Explore how to improve communication skills for a Gestalt Language Processor

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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.

Speech Therpaist in London

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?

Contact me.


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

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  • A day in my life as an Independent Speech and Language Therapist

    During the pandemic I wrote a blog on what my working day looked like. Now a good year has passed since coming back to some sort of normality and I thought I would update this ‘day in the life of an SLT’ as my working life has changed of course to reflect the ‘new normal’.

    I have become truly busy, perhaps busier than I have ever been to be honest. It’s probably mostly due to the fact that I do most of the aspects of my work myself — though I want to mention two invaluable people here without whom I could not function as well as I do: the excellent Nathalie Mahieu () helps me with my SEO, Insta posts and blog uploading and the wonderful Sue Bainbridge () makes sure that my accounts don’t get into trouble with His Majesty’s tax office.

    Attached to our role as Speech and Language Therapists is an arguably enormous amount of administration/paperwork and preparation required for each and every client. This needs to be factored in when deciding how many families I can realistically see each working day. For me it works out as typically 3–5 clients a day, Monday to Friday.

    So how does my day typically look? Each day varies a lot depending on what type of client I have, but on average it looks a bit like this:

    First thing in the morning — after having a coffee and a quick check-in with my besties on WhatsApp — I do my Buddhist chanting for about an hour. My Buddhist prayers are the base of all I do and get me connected to my higher purpose and how to create value with each activity and each person I see that day. It sets me up for the day, I keep in mind who is going to come and see me and how I can best help them.

    Next up, I do the daily ‘spring-clean’ of my therapy room (on all fours! no joke ???? those kids see every speck!), vacuum the floors, wipe down the toys with flash-wipes and tidy up all my boxes, making sure that the battery toys are working, and everything else is in place. On to the guest toilet, the hallway needs to be rid of all the men’s shoes and trainers and coats… It’s endless what needs tidying when you are living with three men… This takes about 45 minutes.

    An articulation activity – packaging practice into a little game

    Then I prep for all my clients that day. I have now got so much quicker about selecting therapy materials. For one thing I have purchased so many toys and materials over the past five years that I can literally now open a shop and need to consider building an extension! ???? The upside is that it is now very easy for me to select a good handful of toys or games for any one child, even at a minute’s notice. Though, on average, I spend about 30 minutes per child preparing activities.

    Hurrah, it’s 11 am and my first client of the day arrives and the fun begins.

    When they leave around an hour later, the cleaning and wiping down starts again, this time less extensively. I write up my notes and send homework whilst enjoying a cuppa.

    The next client comes at 12.30 pm and once they have left, floor cleaned, toys wiped, notes written it is time for a quick lunch. No more than half an hour usually.

    Afternoon clients tend to be one more little one (nursery age) at 2.15 pm and thereafter I see mostly older school children for a variety of reasons (mainly speech production but also some language-based activities). I tend to say farewell to my last client of the day around 6 pm. I spend another hour, sometimes more, on writing up notes, answering new enquiries, blogging and phone calls to keep my service fresh, inspirational and exciting.

    And then dinner and the rest of the day rushes by. I tend to finish my day with some more Buddhist chanting, not a lot, perhaps 10–20 minutes to reflect on what has gone well and what could have been better — re-determine to improve or make better as needed.

    Tele therapy activity using online materials plus a coreboard

    In terms of where I provide a service, I still do a good mix of online clients (tele-therapy) and in-person clients in my clinic, which I love. Occasionally, I visit children in their nursery or at home but this service is now only available for long-standing clients.

    Each client is hand-picked to make sure that we are a good fit: no one client gets the same treatment as another; each client is unique, we get to know one another well over the time we work together and they are always highly valued. That takes time and, in reality, each client gets about two hours of my time. That is the actual session plus all the preparation and aftercare, i.e., bespoke hand holding, tweaks, problem solving and reassurance in between sessions.

