Feeding therapy: A guide for parents and caregivers

ByLondon Speech and Feeding September 6, 2024September 5, 2024

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

What is feeding therapy?

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

How does feeding therapy work?

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

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

When is feeding therapy needed?

Feeding therapy may be beneficial for children who:

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

Feeding therapy strategies you can try at home

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

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

Seek professional help

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

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

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

Please feel free to contact me.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

Speech and Language Therapy

Could mouth breathing be affecting your child’s speech, sleep and development?
ByLondon Speech and Feeding June 15, 2026June 11, 2026
Understanding Orofacial Myofunctional Disorders (OMDs)

Many parents contact me at London Speech and Feeding because they are worried about their child’s speech. Perhaps their child is difficult to understand, has a persistent lisp, struggles with feeding, snores at night, or always seems to have their mouth open.

What many families don’t realise is that these concerns may all be connected.

Increasingly, research and clinical experience are highlighting the important role of Orofacial Myofunctional Health, the way the muscles of the face, mouth, tongue and airway work together to support breathing, eating, sleeping and communication.

When these muscles are not functioning optimally, children may develop what are known as Orofacial Myofunctional Disorders (OMDs).

What Is Orofacial Myofunctional Health?

Orofacial Myofunctional Health refers to the healthy function and coordination of the:
- lips
- tongue
- jaw
- cheeks
- facial muscles
- airway.
These structures play a vital role in:
breathing

swallowing

chewing

speaking

facial growth

dental development

sleep quality.
When everything is working well, the lips remain gently closed at rest, breathing occurs through the nose, and the tongue rests against the roof of the mouth.

This seemingly simple posture has a profound influence on how a child’s face, teeth and airway develop.

What is an Orofacial Myofunctional Disorder?

An Orofacial Myofunctional Disorder occurs when there is an abnormal pattern of muscle function involving the face, mouth, tongue or airway.

Children with OMDs may experience difficulties with:
- speech
- feeding
- swallowing
- sleep
- breathing
- dental development
- facial growth.
In many cases, these difficulties are linked to chronic mouth breathing.

Signs your child may have an Orofacial Myofunctional Disorder

Breathing and sleep signs
- mouth open at rest
- mouth breathing during the day
- snoring
- noisy breathing
- restless sleep
- frequent waking
- dark circles under the eyes
- chronic congestion
- fatigue despite a full night’s sleep.
Speech signs
- lisping
- unclear speech
- distorted speech sounds
- difficulty producing certain sounds
- persistent articulation difficulties
- reduced speech intelligibility.
Feeding and swallowing signs
- picky eating
- messy eating
- food remaining in the cheeks
- gagging easily
- difficulty chewing
- long mealtimes
- tongue thrust swallowing.
Facial and dental signs
- narrow palate
- crowded teeth
- open bite
- overbite
- underbite
- long face appearance
- receding chin
- poor lip seal.
If several of these signs sound familiar, a comprehensive assessment may be worthwhile.

Why does mouth breathing matter?

Many parents assume mouth breathing is simply a habit.

In reality, mouth breathing is often a symptom that something is preventing efficient nasal breathing.

Common causes include:
- enlarged tonsils
- enlarged adenoids
- allergies
- chronic nasal congestion
- recurrent infections
- structural airway differences
- tongue tie
- prolonged dummy use
- thumb sucking
- poor oral posture.
When nasal breathing becomes difficult, children naturally begin breathing through their mouths.

Over time, this can affect how the face, jaws and airway develop.

What does healthy oral posture look like?

Healthy oral posture is surprisingly simple:
- lips
  
  gently closed
- tongue
  
  resting against the roof of the mouth
- teeth
  
  slightly apart
- breathing
  
  through the nose.
This posture helps guide healthy jaw growth, facial development and airway formation.

Think of the tongue as a natural orthodontic support system. When it rests in the correct position, it helps shape the upper jaw and supports healthy facial growth.

The consequences of chronic mouth breathing

1. Speech difficulties

Children who breathe through their mouths often have altered tongue posture and reduced oral stability.

