Why pointing matters: Unpacking the power of this simple gesture

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As a speech and language therapist, I’m often asked about the significance of seemingly simple gestures in child development. One question that comes up frequently is, ‘Why is pointing so important?’ It might seem like a trivial action, but pointing is a powerful communication tool and a critical milestone in a child’s development.

Why is pointing so important?

Let’s delve into the theory behind why pointing matters:

1. Pointing as pre verbal communication:

Before children can use words, they use gestures to communicate their needs and interests. Pointing is one of the earliest and most important gestures. It allows children to:

  • Request: ‘I want that!’
  • Protest: ‘No, not that!’
  • Direct attention: ‘Look at that!’
  • Share interest: ‘Wow, cool!’

2. Pointing and language development:

Pointing is not just about communicating in the here and now; it also plays a crucial role in language development. Research shows that:

  • Early pointing predicts later language skills: Children who point more often tend to have larger vocabularies and better grammar later on.
  • Pointing helps children learn new words: When children point at something, adults tend to label it, providing valuable language input.
  • Pointing supports joint attention: Joint attention, or the shared focus of two individuals on an object or event, is essential for language learning. Pointing helps establish joint attention, creating opportunities for communication and learning.

3. Pointing and social-emotional development:

Pointing is not just about language; it’s also about social interaction. It allows children to:

  • Engage with others: Pointing invites others to share their focus and participate in their world.
  • Express emotions: Pointing can convey excitement, curiosity, or concern.
  • Develop social understanding: By observing how others respond to their pointing, children learn about social cues and communication.

4. Pointing and cognitive development:

Pointing is linked to cognitive skills, such as:

  • Understanding object permanence: The ability to know that objects exist even when they are out of sight.
  • Categorisation: The ability to group similar objects together.
  • Problem-solving: Pointing can be used to ask for help or to indicate a problem.

5. Types of Pointing:

It’s important to note that there are different types of pointing, each with its own significance:

  • Imperative pointing: To request something.
  • Declarative pointing: To share interest or direct attention.
  • Informative pointing: To provide information.

If you have concerns about your child’s pointing or overall communication development, don’t hesitate to seek professional guidance from a speech-language therapist. Early intervention can make a significant difference in supporting your child’s communication journey.

How can we create opportunities for pointing?

  • ‘Where’s the…?’ games:
    • Play games like ‘Where’s the doggy?’ or ‘Where’s the ball?’ and encourage your toddler to point to the object.
    • Start with familiar objects and gradually introduce new ones.
  • Reading together:
    • When reading picture books, ask your toddler to point to specific objects or characters on the page.
    • Use phrases like, ‘Can you point to the puppy?’
  • Everyday activities:
    • During daily routines, ask your toddler to point to things they want or need.
    • For example, ‘Do you want the apple or the banana?’
    • When walking outside say ‘LOOK’ and encourage pointing.
  • Use of toys:
    • Use toys that have buttons or points of interest that when pressed make a noise. Encourage your toddler to point to the area that makes the noise.
    • Use toys that have many different parts, and ask the toddler to point to a specific part.

Model pointing:

  • Point yourself:
    • When you see something interesting, point to it and say the name of the object.
    • For example, ‘Look! A bird!’
  • Point to show choices:
    • When offering choices, point to each item as you name it.
    • For example, ‘Do you want the blue cup or the red cup?’ (Point to each cup).
  • Point to indicate direction:
    • When giving directions, point in the direction you want your toddler to go.
    • For example, ‘Let’s go that way!’ (Point).

Make it rewarding:

  • Respond to pointing:
    • When your toddler points, immediately respond to their communication.
    • Give them the object they want, or acknowledge what they are pointing at.
  • Use positive reinforcement:
    • Praise and encourage your toddler when they point.
    • Say things like, ‘Good pointing!’ or ‘You showed me the car!’
  • Show excitement:
    • When they point to something, show excitement, this will encourage them to point again.

Use specific techniques:

  • Use gestures and verbal cues:
    • Combine pointing with verbal cues and other gestures.
    • For example, say ‘Look!’ while pointing and nodding your head.
  • Simplify the environment:
    • Reduce distractions to help your toddler focus on the object you want them to point to.
  • Use exaggerated movements:
    • Use large, exaggerated pointing movements to draw your toddler’s attention.

Consider developmental factors:

  • Age-appropriate expectations:
    • Remember that pointing develops at different rates for different children.
    • Be patient and supportive.
  • Underlying issues:
    • If your toddler is not pointing by 18 months, or if you have any concerns about their development, consult with a speech and language therapist.
    • There may be underlying sensory or motor issues.

