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- Katie
- Dimond
- 1300 West Belmont Avenue
Chicago
Illinois
60657
United States - Crossroads Speech Therapy
Chicago
Illinois
60657
United States
It is recommended that children with CAS are seen more frequently and for shorter sessions 3-5 x a week for 30 minutes in the morning and again in the afternoon. I maximize the response trials per session. I maximize their ability to look at my face. I use probe testing to measure progress instead of session data. I incorporate PML (blocked to random practice and frequent and specific to less specific and infrequent feedback.
The treatment method that is the most evidence based is DTTC. So, I would use DTTC with kids with CAS. Prerequisites for use of DTTC are: able to focus attention to the clinician's face for at least a few minutes at a time and able to at least attempt direct imitation. DTTC is an articulatory treatment methods based on integral stimulation.
The treatment emphasizes the shaping of movement gestures for speech production and the continued practice of those gestures, in the context of speech. Practice is organized by blocked practice and moving to random practice. Early in treatment I give more specific feedback and the feedback is faded to less frequent with some delay as well, a temporal delay. We focus on the movement instead of the phoneme. DTTC procedures are simultaneous production, to immediate repetition, then moving to repetition after delay, and finally spontaneous production. Tactile cues, gestural cues, phonetic placement, holding the initial articulatory position longer may be used with simultaneous production.
Parents are very involved. They often sit in on our sessions. I teach them strategies and help them for their home practice. I also help them understand how I am working with their child and all the effort their child is giving. If they do not sit in on the session I go over the session afterwards, explain what we did and why, I always give a carryover activity for home practice and generalization too.
I have used AAC (low tech) for some of the kids on my caseload. Other clinicians in my practice have more extensive experience with high tech AAC and I am able to collaborate with them as well.