From first gestures to conversation: helping every child find a reliable way to understand and be understood.
Communication is more than talking. It includes understanding what others say, using gestures, sharing attention, asking for what you need and taking part in a conversation. When any part of this is hard, children can become frustrated, and behaviour often stands in for the words they do not yet have.
Our speech and language work is play-based and linked to everyday routines. We combine speech therapy with ABA-based teaching of verbal behaviour, such as requesting, labelling, imitation and conversational responses, so that each new skill is useful in your child’s day straight away. Our first goal is always that your child has a dependable way to communicate, whether through words, gestures, pictures or a device.
23 needs explained in plain language
These descriptions help you understand terms you may hear. They are not a diagnosis, which can only come from a qualified clinician.
A child with a speech or language delay is developing communication in the usual order, but later than expected, for example still using very few words at two years. Some children catch up on their own, but support at the right time makes a difference. Therapy builds understanding, words and sentences through play and daily routines.
Speech sound disorders make it hard for a child to produce or combine sounds clearly, so their speech may be hard to understand beyond the age when that is expected. Therapy targets specific sounds and sound patterns through listening, practice and games.
A language disorder is a persistent difficulty understanding or using spoken language: vocabulary, sentence structure or putting ideas together. It is different from difficulty with speech sounds, and it can affect learning and friendships. Therapy works on understanding and expression in small, functional steps.
Receptive language is how a child understands words, questions and instructions. A child may seem not to listen, follow only part of an instruction, or rely on routine and gestures to work out what is happening. We build understanding from single words to longer instructions, with visual support where it helps.
Expressive language is how a child uses words, sentences and gestures to share needs, ideas and feelings. A child may use few words, short or jumbled sentences, or struggle to find the right word. Therapy expands vocabulary and sentence length in ways that connect to the child’s daily life.
Pragmatic language is the social use of language: taking turns, staying on topic, reading tone of voice and adjusting how we speak to different people. A child may talk at length about their interests or miss what others are saying. We practise these skills in structured settings first, then in natural ones.
This broad term covers any difficulty getting a message across or understanding others, whether through speech, gestures, signs or pictures. Our first aim is always a reliable way to communicate, which often reduces frustration and the behaviour that stands in for words.
Functional communication means the everyday messages a child needs most: asking for help, saying no, asking for food or a toy, or telling someone they are hurt. We teach these first, using whichever method works for the child, from words to gestures, pictures or communication devices.
Before first words come the building blocks: eye contact, smiling, babbling, taking turns with sounds, reaching and pointing. When these early skills are slow to develop, we work on them through play and routines, because they lay the ground for spoken language.
Nonverbal communication includes eye gaze, facial expression, gestures, body language and tone of voice. Some children find it hard to use these signals or to read them in others. Therapy teaches and practises them, so interactions feel easier on both sides.
Gestures such as waving, pointing, nodding, shaking the head and showing objects usually appear before or alongside first words. When gestures are limited, we teach them directly, because they help children communicate now and support the move towards spoken words.
Joint attention is when a child and an adult focus on the same thing together, for example when a child points at a dog and looks back to share it with you. It is a key foundation for language and social learning, and we build it through engaging, shared play.
Vocabulary is the store of words a child understands and uses. A small vocabulary limits what a child can say and understand at home and in class. We build word knowledge around themes from the child’s own world, so new words are used straight away.
Narrative skills let a child tell a story or describe an event in order, such as what happened at school today. They support reading comprehension, writing and friendships. Therapy uses pictures, sequencing and retelling to build longer, clearer accounts.
Syntax and grammar govern how words fit together into sentences, including word order, tense and plurals. A child may keep using short or ungrammatical sentences beyond the expected age. We model and practise sentence patterns step by step.
In ABA, a mand is a request: asking for something the child wants or needs, such as a drink, a break or help. Teaching requests is often one of the first and most powerful goals, because it gives the child some control and reduces frustration.
Echoic skills mean repeating sounds, words or phrases after someone else. Being able to imitate speech helps a child learn new words and pronunciation. We build imitation from simple sounds to words and short phrases, at the child’s own pace.
Intraverbal skills are conversational responses: answering questions, finishing a familiar song or rhyme, and talking about things that are not in front of the child. They are a foundation for conversation, and we teach them gradually and in context.
A tact is naming or describing something a child can see, hear or otherwise notice, such as saying “car” as one drives past. Labelling builds vocabulary and lets children share what they notice. We teach it with real objects, pictures and everyday moments.
Some children can answer when asked but rarely start communicating on their own. Spontaneous communication means initiating: asking, commenting or greeting without a prompt. We create natural opportunities and gradually fade prompts, so communication becomes the child’s own.
Conversation asks a child to listen, respond, take turns, ask questions and stay on topic. We teach these skills in small steps, practise them with familiar adults and then help the child use them with other children.
Questions such as what, where, who, why and how each ask for a different kind of thinking. Some children answer only simple questions or repeat the question back. We teach question types one at a time, with visual support where it helps.
Following instructions involves listening, understanding and remembering steps, from “give me the ball” to multi-step classroom directions. We build this from one-step to multi-step instructions and practise it in real routines.
