Using AAC in daily life

ByLondon Speech and Feeding
| |

Communication is a fundamental human right, a bridge that connects us to the world and each other. For many, spoken language is the primary mode, but for individuals with complex communication needs, Augmentative and Alternative Communication (AAC) offers a powerful pathway to expression and connection. This guide will demystify AAC, highlight the crucial role of modelling, and provide practical examples of how low-tech AAC can be seamlessly integrated into everyday activities.

What is AAC in a nutshell?

AAC encompasses a wide range of tools and strategies that supplement or replace spoken language. It’s not about replacing speech, but rather about providing additional ways for individuals to communicate effectively. Think of it as a spectrum:

  • Unaided AAC: This involves using only your body, such as gestures, facial expressions, body language, and sign language.
  • Aided AAC: This involves external tools or devices. These can range from low-tech options like picture boards and communication books to high-tech speech-generating devices (SGDs) and apps on tablets.

The beauty of AAC lies in its flexibility and personalisation. It empowers individuals to express their wants, needs, thoughts, and feelings, fostering independence and participation in all aspects of life.

Modelling is KEY: Showing, not just telling

Imagine trying to learn a new language without ever hearing it spoken. It would be incredibly difficult, right? The same principle applies to AAC. Modelling is the single most important strategy for teaching and supporting AAC users. It means actively using the AAC system yourself while talking, demonstrating how to navigate the system and express messages.

Here’s why modelling is so vital:

  • It’s how we learn language: Typically developing children learn language by hearing it constantly around them. AAC users need the same immersion.
  • It reduces pressure: When you model, you’re not asking the individual to communicate, you’re just showing them how it’s done. This takes the pressure off and makes learning more enjoyable.
  • It expands vocabulary and concepts: By modelling a variety of words and phrases, you introduce new vocabulary and demonstrate how to combine symbols to create more complex messages.
  • It demonstrates purpose: Modelling shows that AAC is a functional and effective way to communicate, not just a set of pictures.

So, how do you model? It’s simple: point to the symbols on the communication board or device as you speak the words. For example, if you say, ‘Time to eat breakfast,’ you might point to ‘time’, ‘eat’, and ‘breakfast’ on the board.

Low-tech AAC in action: Everyday activities

Low-tech AAC, such as communication boards, books, or single-page displays, is incredibly versatile and can be easily incorporated into daily routines. These can be as simple as printed pages with symbols, laminated for durability.

Let’s explore how low-tech AAC can be used throughout a typical day, with examples of symbols:

1. Getting ready for nursery

Mornings can be busy, but they also offer rich communication opportunities. A ‘Getting Ready’ communication board can help sequence activities and offer choices.

Activity example:

‘Time to get up!’ (point to GET UP). ‘What do you want to wear today, the blue shirt or the red shirt?’ (point to GET DRESSED) ‘Then, we brush teeth’ (point to TOOTHBRUSH) and so on.

AAC mornings symbol examples

2. Breakfast Time

Mealtimes are perfect for making choices, expressing preferences, and commenting. A ‘Breakfast’ communication board can focus on food items, actions, and social comments.

Example symbols:

AAC meal times symbol examples

Activity example:

‘What do you want to eat for breakfast?’ (point to EAT). ‘Do you want cereal or toast?’ (point to CEREAL or TOAST). If they finish their milk, you could say, ‘Are you ALL DONE or do you want MORE MILK?’ (point to symbols).

3. Catching the Bus

Even routine transitions like catching the bus can be communication rich. A small, portable ‘Travel’ board can be useful.

Example symbols:

AAC catching the bus symbol examples

3. Being on the playground

The playground is a dynamic environment perfect for commenting, requesting actions, and engaging in social play.

AAC playground symbol examples

Activity example:

‘Let’s PLAY!’ (point to PLAY). ‘Do you want to go on the SWING or the SLIDE?’ (point to symbols). If they are on the swing, you can say, ‘Do you want to go FAST or SLOW?’ (point to symbols) and ‘Push AGAIN!’ (point to PUSH) You can also model social language like ‘It’s MY TURN.’

