Unveiling the hidden spectrum: Why girls and autism often go unseen

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Unveiling the hidden spectrum: Why girls and autism often go unseen
Image by Freepik

Autism is a complex neurodevelopmental condition characterised by social-communication challenges, restricted and repetitive behaviours, and sensory processing difficulties. While the prevalence of autism is estimated at 1 in 54 children, research suggests a significant disparity in diagnoses between genders. Boys are diagnosed with autism roughly four times more often than girls, leading us to question: Why are girls so much harder to diagnose with autism?

The answer lies in a complex interplay of factors, including:

1. Different presentations of autistic traits:

  • Socialisation: The stereotypical image of autism often portrays boys with aloofness and a lack of interest in social interaction. However, autistic girls may exhibit more subtle social difficulties. They may appear interested in socialising but struggle with understanding social cues, maintaining eye contact, or navigating complex social dynamics. This ability to ‘camouflage’ their challenges can lead to misinterpretations of their intentions and abilities.
  • Restricted interests: While autistic boys may have intense interests in stereotypically ‘masculine’ topics like dinosaurs or trains, girls might gravitate towards interests traditionally associated with girls, like specific characters or activities. These interests, often deemed ‘typical’ might be overlooked as potential indicators of autism.
  • Repetitive behaviours: Repetitive behaviours are another core diagnostic feature of autism. However, autistic girls may exhibit these behaviours in more subtle ways, such as intense focus on specific routines, scripting conversations, or engaging in repetitive social interactions. These subtle expressions can easily go unnoticed.

2. The ‘camouflage’ effect:

Autistic girls, particularly those with higher cognitive abilities, may develop coping mechanisms to mask their challenges in social situations. This ‘camouflaging’ can involve mimicking social behaviours they observe in others, leading to significant internal distress and exhaustion. This effort to appear ‘normal/typical’ can further hinder accurate diagnosis.

3. Societal biases and diagnostic tools:

  • Gender bias: The current diagnostic criteria for autism were largely developed based on studies of boys, leading to a potential bias towards male presentations of the condition. This can result in girls who don’t exhibit the ‘typical’ symptoms being missed altogether.
  • Lack of awareness: Healthcare professionals and educators may have limited awareness of how autism manifests differently in girls. This lack of understanding can lead to misinterpretations of their behaviours and missed opportunities for diagnosis and support. I must say that this is really common in my working day. I see a child—girls or boys in this case to be fair, but mainly girls—where parents tell me: the doctor/health visitor/paediatrician has said it was ‘just a little delay’ and I am thinking ‘Really!??? What did they look at? How did they not see X Y Z’… It really is still very common.

4. Co-occurring conditions:

Autistic girls are more likely to experience co-occurring conditions like anxiety and depression, which can overshadow the core features of autism. This makes it even more challenging to identify the underlying autism diagnosis.

The consequences of missed diagnoses and this goes of course for both, autistic girls AND boys!:

The consequences of undiagnosed autism can be significant. Children may experience:

  • Lack of access to appropriate support: Without a diagnosis, children may miss out on crucial interventions and therapies that can help them manage their challenges and thrive.
  • Increased vulnerability to mental health issues: The stress of masking and navigating social complexities can lead to anxiety, depression, and other mental health challenges.
  • Difficulty forming meaningful relationships: Social difficulties and communication challenges can hinder their ability to build and maintain healthy relationships.

Moving forward: Towards a more inclusive diagnosis:

To ensure all individuals on the spectrum receive the support they need, it’s crucial to:

  • Increase awareness and education: Healthcare professionals, educators, and the general public need to be educated about the diverse presentations of autism in girls and of course also in boys. Let’s not forget that we are still seeing older autistic boys with diagnoses given aged 12 years and older who have slipped through the net.
  • Develop gender-neutral diagnostic tools: Diagnostic criteria and assessments should be revised to encompass the broader spectrum of autistic traits, regardless of gender.
  • Encourage open communication: Parents, caregivers, and individuals themselves should be encouraged to voice their concerns and seek evaluations, even if their experiences don’t perfectly align with stereotypical presentations of autism.

