AAC Systems and Speech and Language Development

ByLondon Speech and Feeding
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Introduction

I see a lot of minimally speaking or non-verbal children in my practice. Some children are autistic and others are severely challenged with motor planning and some are both. Some children are simply delayed in their spoken language for reasons that we don’t quite know yet.

Regardless of the causes, what is always apparent pretty quickly is that apart from the odd gestures or Makaton signs (mainly ‘more” ‘finished’ and “biscuit) we don’t have a robust alternative for speech in place. Instead, what we often have is a child with lots of frustration and tantrums and some behaviours we really don’t want like: hitting, biting, pushing, grabbing and often throwing… There are others, too many to mention, but we don’t enjoy watching our children in these states. And we are often fearful of what might happen next if we don’t find a way to calm our child.

Fear not

In my work, before I get to offer an alternative means of communication, I often have to work with a fair amount of resistance on the parents’ side as parents tend to feel that allowing such a system into their lives will prevent their child from speaking. They fear that their child will so enjoy pressing those buttons that they will become lazy and not talk at all.

I totally get it!

Parents often feel overwhelmed by the task of getting their own heads round how to use AAC, either in paper form or a computerised system. This can be a great turn-off for lots of people who feel they are not very “techy” – like myself actually! Indeed, it is true to say that I resisted operating in this field for a long time as I didn’t feel able to navigate electronic devices. But fear not. Truly, most systems are very user-friendly. The support is great. And I have managed to become quite proficient in one or two of these systems, through using it daily. It really is as simple as that.

Alternative and Augmentative Communication (AAC)

There is plenty of research on the efficacy of Alternative and Augmentative Communication (AAC). It is now very well understood and proven that, once we introduce our child to a good, attractive way of communicating that they can actually do, in time children who can speak will speak. Speaking is more effective than any AAC system. It is more versatile, more fun, and when human beings have discovered how to speak, most will do so in favour of any other system.

Many children and adults, for many reasons, were never going to speak an awful lot, or with great difficulty. Or they were not going to like to speak. Or they were going to like to speak some times but not other times… And for all those people an AAC system is invaluable and a wonderful resource.

Neuro-diversity affirming means that we do not impose one system of communication on our children (speaking with our mouth) only because it is the one we are using and most people we know too.

Of course, we want the best for our children, and we want them to have the easiest and most straight forward existence on Earth. Of course we do. Speaking with our mouth does help with that. But we must come to understand that not all children and people feel like that and they struggle to use their mouth for talking.

Personal experience

I have difficulties understanding this myself, I will be very honest here. And I will say that – shoot me down in flames SLT fraternity – but I am learning to accept that using an AAC system proficiently is a very good alternative for when speech is not coming. I am learning to accept that some people are perfectly able to speak, and might do so but not always and only when conditions are right. I came into the profession as a speech therapist with the idea that I would help anybody that came to me to speak with their mouth. But I have changed my stance on that and now am happy to help anybody that comes to me to communicate most effectively with whatever works for them. I will always try for speech if I can … Just because it’s easiest!

Acceptance

Now I will equally celebrate a child pointing to a symbol or making a sign for something. It is a fantastic moment when it happens for the parents and me and the child! And we can always hope for more speech to come as we go. Nothing wrong with our aspirations, is there?

The basic premise is this: accept any mode of communication as valid, as long as your communication partner understands what it means. Don’t require individuals to repeat themselves in another modality. Do model the response in the modality you are trying to teach. So, a child can point to a symbol and I will respond with speaking (with my mouth) but I will also respond by pointing to a symbol because that way I am signalling that both are ok and that I have understood and am encouraging the person to say some more.

Here is some research;

Binger, C., Berens, J., Kent-Walsh, J., & Taylor, S. (2008) The effects of aided AAC interventions on AAC use, speech and symbolic gestures. Seminars in Speech and Language, 29, 101-111.

Sennott, S.C., Light, J., & McNaughton, D. (2016). AAC modelling intervention research review. Research and Practice for Persons with Severe Disabilities, 41, 101–15.

Dada, S., & Alant, E. (2009). The effect of aided language stimulation on vocabulary acquisition in children with little or no functional speech. American Journal of Speech-Language Pathology, 18, 50–64.

Contact me if you would like your child to have neurodiversity affirming speech and language therapy.

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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    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

  • What is FRONTING?

