I used a very blended treatment approach. I begin using alternative or augmentative communication techniques within my first session, whether it is no/low tech or high tech devices. I typically use signed English as a way to help the child learn an alternative way to communicate and as an added visual cue. I may also use picture boards, PECS, or other low tech devices to help the child gain confidence in requesting items. Next, I work on getting approximations of many vowel and consonant sounds. I really like the Easy Does It for Apraxia Program for this. However, I don't focus on the isolation level of sounds too much for CAS as this disorder is a problem with sequencing of sounds. I am a huge proponent of using your whole body. I use a lot of sign language for communication and for self-cuing. I also teach gestures and physical communication . Using tactile/touch cues helps the child remember where in their mouth they need to be making a sound. I use a combination of the tactile cues in the Easy Does It for Apraxia program, the Kaufmann program, and some intuitive tactile cues. I also incorporate music as much as I can to start work on prosody as music helps to engage whole brain activity. This also ties into the use of MIT/DTTC when appropriate. The most important thing, however, is building
trust and FUN with the child. I want speech therapy to be a positive experience that the child looks forward to coming to, not something that they HAVE to do and become disenchanted with. I don't want this to be drill work for half an hour. I typically start all my CAS sessions with a few minutes of practice using apraxia speech materials (such as Kaufmann Speech Praxis Materials), then move into crafting or play while incorporating our targets. As soon as I can, I work on teaching children how to advocate for themselves, including saying "no" and being able to communicate how they feel.

I started my career working under Kathleen Helfrich-Miller who started this practice. While I still consider her a mentor, I did take over the practice in 2019 when she retired. In the 1980s, she did research on using Melodic Intonation Therapy (MIT) in treating CAS, which is quite similar Dynamic Temporal Tactile Cuing (DTTC). DTTC is currently the most researched and recommended treatment of CAS as it teaches the child how to sequence sounds in longer phrases and sentences while keeping the prosody, or “sing-song” nature of language intact. DTTC uses a structured hierarchy to phase out the level of help a child will need in saying that phrase as well. The main difference between the two programs is that MIT uses mostly sign language for the visual and tactile cuing while DTTC uses mainly touch prompts. I use a blend of both depending on the phrase or client.