Tongue-Tie: A complex issue requiring careful assessment

ByLondon Speech and Feeding

Tongue-tie, or ankyloglossia, is a condition where the lingual frenulum, the thin piece of tissue that connects the underside of the tongue to the floor of the mouth, is too short or tight. Tongue-tie is quite common in babies and is often not detected after birth. Tongue-tie can lead to a difficult start with breast feeding as it makes it very difficult for the baby to latch effectively.

In my clinical experience as a feeding therapist, I have seen many babies who were not able to latch well due to the frenulum being tight. In many cases an experienced feeding speech therapist/lactation consultant can really make a difference and help a new mum to latch the baby even though the tongue is tethered to the floor of the baby’s mouth. In some cases the frenulum can be divided and once this has been done, in some cases, feeding improves immediately or soon after the division. But this is not always the case. I have seen several babies who have had as many as four tongue-tie divisions and feeding was still difficult.

It is important to say that while tongue-tie can sometimes impact speech and feeding, it’s important to note that it’s not always the root cause of these difficulties. In recent years, there has been a surge of interest in tongue-tie division surgeries, with some cases being unnecessary. It’s crucial to understand the complexities of tongue-tie and the role of speech therapy in addressing related challenges.

The impact of tongue-tie on speech and feeding

When tongue-tie is severe, it can interfere with the tongue’s ability to move freely, affecting speech production and swallowing. Some common speech and feeding difficulties associated with tongue-tie include:

  • Feeding difficulties: Challenges with sucking, chewing, and swallowing.
  • Drooling: Excessive drooling due to difficulty controlling saliva.
  • Speech problems: Difficulty producing certain sounds, such as /l/, /r/, /t/, /s/ and /d/.

The importance of comprehensive assessment

Before considering any surgical intervention for tongue-tie, it’s essential to undergo a thorough evaluation by a qualified speech-language therapist (SLT). An SLT can assess the severity of the tongue-tie, its impact on speech and feeding, and determine if surgery is necessary.

  • Functional assessment: The SLT will assess the tongue’s range of motion, its impact on speech sounds, and the child’s overall oral motor skills.
  • Feeding evaluation: The SLT will observe the child’s feeding patterns and identify any difficulties related to tongue-tie.
  • Differential diagnosis: The SLT will rule out other potential causes of speech and feeding difficulties, such as apraxia of speech, dysarthria, or sensory processing disorders.

The role of speech therapy

Even in cases where tongue-tie is present, speech therapy can often be highly effective in addressing speech and feeding difficulties. Here’s how speech therapy can help:

  • Articulation therapy: Targeting specific speech sounds that may be affected by tongue-tie.
  • Childhood Apraxia of Speech (CAS): if the diagnosis by the SLT has shown that in fact the child has motor planning difficulties then there are very specific and effective treatment programmes that help with this and can make a real difference over time.
  • Feeding therapy: Strategies to improve swallowing, chewing, and oral-motor skills.
  • Sensory integration: Addressing underlying sensory processing issues that may contribute to feeding difficulties.

London Speech and Feeding Case Study: The importance of comprehensive assessment

One of my clients was initially diagnosed with tongue-tie and recommended for surgery at the age of eight years old. His speech had been perceived by parents and teachers as ‘mumbled and unclear’.

However, after a thorough evaluation, I was able to determine that the child’s primary issue was apraxia of speech, a neurological disorder that affects motor planning for speech. Parents decided to wait with surgery and trust my judgment and we proceeded with weekly intensive speech therapy to address motor planning difficulties around tricky sounds and words. I am delighted to say that the child’s speech has improved significantly, demonstrating the importance of comprehensive assessment and individualised treatment. He is no longer seen as a candidate for an operation, which would have been traumatic for him at his age and, as it turned out, entirely unnecessary.

Below is a short video clip of my working on the /l/ sound with this child.

