Children with autism have a wide variety of skills and talents waiting to be unlocked and taken advantage of. For a speech-language pathologist, helping these little ones improve their communication and interpersonal skills is truly a fulfilling mission to undertake. Jordan Levin sits down with Nancy R. Kaufman, MA, CCC-SLP to share how a pianist like her was transformed into the owner and director of Kaufman Children’s Center for Speech, Language, Sensory-Motor and Autism Treatment in West Bloomfield, Michigan. She talks about her wins and challenges in treating kids with autism as well as guiding their parents on the right way to take care of them. Nancy also discusses how she injects her experiences as a pianist into her current career by developing and providing music therapies.
Listen to the podcast here:
Nancy R. Kaufman, MA, CCC-SLP: Owner & Director, Kaufman Children’s Center for Speech, Language, Sensory-Motor and Autism Treatment
I am here with a special guest, Nancy Kaufman, who I have known for many years. Thank you so much for being here, Nancy.
I can’t tell you how excited I am, first of all, to be able to see you and to be able to observe all your accomplishments. It has been a long time. I remember when I met you, you had authored your book, Speak for Yourself. I was so fascinated with everything that you did. I remember learning that your parents did not know that you were deaf until you were age two and they did everything for you. It reminded me a lot of the parents I work with here at the KCC. I get to see kids from other countries sometimes, too. I know, like your parents, people will do what they need to do to help their kids to succeed. I know your parents found people in California and you learn how to be a vocal communicator even though you’re practically completely deaf. I can’t get over how well you have done. I’m excited for you and that you invited me to your show.
I appreciate that. That was part of what I want to be able to do, is the idea of almost giving back to the people that have surrounded me through the years. You was one of the first people that I thought of as I was going through my list of people that I wanted to interview. Thank you for that. I remember doing a bunch of different speeches through the years. I remember doing that and being at your facility. I was in awe of your facility and how much activity you have going on to accommodate so many different people with different, I’ll use the word abilities instead of disabilities. First of all, let’s tell everybody more specifically, what you’re doing.
I’m a speech and language pathologist and I have a private practice. It’s for children who sometimes cannot speak at all or who struggle to maintain intelligible speech, and also for children who have trouble understanding what is being said to them, receptive language, or children that have difficulty combining words to formulate their thoughts, that would be expressive language. Some children also have difficulty with social language. We are a group of speech and language pathologists, occupational therapists, and board-certified behavior analysts, who are the ones that supervise programs, especially for kids with autism.
As speech pathologists watch the progress of their patients, their own skills and behavior also change.
We have specialized Autism Programs too. I don’t think you know this, but we added another building since you had been here. It’s always exciting to think about my roots and having started off all by myself with an answering machine. We have grown to over 75 staff members. I’m so proud of everyone. We had to have a COVID team during this pandemic. They have worked so hard. We were only close for a couple of months and we were able to reopen in May 2020. Thankfully, we’re keeping everyone safe and healthy. That’s been a challenge but it has been something that opened my eyes to these amazing people that I get to work with every day. We also have ABA technicians. I talked about the BCBAs, those Board-Certified Behavior Analysts that supervise the ABA techs who then provide the therapy for our autism program for those kids.
I’ve always been in awe with so many things going on, especially when you have up to 75 staff. There’s got to be a lot of dedication involved. What I want to know is how you develop those skills to know what you’re good at and what you’re not good at and when to delegate. How did you develop those skills?
The children shape our behavior. We work with the kids and then we learn what we love to do. To be able to watch their progress, that makes us feel better about our own skills. I know that I specialize in what’s called childhood apraxia of speech. I love working with children who may not have any consonants or vowels that they can even produce in isolation and then teaching them how to produce and combine those motor movements, because that’s what they are, they’re fine motor or oral motor movements, and to help them to produce syllables and get them into words, phrases, and sentences. That has propelled me, because of all of the progress that they’re able to make. I feel very much a part of the quality of their lives.
What I’m hearing you say is you’ve learned so much from these kids. Through these kids, you’re able to obviously see their progress but you’ve learned to adapt to so many different situations. You had to come up with these different analogies, thoughts, devices, and methods of teaching these kids how to do it. I think back of what my parents did. They learned from the hearing center in California, but I remember that my dad had to make his method to get me to speak, especially with dealing with consonants, vowels, intonation, and lip movement. I’ve told you this before, if I moved my mouth too much while I was speaking, my dad would put masking tape over my forehead, my nose, and my mouth, so I learned how to talk like this and still be able to enunciate.
That’s a technique that I don’t know about.
There we go. I’m sure that’s not the best thing to be doing for a young child. Social services might have been called to something like that torture thing. I hated it, but in the long run, if you think about it, it was the right thing to do.
