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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    When speech difficulties overlap: Helping children with phonological delay and childhood apraxia of speech

    ByLondon Speech and Feeding

    One of the questions parents often ask is:

    ‘What kind of speech difficulty does my child have?’

    It’s a very understandable question. We often hear different terms such as phonological delay, articulation difficulties, or Childhood Apraxia of Speech (CAS), and it can be confusing.

    The reality is that many children don’t fit neatly into one single category.

    In fact, quite often I see children whose speech profile includes a mixture of difficulties. They might have some phonological patterns (where they substitute one sound for another) alongside challenges with motor speech planning, where coordinating the movements needed for speech is harder.

    When this happens, therapy needs to be flexible, responsive, and tailored to the child sitting in front of us.

    Example

    Recently I filmed a short clip from one of my therapy sessions which shows exactly how this works in practice.

    The child I was working with has difficulties with several speech sounds. Part of the challenge relates to a phonological pattern called fronting.

    Fronting is when sounds that should be made further back in the mouth (like /K/ or /G/) are produced further forward instead.

    At the same time, this child also shows signs of motor speech planning difficulty, which means the brain has to work harder to organise and sequence the movements of the tongue, lips and jaw for speech.

    This type of profile can sometimes overlap with characteristics seen in Childhood Apraxia of Speech (CAS).

    When difficulties overlap like this, therapy cannot rely on a single approach. Instead, it needs to draw on multiple evidence-based strategies.

    That is exactly what you see happening in the clip. We started out generalising the /K/ sound which until recently had been replaced by a /T/ sound. Whilst looking at a sound loaded picture of /K/ sounds we somehow got talking about a ‘dent’ (I don’t recall how we got there!) but the ‘dent’ was a ‘det’ and I decided to tackle this there and then because there are other great words that end in ‘nt’ like : ‘count’ ‘giant’ ‘point’ or ‘paint’.

    Using visual cues to support motor planning

    Speech is incredibly complex. For children with motor speech difficulties, the challenge is not only knowing what sound they want to say, but also how to move their mouth to produce it.

    This is where visual cues can be incredibly helpful.

    In the clip, you can see me using a whiteboard with pictures and simple visual prompts. These help to:

    • Focus attention on the target sound
    • Understand where the sound occurs in the word
    • Remember the sequence of sounds needed

    Visual supports can act almost like a map for the mouth, guiding children as they practise new speech movements.

    For children with motor planning difficulties, this type of cueing can make a huge difference.

    Why repetition of a single word (massed practice) is so important

    Another key feature you will notice in the clip is lots of repetition.

    This is very deliberate.

    When we are supporting children with motor speech challenges, the brain needs repeated opportunities to practise the correct movement patterns. Just like learning a musical instrument or a new sport, repetition helps the brain build stronger and more efficient pathways.

    In therapy we call this massed practice.

    Rather than saying a word only once or twice, we practise it many times in a structured way, helping the child stabilise the new speech pattern.

    But repetition alone is not enough. The child also needs to understand why the sound matters.

    Showing children that sounds change meaning

    This is where another powerful therapy approach comes in: minimal pairs.

    Minimal pairs are word pairs that differ by only one sound. For example:

    • debt
    • dent

    In the clip, I use these two words to help the child realise that the /N/ sound makes a meaningful difference.

    Without the /N/, the word becomes something else entirely.

    This approach helps children recognise that speech sounds are not random: they carry meaning. If a sound is missing or substituted, the message may change.

    Helping children notice these differences can be a very motivating moment in therapy. Suddenly the sound is no longer just an abstract exercise; it becomes part of real communication.

    Blending approaches for the best outcomes

    In this short therapy moment, I am combining:

    • Visual cueing

    • Motor speech practice

    • High repetition (massed practice)

    • Minimal pair contrasts

    • Listening and awareness of sound differences

    Each element supports a different part of the speech system.

    Some strategies help with motor planning, others support phonological awareness, and others build accuracy and consistency.

