Pooja Aggarwal

Progressive Speech Therapy

Credentials: M.S., CCC-SLP; Recognized by Apraxia Kids™ for Advanced Training and Expertise in Childhood Apraxia of Speech
Hours of Operation: Monday-Friday 8 am to 6 pm
Treatment locations: Office/Clinic|Home|Daycare
Ashburn, Virginia 20147

Overall Treatment Approach:
   Overall Philosophy Fun, joy-filled sessions using multi-sensory cuing based on DTTC methodology Target Selection * Use phonetic, phonemic, and phonotactic inventories to come up with a list of targets * Approximate number of targets: severe - 5 targets, moderate - 8 targets, mild - 10 targets * Targets selected by increasing one variable at a time (e.g. sound OR word shape), consideration given to homorganic/heteroganic nature of targets. * Targets selected are targets that are stimulable for correct production (practice makes permanent rather than practice makes perfect) * Exceptions made for “power” words e.g. child’s name * Consideration given to core vocabulary research in order to select high frequency words Dynamic Temporal and Tactile Cueing * Dynamic Cueing: follow a non-sequential hierarchy (max cues are added/faded within/across tx session) * Temporal Cueing: reduced rate for increased proprioception/pairing with prosodic elements * Tactile Cueing: Use of tactile (e.g. PROMPT) & gestural cues (e.g.Turtle Vowels) * Add & Fade Cues as each utterance is produced

Percent of CAS cases: 60

Parent Involvement:
   * During intake processes, our philosophy of TEAM based treatment is shared, with parents being primary team members. A 5-10 minute commitment to daily home practice is agreed upon to maximize progress * Parents are encouraged to be in the therapy room during therapy sessions * Parents are given words to target at home or in other natural functional environments * “Homework” is dependent upon parent-child success level with targets e.g. some families receive retention phase homework, while others are assigned acquisition phase homework * Homework assigned is as functional as possible * Attempts are made to incorporate homework into a daily routine in order to increase feasability of homework completion (as a parent, I know 5 minutes are hard to come by!) * parents are asked to join in therapy activities e.g. return demonstrations of work that will be assigned as homework * sessions are 1 hour in length, 45 minutes of direct therapy followed by 7-8 of therapy session feedback and discussion of homework with parent and child, 7-8 used to type a SOAP note that includes goals, data towards goals, and family homework

Parent Explanation:
   * typically following evaluation and/or a few diagnostic therapy sessions where discussion of execution difficulties have been discussed – e.g. XXX knows what s/he wants to say, but is having trouble physically making his/her mouth get those words out, even though his/her muscles are all working great * analogy e.g. light switch – electicity present, switch works, but connection may be impaired * focus on how fortunate we are that we KNOW this diagnosis, we have research, and we expect to see progress * lots of repetitions * time to answer questions * parents are asked to avoid Dr. Google and look at CASANA website

Community Involvement:
   * Continually mentor clinicians in the Northern Virginia area * Participation in Walk for Apraxia * Given numerous local talks, presented at the CASANA national conference, and produced webinars for CASANA * Offer parent support by phone, email, in person * Offer IEP support and advocacy

Professional consultation/collaboration: Yes

Min Age Treated: Birth (for feeding difficulties), youngest child with suspected CAS was a year old (multiple red flags including family history)

Insurance Accepted: No