Using the Gingo Puppet from GingoTalk

Conclusion

Tongue-tie is a complex issue that requires careful evaluation and individualised treatment. While surgery may certainly be necessary in some cases, it’s essential to consider the potential benefits and risks. Speech therapy can be a highly effective approach for addressing speech and feeding difficulties associated with tongue-tie, even in cases where surgery is still required. By working with a qualified speech-language therapist, parents can ensure that their child receives the best possible care and support.

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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    Ages and Stages: 0–3 months

    ByLondon Speech and Feeding
    Ages and Stages: 0–3 months
    Designed by Freepik

    What do we offer our babies from 0–3 months old? What toys? What are the best early activities for our baby to develop? I get asked this a lot so here are my suggestions.

    You are the best toy

    You the parent or the caregiver are the BEST toy a baby could have in the first three months. The most important thing is to talk and sing to your baby, to look and hold your baby and offer your face and voice! Use sing song intonation as much as you can, and as often as possible. We know that babies respond really well to interesting voices, singing or funny sounds. Use your facial expressions!

    It is important to encourage early turn taking: leave pauses in between what you say or sing to allow your baby to respond to you. Once you see any signs of your baby responding you continue as if you are having a conversation.

    Designed by Freepik

    Visual Stimulation

    We know that baby’s eyesight still needs to develop in those first months and that a newborn can only distinguish light, shapes and faces. And their distance vision is blurry in the first month. A baby can see up to 15 cm away and this is roughly the distance between the feeders’ face when bottle or breastfeeding the baby.

    Black and white

    Your baby can see black and white and some shades of grey. So, in the first month you really will need no toys at all other than your face and your voice, your smile, giggle and your hands! Of course, there are a range of black and white visual toys available these days like the ones below. But if you are on a budget, I would say you don’t need those.

    From the second to third month a baby can begin to follow objects with their eyes. They recognise a familiar face and now they start reaching for things. Their colour vision is also gradually improving.

    Baby gym

    One of the best early toys is a ‘baby gym’ where bright and colourful toys dangle off foam padded arches. You can sometimes get ones with a mirror hanging off one of the arches or a mirror sewn into the mat. This is useful as baby likes to look at his/her face at around three months old and this can also be great for tummy time. If you are on a budget this would be the one toy, I would recommend you to get.

    If there is no mirror on your baby gym you could get a mirror toy. There are lots out there, this one is a good example. I would probably get a mirror toy that has other sensory components attached so you get more value for money, i.e., three toys in one.

    O-ball

    Another great toy to get around 2–3 month is an O-ball for easy grasping, bright colours, very lightweight.

    Sounds

    Lovely early toys are sound makers, bells or rain makers. Some very light weight bells can be attached to your baby’s ankles and they ring every time your baby moves his/her legs. This is a nice and easy introduction to early cause and effect understanding.

    Peek-a-boo

    A great early game is Peek-a Boo and you could complement your hands hiding your eyes with some nice lightweight pieces of material like a piece of organza veil fabric for example. An added benefit is that later on baby can try and grasp the materials and pull them out of the container.

    Music

    Music is very important. Turn on the radio to classical or any easy listening station you like. If nothing else you could sing of course! And do not worry about not hitting the right notes your baby won’t judge you (until they are about three years old!)

    Designed by Freepik

    After three months

    At the end of three months your baby is likely to show you the following:

    • makes cooing and early babbling sounds
    • seems to know your face
    • smiles at you socially
    • cries for different needs: hungry, bored, needing attention, looking for you
    • opens and closes hands to try and grasp items
    • takes swipes at dangling
    • kicks his/her legs
    • looks at faces and toys, lights
    • turns his/her head towards sounds
    • starts to understand the world around him/her.

    Don’t panic!

    But don’t panic at all if you feel your baby has not quite mastered any of those stages. Chances are they are doing so very soon. If you are worried, please do come and bring your baby to our clinic for a screen and we will give you plenty of assurance and ideas on how to help your baby move forward.

    On a final note, Early Intervention is key and bringing your baby for a one-off consultation to a speech and language specialist is always a great idea, just to get ideas, to see that baby is on track and to help baby develop.