    Together they create a therapy session that is both structured and responsive.

    Every child’s speech journey is unique

    One of the most important things I want to convey is that speech development is not always straightforward.

    Two children may both struggle with speech sounds, yet the underlying reasons may be very different.

    This is why careful assessment is essential, and why therapy needs to stay flexible as we learn more about how a child’s speech system works.

    Sometimes a child needs more motor-based work.

    Sometimes the focus shifts towards phonological contrasts.

    Often, as in this example, the most effective therapy uses both.

    Small steps lead to big progress

    Every session helps us understand a little more about how a child’s speech system works and what support will help them move forward.

    And when the pieces start to come together, when a child realises that one tiny sound can change a whole word, that is when the real progress begins.

    If you are concerned about your child’s speech sounds, clarity of speech, or possible motor speech difficulties, early support can make a significant difference. A detailed assessment can help identify the nature of the difficulty and guide a therapy approach tailored to your child’s individual needs.

    Feel free to contact me on www.londonspeechandfeeding.co.uk

    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.

    Reference

    McNeill, B. C., Gillon, G. T., & Dodd, B. (2009). Effectiveness of an integrated phonological awareness approach for children with childhood apraxia of speech (CAS). Child Language Teaching and Therapy, 25(3), 341-366.

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  • ·

    Principles of motor learning in childhood apraxia of speech: A guide for parents and therapists

    ByLondon Speech and Feeding
    Image by Freepik

    Childhood Apraxia of Speech (CAS) is a complex neurological disorder that affects a child’s ability to plan and coordinate the movements necessary for speech production. Children with CAS often have difficulty with articulation, prosody, and fluency, making it challenging for them to communicate effectively. While there is no cure for CAS, speech and language therapy can significantly improve a child’s communication skills and overall quality of life. Understanding the principles of motor learning is crucial for both parents and speech therapists to support children with CAS on their speech journey.

    What is MOTOR LEARNING?

    Motor learning refers to the process of acquiring and refining new skills through practice and experience. This applies to all aspects of movement, including speech production. The brain constantly receives sensory information about the movements being made and adjusts them based on the desired outcome. A breakdown or interruption of this process can make it difficult for children to plan, sequence, and coordinate the intricate movements involved in speech.

    What key principles do we use in speech and language therapy for motor learning?

    • Task Specificity: Speech Therapy activities that directly target the specific speech sounds or skills your child is working on. For example, if your child is struggling with /p/, practising isolated /p/ sounds, words with /p/, and phrases with /p/ would be most beneficial.
    • Massed vs. Distributed Practice: We consider the optimal amount and distribution of practice sessions throughout the day. Massed practice involves concentrated practice in a single session, while distributed practice spreads practice sessions throughout the day. The best approach depends on the individual child’s learning style and attention span.
    • Feedback: We provide clear and immediate feedback to help your child understand the accuracy and effectiveness of their attempts. This feedback can be auditory, visual, or touch based.
    • Error Correction: We aim to gently correct errors so that we can help your child refine their movements and avoid developing bad habits. The focus is on providing specific cues and guidance rather than simply pointing out mistakes.
    • Variety and Progression: We gradually introduce new challenges and variations in speech therapy activities to prevent plateaus and maintain motivation.
    • Motivation and Engagement: A big part of our work is to make therapy sessions fun and engaging to keep your child motivated and actively participating. We use games, songs, and activities that your child enjoys while incorporating targeted practice opportunities.

    What about home work?

    Yes we need your help and here are some examples of how this could look:

    • Task Specificity: During story time, focus on practising target sounds present in the story. Have your child repeat words or phrases containing the sound and encourage them to identify the sound in other words.
    • Massed vs. Distributed Practice: Instead of one long practice session, try shorter, more frequent sessions throughout the day. This can help maintain focus and prevent fatigue. It is recommended to go for 100 repetitions of the target sound per day, every day in between the sessions. We can decide together how you can best do that through either massed or distributed practice. We can decide after the session.
    • Feedback: Use a mirror to provide visual feedback on lip and tongue placement during sound production. Record the child’s speech and play it back to help them self-monitor their accuracy.

