How do we know our Gestalt Learner is moving to Stage 2?

ByLondon Speech and Feeding
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Is our student ready to move to NLA 2 (Natural Language Acquisition stage 2)?

We know that the GLP (Gestalt Language Processor) will move into the next stage when they are ready. But are they now ready you might think? When are they ready? How do I know? If you are not sure whether your child is ready to move forward then go and see your GLP trained Speech Therapist. Together you can work out what the next steps are and how to help your child settle into NLA 2. It’s very exciting!!

Tip

The first useful tip: keep a language sample of phrases your child says. This is very helpful!

You might want to check with your Speech Therapist and offer some language sampling you have taken so they can help you figure out where your child is currently. Always keep an Utterance Journal that you can share with your Speech Therapist and with others who look after your child.

Basically, we want to listen out for phrases our child says that you or nursery don’t say routinely; that way you can presume that this is not an echo but a mixing together of two chunks of gestalts. Watch out for those coco melon phrases though: double check it really isn’t an NLA 1 gestalt that is copied verbatim from a favourite you tube video.

You can best support your child best by listening, and thus figuring out what your child is TRYING TO SAY. Often your child might skip over the parts of gestalts they don’t want to say. This is common in older kids who have long gestalts, sometimes even whole episodes or whole stories!

Try and tease out their shorter mitigations and then focus on practicing and modelling those as they are so much more useful!

So back to our question: are they ready?

Are their gestalts covering a variety of situations and contexts?

Make a note in your journal to see what the backgrounds are to each phrase you ear, so for example:

  • Transitioning: ‘it’s time for the park’ ‘what’s next’ ‘shoes on’
  • Bed Time: ‘we need to wash’ ‘let’s get in (bath/bed)’ ‘ready for our book’
  • Toilet/nappy: ‘we need the potty’ ‘where’s the potty’ ‘let’s wash hands’
  • Mealtime: ‘time to eat’ ‘go get a spoon’ ‘yummy num num’
  • Park/going out: ‘look at the squirrel’ ‘funny doggy’ ‘I wanna swing’
  • At the shops: ‘let’s get the trolley’ ‘lots of veggies’ ‘no tomatoes’ ‘ooh long queue’ ‘back to the car’

And… does the child use the phrases for a variety of functions?

  • labelling
  • providing information
  • calling out
  • affirming
  • requesting
  • protesting
  • directing

We need to offer lots of similar language models so that in their own time our children can extract/mitigate useful phrases for what they want to express. The more similar utterances a child hears around him the more he/she can discover the communalities. Once the child has a small range of phrases, he/she can mix them up and create semi-original own phrases.

If the answer is YES!! our child has perhaps not all but a range of functions and a range of situations where they use a variety of easily mitigable gestalts then yes they are ready for moving to stage 2 of NLA!

Hurrah!

Keeping a journal of what your child is saying and in what circumstance is crucial to help with our ongoing detective work!

Next time I will be looking at how we can help our NLA 2 GLP produce even more of their own mix and match phrases.

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.

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  • ·

    A bite-sized guide to Speech and Language Therapy: feeding and swallowing

    ByLondon Speech and Feeding

    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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  • ·

    How we can help shape smooth consonant blends

    ByLondon Speech and Feeding

    For many children, especially those navigating Childhood Apraxia of Speech (CAS), the challenge isn’t just making individual sounds. It’s the ‘speech gymnastics’ required to move smoothly from one sound to the next.

    You might notice that instead of saying ‘Train’, your child says ‘Ter-ain’, or for ‘Frog’, you hear ‘Fer-og’. That sneaky little ‘uh’ sound in the middle is what we call a schwa vowel. In the world of speech science, this is known as epenthesis. It’s essentially a ‘repair strategy’ the brain uses to break up a difficult cluster of sounds into two easier pieces.

    While it might seem like a small detail, that tiny vowel makes a big difference in how fluent and clear a child’s speech sounds. In today’s post (and the video below), I am working with my student on ironing out that schwa by focusing on co-articulation—the art of getting the mouth ready for the second sound while still finishing the first.

    The ‘best friends’ strategy

    To help my student understand this complex movement, I use visual cues and a story. There are many ways to portray two sounds living closely together, but for this session, I used the ‘Best Friends’ story.

    In our story, the /T/ and the /R/ are older brother best friends who want to play together. The ‘schwa’ sound is represented by a little sister who keeps trying to jump in the middle of their game! Because my student has a younger sister, this scenario was instantly familiar and helped him visualise why we needed to ‘close the gap’ between those two sounds.

