01539 272034 SouthLakes.SLT@gmail.com

Author: Libby

  • ‘What Did You Say?’ Top Tips for Communicating When Your Child’s Speech is Unclear

    ‘What Did You Say?’ Top Tips for Communicating When Your Child’s Speech is Unclear

    Top tips from South Lakes Speech & Language Therapy to support your child’s communication when their speech is unclear.

    1. Get Face-to-Face

    Whenever possible, get eye level with your child when communicating so they can see your mouth moving and how you are forming sounds. Being eye level also helps you and your child see all the clues about what is being communicated that we give through facial expressions and body language.

    2. Eliminate Background Noise

    Turn the radio off in the car and the TV off at home when you are speaking with your child. Children are most successful communicators when they are not competing with background noises and this will give you the best chance of correctly hearing your child’s message.

    3. Encourage Gestures

    If your child’s speech is unclear, encourage them to use gestures and other natural speech signs when talking to give listeners more clues about the message they are communicating. Makaton is another way to support young communicators.

    4. Offer Choices

    When possible, offer a young child two choices so they can communicate which they want. This gives you a better chance of understanding what they say since you already know the message possibilities.

    5. Ask Your Child to Tell You in a Different Way

    If you are struggling to understand your child’s message, ask younger children to show you or take you to what they are talking about when possible. Older children may be able to describe the target word if you prompt them by asking ‘What is it used for? or ‘Where do you find it?’. This could give you the clues you need to figure out their message.

    6. Give the Conversation Context

    If your child’s speech is unclear, ask specific questions such as ‘What was your favourite lesson today?’ or ‘Who did you play with at break time?’ instead of open ended questions such as ‘What did you do at school today?’. The more context you can give the conversation, the better chance you have at figuring out your child’s message.

    7. Instead of Correcting, Model

    If your child mispronounces a word, repeat the word back clearly using the correct
    pronunciation. For example, if your child says “Look, a gog!”, You could say, “Wow, that is a big dog!” while emphasizing the mispronounced sound.

    8. Admit when you Don’t Understand

    If your child has tried several ways to communicate their message and you cannot understand, let them know. Try to be reassuring and let them know that you are sorry that you cannot understand what they are saying.

    9. Keep a ‘Translation List’

    If there are particular words your child regularly says that people find difficult to understand, keep a list of the target words and how your child pronounces them. Share this list with your child’s teacher and family members to help your child be more easily understood by the people in their life.

    10. Get Specialist Support

    A 2021 study on speech intelligibility in children sampled children’s intelligibility at the single- and multiword levels. The study measured how well unfamiliar adults understood children at different ages without contextual clues; parents should expect to understand an even higher percentage of their child’s speech. The study found the following speech intelligibility norms:1

    • 25% intelligible by 3 years of age
    • 50% intelligible by 4 years of age
    • 75% intelligible by 5 years of age
    • 90% intelligible by 7 years of age

    If your child’s speech is difficult to understand and not meeting these intelligibility thresholds, consider seeking specialist support from a speech and language therapist; and if you have concerns for your child’s hearing, consider having their hearing tested.

    If you would like more information about children’s speech and language, please get in touch, and sign up to our newsletter if you would like new posts sent directly to your inbox.

    1. Hustad et al (2021 October 04) Speech Development Between 30 and 119 Months in Typical Children I: Intelligibility Growth Curves for Single-Word and Multiword Productions ASHAWire ↩︎
  • Ready to Wean – Top Tips

    Ready to Wean – Top Tips

    Top Tips from South Lakes Speech & Language Therapy to make weaning easier for you and your baby.

    1. Set Your Baby Up for Success

    Make sure your baby has a comfortable and supportive seat for feeding; and start by offering food at a time of day when your baby is well-rested and has a content belly. No one likes to try something new when they are uncomfortable, tired or overly hungry; and that includes your baby.

    2. No Pressure

    Early weaning is a time for babies to learn about food through play. Between 6 and 12 months breastmilk or infant formula will continue to be your baby’s primary source of nutrition as they learn about solid foods. Don’t worry if they don’t swallow much food when you start weaning; the most important thing is that they enjoy weaning and feel happy exploring a variety of solid foods.

    3. Mess is Good

    Babies need to explore and play with food in order to learn about it. This will be messy. To make clean up easier, put a plastic sheet under your baby’s chair and dress your baby in old (or no) clothing. Try offering food immediately before bathtime.

    4. Calm is Key

    Your baby looks to you to help them regulate their emotions and know whether a new situation is safe. If you are calm around food, that lets your baby know that they can be calm around food too. If you feel anxious about weaning, your baby will too.