    ByLondon Speech and Feeding
    Kids Speech Therapist London

    Does your child say “Dough” instead of “Go”? Or “Tea” instead of “Key”? Do you hear a /Sh/ instead of an /S/ does “see” sound more like “she”?

    We Speechies call this a Fronting Pattern which means that a sound that should be produced at the back of the throat with the back of the tongue, like K or G , is said at the front of the mouth with the tip of the tongue, like a T or a D or SH. When this happens speech can be really hard to make out because these sounds are literally everywhere in everyday sentences. Just think how many K’s and G’s we hear in a simple sentence?

    For example, I heard my little student say earlier today: “I know what game we can play in your garden? It’s the one with cones and rings and cushions! I know where it is I can get it.”

    But it sounded like:

    “I know what DAME we DAN play in the DARDEN! It’s the one with TONES and rings and TUSHIONS! I know where it is I TAN DED it.”

    If that sounds familiar to you, here is a little overview of what we can do about it:

    First up it’s always good to start with general speech sounds awareness: does a child hear syllables and intonation? Do they know words that rhyme? Can they follow or copy a simple beat with a drum? Can they listen and hear quiet sounds and loud sounds and can they copy those? Can they follow mouth and tongue movements:, for example : stick out your tongue, lick your lips, click your tongue, blow raspberries?

    Then it really helps to talk about BACK and FRONT of things and to draw attention to the back of the mouth and the back of the tongue and the front tip of the tongue and how sounds are made in the mouth. I often use a puppet to show this or a model of a mouth like this one here in the picture.

    Next we try and listen to words starting with a BACK sounds like a K or a G , and I read out a list of words with those sounds: COW, CORE, CAT, CONE, KEY etc or ARK, EEK, OAK, ACHE…

    Or GOO GUY GUM GONE

    After that we try and see if a student can actually produce a single sound like a K or a G just by itself. If they can, that’s a really great start and if they can’t I help them to produce one – over a few sessions we usually get there. We call this Sound production in isolation.

    Once a child can produce a sound correctly, on its own, we try and start working on very simple words that are really powerful like “GO”!!!!! in a motivating game or “CAR” for little ones who love a car racing track.

    Now that we have established the back sounds and are using it in short words, we can gradually re-train brain pathways and oral- motor/movement pathways to use these new sounds in many words and then short phrases. That can take time!! This is called generalisation and it is not uncommon for it to take up a whole year for fluent speech to be error-free .

    Why does it take so long? Being able to produce a correct and clear K or G sound does not mean it will be used easily. Our brain pathways are fixated or habituated to the error sound. It takes time for habits to change. A child might be able to hear the word TIGER with a G in the middle and she knows that it is not a TIDER but when saying it her tongue automatically moves forward rather than lifts up at the back. It’s a bit like a person who has a rounded back: the brain knows to stand upright and how not to slouch, but when we don’t focus on it, ooops we have slouched again because that is what we are comfortable doing and our body moves with our habit.

    It takes effort and motivation to change our movement patterns and that includes our tongue and lip patterns! We usually get there through a huge variety of games and practice. Lots and lots of repetition is key as is motivation to change.

    Parents and carers are crucial in the success of Speech Therapy!

    We need your feedback at home, the regular short and sweet exercises, the constant positive encouragement and great modelling of speech sounds. We often find that parents are tuned into their child’s error sounds and can understand them much better than anyone else. This is great of course in many ways, however, it also means that the child has less motivation to change: if mummy understands me then my world is ok.

    I will give you a short outline of what different speech therapy models I use in my practice, be it in clinic face to face or on-line in my future blogs soon.

    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.

  • · ·

    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
  • · · · ·

    Let’s ditch the ‘Fix-It’ approach to autistic play and stimming

    ByLondon Speech and Feeding
    Let’s ditch the 'Fix-It' approach to autistic play and stimming

    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.

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

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

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  • ·

    The importance of child-led therapy

    ByLondon Speech and Feeding

    Child-led therapy is essentially what it says, therapy sessions that are directed by your child. You may think how can my child’s Speech and Language Therapist focus on goals if sessions are led by my child.

    Let us explain…

    Your child will be more receptive and motivated to take part in therapy if they have some form of input. E.g., they can choose what toys they want to play with, or how they want to play with the resources available. If sessions are child-centred then they are much more likely to engage and reach their goals, making intervention valuable. They will also be able to regulate their emotions, and use movement to support their need for regulation. E.g., some children like to jump whilst others like to run. As Speech and Language Therapists we need to use what is meaningful to your child to get the most out of intervention. By focusing on child-led therapy, we can build trust, which will allow us, in time, to use new techniques and activities that your child may enjoy. We want children to be themselves, to show their true personality. Therapy is about enhancing their skills in their own individualised way and child-led therapy allows for this.

