Hard munchables: Chewing through the weaning journey

ByLondon Speech and Feeding July 14, 2025July 23, 2025

As a Speech and Language Therapist with a specialism in paediatric feeding, I’m constantly looking for ways to support families in developing their little ones’ oral motor skills and fostering a positive relationship with food. While Baby-Led Weaning (BLW) has revolutionised how many families introduce solids, (see my previous blog in July 25) a concept that often sparks discussion and curiosity is the use of ‘hard munchables.’

What are hard munchables?

The term ‘hard munchables’ refers to specific types of firm non-digestible food items that are offered to babies for oral exploration and skill development, not for nutrition. These are typically foods that babies cannot bite off or swallow in large pieces due to their texture, but which provide resistance for chewing practice.

The phrase was coined by Marsha Dunn Klein, M.Ed., OTR/L, Occupational Therapist and feeding therapist. Well known for her work in paediatric feeding she introduced and advocated for the concept of hard munchables as part of a therapeutic feeding approach, particularly for infants learning to manage textures and develop crucial oral motor skills.

Common examples of hard munchables include:

Large, raw carrot sticks: Too hard to bite through, but great for gnawing.
Celery sticks: Like carrots, offering firm resistance.
Large, raw apple slices (peeled chunks): A firm, slightly sweet option.
A firm, uncut pear core: With the seeds removed.
Dried mango cheeks (hard, unsweetened varieties): These offer a fibrous texture.
A large, fully cooked but firm piece of meat (like a steak bone with some meat attached): The meat provides flavour and a bit of shreddable texture, while the bone is for gnawing.
Hard crusts of bread or breadsticks (very firm, without soft inner crumb): These can soften slightly with saliva but offer significant resistance.

It’s crucial to emphasise that hard munchables are not for consumption or nutrition. They are tools for oral motor development and should always be offered under strict, active supervision.

How do hard munchables fit into weaning?

While weaning (traditional or Baby-Led Weaning) introduces solid foods that a baby can eventually bite and swallow, hard munchables are complementary to the weaning phase. They enhance that phase by helping a child to develop hand dexterity, hand to mouth movement, and oral development.

It’s important to differentiate: Weaning provides the digestible food for eating, while hard munchables provide the tool for skill practice. They are not substitutes for each other but can be used together under careful guidance.

Pros and cons from a speech therapy perspective

As an SLT, I see both the potential benefits and the necessary precautions when incorporating hard munchables.

Pros:

Enhanced oral motor development: Hard munchables provide excellent resistance training for the jaw, helping to develop the strength, endurance, and coordination needed for efficient chewing. This is foundational for moving beyond purées and very soft textures.
Promotes lateralisation of the tongue: The act of moving the hard item from side to side in the mouth encourages the tongue to move independently of the jaw, a crucial skill for managing food and for speech sound production.
Preparation for more complex textures: By strengthening the oral musculature and refining chewing patterns, hard munchables can help babies transition more smoothly to lumpy and mixed textures.
Sensory exploration: They offer rich sensory input (tactile, proprioceptive) that can be beneficial for oral mapping and awareness, especially for babies who might be orally sensitive.

Cons:

Choking risk: While the intention is for the baby not to bite off pieces, there is always a risk. Small pieces can break off, or a baby might accidentally bite off a larger chunk than he or she can manage. Active, vigilant supervision is non-negotiable.
Not a replacement for digestible solids: It’s vital to remember that hard munchables are for practice, not nutrition. They should complement, not replace, the introduction of varied, digestible solid foods.
Not suitable for all babies: Babies with certain developmental delays, oral motor deficits, or medical conditions might not be appropriate candidates for hard munchables without highly specialised guidance. For instance, babies with an exaggerated gag reflex might find them overwhelming.

Key Considerations for Parents

Here are my top recommendations:

Consult with a professional: Always discuss this with your Paediatric Feeding SLT first before you introduce hard munchables. We can assess your baby’s individual readiness and guide you on safe practices.
Strict supervision: Never leave your baby unsupervised with a hard munchable, even for a second. Your full attention is required.
Appropriate size: Ensure the item is large enough that the baby cannot fit the whole thing in their mouth. It should extend well beyond their fist.
No biting off: The goal is gnawing and scraping, not biting off pieces. If your baby is consistently breaking off chunks, stop using them.
Focus on skill, not consumption: Reiterate to yourself that this is for practice, not for eating.

