Speech Delay

Ages and Stages · Speech and Language Therapy · Top tips

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

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

‘Should my child still be speaking like this?’

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

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

When should children’s speech be clear?

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

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

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

Why some children remain hard to understand

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

Phonological patterns

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

Difficulty producing specific sounds

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

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

Motor speech planning challenges

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

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

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

Why clarity matters for school-age children

Speech clarity becomes particularly important once children start school.

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

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

The good news: speech can improve

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

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

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

When to seek advice

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

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

Every child’s speech journey is different

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

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

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

Feel free to contact me on my contact page.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

3
READ MORE My child is hard to understand at school age. Should I be concerned?
Autism Therapy · Neurodiversity · Speech and Language Therapy

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

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

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

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

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

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

Example

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

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

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

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

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

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

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

Using visual cues to support motor planning

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

This is where visual cues can be incredibly helpful.

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

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

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

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

This is very deliberate.

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

In therapy we call this massed practice.

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

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

Showing children that sounds change meaning

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

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

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

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

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

Blending approaches for the best outcomes

In this short therapy moment, I am combining:

• Visual cueing

• Motor speech practice

• High repetition (massed practice)

• Minimal pair contrasts

• Listening and awareness of sound differences

Each element supports a different part of the speech system.

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

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

Every child’s speech journey is unique

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

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

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

Sometimes a child needs more motor-based work.

Sometimes the focus shifts towards phonological contrasts.

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

Small steps lead to big progress

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

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

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

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

Reference

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

3
READ MORE When speech difficulties overlap: Helping children with phonological delay and childhood apraxia of speech
Speech and Language Therapy

Can AI help my child’s speech delay? What it can do and what it can’t
ByLondon Speech and Feeding March 11, 2026March 9, 2026
If you’re worried about your child’s speech, you are absolutely not alone. Many parents I work with tell me the same thing:

‘I’ve been Googling…’
‘I asked ChatGPT what activities to try…’
‘TikTok said we should practise this sound every day…’

It makes complete sense. When waiting lists are long, evenings are quiet, and your child is struggling to communicate, it’s natural to look for help wherever you can find it.

AI tools can actually be helpful in some ways. But they also have clear limits especially for children with significant speech delays or speech sound disorders.

Here’s an honest, balanced guide to what AI can do, and what it simply can’t.

✔️ What AI can help with

1. Explaining things in simple language

AI can be very helpful for explaining speech and language terms in a way that’s easy for parents to understand for example, what a phonological delay is, or what Childhood Apraxia of Speech means. It can also suggest possible reasons for a child’s speech delay based on the information you provide.

The difficulty is that parents (or teachers) can only ask questions based on what they notice or perceive to be the problem. In practice, this doesn’t always tell the full story. For example, parents often report that their child ‘can say certain words’, but during an assessment we may find those words are actually produced with consistent error patterns. These patterns give important clues about the underlying nature of the difficulty, whether it’s a delay or a disorder and they guide the speech therapist in choosing the most effective targets to improve intelligibility.

2. Suggesting games and activities

AI is very good at suggesting ideas for games and practice, such as word lists, simple play activities, sound practice games, book suggestions, and ways to encourage talking within everyday routines. These can be especially helpful when you feel stuck or want some fresh inspiration for supporting your child at home. It can help to think of AI as a big ideas bank, somewhere to dip into when you need new, playful ways to keep practice engaging.

3. Helping you prepare questions for a therapist

Some parents use AI to list questions before an assessment, understand reports and organise concerns.

This can make therapy feel less overwhelming and more collaborative.

Used this way, AI can actually support the therapy process.

