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’
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.
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.
As professionals, when diagnosing young children with an Autistic Spectrum Condition, it is vital we work as a multi-disciplinary team, so you will likely see many professionals. This may include Educational Psychologist, Dietician, General Practitioner, Occupational Therapist, Paediatrician, Special Educational Needs Coordinator, Speech and Language Therapist and Social worker. Once the evidence is collated, then a diagnosis may be made.
You may be wondering what are some of the early signs of social communication difficulties? Whilst no autistic child is the same and we know Autism is very much a very wide spectrum of abilities and needs there are some autistic spectrum characteristics we do typically see in the early years of childhood. You may wish to think about these areas or presentations to help you prepare for the Speech and Language Therapy appointment.
Twelve questions
Does your child respond to their name?
Are they fixated with watching their hands?
Do they have sensory processing difficulties such as bright lights, food textures, or loud noises?
Are they meeting their milestones or are they delayed?
Do they flap their arms or legs when excited?
Have you noticed any rocking back and forth?
Do they blink excessively or display any facial tics?
Do they play with a particular sort of toy e.g. spinning toys?
Have you noticed that they lack interest in toys?
Have they regressed in their language? Perhaps you’ve noticed they are not using words that they have previously learnt.
Do they use gestures to communicate their needs? How do they communicate their wants and needs?
Do they appear to be in their own world?
You are not alone
These questions are by no means exhaustive and there are many more factors to consider. But it is important to trust your instincts as you are the expert on your child and know your child the best. Regardless of whether you see all of the above points or none, do not hesitate to have an assessment if you are concerned as, even if it turns out to be nothing to worry about, there is always at least one or two great pieces of advice I can offer you on the way and you will leave feeling hopeful and empowered. It’s always best to seek early intervention with communication difficulties. This allows strategies and support to be put in place. Never feel alone, always speak out.
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.
where the cause is NOT a swallowing problem, but we are having a “fussy eater” in the family, seeming for no obvious reason
When parents have a child who find mealtimes or eating difficult, it can put pressure on the whole family dynamics. Once we have observed a child’s eating and drinking skills and found that they are not swallowing impaired, but are for want of a better word “fussy” or “picky”, we can then start to look at what might be underpinning the food aversions/picky eating/food avoidance. Two of the main questions parents have (of course) are:
‘is my child getting the right nutrition?’
‘how can I have less anxiety-provoking and stressful mealtimes?’
We all tend to have an image in our minds about the ‘perfect mealtime’, and how mealtimes ‘should’ be. Speech and Language Therapists with a Feeding Specialism are the perfect professionals to help you unpick feeding issues. We are trained to look at swallowing and oral skills and we also know a lot about feeding behaviours and sensory difficulties which could be causing your child’s eating avoidance.
Here are some strategies that can support children with their eating:
Create and maintain a mealtime culture that suits your home and lifestyle. Then stick to that. We all need some routine in our lives to thrive. Mealtimes are no different. It might be that you eat in the same place for every meal, with the same knives and forks, concentrating on maintaining good posture. Children learn by repetition so the more familiar it is, the easier they will find it. In the physical sense, our bodies also need preparing for food, regardless of whether we are eating with our mouths or we are tube-fed. We want every child to connect all the dots of the process. It starts with their eyes, noses, expectations, memories of past experiences, feelings and then finally their mouths….
Be an excellent role model. Children learn through watching others, so your child will be observing you without you knowing. Ensure that you are positive about the food you are all eating, and talk about how delicious, tasty, juicy, and yummy the foods are. Make the atmosphere around the dinner table light hearted. Even though you are secretly stressed about your child not eating, try and not show this. Instead pick a topic or put on some nice music, or talk about something your child might be interested in, and try and avoid coercing your child to eat. Leave small finger foods on their plates and have a range of foods available on the table so that your child can see that everyone is eating a range of foods and enjoying them.
