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- Yorkville, Upper East Side
- The Speech Spark
In the beginning, the goal is any type of vocalization! I use windup toys, a microphone, a flashlight, any movement that will incite a sound. Then, I work to get that sound more consistent. For example, the child may be able to make "ahh", so then I use that sound "ahh" to make things happen for the child. This becomes the child's first basic mode of communication. I also introduce signs and pictures early on to reduce frustration. For example, for a child able to produce /m/, expanding that sound could be to ask for muh-muh (me) paired with a sign, for all desired objects. My goal is to show the child that he/she can communicate, even with limited sounds. I create language routines and repetitive sounds/phrases paired with their favorite activities to reduce the pressure. For example, for a child working on VC shapes, I repeat the word 'up, up , up' when having the man climb the ladder, up the stairs in the dollhouse, and a car driving up a ramp. I use highly functional words with sounds already in their repertoire if the child is verbalizing some sounds. My approach is highly child-centered to reduce frustration. Depending upon severity level, I use the same words (or syllable shapes) repeated over and over in the session. I choose syllable shapes to target based on Kaufman's hierarchy (CVCV, VC, CV, VCV, CV1CV2...). I use PROMPT when appropriate on my face or the child's face if the child allows. I also give feedback such as "the first sound is lips closed and the next one is a smile sound". I also choose targets based on PROMPT's Motor Speech Hierarchy (voicing, vertical plane, horizontal plane, combined movements).
I work closely with parents of children with suspected CAS. I have been PROMPT Level 1 Trained. I am active in Speech Therapy Facebook groups and leave feedback for SLPs and parents who ask questions regarding CAS. I am currently seeking training in DTTC.
Parents are an integral part of the therapy process. I speak with parents regularly on the phone and in person. I demonstrate techniques. All parents know the exact syllable shapes and target words we are working on. It is also very important to me to train all family members to accept communicative attempts to reduce frustration.
I have used many different types of AAC for children with CAS, including PECS, pictures posted around the child's house, modified sign language, and activity-specific communication boards. I used these to boost communicative attempts and social interaction, as well as to reduce frustration. I used the AAC to improve requesting as well as commenting during play. It has also helped to form sentences and phrases in minimally verbal children. For example, when playing with playdough the child could point to the pictures of 'roll' and 'dough' to form a simple phrase before they could imitate those syllables.