The power of containment: A therapeutic approach for autistic children

ByLondon Speech and Feeding August 16, 2024August 15, 2024

The practice of wrapping or swaddling children, often referred to as ‘containment,’ has been used for centuries to soothe and comfort infants. I use this therapeutic approach with autistic children at the London Speech and Feeding Practice. While it might seem counterintuitive, the act of being tightly wrapped can provide significant benefits for children who struggle with sensory processing, emotional regulation, and communication.

Understanding sensory processing and autism

Autistic persons often experience challenges with sensory processing, which is their brain’s ability to interpret and respond to sensory information. This can lead to sensory overload or under-responsivity. Containment can be a valuable tool in helping children regulate their sensory input.

To summarise, here are some of the benefits of containment:

Sensory Regulation:
- Provides deep pressure input: The tight, enveloping sensation of being wrapped can provide deep pressure input, which is calming and organising for many children.
- Reduces sensory overload: By creating a controlled sensory environment, containment can help to reduce overstimulation and promote a sense of safety.
Emotional Regulation:
- Containment creates a sense of security: Being wrapped tightly can mimic the feeling of being in the womb, providing a sense of security and comfort.
- Facilitates calming: The deep pressure input can help to calm the nervous system and reduce anxiety.
Improved Body Awareness:
- Enhances proprioception: Containment can improve the child’s awareness of their body in space, which is essential for motor development and sensory integration. I often provide extra pressure on a child’s arms and legs sticking out of the yoga mat; this helps my child understand where their limbs are in space: I can feel my legs and I can feel my arms and I can feel where they are right now, i.e. they are under Sonja’s hand, I can feel them.
Facilitates Communication – and this is obviously where I come in as a Speech and Language Therapist:
- Swaddling creates a safe space: When a child feels calm and secure, they are more likely to engage in communication.
- Enhances joint attention: The shared experience of being wrapped can foster joint attention, which is essential for language development. You can see this one in my highlights where I swaddle my student in the yoga mat (picture above). She absolutely loves it, and what is more she is calm and steady when usually this child likes to be on the move constantly. Here we have a wonderful moment of joint engagement. She looks at me, she can listen to what I say or sing, and she can tell me in her own way to carry on rolling her or to carry on singing or providing calming pressure to her legs and arms or to stop.

A few pointers for when you try this at home: How to practise containment safely and effectively

Create a safe environment: Ensure the wrapping material is soft, breathable, and free from any hazards.
Observe your child’s cues: Pay attention to your child’s body language and verbal cues to determine their comfort level.
Respect your child’s boundaries: If your child shows signs of distress, stop the containment immediately – this might seem obvious but sometimes we adults get so carried away with some ‘great idea’ that we have seen work elsewhere. And so we can be a little too ‘determined’ sometimes to ‘make it happen’… perhaps this rings a bell with some of my readers.
MAKE IT FUN: Start carefully and take it step by step. See if the student is having a nice time. It is all about trust and therefore it might not work the very first time you do it.

It’s important to remember that containment is not a one-size-fits-all approach. Some children may respond better to other sensory-based interventions. However, for many autistic children containment can be a valuable tool in their journey towards improved communication and emotional regulation.

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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.

Book corner · Speech and Language Therapy

Support your child’s communication using books: OI FROG
ByLondon Speech and Feeding March 17, 2023February 10, 2023

Oi Frog by Kes Gray and Jim Field

Book corner with Oi Frog! by Kes Gray and Jim Field.

Books are an engaging way to support your child’s communication development. Even if your little one dislikes reading in the traditional sense. They will become immersed in this adventure, without realising they are taking in language and developing vital communication skills. This is one of my favourite series for children.

Increase fun and interaction

These books are made for fun and excitement! It may seem silly putting on different voices for different characters, but this is one way in which you can engage your child. Why not try to use different intonation patterns (e.g., you may use a deep voice for the dog, and a higher pitch for the cat)? Make your story interactive: you could ‘rawww’ like a lion and see who can make the loudest noise. Make noises to encourage interaction (e.g., when scratching his chin, make a squeaky sound!). You could also relate the experience back to your child (e.g., ‘can you scratch your chin?’).

