How do we play with our Gestalt Language Processors?

ByLondon Speech and Feeding
| | |
Image by Freepik

Child-led therapy

When working with Gestalt Language Processors, it is always advisable to use child-led therapy. What does that mean? Child led therapy involves following a child’s interests and allowing her/him to lead the play activity throughout the speech and language therapy session. In other words, instead of having my own ideas of what we might want to play with or what activities I might try and use, I provide a range of toys I know the child likes or has played well with before; then I wait for the child to pick what she/he enjoys doing.

Play can be very repetitive and we can often see our child cycling back to the same one or two toys throughout the session. But this is what she/he needs to do at that time and it means that we have focused attention and engagement. This in turn is very helpful for the therapeutic process, which is to offer great scripts and phrases/words alongside what she/he is playing with.

Monotropic minds

Often the mind of autistic children is more strongly pulled towards a smaller number of interests or hobbies as I like to call them. Dr Dinah Murray, Dr Winn Lawson and Mike Lesser have found in 2005 that autistic people have ‘monotropic’ minds. They explain that autistic children focus their energy on a narrow range of activities as the energy required to switch between several toys is much higher than we would see in the neuro-typical population.

Gestalt Language Processors are often also Gestalt Cognitive Processors. This is when experiences are retained as episodic events and memories. An event is remembered by specific parts of the same event. And, therefore, these specific parts should always be part of that event, when the event is repeated.

Should any of the specifics be changed or are missing, then this can cause great upset to Gestalt Cognitive Processors. So, for example, if the last two times in speech therapy we had the train set out and this was played with happily, then this becomes a specific part of the whole session. If, I then don’t offer the train set the third time a child comes to see me, this could be very upsetting.

This is why I tend to try this out and see what happens. Usually in the 3rd or 4th session: I might not bring out the car run that has hitherto been super successful to see if we are able to transition well to other toys. If yes, then we can have new experiences but if not then I will re-offer the car run/or whatever toy pretty quickly so as not to cause complete dysregulation.

A few pointers below which help with child-led play:

Introduce a few new toys and see what happens

Parents are encouraged to bring some familiar toys their child likes to the session. We can then introduce a couple of different toys to see how we go. Try offering a new toy alongside the familiar one; try offering new toys without the familiar one present, but be prepared to re-offer the “old” toy should our child get upset.

Rotate toys and don’t offer out too many toys

I find that children can get overwhelmed and overstimulated by too many items out all at once. I always talk to parents about toy rotation at home and I encourage storage and ‘tidy up’ of toys so that we can increase attention focus, and also maintain freshness and new interest in older toys.

Some children are not yet ready to play with toys

Here I suggest people games: these are games where the adult becomes part of a more motor-based activity. Some call it ‘rough and tumble play’ but it can be nursery rhymes such as sleeping bunnies/row row the boat or peek-a-boo for the younger ones.

Copy/Imitation is so important – try getting two identical or similar play items

When we are copying our child, it is often not desirable to ‘take turns’ with their toys/blogs/cars etc as our child may not be ready to let us take a turn. Instead, if we have the exact same toy that our child is having then we can play alongside our child and copy them perfectly without interrupting their play.

References:

Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism, 9(2), 139-156.

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.

0

Similar Posts

Help! My child has a lisp. What can we do about it?

Help! My child has a lisp. What can we do about it?

ByLondon Speech and Feeding

What is a LISP?

There are different types of LISPS. Let me explain:

A lisp is the difficulty making a clear ‘S’ and ‘Z’. Other sounds can also be affected by the tongue protruding too far forward and touching the upper teeth or the upper lip even. ‘T’ and ‘D’ can be produced with ‘too much tongue at the front’ and this can also have an impact on ‘CH’ and often also ‘SH’.

  1. Interdental lisp

Protruding the tongue between the front teeth while attempting ‘S’ or ‘Z’ is referred to as interdental lisp; it can make the speech sound ‘muffled’ or ‘hissy’. Often, we associate a lisp with the person sounding a bit immature. The good news is that this type of lisp is the easiest to correct and, in my practice. I have a 100% success rate with this type of lisp.

