Gestalt Language Processors – The London Speech and Feeding Practice

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:

Validates the child’s communication: It honours the child’s natural way of learning language, which boosts their confidence and willingness to communicate.
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.

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.

2

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

The purpose and nature of a speech and language therapy assessment

ByLondon Speech and Feeding May 27, 2025May 19, 2025

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

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

Establishing a detailed profile – a few bullet points:

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

A multi-faceted approach

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

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

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

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

What happens after an assessment?

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

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

1

Autism Therapy · Neurodiversity · Speech and Language Therapy

Explaining pronoun reversal: A window into gestalt language processing

ByLondon Speech and Feeding April 2, 2025April 2, 2025

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

Gestalt language processing: Learning in chunks

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

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

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

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

How can we support their natural language journey

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

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

The big picture: Language unfolds naturally

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

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

So, to summarise:

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

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

If you have any questions or would like some help with understanding your little gestalt language learner, please get in touch with me via my contact form.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

1

Autism Therapy · Neurodiversity · Speech and Language Therapy

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

ByLondon Speech and Feeding November 11, 2024November 13, 2024

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

Introduction

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

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

So let’s look at the ‘4 S’

1. The first one is SAY LESS

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

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

2. The second one is STRESS

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

3. The third one is GO SLOW

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

4. The last one is SHOW

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

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

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

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

The fifth is REPEAT.

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

Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

1

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

Following your child’s lead: A playful path to AAC success

ByLondon Speech and Feeding August 27, 2024August 23, 2024

Unlocking playtime: A guide to child-led learning

Does your child struggle to focus on toys or activities? Do they dart away as soon as you approach? You’re not alone!

The key to unlocking your child’s potential lies in following their lead. Let them guide the play session, and watch their engagement and focus soar.

Why Child-Led Play Works:

Empowerment: Children feel in control, sparking their curiosity and motivation.
Focused attention: They’ll stay engaged with activities for longer periods.
Reduced frustration: By stepping back and observing, you eliminate the pressure and stress that often comes with directed play.

How to Implement Child-Led Play:

Prepare the environment: Set out a limited selection of engaging toys.
Observe and wait: Sit back, watch, and listen to your child’s interests.
Embrace the moment: Resist the urge to direct or question; simply enjoy the process.

Remember: This simple approach can transform playtime and support your child’s development. Give it a try for a week and see the difference!

#OWLing #hanenmorethanwords

Observe, Wait, Listen. It’s a powerful formula for unlocking your child’s potential.

You will likely see:

Your child will stay put with any toy for longer whilst you are near them.
Your child will tolerate you being nearby and he/she won’t move away.
Your child will start giving you brief glances of enjoyment, or perhaps they will hand things to you, or they might take your hand and lead it to something that needs opening etc.
In other words, you will see that there suddenly is JOINT PLAY. Yes, granted it may not be according to your adult agenda, but there will be more togetherness than there was before. And this is the START of communication and social engagement.

USE Core words and a coreboard — to help your child understand the power of words

Core words are the building blocks of communication. Try using a coreboard like the one below, they are versatile and can be used in countless ways. By modelling these words naturally during play, you expose your child to their meaning and function in context. This approach is far more effective than isolated drill and practice, more powerful than flashcards!

Using AAC coreboard — Photo by lemonlenz

A Winning Combination

Combining child-led play and AAC modelling creates a magic effect. To summarise:

Increased engagement: When you follow your child’s lead, they are more likely to be engaged and receptive to learning. This creates optimal conditions for introducing AAC core words.
Natural learning: By modelling AAC core words in the context of play, you help your child understand their meaning and purpose naturally. This fosters generalisation and spontaneous use.
Building relationships: Shared play experiences strengthen the bond between you and your child. This trust and connection are essential for successful communication.
Reduced pressure: Modelling AAC core words without expectation removes the pressure to produce language. This allows your child to explore communication at their own pace.
Expanded vocabulary: As your child becomes more comfortable with AAC, they will begin to incorporate core words into their own communication. This leads to vocabulary growth and increased independence.