In conclusion, hard munchables, when used appropriately and under guidance, can be a very valuable tool to support oral motor development during the weaning journey. However, always be safe and consult with a specialist to ensure your little one develops his or her feeding skills effectively and joyfully.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Royal College of Speech & Language Therapists Member

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.

References:

Rapley, G., & Murkett, T. (2008). Baby-Led Weaning: The Essential Guide to Introducing Solid Foods. Vermilion.

Morris, S. E., & Klein, M. D. (2000). Pre-feeding skills: A comprehensive resource for feeding development. Pro-Ed.

Neurodiversity · Speech and Language Therapy · Top tips

Halloween without the tears: Supporting children through the Spooky Season
ByLondon Speech and Feeding October 27, 2025October 27, 2025
For many families, Halloween is an exciting time filled with costumes, decorations, and sweets. But for children who are sensory sensitive, whether they’re autistic, have sensory processing differences, or simply find new experiences overwhelming, Halloween can feel like a night of chaos rather than fun.

The bright lights, unexpected noises, strange textures, and social pressure to ‘join in’ can quickly become too much. The good news? With some thoughtful planning and gentle support, you can make Halloween a positive and manageable experience for your child.

Understanding sensory overload

Sensory overload happens when a child’s brain receives more sensory input than it can process. This might mean:
- Costumes that itch, squeeze, or feel strange on the skin.
- Loud sounds like doorbells, fireworks, or shrieking decorations.
- Crowds and unpredictability during trick-or-treating.
- Strong smells or tastes from face paint or unfamiliar sweets.
When overloaded, children may cry, cover their ears, hide, run away, or ‘shut down.’ These reactions aren’t ‘bad behaviour’, they’re signs of distress. The goal isn’t to eliminate Halloween fun, but to adjust it to your child’s comfort level.

Step 1: Choose costumes wisely

Costumes are often the biggest trigger. Scratchy fabrics, tight seams, or masks that restrict breathing can be unbearable for some children.

Try these tips:
- Go sensory-friendly: Use soft, breathable fabrics and remove tags. Many retailers now sell sensory-safe costumes.
- Test it early: Let your child wear the outfit around the house before Halloween. If it’s too much, simplify — maybe themed pyjamas or a favourite T-shirt with Halloween accessories.
- Skip the mask: Face paint can be equally challenging, always test on a small patch of skin first. A comfortable headband or hat might be enough to feel ‘in costume.’
Remember, participation doesn’t require perfection. Your child can still ‘be’ their favourite character without a full costume.

Step 2: Plan your Halloween environment

Before the big day, think about what parts of Halloween your child enjoys — and what might overwhelm them.

At home:
- Keep decorations minimal and predictable. Avoid motion-activated sounds or flashing lights.
- Practise knocking at your own front door or saying ‘trick or treat’ with a trusted adult.
- Have a ‘quiet space’ ready, a cosy corner or room where your child can retreat if things get too intense.
If you’re going out:
- Choose earlier, quieter times for trick-or-treating.
- Visit a few familiar houses instead of the whole street.
- Bring ear defenders or noise-cancelling headphones.
- Have a clear exit plan if your child needs a break.
Sometimes, watching from the window and handing out sweets can be just as enjoyable! it still offers social participation without sensory overload.

Step 3: Prepare socially and emotionally

Halloween involves a lot of unexpected social interaction: strangers at the door, unfamiliar greetings, and different rules.

Help your child by:
- Using visuals or stories: Read picture books about Halloween or make a short social story about what will happen.
- Role-playing: Practise saying ‘Trick or treat!’ or handing out sweets in a fun, low-pressure way.
- Labelling feelings: Explain that it’s okay to feel nervous or to take a break if something feels ‘too loud’ or ‘too much.’
Children feel safer when they know what to expect. Predictability reduces anxiety and makes participation more enjoyable.

