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- 310 Corporate Drive, Suite 101
- Sidekick Therapy Partners
Depending on the level of severity of the child and age, I start with the very basics of communication such as, getting the child to engage in play, turn-taking and following directions. I reward any attempt at communicating at first and usually start with simple signs to learn imitation and the need to communicate to get the item they desire. It is impossible to force a sound/word out of a child, but with signing I am able to do hand over hand signing with them in order for them to understand the cause and effect of communication. As a child begins to learn communication is necessary to obtain items I then reward any verbal attempt to imitate the words I am producing. I slowly start to refine words as the child's level of frustration decreases and they are able to engage and allow me to cue them more without shutting down. My treatment session is generally play-based for younger children while I embed simple CV/VC words throughout the activity in context. As my children progress in age and level of difficulty of words I have them sitting at the table working on a variety of syllable shapes utilizing the Kaufman cards while earning pieces to a toy or a turn with a game we are playing. I use Dynamic Temporal and Tactile Cueing with a multi-sensory approach which structures levels of heirarchies of cueing the children to increase accuracy of a word beginning with saying the word in unison to mouthing the word with them and then letting them attempt spontaneously. In addition, I am trained in PROMPT which is physical manipulation of the face to contract the muscles needed for each sound to help map the pathway their mouth needs to take to produce a word correctly.
My current involvement is spreading awareness of apraxia to parents, professionals, etc. I post information on Facebook for others to increase their knowledge of apraxia as well as hand out Apraxia Kids papers and brochures to parents and professionals. I have also held a teach-in for Speech-Language Pathologists in my company I currently work for where they could learn more about the assessment and treatment I use for children with apraxia and could earn CMH for attending. I also encourage parents to check out Apraxia Kids to become more involved and learn more when I suspect their child has apraxia. I am also a part of the apraxia Facebook group put together by Apraxia Kids to better understand parents thoughts/questions on apraxia and to answer questions and help those in need. I would love to increase my involvement by finding a walk near me to participate in. Currently there are no walks near Knoxville, but I continue to look for any I am able to attend. In addition, I am going to attend an Apraxia Kids conference in the future.
I have parents sit in the room with me to observe when possible and if the child does not show increased behavioral difficulties with them in the room. Initially, I encourage the parents to play at home as I play with them in therapy using facilitative play and to utilize basic signs when requesting at home. I send home words to practice that the child is able to spontaneously produce with very minimal to no cueing in the therapy session so that they are reinforcing correct productions and not practicing words they are unable to say with accuracy. If a child is very young and unable to practice words at home I encourage the parent to work on imitating with gross motor movements or funny faces/sounds and practice having the child look at their face while imitating to help prepare them for the way I will cue and help them in therapy. I also encourage working on following directions to help with them being able to participate in therapy.
When I first start working with nonverbal children, I start with sign language to teach a few basic signs to get some wants and needs met and to teach verbal turn-taking skills. After the child learns communicative intent and verbal turn-taking, I often bring in an AAC representative to determine a high-tech device for children with apraxia and low intelligibility because signing and picture exchange communication limits their communicative abilities and a high-tech device can help with a broad range of communication and to decrease frustration and behaviors.