Using AAC – Augmentative and Alternative Communication for non-verbal and early verbal children

ByLondon Speech and Feeding

Using a Core Vocabulary Board

Your Speech Therapist might have been advising you to introduce words to your child with the help of a CORE BOARD. What on earth is she talking about and why would we want to do this, I hear you think – and in fact this is what I get asked a lot, as I often do recommend using Core Boards.

Core boards belong to the category of Augmentative and Alternative Communication (AAC ) and they can be really useful for:

  • Children or adults who cannot speak at all or who are very hard to understand.
  • Children who are slow to speak and have difficulty expressing themselves verbally, due to genetic conditions as Down Syndrome, Verbal dyspraxia, Autism or any other learning difficulty that means a child is slow to develop speech.

Here is what a Core board might look like, in fact this is one that I love to use. It is made by Beautiful Speech Life, there are a ton of similar boards out there for free. I have also made my own, you can check it out on my Instagram feed.

Using a Core Vocabulary Board

What is Core Vocabulary/ Core words?

Core vocabulary consists of the most common words used by children throughout a day. In 2003 Banajee and Dicarlo et al found that 50 % of pre-schoolers in their project used nine words consistently across their daily play and meal routines. These words are Core words and are typically the ones you can see on a board, like the one above.

How To Use It

Adults always first need to consistently model and show their child how to use a board. This is key! For example: Adult can point to “YOU” “WANT” ‘MORE” and then point to the cup of Water on the counter. Child could then reply either by shaking his/her head and/or pointing to “NOT” which also stands for “NO”. Then adult can point to “NOT” “MORE” and do an OK sign as well. Eventually Child can initiate a request and point to “I” “ WANT” “MORE” and then point to the cup on the counter.

This is not as cumbersome or limited as it first sounds or appears. Here’s why: As adult you can talk normally and, of course, many words you are using will not be on this board. But some will be, and you will be surprised how many you can find when you start using it. So you could say quite normally: Hey lovely (name of your child) would YOU LIKE some MORE water? The words in capital are on the board which you can point to as you speak normally. Basically, you are showing/saying to your child: “We can speak and these are the pictures we can use to help us; We call this TOTAL COMMUNICATION, as communication is so much more than just words! Great communication can be silent, where we use our facial expression, our smile, our eyes, our hand gestures, body movements and yes, of course, words. But when words fail us, these boards are so helpful.

This still does not answer your original question of: why would I want to do this, I want my child to talk!? You are a SPEECH Therapist, please help my child TALK, not point to pictures, that is not what I had in mind.

Let Me Explain

When speech is difficult for a child it doesn’t mean that there is nothing to talk about! Of course, we want all our children and all people to speak because it is the easiest and most effective way of communicating, no doubt! However, sometimes this is very hard for some children and whilst we are always working towards speech where possible, we also want to make sure that whilst figuring out how to speak, your child has a MEANS TO COMMUNICATE. Using a board like this might well be a temporary strategy but whilst you are using it and working on their speech you will find a reduction in tantrums and frustration as you child is able to express themselves more effectively.

Often we find that as soon as we offer a CORE VOCABULARY like the above sample a child who has had no or very few words suddenly blossoms and starts to point to new words on the board and starts to PRACTICE USING THESE WORDS!! Practice makes perfect, right? Yes it totally does! There is lots of evidence that tells us that using Core Vocabulary Boards ENHANCE AND SUPPORT SPEECH PRODUCTION AND NOT HINDER IT. Using a board like this will only ever be helpful to your child and will never make your child “lazy” – too lazy to speak? NO SUCH THING!

Here is what one of my parents says about the core board we use with her little boy:

“the board has been a game changer, my son is a visual learner so it really helps to have the board as he associates communication so much easier this way. We have incorporated his twin sister who models it’s use and have definitely seen improvement in speech through its support and his frustration around being unable to verbally communicate at times has definitely lessened”

K Connolly, Mother of Tom (aged 3.5 years).

Reading and hearing this makes me so happy!

In addition to general core board above I also sometimes use a Core Board that is specific to an activity, such as for example BLOWING BUBBLES. Below is an example of such a board, which you can use very nicely during a bubble blowing activity and sometimes it is a nice place to start for newcomers, this can be an easy introduction. You can download this and many similar boards on www.widgit.com for free!

Using a Core Vocabulary Board

There is so much more to say about AAC and using Coreboards, visit my Instagram you can find a bit more information on how I use them.

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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    There is more than one way to model communication: Using speech prompts, signs, and AAC together in therapy

    ByLondon Speech and Feeding

    One of the most important things I have learned as a paediatric speech and language therapist is this:

    Children do not all learn communication in the same way.

    Some children learn best through listening.
    Some need visual support.
    Some need movement and gesture.
    Some benefit from symbols or technology.
    And many children need multiple supports together before communication truly starts to develop.

