How can I incorporate AAC into my speech therapy sessions?

ByLondon Speech and Feeding
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Many parents are surprised when I bring AAC into a session, especially if they’ve come to see me primarily for speech sound work.

They might wonder: ‘If we’re working on pronunciation, why are we using a communication device?’

The simple answer is this: speech therapy is about communication first, and speech sounds second. Supporting a child’s ability to express themselves clearly and confidently is always the priority, and AAC can be a powerful tool alongside spoken speech.

What do we mean by AAC?

AAC stands for Augmentative and Alternative Communication.

This can include:

  • A speech-generating device (such as LAMP Words for Life or GRID as I used in the photo below)
  • A communication app on a tablet
  • A symbol board or communication book
  • Gestures, signs, or visual supports

AAC does not replace speech. Instead, it supports language development, reduces frustration, and builds communication success while speech skills are developing.

Pretend Play using Speech and AAC in my clinic room

But I mainly work on speech sounds… So how does AAC fit?

Most of the children I see are working on:

  • Articulation difficulties
  • Phonological delay
  • Motor planning challenges (including apraxia/dyspraxia)
  • Unclear speech affecting confidence

For these children, AAC isn’t a separate therapy. It’s simply woven naturally into what we are already doing.

If a child brings their device to sessions, I actively include it. If they don’t yet use AAC but could benefit from visual or symbolic support, I may introduce simple options within activities.

Using AAC to support speech practice

Let’s say we are working on early speech targets like: ‘GO’.

We might practise:

  • Saying the word verbally
  • Listening for the target sound
  • Using play (TOY TRAIN GOING ROUND A TRACK)

Now we can extend this using AAC.

On the device or communication board, we might model: ‘LET’S GO’ or ‘IT’s GOING up the hill’.

This allows the child to:

  • Practise their speech sound target
  • Build a simple sentence
  • Experience successful communication even if speech is not fully clear yet

All responses are valid and supported.

AAC helps children communicate more than they can say

Many children can understand and think in longer phrases than they can physically say.

For example:

  • A child who verbally says single words may build longer phrases on AAC.
  • A child who struggles to plan speech movements may use AAC to communicate smoothly while still practising verbal attempts.
  • A child who becomes frustrated when misunderstood gains a reliable backup system.

Rather than slowing speech progress, AAC often:

  • Reduces communication pressure
  • Increases participation in therapy
  • Encourages more attempts at speech
  • Supports language growth

When children feel understood, they usually become more motivated to try speaking.

There are no ‘prerequisites’ for AAC

One of the biggest myths I hear is: ‘My child isn’t ready for AAC yet.’

In reality, children do not need to:

  • Reach a certain speech level
  • Use pictures first
  • Prove they understand everything
  • Show immediate interest

Instead, we presume competence and introduce AAC in meaningful, playful ways.

That means:

  • Modelling words while blowing bubbles
  • Commenting during playdough activities
  • Choosing words during games
  • Building simple phrases in shared reading

AAC should never feel like extra ‘work’. It’s simply another way to join in communication.

My goal is always the same: to help each child communicate as clearly, confidently, and successfully as possible, using every helpful tool available.

If your child uses AAC (or might benefit from it)

 Please feel free to:

  • Bring the device to sessions
  • Show me how your child currently uses it
  • Share advice from school or other therapists

I am very happy to incorporate AAC into our work together so that speech practice, language development, and real communication all move forward hand-in-hand. Because ultimately, therapy isn’t just about producing perfect sounds. It’s about helping your child be heard and understood.

If you’d like support or advice, please contact me and I can help guide the next steps.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

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

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      Dynamic assessment – Let’s look beyond the checklist

      ByLondon Speech and Feeding
      Dynamic assessment – Let’s look beyond the checklist

      As a parent, you’re always observing your child, celebrating his or her milestones, and sometimes, wondering if he or she is quite on track. When it comes to speech, language, play, attention, and listening, these early years are a whirlwind of development! It’s natural to seek guidance if you have concerns, and that’s where a truly comprehensive assessment comes in.

