HANDOUTKaufman Practice Thru Play

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CASANA Webinar
CAS Practice Through Play with K‐SLP Strategies
Nancy R. Kaufman, MA, CCC‐SLP
Disclosure Statement
• Nancy R. Kaufman, MA, CCC‐SLP, serves on the CASANA
Professional Advisory Board. She receives compensation for
conferences and webinars provided.
• Nancy has developed several materials known as the
Kaufman Speech to Language Protocol (K‐SLP ), published by
Northern Speech Services. She receives royalties on all sales.
The K‐SLP Instructional DVD set is also carried by CASANA’s
online store.
• This conference is focused specifically upon the Kaufman
Speech to Language Protocol methods.
What Are Some Challenges With

Speech & Language Practice for CAS?
Many children are uncooperative to work on speech and
language skills with their parents/caregivers, or with their SLP.
Why?
• Therapy cards may signal work and not play. Bringing
them out could send a negative message to the child if the
materials haven’t been paired with highly preferred
activities.
• The parent/caregiver/SLP may be overly serious or

demanding and may signal to the child, “uh oh, my life is
going to get worse.”
“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

Presented by: Nancy Kaufman, MA, CCC-SLP, May 22, 2015, Sponsored by CASANA
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What Are Some Challenges With

Speech & Language Practice for CAS?
• The child may not be motivated, or the toys/activities

are not highly preferred.
• The child may have a high activity level, making it

difficult to sit and attend for “structured” tasks.
How Can Speech & Language Practice

Be a Preferred Activity?
• Whenever therapy cards or materials are taken out, a
highly preferred toy or activity is taken out as well.
• If the SLP or parent is happy and excited, the child will

likely “mirror” this affect.
• Keep new or highly preferred toys inaccessible, and

only bring them out for home program time.
• Play with the toy/activity and slide in cards (if

necessary), but take just a few off a large pile.
How Can Speech & Language Practice

Be an Effective Activity?
• Know how to cue motor‐speech and script functional
language through PLAY (to be discussed ).
• Understand how to implement errorless teaching

(cueing before failure).
• For highly active children, consider a gross‐motor

activity or even “rough housing” (only for
parents/caregivers, not professionals) as a reinforcer.
OR, change up the toys/activities rapidly.

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Ethan & Dad Horsing Around

• Pivot phrase: Put away __________.
• Pie contains a diphthong vowel. Needs to be

pronounced as pahee not just pah.
• Keep the words within the pivot phrase together as

though they are one unit: put away_____ rather than
put _____ away.
Video: Ethan & Dad “Horsing Around”
Ethan
What Single Words Should We Teach

Children Who Struggle to Speak?
List 1 – Syllable Shape Gestures
First, we should consider teaching the children how to
combine simple consonants and vowels to form the
early syllable shape gestures. These are the building
blocks of speech.
C = consonant / V = vowel
CVCV mama, dada CVC hat, boat, bus
VCV oboe, okay CV1CV2 mommy, daddy, puppy
CV hi, no, bye, me C1V1C2V2 happy, bunny, tummy
VC up, out, in, on CVCVCV banana, potato, tomato

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• In the K‐SLP kits, there are pictures of early syllable

shapes for the children to eventually name
spontaneously without cues.
• Cues are necessary at first to help the child with
pronunciation. They are then faded so that the
children can produce those early syllable shapes
(words) without help.
** More specific information about cues can be learned from
the CASANA webinar: Cueing Motor‐Speech to Scripting
Functional Expressive Language (apraxia‐kids.org) and
K‐SLP Instructional DVD (carried by the CASANA online store
and northernspeech.com)

List 2 – Functional Single‐Word Requests (Mands)
Our second word list includes functional words which
serve to manipulate the environment. These can be
paired with a gesture.
open up here come
on down there/deh mama To gain
off yes this/dis dada attention
in no that/dat watch
out don’t go look
“d” for “th” if the child is unsuccessful at producing voiced “th”
These are only some examples of how we might

simplify requesting words (mands) only if the child is
unsucessful with perfect articulation:
on (ah‐n) down (dah‐n) help (heh‐p)
open (op‐en) don’t (do‐t) move (moo‐ff)
out (ou‐t) come (tum) go (do)
up (uh‐p) stop (top) look (wook)
* Try not to make a vocal break. This can be done by

prolonging the vowel or using melody.

