Let’s break it down into steps to make these complicated words easier to understand. Once you have a deeper understanding, you will then be able to support your child or young person develop their communication skills in the best way as a Gestalt Language Processor. Remember not every child will be a Gestalt Language Processor; if your child uses echolalia and/or has a diagnosis of autism then your child’s way of processing language is most likely different to the classic way children typically learn language.
Let’s start with understanding what each of these words “Gestalt Language Processors” mean.
Gestalt: “the way a thing has been placed or put together”
Language: “a system of human communication”
Processors: “responds to and processes basic instruction”
So, let’s put those meanings together. “Gestalt Language Processors are children who process early language in strings of sounds or chunks.” They tend not to process single words.
It is important to understand this way of processing communication because between 75-90% of children with Autistic Spectrum Conditions process language in this way (Blanc, 2012). We know that it’s important for young people to have their voice heard and to be able to express themselves. So, it’s vital that they move from echolalia to self-generated communication to be able to do this. This means that our children’s communication partners play a vital role in supporting their child’s language. We can support our children by modelling phrases until the child has learnt the process themselves.
Let’s explore an example together
X (who is a gestalt language processor) and his family love to feed the ducks in their spare time; this is an activity that takes place regularly. Let’s look at how you, as the adults, could support X in his communication. Look at the phrases that are used. They are meaningful to the activity with repetition used throughout.
Top tip: You could think of an activity you and your child or young person take part in on a regular basis and brainstorm some key phrases that you could use.
Need a boost in confidence to support your child’s gestalt language processing?
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
When children find talking hard, parents often face a difficult question: ‘Should we wait and keep encouraging speech? Or introduce something like AAC?’
AAC (Augmentative and Alternative Communication) can sound intimidating, but it simply means any way we support or replace spoken words, from simple gestures and picture boards to high-tech speech-generating devices. Far from ‘giving up on speech,’ AAC often becomes the bridge that helps children find their voice, in whatever form that takes.
💡 What is AAC, really?
AAC is a spectrum of tools and strategies that help people express themselves when speaking is difficult. It might include:
Low-tech supports: Gestures, key word signs (like Makaton), picture symbols, or printed boards
High-tech systems: Apps on tablets that speak aloud when pictures or words are tapped
AAC is not just for children who will never talk. It’s for anyone whose speech isn’t meeting their communication needs right now.
🤔 When to introduce AAC
There’s a common myth that you should only try AAC after ‘exhausting’ other speech therapy options. In fact, AAC can be introduced at any stage, even alongside speech development.
Here are some helpful signs that AAC might support your child:
Your child understands much more than they can say.
They rely on gestures, sounds, or behaviour to communicate.
They become frustrated trying to express themselves.
You find yourself ‘reading their mind’ to interpret needs.
Speech progress feels slow or inconsistent.
If you recognise these patterns, AAC isn’t a ‘last resort’. It’s a communication support, not a replacement for speech.
Recent research consistently shows that AAC does not stop children from talking. In fact, it can encourage speech to develop. A 2024 systematic review and meta-analysis published in the Journal of Autism and Developmental Disorders found that children who received interventions combining naturalistic developmental behavioural approaches with aided AAC showed improved language outcomes, and that AAC ‘does not negatively impact speech development and may even facilitate spoken language growth’ (Smith et al., 2024).
🌉 How AAC supports speech development
Speech and AAC aren’t competing paths: they’re parallel tracks that often feed each other.
Here’s how AAC helps speech grow:
Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
Encourages turn-taking and social connection: AAC lets children join conversations even before speech is fluent, giving them more practice in real communication.
AAC is not ‘giving up on speech’. It’s giving a child more ways to succeed while speech continues to develop.
🧩 How to introduce AAC gently and effectively
Start small and meaningful: Begin with a few key messages your child wants to say, not just what adults want to hear. Think ‘I want’, ‘stop’, ‘help’, ‘more’, ‘all done’, ‘no’, ‘again’. These are powerful words for real interaction and autonomy.
Model, model, model: The most important part of AAC success is modelling—using the system yourself as you talk. For example: ‘You want banana 🍌’ and you tap the ‘want’ and ‘banana’ symbols. Children need to see and hear AAC used naturally before they try it themselves.
Use it throughout the day: AAC isn’t a therapy tool to take out once a week. It’s a living part of communication. Model a few words during mealtimes, play, and routines. The more consistently it’s embedded, the more fluent both you and your child will become.
Keep it accessible: If using a device or picture board, make sure it’s always nearby. If it’s in a bag or drawer, it can’t be used in real moments.
