One toy, endless targets: How to grow consonant clusters, core words and colours with one flower garden toy

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Sonja McGeachie with the build-a-flower garden toy

If you’ve been following me for a while you already know my absolute favourite rule for speech therapy: let the toy work for you. You don’t need an entire cabinet full of different flashcards or games to target a massive range of speech goals (though truth be told I do have 4 cabinets! What am I saying…) but often I find that sticking to one highly engaging, open-ended toy reduces a child’s cognitive load, keeps them firmly planted in play, and gives you dozens of natural opportunities for high-repetition practice. It also reduced my cognitive load!

In today’s post we are looking at a classic: The build-a-flower garden toy. A link is here: https://www.amazon.co.uk/Fivejoy-Flower-Garden-Building.

This vibrant, stacking toy isn’t just great for fine motor skills. It is an absolute goldmine for speech therapy. While it is incredible for targeting tricky consonant clusters (blends) like /ST/, /SP/, /SPR/, /FL/, /BL/, and /GR/, it is equally powerful for building functional core vocabulary.

1. Digging deep with /ST/

Let’s start building our garden.

Stem & stalk: ‘Look at this long stem!’ or ‘Can you put the stem in?’ or ‘do you want the green or the red stem’?

  • Stuck: If a piece is a little tight to push down, it’s a brilliant opportunity for a natural exclamation: ‘Oh no, it’s stuck! Help me!’
  • Stand: Once it’s secure, you can celebrate: ‘it can stand up now!’
  • 👉 Core word integration: Use this setup stage to practise ANOTHER ONE. As you hold the base pieces, wait for the child to use their words or AAC device to request, ‘I want another one!’ before handing over the next stem.

2. Sowing seeds with /SP/ and /SPR/

Every good gardener needs the right equipment and a close eye for detail. We can introduce tools and descriptive language to hit our /SP/ and triple-blend /SPR/ targets.

  • Spade: Grab a toy shovel or pretend to use one. ‘Let’s dig a hole with the spade.’
  • Spot: Point to the holes on the base. ‘Find a good spot for this flower.’
  • Sprout: Talk about the little green pieces: ‘Look at the little sprout!’
  • 👉 Core word integration: Build on spontaneous requesting here. If they are eyeing a specific piece, model a full phrase like: ‘I WANT THE PINK ONE.’

3. /FL/ and fine motor actions

Now, we can start adding the colourful petals.

  • Flower: This is your high-frequency word for the entire activity. ‘Put the green/blue/pink flower on top.’
  • Flat & flutter: ‘This piece is flat on the ground,’ or ‘The butterfly flutters by!’
  • 👉 Core word integration: This stage is perfect for teaching directional actions. Every time they stack a petal onto a stem, model the core phrase: ‘PUT IT ON!’

4. Blending it all together with /BL/

Building a garden is a fantastic sensory experience because of the vivid colours. We can lean heavily into the /BL/ sound by focusing on colour selection and the action of growth.

  • Blue & bloom: ‘Should we use a blue flower?’ and ‘Watch it bloom!’
  • Blade & blend: Point out the blades of grass and talk about how we blend all the colours together.
  • 👉 Core word integration: Don’t just focus on putting the toy together, taking it apart is half the fun! If a child places a piece they don’t want, or when it’s time to clean up, model: ‘TAKE IT OFF.’

5. Working the /GR/

Finally, we look at the environment supporting our garden. The /GR/ blend can be targeted by looking downward at the base of our toy setup.

  • Green: Nearly every stem and base piece in this toy is a vibrant shade of green.
  • Grass & ground: ‘Put the base down on the ground.’ ‘Look at the green grass.’
  • 👉 Core word integration: Combine your /GR/ blend with a powerful core phrase. As you pull a stem upward slowly or stack the petals higher and higher, chant together: ‘MAKE IT GROW! Grow, grow, grow!’

Maximise your repetitions in play

The beauty of the flower garden toy is its repetitive nature. Because a child builds multiple flowers, you aren’t just saying a word or a phrase once, you have the potential to repeat it 10, 15, or 20 times in a single sitting without the child losing interest.

