Supporting children and families living with verbal dyspraxia

ByLondon Speech and Feeding August 7, 2023July 28, 2023

“It’s brill-i-ant, it’s brill-ant, it’s brillnt”

Have you ever wondered why children may pronounce a word correctly one minute and in the next breath they struggle to say the same word? It’s equally as frustrating for you as it is for your child. The biggest question of all is WHY? Why does this happen and what causes it? Whilst there are many explanations. When it persists, it might be a condition called verbal dyspraxia.

What is verbal dyspraxia

Verbal dyspraxia is a neurological motor speech disorder that affects the coordination and planning of muscle movements that are needed for speech production. A child may have difficulty making the precise movements needed for speech, which may result in inconsistent and unintelligible speech. Children may also have trouble sequencing sounds and syllables, producing speech sounds accurately, and coordinating the movements of their articulators (e.g., lips, tongue, teeth, jaw). This can lead to a range of speech errors (including sound distortions, substitutions, omissions, and difficulty with rhythm and prosody).

We know that these speech errors, and not being able to get a message across, can be frustrating for children with speech difficulties. Can you imagine talking and limited people understanding you? It’s so tough on children and the people trying to communicate with them.

Creating a person-centred therapy plan is vital. This allows your child to stay motivated, as intervention is likely to be long term. This planning may include favourite words to use during their hobby or favourite activity, or person-centred goals such as ‘giving Alexa an instruction’.

Children with verbal dyspraxia can have several different ways of producing words, which often makes it trickier for them as there’s no consistent pattern to work with. So, we’ve put together some top tips to support their communication and make their (and your) lives a little easier in the process.

Ten ways to make communication easier for your child with verbal dyspraxia

Have a list of frequently used words and practise this set. Little and often is best!
Use cued articulation to support speech production (ask your Speech and Language Therapist for the gestures)
Give time and use active listening. This means showing interest and trying not to think about what is on your never ending ‘to do’ list
Reduce frustration in any way that you can. This might mean allowing your child to demonstrate using gestures rather than speech. You might also give top tips for other adults or children who communicate with your child when out and about
Talk about the structure of words with your child (i.e., there are two beats/syllables in this word)
Show the written form of the word to go alongside their production
Split down tasks, so that your child only has to respond to one question at a time, reducing their motor capacity
Recognise when your child is working well and when they may need support of an Alternative and Augmentative Communication device
Allow all environments to have the same training and equipment (i.e., at school, home, out and about)
Have regular periods in the day where your child can practise their specific words in different environments. This can be effective for children with verbal dyspraxia

Do you still have questions? Contact Sonja for support.

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.

Autism Therapy · Feeding · Speech and Language Therapy

The picky eater’s plate: Introducing solids to toddlers with ARFID
ByLondon Speech and Feeding March 17, 2025March 13, 2025
Designed by Freepik

Mealtimes can be a battleground for parents of picky eaters, especially toddlers with Avoidant/Restrictive Food Intake Disorder (ARFID). I see a great number of toddlers with Autism traits and many of my clients are picky eaters from mild to severe. Take a look at my blog for an outline of what the issues are and how to try and help.

ARFID goes beyond typical ‘picky eating’ and can significantly impact a child’s growth, nutrition, and social-emotional well-being. If your toddler is resistant to trying new foods or has a very limited diet, here are some strategies to navigate the introduction of solids:

1. Understand ARFID:

ARFID is a diagnosable eating disorder characterised by:
- Limited food variety: Eating only a small range of foods, often with specific textures or colours.
- Fear of new foods: Intense anxiety or aversion to trying unfamiliar foods.
- Sensory sensitivities: Heightened sensitivity to taste, smell, texture, or appearance of food.
- Lack of interest in eating: May show little interest in food or mealtimes.
2. Seek professional guidance:
- Paediatrician and/or gastroenterologist: Rule out any underlying medical conditions.
- Registered dietitian: Assess nutritional needs and create a balanced meal plan.
- Speech and language therapist (SLT): If oral-motor skills or sensory sensitivities are contributing to feeding difficulties.
- Occupational therapist (OT): If sensory processing challenges are affecting mealtime behaviours.
- Child psychologist: If anxiety or emotional factors are contributing to ARFID.
3. Strategies for introducing solids:
- Start small: Introduce one new food at a time, in small amounts, alongside familiar favourites.
- Patience is key: It can take multiple exposures (up to 10–15 times!) for a child to accept a new food. Don’t give up!
- Positive reinforcement: Praise and encouragement for any interaction with the new food, even just touching or smelling it.
- No pressure: Avoid forcing or pressuring the child to eat. This can create negative associations with food.
- Make it fun: Present food in playful ways, use cookie cutters for fun shapes, or involve the child in food preparation.
- Sensory exploration: Encourage exploration of food through touch, smell, and sight before tasting.
- Role modelling: Show the child that you enjoy eating a variety of foods.
- Use fun utensils: your child might like characters from ‘Frozen’ or ‘Dinosaurs’ or ‘Diggers’ there are a host of character-based cutlery and cups/plates to be had. Also, I really rate these two items very highly they are so good so I want to share these with you. Both are available online. But warning: the cup is outrageously expensive as it comes from the United States and is sold by a small scale company. But I feel this is cup very worth trying, I have had good results with this.
NumNum Baby Spoons Set

