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.

Neurodiversity · Speech and Language Therapy

Principles of motor learning in Childhood Apraxia of Speech (CAS)
ByLondon Speech and Feeding July 5, 2024February 4, 2026
We use powerful motor learning principles to help children with CAS (Childhood Apraxia of Speech) learn how to produce better, clearer speech sounds in words, phrases and sentences.

What are these principles?

Principle 1: MASSED PRACTICE

This is where you see a child for lots of sessions in a shorter period of time, so for instance six weeks of three times weekly for 30 minutes.

This leads to motor performance or automaticity.

Principle 2. DISTRIBUTED PRACTICE

This is what I use, as most of my clients are not able to come and see me that often on a weekly basis. It is hard to travel in London and life is hectic. So I favour one session a week over say a term or two terms and a session is usually 45 minutes long.

This leads to improved Motor Learning and good generalisation.

During either Massed or Distributed Practice, we choose between 4 variables:

Principle 3: Constant vs Variable

Principle 4: Blocked vs Random

To explain:

Constant Practice is where we repeat the practice of a small handful of target words.

We practise the same target sound in the same word position, e.g. at the beginning of a word: ‘bee’, ‘bye’, ‘bow’, ‘baa’ or ‘key’, ‘car’, ‘cow’, ‘Kaye’ etc.

We keep the rate, pitch and intonation constant.

Variable Practice is where we vary the rate, volume, pitch and intonation of the targets

We use a larger number of sounds, and words that are motivating to say for the child.

For example, if a child loves Peppa Pig then I might choose the words: ‘Peppa’, ‘Daddy Pig’, ‘George’, ‘Mummy Pig’ and a couple of other favourite characters. My child might struggle with a number of sound sequences there but we will target them one by one.

We can also select simpler words like ‘cape’ and ‘cake’ or ‘tick’ and ‘tip’.

Blocked Practice is where we practise one target word for say five minutes then we move to another target word for the next five minutes and then we revert back to the first target word again and so on, so blocks of practice.

Random Practice means we practise several target words at the same time.

How do I decide on what to use?

Good question!

I always opt for distributed practice (weekly for up to 45 minutes).

Within that, I tend to find it most successful to start out with constant practice when a child is finding a certain sound sequence really hard and we need to just ‘nail it’. Bearing in mind I only pick sounds that my student can actually make in isolation, so we are not working on articulation! (where we focus on trying to elicit single sounds correctly – or even at all sometimes) Here in CAS work, we are working with sounds the student can make but is having trouble to add together, into a sequence that is needed to make a word sound right.

As soon as I feel we have some traction I will go to variable practice, i.e. I pick words that are either funny or interesting for the child and it can be a slightly larger number.

I tend to use blocked practice in the beginning or when working on vowels. That’s because it is more important we get our vowels right. They carry a word and are very important for overall speech intelligibility. Once we are on a roll, I tend to go more for random practice.

Example

Here in the video clip, we try and work the /e/ vowel in short words likes ‘bell’, ’fell’, ‘dell’, ‘sell’, ‘smell’ and I am using an AAC device to give a child’s voice as auditory feedback as well as using the PROMPT approach to help my student shape his vowels.

So this is:
1. Distributed (1 x week for 45 minutes)
2. Constant – we are practising the /e/ vowel in the same position in six different words
3. Blocked – we did this: several repetitions of each word and after the sixth we moved to another sound, and then later we came back to this.
Please feel free to contact me if your child has speech sound difficulties. It is my passion. I love supporting children with apraxia.

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
READ MORE Principles of motor learning in Childhood Apraxia of Speech (CAS)
Neurodiversity · Speech and Language Therapy · Top tips

Why auditory memory matters (especially for little ones!)
ByLondon Speech and Feeding August 4, 2025August 1, 2025
Have you ever stopped to think about how we learn to speak, understand, and communicate effectively? It’s a complex dance of various cognitive skills, and one often overlooked but absolutely crucial player in this orchestra is auditory memory. It’s not just about remembering sounds. It’s about remembering sequences of sounds, which is fundamental to language development.

What exactly is auditory memory?

At its core, auditory memory is our ability to take in, process, store, and recall information that we hear. Think of it as your brain’s internal recording studio. When someone speaks to you, your auditory memory is busy at work, capturing the individual sounds, the order in which they appear, and the rhythm and intonation of the words. This isn’t just for long-term recall; it’s also vital for working auditory memory, which allows us to hold onto a small amount of auditory information for a short period, just long enough to make sense of it.

