Succeed with lisps at London Speech and Feeding

ByLondon Speech and Feeding
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A child is on the right-hand side, touching their lips and holding a mirror. They're facing an adult on the left hand side, also holding their hand to their lisps.
Mirror game

You may notice that your child or young person finds certain sounds difficult to produce. With a lisp, the sounds /s/ and /z/ are more problematic. You may notice that your child’s speech is affecting their confidence. They are quiet, and the teacher reports they don’t engage in classroom conversations. You feel it’s impacting on their social and emotional wellbeing. The good news is that with the support of a Speech and Language Therapist and the determination and motivation of your child, we can treat a lisp can.

You feel you have so many questions and you don’t know where to begin. Let’s start by answering some of the most frequently asked questions.

1. Is it normal for my child to have a lisp?

It’s important to remember that we can expect a lisp in a child up until four and a half years of age.

2. Can I do anything for my child’s lisp?

The best approach you can take is to provide a good model. You can show the correct sound and you can talk about where in the mouth your tongue or lips are. Your Speech and Language Therapist can recommend you on what you can say.

3. Should I wait to see if my child’s lisp resolves on its own?

As always, early intervention is advised as producing sounds as a lisp can be more ingrained the longer your child waits for therapy. It is true that some children’s lisps resolve on their own.

Therapy depends on many factors, one of which is deciding on whether your child is ready for therapy. It’s best to seek advice from a qualified Speech and Language Therapist about whether your child is ready for therapy. It takes motivation, determination, and practice.

4. What should I expect from a Speech and Language Therapist when they see my child?

Your Speech and Language Therapist will ask you as parents and carers about your child’s history. This is because they’ll want to confirm it is a lisp and no other areas of communication are affected. They may ask your child about the impact of their lisp on them (if your child is aware of their speech difficulty).

They will then assess your child using a speech assessment. Your Speech and Language Therapist will confirm their findings and will put a plan in place with you.

5. How will my child’s therapist fix my child’s lisp?

  • The start to fixing any sound is looking at discrimination between the sound your child is making vs the correct sound. Can your child hear the sound they should be making?
  • Your therapist may still get your child to discriminate two sounds. They will begin to work on the sound in isolation, so saying the child’s tricky sound by itself (e.g., /s/)
  • Then they will ask your child to say their tricky sound with a vowel, with a breath between the consonant and the vowel (e.g., s-oo, s-ow, s-ee, s-aa, s-ai)
  • Your child will then remove the gap between (e.g., soo, sow, see, saa, sai)
  • Your child will then be ready to move onto consonant-vowel-consonant words (e.g., sat, sit, seen, sown)
  • Your child’s therapist will tell that the next step is to produce sentences using your child’s tricky sound, /s/ in this example (e.g., Simon says silly sausages)
  • Your child is working towards generalising their ability but there are a few steps before this happens
  • Choose a context where your child can practise their talking, focusing on one sound (e.g., during 10 minutes of special time). This is an ideal environment as you can create opportunities for your child.
  • The next stage is saying the sounds correctly in general conversation
  • You’ll want your child to be less reliant on you for modelling the sound, so you’ll want to start to phase this out
  • It’s important for your child to self-correct and self-monitor. Encouraging this is the final stage to correcting your child’s lisp.

You and your child will need to be motivated, as it’s true: practice makes perfect!

For support on speech sound difficulties, feel free to contact me.

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

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Similar Posts

Your baby's communication journey: 3—6 months
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Your baby’s communication journey: 3–6 months

ByLondon Speech and Feeding
Your baby's communication journey: 3—6 months
Designed by Freepik

This is an exciting time for both you and your baby! Between 3 and 6 months, communication literally explodes. While your little one may not be saying words yet, he or she is actively learning to understand and express themselves. Here’s a glimpse into what you can expect:

Understanding:

Recognises familiar voices:

Your baby will likely turn his or her head towards the sound of your or other familiar adults’ voices.

