:

Welcome to the SLP Now podcast. I'm really excited to have Dr. Danra Kazenski with us today. She is a speech language pathologist and stuttering ally who works as a clinical associate professor in communication sciences and disorders at the University of Vermont. She's also the owner of Vermont Stuttering Therapy and the founder of the Normalize Stuttering Challenge. And she's a co-chapter leader of the Vermont chapters of the National Stuttering Association or NSA support groups. And she raises funds for the NSA with two online stores. that was just a small snippet of what all of the things that Dr. Janna Kaczynski is up to. But without further ado, let's just hear from her. Thank you, Marisha. I'll take any excuse to talk about stuttering. So thank you for having me. Yeah. And this is an area that I've been really wanting to learn more about. So I'm really excited and grateful that you're here to share with us today. Thank you. And so I read your bio and shared a little bit of your background. But can you share a little bit of your story and kind of... how you ended up where you are today and what led you down this path? Sure. I had never met a person who stutters until I started working with Barry Gattar at the University of Vermont when I was a student there. His class was a game changer for me because I was really inspired by how many complex unanswered questions there are about stuttering and the- the depth of the counseling skills that are involved with that. And Barry, don't know if you know him or have met him, but he's just the nicest human that ever lived. So if you need a good model of how to connect with people and show, like he's basically walking empathy, is how I describe it. And he's very open about his own stuttering. So I just kind of learned how to try and soak all of that up. And I'm not a person who stutters myself. So I try and do that from the... the non-stuttering angle of that and to be open and not make assumptions, those kinds of things. So after school, I worked for five years in Montreal, and then I came back and did my PhD with Barry, and I have stayed at the University of Vermont since then. So I supervised graduate students working with people who stutter there, but I really missed kind of also doing a lot of the hands-on work myself. And Vermont is a very rural state. And so unless you live up near the university, it's hard to access those services. So I did start a private telepractice to kind of offer services outside, you know, a certain distance from the university. And in the meantime, my niece was born and it turns out that she stutters and we don't have anybody who stutters in our family. So that was really interesting. I was there the day that she started to stutter at Christmas. And to see it from that personal angle after working with people who stutter for so long just brought, you know, just it was a different perspective to have it be in my family. And so then I have done this for about 18 years and I have heard a lot of stories from folks and many of them are uplifting, but a lot of them are very upsetting. So in terms of my drive to kind of take some of these advocacy steps, I've One of the men I worked with said that every time he stuttered as a child, he got punched in the head by his father. And a man that I work with just recently got banned from a coffee shop because of his stuttering. I'm sure that he must have had a lot of secondary behaviors and they thought something else was happening, which is terrible. And I've heard really unfortunate stories of even teachers making fun of kids who stutter here in Vermont. Um, and, uh, I also, and this is a content warning for folks. Um, I have lost two of the folks that I work with or were friends with who stuttered to suicide. And, um, so I am, I get very protective of people who stutter and their voice. And it really charged me up to do more, um, and to step in and to generalize, to normalize stuttering and, you know, not just in our own circles, but globally. And so I'm trying to give a platform to stuttered voices. And so I did create those stores. So I do sell basically stutter advocacy swag. I also sell things for allies, so SLP's and SLPA's and audiologists. But the overarching theme that I try and focus on is to is for just the basic human right to be heard, right? I mean, that's really all the people who stutter want and need is to be heard and to say what they want when they want and to have it be okay that when they say it, it's stuttered. So I definitely take more of an acceptance-based approach to how I run things. Yeah. Wow. Thank you so much for sharing that. Your heart for all of this just really shines through. It's great to see that. Amazing. I think it's pretty clear, but I guess just to make sure we're all on the same page, what is stuttering awareness? Yeah, love this. Yeah, juicy question. like a juicy one. If it's okay, I want to break it down into some chunks. The way I think of it is the smallest chunk would be personally for that person. And then the wider chunk is the community. And then the biggest would be society and just globally. So on that real personal level, I like to think of it as just starting to be willing and genuinely curious about what's noticing and noticing what's going on with your own stuttering. Like, what is this all about? And as a person who doesn't stutter, I spend most of my time listening very carefully. to their core message and trying not to make any assumptions about what they think about it. So I have to genuinely ask questions. And also with that gauging kind of what they're ready for me to do. Like what is their readiness for this? Cause everybody comes in at a different level and what we're asking them to do is hard. I've had one person describe it as walking naked through a minefield. Like you're asking me to do that? And like, well, You don't have to step into the red zone yet, but what would you consider being okay as a step towards doing that? And so some people are a hard nope, and some people are like, sure, I'm willing to try this thing for now. And then of course that changes over time. But some people don't even realize the kinds of stutters that they have. Like, oh, I didn't know that when I stretch out my words like this, it's called a prolongation. And sometimes I use, you know, Play-Doh to help with kiddos get to understand that, or we can name it something. Like I have some kids call their stutters clones because they're repetitions and they like Star Wars, things like that. And so the more awareness of also like just how we talk, right? You know, and so I'll get kids to lay on the ground and do an outline of their body to do a little speech machine activity to point out, you know, this is how we talk. put little sticky notes where you feel tension when you stutter and you get really interesting unexpected answers. Like sometimes they say, I feel my stuttering in my back or in the back of my brain. And you get to learn a lot more and it allows them to start talking about something that might have hard to talk about. And then just encouraging them to start noticing those things and the, like what kind of eye contact do I make when I talk to people? Am I actually listening to the other person or am I thinking about what I want to say? You that's a common thing that can affect, you know, your connection and regular conversation, just starting to notice it. And how do you feel about those things? And what changes are important to you? And what difference would that make in your life to help them make their own goals? And so I'll ask them what their best hopes are as a person and how stuttering fits into that. I don't know if you've done anything like narrative therapy. That's one strategy that we use. Yeah. I don't know if that's applicable only to stuttering or if it to other areas. But basically, we have them draw and name their stutter, which gives you a real immediate feedback about what their relationship with their stuttering is right away. Like, is this their friend or a foe, basically? So like, I've seen very colorful unicorns with the words coming out of their horn and, you know, the kiddo says, I wanna take my stutter out for s'mores and we're gonna go skateboarding. It's like, okay, cool. And then they've got other kiddos who draw very dark, like bloody with lots of weaponry and they know, they say, I hate him. And that's important to be able to have a way to get that out. And for that kiddo, we ended up drawing a bunch of his stuttering characters, putting them on bottles and shooting them down with ping pong guns and throwing them in the garbage. He wanted to say, I hate you. And that's the stage that they're at. But for some of the kiddos, it's a really positive. I've... I don't know if you've seen that the Stuttering Foundation of America has a really good newsletter where they'll publish anything that a kiddo will draw or say about their stuttering. And we've had like six of them or so go in and the kids are so proud, you know, like, so they're willing to make something that will help other kids too. So I'm just going to keep going because I can talk forever. That's okay until you tell me to stop. No, this is amazing. Keep going. I'm eating that. Okay. and instead of like, you know how they often could use different scales because we want them to kind of be able to participate in this noticing of their stuttering. So instead of like a stuttering severity rating scale, I have them work pretty early in the process of creating like a joyful scale, you know, and having them define what each end of the scale means for them. Because normally the bottom end of the scale if you were doing severity would be no stuttering. But in this case, that end of the scale is joyful stuttering and it includes stuttering, but maybe it's not as effortful. You're talking to who you want to talk to. You're not using a lot of tricks, those kinds of things. So actually it would be on the other end, like if you were totally fluent, but you were just using all kinds of ways to avoid saying what you wanna say, that is not where we're aiming for the kiddos to be. So I also, in that process, they kind of define what is meaningful to them, like what to flip something that might have been negative into a positive. So they might come up even with like a mantra related to joyful talking. And some of the kids that I work with, we actually say those mantras together at the beginning of every session, like, okay, here we go, let's say our mantras. And some of them would be like, I deserve to be heard, I was born that way and that's okay, stuttering is just how I talk, et cetera. And one adult that I work with actually said that he wanted his scale to be what his, he wants to be the person his younger self would be proud of. And so every week when he comes in, I was like, okay, what did you do this week that your younger self would be proud of? So generally with that whole personal sense of self-awareness, stuttering awareness, I want them to start to be aware of everything that's going on for them and to start considering accepting that full identity as a person who stutters instead of like taking on the false role as somebody who does not stutter and learning to let go of it instead of having those strong needs to like control or to to hide. So that was the personal one. Before we move on to the next one, I know that because I think SLPs are always looking for ways of like, okay, I know that, like, because a lot of us are realizing that we should probably be doing like in working through or like, My words are not working today, but like what we learned in grad school in terms of stuttering therapy is a little bit different than what we're learning about today. I think for many of us, I think a lot of SLPs are like, okay, so how do I navigate this? And what does this look like? And you just gave a beautiful, like so many beautiful examples, but I feel like I'm sure that they'll want to know more about the joyful scale. So it sounds like you kind of customize that scale depending on your client or do you have like a resource as with an example of that? I'd be happy to share one after in the show notes too, but literally I can come in with a blank sheet of paper and say, okay, we're going to just find a way. I'm going to check in with you every week about how you feel you're doing. And we, in order to do that, we need to kind of know. how to gauge that. And so you're, I like to give a lot of power to the students to do this, you know, give them a lot of control in general. So yeah, they might not want to call it joyful talking, they might want to use a different word. And I just kind of go with that. And they're going to define what the other side of the scale means. And then I just try and guide them so that gently that the joyful you know, are you okay that the joyful side includes some stuttering? As long as it's easy, you can say what you want and it doesn't interfere with what you want to do or be or say. They're like, oh yeah, that's fine. And you know, so it just, I give some shaping along those lines, but otherwise, you know, the kiddo is going to define it for themselves. And then, yeah, whenever they come in, we use that in their own words when we... talk about their stuttering, once we do a narrative therapy like that naming the stutter, I don't call their stuttering anything else. You know, like, how was Mr. Unicorn today? Did he visit you? When did he come around? How did you, you know, handle that? What did other people do when Mr. Unicorn came around? It's like a nice little way to separate them from talking about it directly for those kids who are a little more shy. and things like that, gives them just a little bit of space. know, like it's not the stuttering is me. It's Mr. Unicorn who comes and he lives in my brain and these are the things he does. And somehow it's easier to then like talk about it and, you know, come up with ways to, you know, cope or adjust or just tolerate, you know, be, just let it be what it is. SLPs are wanting to learn more about narrative therapy. Do you have any favorite resources for that? Well, I can definitely share that, I have some, there's some articles about that. But yeah, it's very similar to how I just described that I get pretty vivid. Like I would take an entire session to do this. And most kiddos, when you all have art supplies and things ready, you know, say, this is weird. you today we're going to talk about something weird, okay? I'm going to ask you to, you you stutter and we've been talking about your stuttering and I would just like to talk to it sometimes, but the trouble is I don't know what it looks like, you know, and only you know what it looks like. So can you help me understand? And they'll kind of look at me like, I don't know what you want me to do, lady. You know, like what is this? I'll say, your stutter have eyes? You know, does it have eyes? And you know, sometimes it does, sometimes it doesn't. Sometimes people pick a fog and it doesn't have eyeballs. But somehow asking that question, does it have eyes, like leads them to get going. And then you start commenting on, oh, I noticed you picked, you know, yellow and blue crayons here for this color. he's wearing, it looks like he's wearing a cape. What is that cape all about? And it looks like there's stars in the sky. I'm just curious what's happening there. You get them to kind of describe it like vividly, like a movie. And you ask a lot of details about, you know, when does it come around and how does it make you talk differently? And what do you do because you don't stutter all the time. So. You sometimes have them create a second character that is them, that is stronger than the stutterer. And then so what is it that you do? He tries to kick me in the throat and I have this lightsaber that I use to push him away and say, no, I'm going to say it the way that I want to or whatever it is. It's just like a nice. It's very vivid and detailed. And then I always refer to their stuttering by that character name after that. Some of them have created entire comic strips. And, you know, some of those did make it to the Stuttering Foundation newsletter. So, yeah, we try and get as detailed as possible. I love it. I love it as a strategy. Yeah. Yeah, that's great. And then we'll add the... articles that you mentioned in the show notes. think that'll be a great resource. Okay, so just a quick recap. So we're going through the three components of stuttering awareness. So we just chatted about personal and then we have community and society. And for the personal, we talked about like noticing what's going on with our stuttering or the client's stuttering and like the types of stuttering, like the speech machine, where they. where we feel it, incorporating narrative therapy, the Joyful Scale. So that's just a quick recap of some of the things that we went over. So what does the community starting awareness look like? Yeah. So for the individual in the community, I start to have the kiddos talk about, and this is from Vivian Siskin and the avoidance reduction therapy, who I'll talk about a lot because she's my... She and Barry to me are like the people that I would do literally anything they say. But so one activity you can do is called who's in your box. So you have the kiddo identify like who are the people right now that you feel safe and comfortable stuttering openly with. I can have them actually, you know, draw it in a box and put their names and then who are the people just outside the box that you might consider letting in. And then who are the people that are like, wait, nope, not interested in letting them in my box right now. And so part of therapy could be some of their goals, could be creating easy, medium, and hard goals, using that as your framework. So all right, your mom is a person who's in your box. What are you willing to practice with your speech? this week, are you willing to stutter openly with her a few times at breakfast? And you get them to be very specific. Okay, there's a medium person who's just outside the box. Are you willing to talk to them for one five second hello, you know, just to get you a little bit closer to bringing them in your box? And for the outside people, like, or if they have something really high up their hierarchy, they would get like an A plus just for even doing that thing. Like, oh, I never want to give a presentation, but they're willing to do that with their teacher as a starting point. Just because they did it and they were willing to take this risk, that is kind of redefined what their success is. you know, what difference would it make if you were to bring more people into your box or your community? So, I mean, the other people in the community are, of course, their parents and their close family and how they respond to their stuttering. And, you know, there's tons out there with Palin, parent-child interaction and patient listening and low-pressure environment, talking to siblings about interruptions, things like that. But the parents need community, too. So I often will try and connect them with other parents whose child stutters, you know, they have a lot of valid things that they're thinking about. You know, even with a two-year-old, they're like, I don't know if they're going to be able to ask somebody to prom. It's like, okay, this is important to them. They're thinking way into the future. So I ask them their best hopes as well. That's another good cognitive behavioral therapy kind of. discussion where I might even meet with them separately from the child if I see that they're very anxious and I give them a list of or I ask them to say, you know, what's good enough for the outcome of their stuttering? And to kind of rank that from one to 10. If one means it's, you know, not affecting them at all and a 10, like where are you okay? And then Asking them the child's best hopes for their life in general. Oh, I want them to be a good friend and parent and have a job they love, all of those things. And then you can ask them to rate, where are they on their scale to meeting all those best hopes? And if they say, well, he's a four-year-old, so he's like a three, it's like, okay, that's fine, yeah. But what makes him not a zero? and they list all the, he's very clever and creative and independent and funny and smart. And, you know, I have them read that list back. I read it back to them and I say, what does that say about you as a parent? You know, and it's kind of a, and then I asked them again, what is your good enough after that discussion to see if it's changed? And we have seen some dramatic things where they're like, I absolutely want negative five stuttering, don't want it to happen at all. And then after we have this discussion, they realize they've got a great, amazing kid on their hands, it's going to be fine no matter whether they stutter or not. Then they normally adjust that. So that's another really awesome activity for parents that I've found to be successful. And then teachers or other people in the community, of course, I know a lot of SLPs are working in the schools. I encourage my clients to write letters to their teacher and there's a little, you know, there are some templates out there, but mostly it's about to say, you know, these are the kinds of things that I like and this is what my stuttering is like and this is what helps me. And also if they want to talk to them about how presentations might go or. how I choose to kind of raise, I will participate, but please call on me when I raise my hand rather than just like cold calling me. And another member of the community, of course, is teachers. So I work with my kiddos to write a letter to the teacher. So that could say things like, you know, these are the kinds of things that I like. This is what my stuttering sounds like. This is what helps me in the classroom so that you can... so I can participate fully. And then I work with the family to decide, does the kiddo give it to the teacher themselves? Do the parents, are they involved at all? I basically let that be the kiddo's choice, what their comfort is. And then they might have a conversation about, oh, I prefer to raise my hand before you call on me, as opposed to just being cold called, those kinds of things. And so many people may not know. I know a lot of people feel like, They're going through their stuttering alone, but there is a huge, we call it the Stamily. So the stuttering family is enormous and very enthusiastic and supportive. So we have the National Stuttering Association chapter. I've been to the conference like five times. Every time you like vibrate from the energy, I never want it to stop. I totally encourage people to connect with those groups. We allow people to join our group by Zoom. So if anybody doesn't have a chapter and you wanna join our chapter, please just contact me. Friends has great groups that meet. There's lots of camps. I would recommend any way that you can connect anybody to anybody else who stutters because you're definitely not alone. There's this amazing group called Sisters Who Stutter for teens, specifically girls. I love them. Really great advocacy. I highly recommend them. And so, you know, part of this is you're an individual in a community, so you have to also learn to cope with people's responses, which sometimes are going to be rude or not nice. And so part of therapy too is like helping them tolerate that and, you know, get some mantras in your head like, let them think what they think, I can't control how other people react. You know, so we do build in some cognitive messaging around that. I do some predicting and checking the evidence because there's a lot of anticipation anxiety that goes into, they're going to give me the evil eye or I just am guessing that they're going to be rude. We say, okay, yeah, make your prediction and then see what actually happened. If they did give you the stink eye, what else could that have been? It could have been about your speech, but it could be because they ate a weird burrito and they don't feel good. they're late to class or somebody in their family, something happened. And so we just don't wanna always assume it might be about their stuttering. So one activity I do when I leave the clinic with clients is we have this big at University of Vermont, we have this big student center. And so I'll go down to where the people are and I have the person who stutters up on the stairs so they cannot hear me. And I say, okay, you tell me whether I stuttered. just by the reaction of the person that I talk to, right? So they can't hear me, they can't hear if I'm stuttering, they're just looking at the person I'm talking to. And then I'll go up and say, okay, what do you think? Did I stutter or not? They're like, oh, you definitely stuttered because they looked uncomfortable and they ran away from you. And I was like, okay, all right. On that one, I did not stutter. So what else could have been going on? know, oh, they were late for class. We come up with a bunch of different reasons. So anyway, I like that. That's called predicting and checking the evidence, basically, to help learn to undo some assumptions that might be happening. So yeah, that's my community box, I would say. Yeah, I love that. And I love the approach of thinking about, OK, what can we do to educate parents and teachers, but then also helping the clients come up with strategies of because we can't run like, of course, the goal of stuttering awareness would be for everyone to be accepting and all that. But that's likely not going to be the case. So I love incorporating those strategies of just coping with those rude responses, because I think unfortunately, that's just it's life no matter whether we stutter or whatever, whether we have like brown hair, pink hair, whatever it is, there's always going to be that. So I love that. Okay, should we dive into the society piece? Oh yeah, okay, sure. Okay, this is the big one. I know, well, this is a good one in the sense that I think the tide is turning. There's more and more awareness and more people having their voices be heard. So yes, that is the driving force of the normalized stuttering movement. And I've asked people who stutter, you know, when will we know when stuttering is normalized? What is the day where we can be like, okay, we kind of, made it. And so people have said, you know, when there's a person who stutters on a TV show and it's not a big deal, right? And I just heard a podcast because Mark Winsky consulted on the Penguin series. And there is an actor there who does not stutter who he consulted with to help stutter authentically. And I'm like, that is a good baby step because a major production company decided very intentionally to have a character who stutters and they were very good about consulting people who stutter to make it honor and align with what their, as best they could, their real experiences are. So I think that's a good first step, but... you know, where is that actor that's just in a show that, you know, you don't make a big deal, he just stutters and he's just, you know, going about life. And another person said that stuttering will be normalized when we could say that we stutter just as easily as we say our pronouns. You know, and pronouns haven't, that was a relatively recent shift where this is, you know, just what we do. And wouldn't that be great if you could just say, Hi, I'm Dan Rye Stutterer and I use she her pronouns. So to me in the society side of things, there's strength in numbers too. So there's like 81 million people who stutter on the earth. You literally can make the largest nicest street gang ever. Like if you really banded together, you have the power of numbers. And so literally every stuttered voice that comes out chips away at that. So the more the better. So every voice is a baby step to that kind of change of normalizing. So I encourage people to take up space, put your authentic self forward. Don't feel like you have to hide it. You know, do the opposite to the degree that you're comfortable and just step into your full power and stutter. I think that's the actual change. Change making is the actual voices of people stutter and other allies, you know, supporting that and giving that platform to them. So that's why I'm trying to make a dent in that process myself. But yeah, the normalized stuttering challenge was a part of that. So I told you before that we lost a child who stutters to suicide. And so he was 12 years old, devastating, right? This is the kind of thing that like permanently changes your life. And I had worked with him for seven years, and I wasn't working with him at the time. And, you know, there's just so much wrapped up in that that is painful. And I was really motivated because of that. And more recently, an article came out in People Magazine about his death, because his mom is advocating for rights at the state level to protect people from that. And the article came out, so I'm seeing pictures of Ryan, you know, in a magazine that I got off the shelf, you know, from a grocery store. And on that same day, Trump had made fun of Biden's stutter. And so something like changed inside of myself, like this needs to stop, right? Like we need to, as a society, not laugh at these things. Like it's of grave importance. And so the normalized stuttering challenge was for people to take a video of themselves. And if they stutter, they say, stutter and I'm worth listening to. And for allies do say, if you stutter, I'm listening. so I helped spread this out with some colleagues from stutterology, Ezra, Mackenzie from Talking Town Books, who's a kiddo who stutters and she wrote a book. which I'll recommend too, and Martha's speech, who's now from Young Stutters. So we helped spread that and it was amazing. I think on day two, I heard from somebody in Africa who made the video. I mean, it went really fast and so exciting to see people be like, this was really hard for me. I didn't want to do it. I'm never on social media. And those are the voices that stand up. And then the people who love them also making the videos. Anyway, so that I'm kind of like wanting to do more of to keep bringing in, making the community wider in those ways. And I was pleasantly surprised because I think we're all like, oh, if you go on social media, people are going to troll you and be meanies, right, to the people that you care about. And I literally read every message of anybody who did a video because every time they came in, I was like, ah, so excited. No negative messages. anywhere, like literally none. And so I think it was nice to see that if you're brave and you show your authentic self, people respond positively. So I'm trying to come up with something else like that to do the next round of Stuttering Awareness Week. I'm thinking something like, I won't shut up, something like that. You I won't shut up until stuttering is normalized, something like that. But anyway. Yeah, to me, those are the global things that are happening and that people are responding to and willing to do at this point, which is a good sign for society's change, I think. Yeah, I think that's so incredibly powerful. And I don't have personal experience with the stuttering side of things in terms of that being my lived experience, but I've had experiences with other things that I've struggled with and just getting to see I think not feeling alone is the big thing. And then just seeing people navigate it in a positive way, like, oh, this doesn't have to be like a horrible thing. I think that can be really powerful. And I just love your creativity and navigating that. That's great. And then I'll put your Instagram account in the show notes too. So for anyone listening, if you're curious kind of what this looks like. And yeah. Like if they follow you, then they can join in next time you do the challenge and all of that. This is really cool. Okay, so the majority of speech therapists who listen to this podcast are in the schools. So do you have any, and a lot of what you shared is absolutely applicable and can be used, but do you have any like other ideas or suggestions? Cause I feel like, Being in the school community, we have the opportunity to have our own stuttering challenge as one example. But have you come up with any other ideas or anything else you want to speak to in terms of SLPs in the schools navigating this? Yeah, sure. So I'd say number one is first getting them access to the services, right? I know we hear from a lot of people who say, I know they stutter. They do not meet the criteria to be on my caseload. These are smart kiddos who fly under the radar. They're not standing out in any other way. So we talk a bit about adverse effect and going beyond just academics too. That can be sometimes a way to get students in. So for example, there's a questionnaire that we use called the TASCC. So T-A-S-C-C, I'll link it, but the Teacher Assessment of Student Communicative Competence. So that's for kiddos grades one to five. I sometimes give that to the teacher because it helps identify if there are other participation things that are affected at school that could count for adverse effect if needed. So like participation in field trips, after school activities, it's not just the sitting down in class parts. It's anything to do with their day. And we definitely want to help catch that before avoidance behaviors become habits. So anyway, once we get kiddos on the caseload, if you make it that far, which is great, I do everything that we talked about before. So like the speech machine, the awareness, helping them learn about stuttering and expanding their community. being mindful of their readiness levels and toxic positivity. You know, that part, don't, you know, I may come off as rah-rah, but I'm very delicate about those early stages with the kiddos. They need time. And don't underestimate the power and importance of developing a trusting relationship first. You know, they need to, if you're going to ask them to walk naked through a minefield, they're going to need to trust you first. If you want them to be honest with you and raw about their real experiences, you need to validate where they're at and not try and push them too far too fast. So I don't make assumptions about where people are. I need to ask and listen. And generally, tools are annoying and unsustainable. If you're talking about things that the old set of tools like fluency shaping and things like that and do this, do that, it's just not effective in terms of these are little kiddos self-monitoring certain things constantly. It's just not feasible, not for adults. Like I say, think about if I asked you how many times that you blink during a day, it's like, okay, I've made it 12 seconds and now I'm done. Right? So instead, we need that relationship built and start doing these things to help take risks and accept themselves fully as people who stutter. So counseling skills really come into that. And I think that's where student clinicians get very uncomfortable. They're worried about saying the wrong thing. So even though we're speech people, I definitely listen more than I talk. And some of the strategies that are just full proof would be waiting a full 30 seconds after you say something or ask them a question. And that's good for introverts and for any person who stutters because you're giving them the chance to be their own expert. I really resist the expert role. You know, they'll say directly to me, like, well, what do you think? And I like to just boomerang it right back to them and like, this sounds important to you. What was your take on it? I just kind of refuse and give them the autonomy because we want them to be their own clinicians. We don't want them to overly rely on us. And so if you've got a kiddo who's kind of like, you wait the full 30 seconds and they're like, I don't know. I say, well, if you did know, what would you say? And amazingly, most kids answer that second part question. So I just kind of relentlessly put them in the driver's seat, I guess is how I would describe that. I'm also very aware of the language that I use. like instead of how was this week? Because many people would be like, well, I had a bad day on this day and I, you know, whatever happened. So instead I like to frame it as what are you proud of this week? And similar to what that other student said, you know, for him it was what did you do that would make your younger self proud? So I do recommend if people are interested in counseling, they learn a bit about motivational interviewing. There's quite a lot of that in other medical professions. There's a lot of resources. I'm happy to share some of the ones that I have. But it's a way to listen to the core message and reflect back to them and kind of tag it with their values as well. So like if a kiddo says, I want to be fluent before next year, before next school year. you could say, hey, great, and what would be different if that happened? You can turn it into like a discussion point. So they have to verbalize like what all the things that would be different if that happened. And then they might say, oh, I'd walk with my head up high and talk to everybody. And so you've just learned that their value is confidence, right? Right now they're not doing those things, they're hiding away. So that would bring them confidence. And then you can always attach what you're doing and make goals related to that. In schools, I know this is hard, but if you can work closely with the family, I think it's the most effective to not work in a vacuum. That one hour with you a week, ideally, or whatever you're able to do is just, it's gonna be so much better supported if the family's involved. When I was in a school, I met after school at lunch breaks. That would be something that you would have to decide your willingness to do. but I found it to be far more effective. So, and then you can do a lot of the classic kind of supports like the iceberg, know, what's above the surface, what's below the surface. If there's another kid who stutters in the school, even if they're older, I would put them together, you know, as a little mentor relationship. The older one will like supporting the little, the little will be like, wow, look at this cool older person. You know, I'm a middle-aged lady who does not stutter. I am not the cool person in the room, right? So I'm very intentional about if there isn't anybody who stutters in the school. The National Stuttering Association used to have a mentorship program where they will pair you by interest, you know, like a person who loves basketball. And they don't have that anymore formally, but... I know that if you wrote them and said, I'm looking for somebody in Phoenix who likes fishing, I'm sure that they would find a way to put them person together with them. I would really encourage that. SLPs come to our National Stuttering Association meetings with them, and some kids are really shy. And so we say, you don't even have to have your camera on. You know, talk to us in the chat. We just want you to be there and to listen, and it's totally fine. And then eventually they normally kind of get in. there's also lots of really good books for kids who stutter, like I mentioned before, Talking Town book. Daniel the Digger, very cute. I read that with my niece. And she said, oh, I talk like Daniel sometimes too. I'm like, yes. You know, that's so true. So stuttering, you just have to find what motivates them. So sometimes we'll do a stuttering project. That would be good at a school. You know, maybe they want to make a Jeopardy game. You can make that on Jeopardy Labs. Some kids like to make little flyers about how to listen to people stutter. We've had kids make movies or board games, all kinds of things. And if kids are brave enough, they might do a school presentation, you know, so you could definitely facilitate that. They can participate to the degree they want. Some kids like to plan it but not participate. Other kids like to be right up front there. Sometimes I'll bring in a cool older person who stutters to help with that. We have done a Jeopardy game, the finger traps, just like when you're blocking. There's this what would you do video where there's, I think it was, Well, Mark Winsky, the person who helped on the Penguin movie, he was the actor in that and he was being made fun of at a restaurant. And we kind of talked with the kids, what would you do in this case kind of thing. So anyway, I'm a big proponent of focusing goals, even if you're in a school, on the avoidance reduction kind of values, which would be more about joy, sincerity, authenticity, confidence, spontaneity. connection, efficiency, effortlessness. And there's a really great article, Syskin and Goldstein, 2022, which I can share, that has a lot of really good, very practical ideas for how to do these things, which would totally be easy in a school. Yeah. That's amazing. So many incredible resources. Yeah, the show notes are going to be full. And no, but this is amazing because I feel like you did such a nice job of breaking it down and giving really practical examples of what this could actually look like. Because sometimes in presentations, they'll talk about incorporating counseling and it's like, but what does it look like? And I feel like you just gave us a million different examples, which is so empowering. And you did it in such a beautiful way. So before we close out, do you have any last things you wanted to share? Well, I have a few other resources if that helps the SLPs out there. So I mentioned a couple of times ART, so that stands for avoidance reduction therapy. So Vivian Siskin, she has a, it's called openstuttering.org on YouTube and she's done some beautiful videos there. There's also real people. there who have gone through the program. I really encourage people to just go there and listen. She's doing Coffee with Sarah McIntyre. Awesome. I could listen to them all day. Obviously, the National Stuttering Association, totally life changing for many people. You can find them at westutter.org. I know you interviewed Nina Reeves and Scott Yarris. they have stuttering therapy resources and this great verbal diversity movement, which is really in alignment with these things that we've been talking about. And it has a structured way to talk about these things with kids who stutter. And if they're really into art or however they want to express themselves, they can make it however they want. but it gives a nice structure. And then at Sparrow, they have a really excellent video about, families, that I think is good really for anybody to watch, but that's something else that I can link. Talked a lot about readiness. Naomi Rogers from Iowa, great article about that. I can share it as well. And the 8,000 things we're sharing in the show notes. Definitely follow people who stutter who are on Instagram. I like people like Caitlin Cohen who's, you know, a regular person who stutters who just talks openly about it. Sisters who stutter, all kinds of people. Mark Winski's out there, stutterology. There's just a million. I would encourage you to listen. And when you're doing the famous people who stutter, I know that we asked a lot of people who actually don't stutter anymore. And we're kind of moving away from that, right? So there are people like Michael Crest and, know, Emily Blunt, did hear she still, I heard an interview with her. She still does sometimes stutter. George Springer, who's a baseball player. You know, Elvis stuttered his whole life. So I try and find more people who continue to stutter. when we're talking about famous people. So I guess my message too that I hope people who stutter would take from this and maybe you can carry this forward in your work as SLPs is that fluency is overrated. We're encouraging our students to take back their power, be big, make sure they know that their stuttered voice has value. We're listening to them. They deserve to be heard. They're not alone and do not shut up. I think those are my final messages. I love that. Thank you so much for being so generous with your time and expertise. This was incredible podcast. Again, chock full of resources. So thank you. And yeah, thank you to everyone for listening to you. And that's a wrap.

