Bilingualism – should I speak only English with my speech delayed child?

ByLondon Speech and Feeding
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Introduction

Bilingualism is a beautiful aspect of our diverse world. Growing up in a bi- or multi-lingual household is a wonderful gift, allowing children to communicate with a broader range of people and access many cultures.

My own two children grew up in a bilingual German-English speaking household. They have both been so enriched by this experience, not only language- and learning-wise but of course also culturally: their world has always been so open and colourful. Growing up in inner London and having their German family and mum’s friends as well, this has been a wonderful experience. Both my boys speak German well (not quite like native speakers but like very good second language speakers) and both have very easily learned 3rd and 4th languages additionally when in secondary school.

Whilst bilingualism has untold benefits, it’s not uncommon for bilingual children to take slightly longer to reach certain speech milestones. This should not be automatically mistaken for speech disorders but rather seen as a natural part of bilingual language development.

Bilingualism and speech delays

Sometimes, of course, we do see speech delays or disorders where a child’s speech development lags significantly behind their peers. We often see a delay in both languages equally, making it extra hard for to communicate effectively. BUT PLEASE KNOW the family speaking in multi-lingual languages never caused the delay/disorder!

If there is a delay or a disorder any number of other reasons could have caused it, such as:

  • hearing impairments,
  • reduced phonological awareness,
  • sensory processing issues,
  • reduced attention and reduced joint attention,
  • neuro-developmental delays or difficulties,
  • general or specific learning difficulties
  • or sometimes other genetic factors.

So, to say that the difficulty is due to a child being exposed to several languages is a red herring. (no offence to herrings!)

Speech therapy

Speech therapy can be powerful to help bilingual /multilingual children with speech delays unlock their full linguistic potential. By providing individualised assessments, targeted interventions, and involving families, speech therapy can bridge the gap between speech delays and bilingualism. It’s essential for the therapist and parents to work together to support the children in their unique linguistic journeys, helping them communicate effectively and thrive in both of their languages.

Happy Islamic family sitting on the floor
Image by Freepik

Speak your home language at home

Many parents report that they worry about speaking their home language at home and instead they have been focusing on just speaking English at home. They now rarely use their home language with their child. They fear that speaking a language other than English with their child will cause further delay and hinder their progress. All parents want the best for their child and often parents fear that their child won’t fit in or will be seen as ‘different’. So we can understand why parents feel that the English language is the only one worth having.

But the opposite is the case: it is crucial to speak in both languages freely, both at home and outside the home! Both languages will benefit your child, no matter what the delay or difficulty is. Acquiring a ‘mother tongue’ or native language is absolutely vital for children to have a good, solid linguistic grounding on which to build other languages. Bilingual children may mix languages during speaking and parents may equally mix their languages. This does not hinder language development and is a natural part of linguistic development.

Speak freely and naturally

What is far more important than the question: ‘which language should I say this in?’ Instead think: ‘let me speak freely and naturally, let me respond naturally, in good intonation and let communication flow freely to the child.’

Speech therapy can be a crucial resource for bilingual or multilingual children and their families.

We work on targeted interventions to address speech and language difficulties, helping your child develop essential communication skills. For home practice between therapy sessions, we can recommend tailored treatment plans to help you help your child in daily life. Our input could be focusing on articulation, phonological awareness, attention and listening, vocabulary development and grammar.

Family support is crucial in speech therapy. We like to work closely with parents to provide guidance and strategies for fostering language development in both languages at home.

If you have any worries about your child being delayed in a bilingual or multilingual household do get in touch and we will be happy to support you in your journey.

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: A Speech and Language Therapist’s Take

    ByLondon Speech and Feeding
    adorable baby playing with food
    Image by freepik

    Let’s face it, introducing solids is a rollercoaster for parents. You’re bombarded with advice (solicited and otherwise) on purees, spoon-feeding, and the much-discussed ‘baby-led weaning’ (BLW). As a speech-language/feeding therapist I see the world through the lens of communication and development, as well as safe munching and swallowing. BLW can be a fantastic option for many little foodies. But is it right for yours? Let’s take a dive into the messy, hilarious world of toddler feeding.

