The hidden impact of mouth breathing and open mouth posture on speech and feeding
· ·

The hidden impact of mouth breathing and open mouth posture on speech and feeding

ByLondon Speech and Feeding

When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

Mouth breathing and open mouth resting posture can quietly influence everything from how a child’s face grows to how clearly they speak, to how confidently they chew and swallow. It’s something many parents never think about, until they start noticing the subtle signs.

Let’s explore why this happens, what to look for, and how to gently support better breathing and oral posture.

Recent research supports this link between mouth breathing and speech difficulties. For example, a 2022 study by Alhazmi et al., published in the Journal of Pharmacy and Bioallied Sciences, found that 81.7% of children aged 9–17 who breathed primarily through their mouths presented with speech sound disorders. The study highlights how mouth breathing can significantly influence orofacial development and articulation patterns.

💨 Why we’re designed to breathe through our nose

Our bodies are made for nasal breathing. When we breathe through the nose, the air is filtered, warmed, and humidified before reaching the lungs. The tongue naturally rests against the roof of the mouth, the lips close gently, and the jaw stays relaxed, all of which encourage healthy oral development.

In contrast, mouth breathing often means the tongue rests low in the mouth and the lips stay apart. Over time, this posture can subtly reshape how the muscles and bones of the face grow.

Children who breathe through their mouths most of the time may develop:

  • A longer face and narrower palate
  • Forward head posture
  • Slightly open lips and low tongue position at rest
  • A tendency toward drooling or noisy breathing
  • A dry mouth and consequently bad breath
  • At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)

These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

🗣 How mouth breathing affects speech

Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.

  1. Reduced tongue strength and placement, i.e. the tongue rests low in the mouth (as it does in mouth breathing), it’s harder for children to lift it efficiently for sounds like /T/, /D/, /N/, /L/, and /S/. This can lead to speech that sounds slightly slushy or unclear, or a frontal lisp.
  2. Open mouth posture and resonance: An open mouth at rest may affect how air vibrates in the oral and nasal cavities. Children might have speech that sounds a bit ‘muffled’ or lacks crispness because the lips and jaw aren’t fully supporting articulation.
  3. Fatigue and breath control: Mouth breathing can lead to drier mouths and less efficient breath support. That can make longer sentences or conversations feel tiring, especially in noisy environments.

🥄 How mouth breathing affects feeding and chewing

Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.

  1. Chewing efficiency: Children who habitually keep their mouths open often have low tongue tone and reduced jaw stability. They may prefer softer foods, chew slowly, or struggle with mixed textures.
  2. Swallowing pattern: A tongue that rests low may push forward when swallowing. This ‘tongue-thrust swallow’ can interfere with efficient chewing and even affect dental alignment over time.
  3. Breathing while eating: Since it’s hard to chew, swallow, and breathe through the mouth simultaneously, children who can’t comfortably nasal breathe may rush bites or pause to catch their breath. This can contribute to coughing, choking, or food refusal.

Common signs to watch for

Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:

  • Lips habitually open at rest
  • Drooling after the toddler years
  • Snoring or noisy breathing during sleep
  • Preference for soft foods or grazing eating habits
  • Dark circles under the eyes due to allergies
  • Frequent colds, congestion, or mouth odour
  • Speech that sounds slushy or unclear despite good effort

If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

👩‍⚕️ What can help

  1. Address the underlying cause: If nasal blockage, allergies, or enlarged adenoids are making nasal breathing difficult, a medical assessment is the first step. ENT specialists can rule out or treat physical causes.
  2. Encourage closed mouth rest: Gentle reminders like ‘Lips together, tongue up, breathe through your nose’ can help older children become aware of their resting posture. For younger ones, visual cues (stickers or mirrors) can make it a game.
  3. Build oral-motor strength and awareness: Speech therapists can design activities to strengthen the tongue and lips, improve jaw stability, and encourage balanced breathing. This might include blowing games, tongue-tip lifts, use of dental-palatal devices or oral-motor exercises disguised as play.
  4. Support good posture: Sometimes mouth breathing goes hand-in-hand with forward-head posture. Encouraging upright sitting during meals and screen time helps keep the airway open and supports better breathing habits.
  5. Make nasal breathing part of daily routines: Gentle nose-breathing practice during calm times (reading, bedtime, car rides) helps normalise it. Avoid making it a battle: calm, consistent reminders work best.