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

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

      What makes an assessment ‘dynamic’?

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

      Dynamic assessment, on the other hand, is a living, breathing process. It’s called ‘dynamic’ because:

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

      More than just ‘speech’: A deep dive into development

      You might initially be concerned about your child’s speech sounds, or perhaps his or her ability to form sentences. These are vital areas, but my approach goes much further. I’m keen to understand:

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

      The art of observation

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

      This is where the magic happens:

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

      Why choose a clinician who offers dynamic assessment?

      In essence, a dynamic assessment provides a rich, nuanced, and truly personalised understanding of your child. It’s an investment in:

      • Accuracy: Leading to a more precise diagnosis and understanding of his or her unique profile.
      • Tailored support: Enabling the creation of highly individualised therapy goals that truly meet your child where he or she is and gently guide him or her forward.
      • Empowerment: You’ll leave with not just answers, but also practical strategies and a clear path forward, feeling confident and informed.

      If you’re seeking a thorough, empathetic, and truly insightful assessment for your child’s communication development in London, I invite you to get in touch. Let’s work together to unlock your child’s full potential.

      Sonja McGeachie

      Highly Specialist Speech and Language Therapist

      Owner of The London Speech and Feeding Practice.

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

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

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    • · ·

      Baby-led weaning: Empowering little eaters from the start

      ByLondon Speech and Feeding

      I had a mum ask me about Baby Led Weaning the other day. So I thought I would write a blog on all the useful questions she had and what we discussed as it may help lots of mums and dads out there.

      Image by Freepik

      As a Paediatric Feeding SLT, one of the exciting developments in recent years is the growing interest in baby-led weaning (BLW). This approach to introducing solids has gained significant traction, and for good reason. It empowers infants to take the lead in their feeding journey, fostering a positive relationship with food and supporting important developmental milestones.

      What exactly is baby-led weaning?

      At its core, baby-led weaning is about offering your baby appropriately sized and textured solid foods from the very beginning, allowing him or her to self-feed. Instead of spoon-feeding purées, you present whole, soft foods that your baby can grasp, bring to his or her mouth, and explore at his or her own pace. This means no mashing, no blending, and no forcing spoons into reluctant mouths. It’s a fun, messy, and intuitive process that is led by your baby’s natural instincts.

      The genesis of baby-led weaning

      ‘Baby-led weaning’ was popularised by British health visitor Gill Rapley. In the early 2000s, Rapley observed that babies naturally develop the skills needed to self-feed and that traditional spoon-feeding might actually hinder this development. Her work, particularly her book Baby-Led Weaning: The Essential Guide to Introducing Solid Foods (co-authored with Tracey Murkett), published in 2008, brought BLW into the mainstream and provided a structured framework for parents. Her research and observations highlighted the benefits of trusting a baby’s innate ability to regulate his or her intake and explore different textures.

      What’s the deal?

      Implementing BLW is simpler than you might think, though it does require a shift in mindset. Here’s a breakdown of what it typically involves:

      • Readiness is key: The golden rule of BLW is to wait until your baby shows clear signs of readiness. This isn’t about age alone, but rather developmental milestones. Your baby should be at least six months old, able to sit unassisted, have good head and neck control, show an interest in food (e.g., reaching for yours), and have lost his or her tongue-thrust reflex (which pushes solids out of his or her mouth).
      • Offer finger foods: Start with soft, easily graspable foods cut into finger-sized sticks or spears. Think cooked sweet potato fries, steamed broccoli florets (soft enough to mash with gentle pressure), banana sticks, or avocado slices. The goal is for babies to be able to pick it up and get some into their mouth.
      • Embrace the mess: BLW is inherently messy, especially in the beginning. Food will be squished, dropped, and smeared. This is a crucial part of the learning process as babies explore textures, smells, and the properties of food. A wipeable mat under the highchair and a good bib are your best friends!
      • Observe, don’t interfere: Allow your baby to lead. He or she will decide what to eat, how much, and how quickly. Avoid putting food into his or her mouth or pressuring him or her to eat more. This respects his or her hunger and fullness cues, laying the foundation for healthy eating habits.
      • Continue breastmilk or formula: Until your baby is well-established on solids, breastmilk or formula remains his or her primary source of nutrition. Solids are for exploration, taste, and developing skills, gradually increasing in quantity over time.