    Alternative methods I often use:

    Beyond stories, I often use other visual and tactile methods to show the closeness of two sounds:

    • The sliding finger: I draw two dots on a paper—one for /T/ and one for /R/. We slide a finger quickly from one to the other. I might say, ‘Don’t let the ‘uh’ monster jump in the gap!’
    • The rubber band: We stretch a rubber band as we speak. I tell my student that the word is one long, smooth stretch, rather than two separate ‘pops’.
    • Visual cues for ‘quiet’ sounds: I often put my finger to my lips or tap my throat to remind a child to keep the first sound voiceless. If the voice stays ‘off’ during the /T/, it’s much harder for that schwa vowel to creep in.

    The importance of ‘pure’ modelling

    A major hurdle in clearing up these blends is how we, as adults, model sounds. Often, when teaching the alphabet, we say ‘Kuh’, ‘Puh’ or ‘Tuh’. But if you listen closely, you’re actually adding a vowel! If a child learns that /K/ says ‘Kuh’, it’s only natural they will say ‘Kuh-R’ for /KR/.

    To give your child a cleaner blueprint, try modeling ‘pure’ sounds. Think of whispering rather than talking:

    • The /K/ sound: A short, sharp burst of air from the back of the throat. No voice! (A quiet /K/ click).
    • The /P/ sound: Just a ‘pop’ of air from the lips. If your throat vibrates, the vowel has snuck in.
    • The /T/ sound: A tiny tap of the tongue behind the teeth.

    Why is this important?

    You might ask, ‘If I can still understand them, does it really matter if they say “ter-ain”?’

    The goal of speech therapy isn’t just functional communication; it’s building phonological awareness. When a child adds extra vowels, it can eventually impact their literacy. If they hear ‘ter-ain,’ they are much more likely to eventually spell it as ‘terain’ or ‘traint’.

    By helping them master these clusters through co-articulation now, we are setting them up for success in reading and writing. And we are giving them the confidence to speak with ease.

    Feel free to contact me if your child needs help with clusters or other difficulties either aligned with Childhood Apraxia of Speech or other articulation difficulties.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    References

    • Hall, N. (2011). Vowel Epenthesis. In The Blackwell Companion to Phonology (eds M. Oostendorp, C.J. Ewen, E. Hume and K. Rice). In this work, epenthesis is defined as the insertion of a vowel to break up complex consonant clusters into simpler, more manageable syllables. This is often viewed as a ‘repair strategy’ used by the brain when a transition between sounds is too complex to execute quickly.
    • Aichert, I., & Ziegler, W. (2004) Brain and Language 88(1):148-59. Syllable frequency and syllable structure in apraxia of speech. This research highlights that children with Apraxia often struggle specifically with word-onset clusters, leading to distortions like the schwa.
    • Browman, C. P., & Goldstein, L. (1992) Phonetica 1992;49(3-4):155-80. Articulatory Phonology: An Overview. This paper explains that fluent speech requires ‘gestural overlap,’ where the movements for two different sounds happen simultaneously. This supports the ‘Best Friends’ method of keeping sounds close together.
    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.

    3

  • Submucous cleft palate: What is it and how does it impact on speech?

    ByLondon Speech and Feeding
    Submucous cleft palate: What is it and how does it impact on speech?

    What exactly is a submucous cleft palate?

    A submucous cleft palate (SMCP) is much less obvious than its counterparts, cleft of lip and/or palate, and can profoundly impact a child’s speech development. It leads to often extreme hyper nasal speech and difficulty with producing many sounds (/K/ /G/ /T/ /D/ /P/ /B/ /S/ /Z/ /F/ /V/).

    In short, the muscles and bone of the soft palate, and sometimes the hard palate, do not fuse completely during foetal development and the mucous membrane that lines the roof of the mouth remains intact, effectively camouflaging the underlying muscular and bony deficit.

    So, while the surface of the palate appears normal, the essential muscle and functions responsible for sealing off the nasal cavity from the oral cavity during speech are compromised. This cleft (or lack of muscle) can be seen as a bluish midline discoloration of the soft palate, often a bifid (split) uvula, and at times a notch in the posterior border of the hard palate can be felt upon palpation. However, these signs aren’t always present or easily discernible, contributing to the difficulty arriving at a diagnosis.

