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What is ASD?
Autism Spectrum Disorder is a developmental disability that results in social-communication impairments and restrictive/repetitive behaviors.
Link: https://www.mayoclinic.org/diseases-conditions/autism-spectrum-disorder/symptoms-causes/syc-20352928
How common is ASD?
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ASD is diagnosed in 1/54 children in the United States. The male to female ratio is 4:1.
Link: https://www.autismspeaks.org/press-release/cdc-estimate-autism-prevalence-increases-nearly-10-percent-1-54-children-us
What are the characteristics of ASD?
There are several signs in early childhood:
We encourage you to watch this brief video tutorial on the early signs of ASD: https://www.youtube.com/watch?v=YtvP5A5OHpU
Are there screenings available for ASD?
Lindsay Scott SLP and Co. can provide you with a comprehensive screening using the Modified Checklist for Autism in Toddlers (M-CHAT). This is considered the gold standard screening tool for ASD.
How is ASD diagnosed?
Lindsay Scott SLP and Co. is qualified to administer the Autism Diagnostic Observation Schedule-2nd Edition (ADOS-2), considered the gold standard diagnostic tool for ASD. This semi-structured assessment includes play-based activities designed to obtain information in the areas of communication, reciprocal social interactions, and restricted and repetitive behaviors associated with a diagnosis of ASD.
What is PROMPT?
PROMPT is a unique, holistic philosophy and approach to assessment and treatment of speech delays and disorders. PROMPT systematically determines where motor breakdowns occur using a unique assessment including a Conceptual Framework, which helps determine priorities in treatment. Communication is an interaction between the Social-Emotional ability to connect with others, Cognitive-Linguistic understanding of language, and Physical-Sensory ability to produce certain words. According to the PROMPT Institute, a child’s ability to communicate is impacted when any of these areas are disordered or delayed. PROMPT is also most well known for being a tactile-kinesthetic (touch and feel) approach, where an SLP places their hands on the client’s face to help guide the jaw, lips and tongue to produce accurate speech movements.
We encourage you to watch this short informational video explaining and demonstrating what PROMPT is: https://m.youtube.com/watch?feature=youtu.be&v=d1eMHygmIwQ
Can my child receive PROMPT treatment over Tele-therapy?
Although PROMPT is most well known for being a tactile-kinesthetic (touch and feel) approach, PROMPT is not limited to tactile cues. The broader PROMPT philosophy for evaluation and treatment for a child’s whole system- Cognitive Linguistic, Social Emotional and Physical Sensory, can be implemented through Tele-therapy. The principles and theoretical framework for treating the Physical Sensory (motor system) for speech continue to guide PROMPT treatment. Although there is no current research on PROMPT and Tele-therapy, our clinicians are trained to implement Tele-therapy for PROMPT, and we are also excited to share that we’ve had a student graduate speech after a shift to intensive PROMPT Tele-therapy!
What is Childhood Apraxia of Speech (CAS)?
Childhood Apraxia of Speech (CAS) is a label for a specific motor speech disorder that makes it difficult for children to speak. Children with Apraxia of Speech have difficulty with the planning and programming of the complex sequenced movements that are necessary to produce speech sounds and words. Unlike a true developmental speech delay, where children follow a “typical” path of speech development at a slower rate, a child with CAS has difficulty planning the motor movements required to produce speech. This may result in difficulties with smooth transitions from sound to sound, or syllable to syllable, and inconsistent speech errors.
Who can best diagnose Childhood Apraxia of Speech?
Childhood Apraxia of Speech (CAS) is a label for a specific motor speech disorder that makes it difficult for children to speak. Children with Apraxia of Speech have difficulty with the planning and programming of the complex sequenced movements that are necessary to produce speech sounds and words. Unlike a true developmental speech delay, where children follow a “typical” path of speech development at a slower rate, a child with CAS has difficulty planning the motor movements required to produce speech. This may result in difficulties with smooth transitions from sound to sound, or syllable to syllable, and inconsistent speech errors.
What is the difference between CAS and other speech disorders?
Children with Childhood Apraxia of Speech often generally have a good understanding of language and know what they want to say, but have difficulty efficiently programming the complex sequence of movements that are necessary to produce clear speech. Although sometimes CAS can co-occur with other diagnoses, such as Autism Spectrum Disorder, there are certain key characteristics, in the absence of any consistent developmental errors, that help differentiate CAS from other speech sounds disorders. CAS is a difficulty in the planning and execution of the muscle movements needed to produce speech. This is unlike developmental delays, in which motor planning occurs in a “typical” but delayed timeline. Some of the characteristics that differentiate CAS from other speech disorders include:
What are some early warning signs for CAS?