🌱 A gentle note on change

Patterns of mouth breathing develop over time, and change doesn’t happen overnight. It’s important to approach this with curiosity, not criticism. The aim isn’t ‘perfect breathing,’ but to give your child the tools and awareness to breathe comfortably and efficiently.

Small improvements in nasal breathing and resting posture can lead to big gains in speech clarity, eating confidence, and even sleep quality.

💡 The takeaway

Breathing seems automatic, and it is! but how we breathe matters. Mouth breathing and open-mouth posture can quietly shape how a child speaks, eats, and grows.

By noticing early signs, addressing underlying causes, and building supportive habits, you can help your child move toward stronger, clearer speech and more comfortable mealtimes.

Just like every area of development, progress starts with connection, patience, and gentle consistency, one calm breath at a time.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

References

Alhazmi, A., Alshamrani, A., Alhussain, A., et al. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Study. Journal of Pharmacy and Bioallied Sciences 14(5):911. https://www.researchgate.net/publication/361978128_Mouth_breathing_and_speech_disorders_A_multidisciplinary_evaluation_based_on_the_etiology

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.

2
Why auditory memory matters (especially for little ones!)
· ·

Why auditory memory matters (especially for little ones!)

ByLondon Speech and Feeding
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.

1
Seeing sounds: How visual gestures boost speech sound learning
· · ·

Seeing sounds: How visual gestures boost speech sound learning

ByLondon Speech and Feeding

Learning to produce new speech sounds can be a complex process for young children, especially those facing challenges with speech sound disorders or motor planning difficulties. It’s not just about knowing what a sound ‘should’ sound like; it’s about figuring out where to put your tongue, how to shape your lips, and how much air to push out. This is where the power of visual gestures comes in – literally helping children see how to make sounds.

As speech and language therapists, we frequently use visual cues and hand gestures to teach articulation. These techniques are incredibly effective, particularly when a child is struggling with the motor planning aspect of speech production.

In the video clip above you see me teaching

  • the /SH/ sound: the hand makes a C-shape and moves forward showing both how the lips are positioned and the air flowing forward
  • the /S/ sound: the index finger shows a snake like movement going forward- also showing the air flow again
  • the /W/ sound: my right hand moves forward and fingers splay out showing that the lips open up at the end of the sound
  • the /K/ sound: my finger points to the back of my throat where the tongue needs to raise.

An overview of motor planning for speech – what do we mean by that?

Think about learning to ride a bike or play a musical instrument. You don’t just know how to do it instantly. You have to plan the movements, practise them, and make adjustments. Speaking is similar! Our brains must:

  1. Plan the sequence of movements needed for each sound and word (e.g., /B/ requires lips together, then release, while /T/ requires the tongue tip behind the top teeth, then release).
  2. Execute those plans rapidly and precisely.

For some children, especially those with conditions like Childhood Apraxia of Speech (CAS) or other severe articulation disorders, this motor planning process is disrupted. They know what they want to say, but their brain struggles to send the correct, consistent messages to their articulators (lips, tongue, jaw, velum). This can make speech sound learning incredibly frustrating.

Why use visual gestures?

Visual gestures provide an additional, powerful sensory input that can help bridge the gap between knowing a sound and producing it. Here’s how and why they are so beneficial:

1.      Providing a visual map:

  • How it helps: Many speech sounds are ‘hidden’ inside the mouth. It’s hard for a child to see where their tongue needs to go for a /K/ sound (back of the tongue to the roof of the mouth) or a /T/ sound (tongue tip behind teeth). A simple hand gesture can visually represent this mouth movement. For example, a hand gesture for /K/ might involve sweeping the hand back towards the throat, while for /T/, it might be a tap on the chin.
  • Why it works: Children are highly visual learners. Seeing a physical representation of an abstract mouth movement gives them a concrete ‘map’ to follow, making the process less mysterious and more manageable.

