146: Understanding Autism Through a Neurodiversity-Affirming Lens

TRANSCRIPTION

Venita Litvack: Hi everyone. Welcome. I am super excited for my [00:02:00] guest today. We are going to be talking about understanding autism through a neuro diversity affirming that lens really quickly. Since this is available for Ashesi use, the what we're going to be doing today is first talking about introductions and backgrounds.

Then we'll get into a discussion of neuro diversity affirming practices. We'll talk about the different therapy approaches that you can consider. We'll talk about writing functional goals, and finally, when it's important to consider augmentative and alternative communication. So, if you're not familiar with me, my name is Benita lip back.

I have a passion for EAC, assistive technology and literacy. I presented poster presentations at Ash. I used to be an AAC consultant for device company and a school district assisted technology specialist here in Florida. Now I am a part-time tele therapist, AAC consultant, and host for speechy site up.

And my other job is [00:03:00] now being a mom to a little over a one-year-old. And I just decided at the beginning of this year to do a triathlon at the end of the year. So we'll see how that goes. It is a sprint triathlon if anybody's familiar. So it's like the easiest one that you could do, but yeah, that's what I'm doing in my free time.

And here's my guest. Carrie, will you go ahead and introducing.

Cari Ebert: Sure. Uh, first of all, I want to say, thank you for having me on my name is Carrie Ebert. I am a pediatric speech language pathologist in private practice in the Kansas city, Missouri area. I never have and never intend to run a triathlon.

So we do not have that in common. Uh, I specialize in the birth to five population. My real passion is with the birth to three population. I've been an early intervention provider for over two decades, uh, here in the state of Missouri. Uh, what else can I tell you? I am a parent of an autistic son. Uh, Aaron is 17 years old.

And so that just gives me the very unique perspective of being a speech language pathologist, but also being able to engage audiences [00:04:00] as a parent of a neurodivergent child. So my son has taught me an awful lot and he is really, uh, my inspiration for everything that I do. So that's kind of my story. Well,

Venita Litvack: thank you for sharing that.

And he's. Like the world of SLPs so much as well, because you've been sharing a lot of like personal anecdotes and just things, like you said, that you've learned from him recently, did you start off with sharing personal experiences with your son or did you start off with sharing like your early

Cari Ebert: intervention?

Yeah, I got to tell you. So, um, what year is this? 2022. I started, uh, professional speaking. That's when I started my professional speaking career in 2009. And I will tell you nobody knew I had an autistic son. Uh, I didn't talk about him. I never ever spoke on the topic of autism. I've always been in a Praxia specialist and it has just been, I would say in the past, maybe five or six years where.

You know what I'm ready to talk about Erin. So it was, [00:05:00] you have to understand that when my son was diagnosed back in 2006, that was a time when autism was considered a tragedy. And so it was, um, talked about in negative ways. The purpose of therapy was to fix autistic children and make them act more neuro-typical.

So, um, it was a very difficult time for me, but I will tell you now, uh, he is just such an inspiration, not only to, to me and my family, but to all of my followers as well. He continues to make progress in my, my philosophy. The, my mantra, if you will, has been a forward is forward. No matter the speed. And so I take that into my, into my consulting and my coaching parents, um, so that they understand that forget the milestones, you know, the checklist, the standardized tests, as long as your child is, is taking baby steps forward or moving in the right direction.

So, no, I love that you asked that question because I did not, um, start talking about him. It was, um, very cathartic for me when I did, um, because the support was [00:06:00] overwhelming.

Venita Litvack: Oh, I have goosebumps and you'll have to forgive me. I think it's still in hormones after having a baby. But I

Cari Ebert: think now being a parent and just

Venita Litvack: like, you know, you want the best for them and you get so, so many mixed messages of like, what is right.

And like what you should be doing with them. And what's normal. Like I actually saw posted. This, this, and this is not normal. And my daughter happened to do that. And this was from another speech language pathologist. And I was like, is this like the type of messaging that we're sending out is this the type of messaging that I might have sent out as a professional prior to having a child.

So I just love that you share all of these, like neuro-diversity affirming, you know, messages that just really like show that. You know, forward is for it. And like, he is perfect just the way that he is. And absolutely.

Cari Ebert: And one of the things we'll talk about today is just because, um, it doesn't mean that he B [00:07:00] when we talk about autism acceptance, it doesn't mean that, um, autistic children don't need services or supports.

I mean, that's not what we're saying, right? I mean, he is who he is and my son has a disability and my son needs extra supports. Um, but my goal in life is not to change him. It is not to try to make him act like his neuro-typical sisters, you know, which is really what I think, his speech language pathologists, at least when I went to grad school back in the 1990s, that's kind of what we were doing.

We were creating social skills programs, and trying to make autistic children not autistic anymore. Right. We were trying to cure them if you will. So I'm very excited to talk today about neuro-diversity affirming practice with you. Yeah.

Venita Litvack: So on my all right. Before we dive into it, we got to share our disclosures for our purposes really quick.

So I'll let you go first.

Cari Ebert: Yes. Um, I, as far as my financial disclosure, I am author of the learning to learn program, which is an early intervention, uh, uh, [00:08:00] coaching program, uh, for supporting, uh, families who have autistic children. And so I will be referencing that a little bit today. I am also author of a ton of different, uh, handouts, but my understanding autism handouts was my newest release and these are neuro-diversity firming, uh, parent handouts.

So I will be, uh, uh, drawing some of my information from the resources, um, and the references in those products. Uh, and I do, uh, obviously receive, um, uh, benefit financially from all products that are sold on my website. And I do benefit financially from speechy site up for, uh, agreeing to do this podcast today.

My nonfinancial disclosure, I'm a parent of an autistic child, so I do share personal experiences in all of my presentations and in. We're grateful

Venita Litvack: for that. Uh, really briefly I have ownership interest in speechie situp LLC and tassel learning, LLC. And I received royalties from a who knows what to do books series, and I'm also a member [00:09:00] of ASHA's special interest group 12.

So our hope by the end of this podcast is that you will be able to define neuro diversity affirming practices. Describe two types of therapy approaches described three types of functional goals and identify two reasons to

Cari Ebert: consider a. So let's

Venita Litvack: dive in what is considered neuro-diversity affirming practice.

Cari Ebert: Great. So I'm going to go ahead and, and talk a lot because that's what I do. And, uh, there will be a, um, I don't know, a handout, is that right? Nina, then we'll have this information on it so that you don't feel like you have to write like a crazy person, or if you're driving in your car and can't take notes.

But when we talk about neurodiversity affirming practices, or even if you just want to say neurodiversity informed, right. Because I really am becoming more and more informed. And I'm the first one to say, I am not claiming to know everything about this, right? Uh, I don't even say that I'm an expert in autism.

Specialize in working with [00:10:00] autistic children, but the true experts in autism are autistic individuals. And so what I've really learned, um, and the pandemic has given me a lot of time to listen. And so just know that when we talk about neuro-diversity affirming practices, um, the very first thing we're going to do is listen to actually autistic voices.

