What is DTTC?
How is DTTC different from other CAS treatment methods?
Who is a candidate for DTTC?
What evidence supports DTTC?

What is DTTC?

DTTC is a treatment method designed specifically for children with moderate to severe CAS. DTTC is a motor-based approach, meaning it is designed to improve the brain’s ability to plan and program motor movements for speech which most experts believe is the underlying cause of CAS. In DTTC, the therapist selects specific word targets to shape movements of the mouth that are necessary for speech. DTTC is based on motor learning theory and research, integrating Dr. Strand’s personal research and clinical experience treating children with CAS over a span of more than 20 years.

How is DTTC different from other CAS treatment methods?

Like some other methods of treatment, DTTC was designed specifically for children with CAS.   Some components of DTTC that differentiate it from other CAS treatment methods include:

Word targets are individualized to each child – there are no word lists or picture cards that are routinely used in therapy. Through careful assessment, the speech-language pathologist determines speech movement patterns the child needs to work on and then selects relevant, functional words for the child that fit the movement goal. The child practices words that are meaningful and relevant for her.

The therapist uses cues that work best for each child. There are no complicated, standardized cues applied to all children. Instead, the clinician uses several different cueing methods such as saying the word slowing, saying the word in unison with the child, modeling mouth movements for the word, and tactile cues. Cues are individualized to the child.

The cues the therapist uses to help the child are dynamic meaning more cues are given when needed so the child is successful, but cues are then removed or faded as soon as possible to promote independence. This dynamic cueing means that the therapist is constantly responding to the needs of the child throughout practice to avoid frustration while building skills.

Movement, not individual sounds, is the focus of treatment and work on vowels and prosody (inflection and rhythm of speech) begins early in treatment since they are typically difficult for children with CAS.

Therapy sessions are structured to provide the child with LOTS of practice because practice is critical for learning any motor skill, including speech. Therapists use simple, fast reinforcement methods keeping the child focused and engaged during practice to maximize motor learning.

Who is a candidate for DTTC?

DTTC is a treatment method designed specifically for children with moderate to severe CAS. DTTC is a motor-based approach, meaning it is designed to improve the brain’s ability to plan and program motor movements for speech which most experts believe is the underlying cause of CAS. In DTTC, the therapist selects specific word targets to shape movements of the mouth that are necessary for speech. DTTC is based on motor learning theory and research, integrating Dr. Strand’s personal research and clinical experience treating children with CAS over a span of more than 20 years.

What evidence supports DTTC?

DTTC is supported by multiple research studies across independent researchers with evidence of both maintenance and generalization.  Maintenance means that improvements last beyond the treatment period. Generalization means that skills transfer to other situations, such as new words not directly practiced in therapy. Maintenance and generalization are important components of evidence because they indicate true clinical change as a result of the treatment.  

In a systematic review of treatment outcomes for children with CAS, researchers reviewed 42 peer reviewed articles of 13 different treatment approaches and identified as DTTC one of three treatment methods with sufficient evidence for clinical practice (Murray, McCabe and Ballard, 2014). Learn more about evidence-based treatment methods for CAS here.

Dr. Edythe Strand Explains DTTC

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Examples of the DTTC Method

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Free DTTC Workshops for SLPS

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