When you have a child who uses Gestalts it is often difficult to think and adapt clinic activities into those to use at home. More importantly, you find that individualising your activities for your child who uses Gestalt are time-consuming. But you value its importance for their communication development.
You feel so busy, you are taking them to other appointments, or trying to get through your daily activities, all whilst still ensuring your child’s emotional needs are met. You know life should not get in the way of your child’s therapy activities at home, but it does. We know your spare time is precious and limited, so let us achieve your child’s or young person’s goals in the allotted time you have which meets their way of learning (using Gestalts).
We wanted to support you by exploring items which you may have at home, and we will give you some key phrases which you can start to model with your child. Whereas our last blog introduced the idea of gestalt language processors, we are now developing ideas to give you the tools to implement activities at home. We recognise how overwhelming it may feel, and this is one of the reasons to make activities as straight forward as possible. Therapy does not need to be complicated; it just needs to be carried out on a regular basis.
Explore the samples I’ve created to give you an idea of how this might look but please consult with a Speech and Language Therapist who knows about Gestalt Language Processing so that you can work together to develop great home activities for your child.
Want to learn more about gestalt language processing?
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.
Let’s break it down into steps to make these complicated words easier to understand. Once you have a deeper understanding, you will then be able to support your child or young person develop their communication skills in the best way as a Gestalt Language Processor. Remember not every child will be a Gestalt Language Processor; if your child uses echolalia and/or has a diagnosis of autism then your child’s way of processing language is most likely different to the classic way children typically learn language.
Let’s start with understanding what each of these words “Gestalt Language Processors” mean.
Gestalt: “the way a thing has been placed or put together”
Language: “a system of human communication”
Processors: “responds to and processes basic instruction”
So, let’s put those meanings together. “Gestalt Language Processors are children who process early language in strings of sounds or chunks.” They tend not to process single words.
It is important to understand this way of processing communication because between 75-90% of children with Autistic Spectrum Conditions process language in this way (Blanc, 2012). We know that it’s important for young people to have their voice heard and to be able to express themselves. So, it’s vital that they move from echolalia to self-generated communication to be able to do this. This means that our children’s communication partners play a vital role in supporting their child’s language. We can support our children by modelling phrases until the child has learnt the process themselves.
Let’s explore an example together
X (who is a gestalt language processor) and his family love to feed the ducks in their spare time; this is an activity that takes place regularly. Let’s look at how you, as the adults, could support X in his communication. Look at the phrases that are used. They are meaningful to the activity with repetition used throughout.
Top tip: You could think of an activity you and your child or young person take part in on a regular basis and brainstorm some key phrases that you could use.
Need a boost in confidence to support your child’s gestalt language processing?
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.
You have heard strategies from so many different people, you are confused by which you should use with your child. You’ve ended up not using any strategies to support speech and language development because you don’t know where to start. Let me ease your overwhelm and take you through the Observe, Wait and Listen (OWL) strategy, which you can use with any child of any age.
Our goal is to allow children to engage with us, to have that moment of 1:1 shared experience, a moment of curiosity, a moment you can share together. The OWL strategy aims to provide exactly that! The use of ‘observe, wait and listen’ generates spontaneity. After all, we want our children to be able to communicate in all different environments, in a way that is appropriate for different situations and not just the therapy setting.
The OWL strategy
The OWL strategy allows you to gain a connection with your child. But you might be left wondering what each of the stages mean. Let’s explore this further.
Observe: You observe your child carefully, paying close attention to what they say or do.
Wait: You wait. This allows your child time to initiate an interaction or show an interest. Waiting is more difficult than you think. Try practicing this technique for 5-10 seconds. It’s surprising how long it is. Remember silence is golden!
Listen: Listen to your child and respond appropriately. This is instead of thinking about what you are going to say next.
One of my top tips is to choose a time in the day to practice the OWL strategy. This could be as little as 3 minutes in the day. Little and often is best practice for success.
