How to model AAC with our minimally speaking students?

ByLondon Speech and Feeding
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modelling AAC

How should we start? Should we use prompts? What kind of prompts? hand-over-hand or just pointing? Should we wait, and, if so, how long? Introducing an alternative communication system (AAC) to our child is for many of us a confusing and sometimes scary prospect, but it needn’t be! Let me reassure you and share some tricks of my practice in this area.

Once we have decided to try for a picture based communication system, I usually start with a paper-based single page with between 48–88 core-words. I choose the number of words depending on where the child is developmentally and also verbally.

If a child does have a small handful of words already, I might start with the 88-cell board below. If, on the other hand, my student is completely non-speaking and still quite little then I might go for the 48-cell below here or I might have even less cells to start with. Again, sometimes I start with an electronic device in my clinic just to trial and introduce the idea and to see if, or how, a student responds. 

Below are some samples: a 49-cell board which I made for a child in a nursery setting

Below a Saltillo WordPower board that can be downloaded from the Saltillo website:

Example of a slightly more advanced board, again from the Saltillo Website

And here below one example of a board I made for a specific activity for a child who loves water and sand play:

It is perfectly possible to be very flexible and create a suitable board for any student, starting with as few as 2–5 cells and working up to over a 100 (very small ones) on a sheet of A4 or A3 paper.

So once we have a good board for our child, what now? How do we start introducing this into our daily life?

We can start by showing/pointing to the word GO within a play activity. For example:

  • a car run,
  • or a marble run,
  • or a spinner activity,
  • a wind-up toy,
  • anything that can be stopped and started easily.

How to start?

I will talk us through each of the steps using the example for the word ‘GO’.

First phase

The first phase is a TEACHING/ LEARNING PHASE. In this phase we do not expect our student to do anything, to copy us or to point to the board. If they do that it is of course a huge bonus and we will celebrate it.

Our job is to simply MODEL/SHOW/GIVE EXAMPLES of how we can use the board, by steadily and regularly pointing to the chosen word or words. We do so across the day and across settings:

  • play
  • meal time
  • getting dressed/undressed
  • bath time
  • going to the car/shops
  • etc

Once we can be sure that our student has been submerged and SOAKED in seeing the coreboard being used, say after some 3–4 weeks of using it consistently…

Second phase

We can begin to move into the second phase which is the PRACTICE PHASE. By now the student has seen the boards and he or she has seen the word GO (as a example) modelled many times.

Now we can start to see if we can tempt our student into trying this out for themselves.

What sort of TEMPTING are we talking about? Take a look at the Prompt Hierarchy below, which shows us what to do to get our student to be independently communicating as soon as possible. 

The PROMPT HIERARCHY: what sort of prompting should we do, should we expect something from our student or how should we view this stage?

  1.  TEMPT AND PAUSE

I have the AAC near to the toy and each time the child starts another round of the activity I say clearly ‘GO’ and I point to the picture as do so. I then pause and wait to see what happens. NOTHING? Then…

  1. USE SIGNS AND BODY LANGUAGE

Next time the child starts another round I might be very animated and do a Makaton sign for GO as I say ‘GO’ and I make a very over point to the picture again. Then I wait. STILL NOTHING? OK then…

  1. OPEN-ENDED QUESTION

Now I might say ‘GO’ and follow with: ‘OOH I WONDER IF THERE IS A PICTURE TO POINT TO…’

‘OH LOOK HERE IS GO!’ I then point to GO.

 STILL NO RESPONSE?

  1. ASK FOR A RESPONSE

I might say ‘GO’ followed by ‘LOOK! LET’S POINT TO GO HERE ON THE PICTURE.’

STILL NO RESPONSE? 

  1.  PHYSICAL TOUCH

Next time I say ‘GO’ I will try and take the student’s hand, help isolate their finger and help him or her to point to the actual picture.

REMEMBER: Prompting serves a very important function in scaffolding learning for students BUT if we are constantly prompting kids, then we are teaching them to only communicate when someone tells them to. We want our student to become as independent in speaking and using words as possible.

