Target activities and games

ByLondon Speech and Feeding November 19, 2021March 28, 2025

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, 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:

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.

Autism Therapy · Echolalia · Neurodiversity · Speech and Language Therapy

How parent coaching turns story time into a communication success
ByLondon Speech and Feeding October 6, 2025October 2, 2025
We often hear from parents who are trying their best to connect with their child, especially when reading books, but are met with frustration. They’ll say, ‘I read the book exactly as it’s written, but my child can’t focus for very long and just runs off!’ or ‘my child just flicks through the pages then turns it upside down and runs off with it’ or similar.

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

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

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

What changed?

The power of parent coaching and Hanen principles

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

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

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

1. From reader to play partner

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

The result

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

2. Building connection and attention

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

The result

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

3. Creating opportunities for communication

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

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

The result

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

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

4. Acknowledging and interpreting echolalia

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

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

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

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

This strategy is a game-changer because it:
1. Validates the child’s communication: It honours the child’s natural way of learning language, which boosts their confidence and willingness to communicate.
2. Facilitates language development: It provides the child with the next step—a meaningful, functional phrase—to move them from repeating language to generating their own spontaneous sentences.
Look at the child’s face again in the video. When his dad acknowledges and interprets his communication, you see that spark of joy and connection—that’s the moment when true, functional language learning happens!

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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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Feeding · Neurodiversity · Speech and Language Therapy

The hidden impact of mouth breathing and open mouth posture on speech and feeding
ByLondon Speech and Feeding November 17, 2025November 17, 2025
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

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

Why pretend play is the perfect therapy vehicle for children with dyspraxia
ByLondon Speech and Feeding July 6, 2026June 29, 2026
Picture this. A small dinosaur is stomping across a wooden floor. A tiny teacup is being filled with imaginary juice. Someone, probably you, has just been told very firmly that you are the baby and you must go to sleep now.

To the outside world, this is just play. Joyful, chaotic, completely ordinary toddler play.

But for a child with Childhood Apraxia of Speech (CAS), also known as verbal dyspraxia, what is happening inside a well-designed pretend play session is anything but ordinary. It is, in fact, some of the most powerful motor speech therapy we have.

Let me explain why.

First, a quick reminder: what is dyspraxia?

Childhood Apraxia of Speech is a motor speech disorder. The difficulty does not lie in the muscles of the mouth, those are perfectly capable. The difficulty lies in the brain’s ability to plan and sequence the precise movements needed to produce speech sounds consistently and accurately.

A child with CAS knows what they want to say. The message is there. But somewhere between the intention and the execution, the plan breaks down. Words come out differently each time, or not at all. It is effortful, unpredictable, and for many children, deeply frustrating.

What this means for therapy is important: CAS requires motor learning, not just language stimulation. And motor learning has very specific conditions under which it thrives.

Repetition is the medicine and pretend play delivers it without the child noticing

One of the most well-established principles of motor learning is that new movement patterns need to be practised many, many times before they become reliable. Think of learning to ride a bike, or to touch-type. Repetition is how the motor system builds consistency.

For speech, this means a child needs many opportunities to attempt a target word or phrase within a single session. In a formal drilling exercise, this quickly becomes tedious and dysregulating, especially for young children. After five attempts at ‘go’, most three-year-olds have mentally left the building.

But inside a pretend play scenario? The word ‘go’ appears naturally and meaningfully dozens of times. The car goes. The train goes. Ready, steady, go. Go to sleep. Go there doggie. Every repetition is embedded in a moment that makes sense to the child, which means they are motivated to keep going, and the practice is accumulating without any sense of effort or demand.

A relaxed brain learns better

There is a reason I tend not to sit a dyspraxic child at a table with flashcards and ask them to repeat after me. It is not because I lack structure. Every session I run has clear targets and intentional design. It is because we know that anxiety and pressure actively interfere with motor learning.

When a child feels observed, corrected, or under pressure to perform, the cognitive load increases and the very motor planning system we are trying to support becomes less accessible. The errors increase. The frustration escalates. The session unravels.

Pretend play, by contrast, creates a state of engaged, relaxed absorption. The child is leading. They are safe. They are having fun. In this state, the brain is far more receptive to new motor patterns being laid down. I am not asking the child to perform speech. I am simply being present, following their lead, and slipping in carefully chosen models at exactly the right moments.

