My overall approach is to use the skills the child already has to strengthen the areas of weakness. As the areas of weakness become stronger, the supplemental modes of communication (e.g., AAC) can be faded. For example, a child with strong fine-motor skills and receptive language skills, I will integrate a visual supports and/or AAC to supplement his/her speech skills. In addition, I strive to individualize my treatment to the child's specific interests and goals, as well as the family's. For example, if a child has an interest in sea animals, I would work integrate the names of some sea animals into therapy that match the child's phonetic abilities. In addition, I would talk to the family to integrate functional words that are important to the child accessing their daily routine. The long-term goal in my treatment is to increase a child's independence, where they rely less and less on adults and aided supports and can more independently communicate their needs and wants.
I regularly completed Apraxia assessments and consult on complex cases as a consultant for the state of California. In addition, I am a guest speaker across northern California teaching experienced SLPs how to accurately diagnosis and treatment Apraxia in children.
I save a portion of the session for parent coaching, where I will demonstrate a strategy and then have the parent try the strategy while I provide them with feedback. I may even videotape the parent so that they can watch it at a later point to analyze and learn from.
I use AAC to supplement a child with CAS's communication, with the goal of using a multi-modality communication system, where AAC, whether low-tech or high-tech is only one component within the overall system. For example, I may integrate the use of low-tech AAC (e.g., BIGmack switch) to facilitate the child's ability to expressively label items or produce verbal greetings (e.g., "good morning") that are unintelligible or use photo icons (e.g., actual photos on a communication strip/board or on an iPad app) to make choices related to a specific activity (e.g., things you eat, things you play with).