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

Welcome!

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

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

Change

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

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

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

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

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

New perspective

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

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

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.


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

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

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    Explore activities for Gestalt Language Processors to aid communication

    Speech Therpaist in London

    When you have a child who uses Gestalts it is often difficult to think and adapt clinic activities into those to use at home. More importantly, you find that individualising your activities for your child who uses Gestalt are time-consuming. But you value its importance for their communication development.

    You feel so busy, you are taking them to other appointments, or trying to get through your daily activities, all whilst still ensuring your child’s emotional needs are met. You know life should not get in the way of your child’s therapy activities at home, but it does. We know your spare time is precious and limited, so let us achieve your child’s or young person’s goals in the allotted time you have which meets their way of learning (using Gestalts).

    We wanted to support you by exploring items which you may have at home, and we will give you some key phrases which you can start to model with your child. Whereas our last blog introduced the idea of gestalt language processors, we are now developing ideas to give you the tools to implement activities at home. We recognise how overwhelming it may feel, and this is one of the reasons to make activities as straight forward as possible. Therapy does not need to be complicated; it just needs to be carried out on a regular basis.

    Explore the samples I’ve created to give you an idea of how this might look but please consult with a Speech and Language Therapist who knows about Gestalt Language Processing so that you can work together to develop great home activities for your child.

    Want to learn more about gestalt language processing?

    Please contact me for 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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    The power of babble: Why your baby’s ‘talk’ matters

    That adorable string of ‘ba-ba-ga-ga-ma-ma’ might sound like baby gibberish, but it’s actually a crucial milestone in your little one’s language development. Babbling or babble, as we call it, is far more than just cute baby noises. It’s a sequence of sounds that lays the foundation for future communication.

    Image by freepik

    What is babbling?

    Babbling typically begins around six months of age, though the timing can vary slightly from baby to baby. It involves your baby experimenting with different sounds, stringing together consonants and vowels. You might hear them repeating sounds like:

    • ‘Ba-ba’
    • ‘Da-da’
    • ‘Ma-ma’
    • ‘Ga-ga’

    As they progress, the babbling becomes more complex, with variations in pitch, rhythm, and intonation. It might even sound like they’re having a conversation with you!

    Why is babbling so important?

    1. Laying the groundwork for speech: Babbling is like a vocal workout for your baby. By practising these sounds, they’re strengthening the muscles in their mouth, tongue, and vocal cords that are essential for speech.
    2. Developing phonological skills: Through babbling, babies begin to understand the sound patterns of their native language. They’re learning which sounds go together and how they’re used.
    3. Enhancing social interaction: Babbling is a social activity. Babies often babble back and forth with their caregivers, which helps them learn about the give-and-take of communication.
    4. Cognitive development: The act of babbling requires babies to use their brains in new ways. They’re learning to control their vocalisations, pay attention to the sounds they’re making, and connect those sounds to the responses they receive from others.

    How can you encourage babbling?

    • Talk to your baby: Even though they can’t understand your words yet, talking to your baby exposes them to language and encourages them to respond with their own vocalisations.
    • Imitate their sounds: When your baby babbles, imitate them! This shows them that you’re paying attention and encourages them to keep ‘talking.’
    • Respond to their babbling: Treat your baby’s babbling as if it’s a real conversation. Respond with words, smiles, and gestures.
    • Play sound games: Make different sounds for your baby and encourage them to imitate you. This could include animal sounds, silly noises, or simple words.
    • Read to your baby: Even before they can understand the words, reading to your baby exposes them to the rhythm and sounds of language.
    • Sing songs: Singing is a fun and engaging way to introduce your baby to new sounds and words.
    • Use mirrors: Babies often enjoy watching themselves make sounds in a mirror.
    • Tactile stimulation: Gentle massage around the mouth and face can increase oral awareness and encourage vocalisations.
    • Vary textures: Offer different textured teethers.
    • Read books with sound effects: Choose books with animal sounds or other engaging noises.
    • Blow bubbles: The act of blowing and popping bubbles can encourage vocalisations.
    • Use visual aids: Show pictures of objects and say their names, emphasising the consonant sounds.
    • Use exaggerated facial expressions: When you make sounds, exaggerate your mouth movements to help your baby see how sounds are made.
    • Increase joint attention: Follow the child’s gaze and point to objects that they are looking at and say the name of the object.

