The Parish School Blog

Nancy Kaufman: The Apraxia “Guru” and her Methodology

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What is Apraxia?

Childhood apraxia of speech (CAS), a motor speech disorder affecting a child’s ability to coordinate the motor movements of speech, is a diagnosis which many families of The Carruth Center and The Parish School are familiar. Our speech-language pathologists are not only experienced in treating this disorder, but have received extensive, specialized training in CAS, also called “apraxia.” Nancy Kaufman, a well-known and respected expert in the field of childhood apraxia of speech, has provided training and consultation services to The Parish School and Carruth Center therapists since 2009.

As a speech-language pathologist based in Michigan, Nancy has dedicated much of her career to the development and implementation of targeted interventions to bring vocal communication to children with apraxia. Since 1979, Nancy has worked to create the Kaufman Speech to Language Protocol (K-SLP). This effective, evidence-based treatment approach can be consistently utilized by speech-language pathologists worldwide through use of specialized materials and treatment strategies. Nancy is recognized both nationally and internationally for her work in furthering the treatment of CAS, and remains a leader in the field through her research and seminars.

Through her annual trips to Carruth and Parish, Nancy works directly with clinicians and their clients to provide feedback on best practice strategies for each client. She helps train speech-language pathologists in her methods to allow for the most efficacious treatment. As part of her relationship with The Carruth Center and The Parish School, Nancy also gives an annual seminar detailing the treatment of CAS through specific client examples. Anyone who has attended one of her presentations can attest to the fact that Nancy brings that same enthusiasm to the education of parents and therapists that she brings to each therapy session.

boy with speech therapist

What is the K-SLP?

Speech-language pathologists at The Carruth Center and The Parish School implement the Kaufman Speech to Language Protocol (K-SLP) in their treatment for children with childhood apraxia of speech, speech sound disorders, and those who have difficulty with expressive language. The K-SLP program is a treatment methodology that incorporates play, picture cards and repetition. The goal in treatment is to provide children with a practical path to become an effective verbal communicator.

Asking a child who struggles to speak to say full words is too demanding; hence, approximations of words are incorporated (see “why do we teach approximations” below), and the motor planning demands on a child decrease. Through intervention, the child’s team will work towards perfecting words while increasing his or her expressive language using a list of favorites, pivot phrases and words, and functional requests. A favorites list is comprised of everyday vocabulary a child uses or is exposed to in his or her environment. Incorporating these words into therapy is not only functional, but also highly motivating.

Nancy Kaufman stresses the importance of keeping a child motivated in therapy. This can be accomplished through use of toys and a favorites list. It is also important to implement errorless teaching (cueing before failure) so that a child can always feel successful.

Nancy Kaufman is the author of several materials developed for those with CAS. The K-SLP materials are available to the public and are frequently seen in clinics and homes; however, the materials alone do not represent an understanding of the methodology. Training and feedback are essential to gaining the ability to implement the K-SLP program in an efficient and effective manner. While the K-SLP materials, specifically the picture cards, are very beneficial to a child, therapy is much more than drilling cards all session. The goal is to use these visually stimulating cards to target specific syllable shapes, provide a clear model for a child, and allow a significant amount of repetitions each session. The end goal for therapy is to eventually conduct sessions without any cards.

Lastly, the K-SLP focuses on the importance of a child practicing new skills through play and in their natural environment. Parents, other family members, and caregivers can orchestrate the environment to offer even more opportunities for practice of new skills and while providing motor speech cues as needed.

boys in group speech therapy

Why do we teach approximations?

The K-SLP focus on moving toward functional speech is heavily reliant upon the use of approximations at first. An approximation is a simplified version of a target word that incorporates consonants and vowels currently within a child’s repertoire to create a “version” of the word that can be understood by others as a child works towards a full-word production. Approximations are developed based upon the natural speech acquisition pattern. Although a simplified version of the word is provided to increase a child’s communication, the focus of therapy is to shape the child’s production as close as possible to the target word. As a child gains new sounds and syllable shapes, his or her earlier approximations transition to include the most complex, attainable form at that time. Think of approximations as the training wheels that will eventually be removed when a child has practiced to the point of consistency in their two-wheeling abilities.


We are thankful for Nancy Kaufman’s support and contributions to Carruth and Parish staff and in turn, families. We proudly offer K-SLP based services and look forward to using our skills to support your children’s needs.