The method at the heart of the KCC's speech-language programs
The Kaufman Speech to Language Protocol (K-SLP) is a treatment approach for childhood apraxia of speech (CAS), other speech sound disorders, and expressive language challenges.
It began in the 1980s as an approach that followed B.F. Skinner’s principles of operant conditioning, specifically shaping new behaviors. In this case the behavior is that of speech, a fine motor skill.
Full words are often difficult to master for children who struggle to speak. But often there is immediate capability to produce the shell, or an approximation of the words.
The child’s own approximation may be much lower than their true capability. We help children to simplify words at a higher motor-speech level than what they attempt, by assisting them to produce best word approximations toward target vocabulary to be moved into functional expressive language. We then refine each word toward perfection as we continue our therapy efforts. This is performed through using cues, fading cues, using powerful and strategic reinforcement (motor learning principles), errorless teaching (cueing before failure), gaining many responses within a session, and mixing in varying tasks to avoid over generalization. The K-SLP has evolved over the years, following the most current research in CAS, motor learning principles, neurological development, applied behavior analysis, acquired apraxia of speech, and in sensory integration and praxis skills.
The K-SLP focuses upon the child’s motor-speech skills, shaping the consonants, vowels and syllable shapes/ gestures from what they are capable of producing toward higher levels of motor-speech coordination, giving them a functional avenue by which to become an effective vocal communicator.
Words are simplified through the implementation of natural phonological processes such as fronting, stopping, gliding, cluster reduction, deaffrication, final consonant deletion, etc. Each word is simplified to the closest approximation the child can successfully attempt with minimal cues.
We also assist the child to begin to combine words into three or four word phrases with best approximations so that they have opportunities to practice expressive language formulation.
Through specific teaching procedures, we help children to begin to add in syntax and morphology, once they are ready to maintain new speech patterns with extended utterance length and complexity.
The K-SLP requires the child to be able to imitate some vowels and consonants. For those who are not yet at the level of vocal imitation, we begin by teaching sign language as a one-on-one match for their favorite foods, drinks, toys, activities and significant people in their environment, then bridge signs to vocal communication, also through ABA principles. This requires different and specialized teaching methods additional to the K-SLP. (K& K Sign to Talk, 2005, 2009)
SIX STEPS OF THE KAUFMAN SPEECH TO LANGUAGE PROTOCOL
Determine what vowels, consonants and syllable shapes the child has in his/her repertoire via the Kaufman Speech Praxis Test for Children
Establish the syllable shapes that are lacking as well as vowels and consonants that the child is unable to produce, relative to developmental norms
Establish a list of functional nouns, verbs and favorite foods, drinks, toys, activities and significant others for best approximations for requesting and commenting
Script functional expressive language
Build expressive language formulation through adding syntax and morphology
Establish a home program
3-week period of intervention (summers of 2008-2014)
67 children total with characteristics of CAS
30 individual half hours of speech & language therapy
15 hour-long sessions of group speech & language therapy (3 of which were sensory-motor based)
Pre- and post-treatment measures were taken (no control group)
Results of this study suggest that the methodology used in this intensive intervention format may be effective for children with a variety of moderate to severe speech-language challenges.
The data suggest that shaping successive word approximations while employing cues, fading cues, and using strategic reinforcement (without specific oral motor intervention) may result in motor speech and expressive language changes in pre-school aged children with moderate to severe challenges in these areas.
Since this methodology was also used with children without motor speech symptomatology, it is suggested that such an approach might pose an alternative for school-based and private speech language pathologists who face a variety of speech and language problems.
CARBONE CLINIC RESEARCH
Improving the Speech Production of Children with Autism
The results of this study demonstrated that using the Kaufman protocol is superior to the echoic protocol with these participants related to the improvement of articulation.
Baseline data suggested that both learners could not articulate any of the words targeted for treatment prior to implementation of these procedures.
Through the use of reinforcement of successive sound approximations using a sound simplification system, both learners were able to meet criteria faster, in fewer trails than using a treatment that did not take into account a phonological process to simplify words and reinforcement of successive approximations.
This study also demonstrated that there were better results in transferring the words from echoic control to tact control when words were taught using the Kaufman protocol rather than the echoic protocol.
EVIDENCE-BASED RESEARCH ON THE K-SLP
Burns, M. (2011). Apraxia of speech in children and adolescents: applications of neuroscience to differential diagnosis and intervention. ASHA Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 21(1), 15-32
Carbone, V.J., Sweeney-Kerwin, E.J., Attanasio, V., Kasper, T. (2010). Increasing the vocal responses of children with autism and developmental disabilities using manual sign mand training and prompt delay. Journal of Applied Behavior Analysis, 43: 705-709.
Dyer, K. (2009). Clinical application of speech intelligibility research: the river street autism program at Coltsville. Journal of Speech-Language Pathology and Applied Behavior Analysis, 3, 140-153.
Eldridge, A. , Kasper, T. and Goodwin, J. (2006). Effect of tutor modeled successive approximations versus tutor modeled adult forms to improve topography of tacts. Presented at the International Convention of the Association for Behavior Analysis, Atlanta, GA.
Kasper, T. and Goodwin, J. (2003). Improving vocal verbal behavior via tutor-modeled successive approximations. Presented at the International Convention of the Association for Behavior Analysis, San Francisco, CA.
Maas, E. (September, 2013). Demystifying the principles of motor learning in speech therapy [Webinar]. Childhood Apraxia of Speech Association of North America (CASANA). www.apraxia-kids.com
Sweeney-Kerwin, E.J., Zecchin, G., Carbone, V.J., Janecky, M., & McCarthy, K., (2006). Improving the speech production of children with autism. Presented at the New York State Association for Behavior Analysis, Verona, NY.
For more information on the K-SLP, please call the KCC at (248) 737-3430 or email Nancy Kaufman, MA, CCC-SLP.