Tips for supporting and expanding: Talk, sing and chant! Your baby will love and smile at hearing your talking voice, and he or she will not be judging your singing talent! You can sing to your hearts content, perhaps some lovely nursery rhymes you remember from your childhood, or festive songs like Jingle bells !. Or you can simply make up your own little songs and chants alongside all the daily activities you do with or for your baby. You could have a ‘nappy’ song, a ‘let’s get you ready for the park’ song, a ‘I’m hungry’ song or a ‘mummy’s cooking soup’ chant. It does not have to be beautiful but what does help is having little rhymes and rhythms to your singing. Your baby will love it and soak it all up.

Begins to understand ‘no’:

Your baby may pause or stop an action when you say ‘no’ and shake your head at the same time.

Tips for supporting and expanding: I don’t think that at this stage you will have much cause to say ‘no’ to be fair but you could do it playfully and bring it into a ‘no more’ situation so that your baby can make the connection between ‘no’ and ‘finished’ or ‘stop’ or ‘done’. Feeding might be a good opportunity for this one. You could also ask ‘who is it’ when someone is ringing the bell or coming down the stairs, e.g. ‘oh I hear footsteps! Is this daddy??…. no it’s not daddy no it’s grandma! daddy’s gone out!’

Responds to his or her name:

Your baby will start to show a reaction when you call his or her name.

Tips for supporting and expanding: Try calling your baby’s name a lot, and get different family members or visitors calling your baby by his or her name and calling his or her name before saying ‘look’ or ‘peek-a boo’ etc.

Use Baby Signing: You can introduce simple gestures and signs such as ‘milk’ ‘nappy’ ‘sleep’ ‘dog’ ‘cat’ etc to help your baby make the connection between what you are saying and what he or she is seeing.

Expressing:

Cooing, gurgling and babbling:

These sounds are more than just adorable! They are your baby’s way of experimenting with his or her voice and learning to control his or her vocal cords.

You might hear sounds like ‘ba-ba-ba’ or ‘ga-ga-ga’. This is a huge milestone!

Tips for Supporting and expanding: This is a wonderful time to copy your baby’s sounds, celebrate them and show your baby that you are listening to his or her sounds and you are understanding everything he or she is saying! This is also a brilliant time to start reading to your baby. You can read any children’s books you fancy. Again your baby will adore the sound of your voice but increasingly he or she will also look at the pages of a book and try and understand and make connections between the words you say and the pictures he or she sees.

When you hear your child babbling you can try and give it meaning where possible, for example your baby says: ‘ba ba ba’ you could fall into ‘Baa Baa black sheep have you any wool’ song or you could say ‘mmmh banana!’ And show a banana that’s lying on the table. Or you could just say: ‘baba baaaaah you are saying ba! That’s so great!’ Anything goes really at this stage!

Facial expressions:

Your baby uses smiles, frowns, and other facial expressions to communicate his or her emotions (happy, sad, angry).

Tips for supporting and expanding: Try and make interesting and exaggerated facial expressions yourself when you are talking to your baby! Try and be a little bit clowney and really practise showing ‘surprise’ ‘boo’ or a big grin, smile, purse your lips, blow raspberries, open and close your mouth and make funny faces. Copy your baby when you see his or her facial expression change. When your baby looks confused, say ’oh we don’t know what’s happening we are confused!’. When your baby looks happy, say ‘you look soo happy! What a lovely smile!’

Eye contact:

Your baby will start making more and more eye contact with you during interactions.

Tips for supporting and expanding: Try and get ‘face to face’ a lot with your baby. When cuddling your baby look at his or her face and often make sure that it is easy for your baby to see and look at you. If you can lower your position so that your face is in line with your baby that will make things easier for you both.

Good games to play: ‘People-Games’ these are games where you do not need any toys to have a good time. All you need is the other person: Peek-a-boo, bumping your baby up and down on your lap with a song, Row Row Row your boat, tickling games, catch you games etc.