❌ Where and why AI cannot replace real life speech therapy

There is substantial research supporting the effectiveness of real-life speech therapy compared to generic online resources or AI-generated suggestions. Here are some key points highlighting why in-person therapy is often more beneficial:
- Personalisation: Speech therapists assess each child’s unique needs, strengths, and challenges through direct observation and interaction. This personalised approach allows for tailored interventions that address specific issues, which generic resources cannot provide.
- Nuanced understanding: Therapists are trained to recognise subtle cues in speech production, including the nuances of sound articulation, language comprehension, and social communication. This expertise enables us to identify underlying issues that may not be apparent through generic assessments.
- Motivational support: A speech therapist can provide encouragement, motivation, and emotional support, which can significantly enhance a child’s willingness to participate and engage in therapy. This relational aspect is crucial for building confidence and reducing anxiety around communication.
- Evidence-based practices: As a highly trained and specialised speech therapist I utilise evidence-based practices that are grounded in research, ensuring that the techniques used are effective and up to date. This contrasts with generic online information, which may not always be reliable or validated.
- Progress monitoring: In-person therapy allows for ongoing assessment and adjustments to the treatment plan. We track progress over time and modify strategies as needed, ensuring that the therapy remains effective and relevant.
Research studies consistently show that individualised, face-to-face interventions lead to better outcomes in speech therapy than generalised approaches. For parents and caregivers, seeking professional help tends to provide a more effective path toward improving their child’s communication skills.

The healthiest way to think about AI

AI works best as a starting point, not a substitute. You might use it to understand your child’s report and learn how speech develops,

But if your child has significant delay or difficulty being understood, what makes the real difference is:
- A tailored assessment
- A clear therapy plan
- Expert target selection
- Ongoing adjustment
- Support for both child and you the parent!
Dear parents,

If you’ve been turning to AI for help, it doesn’t mean you’re doing anything wrong. It means you care!

But please know the best outcomes usually come from combining your daily support at home with guidance and support from your speech therapist who knows you and your child.

Many of my past and present clients tell me that they really value my ‘handholding’ and me guiding them in between the sessions. A quick check in is often all that is needed but it makes a huge difference!

If you’d like support or advice, please contact me and I can help guide the next steps.

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.

3
READ MORE Can AI help my child’s speech delay? What it can do and what it can’t
Ages and Stages · Speech and Language Therapy · Top tips

Understanding phonological processes in 3–7-year-olds: What’s typical and when to seek help
ByLondon Speech and Feeding February 18, 2026February 13, 2026
As a speech and language therapist, one of the most common questions I hear from parents is:

‘They can talk, but their speech still sounds immature. Is this normal?’

Many children between the ages of three and seven use speech patterns that make their words sound different from adult speech. These patterns are known as phonological processes, and for younger children, they are a normal part of speech development.

However, when these processes persist beyond the expected age, they can start to affect clarity, confidence and learning, especially once children enter school.

This blog will help you understand:
- what phonological processes are
- which patterns are typical at different ages
- and when it might be time to seek speech therapy support
What are phonological processes?

Phonological processes are patterns of sound simplification that children use while their speech system is developing.

Instead of learning each sound one by one, children initially organise sounds into patterns that make speech easier to produce. This is a normal and efficient strategy for a developing brain.

For example:
- saying ‘tar’ instead of ‘car’
- saying ‘poon’ instead of ‘spoon’
- saying ‘bud’ instead of ‘bus’
These are not ‘bad habits’. They are part of how speech develops.

The key question is how long these patterns last.

Common phonological processes (and when they usually disappear)

Below are some of the most common processes parents notice in 3–7-year-olds.

1. Final consonant deletion

Leaving off the last sound in a word
- ‘ca’ for cat, ‘da’ for dog
- Typically resolved by 3–3½ years
2. Fronting

Replacing back sounds (k, g) with front sounds (t, d)
- ‘tar’ for car, ‘do’ for go
- Typically resolved by 3½–4 years
3. Cluster reduction

Omitting one sound in a consonant cluster
- ‘poon’ for spoon, ‘top’ for stop
- Typically resolves by 4–5 years (some clusters slightly later)
4. Gliding

Replacing /R/ or /L/ with /W/ or /Y/
- ‘wabbit’ for rabbit, ‘yion’ for lion
- Can be typical up to 5–6 years
5. Weak syllable deletion

Leaving out unstressed syllables
- ‘nana’ for banana
- Usually resolved by 4 years
If these patterns continue past the expected age, speech can remain difficult to understand particularly for unfamiliar listeners such as teachers, peers, and also Auntie Karen or grandparents who visit once in a while.