By layering structural speech sounds (like blends) over functional communication phrases (like core words), we give children words they can use across their entire day.

What toy would you like to see us target next in our series? Let me know in the comments on Instagram, and don’t forget to swipe through the carousel there to save these word lists for your next playtime!

If you are concerned about your child’s speech, please do not hesitate to get in touch. I would love to help you find some answers.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


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

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

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    How can I incorporate AAC into my speech therapy sessions?

    Many parents are surprised when I bring AAC into a session, especially if they’ve come to see me primarily for speech sound work.

    They might wonder: ‘If we’re working on pronunciation, why are we using a communication device?’

    The simple answer is this: speech therapy is about communication first, and speech sounds second. Supporting a child’s ability to express themselves clearly and confidently is always the priority, and AAC can be a powerful tool alongside spoken speech.

    What do we mean by AAC?

    AAC stands for Augmentative and Alternative Communication.

    This can include:

    • A speech-generating device (such as LAMP Words for Life or GRID as I used in the photo below)
    • A communication app on a tablet
    • A symbol board or communication book
    • Gestures, signs, or visual supports

    AAC does not replace speech. Instead, it supports language development, reduces frustration, and builds communication success while speech skills are developing.

    Pretend Play using Speech and AAC in my clinic room

    But I mainly work on speech sounds… So how does AAC fit?

    Most of the children I see are working on:

    • Articulation difficulties
    • Phonological delay
    • Motor planning challenges (including apraxia/dyspraxia)
    • Unclear speech affecting confidence

    For these children, AAC isn’t a separate therapy. It’s simply woven naturally into what we are already doing.

    If a child brings their device to sessions, I actively include it. If they don’t yet use AAC but could benefit from visual or symbolic support, I may introduce simple options within activities.

    Using AAC to support speech practice

    Let’s say we are working on early speech targets like: ‘GO’.

    We might practise:

    • Saying the word verbally
    • Listening for the target sound
    • Using play (TOY TRAIN GOING ROUND A TRACK)

    Now we can extend this using AAC.

    On the device or communication board, we might model: ‘LET’S GO’ or ‘IT’s GOING up the hill’.

    This allows the child to:

    • Practise their speech sound target
    • Build a simple sentence
    • Experience successful communication even if speech is not fully clear yet

    All responses are valid and supported.

    AAC helps children communicate more than they can say

    Many children can understand and think in longer phrases than they can physically say.

    For example:

    • A child who verbally says single words may build longer phrases on AAC.
    • A child who struggles to plan speech movements may use AAC to communicate smoothly while still practising verbal attempts.
    • A child who becomes frustrated when misunderstood gains a reliable backup system.

    Rather than slowing speech progress, AAC often:

    • Reduces communication pressure
    • Increases participation in therapy
    • Encourages more attempts at speech
    • Supports language growth

    When children feel understood, they usually become more motivated to try speaking.

    There are no ‘prerequisites’ for AAC

    One of the biggest myths I hear is: ‘My child isn’t ready for AAC yet.’

    In reality, children do not need to:

    • Reach a certain speech level
    • Use pictures first
    • Prove they understand everything
    • Show immediate interest

    Instead, we presume competence and introduce AAC in meaningful, playful ways.

    That means:

    • Modelling words while blowing bubbles
    • Commenting during playdough activities
    • Choosing words during games
    • Building simple phrases in shared reading

    AAC should never feel like extra ‘work’. It’s simply another way to join in communication.

    My goal is always the same: to help each child communicate as clearly, confidently, and successfully as possible, using every helpful tool available.

    If your child uses AAC (or might benefit from it)

     Please feel free to:

    • Bring the device to sessions
    • Show me how your child currently uses it
    • Share advice from school or other therapists

    I am very happy to incorporate AAC into our work together so that speech practice, language development, and real communication all move forward hand-in-hand. Because ultimately, therapy isn’t just about producing perfect sounds. It’s about helping your child be heard and understood.

    If you’d like support or advice, please contact me and I can help guide the next steps.

    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.