Now we are at 6 months another very exciting stage has arrived: feeding SOLIDS to our baby! More of this in my next post!

When to Seek Guidance:

If you have any concerns about your baby’s communication development, please don’t hesitate to consult with me. Early intervention can make a significant difference and really help your baby making progress.

Remember: Every baby develops at his or her own pace. These are general guidelines, and some babies may reach certain milestones earlier or later than others.

I look forward to seeing you! Get in touch with me via my contact form.

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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A day in my life as a speech and language therapist

A day in my life as an Independent Speech and Language Therapist

ByLondon Speech and Feeding

During the pandemic I wrote a blog on what my working day looked like. Now a good year has passed since coming back to some sort of normality and I thought I would update this ‘day in the life of an SLT’ as my working life has changed of course to reflect the ‘new normal’.

I have become truly busy, perhaps busier than I have ever been to be honest. It’s probably mostly due to the fact that I do most of the aspects of my work myself — though I want to mention two invaluable people here without whom I could not function as well as I do: the excellent Nathalie Mahieu () helps me with my SEO, Insta posts and blog uploading and the wonderful Sue Bainbridge () makes sure that my accounts don’t get into trouble with His Majesty’s tax office.

Attached to our role as Speech and Language Therapists is an arguably enormous amount of administration/paperwork and preparation required for each and every client. This needs to be factored in when deciding how many families I can realistically see each working day. For me it works out as typically 3–5 clients a day, Monday to Friday.

So how does my day typically look? Each day varies a lot depending on what type of client I have, but on average it looks a bit like this:

First thing in the morning — after having a coffee and a quick check-in with my besties on WhatsApp — I do my Buddhist chanting for about an hour. My Buddhist prayers are the base of all I do and get me connected to my higher purpose and how to create value with each activity and each person I see that day. It sets me up for the day, I keep in mind who is going to come and see me and how I can best help them.

Next up, I do the daily ‘spring-clean’ of my therapy room (on all fours! no joke ???? those kids see every speck!), vacuum the floors, wipe down the toys with flash-wipes and tidy up all my boxes, making sure that the battery toys are working, and everything else is in place. On to the guest toilet, the hallway needs to be rid of all the men’s shoes and trainers and coats… It’s endless what needs tidying when you are living with three men… This takes about 45 minutes.

An articulation activity – packaging practice into a little game

Then I prep for all my clients that day. I have now got so much quicker about selecting therapy materials. For one thing I have purchased so many toys and materials over the past five years that I can literally now open a shop and need to consider building an extension! ???? The upside is that it is now very easy for me to select a good handful of toys or games for any one child, even at a minute’s notice. Though, on average, I spend about 30 minutes per child preparing activities.

Hurrah, it’s 11 am and my first client of the day arrives and the fun begins.

When they leave around an hour later, the cleaning and wiping down starts again, this time less extensively. I write up my notes and send homework whilst enjoying a cuppa.

The next client comes at 12.30 pm and once they have left, floor cleaned, toys wiped, notes written it is time for a quick lunch. No more than half an hour usually.

Afternoon clients tend to be one more little one (nursery age) at 2.15 pm and thereafter I see mostly older school children for a variety of reasons (mainly speech production but also some language-based activities). I tend to say farewell to my last client of the day around 6 pm. I spend another hour, sometimes more, on writing up notes, answering new enquiries, blogging and phone calls to keep my service fresh, inspirational and exciting.

And then dinner and the rest of the day rushes by. I tend to finish my day with some more Buddhist chanting, not a lot, perhaps 10–20 minutes to reflect on what has gone well and what could have been better — re-determine to improve or make better as needed.

Tele therapy activity using online materials plus a coreboard

In terms of where I provide a service, I still do a good mix of online clients (tele-therapy) and in-person clients in my clinic, which I love. Occasionally, I visit children in their nursery or at home but this service is now only available for long-standing clients.

