One of the most important things I have learned as a paediatric speech and language therapist is this:
Children do not all learn communication in the same way.
Some children learn best through listening. Some need visual support. Some need movement and gesture. Some benefit from symbols or technology. And many children need multiple supports together before communication truly starts to develop.
That is why flexible, responsive therapy matters so much.
In this short therapy clip, I model just two simple words: ‘Go’ and ‘Up’.
But underneath those tiny moments is a combination of therapeutic strategies:
speech sound prompting
visual cueing
Makaton signing
AAC (Augmentative and Alternative Communication) modelling
repetition
motor planning support
language modelling
total communication principles.
Communication is bigger than speech alone
One of the biggest misconceptions about speech therapy is the idea that communication only ‘counts’ if a child says the word verbally.
In reality, communication comes in many forms:
speech
gesture
facial expression
signing
pointing
symbols
body language
AAC.
This is particularly true for children with:
developmental language disorder (DLD)
autism
motor speech difficulties
childhood apraxia of speech (CAS)
phonological difficulties
global developmental delay
complex communication needs.
These children often need communication to be presented through multiple pathways at once.
That is where total communication approaches become so powerful.
This is important to know: this does not confuse children. In fact, for many children, it does the opposite. It creates clarity.
Research suggests that learning signs alongside spoken language does not hinder speech development and may support overall language acquisition, communication confidence, and vocabulary growth in many children.
For many children, signs actually help speech emerge because they:
reduce communication pressure
build confidence
strengthen understanding of words.
A child who can successfully communicate is far more likely to keep attempting interaction.
The power of AAC and LAMP Words for Life
In the clip, I also model language using an electronic AAC system: LAMP Words for Life.
AAC stands for Augmentative and Alternative Communication.
AAC includes any tool that supports communication beyond speech alone, including:
picture systems
symbol boards
communication books
speech-generating devices.
LAMP Words for Life is one of my favourite AAC systems because it focuses on consistent motor patterns and meaningful language development. Because communication is not about achieving perfection. It is about connection.
And when children are given multiple ways to express themselves, they often become more confident, more engaged, and more willing to interact with the world around them.
That is the true power of total communication 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.
The /R/ sound is notoriously challenging for many children (and even some adults!). It’s one of the most complex sounds in the English language, with various pronunciations depending on its position in a word. If your child is struggling with their /R/s, you’re not alone. As Speech and Language Therapists (SLTs), we frequently work on this sound, and a key component of our therapy is focusing on proper tongue placement.
Why is the /R/ so difficult?
The /R/ sound requires precise coordination of the tongue, jaw, and lips. Unlike sounds like /P/ or /B/ that involve simple lip movements, the /R/ involves intricate tongue movements and tension. There are also different ways to produce the /R/ sound, which adds to the complexity:
Retroflex /R/: The tongue tip curls up and back towards the roof of the mouth.
Bunched /R/: The body of the tongue bunches up towards the roof of the mouth, while the tongue tip remains down.
The importance of tongue placement
Regardless of which /R/ variation is being targeted, accurate tongue placement is crucial. Even a slight deviation can result in a distorted or inaccurate sound. That’s why SLTs dedicate significant time to teaching and practising tongue positioning.
Speech therapy techniques: Focusing on the tongue
Here’s a glimpse into how I address /R/ sound difficulties, with a focus on tongue placement:
Visual aids:
Mirrors: I use a mirror to help children see their tongue movements and make adjustments.
Tongue diagrams and models: These visual tools provide a clear representation of where the tongue should be positioned.
Tactile cues:
Tongue depressors: These can be used to gently guide the tongue into the correct position.
Food-grade tools: Sometimes, I use flavoured tongue depressors or other tools to provide tactile feedback and increase awareness of tongue placement.
Auditory discrimination:
I help children distinguish between correct and incorrect /R/ sounds.
I use auditory cues and verbal feedback to reinforce proper pronunciation.
Exercises and drills:
Tongue strengthening exercises: Strengthening the tongue muscles can improve control and coordination.
Tongue placement drills: We practise positioning the tongue in the desired location and holding it there.
Sound approximation techniques: Sometimes we use other sounds to help approximate the /R/ sound. For example, I use the /L/ sound, to help achieve the correct tongue placement. Once my child has found the /L/ sound it is then a matter of pulling back just slightly to get a good /R/.
Contextual practice:
Once the child can produce the /R/ sound in isolation, we gradually introduce it into syllables, words, phrases, and sentences.
