“I’ve got something in my bag, in my bag, in my bag,
I’ve got something in my bag,
what it is”
You might be wondering why your Speech and Language Therapist is singing this song and then presenting items from a zipped-up bag. Let me take you through stage one of this evidence-based approach.
There are many aims of ‘bucket or bag time’. During stage one, you are simply engaging your child’s attention (whilst also exposing them to language). It’s important to remember that you are not forcing your child to say or do anything. The idea is that the items in the bag or bucket ‘offers an irresistible invitation to learn’ (Gina Davies, 2020).
You don’t need ‘special’ expensive toys. Use what you have at home. It might be that you have some bubbles, a wind-up toy. You might have some foil that you can roll up into a ball, or a balloon. Keep these items for ‘bucket time’. This means that your child is likely to be excited and motivated for the activity. The only stipulation is that these items must be highly motivating and must be the most exciting thing in the room. You’ll want to cover up any distractions.
So, you have your items and your opaque zipped bag, next you’ll want to put the items into the bag ensuring the zip is closed. The zip is important as it increases suspense and excitement as your child cannot see inside. You can also comment when unzipping ‘open bag’ using the signs ‘open’ + ‘bag’ to support your child’s understanding. Your Speech and Language Therapist can help with any Makaton signs that are unknown. The idea of this activity is that the item isn’t touched by your child. This can seem a little odd or feel “mean” but there is a reason for this: we want our child to look at us as well as the object or toy. As soon as we allow our child to touch and play with that toy their attention will go to the toy alone and we won’t get JOINT attention or engagement. This is the reason why we SHOW interesting things for a brief moment and then put these items back into the bag or bucket and out comes the next item. If your child wants to grab the toy and gets upset, then they may not be quite ready for this approach.
Next, we sing the song (as above) and unzip the bag taking out one of the items. The use of pausing is important. Pause after the song: does your child try to use gesture or sound? You can also use this opportunity to model short phrases, ideally one or two words such “it’s a spinner! Wow… so many colours”. After a couple of turns, repeat the process and pull out a different item. We tend not to sing the song each time for the next item. Just sing it at the beginning and then get on with producing the amazing, wonderful things in your bag. No hard and fast rules though, apart from “don’t let the child touch the toys”.
The biggest factor here is that you and your child enjoy the activity together. Have lots of fun!!
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.
This is a surprisingly common speech error and it can be corrected really well in my experience. I have helped lots of children of all ages learn how to control their tongue movements and produce clear, sharp /s/ sounds and good /sh/ sounds.
There are some factors which need to be considered before we can dive into therapy proper and these are they, in a nutshell:
Student is not currently displaying negative oral habits such as thumb sucking or excessive sucking on clothing. This is because thumb sucking exerts pressure on the teeth and therefore can, over time, push teeth out of their natural order/position.
Student does not have a restricted lingual frenulum or tongue tie which can cause at times restricted movements of the tongue (pending on how tight the frenulum is attaching the tongue to the base of the oral cavity); equally a labial frenulum or lip-tie can restrict lip movement and therefore physically restrict good speech sound production.
Student does not have enlarged tonsils as they can sometimes push a tongue forward and also cause open mouth posture and open mouth breathing.
Student’s motivation to change their speech pattern is high. (this is an important factor though with younger students I can get round this with a lot of fun games and good parental involvement!)
When I do an Oral Assessment of my student these are the first factors I want to look at and consider. Often I will refer to other agencies such as Orthodontists, dentists or ENT specialists to advise and help with some of these factors before we can get going. However, there are strategies that we can work on almost straight away.
Most of my Lisp Students present with an open mouth posture: that is where the student has their mouth always slightly open for breathing. Over time the tongue starts to fall forward and rests on the front teeth or the bottom lip instead of finding a comfortable resting place either at the alveolar ridge (the bumpy spot behind the upper front teeth) or, alternatively, resting at the bottom of the mouth behind the lower front teeth.
