What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?

ByLondon Speech and Feeding September 9, 2021January 31, 2023

Kids Speech Therapist London — What is Speech and Language Therapy (SLT) and what does a Speech Therapist do?

Speech and language therapists provide treatment, support and care for children and adults who have difficulties with communication, eating, drinking and swallowing. We help children and adults who have problems speaking and communicating.

How to find the perfect therapist for my child/client:

There are a huge number of speech and language difficulties, or feeding and swallowing problems that we can help with and the first thing to think about is what age group the person is you are seeking help for. Most SLT’s specialise in a range of disorders and treatments and they often treat specific age ranges. This could be, for instance, very young children up to 3 years, or school aged children, adolescents or just adults. Once you have narrowed it down to age and general area of difficulty you can then go and seek your perfect SLT match.

Generally it is my view that SLT’s with a narrow area of specialist interest are most likely to help you better if the problem you or your child/adult is having is significant and/or profound. For example, if your child has a very severe stutter/stammer but is otherwise developing fine and has good skills all round, then I would recommend to look for an SLT who only specialises in stammering/stuttering, or has only a small range of other specialist areas related to stammering , such as speech and language delay.

The reason is that it is a tall order for any professional to stay up to date with latest research, latest clinical developments and training for more than, say, five distinct areas of interest.

However, a more generalist Speech therapist who has lots of experience in many different areas could be a very good option for your child or adult who has more general speech and language delay in a number of areas, perhaps a global delay or a syndrome which means that their learning is delayed in general. It also means that your child might benefit from a Generalist SLT because they have many more tools in their SLT bag and your child might need a variety of approaches for several areas.

A good place to start is www.asltip.com which is the Association for Independent Speech and Language Therapists in the UK. Any SLT registered with ASLTIP will also be registered with the HCPC (Health Care Professionals Council), as well as RCSLT (Royal College of Speech and Language Therapists). These two important UK professional regulatory bodies ensure all its members are fully qualified, and are fully up to date with latest developments within their areas of work.

Here you can enter your post code and look for a therapist near you and you can look for specific problems such as stammering for example and narrow down your search. Most therapists have a website which you can then access too. I would recommend you speak to a few therapists on your list and then go with the person you had the best rapport with. You and the therapist will be spending a lot of time together and you will need to feel that you trust them and that you can relax into the process.

How I can help you:

I have 3 main areas of specialism:

Parent Child Interaction Coaching

This is an amazing way to help children with the following difficulties:

Social Communication Difficulties, Autistic Spectrum Disorders and
Speech and Language Delay – for children under the age of 4 years old, this is my preferred way of working because it is so very effective and proven to work. If your child is not developing words or not interacting, has reduced attention and listening and you feel is not progressing or, in fact even regressing, then this way of working is the best. For anyone wanting to read a bit more about the efficacy of this method, below are some research articles. You may also like to check out www.hanen.org which is the mainstay of my work and method when it comes to Parent-Interaction Coaching. You can also look at my latest blog, entitled: Tele-therapy, does it work?

In brief, what’s so great about Parent Coaching is that it empowers you the parent to help your child in daily life! This is where speech, language and social communication develop typically, in a naturalistic way and environment. Simple steps and strategies are discussed and demonstrated every week and you are encouraged to use these strategies with your child in daily routines: getting dressed, having breakfast, on the school run, whilst out in the park or shopping or simply playing at home or having dinner or bath time. Whatever your family routine happens to be, every strategy I teach you will help create a responsive communication environment; generally, if your child is able to develop speech then they will do so in direct response to your changed interaction style.

Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation

I love working with children of all ages on developing their speech sounds. Whether your child has a lisp, or a couple of tricky sounds they simply cannot produce quite right, or perhaps your child is really unintelligible because he/she is having lots of different sound errors, making it really hard to understand them. I typically work on getting “most bang for your buck” , meaning I address the sounds that cause the most problems and, therefore, when they are fixed your child/person’s speech becomes that much clearer fairly quickly.

