Autism – Benefits of Early Assessment and Intervention

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I think my child might be autistic – how can we help?
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Consulting a Specialist Speech and Language Therapist can help you in several ways: assessment, informal and formal observation, discussion and advice, onward referrals, direct intervention, parent coaching, educational support and much more, all geared towards supporting you the parents, and helping your child to flourish and thrive.

First up, we can help you with assessment and advice: with a wealth of expertise in observing childrens’ play and communication, as well as knowledge of the latest research we can see a child’s strengths and areas of struggle very quickly indeed.

Within a short space of time, we can identify the areas we need to focus on and start guiding you towards helping your child to connect, respond, react and feel better.

Early detection is key

If autism is detected in infancy, then therapy can take full advantage of the brain’s plasticity. It is hard to diagnose Autism before 18 months but there are early signs we know to look out for. Let’s have a brief look at the sorts of things we look at.

The earliest signs of Autism involve more of an absence of typical behaviours and not the presence of atypical ones.

  • Often the earliest signs are that a baby is very quiet and undemanding. Some babies don’t respond to being cuddled or spoken to. Baby is being described as a ‘good baby, so quiet, no trouble at all’.
  • Baby is very object focused: he/she may look for long periods of time at a red spot/twinkly item further away, at the corner of the room for example.
  • Baby does not make eye contact: we can often see that a baby looks at your glasses for example instead of ‘connecting’ with your eyes.
  • At around 4 months we should see a baby copying adults’ facial expressions and some body movements, gestures and then increasingly cooing sounds we make; babies who were later diagnosed with autism were not seen to be doing this.
  • Baby does not respond with smiles by about 6 months.
  • By about 9 months, baby does not share sounds in a back-and-forth fashion.
  • By about 12 months baby does not respond/turn their heads when their name is called.
  • By around 16 months we have no spoken words; perhaps we hear sounds that sound like ‘speech’ but we cannot make out what the sounds are.
  • By about 24 months we see no meaningful two-word combinations that are self-generated by the toddler. We might see some copying of single words.

24 months plus:

  • Our child is not interested in other children or people and seems unaware of others in the same room/play area.
  • Our child prefers to play alone, and dislikes being touched, held or cuddled.
  • He/she does not share an interest or draw attention to their own achievements e.g., ‘daddy look I got a dog’.
  • We can see our child not being aware that others are talking to them.
  • We see very little creative pretend play.
  • In the nursery our child might be rough with other children, pushing, pinching or scratching, biting sometimes; or our child might simply not interact with others and be unable to sit in a circle when asked to.

What sort of speech and language difficulties might we see?

Our child might do any of the following:

  • have no speech at all, but uses body movements to request things, takes adults by the hand
  • repeat the same word or phrase over and over; sometimes straight away after we have said it or sometimes hours later
  • repeat phrases and songs from adverts or videos, nursery rhymes or what dad says every day when he gets back from work etc.
  • copy our way of intonation
  • not understand questions – and respond by repeating the question just asked:
    • adult: Do you want apple? child: do you want apple?
  • not understand directions or only high frequency directions in daily life
  • avoid eye contact or sometimes ‘stares’
  • lack of pointing or other gestures

Common behaviours:

  • Hand flapping
  • Rocking back-and-forth
  • Finger flicking or wriggling/moving
  • Lining up items/toys
  • Wheel spinning, spinning around self
  • Flicking lights on and off, or other switches
  • Running back-and-forth in the room, needing to touch each wall/door
  • Loud screaming when excited
  • Bashing ears when frustrated or excited
  • Atypical postures or walking, tip toeing, can be falling over easily, uncoordinated
  • Can be hyper sensitive to noises, smells, textures, foods, clothing, hair cutting, washing etc.
  • Being rigid and inflexible, needing to stick to routines, unable to transition into new environments
  • Food sensitivity, food avoidance, food phobias

I mentioned this to be a ‘brief’ look at the areas and it is: each topic is looked at very deeply and each area is multi-facetted therefore a diagnosis is rarely arrived at very quickly. We want to make sure we have covered all aspects and have got to know your child very well before coming to conclusions.