    I absolutely love this way of working and would not ever want to do anything else. Nearly three decades of working both in the NHS and in private practice, countless courses (continual professional development) have enabled me to flourish as a therapist and I know that I offer something special and very valuable to my clients.

    My unique way of working affords all my lovely clients the help they need to support their children to make progress; and it gives me the right balance of job satisfaction and work life balance for now. My lovely reviews and testimonials tell me that my clients appreciate my service and this at the end of the day is the most important.

    If you are interested in exploring Buddhism/buddhist chanting then check out this link (https://sgi-uk.org/), and feel free to contact me about that specifically, regardless of whether you want speech therapy. I am always happy to chat about Buddhism, it has been so enriching for the last 43 years of my life.

    If you need help with your child, please do not hesitate to contact me.


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

    1
  • · ·

    From ‘Nailed it!’ in therapy to ‘Whoops!’ at home: Why generalising speech sounds is tricky

    As a parent, you’ve likely experienced the triumphant feeling when your child, who’s been working so hard on his or her /S/ sound, produces it perfectly in a therapy session. He or she is rocking those ‘sun’ and ‘socks’ words, his or her lisp seemingly a distant memory. You leave feeling elated, confident that all that hard work is finally paying off.

    Then you get home. And within minutes, you hear it: ‘Thooper!’ instead of ‘Super!’ Or maybe the clear /R/ in ‘rabbit’ from therapy reverts to a ‘wabbit’ when his or she is playing with his or her toys. It’s frustrating, confusing, and can feel like you’re back to square one.

    So, what’s going on? Why is it so difficult for children to take those amazing skills learned in a focused therapy session and seamlessly apply them to their everyday conversations? You’re not alone in wondering this. It’s a common challenge in speech therapy and understanding the ‘why’ can help both parents and children navigate this crucial stage.

    The brain’s habits: Old pathways are strong pathways

    Think of your child’s brain as having established ‘pathways’ for how he or she produces certain sounds. If he or she has been lisping his or her /S/ sound for years, that neural pathway is deeply ingrained. It’s like a well-worn path through a field: easy to follow because it’s always been there.

    In therapy, we’re essentially trying to forge a new path. We’re teaching him or her a new, more accurate way to make the sound. This new path is initially faint, like a barely visible trail. It takes conscious effort and repeated practice to strengthen it. Outside of the structured therapy environment, his or her brain often defaults to the old, comfortable, and well-established pathway, even if it’s not the most accurate.

    The demands of daily conversation: A multitasking challenge

    Therapy sessions are designed to be focused and controlled. We isolate sounds, practice them in specific words, and provide immediate feedback. There are minimal distractions, and your child’s full attention is on his or her speech production.

    Now, consider daily conversation:

    • Speed: We speak much faster in natural conversation than we do during structured practice. There is less time to think about individual sounds.
    • Cognitive load: Children are simultaneously thinking about what they want to say, understanding what others are saying, processing social cues, and managing their emotions. Adding the conscious effort of producing a new speech sound correctly on top of all that is a huge cognitive demand.
    • Variety of contexts: In therapy, we might practise ‘sun’ and ‘socks’. In real life, the /S/ sound appears in countless words, in different positions within words, and alongside a vast array of other sounds. Each new word and phonetic context present a fresh challenge.
    • Lack of immediate feedback: In therapy, the speech therapist is right there to provide instant correction and reinforcement. In a playground, during a family dinner, or while playing with friends, that immediate, consistent feedback isn’t present.

    The role of automaticity: Making it second nature

    The ultimate goal of speech therapy isn’t just correct sound production; it’s automaticity. This means producing the sound correctly without having to consciously think about it. It’s like learning to ride a bike. Initially, every pedal stroke and steering adjustment is deliberate. Eventually, it becomes second nature.

    Generalisation is the process of moving from conscious, controlled production to unconscious, automatic production. This takes time, consistent practice, and exposure to a wide variety of real-life speaking situations.

