Writing Neurodiversity Affirming Goals

Marisha (00:00)

Okay, hello there and welcome to the SLP Now podcast. I'm really excited to have two special guests today. We have Jesse Ginsburg and Chris Wenger, and we are going to be chatting about neurodiversity affirming goals. And so I'm, I cannot wait for this conversation. And before we dive into chatting about all things goals,

I thought it would be super helpful to get to know a little bit about Jesse and Chris. They are a dynamic duo with a wealth of knowledge and experiences. So we'll kick things off just letting them share a little bit about their story and kind of how we ended up getting into this conversation about neurodiversity.

Jessie & Chris (00:53)

Yes, thanks so much for having me back. So excited. I know we were talking about so much has changed since we chatted last and now I got to bring Chris along this time. But yep, we're both two SLPs. We are based in Los Angeles and it's kind of fun because not only are we parents together, four boys, but we have very different work settings and just very different experiences, but we both love working with autistic.

kids and that's really our passion area, but I am a clinic based SLP. I own a clinic in Los Angeles for the last over 10 years. And so I work with a lot of littler ones. And then I have a panic attack about the age eight when I call Chris and say what I do with this child. No, but he is a school based SLP working with older kids. So it's fun to come together and have different perspectives.

Yeah, it's so funny that Jesse says that because it's like how I am too when someone approaches me with like a really young child and says, hey, so what about this goal or what about this? And I am I'm like, well, let me let me find out. Let me call Jesse. Yeah, he'll get like his friends from high school who have a kid who need help or something. And then he's like, can you send a voice memo to this person I knew 20 years ago? Totally. That's a baby. And yeah. Yeah. So, you know, following that, that's my setting. It's been my.

The majority of my life has been working with teenagers. So over the years, I've really kind of learned what works, what doesn't work, what makes a neurodiversity affirming goal versus a traditional goal. What are next steps for the future? Like, you know, my whole journey has kind of shaped together to learn this stuff. So but it's all been specific to teens and young adults.

Marisha (02:47)

And I love how we all end up with our areas of specialty and like we can build those networks to help us help all kinds of kiddos. So yeah, I love those stories and this will be a really cool conversation because we'll get the perspective for different age ranges as well as different settings like private practice versus the schools. So I'm really excited to dive into all of this. And.

We've gotten a lot of different questions about neurodiverse, neurodiversity affirming goals and what those look like. And I'm really excited to dive into that. But I know that writing goals is actually a very tiny part of the puzzle. And so, because well, there's a lot more learning that we need to do beyond like, here's a goal bank, for example. So what are some of your?

favorite resources for SLPs are maybe getting started to help give them a good foundation to start thinking about those.

Jessie & Chris (03:49)

Yeah, I mean, I think that it's funny, I was kind of laughing in my head when you said that, that it's such a tiny piece, because it's like, you can't just give someone a neurodiversity affirming goal, and then expect that the therapy is going to be using a neurodiversity affirming approach. You really do need to understand what makes something neurodiversity affirming. And for us, I know our favorite way to learn has always been to learn from autistic people.

and follow autistic people on social media. We have a lot of autistic colleagues and friends that we've had really great conversations with. And that's just, I would say, the number one way that I've at least tried to consume information about how can we best support our autistic kids. Let's ask our autistic adults that we have in our lives and then try to go from there. Yeah. And to shadow that,

back into the goal writing, asking, you know, and connecting with resources with other autistic therapists, autistic voices, which goes right back into the goal writing process, including the client or the student in that goal writing process. That is your first stepping stone on a no diversity affirming goal. Who's the goal for?

Is the goal for the teacher is the goal for the therapist is the goal for the parent or is the goal for the child for the client? That's where we have to step. So that's like one of the very first things we question, like, who's this goal for? Who's it going to benefit? And that right there will help guide the process of writing the goal. But yeah, I always feel like that. Need for connecting with and getting input from that individual.

Because that's intrinsic motivation right there, right? That's like neurodiversity affirming approaches and strategies in general is how do we get away from that externalized motivators and what's intrinsically motivating for the individual? Because if they can have say in their goals, what works for them? What do they need? Then that's where you're going to get a lot more success.