Early detection is key, because we want to start helping your child to make progress as quickly as is possible. If you feel /know that your child is delayed in their speech and language development and you would like a professional opinion then please do contact me, I look forward to supporting you. It is important to know at this point, that if your child only has one or two of the above aspects it may mean that your child is simply delayed for reasons other than Autism and if that is the case, we will be able to help you iron out a few areas of need so that your child can go on thriving.

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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    Baby-led weaning: Empowering little eaters from the start

    I had a mum ask me about Baby Led Weaning the other day. So I thought I would write a blog on all the useful questions she had and what we discussed as it may help lots of mums and dads out there.

    As a Paediatric Feeding SLT, one of the exciting developments in recent years is the growing interest in baby-led weaning (BLW). This approach to introducing solids has gained significant traction, and for good reason. It empowers infants to take the lead in their feeding journey, fostering a positive relationship with food and supporting important developmental milestones.

    What exactly is baby-led weaning?

    At its core, baby-led weaning is about offering your baby appropriately sized and textured solid foods from the very beginning, allowing him or her to self-feed. Instead of spoon-feeding purées, you present whole, soft foods that your baby can grasp, bring to his or her mouth, and explore at his or her own pace. This means no mashing, no blending, and no forcing spoons into reluctant mouths. It’s a fun, messy, and intuitive process that is led by your baby’s natural instincts.

    The genesis of baby-led weaning

    ‘Baby-led weaning’ was popularised by British health visitor Gill Rapley. In the early 2000s, Rapley observed that babies naturally develop the skills needed to self-feed and that traditional spoon-feeding might actually hinder this development. Her work, particularly her book Baby-Led Weaning: The Essential Guide to Introducing Solid Foods (co-authored with Tracey Murkett), published in 2008, brought BLW into the mainstream and provided a structured framework for parents. Her research and observations highlighted the benefits of trusting a baby’s innate ability to regulate his or her intake and explore different textures.

    What’s the deal?

    Implementing BLW is simpler than you might think, though it does require a shift in mindset. Here’s a breakdown of what it typically involves:

    • Readiness is key: The golden rule of BLW is to wait until your baby shows clear signs of readiness. This isn’t about age alone, but rather developmental milestones. Your baby should be at least six months old, able to sit unassisted, have good head and neck control, show an interest in food (e.g., reaching for yours), and have lost his or her tongue-thrust reflex (which pushes solids out of his or her mouth).
    • Offer finger foods: Start with soft, easily graspable foods cut into finger-sized sticks or spears. Think cooked sweet potato fries, steamed broccoli florets (soft enough to mash with gentle pressure), banana sticks, or avocado slices. The goal is for babies to be able to pick it up and get some into their mouth.
    • Embrace the mess: BLW is inherently messy, especially in the beginning. Food will be squished, dropped, and smeared. This is a crucial part of the learning process as babies explore textures, smells, and the properties of food. A wipeable mat under the highchair and a good bib are your best friends!
    • Observe, don’t interfere: Allow your baby to lead. He or she will decide what to eat, how much, and how quickly. Avoid putting food into his or her mouth or pressuring him or her to eat more. This respects his or her hunger and fullness cues, laying the foundation for healthy eating habits.
    • Continue breastmilk or formula: Until your baby is well-established on solids, breastmilk or formula remains his or her primary source of nutrition. Solids are for exploration, taste, and developing skills, gradually increasing in quantity over time.

