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- 21728 Kings Crossing Terrace
- GillIan Robinson-Lavigne
Using initial evaluation results, and feedback from family regarding highly salient words for child/family, a set of target words (5-7words, depending on severity) would be developed using the child's current & stimulable syllable & articulatory inventories, to create combinations that including a known syllable shape with a novel consonant or vowel not currently used in that shape/position, or a novel syllable shape with a known consonant &/or vowel. During Treatment, & usungca DTTC approach, the words would be practiced with the goal of 100 repetitions each, during direct drill practice & through incorporation into activities. Cues & strategies would include rate modification, unison productions, delayed productions, tactile cues such as PROMPT, Visual cues, verbal cues & modifications of loudness, & pitch which would be faded out/in to maintain a high level of successful productions, with the minimal amount of cueing, and to incorporate naturalistic prosodic features. The child would be provided immediate & specific feedback in early sessions, & delayed, results oriented (correct/incorrect) feedback as proficiency improved, with allowance for child to evaluate their own productions. Predictability would decrease over sessions, with respect to frequency & order of repetitions to improve generalization. 2-3 sessions per week would be recommended. A 90% accuracy of productions is target for incorporation of a novel word into protocol. Probe words would be incorporated that resemble target words to assess generalization of motor movements. Assessment & introduction of AAC strategies including gesture, sign, hi tech & low tech options would be considered & incorporated into treatment time, during activities to target functional use of target words & communication to expand & support language development, &social communication. Use of books that include or can be modified to include target words is used often to incorporate literacy skills. As children progress toward achieving independent & accurate productions of targets, parents will be asked to practice at home.
While working for a private practice a few years ago, I became very involved I. Treating & diagnosing CAS with up to 50/75% of my caseload. I participated in Apraxia Awareness walks within my community/DC, provided inservice to fellow colleagues regarding DTTC, motor learning Theory, provided IPad inservice to parents. While currently working privately, in EI & I in Schools through telepractice, I have provided education & resources to teachers & collleagues about CAS & differential diagnosis, as well as advocating for evaluation of students who demonstrate signs/symptoms of suspected CAS.
Parent involvement is critical to success. Parents are involved from the initial contact, providing valuable assessment information & identification of meaningful, highly salient verbal targets, and information on child's interests & family communication goals. Parents are encouraged to participate in therapy, to incorporate verbal targets & AAC in the home & to identify opportunities for functional practice. & to share feedback between treatment sessions to maximize treatment efficacy. Treatment planning is ongoing & parents are a partner in this process.
I have used lie tech such as gesture, and early sign teaching with young children to provide opportunities for child to name, request, protest to support language development, vocabulary, and social communication. I have used lie tech options such as picture boards & higher tech options such as Proloquo2go, including programming buttons & teaching parents, & LAMP program to expand a child's expressive Language & response to questions using phrase-sentence length responses.