Why phonological processes matter in school-age children

By the time children reach reception and Year 1, speech clarity becomes increasingly important.

Persistent phonological difficulties can affect:
- being understood by teachers and peers
- phonics and early reading
- spelling
- confidence in speaking
- willingness to participate in class
Some children become aware that they ‘sound different’ and may speak less, avoid longer words, or become frustrated when misunderstood.

What’s the difference between a delay and a disorder?

This is an important distinction.
- A phonological delay means a child is following the normal pattern of development, just more slowly.
- A phonological disorder means the child is using atypical patterns, or continuing age-expected patterns well beyond when they should have resolved.
A speech and language assessment helps identify:
- which processes are present
- how many are affecting speech
- how consistent the errors are
- and whether intervention is needed
Signs it may be time to seek speech therapy

You may want to seek professional advice if your child:
- is 3½ years or older and still hard to understand
- is understood well by family but not by others
- becomes frustrated or avoids talking
- has difficulty with phonics or spelling
- uses several phonological processes at once
- has not made progress despite time and encouragement
Early support does not mean something is ‘wrong’. It simply helps speech development move forward more efficiently.Research consistently shows that unresolved phonological processes beyond the expected age can impact intelligibility, literacy and confidence (Dodd, 2014; Bowen, 2015).

How speech therapy helps phonological development

Phonological therapy is not about drilling individual sounds endlessly.

Instead, therapy focuses on:
- helping children recognise sound patterns
- building awareness of contrasts (e.g. ‘tar’ vs ‘car’)
- practising speech in meaningful, playful ways
- supporting generalisation so progress carries into everyday speech
For school-aged children, therapy is usually structured, motivating and highly targeted and progress can be very encouraging.

A final reassurance

Many children with phonological difficulties go on to develop clear, confident speech with the right support.

If you’re unsure whether your child’s speech is ‘just a phase’ or something that needs attention, a professional assessment can give clarity and peace of mind.

If you’d like support or advice, please contact me and I can help guide the next steps.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Research references
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.

3
READ MORE Understanding phonological processes in 3–7-year-olds: What’s typical and when to seek help
Ages and Stages · Speech and Language Therapy · Top tips

Childhood Apraxia of Speech: Signs and first steps (2–5 years)
ByLondon Speech and Feeding February 9, 2026February 6, 2026
If you’ve found yourself wondering ‘Why can my child say a word one day, but not at all the next?’ it might be that your child has a motor speech difficulty. This means the challenge isn’t that your child doesn’t know what they want to say; it’s that their brain finds it harder to plan and coordinate the movements needed for clear speech. This speech difficulty is called Childhood Apraxia of Speech (CAS)

In this post, I’ll explain what CAS can look like in 2–5 year olds, what an assessment usually involves, and what you can start doing at home to support your child without turning life into ‘speech homework all day long’.

What is childhood apraxia of speech (CAS)?

Children with CAS often have lots to communicate about (and strong ideas!) but their speech may come out as:
- Unclear
- inconsistent
- hard to ‘copy’ on demand
- frustrating for them and for you
CAS is not caused by laziness and it is not a parenting issue. It is also not something children simply ‘grow out of’ without support. But with the right therapy approach, children can absolutely build clearer speech over time.

If you’d like to read more about verbal dyspraxia, you may also find this helpful: Supporting children and families living with verbal dyspraxia.

Why is CAS such a big topic right now?

Many families come to me after months (or years) of being told:
- ‘She’ll talk when she is ready’
- ‘He’s just shy’
- ‘It’s probably a speech delay’
- ‘It’s normal for toddlers’
And sometimes it is a general delay. But sometimes it’s something more specific, like CAS.

There’s also been a huge rise in parents seeking information online, and CAS is often mentioned alongside speech sound difficulties such as:
- phonological delay (pattern-based speech errors)
- articulation difficulties (one sound that won’t come out clearly)
- inconsistent speech disorder
These can look similar at first glance, which is why a specialist assessment matters.