It's so important that we listen to, um, uh, their voices. And so autistic adults are the experts on autism. And so I have done a whole lot of listening and learning, uh, the 570 days that I was basically unemployed, uh, because when the pandemic kid, I stopped all of my traveling around the country. And so I went 500.

70 days without doing an in-person seminar and for somebody who used to travel 45 weeks a year, uh, it has been quite a change. So, uh, I've done a whole lot of listening. So the first thing we're going to do is listen to actually autistic voices and listen to the way they say that. Um, it is okay. Um, of being human, the autistic way.

That right. What we're going to do is start really [00:11:00] checking our own biases as neuro-typical individuals, we're going to check our biases. And I think one important question to ask yourself, is this, do you view autism as a tragedy? I've heard some people say, oh, autism is a superpower. Okay. So do you view autism as a tragedy?

Do you view as a superpower? Do you view autism is good? Do you view autism is bad because the way I would answer all of those is autism. The end. It is, it is a different neurotype. It is a different way of being human. It is neither a tragedy, nor is it a superpower? It is neither good nor bad autism just simply is.

So for pediatric speech, language pathologists, one of the issues I think we run into is something called norms, right? We do all our standardized tests, right. And, oh, what are the norms? He Stu two standard deviations below the norm. So this word norm, I have a real issue with and, and, and the diversity, um, you know, lens, if you will is, is not, we're not going to talk about norms anymore.

Okay. [00:12:00] I understand. We have to do standardized testing to determine eligibility for services. The end. That is the only reason we're using standardized testing. We're not writing goals from it. We're not drawing any conclusions from it. It is simply to determine eligibility. Does that make sense? So once the child has been deemed eligible for services, um, what we're going to do is recognize that despite what the standardized test says, that there is not one.

Acceptable way of being human and that's the normal way or the neuro-typical way, because what we, as neuro-typical people have assumed our entire lifetime, um, and this plays into the ableism. But what we have assumed our entire lifetime is that the neuro-typical way is the only acceptable way of being human.

And so if you don't act like neuro-typical people, then there's something wrong with you and we need to fix you, right. We need to change the way that you act. So neuro-diversity affirming practices. We're not looking to change the individual individual. We're not trying to, um, make them. Act a certain way.

Okay. So we're going to check our own [00:13:00] biases. We're going to listen to actually autistic voices. We're going to use neuro diversity affirming language. Okay. So for example, saying autistic child, uh, as opposed to child with autism, I know we were all taught in grad school to use child first, right? Child first.

And then he has autism. Well, um, the majority of autistic adults actually prefer identity first language, autistic person, autistic child. And the reason is because they say this is our neuro type, no matter how much therapy you provide, you can't ever make us not autistic. That being autistic defines our humanness.

It is the way that we perceive the world. When I describe what autism is in my own words, instead of using the DSM-V diagnostic criteria, I always explained that autism is a different way of experiencing the world. Is it it's a different way of taking in and processing sensory information, right? It is simply a different way of being human.

And I'm so thankful to Dr. Barry [00:14:00] present for writing this book, uniquely human, because that's where that phrase comes from. It's a different way of being human, right? Autism is an ability. It's not a disease. It doesn't need to be cured. So one of the ways we use a neurodiversity affirming language is we don't say things like red flags for autism symptoms of autism, because red flags indicates there's something alarmingly wrong with your poor child, right?

Oh, I think he has red flags for autism and no wonder the parent thinks it's a tragedy. So instead of using those, those frightening alarming, scary term symptoms indicates there's a disease. Well, if there's a disease, we need a cure for it. Right. We need medicine or we need some kind of treatment. Um, so I mean, I had symptoms of, of, of breast cancer.

I had a tumor, so of course I want to fix that because it could kill me. Right. But you don't have symptoms of autism. You don't have red flags of autism, you have traits or characteristics of autism, right. That just help us to understand your neurotype understand how you think, how you interact with others, how you [00:15:00] perceive the.

So our neurodiversity affirming language, um, is going to really affect how we write goals as well. We're going to be using a strengths-based approach. See what we were trained to do, because most of us were trained under what we call the medical model, the rehabilitation model of doing speech therapy, if you will.

Right? So there's a deficit, so we need to go in and fix that. And so that medical model uses tends to use negative language, negative worded language. What we're going to do is make sure that we're writing goals that are relevant and meaningful, that are based on the autistic child's strengths that are based on their interests that are based on their unique talents.

And we're going to make sure they're relevant and meaningful. So in almost all of my trainings, I introduce the acronym PI P I E. So this is going to be an important thing because the way, you know, if, um, the goals that you're writing are functional is they should focus on improving one or more aspect of PI.

And what does PI stand for participation? Independence and engagement. And as [00:16:00] long as we are focusing on increasing either the child's participation, independence and or engagement in their daily routines and activities, then we're writing functional goals. So that is a huge component. And we are going to look at their special interests.

We are not going to call them obsessions. We are going to call them special interests because that's what they are. And we're going to use those special interests, um, to design our programming, our autism program. Um, we're going to make sure that we don't work on social skills that encourage the autistic individual to mask masking is, um, camouflaging one's autistic traits.

And, uh, what adults autistic adults have explained to us, um, very clearly is that masking leads to, um, huge issues, uh, and uh, later on in life and they start to wonder what's wrong with me? Why am I not normal? That, you know, they they're constantly, um, uh, feeling like they're not good enough. So instead of teaching autistic children to [00:17:00] socialize like their neuro-typical peers, what we're going to do instead is we're going to focus on autism acceptance, and we're going to teach neurotypical people how to interact with autistic.

Do you see how that's totally different than what we were trained to do. So we're really going to make sure we're not teaching anything that has to do with masking, like forcing eye contact or forcing them to stay on topic for five minutes or, you know, whatever. We have to understand that the autistic way of being human is not going to mirror the neuro-typical way of being here.

I think another important part of neuro-diversity a form affirming practice is to focus on an individual needs. I'm sure you've heard the saying once you've met one autistic person, you've met exactly one autistic person. So we don't want to lump all autistic children or all autistic clients, or all autistic people into one category.

And then all of a sudden, have somebody create a goal bank that we can pull goals from, because if you're drawing from a goal bank, you are not, um, uh, providing [00:18:00] individualized, you know, goals and individualized services. So we are going to be very careful about that. And the last thing I will say about neuro-diversity affirming practices is we must all.

Presume competence. Okay. Regardless of what standardized testing tells us, we are going to choose to presume competence. So we're not going to say things like, oh, well, he can't use that AAC device because he's autistic or, you know, because he, um, doesn't have, um, good visual attention. You know, we're going to not talk about autistic children as if they're not in the room, we're not going to talk about their behaviors.

And, um, you know, when they're sitting right there, so we're going to make sure that we presume competence. I did a social media post just this week that had two big eyes on the front. And it was all about, um, uh, what you see is what you will find basically meaning or what you look for is what you will find.