Alongside the OWL strategy, you can copy what your child is doing with respect and enthusiasm. The most important thing to take away from this blog is that you’re making no demands on your child and that it’s all about having fun on a regular basis! Start using the OWL strategy today, it’s never too late to begin!
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.
Watching your child’s confidence grow as their language develops is something you dream of. You feel helpless, you watch your child repeat language over and over and this concerns you. You know you should be supporting their communication development, but you feel stuck. You’ve reached the point where you don’t know where to turn to for support. Accessing the knowledge of a Speech and Language Therapist is a great place to start.
Here are four ways to support your child’s language:
1. Provide great communication models that include scripts or “gestalts”
Instead of commenting with single words like “apple” or two word phrases e.g., “want apple”, it is more beneficial to comment with small sentences or scripts such as “let’s eat an apple”, “I want an apple mummy”, “I want more apple please” or “I’m hungry daddy.”
These are phrases that include more intonation and rhythm (top tip: ensure you do use appropriate intonation and rhythm), and your child is likely to pick up those phrases and copy them much more easily than single words or two-word phrases.
2. Offer a robust Alternative and Augmentative Communication (AAC) device
There are many examples of AAC devices such as ‘Lamp for Life’ or ‘Grid Smartbox’. It’s vital that you consult a Speech and Language Therapist with a specialism within this area of communication. You want your child to be able to communicate their wants and needs. Furthermore, their communication buttons need to be tailored to your child’s interests so they are motivated to use them (e.g. if your child likes Thomas the Tank Engine, you may wish to program in specific phrases such as “I want to watch Thomas the Tank Engine”. It is also important that the devices are suitable for your child’s physical and emotional stage of development.
3. Learn to be a word detective
Listen to your child’s echolalia (or repetitions) and try to understand what they mean. Their communication is often meaningful around a previous experience. For example, one of my students says, “bang my head” and that actually means “I want to play that tickling game again” (where I banged my head the other day).
4. Take turns with your child and copy their scripts
This shows you are listening actively and value their attempts at language. We all love it when someone is actively listening and trying to decode what we are saying.
Take heart and try not to worry. You’re doing the best you can. Your child is more than likely a Gestalt Processing Learner and so they are moving through very defined stages. Echolalia (repetition) is the first of many, so you have an exciting journey ahead watching your little one’s language grow and develop.
Reduce your child’s frustration and build their confidence today.
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.
This is a surprisingly common speech error and it can be corrected really well in my experience. I have helped lots of children of all ages learn how to control their tongue movements and produce clear, sharp /s/ sounds and good /sh/ sounds.
There are some factors which need to be considered before we can dive into therapy proper and these are they, in a nutshell:
Student is not currently displaying negative oral habits such as thumb sucking or excessive sucking on clothing. This is because thumb sucking exerts pressure on the teeth and therefore can, over time, push teeth out of their natural order/position.
Student does not have a restricted lingual frenulum or tongue tie which can cause at times restricted movements of the tongue (pending on how tight the frenulum is attaching the tongue to the base of the oral cavity); equally a labial frenulum or lip-tie can restrict lip movement and therefore physically restrict good speech sound production.
Student does not have enlarged tonsils as they can sometimes push a tongue forward and also cause open mouth posture and open mouth breathing.
Student’s motivation to change their speech pattern is high. (this is an important factor though with younger students I can get round this with a lot of fun games and good parental involvement!)
When I do an Oral Assessment of my student these are the first factors I want to look at and consider. Often I will refer to other agencies such as Orthodontists, dentists or ENT specialists to advise and help with some of these factors before we can get going. However, there are strategies that we can work on almost straight away.
Most of my Lisp Students present with an open mouth posture: that is where the student has their mouth always slightly open for breathing. Over time the tongue starts to fall forward and rests on the front teeth or the bottom lip instead of finding a comfortable resting place either at the alveolar ridge (the bumpy spot behind the upper front teeth) or, alternatively, resting at the bottom of the mouth behind the lower front teeth.