Marisha (06:05)

Yeah, I love that. So Jesse's point was reaching out to or learning from other autistic individuals in the community. And then I love how you added Chris that like our our students and our clients are like they're the stakeholders there. So communicating with them too. And you gave some really good examples of like questions that we can ask our students to help guide that conversation. So I love that.

And then do you have, could we maybe shout out a couple of accounts as examples? Like if an SLP is like, ooh, I love that idea. Like, where can I start on Instagram?

Jessie & Chris (06:45)

I feel bad because I don't want to exclude anyone by not saying names of people. Do you have people you would want to list? my gosh. I mean, I could give you a couple of people who I've worked with directly who have been awesome. It's just there's so many people. Honestly, it's hard to... Maybe we can give you a list to add in your show notes or something. But some people we've worked with and interviewed, one autistic SLP, her name is Sam Roundtree. Her...

Marisha (07:05)

Let's.

Jessie & Chris (07:14)

handle for a long time was the Aussie Specie. She's been awesome, worked on a project with her. my god, I feel like there's just so many people we've interviewed. Lyric, whose handle is neurodivergent rebel and Lyric always posts these questions that say that say autistic asking autistics. So if you go to the post, it's all

Autistic responses, which is really really cool Yeah lived experience educator. Yeah, I like a chain They have like such great content that really focuses on getting away from neuro normativity and working with Our clients and our students through a neuro diversity affirming lens So yeah that handle is at lived experience educator I think like resources to like I really like to go on the website neuro classic comm

you know, Autistic Self Advocacy Network, ASAN is a great one. But yeah, just kind of exploring those and hearing input from from voices has really kind of helped out. Yeah. So there's a few right there. Yeah.

Marisha (08:21)

Yeah, and then I'd love that I'll share the accounts that you mentioned as well as some of those websites. And then you guys highlight people on your accounts as well. So I'll link to Chris and Jesse's Instagrams as well as just another starting point as well. And then, okay, so.

Jessie & Chris (08:39)

awesome.

Marisha (08:43)

Obviously, there's a lot more to learn about goal setting to really help us, but let's humor the people and give them a little bit of what they want in terms of goals. And then I saw, I think it was a collaborative reel that you posted.

between, maybe it was Jesse's, I'll link the real either way in the show notes, but you were sharing about neurodiversity affirming social groups. And one thing that you said, like instead of teaching social skills and making kids sit and forcing conversation, we can provide a safe place for kiddos to be themselves and allow them to move and allow conversation to flow naturally. So I thought that was a really cool.

illustration of kind of some of the thought process. So and I'll share that if people are wanting to look back at that. But what are some important considerations when we are and maybe you have different perspectives based on what age you're working with, but I'm curious what your thoughts are on like, what should we think about as we're writing those goals, in addition to kind of doing our background research and.

listening to the autistic voices and our clients going from there.

Jessie & Chris (10:01)

Yeah, I mean, I think, I mean, Chris could definitely speak to this a lot more specifically, but I think the biggest thing to think about is, you know, our goal is not to just try to take a child and then fit them into the mold of what is quote normal, you know, and previously a lot of our goals would do that. It was, well, most of the time kids can have conversations for five minutes and they can take turns back and forth. So that means this child needs to be able to do that too.

But we want to make sure that our goals are also honoring autistic characteristics and, you know, autistic brains function differently than neurotypical brains and their sensory is going to be different. The way they regulate their emotions is likely going to be different. The way they socialize might be different. The way they communicate might be different. So really taking into consideration that our goal is to really support them in the areas where they

need support or feel they need support. We're not just trying to make them fit into a mold. Yeah. And that's like kind of more exactly on the if we're working on, you know, social engagement, social language, social emotional needs. Shouting what Jesse said is that's the first thing. Are we trying what's the what's the goal? Is it supporting the individual? Because if we're teaching them to act or imitate their typical peers,

then we're inadvertently going to create more stress. We're going to create more anxiety because the goal essentially is telling them, hey, look, your way of communicating or who you are is not OK. You have to you have to not be you anymore. You have to fake your whole identity and pretend to be somebody else. So we're going to create a goal for you to imitate what your typical peers are doing. And there's just a lot of harm in that because.

