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- 421 N Bethlehem Pike
- Medley & Mesaric Therapy Associates, LLC
First and foremost I establish rapport with the ids and a routine in therapy. My clinic uses a "circuit approach" in sessions in that there is a mix of structured tasks (at the table) and less structured tasks (in play on the floor) to help generalize table top skills.. Because we specialize in children and adolescence who have an ASD diagnosis, working on strengthening their social engagement skills is critical to being able to successfully do motor speech work. Clients who have an apraxia diagnosis have goals that target their motor speech deficits written in treatment plan. Data is taken every session and progress is reviewed every 3-4 months. Motor speech targets are chosen based on speech sound inventory gathered from the diagnostic evaluation or therapy sessions in conjunction with the "power" the word will have in the child's life (i.e., the overall motivation to use and practice the speech target). Targets are practiced first at the table utilizing a variety of techniques with ranging prompts depending on what the child needs (direct imitation, chorally, visual tactile cues, physical prompts, etc.) Prompts are faded as quickly as possible. Negative practice is avoided by moving on to the next target following there attempts, with each final attempt being a "success" , even if max assist is needed.
I utilize Apraxia Kids website and often discuss CAS and best practice with colleagues
Goal meetings are held quarterly to discuss goals and progress. During therapy sessions, parents sometimes sit in (if the child can still focus on therapy) and observe the session. In the case that the child does better without a parent present, the parent is asked to join in the last 5 minutes so that s/he can be debriefed on the session. Parents are given suggestions on what motor speech targets to focus on, for the week and how to elicit at home.
Currently, all of my clients who have an apraxia diagnosis also use AAC, ranging from low tech and/or high tech to promote expressive language. This alternative form of communication is essential given that the kiddo's brain is thinking in a lot more words then his/her mouth is able to reliably produce. Low tech visuals such as pacing boards, modified pacing boards, and topic boards are used. AAC devices including Novachat, Touchchat, Proloqup2go, and LAMP are being used by my clients, depedning on what was determined to be the best fit for them.