No Records Found
Sorry, no records were found. Please adjust your search criteria and try again.
Google Map Not Loaded
Sorry, unable to load Google Maps API.
- 822 Montgomery Avenue S., Suite 306
- Therapy Central, LLC
For a child with moderate to severe CAS, a treatment approach will be determined for the child that is a "best fit" based on their needs. For those children who have very limited verbal communication, I am most likely to employ the use of Dynamic Temporal and Tactile Cuing (DTTC) as the primary treatment approach. When using the DTTC approach, I work with the child and family to determine highly functional/meaningful target words or phrases to practice with the child. All targets are selected based on the child's current speech sound and phonotactic abilities as well as what new movement (sounds) and/or syllable shapes the child is able to produce given cuing. Our practice during sessions is intensive, with the child producing new targets through blocked/mass practice (many repetitions in a row) and provided with visual, verbal, and tactile cues to correctly produce the target. A small number of targets are selected for practice, in order to allow for more intensive practice during the session. I look for totally correct production of targets during treatment, meaning all the sounds are correct, the movement between sounds and syllables is smooth, and the syllable stress and/or overall prosody is correct. We vary productions, making sure the child can produce each target with varied volume, speed, and intonation. Cuing is reduced and increased, as needed, to ensure that the child is as often as possible only producing the target perfectly correct. Systematic use of the DTTC cuing hierarchy supports the child in taking increasingly more responsibility for the motor planning of the target. As the child learns to produce a target correctly, practice with the target become more distributed and random to ensure that they are able to "call up" the motor plan for the target independently. As learned targets are mastered and moved into random practice, new targets are introduced through blocked/massed practice.
For some children, another evidence-based motor speech approach may be appropriate in addition to or instead of DTTC. This may include the use of Rapid Syllable Transition Treatment (ReST) for children with more mild-moderate CAS, wherein children practice nonsense syllables with a focus on self-monitoring for correct production of target utterances. Children are taught to attend to the sounds, beats, and smoothness of their productions compared to the models provided.
For those children who present with a mixed speech sound disorder (such as CAS plus phonological patterns of errors, articulation errors and/or dysarthria) a hybridized treatment approach would be developed to address the child's overarching needs, with a focus on the aspects of their speech sound disorder that are most significantly impacting their intelligibility and participation.
I have close, professional relationships with many of the individuals in Southeastern PA who specialize in CAS, including Susan Caspari, who has been my mentor for several year. Because I have been building my family while also starting my journey with CAS therapy, I have not had opportunities to attend the yearly conventions. I do intend to become a more active participant in the Apraxia-kids community, and I hope that my enrolment in this directory will be a first step in that process.
Parents are involved in the assessment process, providing important background information on their child as well as teaming with me in the collection of speech/language sampling if needed. During treatment, I prefer to have parents in the room observing sessions. Each session, I spend time explaining the targets we are working on and assigning home practice for targets that are near mastery. It is expected that parents engage in a robust home practice program with their children as part of our team approach.
I highly encourage parents and SLPs who I team with for a child with CAS to pursue total communication approaches including AAC to help support a child's language and social development as they work to improve their motor planning for speech. Typically, I team with other SLPs (early intervention, school, or other private SLPs) for AAC evaluation and implementation. I encourage families to seek the support of an SLP who specializes in AAC for assessment and procurement of the "best fit" AAC system for a child. During my treatment sessions, I focus primarily on motor speech practice, but any child who is using AAC brings their device/system with them to every session, and we embed use of the device into our practice and breaks. I collaborate with the teaming SLPs for direction on how I can reinforce the child's AAC goals during treatment sessions.