Each client is hand-picked to make sure that we are a good fit: no one client gets the same treatment as another; each client is unique, we get to know one another well over the time we work together and they are always highly valued. That takes time and, in reality, each client gets about two hours of my time. That is the actual session plus all the preparation and aftercare, i.e., bespoke hand holding, tweaks, problem solving and reassurance in between sessions.

I absolutely love this way of working and would not ever want to do anything else. Nearly three decades of working both in the NHS and in private practice, countless courses (continual professional development) have enabled me to flourish as a therapist and I know that I offer something special and very valuable to my clients.

My unique way of working affords all my lovely clients the help they need to support their children to make progress; and it gives me the right balance of job satisfaction and work life balance for now. My lovely reviews and testimonials tell me that my clients appreciate my service and this at the end of the day is the most important.

If you are interested in exploring Buddhism/buddhist chanting then check out this link (https://sgi-uk.org/), and feel free to contact me about that specifically, regardless of whether you want speech therapy. I am always happy to chat about Buddhism, it has been so enriching for the last 43 years of my life.

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

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

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Milestones matter: What to expect in your baby's first year of communication
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Milestones matter: What to expect in your baby’s first year of communication

ByLondon Speech and Feeding
Milestones matter: What to expect in your baby's first year of communication
Designed by Freepik

The first year of your baby’s life is a whirlwind of growth and development. While watching them learn to crawl, walk, and grasp objects is exciting, it’s equally important to pay attention to their developing communication skills. Here are some key speech, language, attention, play, and communication milestones you can expect to see between 6 and 9 months.

Sounds:

  • Babbling becomes more complex, with strings of sounds like ‘bababa’ or ‘dadada.’
  • Your baby may start imitating some sounds.
  • When you call your baby he or she will respond to his or her own name.

What you can do to help your baby

First, please don’t panic. Every baby is different and it does not mean your baby is delayed if he or she is not quite ready.

Make sure you spend time babbling, singing and talking to your baby in a tuneful, happy, sometimes silly! way, pulling faces, smiling, laughing and tickling your baby, all the while sing sing sing and chat!

Try to imitate your baby’s sounds and actions. You will see that your baby likes this a lot and will reward you with smiles, giggles and after a while your baby will want you to continue copying him or her. At that time you will see that he or she will start to copy you more and more.

Try and call your baby’s name lots of times. When you re-enter a room having been out for even a short time, say ‘Hello (baby’s name) I’m back’. Your baby will soon learn to look when you say their name.

Attention:

  • Can follow simple directions (e.g., ‘Come here!’).
  • Shows interest in books and pictures.
  • Begins to understand the word ‘no.’

What you can do to help attention skills develop

Get down to your baby’s eye level or make it easy for your baby to look at you, even briefly.

Try and gain your baby’s attention when he or she is not busy with something else.

Try and become irresistibly funny and interesting to look at! Think of ‘Mr Tumble’! Wear a silly hat, silly glasses, blow some bubbles, blow a funny horn, stand on your head (joking)… make it impossible for your baby to ignore you!

Play:

  • Explores objects by banging, shaking, and mouthing them.
  • Shows interest in cause-and-effect toys (e.g., dropping objects and watching them fall).
  • Engages in simple social games like peek-a-boo.

What you can do to help play skills to develop

Offer suitable objects that are attractive to look at and easy to hold and shake. Show your baby repeatedly what to do with these objects, bang them together and sing a little song, bang bang bang shake shake shake…

Offer containers and drop items into them. Shape sorters, metal bowls make a terrific clangy noise when you drop items into them. Blow feathers or tissues and watch them fall. Blow bubbles and watch them pop.

Sing a range of nursery songs repeatedly and make suitable actions along them. Try and involve your baby by sitting him or her on your lap so he or she can hear and feel you bopping him or her up and down, swinging him or her gently from side to side or row row rowing his or her boat gently down the stream

Communication:

  • Uses gestures like waving ‘bye-bye’ and reaching for desired objects.
  • May begin to use babbling to express needs and wants (e.g., babbling while reaching for a toy).

