We will look at the whole child and assess various aspects of communication, including not only a child’s speech, but also language, and ability to engage in reciprocal communication exchanges necessary for the repetitive practice needed in the treatment of CAS. We will identify target syllables, words and phrases that 1) build in a hierarchical manner based on the child’s motor-speech capabilities identified in assessment, and 2) are motivating and functional in daily routines so that a child is able to get repetitive practice in a meaningful way outside of the therapy session. For example, if a child is working on vowel-consonant production and learning to bring the jaw from open to closed consistently, the child may work on words such as "up" while playing a game shooting butterflies 'up' in the air. The child is then is encouraged to use 'up' when asking a parent to pick him/her up in order to practice generalizing this same pattern. We will practice this target pattern during structured 'mass practice' (i.e. drill) for 5-10 minutes before using it in a game. Once this target is mastered, the next target will contain a slight increase in the motor-planning demand, such as ‘go up’ or ‘more up’. Phrases and sentences are built depending on a child’s ability to voluntarily control and integrate movements between jaw, lips, and tongue, as well as those needed for volitional control of phonation and intonation. Use of meaningful, functional phrases and sentences should aid in generalization into everyday activities.

Regarding Covid-19, we are using clear, enclosed face shields in order for kids to have a visual model of the targeted articulatory patterns during in-person therapy. We are also using teletherapy for those who prefer it.