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Teaching Word Approximations

(Rather than to simply accept the child’s attempt)
When a child cannot produce the single words in

the adult form, we help them to simplify the motor
plan of the words (approximations) as we continue
to help them toward perfection of articulation.
Why Teach Approximations?

(Rather than to simply accept the child’s attempt)
• The child may not be able to produce the vowels,
consonants, or syllables within words, no matter
what techniques have been implemented. We
therefore cannot afford to wait until the child is
able to produce each phoneme (sound) in order
to help them establish vocabulary.
• Word approximations are temporary and functional.

We can move ahead by extinguishing (no longer
accepting) lesser approximations and replacing words
with closer approximations and ultimately perfection
as the child progresses through therapy.
• The child is likely capable of a better or closer
approximation of a word than their own
simplification.
• Approximations give the child the opportunity to use
a word they would otherwise may not have
attempted.

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• The SLP would provide the child’s best

approximations to practice.
• Once the child is stimulable for new vowels and
consonants, the approximation would be changed
toward perfection.

List 3 – Familiar Nouns (Objects)
Suggested approximations
* Or replace /p/ with /b/
water
ball oo-ater
ba-ll wa-tuh
baw wawa
aw-tuh
wa
The backs of the cards are

only suggestions. There are
many ways to simplify words,
depending upon the child’s
consonants and vowels.
These should be practiced with the
guidance of an SLP.

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• Once a child can approximate simple nouns

consistently, we can help them to move into two‐
word combinations while teaching verbs as well.
• Simple nouns of different categories lend themselves
to the ability to then name their function.
bubbles (blow) apple (eat)

water (drink) ball (throw, kick, bounce)
shoes (put on, wear) bike (ride)
We can also help the child to move into three words, by

teaching the pronoun “I”:
“Tell me that you eat an apple.” (provides the answer)
Or: “What do you do with an apple?”
(promotes word retrieval)
I eat apple
At this time we are not emphasizing small function
words like an, the, is, to, etc. as they overload the
motor‐speech planning system.

List 4 – The Child’s FAVORITES
• This is a list of foods, drinks, toys, activities, places, people and
pets names.
• This is where simplification of words is most necessary.
• This list would also include high‐frequency words like please,
thank you, hi, bye, yes, no, see, get, etc. or key words from
favorite songs for fill‐in‐the‐blanks.
• Make sure that priority is given to the child’s own name.
• The SLP will determine the child’s best approximation of their
favorites, and update the approximation as the child
progresses.

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Jayden’s Songs
• Jayden, at age 5, could type words but had no
vocal/verbal skills.
• Started him with a Sign to Talk program to bridge sign

language to vocal/verbal skills (Kasper & Kaufman, 2009).
• Practicing requesting favorite songs and fill in the

blanks.
Video: Jayden’s Songs
Jayden
Very often, the first words or signs SLPs and

parents tend to teach are:
• more
• want
• please
• help
• (all) done
• again
Although these may be initially effective, they begin to
lose their power.

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Words That Become Less Effective Single Word

Mands (Requests) if Overdone
• more * Unless they are a pivot word in a
• want two‐word phrase
• please
**Once these words are taught,
• help
there may be less motivation to
• all done learn additional vocabulary
• again
*** The child may only learn that
when using these single words, good
things will probably happen
Pivot Words
We can now continue to help the children to combine words. This
can be done through teaching pivot (carrier) phrases. These are
words that remain constant, while changing up one word.
my ______ move ______ draw/paint ______
open ______ more ______ tickle ______
help ______ hi ______ push ______
want ______ bye ______ take ______
no ______ red ______ wash ______
on ______ big ______ don’t ______
tie ______ hold ______ eat _______
* Add a person’s name either before or after the phrase to engage them. Mommy open.
Script Functional Language with Three‐Word Pivot Phrases
I want __________. Put on __________.
I need __________. Take off __________.
I want to __________. Pick up __________.
Can (may) I have _________? Watch me __________.
Let me __________. Help me __________.
Put away __________.

