Navigating the exciting 9–18 months journey: Your baby’s communication milestones

ByLondon Speech and Feeding
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Between 9 and 18 months, your little one undergoes a remarkable transformation, blossoming from a curious explorer into a budding communicator. This period is filled with exciting milestones in speech, language, and social development. Let’s delve into what you can expect.

9–12 months: The world opens up

Communication takes flight

  • Babbling becomes more complex with a wider range of sounds. By babbling we mean syllables like: pa ga ka ma da and then ‘baba’ gohgoh’. First we hear one and two syllables together and then longer and longer strings! This is so exciting!
  • First words! One day around the 12 months–14 months mark we hear a first word! My older son’s first word was ‘Licht’ which is the German word for ‘light’ as literally every time I carried him along the corridors in our home, I pointed out the light switches to him and turned them off and on a few times. And each time I said ‘Licht!’ and it stuck! PS: sadly I cannot remember what my younger son’s first word was… poor second and third babies they just have to muddle along and call loudly to get noticed!
  • Understanding grows! Baby now understands simple instructions like ‘where is your ball’ and responds by looking to the ball across the room!

Social butterflies

  • Your baby now starts to show interest in other children, and may try to copy their actions. Now we are getting proper traction with simple social games like peek-a-boo and patty-cake. Whilst your baby is generally interested in other people and children he or she may show separation anxiety when mum or dad or other familiar person suddenly leaves the room and they feel alone with strangers.

Fine motor skills

  • Pincer grasp develops. This is where your child puts an index finger to the thumb in order to pick up of small objects, hold them and transfer them to either a box, back on the floor or into the other hand.
  • Your baby may start to explore objects by banging, shaking, and mouthing.

12–15 months: Words are taking shape

  • Language explosion: From our early words we now suddenly see baby’s vocabulary expanding, with new words added each week. I would highly recommend parents keep a little journal of all the words they hear. If nothing else this is a wonderful aide-memoire for years down the road when you might like to reminisce about the first ten words. I promise you otherwise you won’t recall! (especially for second and third babies; I would do this now, had I the time again).
  • Understanding grows:
    • By about 15 months our baby can follow simple two-step instructions like ‘Go get your shoes and bring them here.’
    • Begins to understand the concept of ‘no.’ and that’s a very useful thing. Though before you breathe a sigh of relief… your toddler may well show you that he is understanding a ‘no’ though he may not stop doing what he is doing or come down off the table!
  • Playtime gets interactive:
    • Now we engage in more complex play, such as stacking blocks, pretending to eat with a spoon, and imitating actions.
    • Many toddlers now start showing an interest in picture books.

15–18 months: Communication blossoms

  • Words combine: Towards 18 months or around about then your toddler may start to put two words together, such as ‘more milk’ or ‘bye-bye dada.’
  • Gestures and sounds: Now we also use gestures to communicate, such as pointing, shaking head ‘no,’ and waving ‘bye-bye.’
  • Exploration and curiosity:
    • Your toddler is now EVERYWHERE! Turn your back and he or she is gone! Your toddler now shows a strong sense of curiosity and explores their environment with enthusiasm.
  • Copying
  • Look out for actions and gestures your toddler will copy such as clapping hands or patting a cushion or banging a spoon on the table .

Remember

  • Every child develops at his or her own pace.
  • These are just general guidelines, and some children may reach certain milestones earlier or later than others.
  • If you have any concerns about your child’s development, please consult with your speech and language therapist. We are always keen to hear from parents and happy to help promote all those lovely early skills.

General tips to encourage communication if you feel your child needs a little more help

  • Talk, talk, talk! Engage in frequent chatting with your child.
  • Listen to your child: Allow for periods of silence when playing with your child to allow them to say something or make sounds which you can then copy and respond to.
  • Read aloud regularly. Use books with simple words and pictures.
  • Play interactive games: Hickory Dickory Dock, Row Row the boat, Old McDonalds, 5 little monkeys jumping on the bed, chasing and catching, tickling games.
  • Respond to your child’s babbling and gestures. You can copy them or if your toddler says long strings of babbling you cannot understand you could just say: ‘Oh ok!? ‘yes that’s great!’ ‘who knew!’ ‘wow you’ve got much to say!’ as if you understood.
  • Limit screen time or if your child is very passionate about watching clips then sit and watch with your child so that you can see what is the best bit, which songs they like the best and what sort of phrases they love hearing.