      3
    • · ·

      Feeding therapy: A guide for parents and caregivers

      Feeding therapy is a specialised form of therapy and support that helps children develop healthy eating habits and overcome challenges related to food. It’s often used for children with picky eating, feeding disorders, or sensory processing issues.

      What is feeding therapy?

      Feeding therapy involves a series of techniques designed to improve a child’s eating skills and attitudes towards food. In the UK it’s typically provided by speech and language therapists and dietitians. These professionals work closely with parents and caregivers to create a personalised treatment plan tailored to each child’s unique needs.

      How does feeding therapy work?

      Feeding therapy sessions are typically 30–60 minutes long and involve a variety of techniques, including:

      • Family counselling: Providing support and guidance to parents and caregivers. This can help address any practical, behavioural and emotional issues that may be impacting the child’s eating.
      • Play-based activities: Engaging children in fun activities while introducing new foods or textures. This can help alleviate anxiety and make mealtimes more enjoyable.
      • Sensory exploration: Helping children become more comfortable with different tastes, smells, and textures. This can be achieved through activities like touching, smelling, and tasting various foods.
      • Oral motor exercises: Improving chewing, swallowing, and lip coordination. These exercises can help children develop the necessary skills for eating independently.
      • Behavioural techniques: Using positive reinforcement to encourage healthy eating habits. This can involve rewarding children for trying new foods or eating a variety of meals.

      When is feeding therapy needed?

      Feeding therapy may be beneficial for children who:

      • Are picky eaters: Refuse to eat a variety of foods or have strong preferences.
      • Have feeding disorders: Experience difficulties with eating, such as swallowing or chewing.
      • Have sensory processing issues: Are sensitive to certain textures, smells, or tastes.
      • Have medical conditions: Such as autism, cerebral palsy, or gastrointestinal disorders.

      Feeding therapy strategies you can try at home

      While professional feeding therapy can be invaluable, there are several techniques you can try at home to support your child’s eating development:

      • Create a positive mealtime environment: Make mealtimes enjoyable and stress-free by avoiding distractions, limiting screen time, and creating a calm atmosphere.
      • Create regular mealtimes and mealtime routines: Introduce set ways of announcing meal times, including songs or short nursery rhymes, try and involve your child with table setting, even just carrying their spoon to the table and putting the beaker next to the plate and ensure that meal time finishes after about 30 minutes, again with a set routine so that the child always knows: this is how we do it in our home, now I am finished and meal time is over.
      • Introduce new foods gradually: Start with small amounts and gradually increase exposure. This can help reduce anxiety and make new foods less overwhelming.
      • Model healthy eating: Show your child how to enjoy a variety of foods by eating a balanced diet yourself.
      • Avoid forcing food: Allow your child to choose and explore foods at their own pace. Forcing them to eat can create negative associations with food.

      Seek professional help

      If you’re concerned about your child’s eating habits, consult with a feeding therapist. We can provide guidance and support.

      Remember, feeding therapy is a collaborative process between parents, caregivers, and professionals. With patience, understanding, and the right strategies, you can help your child develop healthy eating habits and enjoy meals.

      Would you like to know more about specific techniques or have any other questions about feeding therapy?

      Please feel free to contact me.

      Sonja McGeachie

      Early Intervention Speech and Language Therapist

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

      The London Speech and Feeding Practice


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

      1
    • · ·

      Childhood Apraxia of Speech: Signs and first steps (2–5 years)

      If you’ve found yourself wondering ‘Why can my child say a word one day, but not at all the next?’ it might be that your child has a motor speech difficulty. This means the challenge isn’t that your child doesn’t know what they want to say; it’s that their brain finds it harder to plan and coordinate the movements needed for clear speech. This speech difficulty is called Childhood Apraxia of Speech (CAS)

      Sonja showing power words on a board

      In this post, I’ll explain what CAS can look like in 2–5 year olds, what an assessment usually involves, and what you can start doing at home to support your child without turning life into ‘speech homework all day long’.

      What is childhood apraxia of speech (CAS)?

