Transforming Mealtimes

ByLondon Speech and Feeding June 1, 2022January 31, 2023

Transforming Mealtimes

Below are two reviews I got from grateful clients over the past 4-6 weeks; this blog is more about how Feeding Therapy can help you than blowing my own trumpet…. though that said, it is always so nice and gratifying to hear when parents are happy and hopeful about their little one’s feeding journey. Feeding Therapy is a substantial part of my work as a Children’s Speech and Language Therapist. One of my specialist subjects is Autism and we find that many children on the Autism Spectrum are very specific about eating, and will often refuse a range of typical family foods in favour of a narrow range of foods/snacks.

Mostly, feeding difficulties are a combination and complex cocktail of factors that have contributed to the current status quo: sure, there may have been some physical problems to start off with, such as reflux causing the baby discomfort, constipation, a very tight tongue tie or a swallowing problem caused by neurological difficulties and of course sensory processing difficulties are also very physical experiences. We always begin with a very thorough case history taking and information gathering, followed by an oral assessment and observation of the actual swallow to establish what might have been – or still might be – the cause for the feeding difficulties.

In most of the cases I see in my practice, the original obvious cause is no longer present, especially with older children. So, if the swallowing is fine, the reflux is no longer present, the tongue was divided (twice!) why are they still not eating much, refusing to try new foods, only accept certain textures etc.

The answer is extremely complex and multi-faceted and this little blog is not covering any factors in detail (we would be here all night) -I mentioned sensory processing difficulties earlier on. These are mostly still present but often not acknowledged or recognised by parents. And it is certainly the case that one of the contributors is parental anxiety; this tends to run very high and has been for many months, sometimes years. This in turn often leads to very tense and unpleasant, endlessly long meal times and many times children are force-fed several times a day in order to “get something down there” as otherwise they would probably starve themselves.

Additionally, parents end up only offering a very narrow range of foods because that is all their child will eat. This ends up in a vicious cycle of children being fed porridge-style food for all meal times and of course they won’t progress to more mature foods if these mature foods are never on offer.

In order to help address and disentangle some of the issues I often introduce the “Division of Responsibility in Feeding” as researched and recommended by Ellyn Satter (The Satter Feeding Dynamics Model)

Here are the main points of her approach:

Children have a natural ability with eating, they eat as much as they need and they grow in the way that is right for them and they learn to eat what their parents eat. (E Satter). The parent is responsible for WHAT the child eats, WHERE and WHEN the child eats. The child is responsible for HOW MUCH they eat or WHETHER to eat. Satter proposes that parents should guide their child’s transition from nipple feeding through semi-solids, then thick and lumpy foods to finger foods and then on to normal family meals.

Please note: this model is only appropriate for children where the original physical cause is no longer present!

Of course it’s not easy! It requires a huge shift in thinking about feeding and it requires to trust our children to know what is best for them. This is very big for most parents, as it is not how we were brought up and it is not commonly known that babies and children know what is good for them!

However, it is certainly true that parents who follow this particular approach and make small, steady changes in the way the offer foods, and in the way they create family meal times differently, children make very nice, pleasing progress and over some months we often see remarkable positive changes.

I like to work in a team and especially for this type of problem it is essential to have a multi-disciplinary approach. A knowledgeable dietician is an enormous plus in any feeding team as is of course a

Paediatrician and/ or a Gastroenterologist and the most important people in the team are the parents!

Feeding Therapy is all about collaboration and a ‘team around the child” approach. When we have this in place and there is trust amongst the team members then we make fantastic progress.

Do get in touch with me if you would like some help with your tricky feeder.

Lovely Reviews

I visited London Speech and Feeding a couple of days ago with my 8-month-old granddaughter and her mother. Sonja made us feel comfortable and at ease from our first introductions. She was able to pinpoint my granddaughter’s mum’s anxiety around weaning very quickly. She not only gave her the tools to do this successfully, but also really encouraged my granddaughter’s mum and instilled confidence that she had everything she needed to make this sometimes-difficult transition without further anxiety.

Sonja was very thorough in her initial assessment of my granddaughter’s physical milestones and her developing speech. My granddaughter felt very comfortable with Sonja and happily played along with her. Then came the big moment – trying out various foods! We were amazed to see just how easily my granddaughter, with Sonja’s expert encouragement, took to sampling the wonderful array of different delicious morsels Sonja had prepared for the session. My granddaughter even drank from a cup for the first time! Wonderful!

