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- 117 Oscaleta Rd
- Francine Ambrogio Gurtler & Assoc. LLC
Parents and caregivers must understand that progress will be slow but, with intensive and consistent therapy with an experienced therapist, their child will become a more effective communicator. As CAS is a multifaceted disorder, therapy must incorporate multiple modes of intervention. I use a combination of evidenced based therapies and adapt them to meet the skill level, and needs of the child. The overriding principle is to practice motor planning of the articulators moving from one syllable to the next. The child is introduced to a series of simple picture cards representing simple CV or VC words and then works towards building fluent connections between the syllables creating longer strings of nonsense syllables and real words. In addition, these sound/syllable combinations are practiced separately in sentences emphasizing prosody, stress, and rate of speech. Therapy must be engaging and fun and include the child’s interests. Depending on the age of the child songs and poems help improve rhyme. Older children enjoy “reward” time using apps or other online games.
Parents are therapy partners, providing the daily, intense intervention a child needs to meet the challenges of living with CAS. As such, it is important they become educated on CAS, learn the therapy techniques and compensatory strategies appropriate for their child, and, carve out time for daily, at-home practice.
I am familiar with, and have used Proloquo2Go but not with children diagnosed with CAS. There are several commercial apps that support therapy. I do incorporate tactile cueing with all children to help them connect sound production to a kinesthetic cue. The tactile cues are slowly faded until they are only modeled by the clinician or used by the child to help with motor memory. Also, depending on the age of the child and severity of the speech, I may introduce some sign language to help reduce frustration giving the the child some control and independence.