The joyful language toolkit: Strategies for connecting with your child through play
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The joyful language toolkit: Strategies for connecting with your child through play

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.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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How parent coaching turns story time into a communication success
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How parent coaching turns story time into a communication success

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.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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Using AAC in daily life
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Using AAC in daily life

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.

AAC mornings symbol examples

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:

AAC meal times symbol examples

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:

AAC catching the bus symbol examples

3. Being on the playground

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

AAC playground symbol examples

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.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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Dynamic assessment – Let’s look beyond the checklist
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Dynamic assessment – Let’s look beyond the checklist

Dynamic assessment – Let’s look beyond the checklist

As a parent, you’re always observing your child, celebrating his or her milestones, and sometimes, wondering if he or she is quite on track. When it comes to speech, language, play, attention, and listening, these early years are a whirlwind of development! It’s natural to seek guidance if you have concerns, and that’s where a truly comprehensive assessment comes in.

But what exactly does ‘comprehensive’ mean, especially when it goes beyond a typical checklist? You can find any number of check lists online these days but whilst they can give you an overall idea of what a child is typically expected to do at any given age, it can also start leading you into a rabbit hole of anxiety of ‘what-iffery’.

At The London Speech and Feeding Practice I believe in something far more insightful than a static evaluation: Dynamic Assessment. Think of it as an in-depth, interactive investigation into your child’s unique communication landscape, exploring not just what he or she can do, but how he or she learns and why he or she might be facing challenges. This is so important.

What makes an assessment ‘dynamic’?

Imagine trying to understand a child’s personality by just looking at a single photograph. It gives you a glimpse, but it hardly tells the whole story. Traditional, formal assessments, while valuable, can sometimes be like that photograph – a snapshot of skills at one specific moment.

Dynamic assessment, on the other hand, is a living, breathing process. It’s called ‘dynamic’ because:

  • It’s interactive and responsive: It adapts to your child’s needs in real-time. It’s not about sticking rigidly to a pre-set schedule of tests. Instead, it’s about observing, gently prompting, and providing support to see how your child responds and learns. This allows me to understand his or her learning potential, not just his or her current performance.
  • It’s holistic and multi-faceted: I look at the whole child. We delve deep into not just speech and language, but also his or her play skills (a crucial window into cognitive and social development), attention and listening abilities, and his or her social engagement. These areas are intricately linked, and a delay in one can often impact others.
  • It integrates multiple perspectives: Your insights as a parent are invaluable! Before we even meet, my comprehensive onboarding questionnaire gathers essential background. During the assessment, your feedback, observations, and comments are woven into the fabric of our session. You are the expert on your child, and your voice is central to forming a complete picture.
Dynamic assessment – Let’s look beyond the checklist

More than just ‘speech’: A deep dive into development

You might initially be concerned about your child’s speech sounds, or perhaps his or her ability to form sentences. These are vital areas, but my approach goes much further. I’m keen to understand:

  • The ‘why’ behind the ‘what’: Is a child struggling with language because of difficulties with understanding instructions (receptive language), or with expressing themselves (expressive language)? Are his or her attention skills impacting his or her ability to follow a conversation? Is his or her play demonstrating imaginative thought, or does he or she prefer more structured, repetitive activities? These nuances are critical.
  • Differential diagnosis: This is where the skill of an experienced clinician truly comes into its own. Through dynamic assessment, I can differentiate between a developmental delay (where a child is following a typical progression but at a slower pace) and a disorder (where his or her development is following an atypical pattern). This distinction is vital because it guides the type of support and intervention that will be most effective. Understanding the cause of the delay or disorder is paramount to creating a targeted, impactful therapy plan.

The art of observation

While I draw upon evidence-based practice as well as a formal, standardised assessment as well as my extensive clinical knowledge, I also rely heavily on the art of observation. From the moment your child walks into the room, I’m establishing rapport, engaging them in play, and creating a safe, fun environment. It’s through this genuine interaction – often without them even realising they’re being ‘assessed’ – that the most authentic insights emerge.

