Kaufman Speech to Language Protocol, K-SLP, KSLP, apraxia, apraxia of speech, childhood apraxia of speech, CAS, Nancy Kaufman

Kaufman Speech to Language Protocol (K-SLP)

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 methods shape a child’s best approximation of words toward full adult forms, and then into functional, expressive, and social language. It implements the principles of motor learning and the principles of establishing, improving, or eliminating speech and language behaviors.

About the K-SLP Method

Background, development, and use

K-SLP Teaching Strategies

Approaches and principles

K-SLP Test & Materials

Components of the K-SLP treatment program

The K-SLP & Autism

Best practices for children with autism

Evidence Informed Practice

Peer reviewed research & clinical excellence

Myths About the K-SLP

Clearing up some misconceptions

Nancy Kaufman's K-SLP methods are at the heart of the KCC’s speech and language programs to treat children with childhood apraxia of speech (CAS), other speech sound disorders, and expressive language challenges.

The K-SLP focuses upon the child’s speech-motor skills, beginning by shaping the consonants, vowels, and syllable shapes/gestures that they are capable of producing. Treatment then moves toward higher levels of speech-motor coordination, giving them a functional avenue to become an effective vocal communicator.

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.

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.

The K-SLP methods follow these best practices and are implemented here at the KCC.

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.

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.

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.

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.

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.

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.

PRACTICE THE NEW SKILL

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

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 speech motor while also scripting language through play. Contrive the environment to provide more opportunities to practice.

K-SLP Treatment Materials

The K-SLP treatment materials began with the Kaufman Speech Praxis Test, through which SLPs can take data through imitation of which vowels, consonants, and syllable shapes are within the child’s repertoire, and to provide a systematic plan of care.

The additional materials help those with CAS combine vowels and consonants to form the simple syllable shapes, and progress on to more complex words and to combine words to formulate expressive language for effective vocal/verbal communication.

PLEASE NOTE: With the exception of the KSPT test, all K-SLP materials are sold by Northern Speech Services. Links to purchase are available on each product page below.

Speech Praxis Test

The KSPT aids in the diagnosis and treatment of childhood apraxia of speech

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Treatment Kit 1

Teaches children to combine consonants and vowels to form words

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Treatment Kit 2

Refines intelligibility for children who have mastered sounds in Kaufman Kit 1

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Workout Book

After the kits, the workout book expands single words into phrases and sentences

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Total Language Builder

Playful therapy tool that targets receptive and expressive language development

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What’s In Your Doghouse?

Therapy practice for childhood apraxia of speech and language building

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Sign to Talk Nouns

Transitions nonverbal young children with autism from sign to vocal communication

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Sign to Talk Verbs

Transitions nonverbal young children with autism from sign to vocal communication

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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.

These techniques 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.

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Rapid Motor Imitation Antecedent training effectively uses behavioral momentum to gain first words for many children with autism who struggle to speak. This method is used in our ABA program with input from our SLPs.

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Sign to Talk, authored by Tamara Kasper and Nancy Kaufman, is a method to bridge sign language to vocal skills especially for children with ASD who struggle to speak.

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Progressive & Systematic Speech and Language Training for Children on the Autism Spectrum is the most comprehensive course to teach effective vocal communication!

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Evidence Informed 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. Be sure to also read this information on this page regarding EIP and the importance of clinical excellence.

A single case experimental design study using operationalised version of the Kaufman Speech to Language Protocol for children with childhood apraxia of speech. Gomez, M., Purcell, A., Jakielski, K., McCabe, P. (October 19, 2023). International Journal of Speech-Language Pathology. LINK

Apraxia of speech in children & 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. LINK

Bridging the gap between speech & 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. LINK

Increasing the vocal responses of children with autism & developmental disabilities using manual sign mand training & prompt delay. Carbone, V., Sweeney-Kerwin, E., Attanasio, V. & Kasper, T. (2010). Journal of Applied Behavior Analysis, 43(4), 705-709. LINK

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. LINK

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

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.

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.

And, also:

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

K-SLP Research & Clinical Excellence

What’s best for kids is not only researched evidence but also clinical expertise!

A special message from Nancy Kaufman

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. The K-SLP methods are listed here, and there is an e-course through Northern Speech Services that offers ASHA credits.