Key points:

  • Consistency is key. Practise these strategies regularly.
  • Make it fun and engaging for your toddler.
  • Celebrate every success, no matter how small.
  • If you have any concerns about your child’s development, contact your local health services.

Great toys and items for pointing

1. Interactive books:

  • Touch-and-feel books: Books with different textures, flaps to lift, and sounds encourage interaction and pointing. ‘Where’s the…?’ questions prompt pointing to specific features.
  • Books with simple pictures: Clear, uncluttered pictures make it easier for toddlers to focus and point to objects or characters.

2. Cause-and-effect toys:

  • Activity cubes: These often have buttons, dials, and levers that produce sounds or actions when manipulated, prompting pointing and exploration.
  • Pop-up toys: Toys where figures pop up or things happen when a button is pressed encourage anticipation and pointing to the action.
  • Simple musical instruments: A toy piano, drum, or xylophone encourages pointing to the keys/surfaces to make sounds.

3. Toys with parts to manipulate:

  • Shape sorters: Encourage pointing to the shapes and the matching holes.
  • Stacking cups or rings: Nesting cups or stacking rings invite pointing to select the correct size or order.
  • Puzzles with knobs: Simple puzzles with large knobs are easier for toddlers to grasp and point to the pieces.

4. Toys that encourage joint attention:

  • Bubbles: Blowing bubbles and following them with your eyes and pointing encourages joint attention (shared focus).
  • Balls: Rolling a ball back and forth and pointing to where it’s going can promote joint attention and turn-taking.
  • Wind-Up Toys: Wind-up toys that move across the floor can be exciting to follow with pointing.

5. Pretend play toys:

  • Toy telephones: Encourage pointing to the buttons and pretending to dial.
  • Dolls and stuffed animals: Pointing to the doll’s eyes, nose, mouth, etc., or asking the child to point to these features on themselves.
  • Toy food and dishes: Pretend play with food and dishes can involve pointing to request items or indicate actions (e.g., ‘Can I have the apple?’).

Tips for using toys to encourage pointing:

  • Get involved: Play alongside your toddler, modelling pointing and using language to describe what you’re doing.
  • Follow their lead: Observe what your child is interested in and use that to encourage pointing.
  • Limit distractions: Reduce background noise and visual clutter to help your child focus.
  • Use gestures and words: Combine pointing with words and other gestures (e.g., ‘Look!’ while pointing).
  • Be patient and positive: Celebrate all attempts at pointing and provide lots of encouragement.

Remember, the most important factor is the interaction you have with your child while playing. Use these toys as tools to create opportunities for communication and joint attention, and your toddler will be well on their way to mastering pointing!

Get in touch with me via my contact form if you need support

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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    Unlocking language and thinking skills: The power of sequencing

    Sonja demonstrates the power of sequencing

    As speech and language therapists, we often use a variety of techniques to help children develop their communication and cognitive skills. One incredibly valuable tool in our toolkit is the use of sequencing activities. But what exactly is sequencing, and why is it so beneficial?

    What is sequencing?

    Sequencing, at its core, involves arranging items, events, or actions in a specific order. This could involve putting pictures in the correct order to tell a story, following the steps in a recipe, or understanding the order of daily routines like brushing teeth or getting dressed.

    The link between sequencing and language

    Sequencing is fundamental to language development and is quintessential to executive functioning skills in several ways:

    • Narrative skills: Storytelling, whether oral or written, relies heavily on sequencing. A child needs to understand the order of events (beginning, middle, end) to construct a coherent narrative.
    • Explanations and instructions: Providing clear explanations or instructions requires the ability to sequence information logically. For example, explaining how to play a game or how to get from one place to another. In the video clip below we are working on ‘how do make a sandwich’.
    • Vocabulary development: Sequencing helps children understand temporal words and phrases like ‘first,’ ‘then,’ ‘next,’ ‘before,’ and ‘after’.
    • Sentence structure: Constructing grammatically correct sentences often involves sequencing words in a specific order (e.g., subject-verb-object).

    Beyond language, sequencing plays a crucial role in developing executive functioning skills. These are higher-level cognitive skills that help us plan, organise, and manage our time and actions.

