What is FRONTING?

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.

Pip and Posy, The Scary Monster by Axel Scheffler

Book Corner – Pip and Posy by Axel Scheffler

ByLondon Speech and Feeding

Kids Speech Therapist London
Pip and Posy by Axel Scheffler

One of my all time favourite book series, Pip and Posy, oh sooo good.

Before I tell you a bit about this book, just a few tips on reading aloud to children who are behind with their language and struggle to talk.

It is often assumed that “reading a book” means that we read the text exactly as it stands. We tend to read it quite quickly and, therefore, we also turn the pages quite quickly to match our reading. This may be too quick and not quite the right way of reading to your child, if she/he is struggling with speech and language development.

Instead, perhaps try this:

Sit opposite your child so that she can see you easily – check out my previous post – and start by letting your child open the book.

Now, instead of reading and pointing to everything you see, it can be really helpful to “hang back” and wait for your child to lead. S/he can point to what is interesting and then talk about freely what s/he can see. You can then respond and expand on what your child is pointing to or saying.

So, for example:

Child points to Posy looking out of the window and says: “Posy”.

You can then fill it and reply with : yes! there she is! – now give her some time to reply and take her turn.

If she is struggling to say anything more you might add: She is looking at the rain…. . – take another break and wait and let your child take her turn.

Letting your child take the lead and waiting, allowing your child to fill in and take a turn, is a great way to encourage a two-way conversation and it allows your child to lead the pace of what is being said.

So then, Pip and Posy – the scary Monster:

What’s it about:

Posy is bored indoors as it’s raining. She decides to bake some cupcakes and whilst waiting for her cakes to bake there is a knock at the door…..a big blue monster appears. Posy feels scared and starts to cry. Soon she realises that it’s her friend Pip dressed up in a monster costume and now she feels fine and both end up having fun trying on the monster costume. The sun has now come out and they go and play in the garden. It all finishes with a lovely picnic and those home made cupcakes. Happy end!

All Pip and Posy books are simple in that your child will discover every day situations and they are truly beautifully written and illustrated by Axel Scheffler.

Age group:

Around 1-6 years

Explore these themes:

  • animals
  • foods and drinks
  • friendships
  • household activities
  • toys and games
  • dress up and monsters
  • places – kitchen, garden
  • what’s a picnic

Develop Speech Sounds, particularly good for:

  • K – kitchen, cupcakes, cases, careful , costume, cry
  • M – monster, mixture, milk
  • P – Pip, Posy, paper, put, popped, open

Concepts:

  • matching
  • labelling
  • describing
  • predicting
  • prepositions (in/into/upstairs/downstairs/inside/outside)

Emotions and Social concepts

  • making friends
  • taking turns
  • feelings: bored/sad/scared/happy/delighted/hungry/ curious

Published by:

Nosy Crow Ltd in the UK in 2013 (ISBN: 9780857632432)

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.

A woman on the left is pointing to her open mouth. A girl on the right is looking at her and copying the mouth shape.

My child is very hard to understand! How can Speech Therapy help?

ByLondon Speech and Feeding

Kids Speech Therapist London

There are many reasons for speech sound delay or disorders and the first step is a thorough assessment.

What does a Speech Assessment look like?

With younger children, around 2 – 2.5 years we often start by collecting a good speech sample during play or general chatting. Sometimes we do this with an audiotape so that we are able to listen to your child’s speech sounds repeatedly in order to determine any speech error patterns. A good way to get a speech sample is looking at a favourite book together and trying to get your child to name as many items, animals or characters as possible in the book. For older children, 4.5 years plus we do more formal speech sound assessments where we show your child a series of pictures which focus on varying sounds or sound patterns, for example:

  • Are the end sounds present or left off, does your child say BE_ instead of BED for example?
  • Are the back sounds produced at the front of the mouth, is a digger a DIDDER or a pig a PID?
  • Are sound blends reduced, for instances a snake becomes a NAKE ?
  • Or do many phonemes (single speech sounds) collapse all into one error sound? Like all F , R or L become a B?

Once we have discovered the error pattern we can then unravel the problem and work on solutions. We make a plan and prioritise which of the patterns we can target first, second and next. There are several approaches that can be used to tackle speech sound errors and most therapist have two or three favourite approaches as their go-to. I will fill you in on my favourite ones in future blogs.