Time to talk

Talk about what you can see on the front cover (e.g., There’s a frog on a log, how funny!) You could also ask your child to choose the rhyming words on a page in the book. Can your child tell you what rhymes with certain words (e.g., can you guess what a parrot sits on?)? Make use of every page. You could comment on your favourite frog and see if your child can talk about their favourite. You can support them by giving them an example (“my favourite frog is the one swimming backwards because he looks funny”). Then you could use this scaffold to support their answer. Your favourite is [________________] because [_________________]

If your child is reluctant to use language, the use of commenting can take the pressure of them (“look at all those frogs” or “he’s climbing up the stool”) is a powerful way in which you (as parents) can take the pressure off your child. A top tip I like to give is to make sure you pause regularly, which creates opportunities for your child to use language.

This book uses a subject-verb-object sentence structure (e.g., ‘hares sit on chairs’) which allows your child to hear a good model of a sentence. You could also talk about things in the book that belong in a certain category (e.g., animals, food) or begin with a specific sound. See if your child will name any more.

Reap the reward of repetitive language

Oi Frog uses repetitive rhyming language and puts emphasis on these words. This is important because the more your child hears a word, the more likely they are to remember, understand and use it in the correct context.

Emotions matter

Talk about how the animals feel and why they may feel this emotion (e.g., the cat’s feeling annoyed because…, Lions sit on irons, how does the lion feel?). Reasons can be difficult for children with communication difficulties. Support them by giving an example or by giving them an option (e.g., “does the lion feel happy or sad? I think the lion feels sad because he’s burnt his bottom on the iron! It’s too hot!”)

OI Books

Why not read similar stories? I highly recommend OI CAT, OI DOG and OI DUCK-BILLED PLATYPUS.

Need support for your child’s communication? Contact me here.

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

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Ages and Stages · Speech and Language Therapy · Top tips

Understanding phonological processes in 3–7-year-olds: What’s typical and when to seek help
ByLondon Speech and Feeding February 18, 2026February 13, 2026
As a speech and language therapist, one of the most common questions I hear from parents is:

‘They can talk, but their speech still sounds immature. Is this normal?’

Many children between the ages of three and seven use speech patterns that make their words sound different from adult speech. These patterns are known as phonological processes, and for younger children, they are a normal part of speech development.

However, when these processes persist beyond the expected age, they can start to affect clarity, confidence and learning, especially once children enter school.

This blog will help you understand:
- what phonological processes are
- which patterns are typical at different ages
- and when it might be time to seek speech therapy support
What are phonological processes?

Phonological processes are patterns of sound simplification that children use while their speech system is developing.

Instead of learning each sound one by one, children initially organise sounds into patterns that make speech easier to produce. This is a normal and efficient strategy for a developing brain.

For example:
- saying ‘tar’ instead of ‘car’
- saying ‘poon’ instead of ‘spoon’
- saying ‘bud’ instead of ‘bus’
These are not ‘bad habits’. They are part of how speech develops.

The key question is how long these patterns last.

Common phonological processes (and when they usually disappear)

Below are some of the most common processes parents notice in 3–7-year-olds.

1. Final consonant deletion

Leaving off the last sound in a word
- ‘ca’ for cat, ‘da’ for dog
- Typically resolved by 3–3½ years
2. Fronting

Replacing back sounds (k, g) with front sounds (t, d)
- ‘tar’ for car, ‘do’ for go
- Typically resolved by 3½–4 years
3. Cluster reduction

Omitting one sound in a consonant cluster
- ‘poon’ for spoon, ‘top’ for stop
- Typically resolves by 4–5 years (some clusters slightly later)
4. Gliding

Replacing /R/ or /L/ with /W/ or /Y/
- ‘wabbit’ for rabbit, ‘yion’ for lion
- Can be typical up to 5–6 years
5. Weak syllable deletion

Leaving out unstressed syllables
- ‘nana’ for banana
- Usually resolved by 4 years
If these patterns continue past the expected age, speech can remain difficult to understand particularly for unfamiliar listeners such as teachers, peers, and also Auntie Karen or grandparents who visit once in a while.

Why phonological processes matter in school-age children

By the time children reach reception and Year 1, speech clarity becomes increasingly important.

