Why imitation is so important and how can speech and language therapy help children who struggle to imitate?
Imitation or copying starts in early infancy. When we observe a young baby and his parent or familiar adult we can see clearly and frequently that the baby will be intently looking at adult’s face and try to copy their facial expressions, smiles and all those funny baby sounds we often make with young babies.
These sounds are called “motherese” and are the beginnings of a little conversation between the parent and the baby. The “conversation can go back and forth for a long time and include sounds, as well as facial expressions.
A little later on, once the baby can crawl and sit up unaided the copying then goes on to include toys and objects. Mum or Dad will show their toddler how to use a drum or how to put a little train on the wooden tracks and the toddler will try and copy this. They may not succeed and be a little clumsy perhaps but the act of copying anything and everything their favourite adult does is typically seen throughout the day.
We all know and have laughed at mums or dads saying; ssshhh don’t say that in front of the baby he/she will copy you, watch your mouth! (as dad is swearing at the broken radiator….)
This imitation goes on for years and includes eventually of course little words, more words, putting words together and then creating sentences, all the while our toddler is listening to how their adults speak, not only what they say but how they say it. This is how dialects and accents can be transmitted easily from parent /family to child.
Copying in Children with Autism
We know that children with autism often struggle to imitate. We see children on the spectrum typically having great difficulty to copy adults or children; this can be seen in very reduced play with their peers in nursery for example.
Children with autism tend to have reduced joint attention and engagement with others and need to develop the ability and awareness to copy others in order to then engage more jointly with others.
Speech and Language Therapy can help with Parent Child Interaction work and Coaching, here is how:
During my coaching work with parents I teach step by step how to help a child who struggles to imitate:
We look at all the researched skills and actions that adults can take to help their little one to copy, starting with close observation of their child’s interests, then following and including their child’s play and copying/imitating their child in how they play. I teach steps in a graduated way so that it is easy to see the progress and joyful to have the results at the end.
The results are clear to see over time: our children on the spectrum learn to imitate actions, with objects and gestures, then sounds and words. Alongside this increased imitation skill the child can then develop more joint attention and engagement.
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.
Have you ever thought about how difficult it can be to produce certain speech sounds? Some sounds are definitely trickier than others. This is especially true for children with speech sound disorders like Childhood Apraxia of Speech (CAS).
My student with CAS has been working hard on producing the /L/ sound especially when it was followed by an /O/ or /OO/ like, ‘log’ or ‘look’. We’ve practised lots and now that he’s got a good handle on /L/, he’s started replacing another difficult sound, /Y/, with it. So, ‘yes’ becomes ‘less’ and ‘yuck’ becomes ‘luck.’
This is a common pattern in speech development. Once a child masters a new sound, they may start using it in place of other sounds they find even more challenging.
Minimal Pair therapy
I use different evidence-based methods to help my students. And I often like to start out with phonemic awareness and then I move to contrasting the error sound with another sound to make completely different words. This approach is called ‘minimal pair’ therapy: both words are the same except for the initial/final sound which has the error sound, and this is contrasted with the correct sound.
Below is an example of this:
After we have worked on sound awareness, listening and becoming aware of small units of sound matter, then we can move to working on tongue placement and movement.
Tongue placement and movement to produce correct /L/ and /Y/ sounds
To produce these sounds correctly, the tongue needs to be in specific positions and make specific movements.
/L/ sound:
Tip of the tongue touches the alveolar ridge (the bony ridge behind your upper teeth)
Sides of the tongue are raised to the sides of the upper teeth
Airflow escapes through the sides of the tongue
/Y/ sound:
Tip of the tongue touches the roof of the mouth behind the alveolar ridge
Sides of the tongue are raised to the sides of the upper teeth
Airflow escapes through the centre of the mouth
I also use:
Auditory bombardment: Auditory bombardment is a technique that involves repeatedly listening to a target sound. This can help children to develop a better understanding of the sound and how to produce it.
Visual cues: Visual cues can be helpful for children who are having difficulty producing a particular sound. Here I use the image of a ‘standing tongue’ versus a ‘sitting tongue’.
Physical cues: I use my hands to show a ‘standing tongue’ for the /L/ versus a ‘sitting tongue’ for the /Y/. But what worked even better and sadly I don’t have the video clip for it:
Semantic cues: For example a picture of an ‘EAR’ to make the sound /Y/ so we shape the sound /EA/ to /Y/.
Parent involvement: Parents play an important role in their child’s speech sound development by providing opportunities for them to practise their speech sounds at home. This can be done through activities such as reading books, singing songs, and playing games.
Reinforcement: It is important to praise children for their efforts, even if they are not perfect. This will help them to feel motivated to keep practising. Important here for speech correction is concrete reinforcement: I feed back to my student what exactly they were doing correctly with their tongue or lips. Rather than saying ‘well done’, I mention what my student has just done with the tongue to change the sound: ‘I saw you lowered your tongue! That made a good /Y/’.