Use positive reinforcement. Try and think of mealtimes as fun and motivating. Children who are happy will likely be more inclined to try foods and take part in family mealtimes. Reward all interactions around food, so if your child merely touches a new food then praise this behaviour. Or if your child licks a food just once, again make a nice comment and praise your child for touching and licking the food. The takeaway here is to try and keep all messages positive around food.
Keep offering all types of food. What often happens is that parents stop serving foods they know will not be eaten. This makes sense in a way; we don’t want wastage! However, try and keep the doors open and re-offer all types of foods, even the ones that your child has not wanted in the past. Try and give your child one food they will like and one food they have tasted before and liked before, even a little, and then one new food to try. So, your child always has something to fall back on and they can join in with eating. But they can also try (or at least look at and think about trying) other foods that you and perhaps the siblings are eating.
Take a look at this website, I find it very helpful in showing parents what types of foods and how big a portion to offer
Have a go and try and implement some of the ideas above, and should you get stuck please get in touch!
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.
As a speech and language therapist, I’m often asked about the significance of seemingly simple gestures in child development. One question that comes up frequently is, ‘Why is pointing so important?’ It might seem like a trivial action, but pointing is a powerful communication tool and a critical milestone in a child’s development.
Why is pointing so important?
Let’s delve into the theory behind why pointing matters:
1. Pointing as pre verbal communication:
Before children can use words, they use gestures to communicate their needs and interests. Pointing is one of the earliest and most important gestures. It allows children to:
Request: ‘I want that!’
Protest: ‘No, not that!’
Direct attention: ‘Look at that!’
Share interest: ‘Wow, cool!’
2. Pointing and language development:
Pointing is not just about communicating in the here and now; it also plays a crucial role in language development. Research shows that:
Early pointing predicts later language skills: Children who point more often tend to have larger vocabularies and better grammar later on.
Pointing helps children learn new words: When children point at something, adults tend to label it, providing valuable language input.
Pointing supports joint attention: Joint attention, or the shared focus of two individuals on an object or event, is essential for language learning. Pointing helps establish joint attention, creating opportunities for communication and learning.
3. Pointing and social-emotional development:
Pointing is not just about language; it’s also about social interaction. It allows children to:
Engage with others: Pointing invites others to share their focus and participate in their world.
Express emotions: Pointing can convey excitement, curiosity, or concern.
Develop social understanding: By observing how others respond to their pointing, children learn about social cues and communication.
4. Pointing and cognitive development:
Pointing is linked to cognitive skills, such as:
Understanding object permanence: The ability to know that objects exist even when they are out of sight.
Categorisation: The ability to group similar objects together.
Problem-solving: Pointing can be used to ask for help or to indicate a problem.
5. Types of Pointing:
It’s important to note that there are different types of pointing, each with its own significance:
Imperative pointing: To request something.
Declarative pointing: To share interest or direct attention.
Informative pointing: To provide information.
If you have concerns about your child’s pointing or overall communication development, don’t hesitate to seek professional guidance from a speech-language therapist. Early intervention can make a significant difference in supporting your child’s communication journey.
How can we create opportunities for pointing?
‘Where’s the…?’ games:
Play games like ‘Where’s the doggy?’ or ‘Where’s the ball?’ and encourage your toddler to point to the object.
Start with familiar objects and gradually introduce new ones.
Reading together:
When reading picture books, ask your toddler to point to specific objects or characters on the page.
Use phrases like, ‘Can you point to the puppy?’
Everyday activities:
During daily routines, ask your toddler to point to things they want or need.
For example, ‘Do you want the apple or the banana?’
When walking outside say ‘LOOK’ and encourage pointing.
Use of toys:
Use toys that have buttons or points of interest that when pressed make a noise. Encourage your toddler to point to the area that makes the noise.
Use toys that have many different parts, and ask the toddler to point to a specific part.
Model pointing:
Point yourself:
When you see something interesting, point to it and say the name of the object.
For example, ‘Look! A bird!’
Point to show choices:
When offering choices, point to each item as you name it.
For example, ‘Do you want the blue cup or the red cup?’ (Point to each cup).
Point to indicate direction:
When giving directions, point in the direction you want your toddler to go.
