Milestones of autistic children: Crawling, walking, and talking

ByLondon Speech and Feeding October 25, 2023March 25, 2026

Autism Therapy | Speech and Language Therapy

For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.

1. Individual Pacing:

Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.

2. Neurodevelopmental Complexity:

The human brain is a remarkable entity, with a bewildering array of interconnected processes that lead to us achieving our developmental milestones. Autistic children often have variations in “neural wiring”, which can impact the balance between gross motor skills (crawling, walking) and fine motor skills. Speech and language acquisition falls under fine motor skills and may be momentarily disrupted due to the divergent neurological pathways at play in autism.

2. Sensory Processing Differences:

One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.

3. Visual-Spatial Abilities:

Autistic children and adults frequently display excellent visual-spatial abilities. This strength might lead some children to focus more on activities that engage these skills, potentially delaying their engagement with activities like walking or talking. As they navigate their environment and process information visually, they might naturally invest more time in activities that stimulate this particular cognitive ability and strength.

4. Communication Challenges:

For many autistic children, speaking can be a really complex and difficult endeavour. Communication delays are a common feature of autism. This can affect both receptive and expressive language development. While some children might be physically capable of crawling or walking, they may not yet have the tools to communicate their desires and intentions. This leads to a temporary focus on non-speaking forms of expression. This does not mean that they do not communicate at all. But autistic individuals often start out using jargoning or echolalia as a form of communication as well as behaviours and physical forms of communication.

5. Executive Functioning and Motor Skills:

Executive functioning, or abilities for planning, organising, and carrying out tasks, can vary in autistic children. These skills are crucial for activities like crawling, walking, and talking, which need coordination and planning. About 40% of autistic persons have a motor planning difficulty.

6. Intense Interests and Routines:

Autistic children often develop intense interests in specific subjects, sometimes to the exclusion of other activities. These interests might become their primary mode of engagement. They might side-line milestones like crawling, walking, or talking. The mostly rigid adherence to routines and preferences might cause them to allocate more time to their preferred activities. This delays their engagement with other developmental tasks.

How can Speech and Language Therapy help:

Support and Intervention:

Early intervention and regular Speech and Language Therapy play a pivotal role in the developmental journey of autistic children. Therapies tailored to individual needs can aid in bridging the gaps between milestones. Occupational therapy, for example, can help address sensory sensitivities and motor skill challenges that might impact crawling and walking. Speech therapy can help communication development, gradually bridging the gap between non-verbal expressions and spoken language.

For example, we now know that echolalia or jargoning of longer phrases with intonation, repeating scripts from favourite tv shows or songs have many meanings and communicative functions. For example, a child who utters long strings of echolalic utterances, often difficult to understand, might want to do any one of the following:

Comment
greet
ask a question
make a request
express surprise
negate something.

We now understand that the way to support a child with echolalia is to acknowledge all utterances and try and find out what the meaning is behind these scripts. This is very supportive. Over time it will lead a child to move on to understanding and saying more clear and self-generated language. For more information about this Natural Language Acquisition here are some other great websites for you to look at:

Conclusion

In conclusion, the journey of an autistic child’s development is a testament to the uniqueness and complexity of the human mind. The delays or differences in achieving milestones like crawling, walking, and talking can be attributed to a range of factors, including

neurodevelopmental intricacies,
sensory processing variations,
and communication challenges.

It’s crucial to recognise that these delays are not indicative of a lack of potential, but rather a manifestation of the intricate interplay between an autistic child’s strengths and challenges. By embracing these differences and providing tailored support, we can help each autistic child unfold their potential at their own pace.

Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

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.

Feeding · Speech and Language Therapy · Top tips

Hard munchables: Chewing through the weaning journey
ByLondon Speech and Feeding July 14, 2025July 23, 2025
As a Speech and Language Therapist with a specialism in paediatric feeding, I’m constantly looking for ways to support families in developing their little ones’ oral motor skills and fostering a positive relationship with food. While Baby-Led Weaning (BLW) has revolutionised how many families introduce solids, (see my previous blog in July 25) a concept that often sparks discussion and curiosity is the use of ‘hard munchables.’