By acknowledging the complexities of diagnosing autism, particularly in girls, and working towards a more inclusive approach, we can pave the way for earlier diagnoses, appropriate support, and a brighter future for all individuals on the autism spectrum.

Do get in touch if you would like some in-person or on-line 1:1 support with this. It can be overwhelming to figure it all out alone.


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

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    The power of imitation in supporting children with autism

    Image by Freepik

    Imitation, the act of mirroring someone else’s actions, gestures, sounds, or words, is a fundamental skill that plays a crucial role in human development. It’s how babies learn to wave ‘bye-bye’, how toddlers pick up new words, and how children acquire social skills. But for children with autism imitation can be a significant challenge and understanding why it’s important and how to foster it becomes a key focus for parents, educators, and speech and language therapists.

    Why is imitation important?

    Imitation is a building block for a wide range of developmental skills:

    • Social interaction: Imitation is the foundation of social reciprocity. When a child imitates, he or she is engaging in a shared experience, connecting with another person, and learning to take turns in social exchanges.
    • Communication development: Imitation is closely linked to language acquisition. Children often imitate sounds and words before they can produce them independently. Imitation also helps them understand the meaning of gestures and facial expressions, which are vital for nonverbal communication.
    • Cognitive development: Imitation plays a role in problem-solving, learning new skills, and understanding cause and effect. By imitating actions, children explore their environment and learn how things work.
    • Emotional development: Imitation helps children understand and share emotions. When a child imitates a smile, he or she may begin to understand the feeling of happiness.

    Imitation challenges in autism

    Many children with autism face challenges with imitation, which can affect their development in these key areas. These challenges can manifest in different ways:

    • Difficulty imitating motor actions: Children with autism may struggle to imitate simple motor movements, such as clapping hands, waving, or playing ‘peek-a-boo’.
    • Limited vocal imitation: Imitating sounds, words, and phrases can be difficult for some children with autism, which can impact their speech development.
    • Challenges with social imitation: Imitating social cues, such as facial expressions, gestures, and body language, can be particularly challenging for children with autism, affecting their ability to engage in social interactions.

    Why do children with autism struggle with imitation?

    The exact reasons for imitation difficulties in autism are complex and not fully understood. However, several factors may contribute:

    • Neurological differences: Research suggests that differences in brain structure and function, particularly in areas involved in social perception and motor control, may play a role.
    • Sensory processing differences: Some children with autism may have sensory differences that make it difficult to attend to and process the movements or sounds they are expected to imitate.
    • Attention and motivation: Challenges with attention, focus, and social motivation can also affect a child’s ability to engage in imitation.

    How to foster imitation in children with autism

    Fortunately, imitation skills can be developed and improved through targeted interventions and strategies. Here are some approaches that I use in my practice as a speech and language therapist working with autistic children and their families:

    • Create a playful and engaging environment: Children are more likely to imitate when they are having fun and feel motivated. I use toys, games, and activities that the child enjoys.
    • Start with simple imitation: Begin by imitating simple motor movements that the child is already capable of and gradually introduce more complex actions.
    • Imitate the child first: As the Hanen Program emphasises, imitating the child’s actions, sounds, and words can encourage him or her to interact and communicate more.
    • Use visual supports: Visual aids, such as pictures, photos or videos, can help children with autism understand what is expected of them and make imitation easier.
    • Break down complex actions: Divide complex actions into smaller, more manageable steps. For example, to teach a child to brush their teeth, break it down into steps like ‘pick up toothbrush’, ‘put toothpaste on brush’, and ‘move brush on teeth’.
    • Reinforce imitation attempts: Provide positive reinforcement, such as praise, smiles, or preferred activities, when the child attempts to imitate, even if the imitation is not perfect.
    • Integrate imitation into daily routines: Incorporate imitation into everyday activities, such as imitating sounds during playtime, imitating gestures during songs, or imitating actions during self-care routines.