    Sequencing activities can help children improve in the following areas:

    • Planning and organisation: Sequencing tasks require children to think ahead, plan the steps involved, and organise them in a logical order.
    • Problem-solving: When they are faced with a problem, sequencing helps children break it down into smaller, more manageable steps.
    • Working memory: Holding information in mind and manipulating it, such as remembering the steps in a multi-step direction, is supported by sequencing skills.
    • Cognitive flexibility: Being able to adjust to changes in a sequence or think of alternative sequences promotes cognitive flexibility.

    Examples of sequencing activities

    Here are some practical examples of sequencing activities you can do with your child:

    • Picture sequencing: Use a set of picture cards to tell a short story or illustrate a process (e.g., making a sandwich, going to the park). Ask your child to arrange the cards in the correct order.
    • Story retelling: After reading a story, have your child retell it, focusing on the order of events.
    • Following instructions: Give your child multi-step instructions to follow (e.g., ‘First, get your shoes. Then, put on your coat. Next, go to the door.’).
    • Sequencing during play: Integrate sequencing into everyday play. For example, while building with blocks, talk about the steps: ‘First, we put this block here. Next, we add this one…’
    • Daily routines: Create visual schedules for daily routines, like getting ready for school or bedtime, to help children understand the sequence of events.
    • In the video clip below I am using an on-line language activity which is often fun for children as they can use their finger to swipe the pictures effortlessly into the right place and, if we realise at the end of the story that we have made a little error, we can then easily re-jig the pictures into their correct place.

    In conclusion

    Sequencing activities offer a powerful way to support children’s language development and enhance their executive functioning skills. By helping children understand and create order, we equip them with essential tools for communicating, learning, and navigating the world around them.

    Do get in touch via my contact form if you are concerned about your child’s development.

    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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    Principles of motor learning in Childhood Apraxia of Speech (CAS)

    We use powerful motor learning principles to help children with CAS (Childhood Apraxia of Speech) learn how to produce better, clearer speech sounds in words, phrases and sentences.

    What are these principles?

    Principle 1: MASSED PRACTICE

    This is where you see a child for lots of sessions in a shorter period of time, so for instance six weeks of three times weekly for 30 minutes.

    This leads to motor performance or automaticity.

    Principle 2. DISTRIBUTED PRACTICE

    This is what I use, as most of my clients are not able to come and see me that often on a weekly basis. It is hard to travel in London and life is hectic. So I favour one session a week over say a term or two terms and a session is usually 45 minutes long.

    This leads to improved Motor Learning and good generalisation.

    During either Massed or Distributed Practice, we choose between 4 variables:

    Principle 3: Constant vs Variable

    Principle 4: Blocked vs Random

    To explain:

    Constant Practice is where we repeat the practice of a small handful of target words.

    We practise the same target sound in the same word position, e.g. at the beginning of a word: ‘bee’, ‘bye’, ‘bow’, ‘baa’ or ‘key’, ‘car’, ‘cow’, ‘Kaye’ etc.

    We keep the rate, pitch and intonation constant.

    Variable Practice is where we vary the rate, volume, pitch and intonation of the targets

    We use a larger number of sounds, and words that are motivating to say for the child.

    For example, if a child loves Peppa Pig then I might choose the words: ‘Peppa’, ‘Daddy Pig’, ‘George’, ‘Mummy Pig’ and a couple of other favourite characters. My child might struggle with a number of sound sequences there but we will target them one by one.

    We can also select simpler words like ‘cape’ and ‘cake’ or ‘tick’ and ‘tip’.

    Blocked Practice is where we practise one target word for say five minutes then we move to another target word for the next five minutes and then we revert back to the first target word again and so on, so blocks of practice.

    Random Practice means we practise several target words at the same time.

    How do I decide on what to use?

    Good question!

    I always opt for distributed practice (weekly for up to 45 minutes).

    Within that, I tend to find it most successful to start out with constant practice when a child is finding a certain sound sequence really hard and we need to just ‘nail it’. Bearing in mind I only pick sounds that my student can actually make in isolation, so we are not working on articulation! (where we focus on trying to elicit single sounds correctly – or even at all sometimes) Here in CAS work, we are working with sounds the student can make but is having trouble to add together, into a sequence that is needed to make a word sound right.

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    I tend to use blocked practice in the beginning or when working on vowels. That’s because it is more important we get our vowels right. They carry a word and are very important for overall speech intelligibility. Once we are on a roll, I tend to go more for random practice.

    Example

    Here in the video clip, we try and work the /e/ vowel in short words likes ‘bell’, ’fell’, ‘dell’, ‘sell’, ‘smell’ and I am using an AAC device to give a child’s voice as auditory feedback as well as using the PROMPT approach to help my student shape his vowels.

