Empty Set and Phonology approaches

ByLondon Speech and Feeding June 26, 2024June 26, 2024

I have been avoiding the use of the Empty Set approach for the longest time as I was not sure if it would work seeing that I am challenging two sounds my student struggles with at the same time. But I decided to give it a go and it works a treat!

With this approach, we use two sounds that our student is struggling with. For example, in my video this student cannot produce /sh/ and /r/. Both sounds have different rules, so I decided to contrast them with each other.

The rules of /sh/ are: no voice, air is pushed out through teeth, produced at the front.
The rules for /r/ are: use your voice, produce the sound in the middle of the mouth by shaping your tongue in a particular way.

So I chose the words ‘shoes’ and ‘ruse’ as their rules are quite different. Contrasting two sounds the student does not know has been shown to lead to greater change in the child’s articulation. And I can certainly vouch for this as my student is making the best progress with this approach.

Phonology Therapy – what is it, why and how?

Phonology is the study of the sound system of a language. It’s distinct from articulation therapy which focuses on the physical production of sounds.

Phonology therapy focuses on rules. For example, sounds that are produced at the front of the mouth, in contrast to sounds that are produced at the back of the mouth, or sounds that are produced with a long air stream: /s/ or /f/ versus short sounds like /p/ or /t/; sounds are produced with voice or without voice.

Many children, and sometimes adults, are unaware of some of the speech rules and confuse and replace individual sounds. They might say TAT instead of CAT or SIP instead of SHIP.

A quick overview of phonology approaches I use:

Minimal Pairs:

This approach is good for single sound substitutions. We offer word pairs that differ by only one sound, like ‘ship’ and ‘sip.’ One of our first goal in therapy is to highlight the difference between the target sound (e.g., /sh/) and the sound the child uses (e.g., /s/). This helps discriminate and eventually produce the correct sound.

Multiple Oppositions:

A child might replace lots of sounds with a single sound like a /d/. So instead of ‘four’, ‘chore’ and ‘store’ our child says ‘door’, making speech very unintelligible.

The approach is typically geared towards shaking up the phonological system. Our goal is to choose two to four targets that are different from each other, and different from the substituted sound. If our child’s favourite sound is /d/ they can use their voice and make a short sound by stopping their airflow. So I will choose a different target sound to change up the speech system. For example I might choose an /f/, a /m/ and a /k/ sound. So I would contrast: ‘door’ with ‘four’, ‘more’ and ‘core’.

Maximal Oppositions:

In the Maximal Oppositions approach the treatment sets consists of words that are minimally contrasted and that have maximal or near maximal feature differences between each word pair. One word in a pair represents a sound the child ‘knows’ (can say at word level) and the other represents a sound the child does not know (cannot say).

For example, a child may ‘know’ /m/ and be able to say words like ‘man’, ‘mat’ and ‘mine’. However, the same child may be unable to say /f/ as in ‘fan’, ‘fat’ and ‘fine’. The consonants /f/ and /m/ are maximally opposed as follows.

I am always delighted to work on speech sound disorders, I love the challenge and the successes we can celebrate together. Get in touch with 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.

Autism Therapy · Neurodiversity · Printables · Speech and Language Therapy · Top tips

Let’s ditch the ‘Fix-It’ approach to autistic play and stimming
ByLondon Speech and Feeding December 8, 2025December 8, 2025
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.

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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Autism Therapy · Neurodiversity · Speech and Language Therapy · Top tips

The purpose and nature of a speech and language therapy assessment
ByLondon Speech and Feeding May 27, 2025May 19, 2025
If you have ever wondered what happens when you bring your child to a speech and language therapy assessment, then this blog will shed light on the ins and outs of it for you.

At its heart, a speech and language therapy assessment is a systematic and thorough evaluation of your child’s communication or eating/swallowing abilities. It’s more than just asking a few questions. It is a carefully constructed process designed to identify strengths, pinpoint challenges, and ultimately pave the way for effective intervention.