    The earlier you bring your baby the better. Chances are one consultation is all you need and perhaps a six-monthly review to just stay nicely on track.

    Look out for my next Ages and Stages from three to six months old!

    I look forward to seeing you! Get in touch with me via my contact form.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice

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

    1
  • · ·

    Great toys and books for our toddlers (around 1–2 years old)

    ByLondon Speech and Feeding

    As a speech and language therapist, I often get asked by parents what toys and books they should buy for their toddlers. It can feel overwhelming with so many options available! So, I’ve put together a list based on my experience and what I’ve found works well.

    Remember, every child is unique!

    Observe your toddler’s interests and play style. Some toys that are popular might not be engaging for your child.

    Here are a few ideas to get you started:

    Sensory Toys:

    • Stacking cups: These are fantastic for developing hand-eye coordination, fine motor skills, and understanding size relationships. (Various brands available) Note: You can stack many things you have around the house, like bowls or measuring cups, for a similar experience!
    • Shape sorters: Help with shape recognition, hand-eye coordination, and problem-solving. (Melissa & Doug, Vtech)
    • Sensory balls: Balls with different textures (soft, bumpy, squishy) provide tactile stimulation. (Various brands)
    • Push and pull toys: Encourage gross motor development and exploration. (Vtech, Fisher-Price)

    Communication-focused toys:

    • Picture books with flaps: Engage curiosity and encourage language development. (Various brands)
    • Talking toys: Introduce new vocabulary and encourage imitation. (Vtech, Fisher-Price)
    • Simple puzzles: Develop hand-eye coordination, problem-solving, and spatial awareness. (Melissa & Doug, Ravensburger)
    • Musical instruments: Encourage exploration of sounds and develop auditory skills. (Bright Starts, Fisher-Price)

    Now, let’s talk about books:

    • The Very Hungry Caterpillar by Eric Carle: A classic with repetitive text and vibrant illustrations, great for introducing vocabulary and concepts like days of the week.
    • Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr. and Eric Carle: Simple, repetitive text and engaging illustrations make this a favourite for many toddlers.
    • Goodnight Moon by Margaret Wise Brown: A soothing bedtime story with calming illustrations.
    • Pat the Bunny by Dorothy Kunhardt: An interactive book with textures and flaps to engage young children.
    • Corduroy by Don Freeman: A heartwarming story about a teddy bear who loses his button.

    Remember:

    • Observe your child’s interests: Choose toys and books that capture their attention and encourage exploration.
    • Engage with your child: Play with the toys together and read books aloud with enthusiasm.
    • Keep it simple: Start with a few toys and books and gradually introduce new ones.
    • Rotate toys: Keep playtime fresh by rotating toys and books regularly.
    • Most importantly, have fun! Reading and playing with your child should be a joyful experience for both of you.

    Also consider the power of open-ended play

    In today’s world filled with electronic gadgets, it’s easy to overlook the value of open-ended play. Open-ended toys lack specific functions or prescribed outcomes, allowing children to use their imaginations to explore and create. Unlike toys with pre-determined ways to play, open-ended toys encourage:

    • Creative thinking: Children can use them in countless ways, developing their own rules and narratives. A block can become a car, a house, or a spaceship, depending on the child’s imagination.
    • Problem-solving skills: Children learn to figure out how to use the toys, experimenting and adapting as they go. Don’t immediately rush in and fix things for your little one, let them think for themselves and then communication incentive: let them come and find you!
    • Fine motor skills: Many open-ended toys, like blocks, encourage the development of fine motor skills like grasping, stacking, and building.
    • Cognitive development: Children learn about cause and effect, spatial relationships, and problem-solving as they play with open-ended toys.
    • Social-emotional development: Open-ended play can foster social interaction and cooperation as children play together and share ideas.

