There are various great ways to treat speech sound disorders and I use all the approaches available selectively; I decide what works with each individual child and I also vary the approach depending on the child’s frame of mind at any given time during my session.
Some of the approaches are more “drill-based” and require a child to be able to pay attention and really participate actively in the therapy, and this is what I am showing you today with this video clip.
My little student here has been working with me for some time and from only saying a handful of words which were not very easy to understand he has come a long way. He does have some features of Verbal Dyspraxia which I shall briefly outline here:
Making sounds in general is a struggle, especially when asked to copy certain sounds, example: ‘can you say: a ee ou oo?”
Repeating sound sequences or words sequences is hard, for example: “say p-t-k in sequence” or “say fish chips fish chips fish chips
When saying the same word again and again, different mistakes can be heard
Intonation difficulties: speech sounds monotonous
Vocabulary is very limited
Some therapy approaches are more play based, for example the Core Word method: here we pick a few words at a time which are very significant to the child and therefore highly motivating to try and say. These could be characters of Pokemon or Minecraft for example, or simple words like “GO!”
When you watch the video you will see that I use a lot of visual prompting, such as showing him where the tongue is moving to or from. I do this with my index finger and this approach is called Tactile Cueing or “Cued Articulation”. Part of the approach is to give a visual prompt and then reduce the prompt as the learner is more able to produce the correct sounds. Once he can produce the sound on its own, we quickly move to the sound within a word.
I do mix and match my approaches and in fact here I am drilling but I also use the Core Word which for him (YELLOW) — it’s his favourite colour and I happen to have quite a few good games where a YELLOW something or other can be asked for….. WHO KNEW!? 🙂
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.
This is a surprisingly common speech error and it can be corrected really well in my experience. I have helped lots of children of all ages learn how to control their tongue movements and produce clear, sharp /S/ sounds and good /SH/ sounds.
Initial consideration
There are some factors which need to be considered before we can dive into therapy proper and these are they, in a nutshell:
The student is not currently displaying negative oral habits such as thumb sucking or excessive sucking on clothing. This is because thumb sucking exerts pressure on the teeth and therefore can, over time, push teeth out of their natural order/position.
The student does not have a restricted lingual frenulum or tongue tie which can cause at times restricted movements of the tongue (pending on how tight the frenulum is attaching the tongue to the base of the oral cavity); equally a labial frenulum or lip-tie can restrict lip movement and therefore physically restrict good speech sound production.
The student does not have enlarged tonsils as they can sometimes push a tongue forward and also cause open mouth posture and open mouth breathing.
The student’s motivation to change their speech pattern is high. (this is an important factor though with younger students I can get round this with a lot of fun games and good parental involvement!)
When I do an Oral Assessment of my student these are the first factors I want to look at and consider. Often I will refer to other agencies such as Orthodontists, dentists or ENT specialists to advise and help with some of these factors before we can get going. However, there are strategies that we can work on almost straight away.
Most of my Lisp students present with an open mouth posture: that is where the student has their mouth always slightly open for breathing. Over time the tongue starts to fall forward and rests on the front teeth or the bottom lip instead of finding a comfortable resting place either at the alveolar ridge (the bumpy spot behind the upper front teeth) or, alternatively, resting at the bottom of the mouth behind the lower front teeth.
Another common problem is that the tongue is not moving independently from the jaw and so is reluctant to pull back or lift up inside the mouth as the tongue is guided in movement by the jaw.
Combine those two factors and your tongue is not pulling back, or lifting up or doing very much at all without the jaw moving as well. This makes for unclear speech sounds, especially all the sounds we make at the front with our tongue or with our lips: /B/ /P/ /L/ /N/ and of course /S/ and /SH/ are particularly hard to make. We often also struggle with the /Y/ sound so ‘LELLOW’ instead of ‘yellow’.
Do not fear!
But no fear, these problems can be treated over time for sure! We often start with lip, tongue, and jaw exercises that help to move the tongue independently from the Jaw, our student learns that the tongue is a muscle and can be trained to do amazing acrobatic things in the mouth! WOW! It can actually pull back, lift up, and come down again all on its own!
We work on breathing, holding our breath for a bit then pushing it out and then holding it again.
And when it comes to the actual /S/ sound I often try and go a NEW route bypassing the Snake-Sound route if that is what had previously been tried and failed so that we can create completely new sound patterns in our brain and think about our sounds in a completely new way.
