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- 1438 East Kensington Avenue
Salt Lake City
- A Better Path
Salt Lake City
With information I have gathered during assessment I formulate a list of potential treatment targets. I use a list of the child's strongest sounds (consonants and vowels) and a list of their strongest syllable structures to determine what words can be built with those parameters. If the child has a word in their inventory that isn't particularly stable, I would choose to stabilize that. If building new syllables, I would use their strongest sounds to build new syllables. If working on new sounds, I would use sounds that are more similar to ones they currently have mastered or ones that they have good stimulability for and I would put those into their strong syllable structures. I choose to change only one parameter at a time when choosing treatment targets (e.g. strong sounds with new syllables, new consonants with strong syllables and vowels, or new vowels with strong consonants and syllables.) I prioritize real words that would be functional for the child and family whenever possible. I involve the family in helping to create the child's word list. In treatment I set goals to elicit the target word as many times as possible (my target is 100-150 per session). I go through a cue hierarchy to elicit the child's most accurate production of words. I move fluidly through that cue hierarchy with my goal being the least amount of help necessary to keep the child accurate. I use block practice when necessary, but move to more randomized and independent practice as soon as possible. I use AAC as well to help the child develop communicative competence and success within their environment as quickly as possible. I also incorporate literacy enhancing skills to build strong foundations for reading later on by talking about sounds and letter sound relationships when appropriate and possible.
I have attended the national conference several times since 2010. I have also been involved with the Apraxia walk since 2011 in Utah. I have set up an information booth at multiple walks to answer questions for families and help with any resources that I can. I was involved in a KSL news story in 2016 with one of my kids to help educate the community about CAS. I was actively involved in the in-person meetings in Utah for parent support and information in 2017. I also consistently post in our local Facebook group to answer questions and provide support to parents. I regularly take phone calls to consult parents and practitioners.
I have parents in session with me for the duration of the session. I will usually direct the session by establishing the work we are doing that day, what cues are necessary for the child (if any), and how they are going to be the most successful. I also instruct parents to adjust what they are doing to cue or help the child or in what responses I think would be best based on what I see them do. I help parents understand what they can do at home to support treatment goals. Sometimes that is working on AAC, sometimes it is working on a target word, and sometimes it is helping that child with the behavioral skills necessary to participate in treatment. I also explain what I am doing and why as much as necessary so that they understand what is happening in therapy.
I use signs mainly for children who are able physically. I find signs to be easy for family members to use and incorporate in the day and they are always with you...no need to look for the last place the pictures got put down.
When needed, I also use simple pictures to communicate basic needs,ideas of interest to the child, items for the child's safety.
I have used touch to talk type devices before, but often prefer lower tech options unless I think the child will need a device for a longer period of time.
I also use pictures and/or word cards to help older kids build and practice sentences when they are ready.