Another common problem is that the tongue is not moving independently from the jaw and so is reluctant to pull back or lift up inside the mouth as the tongue is guided in movement by the jaw.
Combine those two factors and your tongue is not pulling back, or lifting up or doing very much at all without the jaw moving as well. This makes for unclear speech sounds, especially all the sounds we make at the front with our tongue or with our lips: B/P/L//N/ and of course /S/ and /SH/ are particularly hard to make. We often also struggle with the /Y/ sound so /LELLOW/ instead of /yellow/.
But no fear, these problems can be treated over time for sure! We often start with lip, tongue, and jaw exercises that help to move the tongue independently from the Jaw, our student learns that the tongue is a muscle and can be trained to do amazing acrobatic things in the mouth! WOW! It can actually pull back, lift up, and come down again all on its own!
We work on breathing, holding our breath for a bit then pushing it out and then holding it again.
And when it comes to the actual /s/ sound I often try and go a NEW route bypassing the Snake-Sound route if that is what had previously been tried and failed so that we can create completely new sound patterns in our brain and think about our sounds in a completely new way.
We then work on producing the sound /s/ on its own for a bit, at the end of words, then on either side of complimentary sounds, for instance : ‘EASY” – the sound patterns here are EEE-S –EE : the EEE sound is complimentary to the /S/ sound as the tongue is at the right hight for the /S/ already once you have it in place for /EEE/ -……see?! EASY!
And gradually we work towards saying the /S/ sound clearly at the front of short words, then phrases and then sentences.
The process takes some time and it depends on how ready the student is. This varies of course hugely so I can never promise the exact number of sessions we will take to get that Lisp fixed. A lot depends on home practice in between sessions, and this is of course crucial to all therapy! Every day 15-20 mins practice is a good average time to aim for and when this is done it shortens the therapy block drastically.
I always give plenty of home work so there is never a chance of it getting boring or there being “nothing to do”!
Do contact me. I really enjoy working with this type of student and get a great kick out of FIXING THAT LISP!
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.
SIMPLE SPEECH AND LANGUAGE THERAPY TIPS you can try out at home in daily life!
So many new referrals come to me from parents of toddlers saying help, my little one does not speak yet, what can I do? Consider trying out those strategies, they really help:
Increase playing with your child and try to have MORE FUN. Try and resist the urge to ‘teach’ your child. Fun activities are naturally more motivating and your child will learn new words more easily if you are both having fun together. Try and act goofy to get your child’s attention and make them laugh.
Respect all play forms your child is interested in, not just play with typical/shop bought toys. Be a PLAY PARTNER instead of a PLAY DIRECTOR.
Go With What Your Child Is Interested In
Go with what your child is interested in even if it isn’t that new toy you bought the other day! If you follow your child’s lead by watching him closely, you will discover what they are interested in. Then, if you wait and observe your little one he or she may try to communicate something about that favourite toy or activity.
Use simple words and short phrases with correct grammar about your child’s interests. For example, if he gives you a toy and wants to play, use words to describe that activity, e.g. : “spinning”! “that’s spinning round and round” “wheee” “wow it’s spinning fast!”
Your child is likely to learn the words that match activities he’s motivated and interested in.
Show your child what words mean
You can POINT to something as you say the word (e.g. point to a bird in the sky as you say “Look at the bird!”), ACT out what the word means (e.g. pretend to shiver as you talk about how “cold” it is), or HOLD UP OBJECT as you say it’s name (e.g. hold up your child’s coat as you say, “It’s time to put your coat on”).
Stress key words and repeat them often. Children need to hear words several times in different situations before they really understand what they mean. Try to repeat words that are familiar to your child during everyday activities and routines. For example, you might use the word “go” when you are talking about going outside and duringva “ready steady go” game. Using the same word in different situations gives your child more information about what the word means.
