Explore 12 questions to determine whether your child may be Autistic

A young boy is in the foreground and has turned his head away from the woman sitting next to him.
May your child be autistic?

As professionals, when diagnosing young children with an Autistic Spectrum Condition, it is vital we work as a multi-disciplinary team, so you will likely see many professionals. This may include Educational Psychologist, Dietician, General Practitioner, Occupational Therapist, Paediatrician, Special Educational Needs Coordinator, Speech and Language Therapist and Social worker. Once the evidence is collated, then a diagnosis may be made.

You may be wondering what are some of the early signs of social communication difficulties? Whilst no autistic child is the same and we know Autism is very much a very wide spectrum of abilities and needs there are some autistic spectrum characteristics we do typically see in the early years of childhood. You may wish to think about these areas or presentations to help you prepare for the Speech and Language Therapy appointment.

Twelve questions

  1. Does your child respond to their name?
  2. Are they fixated with watching their hands?
  3. Do they have sensory processing difficulties such as bright lights, food textures, or loud noises?
  4. Are they meeting their milestones or are they delayed?
  5. Do they flap their arms or legs when excited?
  6. Have you noticed any rocking back and forth?
  7. Do they blink excessively or display any facial tics?
  8. Do they play with a particular sort of toy e.g. spinning toys?
  9. Have you noticed that they lack interest in toys?
  10. Have they regressed in their language? Perhaps you’ve noticed they are not using words that they have previously learnt.
  11. Do they use gestures to communicate their needs? How do they communicate their wants and needs?
  12. Do they appear to be in their own world?

You are not alone

These questions are by no means exhaustive and there are many more factors to consider. But it is important to trust your instincts as you are the expert on your child and know your child the best. Regardless of whether you see all of the above points or none, do not hesitate to have an assessment if you are concerned as, even if it turns out to be nothing to worry about, there is always at least one or two great pieces of advice I can offer you on the way and you will leave feeling hopeful and empowered. It’s always best to seek early intervention with communication difficulties. This allows strategies and support to be put in place. Never feel alone, always speak out.

Find communication support here from me, Sonja, (Specialist Speech and Language Therapist)


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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    The power of imitation in supporting children with autism

    Image by Freepik

    Imitation, the act of mirroring someone else’s actions, gestures, sounds, or words, is a fundamental skill that plays a crucial role in human development. It’s how babies learn to wave ‘bye-bye’, how toddlers pick up new words, and how children acquire social skills. But for children with autism imitation can be a significant challenge and understanding why it’s important and how to foster it becomes a key focus for parents, educators, and speech and language therapists.

    Why is imitation important?

    Imitation is a building block for a wide range of developmental skills:

    • Social interaction: Imitation is the foundation of social reciprocity. When a child imitates, he or she is engaging in a shared experience, connecting with another person, and learning to take turns in social exchanges.
    • Communication development: Imitation is closely linked to language acquisition. Children often imitate sounds and words before they can produce them independently. Imitation also helps them understand the meaning of gestures and facial expressions, which are vital for nonverbal communication.
    • Cognitive development: Imitation plays a role in problem-solving, learning new skills, and understanding cause and effect. By imitating actions, children explore their environment and learn how things work.
    • Emotional development: Imitation helps children understand and share emotions. When a child imitates a smile, he or she may begin to understand the feeling of happiness.

    Imitation challenges in autism

    Many children with autism face challenges with imitation, which can affect their development in these key areas. These challenges can manifest in different ways:

    • Difficulty imitating motor actions: Children with autism may struggle to imitate simple motor movements, such as clapping hands, waving, or playing ‘peek-a-boo’.
    • Limited vocal imitation: Imitating sounds, words, and phrases can be difficult for some children with autism, which can impact their speech development.
    • Challenges with social imitation: Imitating social cues, such as facial expressions, gestures, and body language, can be particularly challenging for children with autism, affecting their ability to engage in social interactions.

    Why do children with autism struggle with imitation?

    The exact reasons for imitation difficulties in autism are complex and not fully understood. However, several factors may contribute:

    • Neurological differences: Research suggests that differences in brain structure and function, particularly in areas involved in social perception and motor control, may play a role.
    • Sensory processing differences: Some children with autism may have sensory differences that make it difficult to attend to and process the movements or sounds they are expected to imitate.
    • Attention and motivation: Challenges with attention, focus, and social motivation can also affect a child’s ability to engage in imitation.