Persistent phonological difficulties can affect:
- being understood by teachers and peers
- phonics and early reading
- spelling
- confidence in speaking
- willingness to participate in class
Some children become aware that they ‘sound different’ and may speak less, avoid longer words, or become frustrated when misunderstood.

What’s the difference between a delay and a disorder?

This is an important distinction.
- A phonological delay means a child is following the normal pattern of development, just more slowly.
- A phonological disorder means the child is using atypical patterns, or continuing age-expected patterns well beyond when they should have resolved.
A speech and language assessment helps identify:
- which processes are present
- how many are affecting speech
- how consistent the errors are
- and whether intervention is needed
Signs it may be time to seek speech therapy

You may want to seek professional advice if your child:
- is 3½ years or older and still hard to understand
- is understood well by family but not by others
- becomes frustrated or avoids talking
- has difficulty with phonics or spelling
- uses several phonological processes at once
- has not made progress despite time and encouragement
Early support does not mean something is ‘wrong’. It simply helps speech development move forward more efficiently.Research consistently shows that unresolved phonological processes beyond the expected age can impact intelligibility, literacy and confidence (Dodd, 2014; Bowen, 2015).

How speech therapy helps phonological development

Phonological therapy is not about drilling individual sounds endlessly.

Instead, therapy focuses on:
- helping children recognise sound patterns
- building awareness of contrasts (e.g. ‘tar’ vs ‘car’)
- practising speech in meaningful, playful ways
- supporting generalisation so progress carries into everyday speech
For school-aged children, therapy is usually structured, motivating and highly targeted and progress can be very encouraging.

A final reassurance

Many children with phonological difficulties go on to develop clear, confident speech with the right support.

If you’re unsure whether your child’s speech is ‘just a phase’ or something that needs attention, a professional assessment can give clarity and peace of mind.

If you’d like support or advice, please contact me and I can help guide the next steps.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Research references
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

Neurodiversity affirming Speech and Language Therapy
ByLondon Speech and Feeding November 24, 2023November 24, 2023

Introduction

I am a neurodiversity affirming therapist and I love and endorse play-based therapy. I use it alongside a strengths-focused approach in all my sessions. Find out why we should use these transformative therapy methodologies in all our work and play with our children.

I always have a range of different toys and activities up my sleeve so that when one toy is no longer interesting, that’s fine. ‘Look here’s a new one, how about we try this one?’ When therapy feels like play, children are more likely to be engaged and attentive, which leads to better outcomes.

By using play as a context for Speech and Language Therapy we can create opportunities for children to use and practise their communication skills in a natural, real-life setting. This helps bridge the gap between the therapy room and everyday life.

Goals and targets

What about goals and targets I hear you say? Of course, as Speech and Language Therapists we always have our goals for any particular child. They can be speech goals (we want Bobbi to produce a ‘k’ sound at the end of words) or communication goals (we want Fatima to ask for something by pointing to it rather than grabbing it). And these goals can be achieved where there is a reciprocation and a positive, playful relationship between the adult and the child. That relationship comes through play and fun.

Play and fun

Play is how a child interacts and learns. If it’s fun, interesting, exciting or pleasurable then that is where the magic happens. And that is what we need to return to repeatedly and then see if we can fold our targets into the activity as we go.

As soon as we expect our child to do something and we try and shape their behaviours towards a certain outcome we no longer ‘play’. We are now in teaching mode, where we direct and where we are ‘in charge’. As a neurodiversity affirming therapist, I believe that all play is valid. We must not get into the trap of thinking that only functional play is valid, that there is only one way to play with that car ramp/puzzle/potato head. Our autistic children often need to play in a particular way to navigate their world and we must not try and stop that.

When we affirm and validate our child’s play and copy their play with enthusiasm and respect then, in my experience, all children regardless where they are on the neurodiversity spectrum will begin to engage with us, copy us, and learn how to communicate effectively about things that matter to them.

Play-based therapy allows therapists to tailor interventions to each child’s unique interests and abilities. This individualised approach increases the likelihood of success and progress.

Strengths-Focused Speech Therapy

Strengths-focused therapy emphasizes a child’s strengths and abilities rather than their deficits. It recognises that every person has unique strengths that can be harnessed to overcome challenges.

