Tag: Communication

From A to Z: Teaching Speech Sounds to Your Child

Not every child that has speech sound errors needs support from a Speech and Language Therapist. Sometimes a bit of practice with parents and caregivers at home or school is enough to place a child on the path to clear speech. If your child has speech sound errors, try these tips for teaching specific speech sounds.

Speech Sound	Lips and Tongue Placement	Additional Clues
b	Start with lips together and make them pop while turning on your voice.	There should be a quick vibration in your throat when your voice comes on.
p	Start with lips together and make them pop while blowing. Keep your voice off.	If your child says ‘b’ instead of ‘p,’ have them whisper the sound.
m	Show your child how to close their lips tightly together and hum to say ‘m.’	Your lips and throat should vibrate.
sh	Form you lips into a square and put your tongue tip at the top of your mouth, behind your front teeth while blowing.	You can call this the quiet sound and help your child remember lip position by holding your finger up near your mouth while saying “shhh” as if to quiet someone.
zh (as in camouflage)	Form you lips into a square and put your tongue tip at the top of your mouth, behind your front teeth while humming.	Your mouth and throat should vibrate when saying ‘zh.’
ch	A ‘ch’ is produced by saying ‘t’ and ‘sh’ quickly together. Start by establishing a good ‘sh’ sound. Once your child can consistently say “sh,” ask your child to push their tongue flat on the roof of their mouth behind their front teeth (like a ‘t’) and then explode into a ‘sh.’	This is the ‘choo-choo train’ sound. When your tongue explodes, that is the train engine making the choo-choo noise.
j	A ‘j’ is produced by saying ‘d’ and ‘zh’ quickly together. Start by establishing a good ‘zh’ sound. Once your child can consistently say “zh,” ask your child to push their tongue flat on the roof of their mouth behind their front teeth (like a ‘d’) and then explode into a ‘zh’ while turning on their voice.	There should be a quick vibration in your throat when your voice comes on.
w	Start by saying “oo” as in ‘boo’ and then slowly move the lips apart to say “uh”. It should sound like “oooouuuhh.”	If your child is struggling with ‘w,’ have them pretend they are blowing out a candle then turn on their voice while blowing.
y	Start by saying “ee” as in ‘bee’ and then slowly open your mouth to say “uh”. It should sound like “eeeeuuuhh.”	If your child is putting a pause between the ‘ee’ and the ‘uh,’ cue them to stretch it out and keep their voice on the whole time.
n	Place your tongue tip on the bumps behind the front teeth while humming.	Your mouth and throat should vibrate when saying ‘n.’
v	Ask your child to use their top teeth to gently bite down on their bottom lip then blow air to say ‘v’.	Calling this the ‘noisy rabbit teeth’ sound may help your child remember their teeth placement and voice. Your throat should vibrate when saying ‘v.’
f	Ask your child to use their top teeth to gently bite down on their bottom lip then hum to say ‘f’.	Calling this the ‘quiet rabbit teeth’ sound may help your child remember their teeth placement for ‘f.’
th	Have your child place their tongue between their teeth (with their tongue sticking slightly out of their mouth) and gently bite down while blowing air.	Looking in a mirror can be helpful for tongue placement when learning ‘th.’
L	Ask your child to put their tongue tip to the top of their mouth on the bumps behind their front teeth and turn on their voice.	Use a mirror to show your child correct tongue placement if they are flipping or curling their tongue. Try the ‘sticky spot’ trick for learning to say ‘t’ if your child can’t find where to put their tongue when saying ‘L.’
d	To produce the ‘d’ sound, your tongue taps behind your front teeth while turning on your voice.	There should be a quick vibration in your throat when your voice comes on. Try the ‘sticky spot’ trick for learning to say ‘t’ if tongue placement for ‘d’ is an issue.
t	To produce the ‘t’ sound, your tongue taps behind your front teeth while blowing air. Keep your voice off.	If your child is struggling to find the correct spot to place their tongue to say ‘t,’ put a sticky food, like peanut butter, on the spot right behind their top, front teeth. Then, have your child lick it off. When you are describing that spot again, call it the ‘sticky spot.’
h	‘h’ is produced by making puffs of air at the back of the mouth. Open your mouth and pant.	You can call this the ‘doggie’ sound and practice panting like a dog to make a ‘h.’ Your child should be able to feel air coming out of their mouth while making a ‘h.’
z	Place your tongue tip to the top of the mouth on the bumps behind your front teeth while humming.	Your mouth and throat should vibrate while saying ‘z.’ If the sound is not quite right, try having your child open their lips into a very slight smile while humming.
s	Place your tongue tip to the top of the mouth on the bumps behind your front teeth while blowing.	This is the ‘smiling snake’ sound. You lips should open into a slight smile when saying ‘s.’
r	‘r’ is produced with the sides of your tongue touching your back molars and your tongue pulled back slightly so it is bunched in the back of your mouth. Finally make a small square with your lips and push air past your tongue while turning on your voice.	When learning the tongue position for ‘r,’ some children find it easier to start with the ‘r’ blends ‘cr’ and ‘gr’ (as in crook and green).
g	Tap the back of your tongue to the roof of your mouth and turn on your voice when saying ‘g.’	This is the ‘swallowing or gulping’ sound. You can pretend you are noisely driking a glass of water while practicing the ‘g’ sound. Your throat should vibrate when saying ‘g.’
k	Tap the back of your tongue to the roof of your mouth when saying ‘k.’ Keep your voice off.	If your child is struggling to find the back of their tongue, have them look directly up while tapping their tongue at the back of their mouth.

