One activity, endless opportunities for speech and language therapy targets

ByLondon Speech and Feeding

Communication does not happen in neat little boxes. In Speech and Language Therapy we often use one great activity to target multiple areas of speech and or language development all at once.

Children are trying to:

  • understand language
  • build sentences
  • organise their thoughts
  • pronounce sounds
  • remember words
  • use grammar
  • follow social interaction
  • communicate meaning…

all at the same time.

This short therapy clip is a little example of that.

Within one playful interaction, we naturally work on:

  • grammar
  • sentence expansion
  • pronouns
  • speech sound errors
  • modelling
  • visual cueing
  • turn-taking
  • confidence in communication

And, importantly, the child remains engaged, relaxed, and successful throughout.

Using language activities to refine speech sound targets

We all learn language through:

  • shared attention
  • play
  • repetition
  • connection
  • modelling
  • responsive interaction

As a Speech and Language Therapist I am constantly thinking and considering how to bring in all the targets a child is working on. The reason for that is that often we do not have a full therapy hour to work leisurely and calmly on various targets! Many children have short attention focus and ‘go off the boil’ quickly and often suddenly. Therefore, I always feel a sense of ‘make hay whilst the sun shines’ and pack it all in whilst the going is good. So then we can afford five minutes of trampolining in between activities to help the child regulate themselves without losing valuable speech therapy opportunities or time.

  • How can I expand this sentence?
  • How can I model better grammar?
  • Can I gently shape the pronunciation here?
  • Should I recast that phrase?
  • Is this the right moment to pause and encourage a longer utterance?
  • How can I keep communication flowing while still targeting goals?

These decisions happen continuously during therapy.

Building longer sentences naturally

In this clip, one of the key areas we are targeting is sentence expansion through Colourful Semantics, which is a particularly useful and researched approach, developed by UK Speech and Language Therapist Alison Bryan in 1997 to support children with speech and language difficulties.

Colourful Semantics is a visual, colour-coded therapy approach that helps children break down, understand, and construct sentences by assigning specific colours to thematic roles (e.g., Who, What Doing, What).

Many children with language delay use reduced language for example: they might say:

  • ‘dog’ instead of ‘the dog is running fast’
  • ‘eatin a dinner’ instead of we are eating our dinner
  • ‘baby shhh’ instead of ‘the baby is sleeping’.

Using the Colourful Semantics Framework helps create a solid baseline from which to work and with which to construct basic good sentences using WHO is DOING WHAT and WHERE.

We are building language upward gently and positively.

This technique is incredibly powerful because children learn language through hearing it used meaningfully over and over again.

Supporting pronouns through real conversation

Pronouns can be surprisingly difficult for many children.

Words such as:

  • he
  • she
  • him
  • her
  • they

require children to understand perspective, grammar, and sentence structure all at once. Using pictures and basing the activity on the Colourful Semantics Model I can shape pronouns repeatedly as part of the overall activity.

Books, pictures, and play scenes are fantastic for this because they create endless opportunities for meaningful repetition.

Again, this may look simple from the outside.

But underneath it is highly intentional clinical work.

Listening for speech sound errors at the same time

While supporting grammar and language, I am also constantly listening to the child’s speech production.

In this short interaction, I respond to speech sound errors as they arise.

Sometimes I:

  • model the correct production
  • emphasise a sound slightly
  • use visual cues
  • slow the word down
  • add gesture or sign support
  • encourage another attempt.

And sometimes I intentionally let the error go in order to protect confidence and maintain communication flow.

That balance is incredibly important.

Children need support. But they also need to feel successful communicating.

The child simply experiences this as warm, responsive interaction.

But underneath it is detailed clinical reasoning.

This is why effective therapy is never about simply owning resources or downloading activities online.

The real skill lies in:

  • how the therapist uses the activity
  • how they adapt moment by moment
  • how they analyse communication in real time
  • how they shape interaction to maximise learning opportunities.

One activity. Endless opportunities.

A single book, picture scene, or playful interaction can provide opportunities to support:

  • speech sounds
  • language development
  • grammar
  • vocabulary
  • attention
  • confidence
  • social communication
  • emotional connection.