      Children with CAS often have lots to communicate about (and strong ideas!) but their speech may come out as:

      • Unclear
      • inconsistent
      • hard to ‘copy’ on demand
      • frustrating for them and for you

      CAS is not caused by laziness and it is not a parenting issue. It is also not something children simply ‘grow out of’ without support. But with the right therapy approach, children can absolutely build clearer speech over time.

      If you’d like to read more about verbal dyspraxia, you may also find this helpful: Supporting children and families living with verbal dyspraxia.

      Why is CAS such a big topic right now?

      Many families come to me after months (or years) of being told:

      • ‘She’ll talk when she is ready’
      • ‘He’s just shy’
      • ‘It’s probably a speech delay’
      • ‘It’s normal for toddlers’

      And sometimes it is a general delay. But sometimes it’s something more specific, like CAS.

      There’s also been a huge rise in parents seeking information online, and CAS is often mentioned alongside speech sound difficulties such as:

      • phonological delay (pattern-based speech errors)
      • articulation difficulties (one sound that won’t come out clearly)
      • inconsistent speech disorder

      These can look similar at first glance, which is why a specialist assessment matters.

      Signs of childhood apraxia of speech in 2–5 year olds

      Children develop speech at different rates, and not every unclear speaker has CAS. But here are some common features that may raise a flag, especially when you notice several together.

      1) Inconsistent speech errors

      Your child might say the same word in different ways:

      • ‘banana’ → nana / baba / mana
      • ‘daddy’ → gaga / daddy / dadi

      This inconsistency is one of the biggest clues.

      2) Difficulty copying words on request

      Some children speak more easily in natural play, but when asked ‘Say ___’, they freeze or the word becomes much harder.

      3) Limited sound repertoire

      They may use only a small set of consonants (like /M/, /N/, /B/, /D/) and avoid others.

      4) Vowel distortions

      Many children with typical delays mainly struggle with consonants. But in CAS, vowels can also sound ‘off’ or change between attempts.

      5) Speech that sounds effortful

      You might notice your child:

      • pauses between sounds
      • tries multiple times
      • looks like they’re ‘searching’ for the right mouth movement

      6) Longer words are much harder

      ‘Car’ might be easier than ‘carry’, and ‘carry’ easier than ‘caterpillar’.

      7) Prosody differences (rhythm and stress)

      Some children with CAS sound a little unusual in their speech rhythm, stress, or intonation.

      8) Frustration or reduced confidence

      When a child is frequently misunderstood, they may:

      • talk less
      • use gestures more
      • become upset when asked to repeat themselves

      Important note: none of these signs alone prove CAS but they are a strong reason to seek a speech assessment rather than waiting.

      CAS vs phonological delay vs articulation difficulty (quick guide)

      These are some of the most common questions I hear.

      If it’s mainly an articulation difficulty…

      A child may consistently say one sound incorrectly (for example, ‘thun’ for ‘sun’- lisp- but everything else is developing well.

      If it’s mainly a phonological delay…

      You might notice clear patterns, like:

      • leaving off the ends of words (‘ca’ for ‘cat’)
      • swapping back sounds for front sounds (‘tar’ for ‘car’)

      Patterns are often consistent and respond well to phonology-based therapy.

      If it might be CAS…

      Speech often feels less predictable, harder to imitate, and more impacted by word length and complexity.

      If you’re unsure, that’s completely normal, and exactly why assessment matters.

      What happens in a CAS assessment?

      A high-quality speech assessment for possible CAS usually includes:

      1) Parent discussion and developmental history

      We talk about:

      • pregnancy and birth history (where relevant)
      • feeding history
      • early sounds and babbling
      • first words and how speech has progressed
      • family history of speech/language needs

      2) A speech sound assessment

      Your child might be shown pictures or play-based prompts so we can hear:

      • what sounds they can say
      • what they simplify
      • whether errors are consistent or inconsistent

      3) An oral-motor and movement check

      This isn’t about ‘strength’. It’s about coordination and planning. We look at how your child manages speech movements and transitions.

      4) Stimulability testing

      This means: how easily can your child learn a new sound or word with support?

