Why open cup drinking and good sitting matter for your toddler

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When your baby reaches around 12 months, there is a lot going on developmentally. They are learning to walk, communicate, feed themselves and become increasingly independent. One small but important milestone that can sometimes get overlooked is learning to drink from an open cup.

Many toddlers continue to have milk from a bottle well beyond their first birthday, and parents are often understandably reluctant to take it away. The bottle may be familiar, comforting and convenient, particularly at bedtime.

But moving towards an open cup is not simply about changing the way your child drinks. It is part of their development of oral-motor skills, feeding independence and mealtime development.

And there is another piece of the puzzle that is often overlooked: how your toddler is sitting while they eat and drink.

The way the body is supported can make a real difference to what the mouth is able to do.

Why introduce an open cup from around 12 months?

Babies can begin learning to drink from an open cup much earlier than many parents realise. By around 12 months, most children should be given regular opportunities to practise drinking from an open cup alongside other suitable drinking vessels.

An open cup encourages your toddler to learn a different pattern of drinking from the sucking pattern they have used with a bottle.

With an open cup, your child needs to:

  • lean towards the cup and control its position
  • grade how much liquid enters the mouth
  • use their lips to help control the liquid
  • coordinate breathing and swallowing
  • develop increasingly mature tongue and jaw movements
  • learn to take a drink without relying on a teat or nipple.

These are useful skills for developing efficient eating and drinking.

This doesn’t mean that a toddler who still has a bottle at 14 or 18 months has somehow ‘missed their chance’. Children develop at different rates, and there is always an opportunity to work towards new skills.

However, if a bottle remains the main or only way a child drinks for a long time, there can be fewer opportunities to practise these more mature drinking skills.

What are the pitfalls of staying with a bottle for too long?

The occasional bottle is not the issue. The concern is when a toddler continues to rely heavily on a bottle and therefore has little reason or opportunity to develop other drinking skills.

A bottle encourages a sucking pattern which is appropriate for infancy. As children mature, we want to see increasing use of their lips, tongue, jaw and facial muscles in more sophisticated ways.

Long-term bottle use can also make the transition to an open cup more difficult simply because the child has become very accustomed to the bottle.

There can also be practical considerations around dental health, particularly when milk is offered frequently throughout the day or overnight.

For many toddlers, the bottle has also become associated with comfort, sleep or emotional regulation. This can make giving it up feel like a very big change for the whole family.

So rather than thinking, ‘The bottle has to disappear tomorrow’, think:

‘How can I gradually increase opportunities for open-cup drinking?’

Offer the open cup regularly at meals. Let your toddler experiment. Expect spills. Keep the amount of liquid small initially and provide plenty of encouragement.

Learning to drink is a skill. And skills need practice.

But what has sitting got to do with drinking?

Quite a lot!

When we think about feeding, we naturally tend to focus on the mouth. We watch what the tongue is doing, whether a child chews, whether they cough or gag and what foods they accept.

But feeding is a whole-body activity.

Your child needs a stable body position before they can use their mouth efficiently.

Think about trying to drink from a cup while sitting on a wobbly stool with your feet dangling in the air. You would probably find it much easier if your body was well supported.

The same principle applies to toddlers.

Tripp Trapp® Chair

A well-designed highchair such as a Tripp Trapp chair can provide a stable base when it is correctly adjusted for the individual child. Ideally, your toddler should have:

  • hips well supported
  • knees comfortably bent
  • feet resting firmly on a footplate
  • a stable pelvis and trunk
  • the table or tray at an appropriate height

This gives your child a solid foundation from which to move.

And that matters because stability in the body supports movement and control in the mouth.

Feet supported = better feeding?

I sometimes hear parents say, ‘He doesn’t need the footrest don’t worry about it (as I crouch down with my Allenn key to adjust the Tripp Trapp chair) but I always explain it is very important to have his feet supported. Dangling legs can make it much harder to maintain a stable sitting position.