Beyond the symbols: Key takeaways

  • Consistency is key: Use AAC consistently across all environments and with all communication partners.
  • Be patient: Learning a new language takes time. Celebrate small successes.
  • Make it fun: Integrate AAC into play and enjoyable activities.
  • Follow the individual’s lead: Respond to all communication attempts, even if they are imperfect.

In the video below I model how to integrate AAC into everyday activities with a few more examples and I discuss the difference between AAC and PECS.

If you need some inspiration with using AAC or would like your child assessed for the right type of AAC then please 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
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

Similar Posts

  • A day in my speech clinic: Mastering the /SP/ cluster

    ByLondon Speech and Feeding

    I very often work on /S/ Blends (/SP/ /ST/ /SM/ /SK/ /SN/ and /SL/). When we work on these sound blends (like SPider, STop, or SMile), we are using a clever speech therapy ruse! Because these blends are complex, teaching a child how to master them naturally helps them clear up simpler single sounds (like just /S/ or just /P/) at the same time. Plus, because S-blend words are so common in everyday language think spoon, spy, spot, and spin, practising them gives your child an immediate confidence boost when they are understood much more easily.

    Good news: high-repetition motor practice doesn’t have to be a chore. In fact, the more sensory input we can provide, the faster those new neural pathways are built. Recently, I recorded a series of seven short clips to demonstrate how we can weave intense speech practice into the fabric of play.

    Here is a look at a typical day in the clinic focusing on /SP/ blends.

    1. The sensory sandbox:

    We started our session at the sensory table. Sensory bins can often work well because they provide tactile feedback that grounds the child’s focus (of course they are usually messy, so one needs to have the physical space and energy for it to be fair!).

    • The Activity: I pointed to our ‘I Spy’ board before we dove into the sand. Using a toy spade we dug for hidden objects and named them each time we found one.
    • Every time we scooped, we practised Spade. Every discovery was a spider, a spoon or a spotty animal. By pairing the physical effort of digging with the speech sound, we help the brain synchronise motor planning and vocal execution.

    2. Bingo dabbers rock!

    Next, we moved to making ink marks on paper.

    • The Activity: I demonstrated making spots with coloured bingo dabbers.
    • We treated each ink spot as a visual anchor. Stamp –Spot Stamp –Spot. This creates a rhythmic pacing that prevents the child from rushing. It’s a wonderful way to get 50+ repetitions in under five minutes without the child even realising they are ‘working’.

    3. Drawing spiders

    Building on the previous activity, we took those spots and turned them into something more complex.

    • The Activity: I drew spiders out of the spots we had just made.
    • Drawing the legs provided a perfect opportunity for ‘stretch’ sounds. As we drew a long leg, we practise a long, hissy ‘Sssssssss’, snapping into the /P/ as the pen hits the spot.

    4. Wind-up spinners

    High-energy toys are excellent for eliciting ‘power’ sounds.

    • The Activity: I brought out two mechanical wind-up spinners.
    • Method: The child says Spin or Spinner to get me to wind them up. The anticipation of the toy moving acts as a natural reinforcer.

    5. The Incy Wincy spider game

    • The Activity: I spun a game spinner to determine how many steps our toy spiders would take up the spout.
    • This activity is a triple threat. We practised ‘Spin’, ‘Spider’, and ‘Spout’ all in one go. The visual of the spider moving up the spout also helps with the concept of UP and DOWN of course.

    6. Searching for Spot

    Books are a great tool for generalisation, taking a sound from a single word and moving it into phrases and sentences.

    • The Activity: We went through a ‘Spot the Dog’ book.
    • Instead of just reading, we used the ‘I Spy’ strategy. ‘I spy Spot! He has a big spot on his back!’ This encourages the child to use the target word in a functional, communicative way rather than just repeating it after me.

    7. Finally, sponging off some sand

    We ended the session with some ‘heavy work’ and cleaning.