What you can do to help communication progress

Practise waving ‘bye-bye’ to people coming and going all day long.

When your baby babbles whilst reaching for a toy, you can copy him or her and then name that toy, for example.

Baby: ‘gagabbagaga’ – whilst reaching for a shaker – Adult: ‘gagagag I want my shakey! Aargh I am reaching for it but I can’t get it, help me help me… ah there is my lovely shakey shakey!’

If your baby is not responding to any of your efforts above then please do get in touch with a Speech and Language Therapist near you, or contact me via my contact form. Sometimes one consultation is all you need to get going with helping your baby and before you know it a lots of progress has been made and your baby is on the way to speaking!

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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Unveiling the hidden spectrum: Why girls and autism often go unseen
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Unveiling the hidden spectrum: Why girls and autism often go unseen

ByLondon Speech and Feeding
Unveiling the hidden spectrum: Why girls and autism often go unseen
Image by Freepik

Autism is a complex neurodevelopmental condition characterised by social-communication challenges, restricted and repetitive behaviours, and sensory processing difficulties. While the prevalence of autism is estimated at 1 in 54 children, research suggests a significant disparity in diagnoses between genders. Boys are diagnosed with autism roughly four times more often than girls, leading us to question: Why are girls so much harder to diagnose with autism?

The answer lies in a complex interplay of factors, including:

1. Different presentations of autistic traits:

  • Socialisation: The stereotypical image of autism often portrays boys with aloofness and a lack of interest in social interaction. However, autistic girls may exhibit more subtle social difficulties. They may appear interested in socialising but struggle with understanding social cues, maintaining eye contact, or navigating complex social dynamics. This ability to ‘camouflage’ their challenges can lead to misinterpretations of their intentions and abilities.
  • Restricted interests: While autistic boys may have intense interests in stereotypically ‘masculine’ topics like dinosaurs or trains, girls might gravitate towards interests traditionally associated with girls, like specific characters or activities. These interests, often deemed ‘typical’ might be overlooked as potential indicators of autism.
  • Repetitive behaviours: Repetitive behaviours are another core diagnostic feature of autism. However, autistic girls may exhibit these behaviours in more subtle ways, such as intense focus on specific routines, scripting conversations, or engaging in repetitive social interactions. These subtle expressions can easily go unnoticed.

2. The ‘camouflage’ effect:

Autistic girls, particularly those with higher cognitive abilities, may develop coping mechanisms to mask their challenges in social situations. This ‘camouflaging’ can involve mimicking social behaviours they observe in others, leading to significant internal distress and exhaustion. This effort to appear ‘normal/typical’ can further hinder accurate diagnosis.

3. Societal biases and diagnostic tools:

  • Gender bias: The current diagnostic criteria for autism were largely developed based on studies of boys, leading to a potential bias towards male presentations of the condition. This can result in girls who don’t exhibit the ‘typical’ symptoms being missed altogether.
  • Lack of awareness: Healthcare professionals and educators may have limited awareness of how autism manifests differently in girls. This lack of understanding can lead to misinterpretations of their behaviours and missed opportunities for diagnosis and support. I must say that this is really common in my working day. I see a child—girls or boys in this case to be fair, but mainly girls—where parents tell me: the doctor/health visitor/paediatrician has said it was ‘just a little delay’ and I am thinking ‘Really!??? What did they look at? How did they not see X Y Z’… It really is still very common.

4. Co-occurring conditions:

Autistic girls are more likely to experience co-occurring conditions like anxiety and depression, which can overshadow the core features of autism. This makes it even more challenging to identify the underlying autism diagnosis.

The consequences of missed diagnoses and this goes of course for both, autistic girls AND boys!:

The consequences of undiagnosed autism can be significant. Children may experience:

  • Lack of access to appropriate support: Without a diagnosis, children may miss out on crucial interventions and therapies that can help them manage their challenges and thrive.
  • Increased vulnerability to mental health issues: The stress of masking and navigating social complexities can lead to anxiety, depression, and other mental health challenges.
  • Difficulty forming meaningful relationships: Social difficulties and communication challenges can hinder their ability to build and maintain healthy relationships.