    When to seek help

    If you notice that your baby is not babbling by eight months, it’s a good idea to talk to your speech and language therapist. You might also notice a lack of variation in tone when your child is making sounds, is your baby sounding a little ‘flat’ or monotonous? While every child develops at their own pace, a lack of babbling can sometimes indicate a developmental delay or hearing issue.

    Remember, babbling is a gift. So, enjoy those precious moments of ‘baby talk’ and take comfort in knowing that your little one is on the path to becoming a chatterbox!

    Do get in touch via my contact form if you are concerned about your child’s development or if you simply want some reassurance that your baby is developing well. We will be delighted to arrange a screening appointment for you and give you support and reassurance.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

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

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

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

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

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

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

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

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

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

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


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

  • · · · ·

    Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

    Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

    Holiday meals are meant to be joyful and something we all look forward to. But for many children and their families, these occasions can be overwhelming and be the cause of dread and worry. The combination of new smells, unfamiliar foods, loud environments, social expectations, and allergy anxieties can quickly turn what should be a festive time into a stressful one.

    For parents of children with sensory processing differences, selective eating challenges, or food allergies, holiday gatherings often require careful planning and a big dose of tolerance and compassion. The good news is that with awareness and a few gentle strategies, you can support your child to feel safe, regulated, and included during festive meals without pressure, tears, or discomfort.

    Let’s explore how to make holiday mealtimes calmer, safer, and more connected this season.

    🎄 Why holiday meals feel so overwhelming

    Holiday gatherings usually combine several sensory triggers all at once:

    • Noisy, chaotic rooms
    • Strong smells from a mix of foods we don’t normally cook
    • Multiple conversations happening at once
    • Bright lights, Christmas décor, flickering candles
    • Unfamiliar foods with unexpected textures
    • Expectations to ‘try everything’ or ‘enjoy it’s sooo good!’
    • New environments, seating arrangements, or routines

    For children with sensory sensitivities, this can feel like a tidal wave of input. Research shows that children who are sensory-sensitive often have heightened responses to smell, taste, and texture, which may lead to avoidance or distress at mealtimes (Cermak, Curtin, & Bandini, 2010).

    Add food allergies into the picture and anxiety increases even further for both children and parents. A 2020 study by DunnGalvin et al. found that children with food allergies experience significantly higher stress in shared eating environments, especially when food preparation or contamination risk is hard to control.

    So, if your child becomes tearful, shuts down, or refuses to sit at the festive table, it isn’t ‘bad behaviour.’ It’s sensory overload, heightened vigilance, or discomfort communicating through their body.

    🌟 Preparing your child for a calmer festive meal

    Preparation is especially important for sensory-sensitive or allergy-aware children. Here’s how to set them up for success:

    1. Offer predictability through previewing

    Before the event, show your child pictures of:

    • where you’re going
    • who will be there
    • the types of foods that might be served
    • where they might sit

    A visual schedule or social story can help reduce anxiety and give your child a sense of control.

    2. Pack safe foods without apology

    If your child has allergies or selective eating, bring:

    • ‘Safe foods’ you know they will eat
    • Backup snacks
    • A separate (their own) plate, if needed
    • Emergency medication

    Announce clear, firm boundaries such as:

    ‘Ok people, these are Jamie’s safe foods — we’ll stick with these today.’ This will help relatives understand without pressure or judgement.