What ends up happening over time is you start to create this sense of an individual being more hyper vigilant where they're going into social situations like, well, did I initiate it the right way or did I not? Did I exchange back and forth conversation or not? Did I stay on topic the way I was forced to do or not? And then what ends up happening is they withdraw, become socially isolated. So inadvertently does the thing that we don't want to happen in the end.

So I think that's really something that we can we can focus on. So I guess at this point, what do we do? Well, we would create things, situations that are natural, where conversations can happen naturally, where they can meet peers who are like minded that share similar interests. Right. So like, I'll give you an example. We created a Lego club once a week.

after school and we weren't sure how that was going to kick off. This is just in the past six months. But we had a couple of students that had interest in that. And so we reached out to a teacher who is willing to host it once a week for an hour after school, student led, and it generated 16 students so far. But like up the bat, we have 16 students who were like

Wait a minute, there's a Lego club where I can go connect with other people who like to build Legos. No pressure to socialize. No pressure to have to fake who they are. Conversations happen naturally. Relationships happen authentically. We're not forcing people into conversations they don't want to be a part of. We're not taking away unstructured time for them to have to be forced into conversations. We're not forcing eye contact. We're not forcing...

neurotypical style engagement where one person has to put the Lego on and then the next person puts Lego on like things just happen naturally. That's the way life should be. Right. And so and so that's what we would want to do to create those natural conversations to happen to build those skills. And then another thing that Jesse will will shadow and share a lot more of because I learned this from her. But.

Whatever the goal is, if you're working with language, if you're working with vocabulary, you're working with social emotional needs, you're working with grammar, like whatever the goal is, you always have to ensure that the child's regulated. You're going to not get from point A to point B if you don't start there. And so, yeah, that sometimes can be dismissed or not really viewed as a necessity. So.

What might that look like in context? You have to do a makeup speech session. So your sessions are usually Mondays, you know, third period. But there was a holiday. So you're like, all right, well, I've got some time on Friday. Well, the students working on some makeup work in their study skills class or they're in an art project, they have a monotropic mind, they're focused. And then they get the phone call and their teacher says, hey, you have to go over to A100.

because it's speech time, you're going to have a child whose regulation is not going to be the same as it typically would. And so they come to speech and you're like, darn, they're not saying anything. I'm not getting any results. I'm not, you know, it's like, well, we have to think first and foremost, is this is this individual that I'm working with regulated? How do we get them there?

So so Jesse can kind of share a little bit more on that because that's her area. I learned that was good. He learned something from me. I learned a thing. As you were talking to put the dirty clothes in the laundry basket or else one hour massage punishment. I was thinking about you said something that made me think about how I used to teach. OK, am I the only one who did this? I used to have like popsicle sticks with paper.

glued to it and it would be comment question and then we would go back and forth. Did you ever do that? Probably not. You were ahead of your time. Was this in school? No, like with a student, like a seven, eight year old. Okay, let's have a conversation about a topic we choose. And then I remind them by holding up the thing if they need to ask a question or if they need to make a comment. And anyway, that's exactly kind of what I remember. Like,

having conversations about the popsicles that we ate. But yeah, I know what you're saying. But that's how I would teach conversation skills. It's like, OK, well, a conversation looks like I say something. You respond. You ask a question. I respond. And that's just maybe a neurotypical communication style. But if we are just focused on teaching autistic kids neurotypical communication styles, they're not going to actually go out there and

take those skills to be able to develop authentic friendships. And, you know, compared the popsicle sticks compared to I remember when I had these two girls in my office, they were like maybe six and seven sitting on these very chairs. So they were kind of getting some sensory like spinning around as they were talking to each other. And they spent 25 minutes talking about Pokemon and anime is Pokemon the different completely different or is it like a

No, that isn't. That's anime. Okay, so they were talking about anime for 25 minutes and I was like thinking like, man, I did my job. Like they didn't need anything. I didn't, it's like the way you know you're having a successful social group is when you're not needed. You know, and I think like oftentimes we sit back and we feel like, my God, well, I'm the therapist. I need to be interjecting. I need to be talking. I need to be teaching. But if you can...

create a scenario where you have people having an authentic conversation that they're genuinely interested in and you're not needed, that's an amazing thing.

Yeah, absolutely, I agree.