What does a Speech Therapy session look like?

These days we have two options: on-line via zoom and face to face in the clinic setting.

Both are great options!

For all clients who live far away a zoom session will be the option to go for. But zoom sessions also work really well for the older child as, let’s face it, are there any kids out there who do not like a bit of screen time?

I find that children around 5 years old really love the on-line games and sessions are fun and very effective. We usually start off with a quick game to warm up and then we go into the speech sound patterns we need to improve and work on. There are 100s of tried and tested on-line games and game decks which can be hugely entertaining and really nice to work with.

In clinic, we also often start with a short game to settle in and then we target the various sound patterns we are working on within table top games, or arts and crafts activities. We aim to get up to 100 speech sound trials per session, using a variety of motivating games to keep our little ones going and focused.

Both, face to face and on-line sessions are between 40-45 minutes long – time usually flies by! – and then parents get to practise home exercises to make sure that the new speech sounds are being practised every day.

Over the coming weeks I shall do blogs on great games and home exercises that I give the parents and I will talk about games we do in the session that are fun and can be copied for home use. Watch this space!

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

Two adults and two children. The man, on the right, holds a book and one child points to it. The woman, on the left, holds up a baby.

Reading recommendations

ByLondon Speech and Feeding

Using a Core Vocabulary Board

What a lovely picture you are probably thinking, a dad reading to his child, perfect! hmmmm… yes and no! Let me expand.

It is of course lovely reading a book to your toddler and the more often you do, the better! If your child is speaking and listening well, if he/she is asking little questions and can hear dad talking from behind and pointing to things then all is fine, but then I don’t suppose you would be reading this or having any interest in my website or blog.

Since you are reading this, I suspect your little one is perhaps a little behind with their speech and or language; perhaps he does not ask questions or maybe she does not point to anything you say when you are sitting like this with her. Or perhaps you are finding that your toddler/child just flips the pages back and forth whilst you are trying your best to read the text nicely?

If a child is having difficulties attending, listening, understanding and speaking then this positioning as shown in the picture is not the best. The reason is that a child who is having difficulties attending to adult’s speaking, will find it even harder to listen when the speaker is behind the child or very high up so that he/she needs to really look up at their faces.

Often our children with a delay don’t do this: they find it hard to engage jointly with an adult and can often just be focusing on what they are interested in, to the exclusion of everything around them. If this sounds like your little one, then my recommendation is to try and make it as easy as possible for your child to look at your face whilst you are reading to them. It will really help if the adult is positioned opposite the child, or as near as, so that it is quite easy for the child to make eye contact and quickly look up at adult’s face and mouth to see what is being said.

Now that you have re-positioned yourself and you are at roughly the same height to your child and eye-levels are roughly even, you can begin and enjoy the book together.

And since we are talking about reading to your toddler, let me make a few suggestions for good books to get when speech and language is lagging behind a little .

Below is one of my favourite book suggestions as copying animal noises is one of the first and most fun things to be practising with babies and toddlers.

Published by HarperCollins Publishers in 2016 (ISBN: 9781460752234)

This book is great for :

  • copying animal sounds
  • prepositions
  • ‘what’ questions
  • Speech Sounds (see below)

The simple rhyming text, and cheerful illustrations will quickly draw toddlers in. After encountering each animal, the question ‘But what noise comes from a giraffe?’ is repeated.

  • The language in this book is simple but the illustrations are fun and there is lots to talk about and amuse your toddler
  • As the giraffe appears in a variety of locations we can easily weave in early prepositions (in/under/behind)

Which Speech Sounds can be practised:

  • Dj giraffe, joke
  • M moo, meow, tummy
  • N noise, neigh, near, funny, lion
  • R roar, giraffe
  • T cat, hoot
  • Z noise

Enjoy!

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.

A vocabulary board

Using AAC – Augmentative and Alternative Communication for non-verbal and early verbal children

ByLondon Speech and Feeding

Using a Core Vocabulary Board

Your Speech Therapist might have been advising you to introduce words to your child with the help of a CORE BOARD. What on earth is she talking about and why would we want to do this, I hear you think – and in fact this is what I get asked a lot, as I often do recommend using Core Boards.