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Kiera & Orca Whales

• Age 5, uncooperative to practice with “therapy
materials.”
• Favorite = Orca whales
• __________ go in water pivot phrase.
• Re‐scripting her non‐vocal/verbal communication of

pointing to me.
• Putting the preferred script into my question:

“Do you want Nancy to go in the water?”
Video: Kiara
Kiara
Helping Children to Be Vocal Communicators By

Scripting Functional Language
When we can anticipate what the child is trying to convey, we
can help them to say it.
Example: The child turns the doorknob and can’t open the door.
Say: “Do you want me to open the door?”
(use the answer words within your question)
Get best approximation for yes
Say: “Tell me you want to open the door.”
Help the child to say:
“opuh do” or “I wa o‐puh” or “o‐puh peez” or “o”
(open door) (I want open) (open please) (open)
* Eventually fade cues

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Example of Fading Cues

Eventually, we don’t want to continue to have children
imitate each and every word. We need to fade cues.
1. Simultaneous: Say the whole word or phrase with the
child.
2. Whisper: Whisper the whole word or phrase while the
child says the utterance aloud (hopefully they won’t also
whisper )
3. Provide oral postural cues with gestures.
4. Provide gestures only.
…so that the last utterance is as spontaneous as possible,
and practiced a few more times.
Isabella with Teapot Activity

& Scripting Language
• Age 6, began with single‐word approximations.
• Scripting language through play.
• Scripting questions.
• Scripting negatives.
• Vowel accuracy for /i/ as in eat.
Video: Isabella – Teapot Toy Scripting
Isabella

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Help the child to name simple actions with subject‐verb‐

object (S‐V‐O) utterances, such as “boy ride bike.”
(again, we will build in proper syntax and
morphology/grammatical skills later)
• These can be action pictures
• These can be photos of the child (or others in their lives)
performing simple actions
• Each word may still have to be a best approximation
• It is important to move forward on word combinations
(expressive language formulations) and continue to work
on improving motor‐speech clarity toward perfection
Kai & S‐V‐O with Characters
• _________ go down = pivot phrase.
• Choosing characters to practice simple bisyllabics.
• Practicing the “ny” pivot syllable in Ernie, pony.
• Go can remain constant, and can add:

Bed: _______ go night night
Potty: _______ go potty
Car: _______ go car
Video: Kai
Kai

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Help the child to produce subject‐verb‐object

telegraphic phrases in a simple sequence story
narrative
• Can use a sequence story picture set, books,
magnetics
• Can use real photos to tell a story about a child’s
experiences, example: going to the zoo. (iPad app
known as Pictello works well for this)
More S‐V‐O with sequence story narratives
Kaufman Speech to Language Protocol Workout Book / northernspeech.com
Pivot phrase narratives can be done using

real‐life activities!
Examples: Getting ready for school
Getting ready for bed
Setting or clearing the table
Taking out toys, playing with them, and
putting them away
Going grocery shopping and also back at
home: taking each item out of the bag and
putting away

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Script the Language of:

• Games
• Playground
• School
• Church/Synogogue
• Birthday parties
• …and more!
Sanders & the Language of Games

• All family members can play together, promoting turn
taking and good sportsmanship.
• Scripting the language of games.
• Practicing the /g/ in go and the /n/ in no.
• Vowel accuracy.
• Scripting negatives.
Video: Sanders with Family

The Language of Games
Sanders

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When we can anticipate what a child is trying to convey

(through their non‐verbal or unintelligible attempts) :
• Help them to say it with their best single‐word
approximations, phrases, or full sentences!
• Don’t forget to fade your cues, or the children will
simply wait for each word and not move ahead toward
spontaneous speech and language skills!
Ethan’s Non‐Vocal/Verbal Communication

• He explains to me with sign language and one word,
nope that he doesn’t want a little prize, he wants a big
prize.
• Re‐scripting: I want big prize.
Video: Rescripting Ethan’s Nonverbal

Communication
Ethan

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Once children are able to first be responders, then to

use vocal language functionally (pivot phrases), stop
asking questions and simply make statements
and…wait.
Maybe the bunny wants to hop.
I wonder if the zebra is hungry.
Look, this lion is napping.
Wow, this cat is licking the bowl!
Hey, there are no hippos.
Or, make an absurd comment like: I wonder what
would happen if the dog climbed on the table.
* The child will now enjoy opportunities to create
language and to chime in spontaneously!
Jayden: An Exercise in Commenting

Instead of Questioning
• Jayden’s favorite = horses
• The activity is an exercise to simply comment and not

to ask questions (not an easy task! )
Video: Commenting Instead of Questioning
Jayden

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Helpful Tips for Scripting Language

1. Avoid asking open‐ended questions such as:
What do you want?
What do you want to do?
What happened?
Can you use your words?
Instead…
• Try to anticipate what your child might like to say and put the
answer in your question:
Do you want to go outside? Tell me you want to go outside
(the child hears the answer twice).
• Help the child to produce best approximations and word
combinations for the answer.

