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- 7511 Turner Ridge Road
- TLC Speech Therapy Services
Once a thorough evaluation is completed, therapy targets are identified. Targets are chosen based on stimulability and sounds within child's repertoire, core functional vocabulary, present levels of performance, ease of production, and targets that impact intelligibility the most. THere is no "one size fits all" because each child has different traits AND different needs. Sounds, syllables, multisyllables are practiced with successive approximations using a variety of strategies: backward chaining, multi-modal cueing with visual, tactile, proprioceptive stimuli - high frequency of repetition and fading the cues needed for success. Targets are built around a functional vocabulary that maximizes child's ability to communicate effectively. SIgns / gestures / assistive communication is used as needed for a 'bridge' to allow success in communicating with others. Syllable chains are practiced initially with reduplicated phonemes, then progressing to differentiated phonemes. Therapy targets progress from words to functional phrases and sentences. Natural routines are built into sessions to facilitate easier transition / carryover. Family keeps notebook with practice work; phonemes always have a visual cue and a visual picture for association (ie 'K' is the coughing man). Sessions always begin with a 'drill' that child can be very successful with. Verbal routines are always built into sessions - something that child can routinely say at home and in multiple environments. Building it in to the sessions allows for numerous repetitions and success prior to going home. Examples of this might be "counting to 5" or "I can do it."
My youngest child had apraxia of speech - 25 years ago - when we really did not hear of CAS. He began speech therapy at 18 months of age. I learned more from working with him than I did in all of my undergraduate work combined. The strategies that I developed became "part of who I am as a therapist". I instinctively apply many of those strategies to clients who do NOT have apraxia, because I find that all my 'speech challenged kids" benefit from them. Most of my private therapy apraxia kids are referred by 'word of mouth'. I believe a big part of my job is not just teaching these kiddos to communicate, but also educating the parents and teaching them how to "facilitate" a communication environment with their child.
Parents are always invited to sit in on sessions; specific homework is given that has been practiced successfully in therapy sessions; specific verbal routines or "words for the week" are practiced repetitively in the home environment in natural routines
Most AAC used has been low tech in the form of picture schedules, picture menus, PECS, etc. These are used as a bridge, just as sign is used to facilitate success with the child's communication.