Image by Freepik

What are hard munchables?

The term ‘hard munchables’ refers to specific types of firm non-digestible food items that are offered to babies for oral exploration and skill development, not for nutrition. These are typically foods that babies cannot bite off or swallow in large pieces due to their texture, but which provide resistance for chewing practice.

The phrase was coined by Marsha Dunn Klein, M.Ed., OTR/L, Occupational Therapist and feeding therapist. Well known for her work in paediatric feeding she introduced and advocated for the concept of hard munchables as part of a therapeutic feeding approach, particularly for infants learning to manage textures and develop crucial oral motor skills.

Common examples of hard munchables include:
- Large, raw carrot sticks: Too hard to bite through, but great for gnawing.
- Celery sticks: Like carrots, offering firm resistance.
- Large, raw apple slices (peeled chunks): A firm, slightly sweet option.
- A firm, uncut pear core: With the seeds removed.
- Dried mango cheeks (hard, unsweetened varieties): These offer a fibrous texture.
- A large, fully cooked but firm piece of meat (like a steak bone with some meat attached): The meat provides flavour and a bit of shreddable texture, while the bone is for gnawing.
- Hard crusts of bread or breadsticks (very firm, without soft inner crumb): These can soften slightly with saliva but offer significant resistance.
Image by Freepik

It’s crucial to emphasise that hard munchables are not for consumption or nutrition. They are tools for oral motor development and should always be offered under strict, active supervision.

How do hard munchables fit into weaning?

While weaning (traditional or Baby-Led Weaning) introduces solid foods that a baby can eventually bite and swallow, hard munchables are complementary to the weaning phase. They enhance that phase by helping a child to develop hand dexterity, hand to mouth movement, and oral development.

It’s important to differentiate: Weaning provides the digestible food for eating, while hard munchables provide the tool for skill practice. They are not substitutes for each other but can be used together under careful guidance.

Pros and cons from a speech therapy perspective

As an SLT, I see both the potential benefits and the necessary precautions when incorporating hard munchables.

Pros:
- Enhanced oral motor development: Hard munchables provide excellent resistance training for the jaw, helping to develop the strength, endurance, and coordination needed for efficient chewing. This is foundational for moving beyond purées and very soft textures.
- Promotes lateralisation of the tongue: The act of moving the hard item from side to side in the mouth encourages the tongue to move independently of the jaw, a crucial skill for managing food and for speech sound production.
- Preparation for more complex textures: By strengthening the oral musculature and refining chewing patterns, hard munchables can help babies transition more smoothly to lumpy and mixed textures.
- Sensory exploration: They offer rich sensory input (tactile, proprioceptive) that can be beneficial for oral mapping and awareness, especially for babies who might be orally sensitive.
Cons:
- Choking risk: While the intention is for the baby not to bite off pieces, there is always a risk. Small pieces can break off, or a baby might accidentally bite off a larger chunk than he or she can manage. Active, vigilant supervision is non-negotiable.
- Not a replacement for digestible solids: It’s vital to remember that hard munchables are for practice, not nutrition. They should complement, not replace, the introduction of varied, digestible solid foods.
- Not suitable for all babies: Babies with certain developmental delays, oral motor deficits, or medical conditions might not be appropriate candidates for hard munchables without highly specialised guidance. For instance, babies with an exaggerated gag reflex might find them overwhelming.
Key Considerations for Parents

Here are my top recommendations:
1. Consult with a professional: Always discuss this with your Paediatric Feeding SLT first before you introduce hard munchables. We can assess your baby’s individual readiness and guide you on safe practices.
2. Strict supervision: Never leave your baby unsupervised with a hard munchable, even for a second. Your full attention is required.
3. Appropriate size: Ensure the item is large enough that the baby cannot fit the whole thing in their mouth. It should extend well beyond their fist.
4. No biting off: The goal is gnawing and scraping, not biting off pieces. If your baby is consistently breaking off chunks, stop using them.
5. Focus on skill, not consumption: Reiterate to yourself that this is for practice, not for eating.
In conclusion, hard munchables, when used appropriately and under guidance, can be a very valuable tool to support oral motor development during the weaning journey. However, always be safe and consult with a specialist to ensure your little one develops his or her feeding skills effectively and joyfully.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of 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.