Signs of childhood apraxia of speech in 2–5 year olds

Children develop speech at different rates, and not every unclear speaker has CAS. But here are some common features that may raise a flag, especially when you notice several together.

1) Inconsistent speech errors

Your child might say the same word in different ways:
- ‘banana’ → nana / baba / mana
- ‘daddy’ → gaga / daddy / dadi
This inconsistency is one of the biggest clues.

2) Difficulty copying words on request

Some children speak more easily in natural play, but when asked ‘Say ___’, they freeze or the word becomes much harder.

3) Limited sound repertoire

They may use only a small set of consonants (like /M/, /N/, /B/, /D/) and avoid others.

4) Vowel distortions

Many children with typical delays mainly struggle with consonants. But in CAS, vowels can also sound ‘off’ or change between attempts.

5) Speech that sounds effortful

You might notice your child:
- pauses between sounds
- tries multiple times
- looks like they’re ‘searching’ for the right mouth movement
6) Longer words are much harder

‘Car’ might be easier than ‘carry’, and ‘carry’ easier than ‘caterpillar’.

7) Prosody differences (rhythm and stress)

Some children with CAS sound a little unusual in their speech rhythm, stress, or intonation.

8) Frustration or reduced confidence

When a child is frequently misunderstood, they may:
- talk less
- use gestures more
- become upset when asked to repeat themselves
Important note: none of these signs alone prove CAS but they are a strong reason to seek a speech assessment rather than waiting.

CAS vs phonological delay vs articulation difficulty (quick guide)

These are some of the most common questions I hear.

If it’s mainly an articulation difficulty…

A child may consistently say one sound incorrectly (for example, ‘thun’ for ‘sun’- lisp- but everything else is developing well.

If it’s mainly a phonological delay…

You might notice clear patterns, like:
- leaving off the ends of words (‘ca’ for ‘cat’)
- swapping back sounds for front sounds (‘tar’ for ‘car’)
Patterns are often consistent and respond well to phonology-based therapy.

If it might be CAS…

Speech often feels less predictable, harder to imitate, and more impacted by word length and complexity.

If you’re unsure, that’s completely normal, and exactly why assessment matters.

What happens in a CAS assessment?

A high-quality speech assessment for possible CAS usually includes:

1) Parent discussion and developmental history

We talk about:
- pregnancy and birth history (where relevant)
- feeding history
- early sounds and babbling
- first words and how speech has progressed
- family history of speech/language needs
2) A speech sound assessment

Your child might be shown pictures or play-based prompts so we can hear:
- what sounds they can say
- what they simplify
- whether errors are consistent or inconsistent
3) An oral-motor and movement check

This isn’t about ‘strength’. It’s about coordination and planning. We look at how your child manages speech movements and transitions.

4) Stimulability testing

This means: how easily can your child learn a new sound or word with support?

For CAS, we often explore how they respond to:
- slowed-down speech
- visual cues
- rhythm/tapping
- short, simple syllable shapes
5) Functional communication and confidence

We look at how speech impacts daily life:
- being understood at nursery
- joining in with peers
- asking for help
- managing emotions when misunderstood
At the end, you should leave with:
- a clear explanation of what we think is going on
- a therapy plan
- practical home strategies
- realistic next steps
What parents can do at home

Here are CAS-friendly strategies you can start right away.

1) Choose ‘power words’

Pick 1–2 words that matter most in your child’s daily life, such as:
- more
- help
- mummy
- again
- stop
- open
These words are motivating and functional.

2) Keep it short and successful

For many children with CAS, the goal is quality over quantity.

Try five minutes a day rather than 30 minutes of struggle.

3) Support speech with rhythm

Some children benefit from:
- tapping a beat on the table
- clapping syllables
- using a gentle ‘marching’ rhythm
This can help the brain organise the sequence of movements.

4) Celebrate approximations

If your child says ‘moh’ for ‘more’, that’s communication!

We want them to feel:
- safe
- understood
- proud to try again
Confidence is a key part of progress.