    So this is:

    1. Distributed (1 x week for 45 minutes)
    2. Constant – we are practising the /e/ vowel in the same position in six different words
    3. Blocked – we did this: several repetitions of each word and after the sixth we moved to another sound, and then later we came back to this.

    Please feel free to contact me if your child has speech sound difficulties. It is my passion. I love supporting children with apraxia.

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

    What is a LISP?

    There are different types of LISPS. Let me explain:

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

    1. Interdental lisp

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

    1. Lateral lisp

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

    1. Palatal lisp

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

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

    Some thoughts on Treatment in general:

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

    When should treatment of lisp begin?

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

    Do lots of children lisp—is it normal?

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

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

    What happens during the first Speech and Language Consultation?

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

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

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

    Therapy – what does a session look like?

    Each therapy session consists of:

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

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

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

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

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

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


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

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    Understanding phonological processes in 3–7-year-olds: What’s typical and when to seek help

    As a speech and language therapist, one of the most common questions I hear from parents is:

    ‘They can talk, but their speech still sounds immature. Is this normal?’

    Many children between the ages of three and seven use speech patterns that make their words sound different from adult speech. These patterns are known as phonological processes, and for younger children, they are a normal part of speech development.

    However, when these processes persist beyond the expected age, they can start to affect clarity, confidence and learning, especially once children enter school.

    This blog will help you understand:

    • what phonological processes are
    • which patterns are typical at different ages
    • and when it might be time to seek speech therapy support

    What are phonological processes?

    Phonological processes are patterns of sound simplification that children use while their speech system is developing.

    Instead of learning each sound one by one, children initially organise sounds into patterns that make speech easier to produce. This is a normal and efficient strategy for a developing brain.

    For example:

    • saying ‘tar’ instead of ‘car’
    • saying ‘poon’ instead of ‘spoon’
    • saying ‘bud’ instead of ‘bus’

    These are not ‘bad habits’. They are part of how speech develops.

    The key question is how long these patterns last.

    Common phonological processes (and when they usually disappear)

    Below are some of the most common processes parents notice in 3–7-year-olds.

    1. Final consonant deletion

    Leaving off the last sound in a word

    • ‘ca’ for cat, ‘da’ for dog
    • Typically resolved by 3–3½ years

    2. Fronting

    Replacing back sounds (k, g) with front sounds (t, d)

    • ‘tar’ for car, ‘do’ for go
    • Typically resolved by 3½–4 years

    3. Cluster reduction

    Omitting one sound in a consonant cluster

    • ‘poon’ for spoon, ‘top’ for stop
    • Typically resolves by 4–5 years (some clusters slightly later)

    4. Gliding

    Replacing /R/ or /L/ with /W/ or /Y/

    • ‘wabbit’ for rabbit, ‘yion’ for lion
    • Can be typical up to 5–6 years

    5. Weak syllable deletion

    Leaving out unstressed syllables

    • ‘nana’ for banana
    • Usually resolved by 4 years

    If these patterns continue past the expected age, speech can remain difficult to understand particularly for unfamiliar listeners such as teachers, peers, and also Auntie Karen or grandparents who visit once in a while.

    Why phonological processes matter in school-age children

    By the time children reach reception and Year 1, speech clarity becomes increasingly important.

    Persistent phonological difficulties can affect:

    • being understood by teachers and peers
    • phonics and early reading
    • spelling
    • confidence in speaking
    • willingness to participate in class

    Some children become aware that they ‘sound different’ and may speak less, avoid longer words, or become frustrated when misunderstood.

    What’s the difference between a delay and a disorder?

    This is an important distinction.

    • A phonological delay means a child is following the normal pattern of development, just more slowly.
    • A phonological disorder means the child is using atypical patterns, or continuing age-expected patterns well beyond when they should have resolved.

    A speech and language assessment helps identify:

    • which processes are present
    • how many are affecting speech
    • how consistent the errors are
    • and whether intervention is needed

    Signs it may be time to seek speech therapy

    You may want to seek professional advice if your child:

    • is 3½ years or older and still hard to understand
    • is understood well by family but not by others
    • becomes frustrated or avoids talking
    • has difficulty with phonics or spelling
    • uses several phonological processes at once
    • has not made progress despite time and encouragement

    Early support does not mean something is ‘wrong’. It simply helps speech development move forward more efficiently.Research consistently shows that unresolved phonological processes beyond the expected age can impact intelligibility, literacy and confidence (Dodd, 2014; Bowen, 2015).

