Let’s relax about making EYE CONTACT already…

ByLondon Speech and Feeding April 19, 2023April 11, 2023

Autism Therapy | Speech and Language Therapy

There’s been a long tradition with teaching staff and with Speech and Language Therapists working in schools that eye contact should be a goal. It is well known that Autistic individuals (whether that be children or adults) mostly avoid eye contact. Whilst it’s part of the way we communicate, it shouldn’t be used as a necessity for an individual who feels that it is uncomfortable. Whilst it does show that you’re listening and showing an interest, it’s not a fair expectation for neurodiverse children.

Autistic children can find making and maintaining eye contact physically and emotionally uncomfortable as well as unnatural. It adds an extra layer of stress and has been reported to increase distractions rather than reduce them. Children who engage in conversations in their own way (i.e., with reduced eye contact) are not shown to suffer with schooling, work, or social interaction.

By having fun through meaningful activities, I often experience that ‘BINGO’ moment (a phrase coined by Alex @meaningfulspeech) where the child is enjoying themselves and naturally makes eye contact. There is no demand on them, they are in a fun, engaging environment which suit their strengths and supports their needs.

Following this, I often reflect on this question ‘Should we make eye contact as a goal?’

It very much depends on the situation. If it places more demands on the child and becomes stressful. Then no. There are many strategies we can use which gain eye contact without placing extra demands on the child. We need to be mindful to adapt the environment and not place neurotypical expectations to meet the needs of neurodiverse children.

How can you encourage eye contact without demand?

If you’re using toys, try holding them up to your eye level.
You can adjust your position, try sitting face to face during play.
Always get down to your child’s level. This might mean that you lay on the floor if your child is positioned in this way.
During play, waiting is extremely powerful. Before a key part of the activity, wait and see if your child looks at you. Remember silence is golden!
The best way I find is: do something unusual during play. It might be that you spray shaving foam with the lid still on. Or you bring out a wow toy and make it spin/light up or make a noise. A balloon can be good – see video clip. Use the excitement of the activity, and wait to see if you achieve that ‘BINGO’ moment.
Create opportunities when there are no toys involved such as during ‘tickles’ or ‘hide and seek’. Autistic children find it difficult to shift their attention between a toy and an adult. So by removing one option, you’re setting them up to succeed.

Remember, it takes practice and time for you to develop these skills. Try one at a time and experiment, see which works best for your child. If you need speech, language or communication support or advice, I am always 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.

Ages and Stages · Speech and Language Therapy · Top tips

Ages and Stages: 0–3 months

ByLondon Speech and Feeding December 18, 2024December 11, 2024

What do we offer our babies from 0–3 months old? What toys? What are the best early activities for our baby to develop? I get asked this a lot so here are my suggestions.

You are the best toy

You the parent or the caregiver are the BEST toy a baby could have in the first three months. The most important thing is to talk and sing to your baby, to look and hold your baby and offer your face and voice! Use sing song intonation as much as you can, and as often as possible. We know that babies respond really well to interesting voices, singing or funny sounds. Use your facial expressions!

It is important to encourage early turn taking: leave pauses in between what you say or sing to allow your baby to respond to you. Once you see any signs of your baby responding you continue as if you are having a conversation.

Visual Stimulation

We know that baby’s eyesight still needs to develop in those first months and that a newborn can only distinguish light, shapes and faces. And their distance vision is blurry in the first month. A baby can see up to 15 cm away and this is roughly the distance between the feeders’ face when bottle or breastfeeding the baby.

Black and white

Your baby can see black and white and some shades of grey. So, in the first month you really will need no toys at all other than your face and your voice, your smile, giggle and your hands! Of course, there are a range of black and white visual toys available these days like the ones below. But if you are on a budget, I would say you don’t need those.

From the second to third month a baby can begin to follow objects with their eyes. They recognise a familiar face and now they start reaching for things. Their colour vision is also gradually improving.

Baby gym

One of the best early toys is a ‘baby gym’ where bright and colourful toys dangle off foam padded arches. You can sometimes get ones with a mirror hanging off one of the arches or a mirror sewn into the mat. This is useful as baby likes to look at his/her face at around three months old and this can also be great for tummy time. If you are on a budget this would be the one toy, I would recommend you to get.

If there is no mirror on your baby gym you could get a mirror toy. There are lots out there, this one is a good example. I would probably get a mirror toy that has other sensory components attached so you get more value for money, i.e., three toys in one.

O-ball

Another great toy to get around 2–3 month is an O-ball for easy grasping, bright colours, very lightweight.

Sounds

Lovely early toys are sound makers, bells or rain makers. Some very light weight bells can be attached to your baby’s ankles and they ring every time your baby moves his/her legs. This is a nice and easy introduction to early cause and effect understanding.