Step 4: Rethink the treats

Not every child enjoys sweets; some dislike sticky textures or strong flavours. Offer non-food alternatives like stickers, glow sticks, or small toys.

If your child has feeding difficulties or oral sensitivities, it’s okay to opt out of the traditional treats entirely. They can still join in by giving treats or decorating treat bags instead.

It’s also helpful to prepare your child that others might offer sweets they don’t want. Practising polite ‘no thank you’ responses can make these moments easier. (check out my symbol download for children who struggle to speak)

Step 5: Celebrate your way

Halloween doesn’t have to look like anyone else’s version. Maybe your family watches a ‘not-too-scary’ film, carves pumpkins, or does a flashlight treasure hunt indoors. The goal is joyful connection, not conformity.

A calm, happy experience, even if it looks simple from the outside builds positive associations your child will carry into future celebrations.

In summary

Halloween can be full of sensory surprises, but with empathy, planning, and flexibility, it doesn’t have to end in tears.

The more you adapt to your child’s sensory needs, the more they learn that they are safe, understood, and included not just at Halloween, but in every celebration.

As with all things in speech and feeding development, progress starts with connection. When children feel regulated and supported, communication and confidence follow.

HAPPY HALLOWEEN!

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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Autism Therapy · Speech and Language Therapy

Milestones of autistic children: Crawling, walking, and talking
ByLondon Speech and Feeding October 25, 2023March 25, 2026
Image by wayhomestudio on Freepik

For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.

1. Individual Pacing:

Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.

2. Neurodevelopmental Complexity:

The human brain is a remarkable entity, with a bewildering array of interconnected processes that lead to us achieving our developmental milestones. Autistic children often have variations in “neural wiring”, which can impact the balance between gross motor skills (crawling, walking) and fine motor skills. Speech and language acquisition falls under fine motor skills and may be momentarily disrupted due to the divergent neurological pathways at play in autism.

2. Sensory Processing Differences:

One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.

3. Visual-Spatial Abilities:

Autistic children and adults frequently display excellent visual-spatial abilities. This strength might lead some children to focus more on activities that engage these skills, potentially delaying their engagement with activities like walking or talking. As they navigate their environment and process information visually, they might naturally invest more time in activities that stimulate this particular cognitive ability and strength.

4. Communication Challenges:

For many autistic children, speaking can be a really complex and difficult endeavour. Communication delays are a common feature of autism. This can affect both receptive and expressive language development. While some children might be physically capable of crawling or walking, they may not yet have the tools to communicate their desires and intentions. This leads to a temporary focus on non-speaking forms of expression. This does not mean that they do not communicate at all. But autistic individuals often start out using jargoning or echolalia as a form of communication as well as behaviours and physical forms of communication.

5. Executive Functioning and Motor Skills:

Executive functioning, or abilities for planning, organising, and carrying out tasks, can vary in autistic children. These skills are crucial for activities like crawling, walking, and talking, which need coordination and planning. About 40% of autistic persons have a motor planning difficulty.

6. Intense Interests and Routines:

Autistic children often develop intense interests in specific subjects, sometimes to the exclusion of other activities. These interests might become their primary mode of engagement. They might side-line milestones like crawling, walking, or talking. The mostly rigid adherence to routines and preferences might cause them to allocate more time to their preferred activities. This delays their engagement with other developmental tasks.

How can Speech and Language Therapy help:

Support and Intervention:

Early intervention and regular Speech and Language Therapy play a pivotal role in the developmental journey of autistic children. Therapies tailored to individual needs can aid in bridging the gaps between milestones. Occupational therapy, for example, can help address sensory sensitivities and motor skill challenges that might impact crawling and walking. Speech therapy can help communication development, gradually bridging the gap between non-verbal expressions and spoken language.