For example, ‘Let’s go that way!’ (Point).
Make it rewarding:
Respond to pointing:
When your toddler points, immediately respond to their communication.
Give them the object they want, or acknowledge what they are pointing at.
Use positive reinforcement:
Praise and encourage your toddler when they point.
Say things like, ‘Good pointing!’ or ‘You showed me the car!’
Show excitement:
When they point to something, show excitement, this will encourage them to point again.
Use specific techniques:
Use gestures and verbal cues:
Combine pointing with verbal cues and other gestures.
For example, say ‘Look!’ while pointing and nodding your head.
Simplify the environment:
Reduce distractions to help your toddler focus on the object you want them to point to.
Use exaggerated movements:
Use large, exaggerated pointing movements to draw your toddler’s attention.
Consider developmental factors:
Age-appropriate expectations:
Remember that pointing develops at different rates for different children.
Be patient and supportive.
Underlying issues:
If your toddler is not pointing by 18 months, or if you have any concerns about their development, consult with a speech and language therapist.
There may be underlying sensory or motor issues.
Key points:
Consistency is key. Practise these strategies regularly.
Make it fun and engaging for your toddler.
Celebrate every success, no matter how small.
If you have any concerns about your child’s development, contact your local health services.
Great toys and items for pointing
1. Interactive books:
Touch-and-feel books: Books with different textures, flaps to lift, and sounds encourage interaction and pointing. ‘Where’s the…?’ questions prompt pointing to specific features.
Books with simple pictures: Clear, uncluttered pictures make it easier for toddlers to focus and point to objects or characters.
2. Cause-and-effect toys:
Activity cubes: These often have buttons, dials, and levers that produce sounds or actions when manipulated, prompting pointing and exploration.
Pop-up toys: Toys where figures pop up or things happen when a button is pressed encourage anticipation and pointing to the action.
Simple musical instruments: A toy piano, drum, or xylophone encourages pointing to the keys/surfaces to make sounds.
3. Toys with parts to manipulate:
Shape sorters: Encourage pointing to the shapes and the matching holes.
Stacking cups or rings: Nesting cups or stacking rings invite pointing to select the correct size or order.
Puzzles with knobs: Simple puzzles with large knobs are easier for toddlers to grasp and point to the pieces.
4. Toys that encourage joint attention:
Bubbles: Blowing bubbles and following them with your eyes and pointing encourages joint attention (shared focus).
Balls: Rolling a ball back and forth and pointing to where it’s going can promote joint attention and turn-taking.
Wind-Up Toys: Wind-up toys that move across the floor can be exciting to follow with pointing.
5. Pretend play toys:
Toy telephones: Encourage pointing to the buttons and pretending to dial.
Dolls and stuffed animals: Pointing to the doll’s eyes, nose, mouth, etc., or asking the child to point to these features on themselves.
Toy food and dishes: Pretend play with food and dishes can involve pointing to request items or indicate actions (e.g., ‘Can I have the apple?’).
Tips for using toys to encourage pointing:
Get involved: Play alongside your toddler, modelling pointing and using language to describe what you’re doing.
Follow their lead: Observe what your child is interested in and use that to encourage pointing.
Limit distractions: Reduce background noise and visual clutter to help your child focus.
Use gestures and words: Combine pointing with words and other gestures (e.g., ‘Look!’ while pointing).
Be patient and positive: Celebrate all attempts at pointing and provide lots of encouragement.
Remember, the most important factor is the interaction you have with your child while playing. Use these toys as tools to create opportunities for communication and joint attention, and your toddler will be well on their way to mastering pointing!
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.
What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?
Speech and language therapists provide treatment, support and care for children and adults who have difficulties with communication, eating, drinking and swallowing. We help children and adults who have problems speaking and communicating.
How to find the perfect therapist for my child/client:
There are a huge number of speech and language difficulties, or feeding and swallowing problems that we can help with and the first thing to think about is what age group the person is you are seeking help for. Most SLT’s specialise in a range of disorders and treatments and they often treat specific age ranges. This could be, for instance, very young children up to 3 years, or school aged children, adolescents or just adults. Once you have narrowed it down to age and general area of difficulty you can then go and seek your perfect SLT match.