    • The Activity: We took a soft toy that had gotten a bit ‘dusty’ in the sandbox and used a sponge to clean it down.
    • The action of squeezing the sponge provides proprioceptive input (pressure), which can be very calming and help a child focus on their articulatory placement for those final repetitions of the day.
    A day in my speech clinic: Mastering the /SP/ cluster

    Speech therapy works on motor learning. Just like learning to ride a bike or play the piano, the brain needs thousands of correct repetitions to make a movement automatic. By using /SP/ words in these seven distinct, sensory-rich ways, we:

    1. Reduce frustration: The focus is on the play, not the correction.
    2. Increase engagement: A child who is having fun will stay in the learning zone longer.
    3. Provide context: The child learns that saying /SP/ correctly helps them get the spade, spin the spinner, and find the spider.

    Next time I will show you some more activities for /ST/ and /SM/ words. If you have any super ideas for /S/ cluster words please leave me your suggestions in the comments on instagram, I would appreciate it thank you! 😊

    If you are concerned about your child’s speech, please do not hesitate to get in touch. I would love to help you find some answers.

    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.

    3
  • ·

    Joint attention for children with autism

    ByLondon Speech and Feeding
    Kids Speech Therapist London

    Why is joint engagement important for communication development?

    It has been well-documented that the development of joint attention is impaired in children who have social communication difficulties or autism. It is, in fact, this impairment which distinguishes children with ASD from children who have other developmental delays.

    A lack of joint attention in very young children is an early sign of autism as it is a signal that there is a disruption in the motivation to connect socially with others. Since this is a crucial element, I thought I would outline what we mean by Joint Attention as supported by the research undertaken at Hanen.org.

    In typically developing children, the ability to shift attention between a person and an object for the purposes of connecting socially or for requesting develops around the same time. However, for children with ASD, these components emerge one at a time and in a linear fashion. Children with ASD usually start with requesting something and later they may learn to share attention for social sharing. (see pattern below as a general guide).

    As with typical development, there is variation in the order that these skills emerge but the following patterns of development is commonly seen:

    • Reaching, taking adult’s arm/hand or pointing to ask for something — but without looking at the adult
    • Gradually alternating looking between person and object of desire
    • Then learning to follow the point of another — which is responding to joint attention initiated by another
    • Directing attention to share interests — without looking at the adult: pointing to a truck on the road/ helicopter circling above
    • Then directing attention to share interest by alternating gaze shift between person and object — here the child is now initiating joint attention.

    What is important to note is that in order to fulfil the criteria for true joint attention, the purpose of directing the attention of another person must be social in nature. In other words, it must not be exclusively to obtain a desirable object or event/action. True Joint Attention is seen verbally or non-verbally; we want to share a thought with another person and direct them to something we are interested or excited or spooked by.

    For example: we can see an amazing firework display in the distance and we want to quickly direct our friend’s attention to this. In order to do this we might be tugging their sleeve/arm whilst pointing to the display in the distance, and perhaps we might add “wow look over there!” We are doing so simply to share an interest without obtaining anything, we are just being social with each other. So True Joint Attention is not just looking at what we want to have, then look at the person who can get this for us and then point to the item. We can say that this is the precursor to true joint attention, which is purely social in nature.

    Because true joint attention is an essential precursor to typical language development, the absence of joint attention in children with ASD contributes to difficulties with language learning. Beuker, K., Rommelse, N., Donders, R. & Buitelaar, J. (2013).

    The Hanen programme for Parent Child Interaction teaches parents of children with Social Communication Difficulties step by step how to enable their children to learn to pay attention to an object and the parent at the same time.

    We learn how to enable a child to:

    • engage take turns
    • shift eye gaze between toy and adult
    • copy adult’s actions, gestures and then words
    • play with toys in different, new ways
    • interact and for longer periods of time
    • have fun whilst playing

    If you would like to know more about the Hanen programme please get in touch. I look forward to exploring the topic with you and help guide you forward if this is something your child is struggling with.

    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.

