We are all aware that Autism is on a spectrum. By the very nature of this, it means that every child will present differently, so an individualised approach is required. We need to remember to use a child’s strengths to support their needs. By using a person-centred approach, you’ll see your child’s literacy develop and thrive.
I hear many parents concerns about literacy as well as communication. Will they be able to read, write and spell? How will they manage their literacy independently? The questions are endless, so let’s look at how you can support your child’s literacy skills and how together we can provide a scaffold to them becoming independent learners.
The one thing we know is that Autistic children are visual learners. They succeed by us sharing pictures and demonstrating how the narrative is shown.
Start reading to your child at an early age. You can never start too early. This creates a love for books and supports vital pre-literacy skills (such as increasing vocabulary, following narratives, awareness of sounds in words, and letter recognition and awareness). By supporting pre-literacy skills, you’re starting the process to create confident young readers.
There are many ways to use books. You can narrate the story using different voices and tones to increase interest. You can do this even if your child isn’t interested. They are still listening and learning vital skills. You may even ask and answer questions and voice the skills that they will need for internal monitoring.
Use their interests to select appropriate reading material. In addition, you can then create questions on the book and provide a scaffold to support your child with the answer.
Use technology to spark their interest in reading. Demonstrate how they can read online. This is often successful as it becomes an individual activity as opposed to needing social interaction.
Provide them with a choice of texts (e.g., would you like ‘Perfectly Norman or when things get too loud’) rather than an open-ended question such as ‘What book would you like to read?’
Write key pieces of information down on paper. Research suggests that Autistic learners understand written text better than speech.
You could have a ‘word of the day’ from chosen reading material that you explore together.
Reading aloud to your child can have many benefits which include understanding vocabulary to how the book is read, with appropriate intonation.
I highly recommend the boom decks as they are a great resource!
The ethos at London Speech and Feeding:
“If they can’t learn in the way we teach, then we teach the way they learn”
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.
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!
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.
As a speech and language therapist, one of the most common questions I hear from parents is:
‘They can talk, but their speech still sounds immature. Is this normal?’
Many children between the ages of three and seven use speech patterns that make their words sound different from adult speech. These patterns are known as phonological processes, and for younger children, they are a normal part of speech development.
However, when these processes persist beyond the expected age, they can start to affect clarity, confidence and learning, especially once children enter school.
Phonological processes are patterns of sound simplification that children use while their speech system is developing.
Instead of learning each sound one by one, children initially organise sounds into patterns that make speech easier to produce. This is a normal and efficient strategy for a developing brain.
For example:
saying ‘tar’ instead of ‘car’
saying ‘poon’ instead of ‘spoon’
saying ‘bud’ instead of ‘bus’
These are not ‘bad habits’. They are part of how speech develops.
The key question is how long these patterns last.
Common phonological processes (and when they usually disappear)
Below are some of the most common processes parents notice in 3–7-year-olds.
1. Final consonant deletion
Leaving off the last sound in a word
‘ca’ for cat, ‘da’ for dog
Typically resolved by 3–3½ years
2. Fronting
Replacing back sounds (k, g) with front sounds (t, d)
‘tar’ for car, ‘do’ for go
Typically resolved by 3½–4 years
3. Cluster reduction
Omitting one sound in a consonant cluster
‘poon’ for spoon, ‘top’ for stop
Typically resolves by 4–5 years (some clusters slightly later)
4. Gliding
Replacing /R/ or /L/ with /W/ or /Y/
‘wabbit’ for rabbit, ‘yion’ for lion
Can be typical up to 5–6 years
5. Weak syllable deletion
Leaving out unstressed syllables
‘nana’ for banana
Usually resolved by 4 years
If these patterns continue past the expected age, speech can remain difficult to understand particularly for unfamiliar listeners such as teachers, peers, and also Auntie Karen or grandparents who visit once in a while.
Why phonological processes matter in school-age children
By the time children reach reception and Year 1, speech clarity becomes increasingly important.