Another great way of reinforcing positively is to ask the student how they feel they have done? For the older ones I often ask them to self-rate their sound production out of 10. Then we can work towards the next incremental number upwards. This is very effective and gives the student control over their own work.
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.
The /R/ sound is notoriously challenging for many children (and even some adults!). It’s one of the most complex sounds in the English language, with various pronunciations depending on its position in a word. If your child is struggling with their /R/s, you’re not alone. As Speech and Language Therapists (SLTs), we frequently work on this sound, and a key component of our therapy is focusing on proper tongue placement.
Why is the /R/ so difficult?
The /R/ sound requires precise coordination of the tongue, jaw, and lips. Unlike sounds like /P/ or /B/ that involve simple lip movements, the /R/ involves intricate tongue movements and tension. There are also different ways to produce the /R/ sound, which adds to the complexity:
Retroflex /R/: The tongue tip curls up and back towards the roof of the mouth.
Bunched /R/: The body of the tongue bunches up towards the roof of the mouth, while the tongue tip remains down.
The importance of tongue placement
Regardless of which /R/ variation is being targeted, accurate tongue placement is crucial. Even a slight deviation can result in a distorted or inaccurate sound. That’s why SLTs dedicate significant time to teaching and practising tongue positioning.
Speech therapy techniques: Focusing on the tongue
Here’s a glimpse into how I address /R/ sound difficulties, with a focus on tongue placement:
Visual aids:
Mirrors: I use a mirror to help children see their tongue movements and make adjustments.
Tongue diagrams and models: These visual tools provide a clear representation of where the tongue should be positioned.
Tactile cues:
Tongue depressors: These can be used to gently guide the tongue into the correct position.
Food-grade tools: Sometimes, I use flavoured tongue depressors or other tools to provide tactile feedback and increase awareness of tongue placement.
Auditory discrimination:
I help children distinguish between correct and incorrect /R/ sounds.
I use auditory cues and verbal feedback to reinforce proper pronunciation.
Exercises and drills:
Tongue strengthening exercises: Strengthening the tongue muscles can improve control and coordination.
Tongue placement drills: We practise positioning the tongue in the desired location and holding it there.
Sound approximation techniques: Sometimes we use other sounds to help approximate the /R/ sound. For example, I use the /L/ sound, to help achieve the correct tongue placement. Once my child has found the /L/ sound it is then a matter of pulling back just slightly to get a good /R/.
Contextual practice:
Once the child can produce the /R/ sound in isolation, we gradually introduce it into syllables, words, phrases, and sentences.
We also practise the /R/ sound in different contexts, such as at the beginning, middle, and end of words.
Tips for Parents:
Be patient and supportive: Learning the /R/ sound takes time and practice.
Practise regularly: Short, frequent practice sessions are more effective than long, infrequent ones.
Make it fun! Use games, stories, and other engaging activities to keep your child motivated.
Work with an SLT: A qualified SLT can provide personalised guidance and support.
In conclusion:
The /R/ sound can be challenging, but with targeted speech therapy and a focus on tongue placement, most children can achieve clear and accurate pronunciation.
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.
“Attention Autism” is an Early Years Intervention designed by Gina Davies, Specialist Speech and Language Therapist. Gina created this amazing therapy approach based on her many years of working with children on the autism spectrum. It aims to develop natural and spontaneous communication through the use of highly motivating activities. These activities offer your child an IRRESISTABLE INVITATION to engage and attend to.
I love using this approach and have trained in all of the stages including the Curiosity Stage which is for another blog. I use it frequently with all children who have trouble attending, listening, sitting or waiting regardless of whether they are neuro-diverse or neuro-typical, this activity and method is so great for all children!!
Why is it important for our children to attend and listen?
It is commonly assumed that, as our child has passed their hearing tests he/she will be able to listen and respond to being called, being questioned or asked to do something. However, all children I see in my practice have reduced joint attention skills, which means that whilst their hearing is often good, even brilliant to the point that they can often hear a faint noise somewhere outside the house like a distant train rushing by – but strangely they can’t seem to hear their name being called. Parents often ask me why this is the case, why can my child not turn round when I call him?
The reason lies in the difference between hearing and listening. Listening is a skill that needs to be learned and practiced. As a child develops, their hearing tunes into (listening) the sounds and noises they hear on a daily basis. This is how a child develops understanding of the speech sounds they hear every day (which then form the basis of their native language); they also get to know “their door bell, dog barking next door, daddy coming up the stairs” and so on. They tune into those common every day sounds and noises and gradually start to copy speech sounds to form words. So listening is tuning our ears to the sounds that surround us. In contrast, many of us have to work in large office spaces or noisy environment, perhaps even a café, etc, where we are able to tune out those environmental noises and sounds that surround us, for otherwise we will not get that report/piece of work done in time! Our focus means that we become single-minded and single-channelled concentrating on our work and so we do not hear people chat and clutter all around us.