    How to foster imitation in children with autism

    Fortunately, imitation skills can be developed and improved through targeted interventions and strategies. Here are some approaches that I use in my practice as a speech and language therapist working with autistic children and their families:

    • Create a playful and engaging environment: Children are more likely to imitate when they are having fun and feel motivated. I use toys, games, and activities that the child enjoys.
    • Start with simple imitation: Begin by imitating simple motor movements that the child is already capable of and gradually introduce more complex actions.
    • Imitate the child first: As the Hanen Program emphasises, imitating the child’s actions, sounds, and words can encourage him or her to interact and communicate more.
    • Use visual supports: Visual aids, such as pictures, photos or videos, can help children with autism understand what is expected of them and make imitation easier.
    • Break down complex actions: Divide complex actions into smaller, more manageable steps. For example, to teach a child to brush their teeth, break it down into steps like ‘pick up toothbrush’, ‘put toothpaste on brush’, and ‘move brush on teeth’.
    • Reinforce imitation attempts: Provide positive reinforcement, such as praise, smiles, or preferred activities, when the child attempts to imitate, even if the imitation is not perfect.
    • Integrate imitation into daily routines: Incorporate imitation into everyday activities, such as imitating sounds during playtime, imitating gestures during songs, or imitating actions during self-care routines.

    The role of speech therapy

    Speech-language therapists play a crucial role in helping children with autism develop imitation skills, particularly in the areas of vocal and verbal imitation. As part of my therapeutic role, I offer the following:

    • Assessing a child’s imitation abilities.
    • Developing individualised therapy plans to target specific imitation goals.
    • Using a variety of techniques to encourage vocal imitation.
    • Working with parents and caregivers to provide strategies and support for promoting imitation at home.

    Summary

    Imitation is a fundamental skill that is essential for social, communication, cognitive, and emotional development. While children with autism may face challenges with imitation, it is a skill that can be developed and improved with targeted interventions and support. By understanding the importance of imitation and using effective strategies to foster it, parents, educators, and therapists can make a significant difference in the lives of children with autism, helping them to connect with others, learn new skills, and reach their full potential.

    Do get in touch via my contact form if you have any question or need help with supporting your little one.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

    1
  • · · ·

    The joy of container play: Exploring play development and understanding of how things work

    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.

    Fine motor skill development:

    • Hand-eye coordination: Scooping, pouring, and transferring objects require precise hand-eye coordination.
    • 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.

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    Your child’s communication journey

    Understanding our neurodiversity-affirming, child-led approach

    Welcome to a different kind of therapy!

    Your child’s communication journey

    The start of a new year often brings fresh hope, and sometimes fresh worries, for parents supporting their child’s communication. I am always genuinely excited to begin a new journey with children and their families, and I know that, for many parents, this kind of therapy may look very different from what they were expecting.

    Parents (and children!) are often surprised to discover that our sessions are playful, joyful, and intentionally low-pressure. You won’t see demands for eye contact, sitting still, or being told to ‘do it this way’ or ‘put the red square there’. Instead, you’ll see your child being met exactly where they are.

    For families who have previously experienced more adult-led or behaviour-based approaches including Applied Behaviour Therapy, this difference can feel unfamiliar at first. Because of that, I want to take a moment to prepare you for what child-led, neurodiversity-affirming therapy looks like, so you can feel confident, comfortable, and reassured from day one.

    Why doesn’t child-led therapy look like ‘traditional’ therapy?

    Many people picture speech and language therapy as sitting at a table, using flashcards, or practising words through repetition. While those approaches can work well for some children, they are often not effective or appropriate for many neurodivergent children—including children with autistic profiles, ADHD, or demand-sensitive nervous systems.

    Our approach is grounded in a simple and powerful truth:

    Children learn best when they feel safe, motivated, and emotionally connected.

    When a child’s nervous system feels calm and secure, learning becomes possible. When a child feels pressured or controlled, communication often shuts down, even if they can speak.

    🎯 Our purpose: Communication through connection

    Our goal is not simply to help your child say more words. Our goals go deeper and are built on strong foundations:

    • Trust and regulation: We focus on building a trusting relationship where your child feels safe, understood, and emotionally regulated. A calm nervous system is the starting point for all communication.
    • Motivation: We follow your child’s intrinsic motivation, the things they naturally enjoy to make communication meaningful, joyful, and purposeful.
    • Spontaneous communication: We create opportunities for your child to communicate because they want to, not because they are asked or instructed to.

    🧸 What to expect in a session

    Our sessions are intentionally child-led and often look very much like play.

    FeatureWhat it looks likeWhy we do this
    Minimal toysWe usually offer just 3–4 carefully chosen activities (such as bubbles, blocks, or sensory play).Less is more. Fewer choices reduce overwhelm and help children focus on what genuinely interests them.
    Child choosesYour child decides what to play with and how to engage.This immediately establishes us as a safe, non-demanding partner and increases motivation.
    The therapist’s roleWe join your child’s play, observing closely and responding naturally.We model language, share attention, and reflect your child’s experiences in a way that feels natural and supportive.
    No pressure or demandsThere are no ‘must-do’ tasks. If your child wants to spin, crash, line up toys, or repeat an activity, we follow.Reducing demands lowers anxiety and supports communication, particularly for children with demand-sensitive profiles.