      For CAS, we often explore how they respond to:

      • slowed-down speech
      • visual cues
      • rhythm/tapping
      • short, simple syllable shapes

      5) Functional communication and confidence

      We look at how speech impacts daily life:

      • being understood at nursery
      • joining in with peers
      • asking for help
      • managing emotions when misunderstood

      At the end, you should leave with:

      • a clear explanation of what we think is going on
      • a therapy plan
      • practical home strategies
      • realistic next steps

      What parents can do at home

      Here are CAS-friendly strategies you can start right away.

      1) Choose ‘power words’

      Pick 1–2 words that matter most in your child’s daily life, such as:

      • more
      • help
      • mummy
      • again
      • stop
      • open

      These words are motivating and functional.

      2) Keep it short and successful

      For many children with CAS, the goal is quality over quantity.

      Try five minutes a day rather than 30 minutes of struggle.

      3) Support speech with rhythm

      Some children benefit from:

      • tapping a beat on the table
      • clapping syllables
      • using a gentle ‘marching’ rhythm

      This can help the brain organise the sequence of movements.

      4) Celebrate approximations

      If your child says ‘moh’ for ‘more’, that’s communication!

      We want them to feel:

      • safe
      • understood
      • proud to try again

      Confidence is a key part of progress.

      A short parent story (anonymised)

      One mum said to me:

      ‘We kept being told to wait. But I could see my child understood everything; they just couldn’t get the words out. Once we had an assessment and a plan, it felt like we finally knew what to do. The biggest change was his confidence. He started trying more.’

      When should you seek support?

      You don’t need to wait until school.

      It’s worth getting an assessment if your child is:

      • hard to understand compared with peers
      • becoming frustrated or withdrawing from talking
      • inconsistent with words they used to say
      • struggling to imitate speech sounds
      • showing signs that match CAS

      Early support can reduce stress for the whole family and help your child feel successful in communication.

      Here’s how I can help:

      ✅ A detailed speech assessment (including whether CAS is likely)

      ✅ A clear therapy plan with realistic goals

      ✅ Practical home strategies you can use immediately

      ✅ Support for nurseries and schools (where needed)

      ✅ In-person sessions in North-West London and online options

      Book your consultation here.

      Final gentle reminder

      You are not overreacting. Trust your instincts.

      Your child is communicating the best way they can, and with the right support, speech can become easier, clearer, and more confident.

      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.

      3
    • Submucous cleft palate: What is it and how does it impact on speech?

      Submucous cleft palate: What is it and how does it impact on speech?

      What exactly is a submucous cleft palate?

      A submucous cleft palate (SMCP) is much less obvious than its counterparts, cleft of lip and/or palate, and can profoundly impact a child’s speech development. It leads to often extreme hyper nasal speech and difficulty with producing many sounds (/K/ /G/ /T/ /D/ /P/ /B/ /S/ /Z/ /F/ /V/).

      In short, the muscles and bone of the soft palate, and sometimes the hard palate, do not fuse completely during foetal development and the mucous membrane that lines the roof of the mouth remains intact, effectively camouflaging the underlying muscular and bony deficit.

      So, while the surface of the palate appears normal, the essential muscle and functions responsible for sealing off the nasal cavity from the oral cavity during speech are compromised. This cleft (or lack of muscle) can be seen as a bluish midline discoloration of the soft palate, often a bifid (split) uvula, and at times a notch in the posterior border of the hard palate can be felt upon palpation. However, these signs aren’t always present or easily discernible, contributing to the difficulty arriving at a diagnosis.

      Diagnosing a submucous cleft palate is often akin to searching for a needle in a haystack, especially for the untrained eye. Unlike overt clefts that are visually apparent at birth, an SMCP can go undiagnosed for years, sometimes well into childhood or even adolescence. Paediatricians and even ENT surgeons have been known to miss it during routine checks due to the intact mucosal lining. Parents might notice their child’s speech sounds ‘different’ or ‘nasal’ but struggle to pinpoint the cause. Children might undergo extensive speech therapy without a proper diagnosis, as the underlying structural issue continues to hinder progress.