Peek-a-boo

A great early game is Peek-a Boo and you could complement your hands hiding your eyes with some nice lightweight pieces of material like a piece of organza veil fabric for example. An added benefit is that later on baby can try and grasp the materials and pull them out of the container.

Music

Music is very important. Turn on the radio to classical or any easy listening station you like. If nothing else you could sing of course! And do not worry about not hitting the right notes your baby won’t judge you (until they are about three years old!)

After three months

At the end of three months your baby is likely to show you the following:

makes cooing and early babbling sounds
seems to know your face
smiles at you socially
cries for different needs: hungry, bored, needing attention, looking for you
opens and closes hands to try and grasp items
takes swipes at dangling
kicks his/her legs
looks at faces and toys, lights
turns his/her head towards sounds
starts to understand the world around him/her.

Don’t panic!

But don’t panic at all if you feel your baby has not quite mastered any of those stages. Chances are they are doing so very soon. If you are worried, please do come and bring your baby to our clinic for a screen and we will give you plenty of assurance and ideas on how to help your baby move forward.

On a final note, Early Intervention is key and bringing your baby for a one-off consultation to a speech and language specialist is always a great idea, just to get ideas, to see that baby is on track and to help baby develop.

The earlier you bring your baby the better. Chances are one consultation is all you need and perhaps a six-monthly review to just stay nicely on track.

Look out for my next Ages and Stages from three to six months old!

I look forward to seeing you! Get in touch with 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

Speech and Language Therapy

Teletherapy: A fun and convenient way to help your child master those sounds!

ByLondon Speech and Feeding April 12, 2024April 12, 2024

It can be hard to get your child to come to the clinic on a weekly basis to work on those tricky sounds. Perhaps the car isn’t working, you have had a lot on, or our student has a bit of a cold but is still able to do a little bit of sound practice?

The good news is that Teletherapy can be a fantastic option to continue your child’s speech journey from the comfort of your own home!

Even when your wifi is not working and your laptop is broken, as you can see on this clip I was able to stretch into running the session on WhatsApp video, but that is less then ideal I will say.

What is Teletherapy?

Teletherapy is speech therapy delivered virtually, through a secure video platform. I use Zoom for example, but I have also used WhatsApp Video Call on occasions where parents’ zoom was not working.

When is Teletherapy perfect?

Here’s why teletherapy can be a great fit for helping your child solidify those learned sounds:

Basic sound patterns have been established in clinic: Your child is now able to say those tricky sounds BUT they are not saying them in daily life yet; they are not ‘generalising’ those new sounds into the normal speech.

You just can’t make it today: No more fighting traffic or fitting appointments into busy schedules. Teletherapy sessions happen at home, on your time. Sometimes even in the attic or the garden shed as in my video clip here ????
Your child is about 7 years old or older and is motivated to work on their sounds: I use fun and interactive online tools and games to keep your child engaged during practice sessions. Due to having done teletherapy over the Covid period I have amassed lots of great games and know-how in this area. Our student needs to be mature enough to be able to sit in front of the laptop camera and participate with a minimum of adult help.
Your child loves gaming and is best motivated through online games: Sometimes children are best motivated when playing online games in between speech sound/language activities; in this case teletherapy is totally perfect.
Focus on Carryover: The familiar environment of your home can actually be an advantage! I can guide my student on practising sounds in everyday situations, like reading a book together or playing with toys, sometimes even talking to their sibling or a.n.other in the room.
Parental Involvement: Teletherapy allows you to be directly involved in the sessions just in same way as when I see your child in my clinic. You can learn strategies and techniques from me to continue practising with your child throughout the day. You can also make a note of the online games I have and then use them in your home sessions.

What to Expect During a Teletherapy Session

Initial Consultation: We start with a brief chat on how the week has gone, what gains have been made with the home exercises and we settle the student into a good learning mode; sometimes I start off with a very quick game just to set the scene.
Working on generalising: When asking my student about how their week has been I will remind them to remember their new sounds and to try and produce them whilst talking to me. This is already the start of therapy.
Practising target sounds: We practice our target sounds in different contexts, using games, visuals, and activities.
The teletherapy session lasts the same amount of time as do 1:1 sessions, unless I see that a child becomes very fidgety and we are not able to hold out much longer, I will cut short the session and focus on increased home practice.
Home Practice: Just like in 1:1 clinic sessions, I will provide you with easy-to-follow tips and activities to continue practising sounds throughout the week.

Getting Started with Teletherapy

Technology Check: Ensure you have a reliable internet connection and a device with a camera and microphone.
What device is best: Ideally the student needs to be on a laptop or PC because that way the student can actively engage with their mouse, moving game pieces, or participating in online activities using their mouse. Tablets are ok but do not allow active participation of the student as described above. However once in a while we can make it work and I do have some games and activities that do not rely on student participation.

