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- Madrigal Street
- Wave Speech Therapy
The goals of therapy will focus on communication and not just speech production. Principles of motor learning will be utilized. Goals will focus on movement sequences with coarticulation being critical. Specific goals will work to expand the syllable inventory and phonemic inventory. These goals should always relate to functional language by choosing appropriate vocabulary and phrases. Targets should focus on increasing vocabulary, syntax, and social interaction. I will always include prosody, voicing, and rate in each of my sessions so that we can start targeting that early not waiting until they are speaking at a conversation level. Multi-modality cuing will be utilized through visual, auditory, and kinesthetic.
Each session might start with a direct imitation of 5-10 target words/ phrases. If child is successful in imitation we will move to practice with varied rate/prosody, delayed repetition, and then generalization. If the child is not successful with imitation we will do simultaneous production, slowed rate, or tactile, gestural cues.
I have previously worked primarily with children under 10 who present with Apraxia of Speech. I have worked in our local hospital which has been able to support children across neighborhoods with a variety of backgrounds. If listed in the community, I hope to be able to reach more children who need a specialist in CAS as well as support other SLPs in the community who may need mentoring.
Parents are directly present for each session. Parents help choose vocabulary or phrases. Parents provide weekly check-ins about real world progress and areas of difficulty. Parents are taught direct multi-modality cuing utilized for the specific patient. Parents will be a huge part of deciding when/ if an alternative/ augmentative communication should be utilized. A specific home program will be tailored to the parent child's needs and limitations. Ideally, I would like the family to provide carry-over multiple times a day for very short bursts.
I have used both high tech and low tech for children with CAS. Children who have severe CAS often with underlying medical conditions who may show very slow or limited progress with speech production may benefit from a high tech device such as the Proloquo2Go or a Dynavox. Specifically, these can help to maximize the output of a child who has expressive language skills higher than speech production skills. Within the therapy setting I can specifically help to make sure the child has functional speech capability with their device. Speech targets within the device can be utilized as therapeutic prompts for speech output. For example, if the child is working on CV syllable shapes with bilabials a word list of functional words on their device could include verbs and nouns with this target (i.e., ball, bath, play, more, mom). Low tech devices such as PECS or other communication board can be used similarly for children who are most likely not going to need AAC long term. These targets can be selected to include the speech goals and targets the child is working on .