The magic is not in the activity itself.

The magic is in how a therapist uses it.

Because excellent speech therapy is never ‘just playing’.

It is careful, responsive, evidence-based intervention woven seamlessly into joyful interaction.

Contact me avia my contact form if you would like me to work with your child.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Reference

Bryan A (1997) Colourful semantics. In: Chiat S, Law J, and Marshall J (eds) Language disorders in children and adults: psycholinguistic approaches to therapy. London: Whurr, 143–61.

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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    Communication skills have a strong impact on literacy. Let’s look at some of the facts:

    • 50% of children with language delays also have challenges with literacy (Burns et al, 1999).
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    Have you still got unanswered questions? Contact me here and we can have a look at your child’s phonemic awareness, auditory processing skills, verbal understanding and assess his/her ability and likelihood of reading and literacy struggles. If we find that your child has dyslexia I can refer on to a specialist colleague who can help you further.


    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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    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.

  • · ·

    Why auditory memory matters (especially for little ones!)

    ByLondon Speech and Feeding
    Why auditory memory matters (especially for little ones!)

    Have you ever stopped to think about how we learn to speak, understand, and communicate effectively? It’s a complex dance of various cognitive skills, and one often overlooked but absolutely crucial player in this orchestra is auditory memory. It’s not just about remembering sounds. It’s about remembering sequences of sounds, which is fundamental to language development.

    What exactly is auditory memory?

    At its core, auditory memory is our ability to take in, process, store, and recall information that we hear. Think of it as your brain’s internal recording studio. When someone speaks to you, your auditory memory is busy at work, capturing the individual sounds, the order in which they appear, and the rhythm and intonation of the words. This isn’t just for long-term recall; it’s also vital for working auditory memory, which allows us to hold onto a small amount of auditory information for a short period, just long enough to make sense of it.

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    • Following instructions: Remembering a sequence of commands relies heavily on auditory memory.
    • Learning new words: We hear a word, remember its sound, and connect it to its meaning.
    • Developing phonological awareness: This is the ability to recognise and manipulate the sounds in spoken language, a critical precursor to reading. Auditory memory helps children distinguish between similar-sounding words (e.g., ‘cat’ vs. ‘bat’) and segment words into individual sounds.
    • Producing clear speech: To articulate words correctly, we need to recall the precise sequence of sounds that make up that word.
    • Developing conversational skills: Remembering what was just said helps us formulate appropriate responses.

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    When auditory memory is poor, particularly in young children, the ripple effects on speech and language development can be significant. Children might struggle with:

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    • Learning new vocabulary: They might hear a new word repeatedly but struggle to retain its sound pattern, making it difficult to recognise or use later.
    • Understanding stories or conversations: Missing key details or losing the thread of a narrative because they can’t hold enough information in their working memory.
    • Developing phonological skills: Difficulty with rhyming, identifying initial sounds in words, or blending sounds together to form words, which can impact early literacy.
    • Speech production: They might mispronounce words, omit sounds, or struggle with the correct sequencing of sounds within words.
    • Social communication: Difficulty participating in group discussions, remembering names, or recalling what their peers have said.
    • Academic performance: Auditory memory challenges can impact a child’s ability to learn in a classroom setting, where much of the instruction is delivered verbally.

    It’s important to note that poor auditory memory isn’t a sign of low intelligence, but rather a specific processing challenge that can be addressed with targeted support.

    Nurturing auditory memory in under 5s: Preparing for schooling

    The good news is that auditory memory is a skill that can be strengthened and developed, especially during the crucial early years. For children under five, laying a strong foundation in auditory memory is an invaluable gift as they prepare for the demands of formal schooling. Here’s what we can do to help:

    1. Read aloud regularly: This is perhaps one of the most powerful tools. As you read, encourage your child to listen for specific words, predict what happens next, and retell parts of the story. Vary your voice, use different intonations, and pause to emphasise key words.
    2. Play auditory memory games:
      • ‘Simon says’: This classic game is fantastic for following multi-step instructions. Start with one command and gradually increase the number.
      • ‘I Spy’ with sounds: Instead of colours, describe sounds. ‘I spy with my little ear something that goes “moo”.’
      • Rhyming games: Sing rhyming songs, read rhyming books, and encourage your child to come up with words that rhyme.
      • Sound matching: Use everyday objects to make sounds (e.g., shaking keys, tapping a spoon) and have your child identify or match them.
      • ‘Memory chain’: Start a sentence and have your child add to it, remembering everything that came before: ‘I went to the market and bought an apple.’ ‘I went to the market and bought an apple and a banana.’
    3. Sing songs and nursery rhymes: Repetitive songs and nursery rhymes are excellent for developing auditory memory, rhythm, and phonological awareness. The predictable patterns help children anticipate and remember sequences of sounds and words.
    4. Give multi-step instructions (and praise!): Start with two-step instructions and gradually increase the complexity as your child’s skills improve. Always give positive reinforcement when they succeed. ‘Please pick up the red block and put it in the box.’
    5. Engage in active listening: Model good listening skills yourself. When your child is speaking, give them your full attention. Ask clarifying questions to encourage them to elaborate and organise their thoughts.
    6. Reduce background noise: A quiet environment makes it easier for young children to focus on auditory information. Minimise distractions like TV or loud music during activities that require listening.
    7. Use visual cues: While we’re focusing on auditory memory, sometimes pairing auditory information with visual cues can be helpful, especially initially. For example, when giving instructions, demonstrate the action as you say it.
    8. Be patient and consistent: Developing auditory memory takes time and consistent practice. Celebrate small victories and create a playful, supportive environment for learning.

    By actively engaging in these strategies, we can empower our youngest learners to build robust auditory memory skills, setting them up for success not only in speech and language development but also in their overall academic journey. It’s an investment that truly pays dividends in their future communication and learning abilities.

    Any comments or if you need help and support with your child’s speech please do not hesitate to get in touch with me: simply fill out the contact form here on the website. I endeavour to reply within 48 hours.

    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.

    1
  • ·

    Support your child’s communication using books: OI FROG

    ByLondon Speech and Feeding
    Sonja's top recommendation: Oi Frog, written by Kes Gray and Jim Field. An exciting book for children to enhance their speech, language and communication.
    Oi Frog by Kes Gray and Jim Field

    Book corner with Oi Frog! by Kes Gray and Jim Field.

    Books are an engaging way to support your child’s communication development. Even if your little one dislikes reading in the traditional sense. They will become immersed in this adventure, without realising they are taking in language and developing vital communication skills. This is one of my favourite series for children.

    Increase fun and interaction

    These books are made for fun and excitement! It may seem silly putting on different voices for different characters, but this is one way in which you can engage your child. Why not try to use different intonation patterns (e.g., you may use a deep voice for the dog, and a higher pitch for the cat)? Make your story interactive: you could ‘rawww’ like a lion and see who can make the loudest noise. Make noises to encourage interaction (e.g., when scratching his chin, make a squeaky sound!). You could also relate the experience back to your child (e.g., ‘can you scratch your chin?’).

    Time to talk

    Talk about what you can see on the front cover (e.g., There’s a frog on a log, how funny!) You could also ask your child to choose the rhyming words on a page in the book. Can your child tell you what rhymes with certain words (e.g., can you guess what a parrot sits on?)? Make use of every page. You could comment on your favourite frog and see if your child can talk about their favourite. You can support them by giving them an example (“my favourite frog is the one swimming backwards because he looks funny”). Then you could use this scaffold to support their answer. Your favourite is [________________] because [_________________]

    If your child is reluctant to use language, the use of commenting can take the pressure of them (“look at all those frogs” or “he’s climbing up the stool”) is a powerful way in which you (as parents) can take the pressure off your child. A top tip I like to give is to make sure you pause regularly, which creates opportunities for your child to use language.

    This book uses a subject-verb-object sentence structure (e.g., ‘hares sit on chairs’) which allows your child to hear a good model of a sentence. You could also talk about things in the book that belong in a certain category (e.g., animals, food) or begin with a specific sound. See if your child will name any more.

    Reap the reward of repetitive language

    Oi Frog uses repetitive rhyming language and puts emphasis on these words. This is important because the more your child hears a word, the more likely they are to remember, understand and use it in the correct context.