    BLW in a nutshell

    Your baby, perched in their highchair, eyes wide with excitement and curiosity reaches out for a platter of food. He/She grabs a fat avocado slice, and curiously explore it with his/her lips, gums and tongue. He/She spits some of it out, mashes bits of it into his/her hair, there was a tiny swallow and the rest is smeared onto the high chair tray. Now he/she grabs a bit of the banana and rinse and repeat as before, except this one he/she keeps in his/her mouth for bit longer and takes a tiny bit more before the rest gets deposited into his/her bib.

    This, in a nutshell, is BLW! It’s all about letting your little one take the lead in exploring new foods, textures, and tastes. No spoon-feeding, just pure, messy, self-directed feeding fun.

    The pros of letting your little one loose on solids:

    • Motor Skills: BLW is a sensory party for developing motor skills. Picking up that slippery banana or gumming a chewy piece of toast strengthens those tiny hands and mouth muscles. These are the very skills they’ll need for future talking and chewing.
    • Texture Time: BLW exposes your baby to a variety of textures right from the start. Think soft, steamed broccoli florets or smooth, banana half-slices. This sensory exploration helps them develop an understanding of different textures in the world, which can translate to better oral motor skills needed for speech development.
    • Independence: BLW fosters a sense of self-feeding independence. Your toddler learns to control how much he/she eats and the pace of his/her meal. This can lead to better self-regulation later on, not just with food, but in other areas of his/her development too.
    • A wider variety of flavours: BLW encourages exposure to a wider variety of tastes and smells. Let your baby discover the sweetness of roasted sweet potato or the tang of mashed avocado! This early exploration can lead to less picky eating down the road.

    There are some valid concerns:

    • Gagging vs. Choking: One of the biggest concerns parents have about BLW is choking. However, gagging is a natural reflex that helps babies learn to move food safely around their mouths. Choking is much rarer, and with proper food selection and supervision, the risk is very low. The con here really is parental anxiety more than anything else and if you can overcome this then a bit of gagging is just fine and part of the process. Choking, again most children do choke occasionally a bit! Of course, close supervision and common sense is very important here.
    • It’s ever so messy!: Be prepared for mashed banana on the highchair tray, rogue peas flung across the room, and a general sense of chaos. But then again, this is an important part of the learning process! I would encourage you to embrace the mess (within reason and your personal tolerance level) and focus on the fun of exploration.
    • Nutritional Concerns: Some parents worry that babies won’t get enough nutrients with BLW. While it might take a while for them to master the art of self-feeding, a healthy child’s body is pretty good at self-regulating. Offer a variety of healthy options, and he/she will eventually get the hang of it.

    BLW: Is it right for your Little One?

    BLW isn’t a one-size-fits-all approach. Here are some things to consider:

    • Developmental Milestones: Babies should be able to sit up with good head control and show an interest in food before starting BLW.
    • General good health and absence of food intolerances, allergies, or other significant health issues which might dictatea more controlled feeding regime.
    • Gag Reflex: A strong gag reflex is a good sign. It shows your baby’s natural ability to move food safely around their mouth. If, however, your baby’s gag is overly sensitive and causes frequent bouts of vomiting please consult your health care professional for an assessment (GP, Paediatrician, Dietician, Speech and Language – Feeding Therapist).
    • Your Comfort Level: BLW requires a relaxed and patient approach. If you’re feeling stressed about the mess or potential choking hazards, it might not be the right fit for you.

    A final mouthful:

    BLW can be a fantastic way to introduce your baby to solids. It promotes exploration, independence, and a love for food. Remember, there’s no pressure to go all-in on BLW. You can always combine it with spoon-feeding or purees to find an approach that works for your family and your child. The most important thing is to create a positive and relaxed mealtime environment where your little one can explore the wonderful world of food at their own pace.

    P.S. As an SLT, I always recommend chatting with your health care professional. This way you can address any concerns you might have and ensure your baby is developmentally and physically on track for this exciting new chapter.

    Don’t hesitate to contact me!

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    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.

    1
  • · ·

    The Hanen Program® – The beauty of the ‘4 S’

    ByLondon Speech and Feeding
    Image by freepik

    One of my favourite pieces of advice I give to parents is the ‘4 S’, a strategy coined by the Hanen Program® which I teach, particularly the ‘More than Words’ programme which is designed for and aimed at parents of children with Social Communication Difficulties or Autism. It is honestly one of those golden nuggets that I use myself in my practice and I highly recommend it to all my parents. There is something about terms like the ‘4 S’ that is easy to recall and therefore use.