Focusing on strengths helps us build a positive self-image. This is especially important for children with communication disorders, as it can boost their confidence and self-esteem.

When we encourage children to play in ways that they enjoy and are good at they feel empowered and more in control of their lives and play. This can lead to increased motivation and a sense of ownership over their progress.

Now, imagine the powerful impact that can be achieved by combining play-based therapy and strengths-focused therapy in speech therapy sessions. This dynamic combination brings out the best of both worlds. It creates a therapeutic environment that is not only effective but also enjoyable for children and their families.

As Speech Therapists we can use the child’s strengths and interests as a foundation for play-based activities. This personalisation not only makes therapy more engaging but also more effective.

An example

Charlie, a 3-year-old with social communication challenges, had a deep interest in anything that spins. We used this strength and interest to create a variety of spinning activities. As he is allowed to engage in his spinners, we can practise lots of speech and language and provide great phrases alongside his interest and activities: Ready steady go! Stop! ‘another one’ ‘the red one’ ‘again again’ ‘I love it’ ‘it’s a spinner’ ‘Charlie loves this toy’ ‘it’s going fast’ ‘it’s so fun’ etc..

Over time Charlie started to copy some of these word models and then used them to create his own little phrases, such as ‘the blue one again’. When this occurred, we felt like celebrating because it had come naturally and appropriately to the situation without any coercion or direction. That is what communication is about! Well done Charlie!

Conclusion

Play-based and strengths-focused speech therapy approaches are powerful tools and by combining these approaches, we create a therapeutic environment that is not only effective but also enjoyable and empowering for our clients.

Contact me if you would like your child to have neurodiversity affirming speech and language therapy.

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 · Speech and Language Therapy · Top tips

Feeding therapy: A guide for parents and caregivers
ByLondon Speech and Feeding September 6, 2024September 5, 2024
Image by gpointstudio on Freepik

Feeding therapy is a specialised form of therapy and support that helps children develop healthy eating habits and overcome challenges related to food. It’s often used for children with picky eating, feeding disorders, or sensory processing issues.

What is feeding therapy?

Feeding therapy involves a series of techniques designed to improve a child’s eating skills and attitudes towards food. In the UK it’s typically provided by speech and language therapists and dietitians. These professionals work closely with parents and caregivers to create a personalised treatment plan tailored to each child’s unique needs.

How does feeding therapy work?

Feeding therapy sessions are typically 30–60 minutes long and involve a variety of techniques, including:
- Family counselling: Providing support and guidance to parents and caregivers. This can help address any practical, behavioural and emotional issues that may be impacting the child’s eating.
- Play-based activities: Engaging children in fun activities while introducing new foods or textures. This can help alleviate anxiety and make mealtimes more enjoyable.
- Sensory exploration: Helping children become more comfortable with different tastes, smells, and textures. This can be achieved through activities like touching, smelling, and tasting various foods.
- Oral motor exercises: Improving chewing, swallowing, and lip coordination. These exercises can help children develop the necessary skills for eating independently.
- Behavioural techniques: Using positive reinforcement to encourage healthy eating habits. This can involve rewarding children for trying new foods or eating a variety of meals.
When is feeding therapy needed?

Feeding therapy may be beneficial for children who:
- Are picky eaters: Refuse to eat a variety of foods or have strong preferences.
- Have feeding disorders: Experience difficulties with eating, such as swallowing or chewing.
- Have sensory processing issues: Are sensitive to certain textures, smells, or tastes.
- Have medical conditions: Such as autism, cerebral palsy, or gastrointestinal disorders.
Feeding therapy strategies you can try at home

While professional feeding therapy can be invaluable, there are several techniques you can try at home to support your child’s eating development:
- Create a positive mealtime environment: Make mealtimes enjoyable and stress-free by avoiding distractions, limiting screen time, and creating a calm atmosphere.
- Create regular mealtimes and mealtime routines: Introduce set ways of announcing meal times, including songs or short nursery rhymes, try and involve your child with table setting, even just carrying their spoon to the table and putting the beaker next to the plate and ensure that meal time finishes after about 30 minutes, again with a set routine so that the child always knows: this is how we do it in our home, now I am finished and meal time is over.
- Introduce new foods gradually: Start with small amounts and gradually increase exposure. This can help reduce anxiety and make new foods less overwhelming.
- Model healthy eating: Show your child how to enjoy a variety of foods by eating a balanced diet yourself.
- Avoid forcing food: Allow your child to choose and explore foods at their own pace. Forcing them to eat can create negative associations with food.
Seek professional help

If you’re concerned about your child’s eating habits, consult with a feeding therapist. We can provide guidance and support.