    The benefits of baby-led weaning

    The advantages of BLW extend far beyond simply getting food into your baby. From a speech and feeding perspective, the benefits are compelling:

    • Develops oral motor skills: Chewing, gnawing, and manipulating various food textures are crucial for developing the muscles in the mouth, jaw, and tongue. This strengthens the oral motor skills necessary for speech development.
    • Enhances fine motor skills and hand-eye coordination: The act of grasping food, bringing it to the mouth, and coordinating these movements significantly refines fine motor skills and hand-eye coordination.
    • Promotes self-regulation and intuitive eating: By allowing babies to control their intake, BLW helps them tune into their own hunger and fullness cues, fostering a healthy relationship with food and reducing the likelihood of overeating.
    • Encourages adventurous eating: Exposure to a wide variety of tastes and textures from the outset can lead to less picky eating later. Babies are more likely to accept new foods when they have been in control of their exploration.
    • Facilitates family mealtimes: BLW integrates babies into family mealtimes from an early age, promoting social interaction and making mealtime a shared, enjoyable experience.

    When is baby-led weaning appropriate, and when not?

    While BLW offers numerous benefits, it’s not a one-size-fits-all approach.

    When BLW is appropriate:

    • When your baby meets all the developmental readiness signs: This is paramount for safety and success.
    • When you are comfortable with the mess and the learning curve: It requires patience and a relaxed attitude.
    • When you are committed to offering a variety of safe, appropriate foods.
    • When you are willing to learn about and practise safe food preparation to minimise choking hazards.

    When BLW might not be appropriate (or requires extra caution and professional guidance):

    • If your baby has a history of prematurity or significant developmental delays: His or her oral motor skills might not be sufficiently developed.
    • If your baby has certain medical conditions or anatomical differences (e.g., cleft palate, severe reflux, swallowing difficulties): These may necessitate a modified approach to feeding.
    • If there are significant feeding difficulties, aversion, or a history of choking incidents.
    • If you feel overly anxious about choking: While BLW, when done correctly, is not associated with a higher choking risk than traditional weaning, parental anxiety can impact the feeding experience. Education and consultation with a professional can help alleviate these concerns.

    A note on safety: Choking hazards

    It’s crucial to understand the difference between gagging and choking. Gagging is a natural reflex that helps prevent choking and is very common in BLW as babies learn to manage food in their mouths. Choking is silent and serious. To minimise choking risks:

    • Always supervise your baby closely during mealtimes.
    • Offer appropriately sized and textured foods. Avoid small, round, hard foods like whole grapes, nuts, popcorn, and large chunks of meat.
    • Ensure your baby is sitting upright and calm.
    • Educate yourself on infant CPR.

    Final thoughts

    Baby-led weaning is a wonderfully empowering approach that celebrates a baby’s natural abilities and fosters a positive and independent relationship with food. As Speech and Language Therapists we often see the positive impact it has on oral motor development, self-regulation, and overall feeding confidence. By understanding what it entails, when it’s appropriate, and prioritising safety, you can embark on this exciting journey with your little one, helping him or her become a confident and capable eater from the very first bite.

    If you would like help and support with weaning your baby whilst continuing to breastfeed then please get in touch!

    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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  • ·

    Transforming Mealtimes

    Speech Therpaist in London

    Transforming Mealtimes

    Below are two reviews I got from grateful clients over the past 4-6 weeks; this blog is more about how Feeding Therapy can help you than blowing my own trumpet…. though that said, it is always so nice and gratifying to hear when parents are happy and hopeful about their little one’s feeding journey. Feeding Therapy is a substantial part of my work as a Children’s Speech and Language Therapist. One of my specialist subjects is Autism and we find that many children on the Autism Spectrum are very specific about eating, and will often refuse a range of typical family foods in favour of a narrow range of foods/snacks.

    Mostly, feeding difficulties are a combination and complex cocktail of factors that have contributed to the current status quo: sure, there may have been some physical problems to start off with, such as reflux causing the baby discomfort, constipation, a very tight tongue tie or a swallowing problem caused by neurological difficulties and of course sensory processing difficulties are also very physical experiences. We always begin with a very thorough case history taking and information gathering, followed by an oral assessment and observation of the actual swallow to establish what might have been – or still might be – the cause for the feeding difficulties.