Meaning if you look for bad behavior, what are you. You're going to see bad behavior. If you look for positive behavior, what are you going to [00:19:00] see? Oh, you're going to see the positive. Right? If you look for the child's weaknesses, you're going to find those. If you look for their strengths, you're going to find those.

So you get what you look for. So let's make sure with that, with that, we go into this with, um, a positive attitude and that we are looking for strengths, that we are looking for special interests, that we are looking to make a connection with the autistic child. I

Venita Litvack: like just listening to you're so passionate and you're so knowledgeable on this topic and you said so many good points.

I was writing furiously, but I wanted to just recap on a couple of things. I love what you said about standardized testing, because obviously that is something that is going to come up, but I love that you said that standardized testing is for determining eligibility

Cari Ebert: and that is it. I think

Venita Litvack: that is such an important distinction to make.

And then I love the pie acronym and I know we're going to get into goal writing later on. [00:20:00] So I think that that is really helpful for assessing our current goals. I wanted to ask you, and this is probably individualized, right? Like what is our long-term. Goals or vision for our neuro device, diverse clients.

Is there an easy answer for that

Cari Ebert: or no? Yeah. I mean, I, one of the answers that I almost always give is independence. Everything we are working for is independent. So what we should always do is be writing goals that with faded. Right with faded visual cues, whatever it is that we want, um, uh, the child or the student to become independent with whatever, you know, the, the goal is.

So I always say what we're striving for with our neurodivergent, um, uh, students is, is independence. I can't think something, my husband and I have said for years is we're not raising a child. We're raising an adult. I mean, and I think it's very important to recognize that that, um, we're always shooting for.

So for me, pie is the answer to all. Always want increased participation. My son has [00:21:00] always avoided, um, uh, participating in like, um, family meals. He wanted to eat alone, right? He always avoided participating in like sports with other kids who prefer to play alone. Does this make sense? So participation is how you get varied experiences and varied experiences or how you develop executive function skills.

And so, um, for me, participation is huge. Independence is the second part of I, right? Well obviously that's what we're working for. And then engagement. I mean, um, you know, there's a saying, people will say, oh, autistic people prefer to be alone. Oh no, no, no, no, no, no. We can't say that. That what we need to understand is that autistic people want to have relationships with other people, but their sensory differences often interfere with their ability to handle it.

They get so dysregulated that they often can't handle it. And so we never want to suggest that autistic people. I don't want to be around other people. What we want to do is focus on self-regulation so that they can be around other people. So the older my son gets, the more [00:22:00] regulated his nervous system gets, uh, the more engagement my son has with other people.

And I post about it frequently on social media. Some of the things that he does that just blow my mind. So that's awesome.

Venita Litvack: You said you, like, I mean, you spent a lot of time listening to autistic voices. Do you mind sharing some here in case anybody's interested in

Cari Ebert: following them? Yeah, I, I don't. I mean, the, the, the best thing to do on Instagram for example, is to follow hashtag actually autistic, because the only people who can use hashtag actually autistic are actually autistic people.

So like as a neuro-typical person, I can't make a post and then put hashtag actually autistic. The autistic adults will call you out on that. I tried it once, cause I didn't know the rules. Right. So you learn the rules. So if you just follow that hashtag on Instagram, um, uh, Uh, if you go to autistic cats.

So instead of a risk to cats, it's like autistic cats. That's who I started following. And they have that. I mean, they have so many followers now. It's insane. Um, other than that, I [00:23:00] don't know that I have any, I mean, there are so many, I couldn't even like name them all for you, but if you just follow hashtag actually autistic, you will get to, I mean, you can just pick and choose who you want to follow because there are so many amazing voices out there to listen to.

Perfect. Thanks for sharing

Venita Litvack: that. And then the last thing I wanted to ask, and maybe we'll get into this. I know that you work in early intervention. I work the whole lifespan right now, but I have kids in early intervention and, uh, Andy from miss SPG P posted a funny, real about this, but not funny in the same sense, but a lot of therapists are afraid to.

Like, if they're suspecting that it's autism, they're afraid to say something. And I think that comes from sometimes working in the schools where like some school systems don't let you do that or stepping on other people's toes. What is your perspective on that

Cari Ebert: and how do therapists. Yeah, for years, I've always said, oh my gosh, I have to save a word today.

Like, you know, you dread going to a, an early intervention home visit where you're like, I got to bring it [00:24:00] up. I got to say the, a word. And so that's how we've always thought of it. The, a word it's something taboo. You'd nobody. Cause it was a tragedy. Right? So what is most important now is that before we bring up autism that we need to be bringing.

Some of the traits of autism that the child presents with. So we can say things like, oh my gosh, I noticed that he really seems to be able to self calm by spinning and flapping or, you know, by lining up his tour, whatever it is, whatever you're noticing, or it seems like, um, he, um, when he gets excited, he squeals in that really high, you know, high pitched voice.

And so then as we start pointing those things out, we start talking about how we too have ways of self-regulating. It seems like he calls himself down by lining up his toys or, you know, whatever it is. I know when I get kind of overwhelmed, um, I chew gum or I, um, you know, clean out my closets. Like that's what I literally do.

Like organizing things for me is. Therapeutic. It's very [00:25:00] like when my life is in chaos, my closets need to be cleaned because there's something about that. So I explained, so what we start doing is I start having conversations with parents about what do you do, you know, to calm yourself so that we're all talking about sensory and we're talking about, you know, different ways of communicating.

And I know, I notice he doesn't, um, you know, make eye contact with you. But I do notice that he tries to get your attention in other ways, you know? So we'll point out that autistic joint attention, you know, but we're not going to use that word right away. We're going to start pointing out these developmental differences.

And then when we have a really good relationship with the parents, you know, we're going to say, you know, over the past few weeks I've been pointing out some of the developmental differences. I never say, eh, differences is the word I use. I don't use red flags. I don't use, I just say, I've been, I've been noticing and talking to you about and documenting some of the developmental differences.

You know, Ashley presents with, or that, that, you know, Connor, Carlos, whoever it is has. And I just want you to know that some of those, when you look at them [00:26:00] all together, they are, um, consistent with a child, um, on the autism spectrum. I mean, I'm not saying he is, but I just want you to know that that's kind of where I'm leading.

And I know autism is usually talked about in a negative way, but it's so important to really understand that autism is just a label that helps us to recognize that the child learns differently than other kids, that the child is going to develop language differently from other kids, that the child is going to process sensory information from their world in different ways.

So the label doesn't need to be scary. It's just something that is. And if, if, if it's something you want to talk more about, I'm here for you. You know, it's something along those lines where it's just more after several visits though. I mean, I'm very. I guess explicit in my coaching of parents, of the differences, the developmental differences that I'm seeing in the child, right.

It's not just out of the blue one day, you know, I wonder if you want to take him for a developmental evaluation because he might, [00:27:00] you know, be, be on the autism spectrum. And I mean that, you know, so make sure you'll work up to it. Don't just throw it out there. But, and I think it's a good thing to ask.