Celebrate all communication: If your child points, signs, uses a sound, or taps a symbol, it all counts. Respond warmly and naturally to reinforce communication in any form.
🧠 What parents often worry about
‘Won’t AAC stop them from talking?’: No. Research shows AAC use either has no negative effect on speech or leads to increased spoken output (Smith et al., 2024). When children feel understood, their motivation to communicate grows.
‘What if I model it wrong?’: There’s no perfect way to start. Your effort and consistency matter far more than accuracy.
‘Will they get ‘stuck’ using pictures?’: Some children do continue using AAC long-term; others move naturally toward more spoken language. The goal is always functional communication, not replacing one form with another.
🪞 Bringing AAC into daily life
Here are a few simple, parent-friendly ideas:
Create visual spaces: Post symbols or core words on the fridge, mirror, or play area.
Narrate routines: Use AAC during toothbrushing, dressing, or mealtimes; consistent contexts build understanding.
Pair speech and touch: Always say the word aloud when you point to or tap a symbol.
Involve siblings and friends: Model how they can respond to AAC too. ‘Oh, you said go! Let’s go fast!’
Use shared books and songs: Pause and model key words in stories or songs.
🌱 The takeaway
AAC doesn’t mean giving up on speech; it means opening more doors to communication. When words don’t come easily, AAC gives children a way to connect, share, and be heard.
It helps parents move from guessing to understanding, and gives children the power to express themselves on their own terms.
If you’re unsure where to start, reach out to a speech and language therapist experienced in AAC. Together, you can find a system that fits your child’s strengths, build confidence in modelling, and help every word (spoken or tapped) feel like a step forward.
Because when communication is possible, everything else begins to grow.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
📚 Reference
Smith, K., et al. (2024). The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta‑Analysis. Journal of Autism and Developmental Disorders, 55, 3078–3099. https://doi.org/10.1007/s10803-024-06382-7
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
My baby isn’t babbling and developing speech – what can I do to support?
While every baby develops at their own pace, if your child isn’t babbling by nine months, it’s worth seeking help from an Early Intervention Health Professional, such as a doctor and a speech therapist. Don’t panic! There are many reasons for delayed babbling, and early intervention is key.
In the meantime, it is highly recommended that we talk, sing, and read to our baby often. Exaggerate sounds and expressions, and respond to their coos and smiles. This playful interaction helps stimulate their communication skills.
Below are some tips and tricks from my experience of working with babies and toddlers who need a little bit of help and support to develop.
The benefits of imitating your baby
Copying your baby’s sounds and gestures isn’t just silly fun, it’s a powerful learning tool! By mimicking their babbles and actions, you activate “mirror neurons” in their brain that help them connect sounds with meaning. This playful back-and-forth teaches turn-taking, a foundation for conversation. Plus, it encourages them to copy you, building their own language skills and social interaction abilities.
This is a nice clip on youtube showing how copying/imitating your baby looks like:
Here are some fun ways to imitate your baby:
Matchmaker: Grab two of the same, or two similar toys your child loves, like rainmakers or shakers. Give one to your baby and keep the other for yourself. When your child plays with his/her toy, mirror his/her actions with yours! This creates a fun, interactive game.
Face Time: Get down to your baby’s level, sitting opposite him/her on the floor or kneeling. This makes eye contact easy and encourages him/her to look at you during your playful imitation.
Be the Funniest You: Go all out with silly faces, exaggerated sounds, and big gestures. The goal is to capture your baby’s attention and make you irresistible to watch. This playful energy encourages him/her to interact and potentially imitate you back!
By incorporating these tips, you can turn imitation into a fun and engaging way to boost your baby’s communication skills. I have seen this happen numerous times over the past decades. It is very powerful, go ahead and try it! You cannot be silly and goofy enough!
Did you know that speech and language development starts with how we talk to our babies?
Adults naturally use a special way of speaking called motherese. It involves a higher pitch, slower pace, and exaggerated sounds compared to regular conversation. Sentences are simpler, with shorter words and repetition. This grabs babies’ attention, helps them distinguish sounds, and reinforces word meaning.
Imitation is a key part of motherese. We wait for our baby to make a sound or gesture, then playfully imitate it with exaggeration. Babies notice this right away and often respond with more vocalisations, creating a mini conversation. This back-and-forth teaches turn-taking, a foundation for future conversations.
By responding warmly and engaging in these playful interactions, we encourage our babies to keep exploring the world of communication. Talking, singing, reading and, of course, imitating, these simple actions can have a big impact on a baby’s language development.
