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- 8 Prestige Circle, Suite 101
- Our Children's House at Children's Health - Allen
Once I determine whether to take a motor approach versus a linguistic approach, I then decide on an appropriate method of treatment. Since there are several different methods aimed at treating Childhood Apraxia of Speech, I initially choose a method based on the child’s age and severity, as well as the child’s current deficits. Typically, I use a combination of approaches throughout the course of treatment, as I find treatment methods must change and sometimes overlap as the child’s speech changes. With severe CAS, I focus on improving motor skills and motor learning, but also know that there are often linguistic deficits involved, so I introduce methods for improving language skills as deemed appropriate. Since research shows shorter, more frequent sessions are more effective and for children with CAS, I typically recommend those children with severe CAS come for treatment 3-4 times per week. My facility is open four days per week and we often have to work through struggles with insurance companies such as visit limits and cost; therefore, there are many times when a child is unable to receive the high-frequency treatment session suggested.
My interest in the area of Childhood Apraxia of Speech peaked after attending the Introduction to PROMPT: Technique workshop in 2012. Since then I have treated several children with CAS and have read numerous articles and studied several approaches by experts in the area of CAS, such as Dr. Edythe Strand, Dr. Nancy Kaufman, and Rebecca J. McCauley. I recently had the privilege to apply and be accepted to participate Dr. Edythe Strand’s interactive Childhood Apraxia of Speech Advanced Workshop at UT Dallas and was trained in her Dynamic Temporal and Tactile Cueing (DTTC) approach. Since attending this workshop, I have joined several CAS-related groups on Facebook, such as Apraxia Kids, in order to become more aware of opportunities for training and community involvement for CAS in the Dallas-Fort Worth area. I also plan to attend the 2018 National Conference on Childhood Apraxia of Speech next July.
Working closely with other professionals involved in the child’s care is another way I contribute to the apraxia community. I frequently consult with other professionals the child may see such as physicians, teachers, and other therapists. I also collaborate with other Speech-Language Pathologists involved in the child’s care (such as at school) so that we may provide similar goals and treatment methods when at all possible. I find that often times I play a role in educating the child’s school SLP, as many of the school-based therapists do not have extensive training in the area of CAS, nor the ability to provide frequent, intensive, one-on-one sessions due to constraints of the public school system.
I hope to declare Childhood Apraxia of Speech a specialty area in my career and look forward to training and educating others in this area of Speech-Language Pathology.
I typically have the parent/caregiver present to observe and participate hands-on during each treatment session. I feel this is very important in order to build rapport and trust with the family so the caregiver is confident in my ability to treat his/her child. Heavy caregiver involvement is crucial when treating a child with CAS. It is important that I explain what I am targeting and the reasoning behind it. I also have the caregiver take videos and practice various cueing techniques alongside me so he/she feels comfortable practicing and supporting the child in the home environment. If there is a therapy material or resource used during the treatment session that the caregiver can later use at home, I provide this as well. I firmly believe a strong therapist and caregiver relationship is critical to the development and progress for a child with CAS.
I was a member of my clinic’s multidisciplinary AAC assessment team for several years, so I am very familiar with the various types of augmentative communication support available. I often use the support of AAC early on in the therapy process for the children who have poor speech intelligibility or limited verbal output due to severe CAS. It may be through the use of simple hand signs such as “more,”
all done,” and other functional signs the child’s family deems important in his/her daily life, or through the use of a speech generating device. I tend to use and recommend an iPad with a communication application such as Touch Chat or Proloquo2Go in order to decrease frustration of the child and caregiver and to help aid in language development. Though my final goal is for the child with CAS to use natural speech as his/her primary mode of communication, I feel it’s very important to provide some way for the child to functionally communicate in his/her surroundings while verbal speech is limited.