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- 176 Thomas Johnson Drive, Suite 203
- Community Speech Therapy, Inc.
My overall approach is to first help each child feel comfortable in session and become willing to trust me; in that way they are able to begin taking risks in attempting something they already know is difficult for them. For younger children, working speech production into play is great, then I move as quickly as I can into multiple repetitions of target words or phrases. The target words or phrases are developed with information obtained during dynamic assessment (knowing what syllable shapes the child can produce and moving toward additional shapes the child can have success with) and parent input for words or phrases that are of high functional use for the family. The key is to make it fun while working toward getting as many productions as possible during a session (to improve motor learning). It is also important to use a variety of prompts to make each child successful in saying something as soon as possible, which also improves their motivation to make attempts at speech. If the child is minimally verbal, I start with imitation of large and small motor movements, then work toward speech movements. In addition, parents are present and participate in each session, so they can help support their child in the session and reinforce therapy activities at home when appropriate.
I have primarily been involved in improving my own understanding of diagnosis and treatment of CAS. I have, however, made many contacts with school-based SLPs with whom I share clients. I have also gone to a preschool with the parent of a young child I treat with CAS to help teachers understand a little more about it and tips for supporting this child’s communication. I am working with the local Early Intervention Team to provide a presentation in the identification and treatment of children with suspected CAS. I would like to also do some presentations for the local school system, becoming a resource for the SLPs who have not had specific training in the diagnosis and treatment of CAS. If I am listed in the directory, I am hoping to become a local resource for SLPs and parents, so that parents will not have to travel so far to get the intervention they need for their child.
Parents are strongly encouraged to be present and participate in each of their child’s sessions, sitting right on the floor with us if that’s where we are! It is important to create professional-parent relationships whenever possible, and seeing first-hand the strategies used in treatment, then their child’s response to that treatment, helps them to be the best supporters of their child’s communication outside of the structured speech session. I have found that trying to explain the session to parents at the end is not nearly as beneficial as them actually seeing the strategies, and even trying to use them themselves, during the session. In addition, having a parent in each session allows ample opportunity for education about CAS, with the benefit of being able to point out examples of characteristics of CAS that their child is experiencing and things we want to avoid (segmenting words, i.e.). Parents are expected to complete therapy carryover activities at home whenever appropriate.
I have been involved in using multiple types of AAC throughout the years, although I have used mostly low-tech AAC, pictures and basic paper communication boards (while waiting for AAC device) and simple sign language. I have recently worked with the school SLP and the AAC specialist for the county in supporting the use of TouchChat on the IPad for a child, with the AAC specialist participating a session and collaborating regarding the best strategies to support AAC use for this child. It is important for the child with CAS to have some means of communication before and while speech production is emerging.