    In most of the cases I see in my practice, the original obvious cause is no longer present, especially with older children. So, if the swallowing is fine, the reflux is no longer present, the tongue was divided (twice!) why are they still not eating much, refusing to try new foods, only accept certain textures etc.

    The answer is extremely complex and multi-faceted and this little blog is not covering any factors in detail (we would be here all night) -I mentioned sensory processing difficulties earlier on. These are mostly still present but often not acknowledged or recognised by parents. And it is certainly the case that one of the contributors is parental anxiety; this tends to run very high and has been for many months, sometimes years. This in turn often leads to very tense and unpleasant, endlessly long meal times and many times children are force-fed several times a day in order to “get something down there” as otherwise they would probably starve themselves.

    Additionally, parents end up only offering a very narrow range of foods because that is all their child will eat. This ends up in a vicious cycle of children being fed porridge-style food for all meal times and of course they won’t progress to more mature foods if these mature foods are never on offer.

    In order to help address and disentangle some of the issues I often introduce the “Division of Responsibility in Feeding” as researched and recommended by Ellyn Satter (The Satter Feeding Dynamics Model)

    Here are the main points of her approach:

    Children have a natural ability with eating, they eat as much as they need and they grow in the way that is right for them and they learn to eat what their parents eat. (E Satter). The parent is responsible for WHAT the child eats, WHERE and WHEN the child eats. The child is responsible for HOW MUCH they eat or WHETHER to eat. Satter proposes that parents should guide their child’s transition from nipple feeding through semi-solids, then thick and lumpy foods to finger foods and then on to normal family meals.

    Please note: this model is only appropriate for children where the original physical cause is no longer present!

    Of course it’s not easy! It requires a huge shift in thinking about feeding and it requires to trust our children to know what is best for them. This is very big for most parents, as it is not how we were brought up and it is not commonly known that babies and children know what is good for them!

    However, it is certainly true that parents who follow this particular approach and make small, steady changes in the way the offer foods, and in the way they create family meal times differently, children make very nice, pleasing progress and over some months we often see remarkable positive changes.

    I like to work in a team and especially for this type of problem it is essential to have a multi-disciplinary approach. A knowledgeable dietician is an enormous plus in any feeding team as is of course a

    Paediatrician and/ or a Gastroenterologist and the most important people in the team are the parents!

    Feeding Therapy is all about collaboration and a ‘team around the child” approach. When we have this in place and there is trust amongst the team members then we make fantastic progress.

    Do get in touch with me if you would like some help with your tricky feeder.

    Lovely Reviews

    I visited London Speech and Feeding a couple of days ago with my 8-month-old granddaughter and her mother. Sonja made us feel comfortable and at ease from our first introductions. She was able to pinpoint my granddaughter’s mum’s anxiety around weaning very quickly. She not only gave her the tools to do this successfully, but also really encouraged my granddaughter’s mum and instilled confidence that she had everything she needed to make this sometimes-difficult transition without further anxiety.

    Sonja was very thorough in her initial assessment of my granddaughter’s physical milestones and her developing speech. My granddaughter felt very comfortable with Sonja and happily played along with her. Then came the big moment – trying out various foods! We were amazed to see just how easily my granddaughter, with Sonja’s expert encouragement, took to sampling the wonderful array of different delicious morsels Sonja had prepared for the session. My granddaughter even drank from a cup for the first time! Wonderful!

    Sonja then emailed a summary of the session and an extensive array of resources with suggestions for my granddaughter’s mum which she has now put into action. My granddaughter’s mum couldn’t thank Sonja enough for her caring attitude, extensive knowledge, and warm professionalism. I have no hesitation in recommending Sonja, she’s a fantastic Feeding Therapist!