Practical Tips

Observe and respond: Pay close attention to your child’s interests and actions. Respond to their cues with enthusiasm and support.
Keep it simple: Start with a few core words and gradually introduce new ones as your child’s skills develop.
Be patient: Language learning takes time. Celebrate small successes and avoid frustration.
Have fun: Remember, play is supposed to be enjoyable for both you and your child. Relax and have fun together!

Example:

Let’s say your child is playing with a pop-up toy like you see me do in the above photograph. Here, I followed my child’s lead by waiting to see what she wanted to do with the toy. You are now OWLING! (Observe Wait and Listen)

Once I noticed that there was repetitive opening of the flaps going on I then pointed to OPEN and MORE on the board, as I said: ‘let’s OPEN this one’ / let’s see MORE animals’ / ‘MORE cow! it says moo!’ ‘OPEN another one’ and so on.

Important to know, we are not expecting our child to respond verbally or with AAC, but we are providing language input and demonstrating how these words can be used with enthusiasm.

Naturally in time your child will look at the board and at your pointing and they will eventually want to copy you!

By incorporating these strategies into your daily interactions, you can create a supportive environment that fosters language development and communication growth. If you would like more guidance please get in touch and book in for a consultation, some individual therapy and/ or some parent coaching.

I look forward to supporting you. Please contact me and let’s see how.

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.

1

Autism Therapy · Speech and Language Therapy · Top tips

Using AAC during play with your child

ByLondon Speech and Feeding June 7, 2024June 6, 2024

Playtime! It’s a magic time for exploration, learning, and connection.

If your child is struggling to use words with his/her mouth, we can always use a robust Augmentative and Alternative Communication (AAC) device to help find their words. We know that using such a device does never stop or delay children to speak with their mouths. On the contrary it helps, enormously!

Can playtime still be a blast? Absolutely! In fact, incorporating AAC into play can be a powerful way to boost communication skills, build confidence, and create a truly inclusive play experience. Here’s how to make it happen, with a focus on core words and core scripts for our GLP’s (the building blocks of communication used by everyone). In this video I am using the core word ‘IN’ and ‘MORE’.

The Magic of Core Words

Core words are the most frequently used words in everyday communication. They might be verbs like ‘want’, ‘more’, ‘go’, or ‘stop’, or adjectives like ‘happy’, ‘sad’, and ‘hot’. These words are the foundation for building sentences and expressing needs and desires. They’re perfect for children using AAC because they’re simple to understand and use.

Let’s Play! Here’s How

1. Choose Your AAC System

Many options exist! It could be a low-tech picture board with core words, such as the one you see pasted on my cabinet door in the background, or it can be a dedicated AAC app on your tablet. Here I am using the GRID app but I also love using others, such as LAMP Words for Life.

2. Make it Fun and Functional

No pressure! Integrate your AAC system seamlessly into your play routine. Here are some ideas:

Car/trains: Use core words to describe what the cars are doing: (‘down’, ‘go’, ‘stop’, ‘again’ ‘fast’ ‘slow’).
Dress-up: Use core words to choose clothes (‘want’, ‘hat’, ‘shoes’).
Tea Party: Use core words to ask for and share (‘more’, ‘juice’, ‘give’).
Building Blocks: Use core words to describe what you’re building (‘tall’, ‘big’, ‘house’).
Dolls/Stuffed Animals: Use core words to act out scenarios (‘sleep’, ‘eat’, ‘cry’).
Arts and Crafts: Use core words to describe colours (‘red’, ‘blue’), actions (‘draw’, ‘paint’), and feelings (‘happy’, ‘sad’).