For speech and language, auditory memory is essential for:
- Understanding spoken language: To comprehend a sentence, we need to remember the beginning of the sentence by the time we hear the end.
- Following instructions: Remembering a sequence of commands relies heavily on auditory memory.
- Learning new words: We hear a word, remember its sound, and connect it to its meaning.
- Developing phonological awareness: This is the ability to recognise and manipulate the sounds in spoken language, a critical precursor to reading. Auditory memory helps children distinguish between similar-sounding words (e.g., ‘cat’ vs. ‘bat’) and segment words into individual sounds.
- Producing clear speech: To articulate words correctly, we need to recall the precise sequence of sounds that make up that word.
- Developing conversational skills: Remembering what was just said helps us formulate appropriate responses.
When auditory memory falls short: The impact on speech

When auditory memory is poor, particularly in young children, the ripple effects on speech and language development can be significant. Children might struggle with:
- Following multi-step directions: ‘Put on your shoes, get your coat, and meet me at the door’ can become an overwhelming jumble of sounds.
- Learning new vocabulary: They might hear a new word repeatedly but struggle to retain its sound pattern, making it difficult to recognise or use later.
- Understanding stories or conversations: Missing key details or losing the thread of a narrative because they can’t hold enough information in their working memory.
- Developing phonological skills: Difficulty with rhyming, identifying initial sounds in words, or blending sounds together to form words, which can impact early literacy.
- Speech production: They might mispronounce words, omit sounds, or struggle with the correct sequencing of sounds within words.
- Social communication: Difficulty participating in group discussions, remembering names, or recalling what their peers have said.
- Academic performance: Auditory memory challenges can impact a child’s ability to learn in a classroom setting, where much of the instruction is delivered verbally.
It’s important to note that poor auditory memory isn’t a sign of low intelligence, but rather a specific processing challenge that can be addressed with targeted support.

Nurturing auditory memory in under 5s: Preparing for schooling

The good news is that auditory memory is a skill that can be strengthened and developed, especially during the crucial early years. For children under five, laying a strong foundation in auditory memory is an invaluable gift as they prepare for the demands of formal schooling. Here’s what we can do to help:
1. Read aloud regularly: This is perhaps one of the most powerful tools. As you read, encourage your child to listen for specific words, predict what happens next, and retell parts of the story. Vary your voice, use different intonations, and pause to emphasise key words.
2. Play auditory memory games:
  
  ‘Simon says’: This classic game is fantastic for following multi-step instructions. Start with one command and gradually increase the number.
  
  ‘I Spy’ with sounds: Instead of colours, describe sounds. ‘I spy with my little ear something that goes “moo”.’
  
  Rhyming games: Sing rhyming songs, read rhyming books, and encourage your child to come up with words that rhyme.
  
  Sound matching: Use everyday objects to make sounds (e.g., shaking keys, tapping a spoon) and have your child identify or match them.
  
  ‘Memory chain’: Start a sentence and have your child add to it, remembering everything that came before: ‘I went to the market and bought an apple.’ ‘I went to the market and bought an apple and a banana.’
3. Sing songs and nursery rhymes: Repetitive songs and nursery rhymes are excellent for developing auditory memory, rhythm, and phonological awareness. The predictable patterns help children anticipate and remember sequences of sounds and words.
4. Give multi-step instructions (and praise!): Start with two-step instructions and gradually increase the complexity as your child’s skills improve. Always give positive reinforcement when they succeed. ‘Please pick up the red block and put it in the box.’
5. Engage in active listening: Model good listening skills yourself. When your child is speaking, give them your full attention. Ask clarifying questions to encourage them to elaborate and organise their thoughts.
6. Reduce background noise: A quiet environment makes it easier for young children to focus on auditory information. Minimise distractions like TV or loud music during activities that require listening.
7. Use visual cues: While we’re focusing on auditory memory, sometimes pairing auditory information with visual cues can be helpful, especially initially. For example, when giving instructions, demonstrate the action as you say it.
8. Be patient and consistent: Developing auditory memory takes time and consistent practice. Celebrate small victories and create a playful, supportive environment for learning.
By actively engaging in these strategies, we can empower our youngest learners to build robust auditory memory skills, setting them up for success not only in speech and language development but also in their overall academic journey. It’s an investment that truly pays dividends in their future communication and learning abilities.

