Are the Gestalts I model easy to mix and match later on?

ByLondon Speech and Feeding
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Image by bearfotos on Freepik

Here are some examples of great phrases and Gestalts that we could use:

  • Let’s get a banana / Let’s go out / Let’s play lego / Let’s go see daddy
  • That’s nice! / That’s really good! / That’s a green one / That’s a submarine
  • Need more help / Need a wee wee / Need that / Need to run
  • How about a biscuit / How about a cuddle / How about watching tv
  • We love bananas / We love a monkey / We love a cuddle

Why or how could these examples be mixed and matched?

You can see I have given several examples for each, that is how later a child can take one chunk (let’s) and add another (go out) or (need) + (go out).

What about our own grammar? Should we be using grammatical phrases?

In general for NLA 1 (Natural Language Acquisition stage 1) we want to use short phrases and keep them quite generic, something like:

‘Let’s go’ or ‘let’s play’ and pick 2-3 phrases per communicative function (see next point below).

And if we are going to say longer sentences, for example: ‘let’s go and feed the ducks now’, then we should do so with good grammar and really varied intonation. It sometimes helps me to make up a little song/jingle on the spot that has a lot of intonation, more than I would perhaps use just by speaking.

How many varied communicative functions do we cover with our modelling?

We want to model a variety of Gestalts other than just requesting for example. In general, we are looking at our child having one or two Gestalts in the following areas before they are ready to move on into stage 2.

These are the most common ones I see in my practice:

  • Requesting ‘want a banana/biscuit’ ‘Wanna play ball’
  • Transitioning: ‘what now?’ ‘what next?’
  • Ask for help: ‘need help’ ‘help me’ ‘mummy help’
  • Commenting: ‘it’s big’ ‘it’s red’ ‘it’s fast’ ‘too loud’
  • Speak up for self: ‘not that one’ ‘go now’ ‘stop it’

Is the Gestalt I am modelling meaningful to my child?

We don’t use all available Gestalts for every child. It has to be meaningful to the individual and has to match their interests. If our child is a big fan of feeding the ducks in the park then we can think about Gestalts like:

  • I see ducks!
  • They’re over there
  • Let’s feed them?
  • Let’s get some seeds
  • They’re coming!
  • They want food / They wanna eat!
  • That’s a big one
  • It’s so hungry
  • It loves the seeds!
  • No more! All done! Finished! Let’s go home

What is my child actually trying to tell me?

We have to be become word/phrase detectives! Is the phrase/script/Gestalt they are using right now actually meaning what they said or does it mean something else, and if so, what?

Here is an example from my own personal experience in my practice:

The little boy I was working/playing with was building a tall tower with blocks. When it finally fell with a great big bang he said in a sing-song voice ‘ring-a-ring-a roses’ … then he began to collect the blocks again to make a fresh tower. I sat there and thought: why ‘ring-a-ring-a roses’? What does that mean in this context? I then sang the song (silently) to myself with my detective hat on and realised as I came to the end that it finishes with ‘we all fall down’! it was a real AHA!!! moment for me as I saw right there what the meaning of his Gestalt was. He sang the first line of the song to say ‘all fall down!’

So realising this I waited for the next tower to fall, and there it was again, he sang the first line of the song. I replied thus, copying him at first:

‘RING-A-RING-A ROSES – WE ALL FALL DOWN!…

FALL DOWN

WE LOVE IT FALLING DOWN.’

The process to find what we should say is not always straight forward or easy at all, and often we don’t quite know in the moment what our child is trying to say. But we can try and get to know their interests and then gradually we do know more and more what the meaning behind the Gestalt is or could be.

What pronouns should we use?

This can be a tricky one.

We don’t want to use language that uses the pronouns ‘you’ or ‘you’re’. The reason is that our child will likely copy us exactly as we have said it. Therefore, using pronouns ‘you’ and ‘you’re’ will then sound wrong.

Always try to model language that is from the child’s perspective or in other words how they would say it if they could.