When the feet are supported, your toddler can push gently through their feet and stabilise their pelvis and trunk. This can help them maintain a more organised position while eating and drinking.

They can then devote more attention to the job in front of them:

looking, reaching, grasping, chewing, swallowing and drinking.

This is particularly important for toddlers who are developing their chewing skills or who find mealtimes physically demanding.

A stable body supports a busy mouth

Eating involves an extraordinary amount of coordination.

Your toddler is managing food in their hands, bringing it to their mouth, biting, chewing, moving food around with their tongue, forming a bolus and swallowing,  often while simultaneously looking around, communicating and interacting with you.

Drinking from an open cup adds another layer of coordination.

Good postural support doesn’t teach a child to drink from a cup, but it can give them a much better physical foundation from which to practise the skill.

This is why, when I assess a toddler’s feeding, I don’t just look inside the mouth.

I also look at how the child is positioned.

Making open-cup drinking part of everyday life

You don’t need a complicated programme.

At meals, offer a small amount of water in an open cup. You can help your toddler hold the cup initially, tipping it gently towards their lips and allowing them to control the drinking as much as possible.

Some mess is completely normal!

You might also use a small, lightweight open cup that is easy for little hands to manage.

And remember that the goal is not to make every drink perfect. The goal is to give your child regular, positive opportunities to practise.

If your toddler is struggling with drinking, frequently coughing or choking, refusing cups, relying heavily on a bottle, or experiencing difficulties with chewing and eating, it is worth seeking professional advice from a Speech and Language Therapist with expertise in paediatric feeding.

The bigger picture

Open-cup drinking and good sitting are not two unrelated developmental skills.

They are part of the same picture.

A stable body provides a foundation for skilled movement. Skilled movement supports feeding. And feeding skills develop through practice and opportunity.

So as your toddler approaches and moves beyond their first birthday, think beyond simply asking, ‘How much milk are they drinking?’

Think about how they are drinking, how they are sitting, and what opportunities they have to develop the skills they will need as they grow.

And if you have a little one sitting beautifully at the table in a well-supported Tripp Trapp chair, remember: you’re not just creating a comfortable seat.

You’re creating a stable foundation for eating, drinking, learning and growing.

Do get in touch with me. I would love to hear from you and help your little one develop good sitting and drinking habits.

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.

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    Great toys and books for our toddlers (around 1–2 years old)

    As a speech and language therapist, I often get asked by parents what toys and books they should buy for their toddlers. It can feel overwhelming with so many options available! So, I’ve put together a list based on my experience and what I’ve found works well.

    Remember, every child is unique!

    Observe your toddler’s interests and play style. Some toys that are popular might not be engaging for your child.

    Here are a few ideas to get you started:

    Sensory Toys:

    • Stacking cups: These are fantastic for developing hand-eye coordination, fine motor skills, and understanding size relationships. (Various brands available) Note: You can stack many things you have around the house, like bowls or measuring cups, for a similar experience!
    • Shape sorters: Help with shape recognition, hand-eye coordination, and problem-solving. (Melissa & Doug, Vtech)
    • Sensory balls: Balls with different textures (soft, bumpy, squishy) provide tactile stimulation. (Various brands)
    • Push and pull toys: Encourage gross motor development and exploration. (Vtech, Fisher-Price)

    Communication-focused toys:

    • Picture books with flaps: Engage curiosity and encourage language development. (Various brands)
    • Talking toys: Introduce new vocabulary and encourage imitation. (Vtech, Fisher-Price)
    • Simple puzzles: Develop hand-eye coordination, problem-solving, and spatial awareness. (Melissa & Doug, Ravensburger)
    • Musical instruments: Encourage exploration of sounds and develop auditory skills. (Bright Starts, Fisher-Price)

    Now, let’s talk about books:

    • The Very Hungry Caterpillar by Eric Carle: A classic with repetitive text and vibrant illustrations, great for introducing vocabulary and concepts like days of the week.
    • Brown Bear, Brown Bear, What Do You See? by Bill Martin Jr. and Eric Carle: Simple, repetitive text and engaging illustrations make this a favourite for many toddlers.
    • Goodnight Moon by Margaret Wise Brown: A soothing bedtime story with calming illustrations.
    • Pat the Bunny by Dorothy Kunhardt: An interactive book with textures and flaps to engage young children.
    • Corduroy by Don Freeman: A heartwarming story about a teddy bear who loses his button.

    Remember:

    • Observe your child’s interests: Choose toys and books that capture their attention and encourage exploration.
    • Engage with your child: Play with the toys together and read books aloud with enthusiasm.
    • Keep it simple: Start with a few toys and books and gradually introduce new ones.
    • Rotate toys: Keep playtime fresh by rotating toys and books regularly.
    • Most importantly, have fun! Reading and playing with your child should be a joyful experience for both of you.

    Also consider the power of open-ended play

    In today’s world filled with electronic gadgets, it’s easy to overlook the value of open-ended play. Open-ended toys lack specific functions or prescribed outcomes, allowing children to use their imaginations to explore and create. Unlike toys with pre-determined ways to play, open-ended toys encourage:

    • Creative thinking: Children can use them in countless ways, developing their own rules and narratives. A block can become a car, a house, or a spaceship, depending on the child’s imagination.
    • Problem-solving skills: Children learn to figure out how to use the toys, experimenting and adapting as they go. Don’t immediately rush in and fix things for your little one, let them think for themselves and then communication incentive: let them come and find you!
    • Fine motor skills: Many open-ended toys, like blocks, encourage the development of fine motor skills like grasping, stacking, and building.
    • Cognitive development: Children learn about cause and effect, spatial relationships, and problem-solving as they play with open-ended toys.
    • Social-emotional development: Open-ended play can foster social interaction and cooperation as children play together and share ideas.

    Simple toys with big impact

    Some of the best toys for toddlers are often the simplest ones. Here are a few examples:

    • Wooden blocks: Building towers, bridges, and forts encourages creativity and problem-solving.
    • Balls: Throwing, kicking, and rolling balls promote gross motor skills and hand-eye coordination.
    • Fabric: Bits of fabric can be draped, draped, and used for imaginative play.
    • Empty boxes: From cardboard boxes to tissue boxes, these can be transformed into anything a child can imagine: a car, a house, a spaceship!
    • Natural materials: Sticks, leaves, pinecones, and rocks can be used for imaginative play and sensory exploration.

    Remember, the key to open-ended play is to let children explore and discover

    Step back and observe, allowing your child to use his or her imaginations without too much direction. You might be surprised at the creative ways he or she uses simple toys!

    Happy play times with your little one!

    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.

    1
  • ·

    Target activities and games

    Target Activities and Games For Kids
    Target Activities and Games For Kids

    Target Activities and Games

    AMAZINGLY EASY Activities that we can do at home and in the clinic to help our children practise those targets!

    I bet you have wondered what amazing things are done by a therapist in the clinic that you could not possibly do at home…? Well, if so I am here to tell you that you will be absolutely fine with just a few select toys and games and you will be able to get those targets done in a jiffy!

    What we clinicians do very well and what you probably can’t do yourself is formulate and design the targets that are important for your child to practice. Once we have assessed or reviewed your child’s progress and needs we can then design the perfect next step of targets for you.

    So for example, we have decided your little one needs to be practicing their ‘r’ sounds at the beginning of short words. We decided that based on our clinical expertise and our assessment and we have already worked with your child and managed to get this tricky ‘r’ sound just about right on its own. Now we are ready for short word practice.