Another common problem is that the tongue is not moving independently from the jaw and so is reluctant to pull back or lift up inside the mouth as the tongue is guided in movement by the jaw.
Combine those two factors and your tongue is not pulling back, or lifting up or doing very much at all without the jaw moving as well. This makes for unclear speech sounds, especially all the sounds we make at the front with our tongue or with our lips: B/P/L//N/ and of course /S/ and /SH/ are particularly hard to make. We often also struggle with the /Y/ sound so /LELLOW/ instead of /yellow/.
But no fear, these problems can be treated over time for sure! We often start with lip, tongue, and jaw exercises that help to move the tongue independently from the Jaw, our student learns that the tongue is a muscle and can be trained to do amazing acrobatic things in the mouth! WOW! It can actually pull back, lift up, and come down again all on its own!
We work on breathing, holding our breath for a bit then pushing it out and then holding it again.
And when it comes to the actual /s/ sound I often try and go a NEW route bypassing the Snake-Sound route if that is what had previously been tried and failed so that we can create completely new sound patterns in our brain and think about our sounds in a completely new way.
We then work on producing the sound /s/ on its own for a bit, at the end of words, then on either side of complimentary sounds, for instance : ‘EASY” – the sound patterns here are EEE-S –EE : the EEE sound is complimentary to the /S/ sound as the tongue is at the right hight for the /S/ already once you have it in place for /EEE/ -……see?! EASY!
And gradually we work towards saying the /S/ sound clearly at the front of short words, then phrases and then sentences.
The process takes some time and it depends on how ready the student is. This varies of course hugely so I can never promise the exact number of sessions we will take to get that Lisp fixed. A lot depends on home practice in between sessions, and this is of course crucial to all therapy! Every day 15-20 mins practice is a good average time to aim for and when this is done it shortens the therapy block drastically.
I always give plenty of home work so there is never a chance of it getting boring or there being “nothing to do”!
Do contact me. I really enjoy working with this type of student and get a great kick out of FIXING THAT LISP!
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.
Navigating the education and healthcare system isn’t easy, which you’re all too familiar with. You want what’s best for your child so that they can thrive. This isn’t about achieving top grades in class or getting into a top set in a subject. It’s allowing independence, being able to make developmentally appropriate choices and giving them a voice, allowing them to be heard.
You may be at the start of your journey or going through the process of applying for an Education and Healthcare Plan (EHCP). You feel lost and have minimal confidence in the system, and every question you ask feels like it’s challenging every belief you have. But you know you must carry on. You worry that your child’s EHCP will be rejected and that this will prevent them from achieving their potential. You’re aware of the importance to put forward your child’s case and advocate for them. What the panel don’t see is that you have your child’s best interests in mind every single minute of every single day. Fighting for their needs is tough on your family.
Let me guide you through some of the most frequently asked questions, allowing you to feel more confident in the process and how together we can make a difference to your child’s future.
1. What is an EHCP?
An EHCP is a legal binding document which provides support for children up until the age of 25. These are for children who require more support than the provision given through Special Educational Needs.
2. Why is an EHCP used?
An EHCP is used to help you get the correct support for your child, so they can achieve their potential, and improve the quality of their learning. It also allows support for the family.
3. What is the role of a Speech and Language Therapist in the process of applying for an EHCP?
The role of a Speech and Language Therapist is to assess your child’s speech, language, and communication. It forms part of the plan to see what extra support is needed to access their education and reach their full potential. A report will be formulated and identify any limitations in your child’s communication profile and how these impact on their education.
4. What areas does an EHCP cover?
The EHCP document is very detailed to demonstrate what support your child needs and is likely to need. There are 11 sections (A-K). It covers the following:
A – An overview of the child to include your child’s interests and wishes.
B – A detailed explanation of your child’s needs which includes their cognition and learning ability, communication and interaction skills, social, emotional, and mental health and sensory and physical disabilities.
C – The healthcare needs of your child which may include physical or mental health difficulties, difficulties with eating, anxiety, and epilepsy.
D – The social care needs of your child such as being able to take part in activities outside of school.
