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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  • · ·

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

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

    Sonja showing power words on a board

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

    What is childhood apraxia of speech (CAS)?

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

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

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

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

    Why is CAS such a big topic right now?

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

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

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

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

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

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

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

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

    1) Inconsistent speech errors

    Your child might say the same word in different ways:

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

    This inconsistency is one of the biggest clues.

    2) Difficulty copying words on request

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

    3) Limited sound repertoire

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

    4) Vowel distortions

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

    5) Speech that sounds effortful

    You might notice your child:

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

    6) Longer words are much harder

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

    7) Prosody differences (rhythm and stress)

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

    8) Frustration or reduced confidence

    When a child is frequently misunderstood, they may:

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

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

    CAS vs phonological delay vs articulation difficulty (quick guide)

    These are some of the most common questions I hear.

    If it’s mainly an articulation difficulty…

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

    If it’s mainly a phonological delay…

    You might notice clear patterns, like:

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

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

    If it might be CAS…

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

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

    What happens in a CAS assessment?

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

    1) Parent discussion and developmental history

    We talk about:

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

    2) A speech sound assessment

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

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

    3) An oral-motor and movement check

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

    4) Stimulability testing

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

    For CAS, we often explore how they respond to:

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

    5) Functional communication and confidence

    We look at how speech impacts daily life:

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

    At the end, you should leave with:

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

    What parents can do at home

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

    1) Choose ‘power words’

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

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

    These words are motivating and functional.

    2) Keep it short and successful

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

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

    3) Support speech with rhythm

    Some children benefit from:

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

    This can help the brain organise the sequence of movements.

    4) Celebrate approximations

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

    We want them to feel:

    • safe
    • understood
    • proud to try again

    Confidence is a key part of progress.

    A short parent story (anonymised)

    One mum said to me:

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

    When should you seek support?

    You don’t need to wait until school.

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

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

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

    Here’s how I can help:

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

    ✅ A clear therapy plan with realistic goals

    ✅ Practical home strategies you can use immediately

    ✅ Support for nurseries and schools (where needed)

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

    Book your consultation here.

    Final gentle reminder

    You are not overreacting. Trust your instincts.

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

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

    3
  • A Day In The Life Of An Independent Speech And Language Therapist

    A Day In The Life Of An Independent Speech And Language Therapist

    A Day In The Life Of An Independent Speech And Language Therapist

    I often get asked how many clients/children I see per working day or what my working day/life looks like. I always reply that every day is different, which is true, but there is a sort of average working day which looks a bit like this:

    I usually start preparing for my first client of the day at around 9.30 am: I clean the room, wipe down all the toys and materials (that’s if they are coming to my clinic room) and then it takes me about 30 minutes to select and sometimes make suitable materials, games and activities for the child’s therapy programme. Client arrives at 10.30 am and the fun begins. They leave around 11.30am, and the cleaning and wiping down starts again – yes it’s the pandemic but to be fair I would do this anyway. I quickly write up my notes and send home work to the client via email. Now it’s 12 noon and I start preparing for the next client at 12.30 pm. This might be online parent-child interaction coaching and so I need different materials and activities that are suitable for teletherapy. We finish around 1.30 pm and I will write up my notes before having some lunch.

    Lunch tends to not be around 30 minutes. Around 2.00 pm I start prepping again for the next client: selecting activities, going over their last session, making sure I have everything I need to start at 2.45pm – we finish at 3.45pm, I write up my notes and then have a cuppa. The next client might be more on-line coaching or a child coming to see me: room cleaned and tidy, materials and activities prepared: client arrives at 4.30 pm and we finish at 5.30 pm. I clean the toys again, write up my notes and it is 6.00 pm ready for dinner. So that was four clients between 9 am and 6pm allowing for preparation, aftercare, cleaning and coffee and lunch.

    Other days I might see three clients and do more admin like ordering toys or books or teletherapy activities, or making materials (we therapist make tons of materials, we’d put Blue Peter to shame!) Sometimes I do two home visits, one in the morning and one in the afternoon – the travelling/parking in London is so time consuming that it really reduces the number of clients I can see which is why I don’t do many of those.

    I hand pick my clients to make sure that we are a good fit, and my service is bespoke: no one client gets the same treatment as another; each client is unique, usually very well-known and always highly valued. That takes time and means that in reality each client gets about 2 hours of my time, that is the actual session plus all the preparation and aftercare.

