Using AAC during play with your child

ByLondon Speech and Feeding
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Playtime! It’s a magic time for exploration, learning, and connection.

If your child is struggling to use words with his/her mouth, we can always use a robust Augmentative and Alternative Communication (AAC) device to help find their words. We know that using such a device does never stop or delay children to speak with their mouths. On the contrary it helps, enormously!

Can playtime still be a blast? Absolutely! In fact, incorporating AAC into play can be a powerful way to boost communication skills, build confidence, and create a truly inclusive play experience. Here’s how to make it happen, with a focus on core words and core scripts for our GLP’s (the building blocks of communication used by everyone). In this video I am using the core word ‘IN’ and ‘MORE’.

The Magic of Core Words

Core words are the most frequently used words in everyday communication. They might be verbs like ‘want’, ‘more’, ‘go’, or ‘stop’, or adjectives like ‘happy’, ‘sad’, and ‘hot’. These words are the foundation for building sentences and expressing needs and desires. They’re perfect for children using AAC because they’re simple to understand and use.

Let’s Play! Here’s How

1. Choose Your AAC System

Many options exist! It could be a low-tech picture board with core words, such as the one you see pasted on my cabinet door in the background, or it can be a dedicated AAC app on your tablet. Here I am using the GRID app but I also love using others, such as LAMP Words for Life.

2. Make it Fun and Functional

No pressure! Integrate your AAC system seamlessly into your play routine. Here are some ideas:

  • Car/trains: Use core words to describe what the cars are doing: (‘down’, ‘go’, ‘stop’, ‘again’ ‘fast’ ‘slow’).
  • Dress-up: Use core words to choose clothes (‘want’, ‘hat’, ‘shoes’).
  • Tea Party: Use core words to ask for and share (‘more’, ‘juice’, ‘give’).
  • Building Blocks: Use core words to describe what you’re building (‘tall’, ‘big’, ‘house’).
  • Dolls/Stuffed Animals: Use core words to act out scenarios (‘sleep’, ‘eat’, ‘cry’).
  • Arts and Crafts: Use core words to describe colours (‘red’, ‘blue’), actions (‘draw’, ‘paint’), and feelings (‘happy’, ‘sad’).

If your child is a Gestalt Language Processor you will want to model meaningful, fun scripts instead of single words! As above, but use phrases:

  • Car/trains: Use scripts to describe what the cars are doing: (‘it’s going down’, ‘let’s go’, ‘make it stop’, ‘want it again’, ‘that was fast’, ‘it’s so slow’).
  • Dress-up: Use scripts to choose clothes (‘I’m gonna wear this’ ‘that’s a lovely hat’, ‘let’s choose shoes’).
  • Tea Party: Use scripts to ask for and share (‘I want more’, ‘more juice’, ‘give me this’).
  • Building Blocks: Use scripts to describe what you’re building (‘a tall one’, ‘that’s so big’, ‘it’s a house’).
  • Dolls/Stuffed Animals: Use scripts to act out scenarios (‘it’s time to sleep’, ‘let’s eat’, ‘he’s crying’).
  • Arts and Crafts: Use scripts to describe colours (‘a red crayon’), actions (‘let’s draw’, ‘I’m gonna paint’), and feelings (‘I’m happy’, ‘that’s so sad’).

3. Model, Model, Model

This is key! As you play, constantly model using your child’s AAC system.

  • Point to the picture or word or script you’re using.
  • Speak clearly and slowly while pointing.
  • When using core words for either Analytical or Gestalt Language Processors, try using good phrases. For example, instead of just saying ‘juice’, say, ‘you want more juice?’

4. Make it a Team Effort

Get everyone involved! Encourage siblings, grandparents, and caregivers to use the AAC system with your child during playtime. The more consistent the approach, the faster your child will learn and feel confident using their voice.

5. Celebrate Progress, Big and Small!

Every step counts! Acknowledge and celebrate your child’s efforts, whether it’s reaching for their AAC system or successfully using a core word. This positive reinforcement will keep them motivated.

Remember

  • Playtime should be fun, not stressful. Don’t force your child to use their AAC system. Let them lead the way and follow their interests.
  • Every child develops at their own pace. Celebrate your child’s unique communication journey.
  • Seek professional help when needed. Your SLT can provide tailored strategies and resources to support your child’s development.