Have you ever heard of autism? Do you know anyone who has an autistic child? You know what I mean? Like, let's start the conversation and you're going to have parents who shut you. Okay. And that's why you have to have that relationship first. Right? So that you don't just throw this on them and then they're mad at you and then they start canceling their visits and they want nothing to do with you anymore.

So it is, um, a real art. Um, my pediatrician also has an autistic son. So when my son was two, when I was going to, um, uh, my pediatrician and he gave him a provisional diagnosis. Okay. Um, uh, of autism at age two. And so, uh, a couple of years later after my son got his from diagnosis, from a developmental clinic, I went back to my pediatrician and I asked him, I said, as an early intervention provider, do you think I should talk to parents about autism when I think that's what it is, because remember this is back when autism was [00:28:00] considered a tragedy.

So I asked him, should I? And he looked at me and he said, Karen, It is your professional obligation to tell parents what you think is going on, why their child is not developing, you know, as expected. He said, it doesn't matter if it upsets them. He said, do you think when a doctor tells a patient, they have cancer that they're like having the best, you know, that that's their favorite thing to do, you know, or when they have, you know, need a blood transfusion, he's like, whatever it is, your job is to tell the parents what you think is going on.

He said, and, and don't, don't present it as something tragic, right? Just tell him, this is what I'm seeing. And I'm here, you know, to help, um, navigate this we're on this journey together. So it was really helpful for me back then, when autism was considered a tragedy for him to say, yeah, you should say something, it's your professional duty, it's your professional obligation.

Um, and so that has always stuck with me. Yeah. Well, so many

Venita Litvack: of the things that you just said are going to stick with me and I'm sure that the people that are listening, thank you for that. And I think it's so important for SLPs to [00:29:00] hear this because we're often one of the first professionals that work with them.

Right. And it has been interesting for me to navigate, but you gave me some really good ideas because it's still happening where parents are getting like notified out of the blue that the child is getting an evaluation and. You know, I, I'm kind of in this process where I'm trying to develop rapport, but I also, on the other hand, don't really know how to introduce it in the best way, but what you just said is so helpful.

So thank you for that.

Cari Ebert: I appreciate it. And, and one thing, write this acronym down. Um, the Tassie T a S I, the Tassie is the toddler auto. Symptom inventory. I hate that they use the word symptom, but it is brand new. It just came out. It's from the M chat people, you know, the modified checklist of autism and toddlers, but the Tassie is a newer, much more thorough.

It is just a screening tool. I've used it several times. Um, it is free online. Make sure when you download the PDFs, download all three [00:30:00] sections because you need the questions for the parents. You need the scoring guide and you need the manual of how to interpret it. So you do need all three. So make sure you, you, you do download all three PDFs, but the Tassie is phenomenal.

And what I love is at the end, when you're done scoring it and don't score it in front of the parents. I mean, it takes time. You really need to spend thoughtful time scoring it, but I'm a score of greater. Seven indicates an increased likelihood of autism. Uh, and I think it's seven, but I don't have it right in front of me and a score of less than that indicates a decreased likelihood.

So I really liked the wording there. We're not saying they are or are not autistic, but it is just so much more thorough than the, um, M chat. So I highly recommend that you have that handy and I wish the pediatricians would start using that instead of the M chat at the 18 month visit. Um, you know, when they, when they're supposed to be doing that.

So very helpful screening tool.

Venita Litvack: Thank you. That's awesome. We'll try to include that in the resources section. I'm going to

Cari Ebert: write that down so we don't forget.

Venita Litvack: Awesome. Is there anything else that you wanted to touch on before we move [00:31:00] on? Let's move on.

Cari Ebert: Let's do it. So let's talk

Venita Litvack: about the different therapy approaches that are recommended when working with neuro diverse clients.

Cari Ebert: Okay. And the first thing I want to do is clarify that it's, it would be neurodivergent clients. So this is part of learning the language neuro-diversity is, and I have this great handout in my understanding, uh, autism handouts, because this was so hard for me. So we have the terms neuro-diversity and this is just a big, broad understanding that there are expected variations in the human genome that the unit, the, the world human beings are new neuro-diverse.

Okay. So neurodivergent is referring to a specific, so a person is neurodivergent a person isn't neuro-diverse okay. Society is neurodiverse. Okay. Our world is neurotic. Um, but neurodivergent refers to a person who has some type of variation to their neurology. So a neurodivergent person might have a diagnosis of autism, ADHD, dyslexia, uh [00:32:00] Praxia down syndrome, fragile X, right.

Those are people who are neuro divergent. Okay. So the neuro-diversity movement, which is what I've been learning an awful lot about, and really trying to, um, you know, uh, align my practices and my, uh, professional development courses with this neuro-diversity movement has helped me to understand that the language does matter.

So we are neuro-typical if you don't have a diagnosis, uh, then you're not neurodivergent you're, neuro-typical the other word that I'll throw out there. It's allistic a L L I S T I C alistic just means not autistic. So a person could be neurodivergent. And allistic. So if you're neurodivergent and holistic, it means maybe you have ADHD, but you're not autistic.

Does that make, I mean, I it's a lot of language. I'll try to include that in the, in the, in the notes, but, so, yeah. So when we're working with a neurodivergent okay. Client, um, whether it's a child, uh, whatever, you know, neurodivergent student neurodivergent, uh, child, I really [00:33:00] focus on, you have two choices.

What are our two therapy approaches? Okay. The traditional therapy approach is what we'd call a behaviorist approach, right? We're gonna, we're gonna focus on compliance. We are gonna focus on establishing, uh, behaviors that we feel are socially acceptable. And I am actually consulting with the school district right now, um, because they have an autistic student who has significant challenging behaviors.

I mean, we're talking about. You know, scratching, hitting fecal smearing. I mean it's and he's in sixth grade, right? So these are really significant behaviors to be happening in a middle school. But, um, when I went and did my observation, the thing that I realized is they're using a behaviorist approach. So everything that they are doing is compliance-based, they don't care what he does, but they have, he has to do what they say when they say it, they use candy as reinforcers, right?

So all they're doing is dangling. The carrot is Alfie cone says dangled the carrot to try to get them the child to comply. So, um, when you use [00:34:00] a behaviorist approach, these are, these are going to be terms that are going to be in your documentation and your philosophy is going to be based on compliance.

There's going to be a lot of first, then first do your work. Then you can have your special interest. Oh, you love unicorns. Guess what? I'm going to withhold every unicorn that you love, I'm going to snatch them away from you. And I'm going to make you work for them. You're going to earn, um, you know, those unicorns or.

You know, whatever it is, whatever the kid, his special or her special interest is, I'm gonna make you work for it. Um, uh, another thing that we'll talk a lot about in a behaviorist approach is reinforced. It's going to be rewards driven and they're tangible reinforcers, usually like you, right. You're actually working for something.

It may not be your special interest, but I'm going to give you an M and M when you're done. Right. Or I'm gonna give you a five minutes on the iPad after you've finished this irrelevant activity that we're going to engage. Um, there is a focus on fixing or changing the client's behavior to mirror the behaviors of neuro-typical [00:35:00] students.