    How can we help? Bridging the gap

    So, what can parents do to help their children bridge this gap between therapy success and everyday speech?

    1. Be patient and positive: This is a marathon, not a sprint. Celebrate the small victories and avoid getting discouraged by setbacks. Your positive reinforcement is crucial.
    2. Practise little and often: Instead of long, infrequent practice sessions, aim for short, consistent bursts throughout the day. ‘Sprinkle’ in opportunities to practise their target sounds in natural conversations.
    3. Create ‘sound awareness’ moments: Gently draw your child’s attention to his or her target sounds in everyday words. For example, if he or she is working on /R/, you might say, ‘Oh, you said ‘wabbit.’ Can you try to make your /RRR/ sound for ‘rabbit’?’
    4. Model correct production: Continue to model the correct production of their target sounds in your own speech.
    5. Collaborate with your speech therapist: Your therapist is your best resource! Ask them for specific strategies and activities you can do at home to support generalisation. They can also provide guidance on when and how to gently correct your child.

    Tips and tricks

    Below I have listed a few good tips and tricks that can help the transition from therapy room to daily life:

    Empowering your child as the ‘sound detective’:

    • ‘Secret sound listener’: Instead of you doing the correcting, make your child the detective. When you’re having a conversation, say ‘your /S/ sounds are sometimes a bit “slippery”’ (or whatever fun, non-judgmental term you like). Ask your child to quietly listen for your /S/ sounds. You can even purposely make a few ‘slippery’ ones (or correct yourself immediately after) and see if they notice. This shifts the focus from being corrected to actively listening and identifying the sound in a non-threatening way.
    • ‘Sound scorecard’: For a short period (maybe 10–15 minutes during a specific activity, like dinner or a game), provide a small notepad and pencil. Explain that your child is going to listen for his or her /S/ sounds and gently mark a tally every time he or she uses it correctly. The goal isn’t perfection, but awareness. This gives your child agency and a visual representation of progress. You can even make it a game: ‘Let’s see how many /S/ sounds we can catch in five minutes!’
    • /S/ sound song/rhyme creation: Work together to create silly songs or rhymes that are packed with /S/ sounds. The sillier, the better! You can sing them in the car, while doing chores, etc.
    • /S/ sound superpower: Frame the new sound skill as a ‘superpower’. ‘You’re getting so good at using your /S/ superpower! It’s going to help you speak so clearly and confidently.’
    • Highlighting successes: Always go out of your way to acknowledge and praise successful /S/ productions in natural conversation. ‘I really understood you clearly when you said ”s_top”.’ or ‘That /S/ sound was perfect when you told me about the “s_tory”!’

    Important considerations:

    • Keep it low-pressure: The goal is generalisation, not perfection. If your child is feeling pressured, he or she will likely revert to old patterns.
    • Focus on awareness, not just correction: Help your child become aware of his or her own speech rather than relying on you for corrections.
    • Short, frequent bursts: A few minutes of subtle focus multiple times a day is more effective than one long, forced session.
    • Acknowledge feelings: If your child expresses frustration about ‘being corrected’, validate these feelings. ‘I understand it can feel like a lot of listening, but we’re just trying to help you use that super /S/ sound all the time!’

    By incorporating these strategies, you can help your child naturally integrate the new /S/ sound into daily speech, fostering independence and confidence without it feeling like constant ‘testing’ or ‘correction’. Generalising new speech sounds is arguably the hardest part of speech therapy, but it’s also the most rewarding. With patience, consistent effort, and a collaborative approach between parents and therapists, children can successfully integrate their new, clearer speech sounds into every aspect of their daily lives.

    Any comments or if you need help and support with your child’s speech please do not hesitate to get in touch with me: simply fill out the contact form here on the website. I endeavour to reply within 48 hours.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

    1
  • Help! My child has a lisp. What can we do about it?

    What is a LISP?

