Target activities and games

ByLondon Speech and Feeding
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Target Activities and Games For Kids
Target Activities and Games For Kids

Target Activities and Games

AMAZINGLY EASY Activities that we can do at home and in the clinic to help our children practise those targets!

I bet you have wondered what amazing things are done by a therapist in the clinic that you could not possibly do at home…? Well, if so I am here to tell you that you will be absolutely fine with just a few select toys and games and you will be able to get those targets done in a jiffy!

What we clinicians do very well and what you probably can’t do yourself is formulate and design the targets that are important for your child to practice. Once we have assessed or reviewed your child’s progress and needs we can then design the perfect next step of targets for you.

So for example, we have decided your little one needs to be practicing their ‘r’ sounds at the beginning of short words. We decided that based on our clinical expertise and our assessment and we have already worked with your child and managed to get this tricky ‘r’ sound just about right on its own. Now we are ready for short word practice.

It has been researched that in order for the brain pathways to re-shape or reform we need to get about 100 words in per day of our target sound. That sounds like quite a lot, right? But actually….. it’s not that bad. After all you only need to say 5-7 words about 20 times and hey presto that’s about 80-100 words.

So here are some simple games I use in my clinic all the time and these games are easily available online or in your local toy shops and this is how to do them:

Pop the Pirate

Pop the Pirate, sooo good and popular:

Lay out your target words which you will have been given by your speech therapist and put a few swords on each word.

Each time your child picks up a sword they will need to say the target word 5 x, like:

rip rip rip rip rip or run run run run run just like that in a row, bish bash bosh.

Then they can stick the sword into the barrel. Onto the next sword which they can pick and then again

race race race race race and stick in another sword

So with this little lot I put out 5 target words and 3 swords on each.

You will therefore get…… 15 words per picture, and that makes….75 words , there that is nearly all you need to do.

If you then do another little game like this one:

Magnetic board game

This is a Magnetic Board game, and they are suddenly EVERYWHERE. But you could also just take a baking sheet and some fridge magnet you might have kicking about.

Same principle as before, but now since this is your SECOND game of the day and you have already got 75 targets under your belt you only need to do one more round of 5 target words each:

Each time your child picks up a magnet piece they will say the target word 5 more times:

Ray ray ray ray ray and DONE you will now at the end of this short round have 105!! target words done with just two little fun games.

How good is this? Your child won’t hardly notice that they are in fact doing their speech therapy homework.

You’re welcome 🙂

Get in touch if you would like me to help finding good targets for your child to work on. They can be speech and/or language targets with this game method.

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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    Are the Gestalts I model easy to mix and match later on?

    ByLondon Speech and Feeding
    Image by bearfotos on Freepik

    Here are some examples of great phrases and Gestalts that we could use:

    • Let’s get a banana / Let’s go out / Let’s play lego / Let’s go see daddy
    • That’s nice! / That’s really good! / That’s a green one / That’s a submarine
    • Need more help / Need a wee wee / Need that / Need to run
    • How about a biscuit / How about a cuddle / How about watching tv
    • We love bananas / We love a monkey / We love a cuddle

    Why or how could these examples be mixed and matched?

    You can see I have given several examples for each, that is how later a child can take one chunk (let’s) and add another (go out) or (need) + (go out).

    What about our own grammar? Should we be using grammatical phrases?

    In general for NLA 1 (Natural Language Acquisition stage 1) we want to use short phrases and keep them quite generic, something like:

    ‘Let’s go’ or ‘let’s play’ and pick 2-3 phrases per communicative function (see next point below).

    And if we are going to say longer sentences, for example: ‘let’s go and feed the ducks now’, then we should do so with good grammar and really varied intonation. It sometimes helps me to make up a little song/jingle on the spot that has a lot of intonation, more than I would perhaps use just by speaking.

    How many varied communicative functions do we cover with our modelling?

    We want to model a variety of Gestalts other than just requesting for example. In general, we are looking at our child having one or two Gestalts in the following areas before they are ready to move on into stage 2.

    These are the most common ones I see in my practice:

    • Requesting ‘want a banana/biscuit’ ‘Wanna play ball’
    • Transitioning: ‘what now?’ ‘what next?’
    • Ask for help: ‘need help’ ‘help me’ ‘mummy help’
    • Commenting: ‘it’s big’ ‘it’s red’ ‘it’s fast’ ‘too loud’
    • Speak up for self: ‘not that one’ ‘go now’ ‘stop it’

    Is the Gestalt I am modelling meaningful to my child?

