Support your autistic child’s communication by learning the stages of Gestalt Language Processing

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If your child is using echolalia and/or has a diagnosis of autism, then your child’s way of processing language is most likely different to the classic way children typically learn language. We call this process Natural Language Acquisition or Gestalt Language Processing.

Speech Therpaist in London
Step by Step guide to Gestalt Learning

Let’s explore the following stages of Gestalt Processing:

Stage 1: communicative use of whole language gestalts

(e.g., “let’s get out of here”)

Children and young people in this stage use echolalia. They need to hear more gestalts or scripts. So, your job is to model, model, model and to use functional language that your child can repeat back.

Stage 2: mitigated into chunks and re-combining these chunks

(e.g., “let’s get” + “some more”) and (e.g., “let’s get” + “out of here”)

This is when you take parts of gestalts or phrases and then combine it with other parts.

Stage 3: further mitigation (single words recombining words, formulating two-word phrases)

(e.g., “get…more”)

They are going beyond their gestalts. Furthermore, they may begin to label different objects.

Stage 4: formulating first sentences

(e.g., “let’s get more toys”)

You may see more grammatical errors during this phase as they are creating unique sentences. Please don’t worry about this, it means they are playing and experimenting with language. As communication partners, you could model the correct form of the sentence.

Stages 5 & 6: formulating more complex sentences

(e.g., “how long do you want to play inside for?”)

You can see that language learning is a process, that is trialled and tested, used in different contexts for children to be able to learn and use language appropriately.

My next blog will give you activities ideas and how you might use them specifically with a Gestalt Language Processor.

Remember early intervention is vital. So, if you have any concerns, please seek the advice of a Speech and Language Therapist.

Contact me, Specialist Speech and Language Therapist Sonja here.

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

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  • The art of selective care: My journey as a semi-retired private therapist

    Welcome!

    Hello, and welcome. I’m writing this today to share a bit about my professional journey, a journey that has evolved over many years from a bustling, full-schedule practice to a more intentional, deeply fulfilling semi-retired life. This shift wasn’t born out of a desire to slow down, but rather an understanding of what truly matters: my time, your time, and the quality of the work we do together.

    For decades, I poured my energy into a full calendar, helping as many families as I possibly could. It was a wonderful, demanding, and rewarding time. I learned so much, grew immensely as a professional, and had the privilege of witnessing countless moments of breakthrough and success. But over recent months, I began to realise that the most impactful work wasn’t about quantity; it was about quality. It was about giving my whole, undivided attention to a select few, creating an environment where true progress could flourish.

    Change

    This realisation led to a significant change in my practice. I am now at a point in my career where my time is both valuable and precious. It is no longer a commodity to be filled, but a resource to be invested wisely. This doesn’t just apply to my personal life, but to my professional life as well. I’ve chosen to be more selective about the clients I see, and this selectivity is rooted in a single, powerful question: ‘Who can I truly, profoundly help?’

    I believe that successful therapy is a partnership. It requires commitment, trust, and a genuine connection between therapist and client. When I take on a new family, I am not just filling a slot in my schedule; I am making a deep commitment to them. I am dedicating a part of my precious time and decades of expertise to their child’s success. This is why I am now focusing on who I can really work with: families who are equally invested in the process, who understand that progress is a team effort, and who are ready to engage fully in the journey.

    My fees reflect this deep investment. You will find that my rates are higher than those of many other therapists, and I want to be transparent about why. It’s a reflection of the extensive experience I bring to the table. I have spent years honing my skills, navigating complex cases, and developing a unique, effective approach to speech, language and feeding challenges. This is not just a job for me. It is my life’s work, and I honour the value of that expertise and the time I dedicate to each family.

    I want to ensure that every minute you spend with me is productive, focused, and truly transformative. Therefore, I provide a ‘boutique style’ of care. Think of it as an exclusive, personalised experience where every detail is considered and your needs are at the forefront. You won’t feel like you’re just another appointment on a long list. You will feel that you have my full, undivided attention, as if you were my only client.

