Four struggles parents face when out and about with children with speech, language, and communication difficulties

ByLondon Speech and Feeding
|
A man and a woman hug a young girl at a table
Hug

You (as parents) often describe yourselves as being under constant pressure and stress when looking after your children and young people with Special Educational Needs and Disabilities (SEND). You may find going out to do the simplest of tasks a challenge. And you will try to avoid social situations out of fear and anxiety. One of the most important factors to you is having like-minded people who understand your position as a parent with a young person with additional needs. Let’s look at some of the challenges you face and how I can support you and your family.

1. Challenging behaviour and going out to the shops

When your child displays challenging behaviour and won’t go into a shop without buying a toy that they insist on having, it can be tough on your family. You see people around you staring as you try to manage the situation. They do not understand the pressures you face, or that the simplest of tasks are a huge challenge.

I can support you by giving strategies to use when out and about. I know that using visuals is important for your child. They may not understand or take in language when they are in a heightened state of anxiety or feeling overwhelmed. You could print pictures of the places you’re going to and put them on an easily accessible chain. Then you could use that chain when out and about at the shops. You may want to introduce a visual timetable at home. That way your child or young person understands where they are going. This may lessen their anxiety and subsequent behaviour.

2. Your child is not able to communicate their needs to an unfamiliar communication partner

When your child has difficulty communicating to an unfamiliar person it can be hard to manage. You feel yourself explaining your situation repeatedly. I can provide your child with individualised strategies or communication aids which support your child to communicate with both familiar and unfamiliar communication partners. We’ll work together to find which communication methods work in different situations and how your child will use these to help their independence.

3. Being overwhelmed

Your child or young person may easily be overwhelmed which may contribute to behaviour changes. I’ll work with your family to understand what the behaviour means, looking at what happened before and what happened afterwards. We’ll not only look at the behaviour but at the environment as well. This can inform how you can support your child or young person in the future, to reduce sensory stimuli (if needed) and for them to feel emotionally regulated.

4. People avoid engaging with you

One of the hardest things as a parent is for others to avoid you. You see them crossing the street because they don’t know what to say to you. All you want is them to accept you, to maintain your identity as a person and not as a SEND parent. I can support you emotionally. I can give you advice on local support networks where you can find other parents in a similar situation.

We know the stresses that being a parent with a child with SEND comes with. Please know I am always here to support you, to find solutions so that when you’re next out and about. Your experience will be a little easier and you’ll feel less isolated.

Improve your child’s communication, confidence, reduce overwhelm and feel supported here.

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

Similar Posts

Speech sounds: Expectations vs reality
·

Speech sounds: Expectations vs reality

ByLondon Speech and Feeding

Sometimes our kids find it hard to listen to sounds in words and hearing the difference between sounds. This is an important skill which we call “sound awareness”. A lack of it can really impact on clear speech sounds production.

Your child might be confusing similar sounding words. Or they might not notice that a TAT is not a CAT for a DOD is not a DOG. Often children with speech sound disorders or difficulties don’t tune into individual sounds or even syllables. Grow your knowledge to support your child.

Read our latest blog on hearing the difference between sounds to develop speech sound production.

Practice makes perfect

There is a lot more to speech sound production than first meets the eye. Did you know that producing the correct speech sound at sentence level is the last piece to the communication puzzle? There’s a lot of practice before your child develops this last stage of speaking clearly. Your Speech and Language Therapist will start by determining if your child can hear the difference between the sound they are producing and the correct sound. So if your child says LIT instead of LICK we might contrast those two words by perhaps using a candle and a lollypop. Each time he/she says LICK they get to have a lick (or 3) on the lolly. But if they say LIT then we light up and blow out a candle. This way your child can see that there is a difference between those words and that the sounds we make actually matter. Fancy that!!

We call this auditory awareness, which is essentially hearing the sounds in words. Don’t be surprised if you hear your child’s therapist model the sound a lot. This is to develop their awareness. The more your child hears a sound, the easier they will find production. Furthermore, your Speech and Language Therapist will work on phonemic awareness (sound structures) such as the difference between a sound (e.g. sh, is one sound) vs a syllable (e.g., shell has one syllable) vs total number of sounds in a word (shell has three sounds sh-e-ll ), like you can see in my little video clip.

