My therapy approach aligns with the principles of motor learning. I schedule therapy to occur frequently (3+ times a week) for 30-minute sessions (i.e., distributed practice). I also recommend families practice skills at home at least 5 days a week for 15 minutes daily. Within therapy sessions, I choose activities that are motivating and geared towards the child’s interest but intended to keep the child’s visual attention on the therapist’s face for optimal learning outcomes. The targets/words chosen for each session are specific to that child’s individual skills and practice of these words is focused on sequencing of sounds (not the individual sounds themselves). Target words might contain novel sounds within syllable shapes the child can make and/or novel syllable shapes containing sounds the child can already produce. New words are typically practiced in repetition (i.e., blocked practice) at first, but with the goal of moving towards random/spontaneous practice as accuracy improves. The number and variety of words practiced will also increase as the child progresses in therapy. The types of cues and supports will vary by child, but some consistently implemented strategies include use of tactile and gestural cues, visual cues, moving from simultaneous imitations to spontaneous productions, and moving from specific feedback on performance to more general feedback on results. My overall goal in therapy is to help children make functional gains towards speech motor planning and to promote independence, confidence, and caregiver involvement throughout every step of the process.
I’ve been working with children who have Apraxia since 2015 and my interest in working with this population has continued to grow over the years. My involvement has primarily included keeping up on research from ASHA and completing continuing education provided by experts in the field. In the most recent years, I’ve been delving into the Apraxia Kids community through connecting with parents and professionals on the Facebook group pages and reading through educational resources on the website. I am committed to continuing my learning in this area so that I can best serve my clients with Apraxia!
Caregivers play an essential role in their child’s Apraxia journey. I encourage parents to be active participants in each therapy session (e.g., taking notes, jumping in on an activity for hands-on practice). Throughout the session, I educate parents on the rationale for the targets, cues, and activities I am using. At the end of each session, ideas for home programming are shared to promote carryover outside of speech sessions. My goal is for caregivers to feel comfortable and confident in their ability to work with their child at home. Caregivers add valuable insight into how their child is generalizing skills and their consistent implementation of home programming ultimately facilitates progress and independence. I believe caregivers are our best teammates when it comes to treating communication disorders!
I consider AAC needs when children with CAS are severely impacted by the disorder (e.g., unintelligible to a trained listener at the word level), are making slow progress in therapy and appear frustrated by their failed attempts to communicate with others, and/or have other impeding diagnoses (e.g., Autism) that make attending to and learning speech sound patterns through direct therapy challenging. In these scenarios, I use AAC to supplement communication while I work with the child towards improving speech production simultaneously. I would consider my knowledge in AAC to be a relative strength as I regularly complete AAC evaluations with my current school-based caseload. My evaluations and therapy include use of low-tech (e.g., PECS, CoreBoard), mid-tech (e.g., GoTalk, TechTalk, BigMack) and high-tech (e.g., TouchChat, LAMP) AAC systems. Therefore, if a child with Apraxia appears to be a candidate for AAC, I feel confident in finding a system that works best for them.