    Sonja (and her lovely colleague, Sandra) were stupendous. I had brought my one-year-old son to see them as I was concerned that he wasn’t eating enough. They looked at his history and we ate together to make sure they had all the information they needed to give an accurate diagnosis. Whilst our outcome was that Henry was in fact doing brilliantly (and I just needed to chill out a bit!), I would imagine if there was something more serious going on, Sonja would make you feel just as supported and empowered as she did with us. Excellent follow-ups too. Money well spent for a bit of reassurance for a stressed out mama. Thank you, Sonja!


    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.

  • Learn the benefits of Cycles Phonology Approach in Speech Therapy

    A grey, green and orange circle overlaid with Cycles Phonological Approach
    Cycles Phonogogical approach

    When your child attends Speech and Language Therapy, it can look like your child’s therapist is playing. Therapy needs to be fun, which means carrying out therapy through the medium of play. But remember every approach used has evidence behind it. We need to know that therapy will be successful, so an evidence-based approach is essential.

    One of the approaches used for Speech Therapy (i.e., working on speech sound production) is the Cycles Phonology Approach. This approach focuses on the patterns and processes rather than each individual sound. For example, it may be working on final consonant deletion, so the omission of the final sound in words. As Speech and Language Therapists we understand that children can get frustrated and fatigued working on the same sound every day. This approach attempts to solve that. Hodson suggests, the approach is also useful for children with more speech sound errors, as therapists see progress in areas not targeted.

    How does the Cycles Phonology Approach work?

    Your Speech and Language Therapist will assess your child’s speech development and will then analyse the results. They will also look for which sounds they can produce with support (this is called stimulability). They will analyse patterns in the results and will formulate a plan.

    The Cycles Phonology Approach intervention allows your child to work in blocks. This might mean they work for half a week for 30 minutes on (e.g., clusters). Then the next half they’ll work for 30 minutes on a different process (e.g., omission of sounds at the end of words).

    Research has found that the following error patterns respond well to this approach:

    • Syllables (identifying the different parts in a word e.g., “ae-ro-plane”)
    • Final Consonant deletion (omission of the final sound e.g., “ca” instead of “cat”)
    • Initial consonant deletion (omission of the first sound e.g., “at” instead of “cat”)
    • Fronting (instead of making a sound at the back of the mouth, it’s made at the front e.g., “tatinstead of “cat)
    • Backing (instead of making a sound at the front of the mouth, it’s made at the back e.g., “guninstead of “bun)
    • S blends (e.g., “sl, sm, sn, sk, sw”)
    • Gliding of liquids (e.g., “lellow instead of yellow”, “wabbit instead of rabbit)

    What does a Speech and Language Therapy session look like when using the Phonology Cycles Approach?

    The format of the session remains the same for whichever speech sound pattern your child is working on. Your child’s Speech and Language Therapist will review the previous session. Then they will use an activity to work on your child hearing the sound several times (this is called ‘auditory bombardment’). Then your child will practise saying the sound. Next, the Speech and Language Therapist will check if your child can say any of the sounds which they haven’t been able to produce before, with support. This is called a stimulability check. After this, your child will take part in an activity which builds their awareness of sounds in words (such as a rhyming or syllable activity). The session will finish with another auditory bombardment task (i.e., hearing their tricky sound repeatedly).

    I will give you advice for practising at home, as it’s vital that your child learns in the correct way. We aim for 100 turns in therapy sessions, so it’s vital your child is motivated.

    Contact me to improve your child’s speech sounds and improve their confidence when talking.


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

    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.

  • · ·

    Your child’s communication journey

    Understanding our neurodiversity-affirming, child-led approach

    Welcome to a different kind of therapy!

    Your child’s communication journey

    The start of a new year often brings fresh hope, and sometimes fresh worries, for parents supporting their child’s communication. I am always genuinely excited to begin a new journey with children and their families, and I know that, for many parents, this kind of therapy may look very different from what they were expecting.

