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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    While every baby develops at their own pace, if your child isn’t babbling by nine months, it’s worth seeking help from an Early Intervention Health Professional, such as a doctor and a speech therapist. Don’t panic! There are many reasons for delayed babbling, and early intervention is key.

    In the meantime, it is highly recommended that we talk, sing, and read to our baby often. Exaggerate sounds and expressions, and respond to their coos and smiles. This playful interaction helps stimulate their communication skills.

    Below are some tips and tricks from my experience of working with babies and toddlers who need a little bit of help and support to develop.

    The benefits of imitating your baby

    Copying your baby’s sounds and gestures isn’t just silly fun, it’s a powerful learning tool! By mimicking their babbles and actions, you activate “mirror neurons” in their brain that help them connect sounds with meaning. This playful back-and-forth teaches turn-taking, a foundation for conversation. Plus, it encourages them to copy you, building their own language skills and social interaction abilities.

    Image by freepik

    This is a nice clip on youtube showing how copying/imitating your baby looks like:

    Here are some fun ways to imitate your baby:

    • Matchmaker: Grab two of the same, or two similar toys your child loves, like rainmakers or shakers. Give one to your baby and keep the other for yourself. When your child plays with his/her toy, mirror his/her actions with yours! This creates a fun, interactive game.
    • Face Time: Get down to your baby’s level, sitting opposite him/her on the floor or kneeling. This makes eye contact easy and encourages him/her to look at you during your playful imitation.
    • Be the Funniest You: Go all out with silly faces, exaggerated sounds, and big gestures. The goal is to capture your baby’s attention and make you irresistible to watch. This playful energy encourages him/her to interact and potentially imitate you back!

    By incorporating these tips, you can turn imitation into a fun and engaging way to boost your baby’s communication skills. I have seen this happen numerous times over the past decades. It is very powerful, go ahead and try it! You cannot be silly and goofy enough!

    Great toy ideas:

    Steel Tongue Drum
    Baby Rainbow Rattle toys
    Organza Veil Fabric good for hide and seek
    Light up magic ball toy wand
    The Glowhouse flashing swivel fan
    Mini portable hand held body massager
    Hape Beaded Raindrops
    Bubbles – always handy keep in every room
    Montessori Mirror
    Antic Duck Peekaboo Knob Puzzle Suction Cup Spinner toys

    Did you know that speech and language development starts with how we talk to our babies?

    Adults naturally use a special way of speaking called motherese. It involves a higher pitch, slower pace, and exaggerated sounds compared to regular conversation. Sentences are simpler, with shorter words and repetition. This grabs babies’ attention, helps them distinguish sounds, and reinforces word meaning.

    Imitation is a key part of motherese. We wait for our baby to make a sound or gesture, then playfully imitate it with exaggeration. Babies notice this right away and often respond with more vocalisations, creating a mini conversation. This back-and-forth teaches turn-taking, a foundation for future conversations.

    By responding warmly and engaging in these playful interactions, we encourage our babies to keep exploring the world of communication. Talking, singing, reading and, of course, imitating, these simple actions can have a big impact on a baby’s language development.

    Once your conversation is underway then try and keep it going for as long as possible. It’s a beautiful dance of turn-taking, even without words!

    A last word on oxytocin

    There’s evidence suggesting early non-verbal communication with your baby can increase a mother’s oxytocin levels, often called the ‘love hormone’. This hormone plays a key role in bonding and social connection. Positive interactions, touch, and stress reduction all contribute to oxytocin release, strengthening the mother–baby bond.

    For parents of babies with extra needs

    The stress of caring for a child with medical needs or developmental delays can be difficult. Stress can lower oxytocin levels, creating a cycle of sadness for both parent and child.

    Breaking the cycle:

    1. Knowledge is Power: Understanding the importance of communication can empower parents.
    2. Seek Support: Speech therapists and other healthcare professionals can provide valuable guidance on communication strategies.
    3. Start Small, Celebrate Big: Even small interactions can boost oxytocin. Focus on playful imitation and positive reinforcement. Remember, friends, family and healthcare professionals are there to encourage you.

    This approach can help reverse the negative cycle and create a more positive and connected relationship between parent and child.

    I hope this is helpful! Don’t hesitate to reach out with any questions.

    Kind regards

    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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  • Why imitation is a powerful strategy to support social communication

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    Before reading this blog, it’s important to understand what we mean by ‘social communication’ and ‘imitation’. Social communication is more complex than it first appears. It refers to many aspects of communication such as body language, voice, conversational skills, social ‘rules’ (such as being polite and using manners), interpersonal skills (such as developing friendships), and emotional literacy (such as appropriacy and developing self-awareness). Imitation refers to the simple act of copying.