You asked about the staff and how we learn what we do best. I have so many amazing people that work with me. Some people like the little children, the little twenty months old kids. Some people would prefer to work with the adolescent population. People learn what they’re best at and that’s also what they like to do.
There’s got to be so much patience involved because I’m patient in my head, even myself or another kid coming into the facility and not knowing what’s going on, especially if you have a hard time hearing or trying to speak whatever they’re thinking. They’re just sitting down. With the time allotted for that patient, how did you break off their time so it could be effective?
You talked about patience. Anyone that knows me would probably tell you that I’m the least patient person they know. The reason that I have done well is that I don’t have a lot of patience. I want the kids to do what I want them to do and when I want them to do it. The one thing that we’ve all had to learn is how to motivate the children to want to do their best. It’s our job to find out what their favorite foods, drinks, toys, activities, everything they love and have them available and give them out freely at first. We become the giver of good things first and then the children want to be with us rather than trying to run away.
That would have been me because I was hyperactive as a kid. My parents have told me through the years I would never sit still so they had to come up with different ways to get me to stop.
We have that in common. I was an active young child. It works for us. I do, Jordan. Once we give the children things freely that they love and then they think, “I like being with that person because they have the goods,” and we start to ask them for a little bit of payment, but we start slowly. We start with things that the children can do and then we slowly move into what they need to learn. We’ve had so much influence by our Board-Certified Behavior Analysts, BCBAs. They have taught us so much about managing behavior, but what are the best things to do? How do we get kids to learn a new behavior? We have to teach behaviors that don’t exist, improve upon behaviors that do exist, and eliminate behaviors that are interfering to that process. We mostly do it through using highly-preferred items and activities and we don’t get negative or punitive at all.
Every speech pathologist must focus not only on treating a patient but also on motivating them to do their best.
I didn’t realize the amount of in-depth processes that have to go on to be able to get an individual to be able to do what you want. You have to come up with some different methods of that.
It’s hard work. We also try to coach the parents. They’re the caregivers.
I’m going to use an example of my parents. In elementary school, my mom, at the end of each day, we have a notebook and go to each teacher and say, “Teacher, what did you do today?” We would go home and I have to do everything all over again for that day because I missed the speech and language portion of it. What I’m asking you is, do you find that the parents want the results right away or have you done your job where you’ve educated them well enough to know, “This is going to take time?” How do you deal with a parent who is maybe too aggressive or not aggressive enough?
A few things. First of all, it wasn’t during the pandemic, we have observation rooms. Often, the parents are in there being able to observe and then we can talk through that one-way mirror and let them know what we’re doing and why and what they could do at home. During the pandemic, we are live streaming our sessions. The parents stay in their vehicles. We get the kids from their cars and we livestream the session so they know exactly what we’re doing and some of the things that they could do at home.
We also like to teach parents to try not to use flashcards or therapy materials, but to try to teach them how to get the best out of their children through play. I know what you’re talking about. There are parents that may not be the best fit for the child’s learning ability. We let them off the hook and say, not every parent is going to feel natural about being the one to work with the children at home. Some of the couples, one parent is a little bit better than the other with connecting to the child and motivating them. That’s okay. We tell them that it’s okay. Not every child matches up with the therapists that they’re assigned to. Luckily, that’s not a huge problem here at the KCC, but if it does happen, we find somebody who we think is a better match.
That’s what I call the process of elimination because some people are going to be more visual and some are more auditory and that type of thing. I was looking at the website and I was trying to understand that you have so many different program offerings. Don’t you think there are a lot of overlap with all of that with all of these different clients? It sounds like you have not just a client working with one therapist, it sounds like there are multiple different therapists that are involved.
Some of the children who are in the ABA program, that’s the Applied Behavioral Analysis program for autism. They have a board-certified behavior analyst and they have an ABA technician. During that day, they might also have a speech and language session and an occupational therapy sensory integration session. We all work together as a team. We have it pretty well planned out. The biggest challenges for us are a couple of things. What I don’t love about this job is that often I have to be the messenger. A parent may not be ready to hear some of the things that I might think about the challenges that the child has. That’s always uncomfortable. I’ve worked for so many years. I’ve been in practice for several years.
I wish could be different, but we have to be honest. That’s empowering. We want to do the best for the children. We have to let their parents and caregivers know what the major issues are and what we are going to do to help the children. The other big challenge is having so many staff members in scheduling because people are out sick or they’re out on maternity leaves because this is a highly female-dominated field as I’m sure you probably know. It’s a lot of juggling. We want to support all of our children and our families in the best way we know how.