  1. Lateral lisp

In a lateral lisp the person produces the ‘S’ and ‘Z’ sounds with the air escaping over the sides of the tongue. This renders the ‘S’ as sounding ‘slushy’ or ‘wet’. This type of lisp is a bit harder to correct than the interdental lisp. In my experience this can be fixed but it might need a bit longer, more intensive therapy than the interdental lisp.

  1. Palatal lisp

With a palatal lisp the ‘S’ sound is attempted with the tongue touching the palate, much further back than it should be. The ‘S’ sounds ‘windy’ and ‘hissy’. This is a quite rare lisp production but it is also not difficult to correct.

These types of speech difficulties come under the category of ‘speech delay of unknown origin’ and may persist into adolescence and adulthood as ‘residual errors‘.

Some thoughts on Treatment in general:

Lisps can be treated successfully by a Speech and Language Therapist. However, for the treatment to work well, a student needs to be able to cooperate and want to improve his or her speech. Lisp remediation entails a fair amount of repetitive work and very young children or unmotivated older children don’t make the best candidates for treatment for this reason. Often students present with other speech, language or social communication difficulties and here the lisp might not be the priority for treating. For example, it might be that due to a student’s Attention Deficit Disorder they are simply not able to focus on speech practice in their daily life.

When should treatment of lisp begin?

Waiting well past 4½ years is not advisable as the longer we wait and do nothing the stronger engrained the erroneous tongue/speech habit will become. The ‘right’ age for therapy for one child may be different from the ‘right’ age for another child even within the same family. So do make an appointment with a speech and language therapist to assess and see whether your child might be ready to start therapy.

Do lots of children lisp—is it normal?

Until the age of about 4–4.5 years old it can be a perfectly normal developmental phase for some children to have the interdental lisp. But when we see and hear a lateral or palatal lisp we ought to act and see a speech and language therapist for sure.

After the age of 4.5 or 5 years old most speech therapists would agree on at least having a look to see if treatment could be started. The longer we wait the harder it is to retrain the brain pathways to adopt new speech habits.

What happens during the first Speech and Language Consultation?

The first consultation takes about an hour and involves screening relevant areas of communicative function. We take a detailed history, examine the anatomy of the child’s mouth and tongue movements. We check for tongue tie, teeth formation, palate structure and function, as well as swallowing patterns.

Then we begin straight away to try and see if any of the alveolar sounds (T/D/L/N) can be produced correctly with the right tongue placement as that would be the starting point from where to shape a good, clear ‘S’ sound.

The first consultation usually ends with home practice being given, explained to parents and another appointment being made for follow up.

Therapy – what does a session look like?

Each therapy session consists of:

  1. Listening to sounds, discriminating sounds, identifying sounds, listening to rhyming sounds, sound awareness. We call this Auditory discrimination of single sounds: can the student hear the difference between two words that are the same apart from the first sound: ‘sing’ and ‘thing’ or ‘sigh’ and ‘thigh’?
  2. Sound production: using a variety of different prompts and cues we will teach how to physically make the new sound. Often, we work on making a NEW sound, instead of correcting the OLD one. We work on imitation of single sounds then gradually we try and make new sounds in short words, then longer words and then phrases and sentences.
  3. Games! We play games and try and have fun in between listening and producing our new sounds to help students stay motivated and even enjoy the therapy session and process.

How long does it take to ‘fix up’ a lisp?

It tends to take about one term with weekly sessions to help a student make good ‘S’ sounds in phrases and sentences. If the student can do the home practice every day in between the weekly sessions, then in most cases I am able to pronounce the lisp as ‘fixed’ after about one term.

After that the student needs to practise, practise, practise, at home and in daily life to keep reminding themselves of their new skills and their new sound production.

It is a matter of reminding and wanting to get it right. Occasionally a student returns to me for another term of simply practising their skills together with me as they are finding it hard for any number of reasons to practise at home. But generally, 8/10 students will be fine after some 12–13 sessions and their speech will be perceived as perfectly typical by family and friends.