Persistent phonological difficulties can affect:
being understood by teachers and peers
phonics and early reading
spelling
confidence in speaking
willingness to participate in class
Some children become aware that they ‘sound different’ and may speak less, avoid longer words, or become frustrated when misunderstood.
What’s the difference between a delay and a disorder?
This is an important distinction.
A phonological delay means a child is following the normal pattern of development, just more slowly.
A phonological disorder means the child is using atypical patterns, or continuing age-expected patterns well beyond when they should have resolved.
You may want to seek professional advice if your child:
is 3½ years or older and still hard to understand
is understood well by family but not by others
becomes frustrated or avoids talking
has difficulty with phonics or spelling
uses several phonological processes at once
has not made progress despite time and encouragement
Early support does not mean something is ‘wrong’. It simply helps speech development move forward more efficiently.Research consistently shows that unresolved phonological processes beyond the expected age can impact intelligibility, literacy and confidence (Dodd, 2014; Bowen, 2015).
How speech therapy helps phonological development
Phonological therapy is not about drilling individual sounds endlessly.
Instead, therapy focuses on:
helping children recognise sound patterns
building awareness of contrasts (e.g. ‘tar’ vs ‘car’)
practising speech in meaningful, playful ways
supporting generalisation so progress carries into everyday speech
For school-aged children, therapy is usually structured, motivating and highly targeted and progress can be very encouraging.
A final reassurance
Many children with phonological difficulties go on to develop clear, confident speech with the right support.
If you’re unsure whether your child’s speech is ‘just a phase’ or something that needs attention, a professional assessment can give clarity and peace of mind.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
When working with Gestalt Language Processors, it is always advisable to use child-led therapy. What does that mean? Child led therapy involves following a child’s interests and allowing her/him to lead the play activity throughout the speech and language therapy session. In other words, instead of having my own ideas of what we might want to play with or what activities I might try and use, I provide a range of toys I know the child likes or has played well with before; then I wait for the child to pick what she/he enjoys doing.
Play can be very repetitive and we can often see our child cycling back to the same one or two toys throughout the session. But this is what she/he needs to do at that time and it means that we have focused attention and engagement. This in turn is very helpful for the therapeutic process, which is to offer great scripts and phrases/words alongside what she/he is playing with.
Monotropic minds
Often the mind of autistic children is more strongly pulled towards a smaller number of interests or hobbies as I like to call them. Dr Dinah Murray, Dr Winn Lawson and Mike Lesser have found in 2005 that autistic people have ‘monotropic’ minds. They explain that autistic children focus their energy on a narrow range of activities as the energy required to switch between several toys is much higher than we would see in the neuro-typical population.
Gestalt Language Processors are often also Gestalt Cognitive Processors. This is when experiences are retained as episodic events and memories. An event is remembered by specific parts of the same event. And, therefore, these specific parts should always be part of that event, when the event is repeated.
Should any of the specifics be changed or are missing, then this can cause great upset to Gestalt Cognitive Processors. So, for example, if the last two times in speech therapy we had the train set out and this was played with happily, then this becomes a specific part of the whole session. If, I then don’t offer the train set the third time a child comes to see me, this could be very upsetting.
This is why I tend to try this out and see what happens. Usually in the 3rd or 4th session: I might not bring out the car run that has hitherto been super successful to see if we are able to transition well to other toys. If yes, then we can have new experiences but if not then I will re-offer the car run/or whatever toy pretty quickly so as not to cause complete dysregulation.
A few pointers below which help with child-led play:
Introduce a few new toys and see what happens
Parents are encouraged to bring some familiar toys their child likes to the session. We can then introduce a couple of different toys to see how we go. Try offering a new toy alongside the familiar one; try offering new toys without the familiar one present, but be prepared to re-offer the “old” toy should our child get upset.
Rotate toys and don’t offer out too many toys
I find that children can get overwhelmed and overstimulated by too many items out all at once. I always talk to parents about toy rotation at home and I encourage storage and ‘tidy up’ of toys so that we can increase attention focus, and also maintain freshness and new interest in older toys.
