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- Jennifer
- Maietta
- 275 Cambridge Street, 3rd Floor
Boston
Massachusetts
02114
United States - Mass General Hospital
Boston
Massachusetts
02114
United States
My therapy sessions may look like they vary significantly across children because I work hard to take individual interests, executive functioning, and sensory needs into account. One child may need and want lots of motor movement and excitement, while another may be happy to add stickers to a page. However, the underlying components of my intervention are the same across the children I treat with CAS. I am always using the principles of motor learning, aiming for high repetitions, selectin whether practice should be repetitive or random, providing feedback that improves learning or generalization (depending on the child’s skill level), and varying production of words (changing intonation, volume). I choose words that are important to the child and use my knowledge of the sounds and words that the child already says to refine target selection. I use a lot of cues to encourage them to look at my mouth and copy my mouth movements. I love to celebrate each win with the child and family, whether that be with a quiet high five or a mini dance party.
I have been working with children with apraxia my entire professional career, always learning more and adjusting my approach and methods each step along the way. In 2017, I was fortunate to attend a two-day course with Dr. Edythe Strand in Boston, which truly leveled up my practice. In 2019, I was accepted to undergo training through the Apraxia Kids Intensive Training Institute, and while I was unable to attend the training due to a variety of factors, I did participate in a monthly journal club in 2020-2021 with the Apraxia Kids instructors which I found invaluable. Working at an academic medical center, I conduct many evaluations for families looking for more information about why their child’s speech development is not progressing as expected. Referrals for evaluations to rule in/out apraxia tend to come from pediatricians, neurologists, and other speech-language pathologists in the community. I evaluate and provide treatment for children with CAS as their primary diagnosis, as well as children for whom CAS is a component of a neurodevelopmental disability or genetic syndrome.
Caregiver involvement is critical for optimal progress. Most caregivers sit in on every session and provide input for target word selection. I also train caregivers to carry out home practice when possible, which is particularly important if a child is unable to receive the optimal frequency of therapy.
I recommend an AAC evaluation for all children who receive a CAS diagnosis, and I emphasize to caregivers that use of AAC does not inhibit speech development. In my practice, I aim to provide aided language stimulation whenever possible, and encourage families to do the same. I have access to a high tech options (tablet with TouchChat, GoTalkNow, TD Snap), a mid tech option (QuickTalker with Feather Touch), and a low tech option (i.e., Flip N Talk). Even if we are not actively using the system, I make sure it is present in order to stress its value and importance. Additionally, while I honor American Sign Language as its own language and not a form of AAC, I do have strong basic sign language skills and use them with children who use signs to communicate.