    Emotions matter

    Talk about how the animals feel and why they may feel this emotion (e.g., the cat’s feeling annoyed because…, Lions sit on irons, how does the lion feel?). Reasons can be difficult for children with communication difficulties. Support them by giving an example or by giving them an option (e.g., “does the lion feel happy or sad? I think the lion feels sad because he’s burnt his bottom on the iron! It’s too hot!”)

    A collection of books
    OI Books

    Why not read similar stories? I highly recommend OI CAT, OI DOG and OI DUCK-BILLED PLATYPUS.

    Need support for your child’s communication? Contact me here.

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

    2

  • What is FRONTING?

    ByLondon Speech and Feeding
    Kids Speech Therapist London

    Does your child say “Dough” instead of “Go”? Or “Tea” instead of “Key”? Do you hear a /Sh/ instead of an /S/ does “see” sound more like “she”?

    We Speechies call this a Fronting Pattern which means that a sound that should be produced at the back of the throat with the back of the tongue, like K or G , is said at the front of the mouth with the tip of the tongue, like a T or a D or SH. When this happens speech can be really hard to make out because these sounds are literally everywhere in everyday sentences. Just think how many K’s and G’s we hear in a simple sentence?

    For example, I heard my little student say earlier today: “I know what game we can play in your garden? It’s the one with cones and rings and cushions! I know where it is I can get it.”

    But it sounded like:

    “I know what DAME we DAN play in the DARDEN! It’s the one with TONES and rings and TUSHIONS! I know where it is I TAN DED it.”

    If that sounds familiar to you, here is a little overview of what we can do about it:

    First up it’s always good to start with general speech sounds awareness: does a child hear syllables and intonation? Do they know words that rhyme? Can they follow or copy a simple beat with a drum? Can they listen and hear quiet sounds and loud sounds and can they copy those? Can they follow mouth and tongue movements:, for example : stick out your tongue, lick your lips, click your tongue, blow raspberries?

    Then it really helps to talk about BACK and FRONT of things and to draw attention to the back of the mouth and the back of the tongue and the front tip of the tongue and how sounds are made in the mouth. I often use a puppet to show this or a model of a mouth like this one here in the picture.

    Next we try and listen to words starting with a BACK sounds like a K or a G , and I read out a list of words with those sounds: COW, CORE, CAT, CONE, KEY etc or ARK, EEK, OAK, ACHE…

    Or GOO GUY GUM GONE

    After that we try and see if a student can actually produce a single sound like a K or a G just by itself. If they can, that’s a really great start and if they can’t I help them to produce one – over a few sessions we usually get there. We call this Sound production in isolation.

    Once a child can produce a sound correctly, on its own, we try and start working on very simple words that are really powerful like “GO”!!!!! in a motivating game or “CAR” for little ones who love a car racing track.

    Now that we have established the back sounds and are using it in short words, we can gradually re-train brain pathways and oral- motor/movement pathways to use these new sounds in many words and then short phrases. That can take time!! This is called generalisation and it is not uncommon for it to take up a whole year for fluent speech to be error-free .

    Why does it take so long? Being able to produce a correct and clear K or G sound does not mean it will be used easily. Our brain pathways are fixated or habituated to the error sound. It takes time for habits to change. A child might be able to hear the word TIGER with a G in the middle and she knows that it is not a TIDER but when saying it her tongue automatically moves forward rather than lifts up at the back. It’s a bit like a person who has a rounded back: the brain knows to stand upright and how not to slouch, but when we don’t focus on it, ooops we have slouched again because that is what we are comfortable doing and our body moves with our habit.

    It takes effort and motivation to change our movement patterns and that includes our tongue and lip patterns! We usually get there through a huge variety of games and practice. Lots and lots of repetition is key as is motivation to change.

    Parents and carers are crucial in the success of Speech Therapy!

    We need your feedback at home, the regular short and sweet exercises, the constant positive encouragement and great modelling of speech sounds. We often find that parents are tuned into their child’s error sounds and can understand them much better than anyone else. This is great of course in many ways, however, it also means that the child has less motivation to change: if mummy understands me then my world is ok.