Establishing a detailed profile – a few bullet points:
- Identification of communication and swallowing difficulties: I aim to determine if a communication or swallowing disorder exists. I will establish if the difficulty is a delay or a more complex disorder.
- Diagnosis of the specific disorder/autism: The assessment delves deeper to pinpoint the specific type and nature of the difficulty. For instance, is your child’s language delay due to a specific learning disability, a developmental delay, or another underlying condition?
- Knowing the aetiology or what is causing a difficulty is crucial for targeted intervention. And whilst we are on the topic let’s talk about an autism assessment: I am trained and experienced in assessing and diagnosing autism. However, when it comes to the diagnosis of autism I provide a preliminary ‘working hypothesis’ rather than giving a definite final diagnosis. The reason for this is that it is considered the ‘gold standard’ and ‘best practice’ to diagnose autism in a multi-disciplinary setting and context. Since I work on my own, I always refer to highly recommended multi-disciplinary clinics for the ultimate diagnostic assessment.
- Determination of severity: Understanding the severity of the difficulty is essential for prioritising intervention and measuring progress. Is your child’s difficulty mild, moderate, or severe? This helps me choose a particular approach and then tailor it to suit each individual child.
- Identification of underlying strengths and weaknesses: An assessment doesn’t just focus on what’s wrong. It also highlights your child’s strengths and areas of relative ease. This information is invaluable for building upon existing skills during therapy. Understanding weaknesses provides specific targets for intervention.
- Guiding intervention planning: The assessment provides the crucial information I need to develop an individualised intervention plan. The findings directly inform the selection of therapy goals, strategies, and techniques. Without a thorough assessment, therapy would be a shot in the dark.
A multi-faceted approach

A speech and language therapy assessment is not a ‘one-size-fits-all’ procedure. The specific tools and techniques used will vary depending on a child’s age, the nature of the suspected difficulty, and other relevant factors. However, most comprehensive assessments incorporate several key components:
- Case history: This involves gathering information about your child’s developmental, medical, social, and educational background. We will go through all the relevant milestones and throughout the process I will make notes which will help bring all the puzzle pieces together.
- Observation: I will observe how parent and child play together and we also look at how the child plays by themselves. Additionally of interest is how a child plays with me, the therapist. Through discussion I will also endeavour to find out how your child plays with other children, be it at the nursery or within the family.
- Standardised assessments: These are commercially available tests with specific administration and scoring procedures. They provide norm-referenced data, allowing to compare the individual child’s performance to that of his or her peers. Examples include articulation tests, language comprehension and production tests, and fluency assessments. I tend not to use these assessments a lot.
- Instead, I use non-standardised assessments: These are more flexible and allow to probe specific areas of concern in more detail. This might include language samples (analysing spontaneous speech), dynamic assessment (testing and teaching to identify learning potential), and informal observation of play or interaction.
- Immediate feedback and report writing: During and thenfollowing the assessment, I will bring all the gathered information together and I will discuss with the parents what my findings are and what my recommendations in the short term are. Parents always go home with a good handful of useful strategies that they can implement at home right away. In addition, I provide a comprehensive report outlining the findings, diagnosis (if applicable), severity, strengths and weaknesses, and recommendations for intervention.
In conclusion, a speech and language therapy assessment is a dynamic and essential process. It is a journey of discovery, aiming to understand a child and the child’s family and his or her unique communication or feeding profile. The assessment is usually the start of our wonderful learning journey together.

Below is a short video clip of an assessment where you see me in action explaining a particular therapy approach to a set of parents. It perhaps shows a tiny bit of how relaxed we are in our sessions and that assessment is not at all daunting, but a hugely informative event overall which will leave you feeling empowered and hopeful.

What happens after an assessment?

Please feel free to get in touch with me via my contact form if you wish to have an assessment for your child’s communication difficulties or feeding difficulties.

An assessment is always a stand-alone event and does not mean you need to automatically book follow up sessions at all. It will give a lot of information and based on this you can decide if you would like more therapy or follow up for you and your child. Many times ongoing therapy is not needed! I only recommend a course of therapy if it is really needed and where it would be immediately beneficial for your 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.

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Speech and Language Therapy

Help! My child has a lisp. What can we do about it?
ByLondon Speech and Feeding December 13, 2023February 27, 2024
What is a LISP?