We also practise the /R/ sound in different contexts, such as at the beginning, middle, and end of words.
Tips for Parents:
Be patient and supportive: Learning the /R/ sound takes time and practice.
Practise regularly: Short, frequent practice sessions are more effective than long, infrequent ones.
Make it fun! Use games, stories, and other engaging activities to keep your child motivated.
Work with an SLT: A qualified SLT can provide personalised guidance and support.
In conclusion:
The /R/ sound can be challenging, but with targeted speech therapy and a focus on tongue placement, most children can achieve clear and accurate pronunciation.
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.
As a parent, you’ve likely experienced the triumphant feeling when your child, who’s been working so hard on his or her /S/ sound, produces it perfectly in a therapy session. He or she is rocking those ‘sun’ and ‘socks’ words, his or her lisp seemingly a distant memory. You leave feeling elated, confident that all that hard work is finally paying off.
Then you get home. And within minutes, you hear it: ‘Thooper!’ instead of ‘Super!’ Or maybe the clear /R/ in ‘rabbit’ from therapy reverts to a ‘wabbit’ when his or she is playing with his or her toys. It’s frustrating, confusing, and can feel like you’re back to square one.
So, what’s going on? Why is it so difficult for children to take those amazing skills learned in a focused therapy session and seamlessly apply them to their everyday conversations? You’re not alone in wondering this. It’s a common challenge in speech therapy and understanding the ‘why’ can help both parents and children navigate this crucial stage.
The brain’s habits: Old pathways are strong pathways
Think of your child’s brain as having established ‘pathways’ for how he or she produces certain sounds. If he or she has been lisping his or her /S/ sound for years, that neural pathway is deeply ingrained. It’s like a well-worn path through a field: easy to follow because it’s always been there.
In therapy, we’re essentially trying to forge a new path. We’re teaching him or her a new, more accurate way to make the sound. This new path is initially faint, like a barely visible trail. It takes conscious effort and repeated practice to strengthen it. Outside of the structured therapy environment, his or her brain often defaults to the old, comfortable, and well-established pathway, even if it’s not the most accurate.
The demands of daily conversation: A multitasking challenge
Therapy sessions are designed to be focused and controlled. We isolate sounds, practice them in specific words, and provide immediate feedback. There are minimal distractions, and your child’s full attention is on his or her speech production.
Now, consider daily conversation:
Speed: We speak much faster in natural conversation than we do during structured practice. There is less time to think about individual sounds.
Cognitive load: Children are simultaneously thinking about what they want to say, understanding what others are saying, processing social cues, and managing their emotions. Adding the conscious effort of producing a new speech sound correctly on top of all that is a huge cognitive demand.
Variety of contexts: In therapy, we might practise ‘sun’ and ‘socks’. In real life, the /S/ sound appears in countless words, in different positions within words, and alongside a vast array of other sounds. Each new word and phonetic context present a fresh challenge.
Lack of immediate feedback: In therapy, the speech therapist is right there to provide instant correction and reinforcement. In a playground, during a family dinner, or while playing with friends, that immediate, consistent feedback isn’t present.
The role of automaticity: Making it second nature
The ultimate goal of speech therapy isn’t just correct sound production; it’s automaticity. This means producing the sound correctly without having to consciously think about it. It’s like learning to ride a bike. Initially, every pedal stroke and steering adjustment is deliberate. Eventually, it becomes second nature.
Generalisation is the process of moving from conscious, controlled production to unconscious, automatic production. This takes time, consistent practice, and exposure to a wide variety of real-life speaking situations.
How can we help? Bridging the gap
So, what can parents do to help their children bridge this gap between therapy success and everyday speech?
Be patient and positive: This is a marathon, not a sprint. Celebrate the small victories and avoid getting discouraged by setbacks. Your positive reinforcement is crucial.
Practise little and often: Instead of long, infrequent practice sessions, aim for short, consistent bursts throughout the day. ‘Sprinkle’ in opportunities to practise their target sounds in natural conversations.
Create ‘sound awareness’ moments: Gently draw your child’s attention to his or her target sounds in everyday words. For example, if he or she is working on /R/, you might say, ‘Oh, you said ‘wabbit.’ Can you try to make your /RRR/ sound for ‘rabbit’?’
Model correct production: Continue to model the correct production of their target sounds in your own speech.
Collaborate with your speech therapist: Your therapist is your best resource! Ask them for specific strategies and activities you can do at home to support generalisation. They can also provide guidance on when and how to gently correct your child.
