Cued Articulation – using hand gestures to show how a sound is made

ByLondon Speech and Feeding
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Watch how cued articulation can transform your child’s speech and language skills!

Cued Articulation involves using specific handshapes and placement cues to guide the speaker’s articulators, such as the tongue, lips, and teeth, to produce accurate sounds. It was originally conceptualised by Jane Passy, a speech-language pathologist. But it is important to know that we can, and often do, also use other speech cues which help our student visualise what they need to do. In other words, we can mix and match our cue pictures depending on what works best with each student.

In the beginning of my speech therapy practice I would stick religiously to Jane Passy’s method but over the years I have learned and used many different visual hand cues which all have worked with individual students.

It is important to remember that this is not an exact science, rather than an art! The art is to find the key to each individual student’s understanding and inspire motivation to try out a sound which they find hard to do.

As an example, the hand signs used by Caroline Bowen’s method, an Australian Speech-Language Pathologist, are quite different to Jane Passy’s signs but they can equally work very well. Caroline Bowen’s visual for the /r/ sound is the ‘rowdy rooster’ — a crazed rooster on a motorbike — and the hand signal is that of revving up the motor bike engine with both hands whilst trying out the /r/ sound! I have a good handful of students who really loved this rooster image and were able to eventually produce a good /r/ using this cue.

So, it is horses for courses with many things, and visual images and hand cues are no exception!

Sound picture cards:

Again, there are a host to choose from and I tend to collect a number of different images for each sound I want to practise with my student. As an example, below are a couple of different examples I use for the sound /p/:

The Nuffield Programme suggests to use this popper card, which works well with a student who knows these poppers and perhaps has one on their trousers.

As an alternative, and especially for younger students, I like using the Popper Pig Card – which I also have in my room so I can quickly show how it pops. Or we can have a popping game in between saying the /p/ sound at times. (The popper card is great as I can use the real toy to help with conveying the /p/ sound as it pops.)

Each card has its own merit and I choose the right card for the individual student.

How I use cued articulation and the visuals in Speech Therapy

  1. Cueing and practice: I introduce the appropriate card and handshapes for the targeted sounds. We then practise producing the sounds.
  2. Reinforcement and feedback: Positive reinforcement encourages progress and builds confidence.
  3. Fading out the cues: Once my student is able to say the sound more easily, we can gradually fade out the speech cues.

Benefits and effectiveness

Using Cued Articulation and Speech Image Cards has been shown to be effective in improving speech production for individuals with various speech and language disorders, including:

  • Articulation disorders: Difficulty producing specific sounds accurately.
  • Apraxia of speech: A motor planning disorder that affects the ability to sequence and coordinate movements involved in speech.
  • Phonology disorders or delays: Confusion and delays in how sounds are organised in categories to convey meaning, errors in sound patterns, for example front sounds are produced at the back, or long sounds are produced as stops.
  • Stuttering: A fluency disorder characterised by interruptions in speech, such as repetitions and prolongations.

Tips for parents and student speech therapists

Parents can play a crucial role in supporting the implementation of cued articulation at home and in therapy sessions. Here are some tips:

  • Collaborate with your SLT: Good feedback and communication with the Speech and Language Therapist creates consistency and progress..
  • Practise Regularly: Encourage consistent practice of cued articulation at home to reinforce learning.
  • Use Visual Aids: Use the same visuals that your therapist uses in the speech clinic to help your child at home with recall and practice.

Feel free to contact me if you need help with your child.

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.

    The bright lights, unexpected noises, strange textures, and social pressure to ‘join in’ can quickly become too much. The good news? With some thoughtful planning and gentle support, you can make Halloween a positive and manageable experience for your child.

    Understanding sensory overload

    Sensory overload happens when a child’s brain receives more sensory input than it can process. This might mean:

    • Costumes that itch, squeeze, or feel strange on the skin.
    • 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.

    When overloaded, children may cry, cover their ears, hide, run away, or ‘shut down.’ These reactions aren’t ‘bad behaviour’, they’re signs of distress. The goal isn’t to eliminate Halloween fun, but to adjust it to your child’s comfort level.