    This means less time spent on administrative tasks and more time dedicated to preparing for your sessions, reflecting on our progress, and providing you with the most thoughtful, tailored support possible. It means an environment of calm and focused expertise, where we can truly dive deep into the specific challenges and build a clear, effective path forward.

    New perspective

    For parents reading this, I hope this provides a new perspective. Choosing a therapist for your child is one of the most important decisions you can make. It’s about finding not just a professional, but a partner. I want you to feel that, if we choose to work together, you are entering into a unique partnership where your child’s growth is my singular focus.

    In this next chapter of my career, I am prioritising passion over pace, depth over breadth, and meaningful connections over a packed schedule. I am here to work with families who are ready for a truly collaborative and transformative experience. If you are seeking a level of care that goes beyond the standard, an approach that is both highly experienced and deeply personal, I would be honoured to speak with you.

    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: A Speech and Language Therapist’s Take

    Let’s face it, introducing solids is a rollercoaster for parents. You’re bombarded with advice (solicited and otherwise) on purees, spoon-feeding, and the much-discussed ‘baby-led weaning’ (BLW). As a speech-language/feeding therapist I see the world through the lens of communication and development, as well as safe munching and swallowing. BLW can be a fantastic option for many little foodies. But is it right for yours? Let’s take a dive into the messy, hilarious world of toddler feeding.

    BLW in a nutshell

    Your baby, perched in their highchair, eyes wide with excitement and curiosity reaches out for a platter of food. He/She grabs a fat avocado slice, and curiously explore it with his/her lips, gums and tongue. He/She spits some of it out, mashes bits of it into his/her hair, there was a tiny swallow and the rest is smeared onto the high chair tray. Now he/she grabs a bit of the banana and rinse and repeat as before, except this one he/she keeps in his/her mouth for bit longer and takes a tiny bit more before the rest gets deposited into his/her bib.

    This, in a nutshell, is BLW! It’s all about letting your little one take the lead in exploring new foods, textures, and tastes. No spoon-feeding, just pure, messy, self-directed feeding fun.

    The pros of letting your little one loose on solids:

    • Motor Skills: BLW is a sensory party for developing motor skills. Picking up that slippery banana or gumming a chewy piece of toast strengthens those tiny hands and mouth muscles. These are the very skills they’ll need for future talking and chewing.
    • Texture Time: BLW exposes your baby to a variety of textures right from the start. Think soft, steamed broccoli florets or smooth, banana half-slices. This sensory exploration helps them develop an understanding of different textures in the world, which can translate to better oral motor skills needed for speech development.
    • Independence: BLW fosters a sense of self-feeding independence. Your toddler learns to control how much he/she eats and the pace of his/her meal. This can lead to better self-regulation later on, not just with food, but in other areas of his/her development too.
    • A wider variety of flavours: BLW encourages exposure to a wider variety of tastes and smells. Let your baby discover the sweetness of roasted sweet potato or the tang of mashed avocado! This early exploration can lead to less picky eating down the road.

    There are some valid concerns:

    • Gagging vs. Choking: One of the biggest concerns parents have about BLW is choking. However, gagging is a natural reflex that helps babies learn to move food safely around their mouths. Choking is much rarer, and with proper food selection and supervision, the risk is very low. The con here really is parental anxiety more than anything else and if you can overcome this then a bit of gagging is just fine and part of the process. Choking, again most children do choke occasionally a bit! Of course, close supervision and common sense is very important here.
    • It’s ever so messy!: Be prepared for mashed banana on the highchair tray, rogue peas flung across the room, and a general sense of chaos. But then again, this is an important part of the learning process! I would encourage you to embrace the mess (within reason and your personal tolerance level) and focus on the fun of exploration.
    • Nutritional Concerns: Some parents worry that babies won’t get enough nutrients with BLW. While it might take a while for them to master the art of self-feeding, a healthy child’s body is pretty good at self-regulating. Offer a variety of healthy options, and he/she will eventually get the hang of it.