    5. Gagging will Happen

    Gagging is a normal part of weaning. It is the body’s way of preventing choking, and new feeders will gag while their body learns how to respond to and manage different food textures and sizes. Remember Top Tip number 4, ‘Calm is Key’.

    6. Be a Role Model

    Family meals are an important part of your baby learning to eat solid foods. Include your baby in family mealtimes so they can see you eat and learn about family foods and mealtimes. When possible, give your baby the same foods as the rest of the family so they start to develop a taste for family foods early on in their weaning journey.

    7. ‘No’ Doesn’t Always Mean No

    Babies and young children need multiple exposures to a food before developing a like or dislike for that food. So, if your baby makes an unhappy face the first time they taste broccoli, offer it again (and again) at different meals.

    8. Baby-Led vs Traditional Weaning

    Both weaning styles can lead to happy, healthy eaters; so do what works best for you and your baby, and don’t feel pressure to choose one method over the other.

    9. Store-Bought vs Homemade Baby Foods

    Store-bought baby foods are great for when you are out and about or short on time, but if you want your baby to eat family foods when they have transitioned to table foods, use
    predominantly family foods during weaning.

    10. Batch Cook and Freeze

    If you are making your own baby food, freeze it in ice cube trays so you have a variety of foods and flavours in small portion sizes ready to defrost and serve to your baby when you need it.

    For more information about weaning and children’s feeding, see South Lakes Speech & Language Therapy’s Information and Resources page, and sign up to our newsletter if you would like new posts sent directly to your inbox. If you would like support with feeding your child, please get in touch.

  • Teletherapy’s Success Story

    Teletherapy’s Success Story

    Before COVID-19, most people were not familiar with online therapy, or ‘teletherapy,’ and it was almost unheard of as a way to support children with feeding or communication needs. In March 2020 I, like many people, had to change my way of working (and living) overnight. At the time I was working as a member of a complex needs team seeing children on hospital wards as well as in their homes and in a community clinic. All face-to-face work outside of the hospital stopped overnight and I found myself very quickly becoming familiar with teletherapy. Initially I struggled to imagine how teletherapy would work for the children and families I was supporting; however now that we are five years on, I am pleased to say, it worked (and continues to work) well!

    Despite COVID-19 restrictions being lifted and health care and education services returning to pre-COVID-19 normality, many families and professionals, myself included, continue to view teletherapy as a powerful tool in supporting children’s development. In both my NHS and independent work, I offer teletherapy; and I see positive changes in children’s skills as a result of our video sessions. So I started to wonder, ‘does the research support my anecdotal evidence?,’ and the answer is ‘yes!’

    What is Teletherapy?

    “(Teletherapy) is the delivery of services using telecommunication and internet technology to remotely connect therapists and clients… for screening, assessment, intervention, consultation, and/or education. (Teletherapy) is an appropriate model of service delivery for… speech-language pathologists.”1

    Teletherapy sessions with South Lakes Speech & Language Therapy occur through secure video connection and allow you and your child to receive feeding and/or communication therapy without the limitations of distance or situation.

    Does Teletherapy Work? Yes!

    When I talk with parents about teletherapy, by far the most common question they have is whether or not teletherapy is effective. I was pleased to find that in several studies, “researchers and clinicians have found that tele-speech therapy is an effective tool for improving access to high-quality services and a viable mechanism for delivering speech and language interventions.”2 Studies that looked specifically at using teletherapy with children with Autism and their families, found favourable outcomes and a positive impact3 with one study finding that “…services delivered via (teletherapy) were equivalent to services delivered face-to-face, and superior to comparison groups without (teletherapy) sessions.”4

    The success story of teletherapy is replicated for a variety of patient groups; the American Speech-Language-Hearing Association (ASHA) looked at 40 peer-reviewed studies that confirmed that teletherapy produces outcomes that are as good as direct contact.5 Patient groups that ASHA found had a positive response to teletherapy include (but are not limited to) people with:6

    • Feeding and Swallowing Difficulties
    • Speech and Language Delays
    • Articulation Difficulties
    • Dysfluency (Stuttering)
    • Autism
    • Cerebral Palsy
    • Cognitive-Communication Deficits
    • Acquired and Tramautic Brain Injury

    What Can I Expect from Teletherapy with South Lakes Speech & Language Therapy?

    Teletherapy with South Lakes Speech & Language Therapy includes all of the same principles of face-to-face therapy and is conducted in essentially the same format as an in-person session. Depending on the needs of your child, a teletherapy session with South Lakes Speech & Language Therapy may include hands-on activities, interactive games, or mealtime observations and therapeutic food play. As with our face-to-face sessions, parent coaching is a key component of what we do, so you should expect to be an active part of your child’s teletherapy sessions including hands-on practice with therapeutic techniques and strategies to support your child’s development. During our session, we will ensure you feel confident using appropriate therapeutic techniques and strategies with your child so you can continue to use these techniques and strategies between sessions.

