Cycles Approach speech therapy: Why syllables come first

and why it matters more than you might think!

If your child’s speech is difficult to understand, it can feel tempting to focus straight away on individual sounds: those tricky /S/, /K/, or /SH/ sounds that just won’t come out clearly.

But in therapy, we don’t always start there.

When a child is very difficult to understand, and I have ruled out that the underlying cause is motor-based, I often opt for the Cycles Phonological Approach. This is helpful for those kids where we can feel like we don’t know where to start! The Cycles Approach helps to generate a broad overall increase in speech clarity by sequentially targeting a variety of speech patterns over the course of 8–10 weeks.

So rather than working on one sound until it’s ‘fixed,’ we:

  • Work on patterns (not just individual sounds)
  • Target each pattern for a short period of time
  • Then cycle to the next one
  • And come back around again later

This mirrors how speech development naturally happens: gradually, with increasing accuracy over time.

Why don’t we start by fixing erroneous sounds straight away?

To use a metaphor, if a child doesn’t have a strong syllable structure, working on individual sounds is like decorating a house that doesn’t have solid walls yet.

Many children with speech sound difficulties:

  • Drop syllables (e.g. ‘banana’ → ‘nana’)
  • Simplify longer words
  • Struggle to maintain rhythm and stress patterns

So, before we refine speech sounds, we need to build the framework of speech.

Why syllables come first in every cycle

In the Cycles Approach, we always begin with 2- and 3-syllable words, even if that’s not the main concern.

Why?

Because syllable awareness supports:

  • Speech clarity (intelligibility)
  • Word structure and sequencing
  • Prosody (rhythm and stress)
  • Motor planning for longer words

Without this, even perfectly produced sounds can still be hard to understand in real speech.

What do ‘2 and 3 beats’ mean?

When we talk about ‘beats’ we mean syllables you can clap.

Try it:

  • ‘Table’ → ta-ble (2 beats 👏👏)
  • ‘Banana’ → ba-na-na (3 beats 👏👏👏)

In therapy, we help children:

  • Hear the beats
  • Feel the rhythm
  • Produce the full word (without dropping parts)

What this looks like in therapy

In my sessions, this part of the cycle is active, visual, and repetitive.

You might see me using:

  • 👏 Clapping or tapping out syllables
  • 🧩 Using visual supports or blocks for each beat
  • 🎲 Play-based repetition of target words
  • 🎯 High-frequency practice (lots of turns!)

I also keep the focus on success and flow, rather than correction.

If you’re watching the video clip I’ve shared here, you’ll notice:

  • I’m not over-correcting every sound
  • I’m prioritising getting the whole word out
  • I’m building rhythm, confidence, and consistency

Why this stage is so powerful

It can look simple, but it’s doing a lot of heavy lifting.

Working on syllables helps children:

  • Say longer words more clearly
  • Reduce ‘mumbling’ or collapsing of words
  • Improve overall intelligibility quickly
  • Prepare for more precise sound work later

Often, parents notice early wins like:

✨ ‘They’re easier to understand already’

✨ ‘They’re saying longer words!’

✨ ‘They’re more confident speaking’

And that’s before we’ve even fully targeted specific sounds.

But will my child still learn their sounds?

Yes. Absolutely.

The Cycles Approach is structured so that after syllables, we move into:

  • Early developing sounds
  • Then more complex patterns (like fronting or clusters)

And  importantly, we come back around again.

Nothing is missed. It’s just sequenced in a way that supports success.

A different way of thinking about progress

One of the biggest mindset shifts with the Cycles Approach is this:

👉 We’re not aiming for perfection straight away

👉 We’re aiming for gradual system-wide change

That means:

  • Your child doesn’t need to ‘master’ something before moving on
  • Progress builds across cycles
  • Speech becomes clearer over time, not overnight

So, to sum up

Starting with syllables might seem unexpected but it’s one of the most powerful foundations we can give a child whose speech is hard to understand.

By building rhythm, structure, and confidence first, we make everything that comes next more effective.

If your child is starting speech therapy and you notice we’re clapping words like ‘banana’ or ‘elephant’, there’s a very good reason for it.

We’re not going backwards.

We’re building from the ground up.

We’re making later sound work more effective and more likely to generalise into everyday talking.

