The festive season is a wonderful time for many families, but for children with feeding challenges, sensory differences, or autism traits, December can feel overwhelming. Changes in routine, busier environments, travel, new foods, disrupted sleep, and well-meaning relatives giving ‘advice’ can all affect a child’s feeding, communication and overall regulation.
As a speech and language therapist specialising in Early Years, I see the same pattern each year: children often make progress during the term, only to struggle in late December when everything becomes unpredictable. The good news? With a bit of preparation, children can not only cope better, but they can actually make significant developmental gains during the holidays.
This blog will help you feel confident, supported and prepared for the transition from ‘festive mode’ to a smoother, regulated start in January.
1. Why routines matter so much. Especially now
Young children thrive on predictability. For neurodivergent children or those with sensory, feeding or communication needs, routine isn’t just helpful: it’s the backbone of emotional regulation.
In December, typical patterns change:
Mealtimes shift or become irregular
Bedtime slides
New foods appear
Loud social gatherings overwhelm
Travel disrupts naps and comfort routines
Therapies pause
Childcare closes
Any one of these can lead to feeding refusals, more meltdowns, increased stimming, reduced communication attempts or regression in speech sounds.
It’s simply the nervous system responding to too much change.
2. Protecting feeding progress during holiday mealtimes
My last blog and insta post have a nice social story on festive meals. They are often the trickiest part of the season for families I support. Children with sensory-based feeding challenges, or ARFID traits may find holiday foods completely unfamiliar and challenging.
What helps:
Offer one ‘safe food’ at every meal
Keep portion sizes tiny
Use the ‘buffet rule’
Rehearse tricky moments
3. Supporting communication when routines are disrupted
Holiday time actually offers more opportunities for communication, just in different ways.
Strategies:
Slow down and follow your child’s lead
Use everyday routines as language opportunities
Keep AAC going even if casually
4. Understanding holiday ‘regressions’ and know they’re temporary
This is almost always due to nervous system overload. Children don’t truly ‘lose’ skills; they temporarily prioritise regulation over learning.
5. A gentle January reset: How to start the New Year smoothly
Re-establish predictability early
Return to preferred foods
Book early support if needed
Focus on regulation first
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.
‘What kind of speech difficulty does my child have?’
It’s a very understandable question. We often hear different terms such as phonological delay, articulation difficulties, or Childhood Apraxia of Speech (CAS), and it can be confusing.
The reality is that many children don’t fit neatly into one single category.
In fact, quite often I see children whose speech profile includes a mixture of difficulties. They might have some phonological patterns (where they substitute one sound for another) alongside challenges with motor speech planning, where coordinating the movements needed for speech is harder.
When this happens, therapy needs to be flexible, responsive, and tailored to the child sitting in front of us.
Example
Recently I filmed a short clip from one of my therapy sessions which shows exactly how this works in practice.
The child I was working with has difficulties with several speech sounds. Part of the challenge relates to a phonological pattern called fronting.
Fronting is when sounds that should be made further back in the mouth (like /K/ or /G/) are produced further forward instead.
At the same time, this child also shows signs of motor speech planning difficulty, which means the brain has to work harder to organise and sequence the movements of the tongue, lips and jaw for speech.
This type of profile can sometimes overlap with characteristics seen in Childhood Apraxia of Speech (CAS).
When difficulties overlap like this, therapy cannot rely on a single approach. Instead, it needs to draw on multiple evidence-based strategies.
That is exactly what you see happening in the clip. We started out generalising the /K/ sound which until recently had been replaced by a /T/ sound. Whilst looking at a sound loaded picture of /K/ sounds we somehow got talking about a ‘dent’ (I don’t recall how we got there!) but the ‘dent’ was a ‘det’ and I decided to tackle this there and then because there are other great words that end in ‘nt’ like : ‘count’ ‘giant’ ‘point’ or ‘paint’.
Using visual cues to support motor planning
Speech is incredibly complex. For children with motor speech difficulties, the challenge is not only knowing what sound they want to say, but also how to move their mouth to produce it.