By incorporating AAC and core words into playtime, you’re not just fostering communication; you’re creating a space for your child to thrive, explore, and build strong connections.

So, grab those toys, power up your AAC system, and get ready for a playtime adventure filled with fun, connection and, therefore, communication!

Don’t hesitate to contact me!

Sonja McGeachie

Early Intervention Speech and Language Therapist

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

The London Speech and Feeding Practice

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

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13 tips to support children and young people with food aversions
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13 tips to support children and young people with food aversions

ByLondon Speech and Feeding

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

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

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

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

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

Speech Therpaist in London

Find our top tips here:

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

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

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

Let’s relax about making EYE CONTACT already…
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Let’s relax about making EYE CONTACT already…

ByLondon Speech and Feeding

There’s been a long tradition with teaching staff and with Speech and Language Therapists working in schools that eye contact should be a goal. It is well known that Autistic individuals (whether that be children or adults) mostly avoid eye contact. Whilst it’s part of the way we communicate, it shouldn’t be used as a necessity for an individual who feels that it is uncomfortable. Whilst it does show that you’re listening and showing an interest, it’s not a fair expectation for neurodiverse children.

Autistic children can find making and maintaining eye contact physically and emotionally uncomfortable as well as unnatural. It adds an extra layer of stress and has been reported to increase distractions rather than reduce them. Children who engage in conversations in their own way (i.e., with reduced eye contact) are not shown to suffer with schooling, work, or social interaction.

By having fun through meaningful activities, I often experience that ‘BINGO’ moment (a phrase coined by Alex @meaningfulspeech) where the child is enjoying themselves and naturally makes eye contact. There is no demand on them, they are in a fun, engaging environment which suit their strengths and supports their needs.

Following this, I often reflect on this question ‘Should we make eye contact as a goal?’

It very much depends on the situation. If it places more demands on the child and becomes stressful. Then no. There are many strategies we can use which gain eye contact without placing extra demands on the child. We need to be mindful to adapt the environment and not place neurotypical expectations to meet the needs of neurodiverse children.

How can you encourage eye contact without demand?

  • If you’re using toys, try holding them up to your eye level.
  • You can adjust your position, try sitting face to face during play.
  • Always get down to your child’s level. This might mean that you lay on the floor if your child is positioned in this way.
  • During play, waiting is extremely powerful. Before a key part of the activity, wait and see if your child looks at you. Remember silence is golden!
  • The best way I find is: do something unusual during play. It might be that you spray shaving foam with the lid still on. Or you bring out a wow toy and make it spin/light up or make a noise. A balloon can be good – see video clip. Use the excitement of the activity, and wait to see if you achieve that ‘BINGO’ moment.
  • Create opportunities when there are no toys involved such as during ‘tickles’ or ‘hide and seek’. Autistic children find it difficult to shift their attention between a toy and an adult. So by removing one option, you’re setting them up to succeed.

Remember, it takes practice and time for you to develop these skills. Try one at a time and experiment, see which works best for your child. If you need speech, language or communication support or advice, I am always here to help.

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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Top Tips For The Best Chair When Weaning / Feeding Your Toddler
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Top Tips For The Best Chair When Weaning / Feeding Your Toddler

ByLondon Speech and Feeding
Kids Speech Therapist London
Top Tips For The Best Chair When Weaning / Feeding Your Toddler

Many times I consult families for weaning or feeding difficulties and the immediate and most obvious problem I spot, as soon as I arrive or see any video footage for analysis: the high chair has no footrest! You know the one that is so popular from a certain Swedish company…and don’t get me wrong, most of my furniture is still from that same company and I mostly love it…after assembly and a fair bit of cursing…but the very cheap chair they sell is literally one of my pet hates…perhaps ‘hate’ is a bit strong, but I just do not like this chair at all. And the reason is simply this: IT HAS NO FOOTREST!? PS: it may do now, I have not been to said store in a while, but I have not come across any improved chairs in any of my clients’ homes!

Who likes to have their feet dangling in mid-air at any time of the day? I really don’t!. I need to always have my feet firmly planted on the ground or on a footrest – should I find myself lucky enough to be sitting on a bar stool these days! As soon as I clamber up that stool and I have managed to find a hook for my handbag – here’s another bugbear, but I digress – as soon as…my feet are looking and rooting for that foot rest. Because it gives us stability and let’s face it, when on a bar stool…stability is what gets us through the evening.

