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Dynamic Temporal & Tactile Cueing: Evidence Based Treatment for Childhood Apraxia of Speech

When it comes to treating speech and language disorders, therapists are constantly exploring new innovative techniques to improve communication skills. One such method gaining more recognition is dynamic temporal and tactile cueing (DTTC). This evidence based treatment approach utilizes the power of multi-sensory cues to enhance speech production and improve overall communication abilities. In this blog post, we will delve into the concept of DTTC, its benefits and how it can be used effectively in therapy sessions.

Understanding Dynamic Temporal and Tactile Cueing

Dynamic temporal and tactile cueing is a treatment technique developed by Edith Strand, Ph.D., CCC-SLP a renowned speech language pathologist. It is primarily used for individuals with motor speech disorders, including childhood apraxia of speech (CAS). DTTC combines auditory, visual, and tactile cues to facilitate accurate and fluent speech production.

How Does DTTC Work?

DTTC involves the use of specific cues during speech therapy sessions to assist individuals in producing targeted speech sounds and words. Let's take a closer look at the key components of this treatment approach:

1. Temporal Cueing: temporal cues focus on the timing and rhythm of speech movements. Therapists may use metronome-like cues or rhythmic tapping to help individuals to establish and maintain a steady rhythm for speech production. This aids in improving the coordination and sequencing of speech sounds.

2. Tactile Cueing: tactile cues involve touch and proprioceptive input therapists provide gentle touches or pressure to specific articulatory areas, such as lips, tongue, or jaw to guide proper placement and movement. This tactile feedback enhances kinesthetic awareness and supports individuals in achieving the correct articulatory positions.

3. Dynamic Cueing: involves providing real-time support and feedback to the individual during speech production. The clinician or SLP guides the individual through the production of the target sounds or words, adjusting the cues as needed based on the individuals response.

4. Gradual Fading: As the individual's speech production improves, the clinician gradually reduces the level of cues provided. The goal is to promote independence in speech production while still providing support as needed.

5. Functional Contexts: DTTC focuses on practicing speech in meaningful and functional contexts. This involves using words and phrases that are relevant and useful to the individual's daily communication needs.

6. Repetition and Practice: Like many approaches, DTTC emphasizes repetitive practice. Consistent practice of target sounds, words and phrases helps to reinforce motor planning and coordination for speech.

7. Generalization: The ultimate goal of DTTC is to promote generalization of improved speech production skills to various communication situations and environments.

Benefits of DTTC:

Dynamic temporal and tactile cueing offers several advantages that make it an effective treatment approach:

1. Promotes Motor Learning: incorporating multiple sensory modalities, DTTC maximizes the potential for motor learning and neural plasticity. The combination of auditory, visual, and tactile cues helps individuals form stronger connections between brain regions responsible for speech production.

2. Enhances Motor Planning and Accuracy of Execution: DTTC supports the development of motor planning and execution skills by providing explicit cues and feedback, this allows individuals to overcome motor coordination challenges and produce clear and intelligible speech.

3. Increases Speech Intelligibility: through the systematic use of cues, DTTC helps improve speech clarity and intelligibility. It targets the specific speech sounds or words that individuals find challenging, gradually shaping their production skills and overall communication abilities.

Incorporating DTTC into Therapy Sessions:

if you are a speech- language pathologist or a parent seeking to explore DTTC as a treatment method, here are some strategies to consider:

1. Collaborate with a Qualified Professional: work with a speech- language pathologist who has experience with dynamic temporal and tactile cueing to receive guidance on implementing this method effectively.

2. Customize Treatment Goals: meet the individualized specific needs of client's and address their speech production challenges. The cues provided should be specific to the target sounds or words.

3. Consistency and Repetition: practice regularly and maintain consistency during therapy sessions. Repetition helps reinforce learning and facilitates the integration of new speech patterns.

4. Parent Involvement: encourage parents to actively participate in therapy and provide consistent cues and supports at home. This reinforces the use of DTTC outside of therapy sessions, promoting generalization of skills.


It is important to note that DTTC is just one of several approaches to treat childhood apraxia of speech. However, dynamic temporal and tactile cueing is a promising treatment method for individuals with motor speech disorders, particularly childhood apraxia of speech. By incorporating auditory, visual, and tactile cues, DTTC assists in improving speech production, motor planning, and overall communication abilities. With the guidance of the qualified professional, individuals can benefit from this multi- sensory approach and make significant progress in their speech and language skills. Click here to learn more about DTTC.


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