Posts Tagged by K-SLP
The PROMPT Approach
| July 10, 2011 | Posted by Laura under 2011 CASANA Conference, K-SLP, Prompt, Treatment |
– I’m not necessarily writing about each session in the order that we attended. These are my thoughts after hearing each of these speakers and should not be construed as a summary of each speaker’s presentation. –
The first session we attended Friday morning was The Prompt Approach: An Overview presented by Deborah Hayden, MA, CCC-SLP who is the Executive Director and Founder of the PROMPT Institute in Santa Fe, New Mexico. Ms. Hayden developed the PROMPT method (Prompts for Restructuring Oral Muscular Phonetic Targets). There is an interesting history here about the development of this method.
PROMPT was not developed specifically for children with CAS and is also used with adults with Acquired Apraxia of Speech as well as other speech disordered populations. It differs in the more traditional type of speech therapy which relies particularly on auditory and visual input. PROMPT requires the practitioner to actually touch the patient’s face to give them tactile cues about which muscles and parts of the mouth, tongue, neck, and throat to move when speaking. If done correctly, these tactile cues are eventually faded.
In my experience prior to this conference, I have found that the speech therapists that we have seen who have treated E have either relied on the Kaufman Speech to Language Protocol (K-SLP) or the PROMPT method. I now know that these are not the only two choices. (More on that later).
Speech therapists that choose to undergo extensive training can become certified in PROMPT. Go here to find speech therapists in your area who have received training. Other speech therapists may undergo even further training and may become certified PROMPT instructors as well. Ms. Hayden primarily lectures now and no longer teaches training sessions. How lucky for us to receive an overview by the creator of PROMPT!
E’s current private speech therapist is trained in PROMPT but has not completed enough sessions to be certified. My husband and I chose this session to attend so that we could learn more about the type of therapy E is receiving,
There is not enough research about CAS. However, there is research showing the effectiveness of PROMPT on people with motor speech disorders – CAS is one of them.
We were shown videos of children with CAS in PROMPT therapy sessions. We were also able to watch Ms. Hayden do some of the PROMPT cues on herself. I can’t imagine how good she must be at this to do this movements on herself as well as from behind the patient in one of the videos.
The main thing that I came away with from this presentation was that PROMPT is a holistic approach to speech therapy. The practitioner will not always have his or her hands on the patient. In children specifically, attention and waiting need to be learned in order for PROMPT to be most successful. Furthermore, it is extremely important that the patient TRUST the practitioner. The practitioner will, after all, have their hands all over the patients face, mouth, and throat. It is important for the practitioner to meet the child were they are at – both developmentally as well as interest wise. The patient needs to be motivated, trusting, and learn turn taking and waiting.
Even though our private speech therapist is not PROMPT certified, I came away feeling good about the way she approaches E. E likes her and trusts her which is so important – especially when you consider that E has now seen 11 speech therapists regularly over the last two and half years. I left the session knowing that PROMPT requires a high level of training, which neither my husband not I have, but that we know enough about it to recognize when someone is practicing it appropriately.
Appropriate vs. Optimal
| May 31, 2011 | Posted by Laura under Special Education, Treatment |
The laws surrounding special education can be confusing, contradictory, and endless. Case law (that is decisions made by other judges about cases with similar circumstances) make up much of the law surrounding IDEA. One of the first things you’ll learn when you enter the public education system is that you need to do your homework. You, and no one else, is your child’s advocate. You have an extremely important job to do. If you thought being a parent was difficult and unforgiving, try being a special needs parents. The stakes are higher and the mistakes are magnified.
According to IDEA, schools are to provide special needs students with a FAPE (Free and Appropriate Public Education). Notice, it is not optimal but appropriate. The school district does not need to provide your child with the best education possible nor are they required to help your child reach his or her potential. All they are required to do is provide an “appropriate” education for your child that will enable him or her to “access the curriculum” in a meaningful way. Whether or not you agree with this explanation, it is the law and you will not find success challenging it.
In the case of CAS, the terms appropriate and optimal come into play regarding speech therapy. The American Speech-Language-Hearing Association came out with a Technical Report on CAS in 2007. (I think every parent of a child with CAS should have a copy of this report printed and have ready access to it. See pp. 39-42 for an extensive summary of appropriate treatment.) ASHA recommends individual, intensive speech therapy, three to five times a week, for 30 minutes each session. Be prepared that the first time you bring this up to the school district, you may be laughed at. Speech therapy is expensive and even though school districts are required to address every student’s unique needs, individual, intensive speech therapy is most likely not something you will get easily.
The school district may try to describe this treatment as optimal rather than appropriate. But you need to find evidence to the contrary. I live in California and found this decision in a due process case in the fall of 2009 between the parents of a child with CAS and the Los Angeles Unified School District. There are several issues at play in this case but one of them is the appropriate amount of therapy for a student with CAS. Be sure to look at p. 35 for the judge’s findings about the student’s Language and Speech Services (LAS). He writes,
“Pursuant to Factual Findings 12 through 31, 36, 37, and 67 and Legal Conclusions 2, 3, 4, and 25 through 28, the District denied Student a FAPE since the amount of LAS is inappropriate to meet his unique needs in language and speech. Student suffers from apraxia. The proper level of speech therapy to treat this disability is that recommended by the American Speech and Hearing Association which is three to five times per week for aweekly total of 150 minutes. The District offer of one hour per week of LAS is an insufficient amount of services to meet Student’s unique needs.”
The italics are mine.
I find this case extremely interesting and will be bringing it up at our next IEP meeting. Have any other parents found any cases referring to the amount of individual speech therapy your child should be receiving? What did they say was the appropriate amount? I’m interested to read others’ thoughts on this subject.