    Simple toys with big impact

    Some of the best toys for toddlers are often the simplest ones. Here are a few examples:

    • Wooden blocks: Building towers, bridges, and forts encourages creativity and problem-solving.
    • Balls: Throwing, kicking, and rolling balls promote gross motor skills and hand-eye coordination.
    • Fabric: Bits of fabric can be draped, draped, and used for imaginative play.
    • Empty boxes: From cardboard boxes to tissue boxes, these can be transformed into anything a child can imagine: a car, a house, a spaceship!
    • Natural materials: Sticks, leaves, pinecones, and rocks can be used for imaginative play and sensory exploration.

    Remember, the key to open-ended play is to let children explore and discover

    Step back and observe, allowing your child to use his or her imaginations without too much direction. You might be surprised at the creative ways he or she uses simple toys!

    Happy play times with your little one!

    Contact me via my contact form.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice

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

    1
  • · ·

    My child won’t eat! What can we do to help?

    ByLondon Speech and Feeding
    Image by freepik

    I get lots of enquiries about this topic, parents up and down the country struggle to feed their children. Mealtimes with toddlers can sometimes feel like a war zone!

    Reasons

    The reasons for food refusal are many and very varied. Perhaps your child was born prematurely and had lots of tubes and things sticking to his or her face? Or maybe your child had gastro-oesophageal reflux and this caused pain every time he or she swallowed. Some children have motor problems so it was hard to coordinate swallowing with breathing and caused frustration and anxiety? Many children have sensory integration difficulties and these make it difficult for them to grasp all the different textures and colours they are eating.

    When I take a case history for a new feeding client, I always try to first establish how the child learned not to feed/eat. I use the word ‘learned’ here with intent as eating is a learned behaviour. We tend to think that it must just be instinctive and natural but this is not the case. Instinct is a small part of the very beginning of feeding, in that a baby naturally roots for the breast but this only works out well and leads to more natural ‘instinctive’ feeding if that initial instinct is not interrupted or impacted on negatively by any of the above reasons.

    So just as a baby learns to eat or drink the milk it can also learn not to do so. The baby can learn to avoid eating in order to bypass discomfort, or — and this is another important factor — in order to gain more positive attention from the caregiver!

    Research shows that we learn about food in two ways:

    1. A connection is made between a food and a physical reaction. This needs to happen only once and it can stick: think about feeling sick after a binge on a certain food/drink… You won’t want to go near that very food again for some time, if ever! If a certain food causes pain then that connection can be made quickly and we won’t want to touch this food again.
    2.  We learn through reinforcement and punishment:
    1. Reinforcement:
    • If we get praised for eating our plate with a pudding, then we tend to eat more to get the pudding.
    • Equally if granny sits with us for hours at the table reading us a story because we do not eat or don’t eat much/quickly, we will continue this because we want granny to keep reading for us.
    1. Punishment can work in two ways:
    • Child gets punished for not eating and will eat more to avoid punishment.
    • Child eats less as the fear of punishment is so unpleasant and leads to total lack of appetite.

    As speech therapists we do not endorse any of those above strategies because none of them give us the desired effect.

    What do we want to achieve? We want our children to eat naturally, with enjoyment. We don’t want them to over eat, to binge eat, or to starve themselves. Eating needs to become a joyful, natural and organic behaviour if our child is to be healthy and thrive.

    Recommendations

    Here are three top recommendations I make regularly with good effect:

    1. Structure: have a routine at mealtimes, eating at the table, in the same room with our favourite utensils. Always helping in food preparation, perhaps setting out the table placemats etc, and then tidying up — taking the plate to the kitchen counter, scraping left overs into the recycle bin can be part of this. This way we can introduce repetition to our food/eating learning.
    • Positioning: the right chair with a good footrest, supporting our child’s trunk well, and facilitating our child eating at the table (instead of sitting in a high chair with a tray) is one of my first and favourite tips. I do favour a Tripp Trapp style chair (I have no association with that company).

    Tube fed children ought to also sit at the table with the rest of the family and first of all be offered foods and drinks to handle or play with. Some tube fed children are able to eat a small amount of pureed foods and they ought to be offered this first before being topped up with their tube feeds, whilst sitting down. Lying down for your tube feed is not a normal way of eating. Tube feed infants should be offered a pacifier whilst being tube fed and be in an upright position so that they start having an association between getting full/feeling satiated and their mouth.

