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.
There’s been a long tradition with teaching staff and with Speech and Language Therapists working in schools that eye contact should be a goal. It is well known that Autistic individuals (whether that be children or adults) mostly avoid eye contact. Whilst it’s part of the way we communicate, it shouldn’t be used as a necessity for an individual who feels that it is uncomfortable. Whilst it does show that you’re listening and showing an interest, it’s not a fair expectation for neurodiverse children.
Autistic children can find making and maintaining eye contact physically and emotionally uncomfortable as well as unnatural. It adds an extra layer of stress and has been reported to increase distractions rather than reduce them. Children who engage in conversations in their own way (i.e., with reduced eye contact) are not shown to suffer with schooling, work, or social interaction.
By having fun through meaningful activities, I often experience that ‘BINGO’ moment (a phrase coined by Alex @meaningfulspeech) where the child is enjoying themselves and naturally makes eye contact. There is no demand on them, they are in a fun, engaging environment which suit their strengths and supports their needs.
Following this, I often reflect on this question ‘Should we make eye contact as a goal?’
It very much depends on the situation. If it places more demands on the child and becomes stressful. Then no. There are many strategies we can use which gain eye contact without placing extra demands on the child. We need to be mindful to adapt the environment and not place neurotypical expectations to meet the needs of neurodiverse children.
How can you encourage eye contact without demand?
If you’re using toys, try holding them up to your eye level.
You can adjust your position, try sitting face to face during play.
Always get down to your child’s level. This might mean that you lay on the floor if your child is positioned in this way.
During play, waiting is extremely powerful. Before a key part of the activity, wait and see if your child looks at you. Remember silence is golden!
The best way I find is: do something unusual during play. It might be that you spray shaving foam with the lid still on. Or you bring out a wow toy and make it spin/light up or make a noise. A balloon can be good – see video clip. Use the excitement of the activity, and wait to see if you achieve that ‘BINGO’ moment.
Create opportunities when there are no toys involved such as during ‘tickles’ or ‘hide and seek’. Autistic children find it difficult to shift their attention between a toy and an adult. So by removing one option, you’re setting them up to succeed.
Remember, it takes practice and time for you to develop these skills. Try one at a time and experiment, see which works best for your child. If you need speech, language or communication support or advice, I am always here to help.
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 parents first enquire about speech and language therapy, many assume it will happen face-to-face, in a clinic room, with a therapist sitting across from their child.
So when therapy is offered online, it’s natural for questions to arise:
Can this really work? Will my child engage? Will progress be slower?
This short video offers a glimpse into what online therapy can look like: calm, interactive, relationship-based, and surprisingly effective.
Online therapy is not ‘less than’ in the right circumstances
Teletherapy is not suitable for every child in every situation. However, for many school-aged children, particularly those who enjoy conversation, technology, and shared activities, online therapy can be an excellent fit.
The child you see in this video is around eight years old and was supported for a persistent lisp. Sessions were primarily online, with the occasional in-person appointment when helpful.
What made the difference was not the screen. It was the combination of engagement, support, and consistency.
Parent involvement changes everything
One of the greatest strengths of online therapy is the way it naturally invites parents in.
In this case, parents regularly joined the video sessions:
Listening in
Taking part when appropriate
Learning how to support practice gently between sessions
This meant that therapy didn’t stay ‘on the screen’. Strategies carried over into everyday conversation, making progress faster and more meaningful.
Speech sound therapy, including support for lisps, relies heavily on awareness, feedback, and confidence, all of which can be supported very effectively at home with the right guidance.
Therapy through a screen can still be deeply relational
A common concern is whether connection can truly be built online.
In reality, many children feel more relaxed in their own home environment. They are often more willing to talk, experiment with sounds, and reflect on their speech when they feel comfortable and supported.
Online sessions allow:
Shared focus and conversation
Clear visual feedback
Real-life practice in a familiar setting
Immediate parent support
For some children, this actually enhances engagement rather than limits it.
Real progress, real outcomes
Over the course of approximately 12 online sessions, alongside a small number of in-person appointments, this child achieved resolution of their lisp.
Progress was steady, positive, and confidence-building. Importantly, the child remained motivated and proud of their achievements throughout the process.