Research has started to demonstrate some early warning signs of CAS in infants and toddlers, which SLPs and parents should consider. The following symptoms do not diagnose a child with CAS; rather they are red flags which indicate early intervention speech therapy is advisable, and which have been linked in studies to a later label of CAS. Here are some early warning signs for CAS in toddlers that were found to correlate with a later diagnosis of CAS,by Overby, Caspari, and Schreiber (2019):
Overby MS, Caspari SS, Schreiber J. Volubility, Consonant Emergence, and Syllabic Structure in Infants and Toddlers Later Diagnosed With Childhood Apraxia of Speech, Speech Sound Disorder, and Typical Development: A Retrospective Video Analysis. J Speech Lang Hear Res. 2019;62(6):1657‐1675. doi:10.1044/2019_JSLHR-S-18-0046
What kind of therapy does my child need for treating CAS?
Appropriate treatment for CAS should focus on the motor planning and programming needed to produce speech, since the main problem of CAS is in motor programming for speech. Unique motor planning based therapy treatment for CAS, including Dynamic Temporal Tactile Cueing (DTTC) or PROMPT, focuses on planning of the sequenced movements of the articulators (tongue, lips, jaw, vocal folds) and muscles that need to move during speech attempts. Therapy for CAS concentrates on the motor movements in order to help the child produce more precise sounds, words, phrases, and spontaneous speech.
We encourage you to watch this video about treatment for CAS with Dr. Edythe Strand, Emeritus Professor and Consultant, division of Speech Pathology, Department of Neurology, Mayo Clinic, in which she discusses basic approaches to treatment of CAS and provides a number of video examples of therapy.
https://www.youtube.com/watch?v=sq7vFWLqodM
What is Dynamic Temporal Tactile Cueing (DTTC)?
Dynamic Temporal Tactile Cueing (DTTC) was developed by Dr. Edythe Strand Ph.D. CCC-SLP to treat students with Childhood Apraxia of Speech (CAS). DTTC is based on the Integral Stimulation Method (i.e., “watch me, do what I do”). DTTC also applies the Principles of Motor Learning to motor speech treatment to help make the motor programming for speech more efficient, and make the speech movements more precise. DTTC treats the motor programming needed to produce accurate speech movements at the level of the tongue, lips, jaw, vocal folds, and vocal tract. DTTC utilizes a unique and specific hierarchy of cueing and practice which facilitates motor speech learning, with prosodic (melodic, intonation) variation built into every level of the hierarchy. This helps encourage flexibility and generalization of motor speech skills. A careful analysis of each child’s motor speech skills and communication needs are considered in treatment planning and selection of motor targets, and the process of shifting the amounts of cueing and support is dynamic and fluid as progress is made over time. The use of DTTC has proven to be an effective method for treatment of CAS in current literature. Within our practice, we have also found DTTC treatment techniques and strategies to be efficient and successful for treatment of other motor speech disorders as well.
Strand, Edythe. (2019). Dynamic Temporal and Tactile Cueing: A Treatment Strategy for Childhood Apraxia of Speech. American Journal of Speech-Language Pathology. 29. 1-19. 10.1044/2019_AJSLP-19-0005.
What is JASPER?
JASPER is an evidenced based treatment approach based on a combination of developmental and behavioral principles developed by Dr. Connie Kasari at UCLA. It targets the foundations of social communication (joint attention, imitation and play) and uses naturalistic strategies to increase the rate and complexity of social communication. (Kasari, 2017)
What does JASPER stand for?
Joint Attention, Symbolic Play, Engagement and Regulation (Kasari, 2017)
Research, Evidence and Results of JASPER
JASPER is one of two social communication interventions recommended by the UK NICE as evidence based (2013).
JASPER holds over 15 years of research, involving nearly 500 children with Autism Spectrum Disorder (ASD) in randomized controlled trials (RCTs). The trials evaluating JASPER’s efficacy, the researchers within the Kasari Lab as well as independent evaluators, found improvements in joint engagement, social communication, and emotional regulation with decreasing negative overtime. (Kasari, 2017)
Implementation
JASPER has been empirically tested with children ranging from ages 12 months-8 years with various developmental abilities. It can be implemented by trained parents, teachers, clinicians, paraprofessionals and other related service providers.
JASPER works well in conjunction with other behavioral based therapies and can be natural incorporated into inclusion and special education classrooms and every day at home. The materials only require developmentally appropriate toys/activities. (Kasari, 2017)