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- Wayne - Houtz
- Independent - New York City Early Intervention and Committee on Preschool Education
For a child with moderate to severe CAS, we (meaning myself as well as the child's family) will start with a small target list. We will use the sounds the child already has in his/her repertoire, and the family will also provide a few words that are functional, as well as motivational, to help create this list. The syllable length that is achievable will also be taken into consideration. Possible words include "mom/mommy," "dad/daddy," and the child's name. I always tell my parents, "slow and steady wins the race." This also helps to improve a child's confidence in being an effective communicator. As things are mastered, we will move up the totem pole (i.e., "eat" --> "eating", small phrases, etc.).
Therapy will consist of multiple practice trials of the same word. Multiple repetitions will be encouraged as they are necessary to help treat CAS given it is a motor planning disorder. Activities will be chosen by the child/whatever is most motivating for them. For example, if your child likes the ABC's, there are 26 trials right there! DTTC is my main strategy approach, incorporating tactile cues/PROMPT into it if the child is receptive to it.
I will participate in the Walk for Apraxia. I also follow various apraxia accounts on social media and am willing to answer any questions/chime in on those forums.
Parents will be encouraged to observe and participate in the sessions to help carryover the work at home. This includes demonstrating/teaching parents how to provide a child with tactile cues outside of the sessions. I'll also provide the parents with ideas, using everyday items and activities, to help their child get multiple repetitions/practice of the target word(s) in per day. Parents/family members are always encouraged to reach out with questions outside of the sessions should they arise. Additionally, I always tell parents that while it is ok to say a word slowly, to never segment (i.e., cookie -- "coo (pause) kie") as CAS is a movement disorder and we need to work on those coarticulatory movements.
I have not used AAC for children with CAS.