With students who have a severe speech sound disorder, especially CAS, I use the Principles of Motor Learning for intervention, and my preference is the Dynamic Temporal and Tactile Cueing approach (“DTTC”). The DTTC approach utilizes a visual and auditory cueing hierarchy that enables the child to feel success with talking. The focus is on movement gestures, not specific sounds. The movement gesture, or word, is practiced as a whole, with no interruption. The goal of therapy is to maximize the number of responses per session to enable the child to use the word spontaneously. There is power in spoken words!

As a Speech-Language Pathologist (“SLP”) employed by a large urban school district with more than 80,000 students, I provide intervention to students who exhibit CAS or severe speech sound disorders. I also provide consultation to my fellow SLPs who have students that exhibit CAS or severe speech sound disorders. In the consultations, I assist the SLPs in determining the specific sounds, consonants and vowels, that the child can produce in imitation as well as spontaneously. Initial functional target words are determined informally using the DTTC cueing hierarchy so that the child experiences success. The consult includes discussing the Principles of Motor Learning, treatment, frequency and length of sessions, initial targets, and the organization of practice within the sessions. In addition, a functional core vocabulary is suggested with a plan for introducing phonemes and vowels. At the end of the consultation, the campus SLP is ready to begin providing specific therapy to enable the child to become an effective oral communicator.