    Step 1: Choose costumes wisely

    Costumes are often the biggest trigger. Scratchy fabrics, tight seams, or masks that restrict breathing can be unbearable for some children.

    Try these tips:

    • Go sensory-friendly: Use soft, breathable fabrics and remove tags. Many retailers now sell sensory-safe costumes.
    • Test it early: Let your child wear the outfit around the house before Halloween. If it’s too much, simplify — maybe themed pyjamas or a favourite T-shirt with Halloween accessories.
    • 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
  • · · ·

    The quiet power: Why silence and responsiveness boost communication in children with delays

    ByLondon Speech and Feeding
    The quiet power: Why silence and responsiveness boost communication in children with delays
    Supplied by Sonja McGeachie, Practice Owner

    As parents and caregivers, our natural instinct when interacting with a child, especially one who struggles with communication, is often to fill every silence. We might ask lots of questions, offer constant commentary, or try to prompt him or her to speak. Our hearts are in the right place. We want to help him or her communicate! However, for children with language delays or those on the autism spectrum, this well-intentioned approach can sometimes inadvertently create more pressure and fewer opportunities for them to truly initiate and develop their own communication skills.

    What if I told you that one of the most powerful tools in your communication toolkit is often silence? And that responding to your child, rather than always initiating, can unlock incredible potential?

    Let’s explore why these seemingly simple strategies are so profoundly beneficial.

    The unspoken benefits of silence

    In our fast-paced world, silence can feel awkward, but for a child who is processing language differently, it’s a gift:

    1. Time to process: Children with language delays often need more time to process what they hear and to formulate their own thoughts or responses. When we bombard them with words, we don’t give their brains the crucial milliseconds they need to catch up. A pause of 5–10 seconds can make all the difference.
    2. Reduces pressure: Constant questioning or prompting can feel like a test. Silence removes this pressure, creating a more relaxed environment where the child feels safe to communicate without fear of being ‘wrong’ or rushed.
    3. Creates opportunity to initiate: If you’re always talking, when does your child get a turn to start the conversation? Silence opens up a space for him or her to initiate, whether it’s through a sound, a gesture, eye contact, or a word. This is vital for developing spontaneous communication.
    4. Encourages independent thinking: When a child is given space, he or she is more likely to try to figure things out himself or herself. This fosters problem-solving skills and reduces reliance on adult prompts.
    5. Prevents overwhelm (especially for ASD): Many children on the autism spectrum can be sensitive to auditory input. A constant stream of language can be overwhelming, leading to withdrawal or challenging behaviours. Strategic pauses can help them regulate and engage more effectively.

    The power of responding (not just initiating)

    Think of a tennis match: if only one person serves, it’s not a game. Communication is a rally, a back-and-forth exchange. When you primarily respond to your child’s communication attempts, you’re teaching him or her the rhythm of conversation:

    1. Follow the child’s lead: This is a cornerstone of effective language intervention, famously championed by programs like Hanen’s ‘It Takes Two to Talk’. When you respond to what your child is already interested in or doing, the interaction becomes immediately relevant and motivating for him or her.
    2. Validates his or her attempts: Every sound, gesture, glance, or partial word your child offers is a communication attempt. By responding to it, you’re telling him or her, ‘I see you. I hear you. Your communication matters.’ This builds immense confidence and encourages him or her to try again.
    3. Builds confidence and motivation: When a child feels understood and successful in his or her communication, he or she are more likely to communicate more often. It’s a positive feedback loop.
    4. Teaches turn-taking naturally: By taking your turn after his or hers, you model the natural flow of conversation. He or she learns that communication is a shared activity, not a one-sided lecture.
    5. Makes interactions meaningful: When you respond to his or her interests, you’re talking about things that are inherently motivating to him or her. This makes the language you use more easily understood and remembered.

    Practical strategies for parents: Observe, Wait, Listen (OWL)

    The Hanen Centre’s ‘Observe, Wait, Listen’ (OWL) strategy perfectly encapsulates these principles:

    • Observe: Watch your child closely. What is he or she looking at? What is he or she doing? What sounds is he or she making? What gestures is he or she using?
    • Wait: After you’ve observed, wait. Give him or her time. Resist the urge to jump in with a question or comment immediately. Count to five (or even ten) in your head. This silence is an invitation for him or her to communicate.
    • Listen: When he or she does communicate (in any way!), listen intently. Try to understand his or her message or intent.