Feeding and Swallowing Difficulties

Having worked for over 20 years in NHS Child Development Clinics and Special Needs Schools I trained and worked with feeding and swallowing difficulties early on in my SLT career. I later trained as a Lactation Consultant and so I am well placed helping and support all types of Infant feeding, both breast or bottle, as well as toddler weaning. I aim to ensure that your little one swallows the right kind of foods and drinks for their abilities. I am experienced in managing and supporting children with physical needs and mobility problems, Cerebral Palsy, Down Syndrome or any other type of syndrome or presentation.

What does a speech therapy session look like?

All sessions differ slightly depending on the age of the child and the nature of the difficulties.

However, mostly our sessions look like FUN! After arrival and washing hands we tend to start off with the tricky work straight away whilst our child still has energy and the will to engage. So, for speech work we will focus on the target sounds first: this could be sitting at a table doing work sheets together, playing games using the target sound and really any type of activity that gives us around 70-100 repeats of the target pattern. For example, a child who is working towards saying a ‘K’ at the end of the word I will try and get around 100 productions of words like: pack/sack/lick/ pick/bike/lake and so on.

Then we often play a fun game where I might try for a ‘rhyming’ activity or other sound awareness type activities, for perhaps 10 minutes and within that time I aim to trial the next sound pattern we need to improve on; I will test which sound your child can do with help from me. During he last 10 minutes we might look at a book, again listening to and producing whatever sound we are working on. If I did not get 100 sounds earlier on in the session I will try and practice them now as part of the story. In total I aim to have about 40-45 minutes of activities, all aimed at the target sound we are working on.

What does a Coaching session look like?

During a Parent Coaching Session we meet online for about an hour and we discuss how the week has been for you trying out the strategies. Typically parents start off recalling what went well, what progress was made and what had been more tricky. We work through it all, and then follow on to the next strategies: I will show you examples and demonstrations of each strategy and I will get you to think about how you can use this with your child and in what situation you might use it. I will explain what we are doing and what the purpose is. You might want to write down what you are going to work on for the week. Over the course of about sessions we can cover all the major strategies that are proven to help kickstart spoken language and/or help your child to connect more with you. Through that connection spoken words most often develop.

Research Papers on the Efficacy of Parent Child Interaction Coaching

The It Takes Two to Talk Program has been shown to be effective in changing how parents interact with their children, and that children’s communication and language skills improve as a result.
Baumwell, L.B., Tamis-LeMonda, C.S. & Bornstein, M.H. (1997). Maternal verbal sensitivity and child language comprehension. Infant Behavior and Development, 20(2), 247-258.
Beckwith, L. & Cohen, S.E. (1989). Maternal responsiveness with preterm infants and later competency. In M.H. Bornstein (Ed.). Maternal responsiveness: Characteristics and consequences: New directions for child development (pp. 75-87). San Francisco: Jossey Bass.
Bronfenbrenner, U. (1974). Is early intervention effective? (Publication No. (CDH) 74-25). Washington, DC: Department of Health, Education, and Welfare, Office of Child Development.
Girolametto, L. (1988). Improving the social-conversational skills of developmentally delayed children: An intervention study. Journal of Speech and Hearing Disorders, 53, 156-167.

Sonja has been a real help for my 5 year old daughter. Due to her support, my daughter is now able to clearly and correctly enunciate ‘th’ ‘f’ and ’s’. She was also helpful in making positional changes to her seating to help her concentrate better and kept her engaged throughout all the lessons which is a feat in itself on zoom!
Helen, Mother of Catherine Age 5.

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.

Speech and Language Therapy

Tongue-Tie: A complex issue requiring careful assessment
ByLondon Speech and Feeding September 27, 2024September 29, 2024
Tongue-tie, or ankyloglossia, is a condition where the lingual frenulum, the thin piece of tissue that connects the underside of the tongue to the floor of the mouth, is too short or tight. Tongue-tie is quite common in babies and is often not detected after birth. Tongue-tie can lead to a difficult start with breast feeding as it makes it very difficult for the baby to latch effectively.

In my clinical experience as a feeding therapist, I have seen many babies who were not able to latch well due to the frenulum being tight. In many cases an experienced feeding speech therapist/lactation consultant can really make a difference and help a new mum to latch the baby even though the tongue is tethered to the floor of the baby’s mouth. In some cases the frenulum can be divided and once this has been done, in some cases, feeding improves immediately or soon after the division. But this is not always the case. I have seen several babies who have had as many as four tongue-tie divisions and feeding was still difficult.