Sonja then emailed a summary of the session and an extensive array of resources with suggestions for my granddaughter’s mum which she has now put into action. My granddaughter’s mum couldn’t thank Sonja enough for her caring attitude, extensive knowledge, and warm professionalism. I have no hesitation in recommending Sonja, she’s a fantastic Feeding Therapist!

–

Sonja (and her lovely colleague, Sandra) were stupendous. I had brought my one-year-old son to see them as I was concerned that he wasn’t eating enough. They looked at his history and we ate together to make sure they had all the information they needed to give an accurate diagnosis. Whilst our outcome was that Henry was in fact doing brilliantly (and I just needed to chill out a bit!), I would imagine if there was something more serious going on, Sonja would make you feel just as supported and empowered as she did with us. Excellent follow-ups too. Money well spent for a bit of reassurance for a stressed out mama. Thank you, Sonja!

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.

Ages and Stages · Speech and Language Therapy · Top tips

Great toys and books for our toddlers (around 1–2 years old)
ByLondon Speech and Feeding February 24, 2025February 17, 2025
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.

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

Seeing sounds: How visual gestures boost speech sound learning
ByLondon Speech and Feeding June 18, 2025June 18, 2025
Learning to produce new speech sounds can be a complex process for young children, especially those facing challenges with speech sound disorders or motor planning difficulties. It’s not just about knowing what a sound ‘should’ sound like; it’s about figuring out where to put your tongue, how to shape your lips, and how much air to push out. This is where the power of visual gestures comes in – literally helping children see how to make sounds.

As speech and language therapists, we frequently use visual cues and hand gestures to teach articulation. These techniques are incredibly effective, particularly when a child is struggling with the motor planning aspect of speech production.

In the video clip above you see me teaching
- the /SH/ sound: the hand makes a C-shape and moves forward showing both how the lips are positioned and the air flowing forward
- the /S/ sound: the index finger shows a snake like movement going forward- also showing the air flow again
- the /W/ sound: my right hand moves forward and fingers splay out showing that the lips open up at the end of the sound
- the /K/ sound: my finger points to the back of my throat where the tongue needs to raise.
An overview of motor planning for speech – what do we mean by that?

Think about learning to ride a bike or play a musical instrument. You don’t just know how to do it instantly. You have to plan the movements, practise them, and make adjustments. Speaking is similar! Our brains must:
1. Plan the sequence of movements needed for each sound and word (e.g., /B/ requires lips together, then release, while /T/ requires the tongue tip behind the top teeth, then release).
2. Execute those plans rapidly and precisely.
For some children, especially those with conditions like Childhood Apraxia of Speech (CAS) or other severe articulation disorders, this motor planning process is disrupted. They know what they want to say, but their brain struggles to send the correct, consistent messages to their articulators (lips, tongue, jaw, velum). This can make speech sound learning incredibly frustrating.

Why use visual gestures?

Visual gestures provide an additional, powerful sensory input that can help bridge the gap between knowing a sound and producing it. Here’s how and why they are so beneficial:

1. Providing a visual map:
- How it helps: Many speech sounds are ‘hidden’ inside the mouth. It’s hard for a child to see where their tongue needs to go for a /K/ sound (back of the tongue to the roof of the mouth) or a /T/ sound (tongue tip behind teeth). A simple hand gesture can visually represent this mouth movement. For example, a hand gesture for /K/ might involve sweeping the hand back towards the throat, while for /T/, it might be a tap on the chin.
- Why it works: Children are highly visual learners. Seeing a physical representation of an abstract mouth movement gives them a concrete ‘map’ to follow, making the process less mysterious and more manageable.
2. Enhancing motor planning and memory:
- How it helps: When a child simultaneously moves their hand (the visual gesture) and attempts to make the sound, they are engaging multiple sensory systems (visual, tactile, proprioceptive – body awareness). This multi-sensory input strengthens the neural pathways associated with that speech sound.
- Why it works: This multi-modal learning helps to solidify the motor plan for the sound in the brain. It’s like having more ‘hooks’ to hang the information on, making the sound easier to recall and produce consistently. The gesture becomes a built-in reminder.
3. Reducing cognitive load:
- How it helps: Instead of just hearing the sound and trying to figure out the complex motor sequence, the child has a visual cue to guide them. This reduces the mental effort required to decode the sound production.
- Why it works: When cognitive load is lower, the child can focus more effectively on the specific motor execution of the sound, leading to faster progress and less frustration.
4. Increasing engagement and success:
- How it helps: Gestures can make therapy more interactive and fun! When a child successfully produces a sound with the help of a gesture, it’s a tangible victory.
- Why it works: Success is a powerful motivator. When children experience success, they are more likely to stay engaged, participate actively, and feel more confident in their ability to learn new sounds.
5. Supporting self-correction:
- How it helps: Once a child learns the gesture associated with a sound, he or she can use it as a self-monitoring tool. If he or she makes an error, he or she can use the gesture to remind himself or herself of the correct mouth position or movement.
- Why it works: This promotes independent learning and reduces reliance on constant adult prompting.
Conclusion