E – This section collates all the information and discusses the outcomes which are based on the assessment (which includes educational aims such as success in education or participation).
F – Section F details the provision required to meet their needs.
G – Section G is where you’ll need information about their learning difficulty or disability which may include information about equipment or medication (e.g., software or a specialist wheelchair).
H – You’ll provide details on social care for your child (such as activities attended outside of school or any short breaks). This is also the section to write about the support you get at home as a family.
I – Section I should give details on the education setting your child attends.
J – This section contains information about finances you will receive to get the support your child needs.
K – The final section contains all the supporting documentation (such as assessments, reports, and advice).
Together we can achieve support
Whilst this may seem daunting, it is necessary to gain the support your child requires. I will guide you through the process, step by step, so you feel confident in the application that you submit on your child’s behalf. This document supports your child’s future.
Let’s break down the barriers and allow your child to learn and flourish. It’s their time to be independent.
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.
You may notice that your child or young person finds certain sounds difficult to produce. With a lisp, the sounds /s/ and /z/ are more problematic. You may notice that your child’s speech is affecting their confidence. They are quiet, and the teacher reports they don’t engage in classroom conversations. You feel it’s impacting on their social and emotional wellbeing. The good news is that with the support of a Speech and Language Therapist and the determination and motivation of your child, we can treat a lisp can.
You feel you have so many questions and you don’t know where to begin. Let’s start by answering some of the most frequently asked questions.
1.Is it normal for my child to have a lisp?
It’s important to remember that we can expect a lisp in a child up until four and a half years of age.
2.Can I do anything for my child’s lisp?
The best approach you can take is to provide a good model. You can show the correct sound and you can talk about where in the mouth your tongue or lips are. Your Speech and Language Therapist can recommend you on what you can say.
3.Should I wait to see if my child’s lisp resolves on its own?
As always, early intervention is advised as producing sounds as a lisp can be more ingrained the longer your child waits for therapy. It is true that some children’s lisps resolve on their own.
Therapy depends on many factors, one of which is deciding on whether your child is ready for therapy. It’s best to seek advice from a qualified Speech and Language Therapist about whether your child is ready for therapy. It takes motivation, determination, and practice.
4.What should I expect from a Speech and Language Therapist when they see my child?
Your Speech and Language Therapist will ask you as parents and carers about your child’s history. This is because they’ll want to confirm it is a lisp and no other areas of communication are affected. They may ask your child about the impact of their lisp on them (if your child is aware of their speech difficulty).
They will then assess your child using a speech assessment. Your Speech and Language Therapist will confirm their findings and will put a plan in place with you.
5.How will my child’s therapist fix my child’s lisp?
The start to fixing any sound is looking at discrimination between the sound your child is making vs the correct sound. Can your child hear the sound they should be making?
Your therapist may still get your child to discriminate two sounds. They will begin to work on the sound in isolation, so saying the child’s tricky sound by itself (e.g., /s/)
Then they will ask your child to say their tricky sound with a vowel, with a breath between the consonant and the vowel (e.g., s-oo, s-ow, s-ee, s-aa, s-ai)
Your child will then remove the gap between (e.g., soo, sow, see, saa, sai)
Your child will then be ready to move onto consonant-vowel-consonant words (e.g., sat, sit, seen, sown)
Your child’s therapist will tell that the next step is to produce sentences using your child’s tricky sound, /s/ in this example (e.g., Simon says silly sausages)
Your child is working towards generalising their ability but there are a few steps before this happens
Choose a context where your child can practise their talking, focusing on one sound (e.g., during 10 minutes of special time). This is an ideal environment as you can create opportunities for your child.
The next stage is saying the sounds correctly in general conversation
You’ll want your child to be less reliant on you for modelling the sound, so you’ll want to start to phase this out
It’s important for your child to self-correct and self-monitor. Encouraging this is the final stage to correcting your child’s lisp.
You and your child will need to be motivated, as it’s true: practice makes perfect!
For support on speech sound difficulties, feel free 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.