TalkTools Recessed Lid Cup with Handles
- Gradual desensitisation: Start with foods that are similar in texture or taste to accepted foods, then gradually introduce more challenging options.
- Food chaining: Introduce new foods that are similar in taste, texture, or appearance to accepted foods.
4. Mealtime Environment:
- Positive and relaxed: Create a calm and enjoyable mealtime atmosphere.
- No distractions: Minimise distractions like TV or toys.
- Consistent schedule: Offer meals and snacks at regular times.
- Child-sized portions: Offer small, manageable portions to avoid overwhelming the child.
- Involve the child: Let the child choose their utensils, plate, or cup.
5. Remember:
- Every child is different: What works for one child may not work for another.
- Progress takes time: Be patient and celebrate small victories.
- Focus on the positive: Praise any positive interaction with food.
- Seek support: Connect with other parents or support groups.
Introducing solids to toddlers with ARFID can be challenging, but with patience, persistence, and professional guidance, you can help your child develop a healthier relationship with food.

Get in touch with me via my contact form if you need support

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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Autism Therapy · Speech and Language Therapy · Top tips

Discover nine ways to support literacy in autistic children
ByLondon Speech and Feeding April 28, 2023April 11, 2023
We are all aware that Autism is on a spectrum. By the very nature of this, it means that every child will present differently, so an individualised approach is required. We need to remember to use a child’s strengths to support their needs. By using a person-centred approach, you’ll see your child’s literacy develop and thrive.

I hear many parents concerns about literacy as well as communication. Will they be able to read, write and spell? How will they manage their literacy independently? The questions are endless, so let’s look at how you can support your child’s literacy skills and how together we can provide a scaffold to them becoming independent learners.
1. The one thing we know is that Autistic children are visual learners. They succeed by us sharing pictures and demonstrating how the narrative is shown.
2. Start reading to your child at an early age. You can never start too early. This creates a love for books and supports vital pre-literacy skills (such as increasing vocabulary, following narratives, awareness of sounds in words, and letter recognition and awareness). By supporting pre-literacy skills, you’re starting the process to create confident young readers.
3. There are many ways to use books. You can narrate the story using different voices and tones to increase interest. You can do this even if your child isn’t interested. They are still listening and learning vital skills. You may even ask and answer questions and voice the skills that they will need for internal monitoring.
4. Use their interests to select appropriate reading material. In addition, you can then create questions on the book and provide a scaffold to support your child with the answer.
5. Use technology to spark their interest in reading. Demonstrate how they can read online. This is often successful as it becomes an individual activity as opposed to needing social interaction.
6. Provide them with a choice of texts (e.g., would you like ‘Perfectly Norman or when things get too loud’) rather than an open-ended question such as ‘What book would you like to read?’
7. Write key pieces of information down on paper. Research suggests that Autistic learners understand written text better than speech.
8. You could have a ‘word of the day’ from chosen reading material that you explore together.
9. Reading aloud to your child can have many benefits which include understanding vocabulary to how the book is read, with appropriate intonation.
I highly recommend the boom decks as they are a great resource!

The ethos at London Speech and Feeding:

“If they can’t learn in the way we teach, then we teach the way they learn”

If you need speech, language or communication support or advice, I am always here to help.

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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Autism Therapy · Neurodiversity · Speech and Language Therapy · Top tips

The purpose and nature of a speech and language therapy assessment
ByLondon Speech and Feeding May 27, 2025May 19, 2025
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.

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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Autism Therapy · Speech and Language Therapy

Bilingualism – should I speak only English with my speech delayed child?
ByLondon Speech and Feeding November 13, 2023November 20, 2023
Introduction

Bilingualism is a beautiful aspect of our diverse world. Growing up in a bi- or multi-lingual household is a wonderful gift, allowing children to communicate with a broader range of people and access many cultures.

My own two children grew up in a bilingual German-English speaking household. They have both been so enriched by this experience, not only language- and learning-wise but of course also culturally: their world has always been so open and colourful. Growing up in inner London and having their German family and mum’s friends as well, this has been a wonderful experience. Both my boys speak German well (not quite like native speakers but like very good second language speakers) and both have very easily learned 3rd and 4th languages additionally when in secondary school.

Whilst bilingualism has untold benefits, it’s not uncommon for bilingual children to take slightly longer to reach certain speech milestones. This should not be automatically mistaken for speech disorders but rather seen as a natural part of bilingual language development.

Bilingualism and speech delays

Sometimes, of course, we do see speech delays or disorders where a child’s speech development lags significantly behind their peers. We often see a delay in both languages equally, making it extra hard for to communicate effectively. BUT PLEASE KNOW the family speaking in multi-lingual languages never caused the delay/disorder!