    I quite like this mirror below but any table top mirror will work as long as it is not too small. Your child should see their whole face easily.

    tabletop mirror
    • Error Correction: If the child makes an error, gently model the correct sound or movement without shaming or criticising. Provide specific cues such as ‘lips together’ for /p/ or ‘tongue up’ for /t/.
    • Variety and Progression: We will guide you on exactly what words to practise so this is something you need not worry about.
    • Motivation and Engagement: Use games, songs, and activities that your child enjoys. Play a game of ‘I Spy’ focusing on words with the target sound or create silly sentences with the sound to make practice fun.

    Let’s work together!

    It is crucial for parents, therapists, and other caregivers to work collaboratively to ensure a consistent and comprehensive approach to supporting your child’s speech development. Speech and Language Therapists can provide guidance and resources on implementing these principles at home, while parents can share observations and progress updates to inform therapy sessions.

    Remember, every child with CAS learns at their own pace. By understanding and applying the principles of motor learning, parents and speech therapists can create a supportive and stimulating environment that empowers children with CAS to reach their full communication potential.

    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.

    2
  • · · ·

    The quiet power: Why silence and responsiveness boost communication in children with delays

    ByLondon Speech and Feeding
    The quiet power: Why silence and responsiveness boost communication in children with delays
    Supplied by Sonja McGeachie, Practice Owner

    As parents and caregivers, our natural instinct when interacting with a child, especially one who struggles with communication, is often to fill every silence. We might ask lots of questions, offer constant commentary, or try to prompt him or her to speak. Our hearts are in the right place. We want to help him or her communicate! However, for children with language delays or those on the autism spectrum, this well-intentioned approach can sometimes inadvertently create more pressure and fewer opportunities for them to truly initiate and develop their own communication skills.

    What if I told you that one of the most powerful tools in your communication toolkit is often silence? And that responding to your child, rather than always initiating, can unlock incredible potential?

    Let’s explore why these seemingly simple strategies are so profoundly beneficial.

    The unspoken benefits of silence

    In our fast-paced world, silence can feel awkward, but for a child who is processing language differently, it’s a gift:

    1. Time to process: Children with language delays often need more time to process what they hear and to formulate their own thoughts or responses. When we bombard them with words, we don’t give their brains the crucial milliseconds they need to catch up. A pause of 5–10 seconds can make all the difference.
    2. Reduces pressure: Constant questioning or prompting can feel like a test. Silence removes this pressure, creating a more relaxed environment where the child feels safe to communicate without fear of being ‘wrong’ or rushed.
    3. Creates opportunity to initiate: If you’re always talking, when does your child get a turn to start the conversation? Silence opens up a space for him or her to initiate, whether it’s through a sound, a gesture, eye contact, or a word. This is vital for developing spontaneous communication.
    4. Encourages independent thinking: When a child is given space, he or she is more likely to try to figure things out himself or herself. This fosters problem-solving skills and reduces reliance on adult prompts.
    5. Prevents overwhelm (especially for ASD): Many children on the autism spectrum can be sensitive to auditory input. A constant stream of language can be overwhelming, leading to withdrawal or challenging behaviours. Strategic pauses can help them regulate and engage more effectively.

    The power of responding (not just initiating)

    Think of a tennis match: if only one person serves, it’s not a game. Communication is a rally, a back-and-forth exchange. When you primarily respond to your child’s communication attempts, you’re teaching him or her the rhythm of conversation:

    1. Follow the child’s lead: This is a cornerstone of effective language intervention, famously championed by programs like Hanen’s ‘It Takes Two to Talk’. When you respond to what your child is already interested in or doing, the interaction becomes immediately relevant and motivating for him or her.
    2. Validates his or her attempts: Every sound, gesture, glance, or partial word your child offers is a communication attempt. By responding to it, you’re telling him or her, ‘I see you. I hear you. Your communication matters.’ This builds immense confidence and encourages him or her to try again.
    3. Builds confidence and motivation: When a child feels understood and successful in his or her communication, he or she are more likely to communicate more often. It’s a positive feedback loop.
    4. Teaches turn-taking naturally: By taking your turn after his or hers, you model the natural flow of conversation. He or she learns that communication is a shared activity, not a one-sided lecture.
    5. Makes interactions meaningful: When you respond to his or her interests, you’re talking about things that are inherently motivating to him or her. This makes the language you use more easily understood and remembered.