    The role of speech therapy

    Speech-language therapists play a crucial role in helping children with autism develop imitation skills, particularly in the areas of vocal and verbal imitation. As part of my therapeutic role, I offer the following:

    • Assessing a child’s imitation abilities.
    • Developing individualised therapy plans to target specific imitation goals.
    • Using a variety of techniques to encourage vocal imitation.
    • Working with parents and caregivers to provide strategies and support for promoting imitation at home.

    Summary

    Imitation is a fundamental skill that is essential for social, communication, cognitive, and emotional development. While children with autism may face challenges with imitation, it is a skill that can be developed and improved with targeted interventions and support. By understanding the importance of imitation and using effective strategies to foster it, parents, educators, and therapists can make a significant difference in the lives of children with autism, helping them to connect with others, learn new skills, and reach their full potential.

    Do get in touch via my contact form if you have any question or need help with supporting your little one.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.


    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    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
  • · ·

    Chaining: A powerful tool for phonological development

    Understanding chaining

    Chaining is a therapeutic technique I like to use in my speech therapy work with children who have Childhood Apraxia of Speech (CAS) or phonological speech sound difficulties. It helps to break down a complex target behaviour into smaller, more manageable steps. By systematically teaching and reinforcing each step, I can help my students achieve their communication goals.

    There are two types of chaining: Forward and backward chaining

    Today I am going to show and talk about backward chaining. This technique involves starting with the last step and working backward to the first. This approach can be particularly effective for children with persistent speech sound difficulties where combining consonants into clusters, such as /BL/ or /FR/ or /SHR/ is very difficult.

    Backward chaining allows my student to experience immediate success and build his confidence.

    In my video I show you how I applied backward chaining to the words ‘Shriek’, ‘Shrub’, ‘Shrimp’ etc

    My student struggles with both the /SH/ and the /R/ sounds and we have been working on both sounds for some weeks now. He has mild Childhood Apraxia of Speech and he has difficulties with coordinating his tongue movements, breathing and using his jaw effectively to make words. His sound repertoire has grown a lot since we started working together last year. Today in this session I show you how we pulled both the sound /SH/ together with /REEK/ to make ‘SHRIEK’. I love using the pictures and therapy materials from Adventures in Speech Pathology.

    This is also part of the Complexity approach which I will explain in a separate blog post.

    • Step 1 (not shown in the video): I explain what the word means; I find that when my student understands what a word means he is much better at saying it. It increases his confidence and motivation to say a word that he knows the meaning of. Often this student does not tell me that he does not know what a word means, so I always remind myself to check that out first.
    • Step 2 (not shown in the video): We do a little rhyming game and think about what any one word rhymes with: ‘Shriek’ – ‘meek’, ‘weak’, ‘seek’.
    • Step 3: I show my student that there are two parts to this word /reek/ and the sound /SH/.
    • Step 3: We practise the easier part: /reek/ /reek/ /reek/.
    • Step 4: We add the /SH/ sound and pull it together to make our target word ‘Shriek’.

    /REEK/ /REEK/ /REEK/ + /SH/ = ‘SHRIEK’
    /RUB/ /RUB/ /RUB/ + /SH/ = ‘SHRUB’
    /RUG/ /RUG/ /RUG/ + /SH/ = ‘SHRUG’

    By breaking down the word into smaller, manageable steps, my student can focus on each syllable individually, get that right and then gradually build up to the full word. This approach can help to reduce frustration and increase motivation.

    Forward chaining

    Forward chaining is the same process but in reverse: we start with the front sound or syllable and work forward towards the next/last part of the word:

    /SH/ + /REEK/ = ‘SHRIEK’
    /SH/ + /RUB/ = ‘SHRUB’
    /SH/ + /RUG/ = ‘SHRUG’

    Benefits of chaining

    • Increased motivation: By starting with the last step, my student experiences success, which boosts his motivation to continue trying to say the word and trying other words.
    • Reduced frustration: Breaking down the target behaviour into smaller steps can make the task less overwhelming, reducing frustration and anxiety.
    • Improved confidence: As the little learner masters each of the step, his confidence and self-esteem increases. Again, this leads to increased motivation.
    • Faster learning: By focusing on the final step first, and practising lots of chaining (forward and backward), a student can quickly learn to generalise to other words.

