By Leslie Lindsay

I am excited to introduce Melanie Feller, CCC-SLP to “Apraxia Monday.”  Melanie’s article, “7 Common Myths of Childhood Apraxia of Speech” recently appeared on Special Education Advisor http://www.specialeducationadvisor.com/7-common-myths-of-childhood-apraxia-of-speech-cas/ and featured on PediaStaff as a “Worth Repeating” article.  Melanie hails from New Jersey and is currently in Oregon for a professional opportunity.  She continues to practice pediatric speech-language pathology in both locations. 

L4K:  When and how did you get interested in the field of pediatric speech pathology?   Can you tell us a bit about your educational background?  How long have you been a practicing SLP?  (image source: http://www.upwardaz.org/speech-therapy/.  This is not a photo of Melanie or her practice.  The author(s) have no relationship with this company or individuals). 

Melanie, CCC-SLP: As a senior in college. I was a history major, interested in anything but history, and desperately worried about what I would go to graduate school for.  After discovering a book on graduate schools, I came across “communication disorders” in a list of majors, and decided to do some research.  The information I discovered spoke to me, and I went on an observation to see speech therapy in action.  And then I fell in love. Watching that speech pathologist work with a tiny three year old changed my life forever. 

I have a Masters degree from Kean University in Speech Language Pathology and have been practicing for 9 years

I specialize in CAS, as well as overall language delay and disorder and see clients of all ages, but primarily those from 0-12.   For the younger clients, my model is based on play therapy, and I use many aspects of Floortime within my sessions. I am looking forward to starting the Floortime certification process soon! The goal of my practice is to provide therapy that is effective, efficient, and most of all, fun and kind!

L4K: Your area of interest and expertise has a lot to do with childhood apraxia of speech (CAS). Can you tell us a little about your interest in such a complex speech disorder?  Do you have personal experience with apraxia?  (image source: http://specialedpost.com/2012/10/14/floortime-therapy-fosters-social-communication-in-kids-with-autism/ The author(s) have no known affiliation with Special Ed Post. For your information only).

My first experience with CAS came about in graduate school.  One of my first clients was a seven-year-old child who didn’t speak. No-one seemed to know why, and everyone had assumed he was unable to.  I remember thinking he demonstrated all the signs of a disorder I had recently learned about, and I thought it would be interesting to treat him as such (speech therapy for apraxia is, as you know, very specific) and see if I could be the one to get him to talk!  And the funny thing is, within a month, he started to use sounds, and within two months, he was using some words.  That’s how I first discovered the wonders of diagnosing and treating verbal apraxia, and it’s only taken off since then.  I find it endlessly fascinating and a joy to work with.  There’s something about watching someone literally learn how to move his mouth to form sounds, and how to coordinate that movement to produce strings of sounds that I find incredibly satisfying and fulfilling.

L4K: The early stages a parent experiences when first learning of their child’s CAS diagnosis can be very challenging.  How—and what—would you say to a parent just learning the diagnosis? 

Melanie, CCC-SLP:        

#1) I would say “Don’t Panic!!!!” That is the most important thing. Panic leads people to do all sorts of things, and that is not a good mentality when entering the world of treatment for CAS.

#2)  I would also offer that virtually every child can communicate in some manner, and no-one should be telling a parent that their child will never talk because he has CAS. That’s not just dishonest, it’s unreasonable. As SLP’s, we cannot make a final judgment as to what the outcome of therapeutic intervention will be. While we cannot offer false hope, we can also not say that there is no hope at all.

#3)  I would offer that it is important to ensure that the child received an accurate diagnosis. CAS is sadly frequently mis-diagnosed. Too many children are under (or over) diagnosed, leading to all sorts of issues.  Sometimes a second opinion is an excellent option.

L4K: With your article, “The 7 Most Common Myths of CAS,” which myth would you say is the most common? 