This is where visual cues can be incredibly helpful.
In the clip, you can see me using a whiteboard with pictures and simple visual prompts. These help to:
Focus attention on the target sound
Understand where the sound occurs in the word
Remember the sequence of sounds needed
Visual supports can act almost like a map for the mouth, guiding children as they practise new speech movements.
For children with motor planning difficulties, this type of cueing can make a huge difference.
Why repetition of a single word (massed practice) is so important
Another key feature you will notice in the clip is lots of repetition.
This is very deliberate.
When we are supporting children with motor speech challenges, the brain needs repeated opportunities to practise the correct movement patterns. Just like learning a musical instrument or a new sport, repetition helps the brain build stronger and more efficient pathways.
In therapy we call this massed practice.
Rather than saying a word only once or twice, we practise it many times in a structured way, helping the child stabilise the new speech pattern.
But repetition alone is not enough. The child also needs to understand why the sound matters.
Showing children that sounds change meaning
This is where another powerful therapy approach comes in: minimal pairs.
Minimal pairs are word pairs that differ by only one sound. For example:
debt
dent
In the clip, I use these two words to help the child realise that the /N/ sound makes a meaningful difference.
Without the /N/, the word becomes something else entirely.
This approach helps children recognise that speech sounds are not random: they carry meaning. If a sound is missing or substituted, the message may change.
Helping children notice these differences can be a very motivating moment in therapy. Suddenly the sound is no longer just an abstract exercise; it becomes part of real communication.
Blending approaches for the best outcomes
In this short therapy moment, I am combining:
• Visual cueing
• Motor speech practice
• High repetition (massed practice)
• Minimal pair contrasts
• Listening and awareness of sound differences
Each element supports a different part of the speech system.
Some strategies help with motor planning, others support phonological awareness, and others build accuracy and consistency.
Together they create a therapy session that is both structured and responsive.
Every child’s speech journey is unique
One of the most important things I want to convey is that speech development is not always straightforward.
Two children may both struggle with speech sounds, yet the underlying reasons may be very different.
This is why careful assessment is essential, and why therapy needs to stay flexible as we learn more about how a child’s speech system works.
Sometimes a child needs more motor-based work.
Sometimes the focus shifts towards phonological contrasts.
Often, as in this example, the most effective therapy uses both.
Small steps lead to big progress
Every session helps us understand a little more about how a child’s speech system works and what support will help them move forward.
And when the pieces start to come together, when a child realises that one tiny sound can change a whole word, that is when the real progress begins.
If you are concerned about your child’s speech sounds, clarity of speech, or possible motor speech difficulties, early support can make a significant difference. A detailed assessment can help identify the nature of the difficulty and guide a therapy approach tailored to your child’s individual needs.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
Does your child say “Dough” instead of “Go”? Or “Tea” instead of “Key”? Do you hear a /Sh/ instead of an /S/ does “see” sound more like “she”?
We Speechies call this a Fronting Pattern which means that a sound that should be produced at the back of the throat with the back of the tongue, like K or G , is said at the front of the mouth with the tip of the tongue, like a T or a D or SH. When this happens speech can be really hard to make out because these sounds are literally everywhere in everyday sentences. Just think how many K’s and G’s we hear in a simple sentence?
For example, I heard my little student say earlier today: “I know what game we can play in your garden? It’s the one with cones and rings and cushions! I know where it is I can get it.”
But it sounded like:
“I know what DAME we DAN play in the DARDEN! It’s the one with TONES and rings and TUSHIONS! I know where it is I TAN DED it.”
If that sounds familiar to you, here is a little overview of what we can do about it:
First up it’s always good to start with general speech sounds awareness: does a child hear syllables and intonation? Do they know words that rhyme? Can they follow or copy a simple beat with a drum? Can they listen and hear quiet sounds and loud sounds and can they copy those? Can they follow mouth and tongue movements:, for example : stick out your tongue, lick your lips, click your tongue, blow raspberries?