Next steps:

If you’re concerned about your child’s speech clarity or wondering whether they might benefit from a structured approach like this, feel free to get in touch. I offer individualised assessments and therapy plans tailored to each child’s speech profile whether that’s early sound development, phonology, or motor speech difficulties.

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.

Parent FAQ section

Why is my child practising words like ‘banana’ instead of sounds like /K/ or /S/?

Because your child first needs to be able to hold and produce the full shape of a word. If they’re dropping syllables (e.g. ‘banana’ → ‘nana’), working on individual sounds won’t carry over into real speech. We build the structure first, then refine the sounds.

What if my child can already say some long words?

That’s great. But we’re looking for consistency and clarity across many words, not just a few familiar ones. This stage helps stabilise that skill so it becomes reliable in everyday talking.

How long will we stay on syllables?

Usually, this is a short but important phase within each cycle. We revisit it regularly, but we also move on to other patterns (like specific sounds or sound processes) within the same therapy block.

Will this delay my child learning their sounds?

No. In fact, it often speeds things up overall. Once the syllable structure is in place, children are much more able to use correct sounds in longer words and sentences.

What can I do at home?

Keep it simple and playful:

  • Clap out words together (e.g. ‘el-e-phant’)
  • Emphasise full words naturally in conversation
  • Repeat back what your child says with the full structure (without pressure)

Consistency and exposure matter more than correction.

My child gets frustrated. Will this help?

Yes. Many children become frustrated when they’re not understood. Improving syllable structure often leads to quick wins in clarity, which can boost confidence and reduce that frustration.

Building clearer speech: Why we practise syllables first

What are syllables?

Syllables are the ‘beats’ in words.

  • ‘Table’ = 2 beats (ta-ble)
  • ‘Banana’ = 3 beats (ba-na-na)

Why is my child working on this?

If your child:

  • Drops parts of words (‘banana’ → ‘nana’)
  • Mumbles longer words
  • Is hard to understand

…then we need to build the structure of words first.

This helps your child:

✔ Say longer words clearly

✔ Be easier to understand

✔ Feel more confident speaking

What does this look like in therapy?

We practise:

  • Clapping or tapping out beats 👏
  • Saying full words with rhythm
  • Repeating target words through play
  • Using visuals or actions to support learning

How you can help at home

Keep it light and playful, little and often!

Try this:

  • Clap words together أثناء play (e.g. toys, food, animals)
  • Model full words naturally (‘Yes, ba-na-na!’)
  • Repeat and expand what your child says

Example:

Child: ‘nana’

You: ‘Yes! Ba-na-na‘

Important to know

  • This is a key first step in speech therapy
  • We will move on to sounds—but this helps them stick
  • Small changes here can make a big difference in clarity
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  • ·

    Tongue training: Why tongue placement matters for clear speech

    As speech and Language therapists (SLTs), we know that where your tongue goes, so goes your sound. This blog post will explore why tongue placement is so vital for speech correction and how we use tools and techniques to help our clients find their ‘sweet spot’ for sound production.

    Let me show you here a little video clip where I am using my dentist’s mouth/teeth model to help my clients navigate their tongue movements.

    The tongue: A tiny muscle with a big job

    The tongue is a small but mighty muscle. It’s incredibly versatile, playing a key role in eating, swallowing, and, of course, speaking. For each speech sound, the tongue, along with the lips and jaw, needs to move to a very specific spot. Think of it like a dance: every part of your mouth has a choreographed movement to produce the correct sound. If the tongue is out of sync, the sound comes out muffled, distorted, or just plain wrong.

    The trouble with our tongue movements is that most of us never think about how the tongue has to move and what it does to: swallow, chew, drink, suck and speak. Most parents when asked to think about their own tongue placement for say the /S/ sound are completely lost as to what their tongue is doing. Yet, of course, they produce a perfect /S/ and perfect speech in general. The same goes for swallowing. When did you last think about what happens in your mouth when you swallow? I bet you have not thought about it. We ‘just do it’, right?

    Why is tongue placement so important?