This can contribute to:
- lisping
- distorted sounds
- reduced speech clarity
- difficulty learning new speech sounds.
2. Feeding and swallowing difficulties

A low tongue posture may affect:
- chewing efficiency
- swallowing patterns
- food management
- oral motor coordination.
Many children develop a tongue thrust swallow, where the tongue pushes forward instead of moving efficiently during swallowing.

3. Poor sleep quality

Mouth breathing can contribute to:
- snoring
- restless sleep
- frequent waking
- daytime fatigue
- reduced concentration.
Poor sleep can have a significant impact on learning, behaviour and emotional regulation.

4. Changes to facial growth

Over time, chronic mouth breathing may influence:
- jaw development
- facial proportions
- dental alignment
- airway size.
This can result in:
- narrow palates
- crowded teeth
- long facial appearance
- increased orthodontic needs.
5. Oral health concerns

The nose acts as a natural filter and humidifier.

When children breathe through their mouths:
- The mouth becomes dry.
- Saliva protection is reduced.
- Risk of tooth decay increases.
- Gum health may be affected.
Why this matters for speech therapy

Speech does not develop in isolation.

The tongue, lips, jaw and airway work together to support clear communication.

At London Speech and Feeding, we look beyond speech sounds alone.

A child who presents with:
- persistent speech difficulties
- lisping
- feeding challenges
- open mouth posture
- snoring
- poor sleep
may benefit from an assessment that explores underlying orofacial myofunctional factors.

Addressing these foundations can often support more effective progress in speech and feeding therapy.

How London Speech and Feeding can help

A comprehensive assessment may include observation of:
- breathing patterns
- lip posture
- tongue posture
- swallowing function
- feeding skills
- speech sound development
- sleep concerns
- oral structures.
Where appropriate, recommendations may include:
- orofacial myofunctional therapy
- speech therapy
- feeding therapy
- home programmes
- ENT referral
- orthodontic referral
- collaborative multidisciplinary support.
The good news

Orofacial Myofunctional Disorders are often highly treatable when identified early.

Supporting healthy breathing, tongue posture and oral muscle function can positively influence:

If your child regularly breathes through their mouth, snores, struggles with speech clarity or has feeding difficulties, a specialist assessment may help identify the underlying cause.
speech clarity

feeding skills

sleep quality

facial growth

dental development

overall wellbeing.
At London Speech and Feeding, we are passionate about looking beyond symptoms and understanding the whole child. Contact me!

Sometimes the key to clearer speech starts with a simple question:

‘Is my child breathing through their nose?’

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Frequently Asked Questions

Can mouth breathing cause speech problems?

Yes. Mouth breathing can alter tongue posture, lip strength and oral stability, which may contribute to articulation difficulties and lisps.

Should I be worried if my child snores?

Regular snoring is not considered normal in children and may indicate airway obstruction or sleep-disordered breathing.

Can enlarged tonsils affect speech?

Yes. Enlarged tonsils may affect resonance, tongue positioning, swallowing and breathing patterns.

What age can children be assessed?

Children of all ages can be assessed if parents have concerns about speech, feeding, breathing or oral development.

What is Orofacial Myofunctional Therapy?

Orofacial Myofunctional Therapy focuses on improving breathing patterns, tongue posture, lip seal and oral muscle function to support overall health and development.

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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Speech and Language Therapy

Learn the benefits of Cycles Phonology Approach in Speech Therapy
ByLondon Speech and Feeding March 6, 2023February 10, 2023
Cycles Phonogogical approach

When your child attends Speech and Language Therapy, it can look like your child’s therapist is playing. Therapy needs to be fun, which means carrying out therapy through the medium of play. But remember every approach used has evidence behind it. We need to know that therapy will be successful, so an evidence-based approach is essential.

One of the approaches used for Speech Therapy (i.e., working on speech sound production) is the Cycles Phonology Approach. This approach focuses on the patterns and processes rather than each individual sound. For example, it may be working on final consonant deletion, so the omission of the final sound in words. As Speech and Language Therapists we understand that children can get frustrated and fatigued working on the same sound every day. This approach attempts to solve that. Hodson suggests, the approach is also useful for children with more speech sound errors, as therapists see progress in areas not targeted.

How does the Cycles Phonology Approach work?