While every child’s journey is different, this example highlights what is possible when:
The child is ready
Parents are involved
Therapy is tailored and collaborative
If you’re considering online therapy
If you’re unsure whether teletherapy could work for your child, it’s worth remembering that effective speech and language therapy is less about the room you’re in, and more about:
Relationship
Understanding
Consistency
Carryover into daily life
For many families, online therapy offers flexibility, accessibility, and excellent outcomes especially when parents are active partners in the process.
If you’re at the start of your child’s speech journey and wondering whether online therapy could be the right fit, I’m always happy to talk it through. Sometimes clarity begins with simply understanding what therapy can look like
Teletherapy: Frequently Asked Questions
Is online speech and language therapy really effective?
Yes. For many children, particularly school-aged children, online therapy can be highly effective. Progress depends far more on engagement, consistency, and support than on physical location.
What age does online therapy work best for?
Teletherapy often works well for children from around six years and up, especially those who can attend to a screen, enjoy conversation, and follow simple instructions. That said, suitability is always considered individually and often a supportive adult is needed to help guide the child through the activities.
Can speech sound work (such as a lisp) really be done online?
Absolutely. Speech sound therapy relies on clear visual feedback, listening skills, and practice all of which can be supported very effectively online. Many children respond particularly well when practising in their own home environment.
Do parents need to be involved in sessions?
Parental involvement is strongly encouraged. Parents may sit in, join parts of the session, or support practice between appointments. This involvement often leads to quicker progress and better carryover into everyday speech.
Will my child still build a relationship with the therapist?
Yes. Strong therapeutic relationships can and do develop online. Many children feel more relaxed and confident communicating from home, which can actually enhance connection and learning.
Is online therapy suitable for every child?
Not in my experience. Some children benefit more from in-person support, or a combination of online and face-to-face sessions. A discussion and initial assessment help determine the best approach for each child.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Why imitation is so important and how can speech and language therapy help children who struggle to imitate?
Imitation or copying starts in early infancy. When we observe a young baby and his parent or familiar adult we can see clearly and frequently that the baby will be intently looking at adult’s face and try to copy their facial expressions, smiles and all those funny baby sounds we often make with young babies.
These sounds are called “motherese” and are the beginnings of a little conversation between the parent and the baby. The “conversation can go back and forth for a long time and include sounds, as well as facial expressions.
A little later on, once the baby can crawl and sit up unaided the copying then goes on to include toys and objects. Mum or Dad will show their toddler how to use a drum or how to put a little train on the wooden tracks and the toddler will try and copy this. They may not succeed and be a little clumsy perhaps but the act of copying anything and everything their favourite adult does is typically seen throughout the day.
We all know and have laughed at mums or dads saying; ssshhh don’t say that in front of the baby he/she will copy you, watch your mouth! (as dad is swearing at the broken radiator….)
This imitation goes on for years and includes eventually of course little words, more words, putting words together and then creating sentences, all the while our toddler is listening to how their adults speak, not only what they say but how they say it. This is how dialects and accents can be transmitted easily from parent /family to child.
Copying in Children with Autism
We know that children with autism often struggle to imitate. We see children on the spectrum typically having great difficulty to copy adults or children; this can be seen in very reduced play with their peers in nursery for example.
Children with autism tend to have reduced joint attention and engagement with others and need to develop the ability and awareness to copy others in order to then engage more jointly with others.
Speech and Language Therapy can help with Parent Child Interaction work and Coaching, here is how:
During my coaching work with parents I teach step by step how to help a child who struggles to imitate:
We look at all the researched skills and actions that adults can take to help their little one to copy, starting with close observation of their child’s interests, then following and including their child’s play and copying/imitating their child in how they play. I teach steps in a graduated way so that it is easy to see the progress and joyful to have the results at the end.
The results are clear to see over time: our children on the spectrum learn to imitate actions, with objects and gestures, then sounds and words. Alongside this increased imitation skill the child can then develop more joint attention and engagement.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
‘What kind of speech difficulty does my child have?’
It’s a very understandable question. We often hear different terms such as phonological delay, articulation difficulties, or Childhood Apraxia of Speech (CAS), and it can be confusing.
The reality is that many children don’t fit neatly into one single category.