    It has been researched that in order for the brain pathways to re-shape or reform we need to get about 100 words in per day of our target sound. That sounds like quite a lot, right? But actually….. it’s not that bad. After all you only need to say 5-7 words about 20 times and hey presto that’s about 80-100 words.

    So here are some simple games I use in my clinic all the time and these games are easily available online or in your local toy shops and this is how to do them:

    Pop the Pirate

    Pop the Pirate, sooo good and popular:

    Lay out your target words which you will have been given by your speech therapist and put a few swords on each word.

    Each time your child picks up a sword they will need to say the target word 5 x, like:

    rip rip rip rip rip or run run run run run just like that in a row, bish bash bosh.

    Then they can stick the sword into the barrel. Onto the next sword which they can pick and then again

    race race race race race and stick in another sword

    So with this little lot I put out 5 target words and 3 swords on each.

    You will therefore get…… 15 words per picture, and that makes….75 words , there that is nearly all you need to do.

    If you then do another little game like this one:

    Magnetic board game

    This is a Magnetic Board game, and they are suddenly EVERYWHERE. But you could also just take a baking sheet and some fridge magnet you might have kicking about.

    Same principle as before, but now since this is your SECOND game of the day and you have already got 75 targets under your belt you only need to do one more round of 5 target words each:

    Each time your child picks up a magnet piece they will say the target word 5 more times:

    Ray ray ray ray ray and DONE you will now at the end of this short round have 105!! target words done with just two little fun games.

    How good is this? Your child won’t hardly notice that they are in fact doing their speech therapy homework.

    You’re welcome 🙂

    Get in touch if you would like me to help finding good targets for your child to work on. They can be speech and/or language targets with this game method.


    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.

  • · ·

    How can we support babbling and early speech development? SLT tricks and tips

    My baby isn’t babbling and developing speech – what can I do to support?

    While every baby develops at their own pace, if your child isn’t babbling by nine months, it’s worth seeking help from an Early Intervention Health Professional, such as a doctor and a speech therapist. Don’t panic! There are many reasons for delayed babbling, and early intervention is key.

    In the meantime, it is highly recommended that we talk, sing, and read to our baby often. Exaggerate sounds and expressions, and respond to their coos and smiles. This playful interaction helps stimulate their communication skills.

    Below are some tips and tricks from my experience of working with babies and toddlers who need a little bit of help and support to develop.

    The benefits of imitating your baby

    Copying your baby’s sounds and gestures isn’t just silly fun, it’s a powerful learning tool! By mimicking their babbles and actions, you activate “mirror neurons” in their brain that help them connect sounds with meaning. This playful back-and-forth teaches turn-taking, a foundation for conversation. Plus, it encourages them to copy you, building their own language skills and social interaction abilities.

    This is a nice clip on youtube showing how copying/imitating your baby looks like:

    Here are some fun ways to imitate your baby:

    • Matchmaker: Grab two of the same, or two similar toys your child loves, like rainmakers or shakers. Give one to your baby and keep the other for yourself. When your child plays with his/her toy, mirror his/her actions with yours! This creates a fun, interactive game.
    • Face Time: Get down to your baby’s level, sitting opposite him/her on the floor or kneeling. This makes eye contact easy and encourages him/her to look at you during your playful imitation.
    • Be the Funniest You: Go all out with silly faces, exaggerated sounds, and big gestures. The goal is to capture your baby’s attention and make you irresistible to watch. This playful energy encourages him/her to interact and potentially imitate you back!

    By incorporating these tips, you can turn imitation into a fun and engaging way to boost your baby’s communication skills. I have seen this happen numerous times over the past decades. It is very powerful, go ahead and try it! You cannot be silly and goofy enough!

    Great toy ideas:

    Did you know that speech and language development starts with how we talk to our babies?

    Adults naturally use a special way of speaking called motherese. It involves a higher pitch, slower pace, and exaggerated sounds compared to regular conversation. Sentences are simpler, with shorter words and repetition. This grabs babies’ attention, helps them distinguish sounds, and reinforces word meaning.