    • Sociability: I encourage family mealtimes, or at least the caregiver eating with their child together, so that the child is able to copy and observe what normal eating looks like. We need to be super positive about eating and food consumption so that our child can see and copy this. If the parent is a fussy eater then this may cause the child to copy exactly the same behaviour. Many parents who come to me with their fussy children are themselves also picky about food.

    There are many other tips and strategies and I will be more than pleased to assist, please 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.

    1
  • · ·

    Practical tips for speech and language development

    ByLondon Speech and Feeding
    Image by Racool_studio on Freepik

    As parents, we all want our children to develop strong communication skills. This starts early, with the simple sounds and babbles of a new-born baby. Here are some practical tips to help you encourage your baby or toddler’s speech and language development through play and everyday activities.

    General tips for creating a language-rich environment

    • Talk to your child frequently throughout the day: Even when they’re young, they’re absorbing information. Describe what you’re doing, name objects around the house, and respond to their babbling.
    • Read aloud regularly: Books are a great way to introduce new words and concepts. Choose books with simple language, bright pictures, and repetitive phrases.
    • Sing songs and nursery rhymes: These provide a fun way to practise pronunciation and rhythm.
    • Label objects: Put labels on toys, furniture, and everyday items to help your child associate words with objects.

    Engage with your child in their play activities

    • Pretend play: Encourage imaginative play by pretending to be different characters or animals.
    • Build and create: Use blocks, Legos, or playdough to build and create different structures.
    • Outdoor activities: Explore the world around you. Talk about different plants, animals, and weather conditions.

    Tips for effective communication

    • Get down to their level: When talking to your child, get down on their level to make eye contact and show that you’re listening.
    • Use simple language: Avoid using too many complex words or long sentences. In the early years (0–3 years) try and make things concrete, stay in the ‘here and now’ — point and gesture lots to help your child understand what you say
    • Be patient: Give your child time to respond and don’t rush them.
    • Model good language: Use clear and correct language yourself.
    • Speak in your native, natural Language: If English is your second language try and speak to your child in your native language: it is more natural and your will probably know better how to speak and sing to young children in your own native language.

    Reading to your child

    Reading to your child is a powerful way to boost their language skills and create lasting memories.

    Reading to your child is more than just a bedtime ritual; it’s a powerful tool for fostering their language and literacy skills. Studies have shown that children who are read to regularly develop larger vocabularies, stronger comprehension skills, and a greater love of learning.

    Why is reading so important?

    • Vocabulary expansion: When you read to your child, you expose them to new words and concepts. This helps them build a strong vocabulary, which is essential for effective communication and learning.
    • Improved comprehension: Reading aloud helps children understand the meaning of words and sentences. This improves their comprehension skills, making it easier for them to learn and understand new information.
    • Enhanced cognitive development: Reading stimulates a child’s brain and helps them develop critical thinking skills, problem-solving abilities, and imagination.
    • Stronger emotional bonds: Reading together creates a special bond between you and your child. It’s a time for cuddling, bonding, and sharing stories.
    • The Reach Out and Read Foundation found that children who are read to regularly have significantly larger vocabularies and better language skills than those who are not.
    • A study published in the journal Paediatrics revealed that reading to children can have a positive impact on their academic achievement, even years later.

    By making reading a regular part of your child’s life, you are investing in their future success. So, grab a book, get cozy, and enjoy the wonderful world of stories together!

    Here are some great books I love using in my Speech Therapy sessions:

    Books for 6 months to 2 years

    Touch and Feel Books

    • Touchy-Feely Farm by DK Books: This book features different textures to explore, such as soft fur, rough bark, and squishy mud.
    • Baby Touch: Animals by DK Books: This book introduces various animals and their textures, like soft feathers, scaly skin, and furry coats.

