I use Dynamic Temporal and Tactile Cueing (DTTC) when treating children with CAS. I start with simultaneous productions with tactile cues at a slow rate within mass practice. My tactile cues are similar to what is taught in PROMPT, but can change depending on what the child responds to. These cues assist in attaining “starting positions”, “ending positions”, and jaw stability. As correct production continues, I take away my voicing and mime the word while the child produces it, still using tactile cues. I will fade my cues as long as correct production continues. If the child produces the target incorrectly, I will go back to simultaneous production or direct imitation. I also vary the practice of the target, knowing that I am creating a new motor plan. We will start in mass practice, and eventually change the prosody, stress, and rate of the target and increase the level of complexity. This not only means moving to a functional phrase with the target, but practicing the target within blocked, distributed, and random practice.
I have encouraged and supported my clients in getting involved within the Apraxia community. I hope to reach more families and provide them with the appropriate diagnosis, treatment, and support in order for their child to improve their functional communication skills.
Parents are very involved in my therapy sessions and assist in choosing targets. Parents also receive hands-on learning in how to support their child's speech development outside of speech therapy sessions and a home program is provided.