    Diagnosing a submucous cleft palate is often akin to searching for a needle in a haystack, especially for the untrained eye. Unlike overt clefts that are visually apparent at birth, an SMCP can go undiagnosed for years, sometimes well into childhood or even adolescence. Paediatricians and even ENT surgeons have been known to miss it during routine checks due to the intact mucosal lining. Parents might notice their child’s speech sounds ‘different’ or ‘nasal’ but struggle to pinpoint the cause. Children might undergo extensive speech therapy without a proper diagnosis, as the underlying structural issue continues to hinder progress.

    My experience as a speech therapist in private practice:

    Over my years of practice, I have encountered several children presenting with persistent hyper-nasal speech and significant difficulties producing plosive and fricative sounds.

    It has been incredibly rewarding, though at times challenging, to successfully diagnose SMCP in a number of these children. My approach often involves:

    • a meticulous oral motor examination,
    • careful listening for the specific qualities of hypernasality,
    • and a deep understanding of the physiological requirements for clear speech sound production.

    When I suspect an SMCP, I refer these children to Great Ormond Street Hospital where a fantastic multidisciplinary team, typically including ENT surgeons and a specialist speech-language therapist can conduct more definitive assessments. These assessments often involve instrumental analyses such as videofluoroscopy or nasoendoscopy, which provide objective measures of velopharyngeal function and visual confirmation of the anatomical deficit.

    The path to resolution: surgery, therapy, and successful outcomes

    Surgery

    The journey for these children, once diagnosed, often involves surgical intervention. It’s not uncommon for children with SMCP to undergo multiple operations to achieve optimal velopharyngeal closure. These procedures aim to reconstruct or augment the velopharyngeal mechanism, enabling it to effectively separate the oral and nasal cavities during speech. The specific surgical approach depends on the individual child’s anatomy and the severity of the velopharyngeal insufficiency. It’s a testament to the skill of these specialised surgeons that such intricate repairs can be performed with remarkable success.

    Speech therapy

    Following surgery these children embark on the crucial phase of speech therapy. While surgery addresses the structural problem, speech therapy helps a child learn to utilise their newly improved anatomy. It involves intensive work on developing oral airflow, establishing correct articulatory placement, and reducing learned compensatory strategies that have developed due to the original structural deficit. It is immensely gratifying to witness the transformation. Children who once struggled to produce basic sounds, whose speech was difficult to understand, gradually develop clear speech.

    Next steps?

    If you’re a parent concerned about your child’s speech and feeding, you’re not alone. The journey can feel confusing, but professional guidance can make all the difference. Never hesitate to have a second opinion when you have that niggling feeling that there is something that has not yet been explored. At London Speech and Feeding I specialise in being thorough and thinking outside the box.

    I am here to provide the support you need. Reach out to schedule a consultation and take the first step towards helping your child communicate and thrive.

    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
  • · · ·

    How parent coaching turns story time into a communication success

    ByLondon Speech and Feeding

    We often hear from parents who are trying their best to connect with their child, especially when reading books, but are met with frustration. They’ll say, ‘I read the book exactly as it’s written, but my child can’t focus for very long and just runs off!’ or ‘my child just flicks through the pages then turns it upside down and runs off with it’ or similar.

    It’s a common story. Traditional reading—going through the text from cover-to-cover—has its place of course, but for little ones with a language delay or autism it can move too quickly and place all the focus on the book’s words, not on the interaction.

    But what if I told you that story time could become one of the most fun and productive times for your child’s communication development?

    Watch the fantastic little video clip above! You can see the pure joy and connection between this dad and his son. This is the same family who, just a few weeks ago, felt defeated when trying to read a book, with their child quickly losing interest and leaving the reading/book corner.

    What changed?

    The power of parent coaching and Hanen principles

    The difference you see in the video is the direct result of parent interaction therapy, or parent coaching, based on the internationally recognised Hanen principles.

    I didn’t ‘fix’ the child. Instead, I coached the parents in a few simple, powerful strategies that completely changed the dynamic of their interaction. Instead of being a time for teaching and instruction, story time became a back-and-forth conversation.

    Here are the four major transformations that coaching helped this family achieve:

    1. From reader to play partner

    Before coaching, the parents felt their job was to read the text and to teach the words in it to their child. Now, their job is to follow their child’s lead. They learned to Observe, Wait, and Listen (OWL). If the child points to the tree or the badger on the page, the parent talks about the tree or the badger.

    The result

    The child is now initiating and leading the conversation! He is sharing what he finds interesting, which makes him feel powerful and keeps him deeply engaged.

