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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    Discover speech and language regression in autistic children and how you can support your child

    ByLondon Speech and Feeding
    Discover speech and language regression in autistic children and how you can support your child

    There’s often this idea that autistic children have extensive vocabulary and knowledge, but this is not always the case. In fact, 30% of autistic children have language regression.

    Goldberg (2003) suggested that speech and language regression refers to the decline in a young child’s speech and communication abilities. We know that regression in speech, language and communication skills often occur before the age of two years. 25% of autistic children develop language at word level between 12 and 18 months of age before losing this language they have learned. As you’re probably aware this regression in communication is a diagnostic indicator of Autism.

    We understand that you want your child to progress, and you struggle to watch as their frustration grows as you feel helpless. I want to provide you with tips so that you can feel empowered to support your autistic child and reduce the impact their communication skills have on the family.

    1. Reduce frustration by providing visuals to support their communication
    2. Model gestalts. We know that autistic children are often gestalt language processors. Learn more about gestalt language processors in one of my previous posts.
    3. Praise the ability to communicate. Focus on what they say not how they say it. E.g., good listening, nice talking.
    4. Provide your child with choices (using real objects to represent your choices). E.g., do you want an apple or banana?
    5. Your child must be motivated and have a purpose to communicate. So, ensure you use highly motivating objects for conversations
    6. Provide them with opportunities to communicate. We need to teach children that if they want something, there’s a process that you need to have the opportunity to ask for it. We find that if parents understand what their child wants (without them asking), the object is given to them, and so there’s no reason for your child to ask.
    7. There’s this idea that we need to teach children eye contact. This is not always the case. Your child is unique, we do not want to take their unique skills away.
    8. Model words which are concrete. E.g., words such as ‘finished’, ‘more’. You can model these several times within the day. You can use a gesture to make the word more visual (see the images below). We know that autistic children are often visual learners.
    Makaton fro "more"
    Makaton for “more”
    Makaton for "finished"
    Makaton for “finished”

    Credit: Little Dots Makaton, Polkadot World

    Remember that if your child has speech, language and communication regression, it doesn’t mean your child will stay static.

    It’s vital that you seek support from a qualified Speech and Language Therapist. We can tell you at what point in the communication development that your child is at. And we can support you through the process. We can provide you with an individualised plan specifically for your child to ensure you maximise their potential.

    Contact me for 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.

    1

  • Can AI help my child’s speech delay? What it can do and what it can’t

    ByLondon Speech and Feeding

    If you’re worried about your child’s speech, you are absolutely not alone. Many parents I work with tell me the same thing:

    ‘I’ve been Googling…’
    ‘I asked ChatGPT what activities to try…’
    ‘TikTok said we should practise this sound every day…’

    It makes complete sense. When waiting lists are long, evenings are quiet, and your child is struggling to communicate, it’s natural to look for help wherever you can find it.

    AI tools can actually be helpful in some ways. But they also have clear limits especially for children with significant speech delays or speech sound disorders.

    Here’s an honest, balanced guide to what AI can do, and what it simply can’t.

    ✔️ What AI can help with

    1. Explaining things in simple language

    AI can be very helpful for explaining speech and language terms in a way that’s easy for parents to understand for example, what a phonological delay is, or what Childhood Apraxia of Speech means. It can also suggest possible reasons for a child’s speech delay based on the information you provide.

    The difficulty is that parents (or teachers) can only ask questions based on what they notice or perceive to be the problem. In practice, this doesn’t always tell the full story. For example, parents often report that their child ‘can say certain words’, but during an assessment we may find those words are actually produced with consistent error patterns. These patterns give important clues about the underlying nature of the difficulty, whether it’s a delay or a disorder and they guide the speech therapist in choosing the most effective targets to improve intelligibility.

    2. Suggesting games and activities

    AI is very good at suggesting ideas for games and practice, such as word lists, simple play activities, sound practice games, book suggestions, and ways to encourage talking within everyday routines. These can be especially helpful when you feel stuck or want some fresh inspiration for supporting your child at home. It can help to think of AI as a big ideas bank, somewhere to dip into when you need new, playful ways to keep practice engaging.