A short parent story (anonymised)

One mum said to me:

‘We kept being told to wait. But I could see my child understood everything; they just couldn’t get the words out. Once we had an assessment and a plan, it felt like we finally knew what to do. The biggest change was his confidence. He started trying more.’

When should you seek support?

You don’t need to wait until school.

It’s worth getting an assessment if your child is:
- hard to understand compared with peers
- becoming frustrated or withdrawing from talking
- inconsistent with words they used to say
- struggling to imitate speech sounds
- showing signs that match CAS
Early support can reduce stress for the whole family and help your child feel successful in communication.

Here’s how I can help:

✅ A detailed speech assessment (including whether CAS is likely)

✅ A clear therapy plan with realistic goals

✅ Practical home strategies you can use immediately

✅ Support for nurseries and schools (where needed)

✅ In-person sessions in North-West London and online options

Book your consultation here.

Final gentle reminder

You are not overreacting. Trust your instincts.

Your child is communicating the best way they can, and with the right support, speech can become easier, clearer, and more confident.

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.

3
READ MORE Childhood Apraxia of Speech: Signs and first steps (2–5 years)
Feeding · Speech and Language Therapy

Dynamic assessment – Let’s look beyond the checklist
ByLondon Speech and Feeding September 15, 2025November 6, 2025
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.
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.

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
READ MORE Dynamic assessment – Let’s look beyond the checklist
Speech and Language Therapy

Submucous cleft palate: What is it and how does it impact on speech?
ByLondon Speech and Feeding August 26, 2025November 17, 2025
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.

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
READ MORE Submucous cleft palate: What is it and how does it impact on speech?
Lisp · Speech and Language Therapy · Top tips

Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps
ByLondon Speech and Feeding August 13, 2025November 27, 2025
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.

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
READ MORE Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps
Neurodiversity · Speech and Language Therapy · Top tips

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

What exactly is auditory memory?

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

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

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

Nurturing auditory memory in under 5s: Preparing for schooling

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

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

1
READ MORE Why auditory memory matters (especially for little ones!)
Neurodiversity · Speech and Language Therapy

Understanding Angelman Syndrome: A guide for parents
ByLondon Speech and Feeding May 8, 2025May 7, 2025
Angelman Syndrome (AS) is a complex neurological disorder that affects development. It’s caused by a missing or functionally incorrect gene (UBE3A) on chromosome 15. While AS is rare, understanding its characteristics is crucial for parents and caregivers.

What are the key characteristics of Angelman Syndrome?

Children with AS typically exhibit a range of unique characteristics, which can include:
- Developmental delay: Significant delays in reaching developmental milestones, such as sitting, crawling, and walking.
- Speech impairment: Limited or absent speech. Individuals with AS may use few or no words.
- Movement and balance issues: Difficulties with coordination, balance, and movement, sometimes causing a jerky or unsteady gait.
- Happy demeanour: Frequent smiling, laughter, and a generally happy, excitable personality.
- Intellectual disability: Varying degrees of intellectual disability.
- Seizures: Seizures are common and often begin in early childhood.
- Sleep difficulties: Disrupted sleep patterns and difficulty falling asleep.
The role of Speech and Language Therapy

Speech development and social communication is significantly affected in Angelman Syndrome, and therefore, Speech and Language Therapy plays a vital role in helping individuals with AS to communicate. As Speech and Language Therapists (SLT) we can work with the child and family support any of the following:
- Assess communication skills: We evaluate the child’s current communication abilities, including any vocalisations, gestures, or signs they may use. With younger children we do this through play and playful social games as well as observation of a child playing and interacting with their siblings or caregivers.
- Develop alternative communication strategies: Since spoken language may be limited, SLTs can help the child learn other ways to communicate, such as nonverbal communication, e.g
  
  Gestures: use of pointing, waving and miming certain activities.
  
  More formal sign language: Teaching basic signs to express needs and wants.
  
  Core boards: Using pictures and symbols to represent everyday common words, actions, and feelings.
  