Marisha (00:01.294)

Hello there and welcome to the SLP Now podcast. We are kicking off a new series on all things stuttering and I cannot tell you how excited I am to have our speaker today, our interviewee. Ezra Horak is a stutterer and the founder of stutterology. And if you don't follow them on Instagram yet, go and...

Switch to Instagram, search Stutterology right now, or check out their website stutterology.com. There are just so many amazing resources there. They are also the board co-chair to space. So Stuttering People Arts Community Education, which is a nonprofit that creates more space for stuttering and changes how society listens. So yeah, I am so excited to have Ezra here today and

just a little bit of context. So I've been on my own personal or professional development journey when it comes to stuttering and it's been a process over the past several years. But I'm really excited to get Ezra's perspective today just to kick off this whole series. We'll be talking about best practices for assessment and treatment and counseling and all of those things. But today we get to hear from Ezra on just

kind of getting our context and our mindset and our framing correct. So without further ado, that was a long intro, but hello, Ezra.

Ezra Horak (01:37.572)

I'm really excited to be here.

Marisha (01:42.2)

Yeah, likewise. I'm just so, grateful for you being so generous with your time and willing to share a little bit about your story, which leads us to the first question. Would you mind sharing just a little bit more of your story? I shared super quick bio that does you absolutely no justice, but tell us a little about you and kind of what led you to start stutterology and yeah.

Ezra Horak (02:08.932)

Sure, yeah. So I've been stutterin' since I was about six years old or so. I was actually already in speech therapy at that time for reverse swallow and not being able to pronounce my Rs. And I began stutterin'. This is in, I'm gonna just let people know how old I am. This is in 1997. And I immediately...

my self-esteem kind of started to drop and my mom had asked me like, you like this speech therapy? And I said no. I she asked me like, do you think it's help, help, helping? I said no. And she pulled me out. And she, I don't even know how she researched this in 1997, to be honest. But she looked her, like she found stutterings, bimashalas, and we got

really, really, really lucky that in the Sandy A. Ago area there happened to be some people. so she took me there instead, which I'll always think is like just a mind boggling thing. I don't know anyone else who has a story like that, especially from the 90s. I grew up, it was just my mom, my brother and me. And then my grandparents were pretty involved.

And my mom didn't know anything about stuttering. Prior to my onset, she had never heard of stuttering before. I asked her recently, I was like, well, what did you think like Porky the Pig was doing? And she's like, I don't know, I just thought he was like being funny or something. I know it was a thing. So had zero context. Which in hindsight, I'm almost like maybe that was a good thing because she got to be a blank slate. And when we went to this

second speech, the therapist, this lady sat her down and was like, okay, you know, it's been going on for six plus months. It might continue for the rest of their life. And we need to make sure you're prepared for that, that you're prepared for the teachers, how they're going to react. You're prepared with future SLPs that you're going to have, like really sat down and said, you know, things will be chat.

Ezra Horak (04:29.284)

challenging, but the most important thing is that your kid continues to talk. That's number one. And I really think that if I hadn't had that, my whole life would have gone a totally different way. I still, as you'll see with my story, it still doesn't go in an ideal situation because there's still like society and there's the future speech therapy I would get and there's other influences, but it still made a foundation that I think I just feel so lucky to at least have had that start.

So then fast forward, eventually I have to go to a different speech therapist. I went through a private school and so it was like not through the school district. It was through, we had to like go through this whole rigmarole, get insurance improved. So I have like letters that teachers wrote about how desperately I needed speech therapy if I wanted to be successful in life going on, which my mom kept everything. And so I still have all of that, which feels odd.

But as far as my mom went, she made number one thing of like, I just want to make sure you keep talking. So I was a very, very social outgoing kid. And you could see that start to take hits as things happen. I was always volunteering and teachers wouldn't call on me in class. I wanted to be in a play in third grade. And the parents of my classmates took my lines from three lines to half a line.

Every time I stuttered they were asking me, are you sure you want to do this? And I was, I, that was my first memory of stuttering. I'd been stuttering for several years, but my first memory was being on stage and those parents asking, are you sure you want to do this? And that's the moment it became very clear to me that people didn't want me to stutter. That like, well, I didn't care. My mom didn't care. At that point, I don't know if I was seeing the same space therapist, probably not.

But other people cared. And it was a battle after that. You know, I had different speech therapists, my family had different reactions. My mom was amazing about my stutter my whole life. I asked her she ever practiced fluency techniques at home because I know that's a pretty common request. And she said one time she was asked to and she started to.

Ezra Horak (06:50.454)

then was like, what am I doing? Like, asked me, do you like doing this? And I was like, no. And so she's like, okay, well, we'll stop. Just listens to me, which I feel so unbelievably grateful. My grandma who helped raise me was a very different story. She was always telling me to slow down, to do my techniques constantly every time I talked.

And she would tell me if I couldn't talk correctly, I should wait until I could, which I think everyone can agree is a pretty harsh and rude thing, especially to a kid who's excited. But my grandma was pretty harsh, and there's a twist to that, but I wouldn't know it for another 25 years. And so anyway, so then I went to public high school and...

did speech therapy through the high school and that was, I'm sorry, that was my worst speech therapy experience. Hands down, this person was quite a bit older and I think she was about to retire. She had a lot of outdated thoughts and wasn't interested in learning more. So as a kid, I had no problem telling my speech therapist they needed to learn more about stuttering. I was, I don't know what that first speech therapist did to make, or if it was just like me and who I was, probably a combination.

But I

clearly had no interest. And then high school was probably, things were pretty hard for me emotionally. I just had like a lot of different things that I wasn't aware. I was undiagnosed ADHD. So I struggled a lot. I did well in school, but it was a struggle. And then I went to college and that's really when things hit the wall. That's really when...

Ezra Horak (09:10.466)

You know, people have asked, what was your hardest year of stuttering? And I, after thinking about it, I realized it was when I was 18, 19. And I was kind of on my own. You know, I was away from my mom and my mom had done so much advocacy on my behalf, had helped me with advocacy things. And I was away from home. I was away from my normal friend group. None of my friends cared that I stuttered, but I never really talked to them about it, unless it was an offhand comment. No one knew.

how much I was thinking about it, how consumed by it I was. They knew I did it and they didn't care, but they didn't realize how much it encompassed like everything I saw and did. I ended up picking to do my degree in accounting, even though I didn't like accounting and it gave me a headache to do because I thought, well, I stutter, I'm capable of this, I'm first generation college, so I'm like picking the safe option.

part of it and another part of it is, well, I couldn't do communication. I couldn't be a journalist because I stutter, right? A lot of it was that. I told myself it was the safe option, but I think a lot of it came down to being afraid that I wouldn't succeed if I had a stutter and I would rather have picked something that was as opposite of what I wanted to do than something that was close that I couldn't do.

because I was so worried other people weren't gonna let me do it, because those were the experiences that I had had. At the end of college, my friend was at my rival college, learned about a senior project this guy, Morgan Lott, was creating called This is Stuttering. And it was like a self documentary he made for his project and his last attempt at speech therapy to get fixed basically before he was gonna graduate college.

And when I sat there and I went to the school, I had emailed him, I went to it, and I sat there and I saw myself on screen for the first time. Like it was him, but he was so, he had so many similar like secondaries. So he would like touch his face in all the same ways I did and like bit his, and like you could tell he wanted to talk and he stopped himself. It was a very transparent documentary that was very painful, but also very, I saw myself and.

Ezra Horak (11:33.8)

I was thinking, no Morgan, like you can do it. And then I had to realize, you know, like, and I, didn't want to realize that the same could apply for me. That was, that took a long time. But, when I walked out of there, I went home and I wrote and I, I, a big, I've always liked to write. and I had a Tumblr at the time and I wrote, I think I'm going to have to.

Accept that this is the rest of my life that I'm not gonna wake up one day It's gonna be gone. So that's what I kept hoping for one day It'll be gone in my life and start that this is gonna be my life and I don't have to like it I can hate it. I But I at the time I was religious and so I saw this but I can thank God that it's here because it's it's a kind of the mindset but the idea was I can hate this but acknowledge that it's here and move

forward with that. And so that was a changing point. That was 11 years ago. It took me a year and a half before I joined one of the local chapter groups with the National Stuttering Association and I started to meet. I was so scared to go to those. I on an email list and every month I was like, I'm coming. And then every month I was like, I was sick or whatever. And the chapter leader was such a sweetheart and was like, well,

I was, hope you feel better. We'll see you next month. And he knew what I was doing, but what just was very sweet. And eventually I went and there was a regional conference in Anaheim that I went to and it was terrifying. It was so scary to meet other people stutter. but when I talked at like an open mic or I made connections, people were so excited and they saw me. They were like, you're an outgoing person. I had never had anyone say that to me. they could see.

like, past the stutter to who I was. They could see those like nervous things, but they knew what they were. They knew it wasn't my personality. And it started to change how I saw myself as I met other people. And I realized how cool some people were. And you meet lawyers, you meet all these career paths, you meet journalists, you meet public speakers, who've mastered those masters or like a grand master.