    Beyond OWL – More tips:

    • Reduce questions, increase comments: Instead of ‘What’s that?’ try ‘Oh, a big red ball!’ or ‘The car is going fast!’ Comments provide language models without demanding a verbal response.
    • Expand, don’t just prompt: If your child says ‘Car’, you could respond with ‘Yes, That’s a big car!’ or ‘It’s really fast!’ You’re building on his or her communication with a slightly richer language model.
    • Create opportunities for communication: Place desired items slightly out of reach. This creates a natural reason for your child to communicate his or her wants (e.g., reaching, pointing, vocalising).
    • Respond to all communication: Don’t just wait for words. If your child points, look where he or she is pointing and comment. If he or she makes a sound, imitate it or respond with a related word.

    In summary

    Embracing silence and prioritising responsiveness might feel counterintuitive at first, especially when you’re eager for your child to talk. However, these powerful strategies create a nurturing, low-pressure environment that encourages spontaneous communication, builds confidence, and truly meets your child where he or she is. By giving your child the space and the meaningful responses he or she needs, you’re laying a strong foundation for his or her communication journey.

    Try incorporating these ‘quiet powers’ into your daily interactions and watch your child’s communication blossom.

    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.

    1

  • Help! My child has a lisp. What can we do about it?

    ByLondon Speech and Feeding

    What is a LISP?

    There are different types of LISPS. Let me explain:

    A lisp is the difficulty making a clear ‘S’ and ‘Z’. Other sounds can also be affected by the tongue protruding too far forward and touching the upper teeth or the upper lip even. ‘T’ and ‘D’ can be produced with ‘too much tongue at the front’ and this can also have an impact on ‘CH’ and often also ‘SH’.

    1. Interdental lisp

    Protruding the tongue between the front teeth while attempting ‘S’ or ‘Z’ is referred to as interdental lisp; it can make the speech sound ‘muffled’ or ‘hissy’. Often, we associate a lisp with the person sounding a bit immature. The good news is that this type of lisp is the easiest to correct and, in my practice. I have a 100% success rate with this type of lisp.

    1. Lateral lisp

    In a lateral lisp the person produces the ‘S’ and ‘Z’ sounds with the air escaping over the sides of the tongue. This renders the ‘S’ as sounding ‘slushy’ or ‘wet’. This type of lisp is a bit harder to correct than the interdental lisp. In my experience this can be fixed but it might need a bit longer, more intensive therapy than the interdental lisp.

    1. Palatal lisp

    With a palatal lisp the ‘S’ sound is attempted with the tongue touching the palate, much further back than it should be. The ‘S’ sounds ‘windy’ and ‘hissy’. This is a quite rare lisp production but it is also not difficult to correct.

    These types of speech difficulties come under the category of ‘speech delay of unknown origin’ and may persist into adolescence and adulthood as ‘residual errors‘.

    Some thoughts on Treatment in general:

    Lisps can be treated successfully by a Speech and Language Therapist. However, for the treatment to work well, a student needs to be able to cooperate and want to improve his or her speech. Lisp remediation entails a fair amount of repetitive work and very young children or unmotivated older children don’t make the best candidates for treatment for this reason. Often students present with other speech, language or social communication difficulties and here the lisp might not be the priority for treating. For example, it might be that due to a student’s Attention Deficit Disorder they are simply not able to focus on speech practice in their daily life.

    When should treatment of lisp begin?

    Waiting well past 4½ years is not advisable as the longer we wait and do nothing the stronger engrained the erroneous tongue/speech habit will become. The ‘right’ age for therapy for one child may be different from the ‘right’ age for another child even within the same family. So do make an appointment with a speech and language therapist to assess and see whether your child might be ready to start therapy.

    Do lots of children lisp—is it normal?

    Until the age of about 4–4.5 years old it can be a perfectly normal developmental phase for some children to have the interdental lisp. But when we see and hear a lateral or palatal lisp we ought to act and see a speech and language therapist for sure.

