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- 2307 Felton Lane
- Chatter House Therapies
When working with a child with moderate to severe CAS, I utilize play-based and relationship-based therapy approaches to engage the child. Once rapport is established, I engage the child to develop consistent motor imitation skills through play (first through gross motor, then fine motor, then oral motor). I utilize principles from Dynamic Temporal and Tactile Cueing (DTTC) and engage the child in simultaneous productions of target words/sounds with varying speed, loudness, and intonation. If the child is unable to get the sound placement correctly, I utilize PROMPT cues to support the child in understanding the articulator placement. Once the child is successful at simultaneous productions, I reduce the level of support so that the child gets opportunities to strengthen those neural pathways. I always incorporate language concepts within speech activities so that I'm working on strengthening the child's language skills at the same time. Language skills are especially important because the child needs to understand specific feedback on their speech productions (I.e. big/small, fast/slow, lips apart/lips together). Language opportunities also provide the child with a chance to functionally use the target words so that the child may continually practice the target words throughout his/her day. I select the target words in consideration of the child's sound and movement repertoire, how functional the word is, frequency that the child may use the word, as well as parental input. I plan for each session with these two questions in mind: "What will be fun for the child?" and "What will the child learn?"
The majority of the children I currently work with have ASD and I see that many of these children also present with oral motor praxis challenges, which make communication that much more difficult. I hope to expand my involvement in the Apraxia community by being a resource to other SLPs, parents, and other professionals who work with this population. I also hope to continue my own learning path through these connections.
I encourage parents to be as hands on as possible in the child's therapy process. For parents with availability, I encourage them to be hands on so that they can learn the therapeutic strategies to help facilitate home practice. I may provide parents with direct feedback and support during the session. For parents who don't have the capacity to attend the sessions, I establish an on-going communication (via email) so that parents know what the child is working on and how they may help in the home environment.
Depending on the child's communication efficacy, I introduce AAC as soon as the child shows communicative intent but inability to use verbal speech. I explain to parents the importance of providing the child with a way to communicate, whether it be via spoken language or an alternative method. I've created and used low tech core boards, free communication apps, and high tech AAC such as Proloquo, Gotalk, etc. I build in multi-modal "communication" goals for the child at the same time that we work on speech.