    We don’t use all available Gestalts for every child. It has to be meaningful to the individual and has to match their interests. If our child is a big fan of feeding the ducks in the park then we can think about Gestalts like:

    • I see ducks!
    • They’re over there
    • Let’s feed them?
    • Let’s get some seeds
    • They’re coming!
    • They want food / They wanna eat!
    • That’s a big one
    • It’s so hungry
    • It loves the seeds!
    • No more! All done! Finished! Let’s go home

    What is my child actually trying to tell me?

    We have to be become word/phrase detectives! Is the phrase/script/Gestalt they are using right now actually meaning what they said or does it mean something else, and if so, what?

    Here is an example from my own personal experience in my practice:

    The little boy I was working/playing with was building a tall tower with blocks. When it finally fell with a great big bang he said in a sing-song voice ‘ring-a-ring-a roses’ … then he began to collect the blocks again to make a fresh tower. I sat there and thought: why ‘ring-a-ring-a roses’? What does that mean in this context? I then sang the song (silently) to myself with my detective hat on and realised as I came to the end that it finishes with ‘we all fall down’! it was a real AHA!!! moment for me as I saw right there what the meaning of his Gestalt was. He sang the first line of the song to say ‘all fall down!’

    So realising this I waited for the next tower to fall, and there it was again, he sang the first line of the song. I replied thus, copying him at first:

    ‘RING-A-RING-A ROSES – WE ALL FALL DOWN!…

    FALL DOWN

    WE LOVE IT FALLING DOWN.’

    The process to find what we should say is not always straight forward or easy at all, and often we don’t quite know in the moment what our child is trying to say. But we can try and get to know their interests and then gradually we do know more and more what the meaning behind the Gestalt is or could be.

    What pronouns should we use?

    This can be a tricky one.

    We don’t want to use language that uses the pronouns ‘you’ or ‘you’re’. The reason is that our child will likely copy us exactly as we have said it. Therefore, using pronouns ‘you’ and ‘you’re’ will then sound wrong.

    Always try to model language that is from the child’s perspective or in other words how they would say it if they could.

    Alternatively, you can model using WE or US. For example, if the child is tired, rather than saying ‘you are so tired’ model language from his or her point of view: ‘I’m tired’ or ‘let’s go have a lie down’.

    There is so much more to talk about. Stay tuned for a blog on NLA stage 2 coming soon.

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

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

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    How to use Attention Autism to develop language and communication

    ByLondon Speech and Feeding

    Now you’ve read Attention Autism (part one), you are familiar with the concept of ‘bucket time’ and the benefits it has to offer your child. It’s time to explore all the different stages. In sessions, it can be noisy and with so much to take in, you may want something to refer to. If you’re in need of a helping hand or memory jogger for stage two, read on…

    Knowing what stage your child is working at is vital. Every stage has different aims to develop and enhance functional communication. So being familiar with your child’s goals ensures you can continue to practise at home. If you’re unsure of their goals, please ask your Speech and Language Therapist.

    With all speech, language and communication goals, the aim is always to generalise skills from therapy settings to home and nursery or school life. This generalisation period will take time. Please try to stick with the plan. You will experience the benefits for your child, and it’ll make family life a little easier.

    You may remember that Autistic children thrive on visuals. Let’s use their strengths to support their communication needs. It is a good idea at the start of the activity to have a visual for what’s happening now and what will happen next. If you’re anything like me, you’ll grab a pen and paper or a whiteboard and whiteboard pen, and will doodle away! You don’t need fancy photos.

    On the left is a bag with Now written above it and Bag below. On the right are three children playing with Net written above and Play written below.

    The attention builder

    Stage two of the Attention Autism approach is called “the attention builder”. The clue is in the name, your child’s goal is to keep focused on the activity for a longer period. The duration will be different for every child, but it’s useful to time their attention, so you can report progress back to your therapist.

    Parents are often worried about doing something wrong. If it all goes a bit pear-shaped or not as you expected, don’t panic! This is the time to ask yourself, did my child have fun? Did they engage in the activity? It’s very helpful to reflect on the experience. What could you do that would make the activity easier for your child to access? (For example, did you set up the activity before your child entered the room? This would allow for a smoother session, so that waiting time was minimal.)

    Three ideas for stage two activities

    There are so many ideas out there, which at times can feel overwhelming. I’m always looking for the easiest options to present to you to reduce overwhelm and allow it to feel manageable.

    Remember this is about having fun. Your child’s communication will benefit from you relaxing and having this structured approach.

    Here are our three top ideas for stage two attention Autism activities:

    1. Flour castles

    You’ll need:

    • Container, cup or glass
    • Flour
    • Sheet (for the table/floor) (optional)

    This is a fun-filled activity to try. But it can get a little messy!