    For more information about teletherapy and feeding and/or communication therapy for your child with South Lakes Speech & Language Therapy, please get in touch. We look forward to meeting you in person or on a screen!

    1. ASHA – Telepractice ↩︎
    2. Farmani E, Fekar Gharamaleki F, Nazari MA. Challenges and opportunities of tele-speech therapy: Before and during the COVID-19 pandemic. J Public Health Res. 2024 Feb 7;13(1):22799036231222115. doi: 10.1177/22799036231222115. PMID: 38333616; PMCID: PMC10851737. ↩︎
    3. Johnsson G, Bulkeley K. Practitioner and Service User Perspectives on the Rapid Shift to Teletherapy for Individuals on the Autism Spectrum as a Result of COVID-19. Int J Environ Res Public Health. 2021 Nov 11;18(22):11812. doi: 10.3390/ijerph182211812. PMID: 34831567; PMCID: PMC8620428. ↩︎
    4. Sutherland R, Trembath D, Roberts J. Telehealth and autism: A systematic search and review of the literature. Int J Speech Lang Pathol. 2018 Jun;20(3):324-336. doi: 10.1080/17549507.2018.1465123. Epub 2018 Apr 30. PMID: 29709201 ↩︎
    5. ASLTIP – Teletherapy: A Proven Way to Provide Speech and Langaueg Therapy… ↩︎
    6. ASHA – The Value of Telepractice in Speech-Language Pathology ↩︎
  • The Importance of Parent Coaching

    The Importance of Parent Coaching

    After over twenty-five years in the field of speech, language and feeding therapy, a lot has changed! My hair style and clothing, not to mention my taste in music; but what hasn’t changed is the importance of parents in their child’s speech, language and feeding therapy success.

    When parents initially seek out speech, language or feeding therapy, they rarely are thinking about how services will be delivered; but, as your therapist, I regularly am thinking about how I can deliver the best and most effective services possible. For young children this almost always means a parent coaching model. Why? Because as a parent, you are your child’s superpower!

    What is Parent Coaching?

    Parent coaching is a collaborative, family-centered way of delivering therapy where the speech and language therapist coaches parents and caregivers in specific techniques and strategies to support their child’s communication and feeding development during everyday activities.

    As a speech, language, and feeding therapist, I want to maximize a child’s opportunities to practice their new communication and feeding skills across their day. The best way to do this is to teach parents and caregivers how to create opportunities and interactions throughout the day that support their child’s communication and feeding learning; voilà, ‘parent coaching!’

    Does it Work? Yes!

    Children spend significantly more time with parents and caregivers compared to the time they spend with their speech and language therapist; so it makes sense that in order for a child to make the most progress, a child’s parents and caregivers need to understand how to use therapeutic strategies with them during everyday activities. A meta-analysis in 2019 found “… a positive association between parent training and child (development)… suggesting that parent training should play a primary role in intervention… (in order to maximize) outcomes for children….1 Notably, the meta-analysis found that children whose parents and caregivers were coached to use specific strategies made more progress than children whose parents and caregivers were not taught these strategies.

    Findings supporting a parent coaching model for young children are repeatedly duplicated in the research and the Royal College of Speech and Language Therapists (RCSLT) recommends a family-centered model of service delivery, such as parent coaching, when working with children.2 3 Not surprisingly, parent (and caregiver) coaching has been shown to be effective across settings (home, community, education) and with a variety of individuals (parents, grandparents, teachers, nursery staff, etc.).4

    What Can I Expect from Parent Coaching with South Lakes Speech & Language Therapy?

    Parent coaching with South Lakes Speech & Language Therapy can take place in your home or in the community and can be in-person or via teletherapy. In-person sessions involve us playing together with your child during which time I will model and teach you specific therapy strategies and help you use these strategies with your child to support their communication skills. If we meet over video, I will rely on you to tell and show me how you and your child play together, and we will talk about specific strategies to support your child ‘s communication during play and every day activities.

    If we are working on feeding, South Lakes Speech & Language Therapy parent coaching sessions usually occur during a mealtime. Either in-person or via teletherapy, I will sit with you and your child and observe a milk feed or mealtime while trialing specific feeding techniques and strategies. We will practice new feeding techniques and strategies together so you are confident using these to support mealtimes with your child.

    If I see your child at school, whenever possible your child’s teacher, teaching assistant, or one-on-one will be involved in the session and directly coached in strategies to support your child’s needs. Following the session, I will leave a detailed note for you and the school describing what was covered during the session and ways to practice and carry-over skills in the classroom and at home.