So back to our toddler: why would we imagine that our toddler feels any different about dangly legs? Imagine if you will, sitting on one of those bouncy gym balls… where would your feet be? Yes of course, on the floor, because otherwise all hell will break loose or, more to the point, your tummy muscles would get a nice work out, and that is FINE, no problem. Go for it, I know I should…

But if you imagine sitting on a ball like this with your feet off the ground and now you are given a plate of food as well….. I personally don’t think that would end well.

Of course our toddler in that high chair without a footrest is not quite as wobbly as you would be on that ball, but the principle is the same: there is very little stability and now s/he is meant to be tucking into some veggies as well.

As I mentioned in my PS above, I do understand that there are now some additional footrests that can be fitted on the above Swedish chair, and if that becomes a bit more common place and is easy enough to do, then all is forgiven and please go ahead. However….. and I am not on ANY commission from the company I am about to recommend, but really, I have not come across a better chair that is so versatile and will last your child until they are about 12years old!! (Both my boys had one each and 20 years later, I still use both their hairs now for children that come to see me in my clinic. They are almost as good as new and adjust so easily and well to all different heights)

Tripp Trapp® Chair
Tripp Trapp® Chair

Enter, the Stokke Tripp Trapp Chair. It costs a small fortune to be fair, but it did win the “best high chair award” in 2021. There are many cheaper versions available, for example, John Lewis sell a similar chair for about half the price! So do shop around.

But what is so important to consider is that your child has a foot rest and that his trunk is at a 90 degree angle with your child’s thighs.

This affords your child maximum stability and so now we can have a look at the rest of your child’s feeding skills and see what else can be done to help things, and there are many more strategies. But this is usually the first and a hugely important bit of advice I will give and the effect of better sitting, and increased stability is huge!

Best of luck with shopping for your great new high chair. I would also say, if you have already got a chair without a footrest and you don’t want to get another one, I totally get that too. In that case, perhaps have a think about how you could enable your child to rest his/her feet on something, with the right 90 degree angle I mentioned above: perhaps a crate of some sort? a coffee/side table that could be placed under the chair for feet to rest on? a box? Once we become aware of the problem there is most often a solution to this issue. Your toddler will thank you!

I hope this is helpful, please feel free to contact me if you have struggled with finding the right position for your child or if you found this blog post helpful.

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.

Feeding therapy: A guide for parents and caregivers
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Feeding therapy: A guide for parents and caregivers

ByLondon Speech and Feeding
Image by gpointstudio on Freepik

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
A Day In The Life Of An Independent Speech And Language Therapist

A Day In The Life Of An Independent Speech And Language Therapist

ByLondon Speech and Feeding
A Day In The Life Of An Independent Speech And Language Therapist

A Day In The Life Of An Independent Speech And Language Therapist

I often get asked how many clients/children I see per working day or what my working day/life looks like. I always reply that every day is different, which is true, but there is a sort of average working day which looks a bit like this:

I usually start preparing for my first client of the day at around 9.30 am: I clean the room, wipe down all the toys and materials (that’s if they are coming to my clinic room) and then it takes me about 30 minutes to select and sometimes make suitable materials, games and activities for the child’s therapy programme. Client arrives at 10.30 am and the fun begins. They leave around 11.30am, and the cleaning and wiping down starts again – yes it’s the pandemic but to be fair I would do this anyway. I quickly write up my notes and send home work to the client via email. Now it’s 12 noon and I start preparing for the next client at 12.30 pm. This might be online parent-child interaction coaching and so I need different materials and activities that are suitable for teletherapy. We finish around 1.30 pm and I will write up my notes before having some lunch.

Lunch tends to not be around 30 minutes. Around 2.00 pm I start prepping again for the next client: selecting activities, going over their last session, making sure I have everything I need to start at 2.45pm – we finish at 3.45pm, I write up my notes and then have a cuppa. The next client might be more on-line coaching or a child coming to see me: room cleaned and tidy, materials and activities prepared: client arrives at 4.30 pm and we finish at 5.30 pm. I clean the toys again, write up my notes and it is 6.00 pm ready for dinner. So that was four clients between 9 am and 6pm allowing for preparation, aftercare, cleaning and coffee and lunch.