    Is this really effective?

    It’s completely natural to wonder, ‘Are they just playing?’ The answer is yes, and very intentionally so.

    Our sessions are guided by nearly 30 years of speech and language therapy experience, alongside clear, achievable goals tailored to each individual child. Play is a child’s natural language and their most powerful learning tool.

    Within play, we are constantly creating opportunities to:

    • Build joint attention (sharing focus and interest)
    • Model language at the right level
    • Encourage back-and-forth communication
    • Develop a deep, authentic connection

    If your child has struggled to engage or communicate in more structured or demand-heavy settings, this child-led approach is often the key to unlocking their potential.

    💛 What this might look like at home

    You may notice that when pressure is reduced:

    • Your child begins communicating more during everyday routines
    • Language emerges through play, movement, or shared enjoyment
    • Communication feels more natural and less forced

    Small moments could be a shared smile, a look, a sound, a gesture. All matter. These are the building blocks of meaningful communication.

    📚 Resources for parents

    If you’d like to explore these ideas further, you may find the following helpful:

    I look forward to meeting you and your child. Please bring any questions, uncertainties, or curiosities to our first session, there is no such thing as a silly question. This is a journey we take together. Contact me via my contact form.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

    3
  • · ·

    Are the Gestalts I model easy to mix and match later on?

    Image by bearfotos on Freepik

    Here are some examples of great phrases and Gestalts that we could use:

    • Let’s get a banana / Let’s go out / Let’s play lego / Let’s go see daddy
    • That’s nice! / That’s really good! / That’s a green one / That’s a submarine
    • Need more help / Need a wee wee / Need that / Need to run
    • How about a biscuit / How about a cuddle / How about watching tv
    • We love bananas / We love a monkey / We love a cuddle

    Why or how could these examples be mixed and matched?

    You can see I have given several examples for each, that is how later a child can take one chunk (let’s) and add another (go out) or (need) + (go out).

    What about our own grammar? Should we be using grammatical phrases?

    In general for NLA 1 (Natural Language Acquisition stage 1) we want to use short phrases and keep them quite generic, something like:

    ‘Let’s go’ or ‘let’s play’ and pick 2-3 phrases per communicative function (see next point below).

    And if we are going to say longer sentences, for example: ‘let’s go and feed the ducks now’, then we should do so with good grammar and really varied intonation. It sometimes helps me to make up a little song/jingle on the spot that has a lot of intonation, more than I would perhaps use just by speaking.

    How many varied communicative functions do we cover with our modelling?

    We want to model a variety of Gestalts other than just requesting for example. In general, we are looking at our child having one or two Gestalts in the following areas before they are ready to move on into stage 2.

    These are the most common ones I see in my practice:

    • Requesting ‘want a banana/biscuit’ ‘Wanna play ball’
    • Transitioning: ‘what now?’ ‘what next?’
    • Ask for help: ‘need help’ ‘help me’ ‘mummy help’
    • Commenting: ‘it’s big’ ‘it’s red’ ‘it’s fast’ ‘too loud’
    • Speak up for self: ‘not that one’ ‘go now’ ‘stop it’

    Is the Gestalt I am modelling meaningful to my child?

    We don’t use all available Gestalts for every child. It has to be meaningful to the individual and has to match their interests. If our child is a big fan of feeding the ducks in the park then we can think about Gestalts like:

    • I see ducks!
    • They’re over there
    • Let’s feed them?
    • Let’s get some seeds
    • They’re coming!
    • They want food / They wanna eat!
    • That’s a big one
    • It’s so hungry
    • It loves the seeds!
    • No more! All done! Finished! Let’s go home

    What is my child actually trying to tell me?

    We have to be become word/phrase detectives! Is the phrase/script/Gestalt they are using right now actually meaning what they said or does it mean something else, and if so, what?

    Here is an example from my own personal experience in my practice:

    The little boy I was working/playing with was building a tall tower with blocks. When it finally fell with a great big bang he said in a sing-song voice ‘ring-a-ring-a roses’ … then he began to collect the blocks again to make a fresh tower. I sat there and thought: why ‘ring-a-ring-a roses’? What does that mean in this context? I then sang the song (silently) to myself with my detective hat on and realised as I came to the end that it finishes with ‘we all fall down’! it was a real AHA!!! moment for me as I saw right there what the meaning of his Gestalt was. He sang the first line of the song to say ‘all fall down!’