Once your conversation is underway then try and keep it going for as long as possible. It’s a beautiful dance of turn-taking, even without words!
A last word on oxytocin
There’s evidence suggesting early non-verbal communication with your baby can increase a mother’s oxytocin levels, often called the ‘love hormone’. This hormone plays a key role in bonding and social connection. Positive interactions, touch, and stress reduction all contribute to oxytocin release, strengthening the mother–baby bond.
For parents of babies with extra needs
The stress of caring for a child with medical needs or developmental delays can be difficult. Stress can lower oxytocin levels, creating a cycle of sadness for both parent and child.
Breaking the cycle:
Knowledge is Power: Understanding the importance of communication can empower parents.
Seek Support: Speech therapists and other healthcare professionals can provide valuable guidance on communication strategies.
Start Small, Celebrate Big: Even small interactions can boost oxytocin. Focus on playful imitation and positive reinforcement. Remember, friends, family and healthcare professionals are there to encourage you.
This approach can help reverse the negative cycle and create a more positive and connected relationship between parent and child.
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.
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!
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.
As speech and Language therapists (SLTs), we know that where your tongue goes, so goes your sound. This blog post will explore why tongue placement is so vital for speech correction and how we use tools and techniques to help our clients find their ‘sweet spot’ for sound production.
Let me show you here a little video clip where I am using my dentist’s mouth/teeth model to help my clients navigate their tongue movements.
The tongue: A tiny muscle with a big job
The tongue is a small but mighty muscle. It’s incredibly versatile, playing a key role in eating, swallowing, and, of course, speaking. For each speech sound, the tongue, along with the lips and jaw, needs to move to a very specific spot. Think of it like a dance: every part of your mouth has a choreographed movement to produce the correct sound. If the tongue is out of sync, the sound comes out muffled, distorted, or just plain wrong.
The trouble with our tongue movements is that most of us never think about how the tongue has to move and what it does to: swallow, chew, drink, suck and speak. Most parents when asked to think about their own tongue placement for say the /S/ sound are completely lost as to what their tongue is doing. Yet, of course, they produce a perfect /S/ and perfect speech in general. The same goes for swallowing. When did you last think about what happens in your mouth when you swallow? I bet you have not thought about it. We ‘just do it’, right?
Why is tongue placement so important?
Accurate tongue placement is the foundation of clear articulation. When a child struggles with a particular sound, it’s often because his or her tongue isn’t quite reaching the right spot or moving in the correct way. For example, the /S/ sound requires the tongue to be slightly raised and positioned behind the top teeth, creating a narrow channel for air to flow through. If the tongue is too far forward, you might get a /TH/ sound instead. If it’s too far back, the /S/ can sound muffled.
Visual aids: Our secret weapon
We SLTs love our visual aids! They’re incredibly helpful for showing clients exactly where their tongue needs to be. Here are some of our favourite tools:
Mirrors: Mirrors provide instant feedback. Clients can see their tongue’s position and make adjustments in real-time. We often use hand mirrors or even the mirror on a compact for quick checks.
Tongue depressors: These simple tools can gently guide the tongue to the correct position. We might use them to show where the tongue tip should rest for the /L/ sound or how the sides of the tongue should touch the molars for the /K/ and /G/ sounds.
Diagrams and models: Pictures and models of the mouth can help clients visualise the tongue’s movements. We might use a cross-section diagram of the mouth to show how the tongue forms different sounds.
Beyond the tongue: The jaw’s role
While the tongue takes centre stage, the jaw plays a supporting role. It provides a stable base for the tongue and helps control the opening and closing of the mouth. Sometimes, jaw stability is an issue, and we might use techniques to help clients find a comfortable and stable jaw position.
Making it fun and engaging
Learning correct tongue placement can be challenging, but we make it fun! We use games, stories, and playful activities to keep clients motivated. For younger children, we might use silly voices or pretend to be animals. For older children, we might incorporate their interests, like using a car analogy for tongue movements.
The takeaway
Correct tongue placement is essential for clear speech. By using visual aids, interactive techniques, and a bit of creativity, we can help our clients master their speech sounds and communicate with confidence.
If you have any concerns about your child’s speech, don’t hesitate to reach out to a qualified speech and language therapist, we are here to help! 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.
As a Speech and Language Therapist specialising in infant feeding, I often hear from worried mums describing their breastfed baby’s fussiness. ‘My baby is so burpy and gassy,’ ‘might it be reflux?’ or ‘she just seems uncomfortable after every feed’. While these concerns are incredibly valid and distressing for both baby and mum (and dads!), the underlying cause isn’t always what you might think. Often, the culprit isn’t primarily a digestive issue, but rather a mechanical one: how effectively your baby is managing air during feeding.