Right? So I'm trying to just make you act in a more socially acceptable way. I want you to act like that I'm a listic child over there. So those are kind of the components of a behaviorist approach. If you can't tell I'm not a fan. Okay. Um, my son has never had any ABA type therapy at all. My son has had very little therapy altogether, and I know this is going to sound strange coming from a pediatric speech language pathologist.

Um, and I did a post on this probably a year ago and the feedback I got was crazy, but my son has had very little therapy in his life. I'm actually not a huge fan of therapy. And I know that sounds crazy, but what I am a huge fan of is parent coaching. I'm a very huge fan of teaching meaningful skills in meaningful ways.

With the meaningful people in the child's life. And that's why early intervention works for me. I, I, um, if I were in the schools, which I've never worked in the schools, but I would be all about coaching the teacher and the paraprofessional and making sure that they are [00:36:00] following through. Um, my big issue is we can therapy.

Kids. And we're pretty notorious for doing that, where they PR they act and perform a certain way in our therapy room, right. Or in our session, but then it's not generalized or carried over into their, their ADL's their activities of daily living. We don't see it anywhere else. So, um, I'm just not a huge proponent.

My son has had, um, very little, um, uh, therapy outside of school and whatever the school provides, I'm grateful for it. It's fine. But I'm not one of those parents who's going to argue over the IEP. I mean, whatever you do is great, but I actually prefer my son stay in the classroom as much as possible. I prefer that he, um, you know, really, um, learn in that environment.

And we do a ton here at home to try to build, um, his, uh, executive function skills. Uh, and I can talk about that all day long, but so that's the behaviorist approach. Okay. Um, they approach that I. Coach everybody on. I include it in all of my trainings and I'm going to go spend a week with this school district in the classroom.

I'm going to be in the [00:37:00] classroom for four days, uh, modeling this and coaching the teacher and the paraprofessionals on this. This is a relationship-based learning approach. So when we focus on the relationship-based approach, what we are going to practice is acceptance. And this is where you've got to check your biases, right?

Because if you think that, um, autism is a tragedy, that autism is bad, um, you know, you're going to have a really tough time trying to build a relationship with this child, no matter what the behavior issues are, no matter how severe they are. Um, you have to make sure that you are. That you are co-regulating.

And to me, this is huge because again, if you look for bad behavior, that's what you're going to see. And that's all you're going to see. So you'll have to be able to start fresh the next day and come in and be excited to see the child, right? You have to be excited to work with the child. Yes. This child presents with some challenges, but we really have to focus on accepting the child for who they are and [00:38:00] recognize that those behaviors, those are communicative, right?

Those that, that, that, that child is trying to tell you something. And so, um, we need to make sure that we are focusing on respectful interactions. And one of the things that I coach people on when I'm, whether I'm in a classroom or in a professional development course, is I like this idea of symmetrical interactions.

Okay. Where there's mutual respect. This is what we tend to see. Especially in children with challenging behavior is there's asymmetrical interaction. So you've got this adult up here, hovering, letting the child know I'm in charge. I'm the teacher, I'm the therapist, I'm the parent. And I am in a top-down fashion.

I'm going to tell you what to do. And I'm going to withhold everything that you love until you do what I tell you to do well when you create this asymmetrical interaction, um, I can tell you right now, the kid doesn't respect you. The kid probably doesn't even like you. So now you're going to ask him to do hard things and you think he's going to do hard things when you don't even like him, when you [00:39:00] don't even respect him.

When you taunt him, when you put your hands on him. I don't know that it comes up specifically here, but, uh, one of the things, um, to make sure, and maybe when we get to goals, we can kind of touch on it if we have time. But, um, we should not be doing any type of hand over hand assistance. I mean, that is a violation of body autonomy.

And so the more you put your hands on the child to get completely. Um, don't you dare be surprised when that child hits you, slaps you spits in your face or puts his hand down his pants and whites poop on the wall. Okay. Because I guarantee you, if I came up to you and said, Hey, Benita, can you go do the dishes for me?

He'd be like, oh no, I don't want to do the dishes right now. Like, I don't have time. And I'm like, need it, go do the dishes. And you're like, um, I'm not going to do it. So I say it again. Did I want you to go do the dishes? And let's say you just flat out, ignore me. We're adults. Right? We're okay. And you just flat out.

Ignore me. What if I walked over to you, put your laptop down or your iPad or your phone or whatever it is you're doing made you stand up, grabbed your arms, made you stand up, drag you to the sink and then hand over hand, put your [00:40:00] hand in the sink, wash the dishes put would you and I be getting along very well.

We do have a really great relationship or would we be. Wait a minute. I mean, does that seem pretty asymmetrical to you? So just because these human beings are children does not give us the right to disrespect them and to put our hands on them. So, um, when we start using a neurodiversity affirming approach, we come in as equals, right.

I just wanna, I w my favorite saying, and I say it all the time on social media focus on connection over instant. Forget trying to teach him something. Okay. First establish that connection. So how are we going to do that? We're going to be calm. We're going to be interesting. We're going to be interested even in their special interests.

If you followed me at all on social media, you know, my son, his special interest is wild animals. And so what have I done? I've turned that into an interactive activity for he and I, where he tells me all the different things about a specific wild animal. And then I create a post on canvas and then he, and I share it together.

We talk about it. And I mean, people have [00:41:00] learned more about wild animals from errands posts, but what could I say as his parent buddy, you need to stop obsessing over wild animals. You've been obsessed with them for like 10 years. Can you find a new hobby? I mean, sure. I could do that, but why would I?

Right. So what I'm going to do is honor and respect that he has a special interest and that it's likely going to determine his profession someday, right? Because we all are going to gravitate towards things that are of interest. The other thing, the other component of a relationship based approach is we are going to respect and acknowledge the child's sensory preferences, because I'm telling you right now, sensory trumps everything.

And if the child is not regulated is not in a ready state for learning, you can kiss your lesson, playing goodbye. I mean, I don't give a crap what your goals are or what your intentions are for teaching or for doing therapy that day. But if the child isn't in a ready state for learning, if the child isn't regulated, you're wasting your time.

So we're going to use co-regulation to make sure that the child and I [00:42:00] feed off of each other in a positive way, we're going to respect their sensory needs and preferences. And we're going to focus on connection over instruction and really build that relationship first. I love

Venita Litvack: that. And I love the examples that you gave too, of like going to wash the dishes and using hand over hand because.

It doesn't always end up that way with hand over hand. Right. But sometimes it can, and it can get aggressive. And when you put it in that perspective, you can absolutely see why that type of interaction can end up that way. So I appreciate you sharing that. I love what you said about,

Cari Ebert: um,

Venita Litvack: sensory trumping, everything and just all of the amazing points you made about the realist relationship based therapy approach and accepting the child

Cari Ebert: for who they are.

So thank you for that. You bet. Awesome. So let's talk about

Venita Litvack: goal writing that are neurodiversity affirming. I'm like, [00:43:00] I'm so grateful that you and thank you for. Your grace in explaining this terminology to me and just, when you know better, you do better. So you'll have to let me know if

Cari Ebert: there's any other terms.

