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- St. George
- 85 N. Malin Rd
- Delaware County Intermediate Unit
My overall treatment approach varies child to child; however, there are basic therapeutic principles I adhere to when treating children with CAS. They are based on motor learning principles, evidence-based practice research, ASHA's Technical Report on CAS, and clinical experience; the following are the key therapeutic components:
- Use of verbal, tactile, gestural and visual cues to focus on placement and manner of sound productions, beginning with syllables and with a focus on oral-motor movement.
- Highlighting and prolonging targeted sounds when modeling with fading as soon as possible
-shorter, frequent practice sessions
-Focus on phoneme sequencing, not just sound production, moving to multisyllabic words and the phase level as soon as possible
-Use meaningful target words
-Use of choral practice (simultaneous production)
- tapping/clapping out syllables
-prompting hierarchy of practice: (first child listens, then produces simultaneously with therapist, then produces after the therapist’s production, given a delay, etcetera)
-Repeated mass practice (practicing fewer targets numerous times) to build muscle memory when teaching new movement patterns
-use distributive practice when habituating skills (practicing numerous targets fewer times, across various learning environments)
-Facilitate word approximation when necessary then gradually shape to adult model
-Provide optimal reinforcement, fading as child improves
AAC low tech and/or high tech options considered
Materials may include flip books, personal photographs, toys, games, music, packaged CAS practice cards/books, iPad applications, amplification tools, tape recorders, books, and anything I can get my hands on which motivates and encourages the child to communicate and expand utterances!
As the Speech & Language Program Supervisor for the Delaware County Intermediate Unit, I ensure, through high-quality supervisory practices and independent study, that our SLPs' clinical skills in the assessment and treatment of Childhood Apraxia of Speech are of high-quality, current, and evidence-based. I frequently bring in top-experts in the field for staff training purposes (i.e., David Hammer, Sue Caspari).
It is important that parents feel part of the team; involve them in therapy and their child's learning. Parents can be involved in the therapy process in multiple ways. They are instrumental in assisting the SLP in the selection of functional/meaningful syllable word targets and motivating activities and materials particular for their child. Parents are counseled on ways to engineer environments that encourage their child's communication in a "safe", supportive way (related to eye- contact, responding, modeling, turn-taking, messaging, and increasing/maximizing communication opportunities).
Parents are encouraged to observe or video-view sessions in order to become familiar and comfortable with strategies and therapy targets. They encouraged to ask the treating SLP questions, follow through with any home practice provided, and to be an active participant in their child's sessions when reasonable, feasible, and meaningful.