    Parents (and children!) are often surprised to discover that our sessions are playful, joyful, and intentionally low-pressure. You won’t see demands for eye contact, sitting still, or being told to ‘do it this way’ or ‘put the red square there’. Instead, you’ll see your child being met exactly where they are.

    For families who have previously experienced more adult-led or behaviour-based approaches including Applied Behaviour Therapy, this difference can feel unfamiliar at first. Because of that, I want to take a moment to prepare you for what child-led, neurodiversity-affirming therapy looks like, so you can feel confident, comfortable, and reassured from day one.

    Why doesn’t child-led therapy look like ‘traditional’ therapy?

    Many people picture speech and language therapy as sitting at a table, using flashcards, or practising words through repetition. While those approaches can work well for some children, they are often not effective or appropriate for many neurodivergent children—including children with autistic profiles, ADHD, or demand-sensitive nervous systems.

    Our approach is grounded in a simple and powerful truth:

    Children learn best when they feel safe, motivated, and emotionally connected.

    When a child’s nervous system feels calm and secure, learning becomes possible. When a child feels pressured or controlled, communication often shuts down, even if they can speak.

    🎯 Our purpose: Communication through connection

    Our goal is not simply to help your child say more words. Our goals go deeper and are built on strong foundations:

    • Trust and regulation: We focus on building a trusting relationship where your child feels safe, understood, and emotionally regulated. A calm nervous system is the starting point for all communication.
    • Motivation: We follow your child’s intrinsic motivation, the things they naturally enjoy to make communication meaningful, joyful, and purposeful.
    • Spontaneous communication: We create opportunities for your child to communicate because they want to, not because they are asked or instructed to.

    🧸 What to expect in a session

    Our sessions are intentionally child-led and often look very much like play.

    FeatureWhat it looks likeWhy we do this
    Minimal toysWe usually offer just 3–4 carefully chosen activities (such as bubbles, blocks, or sensory play).Less is more. Fewer choices reduce overwhelm and help children focus on what genuinely interests them.
    Child choosesYour child decides what to play with and how to engage.This immediately establishes us as a safe, non-demanding partner and increases motivation.
    The therapist’s roleWe join your child’s play, observing closely and responding naturally.We model language, share attention, and reflect your child’s experiences in a way that feels natural and supportive.
    No pressure or demandsThere are no ‘must-do’ tasks. If your child wants to spin, crash, line up toys, or repeat an activity, we follow.Reducing demands lowers anxiety and supports communication, particularly for children with demand-sensitive profiles.

    Is this really effective?

    It’s completely natural to wonder, ‘Are they just playing?’ The answer is yes, and very intentionally so.

    Our sessions are guided by nearly 30 years of speech and language therapy experience, alongside clear, achievable goals tailored to each individual child. Play is a child’s natural language and their most powerful learning tool.

    Within play, we are constantly creating opportunities to:

    • Build joint attention (sharing focus and interest)
    • Model language at the right level
    • Encourage back-and-forth communication
    • Develop a deep, authentic connection

    If your child has struggled to engage or communicate in more structured or demand-heavy settings, this child-led approach is often the key to unlocking their potential.

    💛 What this might look like at home

    You may notice that when pressure is reduced:

    • Your child begins communicating more during everyday routines
    • Language emerges through play, movement, or shared enjoyment
    • Communication feels more natural and less forced

    Small moments could be a shared smile, a look, a sound, a gesture. All matter. These are the building blocks of meaningful communication.

    📚 Resources for parents

    If you’d like to explore these ideas further, you may find the following helpful:

    I look forward to meeting you and your child. Please bring any questions, uncertainties, or curiosities to our first session, there is no such thing as a silly question. This is a journey we take together. Contact me via my contact form.

    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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  • Tele-Speechtherapy: Online, connected, and highly effective

    A different kind of therapy. Online, connected, and highly effective

    When parents first enquire about speech and language therapy, many assume it will happen face-to-face, in a clinic room, with a therapist sitting across from their child.

