Why pretend play is the perfect therapy vehicle for children with dyspraxia

ByLondon Speech and Feeding
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Picture this. A small dinosaur is stomping across a wooden floor. A tiny teacup is being filled with imaginary juice. Someone, probably you, has just been told very firmly that you are the baby and you must go to sleep now.

To the outside world, this is just play. Joyful, chaotic, completely ordinary toddler play.

But for a child with Childhood Apraxia of Speech (CAS), also known as verbal dyspraxia, what is happening inside a well-designed pretend play session is anything but ordinary. It is, in fact, some of the most powerful motor speech therapy we have.

Let me explain why.

First, a quick reminder: what is dyspraxia?

Childhood Apraxia of Speech is a motor speech disorder. The difficulty does not lie in the muscles of the mouth, those are perfectly capable. The difficulty lies in the brain’s ability to plan and sequence the precise movements needed to produce speech sounds consistently and accurately.

A child with CAS knows what they want to say. The message is there. But somewhere between the intention and the execution, the plan breaks down. Words come out differently each time, or not at all. It is effortful, unpredictable, and for many children, deeply frustrating.

What this means for therapy is important: CAS requires motor learning, not just language stimulation. And motor learning has very specific conditions under which it thrives.

Repetition is the medicine and pretend play delivers it without the child noticing

One of the most well-established principles of motor learning is that new movement patterns need to be practised many, many times before they become reliable. Think of learning to ride a bike, or to touch-type. Repetition is how the motor system builds consistency.

For speech, this means a child needs many opportunities to attempt a target word or phrase within a single session. In a formal drilling exercise, this quickly becomes tedious and dysregulating, especially for young children. After five attempts at ‘go’, most three-year-olds have mentally left the building.

But inside a pretend play scenario? The word ‘go’ appears naturally and meaningfully dozens of times. The car goes. The train goes. Ready, steady, go. Go to sleep. Go there doggie. Every repetition is embedded in a moment that makes sense to the child, which means they are motivated to keep going, and the practice is accumulating without any sense of effort or demand.

A relaxed brain learns better

There is a reason I tend not to sit a dyspraxic child at a table with flashcards and ask them to repeat after me. It is not because I lack structure. Every session I run has clear targets and intentional design. It is because we know that anxiety and pressure actively interfere with motor learning.

When a child feels observed, corrected, or under pressure to perform, the cognitive load increases and the very motor planning system we are trying to support becomes less accessible. The errors increase. The frustration escalates. The session unravels.

Pretend play, by contrast, creates a state of engaged, relaxed absorption. The child is leading. They are safe. They are having fun. In this state, the brain is far more receptive to new motor patterns being laid down. I am not asking the child to perform speech. I am simply being present, following their lead, and slipping in carefully chosen models at exactly the right moments.

Child-led play gives us the child’s own words to target

Another reason pretend play works so beautifully for children with dyspraxia is that it tells us exactly which words matter most to this particular child, right now, today. When a child reaches for the toy telephone and hands it to me with enormous expectation, I know that ‘hello’ is a word worth targeting in this moment. When they are clearly trying to tell me that the baby needs feeding, ‘more’ and ‘eat’ have instant, genuine relevance.

Targeting words a child is already motivated to say means the communication attempt is coming from them. And a self-initiated attempt, even an approximation, is neurologically far more valuable than a prompted imitation.

What this looks like in practice

In the short video clip below you can see this dynamic in action. Notice how the session looks relaxed and playful on the surface. The child is absorbed in the pretend play scenario we have created together.

Notice, though, what is happening underneath:

  • the consistent, gentle modelling of target words
  • the use of Makaton signs alongside speech to provide an additional sensory pathway
  • the visual mouth cues that give the child a roadmap for how a sound is shaped
  • and running through all of it, the repetition. The same words, again and again, wrapped in play.

This is not therapy disguised as play. It is therapy that is play, because for a child with dyspraxia, those two things are not in opposition. They are, in fact, perfectly aligned.

If you are concerned about your child’s speech and wondering whether verbal dyspraxia might be a factor, please do not hesitate to get in touch. I would love to help you find some answers.

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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    Image by freepik

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    1. Laying the groundwork for speech: Babbling is like a vocal workout for your baby. By practising these sounds, they’re strengthening the muscles in their mouth, tongue, and vocal cords that are essential for speech.
    2. Developing phonological skills: Through babbling, babies begin to understand the sound patterns of their native language. They’re learning which sounds go together and how they’re used.
    3. Enhancing social interaction: Babbling is a social activity. Babies often babble back and forth with their caregivers, which helps them learn about the give-and-take of communication.
    4. Cognitive development: The act of babbling requires babies to use their brains in new ways. They’re learning to control their vocalisations, pay attention to the sounds they’re making, and connect those sounds to the responses they receive from others.

    How can you encourage babbling?