Stop asking too many questions, this is hard for adults to do as we often try to direct our children’s play.
Respond positively to your child’s attempts to communicate, even if these attempts aren’t perfect. As children are learning about words, they sometimes attempt to say a word but don’t pronounce it correctly, or they might use an action or gesture instead of the word. When you notice your child attempt to communicate with you, respond as if he said the word. This shows him you are listening and that you understand what he is trying to tell you. It also encourages him to keep trying to communicate with you.
Learning to say new words doesn’t happen overnight. It takes time for children to build their understanding enough that they can say a word and use it in the right situation. By using the tips above, you will give your child’s vocabulary a kickstart, and pave the way to new words.
Do get in touch with me if you need more help. I specialise in providing individual on-line virtual coaching with parents . This is helpful and often necessary given how complex our children are and how difficult it is to acquire speech and language when for one reason or another it is not your thing!
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.
There are various great ways to treat speech sound disorders and I use all the approaches available selectively; I decide what works with each individual child and I also vary the approach depending on the child’s frame of mind at any given time during my session.
Some of the approaches are more “drill-based” and require a child to be able to pay attention and really participate actively in the therapy, and this is what I am showing you today with this video clip.
My little student here has been working with me for some time and from only saying a handful of words which were not very easy to understand he has come a long way. He does have some features of Verbal Dyspraxia which I shall briefly outline here:
Making sounds in general is a struggle, especially when asked to copy certain sounds, example: ‘can you say: a ee ou oo?”
Repeating sound sequences or words sequences is hard, for example: “say p-t-k in sequence” or “say fish chips fish chips fish chips
When saying the same word again and again, different mistakes can be heard
Intonation difficulties: speech sounds monotonous
Vocabulary is very limited
Some therapy approaches are more play based, for example the Core Word method: here we pick a few words at a time which are very significant to the child and therefore highly motivating to try and say. These could be characters of Pokemon or Minecraft for example, or simple words like “GO!”
When you watch the video you will see that I use a lot of visual prompting, such as showing him where the tongue is moving to or from. I do this with my index finger and this approach is called Tactile Cueing or “Cued Articulation”. Part of the approach is to give a visual prompt and then reduce the prompt as the learner is more able to produce the correct sounds. Once he can produce the sound on its own, we quickly move to the sound within a word.
I do mix and match my approaches and in fact here I am drilling but I also use the Core Word which for him (YELLOW) — it’s his favourite colour and I happen to have quite a few good games where a YELLOW something or other can be asked for….. WHO KNEW!? 🙂
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.
What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?
Speech and language therapists provide treatment, support and care for children and adults who have difficulties with communication, eating, drinking and swallowing. We help children and adults who have problems speaking and communicating.
How to find the perfect therapist for my child/client:
There are a huge number of speech and language difficulties, or feeding and swallowing problems that we can help with and the first thing to think about is what age group the person is you are seeking help for. Most SLT’s specialise in a range of disorders and treatments and they often treat specific age ranges. This could be, for instance, very young children up to 3 years, or school aged children, adolescents or just adults. Once you have narrowed it down to age and general area of difficulty you can then go and seek your perfect SLT match.
Generally it is my view that SLT’s with a narrow area of specialist interest are most likely to help you better if the problem you or your child/adult is having is significant and/or profound. For example, if your child has a very severe stutter/stammer but is otherwise developing fine and has good skills all round, then I would recommend to look for an SLT who only specialises in stammering/stuttering, or has only a small range of other specialist areas related to stammering , such as speech and language delay.
The reason is that it is a tall order for any professional to stay up to date with latest research, latest clinical developments and training for more than, say, five distinct areas of interest.
However, a more generalist Speech therapist who has lots of experience in many different areas could be a very good option for your child or adult who has more general speech and language delay in a number of areas, perhaps a global delay or a syndrome which means that their learning is delayed in general. It also means that your child might benefit from a Generalist SLT because they have many more tools in their SLT bag and your child might need a variety of approaches for several areas.