If your child has a lisp or any other speech error, 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.

0
Attention Autism Therapy

Attention Autism Therapy

ByLondon Speech and Feeding
Sonja is kneeling on a multicoloured carpet holding a bucket in one hand and a toy in the other
Sonja

“Attention Autism” is an Early Years Intervention designed by Gina Davies, Specialist Speech and Language Therapist. Gina created this amazing therapy approach based on her many years of working with children on the autism spectrum. It aims to develop natural and spontaneous communication through the use of highly motivating activities. These activities offer your child an IRRESISTABLE INVITATION to engage and attend to.

I love using this approach and have trained in all of the stages including the Curiosity Stage which is for another blog. I use it frequently with all children who have trouble attending, listening, sitting or waiting regardless of whether they are neuro-diverse or neuro-typical, this activity and method is so great for all children!!

Why is it important for our children to attend and listen?

It is commonly assumed that, as our child has passed their hearing tests he/she will be able to listen and respond to being called, being questioned or asked to do something. However, all children I see in my practice have reduced joint attention skills, which means that whilst their hearing is often good, even brilliant to the point that they can often hear a faint noise somewhere outside the house like a distant train rushing by – but strangely they can’t seem to hear their name being called. Parents often ask me why this is the case, why can my child not turn round when I call him?

The reason lies in the difference between hearing and listening. Listening is a skill that needs to be learned and practiced. As a child develops, their hearing tunes into (listening) the sounds and noises they hear on a daily basis. This is how a child develops understanding of the speech sounds they hear every day (which then form the basis of their native language); they also get to know “their door bell, dog barking next door, daddy coming up the stairs” and so on. They tune into those common every day sounds and noises and gradually start to copy speech sounds to form words. So listening is tuning our ears to the sounds that surround us. In contrast, many of us have to work in large office spaces or noisy environment, perhaps even a café, etc, where we are able to tune out those environmental noises and sounds that surround us, for otherwise we will not get that report/piece of work done in time! Our focus means that we become single-minded and single-channelled concentrating on our work and so we do not hear people chat and clutter all around us.

Tuning in and out is a skill that we learn and some of us are better than it that others, it comes largely with practice but also with motivation – I go back to the report that needs doing by end of the day – my motivation is strong and I can now focus and blend out all around me so that I get the work done. Other times when I am not so motivated I might doodle and tune into what is being said at the table next to me, because my focus is not that strongly dedicated to my work.

Many children who are delayed in their development and especially children on the neuro-diverse continuum have difficulty with tuning in. By contrast, they are very good at being single-minded, single focused on what it is they are wanting/needing to do at any one point. And so they cannot listen to sounds, speech, noises around them very easily at all. They are fully absorbed in their activity and are not able to look and listen to mum/dad calling their name. Once we understand this we can start helping our children to practise tuning in a bit more bit by bit and day by day.

Enter the Attention Autism approach!

There are 4 stages to this method:

Stage 1: The Bucket to Focus Attention

The first stage involves filling a bucket with visually engaging toys that aim to help children learn how to focus their attention. Three toys will be presented to the child/group one at a time and the therapist will make simple comments about each toy to help introduce them to the children and expand their vocabulary.

Important to know: the Attention Autism approach does not require the child to look at the adult, or to sustain eye-gaze on the objects. Instead engagement may be indicated by non-verbal signals such as seeming alert and interested, and looking frequently at the object.

Stage 2: The Attention Builder

At this stage the child/group is introduced to visually stimulating activities. This stage aims to build and sustain attention for a longer period of time. Activities may include ideas such as:

  • Flour castles which can be built like sandcastles, using flour, a bowl and moulds
  • Erupting volcano activity
  • Wriggly worms foam – pile shaving foam onto an upside down plastic flower pot with the holes taped over; then slowly press down another plastic flower pot over the shaving foam and the foam will come through the top holes looking like wriggly worms, especially if you have dropped a bit of food colouring on top of the foam

Important: children are not required to make eye contact or sit still during these activities. The focus is on engagement, in whatever way the child demonstrates this.

