Discover more about Verbal Dyspraxia

ByLondon Speech and Feeding
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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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Bubble speech with a testimonial

Discover the secrets to applying for an Education and Healthcare Plan

ByLondon Speech and Feeding
Bubble speech with a testimonial

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.

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

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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Milestones of autistic chidren
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Milestones of Autistic Children: Crawling, Walking, and Talking

ByLondon Speech and Feeding
Image by wayhomestudio on Freepik

For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.

1. Individual Pacing:

Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.

2. Neurodevelopmental Complexity:

The human brain is a remarkable entity, with a bewildering array of interconnected processes that lead to us achieving our developmental milestones. Autistic children often have variations in “neural wiring”, which can impact the balance between gross motor skills (crawling, walking) and fine motor skills. Speech and language acquisition falls under fine motor skills and may be momentarily disrupted due to the divergent neurological pathways at play in autism.

2. Sensory Processing Differences:

One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.

3. Visual-Spatial Abilities:

Autistic children and adults frequently display excellent visual-spatial abilities. This strength might lead some children to focus more on activities that engage these skills, potentially delaying their engagement with activities like walking or talking. As they navigate their environment and process information visually, they might naturally invest more time in activities that stimulate this particular cognitive ability and strength.

4. Communication Challenges:

For many autistic children, speaking can be a really complex and difficult endeavour. Communication delays are a common feature of autism. This can affect both receptive and expressive language development. While some children might be physically capable of crawling or walking, they may not yet have the tools to communicate their desires and intentions. This leads to a temporary focus on non-speaking forms of expression. This does not mean that they do not communicate at all. But autistic individuals often start out using jargoning or echolalia as a form of communication as well as behaviours and physical forms of communication.

5. Executive Functioning and Motor Skills:

Executive functioning, or abilities for planning, organising, and carrying out tasks, can vary in autistic children. These skills are crucial for activities like crawling, walking, and talking, which need coordination and planning. About 40% of autistic persons have a motor planning difficulty.

6. Intense Interests and Routines:

Autistic children often develop intense interests in specific subjects, sometimes to the exclusion of other activities. These interests might become their primary mode of engagement. They might side-line milestones like crawling, walking, or talking. The mostly rigid adherence to routines and preferences might cause them to allocate more time to their preferred activities. This delays their engagement with other developmental tasks.

How can Speech and Language Therapy help:

Support and Intervention:

Early intervention and regular Speech and Language Therapy play a pivotal role in the developmental journey of autistic children. Therapies tailored to individual needs can aid in bridging the gaps between milestones. Occupational therapy, for example, can help address sensory sensitivities and motor skill challenges that might impact crawling and walking. Speech therapy can help communication development, gradually bridging the gap between non-verbal expressions and spoken language.

For example, we now know that echolalia or jargoning of longer phrases with intonation, repeating scripts from favourite tv shows or songs have many meanings and communicative functions. For example, a child who utters long strings of echolalic utterances, often difficult to understand, might want to do any one of the following:

  • Comment
  • greet
  • ask a question
  • make a request
  • express surprise
  • negate something.

We now understand that the way to support a child with echolalia is to acknowledge all utterances and try and find out what the meaning is behind these scripts. This is very supportive. Over time it will lead a child to move on to understanding and saying more clear and self-generated language. For more information about this Natural Language Acquisition here are some other great websites for you to look at:

Conclusion

In conclusion, the journey of an autistic child’s development is a testament to the uniqueness and complexity of the human mind. The delays or differences in achieving milestones like crawling, walking, and talking can be attributed to a range of factors, including

  • neurodevelopmental intricacies,
  • sensory processing variations,
  • and communication challenges.

It’s crucial to recognise that these delays are not indicative of a lack of potential, but rather a manifestation of the intricate interplay between an autistic child’s strengths and challenges. By embracing these differences and providing tailored support, we can help each autistic child unfold their potential at their own pace.

Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

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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A woman is looking down at a child in her arms

Ten Top Tips for Parents and Carers to Encourage their Children’s Communication Development

ByLondon Speech and Feeding
A woman is looking down at a child in her arms

Read some of my top tips so you can make your communication as effective as possible. You’ll be able to make the most out of everyday opportunities to support your child’s speech, language and communication development.

  1. We need to go beyond the child’s needs. Think about their interests and what they may want to communicate. If they can express their wants, they are more likely to be motivated. Motivation is a big factor to ensure successful outcomes in therapy.
  2. Practice really does make perfect. So, 10 minutes twice daily is more effective than an hour every two weeks. To begin with, practise these strategies in a structured activity and then, when you’re comfortable, you can begin to generalise them to other contexts in your child’s life.
  3. Add an element of play into your communication. Make it exciting!! You could add suspense or anticipation. You could use exaggeration to add to the drama, or you could simply change the pace to add a different dimension to your interaction.
  4. Use the ‘wait’ from the OWL strategy to see if your child initiates or makes a request.
  5. Create a list of these requests that your child responds well to. You will be able to notice any patterns and create more of these opportunities to give your child more success.
  6. Talk about the rhythm in everyday experiences such as tapping your foot or describe the rhythm of the washing machine or dishwasher. Try to find everyday sounds in your child’s environment that you can talk about.
  7. Add a gesture to the sound or rhythm. We know that a lot of children are visual learners so adding a gesture will support their understanding and use of language.
  8. Ensure you look animated and this will encourage your child to participate.
  9. Learn to create opportunities for your child every day.
  10. Remember that we are not forcing our children to participate. We are simply making the activity irresistible. Above all, remember communication should be fun, so be creative!!