  Augmentative and Alternative Communication (AAC) devices: Providing electronic devices that can produce speech.
- Encourage vocalisations: When words don’t readily develop, SLTs can encourage the child to make vocalisations and sounds, as these can be a form of communication.
- Support language development: SLTs can work on understanding of language, even if expressive language is limited.
- Educate and support families: SLTs provide families with strategies and techniques to support their child’s communication at home.
The importance of a multidisciplinary approach

Caring for a child with Angelman Syndrome requires a team effort. A multidisciplinary approach, involving various healthcare professionals, is essential to address the diverse needs of the individual. This team may include:
- Paediatrician: Provides overall medical care and monitors the child’s health.
- Physiotherapist: Helps with movement, balance, and coordination.
- Occupational therapist: Works on daily living skills, such as feeding, dressing, and self-care.
- Speech and Language Therapist: Addresses communication and language needs.
By working together, we can provide comprehensive care, address the unique challenges of Angelman Syndrome, and help the child reach their full potential.

Conclusion

Angelman Syndrome presents unique challenges and opportunities. With early diagnosis, appropriate interventions, and a strong multidisciplinary team, children with AS can make good progress and live fulfilling, joyful lives. As Speech Therapists we delight in supporting parents in their role in advocating for their child.

Do get in touch via my contact form if you are concerned about your child’s development.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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
READ MORE Understanding Angelman Syndrome: A guide for parents
Speech and Language Therapy

The tricky /R/: Mastering tongue placement for clear speech
ByLondon Speech and Feeding March 5, 2025March 3, 2025
The /R/ sound is notoriously challenging for many children (and even some adults!). It’s one of the most complex sounds in the English language, with various pronunciations depending on its position in a word. If your child is struggling with their /R/s, you’re not alone. As Speech and Language Therapists (SLTs), we frequently work on this sound, and a key component of our therapy is focusing on proper tongue placement.

Why is the /R/ so difficult?

The /R/ sound requires precise coordination of the tongue, jaw, and lips. Unlike sounds like /P/ or /B/ that involve simple lip movements, the /R/ involves intricate tongue movements and tension. There are also different ways to produce the /R/ sound, which adds to the complexity:
- Retroflex /R/: The tongue tip curls up and back towards the roof of the mouth.
- Bunched /R/: The body of the tongue bunches up towards the roof of the mouth, while the tongue tip remains down.
The importance of tongue placement

Regardless of which /R/ variation is being targeted, accurate tongue placement is crucial. Even a slight deviation can result in a distorted or inaccurate sound. That’s why SLTs dedicate significant time to teaching and practising tongue positioning.

Speech therapy techniques: Focusing on the tongue

Here’s a glimpse into how I address /R/ sound difficulties, with a focus on tongue placement:
- Visual aids:
  
  Mirrors: I use a mirror to help children see their tongue movements and make adjustments.
  
  Tongue diagrams and models: These visual tools provide a clear representation of where the tongue should be positioned.
- Tactile cues:
  
  Tongue depressors: These can be used to gently guide the tongue into the correct position.
  
  Food-grade tools: Sometimes, I use flavoured tongue depressors or other tools to provide tactile feedback and increase awareness of tongue placement.
- Auditory discrimination:
  
  I help children distinguish between correct and incorrect /R/ sounds.
  
  I use auditory cues and verbal feedback to reinforce proper pronunciation.
- Exercises and drills:
  
  Tongue strengthening exercises: Strengthening the tongue muscles can improve control and coordination.
  
  Tongue placement drills: We practise positioning the tongue in the desired location and holding it there.
  
  Sound approximation techniques: Sometimes we use other sounds to help approximate the /R/ sound. For example, I use the /L/ sound, to help achieve the correct tongue placement. Once my child has found the /L/ sound it is then a matter of pulling back just slightly to get a good /R/.
- Contextual practice:
  
  Once the child can produce the /R/ sound in isolation, we gradually introduce it into syllables, words, phrases, and sentences.
  