      My experience as a speech therapist in private practice:

      Over my years of practice, I have encountered several children presenting with persistent hyper-nasal speech and significant difficulties producing plosive and fricative sounds.

      It has been incredibly rewarding, though at times challenging, to successfully diagnose SMCP in a number of these children. My approach often involves:

      • a meticulous oral motor examination,
      • careful listening for the specific qualities of hypernasality,
      • and a deep understanding of the physiological requirements for clear speech sound production.

      When I suspect an SMCP, I refer these children to Great Ormond Street Hospital where a fantastic multidisciplinary team, typically including ENT surgeons and a specialist speech-language therapist can conduct more definitive assessments. These assessments often involve instrumental analyses such as videofluoroscopy or nasoendoscopy, which provide objective measures of velopharyngeal function and visual confirmation of the anatomical deficit.

      The path to resolution: surgery, therapy, and successful outcomes

      Surgery

      The journey for these children, once diagnosed, often involves surgical intervention. It’s not uncommon for children with SMCP to undergo multiple operations to achieve optimal velopharyngeal closure. These procedures aim to reconstruct or augment the velopharyngeal mechanism, enabling it to effectively separate the oral and nasal cavities during speech. The specific surgical approach depends on the individual child’s anatomy and the severity of the velopharyngeal insufficiency. It’s a testament to the skill of these specialised surgeons that such intricate repairs can be performed with remarkable success.

      Speech therapy

      Following surgery these children embark on the crucial phase of speech therapy. While surgery addresses the structural problem, speech therapy helps a child learn to utilise their newly improved anatomy. It involves intensive work on developing oral airflow, establishing correct articulatory placement, and reducing learned compensatory strategies that have developed due to the original structural deficit. It is immensely gratifying to witness the transformation. Children who once struggled to produce basic sounds, whose speech was difficult to understand, gradually develop clear speech.

      Next steps?

      If you’re a parent concerned about your child’s speech and feeding, you’re not alone. The journey can feel confusing, but professional guidance can make all the difference. Never hesitate to have a second opinion when you have that niggling feeling that there is something that has not yet been explored. At London Speech and Feeding I specialise in being thorough and thinking outside the box.

      I am here to provide the support you need. Reach out to schedule a consultation and take the first step towards helping your child communicate and thrive.

      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
    • · ·

      Using AAC in daily life

      Communication is a fundamental human right, a bridge that connects us to the world and each other. For many, spoken language is the primary mode, but for individuals with complex communication needs, Augmentative and Alternative Communication (AAC) offers a powerful pathway to expression and connection. This guide will demystify AAC, highlight the crucial role of modelling, and provide practical examples of how low-tech AAC can be seamlessly integrated into everyday activities.

      What is AAC in a nutshell?

      AAC encompasses a wide range of tools and strategies that supplement or replace spoken language. It’s not about replacing speech, but rather about providing additional ways for individuals to communicate effectively. Think of it as a spectrum:

      • Unaided AAC: This involves using only your body, such as gestures, facial expressions, body language, and sign language.
      • Aided AAC: This involves external tools or devices. These can range from low-tech options like picture boards and communication books to high-tech speech-generating devices (SGDs) and apps on tablets.

      The beauty of AAC lies in its flexibility and personalisation. It empowers individuals to express their wants, needs, thoughts, and feelings, fostering independence and participation in all aspects of life.

      Modelling is KEY: Showing, not just telling

      Imagine trying to learn a new language without ever hearing it spoken. It would be incredibly difficult, right? The same principle applies to AAC. Modelling is the single most important strategy for teaching and supporting AAC users. It means actively using the AAC system yourself while talking, demonstrating how to navigate the system and express messages.

      Here’s why modelling is so vital:

      • It’s how we learn language: Typically developing children learn language by hearing it constantly around them. AAC users need the same immersion.
      • It reduces pressure: When you model, you’re not asking the individual to communicate, you’re just showing them how it’s done. This takes the pressure off and makes learning more enjoyable.
      • It expands vocabulary and concepts: By modelling a variety of words and phrases, you introduce new vocabulary and demonstrate how to combine symbols to create more complex messages.
      • It demonstrates purpose: Modelling shows that AAC is a functional and effective way to communicate, not just a set of pictures.