The journey of speech development can be challenging, but visual gestures offer a powerful and effective tool for teaching new sounds, especially when motor planning is a factor. By providing a clear visual map, strengthening motor memory, reducing cognitive load, and fostering engagement, these gestures pave the way for clearer communication and greater confidence. If your child is struggling with speech sounds, consider talking to a Speech and Language Therapist to get guidance on how visual gestures might be incorporated into the therapy plan. Because sometimes, seeing truly is believing (and speaking!).

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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Lisp · Speech and Language Therapy · Top tips

Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps
ByLondon Speech and Feeding August 13, 2025November 27, 2025
As a speech therapist, few things are as rewarding as helping a child find their clear, confident voice. Among the various speech sound disorders, the ‘lateral lisp’ – often described as a ‘slushy’ or ‘wet’ /S/ sound – presents a unique challenge. While it can be tricky to treat, I’m thrilled to share that I’ve had significant success in helping children overcome this particular hurdle.

What is a lateral lisp?

Most people are familiar with a frontal lisp, where the tongue protrudes between the front teeth, resulting in a /TH/ sound for an /S/ (e.g., ‘thun’ for ‘sun’). A lateral lisp, however, is different. Instead of the air escaping over the front of the tongue, it escapes over the sides, often giving the /S/ and /Z/ sounds a distinct, muffled, or ‘slushy’ quality. This happens because the tongue is not forming the correct central groove, allowing air to spill out laterally.

The science behind a perfect /S/ vs. a slushy one

To understand how to fix a lateral lisp, it’s helpful to understand how a ‘perfect’ /S/ sound is made. Imagine a narrow, focused stream of air. For a clear /S/ sound, your tongue forms a shallow groove down its centre, directing a precise, thin stream of air right down the middle, over the tip of your tongue, and out through a tiny opening between your tongue and the roof of your mouth, just behind your front teeth. This focused airflow creates that crisp, sharp /SSSS/ sound we recognise.

Now, picture what happens with a lateral lisp. Instead of that neat, central channel, the tongue is often flatter or positioned in a way that allows the air to escape over one or both sides. Think of it like a river overflowing its banks – the air, instead of flowing in a controlled stream, spills out sideways, creating that characteristic ‘slushy’ sound. This lateral airflow is what we need to retrain.

Why is it tricky to treat?

Treating a lateral lisp can be challenging for a few reasons:
- Habitual muscle memory: The way the tongue moves and positions itself for a lateral lisp is deeply ingrained. It’s a motor habit that needs to be unlearned and replaced with a new, more precise movement.
- Subtle differences: The difference between a lateral lisp and a correct /S/ sound can be quite subtle to perceive, both for the child and sometimes even for parents. This makes it harder for the child to self-monitor and correct.
- Oral motor control: It requires fine motor control of the tongue muscles to create and maintain that central groove for airflow.
My success with children aged six years and over

I’ve found great success in treating lateral lisps, particularly with children aged six years and older. Why this age group? By this age, children typically have:
- Increased awareness: They are more aware of their speech and often more motivated to make changes. They can better perceive the difference between their ‘slushy’ /S/ and a clear one.
- Improved cognitive skills: They can understand and follow more complex instructions and strategies.
- Better self-monitoring: Their ability to listen to themselves and correct their own speech improves significantly.
- Enhanced oral motor control: Their fine motor skills, including those of the tongue, are more developed, allowing for greater precision.
My approach focuses on a combination of auditory discrimination, tactile cues, and targeted myofunctional exercises to help children ‘feel’ the correct airflow and tongue placement. We use a variety of engaging activities to make the process fun and effective.

