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- 24307 E. Fremont Drive
- Cherry Creek School District
Thematically, I prefer to anchor my sessions around a book. I love books to promote language, perspective taking, turn taking, and of course, as a vehicle to select targets for CAS! I find that shared book reading primes the child for a vocabulary framework and for scripts associated with the story's theme. From there, I'm fairly dynamic with my target selection, which consists of 5-10 words per session depending on the child's level. I always have a go-to list of targets appropriate and functional for the child at that time, but my favorite things to work on are things that come up spontaneously from the child and from the material within the session. Some target words will contain mastered syllable shapes with novel consonants, or mastered syllable shapes and consonants in increasingly complex phrases (e.g., length of syllables, contrasting sounds). Once produced correctly with cues, we will practice the word or phrase 5+ times using the principles of motor learning (i.e., varying the feedback type, structure of practice of that target within the session, etc). While I'm always listening for accurate prosody, I have the child vary their prosody once they're completely accurate with the word or phrase. If the child cannot produce the target with cues--and I use DTTC and some visual cues to bring the child to accurate speech movements--we will take a break from that particular target and work on something they are able to produce successfully with cues.
I am committed to learning more about CAS through research, discussion groups, and soon, in my participation in Apraxia Boot Camp. I will also be attending the Apraxia Kids National Conference this year and will make every effort to attend annually to remain attached to the community of SLPs who feel similar passion for working with children with CAS and with the families who rely on this support. Going forward, I would like to provide therapy to more children with CAS and to work with SLPs in my local community on diagnosis and treatment for their own caseloads. I attended the 2020 Virtual Walk for Apraxia in Denver and will be attending annually as part of the Apraxia community.
I think the first step of parent involvement is education and compassion. If the family, to include siblings, understands the difficulty associated with CAS, they may feel more empowered and hopeful for success, and so the therapy journey begins! Any speech therapy for young children benefits greatly from parent involvement. Parents are of course the experts on their children, but watching therapy sessions allows them to more deeply understand their child's communicative strengths and areas of need. They can see first hand what their child can do with the right supports. Parents help shape the therapy by collaborating on target selection and by completing home practice for target words the child can produce accurately. Practice, practice, practice!
I have primarily used light tech approaches to help children build their length of utterance with carrier phrases. If using high tech AAC, I consult with the family and SLPs who specialize in AAC to determine the best device and program for the child. We then use the device to build expressive vocabulary, social skills, and length of utterance, for example. The device provides an immediate avenue for multi-modal communication and a bridge for increased verbal communication.