2.      Enhancing motor planning and memory:

  • How it helps: When a child simultaneously moves their hand (the visual gesture) and attempts to make the sound, they are engaging multiple sensory systems (visual, tactile, proprioceptive – body awareness). This multi-sensory input strengthens the neural pathways associated with that speech sound.
  • Why it works: This multi-modal learning helps to solidify the motor plan for the sound in the brain. It’s like having more ‘hooks’ to hang the information on, making the sound easier to recall and produce consistently. The gesture becomes a built-in reminder.

3.      Reducing cognitive load:

  • How it helps: Instead of just hearing the sound and trying to figure out the complex motor sequence, the child has a visual cue to guide them. This reduces the mental effort required to decode the sound production.
  • Why it works: When cognitive load is lower, the child can focus more effectively on the specific motor execution of the sound, leading to faster progress and less frustration.

4.      Increasing engagement and success:

  • How it helps: Gestures can make therapy more interactive and fun! When a child successfully produces a sound with the help of a gesture, it’s a tangible victory.
  • Why it works: Success is a powerful motivator. When children experience success, they are more likely to stay engaged, participate actively, and feel more confident in their ability to learn new sounds.

5.      Supporting self-correction:

  • How it helps: Once a child learns the gesture associated with a sound, he or she can use it as a self-monitoring tool. If he or she makes an error, he or she can use the gesture to remind himself or herself of the correct mouth position or movement.
  • Why it works: This promotes independent learning and reduces reliance on constant adult prompting.

Conclusion

The journey of speech development can be challenging, but visual gestures offer a powerful and effective tool for teaching new sounds, especially when motor planning is a factor. By providing a clear visual map, strengthening motor memory, reducing cognitive load, and fostering engagement, these gestures pave the way for clearer communication and greater confidence. If your child is struggling with speech sounds, consider talking to a Speech and Language Therapist to get guidance on how visual gestures might be incorporated into the therapy plan. Because sometimes, seeing truly is believing (and speaking!).

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 language and thinking skills: The power of sequencing
·

Unlocking language and thinking skills: The power of sequencing

ByLondon Speech and Feeding
Sonja demonstrates the power of sequencing

As speech and language therapists, we often use a variety of techniques to help children develop their communication and cognitive skills. One incredibly valuable tool in our toolkit is the use of sequencing activities. But what exactly is sequencing, and why is it so beneficial?

What is sequencing?

Sequencing, at its core, involves arranging items, events, or actions in a specific order. This could involve putting pictures in the correct order to tell a story, following the steps in a recipe, or understanding the order of daily routines like brushing teeth or getting dressed.

The link between sequencing and language

Sequencing is fundamental to language development and is quintessential to executive functioning skills in several ways:

  • Narrative skills: Storytelling, whether oral or written, relies heavily on sequencing. A child needs to understand the order of events (beginning, middle, end) to construct a coherent narrative.
  • Explanations and instructions: Providing clear explanations or instructions requires the ability to sequence information logically. For example, explaining how to play a game or how to get from one place to another. In the video clip below we are working on ‘how do make a sandwich’.
  • Vocabulary development: Sequencing helps children understand temporal words and phrases like ‘first,’ ‘then,’ ‘next,’ ‘before,’ and ‘after’.
  • Sentence structure: Constructing grammatically correct sentences often involves sequencing words in a specific order (e.g., subject-verb-object).

Beyond language, sequencing plays a crucial role in developing executive functioning skills. These are higher-level cognitive skills that help us plan, organise, and manage our time and actions.