    Fill a small glass, cup or container with flour and flip the cup over to build flour castles. It’s great to engage your child especially with the “Splat” at the end.

    2. Paint balls

    Another activity which is a little bit cleaner is ‘Paint balls’.

    You’ll need:

    • Tray, container
    • Paint
    • Rubber balls or marbles
    • Paper (optional)

    First dip the marbles into the paint, then drop into the container and roll it around to make a pattern. You could always make a pattern on some paper.

    I love to use everyday objects in therapy, so when I came across this next idea, it was added to the list. It’s simple, effective, not to mention clean!

    3. Skittles

    You’ll need:

    • A packet of skittles
    • Warm water
    • Plate

    You’ll need to create a circle of skittles around the edge of the plate. Then add small amounts of warm water to the plate and watch the rainbow of colours appear.

    These activities offer a sequence to build and sustain your child’s attention. Remember the key is to have fun. Create meaningful interactions that your child cannot miss! If they can learn to hold their attention, they can learn to use functional skills.

    Now you’ve got ideas for stage two activities. Go ahead and carry them out.

    Have fun!

    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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  • ·

    Principles of motor learning in Childhood Apraxia of Speech (CAS)

    ByLondon Speech and Feeding

    We use powerful motor learning principles to help children with CAS (Childhood Apraxia of Speech) learn how to produce better, clearer speech sounds in words, phrases and sentences.

    What are these principles?

    Principle 1: MASSED PRACTICE

    This is where you see a child for lots of sessions in a shorter period of time, so for instance six weeks of three times weekly for 30 minutes.

    This leads to motor performance or automaticity.

    Principle 2. DISTRIBUTED PRACTICE

    This is what I use, as most of my clients are not able to come and see me that often on a weekly basis. It is hard to travel in London and life is hectic. So I favour one session a week over say a term or two terms and a session is usually 45 minutes long.

    This leads to improved Motor Learning and good generalisation.

    During either Massed or Distributed Practice, we choose between 4 variables:

    Principle 3: Constant vs Variable

    Principle 4: Blocked vs Random

    To explain:

    Constant Practice is where we repeat the practice of a small handful of target words.

    We practise the same target sound in the same word position, e.g. at the beginning of a word: ‘bee’, ‘bye’, ‘bow’, ‘baa’ or ‘key’, ‘car’, ‘cow’, ‘Kaye’ etc.

    We keep the rate, pitch and intonation constant.

    Variable Practice is where we vary the rate, volume, pitch and intonation of the targets

    We use a larger number of sounds, and words that are motivating to say for the child.

    For example, if a child loves Peppa Pig then I might choose the words: ‘Peppa’, ‘Daddy Pig’, ‘George’, ‘Mummy Pig’ and a couple of other favourite characters. My child might struggle with a number of sound sequences there but we will target them one by one.

    We can also select simpler words like ‘cape’ and ‘cake’ or ‘tick’ and ‘tip’.

    Blocked Practice is where we practise one target word for say five minutes then we move to another target word for the next five minutes and then we revert back to the first target word again and so on, so blocks of practice.

    Random Practice means we practise several target words at the same time.

    How do I decide on what to use?

    Good question!

    I always opt for distributed practice (weekly for up to 45 minutes).

    Within that, I tend to find it most successful to start out with constant practice when a child is finding a certain sound sequence really hard and we need to just ‘nail it’. Bearing in mind I only pick sounds that my student can actually make in isolation, so we are not working on articulation! (where we focus on trying to elicit single sounds correctly – or even at all sometimes) Here in CAS work, we are working with sounds the student can make but is having trouble to add together, into a sequence that is needed to make a word sound right.

    As soon as I feel we have some traction I will go to variable practice, i.e. I pick words that are either funny or interesting for the child and it can be a slightly larger number.

    I tend to use blocked practice in the beginning or when working on vowels. That’s because it is more important we get our vowels right. They carry a word and are very important for overall speech intelligibility. Once we are on a roll, I tend to go more for random practice.

    Example

    Here in the video clip, we try and work the /e/ vowel in short words likes ‘bell’, ’fell’, ‘dell’, ‘sell’, ‘smell’ and I am using an AAC device to give a child’s voice as auditory feedback as well as using the PROMPT approach to help my student shape his vowels.

    So this is:

    1. Distributed (1 x week for 45 minutes)
    2. Constant – we are practising the /e/ vowel in the same position in six different words
    3. Blocked – we did this: several repetitions of each word and after the sixth we moved to another sound, and then later we came back to this.