If your child is a Gestalt Language Processor you will want to model meaningful, fun scripts instead of single words! As above, but use phrases:

Car/trains: Use scripts to describe what the cars are doing: (‘it’s going down’, ‘let’s go’, ‘make it stop’, ‘want it again’, ‘that was fast’, ‘it’s so slow’).
Dress-up: Use scripts to choose clothes (‘I’m gonna wear this’ ‘that’s a lovely hat’, ‘let’s choose shoes’).
Tea Party: Use scripts to ask for and share (‘I want more’, ‘more juice’, ‘give me this’).
Building Blocks: Use scripts to describe what you’re building (‘a tall one’, ‘that’s so big’, ‘it’s a house’).
Dolls/Stuffed Animals: Use scripts to act out scenarios (‘it’s time to sleep’, ‘let’s eat’, ‘he’s crying’).
Arts and Crafts: Use scripts to describe colours (‘a red crayon’), actions (‘let’s draw’, ‘I’m gonna paint’), and feelings (‘I’m happy’, ‘that’s so sad’).

3. Model, Model, Model

This is key! As you play, constantly model using your child’s AAC system.

Point to the picture or word or script you’re using.
Speak clearly and slowly while pointing.
When using core words for either Analytical or Gestalt Language Processors, try using good phrases. For example, instead of just saying ‘juice’, say, ‘you want more juice?’

4. Make it a Team Effort

Get everyone involved! Encourage siblings, grandparents, and caregivers to use the AAC system with your child during playtime. The more consistent the approach, the faster your child will learn and feel confident using their voice.

5. Celebrate Progress, Big and Small!

Every step counts! Acknowledge and celebrate your child’s efforts, whether it’s reaching for their AAC system or successfully using a core word. This positive reinforcement will keep them motivated.

Remember

Playtime should be fun, not stressful. Don’t force your child to use their AAC system. Let them lead the way and follow their interests.
Every child develops at their own pace. Celebrate your child’s unique communication journey.
Seek professional help when needed. Your SLT can provide tailored strategies and resources to support your child’s development.

By incorporating AAC and core words into playtime, you’re not just fostering communication; you’re creating a space for your child to thrive, explore, and build strong connections.

So, grab those toys, power up your AAC system, and get ready for a playtime adventure filled with fun, connection and, therefore, communication!

Don’t hesitate to contact me!

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.

1

Autism Therapy · Neurodiversity · Speech and Language Therapy

Stage 2 NLA

ByLondon Speech and Feeding February 23, 2024February 15, 2024

Last time we asked: is our child ready tp move to Stage 2 NLA (Natural Language Acquisition stage 2) and we looked at how we can know. Now we know: he/she is ready, they are mixing and matching those scripts quite liberally! Hurrah!

So for example we hear phrases like:

‘let’s go’+ ‘downstairs’
‘it’s’ + ‘downstairs’
‘I see it’ + ‘downstairs‘
‘I want to’ + ‘shoes downstairs’ (I want to put my shoes on downstairs)

To recap, it’s important to listen out to a variety of contexts because if we only hear the single version of a gestalt —this is so great, hurrah!— but that’s not yet Stage 2.

What we can now do on a daily basis to help and support at this time:

1. We need to offer more ‘mix and match’ phrases to help our child establish this new way of communicating.

Good phrases:

It’s … raining / cooking / eating / washing / brushing
That’s … great / cool / amazing / wow / so good
Let’s … see / look / go / run / chase
How’bout … some food / playing / I’ll chase / sleeping / we read a book
I see a … bird / large car / fire engine
I wanna … have a biscuit / have a book / have a snuggle
We’re … going out / going home / going in the car / going upstairs

Here in my video clip of train play I use:

Let’s go
It’s going up the hill
It’s coming down
Ooops it falls!
It’s stopping
Let’s put on another parcel
Ready steady go
Off we go
It’s come off!
Let’s fix it
I can do it
I don’t need help

You can offer these gestalts either with an AAC as you can see me do in the video clip or you can just verbally offer these.

2. Watch out for Pronoun confusion or reversal:

Gestalt kids repeat gestalts, so we don’t want to create ‘pronoun reversal’.