    After the age of 4.5 or 5 years old most speech therapists would agree on at least having a look to see if treatment could be started. The longer we wait the harder it is to retrain the brain pathways to adopt new speech habits.

    What happens during the first Speech and Language Consultation?

    The first consultation takes about an hour and involves screening relevant areas of communicative function. We take a detailed history, examine the anatomy of the child’s mouth and tongue movements. We check for tongue tie, teeth formation, palate structure and function, as well as swallowing patterns.

    Then we begin straight away to try and see if any of the alveolar sounds (T/D/L/N) can be produced correctly with the right tongue placement as that would be the starting point from where to shape a good, clear ‘S’ sound.

    The first consultation usually ends with home practice being given, explained to parents and another appointment being made for follow up.

    Therapy – what does a session look like?

    Each therapy session consists of:

    1. Listening to sounds, discriminating sounds, identifying sounds, listening to rhyming sounds, sound awareness. We call this Auditory discrimination of single sounds: can the student hear the difference between two words that are the same apart from the first sound: ‘sing’ and ‘thing’ or ‘sigh’ and ‘thigh’?
    2. Sound production: using a variety of different prompts and cues we will teach how to physically make the new sound. Often, we work on making a NEW sound, instead of correcting the OLD one. We work on imitation of single sounds then gradually we try and make new sounds in short words, then longer words and then phrases and sentences.
    3. Games! We play games and try and have fun in between listening and producing our new sounds to help students stay motivated and even enjoy the therapy session and process.

    How long does it take to ‘fix up’ a lisp?

    It tends to take about one term with weekly sessions to help a student make good ‘S’ sounds in phrases and sentences. If the student can do the home practice every day in between the weekly sessions, then in most cases I am able to pronounce the lisp as ‘fixed’ after about one term.

    After that the student needs to practise, practise, practise, at home and in daily life to keep reminding themselves of their new skills and their new sound production.

    It is a matter of reminding and wanting to get it right. Occasionally a student returns to me for another term of simply practising their skills together with me as they are finding it hard for any number of reasons to practise at home. But generally, 8/10 students will be fine after some 12–13 sessions and their speech will be perceived as perfectly typical by family and friends.

    If your child has a lisp or any other speech error, 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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  • · ·

    From ‘Nailed it!’ in therapy to ‘Whoops!’ at home: Why generalising speech sounds is tricky

    ByLondon Speech and Feeding

    As a parent, you’ve likely experienced the triumphant feeling when your child, who’s been working so hard on his or her /S/ sound, produces it perfectly in a therapy session. He or she is rocking those ‘sun’ and ‘socks’ words, his or her lisp seemingly a distant memory. You leave feeling elated, confident that all that hard work is finally paying off.

    Then you get home. And within minutes, you hear it: ‘Thooper!’ instead of ‘Super!’ Or maybe the clear /R/ in ‘rabbit’ from therapy reverts to a ‘wabbit’ when his or she is playing with his or her toys. It’s frustrating, confusing, and can feel like you’re back to square one.

    So, what’s going on? Why is it so difficult for children to take those amazing skills learned in a focused therapy session and seamlessly apply them to their everyday conversations? You’re not alone in wondering this. It’s a common challenge in speech therapy and understanding the ‘why’ can help both parents and children navigate this crucial stage.

    The brain’s habits: Old pathways are strong pathways

    Think of your child’s brain as having established ‘pathways’ for how he or she produces certain sounds. If he or she has been lisping his or her /S/ sound for years, that neural pathway is deeply ingrained. It’s like a well-worn path through a field: easy to follow because it’s always been there.

    In therapy, we’re essentially trying to forge a new path. We’re teaching him or her a new, more accurate way to make the sound. This new path is initially faint, like a barely visible trail. It takes conscious effort and repeated practice to strengthen it. Outside of the structured therapy environment, his or her brain often defaults to the old, comfortable, and well-established pathway, even if it’s not the most accurate.

    The demands of daily conversation: A multitasking challenge

    Therapy sessions are designed to be focused and controlled. We isolate sounds, practice them in specific words, and provide immediate feedback. There are minimal distractions, and your child’s full attention is on his or her speech production.