    Introduction

    The ‘4 S’ is a strategy that helps to clarify the words we use with our children so that they can notice us, hear us and understand what we are saying.

    Research shows that we use on average 120-200 words per minute during everyday conversation. That’s a lot! And our children who are still learning to communicate are often bombarded with endless speech coming at them all day long. If we take into account that many of our students are Gestalt Language Processors, we can see that picking out relevant chunks of what we are saying is not at all easy, and this contributes to our children’s delays.

    So let’s look at the ‘4 S’

    1. The first one is SAY LESS

    This means we should use shorter, simpler sentences with good grammar, for example, something like: ‘let’s get ready, time to put our shoes on’ instead of what we might be saying: ‘come on then darling, let’s put your shoes on we need to get going it’s dark outside’ or similar.

    Good grammar helps to give clues about what words mean and how they are used in sentences. So, instead of ‘shoes on’ say ‘let’s put our shoes on’.

    2. The second one is STRESS

    I hear you think ‘I am stressed!‘. – NO! here it means ‘highlight’. We use our voice to highlight the important words in our sentence or phrase. For example, when you say ‘this banana is so yummy’ you can stress the word ‘yummy’ by saying it a bit louder and you can make a gesture, like rubbing your tummy as you say it.

    3. The third one is GO SLOW

    This means to speak a bit slower than you normally would and add pauses. By slowing down the pace of our speaking we give our child time to think and understand what we are saying. When we allow for pauses after we have spoken, we are inviting our child to say something in response.

    4. The last one is SHOW

    Always remember to show actions, gestures, objects, and point to pictures while speaking to help support your child’s understanding. We can show our child what words mean by pointing to things or holding up objects whilst describing or talking about them.

    At this point I would also like to recommend the use of Core Boards, and particularly Electronic AAC devices, such as LAMP Words for Life or PODD. I have written about this in other blogs but can always be persuaded to say a bit more on the matter… 😊 It is such a big help to have an AAC talker available for both the child and the adult so we can find words and pictures to help support the words we are saying.

    For example, today when reading a book like The Hungry Caterpillar (so good!) I used my LAMP AAC talker to make comments as we were looking at the pages together with my student. Example: ‘Look! He is eating more cake he is very hungry’ using my AAC talker I was able to supplement my speech and at the same time I was inviting my minimally speaking child to press a button or two and reply with ‘cake!’ which they would not have said with their mouth otherwise.

    5. It does say ‘4 S’ but really it should be ‘5’ except the fifth is not an ‘S’

    The fifth is REPEAT.

    Repeat words and phrases often throughout the day. When learning a language we all need to hear words and phrases several times and in different situations before we can understand, remember, and then eventually use them. Our children are ‘new language learners’ and so we can apply the same principles that we would when learning a new foreign language ourselves.

    Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    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.

    1
  • · ·

    The power of containment: A therapeutic approach for autistic children

    ByLondon Speech and Feeding
    Photo by lemonlenz

    The practice of wrapping or swaddling children, often referred to as ‘containment,’ has been used for centuries to soothe and comfort infants. I use this therapeutic approach with autistic children at the London Speech and Feeding Practice. While it might seem counterintuitive, the act of being tightly wrapped can provide significant benefits for children who struggle with sensory processing, emotional regulation, and communication.

    Understanding sensory processing and autism

    Autistic persons often experience challenges with sensory processing, which is their brain’s ability to interpret and respond to sensory information. This can lead to sensory overload or under-responsivity. Containment can be a valuable tool in helping children regulate their sensory input.

    Photo by lemonlenz

    To summarise, here are some of the benefits of containment:

    • Sensory Regulation:
      • Provides deep pressure input: The tight, enveloping sensation of being wrapped can provide deep pressure input, which is calming and organising for many children.
      • Reduces sensory overload: By creating a controlled sensory environment, containment can help to reduce overstimulation and promote a sense of safety.
    • Emotional Regulation:
      • Containment creates a sense of security: Being wrapped tightly can mimic the feeling of being in the womb, providing a sense of security and comfort.
      • Facilitates calming: The deep pressure input can help to calm the nervous system and reduce anxiety.
    • Improved Body Awareness:
      • Enhances proprioception: Containment can improve the child’s awareness of their body in space, which is essential for motor development and sensory integration. I often provide extra pressure on a child’s arms and legs sticking out of the yoga mat; this helps my child understand where their limbs are in space: I can feel my legs and I can feel my arms and I can feel where they are right now, i.e. they are under Sonja’s hand, I can feel them.
    • Facilitates Communication – and this is obviously where I come in as a Speech and Language Therapist:
      • Swaddling creates a safe space: When a child feels calm and secure, they are more likely to engage in communication.
      • Enhances joint attention: The shared experience of being wrapped can foster joint attention, which is essential for language development. You can see this one in my highlights where I swaddle my student in the yoga mat (picture above). She absolutely loves it, and what is more she is calm and steady when usually this child likes to be on the move constantly. Here we have a wonderful moment of joint engagement. She looks at me, she can listen to what I say or sing, and she can tell me in her own way to carry on rolling her or to carry on singing or providing calming pressure to her legs and arms or to stop.

    A few pointers for when you try this at home: How to practise containment safely and effectively

    • Create a safe environment: Ensure the wrapping material is soft, breathable, and free from any hazards.
    • Observe your child’s cues: Pay attention to your child’s body language and verbal cues to determine their comfort level.
    • Respect your child’s boundaries: If your child shows signs of distress, stop the containment immediately – this might seem obvious but sometimes we adults get so carried away with some ‘great idea’ that we have seen work elsewhere. And so we can be a little too ‘determined’ sometimes to ‘make it happen’… perhaps this rings a bell with some of my readers.
    • MAKE IT FUN: Start carefully and take it step by step. See if the student is having a nice time. It is all about trust and therefore it might not work the very first time you do it.

    It’s important to remember that containment is not a one-size-fits-all approach. Some children may respond better to other sensory-based interventions. However, for many autistic children containment can be a valuable tool in their journey towards improved communication and emotional regulation.

    For more information follow me on Instagram, Facebook or LinkedIn.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    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.

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  • ·

    How we can help shape smooth consonant blends

    ByLondon Speech and Feeding

    For many children, especially those navigating Childhood Apraxia of Speech (CAS), the challenge isn’t just making individual sounds. It’s the ‘speech gymnastics’ required to move smoothly from one sound to the next.

    You might notice that instead of saying ‘Train’, your child says ‘Ter-ain’, or for ‘Frog’, you hear ‘Fer-og’. That sneaky little ‘uh’ sound in the middle is what we call a schwa vowel. In the world of speech science, this is known as epenthesis. It’s essentially a ‘repair strategy’ the brain uses to break up a difficult cluster of sounds into two easier pieces.

    While it might seem like a small detail, that tiny vowel makes a big difference in how fluent and clear a child’s speech sounds. In today’s post (and the video below), I am working with my student on ironing out that schwa by focusing on co-articulation—the art of getting the mouth ready for the second sound while still finishing the first.

    The ‘best friends’ strategy

    To help my student understand this complex movement, I use visual cues and a story. There are many ways to portray two sounds living closely together, but for this session, I used the ‘Best Friends’ story.

    In our story, the /T/ and the /R/ are older brother best friends who want to play together. The ‘schwa’ sound is represented by a little sister who keeps trying to jump in the middle of their game! Because my student has a younger sister, this scenario was instantly familiar and helped him visualise why we needed to ‘close the gap’ between those two sounds.

    Alternative methods I often use:

    Beyond stories, I often use other visual and tactile methods to show the closeness of two sounds:

    • The sliding finger: I draw two dots on a paper—one for /T/ and one for /R/. We slide a finger quickly from one to the other. I might say, ‘Don’t let the ‘uh’ monster jump in the gap!’
    • The rubber band: We stretch a rubber band as we speak. I tell my student that the word is one long, smooth stretch, rather than two separate ‘pops’.
    • Visual cues for ‘quiet’ sounds: I often put my finger to my lips or tap my throat to remind a child to keep the first sound voiceless. If the voice stays ‘off’ during the /T/, it’s much harder for that schwa vowel to creep in.

    The importance of ‘pure’ modelling

    A major hurdle in clearing up these blends is how we, as adults, model sounds. Often, when teaching the alphabet, we say ‘Kuh’, ‘Puh’ or ‘Tuh’. But if you listen closely, you’re actually adding a vowel! If a child learns that /K/ says ‘Kuh’, it’s only natural they will say ‘Kuh-R’ for /KR/.