For example, we now know that echolalia or jargoning of longer phrases with intonation, repeating scripts from favourite tv shows or songs have many meanings and communicative functions. For example, a child who utters long strings of echolalic utterances, often difficult to understand, might want to do any one of the following:
- Comment
- greet
- ask a question
- make a request
- express surprise
- negate something.
We now understand that the way to support a child with echolalia is to acknowledge all utterances and try and find out what the meaning is behind these scripts. This is very supportive. Over time it will lead a child to move on to understanding and saying more clear and self-generated language. For more information about this Natural Language Acquisition here are some other great websites for you to look at:
- https://www.meaningfulspeech.com/
- https://communicationdevelopmentcenter.com/the-natural-language-acquisition-guide-echolalia-is-all-about-gestalt-language-development/
Conclusion

In conclusion, the journey of an autistic child’s development is a testament to the uniqueness and complexity of the human mind. The delays or differences in achieving milestones like crawling, walking, and talking can be attributed to a range of factors, including
- neurodevelopmental intricacies,
- sensory processing variations,
- and communication challenges.
It’s crucial to recognise that these delays are not indicative of a lack of potential, but rather a manifestation of the intricate interplay between an autistic child’s strengths and challenges. By embracing these differences and providing tailored support, we can help each autistic child unfold their potential at their own pace.

Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

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

A bite-sized guide to Speech and Language Therapy: feeding and swallowing
ByLondon Speech and Feeding October 7, 2024October 7, 2024
What is a Speech and Language – Feeding Therapist?

You’ve probably heard of speech therapists helping people who stutter or struggle to pronounce words. But did you know that they also work with children and adults who have problems with eating and swallowing? This specialised area is called Speech and Language Therapy: Feeding and Swallowing, or Dysphagia Therapy.

Why does a Speech Therapist help with eating and swallowing?

The mouth, tongue, and throat are all involved in both speech and swallowing. When there’s a problem with any of these parts, it can affect both your ability to talk and to eat. For example:
- Weak tongue muscles: Can make it hard to chew food and to form sounds.
- Difficulty coordinating swallowing: Can lead to choking or aspiration (when food or liquid goes into the lungs).
- Sensory issues: Can make certain textures or tastes feel unpleasant or overwhelming.
- Communication: If we are not able to express ourselves we are likely to have difficulties during daily mealtimes: how do we ask for ‘more’ of something, how do we say we have had enough or we don’t like a particular food?
How does a Speech and Language Therapist help?

Our work involves a combination of assessment and therapy. We carefully observe how your child feeds, eats and swallows, and we look into your child’s mouth to help us see what the cause of the difficulties are: could be a very highly-arched palate, it could be a very flaccid/low tone tongue, it could be poor dentition. Then, we create a personalised treatment plan to address your specific needs.

Here are some of the things we might do:
- Teach swallowing techniques: We can help your child learn strategies to improve or facilitate a safe swallow.
- Recommend dietary modifications: We may suggest changes to your child’s diet to make it easier to eat and swallow.
- Provide sensory therapy: If your child has sensory needs we can help your child become more comfortable with different textures, tastes, and smells.
- Work on oral motor skills: We can help to encourage more effective chewing, or drinking skills, or we can help your child to close his/her mouth more during chewing or drinking from a straw.
- Collaborate with other professionals: We often work closely with doctors, nurses, occupational therapists, and dietitians to provide comprehensive care.
What kinds of problems do Speech and Language Therapists help with?

We see a wide range of feeding and swallowing difficulties, including:
- Delayed feeding: Children who are slow to develop feeding skills or who have difficulty transitioning to solid foods.
- Tongue-ties: Babies can have significant difficulties with feeding when the tongue is very tightly tethered to the floor of the mouth.
- Refusal to eat: Children who refuse to eat certain foods or textures.
- Aspiration: When food or liquid goes into the lungs, which can lead to pneumonia and other serious complications.
- Chewing difficulties: Problems with chewing food, such as difficulty breaking down food or keeping food in the mouth.
- Swallowing difficulties: Problems with swallowing, such as feeling like food is stuck or choking.
- Neurological conditions: Conditions like cerebral palsy, down syndrome or other genetic syndromes can affect feeding and swallowing.
- Developmental delays: Children with developmental delays may have difficulties with feeding and swallowing.
Is there hope?

If your child is struggling with feeding or swallowing, know that there is help available. Speech and Language Therapy can make a significant difference in your and your child’s quality of life. We’re here to support you every step of the way.