Ezra Horak (13:59.714)

All these excuses you've told yourself, you meet people who have done it, and it started really shifting and I realized, why aren't we, why are things the way that they are still? Like, why is this something everyone who said or seems to go through this whole, l-l-l-l-l

And so as I went on my own journey for the next like 10 years, I eventually realized I really wanted to create my own thing. wanted kind of a freedom to really say some of the things that I wanted to say, because some of the things I knew I wanted to say could come off to some people as controversial, even if I put a lot of thought, even if I'm really careful, I knew that it was going to rub some people the wrong way. And so

I kind of stepped away from all of the different places I was volunteering and a part of at the time so that I could just like not have any ties and just do it from me from Ezra on stutterology and that's it. And so that's what I started to do. it originally I originally I was just going to be talking for two parents. That was the point of my podcast at first was parents need resources. They need to know like my mom.

The reason she was able to set me up for success is because she was prepared. Someone gave her those resources. So I thought, okay, how can I help to do that? But most of the people I know are people who stutter and they started to listen and they were like, you got some really good stuff in here. We want more of this. And that encouragement, when I first started actually, I would have, if you had asked me,

How do you feel about fluency goals in speech therapy? So not just techniques, I separate those out when I talk about them. I'm sure we'll get into that. But like the goal is fluency. When I first started stutterology, I would have said, well, it depends the person, you know, it's probably okay sometimes if that's what they want. And I had some speech therapists actually who don't stutter who reached out and were like, I'm gonna ask you to think about this a little more. Like, you you're allowed your thoughts, you whatever you want. But like,

Ezra Horak (16:17.622)

you seem like you have these beliefs, but that contrasts with this. And if it's because you're afraid to be bold on this, like here's some thoughts. And it was extraordinarily helpful. And it did help me really rethink things. And so we'll get into that, but yeah, eventually that did change. And I've grown a lot since I even started that. And I'll give you the twist with my grandma since I hinted at it. A couple of years back, we were at, I think it was like a

Mother's Day brunch. And she goes, so you went to your thing this year at the conference. And I was like, yeah, grandma. I went to my stuttering conference and I, cause the NSA has an annual one and she goes, so you guys just accept it. And I was like, yeah, grandma. And she's like, well, I guess it doesn't hurt anyone. Yeah, grandma. And she says, you know,

When I was a kid, I had a stutter.

Ezra Horak (17:23.722)

And that moment, I felt like a reverse, like that's so Raven, where I sat there and everything she had ever said, every comment that was mean, and not that it excused it, but I saw it in a whole new light and I realized she was scared.

And my mom was very upset. My mom was there and almost stood up and left because she had been asking my grandma my whole childhood, do we have any family history? Has anyone in our family ever said or did? My grandma always very confidently said, no. No one has ever. So my mom was upset and I was in shock and my grandma was oblivious to having caused this reaction and no one said anything really. We're just like, okay. And moved on. But it was, it was a very,

eye-opening moment for me to realize that a lot of these times, some of the hardest stories I've heard from people who stutter with parents, often the parent has had a stutter or has one and they're repressing it, there's a trauma reaction, and unfortunately it's taken out on the child. And it just was such a mind-blowing though.

It didn't make any of the things that she had said feel great, but it definitely made it feel different. So that's the twist. That was quite a twist at the time.

Marisha (18:50.92)

Wow. And I think that is so in the series where one of the things we talk about is like navigating this with parents and all of that too. that is like, that is such a beautiful example of, cause the, not all parents are like your mom who like, there's some very, very different reactions, more like your grandma. And as speech therapists, when we're navigating that,

it's important to think about like, like these, like this was, you just provided one example of what might be behind that reaction. But I think a lot of it is fear, whether it's like personal experience, kind of trauma related, or just like fear for your kiddo too. So I think that's such a beautiful example. And my gosh, so many, I feel like I'm gonna have to re-listen to this like 10 times because there's so many.

Ezra Horak (19:44.804)

you

Marisha (19:48.834)

like nuggets and takeaways. my goodness. so thank you so much for sharing so authentically and just so much of your story. I think this will be really helpful for speech therapists to be able to do that perspective taking and, yeah, you did such a beautiful job with that. So, wow. Okay. so I think now I guess we can transition now to chatting about

fluency expectations because that was kind of a common thread in your story in like the difference between the speech therapists that you felt was and I'm interpreting this so you can correct me, but you had a good experience with the speech therapist and not so good experiences with a lot of speech therapists and it seemed like one of the factors was fluency expectations and I guess that could be and that was illustrated in

Ezra Horak (20:23.821)

Okay.

Ezra Horak (20:32.514)

Yeah.

Marisha (20:49.004)

the contrast between your mom and your grandma to potentially. And so I feel like you gave us a lot of different examples, but I think it'd be nice to just like take a bird's eye view and chat about why those expectations can be detrimental and how fluency treatment might be harmful for kiddos.

Ezra Horak (21:10.18)

to definitely yeah, yeah, I will say that is gotta be the biggest game changer for the differences and experiences is one is asking you to be fluent and the other one just is asking you to talk and doesn't care how it comes out. I've also told people one of the best things my mom did. I don't have a single memory of her ever praising fluency. Not single ever. It was always

I'm glad that you talked. I'm glad you shared. It was never good job at how you said it, ever, ever. I don't remember a single thing. And I think that really speaks to that idea, right? It's not even just punishing someone for stutterin'. It's just hoping and wanting. You can't stop the hope and the want, but you can monitor how it comes out and how it happens. And you can work on that for yourself. I know you guys talked to Nino already.

And I know she does a lot of work on processing, parents especially, but species therapists too, like processing some of this on their own time, not in front of the kid. And the reason it makes such a difference is we know that there's no cure for stuttering, right? Like people can argue till they're in the face about if there's things you can do to hide it, but there's not a cure.

The, of kids who stutter, you know, the commonly thrown around percent is that 20 % continue to stutter. And I always frame it that way because I think when we say 80 % grow out of it, we're focused more on that 80 % and why? I want us to focus on the 20%. That's not a small number. That's a lot of, of these kids. And when you're asking them to do something that is physically impossible.

You can't be cured. It's not going to happen. And you're hoping for that for a kid. You're putting those hopes on the kid. You're putting expectations like that. They will fail you. Like they will. Like that's not up for debate. Like it won't. And they'll fail themselves and they'll know it and they're aware of it. Kids are really good at picking up on wanting to please the people around them. So even if like with the praising for fluency, even if you're not saying the negative things about

Ezra Horak (23:33.124)

but you're clapping or you're telling them good job, or when you're doing some of the fluency techniques, you're making them repeat if they stutter during it. All of those things are examples of things a kid is going to pick up on, and they're going to know what the expectation is. And that's only going to be amplified more if they're having some negative experiences outside of the speech therapy room. So like the story, one of the stories I told was about a play that I was in in third grade.

And that was apparent to a classmate. So they were outside of like my mom's level of influence, right? And it impacted me so negatively that it would have eventually impacted the speech therapy room because now I didn't need them to tell me it wasn't okay to stutter. I went in assuming it wasn't okay and then was like, would have needed to be reassured in different ways and by proof.

not just telling me it's okay to stutter, but actually making it okay to stutter. I don't have a lot of memories of that first speech therapist, because I was young. And also, I didn't leave with any trauma, I guess. so, you know, I don't, but I, my mom said, you mostly just went in there and like, you guys talked and you had a good time and you played and, you know, she'd ask you about how you felt. She'd ask you how things were going and she'd ask questions, but it wasn't, you weren't,

sitting there with a list of words, doing these different techniques every time, which is what most of my speech therapy after that was about. And there's different reasons it's frustrating because even if you quote unquote see improvements, which I don't talk about it that way, but like if you know, that's the traditional way to talk about it. If you're seeing these improvements, stuttering is variable. It comes and goes, it changes.

and now you've just assured someone, great, thank goodness you're at 90 % fluency now. And then when you start starting again, you're well aware that people are gonna be disappointed that you didn't keep that up. It's just such an unsustainable and irrational expectation to have on something that isn't.

Ezra Horak (25:52.298)

isn't as easily understood for one, and two, it takes so much effort to control and even that leaves us grasping for straws. The other thing that's really important to understand is that when you're asking someone to do these things, it doesn't feel quote unquote fluent for me to do fluency techniques. So if someone's wanting me to be fluent,

To me, there's no other reason to want that except for a listener reaction. I know that that's not true for everyone who stutters. I know for some people, you But for me, that goal was for other people. It wasn't really for me because I was gonna struggle whether someone else heard stutterate or not. It was gonna be a struggle.

So the only reason to make that goal is if you want it to sound clean. If you don't like how I sound and you want me to sound clean, then we'll do it your way. And it just really broke the way that I saw communication. And I think it still impacts me to this day, unfortunately. It really does come down to exactly like what you said, this like expectation for something that I couldn't give. And even if now I'm okay with my stutter and I feel good,

it seeped into all these other areas. You probably know growing up as a girl or different things, you have other things telling you it's not okay to be who you are and that you're supposed to be smaller and quieter. And there's like an intersection that happens with stuttering that like really amplifies all of those things too. And so even when now I've done so much work and I feel good about my stutter, I don't always know if my voice is, I doubt that my voice is welcome.

conversations very often. And it's probably not just the stutter, but it would be lying to say that that has had no impact, even if I've worked through it. So it causes some pretty intense and deep running impacts to have this expectation to talk in a way that's not how you usually talk, especially if it doesn't really benefit you all that much and you're aware that it's for other people. Hopefully that answered your question.

Marisha (28:11.382)

Yeah, no, that was beautifully said and gosh, so many things. but yeah, and I think that having the focus on having communication feel easy and we don't need fluency techniques. Like from your experience, fluency techniques make communication feel very not easy. So

Ezra Horak (28:36.611)

Yes.

Marisha (28:38.732)

I think that's a really helpful reframe of, cause I think when I first started learning more about the, like the shift away from fluency, that was something that I struggled with a little bit of like, but how do I help them? What do I do? But I think that like focusing on, okay, what can we do to make communication feel

Ezra Horak (28:57.518)

Yeah.

Marisha (29:06.89)

easy and what can we do to empower these students? And unfortunately, there's, it's like, we need major societal change to really address it. But like, what if we lived in an alternate universe where everyone just talked how they talked, there wasn't like a right or a wrong way. And we could just talk like we wouldn't. I don't know. That would be so

Like you wouldn't have felt like you couldn't pursue journalism if that was the universe that we lived in.

Ezra Horak (29:35.79)

Yeah.

Ezra Horak (29:39.33)

Right. Right, you know, and there's probably a couple things that, you know, Duterte would like, like what I would do when I would talk about the journalism suggestion is I'd be like, well, what if I'm at a press conference? I always look the most extreme example. What about a press conference? And I can't yell the word out faster than everyone else. Like that's a reality. And so for that reason alone, I'm not pursuing this entire career. just, but one of the things I think is that like we,

got to get more creative with some of this, you know? Like there are alternatives to things. There are ways to accommodate disabilities in the world. We have learned that with certain things. And so let's get creative. You know, I think of someone like, and maybe I should be careful using a different disability as an example, but I think of someone like Stephen Hawking, who spoke often through, know, who spoke through this, I forget the word for it.

but alternative way of speaking, right? And people who stutter will say, well, we don't wanna, a lot of people sort of resist certain things and resist accommodations. And they'll say, well, at the end of the day, people aren't gonna take us seriously because we stutter. And it's like, well, people didn't take him any less seriously, right? Like maybe some people, but like, no, what he said was important and that's what counted. Like that's what we count. And so I don't think there's any reason to think it's impossible.

to find accommodations. There might be pushback, you know, we're not all, like that's an extreme example of someone who is very prominent. But to me, it sets this idea that it's possible. Like it is possible to find accommodations, even in situations where it seems like, well, that's an option where maybe you would have to do this or that. Like I think maybe not. I think it's at least worth considering.

Instead of the problem, I think that kind of touches on what you were saying, the problem, we often see the thing we, like speech therapists want to help, the parents want to help people who stutter from is the stutter itself. And the, yeah, and the stutter is not the enemy. And that was something I didn't know. I always assumed, you know, and a lot of people who stutter, we talk about our stutter that way. go, my stutter holds me back, my stutter this, my stutter this. But if we were to sit there and very like rationally,

Marisha (31:48.622)

That's not what you need,

Ezra Horak (32:05.924)

approach it from a different mindset of more of like, I'm working on a post right now of the disability models and like the medical model and the social model and all the different ones because there's a whole bunch. But when we work on shifting that and we see it as, wait, there's other things going on, we realize that by helping someone who stutters, we don't need to offer them.

fluency, you know, and you mentioned easy speech and I think I've seen an unfortunate number of people who just swap fluency with easy speech. And they're saying the same thing because they watch someone stut-ut-ut-ut-utter and it looks like a struggle. Whereas if you watched me not talk, you might not think I'm struggling because it's not apparent to you. But for me, not talking or using these fluency techniques would be a lot more of an inner struggle for me than

talking with a setter, even if maybe it doesn't look that way from an outsider's perspective.

Marisha (33:08.418)

Yeah, yeah, I love that.

Okay, and then, so, gosh, there's, I'm gonna just try and process out loud a little bit in terms of maybe some takeaways for SLPs. And there's so many things. I wish I could process it a little bit better. But, so you had said, like, we know there's no.

career first stuttering and like some people will like a percentage of people will grow out of it. And that may or may not be because of the strategies. And like I think taking your experience into consideration is really helpful because

Our ultimate goal is for you to communicate. You have so much to share and your like, yeah, everyone gets to communicate in their own way and just having some acceptance around that would make the ultimate goal of you communicating easily so much easier.

Because even if we're using fluency techniques, that makes communication harder for you.

Ezra Horak (34:43.396)

For me, yeah. And I always acknowledge that when it comes to techniques, there's a difference in different people and there's a difference in where somebody is at life. So maybe at one point in time, they wanna use them and then later they don't. And it is important to at least have them be taught at some point, but depending on the situation and from an informed stance. not one of the things like what was really common.

my friends and I was that we thought we were supposed to use fluency techniques every single time that we started, right? Because the goal was to be fluent. And that's the issue is that when the goal is fluency, that's not going to happen. But when, if I'm on, if I'm stuck on a phone call that's voice activation, I would use a fluency technique for that because I have to. If I'm going to block and I know I'm going to, I'm going to pull something out that I never use. It's not easier.

in conversation, but it's a necessity of a broken society that doesn't currently have an accommodation that I do hope will one day. And I think we can fight for that. And I think there's a responsibility to fight for those types of accommodations. But I, and I've also seen people use that as an excuse to continue with everything that they're doing. And I think there's a difference between showing up on day one or two and overwhelming someone with fluency techniques versus

bringing it up at some point and offering it, seeing how they respond and explaining this isn't for every day. This is for if a situation like this happens, this is for when it is, when it does feel easier for you. And if it doesn't feel easier for you, then absolutely don't do it. Like the goal is, right, like you said, the goal is actually making it easier for the person. that, with me, it almost never means doing any of those techniques.

But everyone is different with that. So I wouldn't want to throw everything out, but I would want to throw all the fluency goals out. And I just want to re-approach the way we see all of this. I don't think they're necessary. I don't think fluency techniques are necessary for everyone.

Marisha (36:55.894)

Yeah, I love that. And so if the ultimate goal is easier communication, then we can tailor the therapy approach to what the individual needs and what actually feels easier to them. So I think that's a really nice takeaway. You explained it so much better than I tried to. It's like trying to consolidate, but yeah. So if we can make the ultimate goal easier communication, and then we can work with the student.

to figure out what that looks like. But it sounds like, especially taking, like the takeaways from your story are that just making it okay to stutter and really just focusing on that overall message. Yeah, okay, awesome.

Ezra Horak (37:43.256)

Yeah, yeah, I think it's huge and I think I wouldn't have been able to get to where I'm at, even though it took a while, faster still than a lot of people I know because I think I had a foundation that was very strong, that even when it got covered with everything else, it was still there. So, yeah.

Marisha (38:05.004)

Yeah, and the speech therapist listening can be that for, like they can provide that same foundation for other students. Okay. And then, so you kind of shared some of this already, but if we're embracing stuttering as like a natural part of communication and we're focusing on just like, okay, what can we do to make communication feel easier? What?

What are some of the things that like your foundational SLP did that were really helpful? And maybe what are some other things that others speech therapists or whether it doesn't matter who did what, but what are some things that weren't helpful in like working towards that goal? you have, can we maybe recap like a handful of things?

Ezra Horak (38:56.612)

Yeah. I think one of the main things is listening to your client and really listening, not just like a surface level, like, you know, asking questions and understanding, because we'll sometimes parrot back what we've heard. If you would have asked me my goal in high school, I would have said fluency. And then you would have written fluency in my goal. And it would have taken, well, what does fluency mean to you? Right. What what's different about your life? If you're like what's

what's really going on. And that takes time. It's about building a relationship. I think my first speech therapist did that. I think some of the other ones I had, not in high school, but a little bit later on, did work on that. And you could see that it did benefit us to have built a relationship and for them to really be listening. And sometimes they were wrong. And the...

I remember the times I called it out, they were embarrassed, sure, as a child saying something to an adult, it's gonna feel a little weird, but they listened to me and in the future changed things. And so I think that really helped give me that agency. So I think agency is another thing is allowing the child to kind of be leading some of the direction and you help guide that, right? You don't just give them, but like you...

the child led kind of thing I think is really important. And knowing that everyone's different, I was super social. I liked to raise my hand every moment I could if I even thought maybe I knew the answer. Not everyone's that way. Some kids may not want to ever raise their hand and it might have nothing to do with stuttering at all, right? Just like there's a variation with non-stuttering kids, there's a variation with stuttering kids. So just kind of trying to suss that out though, needs a relationship. So it really all comes down to like,

listening and building a relationship and having a difference in the expectations, obviously. And she helped prepare the people around and we did self agency things or self advocacy things, I mean. And so would teach me, okay, you you're talking to your teacher, you want to let them know that you set her, how are you going to let them know? And helping me build those kinds of things. Role play, is it something that like

Ezra Horak (41:16.504)

I did much, but I've heard other people really speak highly of it as far as kind of helping build that same confidence. So focusing on like the confidence of the child and if they're spontaneously speaking, because even if they're not an outgoing kid, you would hope that at home or in the therapy room, they're spontaneously speaking of their own accord at times, because that is something that you do expect to see in, maybe not all children, but like a good amount of them. And so just trying to...

navigate more. think Chris Constantino, he's a researcher. He talks about spontaneous speech as a shift in goals. And then some of the things that weren't helpful were lists. And I hate that because I know it's easier and it's like, and I know how overwhelming speech therapists are. But when it's just like, you're going down a list, you're doing the technique, and then you have to repeat things that you do, quote unquote, wrong. Because why else would you repeat it unless you

did it wrong and it was considered wrong if I stuttered when I did it, right? So even if maybe the sweet therapist didn't realize that, being very mindful when you're doing, because sometimes you do, you do your practices, you do your lists or maybe instead of a list you have them like read from a book, which sometimes I did, and practice it on words from the book instead. And just being mindful of what you're doing every time you interrupt someone who stutters.

because it's not gonna be, it's being received as, I did something wrong. Letting go of absolutely any goal that involves or any practice that involves counting how many times someone stutters. And I know that that can be an intro. I'm sure you'll cover it in future ones of how that goes. But the more you can let go of that, especially having the kid or even adult count is...

Ezra Horak (43:11.428)

How do I say, I'm not, I don't want to say like abusive, but it's going to cause trauma. Like that will definitely. And yeah, I think there's like a lot of the things that feel like, okay, well, this would be easier to do. This is measurable. You want to question that. You want to question, well, what am I actually measuring?

is this a full picture of someone? And so it's hard. I'm giving more instead of like a list of things of it's more of a like thought process with the different things, but like questioning when something feels straightforward in stuttering therapy because it's usually not, and I'm sorry, but it's you're working with human beings and we are nothing. We are not straightforward. That's not a word and not consistent across the board. Right. And so

The more nuanced something is, probably the better territory you're in.

Marisha (44:13.718)

Yeah, that's really helpful. And the subsequent episodes will dive into a lot more of the like specific things that we can do and what it looks like to implement that. because there are ways to, cause we need to have our numbers for billing or whatever. And there are some beautiful, like neurodiversity affirming child friendly, child led ways to.

meet our requirements and do what's best for students too. So stay tuned for all the future episodes because we are going to dive into all of that. yeah, Ezra, this was so helpful in just getting to kind of set the stage and thinking about some of the different perspectives and

Like thank you for doing such a nice job of sharing your story. And I feel like I got to kind of.