    How speech therapy helps phonological development

    Phonological therapy is not about drilling individual sounds endlessly.

    Instead, therapy focuses on:

    • helping children recognise sound patterns
    • building awareness of contrasts (e.g. ‘tar’ vs ‘car’)
    • practising speech in meaningful, playful ways
    • supporting generalisation so progress carries into everyday speech

    For school-aged children, therapy is usually structured, motivating and highly targeted and progress can be very encouraging.

    A final reassurance

    Many children with phonological difficulties go on to develop clear, confident speech with the right support.

    If you’re unsure whether your child’s speech is ‘just a phase’ or something that needs attention, a professional assessment can give clarity and peace of mind.

    If you’d like support or advice, please contact me and I can help guide the next steps.

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    Research references


    Health Professions Council registered
    Royal College of Speech & Language Therapists Member
    Member of ASLTIP

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

    3
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    Milestones of autistic children: Crawling, walking, and talking

    For all children every milestone achieved is a testament to the unique and intricate process unfolding within each young mind. For autistic children, this journey may present a distinct pattern, with some reaching developmental milestones like crawling, walking, and talking later than their neurotypical peers. Let’s have a look into the fascinating realm of Autism and explore why some autistic children might crawl, walk, and talk later, shedding light on the underlying factors contributing to this unique way of developing.

    1. Individual Pacing:

    Child development is not a one-size-fits-all journey. Each child, whether neurotypical or autistic, has a unique timeline for achieving milestones. Autistic children, like any other children, follow their own pacing. This individual rhythm might lead them to focus on one set of skills before they progress to others. Like some neurotypical children might focus on talking earlier than walking, autistic children might prioritise other areas before crawling or talking.

    2. Neurodevelopmental Complexity:

    The human brain is a remarkable entity, with a bewildering array of interconnected processes that lead to us achieving our developmental milestones. Autistic children often have variations in “neural wiring”, which can impact the balance between gross motor skills (crawling, walking) and fine motor skills. Speech and language acquisition falls under fine motor skills and may be momentarily disrupted due to the divergent neurological pathways at play in autism.

    2. Sensory Processing Differences:

    One of the hallmarks of autism is altered sensory processing. Autistic children often experience sensory stimuli differently than their neurotypical peers. This heightened or diminished sensitivity can influence a child’s desire or ability to engage in activities like crawling and walking. The sensation of movement while crawling or walking, for instance, might be overwhelming for some autistic children, causing them to either avoid or delay these activities.

    3. Visual-Spatial Abilities:

    Autistic children and adults frequently display excellent visual-spatial abilities. This strength might lead some children to focus more on activities that engage these skills, potentially delaying their engagement with activities like walking or talking. As they navigate their environment and process information visually, they might naturally invest more time in activities that stimulate this particular cognitive ability and strength.

    4. Communication Challenges:

    For many autistic children, speaking can be a really complex and difficult endeavour. Communication delays are a common feature of autism. This can affect both receptive and expressive language development. While some children might be physically capable of crawling or walking, they may not yet have the tools to communicate their desires and intentions. This leads to a temporary focus on non-speaking forms of expression. This does not mean that they do not communicate at all. But autistic individuals often start out using jargoning or echolalia as a form of communication as well as behaviours and physical forms of communication.

    5. Executive Functioning and Motor Skills:

    Executive functioning, or abilities for planning, organising, and carrying out tasks, can vary in autistic children. These skills are crucial for activities like crawling, walking, and talking, which need coordination and planning. About 40% of autistic persons have a motor planning difficulty.

    6. Intense Interests and Routines:

    Autistic children often develop intense interests in specific subjects, sometimes to the exclusion of other activities. These interests might become their primary mode of engagement. They might side-line milestones like crawling, walking, or talking. The mostly rigid adherence to routines and preferences might cause them to allocate more time to their preferred activities. This delays their engagement with other developmental tasks.

    How can Speech and Language Therapy help:

    Support and Intervention:

    Early intervention and regular Speech and Language Therapy play a pivotal role in the developmental journey of autistic children. Therapies tailored to individual needs can aid in bridging the gaps between milestones. Occupational therapy, for example, can help address sensory sensitivities and motor skill challenges that might impact crawling and walking. Speech therapy can help communication development, gradually bridging the gap between non-verbal expressions and spoken language.