This is where the magic happens:

  • Building rapport: A child who feels comfortable and connected will show you so much more of his or her true abilities and personality. I pride myself on creating an atmosphere where children can relax and simply be themselves.
  • Play as a window: Play isn’t just fun; it’s a child’s natural language. It reveals his or her understanding of the world, his or her problem-solving skills, his or her social engagement, and his or her ability to use symbols and language.
  • Skilled interpretation: My years of experience allow me to see beyond surface-level behaviours and interpret the subtle cues that might indicate underlying strengths or challenges. This goes far beyond what any standardised test alone can capture.

Why choose a clinician who offers dynamic assessment?

In essence, a dynamic assessment provides a rich, nuanced, and truly personalised understanding of your child. It’s an investment in:

  • Accuracy: Leading to a more precise diagnosis and understanding of his or her unique profile.
  • Tailored support: Enabling the creation of highly individualised therapy goals that truly meet your child where he or she is and gently guide him or her forward.
  • Empowerment: You’ll leave with not just answers, but also practical strategies and a clear path forward, feeling confident and informed.

If you’re seeking a thorough, empathetic, and truly insightful assessment for your child’s communication development in London, I invite you to get in touch. Let’s work together to unlock your child’s full potential.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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The art of selective care: My Journey as a semi-retired private therapist

The art of selective care: My journey as a semi-retired private therapist

Welcome!

Hello, and welcome. I’m writing this today to share a bit about my professional journey, a journey that has evolved over many years from a bustling, full-schedule practice to a more intentional, deeply fulfilling semi-retired life. This shift wasn’t born out of a desire to slow down, but rather an understanding of what truly matters: my time, your time, and the quality of the work we do together.

For decades, I poured my energy into a full calendar, helping as many families as I possibly could. It was a wonderful, demanding, and rewarding time. I learned so much, grew immensely as a professional, and had the privilege of witnessing countless moments of breakthrough and success. But over recent months, I began to realise that the most impactful work wasn’t about quantity; it was about quality. It was about giving my whole, undivided attention to a select few, creating an environment where true progress could flourish.

Change

This realisation led to a significant change in my practice. I am now at a point in my career where my time is both valuable and precious. It is no longer a commodity to be filled, but a resource to be invested wisely. This doesn’t just apply to my personal life, but to my professional life as well. I’ve chosen to be more selective about the clients I see, and this selectivity is rooted in a single, powerful question: ‘Who can I truly, profoundly help?’

I believe that successful therapy is a partnership. It requires commitment, trust, and a genuine connection between therapist and client. When I take on a new family, I am not just filling a slot in my schedule; I am making a deep commitment to them. I am dedicating a part of my precious time and decades of expertise to their child’s success. This is why I am now focusing on who I can really work with: families who are equally invested in the process, who understand that progress is a team effort, and who are ready to engage fully in the journey.

My fees reflect this deep investment. You will find that my rates are higher than those of many other therapists, and I want to be transparent about why. It’s a reflection of the extensive experience I bring to the table. I have spent years honing my skills, navigating complex cases, and developing a unique, effective approach to speech, language and feeding challenges. This is not just a job for me. It is my life’s work, and I honour the value of that expertise and the time I dedicate to each family.

I want to ensure that every minute you spend with me is productive, focused, and truly transformative. Therefore, I provide a ‘boutique style’ of care. Think of it as an exclusive, personalised experience where every detail is considered and your needs are at the forefront. You won’t feel like you’re just another appointment on a long list. You will feel that you have my full, undivided attention, as if you were my only client.

This means less time spent on administrative tasks and more time dedicated to preparing for your sessions, reflecting on our progress, and providing you with the most thoughtful, tailored support possible. It means an environment of calm and focused expertise, where we can truly dive deep into the specific challenges and build a clear, effective path forward.

New perspective

For parents reading this, I hope this provides a new perspective. Choosing a therapist for your child is one of the most important decisions you can make. It’s about finding not just a professional, but a partner. I want you to feel that, if we choose to work together, you are entering into a unique partnership where your child’s growth is my singular focus.

In this next chapter of my career, I am prioritising passion over pace, depth over breadth, and meaningful connections over a packed schedule. I am here to work with families who are ready for a truly collaborative and transformative experience. If you are seeking a level of care that goes beyond the standard, an approach that is both highly experienced and deeply personal, I would be honoured to speak with you.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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Submucous cleft palate: What is it and how does it impact on speech?

Submucous cleft palate: What is it and how does it impact on speech?

Submucous cleft palate: What is it and how does it impact on speech?

What exactly is a submucous cleft palate?