    Practical strategies for parents: Observe, Wait, Listen (OWL)

    The Hanen Centre’s ‘Observe, Wait, Listen’ (OWL) strategy perfectly encapsulates these principles:

    • Observe: Watch your child closely. What is he or she looking at? What is he or she doing? What sounds is he or she making? What gestures is he or she using?
    • Wait: After you’ve observed, wait. Give him or her time. Resist the urge to jump in with a question or comment immediately. Count to five (or even ten) in your head. This silence is an invitation for him or her to communicate.
    • Listen: When he or she does communicate (in any way!), listen intently. Try to understand his or her message or intent.

    Beyond OWL – More tips:

    • Reduce questions, increase comments: Instead of ‘What’s that?’ try ‘Oh, a big red ball!’ or ‘The car is going fast!’ Comments provide language models without demanding a verbal response.
    • Expand, don’t just prompt: If your child says ‘Car’, you could respond with ‘Yes, That’s a big car!’ or ‘It’s really fast!’ You’re building on his or her communication with a slightly richer language model.
    • Create opportunities for communication: Place desired items slightly out of reach. This creates a natural reason for your child to communicate his or her wants (e.g., reaching, pointing, vocalising).
    • Respond to all communication: Don’t just wait for words. If your child points, look where he or she is pointing and comment. If he or she makes a sound, imitate it or respond with a related word.

    In summary

    Embracing silence and prioritising responsiveness might feel counterintuitive at first, especially when you’re eager for your child to talk. However, these powerful strategies create a nurturing, low-pressure environment that encourages spontaneous communication, builds confidence, and truly meets your child where he or she is. By giving your child the space and the meaningful responses he or she needs, you’re laying a strong foundation for his or her communication journey.

    Try incorporating these ‘quiet powers’ into your daily interactions and watch your child’s communication blossom.

    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
  • ·

    How to model AAC with our minimally speaking students?

    ByLondon Speech and Feeding
    modelling AAC

    How should we start? Should we use prompts? What kind of prompts? hand-over-hand or just pointing? Should we wait, and, if so, how long? Introducing an alternative communication system (AAC) to our child is for many of us a confusing and sometimes scary prospect, but it needn’t be! Let me reassure you and share some tricks of my practice in this area.

    Once we have decided to try for a picture based communication system, I usually start with a paper-based single page with between 48–88 core-words. I choose the number of words depending on where the child is developmentally and also verbally.

    If a child does have a small handful of words already, I might start with the 88-cell board below. If, on the other hand, my student is completely non-speaking and still quite little then I might go for the 48-cell below here or I might have even less cells to start with. Again, sometimes I start with an electronic device in my clinic just to trial and introduce the idea and to see if, or how, a student responds. 

    Below are some samples: a 49-cell board which I made for a child in a nursery setting

    Below a Saltillo WordPower board that can be downloaded from the Saltillo website:

    Example of a slightly more advanced board, again from the Saltillo Website

    And here below one example of a board I made for a specific activity for a child who loves water and sand play:

    It is perfectly possible to be very flexible and create a suitable board for any student, starting with as few as 2–5 cells and working up to over a 100 (very small ones) on a sheet of A4 or A3 paper.

    So once we have a good board for our child, what now? How do we start introducing this into our daily life?

    We can start by showing/pointing to the word GO within a play activity. For example:

    • a car run,
    • or a marble run,
    • or a spinner activity,
    • a wind-up toy,
    • anything that can be stopped and started easily.