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    How will copying my child develop their social communication?

    1. If your child is already engaged with a certain activity, they are already interested and motivated. You’re not competing for their attention.
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    1. Start with observing them. Take the time just to watch. You don’t need to make notes. Sit back and observe their actions, movements, and sounds they make.
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    This may sound daunting, but it doesn’t have to be. Start with a ten-minute time frame where you choose to copy your child. This is where you can practise your imitation strategy. Ten minutes a day is far more effective than an hour every two weeks. You may feel self-conscious but trust the process. Build your confidence, whilst exposing your child’s to increased language and communication, enabling them to develop vital social communication skills.

    Look at the video above to watch the strategy in action!

    Support is only a click away. I’m here to help.

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    Principles of motor learning in Childhood Apraxia of Speech (CAS)

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    We use powerful motor learning principles to help children with CAS (Childhood Apraxia of Speech) learn how to produce better, clearer speech sounds in words, phrases and sentences.

    What are these principles?

    Principle 1: MASSED PRACTICE

    This is where you see a child for lots of sessions in a shorter period of time, so for instance six weeks of three times weekly for 30 minutes.

    This leads to motor performance or automaticity.

    Principle 2. DISTRIBUTED PRACTICE

    This is what I use, as most of my clients are not able to come and see me that often on a weekly basis. It is hard to travel in London and life is hectic. So I favour one session a week over say a term or two terms and a session is usually 45 minutes long.

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    Principle 3: Constant vs Variable

    Principle 4: Blocked vs Random

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    Example

    Here in the video clip, we try and work the /e/ vowel in short words likes ‘bell’, ’fell’, ‘dell’, ‘sell’, ‘smell’ and I am using an AAC device to give a child’s voice as auditory feedback as well as using the PROMPT approach to help my student shape his vowels.

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    Please feel free to contact me if your child has speech sound difficulties. It is my passion. I love supporting children with apraxia.

    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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    Halloween without the tears: Supporting children through the Spooky Season

    ByLondon Speech and Feeding

    For many families, Halloween is an exciting time filled with costumes, decorations, and sweets. But for children who are sensory sensitive, whether they’re autistic, have sensory processing differences, or simply find new experiences overwhelming, Halloween can feel like a night of chaos rather than fun.

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    • Loud sounds like doorbells, fireworks, or shrieking decorations.
    • Crowds and unpredictability during trick-or-treating.
    • Strong smells or tastes from face paint or unfamiliar sweets.

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    Step 1: Choose costumes wisely

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    • Skip the mask: Face paint can be equally challenging, always test on a small patch of skin first. A comfortable headband or hat might be enough to feel ‘in costume.’

    Remember, participation doesn’t require perfection. Your child can still ‘be’ their favourite character without a full costume.

    Step 2: Plan your Halloween environment

    Before the big day, think about what parts of Halloween your child enjoys — and what might overwhelm them.

    At home:

    • Keep decorations minimal and predictable. Avoid motion-activated sounds or flashing lights.
    • Practise knocking at your own front door or saying ‘trick or treat’ with a trusted adult.
    • Have a ‘quiet space’ ready, a cosy corner or room where your child can retreat if things get too intense.

    If you’re going out:

    • Choose earlier, quieter times for trick-or-treating.
    • Visit a few familiar houses instead of the whole street.
    • Bring ear defenders or noise-cancelling headphones.
    • Have a clear exit plan if your child needs a break.

    Sometimes, watching from the window and handing out sweets can be just as enjoyable! it still offers social participation without sensory overload.

    Step 3: Prepare socially and emotionally

    Halloween involves a lot of unexpected social interaction: strangers at the door, unfamiliar greetings, and different rules.

    Help your child by:

    • Using visuals or stories: Read picture books about Halloween or make a short social story about what will happen.
    • Role-playing: Practise saying ‘Trick or treat!’ or handing out sweets in a fun, low-pressure way.
    • Labelling feelings: Explain that it’s okay to feel nervous or to take a break if something feels ‘too loud’ or ‘too much.’

    Children feel safer when they know what to expect. Predictability reduces anxiety and makes participation more enjoyable.

    Step 4: Rethink the treats

    Not every child enjoys sweets; some dislike sticky textures or strong flavours. Offer non-food alternatives like stickers, glow sticks, or small toys.