Other days I might see three clients and do more admin like ordering toys or books or teletherapy activities, or making materials (we therapist make tons of materials, we’d put Blue Peter to shame!) Sometimes I do two home visits, one in the morning and one in the afternoon – the travelling/parking in London is so time consuming that it really reduces the number of clients I can see which is why I don’t do many of those.

I hand pick my clients to make sure that we are a good fit, and my service is bespoke: no one client gets the same treatment as another; each client is unique, usually very well-known and always highly valued. That takes time and means that in reality each client gets about 2 hours of my time, that is the actual session plus all the preparation and aftercare.

I love this way of working and would not ever want to return to seeing tons of clients each day, not knowing any of them really well, due to high caseload numbers, staff shortages and an overload of administration.

My way of working affords all my lovely clients the help they need to be able to feel empowered and to then support their children to make progress; when working with children they make the best progress they can make, fulfilling their potential. My lovely reviews and testimonials tell me that my clients appreciate the extra attention.

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.

Strategies to support children with eating difficulties
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Strategies to support children with eating difficulties

ByLondon Speech and Feeding

where the cause is NOT a swallowing problem, but we are having a “fussy eater” in the family, seeming for no obvious reason

When parents have a child who find mealtimes or eating difficult, it can put pressure on the whole family dynamics. Once we have observed a child’s eating and drinking skills and found that they are not swallowing impaired, but are for want of a better word “fussy” or “picky”, we can then start to look at what might be underpinning the food aversions/picky eating/food avoidance. Two of the main questions parents have (of course) are:

  • ‘is my child getting the right nutrition?’
  • ‘how can I have less anxiety-provoking and stressful mealtimes?’

We all tend to have an image in our minds about the ‘perfect mealtime’, and how mealtimes ‘should’ be. Speech and Language Therapists with a Feeding Specialism are the perfect professionals to help you unpick feeding issues. We are trained to look at swallowing and oral skills and we also know a lot about feeding behaviours and sensory difficulties which could be causing your child’s eating avoidance.

Here are some strategies that can support children with their eating:

  1. Create and maintain a mealtime culture that suits your home and lifestyle. Then stick to that. We all need some routine in our lives to thrive. Mealtimes are no different. It might be that you eat in the same place for every meal, with the same knives and forks, concentrating on maintaining good posture. Children learn by repetition so the more familiar it is, the easier they will find it. In the physical sense, our bodies also need preparing for food, regardless of whether we are eating with our mouths or we are tube-fed. We want every child to connect all the dots of the process. It starts with their eyes, noses, expectations, memories of past experiences, feelings and then finally their mouths….
  2. Be an excellent role model. Children learn through watching others, so your child will be observing you without you knowing. Ensure that you are positive about the food you are all eating, and talk about how delicious, tasty, juicy, and yummy the foods are. Make the atmosphere around the dinner table light hearted. Even though you are secretly stressed about your child not eating, try and not show this. Instead pick a topic or put on some nice music, or talk about something your child might be interested in, and try and avoid coercing your child to eat. Leave small finger foods on their plates and have a range of foods available on the table so that your child can see that everyone is eating a range of foods and enjoying them.
  3. Use positive reinforcement. Try and think of mealtimes as fun and motivating. Children who are happy will likely be more inclined to try foods and take part in family mealtimes. Reward all interactions around food, so if your child merely touches a new food then praise this behaviour. Or if your child licks a food just once, again make a nice comment and praise your child for touching and licking the food. The takeaway here is to try and keep all messages positive around food.
  4. Keep offering all types of food. What often happens is that parents stop serving foods they know will not be eaten. This makes sense in a way; we don’t want wastage! However, try and keep the doors open and re-offer all types of foods, even the ones that your child has not wanted in the past. Try and give your child one food they will like and one food they have tasted before and liked before, even a little, and then one new food to try. So, your child always has something to fall back on and they can join in with eating. But they can also try (or at least look at and think about trying) other foods that you and perhaps the siblings are eating.

Take a look at this website, I find it very helpful in showing parents what types of foods and how big a portion to offer

Have a go and try and implement some of the ideas above, and should you get stuck please get in touch!

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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