Remember, feeding therapy is a collaborative process between parents, caregivers, and professionals. With patience, understanding, and the right strategies, you can help your child develop healthy eating habits and enjoy meals.

Would you like to know more about specific techniques or have any other questions about feeding therapy?

Please feel free to contact me.

Sonja McGeachie

Early Intervention Speech and Language Therapist

Feeding and Dysphagia (Swallowing) Specialist The London Speech and Feeding Practice

The London Speech and Feeding Practice

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

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Speech and Language Therapy · Top tips

Unlocking language and thinking skills: The power of sequencing
ByLondon Speech and Feeding April 28, 2025April 28, 2025
As speech and language therapists, we often use a variety of techniques to help children develop their communication and cognitive skills. One incredibly valuable tool in our toolkit is the use of sequencing activities. But what exactly is sequencing, and why is it so beneficial?

What is sequencing?

Sequencing, at its core, involves arranging items, events, or actions in a specific order. This could involve putting pictures in the correct order to tell a story, following the steps in a recipe, or understanding the order of daily routines like brushing teeth or getting dressed.

The link between sequencing and language

Sequencing is fundamental to language development and is quintessential to executive functioning skills in several ways:
- Narrative skills: Storytelling, whether oral or written, relies heavily on sequencing. A child needs to understand the order of events (beginning, middle, end) to construct a coherent narrative.
- Explanations and instructions: Providing clear explanations or instructions requires the ability to sequence information logically. For example, explaining how to play a game or how to get from one place to another. In the video clip below we are working on ‘how do make a sandwich’.
- Vocabulary development: Sequencing helps children understand temporal words and phrases like ‘first,’ ‘then,’ ‘next,’ ‘before,’ and ‘after’.
- Sentence structure: Constructing grammatically correct sentences often involves sequencing words in a specific order (e.g., subject-verb-object).
Beyond language, sequencing plays a crucial role in developing executive functioning skills. These are higher-level cognitive skills that help us plan, organise, and manage our time and actions.

Sequencing activities can help children improve in the following areas:
- Planning and organisation: Sequencing tasks require children to think ahead, plan the steps involved, and organise them in a logical order.
- Problem-solving: When they are faced with a problem, sequencing helps children break it down into smaller, more manageable steps.
- Working memory: Holding information in mind and manipulating it, such as remembering the steps in a multi-step direction, is supported by sequencing skills.
- Cognitive flexibility: Being able to adjust to changes in a sequence or think of alternative sequences promotes cognitive flexibility.
Examples of sequencing activities

Here are some practical examples of sequencing activities you can do with your child:
- Picture sequencing: Use a set of picture cards to tell a short story or illustrate a process (e.g., making a sandwich, going to the park). Ask your child to arrange the cards in the correct order.
- Story retelling: After reading a story, have your child retell it, focusing on the order of events.
- Following instructions: Give your child multi-step instructions to follow (e.g., ‘First, get your shoes. Then, put on your coat. Next, go to the door.’).
- Sequencing during play: Integrate sequencing into everyday play. For example, while building with blocks, talk about the steps: ‘First, we put this block here. Next, we add this one…’
- Daily routines: Create visual schedules for daily routines, like getting ready for school or bedtime, to help children understand the sequence of events.
- In the video clip below I am using an on-line language activity which is often fun for children as they can use their finger to swipe the pictures effortlessly into the right place and, if we realise at the end of the story that we have made a little error, we can then easily re-jig the pictures into their correct place.
In conclusion

Sequencing activities offer a powerful way to support children’s language development and enhance their executive functioning skills. By helping children understand and create order, we equip them with essential tools for communicating, learning, and navigating the world around them.

Do get in touch via my contact form if you are concerned about your child’s development.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

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

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Autism Therapy · Speech and Language Therapy · Top tips

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

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

The ethos at London Speech and Feeding:

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

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

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

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