      The benefits of baby-led weaning

      The advantages of BLW extend far beyond simply getting food into your baby. From a speech and feeding perspective, the benefits are compelling:

      • Develops oral motor skills: Chewing, gnawing, and manipulating various food textures are crucial for developing the muscles in the mouth, jaw, and tongue. This strengthens the oral motor skills necessary for speech development.
      • Enhances fine motor skills and hand-eye coordination: The act of grasping food, bringing it to the mouth, and coordinating these movements significantly refines fine motor skills and hand-eye coordination.
      • Promotes self-regulation and intuitive eating: By allowing babies to control their intake, BLW helps them tune into their own hunger and fullness cues, fostering a healthy relationship with food and reducing the likelihood of overeating.
      • Encourages adventurous eating: Exposure to a wide variety of tastes and textures from the outset can lead to less picky eating later. Babies are more likely to accept new foods when they have been in control of their exploration.
      • Facilitates family mealtimes: BLW integrates babies into family mealtimes from an early age, promoting social interaction and making mealtime a shared, enjoyable experience.

      When is baby-led weaning appropriate, and when not?

      While BLW offers numerous benefits, it’s not a one-size-fits-all approach.

      When BLW is appropriate:

      • When your baby meets all the developmental readiness signs: This is paramount for safety and success.
      • When you are comfortable with the mess and the learning curve: It requires patience and a relaxed attitude.
      • When you are committed to offering a variety of safe, appropriate foods.
      • When you are willing to learn about and practise safe food preparation to minimise choking hazards.

      When BLW might not be appropriate (or requires extra caution and professional guidance):

      • If your baby has a history of prematurity or significant developmental delays: His or her oral motor skills might not be sufficiently developed.
      • If your baby has certain medical conditions or anatomical differences (e.g., cleft palate, severe reflux, swallowing difficulties): These may necessitate a modified approach to feeding.
      • If there are significant feeding difficulties, aversion, or a history of choking incidents.
      • If you feel overly anxious about choking: While BLW, when done correctly, is not associated with a higher choking risk than traditional weaning, parental anxiety can impact the feeding experience. Education and consultation with a professional can help alleviate these concerns.

      A note on safety: Choking hazards

      It’s crucial to understand the difference between gagging and choking. Gagging is a natural reflex that helps prevent choking and is very common in BLW as babies learn to manage food in their mouths. Choking is silent and serious. To minimise choking risks:

      • Always supervise your baby closely during mealtimes.
      • Offer appropriately sized and textured foods. Avoid small, round, hard foods like whole grapes, nuts, popcorn, and large chunks of meat.
      • Ensure your baby is sitting upright and calm.
      • Educate yourself on infant CPR.

      Final thoughts

      Baby-led weaning is a wonderfully empowering approach that celebrates a baby’s natural abilities and fosters a positive and independent relationship with food. As Speech and Language Therapists we often see the positive impact it has on oral motor development, self-regulation, and overall feeding confidence. By understanding what it entails, when it’s appropriate, and prioritising safety, you can embark on this exciting journey with your little one, helping him or her become a confident and capable eater from the very first bite.

      If you would like help and support with weaning your baby whilst continuing to breastfeed then please get in touch!

      Sonja McGeachie

      Highly Specialist Speech and Language Therapist

      Owner of The London Speech and Feeding Practice.