    3. Helping you prepare questions for a therapist

    Some parents use AI to list questions before an assessment, understand reports and organise concerns.

    This can make therapy feel less overwhelming and more collaborative.

    Used this way, AI can actually support the therapy process.

    ❌ Where and why AI cannot replace real life speech therapy

    There is substantial research supporting the effectiveness of real-life speech therapy compared to generic online resources or AI-generated suggestions. Here are some key points highlighting why in-person therapy is often more beneficial:

    • Personalisation: Speech therapists assess each child’s unique needs, strengths, and challenges through direct observation and interaction. This personalised approach allows for tailored interventions that address specific issues, which generic resources cannot provide.
    • Nuanced understanding: Therapists are trained to recognise subtle cues in speech production, including the nuances of sound articulation, language comprehension, and social communication. This expertise enables us to identify underlying issues that may not be apparent through generic assessments.
    • Motivational support: A speech therapist can provide encouragement, motivation, and emotional support, which can significantly enhance a child’s willingness to participate and engage in therapy. This relational aspect is crucial for building confidence and reducing anxiety around communication.
    • Evidence-based practices: As a highly trained and specialised speech therapist I utilise evidence-based practices that are grounded in research, ensuring that the techniques used are effective and up to date. This contrasts with generic online information, which may not always be reliable or validated.
    • Progress monitoring: In-person therapy allows for ongoing assessment and adjustments to the treatment plan. We track progress over time and modify strategies as needed, ensuring that the therapy remains effective and relevant.

    Research studies consistently show that individualised, face-to-face interventions lead to better outcomes in speech therapy than generalised approaches. For parents and caregivers, seeking professional help tends to provide a more effective path toward improving their child’s communication skills.

    The healthiest way to think about AI

    AI works best as a starting point, not a substitute. You might use it to understand your child’s report and learn how speech develops,

    But if your child has significant delay or difficulty being understood, what makes the real difference is:

    • A tailored assessment
    • A clear therapy plan
    • Expert target selection
    • Ongoing adjustment
    • Support for both child and you the parent!

    Dear parents,

    If you’ve been turning to AI for help, it doesn’t mean you’re doing anything wrong. It means you care!

    But please know the best outcomes usually come from combining your daily support at home with guidance and support from your speech therapist who knows you and your child.

    Many of my past and present clients tell me that they really value my ‘handholding’ and me guiding them in between the sessions. A quick check in is often all that is needed but it makes a huge difference!

    If you’d like support or advice, please contact me and I can help guide the next steps.

    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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  • · · · ·

    Let’s ditch the ‘Fix-It’ approach to autistic play and stimming

    ByLondon Speech and Feeding
    Let’s ditch the 'Fix-It' approach to autistic play and stimming

    December is often presented as a time of perfect, reciprocal play. Children are supposed to be unwrapping toys, sharing, and engaging in imaginative scenarios with family. But for parents of young autistic children, this high-pressure, socially demanding period can often feel like a battleground.

    If you’ve been told to interrupt your child’s stimming, push for eye contact, or force them to play ‘functionally’ with toys, it’s time to take a deep breath. Those traditional approaches are not only stressful—they often miss the point of your child’s communication.

    As a neurodiversity-affirming Speech and Language Therapist, I want to encourage you this December: You are allowed to follow your child’s lead, validate his or her unique interests, and trust that his or her play and movement are profoundly meaningful.

    1. Stimming: not a distraction, but a regulator 💡

    Stimming is short for self-stimulatory behaviour and includes repetitive movements or sounds like hand flapping, humming, rocking, finger flicking, or repeating phrases (called echolalia).

    For years, parents were incorrectly advised to block or eliminate these behaviours. The neurodiversity-affirming view tells us the exact opposite: Stimming is a vital and essential tool for your child’s self-regulation.