Moving forward: Towards a more inclusive diagnosis:

To ensure all individuals on the spectrum receive the support they need, it’s crucial to:

  • Increase awareness and education: Healthcare professionals, educators, and the general public need to be educated about the diverse presentations of autism in girls and of course also in boys. Let’s not forget that we are still seeing older autistic boys with diagnoses given aged 12 years and older who have slipped through the net.
  • Develop gender-neutral diagnostic tools: Diagnostic criteria and assessments should be revised to encompass the broader spectrum of autistic traits, regardless of gender.
  • Encourage open communication: Parents, caregivers, and individuals themselves should be encouraged to voice their concerns and seek evaluations, even if their experiences don’t perfectly align with stereotypical presentations of autism.

By acknowledging the complexities of diagnosing autism, particularly in girls, and working towards a more inclusive approach, we can pave the way for earlier diagnoses, appropriate support, and a brighter future for all individuals on the autism spectrum.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

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

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Teletherapy: A fun and convenient way to help your child master those sounds!

Teletherapy: A fun and convenient way to help your child master those sounds!

ByLondon Speech and Feeding

It can be hard to get your child to come to the clinic on a weekly basis to work on those tricky sounds. Perhaps the car isn’t working, you have had a lot on, or our student has a bit of a cold but is still able to do a little bit of sound practice?

The good news is that Teletherapy can be a fantastic option to continue your child’s speech journey from the comfort of your own home!

Even when your wifi is not working and your laptop is broken, as you can see on this clip I was able to stretch into running the session on WhatsApp video, but that is less then ideal I will say.

What is Teletherapy?

Teletherapy is speech therapy delivered virtually, through a secure video platform. I use Zoom for example, but I have also used WhatsApp Video Call on occasions where parents’ zoom was not working.

When is Teletherapy perfect?

Here’s why teletherapy can be a great fit for helping your child solidify those learned sounds:

  • Basic sound patterns have been established in clinic: Your child is now able to say those tricky sounds BUT they are not saying them in daily life yet; they are not ‘generalising’ those new sounds into the normal speech.
  • You just can’t make it today: No more fighting traffic or fitting appointments into busy schedules. Teletherapy sessions happen at home, on your time. Sometimes even in the attic or the garden shed as in my video clip here ????
  • Your child is about 7 years old or older and is motivated to work on their sounds: I use fun and interactive online tools and games to keep your child engaged during practice sessions. Due to having done teletherapy over the Covid period I have amassed lots of great games and know-how in this area. Our student needs to be mature enough to be able to sit in front of the laptop camera and participate with a minimum of adult help.
  • Your child loves gaming and is best motivated through online games: Sometimes children are best motivated when playing online games in between speech sound/language activities; in this case teletherapy is totally perfect.
  • Focus on Carryover: The familiar environment of your home can actually be an advantage! I can guide my student on practising sounds in everyday situations, like reading a book together or playing with toys, sometimes even talking to their sibling or a.n.other in the room.
  • Parental Involvement: Teletherapy allows you to be directly involved in the sessions just in same way as when I see your child in my clinic. You can learn strategies and techniques from me to continue practising with your child throughout the day. You can also make a note of the online games I have and then use them in your home sessions.

What to Expect During a Teletherapy Session

  • Initial Consultation: We start with a brief chat on how the week has gone, what gains have been made with the home exercises and we settle the student into a good learning mode; sometimes I start off with a very quick game just to set the scene.
  • Working on generalising: When asking my student about how their week has been I will remind them to remember their new sounds and to try and produce them whilst talking to me. This is already the start of therapy.
  • Practising target sounds: We practice our target sounds in different contexts, using games, visuals, and activities.
  • The teletherapy session lasts the same amount of time as do 1:1 sessions, unless I see that a child becomes very fidgety and we are not able to hold out much longer, I will cut short the session and focus on increased home practice.
  • Home Practice: Just like in 1:1 clinic sessions, I will provide you with easy-to-follow tips and activities to continue practising sounds throughout the week.