    Accurate tongue placement is the foundation of clear articulation. When a child struggles with a particular sound, it’s often because his or her tongue isn’t quite reaching the right spot or moving in the correct way. For example, the /S/ sound requires the tongue to be slightly raised and positioned behind the top teeth, creating a narrow channel for air to flow through. If the tongue is too far forward, you might get a /TH/ sound instead. If it’s too far back, the /S/ can sound muffled.

    Visual aids: Our secret weapon

    We SLTs love our visual aids! They’re incredibly helpful for showing clients exactly where their tongue needs to be. Here are some of our favourite tools:

    • Mirrors: Mirrors provide instant feedback. Clients can see their tongue’s position and make adjustments in real-time. We often use hand mirrors or even the mirror on a compact for quick checks.
    • Tongue depressors: These simple tools can gently guide the tongue to the correct position. We might use them to show where the tongue tip should rest for the /L/ sound or how the sides of the tongue should touch the molars for the /K/ and /G/ sounds.
    • Diagrams and models: Pictures and models of the mouth can help clients visualise the tongue’s movements. We might use a cross-section diagram of the mouth to show how the tongue forms different sounds.

    Beyond the tongue: The jaw’s role

    While the tongue takes centre stage, the jaw plays a supporting role. It provides a stable base for the tongue and helps control the opening and closing of the mouth. Sometimes, jaw stability is an issue, and we might use techniques to help clients find a comfortable and stable jaw position.

    Making it fun and engaging

    Learning correct tongue placement can be challenging, but we make it fun! We use games, stories, and playful activities to keep clients motivated. For younger children, we might use silly voices or pretend to be animals. For older children, we might incorporate their interests, like using a car analogy for tongue movements.

    The takeaway

    Correct tongue placement is essential for clear speech. By using visual aids, interactive techniques, and a bit of creativity, we can help our clients master their speech sounds and communicate with confidence.

    If you have any concerns about your child’s speech, don’t hesitate to reach out to a qualified speech and language therapist, we are here to help! Contact me via my contact form.

    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.

    2
  • · · · ·

    What to do when words don’t come fast enough

    What to do when words don’t come fast enough

    When children find talking hard, parents often face a difficult question: ‘Should we wait and keep encouraging speech? Or introduce something like AAC?’

    AAC (Augmentative and Alternative Communication) can sound intimidating, but it simply means any way we support or replace spoken words, from simple gestures and picture boards to high-tech speech-generating devices. Far from ‘giving up on speech,’ AAC often becomes the bridge that helps children find their voice, in whatever form that takes.

    💡 What is AAC, really?

    AAC is a spectrum of tools and strategies that help people express themselves when speaking is difficult. It might include:

    • Low-tech supports: Gestures, key word signs (like Makaton), picture symbols, or printed boards
    • High-tech systems: Apps on tablets that speak aloud when pictures or words are tapped

    AAC is not just for children who will never talk. It’s for anyone whose speech isn’t meeting their communication needs right now.

    🤔 When to introduce AAC

    There’s a common myth that you should only try AAC after ‘exhausting’ other speech therapy options. In fact, AAC can be introduced at any stage, even alongside speech development.

    Here are some helpful signs that AAC might support your child:

    • Your child understands much more than they can say.
    • They rely on gestures, sounds, or behaviour to communicate.
    • They become frustrated trying to express themselves.
    • You find yourself ‘reading their mind’ to interpret needs.
    • Speech progress feels slow or inconsistent.

    If you recognise these patterns, AAC isn’t a ‘last resort’. It’s a communication support, not a replacement for speech.

    Recent research consistently shows that AAC does not stop children from talking. In fact, it can encourage speech to develop. A 2024 systematic review and meta-analysis published in the Journal of Autism and Developmental Disorders found that children who received interventions combining naturalistic developmental behavioural approaches with aided AAC showed improved language outcomes, and that AAC ‘does not negatively impact speech development and may even facilitate spoken language growth’ (Smith et al., 2024).

    🌉 How AAC supports speech development

    Speech and AAC aren’t competing paths: they’re parallel tracks that often feed each other.

    Here’s how AAC helps speech grow:

    1. Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
    2. Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
    3. Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
    4. Encourages turn-taking and social connection: AAC lets children join conversations even before speech is fluent, giving them more practice in real communication.

    AAC is not ‘giving up on speech’. It’s giving a child more ways to succeed while speech continues to develop.

