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.
Reduce frustration by providing visuals to support their communication
Praise the ability to communicate. Focus on what they say not how they say it. E.g., good listening, nice talking.
Provide your child with choices (using real objects to represent your choices). E.g., do you want an apple or banana?
Your child must be motivated and have a purpose to communicate. So, ensure you use highly motivating objects for conversations
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.
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.
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.
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.
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.
Have you heard the term ‘Container play’? I use this very often with children in my sessions as it is so versatile and an enjoyable activity that can be done in parallel with a child or together. Container play is a powerful tool for fostering development in young children, especially those with developmental delays. This seemingly mundane activity provides a rich environment for sensory exploration, motor skill development, and cognitive growth.
What is container play?
Container play involves children interacting with various containers—boxes, buckets, bowls, cups, various bags, etc.—and filling, emptying, and transferring objects within and between them. Objects can include literally anything: small beads, bead chains, table tennis balls, wooden pegs, dinosaurs or any other little person toy, blocks of varying sizes, sand, water, or any other safe material. Larger containers obviously take larger items: socks, stuffed animals, bigger balls, bigger blocks etc really the choices are endless.
Benefits for children with developmental delays:
Sensory exploration:
Touch: Children explore different textures and temperatures of containers and objects.
Sight: They observe how objects look inside and outside the containers, how light reflects off them, and how colours change.
Sound: They listen to the sounds of objects clinking, rattling, and splashing.
Proprioception: Filling and emptying containers helps develop body awareness and spatial awareness.
For neurodivergent children who might have sensory regulation difficulties, consider the following adaptions to accommodate your child’s sensory needs:
Over-stimulation: For children who are easily overstimulated, start with simple setups using a limited number of containers and objects. Gradually increase the complexity as they tolerate it.
Under-stimulation: For children who seek sensory input, provide a variety of textures and materials, such as sand, water, slime, or beans.
Temperature: Offer a variety of temperature options. Some children may enjoy warm water or cool sand.
Lighting: Adjust the lighting to create a calming or stimulating environment.
Focus on one sense at a time: Initially, focus on one sensory aspect, such as the feel of sand or the sound of water.
Weighted containers: Use heavy containers filled with rice or beans to provide deep pressure input.
Fidget toys: Incorporate fidget toys into the activity to provide sensory input and help with self-regulation.
Tactile exploration: Encourage exploration of different textures using objects with varying surfaces.
Pincer grasp: Picking up small objects helps develop fine motor skills like the pincer grasp.
Strength and dexterity: Manipulating containers and objects strengthens hand muscles and improves dexterity. Opening and closing containers can be a huge area of interest; how does the top screw back on, or off?
Cognitive development:
Cause and effect: Children learn that their actions (e.g., pouring water or sand) have consequences (e.g., the water spills).
Spatial awareness: They develop an understanding of concepts like inside, outside, full, empty, and over/under; also how big is the vessel and how much goes in before it’s full or spills over. How small is the vessel opening and what do I need to do to get the beads into the container.
Problem-solving: Children learn to solve problems, such as how to get an object out of a narrow container or how to transfer water without spilling.
Social and emotional development:
Communication: Container play can encourage communication as children interact with others, sharing toys and commenting on their actions. Asking for help to open and close a container is often a great opportunity to practise ‘help me’ or ‘open it’
Turn-taking: Sharing containers and materials helps children learn to take turns and cooperate.
Sensory regulation: For children with sensory sensitivities, container play can be a calming and self-regulating activity.
Tips for engaging children in container play:
Create a safe and inviting environment. A shower curtain on the floor makes things easier for tidy up afterwards. And it allows for spillages.
Provide a variety of containers: Use different sizes, shapes, and materials. Use containers that are visually interesting and pleasing, perhaps a festive biscuit tin, or a tin that looks like train engine. Use see-through containers at first which make the filling and emptying more obvious. This is important for children who have no previous experience with this type of play and need to ‘warm up’ to it. Once a child loves and is used to container play you can go wild with all types of containers.
Offer a variety of objects: Include balls, blocks, sand, water, and other age-appropriate materials.
Join in the fun! Start off the process, show your child what the joy of the activity is for yourself, how fun it is to fill and empty containers, provide enough containers for your child to start playing alongside you, and comment on their actions.
Follow your child’s lead: Allow them to explore and experiment at their own pace.
Adapt activities: Adjust the level of challenge based on your child’s abilities and interests.
Container play is a simple yet powerful tool that can support the overall development of young children, especially those with developmental delays. By providing a rich and engaging sensory experience, container play can help children build essential skills in motor, cognitive, social, and emotional domains.