So once I have done Physical Prompting I will try and phase back down to number 1 where all I need to do is point to the picture or look at the board with the aim that the student will then point to the picture.

Take away points:

  • Keep the learning phase pressure-free and model without expecting our student to jump in. In other words, let’s model first without expectation. Later we can have a little bit of expectation.
  • After they’ve been exposed to and have been ‘soaked’ in plenty of AAC input, then, YES, we can create an opportunity to help them say or point to the word on their own.
  • We can model BOTH with and without expectation.
  • Only after LOTS of exposure, use the least to most prompting hierarchy and start creating opportunities for a student to become an independent communicator.

Do get in touch if you have any questions or comments or if you would like some practical help.

I am always pleased to hear from you.

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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    The quiet power: Why silence and responsiveness boost communication in children with delays

    ByLondon Speech and Feeding
    The quiet power: Why silence and responsiveness boost communication in children with delays
    Supplied by Sonja McGeachie, Practice Owner

    As parents and caregivers, our natural instinct when interacting with a child, especially one who struggles with communication, is often to fill every silence. We might ask lots of questions, offer constant commentary, or try to prompt him or her to speak. Our hearts are in the right place. We want to help him or her communicate! However, for children with language delays or those on the autism spectrum, this well-intentioned approach can sometimes inadvertently create more pressure and fewer opportunities for them to truly initiate and develop their own communication skills.

    What if I told you that one of the most powerful tools in your communication toolkit is often silence? And that responding to your child, rather than always initiating, can unlock incredible potential?

    Let’s explore why these seemingly simple strategies are so profoundly beneficial.

    The unspoken benefits of silence

    In our fast-paced world, silence can feel awkward, but for a child who is processing language differently, it’s a gift:

    1. Time to process: Children with language delays often need more time to process what they hear and to formulate their own thoughts or responses. When we bombard them with words, we don’t give their brains the crucial milliseconds they need to catch up. A pause of 5–10 seconds can make all the difference.
    2. Reduces pressure: Constant questioning or prompting can feel like a test. Silence removes this pressure, creating a more relaxed environment where the child feels safe to communicate without fear of being ‘wrong’ or rushed.
    3. Creates opportunity to initiate: If you’re always talking, when does your child get a turn to start the conversation? Silence opens up a space for him or her to initiate, whether it’s through a sound, a gesture, eye contact, or a word. This is vital for developing spontaneous communication.
    4. Encourages independent thinking: When a child is given space, he or she is more likely to try to figure things out himself or herself. This fosters problem-solving skills and reduces reliance on adult prompts.
    5. Prevents overwhelm (especially for ASD): Many children on the autism spectrum can be sensitive to auditory input. A constant stream of language can be overwhelming, leading to withdrawal or challenging behaviours. Strategic pauses can help them regulate and engage more effectively.

    The power of responding (not just initiating)

    Think of a tennis match: if only one person serves, it’s not a game. Communication is a rally, a back-and-forth exchange. When you primarily respond to your child’s communication attempts, you’re teaching him or her the rhythm of conversation:

    1. Follow the child’s lead: This is a cornerstone of effective language intervention, famously championed by programs like Hanen’s ‘It Takes Two to Talk’. When you respond to what your child is already interested in or doing, the interaction becomes immediately relevant and motivating for him or her.
    2. Validates his or her attempts: Every sound, gesture, glance, or partial word your child offers is a communication attempt. By responding to it, you’re telling him or her, ‘I see you. I hear you. Your communication matters.’ This builds immense confidence and encourages him or her to try again.
    3. Builds confidence and motivation: When a child feels understood and successful in his or her communication, he or she are more likely to communicate more often. It’s a positive feedback loop.
    4. Teaches turn-taking naturally: By taking your turn after his or hers, you model the natural flow of conversation. He or she learns that communication is a shared activity, not a one-sided lecture.
    5. Makes interactions meaningful: When you respond to his or her interests, you’re talking about things that are inherently motivating to him or her. This makes the language you use more easily understood and remembered.

