A bite-sized guide to Speech and Language Therapy: feeding and swallowing

ByLondon Speech and Feeding October 7, 2024October 7, 2024

What is a Speech and Language – Feeding Therapist?

You’ve probably heard of speech therapists helping people who stutter or struggle to pronounce words. But did you know that they also work with children and adults who have problems with eating and swallowing? This specialised area is called Speech and Language Therapy: Feeding and Swallowing, or Dysphagia Therapy.

Why does a Speech Therapist help with eating and swallowing?

The mouth, tongue, and throat are all involved in both speech and swallowing. When there’s a problem with any of these parts, it can affect both your ability to talk and to eat. For example:

Weak tongue muscles: Can make it hard to chew food and to form sounds.
Difficulty coordinating swallowing: Can lead to choking or aspiration (when food or liquid goes into the lungs).
Sensory issues: Can make certain textures or tastes feel unpleasant or overwhelming.
Communication: If we are not able to express ourselves we are likely to have difficulties during daily mealtimes: how do we ask for ‘more’ of something, how do we say we have had enough or we don’t like a particular food?

How does a Speech and Language Therapist help?

Our work involves a combination of assessment and therapy. We carefully observe how your child feeds, eats and swallows, and we look into your child’s mouth to help us see what the cause of the difficulties are: could be a very highly-arched palate, it could be a very flaccid/low tone tongue, it could be poor dentition. Then, we create a personalised treatment plan to address your specific needs.

Here are some of the things we might do:

Teach swallowing techniques: We can help your child learn strategies to improve or facilitate a safe swallow.
Recommend dietary modifications: We may suggest changes to your child’s diet to make it easier to eat and swallow.
Provide sensory therapy: If your child has sensory needs we can help your child become more comfortable with different textures, tastes, and smells.
Work on oral motor skills: We can help to encourage more effective chewing, or drinking skills, or we can help your child to close his/her mouth more during chewing or drinking from a straw.
Collaborate with other professionals: We often work closely with doctors, nurses, occupational therapists, and dietitians to provide comprehensive care.

What kinds of problems do Speech and Language Therapists help with?

We see a wide range of feeding and swallowing difficulties, including:

Delayed feeding: Children who are slow to develop feeding skills or who have difficulty transitioning to solid foods.
Tongue-ties: Babies can have significant difficulties with feeding when the tongue is very tightly tethered to the floor of the mouth.
Refusal to eat: Children who refuse to eat certain foods or textures.
Aspiration: When food or liquid goes into the lungs, which can lead to pneumonia and other serious complications.
Chewing difficulties: Problems with chewing food, such as difficulty breaking down food or keeping food in the mouth.
Swallowing difficulties: Problems with swallowing, such as feeling like food is stuck or choking.
Neurological conditions: Conditions like cerebral palsy, down syndrome or other genetic syndromes can affect feeding and swallowing.
Developmental delays: Children with developmental delays may have difficulties with feeding and swallowing.

Is there hope?

If your child is struggling with feeding or swallowing, know that there is help available. Speech and Language Therapy can make a significant difference in your and your child’s quality of life. We’re here to support you every step of the way.

Remember, you don’t have to suffer in silence. If you’re concerned about your child feeding or swallowing, please reach out. You can find a Speech and Language Therapist with a Feeding/dysphagia qualification near you via www.asltip.co.uk or contact me.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

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

Let’s ditch the ‘Fix-It’ approach to autistic play and stimming
ByLondon Speech and Feeding December 8, 2025December 8, 2025
December is often presented as a time of perfect, reciprocal play. Children are supposed to be unwrapping toys, sharing, and engaging in imaginative scenarios with family. But for parents of young autistic children, this high-pressure, socially demanding period can often feel like a battleground.

If you’ve been told to interrupt your child’s stimming, push for eye contact, or force them to play ‘functionally’ with toys, it’s time to take a deep breath. Those traditional approaches are not only stressful—they often miss the point of your child’s communication.

As a neurodiversity-affirming Speech and Language Therapist, I want to encourage you this December: You are allowed to follow your child’s lead, validate his or her unique interests, and trust that his or her play and movement are profoundly meaningful.

1. Stimming: not a distraction, but a regulator 💡

Stimming is short for self-stimulatory behaviour and includes repetitive movements or sounds like hand flapping, humming, rocking, finger flicking, or repeating phrases (called echolalia).

For years, parents were incorrectly advised to block or eliminate these behaviours. The neurodiversity-affirming view tells us the exact opposite: Stimming is a vital and essential tool for your child’s self-regulation.

