The Kaufman Speech to Language Protocol

The Kaufman Speech to Language Protocol (K-SLP) is the method at the heart of all of the KCC’s speech and language programs. It is a treatment approach for children with childhood apraxia of speech (CAS), other speech sound disorders, and expressive language challenges. 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.

About the K-SLP

The background, development,
and use of the K-SLP method

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K-SLP Teaching Strategies

Approaches and motor-learning
principles that support the K-SLP

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Kaufman Speech Praxis Test

Determining a child's repertoire
and where to begin treatment

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The K-SLP & Autism

Best practices for CAS often work
well for autism spectrum disorders

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K-SLP Kits 1 & 2

Cards build intelligibility through
successive word approximations

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Myths About the K-SLP

Clearing up some misconceptions
and learning the facts about the K-SLP

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About the Kaufman Speech to Language Protocol

The Kaufman Speech to Language Protocol (K-SLP) is an evidenced-based evaluation and treatment method for childhood apraxia of speech (CAS), other speech-sound disorders, and expressive language development. It was created by Nancy R. Kaufman, MA, CCC-SLP, and has been evolving since 1979.

The K-SLP:

 

Is rooted in teaching strategies from applied behavior analysis and principles of motor learning.

 

Corresponds with the most current research in CAS, neuroscience, sensory-motor development, and early language development.

 

Includes techniques gleaned from what is known about acquired apraxia of speech.

 

Implements phonological processes to simplify the motor planning of challenging words, shaping through successive approximations toward perfect articulation and age-appropriate expressive language.

The Kaufman Speech Praxis Test for Children

The Kaufman Speech Praxis Test for Children was established through a grant from the former Research Institute of William Beaumont Hospital and published in 1995 through Wayne State University Press in Detroit, Michigan.

 

The KSPT is a way to:

  • Examine what vowels, consonants, and syllable shape words are within a child’s repertoire
  • Determine whether or not they are exhibiting characteristics of CAS
  • Determine where to begin treatment.

 

No test actually informs us as to a specific diagnosis. Tests are a way to take data on the behaviors that are desired to evaluate. It is the role of the speech-language pathologist to then interpret the data and know the characteristics of CAS to then make a firm diagnosis.

The K-SLP Kits 1 & 2

The K-SLP Kits 1 and 2 were established to provide a visual reference for the different syllable shapes that comprise our speech and thus expressive language behaviors. The pictures are provided for the children to practice for the motor plan of each syllable shape and not necessarily the meaning of the words (though rather than nonsense syllables, they are pictures of real words and help to establish vocabulary as well). Kit 1 contains the earlier consonants and simple syllable shapes while Kit 2 contains more complex motor speech movement and motor planning.

VIDEO: KIT DEMONSTRATION PURCHASE KIT 1 PURCHASE KIT 2

K-SLP Teaching Strategies

Childhood apraxia of speech (CAS) requires specific treatment techniques for successful outcomes. Many teaching strategies of applied behavior analysis (ABA) and more specifically, applied verbal behavior (AVB) are aligned with the most current research in CAS. Combined with the principles of motor learning, they provide an effective framework for solid clinical practice to help those with CAS to become effective vocal communicators.

1

DEFINE THE BEHAVIOR

Clearly define the behavior that is desired to be established, improved upon, or extinguished. In this case, it would be to establish vowels and consonants that are not within the child’s repertoire, establish the combinations of vowels and consonants to create syllable shapes/words, or establish the ability to connect words and move into grammatical skills. Behaviors to extinguish might include the child erroneously adding a schwa “uh” post final consonants. The child might be adding erroneous vowels, consonants, or syllables to words. They also may use filler non-speech vocalizations rather than the new skills that they have developed, to name a few.

2

ESTABLISH MOTIVATION

Determine the child’s highly preferred toys and activities and have them readily available. Then, understand how to use these highly preferred items to reinforce the skill areas being taught, providing feedback as to whether or not the utterance was correct, incorrect or getting closer to the target.

3

MODEL & CUE

Know many different types of multisensory cues to assist the child with initial success, and then fade the cues so that the ultimate response is as spontaneous as possible.

4

IMPLEMENT ERRORLESS TEACHING/LEARNING

Cue before failure. It is important to know the child’s error patterns so they are assisted before making the error and can be reinforced for successes.

5

UNDERSTAND SHAPING

Understand how to shape successive approximations of words toward the ultimate goal of perfect articulation. Many children are not stimulable for the consonants and vowels that are contained in words that are important for them to learn. They will need compensatory placements for some (an easier way to produce complicated consonants or vowels), and simplification of the motor plan for others. This is where phonological processes are implemented to simplify the motor plan and shape toward the target.

6

MIX & VARY TASKS

Mix and vary the tasks so as to not actually teach over generalization. This also involves the principles of motor learning, blocked vs. random practice for retention of the skills to be maintained.

7

PRACTICE THE NEW SKILL

Gain as many responses as possible during a session on each goal.

8

PRACTICE IN THE CHILD’S NATURAL ENVIRONMENT

Help the child to use new behaviors functionally in their natural environment. Provide supports to remember new skills and continue to cue motor speech while also scripting language through play. Contrive the environment to provide more opportunities to practice.

The K-SLP & Autism Spectrum Disorders

There are many children with autism spectrum disorders who are not vocal verbal communicators. It is difficult to determine whether or not CAS is the causal factor. Nevertheless, best practices for CAS are also best practices for these children. Very often, however, the child may not clearly understand the task of producing isolated vowels and consonants. They may not yet be able to imitate behavior in general.