    To give your child a cleaner blueprint, try modeling ‘pure’ sounds. Think of whispering rather than talking:

    • The /K/ sound: A short, sharp burst of air from the back of the throat. No voice! (A quiet /K/ click).
    • The /P/ sound: Just a ‘pop’ of air from the lips. If your throat vibrates, the vowel has snuck in.
    • The /T/ sound: A tiny tap of the tongue behind the teeth.

    Why is this important?

    You might ask, ‘If I can still understand them, does it really matter if they say “ter-ain”?’

    The goal of speech therapy isn’t just functional communication; it’s building phonological awareness. When a child adds extra vowels, it can eventually impact their literacy. If they hear ‘ter-ain,’ they are much more likely to eventually spell it as ‘terain’ or ‘traint’.

    By helping them master these clusters through co-articulation now, we are setting them up for success in reading and writing. And we are giving them the confidence to speak with ease.

    Feel free to contact me if your child needs help with clusters or other difficulties either aligned with Childhood Apraxia of Speech or other articulation difficulties.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    References

    • Hall, N. (2011). Vowel Epenthesis. In The Blackwell Companion to Phonology (eds M. Oostendorp, C.J. Ewen, E. Hume and K. Rice). In this work, epenthesis is defined as the insertion of a vowel to break up complex consonant clusters into simpler, more manageable syllables. This is often viewed as a ‘repair strategy’ used by the brain when a transition between sounds is too complex to execute quickly.
    • Aichert, I., & Ziegler, W. (2004) Brain and Language 88(1):148-59. Syllable frequency and syllable structure in apraxia of speech. This research highlights that children with Apraxia often struggle specifically with word-onset clusters, leading to distortions like the schwa.
    • Browman, C. P., & Goldstein, L. (1992) Phonetica 1992;49(3-4):155-80. Articulatory Phonology: An Overview. This paper explains that fluent speech requires ‘gestural overlap,’ where the movements for two different sounds happen simultaneously. This supports the ‘Best Friends’ method of keeping sounds close together.
    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
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    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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  • · · ·

    How do we play with our Gestalt Language Processors?

    ByLondon Speech and Feeding
    Image by Freepik

    Child-led therapy

    When working with Gestalt Language Processors, it is always advisable to use child-led therapy. What does that mean? Child led therapy involves following a child’s interests and allowing her/him to lead the play activity throughout the speech and language therapy session. In other words, instead of having my own ideas of what we might want to play with or what activities I might try and use, I provide a range of toys I know the child likes or has played well with before; then I wait for the child to pick what she/he enjoys doing.

    Play can be very repetitive and we can often see our child cycling back to the same one or two toys throughout the session. But this is what she/he needs to do at that time and it means that we have focused attention and engagement. This in turn is very helpful for the therapeutic process, which is to offer great scripts and phrases/words alongside what she/he is playing with.

    Monotropic minds

    Often the mind of autistic children is more strongly pulled towards a smaller number of interests or hobbies as I like to call them. Dr Dinah Murray, Dr Winn Lawson and Mike Lesser have found in 2005 that autistic people have ‘monotropic’ minds. They explain that autistic children focus their energy on a narrow range of activities as the energy required to switch between several toys is much higher than we would see in the neuro-typical population.

    Gestalt Language Processors are often also Gestalt Cognitive Processors. This is when experiences are retained as episodic events and memories. An event is remembered by specific parts of the same event. And, therefore, these specific parts should always be part of that event, when the event is repeated.

    Should any of the specifics be changed or are missing, then this can cause great upset to Gestalt Cognitive Processors. So, for example, if the last two times in speech therapy we had the train set out and this was played with happily, then this becomes a specific part of the whole session. If, I then don’t offer the train set the third time a child comes to see me, this could be very upsetting.

    This is why I tend to try this out and see what happens. Usually in the 3rd or 4th session: I might not bring out the car run that has hitherto been super successful to see if we are able to transition well to other toys. If yes, then we can have new experiences but if not then I will re-offer the car run/or whatever toy pretty quickly so as not to cause complete dysregulation.

