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- 7850 Vance Drive, Suite 250
- Laura M. Biegner, MA, CCC, and Associates
In the therapy session, assuming I have the child's attention, I typically start with blocked practice of the target and attempt to achieve as many accurate movement transitions/productions as I can, while varying the cueing as needed and providing specific feedback as needed. Cueing consists of visual, tactile and auditory models which are faded over time. Once a level of accurate motor performance is achieved, I mix it up and elicit spontaneous productions randomly to facilitate generalization of motor learning. When working with a child who can attend well, we practice and then reinforce after "sets" of targets have been completed. On occasion, I have needed to play after only a minimal number of productions have been achieved. I strongly believe relationships are the foundation of all learning, and the relationship between the child and clinician is a significant motivator behind optimal development and learning! Therefore, look for a clinician that is not only passionate but has a strong connection with your child.
I have participated yearly at the Walk for Apraxia in Arvada at the Arbor Lake location and I have also been a financial sponsor in the past. I have also attended the Walk for Apraxia in Denver.
Initially, I prefer the parent to observe the therapy session so they can learn how to cue and facilitate accurate target productions. I stress the importance of ensuring home practice is fun and typically send home easier more established targets for generalization mixed with a few difficult targets and reminding parents the need to have the child's attention at your face. Parents are encouraged to participate in the session to learn firsthand how to facilitate coarticulatory movements. They are given a list of targets , typically 5 -10, that can provide random practice of easier targets. In addition, I request specific practice of target movements and offer suggestions for eliciting these words at home.
I typically begin with teaching children ASL, starting with a beginning vocabulary of 5-10 words to see if the child is motivated . I have used PEC symbols, in the past. More recently I have used I Pads as well. Until speech intelligibility improves, these methods have been successful in supplementing the child's gestures , to decrease frustration and facilitate communication intent. With the slightly older child with CAS, I have seen strong progress with semantic relationships and developing syntax.