Your Speech and Language Therapist will assess your child’s speech development and will then analyse the results. They will also look for which sounds they can produce with support (this is called stimulability). They will analyse patterns in the results and will formulate a plan.

The Cycles Phonology Approach intervention allows your child to work in blocks. This might mean they work for half a week for 30 minutes on (e.g., clusters). Then the next half they’ll work for 30 minutes on a different process (e.g., omission of sounds at the end of words).

Research has found that the following error patterns respond well to this approach:
- Syllables (identifying the different parts in a word e.g., “ae-ro-plane”)
- Final Consonant deletion (omission of the final sound e.g., “ca” instead of “cat”)
- Initial consonant deletion (omission of the first sound e.g., “at” instead of “cat”)
- Fronting (instead of making a sound at the back of the mouth, it’s made at the front e.g., “tat” instead of “cat”)
- Backing (instead of making a sound at the front of the mouth, it’s made at the back e.g., “gun” instead of “bun”)
- S blends (e.g., “sl, sm, sn, sk, sw”)
- Gliding of liquids (e.g., “lellow instead of yellow”, “wabbit instead of rabbit”)
What does a Speech and Language Therapy session look like when using the Phonology Cycles Approach?

The format of the session remains the same for whichever speech sound pattern your child is working on. Your child’s Speech and Language Therapist will review the previous session. Then they will use an activity to work on your child hearing the sound several times (this is called ‘auditory bombardment’). Then your child will practise saying the sound. Next, the Speech and Language Therapist will check if your child can say any of the sounds which they haven’t been able to produce before, with support. This is called a stimulability check. After this, your child will take part in an activity which builds their awareness of sounds in words (such as a rhyming or syllable activity). The session will finish with another auditory bombardment task (i.e., hearing their tricky sound repeatedly).

I will give you advice for practising at home, as it’s vital that your child learns in the correct way. We aim for 100 turns in therapy sessions, so it’s vital your child is motivated.

Contact me to improve your child’s speech sounds and improve their confidence when talking.

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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Autism Therapy · Speech and Language Therapy

Bilingualism – should I speak only English with my speech delayed child?
ByLondon Speech and Feeding November 13, 2023November 20, 2023
Introduction

Bilingualism is a beautiful aspect of our diverse world. Growing up in a bi- or multi-lingual household is a wonderful gift, allowing children to communicate with a broader range of people and access many cultures.

My own two children grew up in a bilingual German-English speaking household. They have both been so enriched by this experience, not only language- and learning-wise but of course also culturally: their world has always been so open and colourful. Growing up in inner London and having their German family and mum’s friends as well, this has been a wonderful experience. Both my boys speak German well (not quite like native speakers but like very good second language speakers) and both have very easily learned 3rd and 4th languages additionally when in secondary school.

Whilst bilingualism has untold benefits, it’s not uncommon for bilingual children to take slightly longer to reach certain speech milestones. This should not be automatically mistaken for speech disorders but rather seen as a natural part of bilingual language development.

Bilingualism and speech delays

Sometimes, of course, we do see speech delays or disorders where a child’s speech development lags significantly behind their peers. We often see a delay in both languages equally, making it extra hard for to communicate effectively. BUT PLEASE KNOW the family speaking in multi-lingual languages never caused the delay/disorder!

If there is a delay or a disorder any number of other reasons could have caused it, such as:
- hearing impairments,
- reduced phonological awareness,
- sensory processing issues,
- reduced attention and reduced joint attention,
- neuro-developmental delays or difficulties,
- general or specific learning difficulties
- or sometimes other genetic factors.
So, to say that the difficulty is due to a child being exposed to several languages is a red herring. (no offence to herrings!)

Speech therapy

Speech therapy can be powerful to help bilingual /multilingual children with speech delays unlock their full linguistic potential. By providing individualised assessments, targeted interventions, and involving families, speech therapy can bridge the gap between speech delays and bilingualism. It’s essential for the therapist and parents to work together to support the children in their unique linguistic journeys, helping them communicate effectively and thrive in both of their languages.