I don't know. feel like it just has really helped with my perspective and you just shared some really beautiful examples. is there anything else that you, I know that we could probably talk for hours and hours and hours, but are there any, is there anything else that you really wanted to share before we wrap up?

Ezra Horak (45:38.212)

Yeah, and I think the main thing is keeping in mind, you know, that people have a lot going in, that they have a history going into speech therapy. And so what might sound like something really clear, I want fluency, maybe, but maybe it's worth going further into those things. I think to me, that's the biggest thing is most people think someone who stutters wants fluency. It's a pretty common thought. It's not true all the time. But I think that that's

mostly a problem in a lot of people who stutter think that everyone who stutters wants fluency because they've never been told anything else. They've never considered anything else. So sometimes you're going to be exposing someone to something they've never even considered in their life and it goes against everything their worldview is based off of. so being aware of that and

mindful of that and knowing it might not go, you're not gonna tell someone, it's actually okay to stutter. You're be like, okay, great, it's great now. It's gonna be a process and it's gonna be probably hard depending how much that person has built it up. Maybe they have nothing, maybe they're like me at six years old and they go in and they're like, okay, it's okay to stutter, sure, great. That's awesome, I want that. I hope that's more and more common as time goes on.

But it's also possible you're gonna get the opposite of that. And also my last thing is, yeah, that kindness with parents and guardians, whoever's helping raise that kid, it's, I imagine, unbelievably hard sometimes. I remember fights between my grandma and the speech therapist. And finding ways to appease them while also protecting the kid is really hard and it's not an easy task. And I admire...

Some of those speech therapists, maybe I didn't have 100 % perfect experience, but I do remember that they found it important to, no matter what they said to her, made sure I felt safe in the speech therapy room. And that was the most important thing I think that they could have offered me at that time.

Marisha (47:50.604)

Yeah. And I love that you, what you pointed out about ask, one of the questions that you said was like, what does fluency mean to you? Because society is telling us that and telling our students you need to be fluent. Like that's kind of the societal expectation at this point. And I feel like it's starting to shift.

Ezra Horak (48:16.568)

Yeah, and I feel like people don't, yeah, sorry.

Marisha (48:19.128)

There's more acceptance in certain places than others. But asking, what does fluency mean to you? And using that to dig down a little bit more and figure out what the student, because the student is probably going to tell us they want to be fluent. I don't know if that would.

Ezra Horak (48:35.748)

Mm hmm. It, checks the box. Yeah.

Marisha (48:39.084)

Yeah, but what do they actually want and what would actually be helpful? And I feel like you gave some really nice examples on how to like dig into that and we might not be taking what students say right at face value.

Ezra Horak (48:54.094)

Yeah, yeah, yeah, because I think people don't even realize how different it can feel for like for me. When I said I wanted to be fluent, what I meant, I didn't want to think about the way that I talked. That's what I meant. And so offering me fluency techniques was to me, that's not fluency. That's still stuttering. I'm still dealing with the stutter. So that's not fluency. But what I didn't know then was that I could not think about the way that I talked and

Marisha (49:04.716)

Mm-hmm. Yeah.

Ezra Horak (49:23.054)

stuttered. I didn't know that that was an option until I was in my 20s. So you'd be surprised by what different people... so that's not the only view of what fluency means. You'll be surprised by the differences that different people have.

Marisha (49:37.25)

Yeah, yeah, I love that. Well, thank you for being an example of kind of what we can just like one of those perspectives and as speech therapists, we get to have those discussions with all of our students or clients and really get to know them and what they need and just empowering them to be the communicators that they are. So.

Yeah, thank you again. This was incredible. I'm so, grateful. I hope that, and then I hope that the listeners have some great takeaways too. The show notes are linked in the description and I'll link to Ezra's Instagram and website and other resources. But yeah, I think that's a wrap.

Ezra Horak (50:26.884)

Great, good. ahead and me on st-t-t-t-t

better. So thank you for doing this.

Marisha (00:01.25)

Welcome back to the podcast. And last week we chatted about strategies and tips to streamline your referrals. And today we are diving into assessments and evaluations. So I have a handful of tips and resources. This is a, like an episode with lots of resources to back it up. So I'm excited. so first step is how we can make assessments easier.

So my number one strategy is to schedule it out. We, with the exception of like student transfers and students moving in and out, we typically know how many evaluations we have due every month. So make sure that you have a list of your students with all of their evaluation dates. This is typically in our paperwork system.

but we just want to make sure that you have access to that and then review the list and just kind of Preview what your year or the next several months are going to look like So do you have one evaluation in January and then? 3 in February and 10 in March if that's the case, we're gonna want to plan ahead a little bit so that you're not like majorly struggling in

when March comes around. So just try to work ahead as possible. And also another component of scheduling is just like if you know roughly how many evaluations you have due every month, just making sure that you have some time set aside for testing to actually get that done because that is an important part of our role. And I know

that we have a lot of scheduling constraints and all of that, but just making sure that we have a plan to get that testing done and just being able to look at it ahead of time versus when we're struggling in the moment can make it a lot easier to problem solve and come up with strategies to get that testing done. Then another component, and I talked about this last week when we talked about referrals, but

Marisha (02:25.836)

you wanna make sure that you have a clear process so that you know all of the steps required to complete that evaluation. So you have to get like parent consent and it'll vary depending on if it's speech only or if you're working with a whole SPED team. There's other service providers, but just make some checklists for the different scenarios for the types of assessments and evaluations that you do.

so that you can keep track of that process. And this is again, a great problem solving tool because if you have it all written out, it one just makes it easier to make sure that you're completing everything and you don't forget important steps. Like I always used to forget the language sample until the very last second. So yeah, just having that checklist and then you can see like, man, I am always forgetting this step or

really struggling with this step or this step takes me way more time than it should. And so you can identify those and find ways to make them easier. Then the third strategy is to make templates and make this easier for yourself. And we'll talk a lot more about templates in the next episode. So stay tuned for episode two 10.

where we dive into all of that. But yeah, so we'll talk more about templates next time, but just starting to, like a quick tip to start off is just to write all of the sections that you're required to fill in for the evaluation. And then kind of starting to build, anytime you write an evaluation, you're like, wow, I did a really great job with that. Or if you read an evaluation of like, I really like how they worded that, just keep,

keep a running document with your favorite snippets so you don't have to reinvent the wheel every time. Obviously, we want the documentation to be individualized, but having a good starting point can help us do a better job of individualizing that. And I'll share, like I said, more strategies coming next week on how to actually streamline that. And then now I wanna move on to chatting about

Marisha (04:51.798)

important elements to include in your assessment. So we want to make sure that we're reviewing like past IEPs and evaluations, session data, anything that we might have on kiddos. And we don't have to completely reinvent the wheel. We can review some of that information, especially for the case history type of stuff.

We'll obviously want to get an update, we don't need to rewrite all of that every single time. We'll also want to complete a classroom observation and or collect work samples. And so this is really helpful information in determining that academic impact and seeing how the student is performing in the classroom and.

can be a great way to see what accommodations and supports might be helpful and all of that. Another thing we'll want to look at is gathering information from the family and the teacher. So just making sure that we're up to date on pertinent medical history, educational impact, like what these evaluations are meant to be a team effort, a team decision.

And so we want to make sure that we're getting feedback and input from them. And then we'll also want formal and informal assessments. We may want to include dynamic assessment as well. Informal assessment might include a language sample. That gives us a lot of really practical, relevant data. And then once we have all of that information put together,

we'll want to identify the strengths, the needs across all of that information and trying to draw parallels and using that to come up with a game plan so that the data is a little bit organized. And so we can come up, because we only have limited time and resources, so we want to make the most of that and come up with the most effective kind of strategies possible.

Marisha (07:10.03)

So those are the things that we'll want to navigate in our assessments and in the show notes, you can find them in the description of the episode. But we have tons of episodes on specific assessment areas and specific considerations for dynamic assessment, language, narratives, phonological processes, speech sound disorders.

This episode is meant to just be like super broad strategies. But yeah, check out those, check out the show notes for links to more episodes if you're looking for strategies for specific areas. And then in terms of navigating this and keeping it organized, I mentioned this in the last episode, but we have a new workload feature in SLP Now.

that helps organize the entire process. we have, we've worked, our team has worked to create like best practice checklist. And so how it works is you set up a new assessment or evaluation for a student, and then you get to select, you can add your own checklist items, or you can use one of our pre-made ones that has like best practices.

and it'll map out the different action items that you'll want to complete. Like you'll have a list of recommended tasks based on best practices and you'll have like the forms and assessments and resources attached to each of those tasks. So when you need to collect parent input for an initial evaluation or a re-evaluation, you can just hit send.

will send that form to the parents. Once the parents complete the form, it'll mark it as complete. And that's just one example. There's also informal assessments attached based on the area that you're assessing. And yeah, it just really, really helps streamline that whole process. And you don't have to guess which steps are next. And it'll help you keep track of where you are across your

Marisha (09:36.566)

evaluations. And we also have these tools for like referrals and IEPs. So lots of good stuff. And you'll have all of your data in one piece. So that last step that I mentioned on like when you're reviewing all of your data and analyzing like the classroom observation, the teacher input, the work samples, you'll have all of this data in one place so that it's really easy to

fill in the evaluation and complete all the required components. You won't have to be digging for different pieces of data. It'll just all be in one place and you're much more likely to have everything you need. don't have to, because we have that checklist, you'll have all of those items completed and you won't have to be like, I didn't grab this language devil. need to go grab the students so I can do that. Like no, everything will be ready to go and organized.

for you so that it's easy to make those.

database decisions. that is a wrap on our episode on assessments. Next week, we'll talk about IEPs a little bit more specifically, and then it'll be jam-packed with some really cool time-saving tools to make that even easier. So can't wait to see you next week, and I hope you have a good one.

Marisha (00:01.538)

I am so ready to kick off this series where we dive into all things referrals, IEPs and evaluations. And today we are starting off with referrals. And this is, so we're heading into one of the busiest paperwork seasons, typically for school-based SLPs. And I know a lot of us get overwhelmed by

all of these components. So I'm really excited to share some of the strategies that have worked for me in managing a caseload in the triple digits and then also working with thousands of SLPs on helping them streamline and save a bunch of time with these types of tasks. So referrals is what's first step. And the first tip that I have for you around referrals,

is to document the steps so that you can kind of inventory the process and by knowing exactly what the steps are, that'll save you a ton of time because you won't be forgetting to do certain steps, which I've definitely done. So you won't be forgetting steps. You'll have like clear process. won't have to think about all the things that you need to do. You'll just have them written out and you can just run through the list.

and get them done much more efficiently. So here's just a brain dump of what some of the steps might include, but I would highly recommend checking out your district's process and checking in with other SLPs or your administrator. A lot of times they'll have a process already written out.

but just make sure that you have that and that you have easy access to it, but some steps are Like a referral is kicked off when a parent or a teacher requests that And so that will look different depending on where you are But maybe it's typically like a verbal type of thing if you don't have the form set up But either you'll get a verbal

Marisha (02:24.654)

request for a referral and you'll have to follow up or the teacher will submit a form and that'll kick off the referral. Then we may need to request additional information. We may schedule screening depending on your state if that's something that's allowed. And then you may be sharing the results with the team and or making recommendations and deciding what the next steps are.

and then we may decide like, no, this doesn't make sense for a referral. referral is cleared or maybe we need to decide to follow up or maybe we're moving them, in a different route. So those are some of the big steps when it comes to referral. And I was purposefully trying to keep it broad because obviously this varies, but hopefully this helps you. Like if you were able to.

of jot down some of your steps as you are listening. That would be super awesome. But yeah, like I said at the beginning, this is a great, like writing out the steps is a great thing to do with your team at the district level or like with other SLPs or with people in your building just so you're on the same page in terms of the process. And then you can share resources to help

streamline and make that even easier. some things that we can do to make that process easier are one, just knowing what the steps are, but then also making sure that we have all of the resources that we need so we're not reinventing the wheel every time. So having a teacher referral form that helps you gather all of the information right off the bat and making it clear to the

people at your school, if you have a referral, we need to fill out this form, this is all the information I need, and then that saves you a bunch of time going back and forth and being like, wait, I needed this and I needed this and can you tell me this? So instead, you'll capture it all on one form. You may need to gather parent permission as well, so you'll want to have a form or process for that.

Marisha (04:50.902)

You may want a quick form to keep track of your results, like if you do a screening or classroom observation or whatever you might do as part of the referral process. Just having a way to document your results. And then one thing that I really like, so you might have a handful of forms and resources. So if you're using hard copies,

I highly recommend just having a binder or like a series of folders and just make sure you have multiple copies so you can just grab and go. You don't have to go to your computer, remember where the file is, hit print, run to the printer, then go. That's a lot of extra steps. So just make sure you have copies of any hard copies that you're any papers that you're using as part of the process. And then one quick tip.

I like to, because it's easier for me to make a copy of something than to try and connect my computer to the printer and do all of those steps. So I tend to use the copy machine for additional copies. And so I like to highlight my original. And if you use a yellow highlighter, the copier doesn't pick up on the highlighting.

So I know that I can never, ever, ever give away a copy of a sheet that has highlighter on it because that's my original. So anytime I run out of copies, that highlighter is a reminder for me. And then I run to the copy machine, make a handful of copies and like replenish that. So I've had file folders with these extra copies or binders with sheet protectors with extra copies in them.

because the sheet protectors fit like a handful of sheets. So those are some ways to keep those things organized so that you have easy access to everything that you need. And then you might want to have a sheet where you can keep track of all of the referrals and like their status and their dates. And you can have this just be written. So

Marisha (07:13.664)

You just have the student's name, the date they were referred, and then the date that you want to follow up, and maybe their status or whatever. So you can have just a printed table that you use. I really like to do this digitally. And I'm super duper excited because we have a feature in SLP Now where it has pre-made checklists. So we've done like

The step one that I shared of documenting the steps, we have a checklist of the common steps that you'll need to complete a successful referral. And then we have all, like we have digital versions of all of the forms that you can send off and it helps you keep track of what you've completed. You like check off the steps, the resources are attached, whether you're using like

teacher forum or collecting information from the parents or whatever it might be. You just click to send it off and the system takes care of it. You check off the steps that you have to do manually and then you can enter in like due dates and statuses so that you can quickly sort your list of students. So it helps organize all of those pieces for you, which I think is super cool. It's saving SLPs a lot of time.

and then yeah, I, one of the things that is also super helpful is having handouts. and so kind of at the very beginning of the process, what makes an effective referral. so if you are getting a ton of referrals and you're not feeling like they're the best referrals, some, did,

episode with Lacey, a handful of episodes back where we talked about communicating with teachers and that's one of the things that we discussed. But if you didn't listen to that episode, one strategy would be to like share handouts with teachers or to do a quick in-service where you talk about what makes a good referral and give teachers some strategies that they can implement because

Marisha (09:36.622)

They really should be implementing some interventions before making a referral. And so, yeah, that's one tip. And then just having, so having a handout for teachers on like what would make a good referral and things to consider. And also having some handouts with strategies that they can implement and you can trickle those throughout the year. And then on the tail end of the referral,

or kind of in the beginning, like resources for parents as well on things that they can try and just some education on the process and all of that. so having those resources helps streamline a lot of the communication as well. And then, yeah, so I think that those are all the tips. So just a quick recap is the biggest thing that you can do to save your time.

is just to document that whole process. as you're doing that, you can look at it. You don't have to streamline everything right off the bat. But if you're seeing those steps on paper, and then you can be like, well, I always forget to do that. So what can I do to help myself? Or, my gosh, I'm getting so many referrals that don't make sense. And so you can look at that and kind of address the very beginning stages.

And over time, you'll able to reflect and identify where you're getting held up, what's taking the most time, and then just streamline that whole process. And so those are my recommendations for navigating referrals. And then, just some keeping track of the copies or managing paperwork digitally.

having a list so that you can easily keep track of who you need to follow up with, whether that's on paper or digitally. Like there's tons of options on, there's 5 million ways that you could organize this and actually implement it. But I think those are the biggest principles. yeah, and if you're wanting to check out the SLP Now workload tools to help streamline your referrals and all the other pieces of paperwork, head to slpnow.

Marisha (12:01.774)

and you'll be able to sign up for a free trial and check out all of those tools and use them as much as you want for two whole weeks. So that is a wrap and we'll see you next week when we talk about assessments and evaluations.

Marisha (00:01.208)

Hey there and welcome to the SLP Now podcast. I am really excited to have Dr. Karen Dudek-Brannan with us today. We are going to be talking about strategies to write effective IEP goals. And Dr. Karen is the founder and owner operator of Dr. Karen LLC and it's a...

a company focused on empowering therapists and educators to design interventions that support language literacy and executive functioning. And a little bit about her background, we're going to turn this over to Dr. Karen in just a second so she can share her story. But she has a doctorate in special education and director of special education and assistive technology credentials from Illinois State University. And she also has her

masters and bachelor's from Illinois State University in speech language pathology. And she spent 14 years in the school systems and she has filled various roles. She's also a fellow podcaster. So even that bio that had a lot in there, but I feel like it hardly does her story justice. So Dr. Karen, welcome to the podcast.

Karen (01:09.878)

Yeah.

Karen (01:15.095)

Thank you for having me.

Marisha (01:16.974)

and would you mind just telling us, so we're focusing on IEP goals today. and I'm just curious to hear a little bit more of your story, because you share so many amazing resources on your website and on your podcast and you just have a wealth of knowledge. so can you just share a little bit of, I know you might have to pick and choose the snippet, but

Karen (01:23.565)

Mm-hmm.

Karen (01:43.381)

Yeah!

Marisha (01:44.686)

Just kind of what led you to create all of these resources and a little of your joining me.

Karen (01:50.303)

Yeah, so I guess I can kind of start at the beginning. So I started off in the schools in the early 2000s and I originally thought I was going to be medical. And then of course, it was easier to get a job in the school. So I ended up there, thought, you know, I'll just finish my CF here and then move over to the hospital. But of course, I ended up staying that position for 14 years. And I really did not enjoy my language disorders course in in grad school because it was so

They threw so much information at you and it really probably should have been three or four courses. that was really, once I got into the schools, that's a huge part of your caseload is language. And then you have to think about literacy on top of that. And it seemed like some of the other areas of therapy that we treat with articulation, fluency, voice, or even some of the things that you might address in adult cognitive rehab, just being in the schools was just,

there were so many different elements that I didn't feel like I knew how to deal with. so I quickly realized that I had to figure out how to handle language therapy and really figure out what my role was on that special ed team, really in literacy, because I kind of felt like I was just grabbing random things off of my shelves. And then you get to the end of the IEP and it's like, what did we even do here when you're filling out your progress updates? I, that,

That's part of why I went back to get my doctorate in special ed. And what that really allowed me to do was kind of customize what I was studying. It's a little bit different when you compare communication sciences and disorders to special ed, because when you're thinking about special ed, you're really thinking about the whole team and all of the whole cluster of special education services and how you fit in within the team. And so that's really where I...

I focused, but my area of research was about vocabulary and metacognition and how we can put supports in place, both in the schools or just what are those language skills that we need to build in order to support comprehension. And so obviously I was focused on literacy. I was in the schools during the time that we were switching from the discrepancy model of identifying students with learning disabilities. So I was really involved on my school team with

Karen (04:13.335)

figuring out what interventions needed to be in place and then was also working on my doctoral work at the same time. And that's really where I put together the first framework that I created that was kind of the first suite of courses that I created for my business. And then I also have expanded that to focus on things like executive functioning, which is really, you're talking beyond the SLP's role, but also just how you work together on that school team.

because really when you're thinking about executive functioning, which applies to language as well, but with executive functioning, you can't not focus on other service delivery models outside of direct intervention. So yeah, that kind of, and then I also have an administrative role right now in the Department of Children and Family Services. doing some other roles in leadership with figuring out how to take, just kind of thinking beyond what do we do when we have

students or clients in front of us and how do we create change in a bigger organization.

Marisha (05:15.514)

that's amazing. You're like the ultimate SLP problem solver. You're helping us figure out how to do intervention and you're helping us figure out how to implement changes in the systems as a whole. That's so cool. I love that. What a fun story. And thank you for...

Karen (05:19.373)

Thank you.

Karen (05:31.531)

Yeah, I like to say I just get bored easily. So I always, you know, have to keep evolving and figuring out a new way to do things. So.

Marisha (05:39.47)

But that is such, like those are such amazing ways to impact the field. So we're lucky to have you. We're lucky that you get bored and that you're like looking at all these different avenues. Yeah. I love it. Okay. So now let's circle back because you have some amazing frameworks that really help reduce the overwhelm for SLPs and help us provide.