Once a child is able to produce a sound on its own and they can hear and identify how a short word is said correctly we can go and repeat lots of similar words with the sound at the beginning or end until it becomes automatic and new neuro pathways are laid in the child’s brain. From there we branch out into short phrases and then eventually sentences.

Six tips to practise auditory discrimination for speech sound production

  1. Sit opposite your child so they can see your mouth or or sit next to the child and place a mirror in front of you so they can see and hear your production.
  2. Make it fun! Once they’ve identified the sounds in the word, play part of a game (e.g., pop up pirate, Jenga, something which allows plenty of turns).
  3. Use car journeys or walking to school to practise (e.g., oh I see a sheep, sh-ee-p, sh-ee-p has three sounds. Can you spot something beginning with /sh/?)
  4. Remember that spellings can differ (e.g., ‘chef’ and ‘shed’ both have the same initial sound).
  5. Talk about what you’re doing with your mouth (e.g., my lips are rounded for /sh/). Your Speech and Language Therapist will be able to support you with this.
  6. Make silly sentences using your child’s special sound (e.g., Sheep show shepherds shearing).

At this stage you are not expecting your child to produce the sound. This is why it’s important that they continually hear an excellent model. If your child attempts speech sound production at any stage, this is to be encouraged as it’s a great opportunity to model the correct version.

Contact me to develop your child’s speech sounds.

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.

0
Living life with a lisp
· ·

Living life with a lisp

ByLondon Speech and Feeding

You may be questioning ‘will my child grow out of having a lisp?’ There are so many myths out there that it’s sometimes difficult to find your way out of a complex maze of information.

The good news: lisps can be successfully treated by a Speech and Language Therapist and the earlier it’s resolved, the better. We know from the evidence base that some children’s lisps will resolve and, as always, it is completely age appropriate to have this speech pattern up until aged 4 ½.

As with any speech and language targets your child will need to be motivated to practise their newly acquired techniques, at home and in other settings. They will eventually be able to generalise this skill, but it takes lots of practice. So, think carefully about if your child is ready and motivated before commencing Speech and Language Therapy.

There are essentially two ways in which your child has acquired a lisp. It’s key here to mention that parents have no blame in this.

  1. They’ve mis-learned it and now incorrect production has become a habit
  2. Children have difficulties organising the sounds to make a clear production

You may be surprised to realise that there are different types of lisps. But all the techniques will be the same.

  1. Interdental lisp

When your child pushes their tongue too far forward, they will make a /th/ sound instead of /s/ and /z/

  1. Dental lisp

This is where your child’s tongue pushes against their teeth

  1. Lateral lisp

Air comes over the top of the tongue and down the sides

  1. Palatal lisp

Your palate is the roof of your child’s mouth. Sometimes they will touch their palate when making certain sounds (e.g., /s/ and /z/)

It’s useful for you to know what type of lisp your child has because you can then support them to make the correct production. You’ll be able to talk about where in the mouth their tongue is and where it needs to be to produce a clear sound. Your Speech and Language Therapist will be able to help you with this.

Top therapy tips for lisps

  1. Awareness is key. Does your child know where their tongue and teeth are (i.e., are they behind their teeth)? Do they notice the air escaping? Use a mirror so that your child can see not only themselves but also you in the mirror.
  2. Repetition! As with most therapeutic intervention, practice makes perfect. So little and often is key!
  3. Make sessions fun, perhaps around your child’s interests or allow them to drink from a straw
  4. Comment on how the sound is produced (e.g., /z/ is like a bee, /s/ is like a snake)
  5. Use tactile cues. Your child’s vocal folds vibrate when they produce a sound like /z/ but not with /s/. You could use the words ‘loud’ and ‘quiet’ to describe this.
  6. Start with a /t/ sound and gradually elongate the sound to an /s/

Having a lisp may not be problematic for some, but for other children, it can have a significant impact on their emotional wellbeing. Intervening at an early age can prevent this from happening. We always advocate for early intervention!

Contact Sonja for support on resolving your child’s lisp.

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.