If you have any questions or would like to have more in-depths demonstration of this or other play styles for your child please contact me.
I look forward to hearing from you.
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.
When you have a child who uses Gestalts it is often difficult to think and adapt clinic activities into those to use at home. More importantly, you find that individualising your activities for your child who uses Gestalt are time-consuming. But you value its importance for their communication development.
You feel so busy, you are taking them to other appointments, or trying to get through your daily activities, all whilst still ensuring your child’s emotional needs are met. You know life should not get in the way of your child’s therapy activities at home, but it does. We know your spare time is precious and limited, so let us achieve your child’s or young person’s goals in the allotted time you have which meets their way of learning (using Gestalts).
We wanted to support you by exploring items which you may have at home, and we will give you some key phrases which you can start to model with your child. Whereas our last blog introduced the idea of gestalt language processors, we are now developing ideas to give you the tools to implement activities at home. We recognise how overwhelming it may feel, and this is one of the reasons to make activities as straight forward as possible. Therapy does not need to be complicated; it just needs to be carried out on a regular basis.
Explore the samples I’ve created to give you an idea of how this might look but please consult with a Speech and Language Therapist who knows about Gestalt Language Processing so that you can work together to develop great home activities for your child.
Want to learn more about gestalt language processing?
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.
Child-led therapy is essentially what it says, therapy sessions that are directed by your child. You may think how can my child’s Speech and Language Therapist focus on goals if sessions are led by my child.
Let us explain…
Your child will be more receptive and motivated to take part in therapy if they have some form of input. E.g., they can choose what toys they want to play with, or how they want to play with the resources available. If sessions are child-centred then they are much more likely to engage and reach their goals, making intervention valuable. They will also be able to regulate their emotions, and use movement to support their need for regulation. E.g., some children like to jump whilst others like to run. As Speech and Language Therapists we need to use what is meaningful to your child to get the most out of intervention. By focusing on child-led therapy, we can build trust, which will allow us, in time, to use new techniques and activities that your child may enjoy. We want children to be themselves, to show their true personality. Therapy is about enhancing their skills in their own individualised way and child-led therapy allows for this.
This way of working may seem daunting to some, but it doesn’t have to feel this way. Parents often feel if they are prepared then activities may go smoother. It might be the case, but perhaps it doesn’t give your child the opportunity for spontaneity. We’d like to suggest something that may lead to some surprises. Put out an activity that is your child’s favourite and then a completely new activity. Remember these activities don’t have to be complicated. Often, the simpler the better!
So, no need to plan, just place two activities out and see what happens! Look out for anything which surprises you, which activity did they prefer? Do they have any sensory preferences? The freedom of choice is a wonderful thing to explore. So, just go with the flow!
The kind of activities that are useful for child-led play can include:
Hide and seek
Cooking or baking
An Exercise ball
Small world play
Pretend play
Musical instruments (you could even have a go at making your own)
Child-led therapy is a very useful resource. We have it at our fingertips. We don’t need special resources. You just need yourselves and your child! Sometimes, child-led therapy can be tricky to put in place. It sounds easy but is much harder in reality. So, make sure you give it time and reflect on your experiences. Ask yourselves ‘what went well’, and ‘what could be improved’. E.g., perhaps you gave your child time to lead to begin with, but you didn’t give them enough time to think about their options during the activity.
How can parents become more child-led in the home environment?
Pause and use silence. This gives your child the opportunity to lead.
It’s perfectly natural to want to talk. Afterall, this is how adults maintain conversations. If you find yourself talking too much, count to ten! This will allow your child time to respond or initiate in the conversation or interaction.
Move down to your child’s level. It’s much easier to see what’s going on if you’re at the same height.
Videoing you and your child can really help you to see where your strengths lie. You’ll also be able to make minor tweaks to improve your communication during child-led play.
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 children find talking hard, parents often face a difficult question: ‘Should we wait and keep encouraging speech? Or introduce something like AAC?’
AAC (Augmentative and Alternative Communication) can sound intimidating, but it simply means any way we support or replace spoken words, from simple gestures and picture boards to high-tech speech-generating devices. Far from ‘giving up on speech,’ AAC often becomes the bridge that helps children find their voice, in whatever form that takes.
💡 What is AAC, really?
AAC is a spectrum of tools and strategies that help people express themselves when speaking is difficult. It might include:
Low-tech supports: Gestures, key word signs (like Makaton), picture symbols, or printed boards
High-tech systems: Apps on tablets that speak aloud when pictures or words are tapped
AAC is not just for children who will never talk. It’s for anyone whose speech isn’t meeting their communication needs right now.