Remember, you don’t have to suffer in silence. If you’re concerned about your child feeding or swallowing, please reach out. You can find a Speech and Language Therapist with a Feeding/dysphagia qualification near you via www.asltip.co.uk or contact me.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

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Speech and Language Therapy · Top tips

The importance of child-led therapy
ByLondon Speech and Feeding June 30, 2023May 31, 2023
Child-led therapy is essentially what it says, therapy sessions that are directed by your child. You may think how can my child’s Speech and Language Therapist focus on goals if sessions are led by my child.

Let us explain…

Your child will be more receptive and motivated to take part in therapy if they have some form of input. E.g., they can choose what toys they want to play with, or how they want to play with the resources available. If sessions are child-centred then they are much more likely to engage and reach their goals, making intervention valuable. They will also be able to regulate their emotions, and use movement to support their need for regulation. E.g., some children like to jump whilst others like to run. As Speech and Language Therapists we need to use what is meaningful to your child to get the most out of intervention. By focusing on child-led therapy, we can build trust, which will allow us, in time, to use new techniques and activities that your child may enjoy. We want children to be themselves, to show their true personality. Therapy is about enhancing their skills in their own individualised way and child-led therapy allows for this.

This way of working may seem daunting to some, but it doesn’t have to feel this way. Parents often feel if they are prepared then activities may go smoother. It might be the case, but perhaps it doesn’t give your child the opportunity for spontaneity. We’d like to suggest something that may lead to some surprises. Put out an activity that is your child’s favourite and then a completely new activity. Remember these activities don’t have to be complicated. Often, the simpler the better!

So, no need to plan, just place two activities out and see what happens! Look out for anything which surprises you, which activity did they prefer? Do they have any sensory preferences? The freedom of choice is a wonderful thing to explore. So, just go with the flow!

The kind of activities that are useful for child-led play can include:
- Hide and seek
- Cooking or baking
- An Exercise ball
- Small world play
- Pretend play
- Musical instruments (you could even have a go at making your own)
Child-led therapy is a very useful resource. We have it at our fingertips. We don’t need special resources. You just need yourselves and your child! Sometimes, child-led therapy can be tricky to put in place. It sounds easy but is much harder in reality. So, make sure you give it time and reflect on your experiences. Ask yourselves ‘what went well’, and ‘what could be improved’. E.g., perhaps you gave your child time to lead to begin with, but you didn’t give them enough time to think about their options during the activity.

How can parents become more child-led in the home environment?
- Pause and use silence. This gives your child the opportunity to lead.
- It’s perfectly natural to want to talk. Afterall, this is how adults maintain conversations. If you find yourself talking too much, count to ten! This will allow your child time to respond or initiate in the conversation or interaction.
- Move down to your child’s level. It’s much easier to see what’s going on if you’re at the same height.
- Videoing you and your child can really help you to see where your strengths lie. You’ll also be able to make minor tweaks to improve your communication during child-led play.
Contact Sonja for more advice on speech, language and communication during child-led play.

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

Tongue-Tie: A complex issue requiring careful assessment
ByLondon Speech and Feeding September 27, 2024September 29, 2024
Tongue-tie, or ankyloglossia, is a condition where the lingual frenulum, the thin piece of tissue that connects the underside of the tongue to the floor of the mouth, is too short or tight. Tongue-tie is quite common in babies and is often not detected after birth. Tongue-tie can lead to a difficult start with breast feeding as it makes it very difficult for the baby to latch effectively.

In my clinical experience as a feeding therapist, I have seen many babies who were not able to latch well due to the frenulum being tight. In many cases an experienced feeding speech therapist/lactation consultant can really make a difference and help a new mum to latch the baby even though the tongue is tethered to the floor of the baby’s mouth. In some cases the frenulum can be divided and once this has been done, in some cases, feeding improves immediately or soon after the division. But this is not always the case. I have seen several babies who have had as many as four tongue-tie divisions and feeding was still difficult.

It is important to say that while tongue-tie can sometimes impact speech and feeding, it’s important to note that it’s not always the root cause of these difficulties. In recent years, there has been a surge of interest in tongue-tie division surgeries, with some cases being unnecessary. It’s crucial to understand the complexities of tongue-tie and the role of speech therapy in addressing related challenges.