A submucous cleft palate (SMCP) is much less obvious than its counterparts, cleft of lip and/or palate, and can profoundly impact a child’s speech development. It leads to often extreme hyper nasal speech and difficulty with producing many sounds (/K/ /G/ /T/ /D/ /P/ /B/ /S/ /Z/ /F/ /V/).

In short, the muscles and bone of the soft palate, and sometimes the hard palate, do not fuse completely during foetal development and the mucous membrane that lines the roof of the mouth remains intact, effectively camouflaging the underlying muscular and bony deficit.

So, while the surface of the palate appears normal, the essential muscle and functions responsible for sealing off the nasal cavity from the oral cavity during speech are compromised. This cleft (or lack of muscle) can be seen as a bluish midline discoloration of the soft palate, often a bifid (split) uvula, and at times a notch in the posterior border of the hard palate can be felt upon palpation. However, these signs aren’t always present or easily discernible, contributing to the difficulty arriving at a diagnosis.

Diagnosing a submucous cleft palate is often akin to searching for a needle in a haystack, especially for the untrained eye. Unlike overt clefts that are visually apparent at birth, an SMCP can go undiagnosed for years, sometimes well into childhood or even adolescence. Paediatricians and even ENT surgeons have been known to miss it during routine checks due to the intact mucosal lining. Parents might notice their child’s speech sounds ‘different’ or ‘nasal’ but struggle to pinpoint the cause. Children might undergo extensive speech therapy without a proper diagnosis, as the underlying structural issue continues to hinder progress.

My experience as a speech therapist in private practice:

Over my years of practice, I have encountered several children presenting with persistent hyper-nasal speech and significant difficulties producing plosive and fricative sounds.

It has been incredibly rewarding, though at times challenging, to successfully diagnose SMCP in a number of these children. My approach often involves:

  • a meticulous oral motor examination,
  • careful listening for the specific qualities of hypernasality,
  • and a deep understanding of the physiological requirements for clear speech sound production.

When I suspect an SMCP, I refer these children to Great Ormond Street Hospital where a fantastic multidisciplinary team, typically including ENT surgeons and a specialist speech-language therapist can conduct more definitive assessments. These assessments often involve instrumental analyses such as videofluoroscopy or nasoendoscopy, which provide objective measures of velopharyngeal function and visual confirmation of the anatomical deficit.

The path to resolution: surgery, therapy, and successful outcomes

Surgery

The journey for these children, once diagnosed, often involves surgical intervention. It’s not uncommon for children with SMCP to undergo multiple operations to achieve optimal velopharyngeal closure. These procedures aim to reconstruct or augment the velopharyngeal mechanism, enabling it to effectively separate the oral and nasal cavities during speech. The specific surgical approach depends on the individual child’s anatomy and the severity of the velopharyngeal insufficiency. It’s a testament to the skill of these specialised surgeons that such intricate repairs can be performed with remarkable success.

Speech therapy

Following surgery these children embark on the crucial phase of speech therapy. While surgery addresses the structural problem, speech therapy helps a child learn to utilise their newly improved anatomy. It involves intensive work on developing oral airflow, establishing correct articulatory placement, and reducing learned compensatory strategies that have developed due to the original structural deficit. It is immensely gratifying to witness the transformation. Children who once struggled to produce basic sounds, whose speech was difficult to understand, gradually develop clear speech.

Next steps?

If you’re a parent concerned about your child’s speech and feeding, you’re not alone. The journey can feel confusing, but professional guidance can make all the difference. Never hesitate to have a second opinion when you have that niggling feeling that there is something that has not yet been explored. At London Speech and Feeding I specialise in being thorough and thinking outside the box.

I am here to provide the support you need. Reach out to schedule a consultation and take the first step towards helping your child communicate and thrive.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps
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Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps

Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps

As a speech therapist, few things are as rewarding as helping a child find their clear, confident voice. Among the various speech sound disorders, the ‘lateral lisp’ – often described as a ‘slushy’ or ‘wet’ /S/ sound – presents a unique challenge. While it can be tricky to treat, I’m thrilled to share that I’ve had significant success in helping children overcome this particular hurdle.

What is a lateral lisp?