    A few pointers below which help with child-led play:

    Introduce a few new toys and see what happens

    Parents are encouraged to bring some familiar toys their child likes to the session. We can then introduce a couple of different toys to see how we go. Try offering a new toy alongside the familiar one; try offering new toys without the familiar one present, but be prepared to re-offer the “old” toy should our child get upset.

    Rotate toys and don’t offer out too many toys

    I find that children can get overwhelmed and overstimulated by too many items out all at once. I always talk to parents about toy rotation at home and I encourage storage and ‘tidy up’ of toys so that we can increase attention focus, and also maintain freshness and new interest in older toys.

    Some children are not yet ready to play with toys

    Here I suggest people games: these are games where the adult becomes part of a more motor-based activity. Some call it ‘rough and tumble play’ but it can be nursery rhymes such as sleeping bunnies/row row the boat or peek-a-boo for the younger ones.

    Copy/Imitation is so important – try getting two identical or similar play items

    When we are copying our child, it is often not desirable to ‘take turns’ with their toys/blogs/cars etc as our child may not be ready to let us take a turn. Instead, if we have the exact same toy that our child is having then we can play alongside our child and copy them perfectly without interrupting their play.

    References:

    Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139-156.

    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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  • Could mouth breathing be affecting your child’s speech, sleep and development?

    ByLondon Speech and Feeding
    Could mouth breathing be affecting your child's speech, sleep and development?

    Understanding Orofacial Myofunctional Disorders (OMDs)

    Many parents contact me at London Speech and Feeding because they are worried about their child’s speech. Perhaps their child is difficult to understand, has a persistent lisp, struggles with feeding, snores at night, or always seems to have their mouth open.

    What many families don’t realise is that these concerns may all be connected.

    Increasingly, research and clinical experience are highlighting the important role of Orofacial Myofunctional Health, the way the muscles of the face, mouth, tongue and airway work together to support breathing, eating, sleeping and communication.

    When these muscles are not functioning optimally, children may develop what are known as Orofacial Myofunctional Disorders (OMDs).

    What Is Orofacial Myofunctional Health?

    Orofacial Myofunctional Health refers to the healthy function and coordination of the:

    • lips
    • tongue
    • jaw
    • cheeks
    • facial muscles
    • airway.

    These structures play a vital role in:

    • breathing
    • swallowing
    • chewing
    • speaking
    • facial growth
    • dental development
    • sleep quality.

    When everything is working well, the lips remain gently closed at rest, breathing occurs through the nose, and the tongue rests against the roof of the mouth.

    This seemingly simple posture has a profound influence on how a child’s face, teeth and airway develop.

    What is an Orofacial Myofunctional Disorder?

    An Orofacial Myofunctional Disorder occurs when there is an abnormal pattern of muscle function involving the face, mouth, tongue or airway.

    Children with OMDs may experience difficulties with:

    • speech
    • feeding
    • swallowing
    • sleep
    • breathing
    • dental development
    • facial growth.

    In many cases, these difficulties are linked to chronic mouth breathing.

    Signs your child may have an Orofacial Myofunctional Disorder

    Breathing and sleep signs

    • mouth open at rest
    • mouth breathing during the day
    • snoring
    • noisy breathing
    • restless sleep
    • frequent waking
    • dark circles under the eyes
    • chronic congestion
    • fatigue despite a full night’s sleep.

    Speech signs

    • lisping
    • unclear speech
    • distorted speech sounds
    • difficulty producing certain sounds
    • persistent articulation difficulties
    • reduced speech intelligibility.

    Feeding and swallowing signs

    • picky eating
    • messy eating
    • food remaining in the cheeks
    • gagging easily
    • difficulty chewing
    • long mealtimes
    • tongue thrust swallowing.

    Facial and dental signs

    • narrow palate
    • crowded teeth
    • open bite
    • overbite
    • underbite
    • long face appearance
    • receding chin
    • poor lip seal.

    If several of these signs sound familiar, a comprehensive assessment may be worthwhile.

    Why does mouth breathing matter?

    Many parents assume mouth breathing is simply a habit.

    In reality, mouth breathing is often a symptom that something is preventing efficient nasal breathing.

    Common causes include:

    • enlarged tonsils
    • enlarged adenoids
    • allergies
    • chronic nasal congestion
    • recurrent infections
    • structural airway differences
    • tongue tie
    • prolonged dummy use
    • thumb sucking
    • poor oral posture.