Instead model from a:

first person perspective: ‘I’ / ‘Our’ / ‘Us’
joint perspective: ‘We’ / ‘Let’s’ or a
neutral perspective: ‘It’

You can turn almost any sentence into a good language model once you get used to it. And you can avoid ‘you’ and ‘your’ at the same time!

So instead of saying, ‘Do you want to go to the park?’

You could say:

We wanna go to the park?
Let’s go out?
Shall we go out / to the park?

3. Start providing ‘variation’ in your language modelling:

Instead of just modelling something one way, start thinking about offering a pattern in a couple of other ways, in a couple of different situations, then several ways in several different situations.

Example: once you hear your child saying: ‘it’s raining’ and you know it’s a mitigation, because you don’t often say ‘it’s raining’, or haven’t said it in a while and you know your child says other ‘it’s’ phrases.

Repeat: ‘it’s raining!’

Then: ‘it’s’ + ‘raining hard’ / ‘it’s wet out there’ / ‘It’s’ + ‘raining lot’s’.

Then later think of other combinations for ‘it’s’ + ‘something’:

(rice) ‘It’s’ + ‘cooking’
(water/tap) ‘It’s’ + ‘running’
(radio) ‘It’s’ + ‘singing
(dog) ‘It’s’ + ‘peeing’ / ‘it’s’ + ‘running’ / ‘it’s’ + ‘jumping’

In my train video clip:

Let’s go
It’s going
Let’s make it go
Ready steady go
Oops its gone

4. Use natural intonation that shows you really mean what you’re saying.

You can be animated or try for musical if your child prefers that / doesn’t mind you singing —they might not like it if their hearing is pitch perfect and your singing is off key…—

‘I’m’ + ‘trying to find you!’ (animated, goofy face)
‘I’m’ +’ getting tired!’ (exaggerated stretch and yawn)
‘I’m’ + ‘catching up with you!’ (animated goofy)
‘I’m’ + ‘gonna get you!’ (animated goofy)
‘I’m’ + ‘sad right now’ (exaggerated face and tone of voice)

5. USE SILENCE!

Important, I might not have said this before but we need to hold back sometimes (hard I know) and not constantly offer models. Let our child sit in a bit of silence with us there just observing and waiting for their own offers. This is a very important point. Silence is golden sometimes. Try it out. I am not talking about the silence that comes with a person scrolling on their phone though, we do need to be present and receptive.

You will see this works wonders!

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

You can also check my friend’s lovely handmade jewelry on her website.

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

How do we know our Gestalt Learner is moving to Stage 2?

ByLondon Speech and Feeding February 14, 2024February 14, 2024

Is our student ready to move to NLA 2 (Natural Language Acquisition stage 2)?

We know that the GLP (Gestalt Language Processor) will move into the next stage when they are ready. But are they now ready you might think? When are they ready? How do I know? If you are not sure whether your child is ready to move forward then go and see your GLP trained Speech Therapist. Together you can work out what the next steps are and how to help your child settle into NLA 2. It’s very exciting!!

Tip

The first useful tip: keep a language sample of phrases your child says. This is very helpful!

You might want to check with your Speech Therapist and offer some language sampling you have taken so they can help you figure out where your child is currently. Always keep an Utterance Journal that you can share with your Speech Therapist and with others who look after your child.

Basically, we want to listen out for phrases our child says that you or nursery don’t say routinely; that way you can presume that this is not an echo but a mixing together of two chunks of gestalts. Watch out for those coco melon phrases though: double check it really isn’t an NLA 1 gestalt that is copied verbatim from a favourite you tube video.

You can best support your child best by listening, and thus figuring out what your child is TRYING TO SAY. Often your child might skip over the parts of gestalts they don’t want to say. This is common in older kids who have long gestalts, sometimes even whole episodes or whole stories!

Try and tease out their shorter mitigations and then focus on practicing and modelling those as they are so much more useful!