We then work on producing the sound /S/ on its own for a bit, at the end of words, then on either side of complimentary sounds, for instance : ‘EASY” – the sound patterns here are EEE-S–EE : the /EEE/ sound is complimentary to the /S/ sound as the tongue is at the right hight for the /S/ already once you have it in place for /EEE/ -……see?! EASY!
And gradually we work towards saying the /S/ sound clearly at the front of short words, then phrases and then sentences.
The process takes some time and it depends on how ready the student is. This varies of course hugely so I can never promise the exact number of sessions we will take to get that Lisp fixed. A lot depends on home practice in between sessions, and this is of course crucial to all therapy! Every day 15-20 mins practice is a good average time to aim for and when this is done it shortens the therapy block drastically.
I always give plenty of home work so there is never a chance of it getting boring or there being “nothing to do”!
Do contact me. I really enjoy working with this type of student and get a great kick out of FIXING THAT LISP!
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.
Angelman Syndrome (AS) is a complex neurological disorder that affects development. It’s caused by a missing or functionally incorrect gene (UBE3A) on chromosome 15. While AS is rare, understanding its characteristics is crucial for parents and caregivers.
What are the key characteristics of Angelman Syndrome?
Children with AS typically exhibit a range of unique characteristics, which can include:
Developmental delay: Significant delays in reaching developmental milestones, such as sitting, crawling, and walking.
Speech impairment: Limited or absent speech. Individuals with AS may use few or no words.
Movement and balance issues: Difficulties with coordination, balance, and movement, sometimes causing a jerky or unsteady gait.
Happy demeanour: Frequent smiling, laughter, and a generally happy, excitable personality.
Intellectual disability: Varying degrees of intellectual disability.
Seizures: Seizures are common and often begin in early childhood.
Sleep difficulties: Disrupted sleep patterns and difficulty falling asleep.
The role of Speech and Language Therapy
Speech development and social communication is significantly affected in Angelman Syndrome, and therefore, Speech and Language Therapy plays a vital role in helping individuals with AS to communicate. As Speech and Language Therapists (SLT) we can work with the child and family support any of the following:
Assess communication skills: We evaluate the child’s current communication abilities, including any vocalisations, gestures, or signs they may use. With younger children we do this through play and playful social games as well as observation of a child playing and interacting with their siblings or caregivers.
Develop alternative communication strategies: Since spoken language may be limited, SLTs can help the child learn other ways to communicate, such as nonverbal communication, e.g
Gestures: use of pointing, waving and miming certain activities.
More formal sign language: Teaching basic signs to express needs and wants.
Core boards: Using pictures and symbols to represent everyday common words, actions, and feelings.
Augmentative and Alternative Communication (AAC) devices: Providing electronic devices that can produce speech.
Encourage vocalisations: When words don’t readily develop, SLTs can encourage the child to make vocalisations and sounds, as these can be a form of communication.
Support language development: SLTs can work on understanding of language, even if expressive language is limited.
Educate and support families: SLTs provide families with strategies and techniques to support their child’s communication at home.
The importance of a multidisciplinary approach
Caring for a child with Angelman Syndrome requires a team effort. A multidisciplinary approach, involving various healthcare professionals, is essential to address the diverse needs of the individual. This team may include:
Paediatrician: Provides overall medical care and monitors the child’s health.
Physiotherapist: Helps with movement, balance, and coordination.
Occupational therapist: Works on daily living skills, such as feeding, dressing, and self-care.
Speech and Language Therapist: Addresses communication and language needs.
By working together, we can provide comprehensive care, address the unique challenges of Angelman Syndrome, and help the child reach their full potential.
Conclusion
Angelman Syndrome presents unique challenges and opportunities. With early diagnosis, appropriate interventions, and a strong multidisciplinary team, children with AS can make good progress and live fulfilling, joyful lives. As Speech Therapists we delight in supporting parents in their role in advocating for their child.
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.
For many families, Halloween is an exciting time filled with costumes, decorations, and sweets. But for children who are sensory sensitive, whether they’re autistic, have sensory processing differences, or simply find new experiences overwhelming, Halloween can feel like a night of chaos rather than fun.
The bright lights, unexpected noises, strange textures, and social pressure to ‘join in’ can quickly become too much. The good news? With some thoughtful planning and gentle support, you can make Halloween a positive and manageable experience for your child.
Understanding sensory overload
Sensory overload happens when a child’s brain receives more sensory input than it can process. This might mean:
Costumes that itch, squeeze, or feel strange on the skin.
Loud sounds like doorbells, fireworks, or shrieking decorations.
Crowds and unpredictability during trick-or-treating.
Strong smells or tastes from face paint or unfamiliar sweets.