0
Explore the world of speech sound therapy for young children
·

Explore the world of speech sound therapy for young children

ByLondon Speech and Feeding

Many parents who come to the clinic voice with the concerns about their child’s “speech”. On assessment we discover that actually besides the words not being clear what we most often don’t see is “language” (putting words together to request something for example). And we don’t see “social communication” (waving bye with a smile for example). So what is perceived as “speech” is much more than just not saying the speech sounds correctly. It might be that we need to increase the child’s vocabulary and language so that we can target specific speech sound patterns.

We’ll guide you through some of the most frequently asked questions.

What is the difference between speech and language?

Language is how we put words together (e.g., the cat ran up a tree). For non-verbal children this might be how gestures and symbols are put together. Both will put these into a meaningful context. Language needs to use either speech and/or gestures or signs or pointing to symbols in order to come into being. It needs words, either spoken or written, put into grammatical order so that thoughts can be expressed adequately: about the here and now, about what he had for breakfast this morning or what we are going to do this coming weekend. We put words together to express our feelings and thoughts. Speech is one aspect of this very complex process.

Speech is the specific sounds that make up a word (e.g., the sounds in fish are /f-i-sh/).

Some children are delayed in their speech but will catch up with their peers’ development with time. Others may be using disordered speech sound patterns. If you’re unsure, contact your Speech and Language Therapist as early intervention is vital. It might be that you’re given activities to carry out at home. Or a direct therapeutic intervention may be required, along with regular practice at home. The approach depends on your child and how they learn best.

When might your Speech and Language Therapist recommend direct Speech and Language Therapy?

There are several reasons why your child may need intervention to support their communication. Some of these include:

  • When they produce vowels incorrectly
  • When a child has significantly fewer consonants than they should have by their age
  • Error patterns that are not following a typical process
  • Fewer word approximations
  • When a child is ready for speech therapy. That is to say, when we can target speech production through interactive play but most often speech is targeted through repeated activities which focus on a few sounds or words at a time. For this to work ideally a child does need to be able to sit at a table and take part in the activities and games.

How can I work on speech and language targets at the same time?

You’ll want your child to be engaged in activities. It’ll need to be in short bursts to keep their attention. Let’s say you’re focusing on the /p/ sound. You may get a bag with objects and items with /p/ in them. Speak to your child’s Speech and Language Therapist about what position in the word they are targeting now.

Sing the ‘what’s in the bag’ song. Pull out each item in turn and emphasise the sound that you are working on such as “it’s a fox, ffffox”. You can then comment on what the fox is doing, or what they look like (e.g., look at this fffurry fffox. It’s very fffriendly. Oh, the fffox is running).

This activity gives you the opportunity not only to build vocabulary but also to expose your little one to a good model of speech sounds.

“I’m concerned my child won’t sit through the assessment”

This is a common concern. Don’t worry. If your child is not able to sit through an assessment then we usually offer play-based assessment. This means it is activity focused and can be wherever your child feels most comfortable; this is usually on the floor. It is often best to see children in their own homes or even nursery places where they can roam more freely and where they feel most comfortable. On reading the filled-out parent questionnaire we can decide whether a home visit/nursery visit or a clinic visit might work best for your child.

You will be guided all the way through from assessment to intervention and beyond. So, you’ll leave feeling empowered and confident to get started!

Contact Sonja for support with your child’s speech.

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.

0
Four Ways to Progress your Child’s Language and Build Confidence
·

Four Ways to Progress your Child’s Language and Build Confidence

ByLondon Speech and Feeding
A child is using a tablet

Watching your child’s confidence grow as their language develops is something you dream of. You feel helpless, you watch your child repeat language over and over and this concerns you. You know you should be supporting their communication development, but you feel stuck. You’ve reached the point where you don’t know where to turn to for support. Accessing the knowledge of a Speech and Language Therapist is a great place to start.

Here are four ways to support your child’s language:

1. Provide great communication models that include scripts or “gestalts”

Instead of commenting with single words like “apple” or two word phrases e.g., “want apple”, it is more beneficial to comment with small sentences or scripts such as “let’s eat an apple”, “I want an apple mummy”, “I want more apple please” or “I’m hungry daddy.”

These are phrases that include more intonation and rhythm (top tip: ensure you do use appropriate intonation and rhythm), and your child is likely to pick up those phrases and copy them much more easily than single words or two-word phrases.