This exciting period of rapid growth and development is a precious time for both you and your child.

By providing a loving, stimulating, and responsive environment, you will naturally nurture their communication skills! Any more questions, please get in touch!

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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    The hidden impact of mouth breathing and open mouth posture on speech and feeding

    ByLondon Speech and Feeding

    When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

    Mouth breathing and open mouth resting posture can quietly influence everything from how a child’s face grows to how clearly they speak, to how confidently they chew and swallow. It’s something many parents never think about, until they start noticing the subtle signs.

    Let’s explore why this happens, what to look for, and how to gently support better breathing and oral posture.

    Recent research supports this link between mouth breathing and speech difficulties. For example, a 2022 study by Alhazmi et al., published in the Journal of Pharmacy and Bioallied Sciences, found that 81.7% of children aged 9–17 who breathed primarily through their mouths presented with speech sound disorders. The study highlights how mouth breathing can significantly influence orofacial development and articulation patterns.

    💨 Why we’re designed to breathe through our nose

    Our bodies are made for nasal breathing. When we breathe through the nose, the air is filtered, warmed, and humidified before reaching the lungs. The tongue naturally rests against the roof of the mouth, the lips close gently, and the jaw stays relaxed, all of which encourage healthy oral development.

    In contrast, mouth breathing often means the tongue rests low in the mouth and the lips stay apart. Over time, this posture can subtly reshape how the muscles and bones of the face grow.

    Children who breathe through their mouths most of the time may develop:

    • A longer face and narrower palate
    • Forward head posture
    • Slightly open lips and low tongue position at rest
    • A tendency toward drooling or noisy breathing
    • A dry mouth and consequently bad breath
    • At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)

    These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

    🗣 How mouth breathing affects speech

    Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.

    1. Reduced tongue strength and placement, i.e. the tongue rests low in the mouth (as it does in mouth breathing), it’s harder for children to lift it efficiently for sounds like /T/, /D/, /N/, /L/, and /S/. This can lead to speech that sounds slightly slushy or unclear, or a frontal lisp.
    2. Open mouth posture and resonance: An open mouth at rest may affect how air vibrates in the oral and nasal cavities. Children might have speech that sounds a bit ‘muffled’ or lacks crispness because the lips and jaw aren’t fully supporting articulation.
    3. Fatigue and breath control: Mouth breathing can lead to drier mouths and less efficient breath support. That can make longer sentences or conversations feel tiring, especially in noisy environments.

    🥄 How mouth breathing affects feeding and chewing

    Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.

    1. Chewing efficiency: Children who habitually keep their mouths open often have low tongue tone and reduced jaw stability. They may prefer softer foods, chew slowly, or struggle with mixed textures.
    2. Swallowing pattern: A tongue that rests low may push forward when swallowing. This ‘tongue-thrust swallow’ can interfere with efficient chewing and even affect dental alignment over time.
    3. Breathing while eating: Since it’s hard to chew, swallow, and breathe through the mouth simultaneously, children who can’t comfortably nasal breathe may rush bites or pause to catch their breath. This can contribute to coughing, choking, or food refusal.

    Common signs to watch for

    Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:

    • Lips habitually open at rest
    • Drooling after the toddler years
    • Snoring or noisy breathing during sleep
    • Preference for soft foods or grazing eating habits
    • Dark circles under the eyes due to allergies
    • Frequent colds, congestion, or mouth odour
    • Speech that sounds slushy or unclear despite good effort