Karen (05:47.501)

Thank you. Yeah, a blessing and a curse.

Marisha (06:06.248)

more effective intervention, operate at the top of our license, all of that good stuff. And part of like one of the questions that I get all the time, and I know that there's so much that goes into this, but I wanted to talk a little bit about IEP goals and just kind of, I know you're going to share a little bit of your frameworks and everything as we go through that. But when we're thinking about IEP goals, what does an effective

Karen (06:19.648)

Right.

Karen (06:23.744)

Mm-hmm.

Marisha (06:35.598)

goal look like or what should it include? What are some of the big things that we need to be thinking about as we start, like as we're sitting down looking at an IEP, deciding what the goals are.

Karen (06:44.587)

Yeah, so that's it's I also get that question all the time. So definitely relate. get how do I write goals for this and how do I evaluate whenever I share a framework? It's like, this is different. But so how do I switch my goals? So I when when people ask me that question and I will share some specific set of questions or principles that you can think about when writing goals, because that's where I really like to start rather than a gold bank. Not that I think all gold banks are bad, but I think that if you

jump right to that before you understand the process, then sometimes it can be kind of a bandaid. So just wanted to say that. But where I always start with people before we get to goals is the framework, whether it's language, whether it's executive functioning, because in order for you to understand what is meaningful and relevant and how to measure, you have to understand what you're working on. Now, obviously, it does make sense to start with evaluations. But a lot of times people who come to me

There are clinicians, they're already practicing, so they at least have some knowledge on how to do an evaluation. So I don't feel like I need to start there. Really what we need to do is kind of zoom out and back up. So that's why I don't start with the goals and evaluations. I give the framework first and then it's like, okay, once we understand what we're working on and we can start adjusting your therapy, now we can start working on these goals and now we can start figuring out what you have and how to adjust it. So.

Whenever I teach a framework, what I do with people and how I recommend that they start making updates to their entire system is just because you're doing a new thing in therapy, you're changing the vehicle to get to the end destination, which would be your goals or your outcomes. But just because you're changing the vehicle, like your therapy technique or your framework, doesn't mean you have to change the end destination. you don't have to just...

know, panic and feel like you need to rewrite all of your IEP goals. You can make little adjustments and then update as you go. So that's what I recommend for people. What I really focus on helping people do is figure out how to write goals and just really do intervention for language and executive functioning. And I think we can, I think about writing goals for those two things a little bit differently.

Karen (09:09.213)

where I usually start with people. So I guess I can go through my questions and sort of my highlights of what I can cover today and then we can dive into each specific. So I would say things like language and some of those other things that you're addressing in therapy can be a little bit different than thinking about executive functioning. That would be the first thing. The second thing would be the actual syntax and structure of your goal. And then the other things are how you think about

what should be in the goal versus what should be in accommodations that might help you get to the goal. And then also thinking about, do I want to address a strategy or a specific task or do I want to teach the child to do a specific strategy? And so I want to come back to that last one because I think I'll have to give some more context for people to understand. So

Yeah, should we start with the syntax of goals? So syntax about goals about syntax being really meta here.

Marisha (10:11.502)

I love it. Let's do it.

Karen (10:13.973)

Okay, so, and I actually don't like to, in practice, spend a ton of time thinking about goals, but I get that it's such a headache for people. I always, my philosophy on goals and data is that you want to make sure that you're compliant. You want to make sure that you are, you know, getting enough information that you can make good decisions.

But beyond that, there can be diminishing returns. So you don't want to take away from your therapy. So that's why I like to be really efficient with the frameworks. really, can start with the basic syntax of a goal is client will do x with y. So client will do x, which is your behavior or observable behavior, with y, which is that level of accuracy.

And so I always start with that. And so when you have that basic syntax of the goal, the place that I have people start with first after the framework is thinking about what is that observable behavior. So with something like language, what I usually give people is just kind of a set of things that can go with the specific framework that I teach. It's a lot.

smaller and more condensed than a goal bank, because when you start with just maybe five or six observable behaviors, then you can kind of tweak and customize and go from there rather than having huge drop downs. for example, and I can actually link to some resources rather than getting into really specific things here, but if you're wanting to build vocabulary, one of the goals that I commonly do is just defining and describing

words. So that's something that you can physically see. We're not saying things that are vague that you can't necessarily observe, like comprehend or understand, but defining and describing words with two to three attributes. I can actually see somebody doing that. Or even, and I know this sounds super basic, something like syntax. How can you tell if someone has their syntactic skills intact? They're saying a sentence or they're writing a sentence.

Karen (12:27.755)

Like that's your base observable behavior. Now, of course you might put a specific sentence type in there, but that's what you physically want to see. Or maybe we'll answer a question about a sentence. We'll pull out a morpheme in a word or explain what different word parts mean. We'll be able to segment a word into morpheme. So again, just some basic behaviors that we want to see in order to

show those language skills. And obviously, all of those examples that I gave might make sense to people, obviously, if they're an SLP, but it would make more sense if they had the whole framework. But really, the key takeaway here is what is that observable behavior? And then we can move on to what level of accuracy makes sense here. And I think that where I tend to err is I like trials better than accuracy because

When we think about language and when we think about executive functioning, sometimes it's really hard to measure level of accuracy. So like, if you are working on writing, almost, it almost makes more sense to figure out what are the elements of, of, that I want to see in this paragraph and go and see if they've done all of those elements. And you're kind of like, well, maybe they did the introduction, but not the conclusion and their syntax.

you know, wasn't intact, they, they, cause they sometimes do some, but not all. And so it almost makes more sense to say, like, did they complete the task? Cause you can get through the whole thing maybe once, maybe twice in a therapy session, you're not going to get, you know, all these different trials where you could do 80 to 90%. So when you have those bigger, bigger chunks of things where you're only going to have maybe one, maybe two, three trials per session, it almost,

more often than not, it's easier to track if you go with trials. Now, obviously things with articulation, you can get a lot of trials and then it does make sense to do that percentage, but that's where I go with some of those bigger things where it's a process with a lot of steps. just some things to think about within that syntax.

Marisha (14:42.828)

Yeah, that makes a lot of sense. So the basic goal is client will do X with Y. X is the observable behavior and then Y is the level of accuracy. And then yeah, you have lots of other great tips in there, but I won't recap all of them because we have good comprehension here. OK, so that's the syntax side of things. Are we ready to chat about?

Karen (14:51.127)

We'll see.

Karen (15:01.611)

Yes, I hope so.

Marisha (15:10.904)

what should be a goal versus an accommodation.

Karen (15:13.345)

Yes, and I think that kind of that can is a good piggyback to the syntax conversation. So what I've seen people do and get carried away with, and I'm not saying you should never do this because sometimes it's appropriate, but what people sometimes do is put what they do in the goal, like what the clinician is doing versus what the child is doing. So where I recommend people start is what do you want the child to do? That's what the goal is.

And then when people start to put things like given assistance, given a prompt, given, and then they'll start listing out the accommodations that they need. I've seen people write a goal that is a paragraph long with all these accommodations in there. And sometimes that is appropriate. Sometimes you do need to say, this client needs a phonemic cue or whatever it is. Sometimes you might have

they want, they're going to do all of these steps in the task. And the goal is that you want to have them complete the entire task and fade the prompts rather than trying to make the task progressively harder, especially with executive functioning. sometimes does make sense to have the goal be to fade the prompts rather than to work up a hierarchy, which you kind of have to toggle back and forth with some things that we're working on. But,

In those cases, it is appropriate to say with fading prompts. Where it gets really tricky is one, the goal gets really wordy and you almost can't read what the goal actually is. Two, it's kind of vague, which sometimes we do have to settle for things that are a little bit vague, but sometimes I'm like, I ask people, what are you trying to accomplish by putting that in that goal? Are you just...

Do you feel like you need to put it in there? Is it really adding something? Would another clinician pick up this goal and know what that means? Now, of course, again, we can't always guarantee that somebody's gonna pick up your paperwork and know exactly what's happening, but I always, I just encourage people to, when they feel the urge to do that, just figure out what am I trying to accomplish here? Because again, sometimes it's appropriate, but I've seen people get carried away with it.

Karen (17:30.293)

And then the other thing that happens is that people try to put in all these, their accommodations sometimes, like given visual supports, given, you know, a queue, given multiple modes of communication. And they're almost putting things in this goal that you should be just doing anyways, that almost should be more of an accommodation on the IEP that's just globally applied to the student's plan. And they're putting it in all the goals and it's just making the goals wordier. So again, not saying that you should never

link a support or a specific cue to a goal. But I always encourage people to think, hmm, should this be in the goal or should this be an accommodation? And why am I trying to put it in the goal? I think sometimes people are almost, they're putting it in the goal because they're worried that the student is not going to get all the support that they need. Which if that's the case, you don't have a goal writing issue, you have an issue with the team and the leadership and which of course is a much more challenging problem to address. But

But yeah, I always say don't try to fix an issue with your team by trying to focus on your paperwork. Again, this is where it's so, it just depends. And that's why I always encourage people to ask themselves a set of questions rather than be like, this is the way that you do it. Because I used to be more of a, this is the way that you do it person. And you always find situations when that you've got to just understand the nuance.

Marisha (18:57.876)

And there's so much gray in what we do. And then, because I use a similar approach with my goals too. I like to focus on the observable behavior. I just feel like, cause especially it's hard to clearly describe the support. And I feel like a lot of my, I've had a lot of very transient students and I want to make sure that we're having like consistency and continuity across SLPs and.

Karen (19:00.278)

Mm-hmm. Yeah.

Karen (19:19.511)

Mm-hmm.

Marisha (19:27.65)

that just felt like the easiest way to accomplish that. But then I know there's a lot of, so when you're like, if you're, I'm just curious in your practice, like when you were writing these types of goals for kiddos, did you, when you're doing progress monitoring, if you have the supports and the accommodations, do you provide the accommodations when you're progress monitoring for the goal or do you do that without support?

Karen (19:30.817)

bright.

Karen (19:57.141)

It kind of depends on where I want the student to be. I mean, to be honest, in practice, you kind of toggle back and forth. It's because in your session, you're always just, you're right there and it's like, do I need to jump in? Do I need to back up? And so we do that in practice anyways. And that's another thing where it's, well, this is what you should be doing in therapy. So you don't necessarily have to explain all of it in your goal. The goal should be something that is a meaningful.

Marisha (20:16.355)

Mm-hmm.

Karen (20:26.421)

way to give a picture or a snapshot. You know, I, if when I was actually in just like practicing, I would usually do both in the session and have both depending on where the child was. And then the goal would just be like, would, I would take the data and actually write down what was actually relevant to what was on paper.

Now, I would say if I knew the child was going to get such a low level of accuracy without the support, I would be asking myself the question of one, should I actually be taking data and putting a prompt in the goal or should I making the goal easier? Again, that's the question of does it make sense to try to get the child to do it and have the goal be to have them do the whole task?

Or does it make sense to expect less and take the prompting out of the goal or change the level of accuracy? And so a specific example that comes up for some of the students or the SLPs that are going through My Language Therapy Advanced program is that if we're doing semantic feature analysis and we're doing like state in the category and the function and the attributes and we're trying to get students to use self questioning to describe

multiple things about a word and the goal is maybe you want them to give you at least three to four different attributes. A lot of times people are like well should I make the goal to be just do one? Should I only make goals about categories? And I usually start with see if you can get as many different attributes at once or like see what you can get from the students even though we know that there's a hierarchy within those skills. We know that category is more difficult than stating a function.

for example. So, but just see what you can get from students and then, you know, let that be your guide for determining how much needs to be in that goal as far as like you make it difficult, more or less difficult. And I think the other thing that I would add in here to help you figure out some of these questions is that you can do therapy and try some of these things as part of your evaluation in addition to the formal assessments.

Karen (22:53.567)

as part of a dynamic assessment is measuring things like test, retest, and the ability to respond to some interventions to see what would be an appropriate goal for this task. And that's why it's important to have your framework first because sometimes your framework can actually give you additional processes that you can use in your evaluations, especially with executive functioning, where it's even harder to measure that the language.

I actually have a couple tools that I teach where I recommend that be part of your evaluation because you're really going to get a very limited picture from rating scales and standard assessments that are available for executive functioning, which of course is true for language as well, but is even more true for some of those other cognitive skills. I think you asked me the question of, I think you asked me about, I take data on

Marisha (23:42.446)

Yeah.

Karen (23:49.429)

if I did the prompt or not. Yeah, I mean, I always took as much, like gave as much information as I thought was relevant within that context. Like what is gonna give a good picture of the progress that we've made, so.

Marisha (24:05.526)

Yeah, and I like to, I feel like we have a similar approach, but I like to have that data without the support because then like every SLP will, especially if like it's a really clear goal, every SLP will be able to take data and it'll be pretty consistent. So then we have like a better measure of progress over time. And then

Karen (24:23.841)

Right.

Marisha (24:31.17)

Like in my therapy sessions, I'm always documenting what types of supports were helpful. And, yeah, so I like having both of those pieces of data. I think there's benefits to having both. I also like having like a nice simple goal because it just, it's easier to keep track of.

Karen (24:43.906)

Yeah.

Karen (24:47.915)

I know. Yeah. I mean, I always start with simple, you know, start with simple and then you can make it more specific as you work with the client.

Marisha (24:56.002)

Mm-hmm. Yep. Yeah, and I know there's different youth. Like, we get to live in the gray a lot, as SLPs. So that makes sense that there are definitely cases when we do want to do things a little bit differently.

Karen (25:04.525)

Mm-hmm.

Karen (25:12.365)

And that's another way that you could, when people are like, how do I avoid writing the same goal every year? Is, you know, then you might specify, like for the example that I gave, define and describe using the category or take the prompts away. Like that's another way you can make the goal harder, but still be working on the same skill.

Marisha (25:17.358)

Mm-hmm.

Marisha (25:31.886)

Mm-hmm. Yeah. Yeah. And we do want to see change in our goals over time. We could also increase the level of accuracy or like the trials, like providing one out of five descriptors or whatever, however we want to word that. But yeah, so we have, and we have so many options and we get to be problem solvers and figure out all the things. Okay. So that makes sense.

Karen (25:41.057)

Mm-hmm. Yeah.

Karen (25:47.885)

Mm-hmm.

Karen (25:54.007)

Yeah.

Marisha (25:58.71)

I love that distinction between the goals versus the accommodations and that as a strategy to consider. So the third thing you mentioned was, we addressing a strategy or teaching a specific task? So can we dive into that a little bit?

Karen (26:15.201)

Yeah. Yeah. Okay. So I have changed the way that I teach this over the years. So I went, so I had my, again, communication sciences and disorders where we are very much like, you know, 80 % accuracy and it was very structured. And then in the special ed program, it was very much about smart goals and observable. And so that idea was reinforced.

in me and, you know, multiple programs. And I, when I first started teaching my language therapy framework, I even went to the level of specificity, which I actually still use this explanation, but I give additional context. But I would say, here's a bit, here is a verb that you can observe. And here is a verb that is a little bit clearer, but not as much. And then here is something that is really vague. Cause people would say things like,

will demonstrate understanding, which is kind of vague. Instead of saying, well, point to a picture, we'll identify a picture, we'll say a word, things that you can actually observe. Those principles still apply for many things. With language, we can often define those observable behaviors, like are they saying a sentence, are they writing a sentence or a word?

Are they saying sentences with certain sentence types or giving you specific attributes? Or I'm trying to think of a couple other ones. Again, even following directions, which again, following directions goals that can be a whole conversation about the purpose of them and when they're appropriate and whether you're just focused on vocabulary or compliance, whole other conversation. But again, you can still observe somebody doing that. And if you understand what you're working on, that could be appropriate because you're assessing comprehension now.

So all of those things, and that's where I start with language. But where it gets trickier is with executive functioning, because when people think about executive functioning, they're so focused on the external behavior. Is the folder organized? Did they complete the steps? Are they able to wait their turn? And are they able to stay on topic? Which it's not that those things are irrelevant, but

Karen (28:37.227)

They are very, again, external symptoms of things that are internal processes. And if you're focused on those behaviors and you don't really understand that really when we're working on executive functioning, we're thinking about our ability to use self-talk, our ability to sense the passage of time and think into the future and utilize episodic memory to go back, think back on past experiences and apply them to future and then use language to visualize steps.

and say language to ourselves about those steps to engage in that goal, directed behavior and envision this end goal and figure out what should I be doing now to get myself to this end goal. So it's very internal. so while I used to be a person that was like, just like I used to say for writing, which is something that involves a lot of executive functioning, I would say, so a graphic organizer and the getting ready is just like,

That's the process, the end goal is that we want to have the five paragraph essay or whatever it is. And I used to say, this is your end goal, this is what you should write on the IEP. And, cause I would see goals for like, we'll fill out graphic organizer or, know, things like that. And I used to say, don't worry about the process, just worry about the end goal. Now I say, think about both.

especially when you're working on executive functioning, because the reason that kids can't get to this end goal is because they have a difficult time with the planning and the thinking and the brainstorming and the gathering of materials and the articulating the steps in a process. So that's where I have changed how I explain goals and where I, I would say it's even more important to think about the external end product that you want.

and the process and the strategy that you use to get to the end goal. Now you could use the same philosophy for language as well, but it is really important with executive functioning because people tend to be very focused on the wrong things if you only focus on the end or tend to be so focused on writing this essay that you don't realize that you're prompting your students so much with constant questions when they should be.

Karen (31:01.341)

using self questioning and planning and using strategies to do that themselves. And that's where we get into, you know, either making students, not giving enough support for students and leaving them very frustrated or prompting them so much that they never learned to be independent. So yeah, that's the soap box there. So where we want to think about both, but again, you always want to ask yourself the question, what is the point of what I'm doing? Like, does it make sense to focus on

a strategy to get to this end product or do I focus on the end product or do I focus on both?

Marisha (31:38.338)

Yeah, that's great. and so, cause I love how your, your, like what you teach has kind of evolved over the time, over the years. And as we get new information and as we get to see more examples and all of that, but yeah, that makes sense that we want to think about the, the process and the end goal. And we may.

Karen (31:50.829)

Mm-hmm.

Yeah.

Marisha (32:06.784)

or may not want to include both of those intervals.

Karen (32:09.033)

Mm hmm. And sometimes you might be, you know, collaborating with your team members, like writing. A lot of times the special ed teacher was working on that, but I knew she was working on it so we could figure out who's doing what. And, you know, how are we both supporting this in different ways?

Marisha (32:27.118)

Yeah, that makes a lot of sense. So was there anything else that you wanted to add around...

Karen (32:34.34)

well that could be a whole other podcast, I mean, can share what I wanted to do. I can share a couple of resources to just give some more specific examples. Cause we've talked a little high level. I know I've given some examples of goals, but it really does help when people can see what are specific examples of executive functioning goals and tasks and frameworks. So.

What I can do is that I can share some resources where people can start to learn about the framework, which is where I always start. And then I can also share some links of articles and things that will give some specific tips about goals and specific examples, which is what I also do after I teach the framework. So I do have my language therapy training. People can sign up for that at drkarenspeech.com backslash language, and then the executive functioning training.

People can sign up for that at drkarendudekbrannon.com backslash EF leadership. And those are both free trainings. And then there's information about some of my paid trainings at the very end for people who are interested in learning more.

Marisha (33:43.694)

Perfect. So we will add those links to the show notes. Yeah, I think I love a good framework and I think you've got some really great resources for SLPs to help them because you're so right. We need to have that framework built and then we can implement the strategies. And I think it'll just make this whole conversation make just a little bit more sense. Cool. So.

Karen (33:54.957)

Thank you.

Karen (34:06.101)

Right, exactly.

Marisha (34:10.976)

Yeah, no, this was super helpful. Thank you so much for being so generous with your time. It's always a pleasure to get to learn from you. And then, yeah, thank you to, if you've listened this far, thanks for joining us and hanging out with us as we nerd out about IEP goals.

Karen (34:20.151)

Thank you.

Karen (34:29.537)

Thanks for having me.

Marisha (34:31.052)

Yeah, have a good one.

Marisha (00:01.281)

Hey there and welcome to the SLP Now podcast. I am super grateful to have Stephanie DeLessie with us here today. She is a dual certified veteran special education teacher, IEP coach, author, teacher, mentor. She does all the things and I'm really excited. I was looking for someone to have a conversation about strength-based IEPs with and just

from following her on social media and checking out her resources. I thought she would be a perfect person to have that conversation with. So hello, Stephanie.

Stephanie (00:39.656)

Hi, thank you so much for having me.