In fact, quite often I see children whose speech profile includes a mixture of difficulties. They might have some phonological patterns (where they substitute one sound for another) alongside challenges with motor speech planning, where coordinating the movements needed for speech is harder.
When this happens, therapy needs to be flexible, responsive, and tailored to the child sitting in front of us.
Example
Recently I filmed a short clip from one of my therapy sessions which shows exactly how this works in practice.
The child I was working with has difficulties with several speech sounds. Part of the challenge relates to a phonological pattern called fronting.
Fronting is when sounds that should be made further back in the mouth (like /K/ or /G/) are produced further forward instead.
At the same time, this child also shows signs of motor speech planning difficulty, which means the brain has to work harder to organise and sequence the movements of the tongue, lips and jaw for speech.
This type of profile can sometimes overlap with characteristics seen in Childhood Apraxia of Speech (CAS).
When difficulties overlap like this, therapy cannot rely on a single approach. Instead, it needs to draw on multiple evidence-based strategies.
That is exactly what you see happening in the clip. We started out generalising the /K/ sound which until recently had been replaced by a /T/ sound. Whilst looking at a sound loaded picture of /K/ sounds we somehow got talking about a ‘dent’ (I don’t recall how we got there!) but the ‘dent’ was a ‘det’ and I decided to tackle this there and then because there are other great words that end in ‘nt’ like : ‘count’ ‘giant’ ‘point’ or ‘paint’.
Using visual cues to support motor planning
Speech is incredibly complex. For children with motor speech difficulties, the challenge is not only knowing what sound they want to say, but also how to move their mouth to produce it.
This is where visual cues can be incredibly helpful.
In the clip, you can see me using a whiteboard with pictures and simple visual prompts. These help to:
Focus attention on the target sound
Understand where the sound occurs in the word
Remember the sequence of sounds needed
Visual supports can act almost like a map for the mouth, guiding children as they practise new speech movements.
For children with motor planning difficulties, this type of cueing can make a huge difference.
Why repetition of a single word (massed practice) is so important
Another key feature you will notice in the clip is lots of repetition.
This is very deliberate.
When we are supporting children with motor speech challenges, the brain needs repeated opportunities to practise the correct movement patterns. Just like learning a musical instrument or a new sport, repetition helps the brain build stronger and more efficient pathways.
In therapy we call this massed practice.
Rather than saying a word only once or twice, we practise it many times in a structured way, helping the child stabilise the new speech pattern.
But repetition alone is not enough. The child also needs to understand why the sound matters.
Showing children that sounds change meaning
This is where another powerful therapy approach comes in: minimal pairs.
Minimal pairs are word pairs that differ by only one sound. For example:
debt
dent
In the clip, I use these two words to help the child realise that the /N/ sound makes a meaningful difference.
Without the /N/, the word becomes something else entirely.
This approach helps children recognise that speech sounds are not random: they carry meaning. If a sound is missing or substituted, the message may change.
Helping children notice these differences can be a very motivating moment in therapy. Suddenly the sound is no longer just an abstract exercise; it becomes part of real communication.
Blending approaches for the best outcomes
In this short therapy moment, I am combining:
• Visual cueing
• Motor speech practice
• High repetition (massed practice)
• Minimal pair contrasts
• Listening and awareness of sound differences
Each element supports a different part of the speech system.
Some strategies help with motor planning, others support phonological awareness, and others build accuracy and consistency.
Together they create a therapy session that is both structured and responsive.
Every child’s speech journey is unique
One of the most important things I want to convey is that speech development is not always straightforward.
Two children may both struggle with speech sounds, yet the underlying reasons may be very different.
This is why careful assessment is essential, and why therapy needs to stay flexible as we learn more about how a child’s speech system works.
Sometimes a child needs more motor-based work.
Sometimes the focus shifts towards phonological contrasts.
Often, as in this example, the most effective therapy uses both.
Small steps lead to big progress
Every session helps us understand a little more about how a child’s speech system works and what support will help them move forward.
And when the pieces start to come together, when a child realises that one tiny sound can change a whole word, that is when the real progress begins.
If you are concerned about your child’s speech sounds, clarity of speech, or possible motor speech difficulties, early support can make a significant difference. A detailed assessment can help identify the nature of the difficulty and guide a therapy approach tailored to your child’s individual needs.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
What is a Speech and Language – Feeding Therapist?