References:

Rapley, G., & Murkett, T. (2008). Baby-Led Weaning: The Essential Guide to Introducing Solid Foods. Vermilion.

Morris, S. E., & Klein, M. D. (2000). Pre-feeding skills: A comprehensive resource for feeding development. Pro-Ed.

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Ages and Stages · Speech and Language Therapy · Top tips

The power of babble: Why your baby’s ‘talk’ matters
ByLondon Speech and Feeding April 16, 2025April 15, 2025
That adorable string of ‘ba-ba-ga-ga-ma-ma’ might sound like baby gibberish, but it’s actually a crucial milestone in your little one’s language development. Babbling or babble, as we call it, is far more than just cute baby noises. It’s a sequence of sounds that lays the foundation for future communication.

Image by freepik

What is babbling?

Babbling typically begins around six months of age, though the timing can vary slightly from baby to baby. It involves your baby experimenting with different sounds, stringing together consonants and vowels. You might hear them repeating sounds like:
- ‘Ba-ba’
- ‘Da-da’
- ‘Ma-ma’
- ‘Ga-ga’
As they progress, the babbling becomes more complex, with variations in pitch, rhythm, and intonation. It might even sound like they’re having a conversation with you!

Why is babbling so important?
1. Laying the groundwork for speech: Babbling is like a vocal workout for your baby. By practising these sounds, they’re strengthening the muscles in their mouth, tongue, and vocal cords that are essential for speech.
2. Developing phonological skills: Through babbling, babies begin to understand the sound patterns of their native language. They’re learning which sounds go together and how they’re used.
3. Enhancing social interaction: Babbling is a social activity. Babies often babble back and forth with their caregivers, which helps them learn about the give-and-take of communication.
4. Cognitive development: The act of babbling requires babies to use their brains in new ways. They’re learning to control their vocalisations, pay attention to the sounds they’re making, and connect those sounds to the responses they receive from others.
How can you encourage babbling?
- Talk to your baby: Even though they can’t understand your words yet, talking to your baby exposes them to language and encourages them to respond with their own vocalisations.
- Imitate their sounds: When your baby babbles, imitate them! This shows them that you’re paying attention and encourages them to keep ‘talking.’
- Respond to their babbling: Treat your baby’s babbling as if it’s a real conversation. Respond with words, smiles, and gestures.
- Play sound games: Make different sounds for your baby and encourage them to imitate you. This could include animal sounds, silly noises, or simple words.
- Read to your baby: Even before they can understand the words, reading to your baby exposes them to the rhythm and sounds of language.
- Sing songs: Singing is a fun and engaging way to introduce your baby to new sounds and words.
- Use mirrors: Babies often enjoy watching themselves make sounds in a mirror.
- Tactile stimulation: Gentle massage around the mouth and face can increase oral awareness and encourage vocalisations.
- Vary textures: Offer different textured teethers.
- Read books with sound effects: Choose books with animal sounds or other engaging noises.
- Blow bubbles: The act of blowing and popping bubbles can encourage vocalisations.
- Use visual aids: Show pictures of objects and say their names, emphasising the consonant sounds.
- Use exaggerated facial expressions: When you make sounds, exaggerate your mouth movements to help your baby see how sounds are made.
- Increase joint attention: Follow the child’s gaze and point to objects that they are looking at and say the name of the object.
When to seek help

If you notice that your baby is not babbling by eight months, it’s a good idea to talk to your speech and language therapist. You might also notice a lack of variation in tone when your child is making sounds, is your baby sounding a little ‘flat’ or monotonous? While every child develops at their own pace, a lack of babbling can sometimes indicate a developmental delay or hearing issue.