If your child is not progressing after practicing speech sounds with you at home or their
sound errors are making it difficult for them to learn phonics and early literacy skills, your child may need support from a speech and language therapist. Furthermore, if they have delayed speech sound development, persisting phonological processes, and/or their intelligibility rating ¹ is lower than expected for their age, specialist advice from a speech and language therapist should be sought.

If you would like more information about speech sound development in children or speech therapy with South Lakes Speech & Language Therapy, please get in touch. Follow us on Facebook for more speech, language and feeding tips and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.

Speech Intelligibility Rating by age:
18 months old – 25% intelligible
24 months old – 50% intelligible
3 years old – 75% intelligible
4 to 5 years old – 100% intelligible ↩︎

12 November 2025

Top Tips for Supporting Early Communicators
Learning to communicate starts at birth. Babies and young children gain an understanding of communication by watching others around them and participating in meaningful interactions that support the development of early communication skills. Help your child develop their early communication skills with these top tips!

1. Communication Starts with Attention

Young children need to develop their attention to and interest in other people in order to learn how to effectively communicate. You can help your young child develop their attention by:
- Reducing background noise and turning off the TV and other distractions when interacting with your child.
- Practicing joint attention skills by focusing on something together during an interaction (e.g., looking at a book together).
- When possible, creating predictable routines as a part of your child’s day such as bath, books, lullabies, then bed. Young children find it easier to attend and learn when they have the security of routines and know what to expect.
2. Follow Your Child’s Lead

Children learn best when they are interested and engaged in the interaction. By observing your child, you will learn what they are interested in; you then can respond to and expand on what your child enjoys to help develop new skills. For example, if your child enjoys rolling cars back and forth, you can sit with your child and roll cars while making a car noise (“vroom” or “beep-beep”).

3. Be Face-to-Face when possible

Children learning to communicate benefit from seeing the facial expressions of others as well as how sounds are formed when people move their mouths. Being face-to-face with your child gives them the best opportunity to learn these important communication skills from you.

4. Practice ‘Serve and Return’ Interactions

‘Serve and return’ interactions occur when your child (or you) does something (‘serve’) and the other person does something back (‘return’). Games such as rolling a ball back and forth, peek-a-boo, making facial expressions or noises in turn, and taking turns dropping blocks into a container, are all communication building ‘serve and return’ interactions.

