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- 4220 Proton Road, Suite 165
- Apraxia Dallas
As Edythe Strand recommended, the child needs to understand the concept of “simultaneous”. I would start with teaching this concept. Starting with gross motor skills, walking, jumping, clapping…. Once the child understands this concept, I would move to words. I would start Simultaneous speaking with words/sounds that are in the child’s repertoire. Once the child is successful and understands Sim Speak, I would begin a DTTC approach using the words that were in the repertoire, or CVCV words. Targets that are power words are normally the beginning targets. NO, Yeah, go, need, want… The goal is to work on speech, but if the child is not ready, then we have to add many breaks, using games, or fun activities as motivation. Probably start with a fun game, then work on a target, then take a break, then the next target. I like to use the Hierarchy Ladders by Kay Giesecke & Heater MacFadyn to help pick targets and the DTTC Progress Monitoring Grid to monitor progress.
The owner of the company that I work with is in charge of the Apraxia walk for north Texas. Last year I volunteered. This year, the walk was different due to being online, so I was not involved other than being in the video to support/encourage the children. I am just beginning my involvement in the Apraxia community so I will continue to seek ways to support and educate others about Apraxia. I work part time at the Apraxia Clinic and full time in the local school district. I am slowly becoming the professional who other school SLPs seek out to learn more about apraxia and apraxia therapy.
Parents are encouraged to observe each session. This gives the parent insight on what we do in therapy. I am able to talk with the parent during therapy and point out what we are working on and why. IF the client is ready for home practice, I can specifically explain what to do and how to cue the child. The parent is encouraged to take notes during therapy. The parents often help with choosing the target words that would be most powerful words to use at the start.
I currently have a 3-year-old client identified as a child with CAS. She has approximately 12 word she uses at home. I have introduced a core board during therapy. We use the therapy during “play time” activities. Using a car that when it is pulled back, it will go forward on its own. I have modeled “it go” and then move the car. We work on pointing to the “it go” or “go” pictures on the core board to make the car move. The other phrase we have worked on is “I want that”. I started by modeling it many times and then use hand over hand to help the child point to the pictures. She is able to point to “I want”, but typically points to the object instead of the picture, but this is acceptable way to communicate verbally, so it is reinforced during therapy. LAMP has been introduced, similarly to the core board and “go”. The client has demonstrated using LAMP on the iPad. The LAMP screen has been modified to show only a few pictures to help with locating the correct item.