Remember, babbling is a gift. So, enjoy those precious moments of ‘baby talk’ and take comfort in knowing that your little one is on the path to becoming a chatterbox!

Do get in touch via my contact form if you are concerned about your child’s development or if you simply want some reassurance that your baby is developing well. We will be delighted to arrange a screening appointment for you and give you support and reassurance.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

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Speech and Language Therapy · Top tips

Five ways to increase confidence and reduce frustration in children with speech and language and communication difficulties
ByLondon Speech and Feeding February 27, 2023February 10, 2023

Your child’s speech, language and communication difficulties may impact their self-esteem. And they may show signs of increased frustration. You want them to be full of confidence, increasing their participation in school and fully engaging with their peers.

1. Practise active listening

Speech difficulties can mean that it’s more challenging to understand what your child says. It’s important to show that you’re paying attention, giving them time to express themselves. Focus on what your child says rather than how they are speaking. Remember to maintain eye contact, and actively listen. Active listening and giving time can be trickier than it sounds. I can provide strategies to support your active listening skills.

2. Give other means and forms of communication

Allowing children to express themselves in a variety of ways (e.g., gesture, signs, written, use descriptions to describe a word (e.g., sand – you find it out the beach, it can have pebbles on it, it’s not the sea), use of symbols or high-tech augmentative communication methods such as a computer). Using different ways is vital in reducing frustration and communicating their message. If you’re unsure of what other forms of communication you can use, please contact me for some top tips.

3. Praise efforts

Providing specific praise allows your child to understand what they’ve achieved. E.g., you could praise the way your child listens, or how they take turns, or their resilience (e.g., “I like the way you listened” or “good listening”). Think of different ways you could praise you child during different activities, so you are prepared with phrases that you can use.

4. Have clear start and end points in activities

Some children with speech, language and communication needs have difficulties with transitioning from one activity to another. They also have difficulties with changes in routine. This can add to their frustration and changes in behaviour. So, how do you show a clear start and end to an activity? You can have a visual timetable, or you could have ‘start’ and ‘finish’ boxes where you place all the materials in the box labelled ‘start’. And once the activity has finished, you put the items in the box labelled ’finished’. If you need support with transitions, please contact me.

5. Use visuals

Visuals can support your child to understand routine and spoken language. Visuals can range from symbols to online images, to photographs, or a combination. Explore which type of visuals work well for your children. Using visuals can be powerful if used correctly. Make the most of the opportunities that visuals can provide for your family.

Increase confidence and reduce frustration in children with speech and language and communication difficulties today. Please feel free to contact me if you need any support or tips on maximising these opportunities.

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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Speech and Language Therapy · Top tips

Cued Articulation – using hand gestures to show how a sound is made
ByLondon Speech and Feeding October 16, 2024October 17, 2024
Watch how cued articulation can transform your child’s speech and language skills!

Cued Articulation involves using specific handshapes and placement cues to guide the speaker’s articulators, such as the tongue, lips, and teeth, to produce accurate sounds. It was originally conceptualised by Jane Passy, a speech-language pathologist. But it is important to know that we can, and often do, also use other speech cues which help our student visualise what they need to do. In other words, we can mix and match our cue pictures depending on what works best with each student.

In the beginning of my speech therapy practice I would stick religiously to Jane Passy’s method but over the years I have learned and used many different visual hand cues which all have worked with individual students.

It is important to remember that this is not an exact science, rather than an art! The art is to find the key to each individual student’s understanding and inspire motivation to try out a sound which they find hard to do.

As an example, the hand signs used by Caroline Bowen’s method, an Australian Speech-Language Pathologist, are quite different to Jane Passy’s signs but they can equally work very well. Caroline Bowen’s visual for the /r/ sound is the ‘rowdy rooster’ — a crazed rooster on a motorbike — and the hand signal is that of revving up the motor bike engine with both hands whilst trying out the /r/ sound! I have a good handful of students who really loved this rooster image and were able to eventually produce a good /r/ using this cue.

So, it is horses for courses with many things, and visual images and hand cues are no exception!