    3. Choose seating that supports sensory regulation

    If possible, seat your child:

    • at the end of the table
    • near a familiar adult
    • away from the kitchen (strong smells)
    • away from noise clusters
    • give them their favourite toy or fidget whilst waiting

    Let them take breaks when needed. This isn’t ‘rude,’ it’s self-regulation.

    🍽️ Supporting children during the meal

    1. Focus on connection, not consumption

    The holidays are not the time to expand your child’s food range. Keeping mealtimes low-pressure actually supports long-term progress.

    In fact, the research is clear: pressuring children to eat decreases acceptance and increases refusal (Galloway et al., 2006).

    So instead of ‘Just try it!’ try:

    • ‘You don’t have to eat it, you can look at it.’
    • ‘You’re in charge of what goes in your mouth.’
    • ‘You can keep your safe foods on your plate.’

    2. Protect your child’s allergy safety

    Holiday meals often include:

    • cross-contamination risks
    • shared utensils
    • buffets
    • homemade dishes without ingredient lists

    Use gentle but firm scripts:

    • ‘Because of Ellie’s allergies, we’ll keep her plate separate.’
    • ‘We’ll serve her food ourselves to make sure she stays safe.’

    Confidence in your boundary helps others respect it.

    3. Manage sensory load in real time

    Offer:

    • headphones
    • a small chew or fidget toy
    • a designated ‘calm corner’
    • time outside for fresh air
    • a predictable signal for breaks (e.g., a hand squeeze or card)

    Remember, sensory regulation is healthcare, not ‘giving in.’

    4. Model calm eating

    Children learn most from watching.

    Slow, happy bites and relaxed facial expressions tell the nervous system: ‘This environment is safe’.

    💛 What to say to well-meaning relatives

    Families often have big feelings about food. You can prepare nice phrases like:

    • ‘We’re focusing on helping him feel safe around food today.’
    • ‘She has allergies, so we’re sticking to our plan.’
    • ‘We’re avoiding pressure because it helps him eat better long term.’
    • ‘We’re celebrating together, eating is not the goal today.’

    Setting expectations ahead of time can reduce awkward moments later.

    🎁 The bigger picture: It’s about safety, not ‘picky eating’

    Children with allergies, sensory differences, or feeding challenges aren’t trying to be difficult. They are trying to stay safe, regulated, and comfortable.

    Your calm presence, gentle boundaries, and preparation create the conditions for a holiday that feels peaceful, not pressured.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


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

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

    📚Research References

    Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–246.

    DunnGalvin, A. et al. (2020). APPEAL-2: A pan-European qualitative study to explore the burden of peanut-allergic children, teenagers and their caregivers. Clinical & Experimental Allergy, 50(11), 1238–1248.

    Galloway, A. T., Fiorito, L. M., Francis, L. A., & Birch, L. L. (2006). ‘Finish your soup!’ Counterproductive effects of pressuring children to eat on intake and affect. Appetite, 46(3), 318–323.

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  • ·

    Discover more about Verbal Dyspraxia

    What is Verbal Dyspraxia?

    Apraxia or dyspraxia is a difficulty in motor planning, which sometimes can be seen in both gross and fine motor skills, as well as speech. Gross motor refers to difficulties in coordinating the whole body (e.g., bumping into things frequently, often falling over hurting themselves or others through being “clumsy” or unsteady). Fine motor movements refer to smaller, more precise movements (e.g., difficulties doing anything with their hands such as holding a spoon or pen).

    Verbal dyspraxia

    In Dyspraxia of Speech, instead of seeing a coordinated smooth way of talking, we see the articulators (tongue, lips, cheeks) and voice coordinating very smoothly. The voice can be very quiet or very loud. Muscle tone can be weaker at times. Speech sounds are very unintelligible, with a flat voice that can sound forced. It may be that the timings of verbalisation appear random and that children can say a certain word once and never again. This is often what we hear from parents.