    I love this way of working and would not ever want to return to seeing tons of clients each day, not knowing any of them really well, due to high caseload numbers, staff shortages and an overload of administration.

    My way of working affords all my lovely clients the help they need to be able to feel empowered and to then support their children to make progress; when working with children they make the best progress they can make, fulfilling their potential. My lovely reviews and testimonials tell me that my clients appreciate the extra attention.


    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.

  • ·

    Joint attention for children with autism

    Kids Speech Therapist London

    Why is joint engagement important for communication development?

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

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

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

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

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

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

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

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

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

    We learn how to enable a child to:

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

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


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

  • · ·

    The hidden impact of mouth breathing and open mouth posture on speech and feeding

    When most people think about speech or feeding difficulties, they picture the tongue, lips, or chewing skills, but how a child breathes at rest plays a surprisingly big role too.

    Mouth breathing and open mouth resting posture can quietly influence everything from how a child’s face grows to how clearly they speak, to how confidently they chew and swallow. It’s something many parents never think about, until they start noticing the subtle signs.

    Let’s explore why this happens, what to look for, and how to gently support better breathing and oral posture.

    Recent research supports this link between mouth breathing and speech difficulties. For example, a 2022 study by Alhazmi et al., published in the Journal of Pharmacy and Bioallied Sciences, found that 81.7% of children aged 9–17 who breathed primarily through their mouths presented with speech sound disorders. The study highlights how mouth breathing can significantly influence orofacial development and articulation patterns.

    💨 Why we’re designed to breathe through our nose

    Our bodies are made for nasal breathing. When we breathe through the nose, the air is filtered, warmed, and humidified before reaching the lungs. The tongue naturally rests against the roof of the mouth, the lips close gently, and the jaw stays relaxed, all of which encourage healthy oral development.

    In contrast, mouth breathing often means the tongue rests low in the mouth and the lips stay apart. Over time, this posture can subtly reshape how the muscles and bones of the face grow.

    Children who breathe through their mouths most of the time may develop:

    • A longer face and narrower palate
    • Forward head posture
    • Slightly open lips and low tongue position at rest
    • A tendency toward drooling or noisy breathing
    • A dry mouth and consequently bad breath
    • At times the tongue pushes constantly against the front teeth causing them to grow forward (buck teeth)

    These changes are not anyone’s fault, as they often start because of blocked noses, allergies, enlarged adenoids, low facial muscle tone or habits formed when a child was younger. But understanding the pattern helps us know how to support change.

    🗣 How mouth breathing affects speech

    Speech depends on precise coordination between the lips, tongue, and jaw. The resting position of these structures affects how ready they are to move.

    1. Reduced tongue strength and placement, i.e. the tongue rests low in the mouth (as it does in mouth breathing), it’s harder for children to lift it efficiently for sounds like /T/, /D/, /N/, /L/, and /S/. This can lead to speech that sounds slightly slushy or unclear, or a frontal lisp.
    2. Open mouth posture and resonance: An open mouth at rest may affect how air vibrates in the oral and nasal cavities. Children might have speech that sounds a bit ‘muffled’ or lacks crispness because the lips and jaw aren’t fully supporting articulation.
    3. Fatigue and breath control: Mouth breathing can lead to drier mouths and less efficient breath support. That can make longer sentences or conversations feel tiring, especially in noisy environments.

    🥄 How mouth breathing affects feeding and chewing

    Feeding involves the same structures that control speech, so posture and breathing patterns matter here, too.

    1. Chewing efficiency: Children who habitually keep their mouths open often have low tongue tone and reduced jaw stability. They may prefer softer foods, chew slowly, or struggle with mixed textures.
    2. Swallowing pattern: A tongue that rests low may push forward when swallowing. This ‘tongue-thrust swallow’ can interfere with efficient chewing and even affect dental alignment over time.
    3. Breathing while eating: Since it’s hard to chew, swallow, and breathe through the mouth simultaneously, children who can’t comfortably nasal breathe may rush bites or pause to catch their breath. This can contribute to coughing, choking, or food refusal.