    There are different types of LISPS. Let me explain:

    A lisp is the difficulty making a clear ‘S’ and ‘Z’. Other sounds can also be affected by the tongue protruding too far forward and touching the upper teeth or the upper lip even. ‘T’ and ‘D’ can be produced with ‘too much tongue at the front’ and this can also have an impact on ‘CH’ and often also ‘SH’.

    1. Interdental lisp

    Protruding the tongue between the front teeth while attempting ‘S’ or ‘Z’ is referred to as interdental lisp; it can make the speech sound ‘muffled’ or ‘hissy’. Often, we associate a lisp with the person sounding a bit immature. The good news is that this type of lisp is the easiest to correct and, in my practice. I have a 100% success rate with this type of lisp.

    1. Lateral lisp

    In a lateral lisp the person produces the ‘S’ and ‘Z’ sounds with the air escaping over the sides of the tongue. This renders the ‘S’ as sounding ‘slushy’ or ‘wet’. This type of lisp is a bit harder to correct than the interdental lisp. In my experience this can be fixed but it might need a bit longer, more intensive therapy than the interdental lisp.

    1. Palatal lisp

    With a palatal lisp the ‘S’ sound is attempted with the tongue touching the palate, much further back than it should be. The ‘S’ sounds ‘windy’ and ‘hissy’. This is a quite rare lisp production but it is also not difficult to correct.

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

    Some thoughts on Treatment in general:

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

    When should treatment of lisp begin?

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

    Do lots of children lisp—is it normal?

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

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

    What happens during the first Speech and Language Consultation?

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

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

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

    Therapy – what does a session look like?

    Each therapy session consists of:

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

    How long does it take to ‘fix up’ a lisp?

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

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

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

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


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

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  • · ·

    Explaining pronoun reversal: A window into gestalt language processing

    Explaining pronoun reversal: A window into gestalt language processing

    Have you noticed your child referring to themselves as ‘you’, or calling you ‘me’? This seemingly confusing mix-up of pronouns, known as pronoun reversal, often raises concerns for parents. Below I outline why your child does this and want to reassure you that it is to do with his or her unique language learning style.

    Gestalt language processing: Learning in chunks

    Many children, particularly those on the autism spectrum, use a gestalt language processing approach. Unlike analytic language processors who learn individual words and build sentences, gestalt language processors learn language in whole ‘chunks’ or ‘gestalts’. Think of these gestalts as pre-packaged scripts they pick up from their environment — phrases, sentences, even snippets of songs or movie lines.

    As Marge Blanc, author of Natural language acquisition on the autism spectrum, explains, ‘When a child picks up an entire gestalt (script), he’s got the pronoun of the original speaker. So ‘pronoun reversal’ is nothing more than that.’

    So your child is simply repeating what they’ve heard, without yet understanding the individual word meanings or grammatical functions.

    Imagine your child hearing ‘You want a rice cake?’ repeated frequently. They might then use this phrase to express their own desire for a rice cake, even though it doesn’t grammatically fit. So they are thinking and saying ‘You want a rice cake?’ and the meaning of this phrase is: ‘I want a rice cake’. This isn’t a sign of confusion, but a natural step in their language development. They’re working with the tools they have: the scripts they’ve acquired.

    How can we support their natural language journey

    Instead of trying to ‘correct’ pronoun usage, our role as caregivers and speech therapists is to support the child’s natural language progression. Here’s how we can do this:

    1. Learn about their gestalt stage and run with it: In the early stages (1–3) of gestalt language development, correcting pronouns can be counterproductive. These children are still processing language as whole units, not individual words. Direct corrections can lead to frustration and hinder their natural language exploration.
    2. Patience and trust: Gestalt language processing follows a predictable, albeit sometimes non-linear, path. By understanding their current stage, we can provide targeted support. Language sampling and scoring, guided by the Natural Language Acquisition framework, help us pinpoint their stage and tailor our approach.
    3. Model language strategically: In the early stages, avoid using pronouns like ‘you’ and ‘you’re’. Instead, model language from the child’s perspective or use joint perspectives. For example, instead of ‘Are you thirsty?’, try ‘I’m thirsty!’ or ‘Let’s get some water’,

    The big picture: Language unfolds naturally

    Pronoun reversal is a stepping stone, not a stumbling block. As gestalt language processors progress, they begin to break down these gestalts into smaller units and develop their own self-generated language. This is when their understanding and use of pronouns naturally emerge.