    Practical strategies for parents: Observe, Wait, Listen (OWL)

    The Hanen Centre’s ‘Observe, Wait, Listen’ (OWL) strategy perfectly encapsulates these principles:

    • Observe: Watch your child closely. What is he or she looking at? What is he or she doing? What sounds is he or she making? What gestures is he or she using?
    • Wait: After you’ve observed, wait. Give him or her time. Resist the urge to jump in with a question or comment immediately. Count to five (or even ten) in your head. This silence is an invitation for him or her to communicate.
    • Listen: When he or she does communicate (in any way!), listen intently. Try to understand his or her message or intent.

    Beyond OWL – More tips:

    • Reduce questions, increase comments: Instead of ‘What’s that?’ try ‘Oh, a big red ball!’ or ‘The car is going fast!’ Comments provide language models without demanding a verbal response.
    • Expand, don’t just prompt: If your child says ‘Car’, you could respond with ‘Yes, That’s a big car!’ or ‘It’s really fast!’ You’re building on his or her communication with a slightly richer language model.
    • Create opportunities for communication: Place desired items slightly out of reach. This creates a natural reason for your child to communicate his or her wants (e.g., reaching, pointing, vocalising).
    • Respond to all communication: Don’t just wait for words. If your child points, look where he or she is pointing and comment. If he or she makes a sound, imitate it or respond with a related word.

    In summary

    Embracing silence and prioritising responsiveness might feel counterintuitive at first, especially when you’re eager for your child to talk. However, these powerful strategies create a nurturing, low-pressure environment that encourages spontaneous communication, builds confidence, and truly meets your child where he or she is. By giving your child the space and the meaningful responses he or she needs, you’re laying a strong foundation for his or her communication journey.

    Try incorporating these ‘quiet powers’ into your daily interactions and watch your child’s communication blossom.

    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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    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
  • · ·

    Great toys and books for our toddlers (around 1–2 years old)

    ByLondon Speech and Feeding

    As a speech and language therapist, I often get asked by parents what toys and books they should buy for their toddlers. It can feel overwhelming with so many options available! So, I’ve put together a list based on my experience and what I’ve found works well.

    Remember, every child is unique!

    Observe your toddler’s interests and play style. Some toys that are popular might not be engaging for your child.

    Here are a few ideas to get you started:

    Sensory Toys:

    • Stacking cups: These are fantastic for developing hand-eye coordination, fine motor skills, and understanding size relationships. (Various brands available) Note: You can stack many things you have around the house, like bowls or measuring cups, for a similar experience!
    • Shape sorters: Help with shape recognition, hand-eye coordination, and problem-solving. (Melissa & Doug, Vtech)
    • Sensory balls: Balls with different textures (soft, bumpy, squishy) provide tactile stimulation. (Various brands)
    • Push and pull toys: Encourage gross motor development and exploration. (Vtech, Fisher-Price)

    Communication-focused toys:

    • Picture books with flaps: Engage curiosity and encourage language development. (Various brands)
    • Talking toys: Introduce new vocabulary and encourage imitation. (Vtech, Fisher-Price)
    • Simple puzzles: Develop hand-eye coordination, problem-solving, and spatial awareness. (Melissa & Doug, Ravensburger)
    • Musical instruments: Encourage exploration of sounds and develop auditory skills. (Bright Starts, Fisher-Price)

    Now, let’s talk about books:

    • The Very Hungry Caterpillar by Eric Carle: A classic with repetitive text and vibrant illustrations, great for introducing vocabulary and concepts like days of the week.
    • Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr. and Eric Carle: Simple, repetitive text and engaging illustrations make this a favourite for many toddlers.
    • Goodnight Moon by Margaret Wise Brown: A soothing bedtime story with calming illustrations.
    • Pat the Bunny by Dorothy Kunhardt: An interactive book with textures and flaps to engage young children.
    • Corduroy by Don Freeman: A heartwarming story about a teddy bear who loses his button.