2. Offer a robust Alternative and Augmentative Communication (AAC) device

There are many examples of AAC devices such as ‘Lamp for Life’ or ‘Grid Smartbox’. It’s vital that you consult a Speech and Language Therapist with a specialism within this area of communication. You want your child to be able to communicate their wants and needs. Furthermore, their communication buttons need to be tailored to your child’s interests so they are motivated to use them (e.g. if your child likes Thomas the Tank Engine, you may wish to program in specific phrases such as “I want to watch Thomas the Tank Engine”. It is also important that the devices are suitable for your child’s physical and emotional stage of development.

3. Learn to be a word detective

Listen to your child’s echolalia (or repetitions) and try to understand what they mean. Their communication is often meaningful around a previous experience. For example, one of my students says, “bang my head” and that actually means “I want to play that tickling game again” (where I banged my head the other day).

4. Take turns with your child and copy their scripts

This shows you are listening actively and value their attempts at language. We all love it when someone is actively listening and trying to decode what we are saying.

Take heart and try not to worry. You’re doing the best you can. Your child is more than likely a Gestalt Processing Learner and so they are moving through very defined stages. Echolalia (repetition) is the first of many, so you have an exciting journey ahead watching your little one’s language grow and develop.

Reduce your child’s frustration and build their confidence today.

Contact me here for speech and language advice and AAC support

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

My child won’t eat! What can we do to help?
· ·

My child won’t eat! What can we do to help?

ByLondon Speech and Feeding
Image by freepik

I get lots of enquiries about this topic, parents up and down the country struggle to feed their children. Mealtimes with toddlers can sometimes feel like a war zone!

Reasons

The reasons for food refusal are many and very varied. Perhaps your child was born prematurely and had lots of tubes and things sticking to his or her face? Or maybe your child had gastro-oesophageal reflux and this caused pain every time he or she swallowed. Some children have motor problems so it was hard to coordinate swallowing with breathing and caused frustration and anxiety? Many children have sensory integration difficulties and these make it difficult for them to grasp all the different textures and colours they are eating.

When I take a case history for a new feeding client, I always try to first establish how the child learned not to feed/eat. I use the word ‘learned’ here with intent as eating is a learned behaviour. We tend to think that it must just be instinctive and natural but this is not the case. Instinct is a small part of the very beginning of feeding, in that a baby naturally roots for the breast but this only works out well and leads to more natural ‘instinctive’ feeding if that initial instinct is not interrupted or impacted on negatively by any of the above reasons.

So just as a baby learns to eat or drink the milk it can also learn not to do so. The baby can learn to avoid eating in order to bypass discomfort, or — and this is another important factor — in order to gain more positive attention from the caregiver!

Research shows that we learn about food in two ways:

  1. A connection is made between a food and a physical reaction. This needs to happen only once and it can stick: think about feeling sick after a binge on a certain food/drink… You won’t want to go near that very food again for some time, if ever! If a certain food causes pain then that connection can be made quickly and we won’t want to touch this food again.
  2.  We learn through reinforcement and punishment:
  1. Reinforcement:
  • If we get praised for eating our plate with a pudding, then we tend to eat more to get the pudding.
  • Equally if granny sits with us for hours at the table reading us a story because we do not eat or don’t eat much/quickly, we will continue this because we want granny to keep reading for us.
  1. Punishment can work in two ways:
  • Child gets punished for not eating and will eat more to avoid punishment.
  • Child eats less as the fear of punishment is so unpleasant and leads to total lack of appetite.

As speech therapists we do not endorse any of those above strategies because none of them give us the desired effect.

What do we want to achieve? We want our children to eat naturally, with enjoyment. We don’t want them to over eat, to binge eat, or to starve themselves. Eating needs to become a joyful, natural and organic behaviour if our child is to be healthy and thrive.

Recommendations

Here are three top recommendations I make regularly with good effect:

  1. Structure: have a routine at mealtimes, eating at the table, in the same room with our favourite utensils. Always helping in food preparation, perhaps setting out the table placemats etc, and then tidying up — taking the plate to the kitchen counter, scraping left overs into the recycle bin can be part of this. This way we can introduce repetition to our food/eating learning.
  • Positioning: the right chair with a good footrest, supporting our child’s trunk well, and facilitating our child eating at the table (instead of sitting in a high chair with a tray) is one of my first and favourite tips. I do favour a Tripp Trapp style chair (I have no association with that company).

