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- 1055 Cornell
- Autism Collaborative Center
I like the family to be very involved throughout the course of treatment. I have them doing parameter prompts if applicable as well as using the same terms and performance feedback at home that I use in therapy. Ex: make your popping sound! (/p/) I try to always start with a sound or oral position the client can do successfully and consistently on command. I move up from there based on stimulability, typical developmental milestones, client motivation and family input. I try to follow Kaufman's syllable shaping protocol she uses on her Apraxia cards moving from the front to the back of the mouth and through the developmentally appropriate phonological processes in order to build syllable shape and successive approximations.I think it is very important to use a variety of prompting techniques as well. I use verbal feedback, gestural prompting, tactile PROMPTing, as well as video modeling within my therapy activities. I always try to embed my therapeutic activities within a game or fun activity to keep my clients motivated and to get as many trials in as possible.
I am looking forward to being more involved in the Apraxia community. I work at an Autism center so I find myself being more involved with that community but as I practice longer and longer I feel that more kids with Autism have some motor-planning difficulties. I think there is so much knowledge to share and learn when working with other SLPs who have experience working with kids who have CAS.
I require parents to be present for individual sessions as much as possible. As long as they are not a hindrance to therapy, I prefer parents in my actual treatment room. I want them to see exactly what I am doing and often ask them to practice the set of skills I will be asking them to do as homework. I like them to feel that they have the ability to ask questions in the moment and hear the terms and feedback I am using to provide consistent feedback at home.
I use communication apps on the iPad such as TouchChat and LAMP to help support my young clients with CAS. I always have goals that address verbal production/motor planning as well as increasing the use of AAC. I focus on using core vocabulary that the client can use in a variety of settings and with a variety of listeners as well as very motivating/functional vocabulary. I feel that implementing AAC early on in therapy is really supports the confidence building that needs to be done in so many of our CAS clients. I also feel that it helps reduce anxiety when they know they have a modality that they can successfully use to communicate even though verbal communication may not be easy. I try to make sure that there are vocab words on the iPad that match the syllable structure that my client is addressing. Example: If my client is just starting to produce vowels and we are working on producing a variety of vowels verbally including 'ah', 'uh', and 'oh' then I would make sure the vocabulary on the iPad included such words as 'on', 'up' and 'open' so we could take those vowel sounds and turn them into functional words on the iPad.I also use a variety of visual supports including a printed core vocabulary board, pictures of materials, first-then schedule as well as a complete visual schedule.