    Think of stimming as an internal volume dial:

    • Too loud/overwhelmed: Your child may stim to reduce incoming sensory input (e.g., rocking to ground himself or herself in a busy room).
    • Too quiet/under-stimulated: Your child may stim to increase sensory input and focus (e.g., running back and forth to maintain alertness).

    The shift: validate, don’t block

    Instead of saying, ‘Stop flapping your hands’, try to understand the message behind the movement.

    • Observe: When does the stimming happen? Is it before a meltdown? When your child excited? When your child is bored?
    • Validate: Name the need, not just the behaviour. You might say, ‘I see your body needs to move fast right now. That helps you calm down!’
    • Co-regulate: If the stim is unsafe (e.g., head-banging), help your child find a safer, alternative stim that meets the same sensory need (e.g., pushing hard against a wall, squeezing a stress ball).

    By validating your child’s need to regulate, you are building trust, reducing anxiety, and teaching him or her critical self-awareness.

    2. Autistic play: Meaningful, even if it’s monologue

    The traditional idea of ‘good play’ often involves turn-taking, pretending, and specific toy functions (e.g., pushing a train around a track). When an autistic child spends 30 minutes lining up cars, spinning their wheels, or scripting whole scenes from a favourite movie, it can often be dismissed as non-functional or repetitive.

    In neurodiversity-affirming practice, we recognise that autistic play is authentic play. These activities are crucial for learning, deep focus, and imaginative development.

    • Lining up toys may be an exploration of patterns, visual organisation, and order.
    • Spinning wheels may be a deep interest in cause-and-effect and visual sensory input.
    • Scripting is often a way to process language, regulate emotions, and practise complex social situations in a safe, controlled way.

    Make a change: Join your child’s world, don’t drag them to yours.

    Stop trying to force the ‘right’ way to play. Instead, try these neuro-affirming strategies:

    1. Be a co-regulator, not a director: If your child is lining up cars, sit down next to him or her. Instead of moving a car, try handing him or her another car to line up. Focus on the shared interest rather than forcing interaction.
    2. Narrate (don’t question): Avoid constantly asking, ‘What are you doing?’ or ‘What does this car say?’ This puts pressure on your child to perform. Instead, narrate your observations using his or her interest: ‘I see you made a long, straight line of red cars. Look at all the wheels spinning!’
    3. Validate the interest: Show genuine appreciation for your child’s focus. ‘Wow, you know so much about how magnets stick together! That’s incredible.’

    3. The communication revolution: Honouring gestalt language processing 

    Many young autistic children communicate in ways that don’t fit the traditional model of building language word-by-word. Many use Gestalt Language Processing (GLP).

    A gestalt language processor learns language in chunks or scripts (e.g., ‘what’s-in-there?’ or ‘ready-go!’). These chunks (or gestalts) are not random; they are often tied to an emotional memory or meaning. Over time, the child breaks down these big chunks into individual words then learns to recombine those words creatively.

    If your child repeats movie phrases or whole sentences that seem unrelated, he or she is likely a gestalt language processor!

    Affirm the script, then model something useful.

    1. Affirm the script: When your child says a script, respond to the meaning or emotion behind it, not the literal words. If he or she says, ‘We’re going to need a bigger boat’, and he or she is looking at a messy toy pile, he or she may be trying to express overwhelm or a need for help. You can affirm: ‘That pile is too big! I can help you move it.’
    2. Model new ‘mix and match’ scripts: To help your child move from whole scripts to single words, you can model shorter, slightly changed versions of the script, also called ‘mitigated gestalts’. If they say, ‘I want to go home now’, you might model, ‘Let’s go home, now’ or ‘I wanna go home’.

    By honouring your child’s communication style, you validate his or her experience and naturally support his or her path to language development—a core part of neurodiversity-affirming SLT.

    Your December gift to your little one:

    This December, stop trying to make your child fit into a neurotypical box. Instead, make your home a safe space where he or she can be his or her authentic selves.

    Prioritise regulation and connection over compliance.