  • · · ·

    Autism – Benefits of Early Assessment and Intervention

    ByLondon Speech and Feeding
    I think my child might be autistic – how can we help?
    Image by macrovector on Freepik

    Consulting a Specialist Speech and Language Therapist can help you in several ways: assessment, informal and formal observation, discussion and advice, onward referrals, direct intervention, parent coaching, educational support and much more, all geared towards supporting you the parents, and helping your child to flourish and thrive.

    First up, we can help you with assessment and advice: with a wealth of expertise in observing childrens’ play and communication, as well as knowledge of the latest research we can see a child’s strengths and areas of struggle very quickly indeed.

    Within a short space of time, we can identify the areas we need to focus on and start guiding you towards helping your child to connect, respond, react and feel better.

    Early detection is key

    If autism is detected in infancy, then therapy can take full advantage of the brain’s plasticity. It is hard to diagnose Autism before 18 months but there are early signs we know to look out for. Let’s have a brief look at the sorts of things we look at.

    The earliest signs of Autism involve more of an absence of typical behaviours and not the presence of atypical ones.

    • Often the earliest signs are that a baby is very quiet and undemanding. Some babies don’t respond to being cuddled or spoken to. Baby is being described as a ‘good baby, so quiet, no trouble at all’.
    • Baby is very object focused: he/she may look for long periods of time at a red spot/twinkly item further away, at the corner of the room for example.
    • Baby does not make eye contact: we can often see that a baby looks at your glasses for example instead of ‘connecting’ with your eyes.
    • At around 4 months we should see a baby copying adults’ facial expressions and some body movements, gestures and then increasingly cooing sounds we make; babies who were later diagnosed with autism were not seen to be doing this.
    • Baby does not respond with smiles by about 6 months.
    • By about 9 months, baby does not share sounds in a back-and-forth fashion.
    • By about 12 months baby does not respond/turn their heads when their name is called.
    • By around 16 months we have no spoken words; perhaps we hear sounds that sound like ‘speech’ but we cannot make out what the sounds are.
    • By about 24 months we see no meaningful two-word combinations that are self-generated by the toddler. We might see some copying of single words.

    24 months plus:

    • Our child is not interested in other children or people and seems unaware of others in the same room/play area.
    • Our child prefers to play alone, and dislikes being touched, held or cuddled.
    • He/she does not share an interest or draw attention to their own achievements e.g., ‘daddy look I got a dog’.
    • We can see our child not being aware that others are talking to them.
    • We see very little creative pretend play.
    • In the nursery our child might be rough with other children, pushing, pinching or scratching, biting sometimes; or our child might simply not interact with others and be unable to sit in a circle when asked to.

    What sort of speech and language difficulties might we see?

    Our child might do any of the following:

    • have no speech at all, but uses body movements to request things, takes adults by the hand
    • repeat the same word or phrase over and over; sometimes straight away after we have said it or sometimes hours later
    • repeat phrases and songs from adverts or videos, nursery rhymes or what dad says every day when he gets back from work etc.
    • copy our way of intonation
    • not understand questions – and respond by repeating the question just asked:
      • adult: Do you want apple? child: do you want apple?
    • not understand directions or only high frequency directions in daily life
    • avoid eye contact or sometimes ‘stares’
    • lack of pointing or other gestures

    Common behaviours:

    • Hand flapping
    • Rocking back-and-forth
    • Finger flicking or wriggling/moving
    • Lining up items/toys
    • Wheel spinning, spinning around self
    • Flicking lights on and off, or other switches
    • Running back-and-forth in the room, needing to touch each wall/door
    • Loud screaming when excited
    • Bashing ears when frustrated or excited
    • Atypical postures or walking, tip toeing, can be falling over easily, uncoordinated
    • Can be hyper sensitive to noises, smells, textures, foods, clothing, hair cutting, washing etc.
    • Being rigid and inflexible, needing to stick to routines, unable to transition into new environments
    • Food sensitivity, food avoidance, food phobias

    I mentioned this to be a ‘brief’ look at the areas and it is: each topic is looked at very deeply and each area is multi-facetted therefore a diagnosis is rarely arrived at very quickly. We want to make sure we have covered all aspects and have got to know your child very well before coming to conclusions.