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

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

      1

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

      ByLondon Speech and Feeding

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

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

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

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

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

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

      An articulation activity – packaging practice into a little game

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

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

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

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

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

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

      Tele therapy activity using online materials plus a coreboard

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

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

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

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

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

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

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

      1
    • · ·

      The power of containment: A therapeutic approach for autistic children

      ByLondon Speech and Feeding
      Photo by lemonlenz

      The practice of wrapping or swaddling children, often referred to as ‘containment,’ has been used for centuries to soothe and comfort infants. I use this therapeutic approach with autistic children at the London Speech and Feeding Practice. While it might seem counterintuitive, the act of being tightly wrapped can provide significant benefits for children who struggle with sensory processing, emotional regulation, and communication.

      Understanding sensory processing and autism

      Autistic persons often experience challenges with sensory processing, which is their brain’s ability to interpret and respond to sensory information. This can lead to sensory overload or under-responsivity. Containment can be a valuable tool in helping children regulate their sensory input.

      Photo by lemonlenz

      To summarise, here are some of the benefits of containment:

      • Sensory Regulation:
        • Provides deep pressure input: The tight, enveloping sensation of being wrapped can provide deep pressure input, which is calming and organising for many children.
        • Reduces sensory overload: By creating a controlled sensory environment, containment can help to reduce overstimulation and promote a sense of safety.
      • Emotional Regulation:
        • Containment creates a sense of security: Being wrapped tightly can mimic the feeling of being in the womb, providing a sense of security and comfort.
        • Facilitates calming: The deep pressure input can help to calm the nervous system and reduce anxiety.
      • Improved Body Awareness:
        • Enhances proprioception: Containment can improve the child’s awareness of their body in space, which is essential for motor development and sensory integration. I often provide extra pressure on a child’s arms and legs sticking out of the yoga mat; this helps my child understand where their limbs are in space: I can feel my legs and I can feel my arms and I can feel where they are right now, i.e. they are under Sonja’s hand, I can feel them.
      • Facilitates Communication – and this is obviously where I come in as a Speech and Language Therapist:
        • Swaddling creates a safe space: When a child feels calm and secure, they are more likely to engage in communication.
        • Enhances joint attention: The shared experience of being wrapped can foster joint attention, which is essential for language development. You can see this one in my highlights where I swaddle my student in the yoga mat (picture above). She absolutely loves it, and what is more she is calm and steady when usually this child likes to be on the move constantly. Here we have a wonderful moment of joint engagement. She looks at me, she can listen to what I say or sing, and she can tell me in her own way to carry on rolling her or to carry on singing or providing calming pressure to her legs and arms or to stop.

      A few pointers for when you try this at home: How to practise containment safely and effectively

      • Create a safe environment: Ensure the wrapping material is soft, breathable, and free from any hazards.
      • Observe your child’s cues: Pay attention to your child’s body language and verbal cues to determine their comfort level.
      • Respect your child’s boundaries: If your child shows signs of distress, stop the containment immediately – this might seem obvious but sometimes we adults get so carried away with some ‘great idea’ that we have seen work elsewhere. And so we can be a little too ‘determined’ sometimes to ‘make it happen’… perhaps this rings a bell with some of my readers.
      • MAKE IT FUN: Start carefully and take it step by step. See if the student is having a nice time. It is all about trust and therefore it might not work the very first time you do it.

      It’s important to remember that containment is not a one-size-fits-all approach. Some children may respond better to other sensory-based interventions. However, for many autistic children containment can be a valuable tool in their journey towards improved communication and emotional regulation.

      For more information follow me on Instagram, Facebook or LinkedIn.

      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
    • ·

      The role of spinning and swinging in speech and language therapy

      ByLondon Speech and Feeding
      Sonja with a child on a swinging with a stuffed monkey

      Spinning and swinging are often observed behaviours in autistic children. While these actions might seem repetitive or unusual to some, they serve crucial functions for these children. Understanding the underlying reasons for spinning and swinging can provide valuable insights into how to support autistic children and incorporate these activities into therapeutic settings.