There are different types of LISPS. Let me explain:

A lisp is the difficulty making a clear ‘S’ and ‘Z’. Other sounds can also be affected by the tongue protruding too far forward and touching the upper teeth or the upper lip even. ‘T’ and ‘D’ can be produced with ‘too much tongue at the front’ and this can also have an impact on ‘CH’ and often also ‘SH’.
1. Interdental lisp
Protruding the tongue between the front teeth while attempting ‘S’ or ‘Z’ is referred to as interdental lisp; it can make the speech sound ‘muffled’ or ‘hissy’. Often, we associate a lisp with the person sounding a bit immature. The good news is that this type of lisp is the easiest to correct and, in my practice. I have a 100% success rate with this type of lisp.
1. Lateral lisp
In a lateral lisp the person produces the ‘S’ and ‘Z’ sounds with the air escaping over the sides of the tongue. This renders the ‘S’ as sounding ‘slushy’ or ‘wet’. This type of lisp is a bit harder to correct than the interdental lisp. In my experience this can be fixed but it might need a bit longer, more intensive therapy than the interdental lisp.
1. Palatal lisp
With a palatal lisp the ‘S’ sound is attempted with the tongue touching the palate, much further back than it should be. The ‘S’ sounds ‘windy’ and ‘hissy’. This is a quite rare lisp production but it is also not difficult to correct.

These types of speech difficulties come under the category of ‘speech delay of unknown origin’ and may persist into adolescence and adulthood as ‘residual errors‘.

Some thoughts on Treatment in general:

Lisps can be treated successfully by a Speech and Language Therapist. However, for the treatment to work well, a student needs to be able to cooperate and want to improve his or her speech. Lisp remediation entails a fair amount of repetitive work and very young children or unmotivated older children don’t make the best candidates for treatment for this reason. Often students present with other speech, language or social communication difficulties and here the lisp might not be the priority for treating. For example, it might be that due to a student’s Attention Deficit Disorder they are simply not able to focus on speech practice in their daily life.

When should treatment of lisp begin?

Waiting well past 4½ years is not advisable as the longer we wait and do nothing the stronger engrained the erroneous tongue/speech habit will become. The ‘right’ age for therapy for one child may be different from the ‘right’ age for another child even within the same family. So do make an appointment with a speech and language therapist to assess and see whether your child might be ready to start therapy.

Do lots of children lisp—is it normal?

Until the age of about 4–4.5 years old it can be a perfectly normal developmental phase for some children to have the interdental lisp. But when we see and hear a lateral or palatal lisp we ought to act and see a speech and language therapist for sure.

After the age of 4.5 or 5 years old most speech therapists would agree on at least having a look to see if treatment could be started. The longer we wait the harder it is to retrain the brain pathways to adopt new speech habits.

What happens during the first Speech and Language Consultation?

The first consultation takes about an hour and involves screening relevant areas of communicative function. We take a detailed history, examine the anatomy of the child’s mouth and tongue movements. We check for tongue tie, teeth formation, palate structure and function, as well as swallowing patterns.

Then we begin straight away to try and see if any of the alveolar sounds (T/D/L/N) can be produced correctly with the right tongue placement as that would be the starting point from where to shape a good, clear ‘S’ sound.

The first consultation usually ends with home practice being given, explained to parents and another appointment being made for follow up.

Therapy – what does a session look like?

Each therapy session consists of:
1. Listening to sounds, discriminating sounds, identifying sounds, listening to rhyming sounds, sound awareness. We call this Auditory discrimination of single sounds: can the student hear the difference between two words that are the same apart from the first sound: ‘sing’ and ‘thing’ or ‘sigh’ and ‘thigh’?
2. Sound production: using a variety of different prompts and cues we will teach how to physically make the new sound. Often, we work on making a NEW sound, instead of correcting the OLD one. We work on imitation of single sounds then gradually we try and make new sounds in short words, then longer words and then phrases and sentences.
3. Games! We play games and try and have fun in between listening and producing our new sounds to help students stay motivated and even enjoy the therapy session and process.
How long does it take to ‘fix up’ a lisp?

It tends to take about one term with weekly sessions to help a student make good ‘S’ sounds in phrases and sentences. If the student can do the home practice every day in between the weekly sessions, then in most cases I am able to pronounce the lisp as ‘fixed’ after about one term.