Most people are familiar with a frontal lisp, where the tongue protrudes between the front teeth, resulting in a /TH/ sound for an /S/ (e.g., ‘thun’ for ‘sun’). A lateral lisp, however, is different. Instead of the air escaping over the front of the tongue, it escapes over the sides, often giving the /S/ and /Z/ sounds a distinct, muffled, or ‘slushy’ quality. This happens because the tongue is not forming the correct central groove, allowing air to spill out laterally.

The science behind a perfect /S/ vs. a slushy one

To understand how to fix a lateral lisp, it’s helpful to understand how a ‘perfect’ /S/ sound is made. Imagine a narrow, focused stream of air. For a clear /S/ sound, your tongue forms a shallow groove down its centre, directing a precise, thin stream of air right down the middle, over the tip of your tongue, and out through a tiny opening between your tongue and the roof of your mouth, just behind your front teeth. This focused airflow creates that crisp, sharp /SSSS/ sound we recognise.

Now, picture what happens with a lateral lisp. Instead of that neat, central channel, the tongue is often flatter or positioned in a way that allows the air to escape over one or both sides. Think of it like a river overflowing its banks – the air, instead of flowing in a controlled stream, spills out sideways, creating that characteristic ‘slushy’ sound. This lateral airflow is what we need to retrain.

Why is it tricky to treat?

Treating a lateral lisp can be challenging for a few reasons:

  • Habitual muscle memory: The way the tongue moves and positions itself for a lateral lisp is deeply ingrained. It’s a motor habit that needs to be unlearned and replaced with a new, more precise movement.
  • Subtle differences: The difference between a lateral lisp and a correct /S/ sound can be quite subtle to perceive, both for the child and sometimes even for parents. This makes it harder for the child to self-monitor and correct.
  • Oral motor control: It requires fine motor control of the tongue muscles to create and maintain that central groove for airflow.

My success with children aged six years and over

I’ve found great success in treating lateral lisps, particularly with children aged six years and older. Why this age group? By this age, children typically have:

  • Increased awareness: They are more aware of their speech and often more motivated to make changes. They can better perceive the difference between their ‘slushy’ /S/ and a clear one.
  • Improved cognitive skills: They can understand and follow more complex instructions and strategies.
  • Better self-monitoring: Their ability to listen to themselves and correct their own speech improves significantly.
  • Enhanced oral motor control: Their fine motor skills, including those of the tongue, are more developed, allowing for greater precision.

My approach focuses on a combination of auditory discrimination, tactile cues, and targeted myofunctional exercises to help children ‘feel’ the correct airflow and tongue placement. We use a variety of engaging activities to make the process fun and effective.

It is crucial to understand tongue functioning and focusing on correcting improper oral resting posture and muscle function, which are often significant contributors to a lateral lisp. For example, if the tongue rests low and wide in the mouth consistently, or if there’s a tongue thrust during swallowing, these habits can prevent the tongue from achieving the precise, midline placement necessary for a clear /S/ or /Z/ sound. Through targeted exercises I aim to re-educate the oral and facial muscles, promoting correct tongue posture at rest, during swallowing, and, ultimately, during speech production. By strengthening the muscles responsible for tongue lifting and encouraging a more appropriate swallowing pattern we can establish the correct oral motor skills needed to overcome a lateral lisp and achieve clearer articulation.

The recipe for success: Little and often

The single most crucial ingredient for success in treating a lateral lisp is daily home practice of all the strategies given. This isn’t about long, arduous sessions; it’s about consistency. Think of it like building a muscle: short, frequent workouts yield better results than sporadic, intense ones.

My recommended formula is ‘little and often’. This means:

  • Short, focused sessions: Aim for 5-10 minutes of practice, 2-3 times a day. This prevents fatigue and keeps the child engaged.
  • Integrate into daily routines: Practise while waiting for dinner, during a car ride, or before bedtime. Make it a natural part of their day.
  • Positive reinforcement: Celebrate every small success! Encouragement goes a long way in building confidence and motivation.
  • Parental involvement: Parents play a vital role in providing consistent cues and encouragement at home. I equip families with clear, easy-to-follow strategies.

Overcoming a lateral lisp requires dedication, but with the right guidance and consistent practice, a clear, confident /S/ sound is achievable. If your child is struggling with a ‘slushy’ /S/, please don’t hesitate to reach out. Together, we can achieve success!