    Backward chaining (and forward chaining) is a really great tool for teaching complex speech sounds and words to children with phonological disorders.

    Watch out for my next blog which is all about the complexity approach in Phonology.

    Do get in touch if your child has a speech sound disorder, I would love to help.

    Any questions or need help with supporting your little one’s language please contact me via my contact form, or you could also check out www.hanen.org for advice and lots of inspiration.

    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

    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
  • · ·

    Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps

    Conquering the ‘slushy’ /S/: Your guide to treating lateral lisps

    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.


    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

    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
  • · ·

    Feeding therapy: A guide for parents and caregivers

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

    What is feeding therapy?

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

    How does feeding therapy work?

    Feeding therapy sessions are typically 30–60 minutes long and involve a variety of techniques, including:

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

    When is feeding therapy needed?

    Feeding therapy may be beneficial for children who:

    • Are picky eaters: Refuse to eat a variety of foods or have strong preferences.
    • Have feeding disorders: Experience difficulties with eating, such as swallowing or chewing.
    • Have sensory processing issues: Are sensitive to certain textures, smells, or tastes.
    • Have medical conditions: Such as autism, cerebral palsy, or gastrointestinal disorders.

    Feeding therapy strategies you can try at home

    While professional feeding therapy can be invaluable, there are several techniques you can try at home to support your child’s eating development:

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

    Seek professional help

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

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

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

    Please feel free to contact me.

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice


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

    1
  • ·

    Explore four truths or myths about speech, language, and communication

    There are many truths and myths out there that I’d like to explain to prevent misunderstanding. This will enable you to support your child by seeking the correct information.

    Why not have a look at the following statements and decide if you think they are true or false?

    1. Flashcards will fix my child’s speech, language, and communication needs.
    2. Singing to my child will not help their language development.
    3. My child communicates in a variety of ways not just through speech.
    4. Learning another language is good for my child.
    Speech Therpaist in London

    Now let’s explore these statements in more detail.

    1. Flashcards will fix my child’s speech, language and communication needs – False

    To develop your child’s communication skills, you’ll want your child to generalise their skills across multiple areas. I would highly recommend staying away from flashcards if they are only teaching ‘rote learning’. Children need to explore the world through play. However if you’re looking at cards, talking about them and having meaningful conversations, and your child is enjoying it, then there potentially is a use for flashcards. But at London Speech and Feeding, we love innovative activities that your child is fully immersed in.

    2. Singing to my child will not help their language development – False

    Singing introduces your child to rhyme, and repetition amongst many other benefits. It allows them to attend and listen to you as their caregiver and develop the vital stages of early communication. Singing slows down language so your child becomes more aware of the relationship between letters and sounds. You’re also supporting your child’s oral fluency as well as their memory. Furthermore, you’ll often be face to face with your child singing which allows them to see your facial expressions, lip patterns and eye contact (to name a few).

    3. My child communicates in a variety of ways not just through speech – True

    Communication is much more than just talking. So, it’s true that communication happens in a variety of ways. Think about it. If you didn’t talk and you wanted to convey a message of frustration, you may show different facial expressions, body language; you may point at something which has caused your frustration. We can communicate through a variety of means (some of which include symbols, gestures, hand signals, and pictures). Can you think of any other ways in which you communicate to others?

    4. Learning another language is good for my child – True

    Current evidence suggests that speaking another language to your child is a positive. It allows your child to interact with different members of the family or with their friends. ASHA suggests that children who speak two languages fluently often learn new vocabulary easier and find categorisation simpler. Bilingual children have been shown to understand the needs of their communication partner. In addition, increased vocabulary may support better understanding. There are no negative factors about learning more than one language. We would recommend that, whatever language(s) your child is learning, they have a good model of that language, so they learn best practice.

    Always seek the advice from a qualified Speech and Language Therapist if you’re unsure of how your child’s speech, language and communication is developing, as there are lots of information online that aren’t always accurate.

    I’m always happy to support your family to increase your knowledge and understanding.

    You can find support by contacting Specialist Speech and Language Therapist Sonja 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.