Tips and tricks
Below I have listed a few good tips and tricks that can help the transition from therapy room to daily life:
Empowering your child as the ‘sound detective’:
‘Secret sound listener’: Instead of you doing the correcting, make your child the detective. When you’re having a conversation, say ‘your /S/ sounds are sometimes a bit “slippery”’ (or whatever fun, non-judgmental term you like). Ask your child to quietly listen for your /S/ sounds. You can even purposely make a few ‘slippery’ ones (or correct yourself immediately after) and see if they notice. This shifts the focus from being corrected to actively listening and identifying the sound in a non-threatening way.
‘Sound scorecard’: For a short period (maybe 10–15 minutes during a specific activity, like dinner or a game), provide a small notepad and pencil. Explain that your child is going to listen for his or her /S/ sounds and gently mark a tally every time he or she uses it correctly. The goal isn’t perfection, but awareness. This gives your child agency and a visual representation of progress. You can even make it a game: ‘Let’s see how many /S/ sounds we can catch in five minutes!’
/S/ sound song/rhyme creation: Work together to create silly songs or rhymes that are packed with /S/ sounds. The sillier, the better! You can sing them in the car, while doing chores, etc.
/S/ sound superpower: Frame the new sound skill as a ‘superpower’. ‘You’re getting so good at using your /S/ superpower! It’s going to help you speak so clearly and confidently.’
Highlighting successes: Always go out of your way to acknowledge and praise successful /S/ productions in natural conversation. ‘I really understood you clearly when you said ”s_top”.’ or ‘That /S/ sound was perfect when you told me about the “s_tory”!’
Important considerations:
Keep it low-pressure: The goal is generalisation, not perfection. If your child is feeling pressured, he or she will likely revert to old patterns.
Focus on awareness, not just correction: Help your child become aware of his or her own speech rather than relying on you for corrections.
Short, frequent bursts: A few minutes of subtle focus multiple times a day is more effective than one long, forced session.
Acknowledge feelings: If your child expresses frustration about ‘being corrected’, validate these feelings. ‘I understand it can feel like a lot of listening, but we’re just trying to help you use that super /S/ sound all the time!’
By incorporating these strategies, you can help your child naturally integrate the new /S/ sound into daily speech, fostering independence and confidence without it feeling like constant ‘testing’ or ‘correction’. Generalising new speech sounds is arguably the hardest part of speech therapy, but it’s also the most rewarding. With patience, consistent effort, and a collaborative approach between parents and therapists, children can successfully integrate their new, clearer speech sounds into every aspect of their daily lives.
Any comments or if you need help and support with your child’s speech please do not hesitate to get in touch with me: simply fill out the contact form here on the website. I endeavour to reply within 48 hours.
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.
Childhood Apraxia of Speech (CAS) is a complex neurological disorder that affects a child’s ability to plan and coordinate the movements necessary for speech production. Children with CAS often have difficulty with articulation, prosody, and fluency, making it challenging for them to communicate effectively. While there is no cure for CAS, speech and language therapy can significantly improve a child’s communication skills and overall quality of life. Understanding the principles of motor learning is crucial for both parents and speech therapists to support children with CAS on their speech journey.
What is MOTOR LEARNING?
Motor learning refers to the process of acquiring and refining new skills through practice and experience. This applies to all aspects of movement, including speech production. The brain constantly receives sensory information about the movements being made and adjusts them based on the desired outcome. A breakdown or interruption of this process can make it difficult for children to plan, sequence, and coordinate the intricate movements involved in speech.
What key principles do we use in speech and language therapy for motor learning?
Task Specificity: Speech Therapy activities that directly target the specific speech sounds or skills your child is working on. For example, if your child is struggling with /p/, practising isolated /p/ sounds, words with /p/, and phrases with /p/ would be most beneficial.
Massed vs. Distributed Practice: We consider the optimal amount and distribution of practice sessions throughout the day. Massed practice involves concentrated practice in a single session, while distributed practice spreads practice sessions throughout the day. The best approach depends on the individual child’s learning style and attention span.
Feedback: We provide clear and immediate feedback to help your child understand the accuracy and effectiveness of their attempts. This feedback can be auditory, visual, or touch based.
Error Correction: We aim to gently correct errors so that we can help your child refine their movements and avoid developing bad habits. The focus is on providing specific cues and guidance rather than simply pointing out mistakes.
Variety and Progression: We gradually introduce new challenges and variations in speech therapy activities to prevent plateaus and maintain motivation.