2. If the child changes the first consonant in a CVC word,
keep the initial (first) consonants paired with the vowel
and segment away the final consonant (without making a
vocal break, if possible).
For boot, child says: doot
Try: booo‐t (prolong the vowel)
3. Many children delete final consonants. Be mindful
to not over‐emphasize them by adding a vowel
“uh” (schwa) erroneously.
boo‐t NOT boo‐tuh

4. When moving into two‐word phrases, consider
descriptive words (adjectives) or action words (verbs),
instead of want, more, please, help:
red _____ tickle _____ don’t _____
big _____ move _____ kick _____
round _____ push _____ blow _____
eat _____ throw _____ tie _____
draw _____ no _____ zip _____
* These are pivot words. They remain constant while the child
only has to push in one novel word. This will help the child to
learn new vocabulary.

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5. Learn how to fade cues so that the child does not simply
wait for each word.
6. Be mindful of your own vocal inflections. Many of us
have the tendency to use upward vocal inflection as
though we are asking a question. The children will
imitate our own inflection, so it should sound the way
the child should sound.
If the child wants you to tickle their belly, we would help

them to say, Tickle my belly. NOT, Tickle my belly?

7. Remember to model speech and language fully and
correctly, ideally both before and after the child’s
response.
It is only when we are helping a child to produce their
best approximation that we would then say and teach
the approximation.
So if a child’s best approximation for cookie is tootie, we
wouldn’t say, do you want a tootie? We would say, do
you want a cookie? and then help the child to produce
cookie with their best approximation.
Then say, “Sure, here’s a cookie.”
Simple Activities at Home

Pots and pans with lids (pivot phrase scripts)
on (put on) off (take off) in (put in)
out (take out) big (top or pot) little (top or pot)
Or, use the word (lid)
Pour (in) water dump (out) water
Food coloring: put in blue

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Colorful plastic eggs (pivot phrase scripts)
Place small familiar objects inside.
(You can do this with pots and pans, too).
“Want color”
“Open _____.
Name the object.
Name the function of the object.
“Put in” or “put away _____.

Grocery shopping (pivot phrase scripts)
Before you go (making the list):
I want _____. We need _____.
While in the store:
I pick _____. I buy _____. I want _____.
Put in cart. or Put _____ in cart.
Let me push.
Back at home (taking put of the grocery bags):
Take out _____. Put away _____.
Also…where the item goes for prepositional phrases:
In the fridge, drawer, pantry. Need word approximations.

Toy box (pivot phrase scripts)
Open box or take out _____
Describe play: I blow bubbles, I blow horn, I kick ball, etc.
Or, have the child tell YOU what to do:
blow horn, kick ball, hug baby.
Put in _____ or put away ______.
Close box or shut box.

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Baby dolls or familiar characters (pivot phrase scripts)
Put on _____ or take off ______ (different clothes)
While feeding the baby:
Eat /drink _____ or baby eat/drink _____
Characters: Minnie, Winnie, Ernie, Bunny (pivot
syllable “ny”) or Anna, Elsa, Olaf, or current favorites.
Use familiar house or playground toys:
Slide: Elmo go up/down Bed: Elmo go night night /wake up
Book: Elmo read book Car: Elmo go car (or ride, drive)

Bath time (pivot phrase scripts)
Use items that stick to the sides of tub (letters, numbers,
characters) and straws to blow bubbles in the water (make sure
they don’t drink it!) Wash my _____
Put on _____ Take off _____ Go in water
I (throw) ______ ______ on head, toes, nose, arm, elbow
Give items that float or sink, such as a penny that will sink but a
boat that will float:
_____ on top _____ on water
_____ go down _____ under water

Playground (pivot phrase scripts)
Slide: I go up or climb (kime)
I go down
Catch me
See‐saw: Up/down, OR
Let me up / let me down
Swing: Push me, push me high,
go up, go down,
stop me

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Cooking (pivot phrase scripts)
I need ______
Put in ______
Stir, pour
Put on _____ (toppings, colors, facial parts)
Knead, cut

Bucket with objects or sea creatures (pivot phrase scripts)
Throw in ______
Dump out ______
Put in ______
Take out _____
Splash!
* Use a tarp underneath and put a small amount of water in the
bucket so the items make a splash (if you dare )

Wind‐up toys (pivot phrase scripts)
Subject‐verb‐object
Robot dance (slow)
Monkey clap (fast)
Bunny hop (high)
Puppy jump (up)
Car go (off) (table)
* Pull‐back or push‐down toys can each “go off the table.”

