For those of you who know me well, you know I'm not a fan of teaching carrier phrases to kids
with autism.
So today, I'm going to tell you why.
Hi, I'm Dr. Mary Barbera, autism mom, BCBA-D and bestselling author.
I've never done a full blog on carrier phrases, but my blog on teaching Timmy to talk in four
word utterances where I talk a little bit about carrier phrases spurred on some controversy
from both SLPs and a few BCBAs too.
A professional even messaged me and asked me to provide the research that justifies
my position that teaching kids with autism to use carrier phrases is almost always a
bad idea.
So what is a carrier phrase, and why all the controversy?
It's a really common practice to teach children with autism to form sentences, so once a child
can say or exchange a picture of juice when he wants juice, for instance, a lot of speech
and language pathologists, teachers, parents, and behavior analysts start teaching and then
requiring the child to build sentences by adding "I want" in the front of requests.
This "I want" is a carrier phrase, but the "I want" is not the only carrier phrase that
I'm concerned about.
Other carrier phrases include: "I need", "I see", and "that's a".
So here are my thoughts and why I think carrier phrases, teaching that, is almost always a
bad idea and my response to the professional who was looking for research.
I can't point you towards a research study to prove my position, but I can tell you that
in my 15 years as a BCBA I have hundreds of examples of how teaching and requiring carrier
phrases almost often backfires.
For early learners who aren't talking much or at all, teaching carrier phrases causes
more articulation errors, so if a child can barely pronounce "pretzel" so they may say
"pretzel" or ball, they might say "ball", so it's not clear.
Now we're talking about just one or two syllable nouns.
Now, we start requiring "I want pretzel" and now we're up to four syllables, so it might
sound something like "I want pretzel".
So it is not helpful to add the "I want".
In fact, my preference would be to go back and get those one to two syllable words more
clear so that everyone can understand.
I also think teaching carrier phrases as the next step takes the focus off of vocalization.
I've seen so many kids where they're described as nonverbal when actually they are trying
to speak, and a lot of times they are speaking with their main request, and they're still
being labeled as nonvocal.
People are now focusing on devices and focusing on these longer length of utterances, and
it's just making a mess of language.
I also think that early learners, I've seen it where they don't have the discrimination
to switch between "I want", "I see" and "I need" so they don't know which carrier phrase
to use and when to use a carrier phrases and when not to use a carrier phrases, making
their language even less functional.
Even if you have a child who's considered more of an intermediate learner with dozens
or even hundreds of labels, adding a carrier phrase such as "that's a", so "That's a ball,"
can quickly become rote and can backfire.
So I have client, her name is Faith, and when I went to see her we started teaching her
nouns.
Pretty soon, just a month or two after I started, instead of having 50 words, she had hundreds
of words.
So there was a gap in between when I saw her from one time to the next of about three months.
I went to see Faith at preschool, and all the sudden we were holding up pictures and
she'd say, "That's a ball."
"That's a frog."
"That's a ..." I'm like, "Where did 'that's a' come from because that's not good."
I think she had gone to some private speech therapist who had probably introduced "that's
a" but Faith was just using it constantly.
In fact, when I said, "What's your name," she said, "That's a Faith," so I worked with
the therapist to get rid of "that's a" and I'm happy to report, I just saw her last week
and "that's a" is gone.
But had I not gone in and tackled that, her language would've become less and less functional.
So for all learners, the push towards increasing length of utterance with carrier phrases and
teaching manners too, which is a whole other issue, it kills spontaneous manding and, in
my opinion, leads to prompt dependency.
Here's what I see.
Child vocally mands for water by saying, "Water," or maybe it's not as clear, but maybe it's
clear enough, so "water".
The adult says, "Tell me in a sentence.
Talk like a big boy," whatever the prompt is, which means that the child now has to add
"I want water," or "Water please," or "I want water please," essentially treating a spontaneous
single word mand or request as an error and making the response of the full sentence dependent
on an adult prompting.
In general, I can't think of a case after working with hundreds of children with autism
over the past 15 years where I can say teaching carrier phrases has helped make language more
effective and functional.
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I know it is kind of a controversial issue because a lot of people have been teaching
carrier phrases for many years, but I think I have provided a few points for you to consider
so that next time you might think about how not to teach a carrier phrase that might become
rote.
I'm on a mission to turn autism around for two million kids by 2020, so I hope you'll
join me by clicking the link in the description and downloading my free, new, three-step guide,
or by going to MaryBarbera.com/join.
Tell all your other professionals and parents too because everyone's welcome to join me
on my mission to turn autism around.
I'll see you next week.