      Why do children spin?

      Spinning is a common sensory-seeking activity in autistic children. Sensory seeking means that the child actively looks for sensory input to regulate their nervous system. Here’s why spinning can be beneficial:

      • Vestibular input: Spinning stimulates the vestibular system, which is located in the inner ear and is responsible for balance and spatial orientation. For children with sensory processing difficulties, spinning can provide essential sensory input.
      • Calming effect: For some children, spinning can be a self-regulating strategy. The rhythmic motion can help to calm the nervous system and reduce anxiety.
      • Sensory exploration: Spinning allows children to explore their sensory experiences. It can help them understand their bodies and how they move in space.

      The allure of swinging

      The rhythmic back-and-forth motion of a swing offers several benefits:

      • Vestibular input: Like spinning, swinging stimulates the vestibular system, helping to improve balance and coordination.
      • Proprioceptive input: Swinging provides proprioceptive input, which is the sense of where your body is in space. This information is crucial for motor planning and coordination.
      • Calming and organising: The rhythmic motion of swinging can have a calming effect on the nervous system, helping to regulate emotions and improve focus.
      • Social interaction: Swinging can be a shared experience, fostering social interaction and communication.
      • Facilitating communication: While swinging, children are so much more relaxed and open to communication. The rhythmic motion can also help facilitate singing, humming, listening to my singing, non-verbal communication for sure but also more verbal and mouth words can be heard from children on my swing. If nothing else, it is so fun and helps build trust and rapport between my child and me.

      Therapeutic Activities Combining Spinning, Swinging, and Speech and Language Therapy

      Here are some therapeutic techniques that I use at London Speech and Feeding to combine movement with speech and language development:

      • Swinging with verbal prompts: While the child is swinging, I provide simple verbal prompts such as ‘up’, ‘down’, ‘fast’, and ‘slow.’ This helps to develop receptive language skills and improve auditory processing.
      • Sensory-motor play: I like to combine swinging with tactile activities like playing with textured balls or bean bags. This can facilitate language development through descriptive language, words and scripts like: ‘that’s so soft’, ‘oooh tickle tickle tickle!’
      • Storytelling on the swing: Often I manage to create a story while the child is swinging. This can improve narrative skills, vocabulary, and imagination. Recently I did the ‘Tiger who came to tea’ story and each time the swing stopped the tiger came and ‘ate some more cakes’ and ‘tickled their tummy’ whilst eating. It may make not much sense but my child loved it and we had ‘more tiger eat more’.
      • Song and rhyme time: Often I sing the ‘rumble in the jungle’ song while swinging my child to enhance phonological awareness, rhythm, and timing.
      • Visual supports always help: I use LAMP Words for Life AAC support during swinging and show core words such as: ‘go’ / ‘stop’/ ‘more’ / ‘tickle tickle’ etc. #lampwordsforlife #aac
      • Movement-based activities: We can incorporate activities that require sequencing, such as imitating animal movements or following simple commands while swinging. This can improve motor planning and language comprehension.

      For more information follow me on Instagram, Facebook or LinkedIn.

      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

    • What is Total Communication, and why your child might need it more than just speech

      ByLondon Speech and Feeding
      Sonja smiling

      When a child’s speech is difficult to understand, it can feel overwhelming for everyone involved. As a parent, your instinct is often to focus on helping your child ‘talk properly’. And that makes complete sense. Speech is important. But here’s the key message I want to share with you:

      Speech is just one way to communicate.

      And when speech is not yet clear, not yet reliable, or not yet available, children need other ways to get their message across.

      This is where Total Communication comes in.

      What is Total Communication?

      Total Communication is an approach that encourages the use of all available ways to communicate, not just speech.