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.

1
READ MORE Why auditory memory matters (especially for little ones!)
Lisp · Speech and Language Therapy · Top tips

Speech prompts and strategies I use in Speech Sound Therapy
ByLondon Speech and Feeding May 14, 2024May 13, 2024

This particular student has a mild motor planning difficulty and six weeks ago he came to me with a very strong lisp. In addition to the lisp he is struggling to produce a number of sounds, SH and L on its own and all the clusters (FL/BL/KL/PL) but also CH together with some vowel difficulties.

The prompts are a mix partially from the DTTC (Dynamic Temporal and Tactile Cueing) model by Dr Edythe Strand as well as phonological models I have learned over the years, and some of them are my own.

Visual/picture prompts and Images

Here I use the ‘Flat Tyre’ Sound, to offer as an image for a new S sound and the ‘Tick Tock’ Sound for a new image of the T sound. Both cards are from the Bjorem Speech Sound Deck, which I love and use almost daily.

Gestural Cues

I like to use all the ‘cued articulation’ hand cues by Jane Passy for consonants and fricatives. Here we use our fingers and hand to illustrate what our tongue does, and we also show whether a sound is voiced or voiceless. When I use one finger it is voiceless (k/f/s/p) and when I use two fingers for the same cue it means that the voice needs to be turned on: (g/v/z/b/n/m). For vowels I like to use Pam Marshalla’s cue system.

Simultaneous production

We say the word together.

Direct imitation

I say the word and my student copies me directly.

Imitation after a delay

I say the word and then after a little wait my student says the word.

Spontaneous production

My student has now learned to say the word by him/herself.

Offering feedback

It sounds like… I just heard… I didn’t hear the first sound there? Can you try again?

Letting the student reflect

By just shaking my head or by looking quizzical so that my student realises something didn’t quite go right.

Postitive reinforcement

‘Yes that was it, do it again, nice one…’

Cognitive reframing

This is a technique where we identify different semantic cues and metaphors or imagery cues, so instead of teaching or focusing on a sound we try out viewing each syllable from a different point of view.

For example: ‘yellow’. I have had great success with this one: we start with just saying ‘yeah yeah yeah’. I might make a little joke and say something like ‘imagine your mum says tidy your bedroom, what do you say or what do you think?’ Answer: ‘yeah yeah yeah’. Then we practice ‘low’ together, I might blow some bubbles high and low and we talk about ‘low’. And then we put ‘Yeah’ and ‘Low’ together and now we have YELLOW!! It might at first still sound a bit odd, like ‘yea-low’ but we soon shape that up and have the real word.

Each student is different and having a great rapport is crucial to our success.

Then a little game break after some 7–10 or so repetitions and always trying to finish on a positive note.

What game breaks do I use:

Very quick ones! Students can post something, place a counter in a game, take out a Jenga block from the tower, pop in a counter for ‘connect 4’, stick a sword into the Pop the Pirate barrel or add a couple of Lego blocks to something they are building.

I hope this is helpful, please contact me for any questions.

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

READ MORE Speech prompts and strategies I use in Speech Sound Therapy
Speech and Language Therapy

Help! My child has a lisp. What can we do about it?
ByLondon Speech and Feeding December 13, 2023February 27, 2024
What is a LISP?

There are different types of LISPS. Let me explain:

A lisp is the difficulty making a clear ‘S’ and ‘Z’. Other sounds can also be affected by the tongue protruding too far forward and touching the upper teeth or the upper lip even. ‘T’ and ‘D’ can be produced with ‘too much tongue at the front’ and this can also have an impact on ‘CH’ and often also ‘SH’.
1. Interdental lisp
Protruding the tongue between the front teeth while attempting ‘S’ or ‘Z’ is referred to as interdental lisp; it can make the speech sound ‘muffled’ or ‘hissy’. Often, we associate a lisp with the person sounding a bit immature. The good news is that this type of lisp is the easiest to correct and, in my practice. I have a 100% success rate with this type of lisp.
1. Lateral lisp
In a lateral lisp the person produces the ‘S’ and ‘Z’ sounds with the air escaping over the sides of the tongue. This renders the ‘S’ as sounding ‘slushy’ or ‘wet’. This type of lisp is a bit harder to correct than the interdental lisp. In my experience this can be fixed but it might need a bit longer, more intensive therapy than the interdental lisp.
1. Palatal lisp
With a palatal lisp the ‘S’ sound is attempted with the tongue touching the palate, much further back than it should be. The ‘S’ sounds ‘windy’ and ‘hissy’. This is a quite rare lisp production but it is also not difficult to correct.