5. Model Communication

Children need to hear and see communication to learn to communicate; so talk with your child about what the two of you are doing together and what you see. Use simple language that your child understands, and include nonverbal communication such as facial expressions and gestures in your communicative interactions.

6. Use Expectant Pauses

During routine language interactions, pause and look at your child expectantly to encourage them to actively participate in the communicative exchange.

For children not yet using words, try putting an expectant pause in a motivating interaction. For example, after pushing your child a few times on the swing, pause and look at your child expectantly to let them know you are waiting for them to tell you to keep pushing the swing. Your child may communicate this by making a noise, reaching, or looking toward you.

If your child has newly started using words, use an expectant pause during a verbal routine such as a favourite song or familiar phrase. For example, just before releasing your child to go down the slide you might say “ready, steady…” and wait for your child to say “go!”.

7. Offer Choices

Offering your child a choice by holding up two objects is a great way to encourage communication. Children are naturally motivated to communicate when offered a desired item and giving a visual choice allows your child to communicate through reaching, pointing, vocalizing and/or verbalizing.

8. Match Plus One

When your child starts using words, use ‘match plus one’ to help them learn new words and start to build sentences. With ‘match plus one,’ you repeat what your child says and add one word or concept. For example:
- Child: “Dog” Adult: “Big dog”
- Child: “Mummy car” Adult: “Mummy’s red car”
- Child: “Biscuit” Adult: “Eat biscuit”
- Child: “Baby bed” Adult: “Baby is going to bed” or Baby is tired”
9. Fewer Questions

When children are early communicators, it is easy for adults to get in the habit of asking questions. However, for children not yet using words, answering questions is difficult. Plus children learn language by hearing others use language; hearing too many questions limits a young child’s language learning opportunities. Instead of asking your early communicator a question, comment on what he or she is doing. For example, instead of asking “What are you doing?” or “What do you have?”, comment “You are playing blocks” or “Wow, a big block tower!”.

10. Limit Screen Time

Babies and young children learn best from in-person, face-to-face interactions with you and other important people in their life. Limit screen time to video calls with friends and family so your early communicator has plenty of practice and learning time with face-to-face interactions.

If you would like more information about children’s speech and language, please get in touch. Follow us on Facebook for more speech, language and feeding tips and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.
5 November 2025
Big Chef, Little Chef: Cooking Together to Support Communication and Mealtime Skills
As the nights draw in and the trees lose their leaves, the distinct feeling of autumn is here. In my household, the excitement starts to build as the 31st of October approaches… what will the Halloween costume be this year, what sweets will be given out, and when are we making the cupcakes? Yes, Halloween cupcakes!

We started the tradition when my son was three and it has evolved over the years. Early creations involved smiling ghosts and Oreo cookie spiders. More recent versions have included bats, mummies and other creatures emerging from a chocolate grave. The joy I get as parent spending time with my child is immeasurable, as is the joy I have as a speech, language and feeding therapist thinking about all the language and mealtime learning that occurs as a part of parents and children spending time together in the kitchen.