  We also practise the /R/ sound in different contexts, such as at the beginning, middle, and end of words.
Tips for Parents:
- Be patient and supportive: Learning the /R/ sound takes time and practice.
- Practise regularly: Short, frequent practice sessions are more effective than long, infrequent ones.
- Make it fun! Use games, stories, and other engaging activities to keep your child motivated.
- Work with an SLT: A qualified SLT can provide personalised guidance and support.
In conclusion:

The /R/ sound can be challenging, but with targeted speech therapy and a focus on tongue placement, most children can achieve clear and accurate pronunciation.

I hope this blog post is helpful!

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

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

1
READ MORE The tricky /R/: Mastering tongue placement for clear speech
Lisp · Speech and Language Therapy

Tongue training: Why tongue placement matters for clear speech
ByLondon Speech and Feeding February 12, 2025February 3, 2025
As speech and Language therapists (SLTs), we know that where your tongue goes, so goes your sound. This blog post will explore why tongue placement is so vital for speech correction and how we use tools and techniques to help our clients find their ‘sweet spot’ for sound production.

Let me show you here a little video clip where I am using my dentist’s mouth/teeth model to help my clients navigate their tongue movements.

The tongue: A tiny muscle with a big job

The tongue is a small but mighty muscle. It’s incredibly versatile, playing a key role in eating, swallowing, and, of course, speaking. For each speech sound, the tongue, along with the lips and jaw, needs to move to a very specific spot. Think of it like a dance: every part of your mouth has a choreographed movement to produce the correct sound. If the tongue is out of sync, the sound comes out muffled, distorted, or just plain wrong.

The trouble with our tongue movements is that most of us never think about how the tongue has to move and what it does to: swallow, chew, drink, suck and speak. Most parents when asked to think about their own tongue placement for say the /S/ sound are completely lost as to what their tongue is doing. Yet, of course, they produce a perfect /S/ and perfect speech in general. The same goes for swallowing. When did you last think about what happens in your mouth when you swallow? I bet you have not thought about it. We ‘just do it’, right?

Why is tongue placement so important?

Accurate tongue placement is the foundation of clear articulation. When a child struggles with a particular sound, it’s often because his or her tongue isn’t quite reaching the right spot or moving in the correct way. For example, the /S/ sound requires the tongue to be slightly raised and positioned behind the top teeth, creating a narrow channel for air to flow through. If the tongue is too far forward, you might get a /TH/ sound instead. If it’s too far back, the /S/ can sound muffled.

Visual aids: Our secret weapon

We SLTs love our visual aids! They’re incredibly helpful for showing clients exactly where their tongue needs to be. Here are some of our favourite tools:
- Mirrors: Mirrors provide instant feedback. Clients can see their tongue’s position and make adjustments in real-time. We often use hand mirrors or even the mirror on a compact for quick checks.
- Tongue depressors: These simple tools can gently guide the tongue to the correct position. We might use them to show where the tongue tip should rest for the /L/ sound or how the sides of the tongue should touch the molars for the /K/ and /G/ sounds.
- Diagrams and models: Pictures and models of the mouth can help clients visualise the tongue’s movements. We might use a cross-section diagram of the mouth to show how the tongue forms different sounds.
Beyond the tongue: The jaw’s role

While the tongue takes centre stage, the jaw plays a supporting role. It provides a stable base for the tongue and helps control the opening and closing of the mouth. Sometimes, jaw stability is an issue, and we might use techniques to help clients find a comfortable and stable jaw position.

Making it fun and engaging

Learning correct tongue placement can be challenging, but we make it fun! We use games, stories, and playful activities to keep clients motivated. For younger children, we might use silly voices or pretend to be animals. For older children, we might incorporate their interests, like using a car analogy for tongue movements.

The takeaway

Correct tongue placement is essential for clear speech. By using visual aids, interactive techniques, and a bit of creativity, we can help our clients master their speech sounds and communicate with confidence.

If you have any concerns about your child’s speech, don’t hesitate to reach out to a qualified speech and language therapist, we are here to help! Contact me via my contact form.

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.

2
READ MORE Tongue training: Why tongue placement matters for clear speech