    Trust that when your child is regulated, his or her communication, learning, and engagement will flourish naturally. This is the true gift of neurodiversity-affirming practice.

    Download and print my neuro-affirming quick reference guide and keep this guide handy on your fridge and/or in your child’s play area for a quick reminder to prioritise connection over conformity.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

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

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

    2
  • · ·

    My child is hard to understand at school age. Should I be concerned?

    ByLondon Speech and Feeding

    Many parents notice speech errors when their children are toddlers. At that stage it often feels quite normal. Young children are still learning the sounds of their language, and those early mispronunciations can be very endearing.

    But as children grow older, parents sometimes begin to wonder:

    ‘Should my child still be speaking like this?’

    A common concern I hear from families is that their child is still difficult to understand even after starting school. Sometimes it is a parent who notices it first. Other times it is a teacher who gently mentions that classmates occasionally struggle to understand what a child is saying.

    When this happens, parents naturally wonder whether it is something their child will grow out of, or whether some extra support might help.

    When should children’s speech be clear?

    Children learn speech sounds gradually over several years. Some sounds develop earlier, while others take longer to master.

    By the time children reach five to six years of age, most of their speech should be clear enough for unfamiliar adults to understand. There may still be a few tricky sounds developing (such as /R/ or /TH/), but overall speech should be fairly easy to follow.

    If a child is frequently difficult to understand at school age, it can sometimes indicate that a speech sound difficulty has persisted beyond the stage when it would normally resolve on its own.

    Why some children remain hard to understand

    There are several reasons why speech clarity may still be developing in older children.

    Phonological patterns

    Some children continue to use speech patterns that are typical of younger children. For example:

    • saying ‘tat’ instead of ‘cat’
    • saying ‘doe’ instead of ‘go’
    • leaving sounds out of words

    These patterns are called phonological processes. They are a normal part of early speech development, but when they persist into the school years they can make speech difficult for others to understand.

    Difficulty producing specific sounds

    Other children may have difficulty producing certain individual sounds clearly. This might include sounds such as:

    • /S/
    • /SH/
    • /R/
    • /TH/

    These difficulties are called articulation difficulties.

    A child might understand exactly what they want to say but find it hard to produce the sound accurately with their tongue, lips or airflow.

    Motor speech planning challenges

    For some children, the difficulty lies in the planning and coordination of the movements needed for speech.

    Speech requires very precise timing between the tongue, lips, jaw and breath. If the brain finds it difficult to organise these movements consistently, speech can sound unclear or inconsistent.

    In some cases this may relate to Childhood Apraxia of Speech, although only a full assessment can determine this.

    Why clarity matters for school-age children

    Speech clarity becomes particularly important once children start school.

    At this stage, children are:

    • Answering questions in class
    • Talking with friends
    • Reading aloud
    • Developing confidence in communication

    When speech is difficult to understand, children sometimes become more hesitant to speak, particularly in group situations.

    This can affect confidence and participation, even when the child has lots of ideas they would like to share.

    The good news: speech can improve

    The encouraging news is that speech sound difficulties can often improve significantly with the right support.

    Speech therapy focuses on helping children:

    • Learn how sounds are produced
    • Practise accurate speech movements
    • Understand how sounds change meaning in words
    • Build consistency through structured practice

    Different children benefit from different therapy approaches. Some need support with phonological patterns, while others benefit from more motor-based practice that strengthens speech coordination.

    Often therapy combines several strategies to support the child’s individual speech profile.

    When to seek advice

    If your child is already at school and you find that people outside the family often struggle to understand them, it can be helpful to seek advice from a speech and language therapist.

    A detailed assessment can help identify:

    • Which sounds are causing difficulty
    • Whether patterns such as fronting or sound substitutions are present
    • Whether motor planning challenges may be contributing
    • Which therapy approach is likely to be most effective

    Early support can help children develop clearer speech and greater confidence in communication.

    Every child’s speech journey is different

    Speech development is not the same for every child. Some children master speech sounds quickly, while others need a little more guidance along the way.