It is important to say that while tongue-tie can sometimes impact speech and feeding, it’s important to note that it’s not always the root cause of these difficulties. In recent years, there has been a surge of interest in tongue-tie division surgeries, with some cases being unnecessary. It’s crucial to understand the complexities of tongue-tie and the role of speech therapy in addressing related challenges.

The impact of tongue-tie on speech and feeding

When tongue-tie is severe, it can interfere with the tongue’s ability to move freely, affecting speech production and swallowing. Some common speech and feeding difficulties associated with tongue-tie include:
- Feeding difficulties: Challenges with sucking, chewing, and swallowing.
- Drooling: Excessive drooling due to difficulty controlling saliva.
- Speech problems: Difficulty producing certain sounds, such as /l/, /r/, /t/, /s/ and /d/.
The importance of comprehensive assessment

Before considering any surgical intervention for tongue-tie, it’s essential to undergo a thorough evaluation by a qualified speech-language therapist (SLT). An SLT can assess the severity of the tongue-tie, its impact on speech and feeding, and determine if surgery is necessary.
- Functional assessment: The SLT will assess the tongue’s range of motion, its impact on speech sounds, and the child’s overall oral motor skills.
- Feeding evaluation: The SLT will observe the child’s feeding patterns and identify any difficulties related to tongue-tie.
- Differential diagnosis: The SLT will rule out other potential causes of speech and feeding difficulties, such as apraxia of speech, dysarthria, or sensory processing disorders.
The role of speech therapy

Even in cases where tongue-tie is present, speech therapy can often be highly effective in addressing speech and feeding difficulties. Here’s how speech therapy can help:
- Articulation therapy: Targeting specific speech sounds that may be affected by tongue-tie.
- Childhood Apraxia of Speech (CAS): if the diagnosis by the SLT has shown that in fact the child has motor planning difficulties then there are very specific and effective treatment programmes that help with this and can make a real difference over time.
- Feeding therapy: Strategies to improve swallowing, chewing, and oral-motor skills.
- Sensory integration: Addressing underlying sensory processing issues that may contribute to feeding difficulties.
London Speech and Feeding Case Study: The importance of comprehensive assessment

One of my clients was initially diagnosed with tongue-tie and recommended for surgery at the age of eight years old. His speech had been perceived by parents and teachers as ‘mumbled and unclear’.

However, after a thorough evaluation, I was able to determine that the child’s primary issue was apraxia of speech, a neurological disorder that affects motor planning for speech. Parents decided to wait with surgery and trust my judgment and we proceeded with weekly intensive speech therapy to address motor planning difficulties around tricky sounds and words. I am delighted to say that the child’s speech has improved significantly, demonstrating the importance of comprehensive assessment and individualised treatment. He is no longer seen as a candidate for an operation, which would have been traumatic for him at his age and, as it turned out, entirely unnecessary.

Below is a short video clip of my working on the /l/ sound with this child.

Using the Gingo Puppet from GingoTalk

Conclusion

Tongue-tie is a complex issue that requires careful evaluation and individualised treatment. While surgery may certainly be necessary in some cases, it’s essential to consider the potential benefits and risks. Speech therapy can be a highly effective approach for addressing speech and feeding difficulties associated with tongue-tie, even in cases where surgery is still required. By working with a qualified speech-language therapist, parents can ensure that their child receives the best possible care and support.

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.

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Autism Therapy · Neurodiversity · Speech and Language Therapy

Explaining pronoun reversal: A window into gestalt language processing
ByLondon Speech and Feeding April 2, 2025April 2, 2025
Have you noticed your child referring to themselves as ‘you’, or calling you ‘me’? This seemingly confusing mix-up of pronouns, known as pronoun reversal, often raises concerns for parents. Below I outline why your child does this and want to reassure you that it is to do with his or her unique language learning style.

Gestalt language processing: Learning in chunks

Many children, particularly those on the autism spectrum, use a gestalt language processing approach. Unlike analytic language processors who learn individual words and build sentences, gestalt language processors learn language in whole ‘chunks’ or ‘gestalts’. Think of these gestalts as pre-packaged scripts they pick up from their environment — phrases, sentences, even snippets of songs or movie lines.