    That is why flexible, responsive therapy matters so much.

    In this short therapy clip, I model just two simple words:
    ‘Go’ and ‘Up’.

    But underneath those tiny moments is a combination of therapeutic strategies:

    • speech sound prompting
    • visual cueing
    • Makaton signing
    • AAC (Augmentative and Alternative Communication) modelling
    • repetition
    • motor planning support
    • language modelling
    • total communication principles.

    Communication is bigger than speech alone

    One of the biggest misconceptions about speech therapy is the idea that communication only ‘counts’ if a child says the word verbally.

    In reality, communication comes in many forms:

    • speech
    • gesture
    • facial expression
    • signing
    • pointing
    • symbols
    • body language
    • AAC.

    This is particularly true for children with:

    • developmental language disorder (DLD)
    • autism
    • motor speech difficulties
    • childhood apraxia of speech (CAS)
    • phonological difficulties
    • global developmental delay
    • complex communication needs.

    These children often need communication to be presented through multiple pathways at once.

    That is where total communication approaches become so powerful.

    This is important to know: this does not confuse children. In fact, for many children, it does the opposite. It creates clarity.

    Careful sound prompting helps bridge that gap.

    Research and clinical experience consistently show that signs often support spoken language development rather than hinder it.

    Research suggests that learning signs alongside spoken language does not hinder speech development and may support overall language acquisition, communication confidence, and vocabulary growth in many children.

    For many children, signs actually help speech emerge because they:

    • reduce communication pressure
    • build confidence
    • strengthen understanding of words.

    A child who can successfully communicate is far more likely to keep attempting interaction.

    The power of AAC and LAMP Words for Life

    In the clip, I also model language using an electronic AAC system: LAMP Words for Life.

    AAC stands for Augmentative and Alternative Communication.

    AAC includes any tool that supports communication beyond speech alone, including:

    • picture systems
    • symbol boards
    • communication books
    • speech-generating devices.

    LAMP Words for Life is one of my favourite AAC systems because it focuses on consistent motor patterns and meaningful language development. Because communication is not about achieving perfection. It is about connection.

    And when children are given multiple ways to express themselves, they often become more confident, more engaged, and more willing to interact with the world around them.

    That is the true power of total communication therapy.

    Contact me via my contact form if you would like me to work with your child.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Reference

    Pontecorvo, Elana & Higgins, Michael & Mora, Joshua & Lieberman, Amy & Pyers, Jennie & Caselli, Naomi. (2023). Learning a Sign Language Does Not Hinder Acquisition of a Spoken Language. Journal of Speech, Language, and Hearing Research. 66. 1291-1308. DOI 10.1044/2022_JSLHR-22-00505.

    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.

    3
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    Principles of motor learning in Childhood Apraxia of Speech (CAS)

    ByLondon Speech and Feeding

    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

  • What is FRONTING?

    ByLondon Speech and Feeding
    Kids Speech Therapist London

    Does your child say “Dough” instead of “Go”? Or “Tea” instead of “Key”? Do you hear a /Sh/ instead of an /S/ does “see” sound more like “she”?

    We Speechies call this a Fronting Pattern which means that a sound that should be produced at the back of the throat with the back of the tongue, like K or G , is said at the front of the mouth with the tip of the tongue, like a T or a D or SH. When this happens speech can be really hard to make out because these sounds are literally everywhere in everyday sentences. Just think how many K’s and G’s we hear in a simple sentence?

    For example, I heard my little student say earlier today: “I know what game we can play in your garden? It’s the one with cones and rings and cushions! I know where it is I can get it.”

    But it sounded like:

    “I know what DAME we DAN play in the DARDEN! It’s the one with TONES and rings and TUSHIONS! I know where it is I TAN DED it.”

    If that sounds familiar to you, here is a little overview of what we can do about it:

    First up it’s always good to start with general speech sounds awareness: does a child hear syllables and intonation? Do they know words that rhyme? Can they follow or copy a simple beat with a drum? Can they listen and hear quiet sounds and loud sounds and can they copy those? Can they follow mouth and tongue movements:, for example : stick out your tongue, lick your lips, click your tongue, blow raspberries?

    Then it really helps to talk about BACK and FRONT of things and to draw attention to the back of the mouth and the back of the tongue and the front tip of the tongue and how sounds are made in the mouth. I often use a puppet to show this or a model of a mouth like this one here in the picture.

    Next we try and listen to words starting with a BACK sounds like a K or a G , and I read out a list of words with those sounds: COW, CORE, CAT, CONE, KEY etc or ARK, EEK, OAK, ACHE…

    Or GOO GUY GUM GONE

    After that we try and see if a student can actually produce a single sound like a K or a G just by itself. If they can, that’s a really great start and if they can’t I help them to produce one – over a few sessions we usually get there. We call this Sound production in isolation.

