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- 4102 North Roxboro Street
- North Carolina Eye, Ear, Nose, & Throat
I believe in using all modalities to help children with CAS. I draw from the PROMPT approach for analyzing the motor speech system and determining the levels of breakdown and I also incorporate the principals developed by Nancy Kaufman in the K-SLP. I believe PROMPT is very useful in looking at the motor system as a complex, interconnected system including tone, phonatory control, mandibular control, labio-facial control, lingual control, control of sequenced movements, and prosody. With the jaw as the foundation of the motor speech system, more precise speech movements can be developed by achieving stability and control of the jaw. When a child begins to develop more volitional control over the jaw for open-close, close-open-close, and close-open patterns, it is important to begin to integrate variety in vowels and anterior lingual sounds. Correcting errors with vowels is important in supporting improvements in overall intelligibility. I utilize pivot phrases to increase MLU for children who want/need to speak in more complex utterances while developing and teaching the highest possible successive approximations for favorites and high frequency words to maximize effectiveness in conversation. I use visual and tactile cues and supports to maximize motor speech control. I believe in making tasks functional to help with carryover and generalization in addition to shifting from blocked practice to more varied tasks to allow for more flexibility. I believe that various forms of augmentative communication can be effective to bridge the gap between expressive language and motor speech control for children with CAS. I have children using sign language, communication books, apps on iPads, and dedicated communication devices to support their language complexity and maximize their social and educational opportunities while continuing to address motor speech control. It is important to remember that speech is difficult for children with CAS, and it is essential to find activities to make sessions rewarding and motivating for these children.
I have participated in and promoted the local Triangle Walk for Apraxia in my community. I have also helped families of children with CAS in my clinic by developing networks for support and education throughout the journey.
Families need to be involved in the therapy process so that they can help to facilitate carryover in the home through conversational monitors and customized, evolving home programs. It is important for parents to understand the short term goals and how these connect to long term changes. Parents should participate in therapy sessions to have models for techniques and approaches to utilize when appropriate in the home environment. It takes a devoted, united team to "beat" CAS.
I believe that various forms of augmentative communication can be effective to bridge the gap between expressive language and motor speech control for children with CAS. I have children using sign language, communication books, apps on iPads, and dedicated communication devices to support their language complexity and maximize their social and educational opportunities while continuing to address motor speech control.