    How to start?

    I will talk us through each of the steps using the example for the word ‘GO’.

    First phase

    The first phase is a TEACHING/ LEARNING PHASE. In this phase we do not expect our student to do anything, to copy us or to point to the board. If they do that it is of course a huge bonus and we will celebrate it.

    Our job is to simply MODEL/SHOW/GIVE EXAMPLES of how we can use the board, by steadily and regularly pointing to the chosen word or words. We do so across the day and across settings:

    • play
    • meal time
    • getting dressed/undressed
    • bath time
    • going to the car/shops
    • etc

    Once we can be sure that our student has been submerged and SOAKED in seeing the coreboard being used, say after some 3–4 weeks of using it consistently…

    Second phase

    We can begin to move into the second phase which is the PRACTICE PHASE. By now the student has seen the boards and he or she has seen the word GO (as a example) modelled many times.

    Now we can start to see if we can tempt our student into trying this out for themselves.

    What sort of TEMPTING are we talking about? Take a look at the Prompt Hierarchy below, which shows us what to do to get our student to be independently communicating as soon as possible. 

    The PROMPT HIERARCHY: what sort of prompting should we do, should we expect something from our student or how should we view this stage?

    1.  TEMPT AND PAUSE

    I have the AAC near to the toy and each time the child starts another round of the activity I say clearly ‘GO’ and I point to the picture as do so. I then pause and wait to see what happens. NOTHING? Then…

    1. USE SIGNS AND BODY LANGUAGE

    Next time the child starts another round I might be very animated and do a Makaton sign for GO as I say ‘GO’ and I make a very over point to the picture again. Then I wait. STILL NOTHING? OK then…

    1. OPEN-ENDED QUESTION

    Now I might say ‘GO’ and follow with: ‘OOH I WONDER IF THERE IS A PICTURE TO POINT TO…’

    ‘OH LOOK HERE IS GO!’ I then point to GO.

     STILL NO RESPONSE?

    1. ASK FOR A RESPONSE

    I might say ‘GO’ followed by ‘LOOK! LET’S POINT TO GO HERE ON THE PICTURE.’

    STILL NO RESPONSE? 

    1.  PHYSICAL TOUCH

    Next time I say ‘GO’ I will try and take the student’s hand, help isolate their finger and help him or her to point to the actual picture.

    REMEMBER: Prompting serves a very important function in scaffolding learning for students BUT if we are constantly prompting kids, then we are teaching them to only communicate when someone tells them to. We want our student to become as independent in speaking and using words as possible.

    So once I have done Physical Prompting I will try and phase back down to number 1 where all I need to do is point to the picture or look at the board with the aim that the student will then point to the picture.

    Take away points:

    • Keep the learning phase pressure-free and model without expecting our student to jump in. In other words, let’s model first without expectation. Later we can have a little bit of expectation.
    • After they’ve been exposed to and have been ‘soaked’ in plenty of AAC input, then, YES, we can create an opportunity to help them say or point to the word on their own.
    • We can model BOTH with and without expectation.
    • Only after LOTS of exposure, use the least to most prompting hierarchy and start creating opportunities for a student to become an independent communicator.

    Do get in touch if you have any questions or comments or if you would like some practical help.

    I am always pleased to hear from you.

    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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  • When ‘star’ sounds like ‘dar’: Understanding speech sound disorders and the path to clearer speech

    ByLondon Speech and Feeding

    If your child says ‘dar’ instead of ‘star’, you might be wondering if they will simply outgrow it or if they require specialised support. While ‘cluster reduction’—dropping one of the sounds in a blend—is a normal part of learning to talk, we typically expect these sounds to lock into place by age four years. If these errors persist as a child approaches school age, it often signals a speech sound delay that may now no longer pass without help. As a Speech and Language Therapist, I specialise in helping children bridge this gap using evidence-based techniques like backward chaining.

    This isn’t about constant correction; it’s about providing the right clinical scaffolding to move a child from ‘frustrated’ to ‘fluent’ before they hit those critical early school years.