So back to our question: are they ready?

Are their gestalts covering a variety of situations and contexts?

Make a note in your journal to see what the backgrounds are to each phrase you ear, so for example:

Transitioning: ‘it’s time for the park’ ‘what’s next’ ‘shoes on’
Bed Time: ‘we need to wash’ ‘let’s get in (bath/bed)’ ‘ready for our book’
Toilet/nappy: ‘we need the potty’ ‘where’s the potty’ ‘let’s wash hands’
Mealtime: ‘time to eat’ ‘go get a spoon’ ‘yummy num num’
Park/going out: ‘look at the squirrel’ ‘funny doggy’ ‘I wanna swing’
At the shops: ‘let’s get the trolley’ ‘lots of veggies’ ‘no tomatoes’ ‘ooh long queue’ ‘back to the car’

And… does the child use the phrases for a variety of functions?

labelling
providing information
calling out
affirming
requesting
protesting
directing

We need to offer lots of similar language models so that in their own time our children can extract/mitigate useful phrases for what they want to express. The more similar utterances a child hears around him the more he/she can discover the communalities. Once the child has a small range of phrases, he/she can mix them up and create semi-original own phrases.

If the answer is YES!! our child has perhaps not all but a range of functions and a range of situations where they use a variety of easily mitigable gestalts then yes they are ready for moving to stage 2 of NLA!

Hurrah!

Keeping a journal of what your child is saying and in what circumstance is crucial to help with our ongoing detective work!

Next time I will be looking at how we can help our NLA 2 GLP produce even more of their own mix and match phrases.

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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Autism Therapy · Neurodiversity · Speech and Language Therapy · Toys

How do we play with our Gestalt Language Processors?

ByLondon Speech and Feeding January 17, 2024January 4, 2024

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 3^rd or 4^th 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. Autism, 9(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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Neurodiversity afferming Speech and Language Therapy

Autism Therapy · Neurodiversity · Speech and Language Therapy

Neurodiversity affirming Speech and Language Therapy

ByLondon Speech and Feeding November 24, 2023November 24, 2023

Introduction

I am a neurodiversity affirming therapist and I love and endorse play-based therapy. I use it alongside a strengths-focused approach in all my sessions. Find out why we should use these transformative therapy methodologies in all our work and play with our children.

I always have a range of different toys and activities up my sleeve so that when one toy is no longer interesting, that’s fine. ‘Look here’s a new one, how about we try this one?’ When therapy feels like play, children are more likely to be engaged and attentive, which leads to better outcomes.

By using play as a context for Speech and Language Therapy we can create opportunities for children to use and practise their communication skills in a natural, real-life setting. This helps bridge the gap between the therapy room and everyday life.

Goals and targets

What about goals and targets I hear you say? Of course, as Speech and Language Therapists we always have our goals for any particular child. They can be speech goals (we want Bobbi to produce a ‘k’ sound at the end of words) or communication goals (we want Fatima to ask for something by pointing to it rather than grabbing it). And these goals can be achieved where there is a reciprocation and a positive, playful relationship between the adult and the child. That relationship comes through play and fun.

Play and fun

Play is how a child interacts and learns. If it’s fun, interesting, exciting or pleasurable then that is where the magic happens. And that is what we need to return to repeatedly and then see if we can fold our targets into the activity as we go.

As soon as we expect our child to do something and we try and shape their behaviours towards a certain outcome we no longer ‘play’. We are now in teaching mode, where we direct and where we are ‘in charge’. As a neurodiversity affirming therapist, I believe that all play is valid. We must not get into the trap of thinking that only functional play is valid, that there is only one way to play with that car ramp/puzzle/potato head. Our autistic children often need to play in a particular way to navigate their world and we must not try and stop that.

When we affirm and validate our child’s play and copy their play with enthusiasm and respect then, in my experience, all children regardless where they are on the neurodiversity spectrum will begin to engage with us, copy us, and learn how to communicate effectively about things that matter to them.

