Monday, February 8, 2016

SLPs, Sometimes Love Hurts

I am linking up with the Frenzied SLP's to talk about love. Everyone is talking about love this week- after all, Valentine's Day is coming. But sometimes love hurts.

If you are an SLP  working with children, sooner or later, you get hurt. It happens. 

Sometimes when you least expect it. It comes with the territory.

Sitting in a parent meeting- seems pretty safe? 

Sometimes parents bring the child with them, I like to have a selection of toys to help keep the kiddos busy so Mom and Dad can listen to the discussion.

One child was interested in the toys, but had a short attention span. After quietly slipping him a few toys in succession, he busied himself with a metal toy car as I explained my report to the parent. Well, apparently the little guy tired of that car, and I was not paying attention to his need for a new diversion... and I got clocked. Pay attention to me please. POW!

It must have strained my jaw, because I experienced TMJ for the first time in my life. Couldn't hardly open my mouth, definitely couldn't chew without intense pain for 2 weeks. I ate a lot of yogurt and cream style soup.

Lesson learned.

 Provide lightweight toys. Don't turn your attention away from a bored or frustrated child.

We eventually became good buddies, and he never lashed out again. I kept him busy, busy, and loved working with the little guy.

Head over to the linky to read more stories about love. And when sometimes #slpLoveHurts.

Tumblr code:

Sunday, February 7, 2016

Childhood Apraxia of Speech: Your Questions

Childhood Apraxia of Speech. 

Childhood apraxia of speech is a  disorder that can have a profound impact on a child's ability to communicate. 

Childhood Apraxia of Speech: Your Questions about this tricky disorder
Many SLP's have questions about how to diagnose and treat CAS

Do you have a child on your caseload you suspect or have diagnosed as having Childhood Apraxia of Speech or CAS? 

Maybe a  child who speaks in little more than vowels, and those may not be entirely accurate? Highly unintelligible, inconsistent when she repeats a word or makes unusual mouth movements when speaking? A child who has not made much progress in therapy with your usual approaches?

Perhaps you are an SLP who is not 100% comfortable with diagnosing and treating apraxia of speech in children. 

Diagnosis is tricky, even for the experts. Maybe you have questions about goal setting and treatment planning.

We learned about motor speech disorders in grad school, didn't we? True, we were taught CAS was a disorder of "motor planning" which required a different approach to treatment. Intensive treatment based on "motor learning theory." I will admit, I was unsure of what that really meant. Are you?

So what to do? I started reading everything could get my hands on. I ordered some books and programs and went to workshops. I still had many questions when faced with diagnosing a new preschooler or planning effective treatment.

Aha Moment!

Then one day, I had the opportunity to see Dr. Edythe Strand of Mayo Clinic present at a workshop. If you have had the privilege of hearing her speak, you know what a dynamic teacher she is, and a fabulous clinician. That day I was wondering "What does therapy based on motor learning theory really look like? How is it different from the way I approach a child with a developmental speech delay?"
Childhood Apraxia of Speech: Your Questions about this tricky disorder
Childhood Apraxia Of Speech:
Model the motor movements 

The light bulb turned on when Dr. Strand demonstrated how to model a word.... silently. Oh my gosh, it clicked for me. Modeling speech sounds is not enough. We need to make the movements of the articulators the main focus... it's about the muscles and how they move from one position to another. So a child must watch as well as listen. Eureka!

I was completely energized by hearing Dr. Strand and left thinking how I wished I could go to Mayo and learn more from her. I am beyond thrilled to tell you that my journey to learn more about CAS  continues with a wonderful opportunity.

This spring, I will be joining 24 other SLP's for a 3-day Intensive workshop on Childhood Apraxia of Speech with Dr. Strand. 

I am so excited, I still have so many questions. I am going to bring a list of those questions with me, and hopefully will have the opportunity to find many answers.

For me, I want to learn more about therapy techniques for vowel errors. And how to chose targets that give you and your student/client the most bang for your buck as the child progresses.

So I am wondering, what questions do you have?

 I asked in a Facebook group I belong to: School-Based Speech and Language Therapy. Here's what some of the SLP's who replied said:

Childhood Apraxia of Speech: Your Questions about this tricky disorder
Childhood Apraxia of Speech:
What would you ask an expert?

 AshleyI would love to know how to make treatment more functional for my kids with CAS.

Tina: I'd love to know where to find more info on DTTC training

Amanda: I would love to know how to help a student with severe apraxia...she has difficulty imitating most lip/tongue movements or sounds.

Cathy: I'd like to know what the best app is for apraxia

Griffin Speech:  I find it particularly challenging figuring out where to start with this population and I work exclusively with junior high aged students.

Jand: I'm distinguishing right now b/w CAS and severe phonological disorder. Help in that area would be great.

KathyrnEvidence-based practice for service delivery! I've heard that it's supposed to be intense like 5 hours a week for CAS but that just isn't practical for the school setting. I would like to know what they recommend for school-based SLP's and home program support.

Giane: I am also interested in the techniques you'll learn (and their differentiation from PROMPT

Kymmbo: What is best practice for teaching students with apraxia how to read? It's definitely not the same for them, and it can be a very frustrating experience. And I want to know best practices for those "lingering" apraxic characteristics in older children who may still have prosodic issues 

Donna (Badger State Speechy).What are the primary research-based interventions for treating CAS? I am also curious to know how often CAS coexists with the diagnosis of autism? 

Lets Tackle Apraxia Together!

Do YOU have questions about CAS? I would love to hear from you. Leave a comment or question. and I will definitely be back, sharing what I learn. 


Read all about what I learned (tons!), in my Apraxia series starting with this post: Childhood Apraxia of Speech: What SLPs Need to Know

See you there!