Speech and Language Learning through Cooking

Learning becomes more meaningful when it happens in the real world, and the kitchen is a fantastic place to build on your child’s speech and language skills. You might be surprised at all the communication skills you can target while cooking together.
- Vocabulary – Cooking together naturally exposes your child to new words such as recipe, boil, measure, slice, chop, etc.
- Basic Concepts – Time in the kitchen together provides opportunities to introduce basic concepts including: hot/cold; full/empty; dirty/clean; wet/dry; big/little; heavy/light; shiny/dull; first/next/last; and more.
- Verbs – Cooking action words such as stir, whisk, pour, cut, heat, etc. can be practiced throughout your cooking activity in present, past and future tense forms.
- Following Directions – Cooking is a multi-step activity and you can use time in the kitchen to support your child’s ability to follow one-, two- and multi-step directions.
  - Let’s get a spoon.
  - Get a spoon and put it in the bowl.
  - Get a spoon and put it in the bowl, then pour the milk in the bowl.
- Understanding and Answering Questions
  - Who baked the cookies?
  - Where is the cookbook?
  - What did you use to mix?
  - When do we turn on the oven?
  - How many cupcakes did we make?
  - How did we open the tin?
- Speech Sounds – Practice sounds your child has not yet mastered while cooking.
  - /s/ – salt, soup, sauté
  - /s/ blends – slice, steam, stir
  - /l/ – liquid, lettuce, ladle
  - ‘sh’ – sugar, chef, mash
  - /r/ – roast, rice, ravioli
- Narrative Skills – Using narrative refers to a child’s ability to tell about a sequence of events in the correct order with a clear beginning, middle and end. When you finish cooking, have your child re-tell you the story of what you did in the kitchen together.
Mealtime Learning through Cooking

For children who enjoy eating as well as for those who struggle with eating or are ‘picky eaters,’ time around food in a no pressure environment, such as cooking, supports the development of skills needed to manage food at the table.

To help your child build positive food connections, when cooking together focus on:
- Sensory Exploration – Encourage your child to smell, touch, and look at the food without pressure to it eat. Use vocabulary such as soft, crunchy, firm, and colour words to describe what you feel and see.
- Being Okay with Food Mess – Cooking and eating are messy at times. Practice with food on hands and clothes while cooking helps children to be comfortable with food mess while eating.
- Food Choices – ask your child to decide what vegetable to serve with the evening meal and let your child wash, cut and boil or bake the vegetable in an age-appropriate way. You may even want to let your child plan the entire meal!
- Enjoying Time Together around Food – Part of building positive food connections is enjoying time around food. When your child has fun cooking with you, that supports their development of a positive association with food. Be silly, smile and laugh together while you create your tasty treat.
Happy Halloween and Happy Cooking with your Child!

If you would like more information about children’s communication or feeding, please get in touch. Follow us on Facebook for more speech, language and feeding tips, and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.
27 October 2025
From Question to Answer: Teaching Your Child the Skill of Understanding and Answering Questions
When most people think of speech and language therapy, they think of supporting children who are struggling to use and/or pronounce words. However, an equal part of a speech and language therapist’s role is supporting children who struggle with their comprehension. Understanding and answering questions is a common challenge faced by children with receptive communication difficulties and there are things you can do at home with your child to support their question skills.

A Hierarchy of Questions

When looking at the development of a child’s understanding of questions, Blank’s Levels is a helpful way to think about what a child understands and what they need to learn next. Blank’s Levels of Questioning was developed by psychologist Marion Blank and is a hierarchical way of thinking about question skills. There are four levels of questions that move from simple, concrete questions to more complex, abstract questions. In addition to supporting a child’s understanding of questions, as a child moves through the levels, their reasoning, inferencing, predicting and problem solving skills develop.¹

How Can I Use Blank’s Levels with my Child?

When you are helping your child develop their question skills, it is important to work at the right level. Asking too many questions that a child does not understand is confusing and may be frustrating for your child. As a rough guide, children ages 2 to 3 years will be working at Blank’s Levels 1 and 2. Children ages 4 and 5 years will be working at Blank’s levels 3 and 4. If your child sees a speech and language therapist, ask them for guidance about where to start with your child.

What if my Child Does Not Understand the Question?

Make sure you are pausing and giving your child enough time to think about and process the question before expecting an answer. If your child does not understand the question, you can provide a prompt to support their ability to answer. Some prompts that may help your child include:
- Offering a choice: ‘Is it a book or a bear?’
- Physical promoting through pointing or showing
- Providing an answer sentence starter: ‘because the boy needs…’
If your child still does not know how to answer the question following a prompt, model the answer for them. The goal is to help your child understand and answer questions, and they will need to hear good language models to help them learn this skill. If you child repeatedly does not understand questions at a particular Blank’s Level, spend some time working at a lower level to make sure they are secure with more concrete question skills.