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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Why auditory memory matters (especially for little ones!)
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Why auditory memory matters (especially for little ones!)

Why auditory memory matters (especially for little ones!)

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.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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From ‘Nailed it!’ in therapy to ‘Whoops!’ at home: Why generalising speech sounds is tricky
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From ‘Nailed it!’ in therapy to ‘Whoops!’ at home: Why generalising speech sounds is tricky

As a parent, you’ve likely experienced the triumphant feeling when your child, who’s been working so hard on his or her /S/ sound, produces it perfectly in a therapy session. He or she is rocking those ‘sun’ and ‘socks’ words, his or her lisp seemingly a distant memory. You leave feeling elated, confident that all that hard work is finally paying off.

Then you get home. And within minutes, you hear it: ‘Thooper!’ instead of ‘Super!’ Or maybe the clear /R/ in ‘rabbit’ from therapy reverts to a ‘wabbit’ when his or she is playing with his or her toys. It’s frustrating, confusing, and can feel like you’re back to square one.

So, what’s going on? Why is it so difficult for children to take those amazing skills learned in a focused therapy session and seamlessly apply them to their everyday conversations? You’re not alone in wondering this. It’s a common challenge in speech therapy and understanding the ‘why’ can help both parents and children navigate this crucial stage.

The brain’s habits: Old pathways are strong pathways

Think of your child’s brain as having established ‘pathways’ for how he or she produces certain sounds. If he or she has been lisping his or her /S/ sound for years, that neural pathway is deeply ingrained. It’s like a well-worn path through a field: easy to follow because it’s always been there.

In therapy, we’re essentially trying to forge a new path. We’re teaching him or her a new, more accurate way to make the sound. This new path is initially faint, like a barely visible trail. It takes conscious effort and repeated practice to strengthen it. Outside of the structured therapy environment, his or her brain often defaults to the old, comfortable, and well-established pathway, even if it’s not the most accurate.

The demands of daily conversation: A multitasking challenge

Therapy sessions are designed to be focused and controlled. We isolate sounds, practice them in specific words, and provide immediate feedback. There are minimal distractions, and your child’s full attention is on his or her speech production.

Now, consider daily conversation:

  • Speed: We speak much faster in natural conversation than we do during structured practice. There is less time to think about individual sounds.
  • Cognitive load: Children are simultaneously thinking about what they want to say, understanding what others are saying, processing social cues, and managing their emotions. Adding the conscious effort of producing a new speech sound correctly on top of all that is a huge cognitive demand.
  • Variety of contexts: In therapy, we might practise ‘sun’ and ‘socks’. In real life, the /S/ sound appears in countless words, in different positions within words, and alongside a vast array of other sounds. Each new word and phonetic context present a fresh challenge.
  • Lack of immediate feedback: In therapy, the speech therapist is right there to provide instant correction and reinforcement. In a playground, during a family dinner, or while playing with friends, that immediate, consistent feedback isn’t present.

The role of automaticity: Making it second nature

The ultimate goal of speech therapy isn’t just correct sound production; it’s automaticity. This means producing the sound correctly without having to consciously think about it. It’s like learning to ride a bike. Initially, every pedal stroke and steering adjustment is deliberate. Eventually, it becomes second nature.

Generalisation is the process of moving from conscious, controlled production to unconscious, automatic production. This takes time, consistent practice, and exposure to a wide variety of real-life speaking situations.

How can we help? Bridging the gap

So, what can parents do to help their children bridge this gap between therapy success and everyday speech?

  1. Be patient and positive: This is a marathon, not a sprint. Celebrate the small victories and avoid getting discouraged by setbacks. Your positive reinforcement is crucial.
  2. Practise little and often: Instead of long, infrequent practice sessions, aim for short, consistent bursts throughout the day. ‘Sprinkle’ in opportunities to practise their target sounds in natural conversations.
  3. Create ‘sound awareness’ moments: Gently draw your child’s attention to his or her target sounds in everyday words. For example, if he or she is working on /R/, you might say, ‘Oh, you said ‘wabbit.’ Can you try to make your /RRR/ sound for ‘rabbit’?’
  4. Model correct production: Continue to model the correct production of their target sounds in your own speech.
  5. Collaborate with your speech therapist: Your therapist is your best resource! Ask them for specific strategies and activities you can do at home to support generalisation. They can also provide guidance on when and how to gently correct your child.