Some children are not yet ready to play with toys
Here I suggest people games: these are games where the adult becomes part of a more motor-based activity. Some call it ‘rough and tumble play’ but it can be nursery rhymes such as sleeping bunnies/row row the boat or peek-a-boo for the younger ones.
Copy/Imitation is so important – try getting two identical or similar play items
When we are copying our child, it is often not desirable to ‘take turns’ with their toys/blogs/cars etc as our child may not be ready to let us take a turn. Instead, if we have the exact same toy that our child is having then we can play alongside our child and copy them perfectly without interrupting their play.
References:
Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139-156.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
When parents first enquire about speech and language therapy, many assume it will happen face-to-face, in a clinic room, with a therapist sitting across from their child.
So when therapy is offered online, it’s natural for questions to arise:
Can this really work? Will my child engage? Will progress be slower?
This short video offers a glimpse into what online therapy can look like: calm, interactive, relationship-based, and surprisingly effective.
Online therapy is not ‘less than’ in the right circumstances
Teletherapy is not suitable for every child in every situation. However, for many school-aged children, particularly those who enjoy conversation, technology, and shared activities, online therapy can be an excellent fit.
The child you see in this video is around eight years old and was supported for a persistent lisp. Sessions were primarily online, with the occasional in-person appointment when helpful.
What made the difference was not the screen. It was the combination of engagement, support, and consistency.
Parent involvement changes everything
One of the greatest strengths of online therapy is the way it naturally invites parents in.
In this case, parents regularly joined the video sessions:
Listening in
Taking part when appropriate
Learning how to support practice gently between sessions
This meant that therapy didn’t stay ‘on the screen’. Strategies carried over into everyday conversation, making progress faster and more meaningful.
Speech sound therapy, including support for lisps, relies heavily on awareness, feedback, and confidence, all of which can be supported very effectively at home with the right guidance.
Therapy through a screen can still be deeply relational
A common concern is whether connection can truly be built online.
In reality, many children feel more relaxed in their own home environment. They are often more willing to talk, experiment with sounds, and reflect on their speech when they feel comfortable and supported.
Online sessions allow:
Shared focus and conversation
Clear visual feedback
Real-life practice in a familiar setting
Immediate parent support
For some children, this actually enhances engagement rather than limits it.
Real progress, real outcomes
Over the course of approximately 12 online sessions, alongside a small number of in-person appointments, this child achieved resolution of their lisp.
Progress was steady, positive, and confidence-building. Importantly, the child remained motivated and proud of their achievements throughout the process.
While every child’s journey is different, this example highlights what is possible when:
The child is ready
Parents are involved
Therapy is tailored and collaborative
If you’re considering online therapy
If you’re unsure whether teletherapy could work for your child, it’s worth remembering that effective speech and language therapy is less about the room you’re in, and more about:
Relationship
Understanding
Consistency
Carryover into daily life
For many families, online therapy offers flexibility, accessibility, and excellent outcomes especially when parents are active partners in the process.
If you’re at the start of your child’s speech journey and wondering whether online therapy could be the right fit, I’m always happy to talk it through. Sometimes clarity begins with simply understanding what therapy can look like
Teletherapy: Frequently Asked Questions
Is online speech and language therapy really effective?
Yes. For many children, particularly school-aged children, online therapy can be highly effective. Progress depends far more on engagement, consistency, and support than on physical location.
What age does online therapy work best for?
Teletherapy often works well for children from around six years and up, especially those who can attend to a screen, enjoy conversation, and follow simple instructions. That said, suitability is always considered individually and often a supportive adult is needed to help guide the child through the activities.
Can speech sound work (such as a lisp) really be done online?
Absolutely. Speech sound therapy relies on clear visual feedback, listening skills, and practice all of which can be supported very effectively online. Many children respond particularly well when practising in their own home environment.
Do parents need to be involved in sessions?
Parental involvement is strongly encouraged. Parents may sit in, join parts of the session, or support practice between appointments. This involvement often leads to quicker progress and better carryover into everyday speech.
Will my child still build a relationship with the therapist?