    2. Building connection and attention

    When parents focus solely on reading, they often forget to make frequent eye contact and use animated facial expressions. The principles taught them to put the text aside and prioritise connection.

    The result

    Our little boy is looking at his dad more frequently, making great eye contact, and clearly having fun! When the interaction is fun, the child’s attention span naturally lengthens, allowing him to attend to the book and the interaction for a much longer time.

    3. Creating opportunities for communication

    The parents learned simple ways to prompt communication without pressure. They stopped asking knowledge-based questions (‘What colour is that? Or point to the pig!’), which can feel like a test.

    Instead, they learned to use techniques like ‘Saying less and pausing’ or ‘copying their little one’s echolalia ‘, signalling that they are very interested in what he is saying and that his communication matters!

    The result

    The child is now spontaneously using strings of sounds and gestures to communicate his needs and interests, knowing and enjoying his parents’ enthusiastic responses.

    This video is a testament to the fact that you are your child’s best therapist. With the right tools and coaching, you can transform everyday routines, like reading a book, into the most joyful and effective communication sessions.

    4. Acknowledging and interpreting echolalia

    In the video, you may hear the little boy repeat a phrase from the book or from what his dad just said. This is called echolalia, and for a long time, it was often dismissed or discouraged.

    However, a core principle of our parent coaching is that echolalia is communication. For children who are ‘Gestalt Language Processors,’ these memorised phrases (or ‘gestalts’) are their building blocks of language.

    The key is not to stop the repetition, but to become a ‘language detective’ and ‘interpreter’!

    By modelling the correct, first-person phrase right after the echo, parents/caregivers are teaching a child how to break down the ‘chunk’ and use the individual words functionally. They are showing their child: ‘I heard you. Your communication makes sense to me.’

    This strategy is a game-changer because it:

    1. Validates the child’s communication: It honours the child’s natural way of learning language, which boosts their confidence and willingness to communicate.
    2. Facilitates language development: It provides the child with the next step—a meaningful, functional phrase—to move them from repeating language to generating their own spontaneous sentences.

    Look at the child’s face again in the video. When his dad acknowledges and interprets his communication, you see that spark of joy and connection—that’s the moment when true, functional language learning happens!

    Ready to unlock the potential in your family’s story time? Contact me to learn more about our parent coaching programs.

    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.

    2

  • Why imitation is a powerful strategy to support social communication

    ByLondon Speech and Feeding

    Before reading this blog, it’s important to understand what we mean by ‘social communication’ and ‘imitation’. Social communication is more complex than it first appears. It refers to many aspects of communication such as body language, voice, conversational skills, social ‘rules’ (such as being polite and using manners), interpersonal skills (such as developing friendships), and emotional literacy (such as appropriacy and developing self-awareness). Imitation refers to the simple act of copying.

    You may have noticed that your child has difficulties in some of the areas mentioned above. They might be less responsive to you and appear to be quite happy in their own world. Whilst we do not want to change their unique characteristics, we do need to prepare them for future experiences, and what is socially acceptable.

    How will copying my child develop their social communication?

    1. If your child is already engaged with a certain activity, they are already interested and motivated. You’re not competing for their attention.
    2. Both yours and your child’s attention is on the same activity which makes imitating for you (as the parent) easier.
    3. Studies have demonstrated that when a parent imitates a child, they are more likely to look at the adult.
    4. Imitation not only supports eye contact but supports facial expressions (such as smiling), may increase vocalisations, and encourages your child to sit closer to you.
    5. Children learn through trial and error. They may start to try to perform new actions to gain their parents attention. Let your child lead the play!!

    How do I start imitating my child?

    1. Start with observing them. Take the time just to watch. You don’t need to make notes. Sit back and observe their actions, movements, and sounds they make.
    2. Wait for your child’s reaction when they realise you are copying their actions. Remember they may not notice, you don’t need to remind them, simply copy them again.
    3. Having the same set up as your child allows them to feel in control. So, you may have two sets of the same activity rather than copying using their set of toys.

    This may sound daunting, but it doesn’t have to be. Start with a ten-minute time frame where you choose to copy your child. This is where you can practise your imitation strategy. Ten minutes a day is far more effective than an hour every two weeks. You may feel self-conscious but trust the process. Build your confidence, whilst exposing your child’s to increased language and communication, enabling them to develop vital social communication skills.

    Look at the video above to watch the strategy in action!

    Support is only a click away. I’m here to help.

    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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  • 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.

    3