficulties, this type of cueing can make a huge difference.

Why repetition of a single word (massed practice) is so important

Another key feature you will notice in the clip is lots of repetition.

This is very deliberate.

When we are supporting children with motor speech challenges, the brain needs repeated opportunities to practise the correct movement patterns. Just like learning a musical instrument or a new sport, repetition helps the brain build stronger and more efficient pathways.

In therapy we call this massed practice.

Rather than saying a word only once or twice, we practise it many times in a structured way, helping the child stabilise the new speech pattern.

But repetition alone is not enough. The child also needs to understand why the sound matters.

Showing children that sounds change meaning

This is where another powerful therapy approach comes in: minimal pairs.

Minimal pairs are word pairs that differ by only one sound. For example:
- debt
- dent
In the clip, I use these two words to help the child realise that the /N/ sound makes a meaningful difference.

Without the /N/, the word becomes something else entirely.

This approach helps children recognise that speech sounds are not random: they carry meaning. If a sound is missing or substituted, the message may change.

Helping children notice these differences can be a very motivating moment in therapy. Suddenly the sound is no longer just an abstract exercise; it becomes part of real communication.

Blending approaches for the best outcomes

In this short therapy moment, I am combining:

• Visual cueing

• Motor speech practice

• High repetition (massed practice)

• Minimal pair contrasts

• Listening and awareness of sound differences

Each element supports a different part of the speech system.

Some strategies help with motor planning, others support phonological awareness, and others build accuracy and consistency.

Together they create a therapy session that is both structured and responsive.

Every child’s speech journey is unique

One of the most important things I want to convey is that speech development is not always straightforward.

Two children may both struggle with speech sounds, yet the underlying reasons may be very different.

This is why careful assessment is essential, and why therapy needs to stay flexible as we learn more about how a child’s speech system works.

Sometimes a child needs more motor-based work.

Sometimes the focus shifts towards phonological contrasts.

Often, as in this example, the most effective therapy uses both.

Small steps lead to big progress

Every session helps us understand a little more about how a child’s speech system works and what support will help them move forward.

And when the pieces start to come together, when a child realises that one tiny sound can change a whole word, that is when the real progress begins.

If you are concerned about your child’s speech sounds, clarity of speech, or possible motor speech difficulties, early support can make a significant difference. A detailed assessment can help identify the nature of the difficulty and guide a therapy approach tailored to your child’s individual needs.

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

Reference

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

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Autism Therapy · Neurodiversity · Speech and Language Therapy

Your child’s communication journey

ByLondon Speech and Feeding January 7, 2026January 5, 2026

Understanding our neurodiversity-affirming, child-led approach

Welcome to a different kind of therapy!

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

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

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

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

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

Our approach is grounded in a simple and powerful truth:

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

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

🎯 Our purpose: Communication through connection

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

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

🧸 What to expect in a session

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

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

Is this really effective?

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

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

Within play, we are constantly creating opportunities to:

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

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

💛 What this might look like at home

You may notice that when pressure is reduced:

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

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

📚 Resources for parents

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

Book: Uniquely Human by Dr Barry Prizant
Approaches: The Hanen Program and DIR/Floortime Model
Further reading: Searching ‘Neurodiversity-affirming speech therapy’ or ‘Child-led therapy’

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Royal College of Speech & Language Therapists Member

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.

Autism Therapy · Neurodiversity · Printables · Speech and Language Therapy · Top tips

Let’s ditch the ‘Fix-It’ approach to autistic play and stimming
ByLondon Speech and Feeding December 8, 2025December 8, 2025
December is often presented as a time of perfect, reciprocal play. Children are supposed to be unwrapping toys, sharing, and engaging in imaginative scenarios with family. But for parents of young autistic children, this high-pressure, socially demanding period can often feel like a battleground.

