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- New York State
- Marissa Magro, M.S.Ed, CCC-SLP
Following assessment and conclusion of a diagnosis of moderate to severe CAS, I spend time to educate the family about the diagnosis and provide resources. We work together to create a list of functional and motivational therapy targets that are important to the child and family. At the onset of therapy, I would select approximately 5 of the listed targets that contain sounds and/or syllable shapes that the child is already able to produce successfully. I structure my sessions around play that is engaging and motivating to the child; within play we I initially use mass practice to obtain many repetitions of the same target word(s) throughout the session. In order to obtain accurate trials of therapy targets, I implement principles of motor learning and use the DTTC approach within which I use a hierarchy of cues. In addition to the DTTC hierarchy cues, I use a variety of tactile kinesthetic, visual, auditory, and metacognitive cues. I am able to utilize my training in PROMPT to support tactile cues when necessary and when the child and parent(s) feels comfortable with a hands-on approach.
My involvement in the Apraxia community is evolving and growing as I grow as a clinician. I have been completing extensive continuing education opportunities and participating in Facebook groups for families of children with Apraxia for the past year and a half. It’s very important to me to gain as much knowledge as I can in order to best educate, empower, and support families and children with Apraxia. I also make an effort to provide education to other providers, including SLPs, OTs, ABA therapists, teachers, etc who may be involved in the child’s care. As I continue to grow as a therapist, I would like to increase my community outreach by providing consultations, presentations, and organizing local activities to increase awareness and provide support to providers, the community, and most importantly to families and children with Apraxia.
Parental involvement is an essential component of the therapy process. I keep parent education and coaching at the forefront of my process and work to empower parents with knowledge of CAS, as well as with strategies to support their child’s growth and success. Parents are involved in the therapy process from the very beginning by helping to create a target list of meaningful and functional words and/or phrases to address in therapy. If a parent is not present for a session, each session is reviewed in detail with the parent, and home practice is provided if appropriate at the time. Additionally, I love to incorporate AAC into the process whenever possible in order to provide the child with a means to repair communication breakdowns, reduce frustration, and increase communicative confidence. I encourage parent observation and training in utilizing an AAC system.
I really love to incorporate AAC into my therapy approach for children with CAS. I explain and discuss the usage of AAC with parents of children with CAS very early in therapy. I explain the different types of AAC (low-tech and high-tech), the benefits of incorporating AAC, provide demonstrations using a variety or combinations of AAC, and ask for parent input regarding feelings towards utilizing AAC. I have families who are uncomfortable with a high-tech device, so I offer various other options until we find something that works for the family and child! I consistently incorporate AAC into therapy sessions, even if I am simply modeling the AAC without expectations for the child to use it. I think it’s important that children are exposed to a variety of means to communicate in order to empower them to communicate in whichever way is most appropriate for them.