Explore how Intensive Interaction develops Autistic children’s communication

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Intensive Interaction is an approach that I might suggest for your child. Here is an overview of this approach to increase your knowledge. There are a range of approaches that overlap and having trained in them all I use them all interchangeably to tailor to each child individually. This approach is particularly good for children who work mostly to their own agenda and find it hard to engage with others.

So, what is Intensive Interaction?

According to its founder, Hewett (1980), the approach “involves mirroring a person’s actions, sounds and facial expressions.” This allows your child to recognise and form communication between themselves and another, in a fun, play-based setting. Attention and listening are the fundamentals to speech and language development. By using the Intensive Interaction approach, we can increase the time your child can attend for and with another person. We are working towards a child enjoying another person’s presence. We are hoping to make gains with playing together with a child, taking turns and achieving reciprocity. That is the platform which we need to start with to build communication, language, words and perhaps even speech.

There are many aspects that this approach supports:

  • such as using facial expressions
  • being in the presence of other people
  • having a shared space
  • attending to others
  • recognising and using non-verbal behaviours (e.g., gestures)
  • making sounds/noises (vocalisations) that have meaning
  • and eye contact. Although, we must be careful when suggesting ‘improving’ the use of eye contact. For some individuals making eye contact can be physically painful. So be aware that we are not making our children ‘look’ we are encouraging their natural behaviour.

Who benefits from Intensive Interaction?

Children with more complex communication and learning delay can benefit from the Intensive Interaction approach. Each session can be adapted to the needs of the individual and the sessions can be designed to use the whole or part of the approach. It is especially useful for children who are finding it hard to engage in any way socially with another person. Autistic children who tend to work to their own agenda often benefit from this approach.

How is Intensive Interaction implemented?

You need to have an environment that your child is comfortable in, and to be able to come down to their level so that you can see each other. This is why I often visit children in their own homes to ensure that they are comfortable and that they can withdraw for periods of time if they need to as well.

Ensure your child knows you’re there and you are 100% present. This is very important. I would recommend that you put your phone away for some 10 minutes or so and give your undivided attention to your child for that period of time.

Waiting

Waiting is very important: we need to give your child time to process what is happening around them. After waiting for a response, you might want to start copying any gestures they use, any facial expressions they make, or perhaps imitate any sounds. You’ll want to continue with this for a few minutes to see if the communication between you and your child changes. Remember always take the cues from your child; if they communicate a message with you, respond. It might be that they are ready to finish and that they’ve shown this by walking away or signing.

Giving your child a way to respond is vital. We can use visuals to support their communication. We can create ‘yes’ and ‘no’ symbols so they can use them in a functional way.

A top tip in these sessions is to use mirrors, so that your child can see and begin to recognise their own facial expressions.

There are other programmes that overlap with Intensive Interaction such as Hanen with following your child’s lead and the Gina Davies Curiosity Programme.

Now you know a bit about Intensive Interaction, why not book a call to discuss how we can support your Autistic child’s communication using this evidence-based approach.


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 babble: Why your baby’s ‘talk’ matters

    That adorable string of ‘ba-ba-ga-ga-ma-ma’ might sound like baby gibberish, but it’s actually a crucial milestone in your little one’s language development. Babbling or babble, as we call it, is far more than just cute baby noises. It’s a sequence of sounds that lays the foundation for future communication.

    Image by freepik

    What is babbling?

    Babbling typically begins around six months of age, though the timing can vary slightly from baby to baby. It involves your baby experimenting with different sounds, stringing together consonants and vowels. You might hear them repeating sounds like:

    • ‘Ba-ba’
    • ‘Da-da’
    • ‘Ma-ma’
    • ‘Ga-ga’

    As they progress, the babbling becomes more complex, with variations in pitch, rhythm, and intonation. It might even sound like they’re having a conversation with you!

    Why is babbling so important?