    Imitation is a key part of motherese. We wait for our baby to make a sound or gesture, then playfully imitate it with exaggeration. Babies notice this right away and often respond with more vocalisations, creating a mini conversation. This back-and-forth teaches turn-taking, a foundation for future conversations.

    By responding warmly and engaging in these playful interactions, we encourage our babies to keep exploring the world of communication. Talking, singing, reading and, of course, imitating, these simple actions can have a big impact on a baby’s language development.

    Once your conversation is underway then try and keep it going for as long as possible. It’s a beautiful dance of turn-taking, even without words!

    A last word on oxytocin

    There’s evidence suggesting early non-verbal communication with your baby can increase a mother’s oxytocin levels, often called the ‘love hormone’. This hormone plays a key role in bonding and social connection. Positive interactions, touch, and stress reduction all contribute to oxytocin release, strengthening the mother–baby bond.

    For parents of babies with extra needs

    The stress of caring for a child with medical needs or developmental delays can be difficult. Stress can lower oxytocin levels, creating a cycle of sadness for both parent and child.

    Breaking the cycle:

    1. Knowledge is Power: Understanding the importance of communication can empower parents.
    2. Seek Support: Speech therapists and other healthcare professionals can provide valuable guidance on communication strategies.
    3. Start Small, Celebrate Big: Even small interactions can boost oxytocin. Focus on playful imitation and positive reinforcement. Remember, friends, family and healthcare professionals are there to encourage you.

    This approach can help reverse the negative cycle and create a more positive and connected relationship between parent and child.

    I hope this is helpful! Don’t hesitate to reach out with any questions.

    Kind regards

    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.

    2
  • · · · ·

    Let’s ditch the ‘Fix-It’ approach to autistic play and stimming

    Let’s ditch the 'Fix-It' approach to autistic play and stimming

    December is often presented as a time of perfect, reciprocal play. Children are supposed to be unwrapping toys, sharing, and engaging in imaginative scenarios with family. But for parents of young autistic children, this high-pressure, socially demanding period can often feel like a battleground.

    If you’ve been told to interrupt your child’s stimming, push for eye contact, or force them to play ‘functionally’ with toys, it’s time to take a deep breath. Those traditional approaches are not only stressful—they often miss the point of your child’s communication.

    As a neurodiversity-affirming Speech and Language Therapist, I want to encourage you this December: You are allowed to follow your child’s lead, validate his or her unique interests, and trust that his or her play and movement are profoundly meaningful.

    1. Stimming: not a distraction, but a regulator 💡

    Stimming is short for self-stimulatory behaviour and includes repetitive movements or sounds like hand flapping, humming, rocking, finger flicking, or repeating phrases (called echolalia).

    For years, parents were incorrectly advised to block or eliminate these behaviours. The neurodiversity-affirming view tells us the exact opposite: Stimming is a vital and essential tool for your child’s self-regulation.

    Think of stimming as an internal volume dial:

    • Too loud/overwhelmed: Your child may stim to reduce incoming sensory input (e.g., rocking to ground himself or herself in a busy room).
    • Too quiet/under-stimulated: Your child may stim to increase sensory input and focus (e.g., running back and forth to maintain alertness).

    The shift: validate, don’t block

    Instead of saying, ‘Stop flapping your hands’, try to understand the message behind the movement.

    • Observe: When does the stimming happen? Is it before a meltdown? When your child excited? When your child is bored?
    • Validate: Name the need, not just the behaviour. You might say, ‘I see your body needs to move fast right now. That helps you calm down!’
    • Co-regulate: If the stim is unsafe (e.g., head-banging), help your child find a safer, alternative stim that meets the same sensory need (e.g., pushing hard against a wall, squeezing a stress ball).

    By validating your child’s need to regulate, you are building trust, reducing anxiety, and teaching him or her critical self-awareness.

