Discover more about Verbal Dyspraxia

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What is Verbal Dyspraxia?

Apraxia or dyspraxia is a difficulty in motor planning, which sometimes can be seen in both gross and fine motor skills, as well as speech. Gross motor refers to difficulties in coordinating the whole body (e.g., bumping into things frequently, often falling over hurting themselves or others through being “clumsy” or unsteady). Fine motor movements refer to smaller, more precise movements (e.g., difficulties doing anything with their hands such as holding a spoon or pen).

Verbal dyspraxia

In Dyspraxia of Speech, instead of seeing a coordinated smooth way of talking, we see the articulators (tongue, lips, cheeks) and voice coordinating very smoothly. The voice can be very quiet or very loud. Muscle tone can be weaker at times. Speech sounds are very unintelligible, with a flat voice that can sound forced. It may be that the timings of verbalisation appear random and that children can say a certain word once and never again. This is often what we hear from parents.

It is interesting to note that many of our autistic clients are either non-speaking or are reluctant speakers. Sometimes they say a word once and then never again. Others say lots of words but the words are very hard to make out. Did you know that about 40% of autistic people have verbal dyspraxia? (Richard, 1997). Because the problem is one of motor planning, not of automatic motor execution, once a plan has become automatic, it is easier to get back to it and this is why we often see repetitive patterns that can be called ‘stims’ (Marge Blanc, 2004).

How can Speech and Language Therapy help?

Children with verbal dyspraxia can make great progress!

We provide frequent and appropriate speech movement opportunities and with time and the right support, children will move forward and begin to speak more fluently and with greater intelligibility. It is important to know this can take time.

We provide Oral Motor Therapy using a variety of approaches to practise breathing, vocalising on the outbreath, and sequencing our speech movements.

We design carefully tailored programmes focusing on words that have a lot of power (e.g., NO, GO, UP, IN, OUT, LET’S GO, STOP).

We offer shared enjoyment, and laughter. This helps a child find their voice. Other ways of finding our voices include singing or humming, or even yelling/shouting!

The most difficult phase of verbal dyspraxia is initiation, that is to start talking, to start producing a word. Frequent “automatic” repetition supports children with initiation because it removes the element of “thinking to start”. I often ask a child to repeat a word 5-10 times (with rewards at the end. A little game works well). You can see that with repetition the act of initiating is taken out of the equation as you are “on a roll “as it were.

Once a child starts to find their voice, we will be able to hear them talk lot… And if we give them credit and presume that what they are saying has meaning, we will find in time that their words become clearer and more intelligible. If we listen carefully, we can detect real words and phrases.

For more tips and support, please get in touch!


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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    The power of imitation in supporting children with autism

    Image by Freepik

    Imitation, the act of mirroring someone else’s actions, gestures, sounds, or words, is a fundamental skill that plays a crucial role in human development. It’s how babies learn to wave ‘bye-bye’, how toddlers pick up new words, and how children acquire social skills. But for children with autism imitation can be a significant challenge and understanding why it’s important and how to foster it becomes a key focus for parents, educators, and speech and language therapists.

    Why is imitation important?

    Imitation is a building block for a wide range of developmental skills:

    • Social interaction: Imitation is the foundation of social reciprocity. When a child imitates, he or she is engaging in a shared experience, connecting with another person, and learning to take turns in social exchanges.
    • Communication development: Imitation is closely linked to language acquisition. Children often imitate sounds and words before they can produce them independently. Imitation also helps them understand the meaning of gestures and facial expressions, which are vital for nonverbal communication.
    • Cognitive development: Imitation plays a role in problem-solving, learning new skills, and understanding cause and effect. By imitating actions, children explore their environment and learn how things work.
    • Emotional development: Imitation helps children understand and share emotions. When a child imitates a smile, he or she may begin to understand the feeling of happiness.