Sound picture cards:

Again, there are a host to choose from and I tend to collect a number of different images for each sound I want to practise with my student. As an example, below are a couple of different examples I use for the sound /p/:

The Nuffield Programme suggests to use this popper card, which works well with a student who knows these poppers and perhaps has one on their trousers.

As an alternative, and especially for younger students, I like using the Popper Pig Card – which I also have in my room so I can quickly show how it pops. Or we can have a popping game in between saying the /p/ sound at times. (The popper card is great as I can use the real toy to help with conveying the /p/ sound as it pops.)

Each card has its own merit and I choose the right card for the individual student.

How I use cued articulation and the visuals in Speech Therapy
1. Cueing and practice: I introduce the appropriate card and handshapes for the targeted sounds. We then practise producing the sounds.
2. Reinforcement and feedback: Positive reinforcement encourages progress and builds confidence.
3. Fading out the cues: Once my student is able to say the sound more easily, we can gradually fade out the speech cues.
Benefits and effectiveness

Using Cued Articulation and Speech Image Cards has been shown to be effective in improving speech production for individuals with various speech and language disorders, including:
- Articulation disorders: Difficulty producing specific sounds accurately.
- Apraxia of speech: A motor planning disorder that affects the ability to sequence and coordinate movements involved in speech.
- Phonology disorders or delays: Confusion and delays in how sounds are organised in categories to convey meaning, errors in sound patterns, for example front sounds are produced at the back, or long sounds are produced as stops.
- Stuttering: A fluency disorder characterised by interruptions in speech, such as repetitions and prolongations.
Tips for parents and student speech therapists

Parents can play a crucial role in supporting the implementation of cued articulation at home and in therapy sessions. Here are some tips:
- Collaborate with your SLT: Good feedback and communication with the Speech and Language Therapist creates consistency and progress..
- Practise Regularly: Encourage consistent practice of cued articulation at home to reinforce learning.
- Use Visual Aids: Use the same visuals that your therapist uses in the speech clinic to help your child at home with recall and practice.
Feel free to contact me if you need help with your child.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

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Speech and Language Therapy

What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?
ByLondon Speech and Feeding September 9, 2021January 31, 2023
What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?

Speech and language therapists provide treatment, support and care for children and adults who have difficulties with communication, eating, drinking and swallowing. We help children and adults who have problems speaking and communicating.

How to find the perfect therapist for my child/client:

There are a huge number of speech and language difficulties, or feeding and swallowing problems that we can help with and the first thing to think about is what age group the person is you are seeking help for. Most SLT’s specialise in a range of disorders and treatments and they often treat specific age ranges. This could be, for instance, very young children up to 3 years, or school aged children, adolescents or just adults. Once you have narrowed it down to age and general area of difficulty you can then go and seek your perfect SLT match.

Generally it is my view that SLT’s with a narrow area of specialist interest are most likely to help you better if the problem you or your child/adult is having is significant and/or profound. For example, if your child has a very severe stutter/stammer but is otherwise developing fine and has good skills all round, then I would recommend to look for an SLT who only specialises in stammering/stuttering, or has only a small range of other specialist areas related to stammering , such as speech and language delay.

The reason is that it is a tall order for any professional to stay up to date with latest research, latest clinical developments and training for more than, say, five distinct areas of interest.

However, a more generalist Speech therapist who has lots of experience in many different areas could be a very good option for your child or adult who has more general speech and language delay in a number of areas, perhaps a global delay or a syndrome which means that their learning is delayed in general. It also means that your child might benefit from a Generalist SLT because they have many more tools in their SLT bag and your child might need a variety of approaches for several areas.

A good place to start is www.asltip.com which is the Association for Independent Speech and Language Therapists in the UK. Any SLT registered with ASLTIP will also be registered with the HCPC (Health Care Professionals Council), as well as RCSLT (Royal College of Speech and Language Therapists). These two important UK professional regulatory bodies ensure all its members are fully qualified, and are fully up to date with latest developments within their areas of work.