    Common signs to watch for

    Parents often notice subtle clues before realising mouth breathing is a pattern. Some red flags include:

    • Lips habitually open at rest
    • Drooling after the toddler years
    • Snoring or noisy breathing during sleep
    • Preference for soft foods or grazing eating habits
    • Dark circles under the eyes due to allergies
    • Frequent colds, congestion, or mouth odour
    • Speech that sounds slushy or unclear despite good effort

    If several of these sound familiar, it’s worth mentioning them to your child’s GP, dentist, or speech and language therapist.

    👩‍⚕️ What can help

    1. Address the underlying cause: If nasal blockage, allergies, or enlarged adenoids are making nasal breathing difficult, a medical assessment is the first step. ENT specialists can rule out or treat physical causes.
    2. Encourage closed mouth rest: Gentle reminders like ‘Lips together, tongue up, breathe through your nose’ can help older children become aware of their resting posture. For younger ones, visual cues (stickers or mirrors) can make it a game.
    3. Build oral-motor strength and awareness: Speech therapists can design activities to strengthen the tongue and lips, improve jaw stability, and encourage balanced breathing. This might include blowing games, tongue-tip lifts, use of dental-palatal devices or oral-motor exercises disguised as play.
    4. Support good posture: Sometimes mouth breathing goes hand-in-hand with forward-head posture. Encouraging upright sitting during meals and screen time helps keep the airway open and supports better breathing habits.
    5. Make nasal breathing part of daily routines: Gentle nose-breathing practice during calm times (reading, bedtime, car rides) helps normalise it. Avoid making it a battle: calm, consistent reminders work best.

    🌱 A gentle note on change

    Patterns of mouth breathing develop over time, and change doesn’t happen overnight. It’s important to approach this with curiosity, not criticism. The aim isn’t ‘perfect breathing,’ but to give your child the tools and awareness to breathe comfortably and efficiently.

    Small improvements in nasal breathing and resting posture can lead to big gains in speech clarity, eating confidence, and even sleep quality.

    💡 The takeaway

    Breathing seems automatic, and it is! but how we breathe matters. Mouth breathing and open-mouth posture can quietly shape how a child speaks, eats, and grows.

    By noticing early signs, addressing underlying causes, and building supportive habits, you can help your child move toward stronger, clearer speech and more comfortable mealtimes.

    Just like every area of development, progress starts with connection, patience, and gentle consistency, one calm breath at a time.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    References

    Alhazmi, A., Alshamrani, A., Alhussain, A., et al. (2022). Mouth Breathing and Speech Disorders: A Multidisciplinary Study. Journal of Pharmacy and Bioallied Sciences 14(5):911. https://www.researchgate.net/publication/361978128_Mouth_breathing_and_speech_disorders_A_multidisciplinary_evaluation_based_on_the_etiology


    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.

    2
  • · · ·

    The purpose and nature of a speech and language therapy assessment

    If you have ever wondered what happens when you bring your child to a speech and language therapy assessment, then this blog will shed light on the ins and outs of it for you.

    At its heart, a speech and language therapy assessment is a systematic and thorough evaluation of your child’s communication or eating/swallowing abilities. It’s more than just asking a few questions. It is a carefully constructed process designed to identify strengths, pinpoint challenges, and ultimately pave the way for effective intervention.

    Establishing a detailed profile – a few bullet points:

    • Identification of communication and swallowing difficulties: I aim to determine if a communication or swallowing disorder exists. I will establish if the difficulty is a delay or a more complex disorder.
    • Diagnosis of the specific disorder/autism: The assessment delves deeper to pinpoint the specific type and nature of the difficulty. For instance, is your child’s language delay due to a specific learning disability, a developmental delay, or another underlying condition?
    • Knowing the aetiology or what is causing a difficulty is crucial for targeted intervention. And whilst we are on the topic let’s talk about an autism assessment: I am trained and experienced in assessing and diagnosing autism. However, when it comes to the diagnosis of autism I provide a preliminary ‘working hypothesis’ rather than giving a definite final diagnosis. The reason for this is that it is considered the ‘gold standard’ and ‘best practice’ to diagnose autism in a multi-disciplinary setting and context. Since I work on my own, I always refer to highly recommended multi-disciplinary clinics for the ultimate diagnostic assessment.
    • Determination of severity: Understanding the severity of the difficulty is essential for prioritising intervention and measuring progress. Is your child’s difficulty mild, moderate, or severe? This helps me choose a particular approach and then tailor it to suit each individual child.
    • Identification of underlying strengths and weaknesses: An assessment doesn’t just focus on what’s wrong. It also highlights your child’s strengths and areas of relative ease. This information is invaluable for building upon existing skills during therapy. Understanding weaknesses provides specific targets for intervention.
    • Guiding intervention planning: The assessment provides the crucial information I need to develop an individualised intervention plan. The findings directly inform the selection of therapy goals, strategies, and techniques. Without a thorough assessment, therapy would be a shot in the dark.