Sequencing activities can help children improve in the following areas:

  • Planning and organisation: Sequencing tasks require children to think ahead, plan the steps involved, and organise them in a logical order.
  • Problem-solving: When they are faced with a problem, sequencing helps children break it down into smaller, more manageable steps.
  • Working memory: Holding information in mind and manipulating it, such as remembering the steps in a multi-step direction, is supported by sequencing skills.
  • Cognitive flexibility: Being able to adjust to changes in a sequence or think of alternative sequences promotes cognitive flexibility.

Examples of sequencing activities

Here are some practical examples of sequencing activities you can do with your child:

  • Picture sequencing: Use a set of picture cards to tell a short story or illustrate a process (e.g., making a sandwich, going to the park). Ask your child to arrange the cards in the correct order.
  • Story retelling: After reading a story, have your child retell it, focusing on the order of events.
  • Following instructions: Give your child multi-step instructions to follow (e.g., ‘First, get your shoes. Then, put on your coat. Next, go to the door.’).
  • Sequencing during play: Integrate sequencing into everyday play. For example, while building with blocks, talk about the steps: ‘First, we put this block here. Next, we add this one…’
  • Daily routines: Create visual schedules for daily routines, like getting ready for school or bedtime, to help children understand the sequence of events.
  • In the video clip below I am using an on-line language activity which is often fun for children as they can use their finger to swipe the pictures effortlessly into the right place and, if we realise at the end of the story that we have made a little error, we can then easily re-jig the pictures into their correct place.

In conclusion

Sequencing activities offer a powerful way to support children’s language development and enhance their executive functioning skills. By helping children understand and create order, we equip them with essential tools for communicating, learning, and navigating the world around them.

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.

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
Speech Sound Challenges: A focus on /L/ and /Y/
· ·

Speech Sound Challenges: A focus on /L/ and /Y/

ByLondon Speech and Feeding

Have you ever thought about how difficult it can be to produce certain speech sounds? Some sounds are definitely trickier than others. This is especially true for children with speech sound disorders like Childhood Apraxia of Speech (CAS).

My student with CAS has been working hard on producing the /L/ sound especially when it was followed by an /O/ or /OO/ like, ‘log’ or ‘look’. We’ve practised lots and now that he’s got a good handle on /L/, he’s started replacing another difficult sound, /Y/, with it. So, ‘yes’ becomes ‘less’ and ‘yuck’ becomes ‘luck.’

This is a common pattern in speech development. Once a child masters a new sound, they may start using it in place of other sounds they find even more challenging.

Minimal Pair therapy

I use different evidence-based methods to help my students. And I often like to start out with phonemic awareness and then I move to contrasting the error sound with another sound to make completely different words. This approach is called ‘minimal pair’ therapy: both words are the same except for the initial/final sound which has the error sound, and this is contrasted with the correct sound.

Below is an example of this:

After we have worked on sound awareness, listening and becoming aware of small units of sound matter, then we can move to working on tongue placement and movement.

Tongue placement and movement to produce correct /L/ and /Y/ sounds

To produce these sounds correctly, the tongue needs to be in specific positions and make specific movements.

  • /L/ sound:
    • Tip of the tongue touches the alveolar ridge (the bony ridge behind your upper teeth)
    • Sides of the tongue are raised to the sides of the upper teeth
    • Airflow escapes through the sides of the tongue
  • /Y/ sound:
    • Tip of the tongue touches the roof of the mouth behind the alveolar ridge
    • Sides of the tongue are raised to the sides of the upper teeth
    • Airflow escapes through the centre of the mouth

I also use:

  • Auditory bombardment: Auditory bombardment is a technique that involves repeatedly listening to a target sound. This can help children to develop a better understanding of the sound and how to produce it.
  • Visual cues: Visual cues can be helpful for children who are having difficulty producing a particular sound. Here I use the image of a ‘standing tongue’ versus a ‘sitting tongue’.
  • Physical cues: I use my hands to show a ‘standing tongue’ for the /L/ versus a ‘sitting tongue’ for the /Y/. But what worked even better and sadly I don’t have the video clip for it:
  • Semantic cues: For example a picture of an ‘EAR’ to make the sound /Y/ so we shape the sound /EA/ to /Y/.
  • Parent involvement: Parents play an important role in their child’s speech sound development by providing opportunities for them to practise their speech sounds at home. This can be done through activities such as reading books, singing songs, and playing games.
  • Reinforcement: It is important to praise children for their efforts, even if they are not perfect. This will help them to feel motivated to keep practising. Important here for speech correction is concrete reinforcement: I feed back to my student what exactly they were doing correctly with their tongue or lips. Rather than saying ‘well done’, I mention what my student has just done with the tongue to change the sound: ‘I saw you lowered your tongue! That made a good /Y/’.

