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- 826 Westpoint Parkway, Suite 1200
- Cleveland Clinic Children's Hospital for Rehabilitation
I implement a child centered approach and apply the principals of motor learning to my patients with moderate to severe CAS. The initial sessions focus on building rapport and gaining the child’s trust. Since children with CAS struggle to produce spoken language on command, I feel that it is extremely important that they trust me and don’t feel pressured. I aim to build the child’s functional communication skills as well as expanding their repertoire of sounds and words/word structurers using a multi-sensory approach and dynamic cuing. I used a variety of evidence based practices to increase sound repertoire and syllable shapes as well as focusing on increasing the child’s confidence.
My involvement in the apraxia community has advanced during my 16 years of practice. I have continuously increased my knowledge of CAS through attending in person courses as well as staying up to date on the most recent research on both assessment and treatment of CAS. I am a member of my facility’s CAS team, which consists of therapist who are highly trained and experienced in assessment and intervention. I was personally trained by a therapist who is recognized by Apraxia Kids for Advanced Training and Expertise in Childhood Apraxia of Speech. I have provided CAS mentoring to SLPs at my facility and will be presenting an in-service to our staff this fall along with the rest of our department’s apraxia team. I have also participated in the Apraxia Kids walks.
During the initial evaluation, I ask the parents/caregivers to share their functional goals for the child. I use their input as well as the information gathered from my assessment to shape functional communication goals for the child. Parents/caregivers are encouraged to be present for an actively participate in treatment sessions whenever possible. I also provide the option of observing through an observation room when scheduling and space allows for it. I feel strongly that parent involvement is essential for implementing home programming, providing consistent cueing, and generalizing therapy techniques into everyday life. Session progress and feedback is shared with the family at the end of the session and home exercise programs are reviewed each session.
I have used both high and low tech AAC as a bridge to spoken communication. I try to incorporate AAC before the child starts to develop any frustration surrounding expressive communication. I do find that buy in from parents is often an obstacle as they feel that the child will rely on the AAC and not develop spoken language even though I present them with evidence that supports the opposite. I explain to parents that the use of an alternative form of communication teaches the child “how” to communicate and the social aspects of communication such as turn taking, waiting, etc. I explain that once the child develops words the child needs to know how to use them and AAC helps with that early on. The goal is always to use the AAC as a temporary form of communication that would fade as the child develops functional spoken language; however, in the event that the child does not achieve the level of spoken language they are left with a form of communication.