Tuning in and out is a skill that we learn and some of us are better than it that others, it comes largely with practice but also with motivation – I go back to the report that needs doing by end of the day – my motivation is strong and I can now focus and blend out all around me so that I get the work done. Other times when I am not so motivated I might doodle and tune into what is being said at the table next to me, because my focus is not that strongly dedicated to my work.
Many children who are delayed in their development and especially children on the neuro-diverse continuum have difficulty with tuning in. By contrast, they are very good at being single-minded, single focused on what it is they are wanting/needing to do at any one point. And so they cannot listen to sounds, speech, noises around them very easily at all. They are fully absorbed in their activity and are not able to look and listen to mum/dad calling their name. Once we understand this we can start helping our children to practise tuning in a bit more bit by bit and day by day.
Enter the Attention Autism approach!
There are 4 stages to this method:
Stage 1: The Bucket to Focus Attention
The first stage involves filling a bucket with visually engaging toys that aim to help children learn how to focus their attention. Three toys will be presented to the child/group one at a time and the therapist will make simple comments about each toy to help introduce them to the children and expand their vocabulary.
Important to know: the Attention Autism approach does not require the child to look at the adult, or to sustain eye-gaze on the objects. Instead engagement may be indicated by non-verbal signals such as seeming alert and interested, and looking frequently at the object.
Stage 2: The Attention Builder
At this stage the child/group is introduced to visually stimulating activities. This stage aims to build and sustain attention for a longer period of time. Activities may include ideas such as:
Flour castles which can be built like sandcastles, using flour, a bowl and moulds
Erupting volcano activity
Wriggly worms foam – pile shaving foam onto an upside down plastic flower pot with the holes taped over; then slowly press down another plastic flower pot over the shaving foam and the foam will come through the top holes looking like wriggly worms, especially if you have dropped a bit of food colouring on top of the foam
Important: children are not required to make eye contact or sit still during these activities. The focus is on engagement, in whatever way the child demonstrates this.
Stage 3: The Interactive Game – Turn-Taking and Shifting Attention
The therapist demonstrates a simple engaging activity and invites children up to have a turn. This may be the same activity from stage 2 or something new. The aim is for children to learn to shift their attention from the group/sitting experience to doing something and then going back to sitting again.
Stage 4: Individual Activity
In the final stage of Attention Autism, the adult models an activity, and then each child is given the same equipment to use themselves. They do not have to copy exactly what the adult modelled. The aim is for the child watching to have a go independently with confidence, and then to take their materials back to the leading adult at the end. The activity should be engaging and enjoyable for the children. The Attention Autism approach aims to foster an interest in learning new things and to inspire communication in whatever form works for the child.
Ideally this should be practised 4-5 times a week aside from the therapy session. But I have seen it work with just 2-3 practice repeats per week. It can be tough in the beginning until your child gets used to the “no touch just look” rule but with a little bit of practice usually children do sit well for the first part of the Bucket activity within about 10 sessions and after that you are on a roll!
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.
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.
Reduce frustration by providing visuals to support their communication
Praise the ability to communicate. Focus on what they say not how they say it. E.g., good listening, nice talking.
Provide your child with choices (using real objects to represent your choices). E.g., do you want an apple or banana?
Your child must be motivated and have a purpose to communicate. So, ensure you use highly motivating objects for conversations
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.
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.
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.
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.
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.
As a Speech and Language Therapist with a specialism in paediatric feeding, I’m constantly looking for ways to support families in developing their little ones’ oral motor skills and fostering a positive relationship with food. While Baby-Led Weaning (BLW) has revolutionised how many families introduce solids, (see my previous blog in July 25) a concept that often sparks discussion and curiosity is the use of ‘hard munchables.’
The term ‘hard munchables’ refers to specific types of firm non-digestible food items that are offered to babies for oral exploration and skill development, not for nutrition. These are typically foods that babies cannot bite off or swallow in large pieces due to their texture, but which provide resistance for chewing practice.
The phrase was coined by Marsha Dunn Klein, M.Ed., OTR/L, Occupational Therapist and feeding therapist. Well known for her work in paediatric feeding she introduced and advocated for the concept of hard munchables as part of a therapeutic feeding approach, particularly for infants learning to manage textures and develop crucial oral motor skills.
Common examples of hard munchables include:
Large, raw carrot sticks: Too hard to bite through, but great for gnawing.
Celery sticks: Like carrots, offering firm resistance.
Large, raw apple slices (peeled chunks): A firm, slightly sweet option.
A firm, uncut pear core: With the seeds removed.
Dried mango cheeks (hard, unsweetened varieties): These offer a fibrous texture.