Alternatively, you can model using WE or US. For example, if the child is tired, rather than saying ‘you are so tired’ model language from his or her point of view: ‘I’m tired’ or ‘let’s go have a lie down’.

There is so much more to talk about. Stay tuned for a blog on NLA stage 2 coming soon.

If you need help with your child, please do not hesitate to contact me.

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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Why Imitation is so Important
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Why Imitation is so Important

ByLondon Speech and Feeding
Target Activities and Games For Kids

Why imitation is so important and how can speech and language therapy help children who struggle to imitate?

Imitation or copying starts in early infancy. When we observe a young baby and his parent or familiar adult we can see clearly and frequently that the baby will be intently looking at adult’s face and try to copy their facial expressions, smiles and all those funny baby sounds we often make with young babies.

These sounds are called “motherese” and are the beginnings of a little conversation between the parent and the baby. The “conversation can go back and forth for a long time and include sounds, as well as facial expressions.

A little later on, once the baby can crawl and sit up unaided the copying then goes on to include toys and objects. Mum or Dad will show their toddler how to use a drum or how to put a little train on the wooden tracks and the toddler will try and copy this. They may not succeed and be a little clumsy perhaps but the act of copying anything and everything their favourite adult does is typically seen throughout the day.

We all know and have laughed at mums or dads saying; ssshhh don’t say that in front of the baby he/she will copy you, watch your mouth! (as dad is swearing at the broken radiator….)

This imitation goes on for years and includes eventually of course little words, more words, putting words together and then creating sentences, all the while our toddler is listening to how their adults speak, not only what they say but how they say it. This is how dialects and accents can be transmitted easily from parent /family to child.

Copying in Children with Autism

We know that children with autism often struggle to imitate. We see children on the spectrum typically having great difficulty to copy adults or children; this can be seen in very reduced play with their peers in nursery for example.

Children with autism tend to have reduced joint attention and engagement with others and need to develop the ability and awareness to copy others in order to then engage more jointly with others.

Speech and Language Therapy can help with Parent Child Interaction work and Coaching, here is how:

During my coaching work with parents I teach step by step how to help a child who struggles to imitate:

We look at all the researched skills and actions that adults can take to help their little one to copy, starting with close observation of their child’s interests, then following and including their child’s play and copying/imitating their child in how they play. I teach steps in a graduated way so that it is easy to see the progress and joyful to have the results at the end.

The results are clear to see over time: our children on the spectrum learn to imitate actions, with objects and gestures, then sounds and words. Alongside this increased imitation skill the child can then develop more joint attention and engagement.

I would always recommend Parent Child Interaction Training as a first port of call as we learn so many great techniques which are well researched by the Hanen Programme, www.hanen.org. Do drop me a line if you would like to find out more.

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.

Four struggles parents face when out and about with children with speech, language, and communication difficulties
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Four struggles parents face when out and about with children with speech, language, and communication difficulties

ByLondon Speech and Feeding
A man and a woman hug a young girl at a table
Hug

You (as parents) often describe yourselves as being under constant pressure and stress when looking after your children and young people with Special Educational Needs and Disabilities (SEND). You may find going out to do the simplest of tasks a challenge. And you will try to avoid social situations out of fear and anxiety. One of the most important factors to you is having like-minded people who understand your position as a parent with a young person with additional needs. Let’s look at some of the challenges you face and how I can support you and your family.

1. Challenging behaviour and going out to the shops

When your child displays challenging behaviour and won’t go into a shop without buying a toy that they insist on having, it can be tough on your family. You see people around you staring as you try to manage the situation. They do not understand the pressures you face, or that the simplest of tasks are a huge challenge.

I can support you by giving strategies to use when out and about. I know that using visuals is important for your child. They may not understand or take in language when they are in a heightened state of anxiety or feeling overwhelmed. You could print pictures of the places you’re going to and put them on an easily accessible chain. Then you could use that chain when out and about at the shops. You may want to introduce a visual timetable at home. That way your child or young person understands where they are going. This may lessen their anxiety and subsequent behaviour.