As Marge Blanc, author of Natural language acquisition on the autism spectrum, explains, ‘When a child picks up an entire gestalt (script), he’s got the pronoun of the original speaker. So ‘pronoun reversal’ is nothing more than that.’

So your child is simply repeating what they’ve heard, without yet understanding the individual word meanings or grammatical functions.

Imagine your child hearing ‘You want a rice cake?’ repeated frequently. They might then use this phrase to express their own desire for a rice cake, even though it doesn’t grammatically fit. So they are thinking and saying ‘You want a rice cake?’ and the meaning of this phrase is: ‘I want a rice cake’. This isn’t a sign of confusion, but a natural step in their language development. They’re working with the tools they have: the scripts they’ve acquired.

How can we support their natural language journey

Instead of trying to ‘correct’ pronoun usage, our role as caregivers and speech therapists is to support the child’s natural language progression. Here’s how we can do this:
1. Learn about their gestalt stage and run with it: In the early stages (1–3) of gestalt language development, correcting pronouns can be counterproductive. These children are still processing language as whole units, not individual words. Direct corrections can lead to frustration and hinder their natural language exploration.
2. Patience and trust: Gestalt language processing follows a predictable, albeit sometimes non-linear, path. By understanding their current stage, we can provide targeted support. Language sampling and scoring, guided by the Natural Language Acquisition framework, help us pinpoint their stage and tailor our approach.
3. Model language strategically: In the early stages, avoid using pronouns like ‘you’ and ‘you’re’. Instead, model language from the child’s perspective or use joint perspectives. For example, instead of ‘Are you thirsty?’, try ‘I’m thirsty!’ or ‘Let’s get some water’,
The big picture: Language unfolds naturally

Pronoun reversal is a stepping stone, not a stumbling block. As gestalt language processors progress, they begin to break down these gestalts into smaller units and develop their own self-generated language. This is when their understanding and use of pronouns naturally emerge.

By shifting our perspective from ‘error correction’ to ‘developmental support’, we create a nurturing environment for these children to thrive. We empower them to navigate their unique language journey, ultimately leading to more meaningful and independent communication.

So, to summarise:
- Pronoun reversal is a typical characteristic of early-stage gestalt language processing.
- Focus on modelling language from the child’s perspective or a joint perspective.
- Avoid correcting pronouns in the early stages.
- Trust the process and support the child’s natural language development.
Let’s celebrate the diverse ways our children learn to communicate and empower them to find their unique voice!

If you have any questions or would like some help with understanding your little gestalt language learner, please get in touch with me via my contact form.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of 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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Neurodiversity · Speech and Language Therapy · Top tips

Why auditory memory matters (especially for little ones!)
ByLondon Speech and Feeding August 4, 2025August 1, 2025
Have you ever stopped to think about how we learn to speak, understand, and communicate effectively? It’s a complex dance of various cognitive skills, and one often overlooked but absolutely crucial player in this orchestra is auditory memory. It’s not just about remembering sounds. It’s about remembering sequences of sounds, which is fundamental to language development.

What exactly is auditory memory?

At its core, auditory memory is our ability to take in, process, store, and recall information that we hear. Think of it as your brain’s internal recording studio. When someone speaks to you, your auditory memory is busy at work, capturing the individual sounds, the order in which they appear, and the rhythm and intonation of the words. This isn’t just for long-term recall; it’s also vital for working auditory memory, which allows us to hold onto a small amount of auditory information for a short period, just long enough to make sense of it.