You’re doing a wonderful job at that, so I don’t think you have to worry about any of the problems that you might have because you’re in the zone. When you’re in the zone, you don’t have to think so much. You’re able to do it without thinking. It flows. That’s your niche. If you ever do that, that’s a powerful thing. What I’m curious about is how did you get into this whole speech and language thing? What were you doing as a kid, somebody, some person, a thing, or school? How did you get into it?
When I think back on myself as a child, I probably had some degree of ADD myself because I always was in trouble for talking constantly. The teachers called my parents and they don’t know what to do about it. It served me well in my occupation now. This is what I was told, I don’t remember, but when I was three years old, there was a movie called Never on Sunday and there was some music in it on TV. At three years old, my mother told me, I went right to the piano and I played the tune. All of a sudden, they got excited that, “We have got a child that can play music by ear.” They got me piano lessons via famous pianist in Detroit. I wasn’t good at learning how to read notes. I’ll be honest with you. I did much better with, ironically, a good ear.
I took piano lessons from ages 5 to 10. I don’t know how I learned these scherzos and sonatas. I must have learned them somehow. I got fired by the teacher. When I went to Michigan State University, because I did have some degree of talent in music, I thought that I might go into Music Therapy. I had to have my tonsils out at age eighteen, my freshman year of college. I always had sore throats and problems and I thought, “I’m not going to go into Music Therapy.” Maybe I should go into something else that’s similar that I can use my talent with how I process music or other things, so I picked Speech and Language Pathology. I went to Michigan State for undergrad and Wayne State University for grad school. I loved both of them.
There’s always some way of finding the next spot. What I talk about in this show, all good things start with you. You finished college, you’ve got a Speech-Language Pathology Degree and all that, did you work for other companies first before starting this? How did you get into that?
I worked for Beaumont Hospital for the first thirteen years of my experience and then it was time for me to go off on my own. I started with renting some space and had an answering machine and I started to use some graduate students in Speech and Language Pathology to help me out. Little by little, other SLPs who I’ve known in the past started to join me. It snowballed from there. Children who struggle to speak often have difficulties with fine motor skills as well. Children who struggle to process and comprehend language also may have some other sensory processing issues. That’s where we opened up occupational therapy because it went hand in hand with our speaking language programs. There were so much more of a higher frequency of children with autism spectrum disorders. We wanted to have specialized programs for that population. Ergo, we needed a second building to accommodate everyone.
When did you get the second building?
Several years ago. I can’t remember the year. I owe everything to the amazing colleagues that I have been able to choose. You can choose your friends and colleagues. I’ve been fortunate.
It makes it exciting. It makes you want to work every day. It’s not even work. It’s coming into this good community. You’ve got a massive community, not just the staff but you’ve got the kids and the parents. There are a lot of moving parts. You’ve done a wonderful job.
For anybody that is successful, there are 1 or 2 people in their lives that are that base of the pyramid, that foundation. I have to mention my husband, Joel Kaufman, because without him, I don’t think that I would be doing any of these things. He’s so generous and kind and he’s always been so supportive of me and my own three grown children and Kelly Swagler, who’s been with me from day one is my Administrative Director. I miss her because she’s working remotely from home. I don’t get to see her as much. Also, I’m a grandparent now. It’s been interesting to, first of all, watch my daughter and her husband be parents and also to watch her speech and language development without having to worry so much about her welfare because she’s got parents to do that. I get to play with her and enjoy her.
I need to think about that in that aspect. I like it. What I’m curious about and we didn’t talk about it, you developed your own specific program. How is this specific program? What is it about that it makes it so different in why people come to you from other state?
It is okay that not every child matches up with the therapist that they’re assigned to.
I had been influenced by so many different speech and language pathologists. When I worked at Beaumont, I had a supervisor named Carole Goff. She was brilliant. She taught me something that she called, word shells. When children struggle to produce a full word, she taught them by simplifying the motor plan of those words, so they had a way to communicate with approximations better than what they attempted to do to simplify those words on their own.
From there, I learned a lot about phonology, which is technical. It’s more about children who are typically developing, what rules do they use to simplify words because when children first start to talk, they don’t say, “Ball,” they say, “Bah.” I’m Grandma but my granddaughter calls me Gaga. That’s her simplification of that word, Grandma, until she continues to progress and she’ll eventually get to grandma or whatever she would like to call me. I don’t know yet. I also had internships at hospitals with adults.
Some of the things that we learned about adults who had maybe suffered a stroke and took away their ability to speak, how we could teach those adults were some of the things that I wanted to use with children as well. One of them is that melody seemed to help adults who struggle to speak to be able to be more fluent and clear. I started to implement melody with the children who struggled to speak and things about those rules about how to simplify words for the children better than how they’re simplifying. I learned a lot about shaping, it’s behavioral shaping from our BCBAs, and how to move those word approximations toward that target vocabulary and the adult forms of words little by little.
