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- 108 Washington Street
- The Speech Scene
I use a functional communication treatment approach which incorporates the principles of motor learning. I use frequent therapy sessions with heavy repetition throughout, but I also like to keep the students engaged and having fun. I've found that using approaches from multiple treatments proves most beneficial, as I like to tailor treatment to each individual student's needs . I frequently use recommendations from the Kaufman approach, such as shaping word approximations and the use of a core vocab book from David Hammer. I first see what the student is able to produce and try to develop vocabulary words from there. I then see if the child is able to produce additional productions while using multi-sensory cues or syllable shaping. I frequently utilize the Dynamic Temporal and Tactile Cueing approach along with recommendations from PROMPT, such as using touch to provide additional sensory input to assist with speech motor planning. I work with what the child currently has and with cueing, modeling, and word shaping create words that are possible and meaningful for the student. I always implement a home program to assist with carryover/generalization, and I always try to find out what productions would be most meaningful for the student. I incorporate carrier phrases as necessary and adjust my cues as the student progresses in therapy to facilitate and encourage proper self-monitoring and motor learning within the student. Language, literacy, prosody, and social skills are worked on throughout therapy sessions as needed. If a student initially does not have a form of functional communication, I would look to incorporate ASL or an AAC along with continuing to build functional verbal communication.
I have always had a passion for working with children with apraxia of speech, but I am just starting to become more involved in the Apraxia community. I receive newsletters regarding CAS, and I take any CEU courses I can find. I am in charge of social media at my current position, and I frequently share information regarding CAS. I encourage parents/teachers to read the information on the Apraxia Kids website, and I use the handouts as needed.
I encourage parents to be present for the majority of each session. In private practice, this is possible, but in a school-based setting it is difficult. If the parent is able, I like family members to be active participants in therapy sessions so that they can learn, imitate, and then carry over strategies we are working on. Parents and other family members are huge parts of speech therapy success given they spend the most time with the student. They can reinforce words the student has produced in therapy, and help the student carry the productions over to functional daily tasks. This helps the student get in more repetitions, and helps with overall motor learning. Family members can also provide great information regarding what motivates the student and how the student deals with frustration. If the parent cannot be present during the session, I like to correspond frequently regarding therapy approaches and progress. I send detailed homework with words the student has been successful with and how to incorporate them at home. Ideally, I will send a voice recording or video clip home.
The overall goal of speech therapy is to establish functional communication and facilitate social engagement. Many students with severe CAS do not have a way to express basic wants/needs or interact with peers. AAC is a wonderful way to help the student achieve those communication goals while he/she is building on her verbal communication. I have used low-tech and high-tech AAC devices from picture boards to a Dynavox to assist students with productions. I like to trial different devices to see what the student likes more and what is more effective for the student based on age, needs, and level. I use AAC to "supplement" verbal speech whether the student needs to use the AAC 90% and verbal communication 10% or vice versa. Many times students with CAS can approximate a word, but to an average listener, the message may not be 100% clear. The student can make his/her best production and then reinforce the production with the AAC. This takes the pressure off the student and helps facilitate effective communication.