    Once a child can produce a sound correctly, on its own, we try and start working on very simple words that are really powerful like “GO”!!!!! in a motivating game or “CAR” for little ones who love a car racing track.

    Now that we have established the back sounds and are using it in short words, we can gradually re-train brain pathways and oral- motor/movement pathways to use these new sounds in many words and then short phrases. That can take time!! This is called generalisation and it is not uncommon for it to take up a whole year for fluent speech to be error-free .

    Why does it take so long? Being able to produce a correct and clear K or G sound does not mean it will be used easily. Our brain pathways are fixated or habituated to the error sound. It takes time for habits to change. A child might be able to hear the word TIGER with a G in the middle and she knows that it is not a TIDER but when saying it her tongue automatically moves forward rather than lifts up at the back. It’s a bit like a person who has a rounded back: the brain knows to stand upright and how not to slouch, but when we don’t focus on it, ooops we have slouched again because that is what we are comfortable doing and our body moves with our habit.

    It takes effort and motivation to change our movement patterns and that includes our tongue and lip patterns! We usually get there through a huge variety of games and practice. Lots and lots of repetition is key as is motivation to change.

    Parents and carers are crucial in the success of Speech Therapy!

    We need your feedback at home, the regular short and sweet exercises, the constant positive encouragement and great modelling of speech sounds. We often find that parents are tuned into their child’s error sounds and can understand them much better than anyone else. This is great of course in many ways, however, it also means that the child has less motivation to change: if mummy understands me then my world is ok.

    I will give you a short outline of what different speech therapy models I use in my practice, be it in clinic face to face or on-line in my future blogs soon.

    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.

  • ·

    Transforming Mealtimes

    ByLondon Speech and Feeding
    Speech Therpaist in London

    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.

  • · · · ·

    Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

    ByLondon Speech and Feeding
    Managing mealtime sensory overload at holiday gatherings: Supporting children with allergies and feeding differences

    Holiday meals are meant to be joyful and something we all look forward to. But for many children and their families, these occasions can be overwhelming and be the cause of dread and worry. The combination of new smells, unfamiliar foods, loud environments, social expectations, and allergy anxieties can quickly turn what should be a festive time into a stressful one.

    For parents of children with sensory processing differences, selective eating challenges, or food allergies, holiday gatherings often require careful planning and a big dose of tolerance and compassion. The good news is that with awareness and a few gentle strategies, you can support your child to feel safe, regulated, and included during festive meals without pressure, tears, or discomfort.

    Let’s explore how to make holiday mealtimes calmer, safer, and more connected this season.

    🎄 Why holiday meals feel so overwhelming

    Holiday gatherings usually combine several sensory triggers all at once:

    • Noisy, chaotic rooms
    • Strong smells from a mix of foods we don’t normally cook
    • Multiple conversations happening at once
    • Bright lights, Christmas décor, flickering candles
    • Unfamiliar foods with unexpected textures
    • Expectations to ‘try everything’ or ‘enjoy it’s sooo good!’
    • New environments, seating arrangements, or routines

    For children with sensory sensitivities, this can feel like a tidal wave of input. Research shows that children who are sensory-sensitive often have heightened responses to smell, taste, and texture, which may lead to avoidance or distress at mealtimes (Cermak, Curtin, & Bandini, 2010).

    Add food allergies into the picture and anxiety increases even further for both children and parents. A 2020 study by DunnGalvin et al. found that children with food allergies experience significantly higher stress in shared eating environments, especially when food preparation or contamination risk is hard to control.

    So, if your child becomes tearful, shuts down, or refuses to sit at the festive table, it isn’t ‘bad behaviour.’ It’s sensory overload, heightened vigilance, or discomfort communicating through their body.

    🌟 Preparing your child for a calmer festive meal

    Preparation is especially important for sensory-sensitive or allergy-aware children. Here’s how to set them up for success:

    1. Offer predictability through previewing

    Before the event, show your child pictures of:

    • where you’re going
    • who will be there
    • the types of foods that might be served
    • where they might sit

    A visual schedule or social story can help reduce anxiety and give your child a sense of control.

    2. Pack safe foods without apology

    If your child has allergies or selective eating, bring:

    • ‘Safe foods’ you know they will eat
    • Backup snacks
    • A separate (their own) plate, if needed
    • Emergency medication

    Announce clear, firm boundaries such as:

    ‘Ok people, these are Jamie’s safe foods — we’ll stick with these today.’ This will help relatives understand without pressure or judgement.

    3. Choose seating that supports sensory regulation

    If possible, seat your child:

    • at the end of the table
    • near a familiar adult
    • away from the kitchen (strong smells)
    • away from noise clusters
    • give them their favourite toy or fidget whilst waiting

    Let them take breaks when needed. This isn’t ‘rude,’ it’s self-regulation.