2. Your child is not able to communicate their needs to an unfamiliar communication partner

When your child has difficulty communicating to an unfamiliar person it can be hard to manage. You feel yourself explaining your situation repeatedly. I can provide your child with individualised strategies or communication aids which support your child to communicate with both familiar and unfamiliar communication partners. We’ll work together to find which communication methods work in different situations and how your child will use these to help their independence.

3. Being overwhelmed

Your child or young person may easily be overwhelmed which may contribute to behaviour changes. I’ll work with your family to understand what the behaviour means, looking at what happened before and what happened afterwards. We’ll not only look at the behaviour but at the environment as well. This can inform how you can support your child or young person in the future, to reduce sensory stimuli (if needed) and for them to feel emotionally regulated.

4. People avoid engaging with you

One of the hardest things as a parent is for others to avoid you. You see them crossing the street because they don’t know what to say to you. All you want is them to accept you, to maintain your identity as a person and not as a SEND parent. I can support you emotionally. I can give you advice on local support networks where you can find other parents in a similar situation.

We know the stresses that being a parent with a child with SEND comes with. Please know I am always here to support you, to find solutions so that when you’re next out and about. Your experience will be a little easier and you’ll feel less isolated.

Improve your child’s communication, confidence, reduce overwhelm and feel supported here.

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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Stage 2 NLA
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Stage 2 NLA

ByLondon Speech and Feeding
Image by Freepik

Last time we asked: is our child ready tp move to Stage 2 NLA (Natural Language Acquisition stage 2) and we looked at how we can know. Now we know: he/she is ready, they are mixing and matching those scripts quite liberally! Hurrah!

So for example we hear phrases like:

  • ‘let’s go’+ ‘downstairs’
  • ‘it’s’ + ‘downstairs’
  • ‘I see it’ + ‘downstairs‘
  • ‘I want to’ + ‘shoes downstairs’ (I want to put my shoes on downstairs)

To recap, it’s important to listen out to a variety of contexts because if we only hear the single version of a gestalt —this is so great, hurrah!— but that’s not yet Stage 2.

What we can now do on a daily basis to help and support at this time:

1. We need to offer more ‘mix and match’ phrases to help our child establish this new way of communicating.

Good phrases:

  • It’s … raining / cooking / eating / washing / brushing
  • That’s … great / cool / amazing / wow / so good
  • Let’s … see / look / go / run / chase
  • How’bout … some food / playing / I’ll chase / sleeping / we read a book
  • I see a … bird / large car / fire engine
  • I wanna … have a biscuit / have a book / have a snuggle
  • We’re … going out / going home / going in the car / going upstairs

Here in my video clip of train play I use:

  • Let’s go
  • It’s going up the hill
  • It’s coming down
  • Ooops it falls!
  • It’s stopping
  • Let’s put on another parcel
  • Ready steady go
  • Off we go
  • It’s come off!
  • Let’s fix it
  • I can do it
  • I don’t need help

You can offer these gestalts either with an AAC as you can see me do in the video clip or you can just verbally offer these.

2. Watch out for Pronoun confusion or reversal:

Gestalt kids repeat gestalts, so we don’t want to create ‘pronoun reversal’.

Instead model from a:

  • first person perspective: ‘I’ / ‘Our’ / ‘Us’
  • joint perspective: ‘We’ / ‘Let’s’ or a
  • neutral perspective: ‘It’

You can turn almost any sentence into a good language model once you get used to it. And you can avoid ‘you’ and ‘your’ at the same time!

So instead of saying, ‘Do you want to go to the park?’

You could say:

  • We wanna go to the park?
  • Let’s go out?
  • Shall we go out / to the park?

3. Start providing ‘variation’ in your language modelling:

Instead of just modelling something one way, start thinking about offering a pattern in a couple of other ways, in a couple of different situations, then several ways in several different situations.