    By shifting our perspective from ‘error correction’ to ‘developmental support’, we create a nurturing environment for these children to thrive. We empower them to navigate their unique language journey, ultimately leading to more meaningful and independent communication.

    So, to summarise:

    • Pronoun reversal is a typical characteristic of early-stage gestalt language processing.
    • Focus on modelling language from the child’s perspective or a joint perspective.
    • Avoid correcting pronouns in the early stages.
    • Trust the process and support the child’s natural language development.

    Let’s celebrate the diverse ways our children learn to communicate and empower them to find their unique voice!

    If you have any questions or would like some help with understanding your little gestalt language learner, please get in touch with me via my contact form.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

    1
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    Speech prompts and strategies I use in Speech Sound Therapy

    This particular student has a mild motor planning difficulty and six weeks ago he came to me with a very strong lisp. In addition to the lisp he is struggling to produce a number of sounds, SH and L on its own and all the clusters (FL/BL/KL/PL) but also CH together with some vowel difficulties.

    The prompts are a mix partially from the DTTC (Dynamic Temporal and Tactile Cueing) model by Dr Edythe Strand as well as phonological models I have learned over the years, and some of them are my own.

    Visual/picture prompts and Images

    Here I use the ‘Flat Tyre’ Sound, to offer as an image for a new S sound and the ‘Tick Tock’ Sound for a new image of the T sound. Both cards are from the Bjorem Speech Sound Deck, which I love and use almost daily.

    Gestural Cues

    I like to use all the ‘cued articulation’ hand cues by Jane Passy for consonants and fricatives. Here we use our fingers and hand to illustrate what our tongue does, and we also show whether a sound is voiced or voiceless. When I use one finger it is voiceless (k/f/s/p) and when I use two fingers for the same cue it means that the voice needs to be turned on: (g/v/z/b/n/m). For vowels I like to use Pam Marshalla’s cue system.

    Simultaneous production

    We say the word together.

    Direct imitation

    I say the word and my student copies me directly.

    Imitation after a delay

    I say the word and then after a little wait my student says the word.

    Spontaneous production

    My student has now learned to say the word by him/herself.

    Offering feedback

    It sounds like… I just heard… I didn’t hear the first sound there? Can you try again?

    Letting the student reflect

    By just shaking my head or by looking quizzical so that my student realises something didn’t quite go right.

    Postitive reinforcement

    ‘Yes that was it, do it again, nice one…’

    Cognitive reframing

    This is a technique where we identify different semantic cues and metaphors or imagery cues, so instead of teaching or focusing on a sound we try out viewing each syllable from a different point of view.

    For example: ‘yellow’. I have had great success with this one: we start with just saying ‘yeah yeah yeah’. I might make a little joke and say something like ‘imagine your mum says tidy your bedroom, what do you say or what do you think?’ Answer: ‘yeah yeah yeah’. Then we practice ‘low’ together, I might blow some bubbles high and low and we talk about ‘low’. And then we put ‘Yeah’ and ‘Low’ together and now we have YELLOW!! It might at first still sound a bit odd, like ‘yea-low’ but we soon shape that up and have the real word.

    Each student is different and having a great rapport is crucial to our success.

    Then a little game break after some 7–10 or so repetitions and always trying to finish on a positive note.