    1. Laying the groundwork for speech: Babbling is like a vocal workout for your baby. By practising these sounds, they’re strengthening the muscles in their mouth, tongue, and vocal cords that are essential for speech.
    2. Developing phonological skills: Through babbling, babies begin to understand the sound patterns of their native language. They’re learning which sounds go together and how they’re used.
    3. Enhancing social interaction: Babbling is a social activity. Babies often babble back and forth with their caregivers, which helps them learn about the give-and-take of communication.
    4. Cognitive development: The act of babbling requires babies to use their brains in new ways. They’re learning to control their vocalisations, pay attention to the sounds they’re making, and connect those sounds to the responses they receive from others.

    How can you encourage babbling?

    • Talk to your baby: Even though they can’t understand your words yet, talking to your baby exposes them to language and encourages them to respond with their own vocalisations.
    • Imitate their sounds: When your baby babbles, imitate them! This shows them that you’re paying attention and encourages them to keep ‘talking.’
    • Respond to their babbling: Treat your baby’s babbling as if it’s a real conversation. Respond with words, smiles, and gestures.
    • Play sound games: Make different sounds for your baby and encourage them to imitate you. This could include animal sounds, silly noises, or simple words.
    • Read to your baby: Even before they can understand the words, reading to your baby exposes them to the rhythm and sounds of language.
    • Sing songs: Singing is a fun and engaging way to introduce your baby to new sounds and words.
    • Use mirrors: Babies often enjoy watching themselves make sounds in a mirror.
    • Tactile stimulation: Gentle massage around the mouth and face can increase oral awareness and encourage vocalisations.
    • Vary textures: Offer different textured teethers.
    • Read books with sound effects: Choose books with animal sounds or other engaging noises.
    • Blow bubbles: The act of blowing and popping bubbles can encourage vocalisations.
    • Use visual aids: Show pictures of objects and say their names, emphasising the consonant sounds.
    • Use exaggerated facial expressions: When you make sounds, exaggerate your mouth movements to help your baby see how sounds are made.
    • Increase joint attention: Follow the child’s gaze and point to objects that they are looking at and say the name of the object.

    When to seek help

    If you notice that your baby is not babbling by eight months, it’s a good idea to talk to your speech and language therapist. You might also notice a lack of variation in tone when your child is making sounds, is your baby sounding a little ‘flat’ or monotonous? While every child develops at their own pace, a lack of babbling can sometimes indicate a developmental delay or hearing issue.

    Remember, babbling is a gift. So, enjoy those precious moments of ‘baby talk’ and take comfort in knowing that your little one is on the path to becoming a chatterbox!

    Do get in touch via my contact form if you are concerned about your child’s development or if you simply want some reassurance that your baby is developing well. We will be delighted to arrange a screening appointment for you and give you support and reassurance.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

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    Baby-led weaning: Empowering little eaters from the start

    I had a mum ask me about Baby Led Weaning the other day. So I thought I would write a blog on all the useful questions she had and what we discussed as it may help lots of mums and dads out there.

    As a Paediatric Feeding SLT, one of the exciting developments in recent years is the growing interest in baby-led weaning (BLW). This approach to introducing solids has gained significant traction, and for good reason. It empowers infants to take the lead in their feeding journey, fostering a positive relationship with food and supporting important developmental milestones.

    What exactly is baby-led weaning?

    At its core, baby-led weaning is about offering your baby appropriately sized and textured solid foods from the very beginning, allowing him or her to self-feed. Instead of spoon-feeding purées, you present whole, soft foods that your baby can grasp, bring to his or her mouth, and explore at his or her own pace. This means no mashing, no blending, and no forcing spoons into reluctant mouths. It’s a fun, messy, and intuitive process that is led by your baby’s natural instincts.

    The genesis of baby-led weaning

    ‘Baby-led weaning’ was popularised by British health visitor Gill Rapley. In the early 2000s, Rapley observed that babies naturally develop the skills needed to self-feed and that traditional spoon-feeding might actually hinder this development. Her work, particularly her book Baby-Led Weaning: The Essential Guide to Introducing Solid Foods (co-authored with Tracey Murkett), published in 2008, brought BLW into the mainstream and provided a structured framework for parents. Her research and observations highlighted the benefits of trusting a baby’s innate ability to regulate his or her intake and explore different textures.