    If your child has feeding difficulties or oral sensitivities, it’s okay to opt out of the traditional treats entirely. They can still join in by giving treats or decorating treat bags instead.

    It’s also helpful to prepare your child that others might offer sweets they don’t want. Practising polite ‘no thank you’ responses can make these moments easier. (check out my symbol download for children who struggle to speak)

    Step 5: Celebrate your way

    Halloween doesn’t have to look like anyone else’s version. Maybe your family watches a ‘not-too-scary’ film, carves pumpkins, or does a flashlight treasure hunt indoors. The goal is joyful connection, not conformity.

    A calm, happy experience, even if it looks simple from the outside builds positive associations your child will carry into future celebrations.

    In summary

    Halloween can be full of sensory surprises, but with empathy, planning, and flexibility, it doesn’t have to end in tears.

    The more you adapt to your child’s sensory needs, the more they learn that they are safe, understood, and included not just at Halloween, but in every celebration.

    As with all things in speech and feeding development, progress starts with connection. When children feel regulated and supported, communication and confidence follow.

    HAPPY HALLOWEEN!

    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.

    2

  • Why I love ‘Colourful Semantics’ in speech therapy

    ByLondon Speech and Feeding

    One of the most common concerns parents bring to speech and language therapy is:
    ‘My child understands so much… but they struggle to put sentences together’.

    Some children use only single words.
    Others miss out key parts of sentences.
    Some mix up word order.
    Others find it difficult to answer questions or explain their ideas clearly.

    This is where one of my favourite therapy approaches can be incredibly powerful: Colourful Semantics.

    Colourful Semantics is a highly effective and evidence-informed way of supporting children to build stronger sentence structure, grammar, understanding, and expressive language skills.

    It is a visual approach to language development originally created by a UK Speech and Language Therapist, Alyson Bryan in 1997 to help children understand how sentences are organised.

    Different parts of a sentence are represented by different colours.

    For example:

    • Who? is orange.
    • What doing? is yellow.
    • What? is green.
    • Where? is blue.

    As children progress more colours are added:

    • To Whom? Is pink.
    • Adjectives (what like) is purple.
    • Time Phrase is brown.

    Using colours gives children a visual framework for building sentences in a way that feels structured, predictable, and achievable.

    Instead of language feeling abstract and overwhelming, children can see how sentences fit together.

    For many children, this is massively helpful as it gives structure and predictability.

    Why some children struggle with sentences

    Language development is incredibly complex.

    To build a sentence, we need to:

    • think of vocabulary
    • organise grammar
    • sequence words
    • understand meaning
    • remember sentence structure
    • physically say the words clearly enough to communicate

    That is a huge amount happening all at once.

    Some children may:

    • leave out verbs
    • miss pronouns
    • use immature grammar
    • struggle with word order
    • rely on very short phrases
    • find it difficult to expand beyond single words.

    For example:

    • ‘Boy jump’
    • ‘Him eating’
    • ‘Dog there’
    • ‘Want juice’.

    These children often know more than they can express.

    Colourful Semantics helps bridge that gap.

    Why visual supports matter

    Many children—especially those with language delays, developmental language disorder (DLD), autism, or social communication difficulties—benefit enormously from visual support.

    Visual systems reduce the processing load.

    Instead of relying only on spoken language, children are given an additional way to organise information.

    The colours act almost like ‘anchors’ for language.

    A child may begin to understand:

    • orange = who
    • yellow = action
    • green = object
    • blue = place.

    This makes sentence building more concrete and less overwhelming.

    It also supports children who struggle with:

    • attention
    • auditory memory
    • processing spoken language
    • sequencing
    • confidence using language independently.

    Supporting sentence expansion naturally

    One of the things I love most about Colourful Semantics is how flexible it is.

    It can be used:

    • in play
    • with books
    • during conversation
    • with picture scenes
    • in storytelling
    • during movement activities
    • within everyday routines.

    Therapy does not need to feel rigid or worksheet-heavy.

    Many children who usually avoid talking become much more willing to attempt longer sentences when they feel successful.

    Children often begin to use:

    • verbs more accurately
    • pronouns more consistently
    • better word order
    • improved sentence organisation
    • and more complete ideas.

    For example, instead of:

    • ‘Him running’

    A child may gradually move toward:

    • ‘He is running.’

    The colours help children understand the ‘jobs’ words have within a sentence.

    This is particularly useful for children who need explicit teaching of language structure rather than simply learning through exposure alone.

