In CAS the goal of treatment is to improve the individual’s ability to assemble, retrieve, and execute motor plans for speech. Thus, the focus is on movement versus sound errors or sound production. My approach to treatment focuses on this movement with the use of Dynamic Temporal and Tactile Cueing.

Target Selection: I select specific stimuli to target in treatment based on the child’s vowel content and syllable shapes. I consider word shapes and consonants/vowels that are missing from the child’s repertoire and select target words that are functional and in the form of word shapes he/she does not have (usually between 5-12). I depend on parent input here to help develop a list of functional words tailored to the child. I first use phonemes already in their repertoire and introduce one or two new phonemes at a time. When each target word meets criteria for going out of training, then a new target is brought into the list. As the child improves motor skill and targets are moving to generalization, new targets will be brought in to increase the set size.

Cueing: I provide maximum support in the form of visual, tactile, and auditory models and fade these cues over time so the child takes increasing responsibility to formulate and execute the plan on his or her own. I specifically use Dynamic Temporal and Tactile Cueing. I continue the process of adding and fading cues until the child can produce the target accurately with no hesitation, normal rate, and can vary prosody. The hierarchy of cueing is constantly changing as I add or fade cues depending on the child's response. I have completed PROMPT Level 1 training and will often use PROMPT as my system of tactile cueing.

Treatment principles: My treatment sessions follow the principles of motor learning. I provide frequent, specific feedback at first fading towards more random feedback to improve motor learning. Following the priciples of motor learning, shorter, more frequent sessions, ideally 4-5 times per week, for 30 minutes are recommended. I also implement variability of practice in which I practice movement sequences in different contexts and conditions to facilitate motor learning.