Many parents are told their baby has ‘colic’ or ‘reflux’ and are offered solutions that don’t quite hit the mark because they overlook a fundamental aspect of feeding: the suck-swallow-breathe sequence. Understanding this intricate dance can be the key to unlocking a calmer, happier feeding experience for your baby and you.
Understanding the suck-swallow-breathe sequence
Your baby’s mouth, tongue, jaw, and throat muscles work together in a precise rhythm like a beautifully orchestrated symphony. First your baby draws milk, then swallows it, and then takes a breath, all without interruption. This is the ideal suck-swallow-breathe (SSB) sequence.
When the SSB sequence functions optimally, a baby latches deeply, creates good suction, draws milk, swallows efficiently, and then pauses just long enough to take a gentle breath before the next suck. This smooth, coordinated process minimises the amount of air swallowed.
However, for various reasons (it could be a shallow latch, oral motor challenges, an uncoordinated suck, or even an overly fast milk flow) this sequence can get a bit out of sync. Instead of a smooth rhythm, you might see:
Suck-suck-swallow-gasp!: Too much air pulled in with the swallow.
Rapid, shallow sucking followed by gulping: Inefficient milk transfer and air intake.
Clicking noises during feeding: Loss of suction, indicating air entry.
Frequent detaching and re-latching: Often to ‘catch a breath’ or because of discomfort.
Each of these patterns can lead to increased air intake.
The root cause: Air trapping leading to a gassy breastfed baby
When a baby swallows too much air during a feed, that air must go somewhere. It builds up in the stomach, causing bloating, discomfort, and often leads to the familiar reflux-like symptoms parents describe: arching, spitting up, burping excessively, or simply appearing distressed.
It’s a common misconception that all gassiness or reflux symptoms in a breastfed baby are due to something in the mother’s diet or a genuine digestive disorder. While these can be factors, as an SLT, we first look at the mechanics of the feed. If a baby is constantly struggling to maintain a seal, sucking inefficiently, or having to gulp to keep up with flow, he or she is inevitably swallowing air. This air then creates pressure, which can push milk back up (silent reflux) or out (visible reflux).
Think of it like trying to drink through a straw with a hole in it. You’re sucking, but you’re also pulling in air, making it harder to get the liquid and leaving you with more bubbles in your stomach.
Why mechanical speech therapy assessment is key
This is where the distinction between a medical diagnosis (true gastro oesophageal reflux disease or GORD) and a functional feeding challenge becomes critical. A paediatrician will assess for medical causes and may prescribe medication to reduce stomach acid. This can be appropriate for severe cases of GORD.
However, if the primary issue is air being trapped due to a suboptimal suck-swallow pattern, medication only treats the symptom (acid burning) and not the root cause (air intake). This is precisely where a Speech and Language Therapist specialising in infant feeding comes in.
My role is to meticulously observe and assess your baby’s oral motor skills, latch, tongue function, and the efficiency of their SSB sequence. I look for subtle signs of inefficiency that contribute to excessive air swallowing.
Is the tongue elevating correctly to create suction?
Is the jaw stable, or is it excessively moving?
Is the latch deep enough to prevent air leaks?
Can the baby coordinate suck, swallow, and breathe without gasping?
By identifying these mechanical challenges, I can then implement targeted strategies to improve feeding efficiency and reduce air intake, often leading to a significant reduction in reflux-like symptoms and overall discomfort.
Strategies to optimise air management during breastfeeding
The good news is that many babies can learn to feed more efficiently with the right support. Here are some general strategies we might explore:
Optimise latch and position: A deep, asymmetric latch is crucial. Experiment with different positions that allow for a deeper latch and better head/neck alignment, such as laid-back feeding or upright positions.
Paced feeding (even at the breast): If your milk flow is very fast, consider removing your baby from the breast briefly if you hear excessive gulping or see him or her struggling to breathe. This allows him or her to catch up and manage the flow.
Support the jaw and cheeks: Sometimes, gentle support to the baby’s jaw or cheeks can help them maintain a more stable, efficient suck. I can demonstrate specific techniques for this.
Burping effectively: While burping won’t get rid of all swallowed air, upright burping positions and gentle back rubs can help release some of it.
Pre-feed oral preparation: Gentle oral massage or stretches before a feed can sometimes ‘wake up’ the oral muscles and improve coordination.