    🍽️ Supporting children during the meal

    1. Focus on connection, not consumption

    The holidays are not the time to expand your child’s food range. Keeping mealtimes low-pressure actually supports long-term progress.

    In fact, the research is clear: pressuring children to eat decreases acceptance and increases refusal (Galloway et al., 2006).

    So instead of ‘Just try it!’ try:

    • ‘You don’t have to eat it, you can look at it.’
    • ‘You’re in charge of what goes in your mouth.’
    • ‘You can keep your safe foods on your plate.’

    2. Protect your child’s allergy safety

    Holiday meals often include:

    • cross-contamination risks
    • shared utensils
    • buffets
    • homemade dishes without ingredient lists

    Use gentle but firm scripts:

    • ‘Because of Ellie’s allergies, we’ll keep her plate separate.’
    • ‘We’ll serve her food ourselves to make sure she stays safe.’

    Confidence in your boundary helps others respect it.

    3. Manage sensory load in real time

    Offer:

    • headphones
    • a small chew or fidget toy
    • a designated ‘calm corner’
    • time outside for fresh air
    • a predictable signal for breaks (e.g., a hand squeeze or card)

    Remember, sensory regulation is healthcare, not ‘giving in.’

    4. Model calm eating

    Children learn most from watching.

    Slow, happy bites and relaxed facial expressions tell the nervous system: ‘This environment is safe’.

    💛 What to say to well-meaning relatives

    Families often have big feelings about food. You can prepare nice phrases like:

    • ‘We’re focusing on helping him feel safe around food today.’
    • ‘She has allergies, so we’re sticking to our plan.’
    • ‘We’re avoiding pressure because it helps him eat better long term.’
    • ‘We’re celebrating together, eating is not the goal today.’

    Setting expectations ahead of time can reduce awkward moments later.

    🎁 The bigger picture: It’s about safety, not ‘picky eating’

    Children with allergies, sensory differences, or feeding challenges aren’t trying to be difficult. They are trying to stay safe, regulated, and comfortable.

    Your calm presence, gentle boundaries, and preparation create the conditions for a holiday that feels peaceful, not pressured.

    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.

    📚Research References

    Cermak, S. A., Curtin, C., & Bandini, L. G. (2010). Food selectivity and sensory sensitivity in children with autism spectrum disorders. Journal of the American Dietetic Association, 110(2), 238–246.

    DunnGalvin, A. et al. (2020). APPEAL-2: A pan-European qualitative study to explore the burden of peanut-allergic children, teenagers and their caregivers. Clinical & Experimental Allergy, 50(11), 1238–1248.

    Galloway, A. T., Fiorito, L. M., Francis, L. A., & Birch, L. L. (2006). ‘Finish your soup!’ Counterproductive effects of pressuring children to eat on intake and affect. Appetite, 46(3), 318–323.

    2

  • Speech sound disorders

    ByLondon Speech and Feeding
    Kids Speech Therapist London
    Speech Sound Disorders

    Treatment Approaches – A Typical Session

    There are various great ways to treat speech sound disorders and I use all the approaches available selectively; I decide what works with each individual child and I also vary the approach depending on the child’s frame of mind at any given time during my session.

    Some of the approaches are more “drill-based” and require a child to be able to pay attention and really participate actively in the therapy, and this is what I am showing you today with this video clip.

    My little student here has been working with me for some time and from only saying a handful of words which were not very easy to understand he has come a long way. He does have some features of Verbal Dyspraxia which I shall briefly outline here:

    • Making sounds in general is a struggle, especially when asked to copy certain sounds, example: ‘can you say: a ee ou oo?”
    • Repeating sound sequences or words sequences is hard, for example: “say p-t-k in sequence” or “say fish chips fish chips fish chips
    • When saying the same word again and again, different mistakes can be heard
    • Intonation difficulties: speech sounds monotonous
    • Vocabulary is very limited

    Some therapy approaches are more play based, for example the Core Word method: here we pick a few words at a time which are very significant to the child and therefore highly motivating to try and say. These could be characters of Pokemon or Minecraft for example, or simple words like “GO!”

    When you watch the video you will see that I use a lot of visual prompting, such as showing him where the tongue is moving to or from. I do this with my index finger and this approach is called Tactile Cueing or “Cued Articulation”. Part of the approach is to give a visual prompt and then reduce the prompt as the learner is more able to produce the correct sounds. Once he can produce the sound on its own, we quickly move to the sound within a word.

    I do mix and match my approaches and in fact here I am drilling but I also use the Core Word which for him (YELLOW) — it’s his favourite colour and I happen to have quite a few good games where a YELLOW something or other can be asked for….. WHO KNEW!? 🙂

    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.