Finally, I would say that Teletherapy is a safe, fun and effective way to continue your child’s speech therapy journey. It’s convenient, engaging, and it is perfect on a rainy day when you don’t want to or can’t come out to bring your child to clinic.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

Autism Therapy · Speech and Language Therapy

Discover how Attention Autism can support your Autistic child’s communication

ByLondon Speech and Feeding May 5, 2023May 31, 2023

“I’ve got something in my bag, in my bag, in my bag,

I’ve got something in my bag,

what it is”

You might be wondering why your Speech and Language Therapist is singing this song and then presenting items from a zipped-up bag. Let me take you through stage one of this evidence-based approach.

There are many aims of ‘bucket or bag time’. During stage one, you are simply engaging your child’s attention (whilst also exposing them to language). It’s important to remember that you are not forcing your child to say or do anything. The idea is that the items in the bag or bucket ‘offers an irresistible invitation to learn’ (Gina Davies, 2020).

You don’t need ‘special’ expensive toys. Use what you have at home. It might be that you have some bubbles, a wind-up toy. You might have some foil that you can roll up into a ball, or a balloon. Keep these items for ‘bucket time’. This means that your child is likely to be excited and motivated for the activity. The only stipulation is that these items must be highly motivating and must be the most exciting thing in the room. You’ll want to cover up any distractions.

So, you have your items and your opaque zipped bag, next you’ll want to put the items into the bag ensuring the zip is closed. The zip is important as it increases suspense and excitement as your child cannot see inside. You can also comment when unzipping ‘open bag’ using the signs ‘open’ + ‘bag’ to support your child’s understanding. Your Speech and Language Therapist can help with any Makaton signs that are unknown. The idea of this activity is that the item isn’t touched by your child. This can seem a little odd or feel “mean” but there is a reason for this: we want our child to look at us as well as the object or toy. As soon as we allow our child to touch and play with that toy their attention will go to the toy alone and we won’t get JOINT attention or engagement. This is the reason why we SHOW interesting things for a brief moment and then put these items back into the bag or bucket and out comes the next item. If your child wants to grab the toy and gets upset, then they may not be quite ready for this approach.

Next, we sing the song (as above) and unzip the bag taking out one of the items. The use of pausing is important. Pause after the song: does your child try to use gesture or sound? You can also use this opportunity to model short phrases, ideally one or two words such “it’s a spinner! Wow… so many colours”. After a couple of turns, repeat the process and pull out a different item. We tend not to sing the song each time for the next item. Just sing it at the beginning and then get on with producing the amazing, wonderful things in your bag. No hard and fast rules though, apart from “don’t let the child touch the toys”.

The biggest factor here is that you and your child enjoy the activity together. Have lots of fun!!

Keep up to date with our latest blogs to explore more stages of Attention Autism.

If you need speech, language or communication support or advice, I am always here to help.

Brighly coloured animals circled by coloured words

Autism Therapy · Speech and Language Therapy

Explore activities for Gestalt Language Processors to aid communication

ByLondon Speech and Feeding September 16, 2022January 3, 2024

When you have a child who uses Gestalts it is often difficult to think and adapt clinic activities into those to use at home. More importantly, you find that individualising your activities for your child who uses Gestalt are time-consuming. But you value its importance for their communication development.

You feel so busy, you are taking them to other appointments, or trying to get through your daily activities, all whilst still ensuring your child’s emotional needs are met. You know life should not get in the way of your child’s therapy activities at home, but it does. We know your spare time is precious and limited, so let us achieve your child’s or young person’s goals in the allotted time you have which meets their way of learning (using Gestalts).

We wanted to support you by exploring items which you may have at home, and we will give you some key phrases which you can start to model with your child. Whereas our last blog introduced the idea of gestalt language processors, we are now developing ideas to give you the tools to implement activities at home. We recognise how overwhelming it may feel, and this is one of the reasons to make activities as straight forward as possible. Therapy does not need to be complicated; it just needs to be carried out on a regular basis.

Explore the samples I’ve created to give you an idea of how this might look but please consult with a Speech and Language Therapist who knows about Gestalt Language Processing so that you can work together to develop great home activities for your child.

Want to learn more about gestalt language processing?

Please contact me for help.

Speech and Language Therapy

Quick Overview Of How To Implement Those Early Hanen Speech And Language Strategies

ByLondon Speech and Feeding December 18, 2021January 31, 2023

First up try and get down at eye level or Face-to-Face with your child

Try to sit so that your child can see you easily, i. e. your child does not have to look up to make eye contact with you. We call that Face to Face: try and sit opposite your child. This makes it easier for you to see facial expressions and therefore pick up nonverbal /pre-verbal communication. Now you can connect and share the moment with your child.

OWL (Observe, Wait and Listen)

Never skip this step as it prepares us for what happens next !