A large, fully cooked but firm piece of meat (like a steak bone with some meat attached): The meat provides flavour and a bit of shreddable texture, while the bone is for gnawing.
Hard crusts of bread or breadsticks (very firm, without soft inner crumb): These can soften slightly with saliva but offer significant resistance.
Image by Freepik
It’s crucial to emphasise that hard munchables are not for consumption or nutrition. They are tools for oral motor development and should always be offered under strict, active supervision.
How do hard munchables fit into weaning?
While weaning (traditional or Baby-Led Weaning) introduces solid foods that a baby can eventually bite and swallow, hard munchables are complementary to the weaning phase. They enhance that phase by helping a child to develop hand dexterity, hand to mouth movement, and oral development.
It’s important to differentiate: Weaning provides the digestible food for eating, while hard munchables provide the tool for skill practice. They are not substitutes for each other but can be used together under careful guidance.
Pros and cons from a speech therapy perspective
As an SLT, I see both the potential benefits and the necessary precautions when incorporating hard munchables.
Pros:
Enhanced oral motor development: Hard munchables provide excellent resistance training for the jaw, helping to develop the strength, endurance, and coordination needed for efficient chewing. This is foundational for moving beyond purées and very soft textures.
Promotes lateralisation of the tongue: The act of moving the hard item from side to side in the mouth encourages the tongue to move independently of the jaw, a crucial skill for managing food and for speech sound production.
Preparation for more complex textures: By strengthening the oral musculature and refining chewing patterns, hard munchables can help babies transition more smoothly to lumpy and mixed textures.
Sensory exploration: They offer rich sensory input (tactile, proprioceptive) that can be beneficial for oral mapping and awareness, especially for babies who might be orally sensitive.
Cons:
Choking risk: While the intention is for the baby not to bite off pieces, there is always a risk. Small pieces can break off, or a baby might accidentally bite off a larger chunk than he or she can manage. Active, vigilant supervision is non-negotiable.
Not a replacement for digestible solids: It’s vital to remember that hard munchables are for practice, not nutrition. They should complement, not replace, the introduction of varied, digestible solid foods.
Not suitable for all babies: Babies with certain developmental delays, oral motor deficits, or medical conditions might not be appropriate candidates for hard munchables without highly specialised guidance. For instance, babies with an exaggerated gag reflex might find them overwhelming.
Key Considerations for Parents
Here are my top recommendations:
Consult with a professional: Always discuss this with your Paediatric Feeding SLT first before you introduce hard munchables. We can assess your baby’s individual readiness and guide you on safe practices.
Strict supervision: Never leave your baby unsupervised with a hard munchable, even for a second. Your full attention is required.
Appropriate size: Ensure the item is large enough that the baby cannot fit the whole thing in their mouth. It should extend well beyond their fist.
No biting off: The goal is gnawing and scraping, not biting off pieces. If your baby is consistently breaking off chunks, stop using them.
Focus on skill, not consumption: Reiterate to yourself that this is for practice, not for eating.
In conclusion, hard munchables, when used appropriately and under guidance, can be a very valuable tool to support oral motor development during the weaning journey. However, always be safe and consult with a specialist to ensure your little one develops his or her feeding skills effectively and joyfully.
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.
If your child is using echolalia and/or has a diagnosis of autism, then your child’s way of processing language is most likely different to the classic way children typically learn language. We call this process Natural Language Acquisition or Gestalt Language Processing.
Step by Step guide to Gestalt Learning
Let’s explore the following stages of Gestalt Processing:
Stage 1: communicative use of whole language gestalts
(e.g., “let’s get out of here”)
Children and young people in this stage use echolalia. They need to hear more gestalts or scripts. So, your job is to model, model, model and to use functional language that your child can repeat back.
Stage 2: mitigated into chunks and re-combining these chunks
(e.g., “let’s get” + “some more”) and (e.g., “let’s get” + “out of here”)
This is when you take parts of gestalts or phrases and then combine it with other parts.
Stage 3: further mitigation (single words recombining words, formulating two-word phrases)
(e.g., “get…more”)
They are going beyond their gestalts. Furthermore, they may begin to label different objects.
Stage 4: formulating first sentences
(e.g., “let’s get more toys”)
You may see more grammatical errors during this phase as they are creating unique sentences. Please don’t worry about this, it means they are playing and experimenting with language. As communication partners, you could model the correct form of the sentence.
Stages 5 & 6: formulating more complex sentences
(e.g., “how long do you want to play inside for?”)
You can see that language learning is a process, that is trialled and tested, used in different contexts for children to be able to learn and use language appropriately.
My next blog will give you activities ideas and how you might use them specifically with a Gestalt Language Processor.
Remember early intervention is vital. So, if you have any concerns, please seek the advice of a Speech and Language Therapist.
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.