    So when therapy is offered online, it’s natural for questions to arise:

    Can this really work? Will my child engage? Will progress be slower?

    This short video offers a glimpse into what online therapy can look like: calm, interactive, relationship-based, and surprisingly effective.

    Online therapy is not ‘less than’ in the right circumstances

    Teletherapy is not suitable for every child in every situation. However, for many school-aged children, particularly those who enjoy conversation, technology, and shared activities, online therapy can be an excellent fit.

    The child you see in this video is around eight years old and was supported for a persistent lisp. Sessions were primarily online, with the occasional in-person appointment when helpful.

    What made the difference was not the screen. It was the combination of engagement, support, and consistency.

    Parent involvement changes everything

    One of the greatest strengths of online therapy is the way it naturally invites parents in.

    In this case, parents regularly joined the video sessions:

    • Listening in
    • Taking part when appropriate
    • Learning how to support practice gently between sessions

    This meant that therapy didn’t stay ‘on the screen’. Strategies carried over into everyday conversation, making progress faster and more meaningful.

    Speech sound therapy, including support for lisps, relies heavily on awareness, feedback, and confidence, all of which can be supported very effectively at home with the right guidance.

    Therapy through a screen can still be deeply relational

    A common concern is whether connection can truly be built online.

    In reality, many children feel more relaxed in their own home environment. They are often more willing to talk, experiment with sounds, and reflect on their speech when they feel comfortable and supported.

    Online sessions allow:

    • Shared focus and conversation
    • Clear visual feedback
    • Real-life practice in a familiar setting
    • Immediate parent support

    For some children, this actually enhances engagement rather than limits it.

    Real progress, real outcomes

    Over the course of approximately 12 online sessions, alongside a small number of in-person appointments, this child achieved resolution of their lisp.

    Progress was steady, positive, and confidence-building. Importantly, the child remained motivated and proud of their achievements throughout the process.

    While every child’s journey is different, this example highlights what is possible when:

    • The child is ready
    • Parents are involved
    • Therapy is tailored and collaborative

    If you’re considering online therapy

    If you’re unsure whether teletherapy could work for your child, it’s worth remembering that effective speech and language therapy is less about the room you’re in, and more about:

    • Relationship
    • Understanding
    • Consistency
    • Carryover into daily life

    For many families, online therapy offers flexibility, accessibility, and excellent outcomes especially when parents are active partners in the process.

    If you’re at the start of your child’s speech journey and wondering whether online therapy could be the right fit, I’m always happy to talk it through. Sometimes clarity begins with simply understanding what therapy can look like

    Teletherapy: Frequently Asked Questions

    Is online speech and language therapy really effective?

    Yes. For many children, particularly school-aged children, online therapy can be highly effective. Progress depends far more on engagement, consistency, and support than on physical location.

    What age does online therapy work best for?

    Teletherapy often works well for children from around six years and up, especially those who can attend to a screen, enjoy conversation, and follow simple instructions. That said, suitability is always considered individually and often a supportive adult is needed to help guide the child through the activities.

    Can speech sound work (such as a lisp) really be done online?

    Absolutely. Speech sound therapy relies on clear visual feedback, listening skills, and practice all of which can be supported very effectively online. Many children respond particularly well when practising in their own home environment.

    Do parents need to be involved in sessions?

    Parental involvement is strongly encouraged. Parents may sit in, join parts of the session, or support practice between appointments. This involvement often leads to quicker progress and better carryover into everyday speech.

    Will my child still build a relationship with the therapist?

    Yes. Strong therapeutic relationships can and do develop online. Many children feel more relaxed and confident communicating from home, which can actually enhance connection and learning.

    Is online therapy suitable for every child?

    Not in my experience. Some children benefit more from in-person support, or a combination of online and face-to-face sessions. A discussion and initial assessment help determine the best approach for each child.

    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.

    3