A good place to start is www.asltip.com which is the Association for Independent Speech and Language Therapists in the UK. Any SLT registered with ASLTIP will also be registered with the HCPC (Health Care Professionals Council), as well as RCSLT (Royal College of Speech and Language Therapists). These two important UK professional regulatory bodies ensure all its members are fully qualified, and are fully up to date with latest developments within their areas of work.
Here you can enter your post code and look for a therapist near you and you can look for specific problems such as stammering for example and narrow down your search. Most therapists have a website which you can then access too. I would recommend you speak to a few therapists on your list and then go with the person you had the best rapport with. You and the therapist will be spending a lot of time together and you will need to feel that you trust them and that you can relax into the process.
How I can help you:
I have 3 main areas of specialism:
Parent Child Interaction Coaching
This is an amazing way to help children with the following difficulties:
Social Communication Difficulties, Autistic Spectrum Disordersand
Speech and Language Delay – for children under the age of 4 years old, this is my preferred way of working because it is so very effective and proven to work. If your child is not developing words or not interacting, has reduced attention and listening and you feel is not progressing or, in fact even regressing, then this way of working is the best. For anyone wanting to read a bit more about the efficacy of this method, below are some research articles. You may also like to check out www.hanen.org which is the mainstay of my work and method when it comes to Parent-Interaction Coaching. You can also look at my latest blog, entitled: Tele-therapy, does it work?
In brief, what’s so great about Parent Coaching is that it empowers you the parent to help your child in daily life! This is where speech, language and social communication develop typically, in a naturalistic way and environment. Simple steps and strategies are discussed and demonstrated every week and you are encouraged to use these strategies with your child in daily routines: getting dressed, having breakfast, on the school run, whilst out in the park or shopping or simply playing at home or having dinner or bath time. Whatever your family routine happens to be, every strategy I teach you will help create a responsive communication environment; generally, if your child is able to develop speech then they will do so in direct response to your changed interaction style.
Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation
I love working with children of all ages on developing their speech sounds. Whether your child has a lisp, or a couple of tricky sounds they simply cannot produce quite right, or perhaps your child is really unintelligible because he/she is having lots of different sound errors, making it really hard to understand them. I typically work on getting “most bang for your buck” , meaning I address the sounds that cause the most problems and, therefore, when they are fixed your child/person’s speech becomes that much clearer fairly quickly.
Feeding and Swallowing Difficulties
Having worked for over 20 years in NHS Child Development Clinics and Special Needs Schools I trained and worked with feeding and swallowing difficulties early on in my SLT career. I later trained as a Lactation Consultant and so I am well placed helping and support all types of Infant feeding, both breast or bottle, as well as toddler weaning. I aim to ensure that your little one swallows the right kind of foods and drinks for their abilities. I am experienced in managing and supporting children with physical needs and mobility problems, Cerebral Palsy, Down Syndrome or any other type of syndrome or presentation.
What does a speech therapy session look like?
All sessions differ slightly depending on the age of the child and the nature of the difficulties.
However, mostly our sessions look like FUN! After arrival and washing hands we tend to start off with the tricky work straight away whilst our child still has energy and the will to engage. So, for speech work we will focus on the target sounds first: this could be sitting at a table doing work sheets together, playing games using the target sound and really any type of activity that gives us around 70-100 repeats of the target pattern. For example, a child who is working towards saying a ‘K’ at the end of the word I will try and get around 100 productions of words like: pack/sack/lick/ pick/bike/lake and so on.
Then we often play a fun game where I might try for a ‘rhyming’ activity or other sound awareness type activities, for perhaps 10 minutes and within that time I aim to trial the next sound pattern we need to improve on; I will test which sound your child can do with help from me. During he last 10 minutes we might look at a book, again listening to and producing whatever sound we are working on. If I did not get 100 sounds earlier on in the session I will try and practice them now as part of the story. In total I aim to have about 40-45 minutes of activities, all aimed at the target sound we are working on.