You’ve probably heard of speech therapists helping people who stutter or struggle to pronounce words. But did you know that they also work with children and adults who have problems with eating and swallowing? This specialised area is called Speech and Language Therapy: Feeding and Swallowing, or Dysphagia Therapy.
Why does a Speech Therapist help with eating and swallowing?
The mouth, tongue, and throat are all involved in both speech and swallowing. When there’s a problem with any of these parts, it can affect both your ability to talk and to eat. For example:
Weak tongue muscles: Can make it hard to chew food and to form sounds.
Difficulty coordinating swallowing: Can lead to choking or aspiration (when food or liquid goes into the lungs).
Sensory issues: Can make certain textures or tastes feel unpleasant or overwhelming.
Communication: If we are not able to express ourselves we are likely to have difficulties during daily mealtimes: how do we ask for ‘more’ of something, how do we say we have had enough or we don’t like a particular food?
How does a Speech and Language Therapist help?
Our work involves a combination of assessment and therapy. We carefully observe how your child feeds, eats and swallows, and we look into your child’s mouth to help us see what the cause of the difficulties are: could be a very highly-arched palate, it could be a very flaccid/low tone tongue, it could be poor dentition. Then, we create a personalised treatment plan to address your specific needs.
Here are some of the things we might do:
Teach swallowing techniques: We can help your child learn strategies to improve or facilitate a safe swallow.
Recommend dietary modifications: We may suggest changes to your child’s diet to make it easier to eat and swallow.
Provide sensory therapy: If your child has sensory needs we can help your child become more comfortable with different textures, tastes, and smells.
Work on oral motor skills: We can help to encourage more effective chewing, or drinking skills, or we can help your child to close his/her mouth more during chewing or drinking from a straw.
Collaborate with other professionals: We often work closely with doctors, nurses, occupational therapists, and dietitians to provide comprehensive care.
What kinds of problems do Speech and Language Therapists help with?
We see a wide range of feeding and swallowing difficulties, including:
Delayed feeding: Children who are slow to develop feeding skills or who have difficulty transitioning to solid foods.
Tongue-ties: Babies can have significant difficulties with feeding when the tongue is very tightly tethered to the floor of the mouth.
Refusal to eat: Children who refuse to eat certain foods or textures.
Aspiration: When food or liquid goes into the lungs, which can lead to pneumonia and other serious complications.
Chewing difficulties: Problems with chewing food, such as difficulty breaking down food or keeping food in the mouth.
Swallowing difficulties: Problems with swallowing, such as feeling like food is stuck or choking.
Neurological conditions: Conditions like cerebral palsy, down syndrome or other genetic syndromes can affect feeding and swallowing.
Developmental delays: Children with developmental delays may have difficulties with feeding and swallowing.
Is there hope?
If your child is struggling with feeding or swallowing, know that there is help available. Speech and Language Therapy can make a significant difference in your and your child’s quality of life. We’re here to support you every step of the way.
Remember, you don’t have to suffer in silence. If you’re concerned about your child feeding or swallowing, please reach out. You can find a Speech and Language Therapist with a Feeding/dysphagia qualification near you via www.asltip.co.uk or contact me.
Sonja McGeachie
Early Intervention Speech and Language Therapist
Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice
The London Speech and Feeding Practice
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
December is often presented as a time of perfect, reciprocal play. Children are supposed to be unwrapping toys, sharing, and engaging in imaginative scenarios with family. But for parents of young autistic children, this high-pressure, socially demanding period can often feel like a battleground.
If you’ve been told to interrupt your child’s stimming, push for eye contact, or force them to play ‘functionally’ with toys, it’s time to take a deep breath. Those traditional approaches are not only stressful—they often miss the point of your child’s communication.
As a neurodiversity-affirming Speech and Language Therapist, I want to encourage you this December: You are allowed to follow your child’s lead, validate his or her unique interests, and trust that his or her play and movement are profoundly meaningful.
1. Stimming: not a distraction, but a regulator 💡
Stimming is short for self-stimulatory behaviour and includes repetitive movements or sounds like hand flapping, humming, rocking, finger flicking, or repeating phrases (called echolalia).