Tips and tricks

Below I have listed a few good tips and tricks that can help the transition from therapy room to daily life:

Empowering your child as the ‘sound detective’:

  • ‘Secret sound listener’: Instead of you doing the correcting, make your child the detective. When you’re having a conversation, say ‘your /S/ sounds are sometimes a bit “slippery”’ (or whatever fun, non-judgmental term you like). Ask your child to quietly listen for your /S/ sounds. You can even purposely make a few ‘slippery’ ones (or correct yourself immediately after) and see if they notice. This shifts the focus from being corrected to actively listening and identifying the sound in a non-threatening way.
  • ‘Sound scorecard’: For a short period (maybe 10–15 minutes during a specific activity, like dinner or a game), provide a small notepad and pencil. Explain that your child is going to listen for his or her /S/ sounds and gently mark a tally every time he or she uses it correctly. The goal isn’t perfection, but awareness. This gives your child agency and a visual representation of progress. You can even make it a game: ‘Let’s see how many /S/ sounds we can catch in five minutes!’
  • /S/ sound song/rhyme creation: Work together to create silly songs or rhymes that are packed with /S/ sounds. The sillier, the better! You can sing them in the car, while doing chores, etc.
  • /S/ sound superpower: Frame the new sound skill as a ‘superpower’. ‘You’re getting so good at using your /S/ superpower! It’s going to help you speak so clearly and confidently.’
  • Highlighting successes: Always go out of your way to acknowledge and praise successful /S/ productions in natural conversation. ‘I really understood you clearly when you said ”s_top”.’ or ‘That /S/ sound was perfect when you told me about the “s_tory”!’

Important considerations:

  • Keep it low-pressure: The goal is generalisation, not perfection. If your child is feeling pressured, he or she will likely revert to old patterns.
  • Focus on awareness, not just correction: Help your child become aware of his or her own speech rather than relying on you for corrections.
  • Short, frequent bursts: A few minutes of subtle focus multiple times a day is more effective than one long, forced session.
  • Acknowledge feelings: If your child expresses frustration about ‘being corrected’, validate these feelings. ‘I understand it can feel like a lot of listening, but we’re just trying to help you use that super /S/ sound all the time!’

By incorporating these strategies, you can help your child naturally integrate the new /S/ sound into daily speech, fostering independence and confidence without it feeling like constant ‘testing’ or ‘correction’. Generalising new speech sounds is arguably the hardest part of speech therapy, but it’s also the most rewarding. With patience, consistent effort, and a collaborative approach between parents and therapists, children can successfully integrate their new, clearer speech sounds into every aspect of their daily lives.

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.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

1
Hard munchables: Chewing through the weaning journey
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Hard munchables: Chewing through the weaning journey

As a Speech and Language Therapist with a specialism in paediatric feeding, I’m constantly looking for ways to support families in developing their little ones’ oral motor skills and fostering a positive relationship with food. While Baby-Led Weaning (BLW) has revolutionised how many families introduce solids, (see my previous blog in July 25) a concept that often sparks discussion and curiosity is the use of ‘hard munchables.’

What are hard munchables?

The term ‘hard munchables’ refers to specific types of firm non-digestible food items that are offered to babies for oral exploration and skill development, not for nutrition. These are typically foods that babies cannot bite off or swallow in large pieces due to their texture, but which provide resistance for chewing practice.

The phrase was coined by Marsha Dunn Klein, M.Ed., OTR/L, Occupational Therapist and feeding therapist. Well known for her work in paediatric feeding she introduced and advocated for the concept of hard munchables as part of a therapeutic feeding approach, particularly for infants learning to manage textures and develop crucial oral motor skills.

Common examples of hard munchables include:

  • Large, raw carrot sticks: Too hard to bite through, but great for gnawing.
  • Celery sticks: Like carrots, offering firm resistance.
  • Large, raw apple slices (peeled chunks): A firm, slightly sweet option.
  • A firm, uncut pear core: With the seeds removed.
  • Dried mango cheeks (hard, unsweetened varieties): These offer a fibrous texture.
  • A large, fully cooked but firm piece of meat (like a steak bone with some meat attached): The meat provides flavour and a bit of shreddable texture, while the bone is for gnawing.
  • Hard crusts of bread or breadsticks (very firm, without soft inner crumb): These can soften slightly with saliva but offer significant resistance.
Image by Freepik

It’s crucial to emphasise that hard munchables are not for consumption or nutrition. They are tools for oral motor development and should always be offered under strict, active supervision.