    2. Autistic play: Meaningful, even if it’s monologue

    The traditional idea of ‘good play’ often involves turn-taking, pretending, and specific toy functions (e.g., pushing a train around a track). When an autistic child spends 30 minutes lining up cars, spinning their wheels, or scripting whole scenes from a favourite movie, it can often be dismissed as non-functional or repetitive.

    In neurodiversity-affirming practice, we recognise that autistic play is authentic play. These activities are crucial for learning, deep focus, and imaginative development.

    • Lining up toys may be an exploration of patterns, visual organisation, and order.
    • Spinning wheels may be a deep interest in cause-and-effect and visual sensory input.
    • Scripting is often a way to process language, regulate emotions, and practise complex social situations in a safe, controlled way.

    Make a change: Join your child’s world, don’t drag them to yours.

    Stop trying to force the ‘right’ way to play. Instead, try these neuro-affirming strategies:

    1. Be a co-regulator, not a director: If your child is lining up cars, sit down next to him or her. Instead of moving a car, try handing him or her another car to line up. Focus on the shared interest rather than forcing interaction.
    2. Narrate (don’t question): Avoid constantly asking, ‘What are you doing?’ or ‘What does this car say?’ This puts pressure on your child to perform. Instead, narrate your observations using his or her interest: ‘I see you made a long, straight line of red cars. Look at all the wheels spinning!’
    3. Validate the interest: Show genuine appreciation for your child’s focus. ‘Wow, you know so much about how magnets stick together! That’s incredible.’

    3. The communication revolution: Honouring gestalt language processing 

    Many young autistic children communicate in ways that don’t fit the traditional model of building language word-by-word. Many use Gestalt Language Processing (GLP).

    A gestalt language processor learns language in chunks or scripts (e.g., ‘what’s-in-there?’ or ‘ready-go!’). These chunks (or gestalts) are not random; they are often tied to an emotional memory or meaning. Over time, the child breaks down these big chunks into individual words then learns to recombine those words creatively.

    If your child repeats movie phrases or whole sentences that seem unrelated, he or she is likely a gestalt language processor!

    Affirm the script, then model something useful.

    1. Affirm the script: When your child says a script, respond to the meaning or emotion behind it, not the literal words. If he or she says, ‘We’re going to need a bigger boat’, and he or she is looking at a messy toy pile, he or she may be trying to express overwhelm or a need for help. You can affirm: ‘That pile is too big! I can help you move it.’
    2. Model new ‘mix and match’ scripts: To help your child move from whole scripts to single words, you can model shorter, slightly changed versions of the script, also called ‘mitigated gestalts’. If they say, ‘I want to go home now’, you might model, ‘Let’s go home, now’ or ‘I wanna go home’.

    By honouring your child’s communication style, you validate his or her experience and naturally support his or her path to language development—a core part of neurodiversity-affirming SLT.

    Your December gift to your little one:

    This December, stop trying to make your child fit into a neurotypical box. Instead, make your home a safe space where he or she can be his or her authentic selves.

    Prioritise regulation and connection over compliance.

    Trust that when your child is regulated, his or her communication, learning, and engagement will flourish naturally. This is the true gift of neurodiversity-affirming practice.

    Download and print my neuro-affirming quick reference guide and keep this guide handy on your fridge and/or in your child’s play area for a quick reminder to prioritise connection over conformity.

    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.

    2
  • Learn the benefits of Cycles Phonology Approach in Speech Therapy

    A grey, green and orange circle overlaid with Cycles Phonological Approach
    Cycles Phonogogical approach

    When your child attends Speech and Language Therapy, it can look like your child’s therapist is playing. Therapy needs to be fun, which means carrying out therapy through the medium of play. But remember every approach used has evidence behind it. We need to know that therapy will be successful, so an evidence-based approach is essential.