    The important thing is that support is available when children need it.

    With the right strategies and practice, many children make excellent progress and develop speech that is clearer, more confident and easier for others to understand. If you are concerned about your child’s speech clarity or ongoing speech sound errors, a speech and language assessment can help identify the underlying difficulty and guide the most appropriate support.

    Feel free to contact me on my contact page.

    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.

    3

  • Submucous cleft palate: What is it and how does it impact on speech?

    ByLondon Speech and Feeding
    Submucous cleft palate: What is it and how does it impact on speech?

    What exactly is a submucous cleft palate?

    A submucous cleft palate (SMCP) is much less obvious than its counterparts, cleft of lip and/or palate, and can profoundly impact a child’s speech development. It leads to often extreme hyper nasal speech and difficulty with producing many sounds (/K/ /G/ /T/ /D/ /P/ /B/ /S/ /Z/ /F/ /V/).

    In short, the muscles and bone of the soft palate, and sometimes the hard palate, do not fuse completely during foetal development and the mucous membrane that lines the roof of the mouth remains intact, effectively camouflaging the underlying muscular and bony deficit.

    So, while the surface of the palate appears normal, the essential muscle and functions responsible for sealing off the nasal cavity from the oral cavity during speech are compromised. This cleft (or lack of muscle) can be seen as a bluish midline discoloration of the soft palate, often a bifid (split) uvula, and at times a notch in the posterior border of the hard palate can be felt upon palpation. However, these signs aren’t always present or easily discernible, contributing to the difficulty arriving at a diagnosis.

    Diagnosing a submucous cleft palate is often akin to searching for a needle in a haystack, especially for the untrained eye. Unlike overt clefts that are visually apparent at birth, an SMCP can go undiagnosed for years, sometimes well into childhood or even adolescence. Paediatricians and even ENT surgeons have been known to miss it during routine checks due to the intact mucosal lining. Parents might notice their child’s speech sounds ‘different’ or ‘nasal’ but struggle to pinpoint the cause. Children might undergo extensive speech therapy without a proper diagnosis, as the underlying structural issue continues to hinder progress.

    My experience as a speech therapist in private practice:

    Over my years of practice, I have encountered several children presenting with persistent hyper-nasal speech and significant difficulties producing plosive and fricative sounds.

    It has been incredibly rewarding, though at times challenging, to successfully diagnose SMCP in a number of these children. My approach often involves:

    • a meticulous oral motor examination,
    • careful listening for the specific qualities of hypernasality,
    • and a deep understanding of the physiological requirements for clear speech sound production.

    When I suspect an SMCP, I refer these children to Great Ormond Street Hospital where a fantastic multidisciplinary team, typically including ENT surgeons and a specialist speech-language therapist can conduct more definitive assessments. These assessments often involve instrumental analyses such as videofluoroscopy or nasoendoscopy, which provide objective measures of velopharyngeal function and visual confirmation of the anatomical deficit.

    The path to resolution: surgery, therapy, and successful outcomes

    Surgery

    The journey for these children, once diagnosed, often involves surgical intervention. It’s not uncommon for children with SMCP to undergo multiple operations to achieve optimal velopharyngeal closure. These procedures aim to reconstruct or augment the velopharyngeal mechanism, enabling it to effectively separate the oral and nasal cavities during speech. The specific surgical approach depends on the individual child’s anatomy and the severity of the velopharyngeal insufficiency. It’s a testament to the skill of these specialised surgeons that such intricate repairs can be performed with remarkable success.

    Speech therapy

    Following surgery these children embark on the crucial phase of speech therapy. While surgery addresses the structural problem, speech therapy helps a child learn to utilise their newly improved anatomy. It involves intensive work on developing oral airflow, establishing correct articulatory placement, and reducing learned compensatory strategies that have developed due to the original structural deficit. It is immensely gratifying to witness the transformation. Children who once struggled to produce basic sounds, whose speech was difficult to understand, gradually develop clear speech.