Blank’s Levels Explained

Level 1: Matching Perception

At Blanks Level 1, questions focus on things in your child’s immediate environment and responses can be verbal or non verbal. Your child should be able to see the things you are asking about.

Examples of Level 1 questions include:
- Find one like this. (matching objects)
- What can you hear?
- What did you touch?
- What is this? (pointing to an object)
- Who is this? (pointing to a person)
- What is ___ doing?
- Say ‘___’. (imitation)
- What did you see? (remembering items in books)
Level 2: Selective Analysis of Perception

At Blanks Level 2, questions focus on the details of things your child knows but are not necessarily visible at the time of questioning. Your child may or may not be able to see the things you are asking about, and at Level 2 you are asking about things in more detail compared to Level 1.

Examples of Level 2 questions include:
- What happened?
- Who / what / where is ____? (remembering information)
- Describing characteristics of objects (e.g., size, shape, colour, taste, smell, feel)
- Which one do we use to ___? (identifying an object function)
- What do we use a ___ for? (describing an object by function)
- Tell me something that is a type of ____. (naming an object from a category)
- How are these different?
- Tell me two things that are ___ and ___. (attending to two characteristics)
Level 3: Reordering Perception

At Blanks Level 3, the questions are not about direct objects and answering requires your child to use their own knowledge and higher order thinking. To answer Level 3 questions, your child will need to make basic predictions, assume the role of another, or make generalizations.

Examples of Level 3 questions include:
- What will happen next? (prediction)
- What is a _____? (definition)
- How are these the same?
- Find one to use with this.
- Find the things that are not _____. (understanding negatives)
- What could she say? or How does she feel? (assuming the role of another).
- (In a given situation), what should I/we do? (problem-solving)
- What else can ___? What can we use instead of ___? (identifying an alternative)
- Tell me how to do it. (giving directions)
- Tell me the story. What happened when ___? (Describing pictures in a sequence or retelling an event that happened)
Level 4: Reasoning About Perception

At Blanks Level 4, the questions are not about direct objects, and answering requires your child to use reasoning and draw on past experiences. To answer Level 4 questions, your child will need to problem-solve, predict, and provide explanations.

Examples of Level 4 questions include:
- What will happen if? (prediction)
- Why did ____? (justifying cause of event)
- What could ____ do / use? (solution)
- Why could ____ do that / use that? (explaining means to goal)
- Why can’t we ____? (explaining an obstacle to a solution)
- How can we tell ____? (explaining observation)
- Why is ___ made of ___? (explaining construction of objects)
- Why is this called a motorbike / sunflower / bedroom? (explaining the logic of compound words)
- Why will / won’t ___ happen? (justifying a prediction)
- Why would / wouldn’t it? (justifying a decision)
Examples of Blank’s Levels in Everyday Situations

Below are some examples of questions at each of Blank’s Levels that you could ask your child during mealtime:

Level 1
- What’s this? (while holding up a plate)
- What’s that called? (while pointing to a bowl)
- What am I doing? (e.g., cutting, scooping, serving)
- Can you find me a spoon?
- Can you find another like this? (while pointing to a fork).
- Who has the salt?
Level 2
- Where is the bread?
- What is in the bowl?
- What colour is the soup?
- What do we use a napkin for?
- Tell me two things that are warm and we can drink.
Level 3
- What is a spoon / fork / cup? (definition).
- We have finished eating, what will happen next? (prediction)
- Uh-oh, I spilled pasta on the floor. What should I do next? (problem-solving)
- Find something you use with this (while pointing to a knife, child would then find a fork). (word associations)
- This is James’ favourite dinner. How does James feel? (assuming the role of another)
- Find me something that is not red. (understanding negatives)
- Can you tell me how to set the table (sequencing)
- Pass me the salt, then give James a spoon. (multi-step direction)
Level 4
- What would happen if we left our food on the floor? (consequence)
- Why can’t we put our milk on a plate? (negative + consequence)
- My toast is burnt. Why do you think it is burnt? (explanation)
- We’ve run out of ice cream for pudding, what could we do? (problem-solving)
- How can we tell the soup is hot?
If you would like more information about Blank’s Levels or receptive communication, please get in touch. Follow us on Facebook for more speech, language and feeding tips, and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.
1. Language Disorder Australia ↩︎
20 October 2025
Tongue-Tie: A Controversial Band of Tissue
As a speech and feeding therapist, I regularly am asked whether a tongue-tie may be a factor in a child’s speech or feeding difficulties. Over the course of my career, I have completed additional training in tongue-tie and have worked alongside colleagues who sit on both sides of the tongue-tie debate. Increasingly, I find myself squarely in the middle which got me thinking; why are tongue-ties controversial and why do we not have a definitive, universally agreed upon way to diagnose and manage tongue-ties in children?¹

A Brief History of the Tethered Tongue

If you are wondering whether tongue-tie is a fad or a condition with historical roots, wonder no longer! Almost 2000 years ago, Cornelius Celsus, a Roman encyclopaedist, described ankyloglossia or what we more commonly refer to as ‘tongue-tie’. A reference to tongue-tie can also be found in the bible, where it is noted that speech was improved when “the string of his tongue was loosened”.² As early as the 1600s tongue-ties were regularly treated in newborns with midwives keeping one fingernail longer and sharper to cut a tethered tongue.² ³ However in the 1900s, as formula milk grew in popularity, this practice fell out of favour.²

The diagnosis and medical management of tongue-tie has ebbed and flowed with many linking it to the rise and fall of breastfeeding rates; in other words, when breastfeeding is more common, so is the diagnosis and treatment of tongue-tie.⁴ So, where does that leave ankyloglossia today, at a time where The World Health Organization (WHO) recommends exclusive breastfeeding for the first six months of life?⁵ You guessed it, diagnosis and treatment of tongue-tie has sky rocketed in the developed world. It is estimated that between 4% and 11% of babies are born with tongue-tie.⁶ With one study finding an almost 10-fold increase in the diagnosis of ankyloglossia between 1997 and 2012 and a further doubling between 2012 and 2016.⁷ As the diagnosis of tongue-tie increases, so do the number of tongue-tie surgeries with rates of tongue-tie surgeries more than quadrupling in high-income countries over the past ten years.⁶ This increase in tongue-tie diagnoses and surgical procedures however, is not without controversy.⁸

An Agreed Upon Definition and Response?

Surprisingly (or perhaps not so surprisingly) the controversy over tongue-tie starts with the definition. Most professionals agree that a tongue-tie involves an abnormally tight lingual frenulum, the band of tissue that connects the tongue to the floor of the mouth; but that is where the agreement ends. Some tongue-ties are attached close to the front of a person’s mouth with a visible short and tight lingual frenulum (resulting in a heart shaped tip of the tongue); while others are attached toward the back of the mouth where the lingual frenulum may not be visible but there is restricted tongue movement (a ‘posterior tongue-tie’).⁹ So, the question becomes, ‘Should we diagnose a tongue-tie when we see the ‘tie’, or should we diagnose a tongue-tie when we ‘see’ decreased tongue function?’ (Professionals have yet to agree on an answer to this.) And, ‘What do we do when we diagnose a tongue-tie?’

The most common and immediate fix for a tongue-tie is a lingual frenectomy which involves cutting or lasering the lingual frenulum. For babies under 6 months, this generally can be done as a part of an office visit with a skilled practitioner, but older babies and children will need an anaesthetic.¹⁰ Following a lingual frenectomy, most practitioners recommend specific aftercare to prevent re-attachment.¹¹

But, does every tongue-tie warrant a lingual frenectomy or are there some tongue-ties that can be managed with specialist input and a ‘wait and see’ approach? And how do we know which is which? (Professionals have yet to agree on an answer to this as well.)