Another great way of reinforcing positively is to ask the student how they feel they have done? For the older ones I often ask them to self-rate their sound production out of 10. Then we can work towards the next incremental number upwards. This is very effective and gives the student control over their own work.

Please contact me if your child has speech sound difficulties.

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
Chaining
· ·

Chaining: A powerful tool for phonological development

ByLondon Speech and Feeding

Understanding chaining

Chaining is a therapeutic technique I like to use in my speech therapy work with children who have Childhood Apraxia of Speech (CAS) or phonological speech sound difficulties. It helps to break down a complex target behaviour into smaller, more manageable steps. By systematically teaching and reinforcing each step, I can help my students achieve their communication goals.

There are two types of chaining: Forward and backward chaining

Today I am going to show and talk about backward chaining. This technique involves starting with the last step and working backward to the first. This approach can be particularly effective for children with persistent speech sound difficulties where combining consonants into clusters, such as /BL/ or /FR/ or /SHR/ is very difficult.

Backward chaining allows my student to experience immediate success and build his confidence.

In my video I show you how I applied backward chaining to the words ‘Shriek’, ‘Shrub’, ‘Shrimp’ etc

My student struggles with both the /SH/ and the /R/ sounds and we have been working on both sounds for some weeks now. He has mild Childhood Apraxia of Speech and he has difficulties with coordinating his tongue movements, breathing and using his jaw effectively to make words. His sound repertoire has grown a lot since we started working together last year. Today in this session I show you how we pulled both the sound /SH/ together with /REEK/ to make ‘SHRIEK’. I love using the pictures and therapy materials from Adventures in Speech Pathology.

This is also part of the Complexity approach which I will explain in a separate blog post.

  • Step 1 (not shown in the video): I explain what the word means; I find that when my student understands what a word means he is much better at saying it. It increases his confidence and motivation to say a word that he knows the meaning of. Often this student does not tell me that he does not know what a word means, so I always remind myself to check that out first.
  • Step 2 (not shown in the video): We do a little rhyming game and think about what any one word rhymes with: ‘Shriek’ – ‘meek’, ‘weak’, ‘seek’.
  • Step 3: I show my student that there are two parts to this word /reek/ and the sound /SH/.
  • Step 3: We practise the easier part: /reek/ /reek/ /reek/.
  • Step 4: We add the /SH/ sound and pull it together to make our target word ‘Shriek’.

/REEK/ /REEK/ /REEK/ + /SH/ = ‘SHRIEK’
/RUB/ /RUB/ /RUB/ + /SH/ = ‘SHRUB’
/RUG/ /RUG/ /RUG/ + /SH/ = ‘SHRUG’

By breaking down the word into smaller, manageable steps, my student can focus on each syllable individually, get that right and then gradually build up to the full word. This approach can help to reduce frustration and increase motivation.

Forward chaining

Forward chaining is the same process but in reverse: we start with the front sound or syllable and work forward towards the next/last part of the word:

/SH/ + /REEK/ = ‘SHRIEK’
/SH/ + /RUB/ = ‘SHRUB’
/SH/ + /RUG/ = ‘SHRUG’

Benefits of chaining

  • Increased motivation: By starting with the last step, my student experiences success, which boosts his motivation to continue trying to say the word and trying other words.
  • Reduced frustration: Breaking down the target behaviour into smaller steps can make the task less overwhelming, reducing frustration and anxiety.
  • Improved confidence: As the little learner masters each of the step, his confidence and self-esteem increases. Again, this leads to increased motivation.
  • Faster learning: By focusing on the final step first, and practising lots of chaining (forward and backward), a student can quickly learn to generalise to other words.

