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- Tiffany
- Davis
- No
- 4126 Briargrove Lane
Dallas
Texas
75287
United States - Wildflower Kids Speech and Feeding Therapy
Dallas
Texas
75287
United States
When starting with a child who has moderate to severe CAS, I would first look at their sound and word inventory, what words/sounds do they currently have. I use that information to help determine what sounds, syllable structures and words we would target next. Based on that information I would also create a target "functional" word list so that while we are working on increasing speech sounds and syllable structures we are also building a functional vocabulary so that the child is better able to communicate their wants and needs with those around them. My therapy sessions are always play based. I find games, activities, books, toys with which I can functionally target the sounds/syllable structures/words that we are working on so that the child is motivated. I typically also use flashcards, briefly at the beginning of each session as a warm up of the sounds/words we are targeting. This activity is typically brief as most children have a short attention span for drill work, but may increase with age and increased tolerance. I use PROMPT cues, simultaneous speaking, visual and verbal prompts to help the child achieve their target goals. Cues are faded over time, as the child shows increased accuracy in productions, but it is important to for children with apraxia to get as many accurate repetitions as possible and to get accurate feedback about whether their sound production was correct or not. Cues and feedback as adjusted each session, based on the child's level of success. As the child experiences success, we will slowly add in new and more complex words or syllable structures and sounds as well as increasing to phrases and sentences, to build upon what they have already accomplished.
I believe parent/caregiver involvement is crucial in the treatment of CAS. I always encourage the parent/caregiver to attend each session, so that they can observe what I am doing and how I am cueing the sounds/words that are being targeted in therapy sessions. I provide parent coaching throughout the session, so that the parent feels equipped with strategies to use when they are at home. As the parent watches and becomes more comfortable with what we are doing, I will also have the parent practice strategies with their child in front of me so that they can feel confident that they are providing the right kind of cueing and support for their child. Parents are welcome to video record parts of the session, if they feel it will be helpful for them to review with other caregivers or on their own later. I also provide copies of target words/sounds or other therapy materials that are used in the session, so that the parents are able to continue practice at home without having to do extra work creating practice material themselves.
I have introduced AAC (either through PECS or proloquo to go on the i-pad) for children who are not yet speaking but are clearly showing very strong non-verbal communication skills/vocabulary. So that they are able to decrease their frustration, have a positive means of communication with their families. When introducing AAC, I always teach parents to model and push for verbalizations and approximations when using AAC. It is typically only used for a short period of time and then slowly phased out of the treatment plan as the child begins to communicate more verbally. For some children, that have other developmental or medical issues as well as apraxia of speech, the use of AAC may be a more long term solution as the child still targets verbal speech. AAC, for most children with apraxia of speech is not their to replace verbal speech, it is a tool to help them communicate more effectively and reduce frustration, so that we can more easily target speech production and grow their verbal vocabulary.
