Seeing sounds: How visual gestures boost speech sound learning

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Learning to produce new speech sounds can be a complex process for young children, especially those facing challenges with speech sound disorders or motor planning difficulties. It’s not just about knowing what a sound ‘should’ sound like; it’s about figuring out where to put your tongue, how to shape your lips, and how much air to push out. This is where the power of visual gestures comes in – literally helping children see how to make sounds.

As speech and language therapists, we frequently use visual cues and hand gestures to teach articulation. These techniques are incredibly effective, particularly when a child is struggling with the motor planning aspect of speech production.

In the video clip above you see me teaching

  • the /SH/ sound: the hand makes a C-shape and moves forward showing both how the lips are positioned and the air flowing forward
  • the /S/ sound: the index finger shows a snake like movement going forward- also showing the air flow again
  • the /W/ sound: my right hand moves forward and fingers splay out showing that the lips open up at the end of the sound
  • the /K/ sound: my finger points to the back of my throat where the tongue needs to raise.

An overview of motor planning for speech – what do we mean by that?

Think about learning to ride a bike or play a musical instrument. You don’t just know how to do it instantly. You have to plan the movements, practise them, and make adjustments. Speaking is similar! Our brains must:

  1. Plan the sequence of movements needed for each sound and word (e.g., /B/ requires lips together, then release, while /T/ requires the tongue tip behind the top teeth, then release).
  2. Execute those plans rapidly and precisely.

For some children, especially those with conditions like Childhood Apraxia of Speech (CAS) or other severe articulation disorders, this motor planning process is disrupted. They know what they want to say, but their brain struggles to send the correct, consistent messages to their articulators (lips, tongue, jaw, velum). This can make speech sound learning incredibly frustrating.

Why use visual gestures?

Visual gestures provide an additional, powerful sensory input that can help bridge the gap between knowing a sound and producing it. Here’s how and why they are so beneficial:

1.      Providing a visual map:

  • How it helps: Many speech sounds are ‘hidden’ inside the mouth. It’s hard for a child to see where their tongue needs to go for a /K/ sound (back of the tongue to the roof of the mouth) or a /T/ sound (tongue tip behind teeth). A simple hand gesture can visually represent this mouth movement. For example, a hand gesture for /K/ might involve sweeping the hand back towards the throat, while for /T/, it might be a tap on the chin.
  • Why it works: Children are highly visual learners. Seeing a physical representation of an abstract mouth movement gives them a concrete ‘map’ to follow, making the process less mysterious and more manageable.

2.      Enhancing motor planning and memory:

  • How it helps: When a child simultaneously moves their hand (the visual gesture) and attempts to make the sound, they are engaging multiple sensory systems (visual, tactile, proprioceptive – body awareness). This multi-sensory input strengthens the neural pathways associated with that speech sound.
  • Why it works: This multi-modal learning helps to solidify the motor plan for the sound in the brain. It’s like having more ‘hooks’ to hang the information on, making the sound easier to recall and produce consistently. The gesture becomes a built-in reminder.

3.      Reducing cognitive load:

  • How it helps: Instead of just hearing the sound and trying to figure out the complex motor sequence, the child has a visual cue to guide them. This reduces the mental effort required to decode the sound production.
  • Why it works: When cognitive load is lower, the child can focus more effectively on the specific motor execution of the sound, leading to faster progress and less frustration.

4.      Increasing engagement and success:

  • How it helps: Gestures can make therapy more interactive and fun! When a child successfully produces a sound with the help of a gesture, it’s a tangible victory.
  • Why it works: Success is a powerful motivator. When children experience success, they are more likely to stay engaged, participate actively, and feel more confident in their ability to learn new sounds.

5.      Supporting self-correction:

  • How it helps: Once a child learns the gesture associated with a sound, he or she can use it as a self-monitoring tool. If he or she makes an error, he or she can use the gesture to remind himself or herself of the correct mouth position or movement.
  • Why it works: This promotes independent learning and reduces reliance on constant adult prompting.