Think of stimming as an internal volume dial:
- Too loud/overwhelmed: Your child may stim to reduce incoming sensory input (e.g., rocking to ground himself or herself in a busy room).
- Too quiet/under-stimulated: Your child may stim to increase sensory input and focus (e.g., running back and forth to maintain alertness).
The shift: validate, don’t block

Instead of saying, ‘Stop flapping your hands’, try to understand the message behind the movement.
- Observe: When does the stimming happen? Is it before a meltdown? When your child excited? When your child is bored?
- Validate: Name the need, not just the behaviour. You might say, ‘I see your body needs to move fast right now. That helps you calm down!’
- Co-regulate: If the stim is unsafe (e.g., head-banging), help your child find a safer, alternative stim that meets the same sensory need (e.g., pushing hard against a wall, squeezing a stress ball).
By validating your child’s need to regulate, you are building trust, reducing anxiety, and teaching him or her critical self-awareness.

2. Autistic play: Meaningful, even if it’s monologue

The traditional idea of ‘good play’ often involves turn-taking, pretending, and specific toy functions (e.g., pushing a train around a track). When an autistic child spends 30 minutes lining up cars, spinning their wheels, or scripting whole scenes from a favourite movie, it can often be dismissed as non-functional or repetitive.

In neurodiversity-affirming practice, we recognise that autistic play is authentic play. These activities are crucial for learning, deep focus, and imaginative development.
- Lining up toys may be an exploration of patterns, visual organisation, and order.
- Spinning wheels may be a deep interest in cause-and-effect and visual sensory input.
- Scripting is often a way to process language, regulate emotions, and practise complex social situations in a safe, controlled way.
Make a change: Join your child’s world, don’t drag them to yours.

Stop trying to force the ‘right’ way to play. Instead, try these neuro-affirming strategies:
1. Be a co-regulator, not a director: If your child is lining up cars, sit down next to him or her. Instead of moving a car, try handing him or her another car to line up. Focus on the shared interest rather than forcing interaction.
2. Narrate (don’t question): Avoid constantly asking, ‘What are you doing?’ or ‘What does this car say?’ This puts pressure on your child to perform. Instead, narrate your observations using his or her interest: ‘I see you made a long, straight line of red cars. Look at all the wheels spinning!’
3. Validate the interest: Show genuine appreciation for your child’s focus. ‘Wow, you know so much about how magnets stick together! That’s incredible.’
3. The communication revolution: Honouring gestalt language processing

Many young autistic children communicate in ways that don’t fit the traditional model of building language word-by-word. Many use Gestalt Language Processing (GLP).

A gestalt language processor learns language in chunks or scripts (e.g., ‘what’s-in-there?’ or ‘ready-go!’). These chunks (or gestalts) are not random; they are often tied to an emotional memory or meaning. Over time, the child breaks down these big chunks into individual words then learns to recombine those words creatively.

If your child repeats movie phrases or whole sentences that seem unrelated, he or she is likely a gestalt language processor!

Affirm the script, then model something useful.
1. Affirm the script: When your child says a script, respond to the meaning or emotion behind it, not the literal words. If he or she says, ‘We’re going to need a bigger boat’, and he or she is looking at a messy toy pile, he or she may be trying to express overwhelm or a need for help. You can affirm: ‘That pile is too big! I can help you move it.’
2. Model new ‘mix and match’ scripts: To help your child move from whole scripts to single words, you can model shorter, slightly changed versions of the script, also called ‘mitigated gestalts’. If they say, ‘I want to go home now’, you might model, ‘Let’s go home, now’ or ‘I wanna go home’.
By honouring your child’s communication style, you validate his or her experience and naturally support his or her path to language development—a core part of neurodiversity-affirming SLT.

Your December gift to your little one:

This December, stop trying to make your child fit into a neurotypical box. Instead, make your home a safe space where he or she can be his or her authentic selves.

Prioritise regulation and connection over compliance.

Trust that when your child is regulated, his or her communication, learning, and engagement will flourish naturally. This is the true gift of neurodiversity-affirming practice.

Download and print my neuro-affirming quick reference guide and keep this guide handy on your fridge and/or in your child’s play area for a quick reminder to prioritise connection over conformity.

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.

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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.

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Speech and Language Therapy

Why I love ‘Colourful Semantics’ in speech therapy
ByLondon Speech and Feeding May 28, 2026May 28, 2026
One of the most common concerns parents bring to speech and language therapy is:
‘My child understands so much… but they struggle to put sentences together’.

Some children use only single words.
Others miss out key parts of sentences.
Some mix up word order.
Others find it difficult to answer questions or explain their ideas clearly.