    What’s the deal?

    Implementing BLW is simpler than you might think, though it does require a shift in mindset. Here’s a breakdown of what it typically involves:

    • Readiness is key: The golden rule of BLW is to wait until your baby shows clear signs of readiness. This isn’t about age alone, but rather developmental milestones. Your baby should be at least six months old, able to sit unassisted, have good head and neck control, show an interest in food (e.g., reaching for yours), and have lost his or her tongue-thrust reflex (which pushes solids out of his or her mouth).
    • Offer finger foods: Start with soft, easily graspable foods cut into finger-sized sticks or spears. Think cooked sweet potato fries, steamed broccoli florets (soft enough to mash with gentle pressure), banana sticks, or avocado slices. The goal is for babies to be able to pick it up and get some into their mouth.
    • Embrace the mess: BLW is inherently messy, especially in the beginning. Food will be squished, dropped, and smeared. This is a crucial part of the learning process as babies explore textures, smells, and the properties of food. A wipeable mat under the highchair and a good bib are your best friends!
    • Observe, don’t interfere: Allow your baby to lead. He or she will decide what to eat, how much, and how quickly. Avoid putting food into his or her mouth or pressuring him or her to eat more. This respects his or her hunger and fullness cues, laying the foundation for healthy eating habits.
    • Continue breastmilk or formula: Until your baby is well-established on solids, breastmilk or formula remains his or her primary source of nutrition. Solids are for exploration, taste, and developing skills, gradually increasing in quantity over time.

    The benefits of baby-led weaning

    The advantages of BLW extend far beyond simply getting food into your baby. From a speech and feeding perspective, the benefits are compelling:

    • Develops oral motor skills: Chewing, gnawing, and manipulating various food textures are crucial for developing the muscles in the mouth, jaw, and tongue. This strengthens the oral motor skills necessary for speech development.
    • Enhances fine motor skills and hand-eye coordination: The act of grasping food, bringing it to the mouth, and coordinating these movements significantly refines fine motor skills and hand-eye coordination.
    • Promotes self-regulation and intuitive eating: By allowing babies to control their intake, BLW helps them tune into their own hunger and fullness cues, fostering a healthy relationship with food and reducing the likelihood of overeating.
    • Encourages adventurous eating: Exposure to a wide variety of tastes and textures from the outset can lead to less picky eating later. Babies are more likely to accept new foods when they have been in control of their exploration.
    • Facilitates family mealtimes: BLW integrates babies into family mealtimes from an early age, promoting social interaction and making mealtime a shared, enjoyable experience.

    When is baby-led weaning appropriate, and when not?

    While BLW offers numerous benefits, it’s not a one-size-fits-all approach.

    When BLW is appropriate:

    • When your baby meets all the developmental readiness signs: This is paramount for safety and success.
    • When you are comfortable with the mess and the learning curve: It requires patience and a relaxed attitude.
    • When you are committed to offering a variety of safe, appropriate foods.
    • When you are willing to learn about and practise safe food preparation to minimise choking hazards.

    When BLW might not be appropriate (or requires extra caution and professional guidance):

    • If your baby has a history of prematurity or significant developmental delays: His or her oral motor skills might not be sufficiently developed.
    • If your baby has certain medical conditions or anatomical differences (e.g., cleft palate, severe reflux, swallowing difficulties): These may necessitate a modified approach to feeding.
    • If there are significant feeding difficulties, aversion, or a history of choking incidents.
    • If you feel overly anxious about choking: While BLW, when done correctly, is not associated with a higher choking risk than traditional weaning, parental anxiety can impact the feeding experience. Education and consultation with a professional can help alleviate these concerns.

    A note on safety: Choking hazards

    It’s crucial to understand the difference between gagging and choking. Gagging is a natural reflex that helps prevent choking and is very common in BLW as babies learn to manage food in their mouths. Choking is silent and serious. To minimise choking risks:

    • Always supervise your baby closely during mealtimes.
    • Offer appropriately sized and textured foods. Avoid small, round, hard foods like whole grapes, nuts, popcorn, and large chunks of meat.
    • Ensure your baby is sitting upright and calm.
    • Educate yourself on infant CPR.