Example: once you hear your child saying: ‘it’s raining’ and you know it’s a mitigation, because you don’t often say ‘it’s raining’, or haven’t said it in a while and you know your child says other ‘it’s’ phrases.

Repeat: ‘it’s raining!’

Then: ‘it’s’ + ‘raining hard’ / ‘it’s wet out there’ / ‘It’s’ + ‘raining lot’s’.

Then later think of other combinations for ‘it’s’ + ‘something’:

  • (rice) ‘It’s’ + ‘cooking’
  • (water/tap) ‘It’s’ + ‘running’
  • (radio) ‘It’s’ + ‘singing
  • (dog) ‘It’s’ + ‘peeing’ / ‘it’s’ + ‘running’ / ‘it’s’ + ‘jumping’

In my train video clip:

  • Let’s go
  • It’s going
  • Let’s make it go
  • Ready steady go
  • Oops its gone

4. Use natural intonation that shows you really mean what you’re saying.

You can be animated or try for musical if your child prefers that / doesn’t mind you singing —they might not like it if their hearing is pitch perfect and your singing is off key…—

  • ‘I’m’ + ‘trying to find you!’ (animated, goofy face)
  • ‘I’m’ +’ getting tired!’ (exaggerated stretch and yawn)
  • ‘I’m’ + ‘catching up with you!’ (animated goofy)
  • ‘I’m’ + ‘gonna get you!’ (animated goofy)
  • ‘I’m’ + ‘sad right now’ (exaggerated face and tone of voice)

5. USE SILENCE!

Important, I might not have said this before but we need to hold back sometimes (hard I know) and not constantly offer models. Let our child sit in a bit of silence with us there just observing and waiting for their own offers. This is a very important point. Silence is golden sometimes. Try it out. I am not talking about the silence that comes with a person scrolling on their phone though, we do need to be present and receptive.

You will see this works wonders!

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

You can also check my friend’s lovely handmade jewelry on her website.

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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Tele-Therapy – What Is That And How Does It Work With Speech And Language Therapy?

Tele-Therapy – What Is That And How Does It Work With Speech And Language Therapy?

ByLondon Speech and Feeding
Tele-Therapy – What Is That And How Does It Work With Speech And Language Therapy?
Tele-Therapy – What Is That And How Does It Work With Speech And Language Therapy?

How can I help you assess and support your child when you live outside London or just can’t come to see me for any reason? The short answer is: YES I CAN and we can do it virtually! There are separate areas I can target using Teletherapy.

Here is one of them:

Parent – Child Interaction / Attunement

Through the pandemic and lock-down I have had opportunity to re-think how I can help people virtually and what I can do to ensure that parents continue to feel empowered and help their children make good progress even when I cannot personally come to their home or they cannot visit me.

My training with the HANEN METHOD came in so handy as of course in the US and Canada therapists and families traditionally cover huge areas and often are too far away from each other. They have been practising on-line/virtual or now known TELE-THERAPY for decades and are very advanced with research, materials and support in this area. I skilled up at the beginning of the pandemic early 2020 and by around April I was up and running! Nobody was able to see anyone in lockdown and of course parents were still desperate for help with their children.

The basic premise when supporting young children under the age of 5 years is that a NATURALISTIC approach is the best and very well researched to be highly effective. This means that the parents or caregivers are the most important and consistent key people in every child’s life and they are the best therapists and AGENTS FOR CHANGE.

Parents spent the most time with their child, even when they are working parents! – they are still most likely to spend many hours in the evenings and weekends with their child. When we are looking at how Social Communication develops we know that it emerges from birth through daily interaction and daily activities: playing, snuggling, running, eating, getting dressed, shopping with mum, sitting in the car with dad, playground, dinner around the table, bath time, story time, teeth brushing, bed time. These are the consistent areas where interaction takes place and where social communication can develop/be supported/ be enhanced. – do check out my other blog as well on this topic “What is Speech and Language Therapy”.

