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- 4220 Proton Road, Suite 165
- Apraxia Dallas, PLLC
I use a variety of research-based approaches that are based on the principles of motorlearning. Two of the main approaches that I use are Dynamic Temporal and Tactile Cueing (DTTC) and Rapid Syllable Transition Training (ReST). I strive to highly individualize treatment to each child. Treatment typically includes the use of multi-sensory cueing and feedback, focused attention by the child reinforced by early success, intensive, frequent, individual practice, multiple repetitions of speech movements, slower rate, systematic progression through hierarchies, emphasis on self-monitoring, compensatory speech and language strategies, prosody remediation, and addressing all aspects of disordered communication. For most children, especially young children, I incorporate age-appropriate, motivating materials for the child including books, puzzles and games. Most sessions include a mass practice of recently introduced goals as well as distributed practice of goals that are nearing mastery and generalization. I count responses during sessions and most children obtain at least 50-150 targeted correct responses in a 30 minute session. I used a behavior-management system as well as reinforcement schedules individualized to each child to keep them motivated.
I have been conducting apraxia therapy since 2012, working for Apraxia Dallas (2012-present), over which I took ownership in 2016. I have volunteered as the North Texas Walk for Apraxia Walk Coordinator each year since 2017. Apraxia Dallas is a proud sponsor of the North Texas Walk for Apraxia each year. I have attended the Apraxia Kids conference each year since 2015 and presented at the Apraxia Kids conference every year since 2017. I have also presented on childhood apraxia of speech at the ASHA convention in 2016 and at the Texas Speech-Language Hearing Association convention each year since 2016, as well as providing workshops to school districts. I attended the Apraxia Kids Intensive Training Institute in 2018 and subsequently met all requirements to be recognized with Advanced Training and Expertise in Childhood Apraxia of Speech. I have mentored eight speech-language pathologists over the past 5 years in apraxia therapy. I provide dozens of consultations a year with other professionals including teachers, ABA therapists, and other speech-language pathologists (especially those in school districts).
Parents and/or caregivers are required to attend most, if not all, therapy sessions. Parents are encouraged to bring a notebook or device and to take notes during sessions on the specific targets being addressed and the cueing used. Most sessions begin by asking the parent how practice went at home and if there were any concerns or issuesParents are frequently asked to model new behaviors for the child and are included and incorporated throughout therapy sessions. Parents advice is encouraged and solicited, especially regarding goals and behavior management.
I have Level 1 training in PECS and I sign some (I am not a fluent signer). If a child is already using an AAC system when they come to me, we continue the use of that system. I ask parents to make sure they bring the system (if it's a device or pictures) to our therapy sessions. I do not consider myself a specialist in AAC although I have been seeking additional training in this area. I feel that I am proficient at introducing a system and using it as a bridge to verbal speech. However, if a child continues with AAC and their abilities with the system are surpassing my own, I refer them to other speech language pathologists with more expertise in AAC. I try to stress to parents of children who do not have a communication system that the child needs one and that the system will only facilitate (not harm) their speech development. For parents of young children who are just starting therapy, I discuss the options of picture exchange or signs. Most often, we use signs - I model the signs during therapy and as the children begin to use them the parents who may have been skeptical are usually convinced. I am continually striving to become better at incorporating AAC into my treatment. It is an area of growth for me.