    So realising this I waited for the next tower to fall, and there it was again, he sang the first line of the song. I replied thus, copying him at first:

    ‘RING-A-RING-A ROSES – WE ALL FALL DOWN!…

    FALL DOWN

    WE LOVE IT FALLING DOWN.’

    The process to find what we should say is not always straight forward or easy at all, and often we don’t quite know in the moment what our child is trying to say. But we can try and get to know their interests and then gradually we do know more and more what the meaning behind the Gestalt is or could be.

    What pronouns should we use?

    This can be a tricky one.

    We don’t want to use language that uses the pronouns ‘you’ or ‘you’re’. The reason is that our child will likely copy us exactly as we have said it. Therefore, using pronouns ‘you’ and ‘you’re’ will then sound wrong.

    Always try to model language that is from the child’s perspective or in other words how they would say it if they could.

    Alternatively, you can model using WE or US. For example, if the child is tired, rather than saying ‘you are so tired’ model language from his or her point of view: ‘I’m tired’ or ‘let’s go have a lie down’.

    There is so much more to talk about. Stay tuned for a blog on NLA stage 2 coming soon.

    If you need help with your child, 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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  • · ·

    Why pointing matters: Unpacking the power of this simple gesture

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

    Why is pointing so important?

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

    1. Pointing as pre verbal communication:

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

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

    2. Pointing and language development:

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

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

    3. Pointing and social-emotional development:

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

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

    4. Pointing and cognitive development:

    Pointing is linked to cognitive skills, such as:

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

    5. Types of Pointing:

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

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

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

    How can we create opportunities for pointing?

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

    Model pointing:

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

    Make it rewarding:

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

    Use specific techniques:

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

    Consider developmental factors:

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

    Key points:

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

    Great toys and items for pointing

    1. Interactive books:

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

    2. Cause-and-effect toys:

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

    3. Toys with parts to manipulate:

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

    4. Toys that encourage joint attention:

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

    5. Pretend play toys:

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

    Tips for using toys to encourage pointing:

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

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

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

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice


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

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    Discover more about Verbal Dyspraxia

    What is Verbal Dyspraxia?

    Apraxia or dyspraxia is a difficulty in motor planning, which sometimes can be seen in both gross and fine motor skills, as well as speech. Gross motor refers to difficulties in coordinating the whole body (e.g., bumping into things frequently, often falling over hurting themselves or others through being “clumsy” or unsteady). Fine motor movements refer to smaller, more precise movements (e.g., difficulties doing anything with their hands such as holding a spoon or pen).

    Verbal dyspraxia

    In Dyspraxia of Speech, instead of seeing a coordinated smooth way of talking, we see the articulators (tongue, lips, cheeks) and voice coordinating very smoothly. The voice can be very quiet or very loud. Muscle tone can be weaker at times. Speech sounds are very unintelligible, with a flat voice that can sound forced. It may be that the timings of verbalisation appear random and that children can say a certain word once and never again. This is often what we hear from parents.

    It is interesting to note that many of our autistic clients are either non-speaking or are reluctant speakers. Sometimes they say a word once and then never again. Others say lots of words but the words are very hard to make out. Did you know that about 40% of autistic people have verbal dyspraxia? (Richard, 1997). Because the problem is one of motor planning, not of automatic motor execution, once a plan has become automatic, it is easier to get back to it and this is why we often see repetitive patterns that can be called ‘stims’ (Marge Blanc, 2004).

    How can Speech and Language Therapy help?

    Children with verbal dyspraxia can make great progress!

    We provide frequent and appropriate speech movement opportunities and with time and the right support, children will move forward and begin to speak more fluently and with greater intelligibility. It is important to know this can take time.

    We provide Oral Motor Therapy using a variety of approaches to practise breathing, vocalising on the outbreath, and sequencing our speech movements.

    We design carefully tailored programmes focusing on words that have a lot of power (e.g., NO, GO, UP, IN, OUT, LET’S GO, STOP).

    We offer shared enjoyment, and laughter. This helps a child find their voice. Other ways of finding our voices include singing or humming, or even yelling/shouting!

    The most difficult phase of verbal dyspraxia is initiation, that is to start talking, to start producing a word. Frequent “automatic” repetition supports children with initiation because it removes the element of “thinking to start”. I often ask a child to repeat a word 5-10 times (with rewards at the end. A little game works well). You can see that with repetition the act of initiating is taken out of the equation as you are “on a roll “as it were.

    Once a child starts to find their voice, we will be able to hear them talk lot… And if we give them credit and presume that what they are saying has meaning, we will find in time that their words become clearer and more intelligible. If we listen carefully, we can detect real words and phrases.

    For more tips and support, please get in touch!


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

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