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- 274 Union Blvd. Suite 103
- Therapies of the Rockies
When first getting started: I interview parents to establish core word list, including: favorite foods, best friends & family members' names, favorite toys, favorite TV shows/movies/characters, favorite places to go. I consistently update this throughout treatment progression. I target core functional words, including an emphasis on early developing sounds.
During treatment sessions: I use a motor-learning based approach. I primarily use DTTC principles, incorporating tactile & gestural cues, choral production, immediate/delayed repetition of targets as accuracy increases. I ensure a high number of trials in each session: goal is 100 productions per 30 minute session. I incorporate speech sound targets in play to facilitate engagement, as well as functional use of targets
I graduated from University of Wisconsin-Madison in 2015. As a clinical fellow, my direct supervisor was a specialist in CAS, and I quickly developed a love for treating this disorder. One of my first patients I ever treated as a clinical fellow had been diagnosed with severe CAS one year prior, and had made little progress. I quickly dove into the literature to learn more about best practice for treatment. A year later, this child has made incredible gains and continues to blossom with each session. Since then, I have completed continued CEUs to deepen my knowledge and have increased my caseload in this area. My company is involved with the Apraxia Walk in Denver each year, and it has been a great pleasure to be able to make a difference in the lives of my patients and their families.
Parents are highly involved in the therapy process. From early suspicion of CAS, I begin providing education re: what early signs I'm seeing that may point to a difficulty in motor planning for articulation. During the evaluation process, parents are an invaluable resource. They have the greatest knowledge regarding the child's history, current speech abilities, and knowledge of how they perform across environments (home, school, etc).
After identifying a child as presenting with CAS, I schedule a full session where I can provide education to the parent about how they performed on the evaluation, what a diagnosis of CAS means, and how the treatment approach works. I closely include parents in treatment planning, from organizing core word lists, to teaching parents about cueing for purposes of home practice, and developing home carryover plans.
In the early stages of speech therapy for children with CAS who have significantly decreased intelligibility and/or very few words, I incorporate use of signs to help as an early bridge to communication. I have found that this is incredibly helpful in decreasing communicative frustration in young children. I have also seen use of signs helps during the bridge to verbal communication as children can SEE the way that communicative acts influence their environment.
I have also previously used PECS-type systems, for children who are resistant to use of signs. These systems have been quite simple, generally focusing on preferred toys and foods.
With school-aged and older patients with CAS, I have also had success with use of speech-generating apps on the iPad to facilitate communication with less familiar listeners using core phrases and for use during communication breakdowns.