    For example, we now know that echolalia or jargoning of longer phrases with intonation, repeating scripts from favourite tv shows or songs have many meanings and communicative functions. For example, a child who utters long strings of echolalic utterances, often difficult to understand, might want to do any one of the following:

    • Comment
    • greet
    • ask a question
    • make a request
    • express surprise
    • negate something.

    We now understand that the way to support a child with echolalia is to acknowledge all utterances and try and find out what the meaning is behind these scripts. This is very supportive. Over time it will lead a child to move on to understanding and saying more clear and self-generated language. For more information about this Natural Language Acquisition here are some other great websites for you to look at:

    Conclusion

    In conclusion, the journey of an autistic child’s development is a testament to the uniqueness and complexity of the human mind. The delays or differences in achieving milestones like crawling, walking, and talking can be attributed to a range of factors, including

    • neurodevelopmental intricacies,
    • sensory processing variations,
    • and communication challenges.

    It’s crucial to recognise that these delays are not indicative of a lack of potential, but rather a manifestation of the intricate interplay between an autistic child’s strengths and challenges. By embracing these differences and providing tailored support, we can help each autistic child unfold their potential at their own pace.

    Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive

    Do get in touch if you would like to book an appointment where we can explore how to help your child develop and thrive


    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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  • · · ·

    How do we play with our Gestalt Language Processors?

    Image by Freepik

    Child-led therapy

    When working with Gestalt Language Processors, it is always advisable to use child-led therapy. What does that mean? Child led therapy involves following a child’s interests and allowing her/him to lead the play activity throughout the speech and language therapy session. In other words, instead of having my own ideas of what we might want to play with or what activities I might try and use, I provide a range of toys I know the child likes or has played well with before; then I wait for the child to pick what she/he enjoys doing.

    Play can be very repetitive and we can often see our child cycling back to the same one or two toys throughout the session. But this is what she/he needs to do at that time and it means that we have focused attention and engagement. This in turn is very helpful for the therapeutic process, which is to offer great scripts and phrases/words alongside what she/he is playing with.

    Monotropic minds

    Often the mind of autistic children is more strongly pulled towards a smaller number of interests or hobbies as I like to call them. Dr Dinah Murray, Dr Winn Lawson and Mike Lesser have found in 2005 that autistic people have ‘monotropic’ minds. They explain that autistic children focus their energy on a narrow range of activities as the energy required to switch between several toys is much higher than we would see in the neuro-typical population.

    Gestalt Language Processors are often also Gestalt Cognitive Processors. This is when experiences are retained as episodic events and memories. An event is remembered by specific parts of the same event. And, therefore, these specific parts should always be part of that event, when the event is repeated.

    Should any of the specifics be changed or are missing, then this can cause great upset to Gestalt Cognitive Processors. So, for example, if the last two times in speech therapy we had the train set out and this was played with happily, then this becomes a specific part of the whole session. If, I then don’t offer the train set the third time a child comes to see me, this could be very upsetting.

    This is why I tend to try this out and see what happens. Usually in the 3rd or 4th session: I might not bring out the car run that has hitherto been super successful to see if we are able to transition well to other toys. If yes, then we can have new experiences but if not then I will re-offer the car run/or whatever toy pretty quickly so as not to cause complete dysregulation.

    A few pointers below which help with child-led play:

    Introduce a few new toys and see what happens

    Parents are encouraged to bring some familiar toys their child likes to the session. We can then introduce a couple of different toys to see how we go. Try offering a new toy alongside the familiar one; try offering new toys without the familiar one present, but be prepared to re-offer the “old” toy should our child get upset.

    Rotate toys and don’t offer out too many toys

    I find that children can get overwhelmed and overstimulated by too many items out all at once. I always talk to parents about toy rotation at home and I encourage storage and ‘tidy up’ of toys so that we can increase attention focus, and also maintain freshness and new interest in older toys.

    Some children are not yet ready to play with toys

    Here I suggest people games: these are games where the adult becomes part of a more motor-based activity. Some call it ‘rough and tumble play’ but it can be nursery rhymes such as sleeping bunnies/row row the boat or peek-a-boo for the younger ones.

    Copy/Imitation is so important – try getting two identical or similar play items

    When we are copying our child, it is often not desirable to ‘take turns’ with their toys/blogs/cars etc as our child may not be ready to let us take a turn. Instead, if we have the exact same toy that our child is having then we can play alongside our child and copy them perfectly without interrupting their play.

    References:

    Murray, D., Lesser, M., & Lawson, W. (2005). Attention, monotropism and the diagnostic criteria for autism. Autism9(2), 139-156.

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


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

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