    If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

    👩‍⚕️ What can help

    1. Address the underlying cause: If nasal blockage, allergies, or enlarged adenoids are making nasal breathing difficult, a medical assessment is the first step. ENT specialists can rule out or treat physical causes.
    2. Encourage closed mouth rest: Gentle reminders like ‘Lips together, tongue up, breathe through your nose’ can help older children become aware of their resting posture. For younger ones, visual cues (stickers or mirrors) can make it a game.
    3. Build oral-motor strength and awareness: Speech therapists can design activities to strengthen the tongue and lips, improve jaw stability, and encourage balanced breathing. This might include blowing games, tongue-tip lifts, use of dental-palatal devices or oral-motor exercises disguised as play.
    4. Support good posture: Sometimes mouth breathing goes hand-in-hand with forward-head posture. Encouraging upright sitting during meals and screen time helps keep the airway open and supports better breathing habits.
    5. Make nasal breathing part of daily routines: Gentle nose-breathing practice during calm times (reading, bedtime, car rides) helps normalise it. Avoid making it a battle: calm, consistent reminders work best.

    🌱 A gentle note on change

    Patterns of mouth breathing develop over time, and change doesn’t happen overnight. It’s important to approach this with curiosity, not criticism. The aim isn’t ‘perfect breathing,’ but to give your child the tools and awareness to breathe comfortably and efficiently.

    Small improvements in nasal breathing and resting posture can lead to big gains in speech clarity, eating confidence, and even sleep quality.

    💡 The takeaway

    Breathing seems automatic, and it is! but how we breathe matters. Mouth breathing and open-mouth posture can quietly shape how a child speaks, eats, and grows.

    By noticing early signs, addressing underlying causes, and building supportive habits, you can help your child move toward stronger, clearer speech and more comfortable mealtimes.

    Just like every area of development, progress starts with connection, patience, and gentle consistency, one calm breath at a time.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    References

    Alhazmi, A., Alshamrani, A., Alhussain, A., et al. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Study. Journal of Pharmacy and Bioallied Sciences 14(5):911. https://www.researchgate.net/publication/361978128_Mouth_breathing_and_speech_disorders_A_multidisciplinary_evaluation_based_on_the_etiology

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

    2
  • ·

    The great air debate: How different swallowing patterns impact breastfeeding and reflux

    ByLondon Speech and Feeding

    The great air debate

    As a Speech and Language Therapist specialising in infant feeding, I often hear from worried mums describing their breastfed baby’s fussiness. ‘My baby is so burpy and gassy,’ ‘might it be reflux?’ or ‘she just seems uncomfortable after every feed’. While these concerns are incredibly valid and distressing for both baby and mum (and dads!), the underlying cause isn’t always what you might think. Often, the culprit isn’t primarily a digestive issue, but rather a mechanical one: how effectively your baby is managing air during feeding.

    Many parents are told their baby has ‘colic’ or ‘reflux’ and are offered solutions that don’t quite hit the mark because they overlook a fundamental aspect of feeding: the suck-swallow-breathe sequence. Understanding this intricate dance can be the key to unlocking a calmer, happier feeding experience for your baby and you.

    Understanding the suck-swallow-breathe sequence

    Your baby’s mouth, tongue, jaw, and throat muscles work together in a precise rhythm like a beautifully orchestrated symphony. First your baby draws milk, then swallows it, and then takes a breath, all without interruption. This is the ideal suck-swallow-breathe (SSB) sequence.

    When the SSB sequence functions optimally, a baby latches deeply, creates good suction, draws milk, swallows efficiently, and then pauses just long enough to take a gentle breath before the next suck. This smooth, coordinated process minimises the amount of air swallowed.

    However, for various reasons (it could be a shallow latch, oral motor challenges, an uncoordinated suck, or even an overly fast milk flow) this sequence can get a bit out of sync. Instead of a smooth rhythm, you might see:

    • Suck-suck-swallow-gasp!: Too much air pulled in with the swallow.
    • Rapid, shallow sucking followed by gulping: Inefficient milk transfer and air intake.
    • Clicking noises during feeding: Loss of suction, indicating air entry.
    • Frequent detaching and re-latching: Often to ‘catch a breath’ or because of discomfort.

    Each of these patterns can lead to increased air intake.