Conclusion

The journey of speech development can be challenging, but visual gestures offer a powerful and effective tool for teaching new sounds, especially when motor planning is a factor. By providing a clear visual map, strengthening motor memory, reducing cognitive load, and fostering engagement, these gestures pave the way for clearer communication and greater confidence. If your child is struggling with speech sounds, consider talking to a Speech and Language Therapist to get guidance on how visual gestures might be incorporated into the therapy plan. Because sometimes, seeing truly is believing (and speaking!).

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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    Baby-led weaning: Empowering little eaters from the start

    I had a mum ask me about Baby Led Weaning the other day. So I thought I would write a blog on all the useful questions she had and what we discussed as it may help lots of mums and dads out there.

    As a Paediatric Feeding SLT, one of the exciting developments in recent years is the growing interest in baby-led weaning (BLW). This approach to introducing solids has gained significant traction, and for good reason. It empowers infants to take the lead in their feeding journey, fostering a positive relationship with food and supporting important developmental milestones.

    What exactly is baby-led weaning?

    At its core, baby-led weaning is about offering your baby appropriately sized and textured solid foods from the very beginning, allowing him or her to self-feed. Instead of spoon-feeding purées, you present whole, soft foods that your baby can grasp, bring to his or her mouth, and explore at his or her own pace. This means no mashing, no blending, and no forcing spoons into reluctant mouths. It’s a fun, messy, and intuitive process that is led by your baby’s natural instincts.

    The genesis of baby-led weaning

    ‘Baby-led weaning’ was popularised by British health visitor Gill Rapley. In the early 2000s, Rapley observed that babies naturally develop the skills needed to self-feed and that traditional spoon-feeding might actually hinder this development. Her work, particularly her book Baby-Led Weaning: The Essential Guide to Introducing Solid Foods (co-authored with Tracey Murkett), published in 2008, brought BLW into the mainstream and provided a structured framework for parents. Her research and observations highlighted the benefits of trusting a baby’s innate ability to regulate his or her intake and explore different textures.

    What’s the deal?

    Implementing BLW is simpler than you might think, though it does require a shift in mindset. Here’s a breakdown of what it typically involves:

    • Readiness is key: The golden rule of BLW is to wait until your baby shows clear signs of readiness. This isn’t about age alone, but rather developmental milestones. Your baby should be at least six months old, able to sit unassisted, have good head and neck control, show an interest in food (e.g., reaching for yours), and have lost his or her tongue-thrust reflex (which pushes solids out of his or her mouth).
    • Offer finger foods: Start with soft, easily graspable foods cut into finger-sized sticks or spears. Think cooked sweet potato fries, steamed broccoli florets (soft enough to mash with gentle pressure), banana sticks, or avocado slices. The goal is for babies to be able to pick it up and get some into their mouth.
    • Embrace the mess: BLW is inherently messy, especially in the beginning. Food will be squished, dropped, and smeared. This is a crucial part of the learning process as babies explore textures, smells, and the properties of food. A wipeable mat under the highchair and a good bib are your best friends!
    • Observe, don’t interfere: Allow your baby to lead. He or she will decide what to eat, how much, and how quickly. Avoid putting food into his or her mouth or pressuring him or her to eat more. This respects his or her hunger and fullness cues, laying the foundation for healthy eating habits.
    • Continue breastmilk or formula: Until your baby is well-established on solids, breastmilk or formula remains his or her primary source of nutrition. Solids are for exploration, taste, and developing skills, gradually increasing in quantity over time.

    The benefits of baby-led weaning

    The advantages of BLW extend far beyond simply getting food into your baby. From a speech and feeding perspective, the benefits are compelling:

    • Develops oral motor skills: Chewing, gnawing, and manipulating various food textures are crucial for developing the muscles in the mouth, jaw, and tongue. This strengthens the oral motor skills necessary for speech development.
    • Enhances fine motor skills and hand-eye coordination: The act of grasping food, bringing it to the mouth, and coordinating these movements significantly refines fine motor skills and hand-eye coordination.
    • Promotes self-regulation and intuitive eating: By allowing babies to control their intake, BLW helps them tune into their own hunger and fullness cues, fostering a healthy relationship with food and reducing the likelihood of overeating.
    • Encourages adventurous eating: Exposure to a wide variety of tastes and textures from the outset can lead to less picky eating later. Babies are more likely to accept new foods when they have been in control of their exploration.
    • Facilitates family mealtimes: BLW integrates babies into family mealtimes from an early age, promoting social interaction and making mealtime a shared, enjoyable experience.