Child-led play gives us the child’s own words to target

Another reason pretend play works so beautifully for children with dyspraxia is that it tells us exactly which words matter most to this particular child, right now, today. When a child reaches for the toy telephone and hands it to me with enormous expectation, I know that ‘hello’ is a word worth targeting in this moment. When they are clearly trying to tell me that the baby needs feeding, ‘more’ and ‘eat’ have instant, genuine relevance.

Targeting words a child is already motivated to say means the communication attempt is coming from them. And a self-initiated attempt, even an approximation, is neurologically far more valuable than a prompted imitation.

What this looks like in practice

In the short video clip below you can see this dynamic in action. Notice how the session looks relaxed and playful on the surface. The child is absorbed in the pretend play scenario we have created together.

Notice, though, what is happening underneath:
- the consistent, gentle modelling of target words
- the use of Makaton signs alongside speech to provide an additional sensory pathway
- the visual mouth cues that give the child a roadmap for how a sound is shaped
- and running through all of it, the repetition. The same words, again and again, wrapped in play.
This is not therapy disguised as play. It is therapy that is play, because for a child with dyspraxia, those two things are not in opposition. They are, in fact, perfectly aligned.

If you are concerned about your child’s speech and wondering whether verbal dyspraxia might be a factor, please do not hesitate to get in touch. I would love to help you find some answers.

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

What to do when words don’t come fast enough
ByLondon Speech and Feeding November 26, 2025November 26, 2025
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

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

One book, dozens of therapy opportunities: What speech therapy really looks like
ByLondon Speech and Feeding May 13, 2026May 18, 2026
As speech and language therapists, some of the most effective moments in therapy don’t come from flashcards, worksheets, or even drilling sounds (though to be fair I do drill quite a lot too! needs must…😊).

By and large they happen in natural interaction — during shared attention, laughter, storytelling, and connection.

This short video clip captures that.

In under two minutes, while simply reading a book together with a three-year-old child, we naturally work on:
- Speech sounds
- Vowel production
- Early phonological patterns
- Motor planning
- Signing and total communication
- Visual cueing
- Repetition and practice
- Confidence building
- And engagement through play
To many people, it may just look like ‘reading a book’.

But underneath that moment are years of specialist training, clinical decision-making, preparation, and therapeutic skill.

Therapy hidden inside play

One of the most important parts of paediatric speech therapy is knowing how to embed targets into meaningful interaction.

Books are one of my favourite therapy tools! Why: because as speech therapists we need to prepare for our child and our sessions. And having a book gives me the structure to know beforehand what kind of sounds or words might be coming up. Then I can be prepared for providing extra support for them. As you can see in this clip, I had the sound cards just there because I had anticipated what might be coming up!

A single story can provide opportunities for:
- Speech sound practice
- Vocabulary development
- Sentence building
- Turn-taking
- Symbolic understanding
- Attention and listening
- Gesture and signing
- Motor speech cueing
- And social communication
In this clip, I follow my little one’s interests while carefully weaving in her individual therapy targets.

It looks relaxed and spontaneous — and it is — but it is also highly intentional.

Catching opportunities in the moment

One lovely example in the clip is when she says ‘yes’.

She is now starting to say the final /S/ sound, so I immediately model and draw attention to it using the ‘snake sound’ visual cue, giving her positive feedback that she can now also try using this sound at the start of words.

My gently shaping the word ‘yeSSSS.’ gives her:
- Auditory feedback
- Visual support
- And an achievable opportunity to try again
A few seconds later, we naturally practise it again.

That’s responsive therapy.

Speech therapists are constantly listening, analysing, adapting, and deciding:
- When should I model?
- When should I pause?
- When should I repeat?
- When should I let it go?
- How can I keep confidence high while still targeting speech?
These decisions happen in seconds.

Working on speech without ‘stopping the play’

Another moment in the clip focuses on the word ‘out’, where the vowel sound is one of her speech targets.

Then we move into practising the word ‘open’, a word she has previously found difficult.

Within this one word, we can support:
- Sequencing
- Motor planning
- Lip shape
- Vowel production
- And speech sound accuracy
We also briefly practise the /K/ sound — a sound produced at the back of the mouth which can be particularly tricky to produce.

Instead of explaining it verbally (which is often too abstract for young children), I use:
- Visual demonstration
- Exaggerated mouth movements
- Gesture/sign support
- And playful modelling
Children learn through seeing, hearing, doing, and experiencing.

That is why Speech Therapists use multiple layers of cueing simultaneously.

Why I use signs alongside speech

Throughout the clip, I also use signs such as ‘book’ and ‘pig’.

Using signs does not stop children talking.