For speech and language, auditory memory is essential for:
- Understanding spoken language: To comprehend a sentence, we need to remember the beginning of the sentence by the time we hear the end.
- Following instructions: Remembering a sequence of commands relies heavily on auditory memory.
- Learning new words: We hear a word, remember its sound, and connect it to its meaning.
- Developing phonological awareness: This is the ability to recognise and manipulate the sounds in spoken language, a critical precursor to reading. Auditory memory helps children distinguish between similar-sounding words (e.g., ‘cat’ vs. ‘bat’) and segment words into individual sounds.
- Producing clear speech: To articulate words correctly, we need to recall the precise sequence of sounds that make up that word.
- Developing conversational skills: Remembering what was just said helps us formulate appropriate responses.
When auditory memory falls short: The impact on speech

When auditory memory is poor, particularly in young children, the ripple effects on speech and language development can be significant. Children might struggle with:
- Following multi-step directions: ‘Put on your shoes, get your coat, and meet me at the door’ can become an overwhelming jumble of sounds.
- Learning new vocabulary: They might hear a new word repeatedly but struggle to retain its sound pattern, making it difficult to recognise or use later.
- Understanding stories or conversations: Missing key details or losing the thread of a narrative because they can’t hold enough information in their working memory.
- Developing phonological skills: Difficulty with rhyming, identifying initial sounds in words, or blending sounds together to form words, which can impact early literacy.
- Speech production: They might mispronounce words, omit sounds, or struggle with the correct sequencing of sounds within words.
- Social communication: Difficulty participating in group discussions, remembering names, or recalling what their peers have said.
- Academic performance: Auditory memory challenges can impact a child’s ability to learn in a classroom setting, where much of the instruction is delivered verbally.
It’s important to note that poor auditory memory isn’t a sign of low intelligence, but rather a specific processing challenge that can be addressed with targeted support.

Nurturing auditory memory in under 5s: Preparing for schooling

The good news is that auditory memory is a skill that can be strengthened and developed, especially during the crucial early years. For children under five, laying a strong foundation in auditory memory is an invaluable gift as they prepare for the demands of formal schooling. Here’s what we can do to help:
1. Read aloud regularly: This is perhaps one of the most powerful tools. As you read, encourage your child to listen for specific words, predict what happens next, and retell parts of the story. Vary your voice, use different intonations, and pause to emphasise key words.
2. Play auditory memory games:
  
  ‘Simon says’: This classic game is fantastic for following multi-step instructions. Start with one command and gradually increase the number.
  
  ‘I Spy’ with sounds: Instead of colours, describe sounds. ‘I spy with my little ear something that goes “moo”.’
  
  Rhyming games: Sing rhyming songs, read rhyming books, and encourage your child to come up with words that rhyme.
  
  Sound matching: Use everyday objects to make sounds (e.g., shaking keys, tapping a spoon) and have your child identify or match them.
  
  ‘Memory chain’: Start a sentence and have your child add to it, remembering everything that came before: ‘I went to the market and bought an apple.’ ‘I went to the market and bought an apple and a banana.’
3. Sing songs and nursery rhymes: Repetitive songs and nursery rhymes are excellent for developing auditory memory, rhythm, and phonological awareness. The predictable patterns help children anticipate and remember sequences of sounds and words.
4. Give multi-step instructions (and praise!): Start with two-step instructions and gradually increase the complexity as your child’s skills improve. Always give positive reinforcement when they succeed. ‘Please pick up the red block and put it in the box.’
5. Engage in active listening: Model good listening skills yourself. When your child is speaking, give them your full attention. Ask clarifying questions to encourage them to elaborate and organise their thoughts.
6. Reduce background noise: A quiet environment makes it easier for young children to focus on auditory information. Minimise distractions like TV or loud music during activities that require listening.
7. Use visual cues: While we’re focusing on auditory memory, sometimes pairing auditory information with visual cues can be helpful, especially initially. For example, when giving instructions, demonstrate the action as you say it.
8. Be patient and consistent: Developing auditory memory takes time and consistent practice. Celebrate small victories and create a playful, supportive environment for learning.
By actively engaging in these strategies, we can empower our youngest learners to build robust auditory memory skills, setting them up for success not only in speech and language development but also in their overall academic journey. It’s an investment that truly pays dividends in their future communication and learning abilities.

Any comments or if you need help and support with your child’s speech please do not hesitate to get in touch with me: simply fill out the contact form here on the website. I endeavour to reply within 48 hours.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of 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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Speech and Language Therapy

Could mouth breathing be affecting your child’s speech, sleep and development?
ByLondon Speech and Feeding June 15, 2026June 11, 2026
Understanding Orofacial Myofunctional Disorders (OMDs)

Many parents contact me at London Speech and Feeding because they are worried about their child’s speech. Perhaps their child is difficult to understand, has a persistent lisp, struggles with feeding, snores at night, or always seems to have their mouth open.

