Briefly, the treatment protocols that I utilize have a strong foundation in evidence-based intervention and in motor learning theory. Meaning, I only use interventions that have strong scientific and theoretical bases. Importantly, treatment is designed to focus on functional and motivational speech goals and targets, and is chosen according to the client’s severity level, age, and response to previous intervention. Treatment is specific, systematic, and personalized around the goals and speech targets that are important to the client and the family. We start with a small target set of no more than 5 targets. Specific evidence-based treatment protocols I use include Dynamic Temporal and Tactile Cueing (DTTC), Rapid Syllable Transition Treatment (ReST), and Speech Motor Chaining.

Importantly, treatment is intense. Throughout the process, I need to have a strong connection with your child and be a support. I need to let your child know that I understand that this is hard work and that I realize that speech is not always fun. It is a balance for sure! While motivating your child and having fun, I need to ensure that they are producing 100s of accurate productions during a session. It is intense, hard work but I make it as fun and motivating as possible. As parents, you will help me with this as we will choose reinforcing rewards and motivational targets together.

A typical session includes a probe to assess the current level of speech target acquisition. Here, I may show a photo of the word, the written word, or use a visual and auditory model/delayed imitation to elicit the word. After we have some pre-practice where I ensure that the child understands the task, knows what the correct production looks and sounds like, explain what we will be working on that session and/or share a visual schedule, and ensure that your child is motivated (e.g., likes our speech targets and the reward), and understands that I realize this is difficult work but I am right there with them! During this time, we may also work on any new phonemes or syllable structures that are missing from your child’s repertoire but are not ready to be in our targets/list.

Next, we will practice our targets. The targets will be practiced at different levels of production (e.g., simultaneously/we will say the targets together, after a model), in different practice schedules (e.g., 5 times in a row or interspersed throughout the session), and with various intonation, rate, and loudness. I will try my best to elicit 100s of trials. During practice, depending on the level of production, I will be providing different types of feedback, different feedback amounts, when I give the feedback, and the type of feedback. Feedback with be dynamic and will depend on the level of accuracy and acquisition/learning. For example, you may hear me give super specific feedback regarding what I what them to do or where their speech parts should be (e.g., tighter lips, tongue up, etc.) or it may simply be “that’s right!”, “not quite”, or “you did it!”. After practice, I will help you to understand and learn the techniques and we will practice implementing any homework with targets that are ready for home. We will review the current target set and see if any new targets need to be added. You can share how your home practice went, any daycare/school information, and any new targets that you added to our ongoing motivational target list. Last, together we will make our plan for the next session and say our good-byes.