    When is baby-led weaning appropriate, and when not?

    While BLW offers numerous benefits, it’s not a one-size-fits-all approach.

    When BLW is appropriate:

    • When your baby meets all the developmental readiness signs: This is paramount for safety and success.
    • When you are comfortable with the mess and the learning curve: It requires patience and a relaxed attitude.
    • When you are committed to offering a variety of safe, appropriate foods.
    • When you are willing to learn about and practise safe food preparation to minimise choking hazards.

    When BLW might not be appropriate (or requires extra caution and professional guidance):

    • If your baby has a history of prematurity or significant developmental delays: His or her oral motor skills might not be sufficiently developed.
    • If your baby has certain medical conditions or anatomical differences (e.g., cleft palate, severe reflux, swallowing difficulties): These may necessitate a modified approach to feeding.
    • If there are significant feeding difficulties, aversion, or a history of choking incidents.
    • If you feel overly anxious about choking: While BLW, when done correctly, is not associated with a higher choking risk than traditional weaning, parental anxiety can impact the feeding experience. Education and consultation with a professional can help alleviate these concerns.

    A note on safety: Choking hazards

    It’s crucial to understand the difference between gagging and choking. Gagging is a natural reflex that helps prevent choking and is very common in BLW as babies learn to manage food in their mouths. Choking is silent and serious. To minimise choking risks:

    • Always supervise your baby closely during mealtimes.
    • Offer appropriately sized and textured foods. Avoid small, round, hard foods like whole grapes, nuts, popcorn, and large chunks of meat.
    • Ensure your baby is sitting upright and calm.
    • Educate yourself on infant CPR.

    Final thoughts

    Baby-led weaning is a wonderfully empowering approach that celebrates a baby’s natural abilities and fosters a positive and independent relationship with food. As Speech and Language Therapists we often see the positive impact it has on oral motor development, self-regulation, and overall feeding confidence. By understanding what it entails, when it’s appropriate, and prioritising safety, you can embark on this exciting journey with your little one, helping him or her become a confident and capable eater from the very first bite.

    If you would like help and support with weaning your baby whilst continuing to breastfeed 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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    What Is Echolalia And Does It Have A Function? How Can Speech Therapy Help With Echolalia?

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    Delayed echolalia

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    (Stiegler, 2015, Fay 1967, Blanc 2014)

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    • Vocalisations such as: humming, whistling, clicking, squealing etc.

    Much research has gone into the meaning and treatment of Echolalia and the following list consists of possible functions that have been identified:

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    • Responding to answers
    • Labelling
    • Drawing attention to self
    • Protesting
    • Requesting
    • Giving instructions
    • Self-regulation, calming

    (Stiegler 2015, Prizant 1983)

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    Sonja with a child on a swinging with a stuffed monkey

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    Therapeutic Activities Combining Spinning, Swinging, and Speech and Language Therapy

    Here are some therapeutic techniques that I use at London Speech and Feeding to combine movement with speech and language development:

    • Swinging with verbal prompts: While the child is swinging, I provide simple verbal prompts such as ‘up’, ‘down’, ‘fast’, and ‘slow.’ This helps to develop receptive language skills and improve auditory processing.
    • Sensory-motor play: I like to combine swinging with tactile activities like playing with textured balls or bean bags. This can facilitate language development through descriptive language, words and scripts like: ‘that’s so soft’, ‘oooh tickle tickle tickle!’
    • Storytelling on the swing: Often I manage to create a story while the child is swinging. This can improve narrative skills, vocabulary, and imagination. Recently I did the ‘Tiger who came to tea’ story and each time the swing stopped the tiger came and ‘ate some more cakes’ and ‘tickled their tummy’ whilst eating. It may make not much sense but my child loved it and we had ‘more tiger eat more’.
    • Song and rhyme time: Often I sing the ‘rumble in the jungle’ song while swinging my child to enhance phonological awareness, rhythm, and timing.
    • Visual supports always help: I use LAMP Words for Life AAC support during swinging and show core words such as: ‘go’ / ‘stop’/ ‘more’ / ‘tickle tickle’ etc. #lampwordsforlife #aac
    • Movement-based activities: We can incorporate activities that require sequencing, such as imitating animal movements or following simple commands while swinging. This can improve motor planning and language comprehension.

    For more information follow me on Instagram, Facebook or LinkedIn.

    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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    Joint attention for children with autism

    Kids Speech Therapist London

    Why is joint engagement important for communication development?

    It has been well-documented that the development of joint attention is impaired in children who have social communication difficulties or autism. It is, in fact, this impairment which distinguishes children with ASD from children who have other developmental delays.

    A lack of joint attention in very young children is an early sign of autism as it is a signal that there is a disruption in the motivation to connect socially with others. Since this is a crucial element, I thought I would outline what we mean by Joint Attention as supported by the research undertaken at Hanen.org.

    In typically developing children, the ability to shift attention between a person and an object for the purposes of connecting socially or for requesting develops around the same time. However, for children with ASD, these components emerge one at a time and in a linear fashion. Children with ASD usually start with requesting something and later they may learn to share attention for social sharing. (see pattern below as a general guide).

    As with typical development, there is variation in the order that these skills emerge but the following patterns of development is commonly seen:

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    • Gradually alternating looking between person and object of desire
    • Then learning to follow the point of another — which is responding to joint attention initiated by another
    • Directing attention to share interests — without looking at the adult: pointing to a truck on the road/ helicopter circling above
    • Then directing attention to share interest by alternating gaze shift between person and object — here the child is now initiating joint attention.

    What is important to note is that in order to fulfil the criteria for true joint attention, the purpose of directing the attention of another person must be social in nature. In other words, it must not be exclusively to obtain a desirable object or event/action. True Joint Attention is seen verbally or non-verbally; we want to share a thought with another person and direct them to something we are interested or excited or spooked by.

    For example: we can see an amazing firework display in the distance and we want to quickly direct our friend’s attention to this. In order to do this we might be tugging their sleeve/arm whilst pointing to the display in the distance, and perhaps we might add “wow look over there!” We are doing so simply to share an interest without obtaining anything, we are just being social with each other. So True Joint Attention is not just looking at what we want to have, then look at the person who can get this for us and then point to the item. We can say that this is the precursor to true joint attention, which is purely social in nature.

    Because true joint attention is an essential precursor to typical language development, the absence of joint attention in children with ASD contributes to difficulties with language learning. Beuker, K., Rommelse, N., Donders, R. & Buitelaar, J. (2013).

    The Hanen programme for Parent Child Interaction teaches parents of children with Social Communication Difficulties step by step how to enable their children to learn to pay attention to an object and the parent at the same time.

    We learn how to enable a child to:

    • engage take turns
    • shift eye gaze between toy and adult
    • copy adult’s actions, gestures and then words
    • play with toys in different, new ways
    • interact and for longer periods of time
    • have fun whilst playing

    If you would like to know more about the Hanen programme please get in touch. I look forward to exploring the topic with you and help guide you forward if this is something your child is struggling with.


    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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    Strategies to support children with eating difficulties

    where the cause is NOT a swallowing problem, but we are having a “fussy eater” in the family, seeming for no obvious reason

    When parents have a child who find mealtimes or eating difficult, it can put pressure on the whole family dynamics. Once we have observed a child’s eating and drinking skills and found that they are not swallowing impaired, but are for want of a better word “fussy” or “picky”, we can then start to look at what might be underpinning the food aversions/picky eating/food avoidance. Two of the main questions parents have (of course) are:

    • ‘is my child getting the right nutrition?’
    • ‘how can I have less anxiety-provoking and stressful mealtimes?’