Motivation and Engagement: A big part of our work is to make therapy sessions fun and engaging to keep your child motivated and actively participating. We use games, songs, and activities that your child enjoys while incorporating targeted practice opportunities.
What about home work?
Yes we need your help and here are some examples of how this could look:
Task Specificity: During story time, focus on practising target sounds present in the story. Have your child repeat words or phrases containing the sound and encourage them to identify the sound in other words.
Massed vs. Distributed Practice: Instead of one long practice session, try shorter, more frequent sessions throughout the day. This can help maintain focus and prevent fatigue. It is recommended to go for 100 repetitions of the target sound per day, every day in between the sessions. We can decide together how you can best do that through either massed or distributed practice. We can decide after the session.
Feedback: Use a mirror to provide visual feedback on lip and tongue placement during sound production. Record the child’s speech and play it back to help them self-monitor their accuracy.
I quite like this mirror below but any table top mirror will work as long as it is not too small. Your child should see their whole face easily.
Error Correction: If the child makes an error, gently model the correct sound or movement without shaming or criticising. Provide specific cues such as ‘lips together’ for /p/ or ‘tongue up’ for /t/.
Variety and Progression: We will guide you on exactly what words to practise so this is something you need not worry about.
Motivation and Engagement: Use games, songs, and activities that your child enjoys. Play a game of ‘I Spy’ focusing on words with the target sound or create silly sentences with the sound to make practice fun.
Let’s work together!
It is crucial for parents, therapists, and other caregivers to work collaboratively to ensure a consistent and comprehensive approach to supporting your child’s speech development. Speech and Language Therapists can provide guidance and resources on implementing these principles at home, while parents can share observations and progress updates to inform therapy sessions.
Remember, every child with CAS learns at their own pace. By understanding and applying the principles of motor learning, parents and speech therapists can create a supportive and stimulating environment that empowers children with CAS to reach their full communication potential.
Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.
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.
If your child says ‘dar’ instead of ‘star’, you might be wondering if they will simply outgrow it or if they require specialised support. While ‘cluster reduction’—dropping one of the sounds in a blend—is a normal part of learning to talk, we typically expect these sounds to lock into place by age four years. If these errors persist as a child approaches school age, it often signals a speech sound delay that may now no longer pass without help. As a Speech and Language Therapist, I specialise in helping children bridge this gap using evidence-based techniques like backward chaining.
This isn’t about constant correction; it’s about providing the right clinical scaffolding to move a child from ‘frustrated’ to ‘fluent’ before they hit those critical early school years.
Dropping sounds from words is a common feature of speech sound difficulties, and while it can look small on the surface, it can have a big impact on how clearly a child is understood. In this short video clip, I’m working with a child on an /ST/ sound cluster, demonstrating how I use an evidence-based speech therapy technique called backward chaining to help children build clearer speech with confidence.
What’s actually happening when a child drops the ‘S’?
Clusters like /ST/, /SP/, and /SK/ are tricky. They require:
precise timing
careful airflow
and the ability to blend sounds smoothly
For many children, especially those with speech sound difficulties, this is a big ask.
So instead of hearing:
‘star’
we might hear:
‘tar’ or ‘dar’
This isn’t laziness or refusal. It’s the child simplifying the word to make it manageable.
Why I don’t start by saying ‘say star’
Telling a child to ‘just add the S’ rarely works.
Instead, I meet them where they are already successful.
In this clip, the child can already say ‘dar’ clearly. That’s our starting point.
Backward chaining: building speech from success
Backward chaining means we:
Start with the part of the word the child can already say
Gradually add the missing sound
Keep the child feeling successful at every step
So rather than jumping straight to ‘star’, we:
secure the ending
gently introduce the /S/
and blend it in a way that feels achievable
This approach reduces frustration, builds confidence, and helps the sound stick not just in the therapy room, but out in the real world.
Why this matters beyond one word
This isn’t just about saying ‘star’.
It’s about:
teaching the mouth a new movement pattern
giving the brain time to organise the sound sequence
and helping the child feel capable, not corrected
When therapy feels safe and successful, children are far more likely to generalise their new sounds into everyday speech.
Speech therapy works best when children feel supported not tested.
If your child struggles with speech clarity
If your child:
drops sounds from words
avoids longer or trickier words
or becomes frustrated when they’re not understood
This is the kind of work I do every day building speech step by step, in a way that respects each child’s pace and strengths.
Support can be gentle, effective, and empowering.
If you’d like to learn more about how speech therapy can support your child, you’re always welcome 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.
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?
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.
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.
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.
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.
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 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!”)
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.