And I don't like calling people out, but people called me out on social media when I was using it wrong. I was like, oh, I have a neurodiverse son. And they're like, no, you actually don't. You have a neurodivergent sun. I'm like, oh, I do. So for me, this has been a huge learning curve. And so, um, that's why I'm like in my handouts, I'm like, I just want people to like, Have the other difference, you know, not everybody was unemployed for 570 days.

Not everybody was able to just sit on social media and learn and listen and, you know, get yelled at and then refine your practice. And so, like, I feel like I've done some of the hard work, you know, for SLPs and for, you know, other, other, um, providers as well. But, um, I feel like, um, there's a few of us, like you mentioned, Mrs.

BGP and meaningful speech and Jesse Ginsburg, you know, there are, there are at least a, you [00:44:00] know, a handful of us in the SLP world who are like, we're trying really hard, you know, to focus on neurodiversity affirming practices. And the thing is, is I don't have a full caseload of kids, like most SLPs do. So I have the time.

And so, you know, that's, that's part of what, what I'm doing is trying to support. Um, you know, other SLPs and ultimately support autistic client or autistic clients along the way. Yeah. That's the most

Venita Litvack: important piece. That's absolutely awesome. All right. So let's talk about goal

Cari Ebert: writing. I'm excited to hear about.

Yeah. And I know everybody, you know, goal writing is, um, one of those things where it's like, oh, just tell me the goals to write. Well, that's not what this is. Like. I mean, they can't be individualized, you know? So I always encourage you to go back to PI, okay. What is the, the focus? So let's say as SLPs were like, oh, well he needs a way to communicate right.

Where, you know, he doesn't communicate very effectively. Okay. So communicate when this is something I'm always asking the families. You know, when I went in early intervention, they'll say, well, I just want them to talk. And I [00:45:00] say, well, communication, Trump's talking, we're not going to talk about talking.

Okay, we're going to talk about communicating and we're going to talk about all the different ways there are to communicate. How does your child currently. Well, they don't talk. No, I know they don't talk. I want to know how they communicate. Right. So we have to have that huge discussion and really open parents' eyes.

And sometimes, you know, educators, eyes, that communication is happening. It just may not be talking. Right. Which is remember at the beginning, when we first started talking and you said, um, SLPs are often the first ones, like on the case, you know, the first ones to notice? Well, the reason is because the kid doesn't talk usually.

So who gets called? Oh, the SLP. And what do parents say? The only thing I care about is I want them to. Talk, well, sorry. That's not how this works. Okay. So we have to let them know that there are foundation skills, if you will, that we are going to be focusing on and that talking is one way of expressing yourself, but that we're going to focus on all the different ways we're going to give this child [00:46:00] unrestricted access to, um, a multitude of ways to communicate.

So, um, oh, you know, we want our goals to really be strengths-based. So they're not going to be focused on trying to make the child act neuro-typical we're not going to write goals that, um, mirror the behavior or the actions of a neuro-typical child. So we're going to think about what are, and it was so funny when I was doing this.

When I spent a few days in this classroom with this sixth grader who has some significant challenging behaviors, I asked the staff, what are his. So we were sitting around, I observed for a whole day saw behavior. Like, I mean, it, you know, it was intense. So when we sat down for a meeting afterwards, after all the kids had gone home, I said, what are his strengths?

And, you know, they couldn't come up with one thing. I had identified four strengths. So when I identified the strengths, um, some of the staff were rolling their eyes, you know, I mean, because they were like, they just can't see the strengths. Okay. So, I mean, one of this kid's strengths was that he actually.[00:47:00]

Wants to be around people. He's so social, but he's always got his hands on people and he's tough, you know what I mean? But he clearly has an interest in being around people. Um, so anyways, I identified four strengths and they couldn't identify one. So you first, before you ever write your goals, you're going to identify the student's strengths.

And you're going to build off of those. You're not going to do what we were trained in grad school, which is look at what they can't do on a standardized test. Now you're deficit driven, right? If you're looking at what they can't do, you're using a deficit driven model. So then you're going to try to teach them to do those things.

So instead, what we're going to do is focus always on strengths first. Um, I always encourage, when you write goals to think about the child's perspective or the client's perspective, how would they, how would you feel if you were in their shoes? So literally like the example I gave about hand-over-hand assistance, right.

Or whatever it is you need to think about. What if, um, you know, um, you, uh, wrote a goal. Um, has to do with not [00:48:00] talking about wild animals like that was, you know, I mean, my sons, his thing was angry birds when he was in elementary school and he loved angry birds and he wanted to tell you all about angry birds.

And when I sat in one of my son's IEP meetings, um, the OT said, we're just trying to get them to stop talking about angry birds. He, you know, he's obsessing over it. And so that's our goal is to get him to talk about things other than angry birds. So to see how that's a deficit driven, that's gone, we're kind of trying to change him.

And I said, well, but if you use angry birds and build a connection with him, um, I, one of the goals that he wasn't able to meet forever was, um, look at a picture card and recreate a block. Stack blocks, according to a 2d picture. Like, I don't even know. That's like angry birds, like I know. So I was like, you guys, I know you say he can't do this.

He can do it at home. Cause he has all these angry birds cards. And then he has all these bricks, you know, from the angry bird and he can absolutely replicate it. And the OT was like, well, he doesn't do it here. So we have to keep working on it. And I'm like, if you [00:49:00] just tell him, if you just let me send in two angry birds and two pigs, you know, those little plastic ones and just tell him we're building angry bird towers, he'll meet the goal it right, right upfront.

And oh, they him and they hot. Cause they're like, but we're trying to get them to stop talking about it. So I finally convinced him and guess who met his goal? I mean the very first one, they did it. So this is why, and don't ever forget. And this is something I get on a soap box about this parents are the expert on their child and I understand that children act differently at school than they do at home.

But when a parent says. This is going to work. You know what I mean? We at least have to listen. We can't write them off as oh, those crazy parents. I will always be the expert on my son. There is no way any teacher, any therapist will ever know more about my son than I will. So I appreciate it when professionals listen to me as the parent.

So strengths-based, you're going to consider the client's perspective. Um, functional goals, um, is what we should be writing. So in order for them to be functional, what that means is they should be relevant and meaningful and they should have nothing to do with that standardized [00:50:00] test that you just gave.

So I, um, you know, like one of the errands, very first IEP goals when he was three, he went to early childhood and we're sitting at his first IEP meeting. And one of the goals the SLP wrote was Aaron will identify pronouns and pictures with 80% ex. My son didn't even talk at age three. Like he had no real good way of communicating with others and I'm like, and you're going to work on identifying pronouns and pictures.

Okay. And I know exactly where that came from the PLS because there used to be in the PLS for a picture of stairs. And on one set of stairs, there was a roller skate on another set of stairs. There was a girl and on another set of stairs, there were like three or four kids. And the examiner says, show me, she is on the state.