    Final thoughts

    Baby-led weaning is a wonderfully empowering approach that celebrates a baby’s natural abilities and fosters a positive and independent relationship with food. As Speech and Language Therapists we often see the positive impact it has on oral motor development, self-regulation, and overall feeding confidence. By understanding what it entails, when it’s appropriate, and prioritising safety, you can embark on this exciting journey with your little one, helping him or her become a confident and capable eater from the very first bite.

    If you would like help and support with weaning your baby whilst continuing to breastfeed then please get in touch!

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

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  • · ·

    Neurodiversity affirming Speech and Language Therapy

    Introduction

    I am a neurodiversity affirming therapist and I love and endorse play-based therapy. I use it alongside a strengths-focused approach in all my sessions. Find out why we should use these transformative therapy methodologies in all our work and play with our children.

    I always have a range of different toys and activities up my sleeve so that when one toy is no longer interesting, that’s fine. ‘Look here’s a new one, how about we try this one?’ When therapy feels like play, children are more likely to be engaged and attentive, which leads to better outcomes.

    By using play as a context for Speech and Language Therapy we can create opportunities for children to use and practise their communication skills in a natural, real-life setting. This helps bridge the gap between the therapy room and everyday life.

    Goals and targets

    What about goals and targets I hear you say? Of course, as Speech and Language Therapists we always have our goals for any particular child. They can be speech goals (we want Bobbi to produce a ‘k’ sound at the end of words) or communication goals (we want Fatima to ask for something by pointing to it rather than grabbing it). And these goals can be achieved where there is a reciprocation and a positive, playful relationship between the adult and the child. That relationship comes through play and fun.

    Play and fun

    Play is how a child interacts and learns. If it’s fun, interesting, exciting or pleasurable then that is where the magic happens. And that is what we need to return to repeatedly and then see if we can fold our targets into the activity as we go.

    As soon as we expect our child to do something and we try and shape their behaviours towards a certain outcome we no longer ‘play’. We are now in teaching mode, where we direct and where we are ‘in charge’. As a neurodiversity affirming therapist, I believe that all play is valid. We must not get into the trap of thinking that only functional play is valid, that there is only one way to play with that car ramp/puzzle/potato head. Our autistic children often need to play in a particular way to navigate their world and we must not try and stop that.

    When we affirm and validate our child’s play and copy their play with enthusiasm and respect then, in my experience, all children regardless where they are on the neurodiversity spectrum will begin to engage with us, copy us, and learn how to communicate effectively about things that matter to them.

    Play-based therapy allows therapists to tailor interventions to each child’s unique interests and abilities. This individualised approach increases the likelihood of success and progress.

    Strengths-Focused Speech Therapy

    Strengths-focused therapy emphasizes a child’s strengths and abilities rather than their deficits. It recognises that every person has unique strengths that can be harnessed to overcome challenges.

    Focusing on strengths helps us build a positive self-image. This is especially important for children with communication disorders, as it can boost their confidence and self-esteem.

    When we encourage children to play in ways that they enjoy and are good at they feel empowered and more in control of their lives and play. This can lead to increased motivation and a sense of ownership over their progress.

    Now, imagine the powerful impact that can be achieved by combining play-based therapy and strengths-focused therapy in speech therapy sessions. This dynamic combination brings out the best of both worlds. It creates a therapeutic environment that is not only effective but also enjoyable for children and their families.

    As Speech Therapists we can use the child’s strengths and interests as a foundation for play-based activities. This personalisation not only makes therapy more engaging but also more effective.

    An example

    Charlie, a 3-year-old with social communication challenges, had a deep interest in anything that spins. We used this strength and interest to create a variety of spinning activities. As he is allowed to engage in his spinners, we can practise lots of speech and language and provide great phrases alongside his interest and activities: Ready steady go! Stop! ‘another one’ ‘the red one’ ‘again again’ ‘I love it’ ‘it’s a spinner’ ‘Charlie loves this toy’ ‘it’s going fast’ ‘it’s so fun’ etc..