    BLW: Is it right for your Little One?

    BLW isn’t a one-size-fits-all approach. Here are some things to consider:

    • Developmental Milestones: Babies should be able to sit up with good head control and show an interest in food before starting BLW.
    • General good health and absence of food intolerances, allergies, or other significant health issues which might dictatea more controlled feeding regime.
    • Gag Reflex: A strong gag reflex is a good sign. It shows your baby’s natural ability to move food safely around their mouth. If, however, your baby’s gag is overly sensitive and causes frequent bouts of vomiting please consult your health care professional for an assessment (GP, Paediatrician, Dietician, Speech and Language – Feeding Therapist).
    • Your Comfort Level: BLW requires a relaxed and patient approach. If you’re feeling stressed about the mess or potential choking hazards, it might not be the right fit for you.

    A final mouthful:

    BLW can be a fantastic way to introduce your baby to solids. It promotes exploration, independence, and a love for food. Remember, there’s no pressure to go all-in on BLW. You can always combine it with spoon-feeding or purees to find an approach that works for your family and your child. The most important thing is to create a positive and relaxed mealtime environment where your little one can explore the wonderful world of food at their own pace.

    P.S. As an SLT, I always recommend chatting with your health care professional. This way you can address any concerns you might have and ensure your baby is developmentally and physically on track for this exciting new chapter.

    Don’t hesitate to contact me!

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice


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

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    How parent coaching turns story time into a communication success

    We often hear from parents who are trying their best to connect with their child, especially when reading books, but are met with frustration. They’ll say, ‘I read the book exactly as it’s written, but my child can’t focus for very long and just runs off!’ or ‘my child just flicks through the pages then turns it upside down and runs off with it’ or similar.

    It’s a common story. Traditional reading—going through the text from cover-to-cover—has its place of course, but for little ones with a language delay or autism it can move too quickly and place all the focus on the book’s words, not on the interaction.

    But what if I told you that story time could become one of the most fun and productive times for your child’s communication development?

    Watch the fantastic little video clip above! You can see the pure joy and connection between this dad and his son. This is the same family who, just a few weeks ago, felt defeated when trying to read a book, with their child quickly losing interest and leaving the reading/book corner.

    What changed?

    The power of parent coaching and Hanen principles

    The difference you see in the video is the direct result of parent interaction therapy, or parent coaching, based on the internationally recognised Hanen principles.

    I didn’t ‘fix’ the child. Instead, I coached the parents in a few simple, powerful strategies that completely changed the dynamic of their interaction. Instead of being a time for teaching and instruction, story time became a back-and-forth conversation.

    Here are the four major transformations that coaching helped this family achieve:

    1. From reader to play partner

    Before coaching, the parents felt their job was to read the text and to teach the words in it to their child. Now, their job is to follow their child’s lead. They learned to Observe, Wait, and Listen (OWL). If the child points to the tree or the badger on the page, the parent talks about the tree or the badger.

    The result

    The child is now initiating and leading the conversation! He is sharing what he finds interesting, which makes him feel powerful and keeps him deeply engaged.

    2. Building connection and attention

    When parents focus solely on reading, they often forget to make frequent eye contact and use animated facial expressions. The principles taught them to put the text aside and prioritise connection.

    The result

    Our little boy is looking at his dad more frequently, making great eye contact, and clearly having fun! When the interaction is fun, the child’s attention span naturally lengthens, allowing him to attend to the book and the interaction for a much longer time.

    3. Creating opportunities for communication

    The parents learned simple ways to prompt communication without pressure. They stopped asking knowledge-based questions (‘What colour is that? Or point to the pig!’), which can feel like a test.

