[phono-tx] 12 year old student with CAS entering high school

Hello all,

I am currently working with a 12;1 year old student, (Brandon) with CAS.
Brandon comes from a challenging home environment - his parents are not
supportive and are not likely to become so. He was nonverbal when he
began school at 4;11 years and was reported to use very little speech at
home. Brandon continues to be extremely reluctant to speak and rarely
seems to speak to adults or peers. He generally uses single words or
repeated phrases when he is required to speak. His teacher reports that
he occasionally spontaneously speaks to a select group of 2-3 peers.
This behaviour seems consistent across the school and home environment.
He also has a history of stuttering however no stuttering has been noted
in the limited speech observed by me.

Prior to me working with Brandon he completed the following types of
therapy: minimal pairs, listening programs (minimal pairs, auditory
bombardment), some core vocab with no home follow-up, multiple
oppositions, fluency therapy.

Since 2007 he has worked with me and a teacher aide for 1 hour a week .
He has done:

* - 'minimal pair' work for final consonant deletion, medial
consonant deletion, gliding and blends
* -multiple oppostitions (s, ch, sh, j)
* - multisyllabic words - producing words from class lists (drill
work). This included sentence production

Recent assessment revealed that at single word level Brandon is able to
produce a variety of syllable shapes inc things such as CVC.CV.CVC,
CV.CVC, VC.V.CVCC. He was 60% inconsistent on the DEAP with variations
resulting from production of vowels (see below) and changes to syllable
structure (e.g. kangaroo: 1. kangawoo 2. kanawoo 3. kanwoo) and
inconsistent use of phonological processes.

Vowels:

* 'ee' produced as 'i' or 'ee'
* schwa produced as 'a' or schwa
* 'a' produced as schwa, 'e' or 'a'

Brandon could not produce 'p,t,k' sequence and when he attempted to do
so he said 'b,d,g' then 'p,p,t,p,d' then 'p,p,t,t,h,h'.

He inconsistently used phonological processes however he used the
following processes at least once: final consonant deletion, weak
syllable deletion, voicing, stopping and cluster reduction.

His phonetic inventory includes all consonants except voiced and
voiceless 'th'.

I have one term (10 weeks) left to work with Brandon before he goes to
high school. My question is "what is the next step in therapy, both in
terms of improving his speech as well as encouraging him to talk?" I
feel that he percieves himself as a 'nontalker' and I want him to feel
that he can succeed with his talking.

Thanks,

Elaine

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