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

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

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

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

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

Think of stimming as an internal volume dial:
- Too loud/overwhelmed: Your child may stim to reduce incoming sensory input (e.g., rocking to ground himself or herself in a busy room).
- Too quiet/under-stimulated: Your child may stim to increase sensory input and focus (e.g., running back and forth to maintain alertness).
The shift: validate, don’t block

Instead of saying, ‘Stop flapping your hands’, try to understand the message behind the movement.
- Observe: When does the stimming happen? Is it before a meltdown? When your child excited? When your child is bored?
- Validate: Name the need, not just the behaviour. You might say, ‘I see your body needs to move fast right now. That helps you calm down!’
- Co-regulate: If the stim is unsafe (e.g., head-banging), help your child find a safer, alternative stim that meets the same sensory need (e.g., pushing hard against a wall, squeezing a stress ball).
By validating your child’s need to regulate, you are building trust, reducing anxiety, and teaching him or her critical self-awareness.

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

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

In neurodiversity-affirming practice, we recognise that autistic play is authentic play. These activities are crucial for learning, deep focus, and imaginative development.
- Lining up toys may be an exploration of patterns, visual organisation, and order.
- Spinning wheels may be a deep interest in cause-and-effect and visual sensory input.
- Scripting is often a way to process language, regulate emotions, and practise complex social situations in a safe, controlled way.
Make a change: Join your child’s world, don’t drag them to yours.

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

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

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

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

Affirm the script, then model something useful.
1. Affirm the script: When your child says a script, respond to the meaning or emotion behind it, not the literal words. If he or she says, ‘We’re going to need a bigger boat’, and he or she is looking at a messy toy pile, he or she may be trying to express overwhelm or a need for help. You can affirm: ‘That pile is too big! I can help you move it.’
2. Model new ‘mix and match’ scripts: To help your child move from whole scripts to single words, you can model shorter, slightly changed versions of the script, also called ‘mitigated gestalts’. If they say, ‘I want to go home now’, you might model, ‘Let’s go home, now’ or ‘I wanna go home’.
By honouring your child’s communication style, you validate his or her experience and naturally support his or her path to language development—a core part of neurodiversity-affirming SLT.

Your December gift to your little one:

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

Prioritise regulation and connection over compliance.

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

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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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Autism Therapy · Neurodiversity · Speech and Language Therapy

The joyful language toolkit: Strategies for connecting with your child through play
ByLondon Speech and Feeding October 15, 2025October 9, 2025
As parents and therapists, we all want to help our children communicate. But sometimes, the process can feel like ‘work’. If I had a penny for every parent saying ‘I find it so boring!’… Ok hang in… what if I told you the most effective therapy happens when it doesn’t look like therapy at all?

My approach centres on connection, enthusiasm, and multi-sensory engagement. We don’t just teach words; we teach the joy of using them. These strategies can be used whether your child is speaking, using a core board, or communicating in his or her own unique way.

Some of my favourite strategies

Today I want to share a few of my favourite strategies to turn everyday interactions into powerful communication opportunities regardless of why or how big a delay your child is having.
1. Facial expressions & exaggeration: Use an exaggerated facial expression to show surprise (wide eyes!), excitement (big smile!), or confusion (a crinkled brow!). Your face is a powerful teaching tool. I am always talking like a clown in my sessions. I can announce that I have also a normal speaking voice outside my clinic room! 😊
2. Using your voice with intonation: Your voice is music! Use a singsong or ‘tuneful’ repeat to make words stand out. For example, ‘It’s a BIIIG ball!’ or ‘Let’s GO-O-O!’. Again think: clown!!
3. Hands and body to show: Use gestures, hands, and body movements to demonstrate. Say ‘OPEN’ while pulling your hands apart, or ‘UP’ while raising the toy high above your head.
4. Elongating our words: Stretching out key sounds or words gives them emphasis and more time for your child to process. ‘Criiiinkley’ ‘tiiickleyyyy’
5. Core board & language modelling:
  
  Model the core board with joy: Don’t just point: point with energy!
  
  Model the core board repeatedly throughout the activity, showing genuine excitement. This demonstrates the board is a joyful tool, not homework.
  