Generally it is my view that SLT’s with a narrow area of specialist interest are most likely to help you better if the problem you or your child/adult is having is significant and/or profound. For example, if your child has a very severe stutter/stammer but is otherwise developing fine and has good skills all round, then I would recommend to look for an SLT who only specialises in stammering/stuttering, or has only a small range of other specialist areas related to stammering , such as speech and language delay.
The reason is that it is a tall order for any professional to stay up to date with latest research, latest clinical developments and training for more than, say, five distinct areas of interest.
However, a more generalist Speech therapist who has lots of experience in many different areas could be a very good option for your child or adult who has more general speech and language delay in a number of areas, perhaps a global delay or a syndrome which means that their learning is delayed in general. It also means that your child might benefit from a Generalist SLT because they have many more tools in their SLT bag and your child might need a variety of approaches for several areas.
A good place to start is www.asltip.com which is the Association for Independent Speech and Language Therapists in the UK. Any SLT registered with ASLTIP will also be registered with the HCPC (Health Care Professionals Council), as well as RCSLT (Royal College of Speech and Language Therapists). These two important UK professional regulatory bodies ensure all its members are fully qualified, and are fully up to date with latest developments within their areas of work.
Here you can enter your post code and look for a therapist near you and you can look for specific problems such as stammering for example and narrow down your search. Most therapists have a website which you can then access too. I would recommend you speak to a few therapists on your list and then go with the person you had the best rapport with. You and the therapist will be spending a lot of time together and you will need to feel that you trust them and that you can relax into the process.
How I can help you:
I have 3 main areas of specialism:
Parent Child Interaction Coaching
This is an amazing way to help children with the following difficulties:
Social Communication Difficulties, Autistic Spectrum Disordersand
Speech and Language Delay – for children under the age of 4 years old, this is my preferred way of working because it is so very effective and proven to work. If your child is not developing words or not interacting, has reduced attention and listening and you feel is not progressing or, in fact even regressing, then this way of working is the best. For anyone wanting to read a bit more about the efficacy of this method, below are some research articles. You may also like to check out www.hanen.org which is the mainstay of my work and method when it comes to Parent-Interaction Coaching. You can also look at my latest blog, entitled: Tele-therapy, does it work?
In brief, what’s so great about Parent Coaching is that it empowers you the parent to help your child in daily life! This is where speech, language and social communication develop typically, in a naturalistic way and environment. Simple steps and strategies are discussed and demonstrated every week and you are encouraged to use these strategies with your child in daily routines: getting dressed, having breakfast, on the school run, whilst out in the park or shopping or simply playing at home or having dinner or bath time. Whatever your family routine happens to be, every strategy I teach you will help create a responsive communication environment; generally, if your child is able to develop speech then they will do so in direct response to your changed interaction style.
Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation
I love working with children of all ages on developing their speech sounds. Whether your child has a lisp, or a couple of tricky sounds they simply cannot produce quite right, or perhaps your child is really unintelligible because he/she is having lots of different sound errors, making it really hard to understand them. I typically work on getting “most bang for your buck” , meaning I address the sounds that cause the most problems and, therefore, when they are fixed your child/person’s speech becomes that much clearer fairly quickly.
Feeding and Swallowing Difficulties
Having worked for over 20 years in NHS Child Development Clinics and Special Needs Schools I trained and worked with feeding and swallowing difficulties early on in my SLT career. I later trained as a Lactation Consultant and so I am well placed helping and support all types of Infant feeding, both breast or bottle, as well as toddler weaning. I aim to ensure that your little one swallows the right kind of foods and drinks for their abilities. I am experienced in managing and supporting children with physical needs and mobility problems, Cerebral Palsy, Down Syndrome or any other type of syndrome or presentation.
What does a speech therapy session look like?
All sessions differ slightly depending on the age of the child and the nature of the difficulties.
