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Business Name: Children's National Health System - Laurel Outpatient Center

Address::
13922 Baltimore Ave
Laurel, Maryland 20905

Phone Number: (240) 568-7026

Email Address: snixon@childrensnational.org

Describe treatment approach used: -Dynamic Temporal and Tactile Cueing is my primary approach. I involve some of the tactile prompts I learned in PROMPT. I do not do PROMPT therapy.
-The best approach would be if I could see my patients 4-5 times per week; however, at Children's we cannot provide as intensive of services. To accommodate this, I allow parents to videotape the techniques and tell them to practice the target words at home for 10-15 minutes at least twice per day when not at speech/language therapy.
-It is important to add that each child is individual. If the child has a phonological component to his speech production difficulties, then I may also add in minimal pairs and/or phonological awareness training.
-I use the Principles of Motor Learning to focus on speech movement performance using repetitive practice. Via this I focus on the movement transition instead of individual phonemes.
-I use functional words as my targets and then matched probe trials at the beginning of each session to monitor progress.
-In therapy, I start at the direct imitation and make sure the child is looking at me. If the child struggles, first I provide specific verbal cues for production (e.g., tongue up in back). If still struggling, I move to simultaneous production. When needed I slow each part of the word proportionally targeting the transition between phonemes. If needed, I add tactile prompts. I then increase the rate of production and start speaking more quietly until the child is able to directly imitate the target. (This is once the child demonstrates no struggle or groping, good accuracy, normal rate, and can vary prosody.) Once the child experiences success with this target in 5-10 direct imitation attempts and can vary prosody, I add about a 5 second delay. Eventually, the goal is for the child to spontaneously produce the target when answering a question.
-I also use blocked practice and limited targets (maybe 5 to start). Once the child is producing a word consistently correctly, I will switch to random practice with that target word.
-Every session, I provide the parent with a list of the target words to practice with their child at home.
-A huge component that I learned from the DTTC trainings with Dr. Strand...I don't need picture cards or items on the table when doing speech production practice. I need the child's attention on my face. As breaks between practice items - or just "brain breaks" - we may play ants in the pants or pop-up-pirate. The game will be something I can remove from the table to refocus the child on me.

Describe parent/caregiver involvement: Parents are expected to be very involved. I model the approach for them. They are expected to go home and practice the current target words. They are also involved in target selection. They help me determine which words are most functional for the child at first. I organize these words for practice.

Describe your past and current involvement in the Apraxia community​?​ I am currently on the CASANA Facebook group for parents. I also correspond with other professionals regarding best practices specific to childhood apraxia of speech.

Do you provide consultation/collaboration with other professionals (for example, ​​attending IEP meetings, co treating, etc.) Yes

Age range​ treated?​ 18 month years to 18 years

Hours of operation: 8-5 Monday through Thursday and 8-4 Friday

Locations where​ treatment ​is ​provided? Office/Clinic

Insurance accepted? Yes

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