🤔 When to introduce AAC
There’s a common myth that you should only try AAC after ‘exhausting’ other speech therapy options. In fact, AAC can be introduced at any stage, even alongside speech development.
Here are some helpful signs that AAC might support your child:
Your child understands much more than they can say.
They rely on gestures, sounds, or behaviour to communicate.
They become frustrated trying to express themselves.
You find yourself ‘reading their mind’ to interpret needs.
Speech progress feels slow or inconsistent.
If you recognise these patterns, AAC isn’t a ‘last resort’. It’s a communication support, not a replacement for speech.
Recent research consistently shows that AAC does not stop children from talking. In fact, it can encourage speech to develop. A 2024 systematic review and meta-analysis published in the Journal of Autism and Developmental Disorders found that children who received interventions combining naturalistic developmental behavioural approaches with aided AAC showed improved language outcomes, and that AAC ‘does not negatively impact speech development and may even facilitate spoken language growth’ (Smith et al., 2024).
🌉 How AAC supports speech development
Speech and AAC aren’t competing paths: they’re parallel tracks that often feed each other.
Here’s how AAC helps speech grow:
Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
Encourages turn-taking and social connection: AAC lets children join conversations even before speech is fluent, giving them more practice in real communication.
AAC is not ‘giving up on speech’. It’s giving a child more ways to succeed while speech continues to develop.
🧩 How to introduce AAC gently and effectively
Start small and meaningful: Begin with a few key messages your child wants to say, not just what adults want to hear. Think ‘I want’, ‘stop’, ‘help’, ‘more’, ‘all done’, ‘no’, ‘again’. These are powerful words for real interaction and autonomy.
Model, model, model: The most important part of AAC success is modelling—using the system yourself as you talk. For example: ‘You want banana 🍌’ and you tap the ‘want’ and ‘banana’ symbols. Children need to see and hear AAC used naturally before they try it themselves.
Use it throughout the day: AAC isn’t a therapy tool to take out once a week. It’s a living part of communication. Model a few words during mealtimes, play, and routines. The more consistently it’s embedded, the more fluent both you and your child will become.
Keep it accessible: If using a device or picture board, make sure it’s always nearby. If it’s in a bag or drawer, it can’t be used in real moments.
Celebrate all communication: If your child points, signs, uses a sound, or taps a symbol, it all counts. Respond warmly and naturally to reinforce communication in any form.
🧠 What parents often worry about
‘Won’t AAC stop them from talking?’: No. Research shows AAC use either has no negative effect on speech or leads to increased spoken output (Smith et al., 2024). When children feel understood, their motivation to communicate grows.
‘What if I model it wrong?’: There’s no perfect way to start. Your effort and consistency matter far more than accuracy.
‘Will they get ‘stuck’ using pictures?’: Some children do continue using AAC long-term; others move naturally toward more spoken language. The goal is always functional communication, not replacing one form with another.
🪞 Bringing AAC into daily life
Here are a few simple, parent-friendly ideas:
Create visual spaces: Post symbols or core words on the fridge, mirror, or play area.
Narrate routines: Use AAC during toothbrushing, dressing, or mealtimes; consistent contexts build understanding.
Pair speech and touch: Always say the word aloud when you point to or tap a symbol.
Involve siblings and friends: Model how they can respond to AAC too. ‘Oh, you said go! Let’s go fast!’
Use shared books and songs: Pause and model key words in stories or songs.
🌱 The takeaway
AAC doesn’t mean giving up on speech; it means opening more doors to communication. When words don’t come easily, AAC gives children a way to connect, share, and be heard.
It helps parents move from guessing to understanding, and gives children the power to express themselves on their own terms.
If you’re unsure where to start, reach out to a speech and language therapist experienced in AAC. Together, you can find a system that fits your child’s strengths, build confidence in modelling, and help every word (spoken or tapped) feel like a step forward.
Because when communication is possible, everything else begins to grow.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
📚 Reference
Smith, K., et al. (2024). The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta‑Analysis. Journal of Autism and Developmental Disorders, 55, 3078–3099. https://doi.org/10.1007/s10803-024-06382-7
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 is a Speech and Language – Feeding Therapist?
You’ve probably heard of speech therapists helping people who stutter or struggle to pronounce words. But did you know that they also work with children and adults who have problems with eating and swallowing? This specialised area is called Speech and Language Therapy: Feeding and Swallowing, or Dysphagia Therapy.
Why does a Speech Therapist help with eating and swallowing?