    Imitation challenges in autism

    Many children with autism face challenges with imitation, which can affect their development in these key areas. These challenges can manifest in different ways:

    • Difficulty imitating motor actions: Children with autism may struggle to imitate simple motor movements, such as clapping hands, waving, or playing ‘peek-a-boo’.
    • Limited vocal imitation: Imitating sounds, words, and phrases can be difficult for some children with autism, which can impact their speech development.
    • Challenges with social imitation: Imitating social cues, such as facial expressions, gestures, and body language, can be particularly challenging for children with autism, affecting their ability to engage in social interactions.

    Why do children with autism struggle with imitation?

    The exact reasons for imitation difficulties in autism are complex and not fully understood. However, several factors may contribute:

    • Neurological differences: Research suggests that differences in brain structure and function, particularly in areas involved in social perception and motor control, may play a role.
    • Sensory processing differences: Some children with autism may have sensory differences that make it difficult to attend to and process the movements or sounds they are expected to imitate.
    • Attention and motivation: Challenges with attention, focus, and social motivation can also affect a child’s ability to engage in imitation.

    How to foster imitation in children with autism

    Fortunately, imitation skills can be developed and improved through targeted interventions and strategies. Here are some approaches that I use in my practice as a speech and language therapist working with autistic children and their families:

    • Create a playful and engaging environment: Children are more likely to imitate when they are having fun and feel motivated. I use toys, games, and activities that the child enjoys.
    • Start with simple imitation: Begin by imitating simple motor movements that the child is already capable of and gradually introduce more complex actions.
    • Imitate the child first: As the Hanen Program emphasises, imitating the child’s actions, sounds, and words can encourage him or her to interact and communicate more.
    • Use visual supports: Visual aids, such as pictures, photos or videos, can help children with autism understand what is expected of them and make imitation easier.
    • Break down complex actions: Divide complex actions into smaller, more manageable steps. For example, to teach a child to brush their teeth, break it down into steps like ‘pick up toothbrush’, ‘put toothpaste on brush’, and ‘move brush on teeth’.
    • Reinforce imitation attempts: Provide positive reinforcement, such as praise, smiles, or preferred activities, when the child attempts to imitate, even if the imitation is not perfect.
    • Integrate imitation into daily routines: Incorporate imitation into everyday activities, such as imitating sounds during playtime, imitating gestures during songs, or imitating actions during self-care routines.

    The role of speech therapy

    Speech-language therapists play a crucial role in helping children with autism develop imitation skills, particularly in the areas of vocal and verbal imitation. As part of my therapeutic role, I offer the following:

    • Assessing a child’s imitation abilities.
    • Developing individualised therapy plans to target specific imitation goals.
    • Using a variety of techniques to encourage vocal imitation.
    • Working with parents and caregivers to provide strategies and support for promoting imitation at home.

    Summary

    Imitation is a fundamental skill that is essential for social, communication, cognitive, and emotional development. While children with autism may face challenges with imitation, it is a skill that can be developed and improved with targeted interventions and support. By understanding the importance of imitation and using effective strategies to foster it, parents, educators, and therapists can make a significant difference in the lives of children with autism, helping them to connect with others, learn new skills, and reach their full potential.

    Do get in touch via my contact form if you have any question or need help with supporting your little one.

    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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    Support your autistic child’s communication by learning the stages of Gestalt Language Processing

    If your child is using echolalia and/or has a diagnosis of autism, then your child’s way of processing language is most likely different to the classic way children typically learn language. We call this process Natural Language Acquisition or Gestalt Language Processing.

    Speech Therpaist in London
    Step by Step guide to Gestalt Learning

    Let’s explore the following stages of Gestalt Processing:

    Stage 1: communicative use of whole language gestalts

    (e.g., “let’s get out of here”)

    Children and young people in this stage use echolalia. They need to hear more gestalts or scripts. So, your job is to model, model, model and to use functional language that your child can repeat back.