When overloaded, children may cry, cover their ears, hide, run away, or ‘shut down.’ These reactions aren’t ‘bad behaviour’, they’re signs of distress. The goal isn’t to eliminate Halloween fun, but to adjust it to your child’s comfort level.
Step 1: Choose costumes wisely
Costumes are often the biggest trigger. Scratchy fabrics, tight seams, or masks that restrict breathing can be unbearable for some children.
Try these tips:
Go sensory-friendly: Use soft, breathable fabrics and remove tags. Many retailers now sell sensory-safe costumes.
Test it early: Let your child wear the outfit around the house before Halloween. If it’s too much, simplify — maybe themed pyjamas or a favourite T-shirt with Halloween accessories.
Skip the mask: Face paint can be equally challenging, always test on a small patch of skin first. A comfortable headband or hat might be enough to feel ‘in costume.’
Remember, participation doesn’t require perfection. Your child can still ‘be’ their favourite character without a full costume.
Step 2: Plan your Halloween environment
Before the big day, think about what parts of Halloween your child enjoys — and what might overwhelm them.
At home:
Keep decorations minimal and predictable. Avoid motion-activated sounds or flashing lights.
Practise knocking at your own front door or saying ‘trick or treat’ with a trusted adult.
Have a ‘quiet space’ ready, a cosy corner or room where your child can retreat if things get too intense.
If you’re going out:
Choose earlier, quieter times for trick-or-treating.
Visit a few familiar houses instead of the whole street.
Bring ear defenders or noise-cancelling headphones.
Have a clear exit plan if your child needs a break.
Sometimes, watching from the window and handing out sweets can be just as enjoyable! it still offers social participation without sensory overload.
Step 3: Prepare socially and emotionally
Halloween involves a lot of unexpected social interaction: strangers at the door, unfamiliar greetings, and different rules.
Help your child by:
Using visuals or stories: Read picture books about Halloween or make a short social story about what will happen.
Role-playing: Practise saying ‘Trick or treat!’ or handing out sweets in a fun, low-pressure way.
Labelling feelings: Explain that it’s okay to feel nervous or to take a break if something feels ‘too loud’ or ‘too much.’
Children feel safer when they know what to expect. Predictability reduces anxiety and makes participation more enjoyable.
Step 4: Rethink the treats
Not every child enjoys sweets; some dislike sticky textures or strong flavours. Offer non-food alternatives like stickers, glow sticks, or small toys.
If your child has feeding difficulties or oral sensitivities, it’s okay to opt out of the traditional treats entirely. They can still join in by giving treats or decorating treat bags instead.
Halloween doesn’t have to look like anyone else’s version. Maybe your family watches a ‘not-too-scary’ film, carves pumpkins, or does a flashlight treasure hunt indoors. The goal is joyful connection, not conformity.
A calm, happy experience, even if it looks simple from the outside builds positive associations your child will carry into future celebrations.
In summary
Halloween can be full of sensory surprises, but with empathy, planning, and flexibility, it doesn’t have to end in tears.
The more you adapt to your child’s sensory needs, the more they learn that they are safe, understood, and included not just at Halloween, but in every celebration.
As with all things in speech and feeding development, progress starts with connection. When children feel regulated and supported, communication and confidence follow.
HAPPY HALLOWEEN!
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
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?
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.
As an AAC speech and language therapist who uses the Saltillo 88 Core board every day, I can tell you it’s more than just a communication tool. It’s a doorway to independence, connection, and expressing my students’ unique voice.
What is the Saltillo 88 and why do I use this one?
In this blog post, I want to share practical, real-world examples of how I integrate the Saltillo 88 into various daily activities, empowering my students and parents to learn to communicate.
There are literally hundreds of core boards out there and I have tried many different ones over the years. Which one should I use with this particular client? Should I make up my own? (I have made up tons!) or should I use a ready-made one like the one below which is what this blog is about.
For me the best ones are boards with a good number of core words (at least 60) so that the board is versatile and can be used across a range of activities. The board needs to have a range of pronouns, verbs, descriptors, prepositions and question words to be useful and to stimulate not just requesting but commenting and asking questions. Another consideration is: can the board easily be transferred to a more robust AAC system. Once my student is used to the symbols and where they are could we move to an electronic talker/device. And if this answer is ’yes’ then we have a great board to get started with.
It has 88 words and I find it really does suit most activities. The same board and design is also then found on the TOUCHCHAT AAC device which can be a seamless transition for our learner.