I know exactly where they got this bull. So when I see that on an IEP, I'm like, ah, right, that is not a functional goal. That is not something, a skill that he needs to be able to participate in his daily, in his daily routine. So we want to make sure that they are functional. Um, so we're not writing goals based on standardized tests and we're not [00:51:00] writing goals based on neuro-typical behavior, right?

We're not trying to get them to act like a neuro-typical student. Um, goal should always focus on increasing at least one aspect of PI participation, independence or engagement, because here's the deal. Guys, think about this as we really intentionally focus on increasing PI during the child's daily routines activities, whatever it is as PI increases, degree of disability, decreases mull on that for a minute as participation, independence, and engagement.

Degree of disability decreases. And ultimately that is our goal as therapist, is it not? I mean, it should be right. Is to decrease the degree. If you will, of disability, how much more can the child participate? How much more independent is the child and how much more is this, is the child engaging in that?

So we're talking now about social, emotional development, right? Being able to learn how to make and keep friends interact with others. Another component to [00:52:00] think about for SLPs when goal writing is we have to determine whether, especially in minimally verbal kids and our younger kids, um, is this a gestalt language processor or is this an analytic language processor?

Because the way most of us were trained to do speech language therapy when we were in grad school was to support analytic language learners. And those are the kids who. Then they make, say one word mama, and then they, you know, so at first I go mom, my, my, my, my, my ma, and then they say mama, and then they say, mama, go, and then they say, mama, go, bye bye.

And then they say, I love you, mama. Let's go bye-bye and they talk in sentences. Right? That's how an analytical language processor develops language. But so many of our autistic children are not analytic language learners. They're just stalled language processors. And so they use scripts. If you will. They use echo Lelea delayed and immediate echo Lelea.

And so, um, my son had a script. It was the only thing he said at age from, I'd say about age two to maybe close to age four. The only thing he said is, are you okay? [00:53:00] Are you okay? And everybody always said, oh, he's so sweet. He wants to know if I'm okay. But he said it like 400 times a day at the time. I didn't know what it just, all language processor was.

So now I understand that was his way of just simply I'm sure. I asked him, picked him up from daycare one day and he was probably crying and I said, are you okay? And then I probably gave him a hug and loved on him. And he's like, oh, that's how I initiated interaction with someone is I say, are you okay?

Are you okay? Are you okay? So see, he was a gestalt language learner. And as an SLP, I thought, why can't I help my own son? Because I was trying to, to help him learn language, using an analytic language processing style. So we have to make sure that we, um, uh, understand how to support just all language learners.

That's what I have on, on writing goals. So again, I know you are super excited and you're like, she's going to give us all the answers and I'm like, go writing. Isn't that simple, unfortunately. Yeah, no,

Venita Litvack: no, no. It reminds me of a real that it's like, it's not that simple. [00:54:00] I actually just spoke with Alex from meaningful speak yesterday and she shared the quote that 75 to 80% of autistic children are also gestural language processors.

So it's a really significant, um, you know, percentage. But I wanted to ask you, because this was a conversation that we kept talking about kind of interweaving yesterday, since you do early intervention, you know, she was saying that you can identify our guests out language processor. You know, early on, but we tend to, don't see, we tend to not notice it until we see that jargon means like type of script where it's unintelligible, but it sounds like jargon.

But what about even earlier than that, like, you know, around the year mark or around the 18 month mark, do you happen to see what a gestalt language processor like what those early markers might be before we get to that

Cari Ebert: jargon phase? That's where I think they may be. Cause like my son didn't babble. I mean, my son was really very quiet as a baby.

Now my [00:55:00] son also, um, has a Praxia so my son it's very difficult because in his, a Praxia is, is not something that really, um, Uh, rears its very its ugly head any more. Um, when he does try to say a really new, long, complex word, he, he struggles. Um, uh, but for the most part, we, we, we resolved uh, the majority of the, uh, Praxia issues.

Um, so with the very young ones, I think you're going to see, you know, it's so hard to know, but I think what you'll hear is their first word. Won't be a first word. It'll be a first phrase. I really still think with the very young kids, the toddlers, that's what you see. So they don't say data. They say, I love you daddy.

And you're like, whoa, that was amazing. You know, just like how my son, his first word is basically, are you okay? Are you okay? And you're like, wow. I mean, the inflection was perfect, you know, but like where's mama and Mike's son didn't say mama data. I don't even know. I mean. I'm going to say it was probably four years old before I ever heard mom, you [00:56:00] know, and it was never mama.

It was just mom, mom, you know? So, um, I don't know if I have anything great to add to what Alex probably talked about, but I just think you're not going to see. So we always are tracking first words. I think what you need to listen for in the really young kids in the toddlers is they're going to be drawn to music.

And I think what you're going to hear, my son was so drawn to music and they, they repeat back in their kind of jargony ways. It's the international pattern. So, you know, you're going to hear a lot of that. Lori Bergner was my son's favorite. I mean, that was back when you had CDs in your car and we had to listen to buzz, buzz, buzz, buzz, buzz, buzz, buzz, buzz, buzz, buzz, buzz, buzz.

I mean my daughters and my husband, and I thought we're going to lose our mind because every time we got in the car, Erin would start going buzz, buzz, buzz, buzz, buzz, buzz, buzz, buzz. And he had the perfect, but you know, and he would sing, but never the words, it was just more the kind of intonation patterns.

You're

Venita Litvack: so. And that's what Alex said. I mean, I was giving her an example of a specific client that I had in mind and just said, how much this client, like really enjoys nursery runs. Like we do the whole session in nursery [00:57:00] runs because that's what they're super enjoyed. You know, that's what she's like, that's what you have to do if that's what they're drawn to.

Um, and you suspect that they might be a guest salt language processor, then that's probably how they're going to

Cari Ebert: learn language, a lot of music and a lot of rhymes until you're going to pick books that are more sing-songy like, if you're trying to introduce books, you know, and like, that's why I love doing like Chicka Chicka, boom, boom.

That was always my son's favorite. Cause we go Chicka, Chicka, boom, boom. And you could add an action to it and really big in the inflection. And so, yeah, I think you're going to see music. You're going to hear international patterns. You're not going to hear first words. You're going to hear first phrases and it's going to people and be like, he's so smart.

He said like, you know something from a show and there'll be a whole line. And you're like, oh, this has nothing to do with intelligence. This is how he's processing language. And it's in, in a, in a chunk, if you will. So. Very interesting stuff. Isn't it? Yeah, it is. That's for sure. All right.

Venita Litvack: So when should I sell, please consider

Cari Ebert: introducing a XD.

Okay. So my main thing [00:58:00] about, um, AAC is that it should never, ever, ever be considered a last resort. Again, I I'm a seasoned SLP. So when I went to grad school in the nineties, I really feel like. I don't know that we were specifically taught that, but I will tell you, we weren't proactive with AAC. It was more of a, oh, he's been in speech for a year.