    Stage 2: mitigated into chunks and re-combining these chunks

    (e.g., “let’s get” + “some more”) and (e.g., “let’s get” + “out of here”)

    This is when you take parts of gestalts or phrases and then combine it with other parts.

    Stage 3: further mitigation (single words recombining words, formulating two-word phrases)

    (e.g., “get…more”)

    They are going beyond their gestalts. Furthermore, they may begin to label different objects.

    Stage 4: formulating first sentences

    (e.g., “let’s get more toys”)

    You may see more grammatical errors during this phase as they are creating unique sentences. Please don’t worry about this, it means they are playing and experimenting with language. As communication partners, you could model the correct form of the sentence.

    Stages 5 & 6: formulating more complex sentences

    (e.g., “how long do you want to play inside for?”)

    You can see that language learning is a process, that is trialled and tested, used in different contexts for children to be able to learn and use language appropriately.

    My next blog will give you activities ideas and how you might use them specifically with a Gestalt Language Processor.

    Remember early intervention is vital. So, if you have any concerns, please seek the advice of a Speech and Language Therapist.

    Contact me, Specialist Speech and Language Therapist Sonja here.

    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.

  • Why I love ‘Colourful Semantics’ in speech therapy

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

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

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

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

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

    Different parts of a sentence are represented by different colours.

    For example:

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

    As children progress more colours are added:

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

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

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

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

    Why some children struggle with sentences

    Language development is incredibly complex.

    To build a sentence, we need to:

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

    That is a huge amount happening all at once.

    Some children may:

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

    For example:

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

    These children often know more than they can express.

    Colourful Semantics helps bridge that gap.

    Why visual supports matter

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

    Visual systems reduce the processing load.

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

    The colours act almost like ‘anchors’ for language.

    A child may begin to understand:

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

    This makes sentence building more concrete and less overwhelming.

    It also supports children who struggle with:

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

    Supporting sentence expansion naturally

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

    It can be used:

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

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

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

    Children often begin to use:

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

    For example, instead of:

    • ‘Him running’

    A child may gradually move toward:

    • ‘He is running.’

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

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

    Supporting children with speech difficulties too

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

    Colourful Semantics is excellent for this.

    While building sentences, we can also naturally target:

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

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

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

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

    Therapy becomes more functional, meaningful, and engaging.

    Building confidence through success

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

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

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

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

    And communication grows through communication.

    Why I use colourful semantics

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

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

    It supports:

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

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

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

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

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Reference

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


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

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

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    Unlocking language and thinking skills: The power of sequencing

    Sonja demonstrates the power of sequencing

    As speech and language therapists, we often use a variety of techniques to help children develop their communication and cognitive skills. One incredibly valuable tool in our toolkit is the use of sequencing activities. But what exactly is sequencing, and why is it so beneficial?

    What is sequencing?

    Sequencing, at its core, involves arranging items, events, or actions in a specific order. This could involve putting pictures in the correct order to tell a story, following the steps in a recipe, or understanding the order of daily routines like brushing teeth or getting dressed.

    The link between sequencing and language

    Sequencing is fundamental to language development and is quintessential to executive functioning skills in several ways:

    • Narrative skills: Storytelling, whether oral or written, relies heavily on sequencing. A child needs to understand the order of events (beginning, middle, end) to construct a coherent narrative.
    • Explanations and instructions: Providing clear explanations or instructions requires the ability to sequence information logically. For example, explaining how to play a game or how to get from one place to another. In the video clip below we are working on ‘how do make a sandwich’.
    • Vocabulary development: Sequencing helps children understand temporal words and phrases like ‘first,’ ‘then,’ ‘next,’ ‘before,’ and ‘after’.
    • Sentence structure: Constructing grammatically correct sentences often involves sequencing words in a specific order (e.g., subject-verb-object).

    Beyond language, sequencing plays a crucial role in developing executive functioning skills. These are higher-level cognitive skills that help us plan, organise, and manage our time and actions.