Marisha (00:41.663)

Yeah, I'm really grateful for your time and just generosity today. But before we dive into all things strengths, strengths based IEPs, I'm curious to hear just a little bit more about you and your story. Like what kind of led you through this journey? Because you have a site now like the intentional IEP. So you do a lot around IEPs. I'm just curious to hear how that all came to be.

Stephanie (01:10.188)

Yeah, so I'm one of those people who has always wanted to be a teacher. And I don't remember how old I was. I don't, couldn't pick this person out of a lineup, but I remember being at Walmart of all places with my mom and she met one of her friends was there. Like we saw them in passing. And I just remember hearing, you know, this person saying, my son needs more supports. He needs more supports. And so that's kind of how I got into special education instead of just doing

general education, although I am dual certified in special ed and gen ed. But, you know, I taught in the classroom for seven and a half years, I believe, and ended up leaving due to my own mental health. This was pre-COVID, but I've taught pretty much everything from kindergarten through 12th grade. I've done inclusion. I've co-taught, done resource, self-contained.

I've taught extended school year for a couple of summers for an intermediate unit, and I've taught in both public schools and charter schools. in a couple of different states, I lost count of how many states now, but yeah, so I've kind of run the gamut of all the things. And so when I left the traditional classroom setting, I had already built Mrs. D.Scorner, so I was kind of doing that, but I was like, I, there's something else. Like I just felt like something was missing from me that I was missing of not being in the classroom.

I am that weirdo that really likes all the paperwork that comes with IEPs. And I'm fully aware that I am like one of like out of every 1,000 special educators and IEP team members who's like, yes, hand me all the paperwork. I'm ready to go. And so I took that and that is kind of where the intentional IEP was born. And so now I do Mrs. D's corner, but I also do the intentional IEP. So the intentional IEP is more where...

I do all the IEP things and then Mrs. D's Corner's more resources classroom things.

Marisha (03:06.987)

I love that story. So cool. I can, so I don't know, I, especially as a new SLP paperwork was a little bit overwhelming and I'm kind of a perfectionist. So I wanted to do it perfectly, which kind of adds to that, but it is a cool opportunity. Like the IEP is a really powerful document. And so even if...

Stephanie (03:22.669)

Yeah.

Stephanie (03:29.635)

Yes.

Marisha (03:32.757)

If someone who's listening isn't a lover of paperwork and all the things, I think it is really helpful to think about just how powerful these documents are and how amazing they can be for our students, especially when they are needing those supports and we're able to set them up.

Stephanie (03:50.452)

Yes, we can make such a big difference with a 40 page document or a 12 page document depending upon where you are and what format you're using for IEPs, but they are so important and we can do so much good for our students with them.

Marisha (04:03.029)

Yeah. So it might be a little bit of a cringy topic for some people, but we can make the most of it. And I'm really excited Stephanie, because I think you can help make this even easier for us. But we're focusing on strength-based IEPs today. So let's just make sure we're all on the same page. What is a strength-based IEP? Why is it important?

Stephanie (04:16.194)

Yes, I'm ready for it.

Stephanie (04:25.494)

Yeah, so strengths based IEP, that is a mouthful by the way, strengths based IEP to get that to come out in the right way. It really focuses on the individual. So you're leveraging a student's strengths, their abilities, their interests, their preferences, as really the foundation for what support you're going to use for addressing that student's needs and helping them with their learning. So instead of emphasizing on challenges and deficits or what the child can't do,

The strengths-based IEP approach is really gonna celebrate what the student can do, and then it builds upon what they can do to promote that growth and progress within their IEP.

Marisha (05:08.247)

Love that. And why is this an important approach to take? Why does it matter?

Stephanie (05:14.348)

Yeah, so when you start working in this manner and you start thinking about it from the strengths-based approach, so you're focusing on what they can do, not what they cannot do, you're really gonna see an increase in student motivation and an increase in their engagement because the students sitting there thinking, I can do this and we're gonna do examples and all of the things of like, how do you do this? What does this look like? But when you see it in action, students are gonna be again, more motivated, more engaged.

They're gonna make more connections to what they're currently learning because you're using what they already know and what they already can do to gain that new knowledge. And so they're gonna be able to make more connections to what you're doing in the classroom based on this. And then in full collaboration mode, cause I am very much a, the whole entire IEP team matters. It's not, a lot of times special educators feel like an island of one and we truly are, I have been there, I have felt that.

But the IEP team truly is a whole team. There's a whole bunch of people sitting at that table. And so when the whole team puts this emphasis on what the child can do, you start seeing more possibilities rather than seeing limitations. And when you approach it in this manner, parents get a lot more buy into what you're doing because they're like, my gosh, like I never thought about it this way.

So it really does, there's so many benefits to just strengths-based IEPs.

Marisha (06:42.923)

Yeah, I love that. I just started a separate, well, it's a little, it's been out for a little bit by the time this episode airs, but I have a podcast where I interview special education leaders. And that's been a huge focus on like navigating all of that. So my brain was just like, Ooh, but yeah, I love that. And I think that makes a lot of sense if we're meeting, it's a better way of meeting students where they're at.

And if we can meet them where they're at, they'll be more engaged and we see more of that progress and all of that. Okay. Awesome. So I think we're all sold. I hope we are. So what does this actually look like? Can you walk us through some like tips, strategies?

Stephanie (07:14.552)

Yeah.

Stephanie (07:20.543)

Hahaha!

Stephanie (07:30.156)

Yeah. So when you're writing an IP, I'm going to start at the basics just to give us all in true special ed terms, a good baseline. So we're all on the same page. So when you're writing an IEP, you're always going to start with writing the present levels. And so the present levels is where all of your data is going to be. Every piece of information on that student is going to be in the present levels. The present levels is then going to leave breadcrumbs is the analogy that I like to use throughout the rest of the IEP as to

what IEP goals you should write, what supports you should put in. And then from there you do the service minutes and then you go into the LRE. So everything stems from that present levels. And so when you start there, that's where you're gonna begin highlighting the student's strengths, their talents, their preferences, what they like to do, how they best learn, what their learning style is. And so once you start there,

that's going to bleed into the rest of the IEP and really set you up for success in terms of, okay, well, how can I, I have these goals that I know the student needs to work on, these skills for these IEP goals. What supports does this child need? And so moving from the present level, so start there, put all of your strengths-based wording, which we're gonna talk about here in a minute, into the present levels, then move into your IEP goals. your,

If you have an IEP goal and an objective, there has to be a need written in the present levels. And so that's your connection from present levels to IEP goals and objectives. And so once you go from present levels to goals, you're going to write them in a way that is not only positive, but it also addresses the need because we still do need to do that. But we're not gonna do it in that deficit-based language, right? Which again, we'll get to, I'm gonna share an example for you here in a minute. So for example,

Let's say that a student loves drawing. The student is not me, because I'm a terrible drawer. But let's say that this student loves to draw and they have a need in math. So let's just say maybe they're working on, you could even focus this also into ELA. So let's just say they love drawing. They have a need for comprehension and we're working on math as well. We have some skills we have to work on in math. So if a student loves drawing,

Stephanie (09:51.916)

we maybe instead of having them verbally retell us a story, maybe we're gonna have them draw the story out in maybe four blocks, or maybe we're gonna have them do like a summary comic or something along the lines that lets them use their strength of drawing something they love to do to show what they've learned. And so same with math, instead of maybe using manipulatives instead of counters or little bears,

Maybe you can still do that, but maybe have the student draw the counters. You can laminate them, have them reuse them, or on a piece of paper, have them draw it out instead of writing out the numbers or something like that. It all depends on the student. But using their strength, their focus, and their just love of drawing, you can map that out over into pretty much any academic area or even social skills behaviors.

And so you're using that strength to harness learning new content. Doesn't have to be done for every single lesson that you're doing or activity, but if you're wanting to collect data, that might be a really good place to start. And that's going to be written into your accommodations and modification section. Drawing would be an accommodation, but you can then use their strength again to work on gaining mastery of a skill that they're working on in their goals.

And so you do that again through highlighting the present, the highlighting the strengths in the present levels, you're writing your goals, you're choosing your supports, you're using that positive language. You also wanna make sure that the student is a part of the IEP process. And I know when I say this, because I have not done this in the past. And so again, I've worked with K through 12. I've worked through the whole transition process. I've worked with the kindergartners, first graders.

You can integrate them in throughout the IEP process in different ways and it's going to look different student to student, but include their voice in the IEP wherever possible. Again, you need to know what their interests are, their preferences are, what are their aspirations? You know, maybe in kindergarten they want to be a basketball player, right? Because kids all want to grow up and be singers and I want to be Taylor Swift and...

Marisha (12:02.349)

Thank

Stephanie (12:06.614)

I want to be Michael. I don't think Michael Jordan is the thing where I don't watch basketball, but I just know Michael Jordan was the big thing growing up. I just aged myself. my gosh, but they all have these aspirations and they change over time when they get into new things and when they learn new things and different ages, you know, when they're in high school, they're not really into blues clues anymore. So we have to keep them included every single year and update all of this in the present levels. You also want to make sure

that you're using a collaborative approach. So not only is the student involved, but you want to make sure that the family's involved and that you're asking them to share their insights, share their child's strengths that they're seeing through their eyes and their perspective, their lens. What's motivating at home? What's motivating in the community? What do they like doing? How can we harness that in the classroom to get them to learn content, to master skills that they need to work on?

This also goes for working with therapists or related service providers. So working with the speech therapist, working with the OT, the PT, working with outside service providers as well, if that's an option for some of your students. But really having that collaborative approach is going to help you in building that strengths-based IEP one, because everyone's going to be engaged, because again, they're thinking, there's possibilities. We're not talking about

limitations or my student can't do this, we're thinking about, well, they can do this. So how can we help them do this based off of where they are now? And so you're going to have more engagement in the IEP process, but also then you're not writing the IEP alone. You don't have to come up with, okay, well, the student loves drawing. So how can I, as the teacher, integrate that into ELA and math and art class and music class and in all of these different places?

You don't have to think about that all by yourself because you have a whole team to come up with those opportunities for growth. And then the last thing is, and it kind of goes back until, you know, why is this important? The strengths-based IEPs are really going to build self-confidence, not only in the student, but also in the IEP team. Because once you see the growth that's going to come from this, you're going to be like, my gosh, like we need to do this with everyone. Right. And so.

Stephanie (14:33.772)

The students really gonna feel valued. Your IEP team members are gonna feel valued because they're part of the team. You're using that collaborative approach, but your students are really gonna feel valued. They're gonna feel capable because they're working on things based off of what they can already do. And so we see a lot of students who shut down immediately because like, can't do this. And I'm the same way when there's something really hard, like, I'd rather pay somebody to come do this for me than me learn how to do it.

But if I even, now I'm gonna coach myself here, if I started thinking about it in a way, how can I get this done based off what I'm good at, what I already know, I'm gonna foster that growth mindset and be like, okay, I can do this. It might take me a couple extra minutes, but I know that I can get it done because I have the skills to get there. Might look a little different than how somebody else is getting there, but I'm still gonna get there. And so that was a lot of information, but.

All in all, it's really just about focusing on what the student can do and leveraging that to build those positive outcomes for students for things that they cannot yet do.

Marisha (15:42.155)

Yeah, I love that. And I'm curious too, if you have any, cause I feel like you're kind of like, I feel like you might be like a process gal like me. If you love paperwork, you probably have a bunch of like templates and systems and things for everything. But what suggestions do you have? Because I love the like strategy mindset of, okay, we're

Stephanie (15:52.387)

I do.

Yes.

Marisha (16:07.223)

Like we're starting with the present levels and thinking about including students strengths and we'll use that throughout the whole IEP. And we get to focus on, like we get to include the students strengths and interests and get the perspective from parents and the team. But do you have any favorite, maybe like just in the interest of time, some of your favorite strategies to actually collect this information?

Because I mean, obviously we work with our students and we get to know them. So a lot of it might just be like, do you have a list of questions that you ask yourself or do you send out forms or like what types of things do you think could help make this easier for ourselves?

Stephanie (16:50.134)

Yeah, so I love a good form, which not everybody does, but I will send out typically anywhere from the 30 to 45 days out from the IEP meeting. I'm gonna send out, I call them input forms, they're the questionnaires, but I'm gonna send them out to everyone on the IEP team, but then I'm also either gonna give one to the student or do one with the student. So for a lot of my students when I taught self-contained, it was, had questions predetermined.

Marisha (16:53.473)

Mm-hmm. You too.

Stephanie (17:17.486)

And then I had three different smiley faces. So there was like a happy face, a sad face, and then like the stalled, I'm indifferent face. And so I would ask them a question and then they would pick up whichever smiley face they felt about how to answer that question and hand that to me. And that would be their response. And so then I could take that data and put that into the present levels. And then all of the data that I got from all the gen ed teachers, the related service providers, my paraprofessionals, from the parents, the caregivers, the guardians,

I would throw that all into the present levels as well. And that's why I always start there. So I send out the forms 30 to 45 days out because that gives me time to start working on the present levels and input data that I've collected in the classroom. But then I give them about a week or two to send that form back to me. And I'll give a gentle reminder here at like the one week mark. I'm like, hey, do you need me to send you another form? like, do you have questions? Or is there anything I can help with?

And then once I get that form back then, because my part of the present levels is already done, I did that while I was waiting for the other forms to return, then I can input that information into the present levels. And then I'm very big on sending out that draft IEP a couple of days before the IEP meeting, so parents are on the same playing field. But that also then, once I have that back, I can determine proposed IEP goals.

for that draft IEP. And so in that draft, I'm only sending out the present levels, because that's all fact. Data is fact, it's not going to change. And then I'm proposing IEP goals based off of all of the data in the present levels. And then from there, we have the IEP meeting and we do all the good IEP meeting stuff.

Marisha (19:03.403)

Yeah. Yeah, and I think forums are a really great way to collect that feedback. like we can obviously enter anything that we've learned over the course of interacting with the team members and families and students, but it is nice to have that on paper and it's a good way to make sure we're covering all the bases. And then I'm curious too, so do you do anything differently?

If we're using a strengths-based approach, do you report your classroom data in a different way or are the numbers always the numbers? I'm just curious if you do that a little bit differently.

Stephanie (19:43.118)

For me, the numbers have always really been the numbers. just is like when you're reporting the data. So it really depends. So if we're talking about progress reports and like that annual IEP and how we're putting it into the IEP, the numbers are the numbers, right? Like those numbers aren't gonna change. It's how we are reporting, I guess, like after we've analyzed the numbers and analyzed the data, it's how we verbally or how we write down.

that information or share that information with the team. It could be, you know, here's an example. So let's just say Stephanie has difficulties with writing tasks, right? She can't do them independently. So that would be more of like deficit-based language or deficit-focused language. And that could very well be what the data is showing. Like Stephanie...

is not doing very hot when it comes to writing tasks. So she has difficulty with it. And then you would include other data, like maybe it's because of XYZ. So instead of maybe saying that, you could say something more along the lines of Stephanie has really good verbal communication, and she benefits more from dictating to you or verbally telling you what's in her brain or what she wants to write or the ideas that she has.

before transferring them into writing. So then you could use that as the accommodation, right? So maybe the first step before she writes is she's going to, maybe she's just gonna speak them into like her phone, cause you're gonna be voice to text, put them into a voice to text option and then throw that into a Google doc. And then from there, she's gonna edit what she said to write the writing task or to complete the writing task.

So it's just all about flipping.

Stephanie (21:40.088)

the verbiage, I guess, when it comes to strengths-based IEPs, because the numbers aren't gonna change. They are what they are. They're going to tell you how the student is doing with that skill. It's all in how you present that data and write about that data in the IEP, in the meetings, in your progress reports.

Marisha (21:54.413)

Yeah.

Marisha (21:58.539)

Yeah, that makes sense. I think so. Like if we give whatever classroom based assessment or whatever it is, we can well obviously just report the number as it is. then because even if writing is a struggle, like there's aspects of writing that a student is mastering. So we can say like the student like the student scored this on the assessment. They

demonstrated strengths in these areas, like they did this, and we can analyze the task and we can say what, like if we do some dynamic assessment, we can talk about the supports that are helpful. So there's lots of ways to, instead of just being like, they scored this and they did all of these aspects wrong, we can include. There's so much more to talk about. And it's so much more helpful. Like when it comes to,

Stephanie (22:42.318)

They did not make progress. This is not at baseline. Yes. Yes.

Marisha (22:55.733)

writing goals, setting up accommodations. Like if we, like we've been talking about this whole episode, but yeah. Okay. So thank you for going down that train of thought for me. I think that's super helpful. Is there anything that you want to add?

Stephanie (23:06.199)

Yes!

Stephanie (23:13.748)

No, I think we covered a good starting place for all of the things, just general starting place for like writing IEPs, but really turning it into like that strengths-based focused IEP instead of focusing on what students can't do.

Marisha (23:30.993)

I love that. And then if listeners are wanting to find out more about you and what you do, what are some good places to go? And I'll share all of these links in the show notes. The show notes will be linked in the episode description. But yeah, where can they hang out with you?

Stephanie (23:47.532)

Yeah, so if they want to follow me for all or find me or ask questions about IEP things, I'm at The Intentional IEP on pretty much everything except TikTok. I can't TikTok. I don't get it. But Pinterest, Facebook, Instagram, I am at The Intentional IEP.

Marisha (23:59.007)

Thank

Marisha (24:06.637)

Perfect. And then you have your intentional IEP website and you have, gets a, isn't it a, is it a membership?

Stephanie (24:10.381)

Yes.

Stephanie (24:19.042)

Yes, so the intentional IEP, we have our blog, which is a lot of free advice. And then we also have our membership, includes a, it's a goal bank, but it's so much more than a goal bank. It's so hard to elaborate on, but it's essentially a goal bank that's spiraled with all of the skills from grade to grade. And then you can put in like what your student is struggling with and it'll recommend IEP goals for you based off of that.

And then we have IEP screeners inside of our goal bank. So anything that is pre-K through grade six, that's an academic skill. We have our IEP screeners, which are your baseline data assessments. You can use them for collecting data on that specific skill. The membership also includes a member library with lots of different IEP printables and things that you can use and also member trainings. So we have.

I've lost count, over 150, maybe probably almost 200 different trainings for special education teachers and team members. So that's all included inside of membership.

Marisha (25:22.709)

I love that. That's awesome. And it is more focused for special education teachers.

Stephanie (25:28.512)

It is, but we do have some parents that are also part of the membership and other related service providers. So it's not solely for the IEP goal bank, I would say is solely for IEP team members and teachers to use, not necessarily parents, although I have had parents and I've walked parents through locating goals inside of the goal bank to help them based off of data they've gotten or things they want to work on with their kids.

Marisha (25:56.983)

Love some active parents and some ownership. That's amazing. Okay. Well, thank you so much, Stephanie. This was so helpful. And thank you to listeners for, if you listen this far, I hope this was super helpful. And yeah, thank you again.

Stephanie (25:58.574)

It is awesome.

Marisha (00:01.332)

Hello there and welcome to the SLP Now podcast. I'm really excited to introduce our guest for today. We have Wendy Taylor joining us and she is a certified educational therapist, Orton Gillingham practitioner and IEP coach. And she does some really amazing work empowering families and professionals to help them navigate the complexities of special education.

she also has an amazing podcast, special ed strategists. So go check that out if you haven't already. know you're going to want to hear more from her after listening to this episode. and she's also the founder of learning essentials. And I mean, there's, won't be able to do her bio justice in this. so I'm going to turn it over to Wendy. So first of all, welcome to the podcast.

Wendy Taylor (00:57.016)

Thank you so much for having me. think it's an important conversation that we're going to have today. So I'm looking forward to chatting and hopefully passing on some knowledge that your listeners can then impart to the folks that they support, whether it's their own personal kiddos or the kiddos that they support out in the professional realm.

Marisha (01:15.976)

Yeah. and then I'm curious, cause I read a little bit of your bio, but I'd love to hear from like interviewees on just like how they got to where they are today. so what led you to become like an educational therapist and kind of diving into this niche of supporting parents and professionals. yeah, just tell us a little bit about your story and how you got.

Wendy Taylor (01:42.786)

Let's do it. All right. So my background is in special education. My first gig was high school juvenile delinquents in the special education self-contained. And I loved it. I loved that no two days were the same. I loved being consistent and supportive of these kiddos and the families that were part of these kiddos' lives. Fast forward, I am a mama of three when I first had our first son, who's now 19.