Then it really helps to talk about BACK and FRONT of things and to draw attention to the back of the mouth and the back of the tongue and the front tip of the tongue and how sounds are made in the mouth. I often use a puppet to show this or a model of a mouth like this one here in the picture.
Next we try and listen to words starting with a BACK sounds like a K or a G , and I read out a list of words with those sounds: COW, CORE, CAT, CONE, KEY etc or ARK, EEK, OAK, ACHE…
Or GOO GUY GUM GONE
After that we try and see if a student can actually produce a single sound like a K or a G just by itself. If they can, that’s a really great start and if they can’t I help them to produce one – over a few sessions we usually get there. We call this Sound production in isolation.
Once a child can produce a sound correctly, on its own, we try and start working on very simple words that are really powerful like “GO”!!!!! in a motivating game or “CAR” for little ones who love a car racing track.
Now that we have established the back sounds and are using it in short words, we can gradually re-train brain pathways and oral- motor/movement pathways to use these new sounds in many words and then short phrases. That can take time!! This is called generalisation and it is not uncommon for it to take up a whole year for fluent speech to be error-free .
Why does it take so long? Being able to produce a correct and clear K or G sound does not mean it will be used easily. Our brain pathways are fixated or habituated to the error sound. It takes time for habits to change. A child might be able to hear the word TIGER with a G in the middle and she knows that it is not a TIDER but when saying it her tongue automatically moves forward rather than lifts up at the back. It’s a bit like a person who has a rounded back: the brain knows to stand upright and how not to slouch, but when we don’t focus on it, ooops we have slouched again because that is what we are comfortable doing and our body moves with our habit.
It takes effort and motivation to change our movement patterns and that includes our tongue and lip patterns! We usually get there through a huge variety of games and practice. Lots and lots of repetition is key as is motivation to change.
Parents and carers are crucial in the success of Speech Therapy!
We need your feedback at home, the regular short and sweet exercises, the constant positive encouragement and great modelling of speech sounds. We often find that parents are tuned into their child’s error sounds and can understand them much better than anyone else. This is great of course in many ways, however, it also means that the child has less motivation to change: if mummy understands me then my world is ok.
I will give you a short outline of what different speech therapy models I use in my practice, be it in clinic face to face or on-line in my future blogs soon.
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.
This is a surprisingly common speech error and it can be corrected really well in my experience. I have helped lots of children of all ages learn how to control their tongue movements and produce clear, sharp /S/ sounds and good /SH/ sounds.
Initial consideration
There are some factors which need to be considered before we can dive into therapy proper and these are they, in a nutshell:
The student is not currently displaying negative oral habits such as thumb sucking or excessive sucking on clothing. This is because thumb sucking exerts pressure on the teeth and therefore can, over time, push teeth out of their natural order/position.
The student does not have a restricted lingual frenulum or tongue tie which can cause at times restricted movements of the tongue (pending on how tight the frenulum is attaching the tongue to the base of the oral cavity); equally a labial frenulum or lip-tie can restrict lip movement and therefore physically restrict good speech sound production.
The student does not have enlarged tonsils as they can sometimes push a tongue forward and also cause open mouth posture and open mouth breathing.
The student’s motivation to change their speech pattern is high. (this is an important factor though with younger students I can get round this with a lot of fun games and good parental involvement!)
When I do an Oral Assessment of my student these are the first factors I want to look at and consider. Often I will refer to other agencies such as Orthodontists, dentists or ENT specialists to advise and help with some of these factors before we can get going. However, there are strategies that we can work on almost straight away.
Most of my Lisp students present with an open mouth posture: that is where the student has their mouth always slightly open for breathing. Over time the tongue starts to fall forward and rests on the front teeth or the bottom lip instead of finding a comfortable resting place either at the alveolar ridge (the bumpy spot behind the upper front teeth) or, alternatively, resting at the bottom of the mouth behind the lower front teeth.
Another common problem is that the tongue is not moving independently from the jaw and so is reluctant to pull back or lift up inside the mouth as the tongue is guided in movement by the jaw.