    Early detection is key, because we want to start helping your child to make progress as quickly as is possible. If you feel /know that your child is delayed in their speech and language development and you would like a professional opinion then please do contact me, I look forward to supporting you. It is important to know at this point, that if your child only has one or two of the above aspects it may mean that your child is simply delayed for reasons other than Autism and if that is the case, we will be able to help you iron out a few areas of need so that your child can go on thriving.

    If you need help with your child, please do not hesitate to contact me.

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

    1

  • One book, dozens of therapy opportunities: What speech therapy really looks like

    ByLondon Speech and Feeding

    As speech and language therapists, some of the most effective moments in therapy don’t come from flashcards, worksheets, or even drilling sounds (though to be fair I do drill quite a lot too! needs must…😊).

    By and large they happen in natural interaction — during shared attention, laughter, storytelling, and connection.

    This short video clip captures that.

    In under two minutes, while simply reading a book together with a three-year-old child, we naturally work on:

    • Speech sounds
    • Vowel production
    • Early phonological patterns
    • Motor planning
    • Signing and total communication
    • Visual cueing
    • Repetition and practice
    • Confidence building
    • And engagement through play

    To many people, it may just look like ‘reading a book’.

    But underneath that moment are years of specialist training, clinical decision-making, preparation, and therapeutic skill.

    Therapy hidden inside play

    One of the most important parts of paediatric speech therapy is knowing how to embed targets into meaningful interaction.

    Books are one of my favourite therapy tools! Why: because as speech therapists we need to prepare for our child and our sessions. And having a book gives me the structure to know beforehand what kind of sounds or words might be coming up. Then I can be prepared for providing extra support for them. As you can see in this clip, I had the sound cards just there because I had anticipated what might be coming up!

    A single story can provide opportunities for:

    • Speech sound practice
    • Vocabulary development
    • Sentence building
    • Turn-taking
    • Symbolic understanding
    • Attention and listening
    • Gesture and signing
    • Motor speech cueing
    • And social communication

    In this clip, I follow my little one’s interests while carefully weaving in her individual therapy targets.

    It looks relaxed and spontaneous — and it is — but it is also highly intentional.

    Catching opportunities in the moment

    One lovely example in the clip is when she says ‘yes’.

    She is now starting to say the final /S/ sound, so I immediately model and draw attention to it using the ‘snake sound’ visual cue, giving her positive feedback that she can now also try using this sound at the start of words.

    My gently shaping the word ‘yeSSSS.’ gives her:

    • Auditory feedback
    • Visual support
    • And an achievable opportunity to try again

    A few seconds later, we naturally practise it again.

    That’s responsive therapy.

    Speech therapists are constantly listening, analysing, adapting, and deciding:

    • When should I model?
    • When should I pause?
    • When should I repeat?
    • When should I let it go?
    • How can I keep confidence high while still targeting speech?

    These decisions happen in seconds.

    Working on speech without ‘stopping the play’

    Another moment in the clip focuses on the word ‘out’, where the vowel sound is one of her speech targets.

    Then we move into practising the word ‘open’, a word she has previously found difficult.

    Within this one word, we can support:

    • Sequencing
    • Motor planning
    • Lip shape
    • Vowel production
    • And speech sound accuracy

    We also briefly practise the /K/ sound — a sound produced at the back of the mouth which can be particularly tricky to produce.

    Instead of explaining it verbally (which is often too abstract for young children), I use:

    • Visual demonstration
    • Exaggerated mouth movements
    • Gesture/sign support
    • And playful modelling

    Children learn through seeing, hearing, doing, and experiencing.

    That is why Speech Therapists use multiple layers of cueing simultaneously.

    Why I use signs alongside speech

    Throughout the clip, I also use signs such as ‘book’ and ‘pig’.