After that the student needs to practise, practise, practise, at home and in daily life to keep reminding themselves of their new skills and their new sound production.

It is a matter of reminding and wanting to get it right. Occasionally a student returns to me for another term of simply practising their skills together with me as they are finding it hard for any number of reasons to practise at home. But generally, 8/10 students will be fine after some 12–13 sessions and their speech will be perceived as perfectly typical by family and friends.

If your child has a lisp or any other speech error, please do not hesitate to contact me.

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

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Speech and Language Therapy

One book, dozens of therapy opportunities: What speech therapy really looks like
ByLondon Speech and Feeding May 13, 2026May 18, 2026
As speech and language therapists, some of the most effective moments in therapy don’t come from flashcards, worksheets, or even drilling sounds (though to be fair I do drill quite a lot too! needs must…😊).

By and large they happen in natural interaction — during shared attention, laughter, storytelling, and connection.

This short video clip captures that.

In under two minutes, while simply reading a book together with a three-year-old child, we naturally work on:
- Speech sounds
- Vowel production
- Early phonological patterns
- Motor planning
- Signing and total communication
- Visual cueing
- Repetition and practice
- Confidence building
- And engagement through play
To many people, it may just look like ‘reading a book’.

But underneath that moment are years of specialist training, clinical decision-making, preparation, and therapeutic skill.

Therapy hidden inside play

One of the most important parts of paediatric speech therapy is knowing how to embed targets into meaningful interaction.

Books are one of my favourite therapy tools! Why: because as speech therapists we need to prepare for our child and our sessions. And having a book gives me the structure to know beforehand what kind of sounds or words might be coming up. Then I can be prepared for providing extra support for them. As you can see in this clip, I had the sound cards just there because I had anticipated what might be coming up!

A single story can provide opportunities for:
- Speech sound practice
- Vocabulary development
- Sentence building
- Turn-taking
- Symbolic understanding
- Attention and listening
- Gesture and signing
- Motor speech cueing
- And social communication
In this clip, I follow my little one’s interests while carefully weaving in her individual therapy targets.

It looks relaxed and spontaneous — and it is — but it is also highly intentional.

Catching opportunities in the moment

One lovely example in the clip is when she says ‘yes’.

She is now starting to say the final /S/ sound, so I immediately model and draw attention to it using the ‘snake sound’ visual cue, giving her positive feedback that she can now also try using this sound at the start of words.

My gently shaping the word ‘yeSSSS.’ gives her:
- Auditory feedback
- Visual support
- And an achievable opportunity to try again
A few seconds later, we naturally practise it again.

That’s responsive therapy.

Speech therapists are constantly listening, analysing, adapting, and deciding:
- When should I model?
- When should I pause?
- When should I repeat?
- When should I let it go?
- How can I keep confidence high while still targeting speech?
These decisions happen in seconds.

Working on speech without ‘stopping the play’

Another moment in the clip focuses on the word ‘out’, where the vowel sound is one of her speech targets.

Then we move into practising the word ‘open’, a word she has previously found difficult.

Within this one word, we can support:
- Sequencing
- Motor planning
- Lip shape
- Vowel production
- And speech sound accuracy
We also briefly practise the /K/ sound — a sound produced at the back of the mouth which can be particularly tricky to produce.

Instead of explaining it verbally (which is often too abstract for young children), I use:
- Visual demonstration
- Exaggerated mouth movements
- Gesture/sign support
- And playful modelling
Children learn through seeing, hearing, doing, and experiencing.

That is why Speech Therapists use multiple layers of cueing simultaneously.

Why I use signs alongside speech

Throughout the clip, I also use signs such as ‘book’ and ‘pig’.

Using signs does not stop children talking.

In fact, for many children, signs:
- Reduce frustration
- Support understanding
- Increase participation
- Reinforce vocabulary
- And help bridge the gap while speech is developing
Communication always comes first.

Speech is only one part of communication.

When children feel successful communicating, they are far more likely to keep trying.

The skill behind ‘natural’ therapy

One thing I often hear from parents is:

‘You make it look so easy.’

