13 Jan Danielle Castle
Posted at 17:01h in Uncategorized
Credentials: MS CCC SLP
Hours of Operation: Monday-Friday 8-7pm
Treatment locations: Office/Clinic|Home|Daycare
Westminster, Colorado 80234
Overall Treatment Approach:
My overall treatment approach for child with CAS is very much like my assessment approach in that I look at the whole child and when it comes to treatment, I need to consider the needs and strengths of the family and school environment as well. What can I do outside of my treatment to encourage carryover and skill generalization across the board? In addition, my kiddos need to be prepared for therapy and to be prepared and ready, they must trust me and WANT to come to speech. This is why my goal is to make it fun while also getting as many trials as I can into a session with appropriate breaks when needed. I have experience with students ages 2 to adult and have gained experience with various challenging behaviors so I know how to adjust my routine, lesson, or game in order to get the most out of a kiddo while still making it fun! I am Level II trained in PROMPT and moving towards certification. PROMPT stands for Prompts for Restructuring Oral Muscular Phonetic Targets. I include this dynamic tactile-kinesthetic approach into my practice where appropriate. It utilizes touch cues on a patient's articulators to manually guide motor movement. I have seen this treatment work with some and not with others, and that is an important observation as a clinician to notice. I consistently look at what cues my patient needs and how to implement them into my lesson plan. In addition, I share with parents what works and what doesn't work. I know that some kiddos respond to PROMPT, Kaufman, sign-language, gross motor movement throughout the whole session, looking in a mirror, making videos, etc. I use a combination of strategies and cues (tactile, verbal, auditory, visual) and approaches and base my treatment on the WHOLE child. I implement AAC (low-tech or high-tech) when necessary and use it to enhance a child's communicative independence. Our exchange of information is crucial to our existence and makes us human! So, I want to ensure that each child is taught and has access to AAC, any form of communucation other than verbal speech to get their message across, anything from gestures and sign language, to pictures, a communication book, all the way to a speech generating high-tech device. CAS's distinctive feature is difficulty with motor planning and programming and so I look at the principles from research and apply those to my treatment which for CAS, includes INTENSIVE speech therapy which incorporates the theory of motor planning. My kiddos get massive amount of production through massed and distributed practice throughout my session and I encourage parents and families to do this at home as well. I know how important feedback is and I am sure to include this throughout the session, using knowledge of results vs performance where appropriate and also instructing parents on how they can do this at home as well. In the end, I love my job and I love working with kiddos who need help in the area of motor speech, articulation, phonology, and language. I am motivated by challenges and thrive in not knowing all the answers all the time because it keeps me on my toes and keeps me trying harder and harder. I enjoy working with families, seeing the results, and helping facilitate communication and independence.
Percent of CAS cases: 20
Parent involvement is crucial to a child's success. If a parent is not interested or involved in therapy, I try to find a way to GET them involved and interested. How can this benefit the whole family? How can I make practicing speech part of an everyday routine so families don't even have to think about it? How can I make generalization fun and beneficial without feeling like I'm just giving HOMEWORK. First of all, if there is an observation window in my treatment room, I encourage parents to watch the session. If not, I take videos when I can and share what we did (as long as there is media release, of course) I invite them into the last 5 or first 5 minutes of every session and try to pick at least 1-2 things each week for them to try at home. When available, I try to do home visits and see what some fresh eyes and my hopefully fresh ideas can help with in the home setting. While it might not directly involve the parents, I try to always do this with teachers as well since I currently see students in the clinic setting and therefore want to see generalization and carryover to home AND school. Motor skills are practiced in my session with many trials and repetitive movements. Motor learning happens when motor skills we are working on are carried over and are built into a functional task, a routine in a family's regular day. Most importantly, I need the parents. I need their expertise on their child! They know this child inside and out, their motivation, their preferences, and we need to work with everything that this child LOVES in order to make successful treatment plans.
Basically, I explain that CAS is a motor speech disorder that affects how the child is able to produce and sequence sounds. Sometimes I talk about it as a disconnect and instead of using jargon, I talk about how the child has a picture and even a sound representation in their head of a word, and they have all the parts they need to say it (tongue, teeth, lips, etc.), but actually saying it is very difficult because of all the fast and tiny movements that need to happen in order to. In addition, all those parts are strong and totally ABLE to say that word. But, the connection and the planning for that word are impaired. It's almost like what I heard another SLP explain once... that the brain is the motor and the mouth, including tongue and lips, are the tires. These are both working fine but the wiring between the motor and the tires are misfiring and as we need to do lots of practice to "rewire" this car. I always take the whole family into account and try to find a way to describe CAS clearly and honestly. I go about it compassionately and I am sure to include when I talk about treatment, how important of a role the parent plays in this. If I do not know something, I will not make up an answer. I will do my research and come back to the family with a response. I want to make sure the family trusts me and feels comfortable asking any question.
I recently moved and am working on building a presence in my new community. I recently attended a CASANA Apraxia Walk and it completely moved me to see all the families there! I network online and on forums with other SLPs and families and am always looking for opportunities to grow and meet new people who need help because of CAS or are experts and can help me help OTHERS with CAS!
Professional consultation/collaboration: Yes
Min Age Treated: 2
Insurance Accepted: Yes