It is crucial to understand tongue functioning and focusing on correcting improper oral resting posture and muscle function, which are often significant contributors to a lateral lisp. For example, if the tongue rests low and wide in the mouth consistently, or if there’s a tongue thrust during swallowing, these habits can prevent the tongue from achieving the precise, midline placement necessary for a clear /S/ or /Z/ sound. Through targeted exercises I aim to re-educate the oral and facial muscles, promoting correct tongue posture at rest, during swallowing, and, ultimately, during speech production. By strengthening the muscles responsible for tongue lifting and encouraging a more appropriate swallowing pattern we can establish the correct oral motor skills needed to overcome a lateral lisp and achieve clearer articulation.

The recipe for success: Little and often

The single most crucial ingredient for success in treating a lateral lisp is daily home practice of all the strategies given. This isn’t about long, arduous sessions; it’s about consistency. Think of it like building a muscle: short, frequent workouts yield better results than sporadic, intense ones.

My recommended formula is ‘little and often’. This means:
- Short, focused sessions: Aim for 5-10 minutes of practice, 2-3 times a day. This prevents fatigue and keeps the child engaged.
- Integrate into daily routines: Practise while waiting for dinner, during a car ride, or before bedtime. Make it a natural part of their day.
- Positive reinforcement: Celebrate every small success! Encouragement goes a long way in building confidence and motivation.
- Parental involvement: Parents play a vital role in providing consistent cues and encouragement at home. I equip families with clear, easy-to-follow strategies.
Overcoming a lateral lisp requires dedication, but with the right guidance and consistent practice, a clear, confident /S/ sound is achievable. If your child is struggling with a ‘slushy’ /S/, please don’t hesitate to reach out. Together, we can achieve success!

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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Speech and Language Therapy

Tele-Speechtherapy: Online, connected, and highly effective
ByLondon Speech and Feeding January 19, 2026January 15, 2026
When parents first enquire about speech and language therapy, many assume it will happen face-to-face, in a clinic room, with a therapist sitting across from their child.

So when therapy is offered online, it’s natural for questions to arise:

Can this really work? Will my child engage? Will progress be slower?

This short video offers a glimpse into what online therapy can look like: calm, interactive, relationship-based, and surprisingly effective.

Online therapy is not ‘less than’ in the right circumstances

Teletherapy is not suitable for every child in every situation. However, for many school-aged children, particularly those who enjoy conversation, technology, and shared activities, online therapy can be an excellent fit.

The child you see in this video is around eight years old and was supported for a persistent lisp. Sessions were primarily online, with the occasional in-person appointment when helpful.

What made the difference was not the screen. It was the combination of engagement, support, and consistency.

Parent involvement changes everything

One of the greatest strengths of online therapy is the way it naturally invites parents in.

In this case, parents regularly joined the video sessions:
- Listening in
- Taking part when appropriate
- Learning how to support practice gently between sessions
This meant that therapy didn’t stay ‘on the screen’. Strategies carried over into everyday conversation, making progress faster and more meaningful.

Speech sound therapy, including support for lisps, relies heavily on awareness, feedback, and confidence, all of which can be supported very effectively at home with the right guidance.

Therapy through a screen can still be deeply relational

A common concern is whether connection can truly be built online.

In reality, many children feel more relaxed in their own home environment. They are often more willing to talk, experiment with sounds, and reflect on their speech when they feel comfortable and supported.

Online sessions allow:
- Shared focus and conversation
- Clear visual feedback
- Real-life practice in a familiar setting
- Immediate parent support
For some children, this actually enhances engagement rather than limits it.

Real progress, real outcomes

Over the course of approximately 12 online sessions, alongside a small number of in-person appointments, this child achieved resolution of their lisp.

Progress was steady, positive, and confidence-building. Importantly, the child remained motivated and proud of their achievements throughout the process.

While every child’s journey is different, this example highlights what is possible when:
- The child is ready
- Parents are involved
- Therapy is tailored and collaborative
If you’re considering online therapy

If you’re unsure whether teletherapy could work for your child, it’s worth remembering that effective speech and language therapy is less about the room you’re in, and more about:
- Relationship
- Understanding
- Consistency
- Carryover into daily life
For many families, online therapy offers flexibility, accessibility, and excellent outcomes especially when parents are active partners in the process.

If you’re at the start of your child’s speech journey and wondering whether online therapy could be the right fit, I’m always happy to talk it through. Sometimes clarity begins with simply understanding what therapy can look like

Teletherapy: Frequently Asked Questions

Is online speech and language therapy really effective?

Yes. For many children, particularly school-aged children, online therapy can be highly effective. Progress depends far more on engagement, consistency, and support than on physical location.

What age does online therapy work best for?