In fact, for many children, signs:
- Reduce frustration
- Support understanding
- Increase participation
- Reinforce vocabulary
- And help bridge the gap while speech is developing
Communication always comes first.

Speech is only one part of communication.

When children feel successful communicating, they are far more likely to keep trying.

The skill behind ‘natural’ therapy

One thing I often hear from parents is:

‘You make it look so easy.’

That is actually one of the biggest compliments a therapist can receive. (Though we also often feel we need to justify our very existence with these thoughts because we don’t just play/just read but we know it can look like that!) 😊 this is the reason for this blog…

High-quality paediatric therapy should feel warm, playful, responsive, and natural.

But underneath that natural interaction is:
- Clinical knowledge
- Phonological analysis
- Motor speech understanding
- Language development expertise
- Sensory awareness
- Relationship-building
- And careful session planning
Before this session even began, I already knew:
- Which speech patterns to target
- Which words would likely appear in the book
- What visual cues might help
- Which signs to model
- And how to adapt depending on the child’s responses
That preparation allows therapy to stay child-led without losing therapeutic focus.

Following the child while leading the therapy

The best therapy is rarely rigid.

Children do not learn communication through pressure or endless correction. They learn through interaction.

That is exactly what this short clip demonstrates.

One book.
One conversation.
Hundreds of tiny therapeutic decisions.

And all within a joyful moment shared together.

Because good speech therapy should never feel like hard work for a child.

It should feel like connection, confidence, success — and fun.

If you’re concerned about your child’s speech and language or wondering whether they might benefit from speech therapy, feel free to get in touch.

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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READ MORE One book, dozens of therapy opportunities: What speech therapy really looks like
Speech and Language Therapy

Quick Overview Of How To Implement Those Early Hanen Speech And Language Strategies
ByLondon Speech and Feeding December 18, 2021January 31, 2023
First up try and get down at eye level or Face-to-Face with your child

Try to sit so that your child can see you easily, i. e. your child does not have to look up to make eye contact with you. We call that Face to Face: try and sit opposite your child. This makes it easier for you to see facial expressions and therefore pick up nonverbal /pre-verbal communication. Now you can connect and share the moment with your child.

OWL (Observe, Wait and Listen)

Never skip this step as it prepares us for what happens next !

Observe

First, try and simply watch your child quietly and listen and observe what he/she says or does; you need to know what your little one is interested in. For example with this toy (pictured below) we could observe that your child loves the actual spinning of the marble, perhaps more than that noisy click-clacking down the run. Or perhaps he loves collecting the marble at the end and feeling it in his hand.

You could start off with showing once how the marble goes down and say:“ look it goes round and round !” Then hold back and observe, without speaking, so that your child has time to explore the toy.

Wait

Just sit and avoid telling or showing your child what he or she could do with the toy. This gives your child an opportunity to explore and experiment.

Listen

Listen to what your child says, or look at your child’s non-verbal communication without interrupting. Your child will now feel and know that you are really present and that what they have to say is important. It’s best to avoid questions like, “What are you doing or “What’s this?” as that might be a lot of pressure when they don’t know what to say about that yet.

Respond immediately by showing interest

Once you have all the information from OWLing you can respond in the right way, for example: if she catches the marble at the end of the run and looks up with a smile or a sound you could respond with: you’ve got it! One marble in your hand! Nice playing!

Now how to join in the play:

First you can copy what your child is doing

If your child puts the first marble at the top of the run you can take a turn and do exactly the same once his marble is done. Ideally you might have another marble run, perhaps a similar one, it does not have to be exactly the same! Once your child has put the first marble in you can do the exact same with your own marble on your run. Your child is likely to look at what you are doing and you might well see a smile on their face or perhaps she might say: look at mine!

Next you can build on that

You can respond with simple comments like: “Wow! Yes I am looking at yours now! It’s spinning on the red one lots! I love the noise!” Now wait once more to see what your child says or does.

To summarise

We are signalling to our child that we are really interested in what they are doing and saying so we can “collect” our child, i.e. bring him/her back into a joint interaction.

Important

We want to try and not direct our child but respond with interest and fun! This creates a lovely stage for interaction and joint play! And this leads in turn to practising conversation and ever more opportunities for great speech and language skills to emerge.

Great activities we use in Speech and Language Therapy:
- Any cause and effect toys like this Marble Run
- Creative activities, such as mark making with crayons
- Train tracks (building and running the trains)
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.
READ MORE Quick Overview Of How To Implement Those Early Hanen Speech And Language Strategies