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Motor play (pivot phrase scripts)
Up, down, on, off, go, stop, fast, slow
Airplane ride
Blanket ride
Horsie ride
Wheelbarrow (hold child’s feet while they walk with their hands)
Motor boat (holding child’s hands and running fast in a circle)
* Help the child request the activity: Boat! Motor Boat! Airplane
ride! (Best approximations may apply)
Hiding an Object for Prepositional Phrases

Take some common objects and hide them
(in, on, under, on top, behind…)
The child finds them and tells you where it was.
Under the table. Behind the chair.
We can build vocabulary by hiding objects by categories,
such as hiding a few different animals, foods, toys, shapes,
clothes, coins, etc.
Nancy’s Favorites
• K‐SLP Kits 1 and 2,
Workout Book, Mutt
Family Practice Puzzle,
K&K Sign to Talk,

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Nancy’s Favorites
• Train sets with many large, easy pieces
• Wind ups, small
and large
• Push down or pull
back toys that
shoot forward
• Large slide with
a bucket ready to
catch items
• Means‐ends
causality toys
Nancy’s Favorites
Bin of characters (stuffed animals preferred):
► Winnie, Barney, Minnie, Bugs Bunny, Ernie (ny pivot syllables).
► Sesame Street, Finding Nemo, Toy Story, and Frozen characters
► Family characters of different ethnic groups
► Animals, ocean characters
Nancy’s Favorites
• Toy household furniture and playground equipment (slide,
swing, chairs, tables, beds, potty, cars, etc)
• Books without words, or with a simple sequence story
• Musical toys that only play for a brief moment
• Magnetics, Colorforms or reusable stickers

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Nancy’s Favorites
• Stim Toys. (Koosh balls, wands that spin, squishy toys, play
dough, light ups, fidgets)
• Blocks
• Simple board games
• DVD player with remote
• Puzzles that “talk”
• iPad
• Ball toys
Have fun
Be excited
Laugh Together
Praxis
Requires
Practice
Thank You!


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1

What Are Some Challenges With

• The parent/caregiver/SLP may be overly serious or

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

What Are Some Challenges With

• The child may not be motivated, or the toys/activities

• The child may have a high activity level, making it

How Can Speech & Language Practice

• If the SLP or parent is happy and excited, the child will

• Keep new or highly preferred toys inaccessible, and

• Play with the toy/activity and slide in cards (if

How Can Speech & Language Practice

• Understand how to implement errorless teaching

• For highly active children, consider a gross‐motor

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

Ethan & Dad Horsing Around

• Pie contains a diphthong vowel. Needs to be

• Keep the words within the pivot phrase together as

Video: Ethan & Dad “Horsing Around”

What Single Words Should We Teach

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

• In the K‐SLP kits, there are pictures of early syllable

What Single Words Should We Teach

These are only some examples of how we might

on (ah‐n) down (dah‐n) help (heh‐p)

open (op‐en) don’t (do‐t) move (moo‐ff)

out (ou‐t) come (tum) go (do)

up (uh‐p) stop (top) look (wook)

* Try not to make a vocal break. This can be done by

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

Teaching Word Approximations

When a child cannot produce the single words in

Why Teach Approximations?

• Word approximations are temporary and functional.

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

• The SLP would provide the child’s best

What Single Words Should We Teach

* Or replace /p/ with /b/

The backs of the cards are

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

• Once a child can approximate simple nouns

bubbles (blow) apple (eat)

We can also help the child to move into three words, by

What Single Words Should We Teach

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

• Started him with a Sign to Talk program to bridge sign

• Practicing requesting favorite songs and fill in the

Video: Jayden’s Songs

Very often, the first words or signs SLPs and

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

Words That Become Less Effective Single Word

Script Functional Language with Three‐Word Pivot Phrases

I want __________. Put on __________.

I need __________. Take off __________.

I want to __________. Pick up __________.

Can (may) I have _________? Watch me __________.

Let me __________. Help me __________.

Put away __________.

“Childhood Apraxia of Speech: Practice Through Play with K-SLP Strategies,”

Kiera & Orca Whales

• Favorite = Orca whales

• __________ go in water pivot phrase.

• Re‐scripting her non‐vocal/verbal communication of

I want . Put on .

I need . Take off .

I want to . Pick up .

Can (may) I have _? Watch me __.

Let me . Help me .