However, mostly our sessions look like FUN! After arrival and washing hands we tend to start off with the tricky work straight away whilst our child still has energy and the will to engage. So, for speech work we will focus on the target sounds first: this could be sitting at a table doing work sheets together, playing games using the target sound and really any type of activity that gives us around 70-100 repeats of the target pattern. For example, a child who is working towards saying a ‘K’ at the end of the word I will try and get around 100 productions of words like: pack/sack/lick/ pick/bike/lake and so on.
Then we often play a fun game where I might try for a ‘rhyming’ activity or other sound awareness type activities, for perhaps 10 minutes and within that time I aim to trial the next sound pattern we need to improve on; I will test which sound your child can do with help from me. During he last 10 minutes we might look at a book, again listening to and producing whatever sound we are working on. If I did not get 100 sounds earlier on in the session I will try and practice them now as part of the story. In total I aim to have about 40-45 minutes of activities, all aimed at the target sound we are working on.
What does a Coaching session look like?
During a Parent Coaching Session we meet online for about an hour and we discuss how the week has been for you trying out the strategies. Typically parents start off recalling what went well, what progress was made and what had been more tricky. We work through it all, and then follow on to the next strategies: I will show you examples and demonstrations of each strategy and I will get you to think about how you can use this with your child and in what situation you might use it. I will explain what we are doing and what the purpose is. You might want to write down what you are going to work on for the week. Over the course of about sessions we can cover all the major strategies that are proven to help kickstart spoken language and/or help your child to connect more with you. Through that connection spoken words most often develop.
Research Papers on the Efficacy of Parent Child Interaction Coaching
The It Takes Two to Talk Program has been shown to be effective in changing how parents interact with their children, and that children’s communication and language skills improve as a result.
Baumwell, L.B., Tamis-LeMonda, C.S. & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20(2), 247-258.
Beckwith, L. & Cohen, S.E. (1989). Maternal responsiveness with preterm infants and later competency. In M.H. Bornstein (Ed.). Maternal responsiveness: Characteristics and consequences: New directions for child development (pp. 75-87). San Francisco: Jossey Bass.
Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.
Sonja has been a real help for my 5 year old daughter. Due to her support, my daughter is now able to clearly and correctly enunciate ‘th’ ‘f’ and ’s’. She was also helpful in making positional changes to her seating to help her concentrate better and kept her engaged throughout all the lessons which is a feat in itself on zoom!
Helen, Mother of Catherine Age 5.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
We are all aware that Autism is on a spectrum. By the very nature of this, it means that every child will present differently, so an individualised approach is required. We need to remember to use a child’s strengths to support their needs. By using a person-centred approach, you’ll see your child’s literacy develop and thrive.
I hear many parents concerns about literacy as well as communication. Will they be able to read, write and spell? How will they manage their literacy independently? The questions are endless, so let’s look at how you can support your child’s literacy skills and how together we can provide a scaffold to them becoming independent learners.
The one thing we know is that Autistic children are visual learners. They succeed by us sharing pictures and demonstrating how the narrative is shown.
Start reading to your child at an early age. You can never start too early. This creates a love for books and supports vital pre-literacy skills (such as increasing vocabulary, following narratives, awareness of sounds in words, and letter recognition and awareness). By supporting pre-literacy skills, you’re starting the process to create confident young readers.
There are many ways to use books. You can narrate the story using different voices and tones to increase interest. You can do this even if your child isn’t interested. They are still listening and learning vital skills. You may even ask and answer questions and voice the skills that they will need for internal monitoring.
Use their interests to select appropriate reading material. In addition, you can then create questions on the book and provide a scaffold to support your child with the answer.
Use technology to spark their interest in reading. Demonstrate how they can read online. This is often successful as it becomes an individual activity as opposed to needing social interaction.
Provide them with a choice of texts (e.g., would you like ‘Perfectly Norman or when things get too loud’) rather than an open-ended question such as ‘What book would you like to read?’
Write key pieces of information down on paper. Research suggests that Autistic learners understand written text better than speech.