Commonly Agreed Upon Symptoms

Despite not agreeing on a definition or response, there are a generally agreed upon set of symptoms of a tongue-tie (although not every person has every symptom). These include:¹² ¹³
- Difficulty with breastfeeding for both baby and mother.
- Difficulty managing solid foods, especially as a part of early weaning.
- Poor oral hygiene for older children and adults (due to an inability to use the tongue to clear food from between the teeth and cheek).
- Difficulty producing speech sounds that involve the tongue tip making contact with the roof of the mouth such as ‘t, d, l, and n’.
- Difficulty with other activities involving specific tongue movements such as licking an ice cream cone, licking one’s lips, and playing a wind instrument.
- A change in oral structures such as the palate, jaw, and teeth (due to an altered resting position of the tongue).
Given this list of clear symptoms, you may wonder why diagnoses and treatment is controversial; can’t we simply agree that a person with the above symptoms has a tongue-tie (and ‘fix’ it)? Unfortunately no, we can’t. Many of the above symptoms can have causes other than tongue-tie, and delaying investigation of other causes in favour of immediately defaulting to tongue-tie as the cause can delay the individual receiving the appropriate treatment (and may put the person through an unnecessary medical procedure).

What Does this Mean for My Child?

The answer to this question is not simple and depends on what medical professional your child sees (much like the answer to the questions of how we identify and treat a tongue-tie). I have met parents whose child had a lingual frenectomy and they found that following the procedure their child’s symptoms improved or resolved; other parents I have met whose child had the procedure reported little or no difference in symptoms. Some families I have worked with who have been offered the procedure and declined, have found that their child’s symptoms improved with therapy and time.

As I finish writing this, I find that I am no closer to shifting my ‘middle of the road’ position when it comes to tongue-ties. Children who have difficulty with feeding or speech need a thorough assessment, including an oral motor examination. If a tongue-tie is identified or suspected, parents should be given the opportunity to discuss their child’s symptoms with a practitioner who specializes in tongue-ties and performs lingual frenectomies to determine whether this is an appropriate consideration for their child. Equally, their child needs quality feeding or speech therapy to directly address their symptoms and improve outcomes whether or not a lingual frenectomy is performed.

If you have concerns for a tongue-tie in your child and would like information about feeding or speech therapy with South Lakes Speech & Language Therapy, please get in touch. Follow us on Facebook for speech, language and feeding tips and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.
1. Becker S, Brizuela M, Mendez MD. Ankyloglossia (Tongue-Tie) [Updated 2023 Jun 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482295/ ↩︎
2. K. Ganesan, S. Girgis, S. Mitchell,
  Lingual frenotomy in neonates: past, present, and future,
  British Journal of Oral and Maxillofacial Surgery,
  Volume 57, Issue 3,
  2019,
  Pages 207-213,
  ISSN 0266-4356,
  https://doi.org/10.1016/j.bjoms.2019.03.004. ↩︎
3. Johns Hopkins Medicine: A Clinical Consensus on Tongue-Tie ↩︎
4. ENT Today ↩︎
5. WHO ↩︎
6. Evans L, Lawson H, Oakeshott P, Knights F, Chadha K. Tongue-tie and breastfeeding problems. Br J Gen Pract. 2023 Jun 29;73(732):297-298. doi: 10.3399/bjgp23X733221. PMID: 37385756; PMCID: PMC10325602. Download .nbib Format: ↩︎
7. HealthyChildren.Org ↩︎
8. Obladen M. Much ado about nothing: two millenia of controversy on tongue-tie. Neonatology. 2010;97(2):83-9. doi: 10.1159/000235682. Epub 2009 Aug 25. PMID: 19707023. Format: ↩︎
9. Infant Journal ↩︎
10. NHS: Tongue Tie ↩︎
11. Alabama Tongue-Tie Center ↩︎
12. Mayo Clinic: Tongue-Tie ↩︎
13. Guy’s and St Thomas’: Tongue-Tie in Children ↩︎
15 October 2025
The Amazing Baby Brain: Zero to 3 is Key!
Have you ever wondered what is going on in your baby’s brain? The answer is a lot! Babies are born with billions of neurons and all those neurons are bumping around in their brain looking for connections.¹ And as these neurons form connections, or synapses, your baby is learning new skills like smiling, reaching, cooing, babbling, chewing, and talking (to name a few).

