No Records Found
Sorry, no records were found. Please adjust your search criteria and try again.
Google Map Not Loaded
Sorry, unable to load Google Maps API.
- 940 West FM 544 #1782
- CMartin Speech Services
First and foremost, I work to establish rapport and instructional control. I follow the patient's areas of interest and motivation to condition myself and the environment with reinforcers. Working on any speech is often hard and incredibly effortful for the child, so it is even more important to keep the value of engagement high.
Depending on motivation and behavior, I strive for frequent and intensive practice of highly specified and limited speech targets with the recommended 100-200 trials within a 30 minute session. These are initially rapidly mass trialed and consistently presented (“blocked practice”) to give sufficient practice for learning the specific speech motor planning for the targeted speech movements.
Treatment procedures are analyzed and modified both moment to moment within the session as well as over the course of treatment as progress is made toward treatment goals. For example, I follow Dynamic Temporal and Tactile Cueing for speech motor learning. Multi-sensory cues are provided to facilitate the correct speech movements (i.e. auditory, visual, tactile, cognitive, etc). As the patient is responding more fluently (accurately and timely), I probe the stimulability of maintaining these correct responses with less intrusive prompts/cues and adjust treatment accordingly (constantly adding or fading cues following each trial). Also, my background as a BCBA has provided specific training and knowledge of the use of errorless teaching (“cueing before failure”) that promotes success using DTTC. Functional vocabulary words are used as targets to maximize the outcome of the treatment. These words typically include the patient’s favorite items, activities, actions, and people.
It is important to note that all sessions are conducted as individual speech therapy, 1:1 direct. Depending on scheduling, funding, and availability, sessions occur multiple times per week.
Registered user on Apraxia Kids website
Apraxia-Kids Email List Serv
Member of the Apraxia-Kids Closed Facebook Group
All of relevant areas are integrated into parent/family training and involvement. These skills involve intensive direction, skill teaching, and feedback. These include motivation, practice intensity, individual targets, descriptive feedback, and use of DTTC. Parent training is required at a minimum of once per month, but it occurs more frequently as the parent/family are able to participate. This occurs as direct overlap in session. Less frequently, it includes role-play or video recordings. Parent education is a vital piece of teaching the importance of how to continue to teach and generalize taught skills. Recommendations for treatment intensity are provided to support parent carryover. Parents are required to complete practice sessions outside of the time the patient comes for direct intervention. Also, therapy materials (i.e. books, games, crafts, toys/prizes) are specified for home sessions to prevent satiation and to provide consistent implementation.
Apraxia-Kids’ tagline “Every Child Deserves a Voice” is a concise and meaningful way to talk about AAC and CAS. Children with CAS are often unable to effectively communicate, but they still have important things to share and they have a basic human right to communicate those thoughts. The fundamental right to effective communication does not start at a specific age nor is it limited to a specific amount of natural speech. Bearing those two key points in mind, I consider AAC options immediately if a patient presents with barriers to communication (which is usually the case if the family is seeking intervention). For very early learners and barring any significant motor deficits, I often investigate the use of sign language because of its portability, allowance for prompting (“I can make your hands move a specific way even if I cannot make your sounds come out a specific way”), and the multi-sensory input it provides. For patients with significant motor deficits, I may probe PECS or another form of picture exchange. For older patients, I have also used a multitude of high tech AAC devices depending on the patient’s specific profile. The bottom line is that we owe it to our patients to provide functional communication while we target speech motor planning. It is not fair to wait until their natural speech develops until it is strong enough to support their communicative needs. These patients need to communicate now, and they have a right to effective communication.