    Over time Charlie started to copy some of these word models and then used them to create his own little phrases, such as ‘the blue one again’. When this occurred, we felt like celebrating because it had come naturally and appropriately to the situation without any coercion or direction. That is what communication is about! Well done Charlie!

    Conclusion

    Play-based and strengths-focused speech therapy approaches are powerful tools and by combining these approaches, we create a therapeutic environment that is not only effective but also enjoyable and empowering for our clients.

    Contact me if you would like your child to have neurodiversity affirming speech and language therapy.


    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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    Great toys and books for our toddlers (around 1–2 years old)

    As a speech and language therapist, I often get asked by parents what toys and books they should buy for their toddlers. It can feel overwhelming with so many options available! So, I’ve put together a list based on my experience and what I’ve found works well.

    Remember, every child is unique!

    Observe your toddler’s interests and play style. Some toys that are popular might not be engaging for your child.

    Here are a few ideas to get you started:

    Sensory Toys:

    • Stacking cups: These are fantastic for developing hand-eye coordination, fine motor skills, and understanding size relationships. (Various brands available) Note: You can stack many things you have around the house, like bowls or measuring cups, for a similar experience!
    • Shape sorters: Help with shape recognition, hand-eye coordination, and problem-solving. (Melissa & Doug, Vtech)
    • Sensory balls: Balls with different textures (soft, bumpy, squishy) provide tactile stimulation. (Various brands)
    • Push and pull toys: Encourage gross motor development and exploration. (Vtech, Fisher-Price)

    Communication-focused toys:

    • Picture books with flaps: Engage curiosity and encourage language development. (Various brands)
    • Talking toys: Introduce new vocabulary and encourage imitation. (Vtech, Fisher-Price)
    • Simple puzzles: Develop hand-eye coordination, problem-solving, and spatial awareness. (Melissa & Doug, Ravensburger)
    • Musical instruments: Encourage exploration of sounds and develop auditory skills. (Bright Starts, Fisher-Price)

    Now, let’s talk about books:

    • The Very Hungry Caterpillar by Eric Carle: A classic with repetitive text and vibrant illustrations, great for introducing vocabulary and concepts like days of the week.
    • Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr. and Eric Carle: Simple, repetitive text and engaging illustrations make this a favourite for many toddlers.
    • Goodnight Moon by Margaret Wise Brown: A soothing bedtime story with calming illustrations.
    • Pat the Bunny by Dorothy Kunhardt: An interactive book with textures and flaps to engage young children.
    • Corduroy by Don Freeman: A heartwarming story about a teddy bear who loses his button.

    Remember:

    • Observe your child’s interests: Choose toys and books that capture their attention and encourage exploration.
    • Engage with your child: Play with the toys together and read books aloud with enthusiasm.
    • Keep it simple: Start with a few toys and books and gradually introduce new ones.
    • Rotate toys: Keep playtime fresh by rotating toys and books regularly.
    • Most importantly, have fun! Reading and playing with your child should be a joyful experience for both of you.

    Also consider the power of open-ended play

    In today’s world filled with electronic gadgets, it’s easy to overlook the value of open-ended play. Open-ended toys lack specific functions or prescribed outcomes, allowing children to use their imaginations to explore and create. Unlike toys with pre-determined ways to play, open-ended toys encourage:

    • Creative thinking: Children can use them in countless ways, developing their own rules and narratives. A block can become a car, a house, or a spaceship, depending on the child’s imagination.
    • Problem-solving skills: Children learn to figure out how to use the toys, experimenting and adapting as they go. Don’t immediately rush in and fix things for your little one, let them think for themselves and then communication incentive: let them come and find you!
    • Fine motor skills: Many open-ended toys, like blocks, encourage the development of fine motor skills like grasping, stacking, and building.
    • Cognitive development: Children learn about cause and effect, spatial relationships, and problem-solving as they play with open-ended toys.
    • Social-emotional development: Open-ended play can foster social interaction and cooperation as children play together and share ideas.