Melanie, CCC-SLP: I would say the most common [myth] is the first [one listed], that an expressive language delay must mean the child has CAS.    As I previously said, CAS is frequently under or over diagnosed, and as a result children with a simple expressive delay are being told they have a rather involved disorder, while those who have that rather involved disorder are told they’re just late talkers, and need to have just a little speech therapy (or maybe none at all) to be “ok.”

L4K: Your company, Alphabet Soup Speech (cute name, by-the-way), focuses on treating children (up to age 21) for speech/language disorders in a traditional in-person approach, but a large part of your practice is done remotely, a growing trend known as telepractice.  Can you tell us a little about how that evolved?  

Melanie, CCC-SLP: Thank you!  It first started when I discovered that many families were unable to obtain speech services due to time or distance constraints.  I had seen an article about telepractice, and realized that it would be great to be able to offer therapy remotely.  It’s also a wonderful option for me, as it allows me to see clients I might not normally have the time to see, or who might be too far away.

L4K: If someone was interested in telepractice (sometimes referred to as telehealth practice), how would they go about requesting those services?  Is it effective for everybody? 

Students work with Leah who is providing Speech services live from BGSU

(image source: http://wiki.hicksvilleschools.org/users/millerk/weblog/07401/Hicksvilles_Partnership_with_BGSUs_Speech_Telepractice_Program.html.  The author(s) have no known affiliation with Hicksville Schools or Bowling Green University.  For your informationation purposes only). 

Melanie, CCC-SLP: It can be a bit difficult to find. The best way may be to contact a particular therapist, and see if they offer that service. Many therapists that offer telpractice now list it on their websites as well.  When someone visits my website, they’ll see telepractice written, with a brief explanation. They can call via phone or email me to discuss their concerns for their child and I’ll make a determination as to whether or not teletherapy might be appropriate.  It works very well with children 6+. For younger children, I can provide parents with consultation services. If we agree that it’s a good fit, we can “meet” online and discuss their child’s particular needs.  The meeting also gives me an opportunity to watch the child communicate, and observe how the parent and child interact.   From that I can provide tips and ideas on how the family can work directly with the child.

Online parent education classes are also in the works! I anticipate that these will be very useful to individuals and small groups who want to learn more about milestones, ways to encourage language building, and red flags to watch out for; all while remaining in the comfort of their particular location.

L4K: What are some of your favorite parent-friendly resources for families walking the apraxia path? 

First off, be careful of just entering “apraxia” on a search engine! There’s lots of mis-information out there, and lots of information that seems to only serve to scare parents, and make them think they have a hopeless, never-ending situation on their hands! 

Some parent friendly resources:   

• The ASHA (American Speech Language and Hearing Association) page on verbal apraxia offers honest, straightforward, and easy to understand information http://www.asha.org/public/speech/disorders/childhoodapraxia.htm They also provide a practitioner search engine for the public. Enter your zip code and they’ll give you a list of ASHA certified speech pathologists in your area.
• The Apraxia-Kids website offers lots and lots of information – it can be overwhelming at times but overall it’s a great resource.http://www.apraxia-kids.org/
• Speaking of Apraxia (Woodbine House, 2012)  There aren’t a lot of good books out there that are accurate, and specifically speak of apraxia on a friendly level (i.e. not a textbook). I’d be interested to know from your readers if there are any books they like that I haven’t heard of!

L4K: Where can readers learn more about you?  Do you blog?  Have a website?  Facebook page?  Twitter account? 

Melanie, CCC-SLP: There are lots of ways! 

• Website: alphabetsoupspeech.com  I am in the process of updating it and am looking forward to a “new and improved” site soon 
• Facebook: Alphabet Soup Speech Consultants, LLC.
• Twitter www.twitter.com@iloveofspeech
• My blog is in the process of being revamped, and I will be blogging again by early spring – http://alphabetsoupspeech.blogspot.com/
  

Many thanks for taking the time to chat with us, Melanie.  Your time and expertise is much appreciated.  Best wishes on your journey!—Leslie : )