Marisha (18:08)

And you gave some good examples of like just kind of, and they even created their own context in that example. Like they figured out what they want to talk about and they were able to keep talking about it. And like with the Lego club, they're kind of self -selecting there of like, yeah, I love that Legos. I'm going to go to that.

So what would that look like, especially for like school -based SLPs? Like how would we reflect that in a student's IEP? Like what does that look like?

Jessie & Chris (18:38)

Yeah, I mean, regarding goals. So I'm going to give myself a shameless plug here because it goes with the topic. Before we start developing the goals, because there's I get this question like so often, what are neurodiversity affirming goals? Does anybody have a gold bank? But prior to the goal, we've got to have some information about what the need is first. Like what is going on in the environment?

I've got to get information about how things are going on in class with their peers. What does the student want? Like all of that information. So it really has to come down to a dynamic assessment. We really want to figure out, you know, in class, is this student when they get stuck on something, what's their way of communicating that they need some support? It doesn't always have to be through spoken language, but.

Are they reaching out to the teacher? Are they talking to their caregiver? Are they writing it down? If they're becoming dysregulated because let's say they had a substitute teacher come in, that was unexpected, which happens quite often. How do they handle their ability to co -regulate? Do they have a safe person in the building? Who is their trusted adult to go to? How are they advocating to?

get a sensory break or how are they working on co -regulating with somebody like we need to know this information. So the questions, this is always a life thing too. The questions we ask are going to determine the outcome of how we how the goal and the reports are written. Right. So it has to start there. The challenging part that we have as SLPs and OTs and PTs and everybody else on the IEP teams and in private practices.

the forms that we have to assess currently, like the standardized ones, ask the wrong questions because they're asking, how do we get this kid to be more neurotypical? So the system for 70 years now has only created more harm than good because now what you're doing is working against a child's neurology and then when they become dysregulated,

A functional behavior analysis comes in and an FBA is done. And then the behavior plans put on this kid when the reality is they don't have a behavior plan. They just had an unmet need and an unsolved problem because we were asking the wrong questions in the first place. So I created a dynamic assessment that asked the right questions, that asked the teachers, hey, I want to know.

What are accommodations that are working? How does this student self -advocate? What's it look like with the dynamics when the class has small groups put together? What's it look like when things, when the child or the student becomes dysregulated? And then we have a whole different set of questions that are asked to the students so we can get insight about what they're looking for in a friend so they're not feeling pressured to have to be forced into a social.

skills group, we ask the caregivers like, you know, what are some things that are working all strengths based, by the way. But that's where we have to start. And then once we get that information, then we can collaborate. We can work with the student and say, hey, now what is the need? Is the need for the student to advocate for a quieter space when there's test testing going on or.

Does the student need some support with noise canceling headphones during the rally and assemblies that are happening on Fridays? Does the student need a little bit of support about the perspectives of their typical peers without sacrificing their autonomy and giving them a variety of things? Does the student need a little bit of support on being aware that their autistic communication style might be a little different than their peers and it's totally OK? Like, what?

is that information and that will drive the goal. That's huge. Let me drop your mic. Mic drop. Yeah. With all of that being said, I want to say this, too. With all of that being said, we can add things in any of the goals where we come from a level of knowing when a student feels like they've been put into the fight, flight, freeze, fawn response, their nervous system.

Marisha (22:33)

Yes, I think that's the whole conversation right there.

Jessie & Chris (22:55)

happens, they've got anxiety, we know that sometimes that verbal speech might not happen in that moment and that's okay. So within the goal, we might put something to add to any of our goals when given access to total communication, right? And then that implies we're not forcing the child to use verbal behavior is what it's called or like spoken language, they must verbalize it. We're honoring the student and giving them

a variety of ways to advocate and to express what helps them out best. That helps in the schools, but it gives them the tools to help beyond the school walls. So if they have a dentist appointment in the future when they graduate or when they're in high school, whatever age they are, they might be thinking it would be really nice if I could wear my noise canceling headphones when I go to the dentist, because I hate that loud sound that squeals.