    I will give you a short outline of what different speech therapy models I use in my practice, be it in clinic face to face or on-line in my future blogs soon.

    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.

  • ·

    Principles of motor learning in childhood apraxia of speech: A guide for parents and therapists

    ByLondon Speech and Feeding
    Image by Freepik

    Childhood Apraxia of Speech (CAS) is a complex neurological disorder that affects a child’s ability to plan and coordinate the movements necessary for speech production. Children with CAS often have difficulty with articulation, prosody, and fluency, making it challenging for them to communicate effectively. While there is no cure for CAS, speech and language therapy can significantly improve a child’s communication skills and overall quality of life. Understanding the principles of motor learning is crucial for both parents and speech therapists to support children with CAS on their speech journey.

    What is MOTOR LEARNING?

    Motor learning refers to the process of acquiring and refining new skills through practice and experience. This applies to all aspects of movement, including speech production. The brain constantly receives sensory information about the movements being made and adjusts them based on the desired outcome. A breakdown or interruption of this process can make it difficult for children to plan, sequence, and coordinate the intricate movements involved in speech.

    What key principles do we use in speech and language therapy for motor learning?

    • Task Specificity: Speech Therapy activities that directly target the specific speech sounds or skills your child is working on. For example, if your child is struggling with /p/, practising isolated /p/ sounds, words with /p/, and phrases with /p/ would be most beneficial.
    • Massed vs. Distributed Practice: We consider the optimal amount and distribution of practice sessions throughout the day. Massed practice involves concentrated practice in a single session, while distributed practice spreads practice sessions throughout the day. The best approach depends on the individual child’s learning style and attention span.
    • Feedback: We provide clear and immediate feedback to help your child understand the accuracy and effectiveness of their attempts. This feedback can be auditory, visual, or touch based.
    • Error Correction: We aim to gently correct errors so that we can help your child refine their movements and avoid developing bad habits. The focus is on providing specific cues and guidance rather than simply pointing out mistakes.
    • Variety and Progression: We gradually introduce new challenges and variations in speech therapy activities to prevent plateaus and maintain motivation.
    • Motivation and Engagement: A big part of our work is to make therapy sessions fun and engaging to keep your child motivated and actively participating. We use games, songs, and activities that your child enjoys while incorporating targeted practice opportunities.

    What about home work?

    Yes we need your help and here are some examples of how this could look:

    • Task Specificity: During story time, focus on practising target sounds present in the story. Have your child repeat words or phrases containing the sound and encourage them to identify the sound in other words.
    • Massed vs. Distributed Practice: Instead of one long practice session, try shorter, more frequent sessions throughout the day. This can help maintain focus and prevent fatigue. It is recommended to go for 100 repetitions of the target sound per day, every day in between the sessions. We can decide together how you can best do that through either massed or distributed practice. We can decide after the session.
    • Feedback: Use a mirror to provide visual feedback on lip and tongue placement during sound production. Record the child’s speech and play it back to help them self-monitor their accuracy.

    I quite like this mirror below but any table top mirror will work as long as it is not too small. Your child should see their whole face easily.

    tabletop mirror
    • Error Correction: If the child makes an error, gently model the correct sound or movement without shaming or criticising. Provide specific cues such as ‘lips together’ for /p/ or ‘tongue up’ for /t/.
    • Variety and Progression: We will guide you on exactly what words to practise so this is something you need not worry about.
    • Motivation and Engagement: Use games, songs, and activities that your child enjoys. Play a game of ‘I Spy’ focusing on words with the target sound or create silly sentences with the sound to make practice fun.

    Let’s work together!

    It is crucial for parents, therapists, and other caregivers to work collaboratively to ensure a consistent and comprehensive approach to supporting your child’s speech development. Speech and Language Therapists can provide guidance and resources on implementing these principles at home, while parents can share observations and progress updates to inform therapy sessions.

    Remember, every child with CAS learns at their own pace. By understanding and applying the principles of motor learning, parents and speech therapists can create a supportive and stimulating environment that empowers children with CAS to reach their full communication potential.

    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.

    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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