      This can include:

      • spoken words
      • gestures and pointing
      • facial expressions
      • signing (such as Makaton)
      • pictures or symbols
      • drawing
      • electronic AAC (Augmentative and Alternative Communication), such as apps like LAMP Words for Life

      It’s not about replacing speech. It’s about supporting communication in every possible way.

      Think of it like this: if speech is currently unclear or limited, why restrict a child to the hardest route? Why not give them more tools to succeed?

      ‘But won’t this stop my child from talking?’

      This is one of the most common concerns I hear in clinic.

      Parents often worry that if a child starts using signs or a communication device, they will become ‘dependent’ on it and stop trying to talk.

      The research tells us something very different.

      Studies consistently show that AAC does not prevent speech development. In fact, it often supports it.

      • A review by Millar, Light & Schlosser (2006) found that AAC interventions do not reduce speech production and may actually increase it.
      • Romski & Sevcik (2005) demonstrated that children given AAC often develop stronger overall communication skills, including spoken language.
      • More recent work continues to show that providing AAC early can accelerate language development, not delay it.

      So rather than ‘giving up on speech’, using AAC is actually building the foundations that speech needs.

      Why Total Communication matters, especially for unintelligible children

      When a child is very difficult to understand, they are often experiencing a hidden frustration:

      ‘I know what I want to say, but no one understands me.’

      Over time, this can lead to:

      • reduced confidence
      • behavioural frustration
      • withdrawal from communication
      • fewer opportunities to practise language

      If a child cannot successfully communicate, they communicate less. And when they communicate less, their language development slows down.

      Total Communication breaks this cycle.

      By giving a child reliable ways to be understood, we:

      • reduce frustration
      • increase interaction
      • build confidence
      • create more opportunities for language learning

      And importantly, we allow them to show us what they already know.

      AAC is a bridge, not a barrier

      Using AAC (whether that’s pointing to pictures, signing, or using a device) does something powerful:

      It separates language from speech.

      A child might have lots of ideas, vocabulary, and understanding but their speech system (especially in cases like phonological disorder or childhood apraxia of speech) cannot yet keep up.

      AAC allows the child to:

      • express complex ideas now
      • practise sentence structure
      • develop vocabulary
      • take part in conversations

      All while their speech is still developing.

      In other words, AAC doesn’t replace speech. It keeps language moving forward while speech catches up.

      What does this look like in real life?

      In therapy, I often use a combination of approaches:

      • modelling simple signs alongside speech
      • pointing to symbols while talking
      • encouraging children to gesture or show
      • using drawings to support understanding
      • incorporating an AAC device such as LAMP Words for Life

      You might see a child:

      • say part of a word
      • point to a symbol
      • use a gesture
      • and look at you expectantly

      That is communication success.

      And success builds motivation.

      ‘I just want them to talk’

      Of course you do. And I do too!! That’s always the goal.

      But here’s the important shift in thinking:

      Children learn to talk by communicating, not by waiting until speech is perfect.

      If we hold out for clear speech before allowing other communication methods, we risk:

      • limiting their ability to interact
      • reducing practice opportunities
      • increasing frustration

      But if we support all communication, we give them:

      • more chances to express themselves
      • more positive communication experiences
      • more input and feedback

      And that is what drives progress.

      A balanced approach

      Total Communication doesn’t mean ‘speech is no longer important’.

      It means:

      • we continue targeted speech therapy
      • we work on sounds and clarity
      • and we support communication in the meantime

      It’s not either/or.

      It’s both/and.

      Final thought

      If your child’s speech is difficult to understand, the most important question is not:

      ‘Are they talking clearly yet?’

      It’s:

      ‘Can they successfully communicate?’

      Because communication is the foundation of:

      • relationships
      • learning
      • confidence
      • wellbeing

      And every child deserves a voice, in whatever form that voice takes right now.

      Feel free to contact me if your child needs help with speech and communication.

      Sonja McGeachie

      Highly Specialist Speech and Language Therapist

      Owner of The London Speech and Feeding Practice.

      References (parent-friendly):

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

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

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