For years, parents were incorrectly advised to block or eliminate these behaviours. The neurodiversity-affirming view tells us the exact opposite: Stimming is a vital and essential tool for your child’s self-regulation.
Think of stimming as an internal volume dial:
Too loud/overwhelmed: Your child may stim to reduce incoming sensory input (e.g., rocking to ground himself or herself in a busy room).
Too quiet/under-stimulated: Your child may stim to increase sensory input and focus (e.g., running back and forth to maintain alertness).
The shift: validate, don’t block
Instead of saying, ‘Stop flapping your hands’, try to understand the message behind the movement.
Observe: When does the stimming happen? Is it before a meltdown? When your child excited? When your child is bored?
Validate: Name the need, not just the behaviour. You might say, ‘I see your body needs to move fast right now. That helps you calm down!’
Co-regulate: If the stim is unsafe (e.g., head-banging), help your child find a safer, alternative stim that meets the same sensory need (e.g., pushing hard against a wall, squeezing a stress ball).
By validating your child’s need to regulate, you are building trust, reducing anxiety, and teaching him or her critical self-awareness.
2. Autistic play: Meaningful, even if it’s monologue
The traditional idea of ‘good play’ often involves turn-taking, pretending, and specific toy functions (e.g., pushing a train around a track). When an autistic child spends 30 minutes lining up cars, spinning their wheels, or scripting whole scenes from a favourite movie, it can often be dismissed as non-functional or repetitive.
In neurodiversity-affirming practice, we recognise that autistic play is authentic play. These activities are crucial for learning, deep focus, and imaginative development.
Lining up toys may be an exploration of patterns, visual organisation, and order.
Spinning wheels may be a deep interest in cause-and-effect and visual sensory input.
Scripting is often a way to process language, regulate emotions, and practise complex social situations in a safe, controlled way.
Make a change: Join your child’s world, don’t drag them to yours.
Stop trying to force the ‘right’ way to play. Instead, try these neuro-affirming strategies:
Be a co-regulator, not a director: If your child is lining up cars, sit down next to him or her. Instead of moving a car, try handing him or her another car to line up. Focus on the shared interest rather than forcing interaction.
Narrate (don’t question): Avoid constantly asking, ‘What are you doing?’ or ‘What does this car say?’ This puts pressure on your child to perform. Instead, narrate your observations using his or her interest: ‘I see you made a long, straight line of red cars. Look at all the wheels spinning!’
Validate the interest: Show genuine appreciation for your child’s focus. ‘Wow, you know so much about how magnets stick together! That’s incredible.’
3. The communication revolution: Honouring gestalt language processing
Many young autistic children communicate in ways that don’t fit the traditional model of building language word-by-word. Many use Gestalt Language Processing (GLP).
A gestalt language processor learns language in chunks or scripts (e.g., ‘what’s-in-there?’ or ‘ready-go!’). These chunks (or gestalts) are not random; they are often tied to an emotional memory or meaning. Over time, the child breaks down these big chunks into individual words then learns to recombine those words creatively.
If your child repeats movie phrases or whole sentences that seem unrelated, he or she is likely a gestalt language processor!
Affirm the script, then model something useful.
Affirm the script: When your child says a script, respond to the meaning or emotion behind it, not the literal words. If he or she says, ‘We’re going to need a bigger boat’, and he or she is looking at a messy toy pile, he or she may be trying to express overwhelm or a need for help. You can affirm: ‘That pile is too big! I can help you move it.’
Model new ‘mix and match’ scripts: To help your child move from whole scripts to single words, you can model shorter, slightly changed versions of the script, also called ‘mitigated gestalts’. If they say, ‘I want to go home now’, you might model, ‘Let’s go home, now’ or ‘I wanna go home’.
By honouring your child’s communication style, you validate his or her experience and naturally support his or her path to language development—a core part of neurodiversity-affirming SLT.
Your December gift to your little one:
This December, stop trying to make your child fit into a neurotypical box. Instead, make your home a safe space where he or she can be his or her authentic selves.
Prioritise regulation and connection over compliance.
Trust that when your child is regulated, his or her communication, learning, and engagement will flourish naturally. This is the true gift of neurodiversity-affirming practice.
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.