    The root cause: Air trapping leading to a gassy breastfed baby

    When a baby swallows too much air during a feed, that air must go somewhere. It builds up in the stomach, causing bloating, discomfort, and often leads to the familiar reflux-like symptoms parents describe: arching, spitting up, burping excessively, or simply appearing distressed.

    It’s a common misconception that all gassiness or reflux symptoms in a breastfed baby are due to something in the mother’s diet or a genuine digestive disorder. While these can be factors, as an SLT, we first look at the mechanics of the feed. If a baby is constantly struggling to maintain a seal, sucking inefficiently, or having to gulp to keep up with flow, he or she is inevitably swallowing air. This air then creates pressure, which can push milk back up (silent reflux) or out (visible reflux).

    Think of it like trying to drink through a straw with a hole in it. You’re sucking, but you’re also pulling in air, making it harder to get the liquid and leaving you with more bubbles in your stomach.

    Why mechanical speech therapy assessment is key

    This is where the distinction between a medical diagnosis (true gastro oesophageal reflux disease or GORD) and a functional feeding challenge becomes critical. A paediatrician will assess for medical causes and may prescribe medication to reduce stomach acid. This can be appropriate for severe cases of GORD.

    However, if the primary issue is air being trapped due to a suboptimal suck-swallow pattern, medication only treats the symptom (acid burning) and not the root cause (air intake). This is precisely where a Speech and Language Therapist specialising in infant feeding comes in.

    My role is to meticulously observe and assess your baby’s oral motor skills, latch, tongue function, and the efficiency of their SSB sequence. I look for subtle signs of inefficiency that contribute to excessive air swallowing.

    • Is the tongue elevating correctly to create suction?
    • Is the jaw stable, or is it excessively moving?
    • Is the latch deep enough to prevent air leaks?
    • Can the baby coordinate suck, swallow, and breathe without gasping?

    By identifying these mechanical challenges, I can then implement targeted strategies to improve feeding efficiency and reduce air intake, often leading to a significant reduction in reflux-like symptoms and overall discomfort.

    Strategies to optimise air management during breastfeeding

    The good news is that many babies can learn to feed more efficiently with the right support. Here are some general strategies we might explore:

    1. Optimise latch and position: A deep, asymmetric latch is crucial. Experiment with different positions that allow for a deeper latch and better head/neck alignment, such as laid-back feeding or upright positions.
    2. Paced feeding (even at the breast): If your milk flow is very fast, consider removing your baby from the breast briefly if you hear excessive gulping or see him or her struggling to breathe. This allows him or her to catch up and manage the flow.
    3. Support the jaw and cheeks: Sometimes, gentle support to the baby’s jaw or cheeks can help them maintain a more stable, efficient suck. I can demonstrate specific techniques for this.
    4. Burping effectively: While burping won’t get rid of all swallowed air, upright burping positions and gentle back rubs can help release some of it.
    5. Pre-feed oral preparation: Gentle oral massage or stretches before a feed can sometimes ‘wake up’ the oral muscles and improve coordination.

    Addressing the ‘Great Air Debate’ isn’t about blaming anyone; it’s about empowering parents with a deeper understanding of their baby’s feeding mechanics. By focusing on the how, not just the what, we can often resolve persistent feeding challenges, reduce discomfort, and make breastfeeding a more joyful, peaceful experience for both you and your little one.

    If you suspect your baby’s gassiness or reflux symptoms are related to how they are managing air during feeds, don’t hesitate to reach out for a specialist assessment.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

    2

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

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

    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)

    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.

  • · · ·

    Autism – Benefits of Early Assessment and Intervention

    ByLondon Speech and Feeding
    I think my child might be autistic – how can we help?
    Image by macrovector on Freepik

    Consulting a Specialist Speech and Language Therapist can help you in several ways: assessment, informal and formal observation, discussion and advice, onward referrals, direct intervention, parent coaching, educational support and much more, all geared towards supporting you the parents, and helping your child to flourish and thrive.

    First up, we can help you with assessment and advice: with a wealth of expertise in observing childrens’ play and communication, as well as knowledge of the latest research we can see a child’s strengths and areas of struggle very quickly indeed.

