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- 50 Main St., Unit 4101
- Michelle Turkoglu
First, I want a child to know that "therapy" is fun, exciting and that he or she is safe/secure. I also want the child to be aware of what will be expected of them and this can be relayed through explaining or through visuals.
Depending on the child's initial level of speech skills, a well-organized, hierarchical approach would be developed. For example where to start and how to progress through the Kaufman Speech Praxis kits. Determine how to move from sound & syllables to multi-syllable structures and then to phrases, sentences, etc. It will also be helpful to know what will be most helpful/functional for the child's communication needs (depending on parent/teacher input and the child's interests).
I truly believe that multi-sensory approaches work best. I incorporate PROMPT technique and other tactile/visual supports (mirrors, tactile cues, mouth pictures or hand cues) for how to make sounds. It sometimes takes time to see what is most helpful for each child.
Children with CAS need LOTS of practice and repetition. Play based activities where we can practice sounds or syllables in repetition are often used. Using words or approximations in context is helpful. One of my favorite activities is doll house play. Easy syllable structures are abundant and can be said over and over again ("ma" or "mama", "dada" or "daddy", "baby", "go", "ca" for car, "weeee", etc.). Using Kaufman Cards and in more structured tasks as well as being incorporated in to play/games. Parent-training and specific "homework" can really make a difference is speed of success.
I've attended a few apraxia seminars and have treated many children with CAS. I refer people to the apraxia-kids.org web site for good, accurate information. I consistently check in with other professionals, ASHA, and apraxia websites for up-to-date information.
I always ask for parent input in terms of what they think is improtant for their child. They are also a good source of information for words that their child uses consistently and which words/approximations the child should learn first so that they can be the most successful.
Depending on the setting and the parent's availability, I will have parents watch therapy when possible. I ask them to practice certain words or syllable structures in play at home. If they can't be present in sessions, a communication log of some sort is given to talk about what we are working on and the progress being made. Homework practice/worksheets can sometimes be given for practice at home.