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- 3577 av Atwater
- Karen Evans Enr.
Treatment is planned based on assessment results. The child's inventory of sounds and syllable shapes plus their ecological use of these skills in communication inform initial treatment targets. Generally, sounds and syllables already in the child's system will be consolidated and expanded to choose word targets, and suggest achievable approximations for high incidence, motivating, important communicative targets eg. family names, desired toys/activities, social expressions etc. Emerging sounds are targeted in simple syllable shapes, and desired (stimulable) sound targets NOT in the system are targeted with maximum support. A support hierarchy is established from maximum-minimum to achieve accurate targets eg. cues (all syllable components) + simultaneous production + slowed rate to cues + mimed production + slowed rate all the way to spontaneous production with silent cues at syllable boundaries. The methods for presenting activities are based on principles of motor learning including: awareness of target, repetition, mass and distributed practice. The target vocabulary initially is limited, modified as necessary (i.e. successive approximations), multiple repetitions + supports. Activities are age-appropriate, engaging, socially and pragmatically useful for communication and support development of communication and play.
I have been working with children with motor speech disorders for +40 years. I have presented workshops and seminars in Canada since 1985, created a cuing system, assembled a descriptive assessment protocol, and developed many materials. As I am now 65, I offer small seminars and workshops and clinician case-based mentoring. In these emerging time of teletherapy, I will be expanding mentoring and seminar possibilities online soon!
Parents must be present for most of their child's sessions. Grandparents, educators, tutors can also be involved as discussed with the family. The emphasis is on establishing a team for the child to support speech in all life contexts.
I advocate the use of natural gestures, pictures, visual prompts and visual schedules, signing, and some AAC APPs to encourage and establish communication, particularly at the early stages of treatment and in the event of complex neurobehavioual diagnoses. The premise is that successful communication, regardless of how, begets more communication and supports efforts for verbal communication. However, my practice no longer supports severely involved children who may require more AAC knowledge and use.