    One of the approaches used for Speech Therapy (i.e., working on speech sound production) is the Cycles Phonology Approach. This approach focuses on the patterns and processes rather than each individual sound. For example, it may be working on final consonant deletion, so the omission of the final sound in words. As Speech and Language Therapists we understand that children can get frustrated and fatigued working on the same sound every day. This approach attempts to solve that. Hodson suggests, the approach is also useful for children with more speech sound errors, as therapists see progress in areas not targeted.

    How does the Cycles Phonology Approach work?

    Your Speech and Language Therapist will assess your child’s speech development and will then analyse the results. They will also look for which sounds they can produce with support (this is called stimulability). They will analyse patterns in the results and will formulate a plan.

    The Cycles Phonology Approach intervention allows your child to work in blocks. This might mean they work for half a week for 30 minutes on (e.g., clusters). Then the next half they’ll work for 30 minutes on a different process (e.g., omission of sounds at the end of words).

    Research has found that the following error patterns respond well to this approach:

    • Syllables (identifying the different parts in a word e.g., “ae-ro-plane”)
    • Final Consonant deletion (omission of the final sound e.g., “ca” instead of “cat”)
    • Initial consonant deletion (omission of the first sound e.g., “at” instead of “cat”)
    • Fronting (instead of making a sound at the back of the mouth, it’s made at the front e.g., “tat” instead of “cat”)
    • Backing (instead of making a sound at the front of the mouth, it’s made at the back e.g., “gun” instead of “bun”)
    • S blends (e.g., “sl, sm, sn, sk, sw”)
    • Gliding of liquids (e.g., “lellow instead of yellow”, “wabbit instead of rabbit”)

    What does a Speech and Language Therapy session look like when using the Phonology Cycles Approach?

    The format of the session remains the same for whichever speech sound pattern your child is working on. Your child’s Speech and Language Therapist will review the previous session. Then they will use an activity to work on your child hearing the sound several times (this is called ‘auditory bombardment’). Then your child will practise saying the sound. Next, the Speech and Language Therapist will check if your child can say any of the sounds which they haven’t been able to produce before, with support. This is called a stimulability check. After this, your child will take part in an activity which builds their awareness of sounds in words (such as a rhyming or syllable activity). The session will finish with another auditory bombardment task (i.e., hearing their tricky sound repeatedly).

    I will give you advice for practising at home, as it’s vital that your child learns in the correct way. We aim for 100 turns in therapy sessions, so it’s vital your child is motivated.

    Contact me to improve your child’s speech sounds and improve their confidence when talking.


    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
  • · ·

    When AAC modelling doesn’t feel natural yet: Helping parents learn to use their chosen AAC system

    One of the most common pieces of advice parents hear when their child starts using AAC is: ‘Just model the words naturally.’

    And, yes, natural modelling is an important part of AAC support.

    But there is something we don’t always talk about: How on earth is a parent supposed to model a word naturally when they are still trying to work out where the word is themselves?

    Using a robust AAC system such as LAMP Words for Life can feel a little like learning a new language.

    The parent is learning the language at the same time as the child they are hoping to teach it to.

    So, although I absolutely want AAC to become part of everyday life, I often begin with something much more structured.

    And I have found that this can make the transition to natural, everyday modelling much easier for families.

    Learning the system first

    In my first video clip, I am using a very simple farm animal sticker activity with LAMP Words for Life.

    The activity gives us the opportunity to practise some useful, functional words:

    • OFF: taking the sticker off
    • FARM ANIMALS: finding the animal category
    • HORSE
    • SHEEP
    • CHICK
    • ON: putting the sticker onto the book

    At first, I am quite explicit about what I am doing.

    I might draw attention to the relevant button, help the child navigate to it, talk through what we are looking for and practise finding the word several times.

    This is more didactic and structured than the idealised picture some people have of AAC modelling.

    And I am completely comfortable with that at the beginning.

    Why start so explicitly?