    Within a short space of time, we can identify the areas we need to focus on and start guiding you towards helping your child to connect, respond, react and feel better.

    Early detection is key

    If autism is detected in infancy, then therapy can take full advantage of the brain’s plasticity. It is hard to diagnose Autism before 18 months but there are early signs we know to look out for. Let’s have a brief look at the sorts of things we look at.

    The earliest signs of Autism involve more of an absence of typical behaviours and not the presence of atypical ones.

    • Often the earliest signs are that a baby is very quiet and undemanding. Some babies don’t respond to being cuddled or spoken to. Baby is being described as a ‘good baby, so quiet, no trouble at all’.
    • Baby is very object focused: he/she may look for long periods of time at a red spot/twinkly item further away, at the corner of the room for example.
    • Baby does not make eye contact: we can often see that a baby looks at your glasses for example instead of ‘connecting’ with your eyes.
    • At around 4 months we should see a baby copying adults’ facial expressions and some body movements, gestures and then increasingly cooing sounds we make; babies who were later diagnosed with autism were not seen to be doing this.
    • Baby does not respond with smiles by about 6 months.
    • By about 9 months, baby does not share sounds in a back-and-forth fashion.
    • By about 12 months baby does not respond/turn their heads when their name is called.
    • By around 16 months we have no spoken words; perhaps we hear sounds that sound like ‘speech’ but we cannot make out what the sounds are.
    • By about 24 months we see no meaningful two-word combinations that are self-generated by the toddler. We might see some copying of single words.

    24 months plus:

    • Our child is not interested in other children or people and seems unaware of others in the same room/play area.
    • Our child prefers to play alone, and dislikes being touched, held or cuddled.
    • He/she does not share an interest or draw attention to their own achievements e.g., ‘daddy look I got a dog’.
    • We can see our child not being aware that others are talking to them.
    • We see very little creative pretend play.
    • In the nursery our child might be rough with other children, pushing, pinching or scratching, biting sometimes; or our child might simply not interact with others and be unable to sit in a circle when asked to.

    What sort of speech and language difficulties might we see?

    Our child might do any of the following:

    • have no speech at all, but uses body movements to request things, takes adults by the hand
    • repeat the same word or phrase over and over; sometimes straight away after we have said it or sometimes hours later
    • repeat phrases and songs from adverts or videos, nursery rhymes or what dad says every day when he gets back from work etc.
    • copy our way of intonation
    • not understand questions – and respond by repeating the question just asked:
      • adult: Do you want apple? child: do you want apple?
    • not understand directions or only high frequency directions in daily life
    • avoid eye contact or sometimes ‘stares’
    • lack of pointing or other gestures

    Common behaviours:

    • Hand flapping
    • Rocking back-and-forth
    • Finger flicking or wriggling/moving
    • Lining up items/toys
    • Wheel spinning, spinning around self
    • Flicking lights on and off, or other switches
    • Running back-and-forth in the room, needing to touch each wall/door
    • Loud screaming when excited
    • Bashing ears when frustrated or excited
    • Atypical postures or walking, tip toeing, can be falling over easily, uncoordinated
    • Can be hyper sensitive to noises, smells, textures, foods, clothing, hair cutting, washing etc.
    • Being rigid and inflexible, needing to stick to routines, unable to transition into new environments
    • Food sensitivity, food avoidance, food phobias

    I mentioned this to be a ‘brief’ look at the areas and it is: each topic is looked at very deeply and each area is multi-facetted therefore a diagnosis is rarely arrived at very quickly. We want to make sure we have covered all aspects and have got to know your child very well before coming to conclusions.

    Early detection is key, because we want to start helping your child to make progress as quickly as is possible. If you feel /know that your child is delayed in their speech and language development and you would like a professional opinion then please do contact me, I look forward to supporting you. It is important to know at this point, that if your child only has one or two of the above aspects it may mean that your child is simply delayed for reasons other than Autism and if that is the case, we will be able to help you iron out a few areas of need so that your child can go on thriving.

    If you need help with your child, please do not hesitate to contact me.

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

    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.