  Pointing to the core board: When you say a core word, point to the corresponding symbol. You are showing your child, ‘My words live here, and your words can too’.
6. Describing it for your child: Help your child build his or her vocabulary by providing rich sensory language. ‘It’s squishy’, ‘It’s very noisy’, or ‘It’s so smooth’.
7. Catchy phrases: Repetitive, positive phrases create a sense of shared fun. Use them consistently: ‘Oh, that’s a nice one!’ or ‘We like that!’
8. Following your child’s Interest: Put down your agenda and follow your child’s lead. If they pick up a block, talk about the block. This ensures they are engaged and ready to learn.
9. Allowing for pauses: This is critical! After you made a comment, allow for a significant pause (count to five in your head) for your child to fill. The silence creates a powerful opportunity for them to initiate communication.
10. Copying your child’s sounds: If he or she makes a sound (‘buh!’), you make the sound back! Copying your child’s sounds shows him or her ‘I hear you, and your communication is important’.
11. Lots of repetition: Hearing a word many times in meaningful contexts is how we learn! Repeat key phrases and core words throughout the activity. Repetition is the key to retention.
12. Getting turns: Explicitly teach and celebrate getting turns in a game. ‘My turn! Your turn!’ This is a foundational social and communication skill.
13. Using tidy up as a teaching activity: Turn cleanup into a fun game! It’s a goldmine for core words like PUT IN, ALL DONE, HELP, and MORE. For example, ‘Let’s PUT IN the red block! Yay!’
14. Using exaggerated repeats: When your child tries a sound or word, give it back with exaggerated, tuneful repeats.
Try out all or even just a few of these strategies, and I can promise you, you’re not just encouraging language; you’re building a joyful, reciprocal relationship based on genuine communication!

Which strategy are you excited to try first? Let me know in the comments!

If I can help you with any of the above, if you want to practise these a bit more, I would love to help you!

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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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Autism Therapy · Echolalia · Neurodiversity · Speech and Language Therapy

How parent coaching turns story time into a communication success
ByLondon Speech and Feeding October 6, 2025October 2, 2025
We often hear from parents who are trying their best to connect with their child, especially when reading books, but are met with frustration. They’ll say, ‘I read the book exactly as it’s written, but my child can’t focus for very long and just runs off!’ or ‘my child just flicks through the pages then turns it upside down and runs off with it’ or similar.

It’s a common story. Traditional reading—going through the text from cover-to-cover—has its place of course, but for little ones with a language delay or autism it can move too quickly and place all the focus on the book’s words, not on the interaction.

But what if I told you that story time could become one of the most fun and productive times for your child’s communication development?

Watch the fantastic little video clip above! You can see the pure joy and connection between this dad and his son. This is the same family who, just a few weeks ago, felt defeated when trying to read a book, with their child quickly losing interest and leaving the reading/book corner.

What changed?

The power of parent coaching and Hanen principles

The difference you see in the video is the direct result of parent interaction therapy, or parent coaching, based on the internationally recognised Hanen principles.

I didn’t ‘fix’ the child. Instead, I coached the parents in a few simple, powerful strategies that completely changed the dynamic of their interaction. Instead of being a time for teaching and instruction, story time became a back-and-forth conversation.

Here are the four major transformations that coaching helped this family achieve:

1. From reader to play partner

Before coaching, the parents felt their job was to read the text and to teach the words in it to their child. Now, their job is to follow their child’s lead. They learned to Observe, Wait, and Listen (OWL). If the child points to the tree or the badger on the page, the parent talks about the tree or the badger.

The result

The child is now initiating and leading the conversation! He is sharing what he finds interesting, which makes him feel powerful and keeps him deeply engaged.

2. Building connection and attention

When parents focus solely on reading, they often forget to make frequent eye contact and use animated facial expressions. The principles taught them to put the text aside and prioritise connection.

The result

Our little boy is looking at his dad more frequently, making great eye contact, and clearly having fun! When the interaction is fun, the child’s attention span naturally lengthens, allowing him to attend to the book and the interaction for a much longer time.