      So, how do you model? It’s simple: point to the symbols on the communication board or device as you speak the words. For example, if you say, ‘Time to eat breakfast,’ you might point to ‘time’, ‘eat’, and ‘breakfast’ on the board.

      Low-tech AAC in action: Everyday activities

      Low-tech AAC, such as communication boards, books, or single-page displays, is incredibly versatile and can be easily incorporated into daily routines. These can be as simple as printed pages with symbols, laminated for durability.

      Let’s explore how low-tech AAC can be used throughout a typical day, with examples of symbols:

      1. Getting ready for nursery

      Mornings can be busy, but they also offer rich communication opportunities. A ‘Getting Ready’ communication board can help sequence activities and offer choices.

      Activity example:

      ‘Time to get up!’ (point to GET UP). ‘What do you want to wear today, the blue shirt or the red shirt?’ (point to GET DRESSED) ‘Then, we brush teeth’ (point to TOOTHBRUSH) and so on.

      AAC mornings symbol examples

      2. Breakfast Time

      Mealtimes are perfect for making choices, expressing preferences, and commenting. A ‘Breakfast’ communication board can focus on food items, actions, and social comments.

      Example symbols:

      AAC meal times symbol examples

      Activity example:

      ‘What do you want to eat for breakfast?’ (point to EAT). ‘Do you want cereal or toast?’ (point to CEREAL or TOAST). If they finish their milk, you could say, ‘Are you ALL DONE or do you want MORE MILK?’ (point to symbols).

      3. Catching the Bus

      Even routine transitions like catching the bus can be communication rich. A small, portable ‘Travel’ board can be useful.

      Example symbols:

      AAC catching the bus symbol examples

      3. Being on the playground

      The playground is a dynamic environment perfect for commenting, requesting actions, and engaging in social play.

      AAC playground symbol examples

      Activity example:

      ‘Let’s PLAY!’ (point to PLAY). ‘Do you want to go on the SWING or the SLIDE?’ (point to symbols). If they are on the swing, you can say, ‘Do you want to go FAST or SLOW?’ (point to symbols) and ‘Push AGAIN!’ (point to PUSH) You can also model social language like ‘It’s MY TURN.’

      Beyond the symbols: Key takeaways

      • Consistency is key: Use AAC consistently across all environments and with all communication partners.
      • Be patient: Learning a new language takes time. Celebrate small successes.
      • Make it fun: Integrate AAC into play and enjoyable activities.
      • Follow the individual’s lead: Respond to all communication attempts, even if they are imperfect.

      In the video below I model how to integrate AAC into everyday activities with a few more examples and I discuss the difference between AAC and PECS.

      If you need some inspiration with using AAC or would like your child assessed for the right type of AAC then please get in touch.

      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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    • · ·

      When speech difficulties overlap: Helping children with phonological delay and childhood apraxia of speech

      One of the questions parents often ask is:

      ‘What kind of speech difficulty does my child have?’

      It’s a very understandable question. We often hear different terms such as phonological delay, articulation difficulties, or Childhood Apraxia of Speech (CAS), and it can be confusing.

      The reality is that many children don’t fit neatly into one single category.

      In fact, quite often I see children whose speech profile includes a mixture of difficulties. They might have some phonological patterns (where they substitute one sound for another) alongside challenges with motor speech planning, where coordinating the movements needed for speech is harder.

      When this happens, therapy needs to be flexible, responsive, and tailored to the child sitting in front of us.

      Example

      Recently I filmed a short clip from one of my therapy sessions which shows exactly how this works in practice.

      The child I was working with has difficulties with several speech sounds. Part of the challenge relates to a phonological pattern called fronting.

      Fronting is when sounds that should be made further back in the mouth (like /K/ or /G/) are produced further forward instead.

      At the same time, this child also shows signs of motor speech planning difficulty, which means the brain has to work harder to organise and sequence the movements of the tongue, lips and jaw for speech.