    Sequencing activities can help children improve in the following areas:

    • Planning and organisation: Sequencing tasks require children to think ahead, plan the steps involved, and organise them in a logical order.
    • Problem-solving: When they are faced with a problem, sequencing helps children break it down into smaller, more manageable steps.
    • Working memory: Holding information in mind and manipulating it, such as remembering the steps in a multi-step direction, is supported by sequencing skills.
    • Cognitive flexibility: Being able to adjust to changes in a sequence or think of alternative sequences promotes cognitive flexibility.

    Examples of sequencing activities

    Here are some practical examples of sequencing activities you can do with your child:

    • Picture sequencing: Use a set of picture cards to tell a short story or illustrate a process (e.g., making a sandwich, going to the park). Ask your child to arrange the cards in the correct order.
    • Story retelling: After reading a story, have your child retell it, focusing on the order of events.
    • Following instructions: Give your child multi-step instructions to follow (e.g., ‘First, get your shoes. Then, put on your coat. Next, go to the door.’).
    • Sequencing during play: Integrate sequencing into everyday play. For example, while building with blocks, talk about the steps: ‘First, we put this block here. Next, we add this one…’
    • Daily routines: Create visual schedules for daily routines, like getting ready for school or bedtime, to help children understand the sequence of events.
    • In the video clip below I am using an on-line language activity which is often fun for children as they can use their finger to swipe the pictures effortlessly into the right place and, if we realise at the end of the story that we have made a little error, we can then easily re-jig the pictures into their correct place.

    In conclusion

    Sequencing activities offer a powerful way to support children’s language development and enhance their executive functioning skills. By helping children understand and create order, we equip them with essential tools for communicating, learning, and navigating the world around them.

    Do get in touch via my contact form if you are concerned about your child’s development.

    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
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    Correcting a lisp

    Correcting A Lisp

    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.

    Initial consideration

    There are some factors which need to be considered before we can dive into therapy proper and these are they, in a nutshell:

    1. The 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.
    2. The 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.
    3. The student does not have enlarged tonsils as they can sometimes push a tongue forward and also cause open mouth posture and open mouth breathing.
    4. The 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’.

    Do not fear!

    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.

  • Speech sound disorders

    Kids Speech Therapist London
    Speech Sound Disorders

    Treatment Approaches – A Typical Session

    There are various great ways to treat speech sound disorders and I use all the approaches available selectively; I decide what works with each individual child and I also vary the approach depending on the child’s frame of mind at any given time during my session.

    Some of the approaches are more “drill-based” and require a child to be able to pay attention and really participate actively in the therapy, and this is what I am showing you today with this video clip.

    My little student here has been working with me for some time and from only saying a handful of words which were not very easy to understand he has come a long way. He does have some features of Verbal Dyspraxia which I shall briefly outline here:

    • Making sounds in general is a struggle, especially when asked to copy certain sounds, example: ‘can you say: a ee ou oo?”
    • Repeating sound sequences or words sequences is hard, for example: “say p-t-k in sequence” or “say fish chips fish chips fish chips
    • When saying the same word again and again, different mistakes can be heard
    • Intonation difficulties: speech sounds monotonous
    • Vocabulary is very limited

    Some therapy approaches are more play based, for example the Core Word method: here we pick a few words at a time which are very significant to the child and therefore highly motivating to try and say. These could be characters of Pokemon or Minecraft for example, or simple words like “GO!”

    When you watch the video you will see that I use a lot of visual prompting, such as showing him where the tongue is moving to or from. I do this with my index finger and this approach is called Tactile Cueing or “Cued Articulation”. Part of the approach is to give a visual prompt and then reduce the prompt as the learner is more able to produce the correct sounds. Once he can produce the sound on its own, we quickly move to the sound within a word.

    I do mix and match my approaches and in fact here I am drilling but I also use the Core Word which for him (YELLOW) — it’s his favourite colour and I happen to have quite a few good games where a YELLOW something or other can be asked for….. WHO KNEW!? 🙂


    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.