 

Here are specific methods that have been developed by speech-language pathologists and others to help this special population.

 

CLICK THE TITLE FOR MORE INFORMATION.

TALKTOOLS

Here at the KCC, methods are used to provide tactile/sensory cues so a child is able to find the correct oral placement or posture to produce sounds they are not yet able to directly imitate. Oral placement techniques include TalkTools.

RAPID MOTOR IMITATION ANTECEDENT TRAINING

We also implement Rapid Motor Imitation Antecedent (RMIA) training, which has proven to be an effective procedure. It uses behavioral momentum to gain first words for many children with autism who struggle to speak.

 

See also:

Rapid Motor Imitation Antecedent Training: Applying Benchmarks for Functional Spoken Language to a Discrete Trial Intervention.

Journal of Autism and Developmental Disorders.

SIGN TO TALK - NOUNS & VERBS

Another avenue by which to gain vocal verbal skills is Sign to Talk, a program authored by Tamara Kasper and Nancy Kaufman. It is a method to bridge sign language to vocal skills especially for children with ASD who struggle to speak. Input from an SLP when teaching vocal imitation is critical as specialized training is necessary to teach vocal verbal skill development for those with ASD.

LEARN MORE

Check out Tamara Kasper’s e-Course, Progressive and Systematic Speech and Language Training for Children on the Autism Spectrum, from Northern Speech. It is the most comprehensive course to teach children, especially those with ASD to become effective vocal communicators!

Myths About the K-SLP

THE MYTH

The K-SLP is just a drill program using picture cards.

THE TRUTH

The K-SLP is not just a drill oriented method. It is not just about the picture cards in Kits 1 and 2. Play is incorporated into every session. Picture cards are initially implemented, as it is too difficult to contrive the specific targets for the child to be able to practice the specific vowels, consonants, and syllable shapes with enough repetition necessary for success.

 

If the SLP is only using the Kit pictures within a session, they are not implementing the K-SLP the way it was intended! Sessions can and eventually should be conducted without any pictures at all. For very young children, pictures are not introduced until the task of imitation is understood, and there are always targeted goals through play.

 

Practicing new skills through play and the natural environment is essential to the K-SLP methods. The K-SLP is implemented with high levels of motivating toys and activities in a warm, encouraging manner. Many responses are necessary for success. Therefore, you will see a great deal of repetition in a K-SLP session.

 

The children are willing, cooperative and successful learners if the K-SLP is done the way in which it was intended.

THE MYTH

One should never teach those with CAS approximations of words. They would then learn erroneous motor plans. They should always be taught full, adult forms of words. Children with CAS should also not be taught an approximation of a difficult consonant or vowel with a compensatory placement.

THE TRUTH

The K-SLP effectively involves teaching word approximations toward target words, phrases and sentences, and not simply just accepting the child’s approximation. Word approximations are continuously shaped toward the full target words to perfection.

 

Once the child learns a closer approximation of a target word, the old approximation is extinguished and only the closer approximation is reinforced. Full correct words and phrases are always modeled for the child. If the child is not stimulable to produce a vowel or consonant accurately, they would be taught a compensatory placement, while continuing to gain stimulability for articulatory accuracy.

 

There is a great deal of research supporting teaching a new behavior (in this instance, the behavior of producing and combining vowels and consonants to form words, and combining words to formulate language) through shaping successive approximations. (See the list of evidence based practice).

 

Every child Nancy Kaufman or any SLP at the Kaufman Children’s Center has ever taught to develop effective vocal communication was taught via successive word approximations and compensatory articulatory placements. The K-SLP methods have been implemented successfully since 1979.

 

Click HERE for more information on the value of teaching successive approximations.

THE MYTH

There is no evidence to back up the K-SLP methods.

THE TRUTH

Due to the nature of the K-SLP, it is difficult to systematize the process so each clinician is using the exact same intervention strategies. The protocol depends upon a wide range of variables including:

  • The individual clinician
  • How cues are chosen
  • How motivation and reinforcement is implemented
  • How to simplify the motor plans of words temporarily based upon the child’s repertoire

However, a great deal of evidence and peer-reviewed research has been completed. You can find a list of resources HERE.

THE MYTH

TalkTools and Oral Placement Therapy (OPT) are simply oral motor therapy exercises and should not be implemented for those with CAS.

THE TRUTH

There are many controversies surrounding “oral motor therapy.” The research has taught us that oral motor exercises do not help children to be more successful vocal communicators if they are exhibiting only characteristics of CAS. We do not implement oral motor exercises at all for this population of children.

 

Specific tools established and offered through TalkTools have been instrumental for those who have very few vowels or consonants within their repertoire and who struggle with the underlying oral placement to sustain the accuracy of a vowel or consonant. When appropriate, a tool will be implemented inside the oral cavity to assist the child as a cue (much like how PROMPT cues are used outside of the oral cavity) for initial success, then the tool is faded out as the child is able to produce the underlying movement to sustain the new vowel or consonant independently.

 

TalkTools are also implemented here at the KCC to assist with the quality of feeding for those children who struggle with sucking, chewing and swallowing, and who also struggle to speak. Horns and/or straws are only introduced to gain the necessary skills for improved feeding or as a tool to gain a vowel or consonant as above. Sometimes, horns are introduced to help the child to practice sustaining respiratory support that would be needed to support sentence length or as a tool to be paired directly with a consonant that requires sustaining and grading air flow such as for /s, f, sh/.