Your child’s speech, language and communication difficulties may impact their self-esteem. And they may show signs of increased frustration. You want them to be full of confidence, increasing their participation in school and fully engaging with their peers.
1. Practise active listening
Speech difficulties can mean that it’s more challenging to understand what your child says. It’s important to show that you’re paying attention, giving them time to express themselves. Focus on what your child says rather than how they are speaking. Remember to maintain eye contact, and actively listen. Active listening and giving time can be trickier than it sounds. I can provide strategies to support your active listening skills.
2. Give other means and forms of communication
Allowing children to express themselves in a variety of ways (e.g., gesture, signs, written, use descriptions to describe a word (e.g., sand – you find it out the beach, it can have pebbles on it, it’s not the sea), use of symbols or high-tech augmentative communication methods such as a computer). Using different ways is vital in reducing frustration and communicating their message. If you’re unsure of what other forms of communication you can use, please contact me for some top tips.
3. Praise efforts
Providing specific praise allows your child to understand what they’ve achieved. E.g., you could praise the way your child listens, or how they take turns, or their resilience (e.g., “I like the way you listened” or “good listening”). Think of different ways you could praise you child during different activities, so you are prepared with phrases that you can use.
4. Have clear start and end points in activities
Some children with speech, language and communication needs have difficulties with transitioning from one activity to another. They also have difficulties with changes in routine. This can add to their frustration and changes in behaviour. So, how do you show a clear start and end to an activity? You can have a visual timetable, or you could have ‘start’ and ‘finish’ boxes where you place all the materials in the box labelled ‘start’. And once the activity has finished, you put the items in the box labelled ’finished’. If you need support with transitions, please contact me.
5. Use visuals
Visuals can support your child to understand routine and spoken language. Visuals can range from symbols to online images, to photographs, or a combination. Explore which type of visuals work well for your children. Using visuals can be powerful if used correctly. Make the most of the opportunities that visuals can provide for your family.
Increase confidence and reduce frustration in children with speech and language and communication difficulties today. Please feel free to contact me if you need any support or tips on maximising these opportunities.
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.
Speech and language therapists provide treatment, support and care for children and adults who have difficulties with communication, eating, drinking and swallowing. We help children and adults who have problems speaking and communicating.
How to find the perfect therapist for my child/client:
There are a huge number of speech and language difficulties, or feeding and swallowing problems that we can help with and the first thing to think about is what age group the person is you are seeking help for. Most SLT’s specialise in a range of disorders and treatments and they often treat specific age ranges. This could be, for instance, very young children up to 3 years, or school aged children, adolescents or just adults. Once you have narrowed it down to age and general area of difficulty you can then go and seek your perfect SLT match.
Generally it is my view that SLT’s with a narrow area of specialist interest are most likely to help you better if the problem you or your child/adult is having is significant and/or profound. For example, if your child has a very severe stutter/stammer but is otherwise developing fine and has good skills all round, then I would recommend to look for an SLT who only specialises in stammering/stuttering, or has only a small range of other specialist areas related to stammering , such as speech and language delay.
The reason is that it is a tall order for any professional to stay up to date with latest research, latest clinical developments and training for more than, say, five distinct areas of interest.
However, a more generalist Speech therapist who has lots of experience in many different areas could be a very good option for your child or adult who has more general speech and language delay in a number of areas, perhaps a global delay or a syndrome which means that their learning is delayed in general. It also means that your child might benefit from a Generalist SLT because they have many more tools in their SLT bag and your child might need a variety of approaches for several areas.
A good place to start is www.asltip.com which is the Association for Independent Speech and Language Therapists in the UK. Any SLT registered with ASLTIP will also be registered with the HCPC (Health Care Professionals Council), as well as RCSLT (Royal College of Speech and Language Therapists). These two important UK professional regulatory bodies ensure all its members are fully qualified, and are fully up to date with latest developments within their areas of work.