    Instead, they learned to use techniques like ‘Saying less and pausing’ or ‘copying their little one’s echolalia ‘, signalling that they are very interested in what he is saying and that his communication matters!

    The result

    The child is now spontaneously using strings of sounds and gestures to communicate his needs and interests, knowing and enjoying his parents’ enthusiastic responses.

    This video is a testament to the fact that you are your child’s best therapist. With the right tools and coaching, you can transform everyday routines, like reading a book, into the most joyful and effective communication sessions.

    4. Acknowledging and interpreting echolalia

    In the video, you may hear the little boy repeat a phrase from the book or from what his dad just said. This is called echolalia, and for a long time, it was often dismissed or discouraged.

    However, a core principle of our parent coaching is that echolalia is communication. For children who are ‘Gestalt Language Processors,’ these memorised phrases (or ‘gestalts’) are their building blocks of language.

    The key is not to stop the repetition, but to become a ‘language detective’ and ‘interpreter’!

    By modelling the correct, first-person phrase right after the echo, parents/caregivers are teaching a child how to break down the ‘chunk’ and use the individual words functionally. They are showing their child: ‘I heard you. Your communication makes sense to me.’

    This strategy is a game-changer because it:

    1. Validates the child’s communication: It honours the child’s natural way of learning language, which boosts their confidence and willingness to communicate.
    2. Facilitates language development: It provides the child with the next step—a meaningful, functional phrase—to move them from repeating language to generating their own spontaneous sentences.

    Look at the child’s face again in the video. When his dad acknowledges and interprets his communication, you see that spark of joy and connection—that’s the moment when true, functional language learning happens!

    Ready to unlock the potential in your family’s story time? Contact me to learn more about our parent coaching programs.

    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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  • ·

    Explore how Intensive Interaction develops Autistic children’s communication

    Intensive Interaction is an approach that I might suggest for your child. Here is an overview of this approach to increase your knowledge. There are a range of approaches that overlap and having trained in them all I use them all interchangeably to tailor to each child individually. This approach is particularly good for children who work mostly to their own agenda and find it hard to engage with others.

    So, what is Intensive Interaction?

    According to its founder, Hewett (1980), the approach “involves mirroring a person’s actions, sounds and facial expressions.” This allows your child to recognise and form communication between themselves and another, in a fun, play-based setting. Attention and listening are the fundamentals to speech and language development. By using the Intensive Interaction approach, we can increase the time your child can attend for and with another person. We are working towards a child enjoying another person’s presence. We are hoping to make gains with playing together with a child, taking turns and achieving reciprocity. That is the platform which we need to start with to build communication, language, words and perhaps even speech.

    There are many aspects that this approach supports:

    • such as using facial expressions
    • being in the presence of other people
    • having a shared space
    • attending to others
    • recognising and using non-verbal behaviours (e.g., gestures)
    • making sounds/noises (vocalisations) that have meaning
    • and eye contact. Although, we must be careful when suggesting ‘improving’ the use of eye contact. For some individuals making eye contact can be physically painful. So be aware that we are not making our children ‘look’ we are encouraging their natural behaviour.

    Who benefits from Intensive Interaction?

    Children with more complex communication and learning delay can benefit from the Intensive Interaction approach. Each session can be adapted to the needs of the individual and the sessions can be designed to use the whole or part of the approach. It is especially useful for children who are finding it hard to engage in any way socially with another person. Autistic children who tend to work to their own agenda often benefit from this approach.

    How is Intensive Interaction implemented?

    You need to have an environment that your child is comfortable in, and to be able to come down to their level so that you can see each other. This is why I often visit children in their own homes to ensure that they are comfortable and that they can withdraw for periods of time if they need to as well.

    Ensure your child knows you’re there and you are 100% present. This is very important. I would recommend that you put your phone away for some 10 minutes or so and give your undivided attention to your child for that period of time.