The mouth, tongue, and throat are all involved in both speech and swallowing. When there’s a problem with any of these parts, it can affect both your ability to talk and to eat. For example:
Weak tongue muscles: Can make it hard to chew food and to form sounds.
Difficulty coordinating swallowing: Can lead to choking or aspiration (when food or liquid goes into the lungs).
Sensory issues: Can make certain textures or tastes feel unpleasant or overwhelming.
Communication: If we are not able to express ourselves we are likely to have difficulties during daily mealtimes: how do we ask for ‘more’ of something, how do we say we have had enough or we don’t like a particular food?
How does a Speech and Language Therapist help?
Our work involves a combination of assessment and therapy. We carefully observe how your child feeds, eats and swallows, and we look into your child’s mouth to help us see what the cause of the difficulties are: could be a very highly-arched palate, it could be a very flaccid/low tone tongue, it could be poor dentition. Then, we create a personalised treatment plan to address your specific needs.
Here are some of the things we might do:
Teach swallowing techniques: We can help your child learn strategies to improve or facilitate a safe swallow.
Recommend dietary modifications: We may suggest changes to your child’s diet to make it easier to eat and swallow.
Provide sensory therapy: If your child has sensory needs we can help your child become more comfortable with different textures, tastes, and smells.
Work on oral motor skills: We can help to encourage more effective chewing, or drinking skills, or we can help your child to close his/her mouth more during chewing or drinking from a straw.
Collaborate with other professionals: We often work closely with doctors, nurses, occupational therapists, and dietitians to provide comprehensive care.
What kinds of problems do Speech and Language Therapists help with?
We see a wide range of feeding and swallowing difficulties, including:
Delayed feeding: Children who are slow to develop feeding skills or who have difficulty transitioning to solid foods.
Tongue-ties: Babies can have significant difficulties with feeding when the tongue is very tightly tethered to the floor of the mouth.
Refusal to eat: Children who refuse to eat certain foods or textures.
Aspiration: When food or liquid goes into the lungs, which can lead to pneumonia and other serious complications.
Chewing difficulties: Problems with chewing food, such as difficulty breaking down food or keeping food in the mouth.
Swallowing difficulties: Problems with swallowing, such as feeling like food is stuck or choking.
Neurological conditions: Conditions like cerebral palsy, down syndrome or other genetic syndromes can affect feeding and swallowing.
Developmental delays: Children with developmental delays may have difficulties with feeding and swallowing.
Is there hope?
If your child is struggling with feeding or swallowing, know that there is help available. Speech and Language Therapy can make a significant difference in your and your child’s quality of life. We’re here to support you every step of the way.
Remember, you don’t have to suffer in silence. If you’re concerned about your child feeding or swallowing, please reach out. You can find a Speech and Language Therapist with a Feeding/dysphagia qualification near you via www.asltip.co.uk or contact me.
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.
Echolalia is a term used when assessing or treating children with Autism. The term refers to the repetition or echoing of utterances, either our own or others’. It can also be echoing phrases heard on television, advertising jingles or catchy repeat phrases used in tv programmes or nursery rhymes and songs. Whilst we all use echolalia occasionally and it can be observed in typically developing children, we tend not to see/hear it beyond the age of 2.5 years old. Children with ASD, however, do use echolalia often into late childhood.
There are generally two types of Echolalia:
Immediate echolalia
Here the repeated phrases or words are produced immediately after someone has spoken the original words or within two conversational turns of the original utterance.
Delayed echolalia
The repeat echoing of the original utterance occurs sometime later, more than two conversational turns or with a much longer time delay. Due to the delay it can be hard to interpret the meaning of the echolalic utterance as it may refer to something that happened long ago and in a different context to the originally utterance.
(Stiegler, 2015, Fay 1967, Blanc 2014)
There are other unconventional speech behaviours which include:
Perseveration of Speech – persistent repetition of speech
Repetitive questioning – persisting even though answers were given
Vocalisations such as: humming, whistling, clicking, squealing etc.
Much research has gone into the meaning and treatment of Echolalia and the following list consists of possible functions that have been identified:
Information sharing
Responding to answers
Labelling
Drawing attention to self
Protesting
Requesting
Giving instructions
Self-regulation, calming
(Stiegler 2015, Prizant 1983)
Echolalia does have a function and is part of the Gestalt Learning Process (where longer units of speech are memorised and then used as a whole without the individual words being meaningful).
As a Speech and Language Therapist I promote sound and proven Intervention based on the Hanen Programme which helps provide a highly facilitative Interaction Style and I will tell you a bit more in my next blog how the “More Than Words” approach can help children with echolalia move through their Gestalt Learning into more analytic processing of language, grammar and meaning.
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.