Combine those two factors and your tongue is not pulling back, or lifting up or doing very much at all without the jaw moving as well. This makes for unclear speech sounds, especially all the sounds we make at the front with our tongue or with our lips: /B/ /P/ /L/ /N/ and of course /S/ and /SH/ are particularly hard to make. We often also struggle with the /Y/ sound so ‘LELLOW’ instead of ‘yellow’.
Do not fear!
But no fear, these problems can be treated over time for sure! We often start with lip, tongue, and jaw exercises that help to move the tongue independently from the Jaw, our student learns that the tongue is a muscle and can be trained to do amazing acrobatic things in the mouth! WOW! It can actually pull back, lift up, and come down again all on its own!
We work on breathing, holding our breath for a bit then pushing it out and then holding it again.
And when it comes to the actual /S/ sound I often try and go a NEW route bypassing the Snake-Sound route if that is what had previously been tried and failed so that we can create completely new sound patterns in our brain and think about our sounds in a completely new way.
We then work on producing the sound /S/ on its own for a bit, at the end of words, then on either side of complimentary sounds, for instance : ‘EASY” – the sound patterns here are EEE-S–EE : the /EEE/ sound is complimentary to the /S/ sound as the tongue is at the right hight for the /S/ already once you have it in place for /EEE/ -……see?! EASY!
And gradually we work towards saying the /S/ sound clearly at the front of short words, then phrases and then sentences.
The process takes some time and it depends on how ready the student is. This varies of course hugely so I can never promise the exact number of sessions we will take to get that Lisp fixed. A lot depends on home practice in between sessions, and this is of course crucial to all therapy! Every day 15-20 mins practice is a good average time to aim for and when this is done it shortens the therapy block drastically.
I always give plenty of home work so there is never a chance of it getting boring or there being “nothing to do”!
Do contact me. I really enjoy working with this type of student and get a great kick out of FIXING THAT 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.
As professionals, when diagnosing young children with an Autistic Spectrum Condition, it is vital we work as a multi-disciplinary team, so you will likely see many professionals. This may include Educational Psychologist, Dietician, General Practitioner, Occupational Therapist, Paediatrician, Special Educational Needs Coordinator, Speech and Language Therapist and Social worker. Once the evidence is collated, then a diagnosis may be made.
You may be wondering what are some of the early signs of social communication difficulties? Whilst no autistic child is the same and we know Autism is very much a very wide spectrum of abilities and needs there are some autistic spectrum characteristics we do typically see in the early years of childhood. You may wish to think about these areas or presentations to help you prepare for the Speech and Language Therapy appointment.
Twelve questions
Does your child respond to their name?
Are they fixated with watching their hands?
Do they have sensory processing difficulties such as bright lights, food textures, or loud noises?
Are they meeting their milestones or are they delayed?
Do they flap their arms or legs when excited?
Have you noticed any rocking back and forth?
Do they blink excessively or display any facial tics?
Do they play with a particular sort of toy e.g. spinning toys?
Have you noticed that they lack interest in toys?
Have they regressed in their language? Perhaps you’ve noticed they are not using words that they have previously learnt.
Do they use gestures to communicate their needs? How do they communicate their wants and needs?
Do they appear to be in their own world?
You are not alone
These questions are by no means exhaustive and there are many more factors to consider. But it is important to trust your instincts as you are the expert on your child and know your child the best. Regardless of whether you see all of the above points or none, do not hesitate to have an assessment if you are concerned as, even if it turns out to be nothing to worry about, there is always at least one or two great pieces of advice I can offer you on the way and you will leave feeling hopeful and empowered. It’s always best to seek early intervention with communication difficulties. This allows strategies and support to be put in place. Never feel alone, always speak out.
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.
As a speech therapist, few things are as rewarding as helping a child find their clear, confident voice. Among the various speech sound disorders, the ‘lateral lisp’ – often described as a ‘slushy’ or ‘wet’ /S/ sound – presents a unique challenge. While it can be tricky to treat, I’m thrilled to share that I’ve had significant success in helping children overcome this particular hurdle.