Play-based therapy allows therapists to tailor interventions to each child’s unique interests and abilities. This individualised approach increases the likelihood of success and progress.

Strengths-Focused Speech Therapy

Strengths-focused therapy emphasizes a child’s strengths and abilities rather than their deficits. It recognises that every person has unique strengths that can be harnessed to overcome challenges.

Focusing on strengths helps us build a positive self-image. This is especially important for children with communication disorders, as it can boost their confidence and self-esteem.

When we encourage children to play in ways that they enjoy and are good at they feel empowered and more in control of their lives and play. This can lead to increased motivation and a sense of ownership over their progress.

Now, imagine the powerful impact that can be achieved by combining play-based therapy and strengths-focused therapy in speech therapy sessions. This dynamic combination brings out the best of both worlds. It creates a therapeutic environment that is not only effective but also enjoyable for children and their families.

As Speech Therapists we can use the child’s strengths and interests as a foundation for play-based activities. This personalisation not only makes therapy more engaging but also more effective.

An example

Charlie, a 3-year-old with social communication challenges, had a deep interest in anything that spins. We used this strength and interest to create a variety of spinning activities. As he is allowed to engage in his spinners, we can practise lots of speech and language and provide great phrases alongside his interest and activities: Ready steady go! Stop! ‘another one’ ‘the red one’ ‘again again’ ‘I love it’ ‘it’s a spinner’ ‘Charlie loves this toy’ ‘it’s going fast’ ‘it’s so fun’ etc..

Over time Charlie started to copy some of these word models and then used them to create his own little phrases, such as ‘the blue one again’. When this occurred, we felt like celebrating because it had come naturally and appropriately to the situation without any coercion or direction. That is what communication is about! Well done Charlie!

Conclusion

Play-based and strengths-focused speech therapy approaches are powerful tools and by combining these approaches, we create a therapeutic environment that is not only effective but also enjoyable and empowering for our clients.

Contact me if you would like your child to have neurodiversity affirming speech and language therapy.

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 · Speech and Language Therapy

Milestones of Autistic Children: Crawling, Walking, and Talking

ByLondon Speech and Feeding October 25, 2023January 3, 2024

For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.

1. Individual Pacing:

Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.

2. Neurodevelopmental Complexity:

The human brain is a remarkable entity, with a bewildering array of interconnected processes that lead to us achieving our developmental milestones. Autistic children often have variations in “neural wiring”, which can impact the balance between gross motor skills (crawling, walking) and fine motor skills. Speech and language acquisition falls under fine motor skills and may be momentarily disrupted due to the divergent neurological pathways at play in autism.

2. Sensory Processing Differences:

One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.

3. Visual-Spatial Abilities:

Autistic children and adults frequently display excellent visual-spatial abilities. This strength might lead some children to focus more on activities that engage these skills, potentially delaying their engagement with activities like walking or talking. As they navigate their environment and process information visually, they might naturally invest more time in activities that stimulate this particular cognitive ability and strength.

4. Communication Challenges:

For many autistic children, speaking can be a really complex and difficult endeavour. Communication delays are a common feature of autism. This can affect both receptive and expressive language development. While some children might be physically capable of crawling or walking, they may not yet have the tools to communicate their desires and intentions. This leads to a temporary focus on non-speaking forms of expression. This does not mean that they do not communicate at all. But autistic individuals often start out using jargoning or echolalia as a form of communication as well as behaviours and physical forms of communication.

5. Executive Functioning and Motor Skills:

Executive functioning, or abilities for planning, organising, and carrying out tasks, can vary in autistic children. These skills are crucial for activities like crawling, walking, and talking, which need coordination and planning. About 40% of autistic persons have a motor planning difficulty.

6. Intense Interests and Routines:

Autistic children often develop intense interests in specific subjects, sometimes to the exclusion of other activities. These interests might become their primary mode of engagement. They might side-line milestones like crawling, walking, or talking. The mostly rigid adherence to routines and preferences might cause them to allocate more time to their preferred activities. This delays their engagement with other developmental tasks.