Backward chaining (and forward chaining) is a really great tool for teaching complex speech sounds and words to children with phonological disorders.

Watch out for my next blog which is all about the complexity approach in Phonology.

Do get in touch if your child has a speech sound disorder, I would love to help.

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

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

1
Cued Articulation – using hand gestures to show how a sound is made
·

Cued Articulation – using hand gestures to show how a sound is made

ByLondon Speech and Feeding
Watch how cued articulation can transform your child’s speech and language skills!

Cued Articulation involves using specific handshapes and placement cues to guide the speaker’s articulators, such as the tongue, lips, and teeth, to produce accurate sounds. It was originally conceptualised by Jane Passy, a speech-language pathologist. But it is important to know that we can, and often do, also use other speech cues which help our student visualise what they need to do. In other words, we can mix and match our cue pictures depending on what works best with each student.

In the beginning of my speech therapy practice I would stick religiously to Jane Passy’s method but over the years I have learned and used many different visual hand cues which all have worked with individual students.

It is important to remember that this is not an exact science, rather than an art! The art is to find the key to each individual student’s understanding and inspire motivation to try out a sound which they find hard to do.

As an example, the hand signs used by Caroline Bowen’s method, an Australian Speech-Language Pathologist, are quite different to Jane Passy’s signs but they can equally work very well. Caroline Bowen’s visual for the /r/ sound is the ‘rowdy rooster’ — a crazed rooster on a motorbike — and the hand signal is that of revving up the motor bike engine with both hands whilst trying out the /r/ sound! I have a good handful of students who really loved this rooster image and were able to eventually produce a good /r/ using this cue.

So, it is horses for courses with many things, and visual images and hand cues are no exception!

Sound picture cards:

Again, there are a host to choose from and I tend to collect a number of different images for each sound I want to practise with my student. As an example, below are a couple of different examples I use for the sound /p/:

The Nuffield Programme suggests to use this popper card, which works well with a student who knows these poppers and perhaps has one on their trousers.

As an alternative, and especially for younger students, I like using the Popper Pig Card – which I also have in my room so I can quickly show how it pops. Or we can have a popping game in between saying the /p/ sound at times. (The popper card is great as I can use the real toy to help with conveying the /p/ sound as it pops.)

Each card has its own merit and I choose the right card for the individual student.

How I use cued articulation and the visuals in Speech Therapy

  1. Cueing and practice: I introduce the appropriate card and handshapes for the targeted sounds. We then practise producing the sounds.
  2. Reinforcement and feedback: Positive reinforcement encourages progress and builds confidence.
  3. Fading out the cues: Once my student is able to say the sound more easily, we can gradually fade out the speech cues.

Benefits and effectiveness

Using Cued Articulation and Speech Image Cards has been shown to be effective in improving speech production for individuals with various speech and language disorders, including:

  • Articulation disorders: Difficulty producing specific sounds accurately.
  • Apraxia of speech: A motor planning disorder that affects the ability to sequence and coordinate movements involved in speech.
  • Phonology disorders or delays: Confusion and delays in how sounds are organised in categories to convey meaning, errors in sound patterns, for example front sounds are produced at the back, or long sounds are produced as stops.
  • Stuttering: A fluency disorder characterised by interruptions in speech, such as repetitions and prolongations.

Tips for parents and student speech therapists

Parents can play a crucial role in supporting the implementation of cued articulation at home and in therapy sessions. Here are some tips:

  • Collaborate with your SLT: Good feedback and communication with the Speech and Language Therapist creates consistency and progress..
  • Practise Regularly: Encourage consistent practice of cued articulation at home to reinforce learning.
  • Use Visual Aids: Use the same visuals that your therapist uses in the speech clinic to help your child at home with recall and practice.

Feel free to contact me if you need help with your child.

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