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- 4103 N. 194th St.
- Beyond Words Speech and Language Therapy
Treatment should be individualized to the child. One treatment method may be appropriate for one child but not another. Typically, I approach treatment for CAS from a motor learning perspective, making sure to address linguistic aspects of the disorder as well. We focus on training muscle movements. I wrote a workbook containing targets for specific muscle movements (i.e., CVC targets bilabial sound to alveolar sound, CVCV targets velar sound to palatal sound). I utilize tactile cues, visual cues, visual cue cards, and phonemic cues. The child and/or child's parents and I brainstorm a list of words specific to the child to target as well. This list would contain names, favorites, common requests, and anything the child might need to say on a frequent basis. Whether or not I use massed practice/distributed practice/knowledge of results/knowledge of performance depends on the accuracy of the specific target. Each child is different as is their accuracy of individual targets. Each treatment session requires a mini evaluation of the child's performance to determine where to address targets as well as what cues and treatment method to use.
I enjoy reading current research on apraxia of speech. I try to focus my CEU's on apraxia of speech as well as several other areas of interest. I frequent CAS websites such as this one, have written grants for AAC devices for current patients, and attend CEU events related to apraxia of speech. Recently, I wrote a grant for a patient to receive an AAC device from a local club. The club had never heard of childhood apraxia of speech. I was excited to educate the members on the topic. They received the information enthusiastically and awarded the child the grant.
Parents are strongly encouraged to participate during sessions. I tell parents that I try to be as transparent as possible during therapy. I explain what I am doing and why I am doing it. I have them practice techniques during the session so they can implement them at home. Parents are asked to assist in daily practice of mastered targets. Parents are also asked to monitor progress at home and report any successes and/or concerns.
There are many ways to use AAC in CAS treatment. I have used picture cue cards to assist with home practice. I have used low tech communication books to decrease frustration and communication breakdowns in the home. Recently, a family and I brainstormed a list of words/items/people that the child used frequently. I created a communication book for him. We learned the pictures and practiced communicating with the book without communication breakdowns so he could quickly resolve a breakdown when it occurred. I have had patients use dynavox communication systems, iPads, iPhones, and other type-to-talk devices. I make sure that the device fits the patient and that the patient is able to quickly and easily access words/phrases. Devices can be used to solve communication breakdowns, be a patient's primary means of communication, or help train speech targets.