Carla Monteleone

Carla Monteleone Speech Therapy

Credentials: MSLP, RSLP SLP(C); Recognized by Apraxia Kids™ for Advanced Training and Expertise in Childhood Apraxia of Speech
Hours of Operation: Tuesday and Thursday 9am to 8pm Wednesday 12pm to 8pm Saturdays 9am to 5pm I do have a flexible schedule and can work outside of the hours as well.
Treatment locations: Office/Clinic|Home
North Vancouver,

Overall Treatment Approach:
   My overall treatment to kids with CAS includes only a few target sounds/words/phrases during a session with multi-sensory cueing (verbal, gestural, tactile). I do use PROMPT with some clients. Treatment sessions include the use of functional vocabulary and frequent intensive practice of the target (sound, syllable, word, sentence). I use both massed and distributed practicing depending on whether I am working towards acquiring the target or generalizing the target. I also make sure to target prosody from the beginning of therapy. I make sure that my sessions are fun and motivating for each client. The use of augmentative and alternative communication may or may not be used in therapy depending on the client. In addition, I don't follow the development hierarchy of speech sounds when picking initial targets.

Percent of CAS cases: 70

Parent Involvement:
   Parents are included in the assessment, goal writing and treatment sessions. They are required to carry on at home with practice on a daily basis. Practice is dependent on the level that the child is at in therapy sessions. For example, a child may say "hi Daddy" everytime he/she sees his/her dad. Parents may be able to provide some level of cueing at home (e.g. initiate the child to say "hi Daddy' by waving to Dad).

Parent Explanation:
   I explain CAS to parents by explaining it is a neurological speech disorder and it affects the way a child is able to clearly produce sounds, syllables and words. I explain to parents that your child knows what he/she wants to say but has a challenging time coordinating all of the oral motor structures involved when sending the message from his brain. I explain that we don't know what causes CAS. I explain that as it is a motor planning disorder, the more the child has an opportunity to practice the speech movement plan, the more automatic it will be. I explain it as learning a new skill (e.g. riding a bike or driving a car). I explain how we have to break down the steps when riding a bike (e.g. where to sit, where to put there feet, how to move their legs). The more we practice this, the more we don't think about how to do it. It becomes automatic. This is how we want speech to be for the clients we work with.

Community Involvement:
   I currently mentor other Speech-Language Pathologists in apraxia of speech and provide consultations with clients and their Speech-Language Pathologists. I have given presentations to other Speech-Language Pathologists in the community on CAS.

Professional consultation/collaboration: Yes

Min Age Treated: 18 months

Insurance Accepted: Yes