    Supporting children with speech difficulties too

    One thing I particularly value in therapy is approaches that support multiple communication areas at once.

    Colourful Semantics is excellent for this.

    While building sentences, we can also naturally target:

    • speech sounds
    • intelligibility
    • vocabulary
    • social communication
    • turn-taking
    • attention and listening
    • confidence speaking.

    For example, if a child is working on the /K/ sound, we might intentionally build sentences containing target words:

    • ‘The cat is coming.’
    • ‘The boy is kicking.’
    • ‘The duck is in the box.’

    This allows speech and language goals to work together rather than separately.

    Therapy becomes more functional, meaningful, and engaging.

    Building confidence through success

    One of the biggest barriers many children experience is not simply language difficulty. It is the emotional impact of struggling to communicate.

    Some children become frustrated.
    Others withdraw.
    Some stop attempting longer sentences altogether because communication feels too hard.

    Colourful Semantics can help rebuild confidence because it gives children a clear structure for success. That feeling matters enormously.

    When children feel successful, they participate more.
    They attempt more.
    They communicate more.

    And communication grows through communication.

    Why I use colourful semantics

    There is no single ‘magic’ therapy approach for every child.

    But Colourful Semantics remains one of the most versatile and effective tools I use because it can be adapted so beautifully to individual children.

    It supports:

    • early language
    • grammar
    • sentence structure
    • comprehension
    • expressive language
    • storytelling
    • confidence
    • functional communication.

    Most importantly, it helps children organise language in a way that finally starts to make sense to them.

    And when language starts to make sense, communication can truly begin to flourish.

    Contact me via my contact form if you would like me to work with your child.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Reference

    Bryan A (1997) Colourful semantics. In: Chiat S, Law J, and Marshall J (eds) Language disorders in children and adults: psycholinguistic approaches to therapy. London: Whurr, 143–61.

    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

  • A Day In The Life Of An Independent Speech And Language Therapist

    ByLondon Speech and Feeding
    A Day In The Life Of An Independent Speech And Language Therapist

    A Day In The Life Of An Independent Speech And Language Therapist

    I often get asked how many clients/children I see per working day or what my working day/life looks like. I always reply that every day is different, which is true, but there is a sort of average working day which looks a bit like this:

    I usually start preparing for my first client of the day at around 9.30 am: I clean the room, wipe down all the toys and materials (that’s if they are coming to my clinic room) and then it takes me about 30 minutes to select and sometimes make suitable materials, games and activities for the child’s therapy programme. Client arrives at 10.30 am and the fun begins. They leave around 11.30am, and the cleaning and wiping down starts again – yes it’s the pandemic but to be fair I would do this anyway. I quickly write up my notes and send home work to the client via email. Now it’s 12 noon and I start preparing for the next client at 12.30 pm. This might be online parent-child interaction coaching and so I need different materials and activities that are suitable for teletherapy. We finish around 1.30 pm and I will write up my notes before having some lunch.

    Lunch tends to not be around 30 minutes. Around 2.00 pm I start prepping again for the next client: selecting activities, going over their last session, making sure I have everything I need to start at 2.45pm – we finish at 3.45pm, I write up my notes and then have a cuppa. The next client might be more on-line coaching or a child coming to see me: room cleaned and tidy, materials and activities prepared: client arrives at 4.30 pm and we finish at 5.30 pm. I clean the toys again, write up my notes and it is 6.00 pm ready for dinner. So that was four clients between 9 am and 6pm allowing for preparation, aftercare, cleaning and coffee and lunch.

    Other days I might see three clients and do more admin like ordering toys or books or teletherapy activities, or making materials (we therapist make tons of materials, we’d put Blue Peter to shame!) Sometimes I do two home visits, one in the morning and one in the afternoon – the travelling/parking in London is so time consuming that it really reduces the number of clients I can see which is why I don’t do many of those.

    I hand pick my clients to make sure that we are a good fit, and my service is bespoke: no one client gets the same treatment as another; each client is unique, usually very well-known and always highly valued. That takes time and means that in reality each client gets about 2 hours of my time, that is the actual session plus all the preparation and aftercare.

    I love this way of working and would not ever want to return to seeing tons of clients each day, not knowing any of them really well, due to high caseload numbers, staff shortages and an overload of administration.

    My way of working affords all my lovely clients the help they need to be able to feel empowered and to then support their children to make progress; when working with children they make the best progress they can make, fulfilling their potential. My lovely reviews and testimonials tell me that my clients appreciate the extra attention.

    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.