Teletherapy often works well for children from around six years and up, especially those who can attend to a screen, enjoy conversation, and follow simple instructions. That said, suitability is always considered individually and often a supportive adult is needed to help guide the child through the activities.

Can speech sound work (such as a lisp) really be done online?

Absolutely. Speech sound therapy relies on clear visual feedback, listening skills, and practice all of which can be supported very effectively online. Many children respond particularly well when practising in their own home environment.

Do parents need to be involved in sessions?

Parental involvement is strongly encouraged. Parents may sit in, join parts of the session, or support practice between appointments. This involvement often leads to quicker progress and better carryover into everyday speech.

Will my child still build a relationship with the therapist?

Yes. Strong therapeutic relationships can and do develop online. Many children feel more relaxed and confident communicating from home, which can actually enhance connection and learning.

Is online therapy suitable for every child?

Not in my experience. Some children benefit more from in-person support, or a combination of online and face-to-face sessions. A discussion and initial assessment help determine the best approach for each child.

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

Let’s live and breathe AAC
ByLondon Speech and Feeding April 24, 2024March 28, 2024
We all have the right and want to express thoughts, feelings, and needs. For non-speaking or minimally speaking children, finding an avenue to communicate effectively can be a challenging journey. Parents are often at a loss as to where to start. Sometimes a little bit of Makaton signing has been used here and there but we mostly find that gradually signing fades as parents feel that it just doesn’t seem to get copied and used by the children.

They live and breathe their system

This is where we need to pick up the pieces and start again: because all successful families where children start using their boards or their electronic AAC (Augmentative and Alternative Communication) systems do this one thing: THEY LIVE AND BREATHE THEIR SYSTEM.
- They have boards in every single room of the house;
- They have a board in the car, attached to the side of car door so their child can point to it as they need to;
- They have a smaller board in their handbag/rucksack when out and about;
- They have a board for shopping and attach it to the shopping trolley;
- They are never ever without their board.
Because they realise that a child should never be without their mouths to speak, should never be without a means to speak. They use their own board to model and the child has always access to their board to model back or to just look.

This is where success begins

Success begins at consistent and joyful use of the board/AAC system throughout the entire day. If we think about it, doesn’t it make sense? Of course, it does! We talk to our child for the first two years of their life continuously wherever we are and our child is continuously encouraged to use their mouths for talking in all situations.

Same goes for Signing: Makaton or any other sign system is a very powerful means to aid communication and I certainly advocate and use it in practice. Though much like words, signs are very elusive and temporary—as soon as the sign has been made it is gone and no longer present. Same with words of course. This can be difficult for people who need longer to process information.

The beauty of symbols or photographs is that they are permanent: they don’t vanish, they stay and with the core board they stay in the same place! This is very reassuring. We can learn where a symbol is and we can be assured that it will still be there the next time we look at the board.

AAC core board

Here is a picture of a core board:

You can download this and other boards for free on the Saltillo Word Power website.

It has 48 cells and we can see the most frequently used core words on here, words that we use 80% of the day when talking with our non-speaking/minimally speaking children, younger children and children with cognitive delay. We keep our sentences short and we say phrases pertaining to their daily lives;
- Let’s GET your toy
- PUT it here, PUT it away, PUT it IN
- Let’s READ a book
- UP you get
- WANT some MORE?
- That’s GOOD isn’t it?
- Let’s OPEN the box and LOOK
And so on… All these phrases can be aided with the above board. Your child will learn OVER TIME and OVER CONTINUOUS USE where GET/PUT/MORE/WANT/IN—where these symbols are. For children who are slow to process this is so helpful, to have a visual representation of what has just been said. It aids understanding in the first place. Gradually as a child starts to copy they will point to powerful symbols themselves and if they want to speak they can also speak of course:

A child might point to WANT + MORE and then say with their mouths: BANANA!

Board examples

Here are some other boards I have made specifically for daily situations and preferences of some of my students. Here is one for toileting:

And another one:

These boards incorporate high-frequency and versatile words, enabling us to make little sentences.

Building Language and Literacy Skills

AAC Core Boards are not just tools for immediate communication. They also play a pivotal role in language and literacy development. By using these boards, non-speaking children engage with words and symbols, reinforcing their understanding of language structure and grammar.

Over time they naturally absorb language patterns, laying the foundation for improved literacy skills.

Customisation for Individual Needs

Every non-speaking child is unique, and their communication needs can vary significantly. AAC Core Boards are designed with this diversity in mind. The boards can be adapted to include specific vocabulary relevant to the child’s daily life, interests, and activities. This personalisation ensures that the AAC Core Board is a true reflection of the child’s personality and needs, making communication more engaging and effective.