And I don't like the bright lights, so I'm wondering if I wear my tinted glasses and I have a certain schedule that works better for me. How can I advocate for those needs? Well, we've given them the resources and the tools like you don't have to call on the phone. But how can you use Yelp to reach out and to connect with them through, you know, written language or through text or through the scheduler? So there's a lot of benefits that these goals can serve on a large scale.

Marisha (24:22)

Yeah, that is incredibly functional.

Jessie & Chris (24:26)

Yeah, absolutely. And it's authentic to them. Like they're not, we're not creating goals that, you know, again, are creating more stress and anxiety. We're creating goals where they're like, yeah, that's what I see. I need help with too. So now they have buy -in into their own goals, which is great. And the parents are like, hey, that sounds like a good plan. I would love for my child to, you know, work on those things. And so then everybody gives each other a high five.

at the meetings. That's huge. Without actually the hands touching, germs and stuff. Air high fives at the IEP meeting.

Marisha (25:06)

That sounds like a really great way for everyone to win.

Jessie & Chris (25:09)

Or we can hold up popsicle sticks and be like, hey, great job. Hey, fantastic.

Marisha (25:12)

I love that. And I think so the first reel that I mentioned was one that Jesse recorded on her own, I think, but there was another one that you all did together, like a conversation about goals. I'll link that in the show notes too. But that's so because I was I see a couple.

kiddos, I don't carry a full caseload anymore, but I was working with an autistic kiddo and I had just updated his goals and I had put in a goal for like to have him after having some conversations with Jesse, I put in a goal to have him like self advocate for sensory supports. And then you did that real and that was the goal you're talking about was like, yeah.

Jessie & Chris (26:04)

my God, so funny. Yes. Rugrats audio. yeah.

Marisha (26:09)

Yeah, I love that one. That was super fun. But it was a really cool, because I still have so much to learn in terms of implementing all of this 100%. But just my experience with those types of goals, like you can really see a huge difference. Like the parents, they're like, of course, like that makes so much sense. And that's so helpful. And it's a goal that helps them at home. And...

in a bunch of settings. And then the kiddo loves it too, because it's really empowering for him to be able to communicate what he needs. So yeah, I've really enjoyed this conversation and getting even more ideas on how we can kind of start to implement that. And I'll definitely link to the dynamic assessment too, because that seems.

Jessie & Chris (26:58)

That would be awesome. Yeah. And I can kind of share where to find it. I wanted to add one more thing, too, because this question comes up, this whole conversation that we've had, there's always one last question that pops up because the majority of parents, when they hear this type of, or caregivers that hear this type of language and this new shift, they're like, yes, this, this, that sounds like so much what my child needs. But then you're going to get that.

really small, small group that isn't on board. And they're like, nope, social skills training right now. My child needs to be like their neurotypical peers, and there's no budging. We want this. Or you might be in a meeting, and there's an advocate that's like, hey, we know what? We want evidence -based programs that are about social skills training.

And I hear this question a lot. So my response is I always try to guide. I don't like try to say, no, don't do that. But I just try to guide with research out there. And I say, you know, I understand where you're coming from with the idea that if they have these social skills like their typical peers are going to be happier and, you know, things are just going to blossom. But the research and what we know is that teaching people in general to heavily mask, to be an authentic.

will lead to future mental health challenges and issues. And here's the research. So that way the parent has information to go, OK, well, you've given me some information so they can do some exploring and understand the harms in it. That's really how I approach that question, because we will, as SLPs, be presented with that question.

or those challenging moments where it's like, no, I hear your neurodiversity friends. I don't want it. I want to force this. And we have to, we do what's ethical, which is supporting the students we work with by not teaching them how to be inauthentic. So I wanted to share that because that's a valuable piece of information I've learned over the past couple of years on how to address that. Yeah. And I think like the underlying ideas.

It always for me at least comes down to a connection driven approach and how can we make this child feel safe and comfortable with us and feel like they can be themselves in front of us and in front of other people as well. And, you know, when we really sit down and think about it, how can I put, you know, connecting with this child, with the student at the forefront of what we do, it's like everything else comes.

more naturally, you know, and that's was the inspiration of my book I just wrote because that's what it's all about. It all comes down to how can we build a connection and that's when kids really learn and that's when kids feel safe and comfortable.

Marisha (29:53)

Love time.

