By Leslie Lindsay

Today I have a special guest interview, Cari Ebert, CCC-SLP of Summit Speech Therapy and fellow speechie blogger.  Thanks a bunch for taking the time to chat with us, Cari.  We are excited to learn speech tips and tricks for the early childhood set from someone who is so well-versed (sorry, couldn’t resist), in the field.  Let’s start by getting to know you a bit. (image source: http://www.blogger.com/profile/06868042271330481283.  Reetrieved 1.21.13)

L4K: When and how did you get interested in the field of pediatric speech pathology?  Is it something that has always been an interest of yours, or did it evolve along with your academic career? 

CE, SLP: I actually started my career working with adults in long-term care.  I worked in skilled nursing facilities and had a special interest in patients who had been diagnosed with Alzheimer’s. After having my first daughter, however, I was so amazed watching her grow and develop that I switched gears, and became a pediatric speech-language pathologist.   I now work primarily in early intervention (EI) with the birth to three population.  The primary purpose of EI is to empower parents by increasing their confidence and competence in facilitating their child’s development.  Parents are a child’s first and most important teacher which is why I believe so strongly in the power of early intervention. 

L4K: Can you tell us a bit about your educational background?  How long have you been a practicing SLP? 

CE, SLP: I completed my undergraduate degree at the University of Iowa (Go Hawkeyes!) in 1993 and my graduate degree at Southern Illinois University in Carbondale (Go Salukis!) in 1995.  I have been a speech-language pathologist for 17 years and have specialized in early intervention for 12 of those years.      

L4K: Do you have any tips for aspiring SLPs?  Keep an open mind about whether you want to work with adults or kids. 

CE, SLP: Depending on where you at in your life, your interests may change over time.  Also, be sure to shadow a few therapists in different settings before you declare your major in school.  You will pour blood, sweat and tears into this degree so be sure it is the one for you! 

L4K: Your area of interest and expertise has a lot to do with childhood apraxia of speech (CAS).  In fact, you lecture on and treat children with CAS.  Can you tell us a little about your interest in such a complex speech disorder?  Do you have personal experience with apraxia—did you or your own children struggle with the disorder? 

CE, SLP: Over the years I have evolved into an apraxia therapist and I strive to help families of very young children who are late to talk.  Early on, when a child is essentially non-verbal, I look for characteristics or “red flags” that make me suspect childhood apraxia of speech as the cause for the lag in expressive language and speech development. 

Because most of the toddlers I see in therapy don’t even know they have lips or a tongue (literally!), we start the therapy process by increasing the child’s awareness of his articulators, and progress from there.  I do have personal experience with apraxia as well.  My 8 year old son has autism and apraxia and he has taught me more about my profession than any book I have ever read and any course I have ever taken.  I love to learn and apraxia is such a complex disorder, that it keeps me on my toes!  (image source: http://pathways.org/pathways-center/services/speech-therapy/.  This is not an image of Cari Ebert, CCC-SLP)   L4K: As you are well-aware, CAS is a challenging disorder/diagnosis.  What would you tell a parent who is suspecting CAS?  How do you usually give  the diagnosis? 

CE, SLP:  CAS is a SPEECH disorder, not a LANGUAGE disorder.  That means the child must actually have speech before it can be diagnosed.  Too many SLPs are mis-diagnosing and over-diagnosing CAS in non-verbal toddlers.  In young children under age 3, I recommend SLPs give the diagnosis of “suspected childhood apraxia of speech” until the child is verbal and the diagnosis can be confirmed. 

CAS is a dynamic disorder and speech characteristics can change over time with appropriate therapy and neurological maturation.  I usually don’t focus too much on the label in the beginning stages of therapy.  I am eager to help the child find his or her voice and experience some much needed success early on in the process.  This is so important because success breeds confidence (“I think I can”), which helps the child become a communication risk-taker (“I’m willing to try new things”).   

Becoming a communication risk-taker is crucial to building both competence and confidence.  I encourage parents to revel in the small achievements that their child makes, because all of those baby steps eventually equal a major milestone.  Progress will not be rapid and I am sure to remind parents of this because every parent will get frustrated at some point in the therapy process. 

L4K: What are some of your favorite parent-friendly resources for families walking the apraxia path?  (websites, clinics, books, groups, etc.) 

CE, SLP:  I encourage parents not to google apraxia because I want to be sure the information obtained is accurate and beneficial.  Three of my favorite websites are:  www.apraxia-kids.org; www.kidspeech.com; and www.cherabfoundation.org.  My two favorite parent friendly books are The Late Talker by Marilyn Agin and Speaking of Apraxia by Leslie Lindsay–what an awesome resource! 

Along with these resources, I have personally created a hierarchy of developmental skills that need to be addressed in therapy to ensure success.  I also think finding or creating a support group can reduce the stress and anxiety that goes along with raising a child with special needs.  The support group I started about 6 years ago is called H.U.G.S. which stands for Helping, Understanding, Guiding, Supporting.  It has been a lifeline for me as I take this journey into the unknown. 

One thing is for sure, we need each other and we don’t have to do it alone!  Being with a group of people who understand my plight, strengthen me when I am down, and revel in my child’s successes has been priceless. 

L4K: Can you tell us more about your clinic, Summit Speech Therapy, LLC.  Do you have a website?  Are you actively taking new clients? 

CE, SLP: Because very young children learn best in their natural environment (home, daycare, etc.), I travel to the child instead of having the child come into a clinic.   I office out of my home and spend my days commuting from one family’s home to the next.  I do consult with families “long distance” via email, phone, & Skype.  Many parents send me videos of their child and I give them my thoughts and analysis based on what I observe.  Occasionally I have families who choose to come spend a few days here in Kansas City where I can consult with them in person. 

As I mentioned before, I strongly believe that parents are a child’s most important teacher, and it is always my goal to coach the parents on how to best facilitate their child’s development.  I recognize that young children learn differently than older children and my therapy style reflects this. 

L4K: I understand you blog as well.  How long—and what is your goal—with blogging? 

CE, SLP: I am not a techno-savvy person, but I decided to start blogging about 6 months ago when I was diagnosed with breast cancer and was unable to work.  Through blogging I was able to stay in touch with my profession and my clients and I know this helped me fight my battle. 

My blog website is www.learning-through-play.com.  My goal in blogging is to help parents and professionals understand how important play is in the development of young children.  You see, very young children do not learn best through flash cards and drill work.  Rather, they learn best through play that is relevant and meaningful to their life.  Too often, therapy with young children is ineffective because therapists are trying to utilize inappropriate therapy methods. 

L4K: One piece of sound advice for the road?  

CE, SLP: One thing I say frequently when I present is that talking does NOT start at the mouth.  A child must possess strong gross and fine motor imitation skills first because a child must imitate what we do before he or she will ever imitate what we say.  Too frequently SLPs put the cart before the horse and start trying to teach the child to talk, when in fact, the child may not even be able to motor plan gross and/or fine motor movements. 

WOW–what a bunch of great information, Cari.  Thank you so very much for offering your time and expertise to “Apraxia Monday.”

Leslie, I want to thank you for your time and commitment to helping parents understand more about apraxia!  And good luck to all your readers and their small talkers!