    When nasal breathing becomes difficult, children naturally begin breathing through their mouths.

    Over time, this can affect how the face, jaws and airway develop.

    What does healthy oral posture look like?

    Healthy oral posture is surprisingly simple:

    • lips
      • gently closed
    • tongue
      • resting against the roof of the mouth
    • teeth
      • slightly apart
    • breathing
      • through the nose.

    This posture helps guide healthy jaw growth, facial development and airway formation.

    Think of the tongue as a natural orthodontic support system. When it rests in the correct position, it helps shape the upper jaw and supports healthy facial growth.

    The consequences of chronic mouth breathing

    1. Speech difficulties

    Children who breathe through their mouths often have altered tongue posture and reduced oral stability.

    This can contribute to:

    • lisping
    • distorted sounds
    • reduced speech clarity
    • difficulty learning new speech sounds.

    2. Feeding and swallowing difficulties

    A low tongue posture may affect:

    • chewing efficiency
    • swallowing patterns
    • food management
    • oral motor coordination.

    Many children develop a tongue thrust swallow, where the tongue pushes forward instead of moving efficiently during swallowing.

    3. Poor sleep quality

    Mouth breathing can contribute to:

    • snoring
    • restless sleep
    • frequent waking
    • daytime fatigue
    • reduced concentration.

    Poor sleep can have a significant impact on learning, behaviour and emotional regulation.

    4. Changes to facial growth

    Over time, chronic mouth breathing may influence:

    • jaw development
    • facial proportions
    • dental alignment
    • airway size.

    This can result in:

    • narrow palates
    • crowded teeth
    • long facial appearance
    • increased orthodontic needs.

    5. Oral health concerns

    The nose acts as a natural filter and humidifier.

    When children breathe through their mouths:

    • The mouth becomes dry.
    • Saliva protection is reduced.
    • Risk of tooth decay increases.
    • Gum health may be affected.

    Why this matters for speech therapy

    Speech does not develop in isolation.

    The tongue, lips, jaw and airway work together to support clear communication.

    At London Speech and Feeding, we look beyond speech sounds alone.

    A child who presents with:

    • persistent speech difficulties
    • lisping
    • feeding challenges
    • open mouth posture
    • snoring
    • poor sleep

    may benefit from an assessment that explores underlying orofacial myofunctional factors.

    Addressing these foundations can often support more effective progress in speech and feeding therapy.

    How London Speech and Feeding can help

    A comprehensive assessment may include observation of:

    • breathing patterns
    • lip posture
    • tongue posture
    • swallowing function
    • feeding skills
    • speech sound development
    • sleep concerns
    • oral structures.

    Where appropriate, recommendations may include:

    • orofacial myofunctional therapy
    • speech therapy
    • feeding therapy
    • home programmes
    • ENT referral
    • orthodontic referral
    • collaborative multidisciplinary support.

    The good news

    Orofacial Myofunctional Disorders are often highly treatable when identified early.

    Supporting healthy breathing, tongue posture and oral muscle function can positively influence:

    If your child regularly breathes through their mouth, snores, struggles with speech clarity or has feeding difficulties, a specialist assessment may help identify the underlying cause.

    • speech clarity
    • feeding skills
    • sleep quality
    • facial growth
    • dental development
    • overall wellbeing.

    At London Speech and Feeding, we are passionate about looking beyond symptoms and understanding the whole child. Contact me!

    Sometimes the key to clearer speech starts with a simple question:

    ‘Is my child breathing through their nose?’

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Frequently Asked Questions

    Can mouth breathing cause speech problems?

    Yes. Mouth breathing can alter tongue posture, lip strength and oral stability, which may contribute to articulation difficulties and lisps.

    Should I be worried if my child snores?

    Regular snoring is not considered normal in children and may indicate airway obstruction or sleep-disordered breathing.

    Can enlarged tonsils affect speech?

    Yes. Enlarged tonsils may affect resonance, tongue positioning, swallowing and breathing patterns.

    What age can children be assessed?

    Children of all ages can be assessed if parents have concerns about speech, feeding, breathing or oral development.

    What is Orofacial Myofunctional Therapy?

    Orofacial Myofunctional Therapy focuses on improving breathing patterns, tongue posture, lip seal and oral muscle function to support overall health and development.

    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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