3. Creating opportunities for communication

The parents learned simple ways to prompt communication without pressure. They stopped asking knowledge-based questions (‘What colour is that? Or point to the pig!’), which can feel like a test.

Instead, they learned to use techniques like ‘Saying less and pausing’ or ‘copying their little one’s echolalia ‘, signalling that they are very interested in what he is saying and that his communication matters!

The result

The child is now spontaneously using strings of sounds and gestures to communicate his needs and interests, knowing and enjoying his parents’ enthusiastic responses.

This video is a testament to the fact that you are your child’s best therapist. With the right tools and coaching, you can transform everyday routines, like reading a book, into the most joyful and effective communication sessions.

4. Acknowledging and interpreting echolalia

In the video, you may hear the little boy repeat a phrase from the book or from what his dad just said. This is called echolalia, and for a long time, it was often dismissed or discouraged.

However, a core principle of our parent coaching is that echolalia is communication. For children who are ‘Gestalt Language Processors,’ these memorised phrases (or ‘gestalts’) are their building blocks of language.

The key is not to stop the repetition, but to become a ‘language detective’ and ‘interpreter’!

By modelling the correct, first-person phrase right after the echo, parents/caregivers are teaching a child how to break down the ‘chunk’ and use the individual words functionally. They are showing their child: ‘I heard you. Your communication makes sense to me.’

This strategy is a game-changer because it:
1. Validates the child’s communication: It honours the child’s natural way of learning language, which boosts their confidence and willingness to communicate.
2. Facilitates language development: It provides the child with the next step—a meaningful, functional phrase—to move them from repeating language to generating their own spontaneous sentences.
Look at the child’s face again in the video. When his dad acknowledges and interprets his communication, you see that spark of joy and connection—that’s the moment when true, functional language learning happens!

Ready to unlock the potential in your family’s story time? Contact me to learn more about our parent coaching programs.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of 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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Autism Therapy · Neurodiversity · Speech and Language Therapy

Using AAC in daily life
ByLondon Speech and Feeding September 24, 2025October 2, 2025
Communication is a fundamental human right, a bridge that connects us to the world and each other. For many, spoken language is the primary mode, but for individuals with complex communication needs, Augmentative and Alternative Communication (AAC) offers a powerful pathway to expression and connection. This guide will demystify AAC, highlight the crucial role of modelling, and provide practical examples of how low-tech AAC can be seamlessly integrated into everyday activities.

What is AAC in a nutshell?

AAC encompasses a wide range of tools and strategies that supplement or replace spoken language. It’s not about replacing speech, but rather about providing additional ways for individuals to communicate effectively. Think of it as a spectrum:
- Unaided AAC: This involves using only your body, such as gestures, facial expressions, body language, and sign language.
- Aided AAC: This involves external tools or devices. These can range from low-tech options like picture boards and communication books to high-tech speech-generating devices (SGDs) and apps on tablets.
The beauty of AAC lies in its flexibility and personalisation. It empowers individuals to express their wants, needs, thoughts, and feelings, fostering independence and participation in all aspects of life.

Modelling is KEY: Showing, not just telling

Imagine trying to learn a new language without ever hearing it spoken. It would be incredibly difficult, right? The same principle applies to AAC. Modelling is the single most important strategy for teaching and supporting AAC users. It means actively using the AAC system yourself while talking, demonstrating how to navigate the system and express messages.

Here’s why modelling is so vital:
- It’s how we learn language: Typically developing children learn language by hearing it constantly around them. AAC users need the same immersion.
- It reduces pressure: When you model, you’re not asking the individual to communicate, you’re just showing them how it’s done. This takes the pressure off and makes learning more enjoyable.
- It expands vocabulary and concepts: By modelling a variety of words and phrases, you introduce new vocabulary and demonstrate how to combine symbols to create more complex messages.
- It demonstrates purpose: Modelling shows that AAC is a functional and effective way to communicate, not just a set of pictures.
So, how do you model? It’s simple: point to the symbols on the communication board or device as you speak the words. For example, if you say, ‘Time to eat breakfast,’ you might point to ‘time’, ‘eat’, and ‘breakfast’ on the board.