Getting Started with Teletherapy

  • Technology Check: Ensure you have a reliable internet connection and a device with a camera and microphone.
  • What device is best: Ideally the student needs to be on a laptop or PC because that way the student can actively engage with their mouse, moving game pieces, or participating in online activities using their mouse. Tablets are ok but do not allow active participation of the student as described above. However once in a while we can make it work and I do have some games and activities that do not rely on student participation.

Finally, I would say that Teletherapy is a safe, fun and effective way to continue your child’s speech therapy journey. It’s convenient, engaging, and it is perfect on a rainy day when you don’t want to or can’t come out to bring your child to clinic.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.

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

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Empty Set and Phonology approaches

Empty Set and Phonology approaches

ByLondon Speech and Feeding

I have been avoiding the use of the Empty Set approach for the longest time as I was not sure if it would work seeing that I am challenging two sounds my student struggles with at the same time. But I decided to give it a go and it works a treat!

With this approach, we use two sounds that our student is struggling with. For example, in my video this student cannot produce /sh/ and /r/. Both sounds have different rules, so I decided to contrast them with each other.

  • The rules of /sh/ are: no voice, air is pushed out through teeth, produced at the front.
  • The rules for /r/ are: use your voice, produce the sound in the middle of the mouth by shaping your tongue in a particular way.

So I chose the words ‘shoes’ and ‘ruse’ as their rules are quite different. Contrasting two sounds the student does not know has been shown to lead to greater change in the child’s articulation. And I can certainly vouch for this as my student is making the best progress with this approach.

Phonology Therapy – what is it, why and how?

Phonology is the study of the sound system of a language. It’s distinct from articulation therapy which focuses on the physical production of sounds.

Phonology therapy focuses on rules. For example, sounds that are produced at the front of the mouth, in contrast to sounds that are produced at the back of the mouth, or sounds that are produced with a long air stream: /s/ or /f/ versus short sounds like /p/ or /t/; sounds are produced with voice or without voice.

Many children, and sometimes adults, are unaware of some of the speech rules and confuse and replace individual sounds. They might say TAT instead of CAT or SIP instead of SHIP.

A quick overview of phonology approaches I use:

Minimal Pairs:

This approach is good for single sound substitutions. We offer word pairs that differ by only one sound, like ‘ship’ and ‘sip.’ One of our first goal in therapy is to highlight the difference between the target sound (e.g., /sh/) and the sound the child uses (e.g., /s/). This helps discriminate and eventually produce the correct sound.

Multiple Oppositions:

A child might replace lots of sounds with a single sound like a /d/. So instead of ‘four’, ‘chore’ and ‘store’ our child says ‘door’, making speech very unintelligible.

The approach is typically geared towards shaking up the phonological system. Our goal is to choose two to four targets that are different from each other, and different from the substituted sound. If our child’s favourite sound is /d/ they can use their voice and make a short sound by stopping their airflow. So I will choose a different target sound to change up the speech system. For example I might choose an /f/, a /m/ and a /k/ sound. So I would contrast: ‘door’ with ‘four’, ‘more’ and ‘core’.

Maximal Oppositions:

In the Maximal Oppositions approach the treatment sets consists of words that are minimally contrasted and that have maximal or near maximal feature differences between each word pair. One word in a pair represents a sound the child ‘knows’ (can say at word level) and the other represents a sound the child does not know (cannot say).

For example, a child may ‘know’ /m/ and be able to say words like ‘man’, ‘mat’ and ‘mine’. However, the same child may be unable to say /f/ as in ‘fan’, ‘fat’ and ‘fine’. The consonants /f/ and /m/ are maximally opposed as follows.

I am always delighted to work on speech sound disorders, I love the challenge and the successes we can celebrate together. Get in touch with 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.

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