For those of you who know me well, you know that I’m not a fan of teaching carrier phrases to kids with autism. So today, I’m going to tell you why.
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 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 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 that teaching carrier phrases 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 always backfires. For early learners who aren’t talking much or at all, teaching carrier phrases causes more articulation errors. If a child can barely pronounce “pretzel”, they may say “pret” or for ball they might say “bil”, 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 von pret”. 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 start focusing on devices and focusing on these longer lengths of utterances, and it’s just making a mess of language.
In 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 phrase and when not to use a carrier phrase, 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.
I had a client name Faith, and 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. There was a gap in between when I saw her the one-time to the next of about three months. I went to see Faith at preschool, and all of a 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, “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 kills spontaneous mands 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. The adult says, “Tell me in a sentence or “Talk like a big boy”. Whatever the prompt is, it 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.
If you like this blog, please leave me a thumbs up or even if you didn’t like this blog, feel free to leave me a comment. Share this video. 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 downloading my free, new, three-step guide. 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.