Low-tech AAC in action: Everyday activities

Low-tech AAC, such as communication boards, books, or single-page displays, is incredibly versatile and can be easily incorporated into daily routines. These can be as simple as printed pages with symbols, laminated for durability.

Let’s explore how low-tech AAC can be used throughout a typical day, with examples of symbols:

1. Getting ready for nursery

Mornings can be busy, but they also offer rich communication opportunities. A ‘Getting Ready’ communication board can help sequence activities and offer choices.

Activity example:

‘Time to get up!’ (point to GET UP). ‘What do you want to wear today, the blue shirt or the red shirt?’ (point to GET DRESSED) ‘Then, we brush teeth’ (point to TOOTHBRUSH) and so on.

2. Breakfast Time

Mealtimes are perfect for making choices, expressing preferences, and commenting. A ‘Breakfast’ communication board can focus on food items, actions, and social comments.

Example symbols:

Activity example:

‘What do you want to eat for breakfast?’ (point to EAT). ‘Do you want cereal or toast?’ (point to CEREAL or TOAST). If they finish their milk, you could say, ‘Are you ALL DONE or do you want MORE MILK?’ (point to symbols).

3. Catching the Bus

Even routine transitions like catching the bus can be communication rich. A small, portable ‘Travel’ board can be useful.

Example symbols:

3. Being on the playground

The playground is a dynamic environment perfect for commenting, requesting actions, and engaging in social play.

Activity example:

‘Let’s PLAY!’ (point to PLAY). ‘Do you want to go on the SWING or the SLIDE?’ (point to symbols). If they are on the swing, you can say, ‘Do you want to go FAST or SLOW?’ (point to symbols) and ‘Push AGAIN!’ (point to PUSH) You can also model social language like ‘It’s MY TURN.’

Beyond the symbols: Key takeaways
- Consistency is key: Use AAC consistently across all environments and with all communication partners.
- Be patient: Learning a new language takes time. Celebrate small successes.
- Make it fun: Integrate AAC into play and enjoyable activities.
- Follow the individual’s lead: Respond to all communication attempts, even if they are imperfect.
In the video below I model how to integrate AAC into everyday activities with a few more examples and I discuss the difference between AAC and PECS.

If you need some inspiration with using AAC or would like your child assessed for the right type of AAC then please get in touch.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of 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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Neurodiversity · Speech and Language Therapy · Top tips

Why auditory memory matters (especially for little ones!)
ByLondon Speech and Feeding August 4, 2025August 1, 2025
Have you ever stopped to think about how we learn to speak, understand, and communicate effectively? It’s a complex dance of various cognitive skills, and one often overlooked but absolutely crucial player in this orchestra is auditory memory. It’s not just about remembering sounds. It’s about remembering sequences of sounds, which is fundamental to language development.

What exactly is auditory memory?

At its core, auditory memory is our ability to take in, process, store, and recall information that we hear. Think of it as your brain’s internal recording studio. When someone speaks to you, your auditory memory is busy at work, capturing the individual sounds, the order in which they appear, and the rhythm and intonation of the words. This isn’t just for long-term recall; it’s also vital for working auditory memory, which allows us to hold onto a small amount of auditory information for a short period, just long enough to make sense of it.

For speech and language, auditory memory is essential for:
- Understanding spoken language: To comprehend a sentence, we need to remember the beginning of the sentence by the time we hear the end.
- Following instructions: Remembering a sequence of commands relies heavily on auditory memory.
- Learning new words: We hear a word, remember its sound, and connect it to its meaning.
- Developing phonological awareness: This is the ability to recognise and manipulate the sounds in spoken language, a critical precursor to reading. Auditory memory helps children distinguish between similar-sounding words (e.g., ‘cat’ vs. ‘bat’) and segment words into individual sounds.
- Producing clear speech: To articulate words correctly, we need to recall the precise sequence of sounds that make up that word.
- Developing conversational skills: Remembering what was just said helps us formulate appropriate responses.
When auditory memory falls short: The impact on speech