Let me dive into how core words/board or AAC can be used daily:
1. Getting dressed
Whilst choosing clothes for your little one and getting them ready for the day you can use the following words: want, like, get, finish. Always pack the words into little phrases you can speak naturally when using a board. I have tried to show you phrases that you could use below.
The words in bold are the core words on the board and the other words are just words you say whilst pointing to the core word.
Goal: Express choices, needs, and preferences about clothing.
Ideas:
‘I want this one [specific item of clothing: ‘shirt’, ‘pants’]’
‘I like that one [colour/type of clothing]’
‘Help me [put/get it on/take off]’
‘let’s get your socks now’
‘finished let’s go’ (when dressed)
2. Having a shower/bath
Goal: Bath time tends to happen daily and so it lends itself to using the same useful phrases and words to chat about temperature preferences, to ask for toys or for washing routines.
Ideas:
‘let’s go have a bath/shower’
‘let’s turn on the tap/water’
‘now turn it off’
‘let’s get/have more toys/water/bubbles/tickles’
‘all gone, what’s next?’
‘how about washing your hands/feet’
‘let’s do that again’
‘need some help?’
‘Stop it now, let’s do something different’
3. Mealtimes
Goal: Mealtimes can be (or should be) enjoyable and motivating to ask for specific things we like, and commenting about our eating experiences.
Ideas:
‘I want/give me [food item: ‘apple’, ‘bread’]/[drink item: ‘water’, ‘juice’]’
‘More foods/drinks/snacks’
‘All done’
‘that’s messy we like that (not)’
‘Like’/‘Don’t like’
‘Big’/‘Little’
‘this is so nice!’
4. Playing
Goal: This is where it’s at for children of course and we can use our core words to chat and engage with our little learners.
Ideas:
‘I want play’
‘Go’/‘Stop’
‘More/again’
‘not it’s my My turn’/’it’s Your turn’
‘that’s a Big one!’/‘let’s do Little bubbles’ (describing toys)
‘let me Open it for you’ (for boxes, doors in play)
‘I See it’ (to draw attention)
‘Help me’ (with a tricky toy)
5. Opening boxes/doors/etc
Goal: Most kids love opening boxes, doors and cabinets to see what there is to play with. Help your child to ask for what they want.
Ideas:
‘let’s Open that box/bag/zip/door’
‘get me a (toy) out of here’
‘Let’s Take it out and see what it is?’
‘finished’ (when finished with the task)
‘I want [what’s inside]’
‘What’s next? Let’s see’
Tips for using AAC effectively
Consistency is key: Emphasise using it regularly, even for small things.
Modelling: this is crucial, the adults need to use the board for all situations first and foremost before we can expect our child to be interested.
Patience: Communication takes time and practice.
Celebrate successes: Acknowledge every communicative attempt.
Make it accessible: Keep the board within easy reach at all times.
Conclusion
If you’re considering the Saltillo 88, or TouchChat, or are already using it, I hope these examples inspire you. It’s a journey of discovery, and every word communicated is a step towards a more connected and independent life. What are your favourite ways to use the Saltillo 88 or which core board do you love using? I would love to hear your comments and stories.
Sonja McGeachie
Highly Specialist Speech and Language Therapist
Owner of The London Speech and Feeding Practice.
Find a speech and language therapist for your child in London. Are you concerned about your child’s speech, feeding or communication skills and don’t know where to turn? Please contact me and we can discuss how I can help you or visit my services page.
When you have a child who uses Gestalts it is often difficult to think and adapt clinic activities into those to use at home. More importantly, you find that individualising your activities for your child who uses Gestalt are time-consuming. But you value its importance for their communication development.
You feel so busy, you are taking them to other appointments, or trying to get through your daily activities, all whilst still ensuring your child’s emotional needs are met. You know life should not get in the way of your child’s therapy activities at home, but it does. We know your spare time is precious and limited, so let us achieve your child’s or young person’s goals in the allotted time you have which meets their way of learning (using Gestalts).
We wanted to support you by exploring items which you may have at home, and we will give you some key phrases which you can start to model with your child. Whereas our last blog introduced the idea of gestalt language processors, we are now developing ideas to give you the tools to implement activities at home. We recognise how overwhelming it may feel, and this is one of the reasons to make activities as straight forward as possible. Therapy does not need to be complicated; it just needs to be carried out on a regular basis.
Explore the samples I’ve created to give you an idea of how this might look but please consult with a Speech and Language Therapist who knows about Gestalt Language Processing so that you can work together to develop great home activities for your child.
Want to learn more about gestalt language processing?
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.