    Next steps?

    If you’re a parent concerned about your child’s speech and feeding, you’re not alone. The journey can feel confusing, but professional guidance can make all the difference. Never hesitate to have a second opinion when you have that niggling feeling that there is something that has not yet been explored. At London Speech and Feeding I specialise in being thorough and thinking outside the box.

    I am here to provide the support you need. Reach out to schedule a consultation and take the first step towards helping your child communicate and thrive.

    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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  • · ·

    Why pointing matters: Unpacking the power of this simple gesture

    ByLondon Speech and Feeding

    As a speech and language therapist, I’m often asked about the significance of seemingly simple gestures in child development. One question that comes up frequently is, ‘Why is pointing so important?’ It might seem like a trivial action, but pointing is a powerful communication tool and a critical milestone in a child’s development.

    Why is pointing so important?

    Let’s delve into the theory behind why pointing matters:

    1. Pointing as pre verbal communication:

    Before children can use words, they use gestures to communicate their needs and interests. Pointing is one of the earliest and most important gestures. It allows children to:

    • Request: ‘I want that!’
    • Protest: ‘No, not that!’
    • Direct attention: ‘Look at that!’
    • Share interest: ‘Wow, cool!’

    2. Pointing and language development:

    Pointing is not just about communicating in the here and now; it also plays a crucial role in language development. Research shows that:

    • Early pointing predicts later language skills: Children who point more often tend to have larger vocabularies and better grammar later on.
    • Pointing helps children learn new words: When children point at something, adults tend to label it, providing valuable language input.
    • Pointing supports joint attention: Joint attention, or the shared focus of two individuals on an object or event, is essential for language learning. Pointing helps establish joint attention, creating opportunities for communication and learning.

    3. Pointing and social-emotional development:

    Pointing is not just about language; it’s also about social interaction. It allows children to:

    • Engage with others: Pointing invites others to share their focus and participate in their world.
    • Express emotions: Pointing can convey excitement, curiosity, or concern.
    • Develop social understanding: By observing how others respond to their pointing, children learn about social cues and communication.

    4. Pointing and cognitive development:

    Pointing is linked to cognitive skills, such as:

    • Understanding object permanence: The ability to know that objects exist even when they are out of sight.
    • Categorisation: The ability to group similar objects together.
    • Problem-solving: Pointing can be used to ask for help or to indicate a problem.

    5. Types of Pointing:

    It’s important to note that there are different types of pointing, each with its own significance:

    • Imperative pointing: To request something.
    • Declarative pointing: To share interest or direct attention.
    • Informative pointing: To provide information.

    If you have concerns about your child’s pointing or overall communication development, don’t hesitate to seek professional guidance from a speech-language therapist. Early intervention can make a significant difference in supporting your child’s communication journey.

    How can we create opportunities for pointing?

    • ‘Where’s the…?’ games:
      • Play games like ‘Where’s the doggy?’ or ‘Where’s the ball?’ and encourage your toddler to point to the object.
      • Start with familiar objects and gradually introduce new ones.
    • Reading together:
      • When reading picture books, ask your toddler to point to specific objects or characters on the page.
      • Use phrases like, ‘Can you point to the puppy?’
    • Everyday activities:
      • During daily routines, ask your toddler to point to things they want or need.
      • For example, ‘Do you want the apple or the banana?’
      • When walking outside say ‘LOOK’ and encourage pointing.
    • Use of toys:
      • Use toys that have buttons or points of interest that when pressed make a noise. Encourage your toddler to point to the area that makes the noise.
      • Use toys that have many different parts, and ask the toddler to point to a specific part.

    Model pointing:

    • Point yourself:
      • When you see something interesting, point to it and say the name of the object.
      • For example, ‘Look! A bird!’
    • Point to show choices:
      • When offering choices, point to each item as you name it.
      • For example, ‘Do you want the blue cup or the red cup?’ (Point to each cup).
    • Point to indicate direction:
      • When giving directions, point in the direction you want your toddler to go.
      • For example, ‘Let’s go that way!’ (Point).