Yes. Strong therapeutic relationships can and do develop online. Many children feel more relaxed and confident communicating from home, which can actually enhance connection and learning.
Is online therapy suitable for every child?
Not in my experience. Some children benefit more from in-person support, or a combination of online and face-to-face sessions. A discussion and initial assessment help determine the best approach for each child.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of 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.
Speech therapists use a variety of tools to help children master specific sounds, and then the students are sent home with some practice sheets to use daily. Parents are able to observe what we do in the session, but I know that back at home three days later they can’t quite remember what it was all about and how to do the practice.
Here I explain the importance of visual cues, finger shapes, pictures, and semantic prompts (fancy speech therapy term for word clues!). By understanding these tools, you can turn practice time into a fun and engaging experience for both of you.
Why Visual Cues matter?
Imagine learning a new language just by listening. It’s tough, right? Young children learning new speech sounds face a similar challenge. Visual cues act like flashcards for their minds, giving them a clear picture of how to position their mouth and tongue.
Mirrors: Encourage your child to watch your face (and theirs) in the mirror as you make the sound together. This helps them see the tongue placement and lip movements required.
Mouth pictures: Speech therapy sheets often have pictures of mouths making specific sounds. Point to the picture and explain how the tongue and lips look, then have your child try to imitate it.
Your face is the best cue! Don’t underestimate the power of your own face. Over-enunciate the sound and let your child observe your mouth movements. Watch this little video clip where I am teaching the /SH/ sound to my little student. You cannot see him but we are both sitting on the floor opposite one another so that he can see me easily.
Finger fun: making sounds with our hands
Finger shapes are another powerful tool in my speech therapy arsenal. Think of them as fun reminders of how to position the tongue.
‘Open Wide’ fingers: For sounds like /AH/ and /OH/, hold your fingers wide apart, mimicking an open mouth.
‘Tongue Up’ fingers: For sounds like /T/ and /D/, touch the tip of your thumb to your other fingers, creating a little ‘wall’ like the tongue tip touches the teeth ridge.
‘Snake Tongue’ fingers: For the /S/ sound, wiggle your pinky finger to represent the snake-like tongue tip.
In this little video clip I am demonstrating the C-shape moving forward which I had taught my child, showing how the windy sound (/SH/) travels forward with lips open and slightly pursed.
Bringing sounds to life with pictures
Pictures serve as visual prompts to connect the sound with a familiar word.
Video clip: I am using the WINDY SOUND picture and the FLAT TYRE sound picture to represent /SH/ and /S/ respectively
Point and Say: Point to each picture and say the word clearly, emphasising the target sound. Encourage your child to repeat.
Unlocking sounds with semantic prompts
Semantic prompts are fancy words for clues that help your child guess the target sound. They can be simple questions or descriptive words.
‘Can you feel the wind whooshing?’ (/SH/)
Think of tyre going flat, or a balloon losing air, or a train coming to a slow halt (/S/)
Practice makes progress, but fun makes it funnier!
Remember, the key is to keep practice sessions light and engaging. Here are some extra tips:
Short and sweet: Stick to short practice times (5-10 minutes) to avoid frustration.
Make it a routine: Integrate practice time into your daily routine, like after breakfast or before bedtime.
Positive reinforcement: Celebrate your child’s efforts with praise and high fives!
Make it multisensory: Incorporate sensory activities like blowing bubbles for /F/ or feeling the wind for /SH/.
Parents you’re a vital part of your child’s speech development, and together we can make huge progress quickly.
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.
‘What kind of speech difficulty does my child have?’
It’s a very understandable question. We often hear different terms such as phonological delay, articulation difficulties, or Childhood Apraxia of Speech (CAS), and it can be confusing.
The reality is that many children don’t fit neatly into one single category.
In fact, quite often I see children whose speech profile includes a mixture of difficulties. They might have some phonological patterns (where they substitute one sound for another) alongside challenges with motor speech planning, where coordinating the movements needed for speech is harder.
When this happens, therapy needs to be flexible, responsive, and tailored to the child sitting in front of us.