Stage 3: The Interactive Game – Turn-Taking and Shifting Attention

The therapist demonstrates a simple engaging activity and invites children up to have a turn. This may be the same activity from stage 2 or something new. The aim is for children to learn to shift their attention from the group/sitting experience to doing something and then going back to sitting again.

Stage 4: Individual Activity

In the final stage of Attention Autism, the adult models an activity, and then each child is given the same equipment to use themselves. They do not have to copy exactly what the adult modelled. The aim is for the child watching to have a go independently with confidence, and then to take their materials back to the leading adult at the end. The activity should be engaging and enjoyable for the children. The Attention Autism approach aims to foster an interest in learning new things and to inspire communication in whatever form works for the child.

Ideally this should be practised 4-5 times a week aside from the therapy session. But I have seen it work with just 2-3 practice repeats per week. It can be tough in the beginning until your child gets used to the “no touch just look” rule but with a little bit of practice usually children do sit well for the first part of the Bucket activity within about 10 sessions and after that you are on a roll!

Do get in touch with me if you would like to find out more about this approach! Here is a great link to Gina Davis’s Autism Centre facebook site for more inspiration: https://facebook.com/ginadaviesautism/.

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.

Support your autistic child’s communication by learning the stages of Gestalt Language Processing
· ·

Support your autistic child’s communication by learning the stages of Gestalt Language Processing

ByLondon Speech and Feeding

If your child is using echolalia and/or has a diagnosis of autism, then your child’s way of processing language is most likely different to the classic way children typically learn language. We call this process Natural Language Acquisition or Gestalt Language Processing.

Speech Therpaist in London
Step by Step guide to Gestalt Learning

Let’s explore the following stages of Gestalt Processing:

Stage 1: communicative use of whole language gestalts

(e.g., “let’s get out of here”)

Children and young people in this stage use echolalia. They need to hear more gestalts or scripts. So, your job is to model, model, model and to use functional language that your child can repeat back.

Stage 2: mitigated into chunks and re-combining these chunks

(e.g., “let’s get” + “some more”) and (e.g., “let’s get” + “out of here”)

This is when you take parts of gestalts or phrases and then combine it with other parts.

Stage 3: further mitigation (single words recombining words, formulating two-word phrases)

(e.g., “get…more”)

They are going beyond their gestalts. Furthermore, they may begin to label different objects.

Stage 4: formulating first sentences

(e.g., “let’s get more toys”)

You may see more grammatical errors during this phase as they are creating unique sentences. Please don’t worry about this, it means they are playing and experimenting with language. As communication partners, you could model the correct form of the sentence.

Stages 5 & 6: formulating more complex sentences

(e.g., “how long do you want to play inside for?”)

You can see that language learning is a process, that is trialled and tested, used in different contexts for children to be able to learn and use language appropriately.

My next blog will give you activities ideas and how you might use them specifically with a Gestalt Language Processor.

Remember early intervention is vital. So, if you have any concerns, please seek the advice of a Speech and Language Therapist.

Contact me, Specialist Speech and Language Therapist Sonja here.

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

Empty Set and Phonology approaches

Empty Set and Phonology approaches

ByLondon Speech and Feeding

I have been avoiding the use of the Empty Set approach for the longest time as I was not sure if it would work seeing that I am challenging two sounds my student struggles with at the same time. But I decided to give it a go and it works a treat!

With this approach, we use two sounds that our student is struggling with. For example, in my video this student cannot produce /sh/ and /r/. Both sounds have different rules, so I decided to contrast them with each other.

  • The rules of /sh/ are: no voice, air is pushed out through teeth, produced at the front.
  • The rules for /r/ are: use your voice, produce the sound in the middle of the mouth by shaping your tongue in a particular way.