      This type of profile can sometimes overlap with characteristics seen in Childhood Apraxia of Speech (CAS).

      When difficulties overlap like this, therapy cannot rely on a single approach. Instead, it needs to draw on multiple evidence-based strategies.

      That is exactly what you see happening in the clip. We started out generalising the /K/ sound which until recently had been replaced by a /T/ sound. Whilst looking at a sound loaded picture of /K/ sounds we somehow got talking about a ‘dent’ (I don’t recall how we got there!) but the ‘dent’ was a ‘det’ and I decided to tackle this there and then because there are other great words that end in ‘nt’ like : ‘count’ ‘giant’ ‘point’ or ‘paint’.

      Using visual cues to support motor planning

      Speech is incredibly complex. For children with motor speech difficulties, the challenge is not only knowing what sound they want to say, but also how to move their mouth to produce it.

      This is where visual cues can be incredibly helpful.

      In the clip, you can see me using a whiteboard with pictures and simple visual prompts. These help to:

      • Focus attention on the target sound
      • Understand where the sound occurs in the word
      • Remember the sequence of sounds needed

      Visual supports can act almost like a map for the mouth, guiding children as they practise new speech movements.

      For children with motor planning difficulties, this type of cueing can make a huge difference.

      Why repetition of a single word (massed practice) is so important

      Another key feature you will notice in the clip is lots of repetition.

      This is very deliberate.

      When we are supporting children with motor speech challenges, the brain needs repeated opportunities to practise the correct movement patterns. Just like learning a musical instrument or a new sport, repetition helps the brain build stronger and more efficient pathways.

      In therapy we call this massed practice.

      Rather than saying a word only once or twice, we practise it many times in a structured way, helping the child stabilise the new speech pattern.

      But repetition alone is not enough. The child also needs to understand why the sound matters.

      Showing children that sounds change meaning

      This is where another powerful therapy approach comes in: minimal pairs.

      Minimal pairs are word pairs that differ by only one sound. For example:

      • debt
      • dent

      In the clip, I use these two words to help the child realise that the /N/ sound makes a meaningful difference.

      Without the /N/, the word becomes something else entirely.

      This approach helps children recognise that speech sounds are not random: they carry meaning. If a sound is missing or substituted, the message may change.

      Helping children notice these differences can be a very motivating moment in therapy. Suddenly the sound is no longer just an abstract exercise; it becomes part of real communication.

      Blending approaches for the best outcomes

      In this short therapy moment, I am combining:

      • Visual cueing

      • Motor speech practice

      • High repetition (massed practice)

      • Minimal pair contrasts

      • Listening and awareness of sound differences

      Each element supports a different part of the speech system.

      Some strategies help with motor planning, others support phonological awareness, and others build accuracy and consistency.

      Together they create a therapy session that is both structured and responsive.

      Every child’s speech journey is unique

      One of the most important things I want to convey is that speech development is not always straightforward.

      Two children may both struggle with speech sounds, yet the underlying reasons may be very different.

      This is why careful assessment is essential, and why therapy needs to stay flexible as we learn more about how a child’s speech system works.

      Sometimes a child needs more motor-based work.

      Sometimes the focus shifts towards phonological contrasts.

      Often, as in this example, the most effective therapy uses both.

      Small steps lead to big progress

      Every session helps us understand a little more about how a child’s speech system works and what support will help them move forward.

      And when the pieces start to come together, when a child realises that one tiny sound can change a whole word, that is when the real progress begins.

      If you are concerned about your child’s speech sounds, clarity of speech, or possible motor speech difficulties, early support can make a significant difference. A detailed assessment can help identify the nature of the difficulty and guide a therapy approach tailored to your child’s individual needs.

      Feel free to contact me on www.londonspeechandfeeding.co.uk

      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

      McNeill, B. C., Gillon, G. T., & Dodd, B. (2009). Effectiveness of an integrated phonological awareness approach for children with childhood apraxia of speech (CAS). Child Language Teaching and Therapy, 25(3), 341-366.

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