I was just really actually tutoring and supporting families for kind of grocery money. kind of kid on that one, but yeah, just kind of, got stepped away from the direct day-to-day in the school system. And then my phone kept ringing. So after a second, the phone kept ringing. My husband's like, know, build a business. And so I really took that to heart of kind of more of this holistic approach in bridging learning gaps and helping families access special education services.

Fast forward a little bit more, our middle son who is now completely healthy, he was five and he's a brain cancer survivor. And so at that moment, I then had to sit at this IEP table as a parent and I knew going in, right? You know the players, you know that it's like walking into a cocktail party and everybody stops and looks at the parent and I knew all of this and I knew that

who was going to be at the table. knew the actual paperwork, the whole process, and I was a wreck. It is very hard when you come from that place of fear and love as a parent. And that really just ignited my desire to further help parents coordinate special education services. And where I found a gap was there's lots of IEP coaches, there's lots of advocates out there that help parents with their actual IEP, but so many

families were coming to me and saying, my kid didn't qualify because they had good grades. They didn't qualify for an IEP because they had good grades. And I was like, all right, this is a void in the market of understanding how to advocate as a parent, right? Because when we think about getting an IEP, you think about bell to bell and thinking about all the elements that impact a student. And so really thinking, how can I better serve parents?

Wendy Taylor (04:06.154)

in this capacity and then what we're talking about today in terms of parent input statements so that you can really make a support for your kiddo that truly reflects who your kiddo is. And I think that's incredibly important. So that's kind of what got me here today.

Marisha (04:26.11)

Yeah. Well, thank you so much for sharing that. And it's, I think this is really important. I mean, a lot of what you shared is, I'm, I don't know, there's so much gold in there, but one thing that really stood out to me was you had experience in special education and you had done the paperwork and gone through all of those steps as a professional.

but it was still overwhelming as a parent and you knew all the acronyms and the lingo and all of that. So like to then I think that helps us put ourselves in parent's shoes if they don't have that background and there's still all of the emotion around their like have that IEP process for their child. Like that's really important to think about.

Wendy Taylor (05:16.8)

It really is. I think it is because you think about your kiddo at school, right? And whether they have an active IEP, you're seeking an active IEP, seeking an IEP as a parent, you have to be able to articulate beyond just emotion. You have to be able to sit at that table and really think of it, which sounds kind of disorient not disoriented, but you know, disconnected in the sense that it's

It really is a business meeting, right? Because it's based in law and data will drive placement, data is going to drive needs. And so if you come in as a parent with your own data through your parent input cement, that's incredibly powerful for you to then have some leverage at the table, even though it is nerve wracking, it is anxiety filled.

even to the best of us, right? So to have that information and again, thinking about Bell to Bell, you think about, you're, and folks that are listening are probably like, well, I'm not in school with them. And so I'd like to kind of just talk about how to collect data so that you can then create a strong parent input statements. But when I say Bell to Bell, think about your kid from the time they get to school, if they're on the bus.

Think about the bus ride. Think about hallways, transitions, the classes that they're taking. I want you to think about lunch, recess, specials, any of those things and thinking about processing memory and attention as it relates to that school setting. But then also think about your kid in the home and in the community, right? So if we think about those three areas, how do they...

respond and react and all of those things at home and at school and in the community so that you can start to pull all that information together. So that when it's time to present that to the team, you have it in an articulate form that they can, you can start to pull data from.

Marisha (07:34.196)

Yeah, that's great. then, so, because today we're going to chat about, you started diving into it a little bit, but we're going to chat about parent input statements. And I love what you said about like parents can contribute their own data because the decisions are data-based. But just to like make sure we're all on the same page, like what is a parent input statement? Where does it go in the IEP?

and just like from, and we're speaking to school-based SLPs, so I think we have some idea, but just to make sure we're all on the same page.

Wendy Taylor (08:13.57)

Right, so a parent input statement is going to be asked because of our federal law IDEA, parents need to be part of the process, whether it is seeking an IEP or a current active IEP. And so prior to an IEP, you should receive something that is a form depending on your district that's asked.

for how are things going? Like what are you thinking? And if it's a kid transitioning, what's going on? And kind of getting some general idea. I, through my years, have had parents say, I've never received that, or they didn't really ask a lot. Does it really go in the IEP? There's a place in the IEP, again, depending on your state and your district, where it should go. But it should be, if you think about our...

baseline for starting an IEP evaluation, meaning like your yearly or annual or whatever, present level of performance. So the school is going to come together. They're going to say, this is where your child is performing in the school day. And then parents should have their input as well. And I think you can, if you did not receive anything, I would encourage you to reach out to that IEP coordinator, case manager, whomever you are in contact with.

about your kiddos IEP, ask them, is there a specific way for me to submit my parent input statement? And I say that because I want you to submit it in writing so that it can, and request that it is part of that IEP so that it becomes a part of the living document that will then be reflected and measured throughout the year and then passed on from years prior for moving forward, I should say. And so making sure that it's in

writing would be the key and making sure that you as a parent then have the time. So now that if you're listening to this and you're encouraging your parents to do this, so they have time to really form their thoughts and how they see their kiddo. And I always say, think about short term. So big picture, little picture, think about six months. Where do you see your kiddo? Where do you see your kiddo in a year? Where do you see your kiddo in three years? Where do you see your kiddo in five years? And we know that we have an annual IEP.

Wendy Taylor (10:32.194)

but I think it's important for parents to start to put that down. So if there are services or elements that need to be on a wait list for, or if you're not sure about moving forward, if you're transitioning from, know, transitioning into kindergarten, into sixth grade, ninth grade, and then after you graduate so that you're really starting to be forward thinking in where this kiddo's growth should take place, needs to take place, where we want to see the kiddo

and how independent can we have our kiddo. So these ideas and people on the team may have different ideas from you. And so kind of coming to that collaborative piece of this is my baby, I'm the consistent person at the IP table. This is where I see my kiddo again in the short term and long term areas. And of course that's gonna change, right? As our kiddos master skills and build and grow, we want those visions to change.

but as a parent really ensuring and then hopefully eventually your kiddo can be that advocate and speak of where they want to go and where they want to see each other so that you're mapping out the courses, you're mapping out the resources, you're mapping out what do you have in the community so you can really start to build this broader support system.

Marisha (11:49.416)

Yeah, I love that. so you talked about how like federal IDAA law says that we need to involve parents in the process. So that's obviously a strong reason for why we want to have those parent input statements. And then you're also saying that if parents are able to share like their vision for their child, like what are the short and long term goals?

Knowing what's important to the parent can help the IEP team, like the teacher and the speech therapist, the OTPT, whoever's involved, that can help direct our goal setting to make sure that it's really meaningful and impactful. Are there any other reasons why you think that the parent input statements are particularly important, or do you feel like that covers it? It's required by law and it helps direct the team.

Are there any other benefits?

Wendy Taylor (12:47.992)

So it's also a great way because as a parent, I may, you know, in my family, we may see a different direction for our kiddo that may differ from what the school feels like they see. And so that's one part, right? So that you can then make sure we're aligning that conversation. Then there's times where there's a lot of things to work on, right? So the kid, like you just mentioned, a kid may have...

as speech services and OT services and maybe behavioral services. So they may have this big comprehensive IEP. And I think it begs the question of what are we prioritizing? Because we can't work, if we put goals on everything for multiple goals on many different areas, sometimes they kind of get washed out. So I think it begs the question for parents of, I was asked like, if you had a magic wand, right?

Again, once you start collecting the data in the areas, and we can talk about that, like the different areas again, a little bit more focused on. But once you have that data, what do we want to prioritize? Whether it's for this IP cycle, but maybe it's not even the whole cycle. What do we want to prioritize now? And then can we reconvene? So what can we do? What do we want to prioritize as our focus to help us get to this bigger picture goal of where

we, kiddo included, see themselves moving. And then from there, we can really make sure that we are drilling down on our goals and the services and the accommodations and the support for that student. And so even as an SLP, as you're calling a parent to say, hey, know, I see we have this IEP scheduled, I'll be at the meeting, you know, I've collected this, you know, however you want to say it, asking, what do you see as a priority?

and us working together with your kiddo. And I think that's really important. Sometimes when we as providers, and I even I say that just being a part of the public school system for a long time and writing IEPs and supporting families, sometimes it surprises you of like, what do you see as a priority? And so having that engagement also then broadens this trust.

Wendy Taylor (15:10.196)

of this conversation with a family. They're going to say, okay, well, they're really listening instead of just saying, all right, here's the data, here's what your kid can do, here's what your kid can't do next meeting. And so I think it really then opens up a broader relationship of trust and conversation so that we can ultimately better support a student.

Marisha (15:33.886)

Yeah, that's huge. Cause you mentioned at the beginning that even as someone with a background in special education, the IEP meeting was still really overwhelming. But if you can walk in and know that your input was taken into consideration and that it's actively being discussed and reviewed and integrated into that discussion and into the IEP, I bet that would really alleviate some of that anxiety.

Wendy Taylor (16:02.966)

Yeah, absolutely. Because I think as parents, again, you have that fear and love and you may not understand the whole process and you may lean to the school for it. But I, it does, you know, I think about the IPs that I've been in as a parent, and how important it has been for me to have a resource provider or an IP team member reach out and say, you know, what are you thinking? What are you seeing? Or I you know, what would you like?

to be a part of it. And that makes you feel more of a team player than this like, I'm on an island, I'm in this, you know, silo operating by myself. And it is a lot that especially if you have a complex kid, whether it's medical needs or just a complex learning pattern. Oftentimes parents feel overwhelmed and exhausted because they are now if especially if you have private therapist, then you have your school based therapist and you're really trying to be that quarterback for your kiddo and

pulling all this information together. But I think having that knowledge of writing a powerful input statement and really keeping it organized. using the notes app on your phone, you can just put something in. But I think it's really important to kind of think about who your kiddo is and what that looks like and how do we prioritize that to then get better services for that kid.

Marisha (17:28.734)

Yeah, I love that. And you've already shared some tips around like gathering input from parents. So I love the and not every parent will get to work with you and have your support in building that statement. And I like I personally really like to send out a form to parents because I feel like the majority of parents if I were to say, OK, send me your input statement, they would be like, and super anxious.

Wendy Taylor (17:55.278)

And that's what it is, right? Yeah, that input statement when you see it, it's just going to be a couple of lines like, how's your kid doing this year? It's more open-ended and it seems overwhelming. having a form ahead of time and hopefully somebody's taking notes and just kind of thinking about these elements to document the data for your kiddo.

Marisha (17:58.61)

you

Wendy Taylor (18:24.782)

which does again, sound kind of counterintuitive when it's your baby and you just want to love up on them and snuggle them and make everything roses and unicorns and to then have to be more sterile and be like, I've got to cut that data. It doesn't have to be that, but I think you parents do need to understand all of this element, like the shell again, bell to bell so that you can then have a stronger IEP and stronger IEP goals.

Marisha (18:51.358)

Yeah. Yeah. And I love the idea of like, I'm going to make sure that this is included every time I send out an input form. And I think it might, it, depending on the parent, it might be, cause just for time sake, I think it is easier to send out a form. And then that helps scaffold it, but we can ask follow up questions like during the IEP and or just like,

a quick phone call or whatnot to fill in some of that extra detail. But I love the question of like, where do you see your student in six months or five years and kind of thinking short term and long term. I feel like that would give us some really, really great information that we can use to help parents craft that. And then I love the question you posed, like if you had a magic wand, like what?

Wendy Taylor (19:36.558)

Yeah.

Marisha (19:47.968)

How would you use it or what would it look like? Like what would you do for your student? Is there anything else that you would, like any other types of questions or things that, like strategies that SLPs can use to like get that really valuable feedback from parents?

Wendy Taylor (20:06.882)

Yeah, I think both as an SLP and a parent, thinking about kind of behavior and emotional regulation, right? So are there triggers? Are there coping strategies? What are the kiddos' emotional reactions? What are the teachers saying? I think that's important. I think when you're thinking about if a student is on medication,

What does it look like when they're off medication? What does that look like when they're on medication? Especially during homework time, think that's a really valuable part as well. And that kind of leads me into thinking about that academic component with learning needs, right? So is there a subject specific challenge?

Is it difficulty with reading or writing? then specifically as a parent, if you understand that, or even as an SLP, if you're working with a kid, is it reading fluency as a comprehension? What are you seeing that you can add to their present level of performance, which is going to help that parent input statement for that guidance? If a student, as a parent, if you have a student and you're seeing these needs, you can also do a quick little video of them reading.

or a quick little video of them getting frustrated with writing or their physical aspect of writing so that you can then show the team of like, this is what home looks like for us. Because we also have students that mask during the day and come off as not as impacted, but then they get home and they're tired. And so really thinking about how we can better put in accommodations and support so that they don't have to be so

tapped out by the time that they get home, right? And then what does homework completion look like and understanding and also thinking about at home, you know, what is nice to know? And if we're having to do homework, what is nice to know what is needed to know? So in the event that, you maybe we can reduce some of this workload for the kiddo and then thinking about sensory, physical and movement means having those conversations. So if you are with your student,

Wendy Taylor (22:15.832)

during the day providing services. As an SLP, are they a sensory seeker? Are they a sensory avoider? Do they become overwhelmed? What does that look like in the cafeteria or tactile or classroom materials? What are their physical comfort and needs? What do their motor skills look like?

And even I think as an SLP, can still observe those skills, right? So we're not necessarily an OT or a PT when we're talking about this, but I think it's important to bring to the table because again, bell to bell, community and home, it's all gonna come together needing support, right? And then cognitive processing and executive function, right? What does task initiation look like? What does memory look like and attention?

planning, organization, and time management. These are all life skills that can receive support under NIAP. And then what is their self-advocacy and independence? think as a parent, that's really important to add to that parent input statement. Are they able to complete tasks independently? Are they able to seek help? What does their daily routine look like? And what I find as parents then

say, I'm actually doing a lot for them. I'm structuring their time. have a landing pad for them when they come home and they put all their stuff and then they set it up the night before so then they can leave with all their organized information. Or taking a shower, I've had to do a picture chart for my kiddo so that they have these hygiene skills built in. expressing that to the team.

so that you can then think creatively of what support can we, know, free and appropriate education, of course, but what can we do in a school setting to build these capacities? And then, you know, obviously as an SLP, you're thinking of that verbal, nonverbal communication. Do they have an AAC device? What does their listening comprehension look like? And then thinking about peer relationships. What does unstructured time look like? You know, go out and see what recess looks like.

Wendy Taylor (24:30.83)

If any of you have been on the recess, out at recess or even in the cafeteria, sometimes it's a little bit like Lord of the Flies. So just seeing how that kiddo interacts, but I think those conversations are important for parents and then to be part, but also as your parent input statement, having that information in there so that it is documented. And then emotional regulation, mental health, what are some triggers, coping strategies, concerns?

And then, like I said, know, do a time lapse documentation if you're thinking about out of the box data tracking strategies, maybe a photo journal, again, a medication and behavior correlation. So kind of start putting your sleuthing hat on of what does that look like and thinking that through. And like you said, then from there, asking those questions, we've now we've painted a picture of this student.

Right? We've got a lot. Now, not all categories are going to fit for every kid, but at least it kind of hopefully gets some juices flowing for parents and providers to think about these things that really make this whole approach and support for a student. And then asking those questions of, okay, from this information, we have our strengths and our pockets of vulnerability. From those pockets of vulnerability, you know, I've even had parents take sticky notes and write on

like what, you know, each sticky note would have one item that they wouldn't want to work on and then have kind of that sticky note party concept of like, all right, I'm going to make a vision board and I'm going to kind of again, prioritize of like, if this is my area of communication, this is what I would like as a parent, I really want to work on, you know, X, Y, and Z. If this is education, academics, this is what I want to work on. And then

again, then you can prioritize. then you're really empowered when you come to that table as a parent. You can say, here's all the areas. This is what we see at home. This is what I'm seeing when this child comes home. This is what I'm seeing in the community. This is what I'm seeing at homework time. we need to, how do we better support this? And then kind of come up with some out of the box ways so that I'm always thinking of trying to support families in the sense that they don't have,

Wendy Taylor (26:51.278)

educators would love something that they're not recreating the wheel, right, or providers. And so as a parent, what can we do to support a kid with free and appropriate education in a way that is not an extra added task on that provider's plate? And so how can we really support this kiddo and the provider at the same sense of understanding and grace?

That was a lot of information I just threw out.

Marisha (27:22.376)

Yeah, no, this is a great list of like areas to look at and questions to ask. and I love the ideas of different types of data that parents can share. like as an SLP, I would love to see a video of, cause I request that for some evaluations, especially for younger kiddos, like for language sampling purposes. But it would be, I feel like it would be helpful for any age just to get to see like.

Wendy Taylor (27:50.828)

Yeah.

Marisha (27:52.094)

what does it look like at home? just to get some, like that's a beautiful data point. And the same thing with the photo journal and.

Wendy Taylor (27:59.63)

And I would say as a parent, I would recommend you do it when the kid's not knowing that they're being recorded because your response is going to be more authentic, right? And then if they're not, you know, if you're like, hey, I'm going to start to record you reading, then their response is very different. You know, it could be an anxiety producing or whatever that may be. But I think if you can kind of put it on the slide. And so then you really see the true environment at home and what the kiddo is trying to navigate.

Marisha (28:05.672)

Okay.

Marisha (28:13.738)

Thank

Marisha (28:29.694)

Yeah, no, that's great. And then I think this will be my last question, but just as a parent, kind of, because you've gone through the process as a parent, like did anything stand out to you that anyone did during the process that like was particularly helpful in like including your feedback or just anything that stood out to you?

Wendy Taylor (28:57.164)

Yeah, I think it's important. I really appreciate the providers that got us I got a sense that they understood my kid, right. And I got a sense that they were on my kiddos side, right. And so, you know, when you're asking kids to do hard things, they may not feel as warm and fuzzy with their energy towards you.

And that can be complicated, but I would, I think it's really important to highlight that communication piece from a parent of communicating again to whether it's the provider, the SLP, the OT, the PT, or the school, the IEP coordinator, the classroom teacher of what is going on so that there is an ongoing dialogue.

And so that that parent input statement is really having a conversation and a growth of an organic process throughout the time. So it's not just like, I haven't heard from, you know, so and so's mom, but here's the IEP or parent, here's the IEP time and let's get all this information. So I think having that flow of communication and that check-in of, you know, not even, you know,

before the quarterly progress notes are gonna go home, right? And so that way you can have like, hey, know, checking in, whether it's monthly, you know, but I do recognize SLP, you guys have a ginormous caseload and it really is not always the easiest to be able to check in with a parent. But I think if you can kind of set up some sort of organized system to check in with that parent and have a little bit of a conversation.

whether it's before the IEP, before you see their parent input statement, and just even looking at before progress notes go home of like, hey, this is what we said we wanted to work on. We've highlighted this, we're making progress. Hey, can we add another objective or goal to broaden what we're doing? Or, hey, we have this goal set and I'm not seeing that we're getting much progress. Can we kind of have a conversation and maybe break that goal down a little bit?

Marisha (31:20.968)

Yeah, no, I love that. And I keep saying that. You have so many good pieces of information. But yeah, I...

Wendy Taylor (31:28.014)

I feel like I'm going on a contingent. I know we're talking about one thing, but I'm like, and then this thought, this thought, but yes.

Marisha (31:33.554)

Yeah, so good. And I think that some of the takeaways that I had here were just that, like, and there's different ways that we can accomplish this. But I think it really is important that parents feel like we understand their kiddo and that we're on their kiddo side. And I think asking these questions and listening and incorporating their feedback are all ways that we can do that.

And yeah, I really appreciated you kind of sharing that experience. And I think it makes a lot of sense to check in. Like another way that we can accomplish that is checking in not just right before the IEP when we need to have this, just like fill in this slot on the IEP. But if we're able to check in with parents throughout the year. And we actually have an episode.

or we have some episodes where we've talked about communicating with parents. So I can add those in the show notes. And Wendy, if you have any other resources, I can link those as well. Yeah, this episode, go ahead.

Wendy Taylor (32:42.914)

Yeah, because I've done some solo episodes of a parent input statement and talking about the quarterly progress as well, that that may be of help.

Marisha (32:55.36)

Okay, yeah, yeah, so I'll link to those episodes for sure. And then, yeah, this episode has been full of so many great tips and resources. Is there anything that you wanted to share before we close out?

Wendy Taylor (33:12.658)

I think just trying to make those connections with the family and just thinking about that parent heart as well. again, I know when we're head down and trying to get all the paperwork done and, you know, collecting all your data as an SLP and a professional, it then can sometimes seem like one more added thing. But there's a lot of cool technology that we can also utilize that I'm sure you talk about in terms of having those conversations with parents, whether it's

an app or electronic folder or something of that nature to kind of really keep and then your programs that you offer so that SLPs can then communicate with other SLPs so they don't feel like they're recreating the wheel is empowering.