Jessie & Chris (29:53)

Yeah, no, that's huge. I think that's at the forefront of it too. Ready, set, connect.

Marisha (30:02)

And we'll link to the book in the show notes as well. But like Chris said, it's called Ready Set Connect.

Jessie & Chris (30:10)

Yeah, I love it.

Marisha (30:11)

Love it. Well, is there any any other last thoughts before we wrap things up? I mean, you shared a huge wealth of knowledge and resources that I'm super proud of.

Jessie & Chris (30:23)

Yeah, I mean, I think the biggest thing is it is so setting specific when we're writing goals. And like, sometimes it's stressful for me just to listen. We're talking, he's like talking maybe about one of his students goals. And it's just, I feel like there are so many hoops you have to jump through in the schools, because he'll all tell him one of my goals. And he would be like, I could never use that goal for X reason, you know? And so,

I feel like writing neurodiversity affirming goals in a clinic at least. And I can't speak for every clinic because of course funding sources are different, but we do take insurance and we try to write goals that are the most, that are very easy, general goals that gives us the most flexibility possible. So back to Chris, he said adding when given, what did you say? When given,

access to total communication. Yeah, so having like a total communication goal, that's like our go -to goal for a child who comes in and is non -speaking or maybe minimally speaking or inconsistently speaking. And that gives us so much flexibility because we can work on anything now because our goal is total communication. You know, whereas if we have a child come in and we know their Gestalt Language Processor and we can identify what stage they're in, we write them a goal for that. And...

So we write our goals to give us a lot of flexibility over what we do and keep them really general so that it's not just that we're targeting specific activities or specific situations. So I think there's a lot of benefit to that. So if you have the ability to make your goals broader and more general, I've always found that to be easier. Yeah, I agree. And better. Yep. We're given access to total communication.

when working with activities where the child is regulated, like all of those things that right off the bat set up the student for success. I think that we are one step closer to meeting that goal and helping the kids. So we mentioned the assessment when it comes to goals within the schools. The reason why it can be sometimes challenging is how do you measure a self advocacy goal? How do you know the student is, you know,

asking for, you know, use of, you know, something that's calming for their sensory needs or requesting to co -regulate with the counselor or the mental health coach that's on campus or how do you know that they're advocating for the accommodations listed in their IEP. So I like to use a rubric -based system. I have a whole system and the assessment.

And so yeah, I'm gonna just share that word you can locate that because it's all kind of in the same place based on whatever is you're looking for if you're looking for beyond that and You're looking for a neurodiversity of activities I got all that. So here's how you do it. You go to my Instagram and Then you go to speech dude. So just type, you know, you find me at speech dude and then DM me the word bananas and there you go That's it. That's all you have to do. Just DM me the word bananas. I

And you're going to go bananas on some great neurodiversity affirming resources. That's how you do it. And then for Jessie, she's got her own stuff as well for where you could locate her book and all of those things. So you want to share? Yeah. The books at ReadySetConnectbook .com. And when you get it, you get the audio book for free. You also get a lot of other awesome stuff for free, like a free training, free event coming up that I'm going to be hosting. And.

Very easy to get anywhere. Yeah. Awesome.

Marisha (34:16)

ReadySetConnectbook .com. Awesome. And then, yeah, I'll link to all of that in the show notes as well. But thank you both for sharing such a wealth of resources. And it's, that bananas DM seems like it'll cover everyone's questions from the, because it sounds like you mentioned everything from dynamic assessment to actual activities. So.

Jessie & Chris (34:19)

Ready, set, connect.

Yeah, dynamic assessment to where you'll find the Gold Bank or something new that I haven't released yet, but a way for to locate providers and autistic therapists and clinical psychs and the right people. That's what the world needs. We need the right people. And so I got information there, too. Yeah, it'll be it's good stuff.

Marisha (35:10)

Amazing. And I know this was such a small, like this, I mean, it's been what 36 minutes or whatnot. This doesn't do the whole conversation justice, but I'm really grateful for you sharing. And then hopefully the listeners have some good resources to continue that conversation and continue growing as professionals. So thanks for doing this with me today.

Jessie & Chris (35:34)

Yeah Marcia, thanks so much for having us on. Thank you for having us. We love being here. Yeah, love the topic and we love being here. We appreciate it.