It’s because of the internet, word of mouth, people from other states and other countries learned about the success of children and then they wanted to participate as well. One thing that I do miss is doing in-person presentations and conferences, where I was flying around. I wasn’t all that great of a flyer with airplanes but I did get a chance to speak around the country and sometimes other countries. Now it’s all Zoom. It takes a little bit of getting used to but at least we’re reaching as many people or even more this way.
That’s the thing. As crazy as this pandemic was, everybody else slowed down and realized how quickly and fast we were moving at that time. I would settle in and we were able to see the bigger picture in a different light than what we were doing before. Do you find that to be true?
I do. We’re able to participate in more learning. We don’t have to physically be somewhere else besides where we are. I get to see a person like you. If you didn’t decide to come to our center or if I hadn’t seen your show, I don’t know that we would have been able to connect like this or have fun about connecting like this. It’s interesting, different, and gratifying to be able to learn from many more people and do many more things online. Teletherapy and trying to work with children online is tough. My daughter is a speech and language pathologist as well in schools. It’s been challenging. Sometimes I don’t know how to help her because I’m not used to being able to teach children remotely like this.
Normally, when you’re in-person, you can see the part of the English word. For me, if I’m reading lips, it’s different. I may be able to hear some of it but I’m relying so much on that visual. That’s a challenge now with the closed captioning. That’s helpful for me in that respect. Here’s my final question to everything we talked about. All this stuff, as busy and awesome as you are, how do you unwind, recalibrate, turn your brain off, and get yourself ready for the next day? If you have a lot of things going on, you have to get out. After this, you have to get to work. How do you decompress?
I used to read a lot, mostly on a plane because nobody could bother me. That’s what I used to do, but now I like to watch TV series. I’m stuck because I want another one that’s as good as Outlander but I have to figure that out. Also, I have gotten so much joy from our first little granddaughter. She’s keeping us busy too.
That was my next question. What brings you joy? Right now, it’s the grandkids.
It’s also having the opportunity to be in touch with someone like you who started out with such an incredible challenge and have had so much success, and because of my age, I get to run into kids that I used to see at 3 and 4 years old. They’re married with their children and they’re doing great. It gives me such joy.
I could understand that. On my last episode, I was talking with the HEAR Center and we talked about some of the different things that were going through the years that brought back to when I was giving this speech in front of this group of 300, 400 people when I was fifteen years old. Before I turned to eleven years, I didn’t even know how to speak. That progression of that. I can see how that brings you joy to be able to see that in this day and age.
It’s incredibly exciting to see you and to be able to observe all of your success. I am grateful that you invited me to your own program. Someday, I’ll have to get to CrossFit. I have to start with CrossFit.
I’m always looking for that, the whole CrossFit. Everybody is intimidated by it, but all my members and coaches, everybody knows that we try to work with all our abilities.
It’s good to know.
Give a quick shout-out. Tell us how you can get a hold of you and how we can find you.
You can look at our website. Kaufman Children’s Center, KidSpeech.com. I love talking on the phone, still. You can find my office number. We have a nice presence on social media. I always love to hear from people. Sometimes parents call me out of the blue because their child is graduating from high school and we’re having some big event and they were thinking about how they used to bring them when they were little. That’s always exciting too.
That’s the thing. My whole theme here is to be able to share stories with people that will lead to histories.
It’s a great series.
I’m glad that we did this. It’s good to see you. I hope we can do this again soon and be able to see each other in person someday.
That would be great.
Thank you again and we’ll see you soon.
- Nancy Kaufman
- Autism Programs
- ABA Program
- Speaking Language Programs
- Last Episode – Ellen Simon and Joey Lorino – HEAR Center on Apple Podcasts
About Nancy R. Kaufman
Nancy R. Kaufman, MA, CCC-SLP, is a speech-language pathologist and the owner and director of the Kaufman Children’s Center for Speech, Language, Sensory-Motor and Autism Treatment in West Bloomfield, Michigan. Since 1979, she has dedicated herself to establishing the Kaufman Speech to Language Protocol (K-SLP), a treatment approach to help children become effective vocal communicators. A renowned expert in the treatment of childhood apraxia of speech and other childhood speech-sound disorders, Nancy frequently presents nationally and internationally on the subject. Families from around the country and the world travel to the KCC to participate in her intensive and specialized therapy programs. Nancy has been recognized by the Michigan Speech-Language-Hearing Association and honored as an outstanding alumnus of both Michigan State University and Wayne State University.