Tube fed children ought to also sit at the table with the rest of the family and first of all be offered foods and drinks to handle or play with. Some tube fed children are able to eat a small amount of pureed foods and they ought to be offered this first before being topped up with their tube feeds, whilst sitting down. Lying down for your tube feed is not a normal way of eating. Tube feed infants should be offered a pacifier whilst being tube fed and be in an upright position so that they start having an association between getting full/feeling satiated and their mouth.

  • Sociability: I encourage family mealtimes, or at least the caregiver eating with their child together, so that the child is able to copy and observe what normal eating looks like. We need to be super positive about eating and food consumption so that our child can see and copy this. If the parent is a fussy eater then this may cause the child to copy exactly the same behaviour. Many parents who come to me with their fussy children are themselves also picky about food.

There are many other tips and strategies and I will be more than pleased to assist, please contact me.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

1
Strategies to support children with eating difficulties
· ·

Strategies to support children with eating difficulties

ByLondon Speech and Feeding

where the cause is NOT a swallowing problem, but we are having a “fussy eater” in the family, seeming for no obvious reason

When parents have a child who find mealtimes or eating difficult, it can put pressure on the whole family dynamics. Once we have observed a child’s eating and drinking skills and found that they are not swallowing impaired, but are for want of a better word “fussy” or “picky”, we can then start to look at what might be underpinning the food aversions/picky eating/food avoidance. Two of the main questions parents have (of course) are:

  • ‘is my child getting the right nutrition?’
  • ‘how can I have less anxiety-provoking and stressful mealtimes?’

We all tend to have an image in our minds about the ‘perfect mealtime’, and how mealtimes ‘should’ be. Speech and Language Therapists with a Feeding Specialism are the perfect professionals to help you unpick feeding issues. We are trained to look at swallowing and oral skills and we also know a lot about feeding behaviours and sensory difficulties which could be causing your child’s eating avoidance.

Here are some strategies that can support children with their eating:

  1. Create and maintain a mealtime culture that suits your home and lifestyle. Then stick to that. We all need some routine in our lives to thrive. Mealtimes are no different. It might be that you eat in the same place for every meal, with the same knives and forks, concentrating on maintaining good posture. Children learn by repetition so the more familiar it is, the easier they will find it. In the physical sense, our bodies also need preparing for food, regardless of whether we are eating with our mouths or we are tube-fed. We want every child to connect all the dots of the process. It starts with their eyes, noses, expectations, memories of past experiences, feelings and then finally their mouths….
  2. Be an excellent role model. Children learn through watching others, so your child will be observing you without you knowing. Ensure that you are positive about the food you are all eating, and talk about how delicious, tasty, juicy, and yummy the foods are. Make the atmosphere around the dinner table light hearted. Even though you are secretly stressed about your child not eating, try and not show this. Instead pick a topic or put on some nice music, or talk about something your child might be interested in, and try and avoid coercing your child to eat. Leave small finger foods on their plates and have a range of foods available on the table so that your child can see that everyone is eating a range of foods and enjoying them.
  3. Use positive reinforcement. Try and think of mealtimes as fun and motivating. Children who are happy will likely be more inclined to try foods and take part in family mealtimes. Reward all interactions around food, so if your child merely touches a new food then praise this behaviour. Or if your child licks a food just once, again make a nice comment and praise your child for touching and licking the food. The takeaway here is to try and keep all messages positive around food.
  4. Keep offering all types of food. What often happens is that parents stop serving foods they know will not be eaten. This makes sense in a way; we don’t want wastage! However, try and keep the doors open and re-offer all types of foods, even the ones that your child has not wanted in the past. Try and give your child one food they will like and one food they have tasted before and liked before, even a little, and then one new food to try. So, your child always has something to fall back on and they can join in with eating. But they can also try (or at least look at and think about trying) other foods that you and perhaps the siblings are eating.

Take a look at this website, I find it very helpful in showing parents what types of foods and how big a portion to offer

Have a go and try and implement some of the ideas above, and should you get stuck please get in touch!

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.

0