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- 900 Junction Drive
- Cutting Edge Pediatric and Adult Therapy
I have been trained in the Dynamic Temporal and Tactile Cueing (DTTC) Approach, which is an evidenced-based treatment for patients with suspected and confirmed CAS. Through this approach, we do intensive movement practice with a small number of highly motivating target words. DTTC is a motor-based treatment involving focused practice with lots of repetition, in addition to varying the prosody and volume of each target. In order to keep the child motivated, I work with the parent to select target words related to the child’s interests, names of family members, and daily activities, taking into account the child’s age. These words are practiced intensively over the course of the session through a cueing hierarchy, which involves saying the word together, slowing the rate, and providing feedback and cues to help the child be successful. Mastered targets are moved to a generalization list and are randomly targeted to maintain progress and carryover as new targets are added to direct practice. Movement is very important for children. I like to start and end treatment sessions with gross motor movement and sensory activities in the gym. This helps to meet the child’s sensory needs and provides input to help the child to focus and maintain attention for the structured practice portion of the session. These breaks can also be incorporated throughout the session, if needed, based on the child’s individual needs. In addition, motivating and fun, yet quick, reinforcement activities are incorporated throughout practice to help maintain attention and make therapy fun and engaging. Speech therapy sessions at our clinic are typically 45 minutes in length.
I remain current with up-to-date research and best practices for apraxia through completion of CEU courses and through social media/networking. My clinic is actively involved in the therapy community and we participate in many different community events each year.
I highly value the importance of parent involvement with apraxia treatment. I like to get parent input for selection of target words so that relevant and motivating words can be addressed. Since consistent home practice is an important aspect of treatment for apraxia, I provide parent education and training sessions, as well as a debrief with the parent after each therapy session. As long as the child continues to participate in therapy and is not distracted, parents are welcome to observe portions of intervention sessions in order to learn more about cueing levels and how to help their child. Because I work at a sensory integration clinic, many rooms and gyms in our clinical setting are very open. Any portion of the session that the parent observes must be provided in an individual treatment room due to our clinic policy and HIPAA guidelines.
Low-tech and high-tech AAC can be used to repair breakdowns in communication and increase the child’s language skills while we are improving the motor system through apraxia intervention. At our clinic, we have used low-tech options, such as a core vocabulary board, and high-tech options, such as an AAC app on an iPad or a dedicated communication device, to help increase the child’s communication options and improve his/her ability to interact with the word around him/her. These decisions are based on the child’s individual needs and rate of progress and are made in conjunction with the child’s caregivers. The AAC research supports the use of AAC to build language skills. I have seen steady development of language skills in my patients who access AAC, both those with and without suspected CAS.