    For more information about parent coaching and communication and/or feeding therapy for your child with South Lakes Speech & Language Therapy, please get in touch, and sign up to our newsletter if you would like new posts sent directly to your inbox.

    1. Roberts MY, Curtis PR, Sone BJ, Hampton LH. Association of Parent Training With Child Language Development: A Systematic Review and Meta-analysis. JAMA Pediatr. 2019 Jul 1;173(7):671-680. doi: 10.1001/jamapediatrics.2019.1197. PMID: 31107508; PMCID: PMC6537769.ggjll ↩︎
    2. RCSLT SLCN Resource Manual ↩︎
    3. RCSLT – Placing Children and Young People at the Heart of Delivering Quality SLT ↩︎
    4. Rush, D.D., and Shelden M.L. (2020).‘
      The Early Childhood Coaching Handbook’,
      2nd ed. Paul H Brookes Publishing Co., Baltimore, MD. ↩︎
  • Back to School

    Back to School

    For children with speech, language, and/or feeding needs, a new school year can bring unique opportunities and challenges. There are some things you can do to help your child feel confident, prepared and supported as they return to school.

    Supporting Children with Speech and Language Needs

    1. Establish a Routine

    Children thrive on predictability. Establish a school day routine with consistent wake-up and go to bed times and structure school mornings so your child can predict what and when things happen before leaving for school (e.g., getting dressed, eating breakfast and brushing teeth). Some children may benefit from a wall calendar that shows the day of the week, and for children using Now / Next boards or other visual schedules, make it clear what days are school days so your child knows what is happening each day.

    2. Practice Self-Advocacy Phrases

    Practicing language such as “I need help”, “I am hungry / thirsty,” or “Where do I go?” can help your child feel more confident advocating for themselves at school. If your child’s speech is difficult to understand, help them communicate in other ways when needed such as describing or showing what they are trying to say; and if your child uses Makaton or other sign language system, make sure you show your child’s teacher the signs and their meaning. Whenever possible, provide pictures of your child’s sign vocabulary to be kept in the classroom. 

    For children who use pictures to communicate, be sure to provide the classroom teacher and teaching assistant with a copy of the pictures you use at home and explain how your child uses the pictures. There will be new picture vocabulary that you child will need at school, so talk to your child’s teacher about what pictures they think may be relevant in school that you have not yet used at home.

    3. Expand School-Related Vocabulary and Activities

    Introduce words your child might hear at school such as, “schedule,” “assembly,” “school hall,” “recess,” etc. and model how to use this new vocabulary in real-life. Looking at books together that tell stories about children at school and have pictures of classrooms and school settings is a good way to support your child to learn school-related vocabulary.

    4. Practice Social Communication and Play

    Practice social situations like asking for help, taking turns, or joining a group during free play or at recess. If your child is shy or has difficulty navigating social scenarios, simple scripts like “Can I play?” or “My turn” can help your child build confidence when meeting new friends. For children who use pictures and/or sign language to communicate, introduce social pictures and signs at home and practice using them in situations your child may encounter at school.

    Supporting Children with Feeding Challenges

    1. School Dinner and Lunchbox ‘Dress Rehearsals’

    Borrow a dinner tray and/or plate from school and let your child practice eating some meals from it at home. If your child will be bringing a packed lunch to school, let them practice eating from their actual lunchbox at home. This includes using the same containers they will bring to school. This way your child gets used to a new mealtime routine and you can see which containers, if any, are difficult for your child to open or close.

    2. Stick to Familiar Foods

    Avoid experimenting with new foods at the start of the school year; the sight, smell and sound of having a mealtime with peers can be overwhelming for some children. Pack safe, preferred foods your child is most likely to eat in a busy, sometimes overstimulating environment.

    3. Involve Your Child in Meal Preparation

    Let your child help pack their lunch and choose containers so they know what to expect when they sit down to eat. 

    4. Talk about Lunchtime Expectations

    Explain school mealtime rules: sitting in one spot, limited time to eat, and not always having an adult to help immediately. Practice these at home, so your child knows what to expect when they sit down to eat at school. 

    5. Help School Understand Your Child’s Mealtime Challenges

    Talk with the school’s mealtime supervisors to make sure they understand your child’s feeding challenges and how to support your child at mealtimes. It is important that mealtimes be pressure free and that your child find mealtimes at school enjoyable which may mean they don’t always make a healthy choice or finish what is on their plate.


    For more information about supporting children with communication and/or feeding difficulties, please see South Lakes Speech & Language Therapy’s Information & Resources page or get in touch; and sign up to our newsletter if you would like new posts sent directly to your inbox.