Here you can enter your post code and look for a therapist near you and you can look for specific problems such as stammering for example and narrow down your search. Most therapists have a website which you can then access too. I would recommend you speak to a few therapists on your list and then go with the person you had the best rapport with. You and the therapist will be spending a lot of time together and you will need to feel that you trust them and that you can relax into the process.

How I can help you:

I have 3 main areas of specialism:

Parent Child Interaction Coaching

This is an amazing way to help children with the following difficulties:
- Social Communication Difficulties, Autistic Spectrum Disorders and
- Speech and Language Delay – for children under the age of 4 years old, this is my preferred way of working because it is so very effective and proven to work. If your child is not developing words or not interacting, has reduced attention and listening and you feel is not progressing or, in fact even regressing, then this way of working is the best. For anyone wanting to read a bit more about the efficacy of this method, below are some research articles. You may also like to check out www.hanen.org which is the mainstay of my work and method when it comes to Parent-Interaction Coaching. You can also look at my latest blog, entitled: Tele-therapy, does it work?
In brief, what’s so great about Parent Coaching is that it empowers you the parent to help your child in daily life! This is where speech, language and social communication develop typically, in a naturalistic way and environment. Simple steps and strategies are discussed and demonstrated every week and you are encouraged to use these strategies with your child in daily routines: getting dressed, having breakfast, on the school run, whilst out in the park or shopping or simply playing at home or having dinner or bath time. Whatever your family routine happens to be, every strategy I teach you will help create a responsive communication environment; generally, if your child is able to develop speech then they will do so in direct response to your changed interaction style.

Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation

I love working with children of all ages on developing their speech sounds. Whether your child has a lisp, or a couple of tricky sounds they simply cannot produce quite right, or perhaps your child is really unintelligible because he/she is having lots of different sound errors, making it really hard to understand them. I typically work on getting “most bang for your buck” , meaning I address the sounds that cause the most problems and, therefore, when they are fixed your child/person’s speech becomes that much clearer fairly quickly.

Feeding and Swallowing Difficulties

Having worked for over 20 years in NHS Child Development Clinics and Special Needs Schools I trained and worked with feeding and swallowing difficulties early on in my SLT career. I later trained as a Lactation Consultant and so I am well placed helping and support all types of Infant feeding, both breast or bottle, as well as toddler weaning. I aim to ensure that your little one swallows the right kind of foods and drinks for their abilities. I am experienced in managing and supporting children with physical needs and mobility problems, Cerebral Palsy, Down Syndrome or any other type of syndrome or presentation.

What does a speech therapy session look like?

All sessions differ slightly depending on the age of the child and the nature of the difficulties.

However, mostly our sessions look like FUN! After arrival and washing hands we tend to start off with the tricky work straight away whilst our child still has energy and the will to engage. So, for speech work we will focus on the target sounds first: this could be sitting at a table doing work sheets together, playing games using the target sound and really any type of activity that gives us around 70-100 repeats of the target pattern. For example, a child who is working towards saying a ‘K’ at the end of the word I will try and get around 100 productions of words like: pack/sack/lick/ pick/bike/lake and so on.

Then we often play a fun game where I might try for a ‘rhyming’ activity or other sound awareness type activities, for perhaps 10 minutes and within that time I aim to trial the next sound pattern we need to improve on; I will test which sound your child can do with help from me. During he last 10 minutes we might look at a book, again listening to and producing whatever sound we are working on. If I did not get 100 sounds earlier on in the session I will try and practice them now as part of the story. In total I aim to have about 40-45 minutes of activities, all aimed at the target sound we are working on.

What does a Coaching session look like?

During a Parent Coaching Session we meet online for about an hour and we discuss how the week has been for you trying out the strategies. Typically parents start off recalling what went well, what progress was made and what had been more tricky. We work through it all, and then follow on to the next strategies: I will show you examples and demonstrations of each strategy and I will get you to think about how you can use this with your child and in what situation you might use it. I will explain what we are doing and what the purpose is. You might want to write down what you are going to work on for the week. Over the course of about sessions we can cover all the major strategies that are proven to help kickstart spoken language and/or help your child to connect more with you. Through that connection spoken words most often develop.