These types of speech difficulties come under the category of ‘speech delay of unknown origin’ and may persist into adolescence and adulthood as ‘residual errors‘.

Some thoughts on Treatment in general:

Lisps can be treated successfully by a Speech and Language Therapist. However, for the treatment to work well, a student needs to be able to cooperate and want to improve his or her speech. Lisp remediation entails a fair amount of repetitive work and very young children or unmotivated older children don’t make the best candidates for treatment for this reason. Often students present with other speech, language or social communication difficulties and here the lisp might not be the priority for treating. For example, it might be that due to a student’s Attention Deficit Disorder they are simply not able to focus on speech practice in their daily life.

When should treatment of lisp begin?

Waiting well past 4½ years is not advisable as the longer we wait and do nothing the stronger engrained the erroneous tongue/speech habit will become. The ‘right’ age for therapy for one child may be different from the ‘right’ age for another child even within the same family. So do make an appointment with a speech and language therapist to assess and see whether your child might be ready to start therapy.

Do lots of children lisp—is it normal?

Until the age of about 4–4.5 years old it can be a perfectly normal developmental phase for some children to have the interdental lisp. But when we see and hear a lateral or palatal lisp we ought to act and see a speech and language therapist for sure.

After the age of 4.5 or 5 years old most speech therapists would agree on at least having a look to see if treatment could be started. The longer we wait the harder it is to retrain the brain pathways to adopt new speech habits.

What happens during the first Speech and Language Consultation?

The first consultation takes about an hour and involves screening relevant areas of communicative function. We take a detailed history, examine the anatomy of the child’s mouth and tongue movements. We check for tongue tie, teeth formation, palate structure and function, as well as swallowing patterns.

Then we begin straight away to try and see if any of the alveolar sounds (T/D/L/N) can be produced correctly with the right tongue placement as that would be the starting point from where to shape a good, clear ‘S’ sound.

The first consultation usually ends with home practice being given, explained to parents and another appointment being made for follow up.

Therapy – what does a session look like?

Each therapy session consists of:
1. Listening to sounds, discriminating sounds, identifying sounds, listening to rhyming sounds, sound awareness. We call this Auditory discrimination of single sounds: can the student hear the difference between two words that are the same apart from the first sound: ‘sing’ and ‘thing’ or ‘sigh’ and ‘thigh’?
2. Sound production: using a variety of different prompts and cues we will teach how to physically make the new sound. Often, we work on making a NEW sound, instead of correcting the OLD one. We work on imitation of single sounds then gradually we try and make new sounds in short words, then longer words and then phrases and sentences.
3. Games! We play games and try and have fun in between listening and producing our new sounds to help students stay motivated and even enjoy the therapy session and process.
How long does it take to ‘fix up’ a lisp?

It tends to take about one term with weekly sessions to help a student make good ‘S’ sounds in phrases and sentences. If the student can do the home practice every day in between the weekly sessions, then in most cases I am able to pronounce the lisp as ‘fixed’ after about one term.

After that the student needs to practise, practise, practise, at home and in daily life to keep reminding themselves of their new skills and their new sound production.

It is a matter of reminding and wanting to get it right. Occasionally a student returns to me for another term of simply practising their skills together with me as they are finding it hard for any number of reasons to practise at home. But generally, 8/10 students will be fine after some 12–13 sessions and their speech will be perceived as perfectly typical by family and friends.

If your child has a lisp or any other speech error, please do not hesitate to contact me.

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.

0
READ MORE Help! My child has a lisp. What can we do about it?
Book corner · Speech and Language Therapy

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

Oi Frog by Kes Gray and Jim Field

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

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

Increase fun and interaction

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

Time to talk

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

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

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

Reap the reward of repetitive language

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

Emotions matter

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

OI Books

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

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

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

2

READ MORE Support your child’s communication using books: OI FROG
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.

1
READ MORE Seeing sounds: How visual gestures boost speech sound learning