How can Speech and Language Therapy help:

Support and Intervention:

Early intervention and regular Speech and Language Therapy play a pivotal role in the developmental journey of autistic children. Therapies tailored to individual needs can aid in bridging the gaps between milestones. Occupational therapy, for example, can help address sensory sensitivities and motor skill challenges that might impact crawling and walking. Speech therapy can help communication development, gradually bridging the gap between non-verbal expressions and spoken language.

For example, we now know that echolalia or jargoning of longer phrases with intonation, repeating scripts from favourite tv shows or songs have many meanings and communicative functions. For example, a child who utters long strings of echolalic utterances, often difficult to understand, might want to do any one of the following:

Comment
greet
ask a question
make a request
express surprise
negate something.

We now understand that the way to support a child with echolalia is to acknowledge all utterances and try and find out what the meaning is behind these scripts. This is very supportive. Over time it will lead a child to move on to understanding and saying more clear and self-generated language. For more information about this Natural Language Acquisition here are some other great websites for you to look at:

Conclusion

In conclusion, the journey of an autistic child’s development is a testament to the uniqueness and complexity of the human mind. The delays or differences in achieving milestones like crawling, walking, and talking can be attributed to a range of factors, including

neurodevelopmental intricacies,
sensory processing variations,
and communication challenges.

It’s crucial to recognise that these delays are not indicative of a lack of potential, but rather a manifestation of the intricate interplay between an autistic child’s strengths and challenges. By embracing these differences and providing tailored support, we can help each autistic child unfold their potential at their own pace.

Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

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 · Speech and Language Therapy

Discover speech and language regression in autistic children and how you can support your child

ByLondon Speech and Feeding February 17, 2023January 3, 2024

There’s often this idea that autistic children have extensive vocabulary and knowledge, but this is not always the case. In fact, 30% of autistic children have language regression.

Goldberg (2003) suggested that speech and language regression refers to the decline in a young child’s speech and communication abilities. We know that regression in speech, language and communication skills often occur before the age of two years. 25% of autistic children develop language at word level between 12 and 18 months of age before losing this language they have learned. As you’re probably aware this regression in communication is a diagnostic indicator of Autism.

We understand that you want your child to progress, and you struggle to watch as their frustration grows as you feel helpless. I want to provide you with tips so that you can feel empowered to support your autistic child and reduce the impact their communication skills have on the family.

Reduce frustration by providing visuals to support their communication
Model gestalts. We know that autistic children are often gestalt language processors. Learn more about gestalt language processors in one of my previous posts.
Praise the ability to communicate. Focus on what they say not how they say it. E.g., good listening, nice talking.
Provide your child with choices (using real objects to represent your choices). E.g., do you want an apple or banana?
Your child must be motivated and have a purpose to communicate. So, ensure you use highly motivating objects for conversations
Provide them with opportunities to communicate. We need to teach children that if they want something, there’s a process that you need to have the opportunity to ask for it. We find that if parents understand what their child wants (without them asking), the object is given to them, and so there’s no reason for your child to ask.
There’s this idea that we need to teach children eye contact. This is not always the case. Your child is unique, we do not want to take their unique skills away.
Model words which are concrete. E.g., words such as ‘finished’, ‘more’. You can model these several times within the day. You can use a gesture to make the word more visual (see the images below). We know that autistic children are often visual learners.

Makaton fro "more" — **Makaton for “more”**

Makaton for "finished" — **Makaton for “finished”**

Credit: Little Dots Makaton, Polkadot World

Remember that if your child has speech, language and communication regression, it doesn’t mean your child will stay static.

It’s vital that you seek support from a qualified Speech and Language Therapist. We can tell you at what point in the communication development that your child is at. And we can support you through the process. We can provide you with an individualised plan specifically for your child to ensure you maximise their potential.

Contact me for help.

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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