You may feel like you need some reassurance, someone to check in with to make sure you’re maximising these opportunities. 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.

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

Learn the benefits of Cycles Phonology Approach in Speech Therapy

ByLondon Speech and Feeding
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., “tat” instead of “cat”)
  • Backing (instead of making a sound at the front of the mouth, it’s made at the back e.g., “gun” instead 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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And woman and a child playing with spades in the sand
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Four reasons to continue Speech and Language Therapy during the summer

ByLondon Speech and Feeding

The summer holidays can be tricky for parents as there is so much to do: organising childcare, the actual holiday, and trying to have some all-important ‘me time’. Speech therapy for your little one might be the last thing on your mind. But …. If we can prioritise only a small amount of time every day then we are maximising time and finances spent thus far and can continue your child’s Speech and Language Therapy sessions throughout the summer, no problem. Have a look at this blog. We’ll take you through good reasons why you shouldn’t ignore Speech and Language Therapy sessions this summer.

1. Building communication skills takes time

You’ve worked so hard throughout the year to support your child’s speech, language and communication. Now is the time to continue, not to stop! You will watch your child’s communication and confidence grow and flourish over the next couple of months. All the different experiences your child will have on holiday or just even pootling about in your local park with you, or granny/nanny will help expand their capacity for learning and using language and words to communicate with you. If you have time during the summer, you can embed the skills your child has learnt into everyday life which is vital . If in doubt ask how you can use the strategies you have learned in any new environment. Together we can workshop all eventualities and make them fun and doable. There is no end of fun and opportunities with a bucket, spade and a bit of sand!

2. Getting to know your child’s Speech and Language Therapist is vital

Here’s a plug for regular therapy sessions: building a rapport with your child’s Speech and Language Therapist is key. If our sessions together are consistent and regular, then it will be so easy for us to develop a good rapport with your little one. Trust is key. So if sessions are infrequent and irregular it is hard for your child to build up trust with their therapist and it is hard for the therapist also to get you know your child and tailor the sessions so that they really work very well. We need to know what your child loves and what activities or toys work well; so, if sessions are missed and irregular then the process just takes longer.

3. Goals are set and measured

Sometimes a break is needed and that’s fine. We measure goals within a certain time frame and whilst a few weeks holiday are great for everyone, we don’t want to lose any progress your child has made. If a child does not attend sessions, progress will often diminish as consistency in therapy is key!

4. You’ll be able to embed skills over the summer at home

Did you know you can access Speech and Language Therapy wherever you are with our remote service? Teletherapy allows flexibility which means your child’s sessions can be wherever you are. Whilst this isn’t for everyone, it does allow regular sessions to continue. If that does not work for you then let’s talk about how we can help you transfer all the therapy goals into your holiday. You will be surprised how easy it is: lots of goals can be worked into snack times for example or bath times. You will have those wherever you are so this won’t take away your holiday fun, promise!

Find out more about teletherapy.

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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Sonja is sitting on the floor facing a young boy. Both are clapping their hands.

Why imitation is a powerful strategy to support social communication

ByLondon Speech and Feeding

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

You may have noticed that your child has difficulties in some of the areas mentioned above. They might be less responsive to you and appear to be quite happy in their own world. Whilst we do not want to change their unique characteristics, we do need to prepare them for future experiences, and what is socially acceptable.

How will copying my child develop their social communication?

  1. If your child is already engaged with a certain activity, they are already interested and motivated. You’re not competing for their attention.
  2. Both yours and your child’s attention is on the same activity which makes imitating for you (as the parent) easier.
  3. Studies have demonstrated that when a parent imitates a child, they are more likely to look at the adult.
  4. Imitation not only supports eye contact but supports facial expressions (such as smiling), may increase vocalisations, and encourages your child to sit closer to you.
  5. Children learn through trial and error. They may start to try to perform new actions to gain their parents attention. Let your child lead the play!!

How do I start imitating my child?

  1. Start with observing them. Take the time just to watch. You don’t need to make notes. Sit back and observe their actions, movements, and sounds they make.
  2. Wait for your child’s reaction when they realise you are copying their actions. Remember they may not notice, you don’t need to remind them, simply copy them again.
  3. Having the same set up as your child allows them to feel in control. So, you may have two sets of the same activity rather than copying using their set of toys.

This may sound daunting, but it doesn’t have to be. Start with a ten-minute time frame where you choose to copy your child. This is where you can practise your imitation strategy. Ten minutes a day is far more effective than an hour every two weeks. You may feel self-conscious but trust the process. Build your confidence, whilst exposing your child’s to increased language and communication, enabling them to develop vital social communication skills.

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

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

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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