Parents Are The Agents Of Change

What do I mean by that? Parent-Child Interaction work focuses on helping the parent to tune in with their child and therefore enabling the child to tune in with the parent, in turn. Its about TUNING IN. This is often missing when children have social communication difficulties: they do not tune in. And parents end up tuning less into their children as time goes on, because the interaction is always so one-sided. Parents tell me again and again how hard it is to engage with their child as there seems to be so little “come-back”.

I teach your really powerful strategies that you can implement quite easily during your normal daily activities! You will not need to do any “home work”, i.e anything extra on top of what you normally do with your child anyway! How good is that!?

Each week I will teach you one or two new strategies to try out and together we will workshop exactly how you could do this. So you will walk away knowing what activities to target and how. Over a short period of time you will see positive changes, because you , the parent, have changed! PARENTS ARE THE AGENTS OF CHANGE. This is incredibly empowering for the parent as in the end you won’t need a therapist because you have become the ideal, consistent, expert therapist for your own child. The strategies will stay with you for life and over time you will be using them without even thinking about it. And your child will learn – over time – to tune in with you. TADAAAH! You’re welcome!

So give Tele-Therapy a try! I would really recommend it:

  • Convenient as you do not need to travel, and therefore cost and time saving.
  • It takes just one hour out of your busy day, not 3 hours with travel in London etc.
  • You will be fully supported with on-line video clips, slides, my write-ups and other materials I often make for you to support your journey.
  • You will feel empowered to help your child develop the very day you start the therapy.
  • You can have weekly support, fortnightly or monthly. You can contact me for brief hand-holds in between and most importantly your child will make progress.

If you would like to discuss this a bit more, get in touch with me! I would love to help. Check out my google reviews of clients who have done Tele-therapy with me, some of them live abroad, as far away as Australia and Tanzania or Germany. You will see it can work so very well.

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.

Teletherapy: A fun and convenient way to help your child master those sounds!

Teletherapy: A fun and convenient way to help your child master those sounds!

ByLondon Speech and Feeding

It can be hard to get your child to come to the clinic on a weekly basis to work on those tricky sounds. Perhaps the car isn’t working, you have had a lot on, or our student has a bit of a cold but is still able to do a little bit of sound practice?

The good news is that Teletherapy can be a fantastic option to continue your child’s speech journey from the comfort of your own home!

Even when your wifi is not working and your laptop is broken, as you can see on this clip I was able to stretch into running the session on WhatsApp video, but that is less then ideal I will say.

What is Teletherapy?

Teletherapy is speech therapy delivered virtually, through a secure video platform. I use Zoom for example, but I have also used WhatsApp Video Call on occasions where parents’ zoom was not working.

When is Teletherapy perfect?

Here’s why teletherapy can be a great fit for helping your child solidify those learned sounds:

  • Basic sound patterns have been established in clinic: Your child is now able to say those tricky sounds BUT they are not saying them in daily life yet; they are not ‘generalising’ those new sounds into the normal speech.
  • You just can’t make it today: No more fighting traffic or fitting appointments into busy schedules. Teletherapy sessions happen at home, on your time. Sometimes even in the attic or the garden shed as in my video clip here ????
  • Your child is about 7 years old or older and is motivated to work on their sounds: I use fun and interactive online tools and games to keep your child engaged during practice sessions. Due to having done teletherapy over the Covid period I have amassed lots of great games and know-how in this area. Our student needs to be mature enough to be able to sit in front of the laptop camera and participate with a minimum of adult help.
  • Your child loves gaming and is best motivated through online games: Sometimes children are best motivated when playing online games in between speech sound/language activities; in this case teletherapy is totally perfect.
  • Focus on Carryover: The familiar environment of your home can actually be an advantage! I can guide my student on practising sounds in everyday situations, like reading a book together or playing with toys, sometimes even talking to their sibling or a.n.other in the room.
  • Parental Involvement: Teletherapy allows you to be directly involved in the sessions just in same way as when I see your child in my clinic. You can learn strategies and techniques from me to continue practising with your child throughout the day. You can also make a note of the online games I have and then use them in your home sessions.