    • Talk to your baby: Even though they can’t understand your words yet, talking to your baby exposes them to language and encourages them to respond with their own vocalisations.
    • Imitate their sounds: When your baby babbles, imitate them! This shows them that you’re paying attention and encourages them to keep ‘talking.’
    • Respond to their babbling: Treat your baby’s babbling as if it’s a real conversation. Respond with words, smiles, and gestures.
    • Play sound games: Make different sounds for your baby and encourage them to imitate you. This could include animal sounds, silly noises, or simple words.
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    • Vary textures: Offer different textured teethers.
    • Read books with sound effects: Choose books with animal sounds or other engaging noises.
    • Blow bubbles: The act of blowing and popping bubbles can encourage vocalisations.
    • Use visual aids: Show pictures of objects and say their names, emphasising the consonant sounds.
    • Use exaggerated facial expressions: When you make sounds, exaggerate your mouth movements to help your baby see how sounds are made.
    • Increase joint attention: Follow the child’s gaze and point to objects that they are looking at and say the name of the object.

    When to seek help

    If you notice that your baby is not babbling by eight months, it’s a good idea to talk to your speech and language therapist. You might also notice a lack of variation in tone when your child is making sounds, is your baby sounding a little ‘flat’ or monotonous? While every child develops at their own pace, a lack of babbling can sometimes indicate a developmental delay or hearing issue.

    Remember, babbling is a gift. So, enjoy those precious moments of ‘baby talk’ and take comfort in knowing that your little one is on the path to becoming a chatterbox!

    Do get in touch via my contact form if you are concerned about your child’s development or if you simply want some reassurance that your baby is developing well. We will be delighted to arrange a screening appointment for you and give you support and reassurance.

    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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    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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  • ·

    The role of spinning and swinging in speech and language therapy

    ByLondon Speech and Feeding
    Sonja with a child on a swinging with a stuffed monkey

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    • Facilitating communication: While swinging, children are so much more relaxed and open to communication. The rhythmic motion can also help facilitate singing, humming, listening to my singing, non-verbal communication for sure but also more verbal and mouth words can be heard from children on my swing. If nothing else, it is so fun and helps build trust and rapport between my child and me.

    Therapeutic Activities Combining Spinning, Swinging, and Speech and Language Therapy

    Here are some therapeutic techniques that I use at London Speech and Feeding to combine movement with speech and language development:

    • Swinging with verbal prompts: While the child is swinging, I provide simple verbal prompts such as ‘up’, ‘down’, ‘fast’, and ‘slow.’ This helps to develop receptive language skills and improve auditory processing.
    • Sensory-motor play: I like to combine swinging with tactile activities like playing with textured balls or bean bags. This can facilitate language development through descriptive language, words and scripts like: ‘that’s so soft’, ‘oooh tickle tickle tickle!’
    • Storytelling on the swing: Often I manage to create a story while the child is swinging. This can improve narrative skills, vocabulary, and imagination. Recently I did the ‘Tiger who came to tea’ story and each time the swing stopped the tiger came and ‘ate some more cakes’ and ‘tickled their tummy’ whilst eating. It may make not much sense but my child loved it and we had ‘more tiger eat more’.
    • Song and rhyme time: Often I sing the ‘rumble in the jungle’ song while swinging my child to enhance phonological awareness, rhythm, and timing.
    • Visual supports always help: I use LAMP Words for Life AAC support during swinging and show core words such as: ‘go’ / ‘stop’/ ‘more’ / ‘tickle tickle’ etc. #lampwordsforlife #aac
    • Movement-based activities: We can incorporate activities that require sequencing, such as imitating animal movements or following simple commands while swinging. This can improve motor planning and language comprehension.

    For more information follow me on Instagram, Facebook or LinkedIn.

    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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  • Quick Overview Of How To Implement Those Early Hanen Speech And Language Strategies

    ByLondon Speech and Feeding
    Quick Overview Of How To Implement Those Early Hanen Speech And Language Strategies

    First up try and get down at eye level or Face-to-Face with your child

    Try to sit so that your child can see you easily, i. e. your child does not have to look up to make eye contact with you. We call that Face to Face: try and sit opposite your child. This makes it easier for you to see facial expressions and therefore pick up nonverbal /pre-verbal communication. Now you can connect and share the moment with your child.

    OWL (Observe, Wait and Listen)

    Never skip this step as it prepares us for what happens next !

    Observe

    First, try and simply watch your child quietly and listen and observe what he/she says or does; you need to know what your little one is interested in. For example with this toy (pictured below) we could observe that your child loves the actual spinning of the marble, perhaps more than that noisy click-clacking down the run. Or perhaps he loves collecting the marble at the end and feeling it in his hand.

    You could start off with showing once how the marble goes down and say:“ look it goes round and round !” Then hold back and observe, without speaking, so that your child has time to explore the toy.

    Wait

    Just sit and avoid telling or showing your child what he or she could do with the toy. This gives your child an opportunity to explore and experiment.