So I chose the words ‘shoes’ and ‘ruse’ as their rules are quite different. Contrasting two sounds the student does not know has been shown to lead to greater change in the child’s articulation. And I can certainly vouch for this as my student is making the best progress with this approach.

Phonology Therapy – what is it, why and how?

Phonology is the study of the sound system of a language. It’s distinct from articulation therapy which focuses on the physical production of sounds.

Phonology therapy focuses on rules. For example, sounds that are produced at the front of the mouth, in contrast to sounds that are produced at the back of the mouth, or sounds that are produced with a long air stream: /s/ or /f/ versus short sounds like /p/ or /t/; sounds are produced with voice or without voice.

Many children, and sometimes adults, are unaware of some of the speech rules and confuse and replace individual sounds. They might say TAT instead of CAT or SIP instead of SHIP.

A quick overview of phonology approaches I use:

Minimal Pairs:

This approach is good for single sound substitutions. We offer word pairs that differ by only one sound, like ‘ship’ and ‘sip.’ One of our first goal in therapy is to highlight the difference between the target sound (e.g., /sh/) and the sound the child uses (e.g., /s/). This helps discriminate and eventually produce the correct sound.

Multiple Oppositions:

A child might replace lots of sounds with a single sound like a /d/. So instead of ‘four’, ‘chore’ and ‘store’ our child says ‘door’, making speech very unintelligible.

The approach is typically geared towards shaking up the phonological system. Our goal is to choose two to four targets that are different from each other, and different from the substituted sound. If our child’s favourite sound is /d/ they can use their voice and make a short sound by stopping their airflow. So I will choose a different target sound to change up the speech system. For example I might choose an /f/, a /m/ and a /k/ sound. So I would contrast: ‘door’ with ‘four’, ‘more’ and ‘core’.

Maximal Oppositions:

In the Maximal Oppositions approach the treatment sets consists of words that are minimally contrasted and that have maximal or near maximal feature differences between each word pair. One word in a pair represents a sound the child ‘knows’ (can say at word level) and the other represents a sound the child does not know (cannot say).

For example, a child may ‘know’ /m/ and be able to say words like ‘man’, ‘mat’ and ‘mine’. However, the same child may be unable to say /f/ as in ‘fan’, ‘fat’ and ‘fine’. The consonants /f/ and /m/ are maximally opposed as follows.

I am always delighted to work on speech sound disorders, I love the challenge and the successes we can celebrate together. Get in touch with me!

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

1
Feeding therapy: A guide for parents and caregivers
· ·

Feeding therapy: A guide for parents and caregivers

ByLondon Speech and Feeding
Image by gpointstudio on Freepik

Feeding therapy is a specialised form of therapy and support that helps children develop healthy eating habits and overcome challenges related to food. It’s often used for children with picky eating, feeding disorders, or sensory processing issues.

What is feeding therapy?

Feeding therapy involves a series of techniques designed to improve a child’s eating skills and attitudes towards food. In the UK it’s typically provided by speech and language therapists and dietitians. These professionals work closely with parents and caregivers to create a personalised treatment plan tailored to each child’s unique needs.

How does feeding therapy work?

Feeding therapy sessions are typically 30–60 minutes long and involve a variety of techniques, including:

  • Family counselling: Providing support and guidance to parents and caregivers. This can help address any practical, behavioural and emotional issues that may be impacting the child’s eating.
  • Play-based activities: Engaging children in fun activities while introducing new foods or textures. This can help alleviate anxiety and make mealtimes more enjoyable.
  • Sensory exploration: Helping children become more comfortable with different tastes, smells, and textures. This can be achieved through activities like touching, smelling, and tasting various foods.
  • Oral motor exercises: Improving chewing, swallowing, and lip coordination. These exercises can help children develop the necessary skills for eating independently.
  • Behavioural techniques: Using positive reinforcement to encourage healthy eating habits. This can involve rewarding children for trying new foods or eating a variety of meals.

When is feeding therapy needed?