    Remember:

    • Observe your child’s interests: Choose toys and books that capture their attention and encourage exploration.
    • Engage with your child: Play with the toys together and read books aloud with enthusiasm.
    • Keep it simple: Start with a few toys and books and gradually introduce new ones.
    • Rotate toys: Keep playtime fresh by rotating toys and books regularly.
    • Most importantly, have fun! Reading and playing with your child should be a joyful experience for both of you.

    Also consider the power of open-ended play

    In today’s world filled with electronic gadgets, it’s easy to overlook the value of open-ended play. Open-ended toys lack specific functions or prescribed outcomes, allowing children to use their imaginations to explore and create. Unlike toys with pre-determined ways to play, open-ended toys encourage:

    • Creative thinking: Children can use them in countless ways, developing their own rules and narratives. A block can become a car, a house, or a spaceship, depending on the child’s imagination.
    • Problem-solving skills: Children learn to figure out how to use the toys, experimenting and adapting as they go. Don’t immediately rush in and fix things for your little one, let them think for themselves and then communication incentive: let them come and find you!
    • Fine motor skills: Many open-ended toys, like blocks, encourage the development of fine motor skills like grasping, stacking, and building.
    • Cognitive development: Children learn about cause and effect, spatial relationships, and problem-solving as they play with open-ended toys.
    • Social-emotional development: Open-ended play can foster social interaction and cooperation as children play together and share ideas.

    Simple toys with big impact

    Some of the best toys for toddlers are often the simplest ones. Here are a few examples:

    • Wooden blocks: Building towers, bridges, and forts encourages creativity and problem-solving.
    • Balls: Throwing, kicking, and rolling balls promote gross motor skills and hand-eye coordination.
    • Fabric: Bits of fabric can be draped, draped, and used for imaginative play.
    • Empty boxes: From cardboard boxes to tissue boxes, these can be transformed into anything a child can imagine: a car, a house, a spaceship!
    • Natural materials: Sticks, leaves, pinecones, and rocks can be used for imaginative play and sensory exploration.

    Remember, the key to open-ended play is to let children explore and discover

    Step back and observe, allowing your child to use his or her imaginations without too much direction. You might be surprised at the creative ways he or she uses simple toys!

    Happy play times with your little one!

    Contact me via my contact form.

    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 Hanen Program® – The beauty of the ‘4 S’

    ByLondon Speech and Feeding
    Image by freepik

    One of my favourite pieces of advice I give to parents is the ‘4 S’, a strategy coined by the Hanen Program® which I teach, particularly the ‘More than Words’ programme which is designed for and aimed at parents of children with Social Communication Difficulties or Autism. It is honestly one of those golden nuggets that I use myself in my practice and I highly recommend it to all my parents. There is something about terms like the ‘4 S’ that is easy to recall and therefore use.

    Introduction

    The ‘4 S’ is a strategy that helps to clarify the words we use with our children so that they can notice us, hear us and understand what we are saying.

    Research shows that we use on average 120-200 words per minute during everyday conversation. That’s a lot! And our children who are still learning to communicate are often bombarded with endless speech coming at them all day long. If we take into account that many of our students are Gestalt Language Processors, we can see that picking out relevant chunks of what we are saying is not at all easy, and this contributes to our children’s delays.

    So let’s look at the ‘4 S’

    1. The first one is SAY LESS

    This means we should use shorter, simpler sentences with good grammar, for example, something like: ‘let’s get ready, time to put our shoes on’ instead of what we might be saying: ‘come on then darling, let’s put your shoes on we need to get going it’s dark outside’ or similar.

    Good grammar helps to give clues about what words mean and how they are used in sentences. So, instead of ‘shoes on’ say ‘let’s put our shoes on’.

    2. The second one is STRESS

    I hear you think ‘I am stressed!‘. – NO! here it means ‘highlight’. We use our voice to highlight the important words in our sentence or phrase. For example, when you say ‘this banana is so yummy’ you can stress the word ‘yummy’ by saying it a bit louder and you can make a gesture, like rubbing your tummy as you say it.