    A multi-faceted approach

    A speech and language therapy assessment is not a ‘one-size-fits-all’ procedure. The specific tools and techniques used will vary depending on a child’s age, the nature of the suspected difficulty, and other relevant factors. However, most comprehensive assessments incorporate several key components:

    • Case history: This involves gathering information about your child’s developmental, medical, social, and educational background. We will go through all the relevant milestones and throughout the process I will make notes which will help bring all the puzzle pieces together.
    • Observation: I will observe how parent and child play together and we also look at how the child plays by themselves. Additionally of interest is how a child plays with me, the therapist. Through discussion I will also endeavour to find out how your child plays with other children, be it at the nursery or within the family.
    • Standardised assessments: These are commercially available tests with specific administration and scoring procedures. They provide norm-referenced data, allowing to compare the individual child’s performance to that of his or her peers. Examples include articulation tests, language comprehension and production tests, and fluency assessments. I tend not to use these assessments a lot.
    • Instead, I use non-standardised assessments: These are more flexible and allow to probe specific areas of concern in more detail. This might include language samples (analysing spontaneous speech), dynamic assessment (testing and teaching to identify learning potential), and informal observation of play or interaction.
    • Immediate feedback and report writing: During and thenfollowing the assessment, I will bring all the gathered information together and I will discuss with the parents what my findings are and what my recommendations in the short term are. Parents always go home with a good handful of useful strategies that they can implement at home right away. In addition, I provide a comprehensive report outlining the findings, diagnosis (if applicable), severity, strengths and weaknesses, and recommendations for intervention.

    In conclusion, a speech and language therapy assessment is a dynamic and essential process. It is a journey of discovery, aiming to understand a child and the child’s family and his or her unique communication or feeding profile. The assessment is usually the start of our wonderful learning journey together.

    Below is a short video clip of an assessment where you see me in action explaining a particular therapy approach to a set of parents. It perhaps shows a tiny bit of how relaxed we are in our sessions and that assessment is not at all daunting, but a hugely informative event overall which will leave you feeling empowered and hopeful.

    What happens after an assessment?

    Please feel free to get in touch with me via my contact form if you wish to have an assessment for your child’s communication difficulties or feeding difficulties.

    An assessment is always a stand-alone event and does not mean you need to automatically book follow up sessions at all. It will give a lot of information and based on this you can decide if you would like more therapy or follow up for you and your child. Many times ongoing therapy is not needed! I only recommend a course of therapy if it is really needed and where it would be immediately beneficial for your child.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

    1
  • · · · ·

    Let’s ditch the ‘Fix-It’ approach to autistic play and stimming

    Let’s ditch the 'Fix-It' approach to autistic play and stimming

    December is often presented as a time of perfect, reciprocal play. Children are supposed to be unwrapping toys, sharing, and engaging in imaginative scenarios with family. But for parents of young autistic children, this high-pressure, socially demanding period can often feel like a battleground.

    If you’ve been told to interrupt your child’s stimming, push for eye contact, or force them to play ‘functionally’ with toys, it’s time to take a deep breath. Those traditional approaches are not only stressful—they often miss the point of your child’s communication.

    As a neurodiversity-affirming Speech and Language Therapist, I want to encourage you this December: You are allowed to follow your child’s lead, validate his or her unique interests, and trust that his or her play and movement are profoundly meaningful.

    1. Stimming: not a distraction, but a regulator 💡

    Stimming is short for self-stimulatory behaviour and includes repetitive movements or sounds like hand flapping, humming, rocking, finger flicking, or repeating phrases (called echolalia).

    For years, parents were incorrectly advised to block or eliminate these behaviours. The neurodiversity-affirming view tells us the exact opposite: Stimming is a vital and essential tool for your child’s self-regulation.

