Karen Fittinger

Bright Start Therapies. Inc.

Credentials: M.S. CCC-SLP
Hours of Operation: Bright Start Therapies, Inc hours of operation Monday-Friday 8-6 pm
Treatment locations: Office/Clinic|Other
198 Cirby Way ste 140
Roseville, California 95678
Phone: (916) 773-8282
Email: brighttherapies@yahoo.com

Overall Treatment Approach:
   Bright Start Therapies has specialized in the assessment and treatment of Childhood Apraxia of Speech (CAS) for over ten years. Our CAS team members provide comprehensive evaluations, treatment, consultation and seminars statewide. Motor speech disorders require repetitive planning, programming, and production practice; therefore, intensive and individualized treatment of childhood apraxia is necessary. Our treatment approach depends on a number of factors, including the severity of the disorder and the communication needs of the child. A combination of approaches is often necessary including motor programming, linguistic approach, and sensory cueing including PROMPT, using augmentative and alternative forms of communication (AAC), such as gestures, manual signs, voice output devices, and context-specific communication boards. This involves utilizing as many important people in the child's life as possible to facilitate carryover and generalization of skills. We strive for a high production rate of 500-600 productions a therapy session. The targets are tracked on our self devised tracking sheets and new targets are updated on a weekly basis. We increase the complexity of the speech sound targets as the child reaches a desired accuracy in his speech production level. We include a functional word, phrase or sentence list depending on the child level and capability for increasing intelligibility. Tactile methods of speech facilitation are those that provide direct tactile input for correct speech production. Using these methods, the SLP applies pressure or otherwise touches the child's face, neck, and head to provide a tactile cue for correct production or speech movement gesture. For example, PROMPT© (Prompts for Restructuring Oral Muscular Phonetic Targets) is a dynamic tactile method of treatment based on touch pressure, kinesthetic, and proprioceptive cues. Apraxia in other systems may also play an important role in treatment. For example, the presence of limb apraxia may preclude using manual signs for functional communication, although sign language cues can still be used by others to support verbal speech, if the primary goal is to help cue words and word sequences. The presence of oral apraxia may support the need for either more aggressive or alternative approaches to the use of phonetic placement cues in speech treatment. Many children with CAS also exhibit phonologic impairment and language impairment and therefore these areas are assessed and addressed as well.

Percent of CAS cases: 75

Parent Involvement:
   At Bright Start Therapies Inc. we believe parents are an integral part of their child’s success. Parents are given a packet of resources that include web resources, book resources, printed articles, and seminar information, as well as opportunities to join in peer support groups and on-site training seminars. In addition, families are given weekly homework with specific targets of sounds with examples of ideas to elicit the sounds or copied materials currently being used in the therapy sessions. Weekly consultation of progress on goals as well as collaboration with all professionals working with the child is encouraged, including sharing of information in the entire child's academic and therapy settings.

Community Involvement:
   Bright Start Therapies Inc. has been providing support services in the CAS community for over a decade. We provide comprehensive IEE assessments in local school districts to rule out or determine the presence of CAS and provide necessary treatment options within the academic setting. Our comprehensive assessments are extremely through and may include diagnosis or provisional diagnosis of CAS or diagnosis of other speech sound disorder (e.g., articulation and/or phonological disorder). We provide a description of the characteristics present in your child’s speech and the severity of the speech disorder. We quantify the impact on language skills, phonological awareness skills, literacy skills, and the need for related supports within the academic setting. We provide recommendation for referral to other professionals as needed, including an occupational therapist if limb apraxia is suspected or sensory-motor, or fine motor issues. Physical therapy if gross motor skills or overall muscle tone are of concern. Referral to a neurologist if neurological indicators are present including (e.g., potential seizure activity, tremors, or imbalance) or to a a geneticist if the child's medical or family history suggests the possibility of a neurobehavioral disorder of genetic origin (e.g., fragile X, Rett syndrome, Anglemans syndrome). In addition, we provide CAS training seminars and training camps for both professionals and parents to educate those working with CAS. We attend the Apraxia Kids yearly conference for support and updated information without the community.

Professional consultation/collaboration: Yes

Min Age Treated: 2

Max Age Treated:

Insurance Accepted: Yes