Image by Freepik

Speak your home language at home

Many parents report that they worry about speaking their home language at home and instead they have been focusing on just speaking English at home. They now rarely use their home language with their child. They fear that speaking a language other than English with their child will cause further delay and hinder their progress. All parents want the best for their child and often parents fear that their child won’t fit in or will be seen as ‘different’. So we can understand why parents feel that the English language is the only one worth having.

But the opposite is the case: it is crucial to speak in both languages freely, both at home and outside the home! Both languages will benefit your child, no matter what the delay or difficulty is. Acquiring a ‘mother tongue’ or native language is absolutely vital for children to have a good, solid linguistic grounding on which to build other languages. Bilingual children may mix languages during speaking and parents may equally mix their languages. This does not hinder language development and is a natural part of linguistic development.

Speak freely and naturally

What is far more important than the question: ‘which language should I say this in?’ Instead think: ‘let me speak freely and naturally, let me respond naturally, in good intonation and let communication flow freely to the child.’

Speech therapy can be a crucial resource for bilingual or multilingual children and their families.

We work on targeted interventions to address speech and language difficulties, helping your child develop essential communication skills. For home practice between therapy sessions, we can recommend tailored treatment plans to help you help your child in daily life. Our input could be focusing on articulation, phonological awareness, attention and listening, vocabulary development and grammar.

Family support is crucial in speech therapy. We like to work closely with parents to provide guidance and strategies for fostering language development in both languages at home.

If you have any worries about your child being delayed in a bilingual or multilingual household do get in touch and we will be happy to support you in your journey.

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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Speech and Language Therapy

Language development
ByLondon Speech and Feeding October 4, 2021March 28, 2025
Language Development

Books, Stories And Colourful Semantics

Many of my students have difficulties telling stories. When looking at a book together, even books they love and have seen many times, they often struggle to understand what they are reading and cannot therefore retell the story in any sequence. A great method I often use with those students is called Colourful Semantics.

What is Colourful Semantics?

Colourful Semantics is an approach aimed at helping children develop grammar and meaning of phrases and sentences. We help children identify WHO is the subject in a story, what is he/she/it DOING to WHAT and WHERE. There are lots of colour coded stages but we tend to start with the basic 4:

WHO = ORANGE

DOING = YELLOW

WHAT = GREEN

WHERE = BLUE

Once a student is accomplished at this level, we move on to different colour codes for describing words (adjectives), connecting words (with/together/and/therefore) feeling words (PINK), timing words (BROWN) eg. when, tomorrow, last week etc.

Colourful Semantics is a really useful method and helps children to organise their sentences. It also helps me knowing how to guide a student in thinking about the story.

The approach can be used with children with a range of Speech and Language Needs, such as:
- Developmental Delay / Disorder
- Autistic Spectrum Condition
- Down Syndrome
- Any other syndromes and related speech and language delays
- General Literacy difficulties
There are a wide range of benefits to using this approach and I use it in my therapeutic work with children of around 3 years plus. Below is a little video which shows how I use it with this student who has general language difficulties associated with Autism. One of the main benefits with this student is that seeing the Cue Cards helps her to use a much wider range of vocabulary than she would ordinarily generate. Her sentences are getting longer and she is more able to answer questions. In general, I find it useful to help with storytelling and to guide us through the story in a sequence.

There are many on-line games these days that have incorporated the Colourful Semantics Approach. Once a child is familiar with the basic colour scheme then gradually the visual prompts can be reduced to using verbal prompts.

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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Feeding · Speech and Language Therapy

The great air debate: How different swallowing patterns impact breastfeeding and reflux
ByLondon Speech and Feeding November 5, 2025November 6, 2025
The great air debate

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:
1. 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.
2. 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.
3. 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.
4. 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.
5. 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.

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Feeding · Speech and Language Therapy

Dynamic assessment – Let’s look beyond the checklist
ByLondon Speech and Feeding September 15, 2025November 6, 2025
As a parent, you’re always observing your child, celebrating his or her milestones, and sometimes, wondering if he or she is quite on track. When it comes to speech, language, play, attention, and listening, these early years are a whirlwind of development! It’s natural to seek guidance if you have concerns, and that’s where a truly comprehensive assessment comes in.