What many families don’t realise is that these concerns may all be connected.

Increasingly, research and clinical experience are highlighting the important role of Orofacial Myofunctional Health, the way the muscles of the face, mouth, tongue and airway work together to support breathing, eating, sleeping and communication.

When these muscles are not functioning optimally, children may develop what are known as Orofacial Myofunctional Disorders (OMDs).

What Is Orofacial Myofunctional Health?

Orofacial Myofunctional Health refers to the healthy function and coordination of the:
- lips
- tongue
- jaw
- cheeks
- facial muscles
- airway.
These structures play a vital role in:
breathing

swallowing

chewing

speaking

facial growth

dental development

sleep quality.
When everything is working well, the lips remain gently closed at rest, breathing occurs through the nose, and the tongue rests against the roof of the mouth.

This seemingly simple posture has a profound influence on how a child’s face, teeth and airway develop.

What is an Orofacial Myofunctional Disorder?

An Orofacial Myofunctional Disorder occurs when there is an abnormal pattern of muscle function involving the face, mouth, tongue or airway.

Children with OMDs may experience difficulties with:
- speech
- feeding
- swallowing
- sleep
- breathing
- dental development
- facial growth.
In many cases, these difficulties are linked to chronic mouth breathing.

Signs your child may have an Orofacial Myofunctional Disorder

Breathing and sleep signs
- mouth open at rest
- mouth breathing during the day
- snoring
- noisy breathing
- restless sleep
- frequent waking
- dark circles under the eyes
- chronic congestion
- fatigue despite a full night’s sleep.
Speech signs
- lisping
- unclear speech
- distorted speech sounds
- difficulty producing certain sounds
- persistent articulation difficulties
- reduced speech intelligibility.
Feeding and swallowing signs
- picky eating
- messy eating
- food remaining in the cheeks
- gagging easily
- difficulty chewing
- long mealtimes
- tongue thrust swallowing.
Facial and dental signs
- narrow palate
- crowded teeth
- open bite
- overbite
- underbite
- long face appearance
- receding chin
- poor lip seal.
If several of these signs sound familiar, a comprehensive assessment may be worthwhile.

Why does mouth breathing matter?

Many parents assume mouth breathing is simply a habit.

In reality, mouth breathing is often a symptom that something is preventing efficient nasal breathing.

Common causes include:
- enlarged tonsils
- enlarged adenoids
- allergies
- chronic nasal congestion
- recurrent infections
- structural airway differences
- tongue tie
- prolonged dummy use
- thumb sucking
- poor oral posture.
When nasal breathing becomes difficult, children naturally begin breathing through their mouths.

Over time, this can affect how the face, jaws and airway develop.

What does healthy oral posture look like?

Healthy oral posture is surprisingly simple:
- lips
  
  gently closed
- tongue
  
  resting against the roof of the mouth
- teeth
  
  slightly apart
- breathing
  
  through the nose.
This posture helps guide healthy jaw growth, facial development and airway formation.

Think of the tongue as a natural orthodontic support system. When it rests in the correct position, it helps shape the upper jaw and supports healthy facial growth.

The consequences of chronic mouth breathing

1. Speech difficulties

Children who breathe through their mouths often have altered tongue posture and reduced oral stability.

This can contribute to:
- lisping
- distorted sounds
- reduced speech clarity
- difficulty learning new speech sounds.
2. Feeding and swallowing difficulties

A low tongue posture may affect:
- chewing efficiency
- swallowing patterns
- food management
- oral motor coordination.
Many children develop a tongue thrust swallow, where the tongue pushes forward instead of moving efficiently during swallowing.

3. Poor sleep quality

Mouth breathing can contribute to:
- snoring
- restless sleep
- frequent waking
- daytime fatigue
- reduced concentration.
Poor sleep can have a significant impact on learning, behaviour and emotional regulation.