    🧩 How to introduce AAC gently and effectively

    1. Start small and meaningful: Begin with a few key messages your child wants to say, not just what adults want to hear. Think ‘I want’, ‘stop’, ‘help’, ‘more’, ‘all done’, ‘no’, ‘again’. These are powerful words for real interaction and autonomy.
    2. Model, model, model: The most important part of AAC success is modelling—using the system yourself as you talk. For example: ‘You want banana 🍌’ and you tap the ‘want’ and ‘banana’ symbols. Children need to see and hear AAC used naturally before they try it themselves.
    3. Use it throughout the day: AAC isn’t a therapy tool to take out once a week. It’s a living part of communication. Model a few words during mealtimes, play, and routines. The more consistently it’s embedded, the more fluent both you and your child will become.
    4. Keep it accessible: If using a device or picture board, make sure it’s always nearby. If it’s in a bag or drawer, it can’t be used in real moments.
    5. Celebrate all communication: If your child points, signs, uses a sound, or taps a symbol, it all counts. Respond warmly and naturally to reinforce communication in any form.

    🧠 What parents often worry about

    • ‘Won’t AAC stop them from talking?’: No. Research shows AAC use either has no negative effect on speech or leads to increased spoken output (Smith et al., 2024). When children feel understood, their motivation to communicate grows.
    • ‘What if I model it wrong?’: There’s no perfect way to start. Your effort and consistency matter far more than accuracy.
    • ‘Will they get ‘stuck’ using pictures?’:  Some children do continue using AAC long-term; others move naturally toward more spoken language. The goal is always functional communication, not replacing one form with another.

    🪞 Bringing AAC into daily life

    Here are a few simple, parent-friendly ideas:

    • Create visual spaces: Post symbols or core words on the fridge, mirror, or play area.
    • Narrate routines: Use AAC during toothbrushing, dressing, or mealtimes; consistent contexts build understanding.
    • Pair speech and touch: Always say the word aloud when you point to or tap a symbol.
    • Involve siblings and friends: Model how they can respond to AAC too. ‘Oh, you said go! Let’s go fast!’
    • Use shared books and songs: Pause and model key words in stories or songs.

    🌱 The takeaway

    AAC doesn’t mean giving up on speech; it means opening more doors to communication. When words don’t come easily, AAC gives children a way to connect, share, and be heard.

    It helps parents move from guessing to understanding, and gives children the power to express themselves on their own terms.

    If you’re unsure where to start, reach out to a speech and language therapist experienced in AAC. Together, you can find a system that fits your child’s strengths, build confidence in modelling, and help every word (spoken or tapped) feel like a step forward.

    And download and print my one page summary.

    Because when communication is possible, everything else begins to grow.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    📚 Reference

    Smith, K., et al. (2024). The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta‑Analysis. Journal of Autism and Developmental Disorders, 55, 3078–3099. https://doi.org/10.1007/s10803-024-06382-7


    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
  • Tongue-Tie: A complex issue requiring careful assessment

    Tongue-tie, or ankyloglossia, is a condition where the lingual frenulum, the thin piece of tissue that connects the underside of the tongue to the floor of the mouth, is too short or tight. Tongue-tie is quite common in babies and is often not detected after birth. Tongue-tie can lead to a difficult start with breast feeding as it makes it very difficult for the baby to latch effectively.

    In my clinical experience as a feeding therapist, I have seen many babies who were not able to latch well due to the frenulum being tight. In many cases an experienced feeding speech therapist/lactation consultant can really make a difference and help a new mum to latch the baby even though the tongue is tethered to the floor of the baby’s mouth. In some cases the frenulum can be divided and once this has been done, in some cases, feeding improves immediately or soon after the division. But this is not always the case. I have seen several babies who have had as many as four tongue-tie divisions and feeding was still difficult.

    It is important to say that while tongue-tie can sometimes impact speech and feeding, it’s important to note that it’s not always the root cause of these difficulties. In recent years, there has been a surge of interest in tongue-tie division surgeries, with some cases being unnecessary. It’s crucial to understand the complexities of tongue-tie and the role of speech therapy in addressing related challenges.