But what exactly does ‘comprehensive’ mean, especially when it goes beyond a typical checklist? You can find any number of check lists online these days but whilst they can give you an overall idea of what a child is typically expected to do at any given age, it can also start leading you into a rabbit hole of anxiety of ‘what-iffery’.

At The London Speech and Feeding Practice I believe in something far more insightful than a static evaluation: Dynamic Assessment. Think of it as an in-depth, interactive investigation into your child’s unique communication landscape, exploring not just what he or she can do, but how he or she learns and why he or she might be facing challenges. This is so important.

What makes an assessment ‘dynamic’?

Imagine trying to understand a child’s personality by just looking at a single photograph. It gives you a glimpse, but it hardly tells the whole story. Traditional, formal assessments, while valuable, can sometimes be like that photograph – a snapshot of skills at one specific moment.

Dynamic assessment, on the other hand, is a living, breathing process. It’s called ‘dynamic’ because:
- It’s interactive and responsive: It adapts to your child’s needs in real-time. It’s not about sticking rigidly to a pre-set schedule of tests. Instead, it’s about observing, gently prompting, and providing support to see how your child responds and learns. This allows me to understand his or her learning potential, not just his or her current performance.
- It’s holistic and multi-faceted: I look at the whole child. We delve deep into not just speech and language, but also his or her play skills (a crucial window into cognitive and social development), attention and listening abilities, and his or her social engagement. These areas are intricately linked, and a delay in one can often impact others.
- It integrates multiple perspectives: Your insights as a parent are invaluable! Before we even meet, my comprehensive onboarding questionnaire gathers essential background. During the assessment, your feedback, observations, and comments are woven into the fabric of our session. You are the expert on your child, and your voice is central to forming a complete picture.
More than just ‘speech’: A deep dive into development

You might initially be concerned about your child’s speech sounds, or perhaps his or her ability to form sentences. These are vital areas, but my approach goes much further. I’m keen to understand:
- The ‘why’ behind the ‘what’: Is a child struggling with language because of difficulties with understanding instructions (receptive language), or with expressing themselves (expressive language)? Are his or her attention skills impacting his or her ability to follow a conversation? Is his or her play demonstrating imaginative thought, or does he or she prefer more structured, repetitive activities? These nuances are critical.
- Differential diagnosis: This is where the skill of an experienced clinician truly comes into its own. Through dynamic assessment, I can differentiate between a developmental delay (where a child is following a typical progression but at a slower pace) and a disorder (where his or her development is following an atypical pattern). This distinction is vital because it guides the type of support and intervention that will be most effective. Understanding the cause of the delay or disorder is paramount to creating a targeted, impactful therapy plan.
The art of observation

While I draw upon evidence-based practice as well as a formal, standardised assessment as well as my extensive clinical knowledge, I also rely heavily on the art of observation. From the moment your child walks into the room, I’m establishing rapport, engaging them in play, and creating a safe, fun environment. It’s through this genuine interaction – often without them even realising they’re being ‘assessed’ – that the most authentic insights emerge.

This is where the magic happens:
- Building rapport: A child who feels comfortable and connected will show you so much more of his or her true abilities and personality. I pride myself on creating an atmosphere where children can relax and simply be themselves.
- Play as a window: Play isn’t just fun; it’s a child’s natural language. It reveals his or her understanding of the world, his or her problem-solving skills, his or her social engagement, and his or her ability to use symbols and language.
- Skilled interpretation: My years of experience allow me to see beyond surface-level behaviours and interpret the subtle cues that might indicate underlying strengths or challenges. This goes far beyond what any standardised test alone can capture.
Why choose a clinician who offers dynamic assessment?

In essence, a dynamic assessment provides a rich, nuanced, and truly personalised understanding of your child. It’s an investment in:
- Accuracy: Leading to a more precise diagnosis and understanding of his or her unique profile.
- Tailored support: Enabling the creation of highly individualised therapy goals that truly meet your child where he or she is and gently guide him or her forward.
- Empowerment: You’ll leave with not just answers, but also practical strategies and a clear path forward, feeling confident and informed.
If you’re seeking a thorough, empathetic, and truly insightful assessment for your child’s communication development in London, I invite you to get in touch. Let’s work together to unlock your child’s full potential.

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.

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