If there is a delay or a disorder any number of other reasons could have caused it, such as:
- hearing impairments,
- reduced phonological awareness,
- sensory processing issues,
- reduced attention and reduced joint attention,
- neuro-developmental delays or difficulties,
- general or specific learning difficulties
- or sometimes other genetic factors.
So, to say that the difficulty is due to a child being exposed to several languages is a red herring. (no offence to herrings!)

Speech therapy

Speech therapy can be powerful to help bilingual /multilingual children with speech delays unlock their full linguistic potential. By providing individualised assessments, targeted interventions, and involving families, speech therapy can bridge the gap between speech delays and bilingualism. It’s essential for the therapist and parents to work together to support the children in their unique linguistic journeys, helping them communicate effectively and thrive in both of their languages.

Image by Freepik

Speak your home language at home

Many parents report that they worry about speaking their home language at home and instead they have been focusing on just speaking English at home. They now rarely use their home language with their child. They fear that speaking a language other than English with their child will cause further delay and hinder their progress. All parents want the best for their child and often parents fear that their child won’t fit in or will be seen as ‘different’. So we can understand why parents feel that the English language is the only one worth having.

But the opposite is the case: it is crucial to speak in both languages freely, both at home and outside the home! Both languages will benefit your child, no matter what the delay or difficulty is. Acquiring a ‘mother tongue’ or native language is absolutely vital for children to have a good, solid linguistic grounding on which to build other languages. Bilingual children may mix languages during speaking and parents may equally mix their languages. This does not hinder language development and is a natural part of linguistic development.

Speak freely and naturally

What is far more important than the question: ‘which language should I say this in?’ Instead think: ‘let me speak freely and naturally, let me respond naturally, in good intonation and let communication flow freely to the child.’

Speech therapy can be a crucial resource for bilingual or multilingual children and their families.

We work on targeted interventions to address speech and language difficulties, helping your child develop essential communication skills. For home practice between therapy sessions, we can recommend tailored treatment plans to help you help your child in daily life. Our input could be focusing on articulation, phonological awareness, attention and listening, vocabulary development and grammar.

Family support is crucial in speech therapy. We like to work closely with parents to provide guidance and strategies for fostering language development in both languages at home.

If you have any worries about your child being delayed in a bilingual or multilingual household do get in touch and we will be happy to support you in your journey.

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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Speech and Language Therapy

Empty Set and Phonology approaches
ByLondon Speech and Feeding June 26, 2024June 26, 2024
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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Speech and Language Therapy · Top tips

The importance of child-led therapy
ByLondon Speech and Feeding June 30, 2023May 31, 2023
Child-led therapy is essentially what it says, therapy sessions that are directed by your child. You may think how can my child’s Speech and Language Therapist focus on goals if sessions are led by my child.

Let us explain…

Your child will be more receptive and motivated to take part in therapy if they have some form of input. E.g., they can choose what toys they want to play with, or how they want to play with the resources available. If sessions are child-centred then they are much more likely to engage and reach their goals, making intervention valuable. They will also be able to regulate their emotions, and use movement to support their need for regulation. E.g., some children like to jump whilst others like to run. As Speech and Language Therapists we need to use what is meaningful to your child to get the most out of intervention. By focusing on child-led therapy, we can build trust, which will allow us, in time, to use new techniques and activities that your child may enjoy. We want children to be themselves, to show their true personality. Therapy is about enhancing their skills in their own individualised way and child-led therapy allows for this.

This way of working may seem daunting to some, but it doesn’t have to feel this way. Parents often feel if they are prepared then activities may go smoother. It might be the case, but perhaps it doesn’t give your child the opportunity for spontaneity. We’d like to suggest something that may lead to some surprises. Put out an activity that is your child’s favourite and then a completely new activity. Remember these activities don’t have to be complicated. Often, the simpler the better!

So, no need to plan, just place two activities out and see what happens! Look out for anything which surprises you, which activity did they prefer? Do they have any sensory preferences? The freedom of choice is a wonderful thing to explore. So, just go with the flow!

The kind of activities that are useful for child-led play can include:
- Hide and seek
- Cooking or baking
- An Exercise ball
- Small world play
- Pretend play
- Musical instruments (you could even have a go at making your own)
Child-led therapy is a very useful resource. We have it at our fingertips. We don’t need special resources. You just need yourselves and your child! Sometimes, child-led therapy can be tricky to put in place. It sounds easy but is much harder in reality. So, make sure you give it time and reflect on your experiences. Ask yourselves ‘what went well’, and ‘what could be improved’. E.g., perhaps you gave your child time to lead to begin with, but you didn’t give them enough time to think about their options during the activity.

How can parents become more child-led in the home environment?
- Pause and use silence. This gives your child the opportunity to lead.
- It’s perfectly natural to want to talk. Afterall, this is how adults maintain conversations. If you find yourself talking too much, count to ten! This will allow your child time to respond or initiate in the conversation or interaction.
- Move down to your child’s level. It’s much easier to see what’s going on if you’re at the same height.
- Videoing you and your child can really help you to see where your strengths lie. You’ll also be able to make minor tweaks to improve your communication during child-led play.
Contact Sonja for more advice on speech, language and communication during child-led play.

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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