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- PO Box 1495, 412 E Spokane Falls Blvd.
- Washington State University
I primarily use a DTTC approach (Dynamic Temporal and Tactile Cueing) with a small number of functional targets, fading of cues, and intense repetition. I use principles of motor learning with blocked practice while the child is acquiring a target and then switch to randomized practice. I vary reinforcement using knowledge of results and knowledge of performance when needed although with DTTC, correct productions (or closely approximated productions) are often self reinforcing. I use Phonic Faces as phonemic cues when addressing CAS and literacy. Depending on the results of my assessment, I may also address co-occurring childhood dysarthria issues of respiration, phonation, and resonance disorders as needed. Most of the therapy I am involved with is in the summer at Camp Candoo, a CAS camp.
I have worked with or consulted on hundreds of children who have CAS and other MSDs. I co-direct a summer CAS camp with Dr. Amy Meredith at Washington State University. I conducted the research study with Larry Shriberg and Edy Strand on classic galactosemia, which was foundational in defining characteristics of CAS and continue to conduct research on MSDs in children. I gave an invited Trailblazer presentation at ASHA with Strand, Wambaugh, and Yorkston on MSDs across the lifespan. I have given and am giving continuing education presentations on CAS across the U.S. . I wrote the speech and language guidelines for classic galactosemia which was published in 2016. Most recently, I have been working on developing an early intervention program with Beate Peter to examine if speech sound disorders can be minimized or prevented in classic galactosemia if intervention is started in infancy.
Parent observe the session while the graduate student I am supervising/co-treating at Camp Candoo is establishing the phrases and the client is accommodating to the intensive repetition regime. Parents are encouraged to video sessions. When the grad student and the client have an adequate working relationship, the parents join the 30 minute 2x/day therapy session during the last 10 minutes and share in eliciting the target phrases. Clients practice each phrase 10x before the next day of camp. We also provide parent education sessions on principles of neuroplasticity, DTTC, incorporating literacy, and advocating for your child. (I am academic faculty and although I have treated children with motor speech disorders for 40 years, my responsibilities in my present position are research, publish, research, publish, research, publish, teach, then therapy.)
I use gestures, signing, photo books, PECS, iPad apps, and Picture It sentence strips to facilitate and augment communication. (My start in using "high tech" was programming a Unicorn Board with an Apple IIE in the early 1990's for children with MSDs.)