    Waiting

    Waiting is very important: we need to give your child time to process what is happening around them. After waiting for a response, you might want to start copying any gestures they use, any facial expressions they make, or perhaps imitate any sounds. You’ll want to continue with this for a few minutes to see if the communication between you and your child changes. Remember always take the cues from your child; if they communicate a message with you, respond. It might be that they are ready to finish and that they’ve shown this by walking away or signing.

    Giving your child a way to respond is vital. We can use visuals to support their communication. We can create ‘yes’ and ‘no’ symbols so they can use them in a functional way.

    A top tip in these sessions is to use mirrors, so that your child can see and begin to recognise their own facial expressions.

    There are other programmes that overlap with Intensive Interaction such as Hanen with following your child’s lead and the Gina Davies Curiosity Programme.

    Now you know a bit about Intensive Interaction, why not book a call to discuss how we can support your Autistic child’s communication using this evidence-based approach.


    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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    Why Imitation is so Important

    Target Activities and Games For Kids

    Why imitation is so important and how can speech and language therapy help children who struggle to imitate?

    Imitation or copying starts in early infancy. When we observe a young baby and his parent or familiar adult we can see clearly and frequently that the baby will be intently looking at adult’s face and try to copy their facial expressions, smiles and all those funny baby sounds we often make with young babies.

    These sounds are called “motherese” and are the beginnings of a little conversation between the parent and the baby. The “conversation can go back and forth for a long time and include sounds, as well as facial expressions.

    A little later on, once the baby can crawl and sit up unaided the copying then goes on to include toys and objects. Mum or Dad will show their toddler how to use a drum or how to put a little train on the wooden tracks and the toddler will try and copy this. They may not succeed and be a little clumsy perhaps but the act of copying anything and everything their favourite adult does is typically seen throughout the day.

    We all know and have laughed at mums or dads saying; ssshhh don’t say that in front of the baby he/she will copy you, watch your mouth! (as dad is swearing at the broken radiator….)

    This imitation goes on for years and includes eventually of course little words, more words, putting words together and then creating sentences, all the while our toddler is listening to how their adults speak, not only what they say but how they say it. This is how dialects and accents can be transmitted easily from parent /family to child.

    Copying in Children with Autism

    We know that children with autism often struggle to imitate. We see children on the spectrum typically having great difficulty to copy adults or children; this can be seen in very reduced play with their peers in nursery for example.

    Children with autism tend to have reduced joint attention and engagement with others and need to develop the ability and awareness to copy others in order to then engage more jointly with others.

    Speech and Language Therapy can help with Parent Child Interaction work and Coaching, here is how:

    During my coaching work with parents I teach step by step how to help a child who struggles to imitate:

    We look at all the researched skills and actions that adults can take to help their little one to copy, starting with close observation of their child’s interests, then following and including their child’s play and copying/imitating their child in how they play. I teach steps in a graduated way so that it is easy to see the progress and joyful to have the results at the end.

    The results are clear to see over time: our children on the spectrum learn to imitate actions, with objects and gestures, then sounds and words. Alongside this increased imitation skill the child can then develop more joint attention and engagement.

    I would always recommend Parent Child Interaction Training as a first port of call as we learn so many great techniques which are well researched by the Hanen Programme, www.hanen.org. Do drop me a line if you would like to find out more.


    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.

  • · ·

    Navigating the exciting 9–18 months journey: Your baby’s communication milestones

    Between 9 and 18 months, your little one undergoes a remarkable transformation, blossoming from a curious explorer into a budding communicator. This period is filled with exciting milestones in speech, language, and social development. Let’s delve into what you can expect.

    9–12 months: The world opens up

    Communication takes flight

    • Babbling becomes more complex with a wider range of sounds. By babbling we mean syllables like: pa ga ka ma da and then ‘baba’ gohgoh’. First we hear one and two syllables together and then longer and longer strings! This is so exciting!
    • First words! One day around the 12 months–14 months mark we hear a first word! My older son’s first word was ‘Licht’ which is the German word for ‘light’ as literally every time I carried him along the corridors in our home, I pointed out the light switches to him and turned them off and on a few times. And each time I said ‘Licht!’ and it stuck! PS: sadly I cannot remember what my younger son’s first word was… poor second and third babies they just have to muddle along and call loudly to get noticed!
    • Understanding grows! Baby now understands simple instructions like ‘where is your ball’ and responds by looking to the ball across the room!

