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- 35 N. Balph Ave.
- Rehabilitation Specialists
I use a blended approach to CAS. I begin using alternative or augmentative communication techniques within my first session, whether it is no/low tech or high tech devices. I typically use signed English as a way to help the child learn an alternative way to communicate and as an added visual cue. I may also use picture boards, PECS, or other low tech devices to help the child gain confidence in requesting items. Next, I work on getting approximations of many vowel and consonant sounds. I really like the Easy Does It for Apraxia Program for this. However, I don't focus on the isolation level of sounds too much for CAS as this disorder is a problem with sequencing of sounds. I am a huge proponent of using your whole body. I use a lot of sign language for communication and for self-cuing. I also teach gestures and physical communication. Using tactile/touch cues helps the child remember where in their mouth they need to be making a sound. I use a combination of the tactile cues in the Easy Does It for Apraxia program, the Kaufmann program, and some intuitive tactile cues. I also incorporate music as much as I can to start work on prosody as music helps to engage whole brain activity. This also ties into the use of Melodic Intonation Therapy when appropriate. The most important thing, however, is building trust and FUN with the child. I want speech therapy to be a positive experience that the child looks forward to coming to, not something that they HAVE to do and become disenchanted with. I don't want this to be drill work for half an hour. I typically start all my CAS sessions with a few minutes of practice using apraxia speech materials (such as Kaufmann Speech Praxis Materials), then move into crafting or play while incorporating our targets. As soon as I can, I work on teaching children how to advocate for themselves, including saying "no" and being able to communicate how they feel.
I have worked with Kathleen Helfrich-Miller (Ph.D, CCC) since 2012, first as a student then as a colleague. She is the leading researcher for Melodic Intonation Therapy use in Childhood Apraxia of Speech and has worked extensively with this population for close to 40 years. She mentored me with this population since that time and trusted me to take her whole CAS caseload in addition to my own when she retired in 2019. I have been working with children and adults with CAS since 2011. In addition, I have spent many, many hours educating and talking with the parents of my clients to help them better understand this diagnosis, find appropriate health-care professionals, and help with school placements/IEPs.
Parents are encouraged to watch sessions in our observation room; we have a two-way mirror connecting the observation room to the therapy room. This allows the parent to see how the therapist is working on their child's goals. I like this because being a parent myself, I know children usually act differently when their parents aren't around. I give as much practice work, suggestions, and communication of techniques as I can at the end of each session. I am also willing to chat with parents at other times with an appointment.
I use sign language, picture boards, PECS, and other low-tech devices for basic requesting and general communication when verbal language is not available. I have also worked with students who came to my caseload already using high-tech devices as their main communication mode with verbal language as a supplement; lastly, I have helped several clients attain high-tech devices through their insurance