    Make it rewarding:

    • Respond to pointing:
      • When your toddler points, immediately respond to their communication.
      • Give them the object they want, or acknowledge what they are pointing at.
    • Use positive reinforcement:
      • Praise and encourage your toddler when they point.
      • Say things like, ‘Good pointing!’ or ‘You showed me the car!’
    • Show excitement:
      • When they point to something, show excitement, this will encourage them to point again.

    Use specific techniques:

    • Use gestures and verbal cues:
      • Combine pointing with verbal cues and other gestures.
      • For example, say ‘Look!’ while pointing and nodding your head.
    • Simplify the environment:
      • Reduce distractions to help your toddler focus on the object you want them to point to.
    • Use exaggerated movements:
      • Use large, exaggerated pointing movements to draw your toddler’s attention.

    Consider developmental factors:

    • Age-appropriate expectations:
      • Remember that pointing develops at different rates for different children.
      • Be patient and supportive.
    • Underlying issues:
      • If your toddler is not pointing by 18 months, or if you have any concerns about their development, consult with a speech and language therapist.
      • There may be underlying sensory or motor issues.

    Key points:

    • Consistency is key. Practise these strategies regularly.
    • Make it fun and engaging for your toddler.
    • Celebrate every success, no matter how small.
    • If you have any concerns about your child’s development, contact your local health services.

    Great toys and items for pointing

    1. Interactive books:

    • Touch-and-feel books: Books with different textures, flaps to lift, and sounds encourage interaction and pointing. ‘Where’s the…?’ questions prompt pointing to specific features.
    • Books with simple pictures: Clear, uncluttered pictures make it easier for toddlers to focus and point to objects or characters.

    2. Cause-and-effect toys:

    • Activity cubes: These often have buttons, dials, and levers that produce sounds or actions when manipulated, prompting pointing and exploration.
    • Pop-up toys: Toys where figures pop up or things happen when a button is pressed encourage anticipation and pointing to the action.
    • Simple musical instruments: A toy piano, drum, or xylophone encourages pointing to the keys/surfaces to make sounds.

    3. Toys with parts to manipulate:

    • Shape sorters: Encourage pointing to the shapes and the matching holes.
    • Stacking cups or rings: Nesting cups or stacking rings invite pointing to select the correct size or order.
    • Puzzles with knobs: Simple puzzles with large knobs are easier for toddlers to grasp and point to the pieces.

    4. Toys that encourage joint attention:

    • Bubbles: Blowing bubbles and following them with your eyes and pointing encourages joint attention (shared focus).
    • Balls: Rolling a ball back and forth and pointing to where it’s going can promote joint attention and turn-taking.
    • Wind-Up Toys: Wind-up toys that move across the floor can be exciting to follow with pointing.

    5. Pretend play toys:

    • Toy telephones: Encourage pointing to the buttons and pretending to dial.
    • Dolls and stuffed animals: Pointing to the doll’s eyes, nose, mouth, etc., or asking the child to point to these features on themselves.
    • Toy food and dishes: Pretend play with food and dishes can involve pointing to request items or indicate actions (e.g., ‘Can I have the apple?’).

    Tips for using toys to encourage pointing:

    • Get involved: Play alongside your toddler, modelling pointing and using language to describe what you’re doing.
    • Follow their lead: Observe what your child is interested in and use that to encourage pointing.
    • Limit distractions: Reduce background noise and visual clutter to help your child focus.
    • Use gestures and words: Combine pointing with words and other gestures (e.g., ‘Look!’ while pointing).
    • Be patient and positive: Celebrate all attempts at pointing and provide lots of encouragement.

    Remember, the most important factor is the interaction you have with your child while playing. Use these toys as tools to create opportunities for communication and joint attention, and your toddler will be well on their way to mastering pointing!

    Get in touch with me via my contact form if you need support

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

    Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

    The London Speech and Feeding Practice

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

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