    2

  • Tele-Speechtherapy: Online, connected, and highly effective

    ByLondon Speech and Feeding
    A different kind of therapy. Online, connected, and highly effective

    When parents first enquire about speech and language therapy, many assume it will happen face-to-face, in a clinic room, with a therapist sitting across from their child.

    So when therapy is offered online, it’s natural for questions to arise:

    Can this really work? Will my child engage? Will progress be slower?

    This short video offers a glimpse into what online therapy can look like: calm, interactive, relationship-based, and surprisingly effective.

    Online therapy is not ‘less than’ in the right circumstances

    Teletherapy is not suitable for every child in every situation. However, for many school-aged children, particularly those who enjoy conversation, technology, and shared activities, online therapy can be an excellent fit.

    The child you see in this video is around eight years old and was supported for a persistent lisp. Sessions were primarily online, with the occasional in-person appointment when helpful.

    What made the difference was not the screen. It was the combination of engagement, support, and consistency.

    Parent involvement changes everything

    One of the greatest strengths of online therapy is the way it naturally invites parents in.

    In this case, parents regularly joined the video sessions:

    • Listening in
    • Taking part when appropriate
    • Learning how to support practice gently between sessions

    This meant that therapy didn’t stay ‘on the screen’. Strategies carried over into everyday conversation, making progress faster and more meaningful.

    Speech sound therapy, including support for lisps, relies heavily on awareness, feedback, and confidence, all of which can be supported very effectively at home with the right guidance.

    Therapy through a screen can still be deeply relational

    A common concern is whether connection can truly be built online.

    In reality, many children feel more relaxed in their own home environment. They are often more willing to talk, experiment with sounds, and reflect on their speech when they feel comfortable and supported.

    Online sessions allow:

    • Shared focus and conversation
    • Clear visual feedback
    • Real-life practice in a familiar setting
    • Immediate parent support

    For some children, this actually enhances engagement rather than limits it.

    Real progress, real outcomes

    Over the course of approximately 12 online sessions, alongside a small number of in-person appointments, this child achieved resolution of their lisp.

    Progress was steady, positive, and confidence-building. Importantly, the child remained motivated and proud of their achievements throughout the process.

    While every child’s journey is different, this example highlights what is possible when:

    • The child is ready
    • Parents are involved
    • Therapy is tailored and collaborative

    If you’re considering online therapy

    If you’re unsure whether teletherapy could work for your child, it’s worth remembering that effective speech and language therapy is less about the room you’re in, and more about:

    • Relationship
    • Understanding
    • Consistency
    • Carryover into daily life

    For many families, online therapy offers flexibility, accessibility, and excellent outcomes especially when parents are active partners in the process.

    If you’re at the start of your child’s speech journey and wondering whether online therapy could be the right fit, I’m always happy to talk it through. Sometimes clarity begins with simply understanding what therapy can look like

    Teletherapy: Frequently Asked Questions

    Is online speech and language therapy really effective?

    Yes. For many children, particularly school-aged children, online therapy can be highly effective. Progress depends far more on engagement, consistency, and support than on physical location.

    What age does online therapy work best for?

    Teletherapy often works well for children from around six years and up, especially those who can attend to a screen, enjoy conversation, and follow simple instructions. That said, suitability is always considered individually and often a supportive adult is needed to help guide the child through the activities.

    Can speech sound work (such as a lisp) really be done online?

    Absolutely. Speech sound therapy relies on clear visual feedback, listening skills, and practice all of which can be supported very effectively online. Many children respond particularly well when practising in their own home environment.

    Do parents need to be involved in sessions?

    Parental involvement is strongly encouraged. Parents may sit in, join parts of the session, or support practice between appointments. This involvement often leads to quicker progress and better carryover into everyday speech.

    Will my child still build a relationship with the therapist?

    Yes. Strong therapeutic relationships can and do develop online. Many children feel more relaxed and confident communicating from home, which can actually enhance connection and learning.

    Is online therapy suitable for every child?

    Not in my experience. Some children benefit more from in-person support, or a combination of online and face-to-face sessions. A discussion and initial assessment help determine the best approach for each child.

    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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