What to do when words don’t come fast enough

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What to do when words don’t come fast enough

When children find talking hard, parents often face a difficult question: ‘Should we wait and keep encouraging speech? Or introduce something like AAC?’

AAC (Augmentative and Alternative Communication) can sound intimidating, but it simply means any way we support or replace spoken words, from simple gestures and picture boards to high-tech speech-generating devices. Far from ‘giving up on speech,’ AAC often becomes the bridge that helps children find their voice, in whatever form that takes.

💡 What is AAC, really?

AAC is a spectrum of tools and strategies that help people express themselves when speaking is difficult. It might include:

  • Low-tech supports: Gestures, key word signs (like Makaton), picture symbols, or printed boards
  • High-tech systems: Apps on tablets that speak aloud when pictures or words are tapped

AAC is not just for children who will never talk. It’s for anyone whose speech isn’t meeting their communication needs right now.

🤔 When to introduce AAC

There’s a common myth that you should only try AAC after ‘exhausting’ other speech therapy options. In fact, AAC can be introduced at any stage, even alongside speech development.

Here are some helpful signs that AAC might support your child:

  • Your child understands much more than they can say.
  • They rely on gestures, sounds, or behaviour to communicate.
  • They become frustrated trying to express themselves.
  • You find yourself ‘reading their mind’ to interpret needs.
  • Speech progress feels slow or inconsistent.

If you recognise these patterns, AAC isn’t a ‘last resort’. It’s a communication support, not a replacement for speech.

Recent research consistently shows that AAC does not stop children from talking. In fact, it can encourage speech to develop. A 2024 systematic review and meta-analysis published in the Journal of Autism and Developmental Disorders found that children who received interventions combining naturalistic developmental behavioural approaches with aided AAC showed improved language outcomes, and that AAC ‘does not negatively impact speech development and may even facilitate spoken language growth’ (Smith et al., 2024).

🌉 How AAC supports speech development

Speech and AAC aren’t competing paths: they’re parallel tracks that often feed each other.

Here’s how AAC helps speech grow:

  1. Reduces frustration: When a child can express their needs, they’re more relaxed and ready to learn.
  2. Provides a visual model: Seeing symbols or words while hearing spoken language strengthens understanding and word recall.
  3. Builds consistent language structure: AAC systems follow the same grammar and word order as speech, helping children internalise how sentences work.
  4. Encourages turn-taking and social connection: AAC lets children join conversations even before speech is fluent, giving them more practice in real communication.

AAC is not ‘giving up on speech’. It’s giving a child more ways to succeed while speech continues to develop.

🧩 How to introduce AAC gently and effectively

  1. Start small and meaningful: Begin with a few key messages your child wants to say, not just what adults want to hear. Think ‘I want’, ‘stop’, ‘help’, ‘more’, ‘all done’, ‘no’, ‘again’. These are powerful words for real interaction and autonomy.
  2. Model, model, model: The most important part of AAC success is modelling—using the system yourself as you talk. For example: ‘You want banana 🍌’ and you tap the ‘want’ and ‘banana’ symbols. Children need to see and hear AAC used naturally before they try it themselves.
  3. Use it throughout the day: AAC isn’t a therapy tool to take out once a week. It’s a living part of communication. Model a few words during mealtimes, play, and routines. The more consistently it’s embedded, the more fluent both you and your child will become.
  4. Keep it accessible: If using a device or picture board, make sure it’s always nearby. If it’s in a bag or drawer, it can’t be used in real moments.
  5. Celebrate all communication: If your child points, signs, uses a sound, or taps a symbol, it all counts. Respond warmly and naturally to reinforce communication in any form.

🧠 What parents often worry about

  • ‘Won’t AAC stop them from talking?’: No. Research shows AAC use either has no negative effect on speech or leads to increased spoken output (Smith et al., 2024). When children feel understood, their motivation to communicate grows.
  • ‘What if I model it wrong?’: There’s no perfect way to start. Your effort and consistency matter far more than accuracy.
  • ‘Will they get ‘stuck’ using pictures?’:  Some children do continue using AAC long-term; others move naturally toward more spoken language. The goal is always functional communication, not replacing one form with another.

🪞 Bringing AAC into daily life

Here are a few simple, parent-friendly ideas:

  • Create visual spaces: Post symbols or core words on the fridge, mirror, or play area.
  • Narrate routines: Use AAC during toothbrushing, dressing, or mealtimes; consistent contexts build understanding.
  • Pair speech and touch: Always say the word aloud when you point to or tap a symbol.
  • Involve siblings and friends: Model how they can respond to AAC too. ‘Oh, you said go! Let’s go fast!’
  • Use shared books and songs: Pause and model key words in stories or songs.

🌱 The takeaway

AAC doesn’t mean giving up on speech; it means opening more doors to communication. When words don’t come easily, AAC gives children a way to connect, share, and be heard.

It helps parents move from guessing to understanding, and gives children the power to express themselves on their own terms.

If you’re unsure where to start, reach out to a speech and language therapist experienced in AAC. Together, you can find a system that fits your child’s strengths, build confidence in modelling, and help every word (spoken or tapped) feel like a step forward.

And download and print my one page summary.

Because when communication is possible, everything else begins to grow.

Sonja McGeachie

Highly Specialist Speech and Language Therapist

Owner of The London Speech and Feeding Practice.

📚 Reference

Smith, K., et al. (2024). The Effect of Naturalistic Developmental Behavioral Interventions and Aided AAC on the Language Development of Children on the Autism Spectrum with Minimal Speech: A Systematic Review and Meta‑Analysis. Journal of Autism and Developmental Disorders, 55, 3078–3099. https://doi.org/10.1007/s10803-024-06382-7


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.

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    Parent Child Interaction Coaching

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

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    • 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

    Speech Sound Disorders, Verbal Dyspraxia, Phonology and Articulation

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    Feeding and Swallowing Difficulties

    Feeding and Swallowing Difficulties

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    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.

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    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

    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.

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  • ·

    Joint attention for children with autism

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    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
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    • 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
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    • copy adult’s actions, gestures and then words
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    • 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.


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