Nancy Kaufman Workshop: Part 3

Part 1 of the workshop was about The Elements of Successful CAS Therapy.

Part 2 was on the 5 Lists of Words to Teach Your Child.

Part 3 is about Pivot Phrases.

I LOVE doing pivot phrases in speech practice with Chelsea! It helps her feel successful with talking, it is fun, and we get in a LOT of repetition on words I want her to work on. 

First of all, WHAT IS A PIVOT PHRASE?

Once your child has a few solid words, you can work on pivot phrases. A pivot phrase is a phrase that keeps a similar word constant, and changes another. For example, while tucking princesses into a bed:

"Ariel go ni-night"
"Belle go ni-night"
"Anna go ni-night"
"Snow White go ni-night"

The name changes (I try and keep it a motivating word for Chelsea), but the "go ni-night" stays consistent. That way, we can put all the princesses to bed (something that Chelsea would like), and get in a TON of reps of "go ni-night" (something that I want her to work on). 


2-Word Pivot Phrases
Draw _____          My ______         More ______
Tickle _____         Open _____       Hi ________
Push_____           Help______        Bye _______
Take_____           Want _____        Move ______
Wash_____          No _______        Red ______
Don't _____          On _______       Big ________
Eat ______           Tie ______         Hold _______

*Remember: Some of the best speech therapy sessions aren't done at a table! Go to the park and practice "Go on ___ (swing/ slide/ car/ ladder)

3+ Word Pivot Phrases
Help me  _____            Tickle my ______
Let me _______            Put on _______
Can I have ____           Take off _______
I want _______             Pick up _______
I need _______            Watch me _______
I want to ______           Draw a ________

You can work speech into any setting! "Pet the _____ (animal)" at the farm/ ranch/ petting zoo. 

*Remember: If your SLP is using just flashcards, run away! If your child doesn't want to go to the speech therapist, they aren't making it fun enough! 

Try to incorporate literacy into your speech sessions! For this one with Chelsea, I have her match words to pictures, and saw "Put on _____" That works speech and reading skills!

Acquisition/ Retention of Words: There will be a difference in how to proceed with speech therapy for when your child is learning new words versus retaining them:

Acquisition of New Words

• High frequency/ many repetitions
• Frequently reinforce effort, after every utterance if needed
• Keep stimulus items in predictable and consistent order
• Use small increments (easy targets) toward more difficult targets
• Provide as many cues and supports as necessary for success

Kaufman Card kits- flashcards for various words

Retention of Learned Words

• Lower frequency/ more time between practicing that word/ phrase
• Less frequent reinforcement. Require more responses per reinforcement
• Mix and vary the stimulus items. Make it less ordered, so it is unpredictable
• Provide minimal or no cues/ support. The child should be able to do this all on their own 

Overgeneralization

If you only work on one ending sound (like "-t"), your child may start to tack the -t onto the end of everything. You teach your child "boot" and "hat" and "pot", but then you start hearing things like "applet".

Repetition

Repetition is the key for successful apraxia of speech therapy! There should be very little down time/ quiet time/ rummaging around for things. Repeating things over and over tells your brain to remember it, because it is important. With repetition, you are creating new motor plans (muscle memory). 

Reinforcement

The more you cue, the smaller the reinforcement should be. If the child makes a colossal effort and is independent on the word, give them a HUGE reward! A bigger payment makes it more motivating for the child to continue to make bigger efforts. If a person feels rewarded for a behavior, they are more likely to repeat it!

Distracting Behavior

If there is a behavior which occurs often, try your hardest to avoid the behavior, rather than correcting it once it does occur. It is easier to stop things BEFORE they happen, then trying to fix it after. 

Chelsea's main tactic to avoid speech is to be silly. Laughter, mainly. Often so loud that she can't hear me. When that doesn't work, she will revert to a sullen "no!" with arms crossed and turning away from me. 

The best way for me to combat these behaviors is to withhold special toys/ activities that she really likes, and only use them for speech time. Then, she is very motivated to be well-behaved and do what I want her to do, because it gets her what she wants. 

For her, this is tea parties, playing princesses, drawing/ getting special art tools (stamp markers, etc), and doing dress up. 

SPEECH THERAPY SHOULD BE FUN FOR THE CHILD!!!!