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- Berneche Stiles
- 63 Ridgewood Terrace
- Jennifer Berneche Stiles, private practice and Cooley Dickinson Hospital
1) Establish rapport and expectations of treatment (focused therapy followed by short breaks). “Integral Stimulation”: Look, Listen, Do what I do introduced in first session.
2) Visual Touch Cues: Introduced and utilized from first session to assist in helping child see and feel the target speech movements. Cues shared with family and school.
3) Frequent drill and practice, focusing on movement sequences, with immediate specific feedback. Carryover suggestions provided at each session.
4) Target several skills at one time to allow for better carryover. Test of Syllable Sequencing Skills utilized as a starting point for this. ‘Syllable Drill’ cards utilized to address 2, 3 and 4 syllable words and vowels targeted with Marshalla’s place cues.
5) Progressive approximation, shaping current production to closer approximation of target.
6) Prosody is focused on using rhythm (tapping/clapping out syllables) as well as melody/song (“Time to Sing”) and repetitive text books (Brown Bear, Brown Bear).
7) Expressive Language skills are worked on during play as well as using tools such as “Build a Sentence”
I have accessed the various websites, asked questions and contributed thoughts. I have also been an advocate for many of my patients, writing letters to insurance companies to support continued treatment. I have attended IEP meetings with parents to advocate for school-based support of CAS, and finally, I have educated speech assistants, parents, insurance companies and teachers about CAS.
1) Parents are encouraged to attend every session.
2) Parents are trained to use Visual Touch Cues
3) Parents are educated about the systematic approach of treatment, as well as the importance of having reasonable expectations
4) Carryover suggestions provided following every session with the goal of gaining multiple repetitions of target movement sequences (e.g. Play with puppet and food and repeat “yum, yum, yum” a variety of times throughout the week)
5) Carryover suggestions also provided regarding how to focus on prosody in the home setting (e.g. play with toy animals and practice using low and high pitch)
6) Encourage parents to break up more intensive practice session (e.g. 5-10 minutes of focused work on flip book, moo-baa-whoa, followed by a short period of language stimulation/play)