    What game breaks do I use:

    Very quick ones! Students can post something, place a counter in a game, take out a Jenga block from the tower, pop in a counter for ‘connect 4’, stick a sword into the Pop the Pirate barrel or add a couple of Lego blocks to something they are building.

    I hope this is helpful, please contact me for any questions.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice


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

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    Chaining: A powerful tool for phonological development

    Understanding chaining

    Chaining is a therapeutic technique I like to use in my speech therapy work with children who have Childhood Apraxia of Speech (CAS) or phonological speech sound difficulties. It helps to break down a complex target behaviour into smaller, more manageable steps. By systematically teaching and reinforcing each step, I can help my students achieve their communication goals.

    There are two types of chaining: Forward and backward chaining

    Today I am going to show and talk about backward chaining. This technique involves starting with the last step and working backward to the first. This approach can be particularly effective for children with persistent speech sound difficulties where combining consonants into clusters, such as /BL/ or /FR/ or /SHR/ is very difficult.

    Backward chaining allows my student to experience immediate success and build his confidence.

    In my video I show you how I applied backward chaining to the words ‘Shriek’, ‘Shrub’, ‘Shrimp’ etc

    My student struggles with both the /SH/ and the /R/ sounds and we have been working on both sounds for some weeks now. He has mild Childhood Apraxia of Speech and he has difficulties with coordinating his tongue movements, breathing and using his jaw effectively to make words. His sound repertoire has grown a lot since we started working together last year. Today in this session I show you how we pulled both the sound /SH/ together with /REEK/ to make ‘SHRIEK’. I love using the pictures and therapy materials from Adventures in Speech Pathology.

    This is also part of the Complexity approach which I will explain in a separate blog post.

    • Step 1 (not shown in the video): I explain what the word means; I find that when my student understands what a word means he is much better at saying it. It increases his confidence and motivation to say a word that he knows the meaning of. Often this student does not tell me that he does not know what a word means, so I always remind myself to check that out first.
    • Step 2 (not shown in the video): We do a little rhyming game and think about what any one word rhymes with: ‘Shriek’ – ‘meek’, ‘weak’, ‘seek’.
    • Step 3: I show my student that there are two parts to this word /reek/ and the sound /SH/.
    • Step 3: We practise the easier part: /reek/ /reek/ /reek/.
    • Step 4: We add the /SH/ sound and pull it together to make our target word ‘Shriek’.

    /REEK/ /REEK/ /REEK/ + /SH/ = ‘SHRIEK’
    /RUB/ /RUB/ /RUB/ + /SH/ = ‘SHRUB’
    /RUG/ /RUG/ /RUG/ + /SH/ = ‘SHRUG’

    By breaking down the word into smaller, manageable steps, my student can focus on each syllable individually, get that right and then gradually build up to the full word. This approach can help to reduce frustration and increase motivation.

    Forward chaining

    Forward chaining is the same process but in reverse: we start with the front sound or syllable and work forward towards the next/last part of the word:

    /SH/ + /REEK/ = ‘SHRIEK’
    /SH/ + /RUB/ = ‘SHRUB’
    /SH/ + /RUG/ = ‘SHRUG’

    Benefits of chaining

    • Increased motivation: By starting with the last step, my student experiences success, which boosts his motivation to continue trying to say the word and trying other words.
    • Reduced frustration: Breaking down the target behaviour into smaller steps can make the task less overwhelming, reducing frustration and anxiety.
    • Improved confidence: As the little learner masters each of the step, his confidence and self-esteem increases. Again, this leads to increased motivation.
    • Faster learning: By focusing on the final step first, and practising lots of chaining (forward and backward), a student can quickly learn to generalise to other words.

    Backward chaining (and forward chaining) is a really great tool for teaching complex speech sounds and words to children with phonological disorders.

    Watch out for my next blog which is all about the complexity approach in Phonology.

    Do get in touch if your child has a speech sound disorder, I would love to help.

    Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice


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

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