What to Expect During a Teletherapy Session

  • Initial Consultation: We start with a brief chat on how the week has gone, what gains have been made with the home exercises and we settle the student into a good learning mode; sometimes I start off with a very quick game just to set the scene.
  • Working on generalising: When asking my student about how their week has been I will remind them to remember their new sounds and to try and produce them whilst talking to me. This is already the start of therapy.
  • Practising target sounds: We practice our target sounds in different contexts, using games, visuals, and activities.
  • The teletherapy session lasts the same amount of time as do 1:1 sessions, unless I see that a child becomes very fidgety and we are not able to hold out much longer, I will cut short the session and focus on increased home practice.
  • Home Practice: Just like in 1:1 clinic sessions, I will provide you with easy-to-follow tips and activities to continue practising sounds throughout the week.

Getting Started with Teletherapy

  • Technology Check: Ensure you have a reliable internet connection and a device with a camera and microphone.
  • What device is best: Ideally the student needs to be on a laptop or PC because that way the student can actively engage with their mouse, moving game pieces, or participating in online activities using their mouse. Tablets are ok but do not allow active participation of the student as described above. However once in a while we can make it work and I do have some games and activities that do not rely on student participation.

Finally, I would say that Teletherapy is a safe, fun and effective way to continue your child’s speech therapy journey. It’s convenient, engaging, and it is perfect on a rainy day when you don’t want to or can’t come out to bring your child to clinic.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

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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Why teletherapy is great

Why teletherapy is great

ByLondon Speech and Feeding

Did you know that you don’t have to see a therapist with your child present to have improved communication? For younger children, evidence suggests that regular tailored interaction with parents/carers is as good as seeing a Speech and Language Therapist, with their advice followed. Often your child will respond better because they are in familiar surroundings with their favourite toys present. By learning the techniques I teach you in our weekly virtual zoom sessions, you can support your child’s language and communication every single day. This can be as good and sometimes even better than coming into clinic once a week. You’re embedding and generalising what your child is learning into everyday situations. This is important for your child’s communication development.

Speech Therpaist in London

It takes two to talk – the Hanen approach

The Hanen approach is about improving your child’s communication by tweaking your own communication style as parents and carers. It looks at your strengths and weaknesses in your communication with your child. You film a session playing with your child, and with a trained Hanen Speech and Language Therapist you review the video identifying strengths and weaknesses in your communication on a regular basis for a set period. For example, you may give your child plenty of time to answer questions, but you might identify from the video that you ask too many questions.

The Hanen approach works well online because:

  • Parents and carers can concentrate on the information they are given without interruption from their child
  • It is a process; you’re not told what’s right and wrong. It’s a process of discussion, reflection, and understanding by analysing the video footage
  • This method can be applied to daily activities, so together we can think about how it can be individualised specifically for your family situation
  • You can carry out the techniques in your own time when your child is well, calm, and willing to engage.

Online therapy is also ideal for older children (aged 7+) who have difficulties with speech, word-finding, sequencing, or executive functioning (planning and processing information) skills. You can see and hear the therapist and gain knowledge from their valuable expertise whilst saving you time, money, and energy resources. In addition, children tend to love technology, so the online resources are motivating and capture their attention.

Remove the barriers and start your online therapy journey today.

Contact me to learn more.

Sonja is a highly knowledgeable and experienced speech and language therapist. Don’t hesitate to contact her, especially if you are concerned that remote/zoom sessions aren’t as effective as ‘real life’. We have found quite the opposite! She has worked with us on Hanen and now troubleshoots when problems come up. This is such a wonderful way of working. She acts as your indispensable guide (a speech and language fairy godmother, if you like) but make no mistake, it’s your application of what she teaches you, on a day-to-day basis that results in the most change.

P. Goeldner


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.