4. Changes to facial growth

Over time, chronic mouth breathing may influence:
- jaw development
- facial proportions
- dental alignment
- airway size.
This can result in:
- narrow palates
- crowded teeth
- long facial appearance
- increased orthodontic needs.
5. Oral health concerns

The nose acts as a natural filter and humidifier.

When children breathe through their mouths:
- The mouth becomes dry.
- Saliva protection is reduced.
- Risk of tooth decay increases.
- Gum health may be affected.
Why this matters for speech therapy

Speech does not develop in isolation.

The tongue, lips, jaw and airway work together to support clear communication.

At London Speech and Feeding, we look beyond speech sounds alone.

A child who presents with:
- persistent speech difficulties
- lisping
- feeding challenges
- open mouth posture
- snoring
- poor sleep
may benefit from an assessment that explores underlying orofacial myofunctional factors.

Addressing these foundations can often support more effective progress in speech and feeding therapy.

How London Speech and Feeding can help

A comprehensive assessment may include observation of:
- breathing patterns
- lip posture
- tongue posture
- swallowing function
- feeding skills
- speech sound development
- sleep concerns
- oral structures.
Where appropriate, recommendations may include:
- orofacial myofunctional therapy
- speech therapy
- feeding therapy
- home programmes
- ENT referral
- orthodontic referral
- collaborative multidisciplinary support.
The good news

Orofacial Myofunctional Disorders are often highly treatable when identified early.

Supporting healthy breathing, tongue posture and oral muscle function can positively influence:

If your child regularly breathes through their mouth, snores, struggles with speech clarity or has feeding difficulties, a specialist assessment may help identify the underlying cause.
speech clarity

feeding skills

sleep quality

facial growth

dental development

overall wellbeing.
At London Speech and Feeding, we are passionate about looking beyond symptoms and understanding the whole child. Contact me!

Sometimes the key to clearer speech starts with a simple question:

‘Is my child breathing through their nose?’

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

Frequently Asked Questions

Can mouth breathing cause speech problems?

Yes. Mouth breathing can alter tongue posture, lip strength and oral stability, which may contribute to articulation difficulties and lisps.

Should I be worried if my child snores?

Regular snoring is not considered normal in children and may indicate airway obstruction or sleep-disordered breathing.

Can enlarged tonsils affect speech?

Yes. Enlarged tonsils may affect resonance, tongue positioning, swallowing and breathing patterns.

What age can children be assessed?

Children of all ages can be assessed if parents have concerns about speech, feeding, breathing or oral development.

What is Orofacial Myofunctional Therapy?

Orofacial Myofunctional Therapy focuses on improving breathing patterns, tongue posture, lip seal and oral muscle function to support overall health and development.

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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Autism Therapy · Speech and Language Therapy

Discover speech and language regression in autistic children and how you can support your child
ByLondon Speech and Feeding February 17, 2023January 3, 2024
There’s often this idea that autistic children have extensive vocabulary and knowledge, but this is not always the case. In fact, 30% of autistic children have language regression.

Goldberg (2003) suggested that speech and language regression refers to the decline in a young child’s speech and communication abilities. We know that regression in speech, language and communication skills often occur before the age of two years. 25% of autistic children develop language at word level between 12 and 18 months of age before losing this language they have learned. As you’re probably aware this regression in communication is a diagnostic indicator of Autism.

We understand that you want your child to progress, and you struggle to watch as their frustration grows as you feel helpless. I want to provide you with tips so that you can feel empowered to support your autistic child and reduce the impact their communication skills have on the family.
1. Reduce frustration by providing visuals to support their communication
2. Model gestalts. We know that autistic children are often gestalt language processors. Learn more about gestalt language processors in one of my previous posts.
3. Praise the ability to communicate. Focus on what they say not how they say it. E.g., good listening, nice talking.
4. Provide your child with choices (using real objects to represent your choices). E.g., do you want an apple or banana?
5. Your child must be motivated and have a purpose to communicate. So, ensure you use highly motivating objects for conversations
6. Provide them with opportunities to communicate. We need to teach children that if they want something, there’s a process that you need to have the opportunity to ask for it. We find that if parents understand what their child wants (without them asking), the object is given to them, and so there’s no reason for your child to ask.
7. There’s this idea that we need to teach children eye contact. This is not always the case. Your child is unique, we do not want to take their unique skills away.
8. Model words which are concrete. E.g., words such as ‘finished’, ‘more’. You can model these several times within the day. You can use a gesture to make the word more visual (see the images below). We know that autistic children are often visual learners.
Makaton for “more”

Makaton for “finished”

Credit: Little Dots Makaton, Polkadot World

Remember that if your child has speech, language and communication regression, it doesn’t mean your child will stay static.