    Now, consider daily conversation:

    • Speed: We speak much faster in natural conversation than we do during structured practice. There is less time to think about individual sounds.
    • Cognitive load: Children are simultaneously thinking about what they want to say, understanding what others are saying, processing social cues, and managing their emotions. Adding the conscious effort of producing a new speech sound correctly on top of all that is a huge cognitive demand.
    • Variety of contexts: In therapy, we might practise ‘sun’ and ‘socks’. In real life, the /S/ sound appears in countless words, in different positions within words, and alongside a vast array of other sounds. Each new word and phonetic context present a fresh challenge.
    • Lack of immediate feedback: In therapy, the speech therapist is right there to provide instant correction and reinforcement. In a playground, during a family dinner, or while playing with friends, that immediate, consistent feedback isn’t present.

    The role of automaticity: Making it second nature

    The ultimate goal of speech therapy isn’t just correct sound production; it’s automaticity. This means producing the sound correctly without having to consciously think about it. It’s like learning to ride a bike. Initially, every pedal stroke and steering adjustment is deliberate. Eventually, it becomes second nature.

    Generalisation is the process of moving from conscious, controlled production to unconscious, automatic production. This takes time, consistent practice, and exposure to a wide variety of real-life speaking situations.

    How can we help? Bridging the gap

    So, what can parents do to help their children bridge this gap between therapy success and everyday speech?

    1. Be patient and positive: This is a marathon, not a sprint. Celebrate the small victories and avoid getting discouraged by setbacks. Your positive reinforcement is crucial.
    2. Practise little and often: Instead of long, infrequent practice sessions, aim for short, consistent bursts throughout the day. ‘Sprinkle’ in opportunities to practise their target sounds in natural conversations.
    3. Create ‘sound awareness’ moments: Gently draw your child’s attention to his or her target sounds in everyday words. For example, if he or she is working on /R/, you might say, ‘Oh, you said ‘wabbit.’ Can you try to make your /RRR/ sound for ‘rabbit’?’
    4. Model correct production: Continue to model the correct production of their target sounds in your own speech.
    5. Collaborate with your speech therapist: Your therapist is your best resource! Ask them for specific strategies and activities you can do at home to support generalisation. They can also provide guidance on when and how to gently correct your child.

    Tips and tricks

    Below I have listed a few good tips and tricks that can help the transition from therapy room to daily life:

    Empowering your child as the ‘sound detective’:

    • ‘Secret sound listener’: Instead of you doing the correcting, make your child the detective. When you’re having a conversation, say ‘your /S/ sounds are sometimes a bit “slippery”’ (or whatever fun, non-judgmental term you like). Ask your child to quietly listen for your /S/ sounds. You can even purposely make a few ‘slippery’ ones (or correct yourself immediately after) and see if they notice. This shifts the focus from being corrected to actively listening and identifying the sound in a non-threatening way.
    • ‘Sound scorecard’: For a short period (maybe 10–15 minutes during a specific activity, like dinner or a game), provide a small notepad and pencil. Explain that your child is going to listen for his or her /S/ sounds and gently mark a tally every time he or she uses it correctly. The goal isn’t perfection, but awareness. This gives your child agency and a visual representation of progress. You can even make it a game: ‘Let’s see how many /S/ sounds we can catch in five minutes!’
    • /S/ sound song/rhyme creation: Work together to create silly songs or rhymes that are packed with /S/ sounds. The sillier, the better! You can sing them in the car, while doing chores, etc.
    • /S/ sound superpower: Frame the new sound skill as a ‘superpower’. ‘You’re getting so good at using your /S/ superpower! It’s going to help you speak so clearly and confidently.’
    • Highlighting successes: Always go out of your way to acknowledge and praise successful /S/ productions in natural conversation. ‘I really understood you clearly when you said ”s_top”.’ or ‘That /S/ sound was perfect when you told me about the “s_tory”!’

