Apraxia Intensive Training Institute 2014

The Apraxia Intensive Training Institute (aka apraxia bootcamp), is an intensive training sponsored by the non-profit organization CASANA of apraxia-kids.org.

WHAT IS SPECIAL ABOUT CASANA?

I love CASANA for SOOO many reasons.  As an SLP but parent first of a child with apraxia, CASANA was literally built on the backs of mothers who had children with apraxia.  Sharon Gretz is the founder and executive director and she attended EVERY session.  This is her baby, next to her two human babies of course.  It was apparent she wanted to make sure that professionals she's endorsing will do right by the kids they see, just like apraxia expert David Hammer did right by her son Luke.  Kathy Hennessy is a mom of not one, but two children who grew up with CAS; and she is the the Education Director for the organization.  She too attended every session.

I get chills thinking about these women, because they are so inspiring to me.  They know the struggle.  They've lived it and they want to ensure that no parent who has a child with apraxia has to feel isolated and alone in their fear of the unknown. More importantly though, they want to ensure that quality therapy is a right that every child with CAS receives.  Our success is their mission, but it's more than professional.  It's personal.  

WHAT WAS THE TRAINING LIKE?

At first, it was so surreal.  Here I was, one of 24 out of a 100 applicants in the country picked for this training.  Beside me were seated fellow SLP's of esteemed caliber and success in treating apraxia.  In front of me stood three top experts in the field, two of them published in the research.  

The training was longer and more intense than ANY conference past, present, or probably future.  We were expected not to be "talked at" but to critically analyze, bounce ideas of of, and problem solve aloud what we knew.  Our mentors only initially acted as guides, mentally exercising our brains, challenging our beliefs, therapy practices, and perceived truths.  We worked from 8:15 to 8 or 9 at night.  We spoke of nothing but CAS.  Eventually, we "local experienced experts" had to let our guard down and problem solve in an environment of mutual respect and learning.  

It was the three E's:

Exhausting: At one point during a differential diagnosis section, Ruth Stoeckel was asking thought provoking questions.  We all had answers, brilliant answers, but she wanted more.  I finally shouted out in exasperation, "Ruth!  Just tell us what you're looking for!!" 

She didn't.

We were forced to think and problem solve some more.  If we are to be true experts in the field, she needed us to come up with it on our own.  Her telling us was simply too easy.

Emotional: There were tears.  Lots of tears.  Tears as experienced, awesome SLP's realized maybe we could have done better with some previous clients.  Not maybe...certainly.  As a professional I loved their passion, but as a mother, it brought me to tears.  I told one SLP, as a mom, I don't care if you're not the best...because your heart, caring, and critical analysis is what will make you my child's "life changing" SLP. 

Exhilarating: A famous quote this bootcamp came from my recently, dear friend Ashley, who was presenting her video case study.  After being constructively criticized, stripped down, and vulnerable she said with poise, "I've found right after the confusion comes the learning."  Brilliant Ashley!! 

I have to admit, wearing two hats at this conference was hard.  The compassion and love these colleagues feel was tangible, and they have to be able to turn it off and let loose or they would never enjoy life.  On Friday night they were all sharing therapy ideas around copious bottles of wine, and I had to slip away.  I felt glad they could escape the pressure they feel to do right by their clients with this challenging disorder, but I also felt jealous they could turn it off...if only for a moment.  

Having a daughter with it leaves no such luxury.  I cried heavy tears that night.

WHAT IS THE BEST TREATMENT APPROACH FOR CHILDHOOD APRAXIA OF SPEECH?

Isn't that the million dollar question?  Usually at professional conferences, the speaker will talk about their treatment approach.  What they do and why it is successful.  You are talked at, occasionally invited to participate, and then sent home with an informational packet.  

This was WAAAAY different.

We had access to all the current treatment approaches: 

PROMPT, KAUFMAN, SpeechEZ, ReST, DTTC.....you name it, we learned it, and if you think I'm blowing smoke, I can tell you that five of the programs agreed to produce an overview CD just for CASANA's bootcamp and also agreed to answer questions gathered from the participants!  I'm telling you, CASANA covered their bases and made sure if they endorse an "expert" you are truly an "expert."

However, we didn't just learn the approaches.  We had to analyze each approach.  I can tell you one thing though.  All these approaches had a common thread of incorporating principles of motor learning theory.  As for the research?  Well, that's still up for debate; however, I can say we read a 2014 review and the method that has the most evidence but is probably the least well known is DTTC. Does that mean the other approaches aren't valid?  No! We concluded a lot of the approaches could be contributed to the fact that the SLP was simply just an amazing SLP, or that there just isn't enough research to prove this or that method has worked with a large population.

WHAT DOES THE RESEARCH SAY?   

Research for speech disorders is incredibly difficult to do, primarily tied into cost.  Sharon Gretz recognized this and that's why CASANA is big on research.  Donations and money through walks help fund research.  This is another reason I have so much respect for CASANA.  Honestly, if we don't have evidence based practice in the treatment of apraxia, how can we be sure this method or that method is sound??  In addition, though one method may work for one child, will the same work for another?  The answer?  We just don't know!  We need research! 

WHAT NOW?

What now?  Another million dollar question.  Sharon Gretz minced no words. 

 "Well, you are nothing." 

We all laughed a nervous laugh. What do you mean we are "nothing?"  

We learned we had to complete a case study that satisfied our instructors. We were told to be prepared to get it back.  They have had two previous cohorts and no one had ever turned in the perfect case study.  We were told they were investing in us.  From now on, we were their colleagues.  If we have a question, they will help us with the answer.  

Say what?

Yep...these busy, in demand apraxia experts are invested in us....and the kids we treat.  They  love kids with apraxia that much; however, we have to prove our worth.  They can't endorse us and not be 100% confident we are doing right by these kids.  That's why we should all expect our case study back again, and again, and again.   

In the back was Sharon and Kathy.  I couldn't ever help but think of them.  They had been burned by too many "experts" saying they would help their child; and here they stood, an advocate for those who are standing in their shoes.  

I was proud and honored to be here.  I'll complete my case study and know I earned it.  I will forever be committed to CAS, and I will never forget my experience at this "bootcamp."