You could have a ‘word of the day’ from chosen reading material that you explore together.
Reading aloud to your child can have many benefits which include understanding vocabulary to how the book is read, with appropriate intonation.
I highly recommend the boom decks as they are a great resource!
The ethos at London Speech and Feeding:
“If they can’t learn in the way we teach, then we teach the way they learn”
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.
As a speech and language therapist, one of the most common questions I hear from parents is:
‘They can talk, but their speech still sounds immature. Is this normal?’
Many children between the ages of three and seven use speech patterns that make their words sound different from adult speech. These patterns are known as phonological processes, and for younger children, they are a normal part of speech development.
However, when these processes persist beyond the expected age, they can start to affect clarity, confidence and learning, especially once children enter school.
Phonological processes are patterns of sound simplification that children use while their speech system is developing.
Instead of learning each sound one by one, children initially organise sounds into patterns that make speech easier to produce. This is a normal and efficient strategy for a developing brain.
For example:
saying ‘tar’ instead of ‘car’
saying ‘poon’ instead of ‘spoon’
saying ‘bud’ instead of ‘bus’
These are not ‘bad habits’. They are part of how speech develops.
The key question is how long these patterns last.
Common phonological processes (and when they usually disappear)
Below are some of the most common processes parents notice in 3–7-year-olds.
1. Final consonant deletion
Leaving off the last sound in a word
‘ca’ for cat, ‘da’ for dog
Typically resolved by 3–3½ years
2. Fronting
Replacing back sounds (k, g) with front sounds (t, d)
‘tar’ for car, ‘do’ for go
Typically resolved by 3½–4 years
3. Cluster reduction
Omitting one sound in a consonant cluster
‘poon’ for spoon, ‘top’ for stop
Typically resolves by 4–5 years (some clusters slightly later)
4. Gliding
Replacing /R/ or /L/ with /W/ or /Y/
‘wabbit’ for rabbit, ‘yion’ for lion
Can be typical up to 5–6 years
5. Weak syllable deletion
Leaving out unstressed syllables
‘nana’ for banana
Usually resolved by 4 years
If these patterns continue past the expected age, speech can remain difficult to understand particularly for unfamiliar listeners such as teachers, peers, and also Auntie Karen or grandparents who visit once in a while.
Why phonological processes matter in school-age children
By the time children reach reception and Year 1, speech clarity becomes increasingly important.
Persistent phonological difficulties can affect:
being understood by teachers and peers
phonics and early reading
spelling
confidence in speaking
willingness to participate in class
Some children become aware that they ‘sound different’ and may speak less, avoid longer words, or become frustrated when misunderstood.
What’s the difference between a delay and a disorder?
This is an important distinction.
A phonological delay means a child is following the normal pattern of development, just more slowly.
A phonological disorder means the child is using atypical patterns, or continuing age-expected patterns well beyond when they should have resolved.
You may want to seek professional advice if your child:
is 3½ years or older and still hard to understand
is understood well by family but not by others
becomes frustrated or avoids talking
has difficulty with phonics or spelling
uses several phonological processes at once
has not made progress despite time and encouragement
Early support does not mean something is ‘wrong’. It simply helps speech development move forward more efficiently.Research consistently shows that unresolved phonological processes beyond the expected age can impact intelligibility, literacy and confidence (Dodd, 2014; Bowen, 2015).
How speech therapy helps phonological development
Phonological therapy is not about drilling individual sounds endlessly.
Instead, therapy focuses on:
helping children recognise sound patterns
building awareness of contrasts (e.g. ‘tar’ vs ‘car’)
practising speech in meaningful, playful ways
supporting generalisation so progress carries into everyday speech
For school-aged children, therapy is usually structured, motivating and highly targeted and progress can be very encouraging.
A final reassurance
Many children with phonological difficulties go on to develop clear, confident speech with the right support.
If you’re unsure whether your child’s speech is ‘just a phase’ or something that needs attention, a professional assessment can give clarity and peace of mind.
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.