    Social butterflies

    • Your baby now starts to show interest in other children, and may try to copy their actions. Now we are getting proper traction with simple social games like peek-a-boo and patty-cake. Whilst your baby is generally interested in other people and children he or she may show separation anxiety when mum or dad or other familiar person suddenly leaves the room and they feel alone with strangers.

    Fine motor skills

    • Pincer grasp develops. This is where your child puts an index finger to the thumb in order to pick up of small objects, hold them and transfer them to either a box, back on the floor or into the other hand.
    • Your baby may start to explore objects by banging, shaking, and mouthing.

    12–15 months: Words are taking shape

    • Language explosion: From our early words we now suddenly see baby’s vocabulary expanding, with new words added each week. I would highly recommend parents keep a little journal of all the words they hear. If nothing else this is a wonderful aide-memoire for years down the road when you might like to reminisce about the first ten words. I promise you otherwise you won’t recall! (especially for second and third babies; I would do this now, had I the time again).
    • Understanding grows:
      • By about 15 months our baby can follow simple two-step instructions like ‘Go get your shoes and bring them here.’
      • Begins to understand the concept of ‘no.’ and that’s a very useful thing. Though before you breathe a sigh of relief… your toddler may well show you that he is understanding a ‘no’ though he may not stop doing what he is doing or come down off the table!
    • Playtime gets interactive:
      • Now we engage in more complex play, such as stacking blocks, pretending to eat with a spoon, and imitating actions.
      • Many toddlers now start showing an interest in picture books.

    15–18 months: Communication blossoms

    • Words combine: Towards 18 months or around about then your toddler may start to put two words together, such as ‘more milk’ or ‘bye-bye dada.’
    • Gestures and sounds: Now we also use gestures to communicate, such as pointing, shaking head ‘no,’ and waving ‘bye-bye.’
    • Exploration and curiosity:
      • Your toddler is now EVERYWHERE! Turn your back and he or she is gone! Your toddler now shows a strong sense of curiosity and explores their environment with enthusiasm.
    • Copying
    • Look out for actions and gestures your toddler will copy such as clapping hands or patting a cushion or banging a spoon on the table .

    Remember

    • Every child develops at his or her own pace.
    • These are just general guidelines, and some children may reach certain milestones earlier or later than others.
    • If you have any concerns about your child’s development, please consult with your speech and language therapist. We are always keen to hear from parents and happy to help promote all those lovely early skills.

    General tips to encourage communication if you feel your child needs a little more help

    • Talk, talk, talk! Engage in frequent chatting with your child.
    • Listen to your child: Allow for periods of silence when playing with your child to allow them to say something or make sounds which you can then copy and respond to.
    • Read aloud regularly. Use books with simple words and pictures.
    • Play interactive games: Hickory Dickory Dock, Row Row the boat, Old McDonalds, 5 little monkeys jumping on the bed, chasing and catching, tickling games.
    • Respond to your child’s babbling and gestures. You can copy them or if your toddler says long strings of babbling you cannot understand you could just say: ‘Oh ok!? ‘yes that’s great!’ ‘who knew!’ ‘wow you’ve got much to say!’ as if you understood.
    • Limit screen time or if your child is very passionate about watching clips then sit and watch with your child so that you can see what is the best bit, which songs they like the best and what sort of phrases they love hearing.

    This exciting period of rapid growth and development is a precious time for both you and your child.

    By providing a loving, stimulating, and responsive environment, you will naturally nurture their communication skills! Any more questions, please get in touch!

    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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