Therapy Treatments:
You may hear people say, “you must go to a (fill in the blank) speech pathologist.” In reality, each type of therapy should be viewed as a tool in a toolbox. Do not allow yourself to get hung up on 1 type of treatment method. Each child is different, each therapist and their approach is different, and the outcome will always be varied due to that. Your child will be the most successful when you are able to find the right combination. With all of this in mind, it is still imperative that your SLP is certified by ASHA. I have included an explanation of some of the most talked about therapy types below. Remember all children will respond to therapy differently - dont give up! Just keep looking for the right fit!
PROMPT: This is the one you probably hear the most about. Some people swear by it, and insist it is the only way to approach apraxia. According to their website, “PROMPT is an acronym for Prompts for Restructuring Oral Muscular Phonetic Targets. The technique is a tactile-kinesthetic approach that uses touch cues to a patient’s articulators (jaw, tongue, lips) to manually guide them through a targeted word, phrase or sentence. The technique develops motor control and the development of proper oral muscular movements, while eliminating unnecessary muscle movements, such as jaw sliding and inadequate lip rounding.” I will say this method never worked for my son, in fact, he hated it.
DTTC: The ASHA website describes it as, “Dynamic Temporal and Tactile Cueing (DTTC) is an IS (Integral Stimulation) method that uses a cueing hierarchy (auditory, visual, and tactile) and systematically decreases supports as the child achieves success at each level of the cueing hierarchy (Strand & Debertine, 2000; Strand et al., 2006). Movement gestures are shaped, beginning with direct imitation, moving to simultaneous production with tactile or gestural cues if direct imitation was unsuccessful, and then fading the simultaneous cue and again moving to direct imitation. The key element of this approach is that the clinician is constantly adding or fading auditory, visual, and tactile cues as needed after each practice trial.”
Sensory Cueing: This is generally referred to as a “multisensory approach” many SLP’s are not familiar with it or do not actively use it. This was by far the most successful form of treatment for my son. He is very active and this approach allowed him to physically move and be much more involved in the actual therapy. It is based upon the incorporation of sensory input depending upon the child and their needs. It can be singular or a combination of proprioceptive, tactile, visual, and / or auditory input, hence the term “multisensory.” For children that also have sensory needs this type of treatment can provide the type of sensory feedback they crave while helping to develop their speech.
ReST: The acronym for Rapid Syllable Transition Treatment has been researched extensively in Australia and is much more common there than the states. With that said, it has shown much promise in assisting children with CAS. This method “applies principles of motor learning to maximize long-term maintenance and generalization of speech skills in children with CAS. ReST involves intensive practice in producing multisyllabic, phonotactically permissible pseudo-words to improve accuracy of speech sound production, rapid and fluent transitioning from one sound or syllable to the next, and control of syllable stress within words. Pseudo-words are used to allow the development and practice of new speech patterns without interference from existing error speech patterns (Murray, McCabe, & Ballard, 2012).”
Treatment Frequency: The number of times and hours per week that a child should attend speech therapy is widely varied based upon the child. You will have to adjust the frequency to find what works best for you and your family. I am a believer in as much as possible, combining school based therapy and private whenever possible. This gives your child variety and may help to offset some of the redundancy that can come with frequent therapy. However, each child is different and responds differently but I think if therapy is fun (as it should be) then get as much in as you can!