    Simple toys with big impact

    Some of the best toys for toddlers are often the simplest ones. Here are a few examples:

    • Wooden blocks: Building towers, bridges, and forts encourages creativity and problem-solving.
    • Balls: Throwing, kicking, and rolling balls promote gross motor skills and hand-eye coordination.
    • Fabric: Bits of fabric can be draped, draped, and used for imaginative play.
    • Empty boxes: From cardboard boxes to tissue boxes, these can be transformed into anything a child can imagine: a car, a house, a spaceship!
    • Natural materials: Sticks, leaves, pinecones, and rocks can be used for imaginative play and sensory exploration.

    Remember, the key to open-ended play is to let children explore and discover

    Step back and observe, allowing your child to use his or her imaginations without too much direction. You might be surprised at the creative ways he or she uses simple toys!

    Happy play times with your little one!

    Contact me via my contact form.

    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.

    1
  • · ·

    Feeding therapy: A guide for parents and caregivers

    Feeding therapy is a specialised form of therapy and support that helps children develop healthy eating habits and overcome challenges related to food. It’s often used for children with picky eating, feeding disorders, or sensory processing issues.

    What is feeding therapy?

    Feeding therapy involves a series of techniques designed to improve a child’s eating skills and attitudes towards food. In the UK it’s typically provided by speech and language therapists and dietitians. These professionals work closely with parents and caregivers to create a personalised treatment plan tailored to each child’s unique needs.

    How does feeding therapy work?

    Feeding therapy sessions are typically 30–60 minutes long and involve a variety of techniques, including:

    • Family counselling: Providing support and guidance to parents and caregivers. This can help address any practical, behavioural and emotional issues that may be impacting the child’s eating.
    • Play-based activities: Engaging children in fun activities while introducing new foods or textures. This can help alleviate anxiety and make mealtimes more enjoyable.
    • Sensory exploration: Helping children become more comfortable with different tastes, smells, and textures. This can be achieved through activities like touching, smelling, and tasting various foods.
    • Oral motor exercises: Improving chewing, swallowing, and lip coordination. These exercises can help children develop the necessary skills for eating independently.
    • Behavioural techniques: Using positive reinforcement to encourage healthy eating habits. This can involve rewarding children for trying new foods or eating a variety of meals.

    When is feeding therapy needed?

    Feeding therapy may be beneficial for children who:

    • Are picky eaters: Refuse to eat a variety of foods or have strong preferences.
    • Have feeding disorders: Experience difficulties with eating, such as swallowing or chewing.
    • Have sensory processing issues: Are sensitive to certain textures, smells, or tastes.
    • Have medical conditions: Such as autism, cerebral palsy, or gastrointestinal disorders.

    Feeding therapy strategies you can try at home

    While professional feeding therapy can be invaluable, there are several techniques you can try at home to support your child’s eating development:

    • Create a positive mealtime environment: Make mealtimes enjoyable and stress-free by avoiding distractions, limiting screen time, and creating a calm atmosphere.
    • Create regular mealtimes and mealtime routines: Introduce set ways of announcing meal times, including songs or short nursery rhymes, try and involve your child with table setting, even just carrying their spoon to the table and putting the beaker next to the plate and ensure that meal time finishes after about 30 minutes, again with a set routine so that the child always knows: this is how we do it in our home, now I am finished and meal time is over.
    • Introduce new foods gradually: Start with small amounts and gradually increase exposure. This can help reduce anxiety and make new foods less overwhelming.
    • Model healthy eating: Show your child how to enjoy a variety of foods by eating a balanced diet yourself.
    • Avoid forcing food: Allow your child to choose and explore foods at their own pace. Forcing them to eat can create negative associations with food.

    Seek professional help

    If you’re concerned about your child’s eating habits, consult with a feeding therapist. We can provide guidance and support.

    Remember, feeding therapy is a collaborative process between parents, caregivers, and professionals. With patience, understanding, and the right strategies, you can help your child develop healthy eating habits and enjoy meals.

    Would you like to know more about specific techniques or have any other questions about feeding therapy?

    Please feel free to 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.

    1
  • One book, dozens of therapy opportunities: What speech therapy really looks like

    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.


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

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

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