    3. The third one is GO SLOW

    This means to speak a bit slower than you normally would and add pauses. By slowing down the pace of our speaking we give our child time to think and understand what we are saying. When we allow for pauses after we have spoken, we are inviting our child to say something in response.

    4. The last one is SHOW

    Always remember to show actions, gestures, objects, and point to pictures while speaking to help support your child’s understanding. We can show our child what words mean by pointing to things or holding up objects whilst describing or talking about them.

    At this point I would also like to recommend the use of Core Boards, and particularly Electronic AAC devices, such as LAMP Words for Life or PODD. I have written about this in other blogs but can always be persuaded to say a bit more on the matter… 😊 It is such a big help to have an AAC talker available for both the child and the adult so we can find words and pictures to help support the words we are saying.

    For example, today when reading a book like The Hungry Caterpillar (so good!) I used my LAMP AAC talker to make comments as we were looking at the pages together with my student. Example: ‘Look! He is eating more cake he is very hungry’ using my AAC talker I was able to supplement my speech and at the same time I was inviting my minimally speaking child to press a button or two and reply with ‘cake!’ which they would not have said with their mouth otherwise.

    5. It does say ‘4 S’ but really it should be ‘5’ except the fifth is not an ‘S’

    The fifth is REPEAT.

    Repeat words and phrases often throughout the day. When learning a language we all need to hear words and phrases several times and in different situations before we can understand, remember, and then eventually use them. Our children are ‘new language learners’ and so we can apply the same principles that we would when learning a new foreign language ourselves.

    Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

    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
  • · ·

    Chaining: A powerful tool for phonological development

    ByLondon Speech and Feeding

    Understanding chaining

    Chaining is a therapeutic technique I like to use in my speech therapy work with children who have Childhood Apraxia of Speech (CAS) or phonological speech sound difficulties. It helps to break down a complex target behaviour into smaller, more manageable steps. By systematically teaching and reinforcing each step, I can help my students achieve their communication goals.

    There are two types of chaining: Forward and backward chaining

    Today I am going to show and talk about backward chaining. This technique involves starting with the last step and working backward to the first. This approach can be particularly effective for children with persistent speech sound difficulties where combining consonants into clusters, such as /BL/ or /FR/ or /SHR/ is very difficult.

    Backward chaining allows my student to experience immediate success and build his confidence.

    In my video I show you how I applied backward chaining to the words ‘Shriek’, ‘Shrub’, ‘Shrimp’ etc

    My student struggles with both the /SH/ and the /R/ sounds and we have been working on both sounds for some weeks now. He has mild Childhood Apraxia of Speech and he has difficulties with coordinating his tongue movements, breathing and using his jaw effectively to make words. His sound repertoire has grown a lot since we started working together last year. Today in this session I show you how we pulled both the sound /SH/ together with /REEK/ to make ‘SHRIEK’. I love using the pictures and therapy materials from Adventures in Speech Pathology.

    This is also part of the Complexity approach which I will explain in a separate blog post.

    • Step 1 (not shown in the video): I explain what the word means; I find that when my student understands what a word means he is much better at saying it. It increases his confidence and motivation to say a word that he knows the meaning of. Often this student does not tell me that he does not know what a word means, so I always remind myself to check that out first.
    • Step 2 (not shown in the video): We do a little rhyming game and think about what any one word rhymes with: ‘Shriek’ – ‘meek’, ‘weak’, ‘seek’.
    • Step 3: I show my student that there are two parts to this word /reek/ and the sound /SH/.
    • Step 3: We practise the easier part: /reek/ /reek/ /reek/.
    • Step 4: We add the /SH/ sound and pull it together to make our target word ‘Shriek’.