Marisha (33:58.846)

Yeah, and I think we can definitely build systems to make this process a lot easier. And then it does take some time, but it is required. So it's something we have to do. We have to incorporate the parent feedback. So we might as well do a good job. I think it can really, by having all of this data right off the bat, I think it can really help.

make the IEP process much easier if the parent is feeling hurt, if they're at ease, it'll be just like an easier, more collaborative process. We'll be able to like help the student make faster progress and just come up with a better plan together. So I think it really is a very valuable use of our time. And it's.

Like it's a really meaningful activity. It's not just like, let's check this out. Like we can really use this to our advantage and have it make a really meaningful impact. So.

Wendy Taylor (35:02.446)

And we need more folks that think that way at an IEP table just to kind of, again, as a parent, just kind of, you know, lower the anxiety and feel like, yeah, they get my kiddo and they're ready to, let's work together on this, that we're a team.

Marisha (35:21.15)

Yeah, yeah, and these, this whole episode has been full of strategies to accomplish that. And then, yeah, like I said, I think that can really make our IEP meetings more effective and it just makes it a better process for everyone involved. Yeah, Wendy, thank you so much for your time today. This was really helpful and I'll link to your, like,

to your podcast and your website. You have a great Instagram account as well. So I'll share all of those resources in the show notes. And yeah, thank you again for your time and thank you to everyone who listened.

Wendy Taylor (36:04.095)

Thank you for having me, but my pleasure. Thank you.

Marisha (00:01.304)

Hello there, and I am super excited to continue our series, our GLP series today. We have Laura Hayes with us. She is a speech language pathologist who specializes in augmentative and alternative communication. And she has over 15 years of experience, AAC experience, in both school and medical settings. And...

I'm not going to be able to do her background justice, so we're going to turn it over to her in just a second. But a couple of things I wanted to highlight, she helped author the GLP and AAC course for meaningful speech. And so we just got to chat with Alex last week, which was awesome. And then you can also find her on Instagram at AAC underscore innovations. She has a great account with a ton of great resources. I'll add the link to the show notes too, but

If you're listening to her as we go through and like, I need to find out more. Definitely go to AAC underscore innovations to find out more. but without further ado, hello, Laura.

Laura Hayes, MS, CCC-SLP (01:08.828)

Hi, thanks so much for having me. So glad to be here.

Marisha (01:10.67)

Thanks for being here. And so I did like super quick intro, but I'm really curious. Can you tell us just a little bit more about your story? Like what led you to focus in on AAC and specific, like what was your process for like the entering into the GLP world too?

Laura Hayes, MS, CCC-SLP (01:29.608)

Yeah. So I always tell people that I started kind of doing the SLP thing when I was a kid. I was like an honorary SLP. I have a sister who has complex communication needs. She's speaking, but very low intelligibility. And I kind of just naturally fell into that role. So when I went off to university, I was kind of exploring different things. did like the complete opposite to start. I was an international marketing major and was like, this is not for me. So when I was exploring, said, oh.

Communication disorders. What's this? And then the rest is history. So I went down that path I started in the medical field of pediatrics and I started as an outpatient therapist and I just kind of felt like I start well Let me step back for a second because I remember taking an AAC class in college and I was like, my god I'm never gonna do AAC. This is not for me There's too many things like this doesn't feel like something that's natural and so I kind of pushed it aside

Fast forward to when I was an outpatient therapist and I had this just kind of curiosity and draw to working with autistic patients and their families. And turns out a lot of them had complex communication needs too. So what does that equal? It equals AAC. And so then I started learning from our AAC team and I started having more and more patients that needed AAC and speech generating devices.

And so then I kind of fell into that role on the inpatient and outpatient AAC team at the hospital. Did that for several years before transitioning into a role for a local school district here in St. Louis. And I'm now a facilitator for them where I support multiple districts and training staff and families and supporting students there with communication devices and doing a lot of trainings. Well, COVID hit.

And when COVID hit, you know, the world shut down and I just felt this draw to, well, there are so many people out there that have nothing like a facilitator to help them learn and coach. we know coaching is so important with devices and with AAC, there's a lot of knowledge gaps. And so I was like, well, why don't I just do that? Why don't let me try to educate and to provide resources for that family that's

Laura Hayes, MS, CCC-SLP (03:50.927)

maybe out there on an island and feeling like they just need something to help them. So that's how it started. And that's how I got to connect with Alex because I was kind of doing, I was doing a presentation on stimming in AAC for AAC in the cloud, which is a great free, if you want more information in general on AAC, it's a free conference that they do every year. So I did that presentation.

And one of the things I talk about in that presentation is about scripting and how it can equate to gestalt language processing. But that was kind of the tip of the iceberg. I didn't dive into it. I didn't have the strategies to talk about it and supports. But within that, I kind of went down some educational rabbit holes and digging. And that's how I found Alex. And we connected. I had her on my podcast and kind of the rest is history. We just kept being in contact and

I learned from her, she learned from me. We kind of built this relationship and that is how I became the author of the meaningful speech course for AAC and GLPs. And so we're continually learning, continually finding resources and just trying to kind of give back those supports and how it relates to Gestalt language processing. Cause it's another layer. It's another layer of how we can support them.

Marisha (05:08.844)

Yeah, it is a whole other layer. And first of all, I love your story. That's super inspiring. like your passion just like, it's like, I don't know how to say that, but your passion really shows. So, I'm so excited to continue diving into this conversation. and so hopefully this is a good place to start, but how do you know, like kind of backing up? Cause we've been talking about salt language processors.

this whole series, but how do we know if a GLP needs AAC?

Laura Hayes, MS, CCC-SLP (05:43.709)

Yeah, so let's, I know if you, let's say you haven't listened to any of the other episodes, if this is your first time, of, well, let's go, I know about, a little bit about it. know, AAC is augmentative and alternative communication. And then, let's start with gestalt language processing. We need to remember that gestalt language processing is not a diagnosis. It's more than just spoken scripts. It's how someone actually processes language.

It's a natural process of how someone can learn language, right? Like I always talk about left-handedness and right-handedness. It's natural. It's just how our brain is processing the language. It's not a treatment method, but it's really important to understand it because it impacts how we can provide implementation supports and strategies and how someone might move to flexible, autonomous language, what that journey might look like.

All of that is still true for someone with complex communication needs, right? Their barrier is that they're struggling with expressive language and expressive spoken communication. So if we think, well, there's two kind of groups that I talk about with GLP that might benefit from AAC. The first is someone with spoken language and that we know they're a gestalt language processor. We've taken language samples. We feel like, hmm, yeah, they are.

But how do we know they benefit from AAC? Well, I always say we all use forms of AAC. We all do. We all use texts and writing and emails and all of those things. So good chance if you're asking yourself the question, would my student or son or daughter or patient, would they benefit from AAC? The chances are yes in some form. But the questions you can really dive into and ask yourself, like do we need to trial robust?

AAC and maybe a speech generating device or app. We need to ask ourselves, are they not really developing spoken language despite good positive GLP strategies? Are they not intelligible all the time where we're not understanding their spoken language or scripts? Are they not easily understood by maybe even unfamiliar communication partners? We know what they mean, but then someone else who's in the community doesn't.

Laura Hayes, MS, CCC-SLP (08:04.328)

Excuse me. Are they not able to achieve self-generated language? And that's really important because that could be something consistent or that could be intermittently depending upon their regulation level or the environment. And really the crux of what I think of is are they showing signs of frustration or communication breakdowns that they're not repairing successfully? That is what I really think of when I think of someone who has spoken words but

could still benefit from AAC. I'm sorry, I'm gonna grab a drink.

Laura Hayes, MS, CCC-SLP (08:45.065)

Hold on, I think it's Okay. Nope, hold on. So sorry. So sorry, my friend. You'll edit all this out, I hope. Okay.

The other category that we might think of when we think of a GLP who could use AAC is someone who is non-speaking or minimally speaking. How do we know they're a GLP? So that's kind of like a different subset of individuals, right? So I would ask myself these questions. Well, how do I know? They may already have robust AAC and they may not, but if you're answering these questions, like they could be a GLP.

chances are they're gonna need AC and we're gonna need GOP strategies. So some of those would include, are they showing gestalt cognitive processing signs overall where they have hold apart thinking, they have episodic memory where they're thinking about an event as a whole, if something breaks from a whole event, they get really upset or dysregulated. Those are kind of cognitive processing signs that show that they are a hold apart thinker. They also could show that

within their gestures. So there's something called eco-praxia where they could actually act out scripts with whole body movements. Lots of, I shouldn't say lots, but some of my kids actually will do that with scenes from their favorite shows. They may be highly musical where they're drawn to songs and melodies and maybe even replaying some of the media that they have access to. That can be a really good indicator. They could be a GLP or jargon.

jargon that's not understood, but rich in intonation. This is one that I'm constantly telling SLPs and teachers that I support. I'm like, did you hear that? Like it's really rich in intonation. It kind of sounded like happy birthday, or it kind of sounded like door of the Explorer. Are you hearing that too? These are things to me that just go, Ooh, maybe, maybe they're a GLP. And last but not least is if I have been giving them positive AAC supports, and I know that they've had those supports for a while.

Laura Hayes, MS, CCC-SLP (10:55.079)

and they're just stuck, they're stuck in single words and they're having a really hard time with two word combinations or they're stuck and those words are not generalized across an activity. So for example, they're saying goldfish every time snack is presented to them, even though they don't really want the goldfish, they actually want something different. That tells me that they might be a GLP because we know in language,

once we have about 50 words, 50 to 100 words, we should start combining those words. And if I see a lot of single words and they're not combining them, it tells me, hmm, what something, something that's not connecting for them. Maybe they are not a bottom-up processor. Maybe they are a GLP or maybe we just need to explore it.

Marisha (11:43.982)

Yeah, that makes a lot of sense. You did such a great job breaking that down. That was amazing. And so you broke down kind of why we might want robust AAC for our kiddos who are.

Like you gave us a bunch of reasons for the kiddos who are producing that communication as well as what to see for our non-speaking GLPs. And then you kind of touched on this already, but what are some common issues with kind of like the mainstream AAC or like how would a GLP approach look different?

Laura Hayes, MS, CCC-SLP (12:28.914)

So mainstream AAC is kind of, it's a really loaded question too, kind of like the first question, right? Because when we think about our AAC systems, there's a lot of components on the backend that I don't think people realize. Even SLPs, they're like, I never realized that this was set up this way because, and so that can take learning on its own. So then you have this added layer of, well, now they process language differently. So I'm not really fully understanding.

how this AAC device was chosen or why the symbols look the way they do, why it's organized this way. We could talk just about Lampwords for Life and that probably in its own podcast because it's so complex and unique to the AAC system itself. So the first thing you need to know is that all AAC apps are designed differently. They have different pragmatic organizations or different types of organizations. So some are organized syntactically, some are organized

with motor planning in mind and how someone might learn or acquire language can be different. And so we feature match to figure out, well, what components of a system would really benefit this individual? And so they all look different. And so we might teach them differently. But we also need to know that for Gestalt language processors,

who might be in early stages, let's say stage one or stage two, where their scripts are highly individualized, highly, not customized, but highly experiential. So again, thinking about how they might have had an emotional tie to an event that's very specific and individualized for that person who's learning language and attaching meaning to something. That is not necessarily or not likely

that individualization is not going to be found in any of our AAC systems that come standard out of a box. And we don't know what that individual is tying meaning to because they are not able to autonomously tell us that yet. so oftentimes we'll see them trying to creatively communicate with us. So it's really our job, especially for early Gestalt language processors, to

Laura Hayes, MS, CCC-SLP (14:50.717)

try to help both build connection and also figure out how they are creatively communicating with us. And I think that is at the crux of like why it's so complex and hard for us to wrap our minds around because it's just not, it's not out of the box, right? When we have someone with spoken scripts, we're like, okay, I know exactly what to acknowledge. I can build off of this. can really figure out what their interests are and follow that lead.

It's not as simple and straightforward when it comes to AAC. They also have the added component of learning a new language. Some AAC users are processing spoken language and are just kind of deciphering where those words are on a device. Like that's kind of the individual where you pull it out of the box and you're like, wow, they just took off because they're seeing where the words are. They might take an entire page of a device and hit all the buttons on there and they're learning that and they're learning that to memory.

and then figuring out, okay, this is where this word is, I heard this word. And then other individuals who are learning AAC devices are not processing that language as easily. And so it takes time to learn that new AAC language. They are not simultaneously processing it with the spoken word. And so we have to teach that. So we have to teach the new language system while also acknowledging how we think they're processing and showing us communication.

It's a lot of things that we have to figure out simultaneously to see, and we're figuring out which features they need in a device. So a lot of components. The last thing I'll say is just that prosody and intonation are super duper important when we're thinking about early GLPs. We talk about them learning and experiencing the soundtracks of their lives. They're tuning into the prosody and intonation. They're the intonation babies.

They're not focused on the words in those early stages yet. So if they're focused on the sound train and they're focused on that original audio source, our AAC systems out of the box are not set up with that in mind. They're not yet really that great. Even if you listen to the voices on AAC devices, they're getting better. They're definitely better than they were 20 years ago. But they're still not.

Laura Hayes, MS, CCC-SLP (17:11.386)

as nuanced as someone who is an early stage GLP might need. And so that might also require customizations too.

Marisha (17:22.178)

That was such a great overview of some things to consider. And again, you did such a beautiful job explaining that. So thank you. Gosh, and I feel like this, because how many hours is your AAC course?

Laura Hayes, MS, CCC-SLP (17:36.969)

So currently, it's over 11 with all of the bonus modules, and we're adding a new one soon. So depending upon when this is released, there's another new bonus module coming. So that's one of the nice things about it is that we're constantly adding. So as we grow and as we learn and as new updates come out, we're staying on top of that so that anyone who is in the course has access to all of those updates.

Marisha (18:03.15)

Yeah. And Alex was saying that it's lifetime access, so you can revisit at any time, which is amazing. But I'm just, cause we try to keep these episodes pretty short and sweet. And I feel like I have 5 million different questions, but it's like, we're not going to cover everything. We can go to the course if we want to learn more. And that is a phenomenal resource. Um, and then yeah, for people who aren't ready for the course, like just following Laura on Instagram, I think is a great.

step two, just to like get your feet wet and start wrapping your head around this. But okay, so there is so much that we could cover, but maybe we can wrap up this episode just by chatting about just some suggestions to help SLPs kind of get started and to like start wrapping their heads around this. Do you maybe have like...

one or two tips or suggestions or things to think about, because I feel like you did a really great job of setting the stage for us. I'm just curious, what would you like to leave SLPs with?

Laura Hayes, MS, CCC-SLP (19:12.167)

Yeah.

Marisha (19:12.204)

like other than go take the course and learn all of the things. There's so much into this.

Laura Hayes, MS, CCC-SLP (19:14.984)

You know, it's so funny. There's so much and that when we were creating the course, I said, I feel like we need different people to contribute to this. So like, just know that if you take that course, you're not just going to be listening to me, you're going to be listening to a variety of AAC experts who have many, many years in the field. I've been honored to be alongside them to help write some of those bonus modules and

I just, can't say enough how important those bonus modules are because we really dive into, well, if you have Proloquo2Go, how does that look? Because that looks very different than what we might do in support and even just what's templated in the devices already that we might explore when we're getting started. Then let's say a Lambo for life or a TD snap. And I know, you know, even parents, it's overwhelming. And like, how do we incorporate it into our daily?

routines, like all that, we really try to dive into that and give people some actionable steps in the course. So if I was coaching someone and I was like, okay, like we're in this together, you're my SLP in the line of fire, we're ready to go, what do you need in your toolbox? So a couple things, I try to make it digestible, right? So like if I was starting and I needed something in my AAC toolbox,

to with a GLP, the first thing I would do is make sure they have access to robust AAC. It sounds very simple. It can be a long process or a quick process depending upon funding, but we have to have access to robust AAC. We just have to. Having just like a simple core board or a flip book or even a phrase based overlay is just not gonna be enough. Like we really need to have access to robust AAC.

We also need to model rich intonation child led within child led activities that we can, especially if we think they're in early stages around those meaningful experiences. They could be a combination. Oftentimes what I'm doing is I'm modeling a combination of words that exist on that homepage of the device or near the homepage, something like, I got it or I like it. This is so fun. Something like that.

Laura Hayes, MS, CCC-SLP (21:38.811)

It's awesome while also considering what are some more customizable things that have high meaning, high intonation and programming those again, depending upon the device organization, programming them somewhere where I can easily model them in a variety of routines and child led experiences. And then last, we can't take for granted just acknowledging the communication. I mentioned earlier that

AC users are still communicating. They're just creating, communicating creatively. So if I see them using media and rewinding it, if I see them using gestures, if I see them using eye gaze out of their periphery, I'm going to honor that. And I'm going to provide symbolic language to accompany that so that they, they feel acknowledged. They know that we are communicating and that we can then support them through.

symbolic communication on a device. So if you have the potential to take a language sample, great. If not, you can take something called an unaided communication sample, which I walk you through in the course, which looks at how they are communicating, how they're using their body, how they're using their eye gaze, how they're using their gestures and facial expressions, and maybe even just what we call proxemics, body awareness within their environment, how they're using that to communicate. And I think

there's little nuance things that we can look at that show us that they are responding to a device, whether it be eye contact, direct or indirect, returning to the device, returning to something that you're talking about on the device. All those can show us that they're connecting, even if it's not in the way we might expect in like a traditional analytic language session. So I think that, and then just, you know, again, don't try to...

Figure everything out all at once. Know that it'll be overwhelming and AAC is a marathon. So start slow, have your family start slow, try to be consistent, pick a few things to start off with, and then see how they respond. And that's just part of dynamic assessment. That's something that we all learn about as therapists, and it's something that, you know, it helps us to take those meaningful steps to where we need to go.

Marisha (24:00.374)

gosh, that's so helpful. So just a quick recap, some action items based on what we talked about. So we want to make sure that kiddos have access to robust AAC. We want to model rich intonation in child led activities, incorporating that AAC, and then always acknowledge communication. And I feel like those are things that are super doable. Like we can do this. We got this.

Laura Hayes, MS, CCC-SLP (24:26.024)

Yep.

Marisha (24:26.766)

And then we want to look for signs that students are responding to the device, even if it's not the way that we'd expect. And you gave some really nice examples of what that looks like. And I love how you said AAC is a marathon, not a sprint. And so just take it slow and one step at a time. wow, that was like, feel, I was like, there's no way we're gonna leave feeling like.

I don't know, but you just did such a great job of giving us some strategies. I was like, okay, we can, there's a lot to learn and there's a lot of complexity here, but there's some simple things that we can do right off the bat. And then hopefully if we have, especially if we have a lot of these kiddos on our caseload, I think it is really important to take some time to learn more and to build our strategies. And, you've shared some really great resources.

Laura Hayes, MS, CCC-SLP (25:25.224)

Let me add one little final takeaway, one final takeaway just because I'm an SLP. I can't help myself. I want to say, like I kind of alluded to it. It's almost more important. I know we're all about taking quantitative data, right? And we're all about percentages and like I got to have my data. Also consider qualitative data. It can be so important to think about.

Marisha (25:25.454)

Yeah, okay, go ahead. Let's do it.

Laura Hayes, MS, CCC-SLP (25:49.287)

I always tell my teams, it can be more important about what happens before or after someone activates something on a device than what they actually said on the device. Like, what did they do before they told you Goldfish? Or what did they do before they said goodbye? And what did they do after they said goodbye? Did they look at you and smile? Did they look at you out of the corner of their eye? Did they walk up and leave the room? Like, these are things that you're not gonna take a percentage point on necessarily.

But I'm going to document it because it shows intent. It shows progress. It shows that they're engaged. It shows meaningful connections, even if it's not a quantitative, like, I got 20 % out of the opportunities that I was given. So.

Marisha (26:34.914)

Yeah. And that can help be huge in like navigating treatment and figuring out strategies and just like that data could be way more impactful than having the number of they activated this many symbols. So I love that you added that. my goodness. Thank you so much, Laura. This was incredible. Like so many great resources. I feel like I could talk to you for.

hours and hours and hours on this. But hopefully this was a nice primer for SLPs listening. Again, check out the show notes for the link to Laura's Instagram and her course and all the things. But yeah, this was phenomenal. Thank you so much. Yeah, and thanks to everyone for listening and I'll see you in the next one.

Laura Hayes, MS, CCC-SLP (27:21.18)

Thanks so much for having me.