This is where one of my favourite therapy approaches can be incredibly powerful: Colourful Semantics.

Colourful Semantics is a highly effective and evidence-informed way of supporting children to build stronger sentence structure, grammar, understanding, and expressive language skills.

It is a visual approach to language development originally created by a UK Speech and Language Therapist, Alyson Bryan in 1997 to help children understand how sentences are organised.

Different parts of a sentence are represented by different colours.

For example:
- Who? is orange.
- What doing? is yellow.
- What? is green.
- Where? is blue.
As children progress more colours are added:
- To Whom? Is pink.
- Adjectives (what like) is purple.
- Time Phrase is brown.
Using colours gives children a visual framework for building sentences in a way that feels structured, predictable, and achievable.

Instead of language feeling abstract and overwhelming, children can see how sentences fit together.

For many children, this is massively helpful as it gives structure and predictability.

Why some children struggle with sentences

Language development is incredibly complex.

To build a sentence, we need to:
- think of vocabulary
- organise grammar
- sequence words
- understand meaning
- remember sentence structure
- physically say the words clearly enough to communicate
That is a huge amount happening all at once.

Some children may:
- leave out verbs
- miss pronouns
- use immature grammar
- struggle with word order
- rely on very short phrases
- find it difficult to expand beyond single words.
For example:
- ‘Boy jump’
- ‘Him eating’
- ‘Dog there’
- ‘Want juice’.
These children often know more than they can express.

Colourful Semantics helps bridge that gap.

Why visual supports matter

Many children—especially those with language delays, developmental language disorder (DLD), autism, or social communication difficulties—benefit enormously from visual support.

Visual systems reduce the processing load.

Instead of relying only on spoken language, children are given an additional way to organise information.

The colours act almost like ‘anchors’ for language.

A child may begin to understand:
- orange = who
- yellow = action
- green = object
- blue = place.
This makes sentence building more concrete and less overwhelming.

It also supports children who struggle with:
- attention
- auditory memory
- processing spoken language
- sequencing
- confidence using language independently.
Supporting sentence expansion naturally

One of the things I love most about Colourful Semantics is how flexible it is.

It can be used:
- in play
- with books
- during conversation
- with picture scenes
- in storytelling
- during movement activities
- within everyday routines.
Therapy does not need to feel rigid or worksheet-heavy.

Many children who usually avoid talking become much more willing to attempt longer sentences when they feel successful.

Children often begin to use:
- verbs more accurately
- pronouns more consistently
- better word order
- improved sentence organisation
- and more complete ideas.
For example, instead of:
- ‘Him running’
A child may gradually move toward:
- ‘He is running.’
The colours help children understand the ‘jobs’ words have within a sentence.

This is particularly useful for children who need explicit teaching of language structure rather than simply learning through exposure alone.

Supporting children with speech difficulties too

One thing I particularly value in therapy is approaches that support multiple communication areas at once.

Colourful Semantics is excellent for this.

While building sentences, we can also naturally target:
- speech sounds
- intelligibility
- vocabulary
- social communication
- turn-taking
- attention and listening
- confidence speaking.
For example, if a child is working on the /K/ sound, we might intentionally build sentences containing target words:
- ‘The cat is coming.’
- ‘The boy is kicking.’
- ‘The duck is in the box.’
This allows speech and language goals to work together rather than separately.

Therapy becomes more functional, meaningful, and engaging.

Building confidence through success

One of the biggest barriers many children experience is not simply language difficulty. It is the emotional impact of struggling to communicate.

Some children become frustrated.
Others withdraw.
Some stop attempting longer sentences altogether because communication feels too hard.

Colourful Semantics can help rebuild confidence because it gives children a clear structure for success. That feeling matters enormously.

When children feel successful, they participate more.
They attempt more.
They communicate more.

And communication grows through communication.

Why I use colourful semantics

There is no single ‘magic’ therapy approach for every child.

But Colourful Semantics remains one of the most versatile and effective tools I use because it can be adapted so beautifully to individual children.

It supports:
- early language
- grammar
- sentence structure
- comprehension
- expressive language
- storytelling
- confidence
- functional communication.
Most importantly, it helps children organise language in a way that finally starts to make sense to them.

And when language starts to make sense, communication can truly begin to flourish.

Contact me via my contact form if you would like me to work with your child.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Reference

Bryan A (1997) Colourful semantics. In: Chiat S, Law J, and Marshall J (eds) Language disorders in children and adults: psycholinguistic approaches to therapy. London: Whurr, 143–61.

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

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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.