The impact of tongue-tie on speech and feeding

When tongue-tie is severe, it can interfere with the tongue’s ability to move freely, affecting speech production and swallowing. Some common speech and feeding difficulties associated with tongue-tie include:
- Feeding difficulties: Challenges with sucking, chewing, and swallowing.
- Drooling: Excessive drooling due to difficulty controlling saliva.
- Speech problems: Difficulty producing certain sounds, such as /l/, /r/, /t/, /s/ and /d/.
The importance of comprehensive assessment

Before considering any surgical intervention for tongue-tie, it’s essential to undergo a thorough evaluation by a qualified speech-language therapist (SLT). An SLT can assess the severity of the tongue-tie, its impact on speech and feeding, and determine if surgery is necessary.
- Functional assessment: The SLT will assess the tongue’s range of motion, its impact on speech sounds, and the child’s overall oral motor skills.
- Feeding evaluation: The SLT will observe the child’s feeding patterns and identify any difficulties related to tongue-tie.
- Differential diagnosis: The SLT will rule out other potential causes of speech and feeding difficulties, such as apraxia of speech, dysarthria, or sensory processing disorders.
The role of speech therapy

Even in cases where tongue-tie is present, speech therapy can often be highly effective in addressing speech and feeding difficulties. Here’s how speech therapy can help:
- Articulation therapy: Targeting specific speech sounds that may be affected by tongue-tie.
- Childhood Apraxia of Speech (CAS): if the diagnosis by the SLT has shown that in fact the child has motor planning difficulties then there are very specific and effective treatment programmes that help with this and can make a real difference over time.
- Feeding therapy: Strategies to improve swallowing, chewing, and oral-motor skills.
- Sensory integration: Addressing underlying sensory processing issues that may contribute to feeding difficulties.
London Speech and Feeding Case Study: The importance of comprehensive assessment

One of my clients was initially diagnosed with tongue-tie and recommended for surgery at the age of eight years old. His speech had been perceived by parents and teachers as ‘mumbled and unclear’.

However, after a thorough evaluation, I was able to determine that the child’s primary issue was apraxia of speech, a neurological disorder that affects motor planning for speech. Parents decided to wait with surgery and trust my judgment and we proceeded with weekly intensive speech therapy to address motor planning difficulties around tricky sounds and words. I am delighted to say that the child’s speech has improved significantly, demonstrating the importance of comprehensive assessment and individualised treatment. He is no longer seen as a candidate for an operation, which would have been traumatic for him at his age and, as it turned out, entirely unnecessary.

Below is a short video clip of my working on the /l/ sound with this child.

Using the Gingo Puppet from GingoTalk

Conclusion

Tongue-tie is a complex issue that requires careful evaluation and individualised treatment. While surgery may certainly be necessary in some cases, it’s essential to consider the potential benefits and risks. Speech therapy can be a highly effective approach for addressing speech and feeding difficulties associated with tongue-tie, even in cases where surgery is still required. By working with a qualified speech-language therapist, parents can ensure that their child receives the best possible care and support.

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.

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Autism Therapy · Neurodiversity · Printables · Speech and Language Therapy · Top tips

What to do when words don’t come fast enough
ByLondon Speech and Feeding November 26, 2025November 26, 2025
When children find talking hard, parents often face a difficult question: ‘Should we wait and keep encouraging speech? Or introduce something like AAC?’

AAC (Augmentative and Alternative Communication) can sound intimidating, but it simply means any way we support or replace spoken words, from simple gestures and picture boards to high-tech speech-generating devices. Far from ‘giving up on speech,’ AAC often becomes the bridge that helps children find their voice, in whatever form that takes.

💡 What is AAC, really?

AAC is a spectrum of tools and strategies that help people express themselves when speaking is difficult. It might include:
- Low-tech supports: Gestures, key word signs (like Makaton), picture symbols, or printed boards
- High-tech systems: Apps on tablets that speak aloud when pictures or words are tapped
AAC is not just for children who will never talk. It’s for anyone whose speech isn’t meeting their communication needs right now.

🤔 When to introduce AAC

There’s a common myth that you should only try AAC after ‘exhausting’ other speech therapy options. In fact, AAC can be introduced at any stage, even alongside speech development.