Use It or Lose It

Between birth and three years of age, your baby’s brain is developing one million neural connections per second.² However, after about three years of age, brain connections slowly reduce through a process called synaptic pruning where connections that are used strengthen, and connections that are not used are lost. Synaptic pruning helps your child’s brain connections become more efficient and effective in their environment³ (which in part explains why a child exposed to two languages from birth will find it easier to learn both languages compared to someone who is not exposed to a second language until later in life).

What Does this Mean for My Child ?

For all children, this means that early experiences (along with genetics) play a key role in future outcomes. Baby’s brains are the most flexible and primed to learn during the early years with sensory pathways such as hearing, language and higher cognitive function peaking by the first three years of life.² As a parent, you play a key role in your child’s early brain development through the experiences that they have with you and their environment.

How Can I Support My Baby’s Feeding and Communication Development?

Early, repeated enjoyable back-and-forth interactions (also known as reciprocal serve and return interactions) are essential to building strong neural connections.³ Serve and return interactions occur when your baby (or you) does something (‘serve’) and the other person does something back (‘return’). It can be as simple as you smiling at your baby when they vocalize or picking them up when they cry. As you baby develops, serve and return interactions may involve rolling a ball back and forth, playing peek-a-boo, or your child holding up their foot so you can put on their sock.

In addition to serve and return interactions, there are many other things you can do with your baby and young child to support their feeding and communication development including:
- Respond to your baby’s feeding cues and keep feeding times relaxed with an emphasis on bonding with your baby in addition to providing nourishment.
- As your baby starts to wean, encourage them to actively explore their foods with their hands. Continue to focus on enjoying time together with food and keeping meal times pressure free.
- Read books together while looking at and talking about the pictures.
- Sing songs with your baby and toddler, including songs with gestures so your child can hear the words and watch your hand movements.
- Talk with your baby and young child throughout the day about what you are doing together.
- Play and interact face-to-face whenever possible so your child can see your eyes and mouth when you are talking to them.
- Provide your baby and toddler with a range of sensory experiences including baby teethers, rattles and toys that make different types of noises, and textured toys to explore.
- Ensure your baby has many opportunities to practice tummy time and moving on the floor (this helps strengthen your baby’s core muscles which are essential for coordinating respiration with eating and speaking).
- Limit screen time to video calls with friends and family (babies and young children learn best from in-person, face-to-face interactions with you and other important people in their life).
If you have concerns for your baby or toddler’s development, seek advice immediately. I frequently am asked by parents how old their child needs to be before starting services with South Lakes Speech & Language Therapy; my answer is always the same, ‘if your child is struggling with communication or feeding, they are ready to start speech, language or feeding therapy’ (usually using a parent coaching model). Early intervention is key and can make a huge difference in the rapidly developing brain of a young child; so, the earlier the better!

If you would like more information about baby and young children’s communication development or feeding, please get in touch. Follow us on Facebook for speech, language and feeding tips, and sign up for South Lakes Speech & Language Therapy’s newsletter if you would like new posts sent directly to your inbox.
9 October 2025
‘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. Follow us on Facebook for more speech, language and feeding tips, and sign up for South Lakes Speech & Language Therapy’s 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 ↩︎
26 September 2025
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 Traumatic 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 ↩︎
5 September 2025
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 speech and 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 speech and 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. ↩︎
4 September 2025
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.

31 August 2025