Feeding therapy may be beneficial for children who:

  • Are picky eaters: Refuse to eat a variety of foods or have strong preferences.
  • Have feeding disorders: Experience difficulties with eating, such as swallowing or chewing.
  • Have sensory processing issues: Are sensitive to certain textures, smells, or tastes.
  • Have medical conditions: Such as autism, cerebral palsy, or gastrointestinal disorders.

Feeding therapy strategies you can try at home

While professional feeding therapy can be invaluable, there are several techniques you can try at home to support your child’s eating development:

  • Create a positive mealtime environment: Make mealtimes enjoyable and stress-free by avoiding distractions, limiting screen time, and creating a calm atmosphere.
  • Create regular mealtimes and mealtime routines: Introduce set ways of announcing meal times, including songs or short nursery rhymes, try and involve your child with table setting, even just carrying their spoon to the table and putting the beaker next to the plate and ensure that meal time finishes after about 30 minutes, again with a set routine so that the child always knows: this is how we do it in our home, now I am finished and meal time is over.
  • Introduce new foods gradually: Start with small amounts and gradually increase exposure. This can help reduce anxiety and make new foods less overwhelming.
  • Model healthy eating: Show your child how to enjoy a variety of foods by eating a balanced diet yourself.
  • Avoid forcing food: Allow your child to choose and explore foods at their own pace. Forcing them to eat can create negative associations with food.

Seek professional help

If you’re concerned about your child’s eating habits, consult with a feeding therapist. We can provide guidance and support.

Remember, feeding therapy is a collaborative process between parents, caregivers, and professionals. With patience, understanding, and the right strategies, you can help your child develop healthy eating habits and enjoy meals.

Would you like to know more about specific techniques or have any other questions about feeding therapy?

Please feel free to contact me.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

1
Why teletherapy is great

Why teletherapy is great

ByLondon Speech and Feeding

Did you know that you don’t have to see a therapist with your child present to have improved communication? For younger children, evidence suggests that regular tailored interaction with parents/carers is as good as seeing a Speech and Language Therapist, with their advice followed. Often your child will respond better because they are in familiar surroundings with their favourite toys present. By learning the techniques I teach you in our weekly virtual zoom sessions, you can support your child’s language and communication every single day. This can be as good and sometimes even better than coming into clinic once a week. You’re embedding and generalising what your child is learning into everyday situations. This is important for your child’s communication development.

Speech Therpaist in London

It takes two to talk – the Hanen approach

The Hanen approach is about improving your child’s communication by tweaking your own communication style as parents and carers. It looks at your strengths and weaknesses in your communication with your child. You film a session playing with your child, and with a trained Hanen Speech and Language Therapist you review the video identifying strengths and weaknesses in your communication on a regular basis for a set period. For example, you may give your child plenty of time to answer questions, but you might identify from the video that you ask too many questions.

The Hanen approach works well online because:

  • Parents and carers can concentrate on the information they are given without interruption from their child
  • It is a process; you’re not told what’s right and wrong. It’s a process of discussion, reflection, and understanding by analysing the video footage
  • This method can be applied to daily activities, so together we can think about how it can be individualised specifically for your family situation
  • You can carry out the techniques in your own time when your child is well, calm, and willing to engage.

Online therapy is also ideal for older children (aged 7+) who have difficulties with speech, word-finding, sequencing, or executive functioning (planning and processing information) skills. You can see and hear the therapist and gain knowledge from their valuable expertise whilst saving you time, money, and energy resources. In addition, children tend to love technology, so the online resources are motivating and capture their attention.

Remove the barriers and start your online therapy journey today.

Contact me to learn more.

Sonja is a highly knowledgeable and experienced speech and language therapist. Don’t hesitate to contact her, especially if you are concerned that remote/zoom sessions aren’t as effective as ‘real life’. We have found quite the opposite! She has worked with us on Hanen and now troubleshoots when problems come up. This is such a wonderful way of working. She acts as your indispensable guide (a speech and language fairy godmother, if you like) but make no mistake, it’s your application of what she teaches you, on a day-to-day basis that results in the most change.

P. Goeldner


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.