Ashley Kreyling

Ashley Kreyling

Credentials: M.S., CCC-SLP
Hours of Operation: Monday-Tuesday 8:00 AM - 4:00 PM
Treatment locations: Home|Daycare
Mexico, Missouri 65265

Overall Treatment Approach:
   I utilize the PROMPT approach to determine a specific course of treatment for each child. Depending on the area of difficulty the child is experiencing according to the PROMPT hierarchy (i.e. mandibular, phonatory, lingual, etc,) three areas of improvement are prioritized and target phonemes and chosen within each of these areas. A total of 10-11 phonemes max are chosen as targets. Words and phrases are chosen utilizing these phonemes. Therapeutic acfivities are selected that can easily be manipulated to target these words and phrases for repetition. Massed practice of target words is introduced at the beginning of each session, followed by random practice during the activity. PROMPT tactile dues are utilized during word productions to map out oral motor movements and to improve incorrect productions. Additionally, words that are highly important to the child or family may be selected as target words (such as a child's name). The family is consulted to determine which words would be appropriate. Data is collected during each session to monitor progress.

Percent of CAS cases: 5

Parent Involvement:
   I work in early intervention and early childhood, so family input is an extremely important aspect in what I do. Parents are interviewed during the assessment process to understand the child's level of functioning at a deeper level. Parents are consulted regarding therapy targets. In-depth discussions are held regarding possible diagnosis and prognosis, as well as intensity and frequency of therapy. Parents are welcomed and encouraged to attend therapy sessions to learn more about the process. Words or phonemes to practice at home are provided, as well as general language-enrichment methods that can be utilized in any environment. Parent feedback and participation is always welcomed!

Parent Explanation:
   CAS is when a child has difficulty coordinating their brain and mouth. Their brain knows what to say, and their mouths usually can make the sounds they need to say those words. But there is a bit of a disconnect. The brain has trouble coordinating all those movements and timing so that words and sounds come out in the right order. It is a bit like having a short. The pieces might be in tact, but the wiring is faulty. Some times you turn it on and it works, and other tines it won't start. And you never know which it will be! Speech is the most intricate movement in the whole body. We have to control our breathing, vocal cords, tongue, lips, jaw, etc. in JUST the right way, or it doesn't come out right. No wonder it is so hard for some kiddos! CAS is very unique in terms of speech impairments. Many speech impairments are made up of a predictable and consistent pattern of errors. For example, you've probably heard children call a rabbit a "wabbit." This is an example of a typical speech error that is consistent and predictable. But CAS is much different. It is sometimes hard to diagnose and treat because it is so UNpredictable. It's like ice skating. You will probably fall down a lot, but you would never fall down the exact same way twice! It is the same with CAS. If we are "falling down" the same way every time in regards to speech, it probably isn't CAS. I want to be very honest with you. CAS can be a difficult speech impairment to work through. It often requires years of very intense speech therapy. Each child's progress is unique and based on their own abilities, so it is almost impossible to predict how much therapy they will need or for how long. But children DO make progress! And in the mean time, if your child has no reliable way to communicate, we will work on building an alternative mode of communication for them so that they are able to express their wants and needs. It may just be a "bridge" from where we are now to where we want to go, but it will be a very valuable bridge for your child. We can explore things like sign language or picture communication systems. There are lots of great options out there!

Community Involvement:
   In the last seven years, I have treated approximately a dozen children with moderate-severe CAS. During that time, I have conducted in-depth assessments and created my own informalized assessment that specifically looks for red-flag signs for CAS. I have directed many families to the CASANA website as a parent-friendly, reliable resource. I have educated many parents and teachers on the warning signs for apraxia, as well as treatment options. I have worked to help implement alternative modes of communication for students whose CAS severely impacted their intelligibility. I have participated in PROMPT level 1 training and intend to complete PROMPT certification when it is available in my area.

Professional consultation/collaboration: Yes

Min Age Treated: Birth

Insurance Accepted: No