Karen Pieters

Monkey Mouths Therapy Services

Credentials: MA CCC-SLP
Hours of Operation: Monday-Thursday 8:00-6:00 Friday 9:00-5:00
Treatment locations: Office/Clinic
Hurst, Texas 76054

Overall Treatment Approach:
   I use proven interventions based on motor learning principles, including DTTC and PROMPT, as well as Kaufman materials to shape speech production. During speech therapy sessions, I target a small number of functional words but provide opportunities for a large number of repetitions to increase motor planning with words the child will use in their daily environment. As therapy progresses, I work to expand the child's phonetic and syllable shape inventory. Throughout the therapy process, I also work to improve prosody in single words, phrases and sentences to assist the child in gaining natural, fluent speech production. If the child needs additional communication support, I am also skilled at introducing and implementing AAC systems. I recommend that therapy sessions for children with apraxia occur several times a week for 30 minutes sessions.

Percent of CAS cases: 25

Parent Involvement:
   Parent involvement is an important part of the therapy process. Parents attend the evaluations and have the opportunity to observe therapy sessions. Parents are given home program activities that extend therapy into the child's natural environment. I consider parents to be an important part of the child's treatment team, and I encourage them to communicate their questions and observations in order to maximize progress.

Parent Explanation:
   I explain that CAS is a motor learning (or motor planning, or motor coordination) deficit that is different from a traditional articulation disorder. I explain that in a traditional articulation disorder there are patterns of sound errors and that generally, the motor system is intact. In diagnosing CAS, I look at the types of errors. Generally, children with CAS produce inconsistent errors and have difficulty with vowels, which is not the case with an articulation disorder. I also look at the motor system to see if there is weakness. Generally, there is no weakness in CAS. If muscle weakness is an issue, then we are typically looking at a different disorder. When we suspect CAS, the treatment involves improving the motor patterns (the coordination of movement). I also give parents information on neurological development and how motor learning develops as well as how we improve it in therapy.

Community Involvement:
   I have been treating children with Apraxia for over 15 years and approximately 25 percent of my caseload is children with CAS. I am familiar with community organizations that support children with CAS and their families, and I assist families in connecting with resources and support.

Professional consultation/collaboration: Yes

Min Age Treated: 2

Insurance Accepted: Yes