    We all tend to have an image in our minds about the ‘perfect mealtime’, and how mealtimes ‘should’ be. Speech and Language Therapists with a Feeding Specialism are the perfect professionals to help you unpick feeding issues. We are trained to look at swallowing and oral skills and we also know a lot about feeding behaviours and sensory difficulties which could be causing your child’s eating avoidance.

    Here are some strategies that can support children with their eating:

    1. Create and maintain a mealtime culture that suits your home and lifestyle. Then stick to that. We all need some routine in our lives to thrive. Mealtimes are no different. It might be that you eat in the same place for every meal, with the same knives and forks, concentrating on maintaining good posture. Children learn by repetition so the more familiar it is, the easier they will find it. In the physical sense, our bodies also need preparing for food, regardless of whether we are eating with our mouths or we are tube-fed. We want every child to connect all the dots of the process. It starts with their eyes, noses, expectations, memories of past experiences, feelings and then finally their mouths….
    2. Be an excellent role model. Children learn through watching others, so your child will be observing you without you knowing. Ensure that you are positive about the food you are all eating, and talk about how delicious, tasty, juicy, and yummy the foods are. Make the atmosphere around the dinner table light hearted. Even though you are secretly stressed about your child not eating, try and not show this. Instead pick a topic or put on some nice music, or talk about something your child might be interested in, and try and avoid coercing your child to eat. Leave small finger foods on their plates and have a range of foods available on the table so that your child can see that everyone is eating a range of foods and enjoying them.
    3. Use positive reinforcement. Try and think of mealtimes as fun and motivating. Children who are happy will likely be more inclined to try foods and take part in family mealtimes. Reward all interactions around food, so if your child merely touches a new food then praise this behaviour. Or if your child licks a food just once, again make a nice comment and praise your child for touching and licking the food. The takeaway here is to try and keep all messages positive around food.
    4. Keep offering all types of food. What often happens is that parents stop serving foods they know will not be eaten. This makes sense in a way; we don’t want wastage! However, try and keep the doors open and re-offer all types of foods, even the ones that your child has not wanted in the past. Try and give your child one food they will like and one food they have tasted before and liked before, even a little, and then one new food to try. So, your child always has something to fall back on and they can join in with eating. But they can also try (or at least look at and think about trying) other foods that you and perhaps the siblings are eating.

    Take a look at this website, I find it very helpful in showing parents what types of foods and how big a portion to offer

    Have a go and try and implement some of the ideas above, and should you get stuck please get in touch!


    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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  • ·

    Cued Articulation – using hand gestures to show how a sound is made

    Watch how cued articulation can transform your child’s speech and language skills!

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

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

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

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

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

    Sound picture cards:

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

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

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

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

    How I use cued articulation and the visuals in Speech Therapy

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

    Benefits and effectiveness

    Using Cued Articulation and Speech Image Cards has been shown to be effective in improving speech production for individuals with various speech and language disorders, including:

    • Articulation disorders: Difficulty producing specific sounds accurately.
    • Apraxia of speech: A motor planning disorder that affects the ability to sequence and coordinate movements involved in speech.
    • Phonology disorders or delays: Confusion and delays in how sounds are organised in categories to convey meaning, errors in sound patterns, for example front sounds are produced at the back, or long sounds are produced as stops.
    • Stuttering: A fluency disorder characterised by interruptions in speech, such as repetitions and prolongations.

    Tips for parents and student speech therapists

    Parents can play a crucial role in supporting the implementation of cued articulation at home and in therapy sessions. Here are some tips:

    • Collaborate with your SLT: Good feedback and communication with the Speech and Language Therapist creates consistency and progress..
    • Practise Regularly: Encourage consistent practice of cued articulation at home to reinforce learning.
    • Use Visual Aids: Use the same visuals that your therapist uses in the speech clinic to help your child at home with recall and practice.

    Feel free to contact me if you need help with your child.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice


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

    1