What is a lateral lisp?
Most people are familiar with a frontal lisp, where the tongue protrudes between the front teeth, resulting in a /TH/ sound for an /S/ (e.g., ‘thun’ for ‘sun’). A lateral lisp, however, is different. Instead of the air escaping over the front of the tongue, it escapes over the sides, often giving the /S/ and /Z/ sounds a distinct, muffled, or ‘slushy’ quality. This happens because the tongue is not forming the correct central groove, allowing air to spill out laterally.
The science behind a perfect /S/ vs. a slushy one
To understand how to fix a lateral lisp, it’s helpful to understand how a ‘perfect’ /S/ sound is made. Imagine a narrow, focused stream of air. For a clear /S/ sound, your tongue forms a shallow groove down its centre, directing a precise, thin stream of air right down the middle, over the tip of your tongue, and out through a tiny opening between your tongue and the roof of your mouth, just behind your front teeth. This focused airflow creates that crisp, sharp /SSSS/ sound we recognise.
Now, picture what happens with a lateral lisp. Instead of that neat, central channel, the tongue is often flatter or positioned in a way that allows the air to escape over one or both sides. Think of it like a river overflowing its banks – the air, instead of flowing in a controlled stream, spills out sideways, creating that characteristic ‘slushy’ sound. This lateral airflow is what we need to retrain.
Why is it tricky to treat?
Treating a lateral lisp can be challenging for a few reasons:
Habitual muscle memory: The way the tongue moves and positions itself for a lateral lisp is deeply ingrained. It’s a motor habit that needs to be unlearned and replaced with a new, more precise movement.
Subtle differences: The difference between a lateral lisp and a correct /S/ sound can be quite subtle to perceive, both for the child and sometimes even for parents. This makes it harder for the child to self-monitor and correct.
Oral motor control: It requires fine motor control of the tongue muscles to create and maintain that central groove for airflow.
My success with children aged six years and over
I’ve found great success in treating lateral lisps, particularly with children aged six years and older. Why this age group? By this age, children typically have:
Increased awareness: They are more aware of their speech and often more motivated to make changes. They can better perceive the difference between their ‘slushy’ /S/ and a clear one.
Improved cognitive skills: They can understand and follow more complex instructions and strategies.
Better self-monitoring: Their ability to listen to themselves and correct their own speech improves significantly.
Enhanced oral motor control: Their fine motor skills, including those of the tongue, are more developed, allowing for greater precision.
My approach focuses on a combination of auditory discrimination, tactile cues, and targeted myofunctional exercises to help children ‘feel’ the correct airflow and tongue placement. We use a variety of engaging activities to make the process fun and effective.
It is crucial to understand tongue functioning and focusing on correcting improper oral resting posture and muscle function, which are often significant contributors to a lateral lisp. For example, if the tongue rests low and wide in the mouth consistently, or if there’s a tongue thrust during swallowing, these habits can prevent the tongue from achieving the precise, midline placement necessary for a clear /S/ or /Z/ sound. Through targeted exercises I aim to re-educate the oral and facial muscles, promoting correct tongue posture at rest, during swallowing, and, ultimately, during speech production. By strengthening the muscles responsible for tongue lifting and encouraging a more appropriate swallowing pattern we can establish the correct oral motor skills needed to overcome a lateral lisp and achieve clearer articulation.
The recipe for success: Little and often
The single most crucial ingredient for success in treating a lateral lisp is daily home practice of all the strategies given. This isn’t about long, arduous sessions; it’s about consistency. Think of it like building a muscle: short, frequent workouts yield better results than sporadic, intense ones.
My recommended formula is ‘little and often’. This means:
Short, focused sessions: Aim for 5-10 minutes of practice, 2-3 times a day. This prevents fatigue and keeps the child engaged.
Integrate into daily routines: Practise while waiting for dinner, during a car ride, or before bedtime. Make it a natural part of their day.
Positive reinforcement: Celebrate every small success! Encouragement goes a long way in building confidence and motivation.