    Using signs does not stop children talking.

    In fact, for many children, signs:

    • Reduce frustration
    • Support understanding
    • Increase participation
    • Reinforce vocabulary
    • And help bridge the gap while speech is developing

    Communication always comes first.

    Speech is only one part of communication.

    When children feel successful communicating, they are far more likely to keep trying.

    The skill behind ‘natural’ therapy

    One thing I often hear from parents is:

    ‘You make it look so easy.’

    That is actually one of the biggest compliments a therapist can receive. (Though we also often feel we need to justify our very existence with these thoughts because we don’t just play/just read but we know it can look like that!) 😊 this is the reason for this blog…

    High-quality paediatric therapy should feel warm, playful, responsive, and natural.

    But underneath that natural interaction is:

    • Clinical knowledge
    • Phonological analysis
    • Motor speech understanding
    • Language development expertise
    • Sensory awareness
    • Relationship-building
    • And careful session planning

    Before this session even began, I already knew:

    • Which speech patterns to target
    • Which words would likely appear in the book
    • What visual cues might help
    • Which signs to model
    • And how to adapt depending on the child’s responses

    That preparation allows therapy to stay child-led without losing therapeutic focus.

    Following the child while leading the therapy

    The best therapy is rarely rigid.

    Children do not learn communication through pressure or endless correction. They learn through interaction.

    That is exactly what this short clip demonstrates.

    One book.
    One conversation.
    Hundreds of tiny therapeutic decisions.

    And all within a joyful moment shared together.

    Because good speech therapy should never feel like hard work for a child.

    It should feel like connection, confidence, success — and fun.

    If you’re concerned about your child’s speech and language or wondering whether they might benefit from speech therapy, feel free 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
    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
  • · ·

    Chaining: A powerful tool for phonological development

    ByLondon Speech and Feeding

    Understanding chaining

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

    There are two types of chaining: Forward and backward chaining

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

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

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

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

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

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

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

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

    Forward chaining

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

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

    Benefits of chaining

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

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

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

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

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

    Sonja McGeachie

    Early Intervention Speech and Language Therapist

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

    The London Speech and Feeding Practice

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

    1

  • Help! My child has a lisp. What can we do about it?

    ByLondon Speech and Feeding

    What is a LISP?

    There are different types of LISPS. Let me explain:

    A lisp is the difficulty making a clear ‘S’ and ‘Z’. Other sounds can also be affected by the tongue protruding too far forward and touching the upper teeth or the upper lip even. ‘T’ and ‘D’ can be produced with ‘too much tongue at the front’ and this can also have an impact on ‘CH’ and often also ‘SH’.

    1. Interdental lisp

    Protruding the tongue between the front teeth while attempting ‘S’ or ‘Z’ is referred to as interdental lisp; it can make the speech sound ‘muffled’ or ‘hissy’. Often, we associate a lisp with the person sounding a bit immature. The good news is that this type of lisp is the easiest to correct and, in my practice. I have a 100% success rate with this type of lisp.

    1. Lateral lisp

    In a lateral lisp the person produces the ‘S’ and ‘Z’ sounds with the air escaping over the sides of the tongue. This renders the ‘S’ as sounding ‘slushy’ or ‘wet’. This type of lisp is a bit harder to correct than the interdental lisp. In my experience this can be fixed but it might need a bit longer, more intensive therapy than the interdental lisp.

    1. Palatal lisp

    With a palatal lisp the ‘S’ sound is attempted with the tongue touching the palate, much further back than it should be. The ‘S’ sounds ‘windy’ and ‘hissy’. This is a quite rare lisp production but it is also not difficult to correct.

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

    Some thoughts on Treatment in general:

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

    When should treatment of lisp begin?

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

    Do lots of children lisp—is it normal?

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

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

    What happens during the first Speech and Language Consultation?

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

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

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

    Therapy – what does a session look like?

    Each therapy session consists of:

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

    How long does it take to ‘fix up’ a lisp?

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

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

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

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

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

    0