    Dropping sounds from words is a common feature of speech sound difficulties, and while it can look small on the surface, it can have a big impact on how clearly a child is understood. In this short video clip, I’m working with a child on an /ST/ sound cluster, demonstrating how I use an evidence-based speech therapy technique called backward chaining to help children build clearer speech with confidence.

    What’s actually happening when a child drops the ‘S’?

    Clusters like /ST/, /SP/, and /SK/ are tricky. They require:

    • precise timing
    • careful airflow
    • and the ability to blend sounds smoothly

    For many children, especially those with speech sound difficulties, this is a big ask.

    So instead of hearing:

    ‘star’

    we might hear:

    ‘tar’ or ‘dar’

    This isn’t laziness or refusal. It’s the child simplifying the word to make it manageable.

    Why I don’t start by saying ‘say star’

    Telling a child to ‘just add the S’ rarely works.

    Instead, I meet them where they are already successful.

    In this clip, the child can already say ‘dar’ clearly. That’s our starting point.

    Backward chaining: building speech from success

    Backward chaining means we:

    1. Start with the part of the word the child can already say
    2. Gradually add the missing sound
    3. Keep the child feeling successful at every step

    So rather than jumping straight to ‘star’, we:

    • secure the ending
    • gently introduce the /S/
    • and blend it in a way that feels achievable

    This approach reduces frustration, builds confidence, and helps the sound stick not just in the therapy room, but out in the real world.

    Why this matters beyond one word

    This isn’t just about saying ‘star’.

    It’s about:

    • teaching the mouth a new movement pattern
    • giving the brain time to organise the sound sequence
    • and helping the child feel capable, not corrected

    When therapy feels safe and successful, children are far more likely to generalise their new sounds into everyday speech.

    Speech therapy works best when children feel supported not tested.

    If your child struggles with speech clarity

    If your child:

    • drops sounds from words
    • avoids longer or trickier words
    • or becomes frustrated when they’re not understood

    This is the kind of work I do every day building speech step by step, in a way that respects each child’s pace and strengths.

    Support can be gentle, effective, and empowering.

    If you’d like to learn more about how speech therapy can support your child, you’re always welcome to get in touch.

    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
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    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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    Explore how to improve communication skills for a Gestalt Language Processor

    ByLondon Speech and Feeding

    Let’s break it down into steps to make these complicated words easier to understand. Once you have a deeper understanding, you will then be able to support your child or young person develop their communication skills in the best way as a Gestalt Language Processor. Remember not every child will be a Gestalt Language Processor; if your child uses echolalia and/or has a diagnosis of autism then your child’s way of processing language is most likely different to the classic way children typically learn language.

    Let’s start with understanding what each of these words “Gestalt Language Processors” mean.

    Gestalt: “the way a thing has been placed or put together”

    Language: “a system of human communication”

    Processors: “responds to and processes basic instruction”

    So, let’s put those meanings together. “Gestalt Language Processors are children who process early language in strings of sounds or chunks.” They tend not to process single words.

    It is important to understand this way of processing communication because between 75-90% of children with Autistic Spectrum Conditions process language in this way (Blanc, 2012). We know that it’s important for young people to have their voice heard and to be able to express themselves. So, it’s vital that they move from echolalia to self-generated communication to be able to do this. This means that our children’s communication partners play a vital role in supporting their child’s language. We can support our children by modelling phrases until the child has learnt the process themselves.

    Speech Therpaist in London

    Let’s explore an example together

    X (who is a gestalt language processor) and his family love to feed the ducks in their spare time; this is an activity that takes place regularly. Let’s look at how you, as the adults, could support X in his communication. Look at the phrases that are used. They are meaningful to the activity with repetition used throughout.

    Top tip: You could think of an activity you and your child or young person take part in on a regular basis and brainstorm some key phrases that you could use.

    Need a boost in confidence to support your child’s gestalt language processing?

    Contact me.

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

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