    The impact of tongue-tie on speech and feeding

    When tongue-tie is severe, it can interfere with the tongue’s ability to move freely, affecting speech production and swallowing. Some common speech and feeding difficulties associated with tongue-tie include:

    • Feeding difficulties: Challenges with sucking, chewing, and swallowing.
    • Drooling: Excessive drooling due to difficulty controlling saliva.
    • Speech problems: Difficulty producing certain sounds, such as /l/, /r/, /t/, /s/ and /d/.

    The importance of comprehensive assessment

    Before considering any surgical intervention for tongue-tie, it’s essential to undergo a thorough evaluation by a qualified speech-language therapist (SLT). An SLT can assess the severity of the tongue-tie, its impact on speech and feeding, and determine if surgery is necessary.

    • Functional assessment: The SLT will assess the tongue’s range of motion, its impact on speech sounds, and the child’s overall oral motor skills.
    • Feeding evaluation: The SLT will observe the child’s feeding patterns and identify any difficulties related to tongue-tie.
    • Differential diagnosis: The SLT will rule out other potential causes of speech and feeding difficulties, such as apraxia of speech, dysarthria, or sensory processing disorders.

    The role of speech therapy

    Even in cases where tongue-tie is present, speech therapy can often be highly effective in addressing speech and feeding difficulties. Here’s how speech therapy can help:

    • Articulation therapy: Targeting specific speech sounds that may be affected by tongue-tie.
    • Childhood Apraxia of Speech (CAS): if the diagnosis by the SLT has shown that in fact the child has motor planning difficulties then there are very specific and effective treatment programmes that help with this and can make a real difference over time.
    • Feeding therapy: Strategies to improve swallowing, chewing, and oral-motor skills.
    • Sensory integration: Addressing underlying sensory processing issues that may contribute to feeding difficulties.

    London Speech and Feeding Case Study: The importance of comprehensive assessment

    One of my clients was initially diagnosed with tongue-tie and recommended for surgery at the age of eight years old. His speech had been perceived by parents and teachers as ‘mumbled and unclear’.

    However, after a thorough evaluation, I was able to determine that the child’s primary issue was apraxia of speech, a neurological disorder that affects motor planning for speech. Parents decided to wait with surgery and trust my judgment and we proceeded with weekly intensive speech therapy to address motor planning difficulties around tricky sounds and words. I am delighted to say that the child’s speech has improved significantly, demonstrating the importance of comprehensive assessment and individualised treatment. He is no longer seen as a candidate for an operation, which would have been traumatic for him at his age and, as it turned out, entirely unnecessary.

    Below is a short video clip of my working on the /l/ sound with this child.

    Using the Gingo Puppet from GingoTalk

    Conclusion

    Tongue-tie is a complex issue that requires careful evaluation and individualised treatment. While surgery may certainly be necessary in some cases, it’s essential to consider the potential benefits and risks. Speech therapy can be a highly effective approach for addressing speech and feeding difficulties associated with tongue-tie, even in cases where surgery is still required. By working with a qualified speech-language therapist, parents can ensure that their child receives the best possible care and support.

    Please feel free 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
  • · · ·

    Unlocking communication: My daily life with the Saltillo 88 Core Board

    Introduction

    As an AAC speech and language therapist who uses the Saltillo 88 Core board every day, I can tell you it’s more than just a communication tool. It’s a doorway to independence, connection, and expressing my students’ unique voice.

    What is the Saltillo 88 and why do I use this one?

    In this blog post, I want to share practical, real-world examples of how I integrate the Saltillo 88 into various daily activities, empowering my students and parents to learn to communicate.

    There are literally hundreds of core boards out there and I have tried many different ones over the years. Which one should I use with this particular client? Should I make up my own? (I have made up tons!) or should I use a ready-made one like the one below which is what this blog is about.

    For me the best ones are boards with a good number of core words (at least 60) so that the board is versatile and can be used across a range of activities. The board needs to have a range of pronouns, verbs, descriptors, prepositions and question words to be useful and to stimulate not just requesting but commenting and asking questions. Another consideration is: can the board easily be transferred to a more robust AAC system. Once my student is used to the symbols and where they are could we move to an electronic talker/device. And if this answer is ’yes’ then we have a great board to get started with.

    Below is a picture of the Saltillo 88.