Parental involvement: Parents play a vital role in providing consistent cues and encouragement at home. I equip families with clear, easy-to-follow strategies.
Overcoming a lateral lisp requires dedication, but with the right guidance and consistent practice, a clear, confident /S/ sound is achievable. If your child is struggling with a ‘slushy’ /S/, please don’t hesitate to reach out. Together, we can achieve success!
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.
Childhood Apraxia of Speech (CAS) is a complex neurological disorder that affects a child’s ability to plan and coordinate the movements necessary for speech production. Children with CAS often have difficulty with articulation, prosody, and fluency, making it challenging for them to communicate effectively. While there is no cure for CAS, speech and language therapy can significantly improve a child’s communication skills and overall quality of life. Understanding the principles of motor learning is crucial for both parents and speech therapists to support children with CAS on their speech journey.
What is MOTOR LEARNING?
Motor learning refers to the process of acquiring and refining new skills through practice and experience. This applies to all aspects of movement, including speech production. The brain constantly receives sensory information about the movements being made and adjusts them based on the desired outcome. A breakdown or interruption of this process can make it difficult for children to plan, sequence, and coordinate the intricate movements involved in speech.
What key principles do we use in speech and language therapy for motor learning?
Task Specificity: Speech Therapy activities that directly target the specific speech sounds or skills your child is working on. For example, if your child is struggling with /p/, practising isolated /p/ sounds, words with /p/, and phrases with /p/ would be most beneficial.
Massed vs. Distributed Practice: We consider the optimal amount and distribution of practice sessions throughout the day. Massed practice involves concentrated practice in a single session, while distributed practice spreads practice sessions throughout the day. The best approach depends on the individual child’s learning style and attention span.
Feedback: We provide clear and immediate feedback to help your child understand the accuracy and effectiveness of their attempts. This feedback can be auditory, visual, or touch based.
Error Correction: We aim to gently correct errors so that we can help your child refine their movements and avoid developing bad habits. The focus is on providing specific cues and guidance rather than simply pointing out mistakes.
Variety and Progression: We gradually introduce new challenges and variations in speech therapy activities to prevent plateaus and maintain motivation.
Motivation and Engagement: A big part of our work is to make therapy sessions fun and engaging to keep your child motivated and actively participating. We use games, songs, and activities that your child enjoys while incorporating targeted practice opportunities.
What about home work?
Yes we need your help and here are some examples of how this could look:
Task Specificity: During story time, focus on practising target sounds present in the story. Have your child repeat words or phrases containing the sound and encourage them to identify the sound in other words.
Massed vs. Distributed Practice: Instead of one long practice session, try shorter, more frequent sessions throughout the day. This can help maintain focus and prevent fatigue. It is recommended to go for 100 repetitions of the target sound per day, every day in between the sessions. We can decide together how you can best do that through either massed or distributed practice. We can decide after the session.
Feedback: Use a mirror to provide visual feedback on lip and tongue placement during sound production. Record the child’s speech and play it back to help them self-monitor their accuracy.
I quite like this mirror below but any table top mirror will work as long as it is not too small. Your child should see their whole face easily.
Error Correction: If the child makes an error, gently model the correct sound or movement without shaming or criticising. Provide specific cues such as ‘lips together’ for /p/ or ‘tongue up’ for /t/.
Variety and Progression: We will guide you on exactly what words to practise so this is something you need not worry about.
Motivation and Engagement: Use games, songs, and activities that your child enjoys. Play a game of ‘I Spy’ focusing on words with the target sound or create silly sentences with the sound to make practice fun.
Let’s work together!
It is crucial for parents, therapists, and other caregivers to work collaboratively to ensure a consistent and comprehensive approach to supporting your child’s speech development. Speech and Language Therapists can provide guidance and resources on implementing these principles at home, while parents can share observations and progress updates to inform therapy sessions.
Remember, every child with CAS learns at their own pace. By understanding and applying the principles of motor learning, parents and speech therapists can create a supportive and stimulating environment that empowers children with CAS to reach their full communication potential.
Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.
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.