    Please feel free to contact me if your child has speech sound difficulties. It is my passion. I love supporting children with apraxia.

    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.

    1
  • · · · ·

    What to do when words don’t come fast enough

    ByLondon Speech and Feeding
    What to do when words don’t come fast enough

    When children find talking hard, parents often face a difficult question: ‘Should we wait and keep encouraging speech? Or introduce something like AAC?’

    AAC (Augmentative and Alternative Communication) can sound intimidating, but it simply means any way we support or replace spoken words, from simple gestures and picture boards to high-tech speech-generating devices. Far from ‘giving up on speech,’ AAC often becomes the bridge that helps children find their voice, in whatever form that takes.

    💡 What is AAC, really?

    AAC is a spectrum of tools and strategies that help people express themselves when speaking is difficult. It might include:

    • Low-tech supports: Gestures, key word signs (like Makaton), picture symbols, or printed boards
    • High-tech systems: Apps on tablets that speak aloud when pictures or words are tapped

    AAC is not just for children who will never talk. It’s for anyone whose speech isn’t meeting their communication needs right now.

    🤔 When to introduce AAC

    There’s a common myth that you should only try AAC after ‘exhausting’ other speech therapy options. In fact, AAC can be introduced at any stage, even alongside speech development.

    Here are some helpful signs that AAC might support your child:

    • Your child understands much more than they can say.
    • They rely on gestures, sounds, or behaviour to communicate.
    • They become frustrated trying to express themselves.
    • You find yourself ‘reading their mind’ to interpret needs.
    • Speech progress feels slow or inconsistent.

    If you recognise these patterns, AAC isn’t a ‘last resort’. It’s a communication support, not a replacement for speech.

    Recent research consistently shows that AAC does not stop children from talking. In fact, it can encourage speech to develop. A 2024 systematic review and meta-analysis published in the Journal of Autism and Developmental Disorders found that children who received interventions combining naturalistic developmental behavioural approaches with aided AAC showed improved language outcomes, and that AAC ‘does not negatively impact speech development and may even facilitate spoken language growth’ (Smith et al., 2024).

    🌉 How AAC supports speech development

    Speech and AAC aren’t competing paths: they’re parallel tracks that often feed each other.

    Here’s how AAC helps speech grow:

    1. Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
    2. Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
    3. Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
    4. Encourages turn-taking and social connection: AAC lets children join conversations even before speech is fluent, giving them more practice in real communication.

    AAC is not ‘giving up on speech’. It’s giving a child more ways to succeed while speech continues to develop.

    🧩 How to introduce AAC gently and effectively

    1. Start small and meaningful: Begin with a few key messages your child wants to say, not just what adults want to hear. Think ‘I want’, ‘stop’, ‘help’, ‘more’, ‘all done’, ‘no’, ‘again’. These are powerful words for real interaction and autonomy.
    2. Model, model, model: The most important part of AAC success is modelling—using the system yourself as you talk. For example: ‘You want banana 🍌’ and you tap the ‘want’ and ‘banana’ symbols. Children need to see and hear AAC used naturally before they try it themselves.
    3. Use it throughout the day: AAC isn’t a therapy tool to take out once a week. It’s a living part of communication. Model a few words during mealtimes, play, and routines. The more consistently it’s embedded, the more fluent both you and your child will become.
    4. Keep it accessible: If using a device or picture board, make sure it’s always nearby. If it’s in a bag or drawer, it can’t be used in real moments.
    5. Celebrate all communication: If your child points, signs, uses a sound, or taps a symbol, it all counts. Respond warmly and naturally to reinforce communication in any form.

    🧠 What parents often worry about

    • ‘Won’t AAC stop them from talking?’: No. Research shows AAC use either has no negative effect on speech or leads to increased spoken output (Smith et al., 2024). When children feel understood, their motivation to communicate grows.
    • ‘What if I model it wrong?’: There’s no perfect way to start. Your effort and consistency matter far more than accuracy.
    • ‘Will they get ‘stuck’ using pictures?’:  Some children do continue using AAC long-term; others move naturally toward more spoken language. The goal is always functional communication, not replacing one form with another.

    🪞 Bringing AAC into daily life

    Here are a few simple, parent-friendly ideas:

    • Create visual spaces: Post symbols or core words on the fridge, mirror, or play area.
    • Narrate routines: Use AAC during toothbrushing, dressing, or mealtimes; consistent contexts build understanding.
    • Pair speech and touch: Always say the word aloud when you point to or tap a symbol.
    • Involve siblings and friends: Model how they can respond to AAC too. ‘Oh, you said go! Let’s go fast!’
    • Use shared books and songs: Pause and model key words in stories or songs.

