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- Christina
- Burnham
- 3810 Village Oaks Drive
Houston
Texas
77339
United States - CB Speech, PLLC ~ CloudSpeech
Houston
Texas
77339
United States
CAS therapy is different than traditional articulation and phonological therapy where we work on what’s missing in a child's repertoire, or what they can’t do yet. In CAS we begin where the child ‘can’, or what is already in their phonetic repertoire. I like to begin with the ‘low hanging fruit’ following typical speech development patterns, which starts with the vowels. I like to begin by introducing the vowels with clear visual supports and move into prosody play and vowel diphthongs through choral speaking activities. I prefer to use a ‘whole language’ approach that incorporates literacy and functional play activities to provide embedded and repetitious presentations of targets. For CAS, I provide more massed or drill based opportunities to practice smaller sets of targets with greater frequency, because CAS needs more repetition than other speech sound disorders. I believe in working at the child’s optimal challenge point, meaning the point where they have some success but still make errors, so that they can learn from my direct feedback. I provide multisensory cues (auditory, visual) as needed, with the goal being to fade as quickly as possible and move the child to an independent production level. I prefer to use functional words as speech therapy targets in order to help the child build vocabulary that is powerful and useful from the very beginning. Power words can be selected even at the early simple CV level, such as ‘no’, ‘go’, ‘me’. For CAS, target practice should emphasize the ‘movement’ between sounds, rather than production of the individual isolated sounds. I typically recommend more frequent therapy sessions that vary in length, such as 40 minutes or 20 minutes, depending on the child’s age, attention, and severity. Therapy moves at the child’s unique rate of progress and advances in complexity as they improve their productions and consistency. I recommend and implement AAC (alternative and augmentative communication) options when appropriate to support children with limited speech as they work towards their goals.
I discovered Apraxia-Kids.org about a year ago while searching for support online, and discovered that there is a growing apraxia community out there. It was so helpful to find the free educational materials that they provide, and be able to share that information in Spanish with the family I was currently working with then. From the website, I found apraxia-kids on instagram and learned about their awareness walks. That led to the discovery of the annual conference which happens to be in my home state this year; I am very excited to be attending in July and look forward to networking and building relationships with other therapists and parents who are passionate about CAS. I passed the exam to be listed in the SLP directory, and I am hopeful that this will create a bridge between children with CAS who could benefit from my services and my private telepractice. I am very interested in continuing to advance my clinical skills with CAS and build a reputation for successful intervention. The experiences that I have had so far with CAS have been special, and until recently finding apraxia-kids, I had no knowledge of a community surrounding this unique disorder. I plan to become an active participant in the CAS community by providing skilled therapy to children with CAS with higher frequency and intensity through more flexible teletherapy models that serve children at home; connecting kids with CAS to therapists that can support them, regardless of their zip code. I will continue to spread the word about CAS, provide links to their information and services via my website and social media, connect with other therapists and families touched by CAS, and perhaps help to organize an awareness walk in my local community. Eventually, as my skills improve, I would look to mentor other therapists so that we can continue to grow our apraxia community and pool of therapists prepared to treat CAS.
I encourage parents to take an active role in the therapeutic process. I provide education about CAS and resources for learning more and getting support. For parents of children with CAS, I recommend home practice activities that are functional, meaningful, and practical, so that the child can increase practice opportunities in more natural and randomized environments. I invite parents to observe therapy sessions and practice different cueing and scaffolding techniques to build their confidence for independent home practice with their child. I provide short videos of therapy sessions for instructional purposes so parents can better understand how their child is doing, and what they are working on.
AAC (Augmentative and Alternative Communication) can be an excellent way to support speech and language development in children with CAS. I often incorporate no-tech picture symbols during therapy sessions to provide opportunities for the child to communicate their responses to questions during literacy activities, to build simple sentences that express their ideas or desires, and to build new vocabulary. I have used simple high-tech options like Go-Talk app for iPad to provide a voice for a child with CAS at home by programming his preferences and routines. When a child has limited verbal output, creating a way for them to express themselves and continue to develop their language skills is an important part of the therapeutic process; AAC can help to accomplish this.