    Listen

    Listen to what your child says, or look at your child’s non-verbal communication without interrupting. Your child will now feel and know that you are really present and that what they have to say is important. It’s best to avoid questions like, “What are you doing or “What’s this?” as that might be a lot of pressure when they don’t know what to say about that yet.

    Respond immediately by showing interest

    Once you have all the information from OWLing you can respond in the right way, for example: if she catches the marble at the end of the run and looks up with a smile or a sound you could respond with: you’ve got it! One marble in your hand! Nice playing!

    Now how to join in the play:

    First you can copy what your child is doing

    If your child puts the first marble at the top of the run you can take a turn and do exactly the same once his marble is done. Ideally you might have another marble run, perhaps a similar one, it does not have to be exactly the same! Once your child has put the first marble in you can do the exact same with your own marble on your run. Your child is likely to look at what you are doing and you might well see a smile on their face or perhaps she might say: look at mine!

    Next you can build on that

    You can respond with simple comments like: “Wow! Yes I am looking at yours now! It’s spinning on the red one lots! I love the noise!” Now wait once more to see what your child says or does.

    To summarise

    We are signalling to our child that we are really interested in what they are doing and saying so we can “collect” our child, i.e. bring him/her back into a joint interaction.

    Important

    We want to try and not direct our child but respond with interest and fun! This creates a lovely stage for interaction and joint play! And this leads in turn to practising conversation and ever more opportunities for great speech and language skills to emerge.

    Great activities we use in Speech and Language Therapy:

    • Any cause and effect toys like this Marble Run
    • Creative activities, such as mark making with crayons
    • Train tracks (building and running the trains)

    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.

  • · ·

    Why auditory memory matters (especially for little ones!)

    ByLondon Speech and Feeding
    Why auditory memory matters (especially for little ones!)

    Have you ever stopped to think about how we learn to speak, understand, and communicate effectively? It’s a complex dance of various cognitive skills, and one often overlooked but absolutely crucial player in this orchestra is auditory memory. It’s not just about remembering sounds. It’s about remembering sequences of sounds, which is fundamental to language development.

    What exactly is auditory memory?

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

    For speech and language, auditory memory is essential for:

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

    When auditory memory falls short: The impact on speech

    When auditory memory is poor, particularly in young children, the ripple effects on speech and language development can be significant. Children might struggle with:

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

    It’s important to note that poor auditory memory isn’t a sign of low intelligence, but rather a specific processing challenge that can be addressed with targeted support.

    Nurturing auditory memory in under 5s: Preparing for schooling

    The good news is that auditory memory is a skill that can be strengthened and developed, especially during the crucial early years. For children under five, laying a strong foundation in auditory memory is an invaluable gift as they prepare for the demands of formal schooling. Here’s what we can do to help:

    1. Read aloud regularly: This is perhaps one of the most powerful tools. As you read, encourage your child to listen for specific words, predict what happens next, and retell parts of the story. Vary your voice, use different intonations, and pause to emphasise key words.
    2. Play auditory memory games:
      • ‘Simon says’: This classic game is fantastic for following multi-step instructions. Start with one command and gradually increase the number.
      • ‘I Spy’ with sounds: Instead of colours, describe sounds. ‘I spy with my little ear something that goes “moo”.’
      • Rhyming games: Sing rhyming songs, read rhyming books, and encourage your child to come up with words that rhyme.
      • Sound matching: Use everyday objects to make sounds (e.g., shaking keys, tapping a spoon) and have your child identify or match them.
      • ‘Memory chain’: Start a sentence and have your child add to it, remembering everything that came before: ‘I went to the market and bought an apple.’ ‘I went to the market and bought an apple and a banana.’
    3. Sing songs and nursery rhymes: Repetitive songs and nursery rhymes are excellent for developing auditory memory, rhythm, and phonological awareness. The predictable patterns help children anticipate and remember sequences of sounds and words.
    4. Give multi-step instructions (and praise!): Start with two-step instructions and gradually increase the complexity as your child’s skills improve. Always give positive reinforcement when they succeed. ‘Please pick up the red block and put it in the box.’
    5. Engage in active listening: Model good listening skills yourself. When your child is speaking, give them your full attention. Ask clarifying questions to encourage them to elaborate and organise their thoughts.
    6. Reduce background noise: A quiet environment makes it easier for young children to focus on auditory information. Minimise distractions like TV or loud music during activities that require listening.
    7. Use visual cues: While we’re focusing on auditory memory, sometimes pairing auditory information with visual cues can be helpful, especially initially. For example, when giving instructions, demonstrate the action as you say it.
    8. Be patient and consistent: Developing auditory memory takes time and consistent practice. Celebrate small victories and create a playful, supportive environment for learning.

    By actively engaging in these strategies, we can empower our youngest learners to build robust auditory memory skills, setting them up for success not only in speech and language development but also in their overall academic journey. It’s an investment that truly pays dividends in their future communication and learning abilities.

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

    Sonja McGeachie

    Highly Specialist Speech and Language Therapist

    Owner of The London Speech and Feeding Practice.

    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.

    1