    🌱 The takeaway

    AAC doesn’t mean giving up on speech; it means opening more doors to communication. When words don’t come easily, AAC gives children a way to connect, share, and be heard.

    It helps parents move from guessing to understanding, and gives children the power to express themselves on their own terms.

    If you’re unsure where to start, reach out to a speech and language therapist experienced in AAC. Together, you can find a system that fits your child’s strengths, build confidence in modelling, and help every word (spoken or tapped) feel like a step forward.

    And download and print my one page summary.

    Because when communication is possible, everything else begins to grow.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    📚 Reference

    Smith, K., et al. (2024). The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta‑Analysis. Journal of Autism and Developmental Disorders, 55, 3078–3099. https://doi.org/10.1007/s10803-024-06382-7

    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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  • · ·

    The picky eater’s plate: Introducing solids to toddlers with ARFID

    ByLondon Speech and Feeding
    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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  • · ·

    Why ‘Prosody’ Matters in Childhood Apraxia of Speech (CAS)

    ByLondon Speech and Feeding

    Prosody refers to the ‘music’ of speech — the rhythm, pitch, stress, and volume that convey meaning and emotion beyond the literal words themselves. Think about a monotone statement like ‘Really?’ compared to one with a rising inflection, expressing genuine curiosity.

    When I work with children on producing speech sound sequences, we focus on mastering individual sounds and then putting them together into target words. A crucial element that can significantly impact a child’s speech production is ‘prosody’.

    In CAS, where the difficulty lies in planning and executing the motor movements for speech, prosody can be a powerful tool for producing clearer words and phrases.

    Here’s why working on prosody is an essential tool in CAS speech therapy:

    1.  It aids Motor Learning:

    Apraxia of Speech means that the planning and execution of speech movements are impaired. When we use exaggerated intonation or stress patterns while modelling words, we are providing additional prosodic variation and, therefore, additional auditory cues. These cues often help my student to carry out the correct motor movements for a word or syllable sequence.

    For instance, I might say ‘ball’ with a high-pitched emphasis on the ‘b’ sound. This auditory cue might be more effective in guiding the child’s tongue placement than simply repeating the word without variation.

    In this little video clip I get my student to say the word ‘snuggle’ (since we were working on that particular sound sequence: snuggle, snout, snore and sneeze) with a high voice and then a lower voice ‘like a bear’ — again it provides that extra auditory cue, but, in addition, the fun aspect also helps to take away the intense focus on a tricky movement pattern.

    By now the new pathways have been laid through repeated practice and now automaticity takes over and without too much effort my student can suddenly produce a motor pattern. It’s magical when it happens and gives me such a thrill.

    2. It makes speech more engaging and natural sounding:

    Children with CAS often sound robotic or flat due to challenges with prosodic elements. By incorporating variations in pitch, volume, and rhythm during therapy, we can help achieve a more natural flow of speech

    3. It makes it easier to express our emotions:

    Children with CAS often struggle to express themselves emotionally; partly through the difficulty of producing clear words — period, but also in addition due to the difficulties or absence of musicality and rhythm in their speech.

    Therefore, it is so important to incorporate activities focused on practising different emotions with varied intonation patterns. This can really empower our students to put emotions into their words.

    Good words to practise are fun words like ‘Wow!’ or ‘Yeiih’ or power words and phrases like ‘No!’ or ‘Gimme that’ etc.

    Making Therapy Fun and Engaging:

    Speech therapy for CAS doesn’t have to be all drills and exercises (though to be fair sometimes we can’t quite get round to making each and every word huge fun though we try…).

    I aim to make all my sessions fun and have intrinsic rewards built into the speech practice where possible.

    Home practice tips:

    Therapy shouldn’t exist in a bubble. Working on prosody during sessions is crucial, but it’s equally important to integrate these skills into everyday interactions. Parents and caregivers can model appropriate prosody during playtime, story time, or even simple conversations. This consistent reinforcement helps our children to generalise their newfound skills and use them naturally in their daily lives.

    • Sing songs and rhymes: Songs naturally incorporate variations in pitch and rhythm. Singing familiar songs and creating silly rhymes can be a delightful way to practise prosody.
    • Use puppets and toys: Assign different voices and personalities to puppets or toys. This encourages children to experiment with pitch and volume to differentiate characters.
    • Read aloud with enthusiasm: Model expressive reading, varying your voice for different characters and emphasising key words. This makes reading time engaging and helps children understand the power of prosody.

    Please feel free to contact me if your child has speech sound difficulties. It is my passion. I love supporting children with apraxia.

    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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