    Lift-the-Flap Books

    • Peek-a-Boo! Animals by DK Books: This book has flaps to lift revealing different animals hiding underneath.
    • Where’s Spot? by Eric Hill: A classic lift-the-flap book that encourages spatial awareness and vocabulary.

    Pop-Up Books

    • Pop-Up Farm by DK Books: This book features fun pop-up elements that bring the farm to life.
    • Pop-Up Jungle by DK Books: Explore a vibrant jungle with this interactive pop-up book.

    Sound Books

    • Sound Books: Farm by DK Books: This book features sounds that correspond to different farm animals.
    • Sound Books: Safari by DK Books: Listen to the sounds of various safari animals in this interactive book.

    Interactive Books

    • That’s Not My… Series by Usborne: These interactive books feature tactile elements that encourage exploration and vocabulary.
    • Peek-a-Boo! I Spy by DK Books: This board book with flaps encourages visual tracking and vocabulary.

    These books are designed to engage young children through their senses and encourage exploration. The repetitive nature of these books helps toddlers learn new words and concepts while having fun.

    Books for 2 years ++

    Classic favourites

    • The Very Hungry Caterpillar by Eric Carle: This colourful and interactive book is a classic for a reason. It introduces simple words, colours, and days of the week.
    • Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr. and Eric Carle: This repetitive story helps children learn colours and animals.
    • Where’s Spot? by Eric Hill: A simple hide-and-seek book that encourages vocabulary and spatial awareness.

    Modern classics for children 3 years – 6 years

    • The Gruffalo by Julia Donaldson and Axel Scheffler: A fun and imaginative story that introduces more complex vocabulary and rhyming.
    • Room on a Broom by Julia Donaldson and Axel Scheffler: Another rhyming story that encourages counting and vocabulary.
    • The Tiger Who Came to Tea by Judith Kerr: A playful and imaginative story that introduces various foods and social skills.

    Books for children 6 years ++

    • The Adventures of the Little Prince by Antoine de Saint-Exupéry: A philosophical tale that introduces complex vocabulary and themes.
    • Charlie and the Chocolate Factory by Roald Dahl: A whimsical and imaginative story that introduces a variety of characters and settings.
    • Harry Potter and the Sorcerer’s Stone by J.K. Rowling: A classic fantasy series that introduces a wide range of vocabulary and concepts.

    Remember: The best books for your child are the ones they enjoy. Encourage them to explore different genres and find stories that spark their imagination.

    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.

    1
  • ·

    What Is Echolalia And Does It Have A Function? How Can Speech Therapy Help With Echolalia?

    ByLondon Speech and Feeding
    What Is Echolalia And Does It Have A Function? How Can Speech Therapy Help With Echolalia?

    Echolalia is a term used when assessing or treating children with Autism. The term refers to the repetition or echoing of utterances, either our own or others’. It can also be echoing phrases heard on television, advertising jingles or catchy repeat phrases used in tv programmes or nursery rhymes and songs. Whilst we all use echolalia occasionally and it can be observed in typically developing children, we tend not to see/hear it beyond the age of 2.5 years old. Children with ASD, however, do use echolalia often into late childhood.

    There are generally two types of Echolalia:

    Immediate echolalia

    Here the repeated phrases or words are produced immediately after someone has spoken the original words or within two conversational turns of the original utterance.

    Delayed echolalia

    The repeat echoing of the original utterance occurs sometime later, more than two conversational turns or with a much longer time delay. Due to the delay it can be hard to interpret the meaning of the echolalic utterance as it may refer to something that happened long ago and in a different context to the originally utterance.

    (Stiegler, 2015, Fay 1967, Blanc 2014)

    There are other unconventional speech behaviours which include:

    • Perseveration of Speech – persistent repetition of speech
    • Repetitive questioning – persisting even though answers were given
    • Vocalisations such as: humming, whistling, clicking, squealing etc.