Here you can enter your post code and look for a therapist near you and you can look for specific problems such as stammering for example and narrow down your search. Most therapists have a website which you can then access too. I would recommend you speak to a few therapists on your list and then go with the person you had the best rapport with. You and the therapist will be spending a lot of time together and you will need to feel that you trust them and that you can relax into the process.
How I can help you:
I have 3 main areas of specialism:
Parent Child Interaction Coaching
This is an amazing way to help children with the following difficulties:
Social Communication Difficulties, Autistic Spectrum Disordersand
Speech and Language Delay – for children under the age of 4 years old, this is my preferred way of working because it is so very effective and proven to work. If your child is not developing words or not interacting, has reduced attention and listening and you feel is not progressing or, in fact even regressing, then this way of working is the best. For anyone wanting to read a bit more about the efficacy of this method, below are some research articles. You may also like to check out www.hanen.org which is the mainstay of my work and method when it comes to Parent-Interaction Coaching. You can also look at my latest blog, entitled: Tele-therapy, does it work?
In brief, what’s so great about Parent Coaching is that it empowers you the parent to help your child in daily life! This is where speech, language and social communication develop typically, in a naturalistic way and environment. Simple steps and strategies are discussed and demonstrated every week and you are encouraged to use these strategies with your child in daily routines: getting dressed, having breakfast, on the school run, whilst out in the park or shopping or simply playing at home or having dinner or bath time. Whatever your family routine happens to be, every strategy I teach you will help create a responsive communication environment; generally, if your child is able to develop speech then they will do so in direct response to your changed interaction style.
Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation
I love working with children of all ages on developing their speech sounds. Whether your child has a lisp, or a couple of tricky sounds they simply cannot produce quite right, or perhaps your child is really unintelligible because he/she is having lots of different sound errors, making it really hard to understand them. I typically work on getting “most bang for your buck” , meaning I address the sounds that cause the most problems and, therefore, when they are fixed your child/person’s speech becomes that much clearer fairly quickly.
Feeding and Swallowing Difficulties
Having worked for over 20 years in NHS Child Development Clinics and Special Needs Schools I trained and worked with feeding and swallowing difficulties early on in my SLT career. I later trained as a Lactation Consultant and so I am well placed helping and support all types of Infant feeding, both breast or bottle, as well as toddler weaning. I aim to ensure that your little one swallows the right kind of foods and drinks for their abilities. I am experienced in managing and supporting children with physical needs and mobility problems, Cerebral Palsy, Down Syndrome or any other type of syndrome or presentation.
What does a speech therapy session look like?
All sessions differ slightly depending on the age of the child and the nature of the difficulties.
However, mostly our sessions look like FUN! After arrival and washing hands we tend to start off with the tricky work straight away whilst our child still has energy and the will to engage. So, for speech work we will focus on the target sounds first: this could be sitting at a table doing work sheets together, playing games using the target sound and really any type of activity that gives us around 70-100 repeats of the target pattern. For example, a child who is working towards saying a ‘K’ at the end of the word I will try and get around 100 productions of words like: pack/sack/lick/ pick/bike/lake and so on.
Then we often play a fun game where I might try for a ‘rhyming’ activity or other sound awareness type activities, for perhaps 10 minutes and within that time I aim to trial the next sound pattern we need to improve on; I will test which sound your child can do with help from me. During he last 10 minutes we might look at a book, again listening to and producing whatever sound we are working on. If I did not get 100 sounds earlier on in the session I will try and practice them now as part of the story. In total I aim to have about 40-45 minutes of activities, all aimed at the target sound we are working on.
What does a Coaching session look like?
During a Parent Coaching Session we meet online for about an hour and we discuss how the week has been for you trying out the strategies. Typically parents start off recalling what went well, what progress was made and what had been more tricky. We work through it all, and then follow on to the next strategies: I will show you examples and demonstrations of each strategy and I will get you to think about how you can use this with your child and in what situation you might use it. I will explain what we are doing and what the purpose is. You might want to write down what you are going to work on for the week. Over the course of about sessions we can cover all the major strategies that are proven to help kickstart spoken language and/or help your child to connect more with you. Through that connection spoken words most often develop.