Core boards belong to the category of Augmentative and Alternative Communication (AAC ) and they can be really useful for:

  • Children or adults who cannot speak at all or who are very hard to understand.
  • Children who are slow to speak and have difficulty expressing themselves verbally, due to genetic conditions as Down Syndrome, Verbal dyspraxia, Autism or any other learning difficulty that means a child is slow to develop speech.

Here is what a Core board might look like, in fact this is one that I love to use. It is made by Beautiful Speech Life, there are a ton of similar boards out there for free. I have also made my own, you can check it out on my Instagram feed.

Using a Core Vocabulary Board

What is Core Vocabulary/ Core words?

Core vocabulary consists of the most common words used by children throughout a day. In 2003 Banajee and Dicarlo et al found that 50 % of pre-schoolers in their project used nine words consistently across their daily play and meal routines. These words are Core words and are typically the ones you can see on a board, like the one above.

How To Use It

Adults always first need to consistently model and show their child how to use a board. This is key! For example: Adult can point to “YOU” “WANT” ‘MORE” and then point to the cup of Water on the counter. Child could then reply either by shaking his/her head and/or pointing to “NOT” which also stands for “NO”. Then adult can point to “NOT” “MORE” and do an OK sign as well. Eventually Child can initiate a request and point to “I” “ WANT” “MORE” and then point to the cup on the counter.

This is not as cumbersome or limited as it first sounds or appears. Here’s why: As adult you can talk normally and, of course, many words you are using will not be on this board. But some will be, and you will be surprised how many you can find when you start using it. So you could say quite normally: Hey lovely (name of your child) would YOU LIKE some MORE water? The words in capital are on the board which you can point to as you speak normally. Basically, you are showing/saying to your child: “We can speak and these are the pictures we can use to help us; We call this TOTAL COMMUNICATION, as communication is so much more than just words! Great communication can be silent, where we use our facial expression, our smile, our eyes, our hand gestures, body movements and yes, of course, words. But when words fail us, these boards are so helpful.

This still does not answer your original question of: why would I want to do this, I want my child to talk!? You are a SPEECH Therapist, please help my child TALK, not point to pictures, that is not what I had in mind.

Let Me Explain

When speech is difficult for a child it doesn’t mean that there is nothing to talk about! Of course, we want all our children and all people to speak because it is the easiest and most effective way of communicating, no doubt! However, sometimes this is very hard for some children and whilst we are always working towards speech where possible, we also want to make sure that whilst figuring out how to speak, your child has a MEANS TO COMMUNICATE. Using a board like this might well be a temporary strategy but whilst you are using it and working on their speech you will find a reduction in tantrums and frustration as you child is able to express themselves more effectively.

Often we find that as soon as we offer a CORE VOCABULARY like the above sample a child who has had no or very few words suddenly blossoms and starts to point to new words on the board and starts to PRACTICE USING THESE WORDS!! Practice makes perfect, right? Yes it totally does! There is lots of evidence that tells us that using Core Vocabulary Boards ENHANCE AND SUPPORT SPEECH PRODUCTION AND NOT HINDER IT. Using a board like this will only ever be helpful to your child and will never make your child “lazy” – too lazy to speak? NO SUCH THING!

Here is what one of my parents says about the core board we use with her little boy:

“the board has been a game changer, my son is a visual learner so it really helps to have the board as he associates communication so much easier this way. We have incorporated his twin sister who models it’s use and have definitely seen improvement in speech through its support and his frustration around being unable to verbally communicate at times has definitely lessened”

K Connolly, Mother of Tom (aged 3.5 years).

Reading and hearing this makes me so happy!

In addition to general core board above I also sometimes use a Core Board that is specific to an activity, such as for example BLOWING BUBBLES. Below is an example of such a board, which you can use very nicely during a bubble blowing activity and sometimes it is a nice place to start for newcomers, this can be an easy introduction. You can download this and many similar boards on www.widgit.com for free!

Using a Core Vocabulary Board

There is so much more to say about AAC and using Coreboards, visit my Instagram you can find a bit more information on how I use them.

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.