It’s vital that you seek support from a qualified Speech and Language Therapist. We can tell you at what point in the communication development that your child is at. And we can support you through the process. We can provide you with an individualised plan specifically for your child to ensure you maximise their potential.

Contact me for 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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READ MORE Discover speech and language regression in autistic children and how you can support your child
Lisp · Speech and Language Therapy

Tongue training: Why tongue placement matters for clear speech
ByLondon Speech and Feeding February 12, 2025February 3, 2025
As speech and Language therapists (SLTs), we know that where your tongue goes, so goes your sound. This blog post will explore why tongue placement is so vital for speech correction and how we use tools and techniques to help our clients find their ‘sweet spot’ for sound production.

Let me show you here a little video clip where I am using my dentist’s mouth/teeth model to help my clients navigate their tongue movements.

The tongue: A tiny muscle with a big job

The tongue is a small but mighty muscle. It’s incredibly versatile, playing a key role in eating, swallowing, and, of course, speaking. For each speech sound, the tongue, along with the lips and jaw, needs to move to a very specific spot. Think of it like a dance: every part of your mouth has a choreographed movement to produce the correct sound. If the tongue is out of sync, the sound comes out muffled, distorted, or just plain wrong.

The trouble with our tongue movements is that most of us never think about how the tongue has to move and what it does to: swallow, chew, drink, suck and speak. Most parents when asked to think about their own tongue placement for say the /S/ sound are completely lost as to what their tongue is doing. Yet, of course, they produce a perfect /S/ and perfect speech in general. The same goes for swallowing. When did you last think about what happens in your mouth when you swallow? I bet you have not thought about it. We ‘just do it’, right?

Why is tongue placement so important?

Accurate tongue placement is the foundation of clear articulation. When a child struggles with a particular sound, it’s often because his or her tongue isn’t quite reaching the right spot or moving in the correct way. For example, the /S/ sound requires the tongue to be slightly raised and positioned behind the top teeth, creating a narrow channel for air to flow through. If the tongue is too far forward, you might get a /TH/ sound instead. If it’s too far back, the /S/ can sound muffled.

Visual aids: Our secret weapon

We SLTs love our visual aids! They’re incredibly helpful for showing clients exactly where their tongue needs to be. Here are some of our favourite tools:
- Mirrors: Mirrors provide instant feedback. Clients can see their tongue’s position and make adjustments in real-time. We often use hand mirrors or even the mirror on a compact for quick checks.
- Tongue depressors: These simple tools can gently guide the tongue to the correct position. We might use them to show where the tongue tip should rest for the /L/ sound or how the sides of the tongue should touch the molars for the /K/ and /G/ sounds.
- Diagrams and models: Pictures and models of the mouth can help clients visualise the tongue’s movements. We might use a cross-section diagram of the mouth to show how the tongue forms different sounds.
Beyond the tongue: The jaw’s role

While the tongue takes centre stage, the jaw plays a supporting role. It provides a stable base for the tongue and helps control the opening and closing of the mouth. Sometimes, jaw stability is an issue, and we might use techniques to help clients find a comfortable and stable jaw position.

Making it fun and engaging

Learning correct tongue placement can be challenging, but we make it fun! We use games, stories, and playful activities to keep clients motivated. For younger children, we might use silly voices or pretend to be animals. For older children, we might incorporate their interests, like using a car analogy for tongue movements.

The takeaway

Correct tongue placement is essential for clear speech. By using visual aids, interactive techniques, and a bit of creativity, we can help our clients master their speech sounds and communicate with confidence.

If you have any concerns about your child’s speech, don’t hesitate to reach out to a qualified speech and language therapist, we are here to help! Contact me via my contact form.

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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READ MORE Tongue training: Why tongue placement matters for clear speech