    This way of working may seem daunting to some, but it doesn’t have to feel this way. Parents often feel if they are prepared then activities may go smoother. It might be the case, but perhaps it doesn’t give your child the opportunity for spontaneity. We’d like to suggest something that may lead to some surprises. Put out an activity that is your child’s favourite and then a completely new activity. Remember these activities don’t have to be complicated. Often, the simpler the better!

    So, no need to plan, just place two activities out and see what happens! Look out for anything which surprises you, which activity did they prefer? Do they have any sensory preferences? The freedom of choice is a wonderful thing to explore. So, just go with the flow!

    The kind of activities that are useful for child-led play can include:

    • Hide and seek
    • Cooking or baking
    • An Exercise ball
    • Small world play
    • Pretend play
    • Musical instruments (you could even have a go at making your own)

    Child-led therapy is a very useful resource. We have it at our fingertips. We don’t need special resources. You just need yourselves and your child! Sometimes, child-led therapy can be tricky to put in place. It sounds easy but is much harder in reality. So, make sure you give it time and reflect on your experiences. Ask yourselves ‘what went well’, and ‘what could be improved’. E.g., perhaps you gave your child time to lead to begin with, but you didn’t give them enough time to think about their options during the activity.

    How can parents become more child-led in the home environment?

    • Pause and use silence. This gives your child the opportunity to lead.
    • It’s perfectly natural to want to talk. Afterall, this is how adults maintain conversations. If you find yourself talking too much, count to ten! This will allow your child time to respond or initiate in the conversation or interaction.
    • Move down to your child’s level. It’s much easier to see what’s going on if you’re at the same height.
    • Videoing you and your child can really help you to see where your strengths lie. You’ll also be able to make minor tweaks to improve your communication during child-led play.

    Contact Sonja for more advice on speech, language and communication during child-led play.

    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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    Let’s relax about making EYE CONTACT already…

    ByLondon Speech and Feeding

    There’s been a long tradition with teaching staff and with Speech and Language Therapists working in schools that eye contact should be a goal. It is well known that Autistic individuals (whether that be children or adults) mostly avoid eye contact. Whilst it’s part of the way we communicate, it shouldn’t be used as a necessity for an individual who feels that it is uncomfortable. Whilst it does show that you’re listening and showing an interest, it’s not a fair expectation for neurodiverse children.

    Autistic children can find making and maintaining eye contact physically and emotionally uncomfortable as well as unnatural. It adds an extra layer of stress and has been reported to increase distractions rather than reduce them. Children who engage in conversations in their own way (i.e., with reduced eye contact) are not shown to suffer with schooling, work, or social interaction.

    By having fun through meaningful activities, I often experience that ‘BINGO’ moment (a phrase coined by Alex @meaningfulspeech) where the child is enjoying themselves and naturally makes eye contact. There is no demand on them, they are in a fun, engaging environment which suit their strengths and supports their needs.

    Following this, I often reflect on this question ‘Should we make eye contact as a goal?’

    It very much depends on the situation. If it places more demands on the child and becomes stressful. Then no. There are many strategies we can use which gain eye contact without placing extra demands on the child. We need to be mindful to adapt the environment and not place neurotypical expectations to meet the needs of neurodiverse children.

    How can you encourage eye contact without demand?

    • If you’re using toys, try holding them up to your eye level.
    • You can adjust your position, try sitting face to face during play.
    • Always get down to your child’s level. This might mean that you lay on the floor if your child is positioned in this way.
    • During play, waiting is extremely powerful. Before a key part of the activity, wait and see if your child looks at you. Remember silence is golden!
    • The best way I find is: do something unusual during play. It might be that you spray shaving foam with the lid still on. Or you bring out a wow toy and make it spin/light up or make a noise. A balloon can be good – see video clip. Use the excitement of the activity, and wait to see if you achieve that ‘BINGO’ moment.
    • Create opportunities when there are no toys involved such as during ‘tickles’ or ‘hide and seek’. Autistic children find it difficult to shift their attention between a toy and an adult. So by removing one option, you’re setting them up to succeed.

    Remember, it takes practice and time for you to develop these skills. Try one at a time and experiment, see which works best for your child. If you need speech, language or communication support or advice, I am always here to help.

    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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