    Important considerations:

    • Keep it low-pressure: The goal is generalisation, not perfection. If your child is feeling pressured, he or she will likely revert to old patterns.
    • Focus on awareness, not just correction: Help your child become aware of his or her own speech rather than relying on you for corrections.
    • Short, frequent bursts: A few minutes of subtle focus multiple times a day is more effective than one long, forced session.
    • Acknowledge feelings: If your child expresses frustration about ‘being corrected’, validate these feelings. ‘I understand it can feel like a lot of listening, but we’re just trying to help you use that super /S/ sound all the time!’

    By incorporating these strategies, you can help your child naturally integrate the new /S/ sound into daily speech, fostering independence and confidence without it feeling like constant ‘testing’ or ‘correction’. Generalising new speech sounds is arguably the hardest part of speech therapy, but it’s also the most rewarding. With patience, consistent effort, and a collaborative approach between parents and therapists, children can successfully integrate their new, clearer speech sounds into every aspect of their daily lives.

    Any comments or if you need help and support with your child’s speech please do not hesitate to get in touch with me: simply fill out the contact form here on the website. I endeavour to reply within 48 hours.

    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.

    1
  • ·

    Explore how Intensive Interaction develops Autistic children’s communication

    ByLondon Speech and Feeding

    Intensive Interaction is an approach that I might suggest for your child. Here is an overview of this approach to increase your knowledge. There are a range of approaches that overlap and having trained in them all I use them all interchangeably to tailor to each child individually. This approach is particularly good for children who work mostly to their own agenda and find it hard to engage with others.

    So, what is Intensive Interaction?

    According to its founder, Hewett (1980), the approach “involves mirroring a person’s actions, sounds and facial expressions.” This allows your child to recognise and form communication between themselves and another, in a fun, play-based setting. Attention and listening are the fundamentals to speech and language development. By using the Intensive Interaction approach, we can increase the time your child can attend for and with another person. We are working towards a child enjoying another person’s presence. We are hoping to make gains with playing together with a child, taking turns and achieving reciprocity. That is the platform which we need to start with to build communication, language, words and perhaps even speech.

    There are many aspects that this approach supports:

    • such as using facial expressions
    • being in the presence of other people
    • having a shared space
    • attending to others
    • recognising and using non-verbal behaviours (e.g., gestures)
    • making sounds/noises (vocalisations) that have meaning
    • and eye contact. Although, we must be careful when suggesting ‘improving’ the use of eye contact. For some individuals making eye contact can be physically painful. So be aware that we are not making our children ‘look’ we are encouraging their natural behaviour.

    Who benefits from Intensive Interaction?

    Children with more complex communication and learning delay can benefit from the Intensive Interaction approach. Each session can be adapted to the needs of the individual and the sessions can be designed to use the whole or part of the approach. It is especially useful for children who are finding it hard to engage in any way socially with another person. Autistic children who tend to work to their own agenda often benefit from this approach.

    How is Intensive Interaction implemented?

    You need to have an environment that your child is comfortable in, and to be able to come down to their level so that you can see each other. This is why I often visit children in their own homes to ensure that they are comfortable and that they can withdraw for periods of time if they need to as well.

    Ensure your child knows you’re there and you are 100% present. This is very important. I would recommend that you put your phone away for some 10 minutes or so and give your undivided attention to your child for that period of time.

    Waiting

    Waiting is very important: we need to give your child time to process what is happening around them. After waiting for a response, you might want to start copying any gestures they use, any facial expressions they make, or perhaps imitate any sounds. You’ll want to continue with this for a few minutes to see if the communication between you and your child changes. Remember always take the cues from your child; if they communicate a message with you, respond. It might be that they are ready to finish and that they’ve shown this by walking away or signing.

    Giving your child a way to respond is vital. We can use visuals to support their communication. We can create ‘yes’ and ‘no’ symbols so they can use them in a functional way.

    A top tip in these sessions is to use mirrors, so that your child can see and begin to recognise their own facial expressions.

    There are other programmes that overlap with Intensive Interaction such as Hanen with following your child’s lead and the Gina Davies Curiosity Programme.

    Now you know a bit about Intensive Interaction, why not book a call to discuss how we can support your Autistic child’s communication using this evidence-based approach.