When auditory memory is poor, particularly in young children, the ripple effects on speech and language development can be significant. Children might struggle with:
- Following multi-step directions: ‘Put on your shoes, get your coat, and meet me at the door’ can become an overwhelming jumble of sounds.
- Learning new vocabulary: They might hear a new word repeatedly but struggle to retain its sound pattern, making it difficult to recognise or use later.
- Understanding stories or conversations: Missing key details or losing the thread of a narrative because they can’t hold enough information in their working memory.
- Developing phonological skills: Difficulty with rhyming, identifying initial sounds in words, or blending sounds together to form words, which can impact early literacy.
- Speech production: They might mispronounce words, omit sounds, or struggle with the correct sequencing of sounds within words.
- Social communication: Difficulty participating in group discussions, remembering names, or recalling what their peers have said.
- Academic performance: Auditory memory challenges can impact a child’s ability to learn in a classroom setting, where much of the instruction is delivered verbally.
It’s important to note that poor auditory memory isn’t a sign of low intelligence, but rather a specific processing challenge that can be addressed with targeted support.

Nurturing auditory memory in under 5s: Preparing for schooling

The good news is that auditory memory is a skill that can be strengthened and developed, especially during the crucial early years. For children under five, laying a strong foundation in auditory memory is an invaluable gift as they prepare for the demands of formal schooling. Here’s what we can do to help:
1. Read aloud regularly: This is perhaps one of the most powerful tools. As you read, encourage your child to listen for specific words, predict what happens next, and retell parts of the story. Vary your voice, use different intonations, and pause to emphasise key words.
2. Play auditory memory games:
  
  ‘Simon says’: This classic game is fantastic for following multi-step instructions. Start with one command and gradually increase the number.
  
  ‘I Spy’ with sounds: Instead of colours, describe sounds. ‘I spy with my little ear something that goes “moo”.’
  
  Rhyming games: Sing rhyming songs, read rhyming books, and encourage your child to come up with words that rhyme.
  
  Sound matching: Use everyday objects to make sounds (e.g., shaking keys, tapping a spoon) and have your child identify or match them.
  
  ‘Memory chain’: Start a sentence and have your child add to it, remembering everything that came before: ‘I went to the market and bought an apple.’ ‘I went to the market and bought an apple and a banana.’
3. Sing songs and nursery rhymes: Repetitive songs and nursery rhymes are excellent for developing auditory memory, rhythm, and phonological awareness. The predictable patterns help children anticipate and remember sequences of sounds and words.
4. Give multi-step instructions (and praise!): Start with two-step instructions and gradually increase the complexity as your child’s skills improve. Always give positive reinforcement when they succeed. ‘Please pick up the red block and put it in the box.’
5. Engage in active listening: Model good listening skills yourself. When your child is speaking, give them your full attention. Ask clarifying questions to encourage them to elaborate and organise their thoughts.
6. Reduce background noise: A quiet environment makes it easier for young children to focus on auditory information. Minimise distractions like TV or loud music during activities that require listening.
7. Use visual cues: While we’re focusing on auditory memory, sometimes pairing auditory information with visual cues can be helpful, especially initially. For example, when giving instructions, demonstrate the action as you say it.
8. Be patient and consistent: Developing auditory memory takes time and consistent practice. Celebrate small victories and create a playful, supportive environment for learning.
By actively engaging in these strategies, we can empower our youngest learners to build robust auditory memory skills, setting them up for success not only in speech and language development but also in their overall academic journey. It’s an investment that truly pays dividends in their future communication and learning abilities.

Any comments or if you need help and support with your child’s speech please do not hesitate to get in touch with me: simply fill out the contact form here on the website. I endeavour to reply within 48 hours.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of 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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Autism Therapy · Neurodiversity · Speech and Language Therapy

The power of imitation in supporting children with autism
ByLondon Speech and Feeding May 19, 2025May 16, 2025
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.

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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