    Imagine that you are given a brand-new device containing hundreds or thousands of words.

    Someone tells you: ‘Don’t worry. Just use it naturally.’

    You might manage to find a few obvious words.

    But when you are suddenly standing in the kitchen taking your child’s coat off and want to say ‘OFFS, you may have absolutely no idea where to look.

    That is exactly why I think parents sometimes need permission to learn the system in a supported way.

    The structured activity creates a safe environment where we can stop and think:

    • Where is that word?
    • How do I get there?
    • What does this word do?
    • What happens when I press it?

    We can practise it more than once.

    We can repeat it.

    And gradually, the route to that word becomes familiar.

    AAC systems are not simply devices that children need to learn. Communication partners need to learn them too. All the AAC research highlights partner training as an important part of AAC intervention and notes that intervention initially includes helping the individual and their family or carers develop operational competence with the system.

    From structured practice to everyday life

    And this is where the useful transfer can happen.

    Take the word OFF.

    In our sticker activity, we may practise:

    ‘OFFS

    ‘OFFS

    ‘OFF’

    We take the sticker off.

    We find the button again.

    We use the word again.

    After several opportunities, the parent has not only seen their child use the word, the parent now knows where the word lives too.

    Then later that day, they are taking their child’s coat off.

    Suddenly:

    ‘OFF!’

    And they know exactly where to find it.

    The same thing might happen with ON.

    Once the parent has practised finding ON several times during play, it becomes much easier to spot opportunities for it during the day:

    ‘Shoes ON.’

    ‘Lights ON.’

    ‘Music ON.’

    ‘Hat ON.’

    ‘Tap ON.’

    This is one of the reasons I like structured AAC activities. They are not necessarily the final goal.

    They can be the rehearsal space that gives parents and children enough confidence to use AAC in real life.

    Natural modelling is still the goal

    This doesn’t mean that I want parents spending their whole day sitting beside their child and directing them towards buttons.

    Quite the opposite.

    The aim is to gradually move towards a much more natural style of AAC use.

    Once parents know their way around the system, they can begin to model words spontaneously as they occur in everyday interactions.

    Research into aided AAC modelling describes adults using AAC alongside speech within meaningful activities, and evidence supports the use of aided input as part of AAC intervention.

    But getting there may take teaching, repetition, practice and coaching.

    And that’s okay.

    It is not about making the child press the button

    There is another important distinction here.

    When I say that I may initially be more explicit or ‘direct’ during an activity, I do not mean that I am trying to make a child perform the correct response.

    I am not interested in turning AAC into a test.

    I am not continually asking:

    ‘Where’s HORSE?’

    ‘Find SHEEP.’

    ‘Show me CHICK.’

    Instead, I am helping the child and parent become familiar with the system.

    I might point, gesture, navigate, model the word and repeat it within a meaningful activity.

    As confidence grows, the support can be reduced so that the child has increasing opportunity to locate and use the language themselves.

    My second video clip shows a child using their own LAMP Words for Life system at home, accessing a category they have chosen which is FOOD.

    This is what I love about AAC.

    The device isn’t just being used in the therapy room.

    It becomes part of the child’s own life.

    And the child is using it around their own interests and choices.

    That is the direction I want families to move towards:

    From ‘I don’t know where anything is!’ to ‘I know where some useful words are.’

    Then ‘I can use those words during our everyday routines.’

    And eventually: ‘This is my communication system, and I can use it to tell you what I think, want, notice, enjoy, reject and choose.’

    Parents don’t have to get it perfect

    This is perhaps the biggest message I would like parents to take away.

    You do not have to become an AAC expert overnight.

    You are learning too.

    It is completely reasonable for a parent to need time to become familiar with the layout, vocabulary and navigation of their child’s system.

    Learn it. Practise it. Model it. Then take it into real life.

    Any questions please contact me via my contact form.

    Sonja McGeachie

    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.

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