    Think of stimming as an internal volume dial:

    • Too loud/overwhelmed: Your child may stim to reduce incoming sensory input (e.g., rocking to ground himself or herself in a busy room).
    • Too quiet/under-stimulated: Your child may stim to increase sensory input and focus (e.g., running back and forth to maintain alertness).

    The shift: validate, don’t block

    Instead of saying, ‘Stop flapping your hands’, try to understand the message behind the movement.

    • Observe: When does the stimming happen? Is it before a meltdown? When your child excited? When your child is bored?
    • Validate: Name the need, not just the behaviour. You might say, ‘I see your body needs to move fast right now. That helps you calm down!’
    • Co-regulate: If the stim is unsafe (e.g., head-banging), help your child find a safer, alternative stim that meets the same sensory need (e.g., pushing hard against a wall, squeezing a stress ball).

    By validating your child’s need to regulate, you are building trust, reducing anxiety, and teaching him or her critical self-awareness.

    2. Autistic play: Meaningful, even if it’s monologue

    The traditional idea of ‘good play’ often involves turn-taking, pretending, and specific toy functions (e.g., pushing a train around a track). When an autistic child spends 30 minutes lining up cars, spinning their wheels, or scripting whole scenes from a favourite movie, it can often be dismissed as non-functional or repetitive.

    In neurodiversity-affirming practice, we recognise that autistic play is authentic play. These activities are crucial for learning, deep focus, and imaginative development.

    • Lining up toys may be an exploration of patterns, visual organisation, and order.
    • Spinning wheels may be a deep interest in cause-and-effect and visual sensory input.
    • Scripting is often a way to process language, regulate emotions, and practise complex social situations in a safe, controlled way.

    Make a change: Join your child’s world, don’t drag them to yours.

    Stop trying to force the ‘right’ way to play. Instead, try these neuro-affirming strategies:

    1. Be a co-regulator, not a director: If your child is lining up cars, sit down next to him or her. Instead of moving a car, try handing him or her another car to line up. Focus on the shared interest rather than forcing interaction.
    2. Narrate (don’t question): Avoid constantly asking, ‘What are you doing?’ or ‘What does this car say?’ This puts pressure on your child to perform. Instead, narrate your observations using his or her interest: ‘I see you made a long, straight line of red cars. Look at all the wheels spinning!’
    3. Validate the interest: Show genuine appreciation for your child’s focus. ‘Wow, you know so much about how magnets stick together! That’s incredible.’

    3. The communication revolution: Honouring gestalt language processing 

    Many young autistic children communicate in ways that don’t fit the traditional model of building language word-by-word. Many use Gestalt Language Processing (GLP).

    A gestalt language processor learns language in chunks or scripts (e.g., ‘what’s-in-there?’ or ‘ready-go!’). These chunks (or gestalts) are not random; they are often tied to an emotional memory or meaning. Over time, the child breaks down these big chunks into individual words then learns to recombine those words creatively.

    If your child repeats movie phrases or whole sentences that seem unrelated, he or she is likely a gestalt language processor!

    Affirm the script, then model something useful.

    1. Affirm the script: When your child says a script, respond to the meaning or emotion behind it, not the literal words. If he or she says, ‘We’re going to need a bigger boat’, and he or she is looking at a messy toy pile, he or she may be trying to express overwhelm or a need for help. You can affirm: ‘That pile is too big! I can help you move it.’
    2. Model new ‘mix and match’ scripts: To help your child move from whole scripts to single words, you can model shorter, slightly changed versions of the script, also called ‘mitigated gestalts’. If they say, ‘I want to go home now’, you might model, ‘Let’s go home, now’ or ‘I wanna go home’.

    By honouring your child’s communication style, you validate his or her experience and naturally support his or her path to language development—a core part of neurodiversity-affirming SLT.

    Your December gift to your little one:

    This December, stop trying to make your child fit into a neurotypical box. Instead, make your home a safe space where he or she can be his or her authentic selves.

    Prioritise regulation and connection over compliance.

    Trust that when your child is regulated, his or her communication, learning, and engagement will flourish naturally. This is the true gift of neurodiversity-affirming practice.

    Download and print my neuro-affirming quick reference guide and keep this guide handy on your fridge and/or in your child’s play area for a quick reminder to prioritise connection over conformity.

    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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