    It is interesting to note that many of our autistic clients are either non-speaking or are reluctant speakers. Sometimes they say a word once and then never again. Others say lots of words but the words are very hard to make out. Did you know that about 40% of autistic people have verbal dyspraxia? (Richard, 1997). Because the problem is one of motor planning, not of automatic motor execution, once a plan has become automatic, it is easier to get back to it and this is why we often see repetitive patterns that can be called ‘stims’ (Marge Blanc, 2004).

    How can Speech and Language Therapy help?

    Children with verbal dyspraxia can make great progress!

    We provide frequent and appropriate speech movement opportunities and with time and the right support, children will move forward and begin to speak more fluently and with greater intelligibility. It is important to know this can take time.

    We provide Oral Motor Therapy using a variety of approaches to practise breathing, vocalising on the outbreath, and sequencing our speech movements.

    We design carefully tailored programmes focusing on words that have a lot of power (e.g., NO, GO, UP, IN, OUT, LET’S GO, STOP).

    We offer shared enjoyment, and laughter. This helps a child find their voice. Other ways of finding our voices include singing or humming, or even yelling/shouting!

    The most difficult phase of verbal dyspraxia is initiation, that is to start talking, to start producing a word. Frequent “automatic” repetition supports children with initiation because it removes the element of “thinking to start”. I often ask a child to repeat a word 5-10 times (with rewards at the end. A little game works well). You can see that with repetition the act of initiating is taken out of the equation as you are “on a roll “as it were.

    Once a child starts to find their voice, we will be able to hear them talk lot… And if we give them credit and presume that what they are saying has meaning, we will find in time that their words become clearer and more intelligible. If we listen carefully, we can detect real words and phrases.

    For more tips and support, please get in touch!


    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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    Discover speech and language regression in autistic children and how you can support your child

    Discover speech and language regression in autistic children and how you can support your child

    There’s often this idea that autistic children have extensive vocabulary and knowledge, but this is not always the case. In fact, 30% of autistic children have language regression.

    Goldberg (2003) suggested that speech and language regression refers to the decline in a young child’s speech and communication abilities. We know that regression in speech, language and communication skills often occur before the age of two years. 25% of autistic children develop language at word level between 12 and 18 months of age before losing this language they have learned. As you’re probably aware this regression in communication is a diagnostic indicator of Autism.

    We understand that you want your child to progress, and you struggle to watch as their frustration grows as you feel helpless. I want to provide you with tips so that you can feel empowered to support your autistic child and reduce the impact their communication skills have on the family.

    1. Reduce frustration by providing visuals to support their communication
    2. Model gestalts. We know that autistic children are often gestalt language processors. Learn more about gestalt language processors in one of my previous posts.
    3. Praise the ability to communicate. Focus on what they say not how they say it. E.g., good listening, nice talking.
    4. Provide your child with choices (using real objects to represent your choices). E.g., do you want an apple or banana?
    5. Your child must be motivated and have a purpose to communicate. So, ensure you use highly motivating objects for conversations
    6. Provide them with opportunities to communicate. We need to teach children that if they want something, there’s a process that you need to have the opportunity to ask for it. We find that if parents understand what their child wants (without them asking), the object is given to them, and so there’s no reason for your child to ask.
    7. There’s this idea that we need to teach children eye contact. This is not always the case. Your child is unique, we do not want to take their unique skills away.
    8. Model words which are concrete. E.g., words such as ‘finished’, ‘more’. You can model these several times within the day. You can use a gesture to make the word more visual (see the images below). We know that autistic children are often visual learners.
    Makaton fro "more"
    Makaton for “more”
    Makaton for "finished"
    Makaton for “finished”

    Credit: Little Dots Makaton, Polkadot World

    Remember that if your child has speech, language and communication regression, it doesn’t mean your child will stay static.

    It’s vital that you seek support from a qualified Speech and Language Therapist. We can tell you at what point in the communication development that your child is at. And we can support you through the process. We can provide you with an individualised plan specifically for your child to ensure you maximise their potential.

    Contact me for 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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