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- 66 Rowe Ave.
- Nicole Guttman SLP PC
My overall treatment approach for childhood apraxia of speech is child specific and varies according to each child's cognitive skills (i.e. attention, learning, comprehension) and behaviors (i.e. cooperation, frustration level, strengths, needs and specific interests). Trust is of utmost importance and each child needs to feel secure and supported. Family members are made to feel included in the sessions as well as in goal implementation. Consistent education as well as ongoing activities for home carryover is provided for a successful team approach. I utilize a variety of multi-sensory cues and input (i.e. visual, verbal and tactile) during play-based sessions. These cues are faded in type and intensity over time as the child progresses. It is important to note that no one treatment is best for all children and that choices need to be based on severity, age and associated deficits. One technique that I utilize is the PROMPT technique, a tactile-kinesthetic-proprioceptive approach to speech therapy that provides input to the neuromotor system to guide movements of the oral musculature that is utilized for speech sound production. Another treatment approach that I utilize to incorporate the principals of motor learning is Dynamic Tactile and Temporal Cueing (DTTC). The principals of motor learning for repetitive motor practice are performed throughout the session. Each child practices movement sequences in different contexts and conditions to facilitate motor learning. Specific and age level feedback is always provided. My method of treatment to improve motor speech learning will change as your child's speech changes/progresses.
Over the past few years I find that I have more and more children with CAS or suspected CAS (children younger than 3 years) on my caseload. I continue to take continuing education courses to further expand my knowledge base on CAS. I subscribe to several Facebook groups for CAS where clinicians and/or parents can discuss issues/concerns and provide education and links for new and significant research material. To stay current, I continue to read updates on both the ASHA and Apraxia Kids websites regarding CAS. I also refer patients and families to these sites as well.
Starting from the time of the initial evaluation and throughout the course of treatment, my job is to always make parents feel at ease. Parents are encouraged to ask questions and voice their concerns regarding their child's communication at any time. I believe a team approach starts from the very first contact. Following the initial evaluation, all diagnostic results are reviewed with the parents. The diagnosis of CAS and other concomitant language disorders (receptive and/or expressive) if applicable are explained thoroughly as well as my rationale for specific therapeutic approaches. Family members are made to feel included in the sessions as well as in goal implementation. Consistent education, feedback as well as ongoing activities for home carryover are provided for a successful team approach.
My experience with AAC has mostly been with use of low tech communication boards with letter and picture symbols as well as use of iPads.