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- Caitlin
- Crall
- 475 E Waterfront Drive
Homestead
Pennsylvania
15120
United States - Allegheny Intermediate Unit
Homestead
Pennsylvania
15120
United States
Your child has just received a diagnosis, maybe the first question(s) on your mind are “How do we fix this? How do we help my son or daughter to communicate?” Let’s discuss what therapy for a child with CAS might entail. In the beginning, progress will be slow – that does not mean that progress is not possible - it simply means that it will not happen as soon as we want it to. However, while we start with some foundational skills in the early stages of therapy, we can also introduce an augmentative communication system to your child, such as a picture exchange system, a high tech speech generating device, sign language, etc., and, depending on the system chosen, training will also be provided to you and your family. After building on some foundational skills needed for motor speech (imitation skills, awareness of body parts needed for speech, establishing speech sounds), we will then pick a set of 5-10 target words for your child to start practicing in speech therapy. At first, therapy will consist of a small set of targets that are practiced repeatedly, but the sounds, words and phrases will grow in length and complexity as your child progresses. A lot of feedback will be provided to your child in the forms of sound (verbal cues), sight (visual cues), and touch (tactile cues). As your child progresses, he/she will need to practice more often outside of the therapy room (in the car, at home, the grocery store, etc.). Sessions may seem short in time, but they will occur frequently throughout the week. While it might feel that there is a lot of drill work occurring, speech pathologists can be very creative and will involve games and activities that can allow for this type of drill work, but also keep therapy fun and engaging. In the end, we will seek to establish a trusting relationship to set the groundwork and foundation for your child’s progress.
As a parent, you play multiple important roles in your child’s treatment. During the diagnostic process, you were relied on for a significant amount of information that assists us in providing an accurate diagnosis. Now, you will be relied on for your child to make meaningful progress in his/her communication. That will entail attending and being a part of therapy sessions so that you can observe what your child is working on and how and when you can utilize these techniques in environments outside of therapy. It also may entail your participation in therapy and the speech pathologist observing you and teaching you how to work with and cue your child. Additionally, “homework” may be assigned to your child, and it will be important for you to participate and help your child with his/her speech homework to provide more practice. Progress in therapy is truly a team effort, and the support and involvement of parents and families is essential.
When it comes to CAS, I often think about my very first client, not as a professional, but in graduate school - a little girl with CAS. AAC had been suggested for her in the past, however, her family did not wish to pursue that route. However, if I knew then what I know now, I would have attempted to offer this suggestion again and possibly advocate for an AAC device for this child. Back in 2022, I worked with a second grade boy who had CAS who was working on motor speech techniques but also had an AAC device. He was very effective with it, and he had an alternative method to request what food he wanted for lunch, when he had to go to the bathroom, what song he wanted to listen to, etc. Because of this, his frustration levels were greatly reduced and negative behaviors were minimal. His therapy sessions consisted of the drill work needed for the motor planning of speech, and also on producing functional phrases on his AAC device. So often we see children exhibit signs of frustration and anger, and a lot of it can be due to the inability to be understood, not so much the inability to communicate, however. This was rarely the case with this second grade boy, but it was frequently the case for my very first client. Currently, about half of the students I work with have an AAC device. They are encouraged to indicate when they want to use it, as this supports their autonomy (many of them communicate through multiple modalities). More specifically, my students can produce a variety of communicative intents, from greeting staff and peers, to requesting food, music or activities, and even protesting (telling me they may not want to do their work on any given day) – and that’s okay – it’s meaningful, functional communication!