Here are some helpful signs that AAC might support your child:
- Your child understands much more than they can say.
- They rely on gestures, sounds, or behaviour to communicate.
- They become frustrated trying to express themselves.
- You find yourself ‘reading their mind’ to interpret needs.
- Speech progress feels slow or inconsistent.
If you recognise these patterns, AAC isn’t a ‘last resort’. It’s a communication support, not a replacement for speech.

Recent research consistently shows that AAC does not stop children from talking. In fact, it can encourage speech to develop. A 2024 systematic review and meta-analysis published in the Journal of Autism and Developmental Disorders found that children who received interventions combining naturalistic developmental behavioural approaches with aided AAC showed improved language outcomes, and that AAC ‘does not negatively impact speech development and may even facilitate spoken language growth’ (Smith et al., 2024).

🌉 How AAC supports speech development

Speech and AAC aren’t competing paths: they’re parallel tracks that often feed each other.

Here’s how AAC helps speech grow:
1. Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
2. Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
3. Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
4. Encourages turn-taking and social connection: AAC lets children join conversations even before speech is fluent, giving them more practice in real communication.
AAC is not ‘giving up on speech’. It’s giving a child more ways to succeed while speech continues to develop.

🧩 How to introduce AAC gently and effectively
1. Start small and meaningful: Begin with a few key messages your child wants to say, not just what adults want to hear. Think ‘I want’, ‘stop’, ‘help’, ‘more’, ‘all done’, ‘no’, ‘again’. These are powerful words for real interaction and autonomy.
2. Model, model, model: The most important part of AAC success is modelling—using the system yourself as you talk. For example: ‘You want banana 🍌’ and you tap the ‘want’ and ‘banana’ symbols. Children need to see and hear AAC used naturally before they try it themselves.
3. Use it throughout the day: AAC isn’t a therapy tool to take out once a week. It’s a living part of communication. Model a few words during mealtimes, play, and routines. The more consistently it’s embedded, the more fluent both you and your child will become.
4. Keep it accessible: If using a device or picture board, make sure it’s always nearby. If it’s in a bag or drawer, it can’t be used in real moments.
5. Celebrate all communication: If your child points, signs, uses a sound, or taps a symbol, it all counts. Respond warmly and naturally to reinforce communication in any form.
🧠 What parents often worry about
- ‘Won’t AAC stop them from talking?’: No. Research shows AAC use either has no negative effect on speech or leads to increased spoken output (Smith et al., 2024). When children feel understood, their motivation to communicate grows.
- ‘What if I model it wrong?’: There’s no perfect way to start. Your effort and consistency matter far more than accuracy.
- ‘Will they get ‘stuck’ using pictures?’: Some children do continue using AAC long-term; others move naturally toward more spoken language. The goal is always functional communication, not replacing one form with another.
🪞 Bringing AAC into daily life

Here are a few simple, parent-friendly ideas:
- Create visual spaces: Post symbols or core words on the fridge, mirror, or play area.
- Narrate routines: Use AAC during toothbrushing, dressing, or mealtimes; consistent contexts build understanding.
- Pair speech and touch: Always say the word aloud when you point to or tap a symbol.
- Involve siblings and friends: Model how they can respond to AAC too. ‘Oh, you said go! Let’s go fast!’
- Use shared books and songs: Pause and model key words in stories or songs.
🌱 The takeaway

AAC doesn’t mean giving up on speech; it means opening more doors to communication. When words don’t come easily, AAC gives children a way to connect, share, and be heard.

It helps parents move from guessing to understanding, and gives children the power to express themselves on their own terms.

If you’re unsure where to start, reach out to a speech and language therapist experienced in AAC. Together, you can find a system that fits your child’s strengths, build confidence in modelling, and help every word (spoken or tapped) feel like a step forward.

And download and print my one page summary.

Because when communication is possible, everything else begins to grow.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

📚 Reference

Smith, K., et al. (2024). The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta‑Analysis. Journal of Autism and Developmental Disorders, 55, 3078–3099. https://doi.org/10.1007/s10803-024-06382-7

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

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