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Speech and Language Therapy

What is Total Communication, and why your child might need it more than just speech
ByLondon Speech and Feeding April 22, 2026April 21, 2026
When a child’s speech is difficult to understand, it can feel overwhelming for everyone involved. As a parent, your instinct is often to focus on helping your child ‘talk properly’. And that makes complete sense. Speech is important. But here’s the key message I want to share with you:

Speech is just one way to communicate.

And when speech is not yet clear, not yet reliable, or not yet available, children need other ways to get their message across.

This is where Total Communication comes in.

What is Total Communication?

Total Communication is an approach that encourages the use of all available ways to communicate, not just speech.

This can include:
- spoken words
- gestures and pointing
- facial expressions
- signing (such as Makaton)
- pictures or symbols
- drawing
- electronic AAC (Augmentative and Alternative Communication), such as apps like LAMP Words for Life
It’s not about replacing speech. It’s about supporting communication in every possible way.

Think of it like this: if speech is currently unclear or limited, why restrict a child to the hardest route? Why not give them more tools to succeed?

‘But won’t this stop my child from talking?’

This is one of the most common concerns I hear in clinic.

Parents often worry that if a child starts using signs or a communication device, they will become ‘dependent’ on it and stop trying to talk.

The research tells us something very different.

Studies consistently show that AAC does not prevent speech development. In fact, it often supports it.
- A review by Millar, Light & Schlosser (2006) found that AAC interventions do not reduce speech production and may actually increase it.
- Romski & Sevcik (2005) demonstrated that children given AAC often develop stronger overall communication skills, including spoken language.
- More recent work continues to show that providing AAC early can accelerate language development, not delay it.
So rather than ‘giving up on speech’, using AAC is actually building the foundations that speech needs.

Why Total Communication matters, especially for unintelligible children

When a child is very difficult to understand, they are often experiencing a hidden frustration:

‘I know what I want to say, but no one understands me.’

Over time, this can lead to:
- reduced confidence
- behavioural frustration
- withdrawal from communication
- fewer opportunities to practise language
If a child cannot successfully communicate, they communicate less. And when they communicate less, their language development slows down.

Total Communication breaks this cycle.

By giving a child reliable ways to be understood, we:
- reduce frustration
- increase interaction
- build confidence
- create more opportunities for language learning
And importantly, we allow them to show us what they already know.

AAC is a bridge, not a barrier

Using AAC (whether that’s pointing to pictures, signing, or using a device) does something powerful:

It separates language from speech.

A child might have lots of ideas, vocabulary, and understanding but their speech system (especially in cases like phonological disorder or childhood apraxia of speech) cannot yet keep up.

AAC allows the child to:
- express complex ideas now
- practise sentence structure
- develop vocabulary
- take part in conversations
All while their speech is still developing.

In other words, AAC doesn’t replace speech. It keeps language moving forward while speech catches up.

What does this look like in real life?

In therapy, I often use a combination of approaches:
- modelling simple signs alongside speech
- pointing to symbols while talking
- encouraging children to gesture or show
- using drawings to support understanding
- incorporating an AAC device such as LAMP Words for Life
You might see a child:
- say part of a word
- point to a symbol
- use a gesture
- and look at you expectantly
That is communication success.

And success builds motivation.

‘I just want them to talk’

Of course you do. And I do too!! That’s always the goal.

But here’s the important shift in thinking:

Children learn to talk by communicating, not by waiting until speech is perfect.

If we hold out for clear speech before allowing other communication methods, we risk:
- limiting their ability to interact
- reducing practice opportunities
- increasing frustration
But if we support all communication, we give them:
- more chances to express themselves
- more positive communication experiences
- more input and feedback
And that is what drives progress.

A balanced approach

Total Communication doesn’t mean ‘speech is no longer important’.

It means:
- we continue targeted speech therapy
- we work on sounds and clarity
- and we support communication in the meantime
It’s not either/or.

It’s both/and.

Final thought

If your child’s speech is difficult to understand, the most important question is not:

‘Are they talking clearly yet?’

It’s:

‘Can they successfully communicate?’

Because communication is the foundation of:
- relationships
- learning
- confidence
- wellbeing
And every child deserves a voice, in whatever form that voice takes right now.

Feel free to contact me if your child needs help with speech and communication.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

References (parent-friendly):
- Romski M & Sevcik R. (2005) Augmentative communication and early intervention: Myths and realities. Infants & Young Children. 18:174-185.
- Millar DC, Light JC, Schlosser RW. (2006) The impact of augmentative and alternative communication intervention on the speech production of individuals with developmental disabilities: a research review. J Speech Lang Hear Res. 49(2):248-264.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.

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Neurodiversity · 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.

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