He still doesn't talk. Maybe we should try to, you know, and back then, pastor in the nineties and really didn't have cell phones. So you, you know how clunky the devices were. I mean, you know, so we are so blessed right now to live in the digital age where, I mean, gosh, you can get, you know, the Proloquo to go, you can get it on your phone, your iPad, right.

There's apps. So, um, the main thing about AAC is to recognize that AAC is not a last resort and it is not. For our non-speaking or minimally verbal children. It is so important to recognize that even children who are verbal, you don't take a COA once they become fairly verbal, because there are times where they are going to have some, either anxiety, maybe social [00:59:00] anxiety.

There might be some times where they're pretty dysregulated. Okay. And they just can not use their spoken words. So they need to have, um, what we would call unrestricted access to AAC. And that should not be taken away when they become verbal. So just recognize that there are, and this is what I've learned from listening to autistic adults is they're autistic adults who are like, oh, I talk, I mean, I, when I'm in the mood, but I also sometimes am like, I'd rather just use my device right now.

I just don't, I'm not regulated. You know, I just, I have so much stress and anxiety right now that I it's easier to use AAC. So, um, it's, it was interesting for me to think about the fact that, oh, even verbally. Can benefit from AAC. So other than it not being a last resort, the most important thing to recognize that it should be robust AAC.

So by, by picks, we are done with this. I want a cookie please. This robotic speech, this sixth grader that I went and spent time with. I'm not kidding you. He sounds exactly like a robot he's been pecked to death because the only phrase he [01:00:00] uses is I want. Do I not sound like a robot. I mean, it is so, and he'll just look right at you.

I want a cookie now plate and it's like, whoa, like it's just so, and PEX is not robust. So what do we mean by robust? Right? Robust means, um, that it should, uh, uh, incorporate literacy. Right? Right. The goals for literacy. Eventually it means it should have, um, a full keyboard access to a full keyboard. It should be always available.

Um, you want to follow on Instagram? Um, the AAC coach. So it's the period AAC period, coach. I mean, she's just phenomenal. You want to get all your information? I mean, she's just so brilliant. Um, robust AAC, uh, should have text prediction. It should have. Uh, an option to put entire phrases and sentences in. So those high-frequency like, what's your name?

That child should be able to hit one button. It says, my name is Carrie I'm 10 years old. Right. Instead of having to type every [01:01:00] single and find all the buttons, if the child has any motor planning struggles, dyspraxia Praxia lamp words for life lamp is the best because it is designed to support a motor planning.

So just make sure it's robust. Um, you can go to the AAC coach, and I know there are tons of others as well, but she can give you, um, uh, you know, some, some recommendations, um, touch chat is one Proloquo to go, uh, lamp words for life. Um, so there's, there are several that are really, really great that are, that are robust, that are fairly easy to use.

The one thing that I think is important to recognize is when we only use AAC for requesting so all, does he uses his devices? He use AAC. Oh yeah. He tells us what snacks. Or he tells us what he wants to play with at circle time. Okay. So I was actually sitting in a meeting with all these teachers and I said, so let's think about this.

The only time he uses he communicates and initiates communication is to, um, [01:02:00] tell you a need. Like I have to go to the bathroom, I'm hungry, I'm thirsty, or to make a forced choice. So it's to request and to make a forced choice. So what if I told you that was the only time you're allowed to talk? Okay. The whole day, you're only allowed to talk if you're making a request or if you're making a forced choice, do you want broccoli or.

Well, I don't want either one. Well, you have to make a forced choice, right? So you're forced to pick one, but, um, if that's the only time I allowed you to talk and gave you your voice, you probably wouldn't say much in the day what'd you, you wouldn't have very many opportunities to practice using your device when we hyper focus on using the device for requesting.

So that is why we want to make sure that we're really thinking about the multi, um, the variety of, of ways that we, um, functions of communication. That's what I'm trying to say. Look for the variety of functions of communication and blasting. I'll say about an AAC. It's never too soon. You don't ever say, oh, he's too young.

Um, research, uh, Davidson came out in 2017, said, um, [01:03:00] research. They find that, um, for children who are struggling with, uh, communication development, It was the best time to introduce AAC 12 months. Okay. So it's never too early. We don't say he's too young. And as, um, Kate from the AAC coach says, don't talk to me about prerequisites.

There are no prerequisites for AAC because what we're going to focus on early on is we are going to model use of the device without any expectation for the child to do it. So we're going to actually, if you will, just like, we become the child's voice when we're teaching them to talk, child pulls on his mom's shirt.

And I say up mama, I don't say, say up mama. I say it from the child's perspective up mama. And that's how the child learns. Well, same thing with the device. I'm going to use the device and show the child like Sam fell down and then the device has Sam fell down. And so it draws, you know, the, the child's attention to his classmate who just fell down and he's hearing the words, you know, through his device.

So lots to learn about AAC. Yeah.

Venita Litvack: Well, I mean, you gave a [01:04:00] really great. Brief summary. And then we do have Kate actually spoke with her earlier this morning, the AAC coach. Yeah. And, uh, it might come out before this, so it'll be a nice segue. They've learned a little bit about AAC and then they get to dive into yours as well.

Um, and then one thing we had, I did mention this, that we had Alex from meaningful speeds. She talks about gestalt language processing. And when you were talking about the goals for requesting and basic needs, she called it survival language. She's like, that's survival language. That's not functional things.

And I like how she said that because

Cari Ebert: it's so true. Yeah. If you're only focusing on basically bodily needs, I have to go to the bathroom. I'm hungry. I'm thirsty. I have a I'm hurt. I'm sick. Yeah. I mean, okay. There's more to express in life than how your body is doing. Right. So I like that survival. Yeah.

Yeah.

Venita Litvack: Oh my goodness. That went by super fast, but it was so amazing. Is there anything else that you wanted to share before we wrap up

Cari Ebert: today? Oh, you [01:05:00] know, no, I just, again, want to thank you for inviting me. I really love talking about this. Uh, it, it hits home for me since I have an autistic son. So thank you for the opportunity to share.

And I am excited to just continue learning. Um, as we all are right now, learning and learning, right. Yeah.

Venita Litvack: Yes. And I'm just so grateful that you agreed to do this and that you keep sharing all of your wonderful resources through your social media platform. So is this the best way for people to connect with you?

Cari Ebert: Yeah. Um, but they can also go to my website, which is just Kerry Ebert seminars.com. And that way you can learn more about me and what I do and my services. I have a ton of Attia approved self study courses on there. I have a ton of products available, so yeah, go to my website as well. But yes, Instagram is where I share.

I do daily posts related to early child development. And they're almost always either about, um, autism or Praxia play-based learning. I mean, those are pretty much the three topics that I, that I harp a lot on. So, [01:06:00] but I didn't know you

Venita Litvack: post daily, but I know you post a lot and it's super fun to watch.

That's

Cari Ebert: awesome. Yes, absolutely.

Venita Litvack: Well, thank you so much again, Carrie. And then we will include this handout and it'll have like some of the talking points that we went over today and references on our platform. So I appreciate it. And hope I get the chance to speak with you again.

Cari Ebert: Yes. Thank you so much.

Take care.