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- Westwood Plaza, 700-76 Broadway, Suite 115
- Marina Vertleyb, MA CCC-SLP, Pediatric Speech Therapy
I start at the level where the child is, with the targets that are motivating, frequent, and give the child most control over the environment ( names, preferred items, food, activities). I start with direct imitation; visual, tactile, and verbal cues, which I fade gradually as the child’s mastery increases. Repetition is important and I structure my sessions to achieve multiple repetitions of target syllables, words, phrases. I use toys, games, repetitive songs and books, and movement to achieve this. Depending on the level of the child, I give the specific feedback and instructions (“big mouth”, “your lips were together”, etc). I utilize PROMPT training, Kaufman Speech Praxis Kit, and Moving Across Syllables program for my English speaking clients. I rely on the same principles when I develop treatment plans and materials suited for by-lingual (Russian-speaking children)
I recommend that parents look at the Apraxia Kids website as a great source of information. I continue to take continuing education courses to further expand my knowledge base on CAS.
I provide speech therapy in my clients’ homes. Parents are encouraged to stay with their child during the session or observe/listen in from another room. I reserve few minutes at the end of the session to discuss what we have worked on. I stress the importance of home practice, give “homework”, and give suggestions of games and activities to use during home practices. I may also help parents establish a more structured reinforcement system to ensure frequent practice.
I have used PECS, as well as voice output devices, such as Dynavox, GoTalk to facilitate communication and reduce frustration in children with CAS. I explain to the parents that “we are not giving up on speech”, and that the use of AAC will not prevent or stop their child’s speech development. Once child develops functional communication, the use of AAC will diminish naturally.