    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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    Beyond the teddy bear picnic: Why language development doesn’t always need imaginative play

    ByLondon Speech and Feeding

    As Speech and Language Therapists (SLTs), we are taught from day one that developmental milestones follow a predictable, linear path: first comes functional play, then symbolic and imaginative play (like pretending to feed a teddy bear or talking on a toy phone), and then comes conversational speech.

    But when working with language delayed children, I have seen something that completely contradicts those textbook charts.

    Many of my students have absolutely no interest in doll play, tea parties, or imaginary scenarios. Yet, as they mature, they still manage to develop robust, meaningful, and conversational language.

    How is this possible? And what does it mean for how we approach therapy?

    Redefining the ‘rules’ of play and language

    The idea that imaginative play is a strict prerequisite for language was built entirely on neurotypical developmental data. But neurodivergent brains don’t follow neurotypical roadmaps. That is not a deficit; it’s simply a different processing style.

    When Gestalt Language Processors bypass traditional imaginative play, they aren’t ‘missing’ a step. They are often using entirely different cognitive vehicles to build their language skills.

    The power of monotropic deep interests

    Video clip 2 lining up dinosaurs

    Many autistic individuals have a monotropic cognitive style, meaning they process the world through deep, single-focused passions (think trains, space, dinosaurs or ocean creatures).

    While a neurotypical child might practise social roles by pretending a doll is going to school, a neuro-diverse child practises language by categorising, analysing, and sharing facts about their deep interest. Their language is anchored in the concrete, fascinating reality of their passion, rather than fictional symbolic play.

    Gestalt Language Processing (GLP)

    A significant number of neuro-diverse children learn language in large ‘chunks’ or ‘gestalts’ (such as movie scripts, songs, or favourite phrases) rather than building sentences word-by-word.

    When a child scripts or uses echolalia, they are storing and mapping vast amounts of conversational data. They don’t need to pretend-feed a teddy bear to practise dialogue; they are actively processing the rhythm, intonation, and structural rules of speech through the media and phrases they love. As they grow, they learn to break these scripts apart to form original sentences.

    Structural play is learning play

    Just because a child is lining up dinosaurs or cars, stacking blocks, or spinning wheels instead of making them ‘talk’ doesn’t mean they aren’t learning. This functional and structural play builds crucial foundational skills like pattern recognition, cause-and-effect, and spatial awareness, all of which directly support cognitive and language development.

    Shifting Our Goals

    Meeting our children on their home turf: if that’s dinosaurs, let’s be creative with dinosaurs!

    If imaginative play isn’t the engine driving language, forcing it in the therapy room can quickly turn into an exercise in compliance rather than connection. Instead of trying to pull a child out of their world and into a neurotypical play model, we can meet them exactly where they are!

    Here are three affirming ways to turn deep interests into conversations:

    • Swap questions for comments (declarative language): Instead of interrogating a child about their play (‘What colour is that train? Where is it going?’) make pressure-free observations (‘Wow, that train is moving fast. Look at those wheels spin.’). This lowers conversational anxiety and models natural communication.
    • Bridge and expand: Use their favourite topic to introduce new ideas and concepts. If we love dinosaurs let’s see if dinos can climb up a ladder, slide down a half pipe into some water, then need drying before making footprints across a piece of paper…
    • Validate any scripts or echolalia and find out the EMOTION underlying it: If your child uses a quote from a favourite cartoon clip, let’s try and figure out in what context this phrase was said in the movie; what is the emotion in the movie when the character says this line? Is it upset? Is it joyful? Is it big surprise or a shock? Don’t dismiss it as meaningless. Acknowledge the emotion behind the script ‘You feel worried right now.’ This way we are showing our child that their unique way of communicating is heard and valued.

    So, to sum up:

    Imaginative play is just one way to learn language, not the only way.

    Let’s stop viewing a lack of pretend play as a barrier to communication, and free ourselves to see our children’s true strengths. By embracing their deep passions, we don’t just help them find their voice. We build a real connection that makes communication possible.

    Are you looking for neurodiversity-affirming speech and language support? Contact my clinic today to learn more about how I tailor my therapy to your child’s unique strengths.

    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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