Research Papers on the Efficacy of Parent Child Interaction Coaching
- The It Takes Two to Talk Program has been shown to be effective in changing how parents interact with their children, and that children’s communication and language skills improve as a result.
- Baumwell, L.B., Tamis-LeMonda, C.S. & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20(2), 247-258.
- Beckwith, L. & Cohen, S.E. (1989). Maternal responsiveness with preterm infants and later competency. In M.H. Bornstein (Ed.). Maternal responsiveness: Characteristics and consequences: New directions for child development (pp. 75-87). San Francisco: Jossey Bass.
- Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
- Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.
Sonja has been a real help for my 5 year old daughter. Due to her support, my daughter is now able to clearly and correctly enunciate ‘th’ ‘f’ and ’s’. She was also helpful in making positional changes to her seating to help her concentrate better and kept her engaged throughout all the lessons which is a feat in itself on zoom!
Helen, Mother of Catherine Age 5.

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.
READ MORE What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?
Lisp · Speech and Language Therapy · Top tips

Speech prompts and strategies I use in Speech Sound Therapy
ByLondon Speech and Feeding May 14, 2024May 13, 2024

This particular student has a mild motor planning difficulty and six weeks ago he came to me with a very strong lisp. In addition to the lisp he is struggling to produce a number of sounds, SH and L on its own and all the clusters (FL/BL/KL/PL) but also CH together with some vowel difficulties.

The prompts are a mix partially from the DTTC (Dynamic Temporal and Tactile Cueing) model by Dr Edythe Strand as well as phonological models I have learned over the years, and some of them are my own.

Visual/picture prompts and Images

Here I use the ‘Flat Tyre’ Sound, to offer as an image for a new S sound and the ‘Tick Tock’ Sound for a new image of the T sound. Both cards are from the Bjorem Speech Sound Deck, which I love and use almost daily.

Gestural Cues

I like to use all the ‘cued articulation’ hand cues by Jane Passy for consonants and fricatives. Here we use our fingers and hand to illustrate what our tongue does, and we also show whether a sound is voiced or voiceless. When I use one finger it is voiceless (k/f/s/p) and when I use two fingers for the same cue it means that the voice needs to be turned on: (g/v/z/b/n/m). For vowels I like to use Pam Marshalla’s cue system.

Simultaneous production

We say the word together.

Direct imitation

I say the word and my student copies me directly.

Imitation after a delay

I say the word and then after a little wait my student says the word.

Spontaneous production

My student has now learned to say the word by him/herself.

Offering feedback

It sounds like… I just heard… I didn’t hear the first sound there? Can you try again?

Letting the student reflect

By just shaking my head or by looking quizzical so that my student realises something didn’t quite go right.

Postitive reinforcement

‘Yes that was it, do it again, nice one…’

Cognitive reframing

This is a technique where we identify different semantic cues and metaphors or imagery cues, so instead of teaching or focusing on a sound we try out viewing each syllable from a different point of view.

For example: ‘yellow’. I have had great success with this one: we start with just saying ‘yeah yeah yeah’. I might make a little joke and say something like ‘imagine your mum says tidy your bedroom, what do you say or what do you think?’ Answer: ‘yeah yeah yeah’. Then we practice ‘low’ together, I might blow some bubbles high and low and we talk about ‘low’. And then we put ‘Yeah’ and ‘Low’ together and now we have YELLOW!! It might at first still sound a bit odd, like ‘yea-low’ but we soon shape that up and have the real word.

Each student is different and having a great rapport is crucial to our success.

Then a little game break after some 7–10 or so repetitions and always trying to finish on a positive note.

What game breaks do I use:

Very quick ones! Students can post something, place a counter in a game, take out a Jenga block from the tower, pop in a counter for ‘connect 4’, stick a sword into the Pop the Pirate barrel or add a couple of Lego blocks to something they are building.

I hope this is helpful, please contact me for any questions.

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

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