Example
Recently I filmed a short clip from one of my therapy sessions which shows exactly how this works in practice.
The child I was working with has difficulties with several speech sounds. Part of the challenge relates to a phonological pattern called fronting.
Fronting is when sounds that should be made further back in the mouth (like /K/ or /G/) are produced further forward instead.
At the same time, this child also shows signs of motor speech planning difficulty, which means the brain has to work harder to organise and sequence the movements of the tongue, lips and jaw for speech.
This type of profile can sometimes overlap with characteristics seen in Childhood Apraxia of Speech (CAS).
When difficulties overlap like this, therapy cannot rely on a single approach. Instead, it needs to draw on multiple evidence-based strategies.
That is exactly what you see happening in the clip. We started out generalising the /K/ sound which until recently had been replaced by a /T/ sound. Whilst looking at a sound loaded picture of /K/ sounds we somehow got talking about a ‘dent’ (I don’t recall how we got there!) but the ‘dent’ was a ‘det’ and I decided to tackle this there and then because there are other great words that end in ‘nt’ like : ‘count’ ‘giant’ ‘point’ or ‘paint’.
Using visual cues to support motor planning
Speech is incredibly complex. For children with motor speech difficulties, the challenge is not only knowing what sound they want to say, but also how to move their mouth to produce it.
This is where visual cues can be incredibly helpful.
In the clip, you can see me using a whiteboard with pictures and simple visual prompts. These help to:
Focus attention on the target sound
Understand where the sound occurs in the word
Remember the sequence of sounds needed
Visual supports can act almost like a map for the mouth, guiding children as they practise new speech movements.
For children with motor planning difficulties, this type of cueing can make a huge difference.
Why repetition of a single word (massed practice) is so important
Another key feature you will notice in the clip is lots of repetition.
This is very deliberate.
When we are supporting children with motor speech challenges, the brain needs repeated opportunities to practise the correct movement patterns. Just like learning a musical instrument or a new sport, repetition helps the brain build stronger and more efficient pathways.
In therapy we call this massed practice.
Rather than saying a word only once or twice, we practise it many times in a structured way, helping the child stabilise the new speech pattern.
But repetition alone is not enough. The child also needs to understand why the sound matters.
Showing children that sounds change meaning
This is where another powerful therapy approach comes in: minimal pairs.
Minimal pairs are word pairs that differ by only one sound. For example:
debt
dent
In the clip, I use these two words to help the child realise that the /N/ sound makes a meaningful difference.
Without the /N/, the word becomes something else entirely.
This approach helps children recognise that speech sounds are not random: they carry meaning. If a sound is missing or substituted, the message may change.
Helping children notice these differences can be a very motivating moment in therapy. Suddenly the sound is no longer just an abstract exercise; it becomes part of real communication.
Blending approaches for the best outcomes
In this short therapy moment, I am combining:
• Visual cueing
• Motor speech practice
• High repetition (massed practice)
• Minimal pair contrasts
• Listening and awareness of sound differences
Each element supports a different part of the speech system.
Some strategies help with motor planning, others support phonological awareness, and others build accuracy and consistency.
Together they create a therapy session that is both structured and responsive.
Every child’s speech journey is unique
One of the most important things I want to convey is that speech development is not always straightforward.
Two children may both struggle with speech sounds, yet the underlying reasons may be very different.
This is why careful assessment is essential, and why therapy needs to stay flexible as we learn more about how a child’s speech system works.
Sometimes a child needs more motor-based work.
Sometimes the focus shifts towards phonological contrasts.
Often, as in this example, the most effective therapy uses both.
Small steps lead to big progress
Every session helps us understand a little more about how a child’s speech system works and what support will help them move forward.
And when the pieces start to come together, when a child realises that one tiny sound can change a whole word, that is when the real progress begins.
If you are concerned about your child’s speech sounds, clarity of speech, or possible motor speech difficulties, early support can make a significant difference. A detailed assessment can help identify the nature of the difficulty and guide a therapy approach tailored to your child’s individual needs.
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.