Addressing the ‘Great Air Debate’ isn’t about blaming anyone; it’s about empowering parents with a deeper understanding of their baby’s feeding mechanics. By focusing on the how, not just the what, we can often resolve persistent feeding challenges, reduce discomfort, and make breastfeeding a more joyful, peaceful experience for both you and your little one.
If you suspect your baby’s gassiness or reflux symptoms are related to how they are managing air during feeds, don’t hesitate to reach out for a specialist assessment.
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.
I very often work on /S/ Blends (/SP/ /ST/ /SM/ /SK/ /SN/ and /SL/). When we work on these sound blends (like SPider, STop, or SMile), we are using a clever speech therapy ruse! Because these blends are complex, teaching a child how to master them naturally helps them clear up simpler single sounds (like just /S/ or just /P/) at the same time. Plus, because S-blend words are so common in everyday language think spoon, spy, spot, and spin, practising them gives your child an immediate confidence boost when they are understood much more easily.
Good news: high-repetition motor practice doesn’t have to be a chore. In fact, the more sensory input we can provide, the faster those new neural pathways are built. Recently, I recorded a series of seven short clips to demonstrate how we can weave intense speech practice into the fabric of play.
Here is a look at a typical day in the clinic focusing on /SP/ blends.
1. The sensory sandbox:
We started our session at the sensory table. Sensory bins can often work well because they provide tactile feedback that grounds the child’s focus (of course they are usually messy, so one needs to have the physical space and energy for it to be fair!).
The Activity: I pointed to our ‘I Spy’ board before we dove into the sand. Using a toy spade we dug for hidden objects and named them each time we found one.
Every time we scooped, we practised Spade. Every discovery was a spider, a spoon or a spotty animal. By pairing the physical effort of digging with the speech sound, we help the brain synchronise motor planning and vocal execution.
2. Bingo dabbers rock!
Next, we moved to making ink marks on paper.
The Activity: I demonstrated making spots with coloured bingo dabbers.
We treated each ink spot as a visual anchor. Stamp –Spot Stamp –Spot. This creates a rhythmic pacing that prevents the child from rushing. It’s a wonderful way to get 50+ repetitions in under five minutes without the child even realising they are ‘working’.
3. Drawing spiders
Building on the previous activity, we took those spots and turned them into something more complex.
The Activity: I drew spiders out of the spots we had just made.
Drawing the legs provided a perfect opportunity for ‘stretch’ sounds. As we drew a long leg, we practise a long, hissy ‘Sssssssss’, snapping into the /P/ as the pen hits the spot.
4. Wind-up spinners
High-energy toys are excellent for eliciting ‘power’ sounds.
The Activity: I brought out two mechanical wind-up spinners.
Method: The child says Spin or Spinner to get me to wind them up. The anticipation of the toy moving acts as a natural reinforcer.
5. The Incy Wincy spider game
The Activity: I spun a game spinner to determine how many steps our toy spiders would take up the spout.
This activity is a triple threat. We practised ‘Spin’, ‘Spider’, and ‘Spout’ all in one go. The visual of the spider moving up the spout also helps with the concept of UP and DOWN of course.
6. Searching for Spot
Books are a great tool for generalisation, taking a sound from a single word and moving it into phrases and sentences.
The Activity: We went through a ‘Spot the Dog’ book.
Instead of just reading, we used the ‘I Spy’ strategy. ‘I spy Spot! He has a big spot on his back!’ This encourages the child to use the target word in a functional, communicative way rather than just repeating it after me.
7. Finally, sponging off some sand
We ended the session with some ‘heavy work’ and cleaning.
The Activity: We took a soft toy that had gotten a bit ‘dusty’ in the sandbox and used a sponge to clean it down.
The action of squeezing the sponge provides proprioceptive input (pressure), which can be very calming and help a child focus on their articulatory placement for those final repetitions of the day.
A day in my speech clinic: Mastering the /SP/ cluster
Speech therapy works on motor learning. Just like learning to ride a bike or play the piano, the brain needs thousands of correct repetitions to make a movement automatic. By using /SP/ words in these seven distinct, sensory-rich ways, we:
Reduce frustration: The focus is on the play, not the correction.
Increase engagement: A child who is having fun will stay in the learning zone longer.
Provide context: The child learns that saying /SP/ correctly helps them get the spade, spin the spinner, and find the spider.
Next time I will show you some more activities for /ST/ and /SM/ words. If you have any super ideas for /S/ cluster words please leave me your suggestions in the comments on instagram, I would appreciate it thank you! 😊
If you are concerned about your child’s speech, please do not hesitate to get in touch. I would love to help you find some answers.
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.
