Kaufman Apraxia Treatment Program | Research

Treating Apraxia?

Use this proven systematic word simplification approach to shape and expand verbal communication. The K-SLP materials were designed by Nancy Kaufman, MA, CCC-SLP, to help children move from sounds to words to sentences while controlling for speech motor difficulty throughout the treatment process.

Evidence-Based Practice

A great deal of evidence and peer-reviewed research on the Kaufman Speech to Language Protocol has been completed! Links to online articles have been included where possible:

  • Apraxia Of Speech In Children And Adolescents: Application Of Neuroscience To Differential Diagnosis & Intervention

    Burns, M.S. (April 01, 2011). Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders, 21, 1, 15

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  • Bridging The Gap Between Speech And Language: Using Multimodal Treatment In A Child With Apraxia

    Tierney, C., Pitterle, K., Kurtz, M., Nakhla, M. & Todorow, C. (September 01, 2016). Pediatrics, 138, 3

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  • Effect Of Tutor-Modeled Successive Approximations Versus Tutor-Modeled Adult Forms To Improve Topography Of Tacts

    Eldridge, A., Kasper, T. & Goodwin, J. (2006). Presented at the International Convention of the Association for Behavior Analysis, Atlanta, GA

  • Efficacy Of The Kaufman Approach In Increasing Speech Output With A Low-Verbal Child With Autism Spectrum Disorder

    Holbrook, S., King, L. & Pelayo, H. (2013). Presented at the Annual Loma Linda University, School of Allied Health Professions, Department of Communication Sciences and Disorders Graduate Research Symposium, Loma Linda, CA

  • Improving Vocal-Verbal Behavior Via Tutor-Modeled Successive Approximations

    Kasper, T. & Godwin, J. (2003). Presented at the International Convention Association for Behavior Analysis, San Francisco, CA

  • Increasing The Vocal Responses Of Children With Autism And Developmental Disabilities Using Manual Sign Mand Training And Prompt Delay

    Carbone, V., Sweeney-Kerwin, E., Attanasio, V., & Kasper, T. (2010). Journal of Applied Behavior Analysis, 43(4), 705-709

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  • Intensive CAS Summer Program: Boost Or Bust?

    Nancarrow, D., Kaufman, N., & Ficker, L. (2013). Poster presented at the American Speech-Language-Hearing Convention, Chicago, IL

  • Shaping Successive Approximations For Speech Intelligibility: Effect Upon Language

    Nancarrow, D., Kaufman, N. & Burns, M. (2009). Presented at the American Speech-Language-Hearing Association Annual Convention, New Orleans, LA

  • Treating Childhood Apraxia Of Speech With The Kaufman Speech To Language Protocol: A Phase 1 Pilot Study

    Gomez, M., McCabe, P., Jakielski, K. & Purcell, A. (January 01, 2018). Language, Speech, And Hearing Services in Schools, 2018, 1-13

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  • Hundreds of hours of video recordings demonstrating the K-SLP teachings, progress, and retention. Plus, nearly 40 years of clinical experience!


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.

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 above.

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/.

THE MYTH

The K-SLP materials must be used when implementing the methods.

THE TRUTH

K-SLP materials are not essential for successful K-SLP methods. They were produced by Nancy as she needed/wanted them for stimuli and assumed that other SLPs might also find them to be useful. If SLPs understand the K-SLP methods, all that is needed are pictures, objects, toys, and other highly preferred items or activities for each child. Each SLP will also require knowledge about how to simplify the motor plans of words by implementing natural phonological processes and understanding shaping methods.


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Nancy Kaufman, MA, CCC-SLP

Meet The Author

Nancy Kaufman, MA, CCC-SLP, has dedicated herself to establishing the Kaufman Speech to Language Protocol (K-SLP) since 1979, a treatment approach to help children become effective vocal communicators. The K-SLP has evolved over the years to include the most current research in childhood apraxia of speech (CAS), motor learning, and applied behavior analysis (ABA), and its methods and materials are used by speech-language pathologists worldwide. In addition, many ABA specialists have adopted the K-SLP for children with autism spectrum disorders.

Nancy lectures locally, nationally, and internationally on the subject of CAS and other speech sound disorders in children. Families from around the country and the world travel to the Kaufman Children's Center for Speech, Language, Sensory-Motor, and Autism Treatment, Inc (KCC) in West Bloomfield, Michigan to participate in intensive, specialized therapy programs. The KCC continues to grow, offering renowned speech, language, occupational therapy, sensory integration, and applied behavior analysis (ABA) center and home-based autism programs.

Nancy served as a member of the Professional Advisory Council for Apraxia Kids for 10 years. Currently, she serves on the board of visitors of Wayne State University's Merrill Palmer Skillman Institute for Child and Family Development and is the speech-language pathologist consultant for the Parish School and Carruth Center in Houston, Texas, and Suburban Speech Center in Short Hills, New Jersey.

Nancy has been honored by both of her alma maters: she received the Distinguished Alumni Award from Wayne State University in 2015 and the Outstanding Alumni Award from Michigan State University in 2010. She was awarded the Michigan Speech-Language-Hearing Association (MSHA) Distinguished Service Award in 2011 and the West Bloomfield Township Chamber of Commerce Community Excellence Business Person of the Year Award in 2015. She was also recognized by the Lawrence Technological University Leaders & Innovators program. The KCC has received MSHA's Clinical Service Award and Corp! Magazine's Best of Michigan Business Award. Nancy has three grown children and resides with her husband in West Bloomfield, Michigan.

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