    /REEK/ /REEK/ /REEK/ + /SH/ = ‘SHRIEK’
    /RUB/ /RUB/ /RUB/ + /SH/ = ‘SHRUB’
    /RUG/ /RUG/ /RUG/ + /SH/ = ‘SHRUG’

    By breaking down the word into smaller, manageable steps, my student can focus on each syllable individually, get that right and then gradually build up to the full word. This approach can help to reduce frustration and increase motivation.

    Forward chaining

    Forward chaining is the same process but in reverse: we start with the front sound or syllable and work forward towards the next/last part of the word:

    /SH/ + /REEK/ = ‘SHRIEK’
    /SH/ + /RUB/ = ‘SHRUB’
    /SH/ + /RUG/ = ‘SHRUG’

    Benefits of chaining

    • Increased motivation: By starting with the last step, my student experiences success, which boosts his motivation to continue trying to say the word and trying other words.
    • Reduced frustration: Breaking down the target behaviour into smaller steps can make the task less overwhelming, reducing frustration and anxiety.
    • Improved confidence: As the little learner masters each of the step, his confidence and self-esteem increases. Again, this leads to increased motivation.
    • Faster learning: By focusing on the final step first, and practising lots of chaining (forward and backward), a student can quickly learn to generalise to other words.

    Backward chaining (and forward chaining) is a really great tool for teaching complex speech sounds and words to children with phonological disorders.

    Watch out for my next blog which is all about the complexity approach in Phonology.

    Do get in touch if your child has a speech sound disorder, I would love to help.

    Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

    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
  • · · · ·

    Holiday disruptions & New Year routines: How to support your child’s feeding, communication and regulation over the festive season

    ByLondon Speech and Feeding
    Holiday disruptions & New Year routines

    The festive season is a wonderful time for many families, but for children with feeding challenges, sensory differences, or autism traits, December can feel overwhelming. Changes in routine, busier environments, travel, new foods, disrupted sleep, and well-meaning relatives giving ‘advice’ can all affect a child’s feeding, communication and overall regulation.

    As a speech and language therapist specialising in Early Years, I see the same pattern each year: children often make progress during the term, only to struggle in late December when everything becomes unpredictable. The good news? With a bit of preparation, children can not only cope better, but they can actually make significant developmental gains during the holidays.

    This blog will help you feel confident, supported and prepared for the transition from ‘festive mode’ to a smoother, regulated start in January.

    1. Why routines matter so much. Especially now

    Young children thrive on predictability. For neurodivergent children or those with sensory, feeding or communication needs, routine isn’t just helpful: it’s the backbone of emotional regulation.

    In December, typical patterns change:

    • Mealtimes shift or become irregular
    • Bedtime slides
    • New foods appear
    • Loud social gatherings overwhelm
    • Travel disrupts naps and comfort routines
    • Therapies pause
    • Childcare closes

    Any one of these can lead to feeding refusals, more meltdowns, increased stimming, reduced communication attempts or regression in speech sounds.

    It’s simply the nervous system responding to too much change.

    2. Protecting feeding progress during holiday mealtimes

    My last blog and insta post have a nice social story on festive meals. They are often the trickiest part of the season for families I support. Children with sensory-based feeding challenges, or ARFID traits may find holiday foods completely unfamiliar and challenging.

    What helps:

    • Offer one ‘safe food’ at every meal
    • Keep portion sizes tiny
    • Use the ‘buffet rule’
    • Rehearse tricky moments

    3. Supporting communication when routines are disrupted

    Holiday time actually offers more opportunities for communication, just in different ways.

    Strategies:

    • Slow down and follow your child’s lead
    • Use everyday routines as language opportunities
    • Keep AAC going even if casually

    4. Understanding holiday ‘regressions’ and know they’re temporary

    This is almost always due to nervous system overload. Children don’t truly ‘lose’ skills; they temporarily prioritise regulation over learning.

    5. A gentle January reset: How to start the New Year smoothly

    • Re-establish predictability early
    • Return to preferred foods
    • Book early support if needed
    • Focus on regulation first

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    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.

    Reference:

    Bronson, M. (2000). Self-regulation in early childhood. Guilford Press.

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