How do hard munchables fit into weaning?

While weaning (traditional or Baby-Led Weaning) introduces solid foods that a baby can eventually bite and swallow, hard munchables are complementary to the weaning phase. They enhance that phase by helping a child to develop hand dexterity, hand to mouth movement, and oral development.

It’s important to differentiate: Weaning provides the digestible food for eating, while hard munchables provide the tool for skill practice. They are not substitutes for each other but can be used together under careful guidance.

Pros and cons from a speech therapy perspective

As an SLT, I see both the potential benefits and the necessary precautions when incorporating hard munchables.

Pros:

  • Enhanced oral motor development: Hard munchables provide excellent resistance training for the jaw, helping to develop the strength, endurance, and coordination needed for efficient chewing. This is foundational for moving beyond purées and very soft textures.
  • Promotes lateralisation of the tongue: The act of moving the hard item from side to side in the mouth encourages the tongue to move independently of the jaw, a crucial skill for managing food and for speech sound production.
  • Preparation for more complex textures: By strengthening the oral musculature and refining chewing patterns, hard munchables can help babies transition more smoothly to lumpy and mixed textures.
  • Sensory exploration: They offer rich sensory input (tactile, proprioceptive) that can be beneficial for oral mapping and awareness, especially for babies who might be orally sensitive.

Cons:

  • Choking risk: While the intention is for the baby not to bite off pieces, there is always a risk. Small pieces can break off, or a baby might accidentally bite off a larger chunk than he or she can manage. Active, vigilant supervision is non-negotiable.
  • Not a replacement for digestible solids: It’s vital to remember that hard munchables are for practice, not nutrition. They should complement, not replace, the introduction of varied, digestible solid foods.
  • Not suitable for all babies: Babies with certain developmental delays, oral motor deficits, or medical conditions might not be appropriate candidates for hard munchables without highly specialised guidance. For instance, babies with an exaggerated gag reflex might find them overwhelming.

Key Considerations for Parents

Here are my top recommendations:

  1. Consult with a professional: Always discuss this with your Paediatric Feeding SLT first before you introduce hard munchables. We can assess your baby’s individual readiness and guide you on safe practices.
  2. Strict supervision: Never leave your baby unsupervised with a hard munchable, even for a second. Your full attention is required.
  3. Appropriate size: Ensure the item is large enough that the baby cannot fit the whole thing in their mouth. It should extend well beyond their fist.
  4. No biting off: The goal is gnawing and scraping, not biting off pieces. If your baby is consistently breaking off chunks, stop using them.
  5. Focus on skill, not consumption: Reiterate to yourself that this is for practice, not for eating.

In conclusion, hard munchables, when used appropriately and under guidance, can be a very valuable tool to support oral motor development during the weaning journey. However, always be safe and consult with a specialist to ensure your little one develops his or her feeding skills effectively and joyfully.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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


References:

Rapley, G., & Murkett, T. (2008). Baby-Led Weaning: The Essential Guide to Introducing Solid Foods. Vermilion.

Morris, S. E., & Klein, M. D. (2000). Pre-feeding skills: A comprehensive resource for feeding development. Pro-Ed.

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

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

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

What exactly is baby-led weaning?

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

The genesis of baby-led weaning

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

What’s the deal?

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

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

The benefits of baby-led weaning

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

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

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

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

When BLW is appropriate:

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

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

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

A note on safety: Choking hazards

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

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

Final thoughts

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

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

1
Unlocking communication: My daily life with the Saltillo 88 Core Board
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Unlocking communication: My daily life with the Saltillo 88 Core Board

Introduction

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

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

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

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

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

Below is a picture of the Saltillo 88.

Saltillo 88 Core Board
Saltillo 88 Core Board

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

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

1.  Getting dressed

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

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

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

2. Having a shower/bath

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

3. Mealtimes

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

4. Playing

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

5. Opening boxes/doors/etc

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

Tips for using AAC effectively

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

Conclusion

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


Health Professions Council registered
Royal College of Speech & Language Therapists Member
Member of ASLTIP

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

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