Collaboration between AAC Core Boards and Speech Therapy

While AAC Core Boards are an incredible tool, they are only used effectively by the non-speaking child when the board is used BY ALL COMMUNICATION PARTNERS around the child.

Again, I know I am being repetitive here, but the board needs to be used and modelled by the adults constantly in the first place and for a period of time before we can expect our children to take an interest and use the boards themselves. Think how long it typically takes for a child to learn their first word: around a year! During that time the adults talk constantly to their child without hesitation or expectation! The same goes for introducing this new way of communicating.

Collaborating with your child’s speech-language therapist (SLT) ensures that your child receives the right guidance in using the AAC system. SLTs can assess your child’s communication abilities, recommend appropriate boards and provide guidance on how to best implement them.

Conclusion

For non-speaking children, AAC Core Boards are bridges to their world.

These boards foster language development, social interaction, and personal expression. AAC Core Boards offer a beacon of hope, helping non-speaking children break through communication barriers and thrive in a world that is waiting to hear their voices. Boards are simple for anyone to use and understand. Have a go! You will be surprised how lovely it is to use a board with ease and once your child sees you do this, you have a chance for your child to start copying you…and express something! HOW ABOUT THAT! I look forward to hearing your stories!

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

Empty Set and Phonology approaches
ByLondon Speech and Feeding June 26, 2024June 26, 2024
I have been avoiding the use of the Empty Set approach for the longest time as I was not sure if it would work seeing that I am challenging two sounds my student struggles with at the same time. But I decided to give it a go and it works a treat!

With this approach, we use two sounds that our student is struggling with. For example, in my video this student cannot produce /sh/ and /r/. Both sounds have different rules, so I decided to contrast them with each other.
- The rules of /sh/ are: no voice, air is pushed out through teeth, produced at the front.
- The rules for /r/ are: use your voice, produce the sound in the middle of the mouth by shaping your tongue in a particular way.
So I chose the words ‘shoes’ and ‘ruse’ as their rules are quite different. Contrasting two sounds the student does not know has been shown to lead to greater change in the child’s articulation. And I can certainly vouch for this as my student is making the best progress with this approach.

Phonology Therapy – what is it, why and how?

Phonology is the study of the sound system of a language. It’s distinct from articulation therapy which focuses on the physical production of sounds.

Phonology therapy focuses on rules. For example, sounds that are produced at the front of the mouth, in contrast to sounds that are produced at the back of the mouth, or sounds that are produced with a long air stream: /s/ or /f/ versus short sounds like /p/ or /t/; sounds are produced with voice or without voice.

Many children, and sometimes adults, are unaware of some of the speech rules and confuse and replace individual sounds. They might say TAT instead of CAT or SIP instead of SHIP.

A quick overview of phonology approaches I use:

Minimal Pairs:

This approach is good for single sound substitutions. We offer word pairs that differ by only one sound, like ‘ship’ and ‘sip.’ One of our first goal in therapy is to highlight the difference between the target sound (e.g., /sh/) and the sound the child uses (e.g., /s/). This helps discriminate and eventually produce the correct sound.

Multiple Oppositions:

A child might replace lots of sounds with a single sound like a /d/. So instead of ‘four’, ‘chore’ and ‘store’ our child says ‘door’, making speech very unintelligible.

The approach is typically geared towards shaking up the phonological system. Our goal is to choose two to four targets that are different from each other, and different from the substituted sound. If our child’s favourite sound is /d/ they can use their voice and make a short sound by stopping their airflow. So I will choose a different target sound to change up the speech system. For example I might choose an /f/, a /m/ and a /k/ sound. So I would contrast: ‘door’ with ‘four’, ‘more’ and ‘core’.

Maximal Oppositions:

In the Maximal Oppositions approach the treatment sets consists of words that are minimally contrasted and that have maximal or near maximal feature differences between each word pair. One word in a pair represents a sound the child ‘knows’ (can say at word level) and the other represents a sound the child does not know (cannot say).

For example, a child may ‘know’ /m/ and be able to say words like ‘man’, ‘mat’ and ‘mine’. However, the same child may be unable to say /f/ as in ‘fan’, ‘fat’ and ‘fine’. The consonants /f/ and /m/ are maximally opposed as follows.

I am always delighted to work on speech sound disorders, I love the challenge and the successes we can celebrate together. Get in touch with 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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