What does a Coaching session look like?
During a Parent Coaching Session we meet online for about an hour and we discuss how the week has been for you trying out the strategies. Typically parents start off recalling what went well, what progress was made and what had been more tricky. We work through it all, and then follow on to the next strategies: I will show you examples and demonstrations of each strategy and I will get you to think about how you can use this with your child and in what situation you might use it. I will explain what we are doing and what the purpose is. You might want to write down what you are going to work on for the week. Over the course of about sessions we can cover all the major strategies that are proven to help kickstart spoken language and/or help your child to connect more with you. Through that connection spoken words most often develop.
Research Papers on the Efficacy of Parent Child Interaction Coaching
The It Takes Two to Talk Program has been shown to be effective in changing how parents interact with their children, and that children’s communication and language skills improve as a result.
Baumwell, L.B., Tamis-LeMonda, C.S. & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20(2), 247-258.
Beckwith, L. & Cohen, S.E. (1989). Maternal responsiveness with preterm infants and later competency. In M.H. Bornstein (Ed.). Maternal responsiveness: Characteristics and consequences: New directions for child development (pp. 75-87). San Francisco: Jossey Bass.
Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.
Sonja has been a real help for my 5 year old daughter. Due to her support, my daughter is now able to clearly and correctly enunciate ‘th’ ‘f’ and ’s’. She was also helpful in making positional changes to her seating to help her concentrate better and kept her engaged throughout all the lessons which is a feat in itself on zoom!
Helen, Mother of Catherine Age 5.
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.
There are many reasons for speech sound delay or disorders and the first step is a thorough assessment.
What does a Speech Assessment look like?
With younger children, around 2 – 2.5 years we often start by collecting a good speech sample during play or general chatting. Sometimes we do this with an audiotape so that we are able to listen to your child’s speech sounds repeatedly in order to determine any speech error patterns. A good way to get a speech sample is looking at a favourite book together and trying to get your child to name as many items, animals or characters as possible in the book. For older children, 4.5 years plus we do more formal speech sound assessments where we show your child a series of pictures which focus on varying sounds or sound patterns, for example:
Are the end sounds present or left off, does your child say BE_ instead of BED for example?
Are the back sounds produced at the front of the mouth, is a digger a DIDDER or a pig a PID?
Are sound blends reduced, for instances a snake becomes a NAKE ?
Or do many phonemes (single speech sounds) collapse all into one error sound? Like all F , R or L become a B?
Once we have discovered the error pattern we can then unravel the problem and work on solutions. We make a plan and prioritise which of the patterns we can target first, second and next. There are several approaches that can be used to tackle speech sound errors and most therapist have two or three favourite approaches as their go-to. I will fill you in on my favourite ones in future blogs.
What does a Speech Therapy session look like?
These days we have two options: on-line via zoom and face to face in the clinic setting.
Both are great options!
For all clients who live far away a zoom session will be the option to go for. But zoom sessions also work really well for the older child as, let’s face it, are there any kids out there who do not like a bit of screen time?
I find that children around 5 years old really love the on-line games and sessions are fun and very effective. We usually start off with a quick game to warm up and then we go into the speech sound patterns we need to improve and work on. There are 100s of tried and tested on-line games and game decks which can be hugely entertaining and really nice to work with.
In clinic, we also often start with a short game to settle in and then we target the various sound patterns we are working on within table top games, or arts and crafts activities. We aim to get up to 100 speech sound trials per session, using a variety of motivating games to keep our little ones going and focused.
Both, face to face and on-line sessions are between 40-45 minutes long – time usually flies by! – and then parents get to practise home exercises to make sure that the new speech sounds are being practised every day.
Over the coming weeks I shall do blogs on great games and home exercises that I give the parents and I will talk about games we do in the session that are fun and can be copied for home use. Watch this space!
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.