Observe

First, try and simply watch your child quietly and listen and observe what he/she says or does; you need to know what your little one is interested in. For example with this toy (pictured below) we could observe that your child loves the actual spinning of the marble, perhaps more than that noisy click-clacking down the run. Or perhaps he loves collecting the marble at the end and feeling it in his hand.

You could start off with showing once how the marble goes down and say:“ look it goes round and round !” Then hold back and observe, without speaking, so that your child has time to explore the toy.

Wait

Just sit and avoid telling or showing your child what he or she could do with the toy. This gives your child an opportunity to explore and experiment.

Listen

Listen to what your child says, or look at your child’s non-verbal communication without interrupting. Your child will now feel and know that you are really present and that what they have to say is important. It’s best to avoid questions like, “What are you doing or “What’s this?” as that might be a lot of pressure when they don’t know what to say about that yet.

Respond immediately by showing interest

Once you have all the information from OWLing you can respond in the right way, for example: if she catches the marble at the end of the run and looks up with a smile or a sound you could respond with: you’ve got it! One marble in your hand! Nice playing!

Now how to join in the play:

First you can copy what your child is doing

If your child puts the first marble at the top of the run you can take a turn and do exactly the same once his marble is done. Ideally you might have another marble run, perhaps a similar one, it does not have to be exactly the same! Once your child has put the first marble in you can do the exact same with your own marble on your run. Your child is likely to look at what you are doing and you might well see a smile on their face or perhaps she might say: look at mine!

Next you can build on that

You can respond with simple comments like: “Wow! Yes I am looking at yours now! It’s spinning on the red one lots! I love the noise!” Now wait once more to see what your child says or does.

To summarise

We are signalling to our child that we are really interested in what they are doing and saying so we can “collect” our child, i.e. bring him/her back into a joint interaction.

Important

We want to try and not direct our child but respond with interest and fun! This creates a lovely stage for interaction and joint play! And this leads in turn to practising conversation and ever more opportunities for great speech and language skills to emerge.

Great activities we use in Speech and Language Therapy:

Any cause and effect toys like this Marble Run
Creative activities, such as mark making with crayons
Train tracks (building and running the trains)

Speech and Language Therapy · Top tips

Explore speech delays and disorders and how you can support your child’s communication

ByLondon Speech and Feeding January 16, 2023February 10, 2023

You often wonder if your child’s speech difficulties will resolve. This very much depends on whether they have a speech disorder or delay. You often wonder if there’s something you’ve done to cause your child’s speech difficulties. Rest assured this is not the case. Let’s explore some of the factors to put your mind at ease.

We know that males are more likely to have a speech, language, or communication difficulty than females. Additionally, if your child has an older sibling, they may not have the opportunities to speak. Their sibling may speak for them, especially if their speech difficulty causes them to be anxious or self-conscious. It’s important to note that bilingualism does not cause a speech delay or difficulty. Your child’s Speech and Language Therapist will ask about your child’s milestones. Research suggests that if your child did not babble then they may be at a higher risk of having communications difficulties.

When it comes to a speech delay or disorder, it’s vital to rule out any other co-occurring difficulties such as hearing loss. Your child’s Speech and Language Therapist will need to factor in the health of your child. They will ask if your child has had lots of colds or ear infections. This may have affected their hearing, so it’s also recommended that your child has a hearing test. Your Speech and Language Therapist will tell you how you can book an appointment.

It’s natural that children learn at different rates. The same is true for speech sounds. Some children are slower to pick up speech sounds, and this might be called a ‘speech delay’. A delay is when a child is behind with the development in a particular area or areas but is generally progressing along typical milestones. They will be progressing at a slower rate than expected. For example, a four-year-old understands two key word instructions and utterances are at a single word level, with some short phrases. But, some may show unusual speech sound error patterns, and this is typically where you may hear it called a ‘speech disorder’. A disorder is where the development we see is patchy and not following what is typically expected for your child’s chronological age. For example, a child understands three key word sentences, but speech is unintelligible and the utterances sound like jargon.

You recognise how important speech is in daily living and want to build your child’s confidence so they can maximise social and educational opportunities. Follow our top tips to support your child’s communication.

Top tips for supporting your child with their speech sounds:

Allow your child to communicate in another way to convey their message if they get stuck (e.g., you could ask ‘show me’, ‘draw it for me’).
Model the correct sound (e.g., child: It’s a thnake, adult: it’s a snake, a slithery snake).
You can emphasise their tricky sound.
Avoid telling your child to ‘say [insert sound here]’.
Your child may speak quickly, especially if they are excited to tell you a story. If you slow down your rate of speech, they will too. This may make it easier for you to understand the message of their story.
Allow your child to speak about how their communication difficulty makes them feel (if they are aware and want to speak about it).

If you are unsure of where to start, contact me to ease your confusion, and allow your child to communicate effectively.