    Much research has gone into the meaning and treatment of Echolalia and the following list consists of possible functions that have been identified:

    • Information sharing
    • Responding to answers
    • Labelling
    • Drawing attention to self
    • Protesting
    • Requesting
    • Giving instructions
    • Self-regulation, calming

    (Stiegler 2015, Prizant 1983)

    Echolalia does have a function and is part of the Gestalt Learning Process (where longer units of speech are memorised and then used as a whole without the individual words being meaningful).

    As a Speech and Language Therapist I promote sound and proven Intervention based on the Hanen Programme which helps provide a highly facilitative Interaction Style and I will tell you a bit more in my next blog how the “More Than Words” approach can help children with echolalia move through their Gestalt Learning into more analytic processing of language, grammar and meaning.

    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.

  • ·

    13 tips to support children and young people with food aversions

    ByLondon Speech and Feeding

    When you have a picky eater it’s easy to feel on edge and that others are judging your parenting skills. It is astonishing how suddenly the world and its brother/sister are all experts on how to feed your child, even the lady in the corner shop is not shy to offer unsolicited tips and advice on your child’s nutrition intake. They will say “try this or that“, “how about these new crackers (only £1.99 special offer)” but…

    The fact is often that you are very concerned about what your child is eating. And you desperately want to give them a healthy, nutritious packed lunch but you know that it will get left, unopened, and unfinished. So, instead, you stick to the same sad soft cheese sandwich on white bread as it is at least something you know they’ll eat.

    Sensory needs can impact on eating with both individuals with and without other conditions. We need to consider all these elements:

    • taste (sweet vs. sour)
    • consistency (crunchy vs. soft)
    • temperature (hot vs. cold)
    • colour (beige vs. colourful)
    • and smell (pungent vs. mild)

    Let’s take a blueberry as an example: it can be sweet or sharp; it can be firm or mushy; it can even differ in colour. Now let’s look at a piece of cereal: it’s crunchy all the time; it looks the same. It’s very predictable, and therefore less anxiety provoking.

    Speech Therpaist in London

    Find our top tips here:

    1. Check with a medical professional that there is nothing physically wrong (e.g. gastrointestinal, or anatomical structural difficulties).
    2. For swallowing difficulties, whether confirmed or suspected, please book an assessment with a certified swallowing/feeding Speech and Language Therapist or please contact me.
    3. Does your child have confirmed or suspected allergies? If so, please contact a dietician who has experience with allergies and can advise, for example: Dr Rosan Meyer.
    4. Talk to other family members about food and their experiences of food. Perhaps there is a family tendency to be picky with eating/food avoidant. This may be important information that you can share with your clinician during the case history taking.
    5. Be patient, though this is easier said than done/felt! Know that many children need repeated exposure to food(s) before liking them, up to 14 spoons! So, take it at your child’s pace and it’s vital we don’t force them to try new foods or use bribes.
    6. You can provide opportunities to engage with food, perhaps you could cook with your child, and allow them to choose what they want to cook. For younger children try Messy Food Play – there are tons of suggestions on Pinterest for ideas on how to incorporate foods into play activities or ask your feeding-Speech and Language Therapist.
    7. You may want to talk about pictures in books that introduce new foods (e.g. The Very Hungry Caterpillar for younger children or magazines if older).
    8. You can play with toy food in a toy kitchen for little ones, or comment on supermarket adverts for young people who are older.
    9. Offer opportunities to taste new foods. You could use a toothpick for bite-sized pieces.
    10. Be sure you eat together with your child as often as you can, modelling positive eating behaviour is most important and can be really effective over time.
    11. You could ask your child to sort foods by colour or stack them on a plate.
    12. We know that Autistic Spectrum Conditions often come with hypersensitivity to textures, so consider what your child prefers (e.g. they may not like slices of tomato but prefer the runnier texture of a tomato sauce).
    13. Reward and give praise following your child’s flexibility with foods and their attempts to try and not whether they like/dislike the food, for example “well done for touching the avocado!” Or “great you licked your fingers with the humous on, that’s excellent”.

    We are always here to support you in whatever way we can. Contact me for support.

    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.