Research Papers on the Efficacy of Parent Child Interaction Coaching
The It Takes Two to Talk Program has been shown to be effective in changing how parents interact with their children, and that children’s communication and language skills improve as a result.
Baumwell, L.B., Tamis-LeMonda, C.S. & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20(2), 247-258.
Beckwith, L. & Cohen, S.E. (1989). Maternal responsiveness with preterm infants and later competency. In M.H. Bornstein (Ed.). Maternal responsiveness: Characteristics and consequences: New directions for child development (pp. 75-87). San Francisco: Jossey Bass.
Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.
Sonja has been a real help for my 5 year old daughter. Due to her support, my daughter is now able to clearly and correctly enunciate ‘th’ ‘f’ and ’s’. She was also helpful in making positional changes to her seating to help her concentrate better and kept her engaged throughout all the lessons which is a feat in itself on zoom!
Helen, Mother of Catherine Age 5.
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.
When you have a picky eater it’s easy to feel on edge and that others are judging your parenting skills. It is astonishing how suddenly the world and its brother/sister are all experts on how to feed your child, even the lady in the corner shop is not shy to offer unsolicited tips and advice on your child’s nutrition intake. They will say “try this or that“, “how about these new crackers (only £1.99 special offer)” but…
The fact is often that you are very concerned about what your child is eating. And you desperately want to give them a healthy, nutritious packed lunch but you know that it will get left, unopened, and unfinished. So, instead, you stick to the same sad soft cheese sandwich on white bread as it is at least something you know they’ll eat.
Sensory needs can impact on eating with both individuals with and without other conditions. We need to consider all these elements:
taste (sweet vs. sour)
consistency (crunchy vs. soft)
temperature (hot vs. cold)
colour (beige vs. colourful)
and smell (pungent vs. mild)
Let’s take a blueberry as an example: it can be sweet or sharp; it can be firm or mushy; it can even differ in colour. Now let’s look at a piece of cereal: it’s crunchy all the time; it looks the same. It’s very predictable, and therefore less anxiety provoking.
Find our top tips here:
Check with a medical professional that there is nothing physically wrong (e.g. gastrointestinal, or anatomical structural difficulties).
For swallowing difficulties, whether confirmed or suspected, please book an assessment with a certified swallowing/feeding Speech and Language Therapist or please contact me.
Does your child have confirmed or suspected allergies? If so, please contact a dietician who has experience with allergies and can advise, for example: Dr Rosan Meyer.
Talk to other family members about food and their experiences of food. Perhaps there is a family tendency to be picky with eating/food avoidant. This may be important information that you can share with your clinician during the case history taking.
Be patient, though this is easier said than done/felt! Know that many children need repeated exposure to food(s) before liking them, up to 14 spoons! So, take it at your child’s pace and it’s vital we don’t force them to try new foods or use bribes.
You can provide opportunities to engage with food, perhaps you could cook with your child, and allow them to choose what they want to cook. For younger children try Messy Food Play – there are tons of suggestions on Pinterest for ideas on how to incorporate foods into play activities or ask your feeding-Speech and Language Therapist.
You may want to talk about pictures in books that introduce new foods (e.g. The Very Hungry Caterpillar for younger children or magazines if older).
You can play with toy food in a toy kitchen for little ones, or comment on supermarket adverts for young people who are older.
Offer opportunities to taste new foods. You could use a toothpick for bite-sized pieces.
Be sure you eat together with your child as often as you can, modelling positive eating behaviour is most important and can be really effective over time.
You could ask your child to sort foods by colour or stack them on a plate.
We know that Autistic Spectrum Conditions often come with hypersensitivity to textures, so consider what your child prefers (e.g. they may not like slices of tomato but prefer the runnier texture of a tomato sauce).
Reward and give praise following your child’s flexibility with foods and their attempts to try and not whether they like/dislike the food, for example “well done for touching the avocado!” Or “great you licked your fingers with the humous on, that’s excellent”.
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.