    Saltillo 88 Core Board
    Saltillo 88 Core Board

    It has 88 words and I find it really does suit most activities. The same board and design is also then found on the TOUCHCHAT AAC device which can be a seamless transition for our learner.

    Let me dive into how core words/board or AAC can be used daily:

    1.  Getting dressed

    Whilst choosing clothes for your little one and getting them ready for the day you can use the following words: want, like, get, finish. Always pack the words into little phrases you can speak naturally when using a board. I have tried to show you phrases that you could use below.

    The words in bold are the core words on the board and the other words are just words you say whilst pointing to the core word.

    • Goal: Express choices, needs, and preferences about clothing.
    • Ideas:
      • ‘I want this one [specific item of clothing: ‘shirt’, ‘pants’]’
      • ‘I like that one [colour/type of clothing]’
      • ‘Help me [put/get it on/take off]’
      • ‘let’s get your socks now’
      • finished let’s go’ (when dressed)

    2. Having a shower/bath

    • Goal: Bath time tends to happen daily and so it lends itself to using the same useful phrases and words to chat about temperature preferences, to ask for toys or for washing routines.
    • Ideas:
      • ‘let’s go have a bath/shower’
      • ‘let’s turn on the tap/water’
      • now turn it off
      • ‘let’s get/have more toys/water/bubbles/tickles’
      • all gone, what’s next?’
      • ‘how about washing your hands/feet’
      • ‘let’s do that again’
      • ‘need some help?’
      • Stop it now, let’s do something different’

    3. Mealtimes

    • Goal: Mealtimes can be (or should be) enjoyable and motivating to ask for specific things we like, and commenting about our eating experiences.
    • Ideas:
      • ‘I want/give me [food item: ‘apple’, ‘bread’]/[drink item: ‘water’, ‘juice’]’
      • More foods/drinks/snacks’
      • All done
      • ‘that’s messy we like that (not)’
      • ‘Like’/‘Don’t like’
      • Big’/‘Little’
      • ‘this is so nice!’

    4. Playing

    • Goal: This is where it’s at for children of course and we can use our core words to chat and engage with our little learners.
    • Ideas:
      • ‘I want play’
      • Go’/‘Stop
      • More/again’
      • ‘not it’s my My turn/’it’s Your turn
      • ‘that’s a Big one!’/‘let’s do Little bubbles (describing toys)
      • ‘let me Open it for you (for boxes, doors in play)
      • ‘I See it’ (to draw attention)
      • Help me’ (with a tricky toy)

    5. Opening boxes/doors/etc

    • Goal: Most kids love opening boxes, doors and cabinets to see what there is to play with. Help your child to ask for what they want.
    • Ideas:
      • let’s Open that box/bag/zip/door’
      • get me a (toy) out of here’
      • ‘Let’s Take it out and see what it is?’
      • finished’ (when finished with the task)
      • ‘I want [what’s inside]’
      • ‘What’s next? Let’s see’

    Tips for using AAC effectively

    • Consistency is key: Emphasise using it regularly, even for small things.
    • Modelling: this is crucial, the adults need to use the board for all situations first and foremost before we can expect our child to be interested.
    • Patience: Communication takes time and practice.
    • Celebrate successes: Acknowledge every communicative attempt.
    • Make it accessible: Keep the board within easy reach at all times.

    Conclusion

    If you’re considering the Saltillo 88, or TouchChat, or are already using it, I hope these examples inspire you. It’s a journey of discovery, and every word communicated is a step towards a more connected and independent life. What are your favourite ways to use the Saltillo 88 or which core board do you love using? I would love to hear your comments and stories.

    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
  • · ·

    Using AAC in daily life

    Communication is a fundamental human right, a bridge that connects us to the world and each other. For many, spoken language is the primary mode, but for individuals with complex communication needs, Augmentative and Alternative Communication (AAC) offers a powerful pathway to expression and connection. This guide will demystify AAC, highlight the crucial role of modelling, and provide practical examples of how low-tech AAC can be seamlessly integrated into everyday activities.

    What is AAC in a nutshell?