That is actually one of the biggest compliments a therapist can receive. (Though we also often feel we need to justify our very existence with these thoughts because we don’t just play/just read but we know it can look like that!) 😊 this is the reason for this blog…

High-quality paediatric therapy should feel warm, playful, responsive, and natural.

But underneath that natural interaction is:
- Clinical knowledge
- Phonological analysis
- Motor speech understanding
- Language development expertise
- Sensory awareness
- Relationship-building
- And careful session planning
Before this session even began, I already knew:
- Which speech patterns to target
- Which words would likely appear in the book
- What visual cues might help
- Which signs to model
- And how to adapt depending on the child’s responses
That preparation allows therapy to stay child-led without losing therapeutic focus.

Following the child while leading the therapy

The best therapy is rarely rigid.

Children do not learn communication through pressure or endless correction. They learn through interaction.

That is exactly what this short clip demonstrates.

One book.
One conversation.
Hundreds of tiny therapeutic decisions.

And all within a joyful moment shared together.

Because good speech therapy should never feel like hard work for a child.

It should feel like connection, confidence, success — and fun.

If you’re concerned about your child’s speech and language or wondering whether they might benefit from speech therapy, feel free to get in touch.

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.

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Neurodiversity · Speech and Language Therapy · Top tips

Creating your calm: containment strategies for Sensory Processing Difficulties
ByLondon Speech and Feeding March 4, 2024March 1, 2024
The world can be a beautiful and stimulating place, but for individuals with Sensory Processing difficulties (SPD), it can also be overwhelming and even painful. Everyday sights, sounds, smells, touches, and tastes can be amplified to uncomfortable or even unbearable levels. This can lead to anxiety, meltdowns, and a constant feeling of being on edge.

One important coping mechanism for SPD is containment. Containment strategies are techniques that help individuals manage their sensory experiences and create a sense of calm and safety.

Understanding containment needs:

Containment needs vary greatly from person to person. Some individuals might find comfort in deep pressure, while others might crave quiet and solitude.

Common containment strategies:

Here are some examples of containment strategies that can be helpful for individuals with SPD:
- Deep pressure: This can involve activities like wearing weighted vests, using weighted blankets, getting firm hugs, or applying deep pressure massage.
- Movement: Engaging in rhythmic movements like rocking, swinging, or jumping can be calming for some individuals.
- Proprioceptive input: Activities that involve proprioception, the sense of body awareness, can be grounding. Examples include yoga, stretching, and proprioceptive toys like chewy necklaces or fidget spinners.
- Visual calming: Utilising calming visuals like nature scenes, dimmed lights, or fidget toys with visual patterns can provide a sense of peace.
- Auditory modifications: Noise-blocking headphones, earplugs, or white noise machines can help block out distracting or overwhelming sounds.
- Oral motor activities: Chewing gum, crunchy snacks, or chewy toys can provide sensory input and help regulate emotions.
- Sensory bottles: Watching calming visuals move within a liquid-filled bottle can be visually stimulating and promote focus.
- Creating a safe space: Having a designated quiet area at home or school where individuals can retreat to self-regulate can be invaluable. This space should be free from clutter and overwhelming stimuli and can include calming sensory items.
Additional tips:
- Be patient and understanding: It takes time and practice to find what works best for each individual. Be patient with yourself or your child as you explore different strategies.
- Consistency is key: Once you find effective strategies, use them consistently in different settings to create a sense of predictability and comfort.
- Communicate openly: Talk to teachers, caregivers, and others about individual needs and how they can support containment strategies.
- Celebrate progress: No matter how small, acknowledge and celebrate successes in managing sensory experiences.
Remember:

Containment is not about suppressing sensory experiences altogether. It’s about creating a sense of control and reducing overwhelming sensations to a manageable level. By exploring different strategies and working with a qualified professional, individuals with SPD can develop the tools they need to navigate the world and experience life to the fullest.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

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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Feeding · Speech and Language Therapy

A bite-sized guide to Speech and Language Therapy: feeding and swallowing
ByLondon Speech and Feeding October 7, 2024October 7, 2024
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.

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READ MORE A bite-sized guide to Speech and Language Therapy: feeding and swallowing