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- 3180 Professional Plaza Suite 101
- Janna Hacker and Associates
For children diagnosed with CAS, I typically recommend no less than 2 individual sessions per week. I encourage 3-5 sessions per week if the child has a moderate to severe impairment. I am careful that my sessions take advantage of all of the time I have with the student. I have found that intensity is key! My sessions focus on comparatively fewer words than if I am working with a child who only has an articulation disorder. I have the child produce many, many repetitions of the few target words. I often use a token tower that holds 30 tokens. Each time the child says the target word he or she puts a token in the tower. This increases motivation and participation. The number of words I “drill” each session depends on each individual client’s age and level of progress. I start with more simple CV combinations such as VC and progress to more difficult ones such as CVC. I encourage my students to focus on what their "speech helpers" are doing- Is your tongue tip curling up? Are your lips coming together? I use visual feedback and auditory feedback. Example: I often call /t/ the clock sound. t-t-t-t. We have a picture of a clock on the table. I use the PROMPT method and the Kaufman Protocol. I give lots of praise to my students with CAS. They work HARD, and it is important for their continued success that I encourage them often.
Often times I find that my job as a speech therapist is to advocate for my students with CAS. I have, more than once, had to recommend that my students not be moved to a special needs classroom because of their decreased speech intelligibility. Unfortunately, many professionals assume that because these students cannot express things they know that means they do not KNOW them. Just because a child can't tell you what he is learning doesn't mean that he isn't! As part of Janna Hacker and Associates, I have provided in-services at schools and preschools in the Memphis area. I educate teachers on how to assess a child's comprehension in ways that don't require the use of expressive language. I teach them how to respond when their student with CAS is speaking and they do not understand what he is saying. My in-services also provide knowledge of what CAS is and is NOT. I often remind them that CAS is not like an articulation disorder. The therapy approach is unique, intensive, and results take time.
I allow the parents to make the choice of whether or not they want to be present during the session. I encourage them to watch the session, so that they can see how many repetitions of words I am requiring. They can also hear the feedback I give the children. I think it's important that we all "speak the same language" when working with children with CAS. Anyone who is going to be helping the child with speech practice (parents, grandparents, teachers, etc.) should use the same exact verbal cues I do. Consistency is SO important. I give a homework list each time with instructions on how and when to practice at home. Practice makes perfect!
I have used sign language with many of my younger students with CAS. Often times I use it as their initial form of communication. I find that it "unlocks" the door for them to communicate effectively. Initial success with communication allows for continued motivation during the course of therapy. I have used PECS with my preschool aged students. Many times they are not able to communicate their wants/needs in a classroom setting and they are able to use PECS to be involved in things like making choices at lunchtime or asking for help during art time. For my older students (often diagnosed with ASD in addition on CAS) I have employed LAMP on a dedicated device.