    AAC encompasses a wide range of tools and strategies that supplement or replace spoken language. It’s not about replacing speech, but rather about providing additional ways for individuals to communicate effectively. Think of it as a spectrum:

    • Unaided AAC: This involves using only your body, such as gestures, facial expressions, body language, and sign language.
    • Aided AAC: This involves external tools or devices. These can range from low-tech options like picture boards and communication books to high-tech speech-generating devices (SGDs) and apps on tablets.

    The beauty of AAC lies in its flexibility and personalisation. It empowers individuals to express their wants, needs, thoughts, and feelings, fostering independence and participation in all aspects of life.

    Modelling is KEY: Showing, not just telling

    Imagine trying to learn a new language without ever hearing it spoken. It would be incredibly difficult, right? The same principle applies to AAC. Modelling is the single most important strategy for teaching and supporting AAC users. It means actively using the AAC system yourself while talking, demonstrating how to navigate the system and express messages.

    Here’s why modelling is so vital:

    • It’s how we learn language: Typically developing children learn language by hearing it constantly around them. AAC users need the same immersion.
    • It reduces pressure: When you model, you’re not asking the individual to communicate, you’re just showing them how it’s done. This takes the pressure off and makes learning more enjoyable.
    • It expands vocabulary and concepts: By modelling a variety of words and phrases, you introduce new vocabulary and demonstrate how to combine symbols to create more complex messages.
    • It demonstrates purpose: Modelling shows that AAC is a functional and effective way to communicate, not just a set of pictures.

    So, how do you model? It’s simple: point to the symbols on the communication board or device as you speak the words. For example, if you say, ‘Time to eat breakfast,’ you might point to ‘time’, ‘eat’, and ‘breakfast’ on the board.

    Low-tech AAC in action: Everyday activities

    Low-tech AAC, such as communication boards, books, or single-page displays, is incredibly versatile and can be easily incorporated into daily routines. These can be as simple as printed pages with symbols, laminated for durability.

    Let’s explore how low-tech AAC can be used throughout a typical day, with examples of symbols:

    1. Getting ready for nursery

    Mornings can be busy, but they also offer rich communication opportunities. A ‘Getting Ready’ communication board can help sequence activities and offer choices.

    Activity example:

    ‘Time to get up!’ (point to GET UP). ‘What do you want to wear today, the blue shirt or the red shirt?’ (point to GET DRESSED) ‘Then, we brush teeth’ (point to TOOTHBRUSH) and so on.

    AAC mornings symbol examples

    2. Breakfast Time

    Mealtimes are perfect for making choices, expressing preferences, and commenting. A ‘Breakfast’ communication board can focus on food items, actions, and social comments.

    Example symbols:

    AAC meal times symbol examples

    Activity example:

    ‘What do you want to eat for breakfast?’ (point to EAT). ‘Do you want cereal or toast?’ (point to CEREAL or TOAST). If they finish their milk, you could say, ‘Are you ALL DONE or do you want MORE MILK?’ (point to symbols).

    3. Catching the Bus

    Even routine transitions like catching the bus can be communication rich. A small, portable ‘Travel’ board can be useful.

    Example symbols:

    AAC catching the bus symbol examples

    3. Being on the playground

    The playground is a dynamic environment perfect for commenting, requesting actions, and engaging in social play.

    AAC playground symbol examples

    Activity example:

    ‘Let’s PLAY!’ (point to PLAY). ‘Do you want to go on the SWING or the SLIDE?’ (point to symbols). If they are on the swing, you can say, ‘Do you want to go FAST or SLOW?’ (point to symbols) and ‘Push AGAIN!’ (point to PUSH) You can also model social language like ‘It’s MY TURN.’

    Beyond the symbols: Key takeaways

    • Consistency is key: Use AAC consistently across all environments and with all communication partners.
    • Be patient: Learning a new language takes time. Celebrate small successes.
    • Make it fun: Integrate AAC into play and enjoyable activities.
    • Follow the individual’s lead: Respond to all communication attempts, even if they are imperfect.

    In the video below I model how to integrate AAC into everyday activities with a few more examples and I discuss the difference between AAC and PECS.

    If you need some inspiration with using AAC or would like your child assessed for the right type of AAC then please get in touch.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

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  • Learn the benefits of Cycles Phonology Approach in Speech Therapy

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

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

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

    How does the Cycles Phonology Approach work?

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

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

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

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

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

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

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

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


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

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