EPISODE 274

[INTRODUCTION]

[0:00:14.1] MD: Hi folks and welcome to First Bite, Fed, Fun, and Functional, a speech therapy podcast sponsored by SpeechTherapyPD.com. I am your host on this nerd venture, Michelle Dawson MS, CCC-SLP, CLC, the all-things PEDs SLP. I am a colleague in the trenches of home health and early intervention right there with you. I run my own private practice at HeartWood Speech Therapy, here in Cola Town, South Carolina and I guest lecture nationwide on best practices for early intervention for the medically complex infant and children.

First BiteÕs mission is short and sweet, to bring light, hope, knowledge, and joy to the pediatric clinician, parent, or advocate. 

[0:01:01.3] EF: By way of a nerdy conversation, so thereÕs plenty of laughter too. 

[0:01:04.8] MD: In this podcast, we cover everything from AAC to breastfeeding. 

[0:01:10.1] EF: Ethics on how to run a private practice. 

[0:01:12.1] MD: Pediatric dysphasia to conical supervision. 

[0:01:16.0] EF: And all other topics in the world of pediatric speech pathology. Our goal is to bring evidence-based practice straight to you by interviewing subject matter experts. 

[0:01:25.0] MD: To break down the communication barriers so that we can access the knowledge of their fields. 

[0:01:31.1] EF: Or as a close friend says, to build the bridge. 

[0:01:34.5] MD: By bringing other professionals and experts in our field together, we hope to spark advocacy, joy, and passion for continuing to grow and advance care for our little ones.

[0:01:45.3] EF: Every fourth episode, I join in. IÕm Erin Forward, MSP, CCC-SLP, the Yankee by way of Rochester, New York transplant who actually inspired this journey. I bring a different perspective that of a new-ish clinician when experience in early intervention, pediatric acute care, and non-profit pediatric outpatient settings. 

[0:02:05.7] MD: So, sit back, relax, and watch out for all her girls, and enjoy this geeky gig brought to you by SpeechTherapyPD.com. 

[DISCLAIMER]

[0:02:20.7] MD: Hey, this is Michelle Dawson and I need to update my disclosure statements. So, my nonfinancial disclosures, I actively volunteer with Feeding Matters, National Foundation of Swallowing Disorders, NFOSD, Dysphasia Outreach Project, DOP. I am a former treasurer with the Council Estate Association Presidency, CESAP. 

A past president of the South Carolina Speech Language and Hearing Association, SCSHA, a current board of trustees member with the Communication Disorders Foundation of Virginia, and I am a current member of ASHA, ASHA SIG 13, SCSHA, The Speech Language Hearing Association of Virginia, SHAV, a member of The National Black Speech Language Hearing Association, NBASLH, and Dysphasia Research Society, DRS.

My financial disclosures include receiving compensation for First Bite Podcast from SpeechTherapyPD.com, as well as from additional webinars, and for webinars associated with understanding dysphasia, which is also a podcast with SpeechTherapyPD.com, and I currently receive a salary from the University of South Carolina in my work as adjunct professor and Student Services Coordinator. 

And I receive royalties from the sale of my book, Chasing the Swallow: Truth, Science, and Hope for Pediatric Feeding and Swallowing Disorders, as well as compensation for the CEUs associated with it from SpeechTherapyPD.com. So those are my current disclosure statements. Thanks, guys. 

[0:04:05.9] EF: Hi, this is Erin Forward and these are my disclosure statements. I receive a salary from Cincinnati ChildrenÕs Hospital Medical Center. I receive royalties from SpeechTherapyPD for my work with First Bite Podcast and other presentations. I also receive payment for sales from the First Bite Boutique, which I have with Michelle Dawson. 

For nonfinancial disclosures, I am a member of ASHA and a member of Special Interest Group 13. I also am a volunteer for Feeding Matters. I am a contributor for the book, Chasing the Swallow, with Michelle Dawson, which I receive no financial gain. I also am a member of the South Carolina Coalition Committee with ICLDI at full-time.

The views and opinions expressed in todayÕs podcast do not reflect the organizationÕs associated with the speakers and are their views and opinions solely. 

[INTERVIEW]

[0:04:54.9] MD: Okay folks, this is truly an event. When I say I am honored and I am humbled to have our guest today, that is, well, hellÕs bells, thatÕs kind of an understatement in truth. You all, I met our guest Farwa Husain at ASHA last year. Actually, on stage, because she was nominated to be an ASHA innovator, representing the state of New Jersey. So, she was like, Ms. New Jersey and I remember her because she was radiant and we were both wearing green, different shades of green but we both wore green, which I guess itÕs a precursor to Seattle. 

So, come to see us in Seattle but you all, she is truly a leader in our field. Now, her subspecialty is actually at gestalt language processing but a little bit about Farwa because I get to toot peopleÕs horns and that makes me very, very happy. She is a bilingual speech-language pathologist, she is a private practice owner of One-on-One speech therapy. She is also the current president of Š it was Morris Speech Language and Hearing. ItÕs an association representing Morris County New Jersey. 

She was also recently nominated to be a clinician of the year for NBASLH, which is the National Black Association of Speech Language, and Hearing. She has such a positive, affirming social media presence, which, letÕs be honest, that is sometimes lost in our field and sheÕs driving the change. Also, at the end, because I donÕt want to pop her bubble, she has like this amazing product that sheÕs come out with and sheÕs looking for spite up with the discount. 

So, huzza. We will hold on to that one until the end but Farwa, thank you so much for coming on, hon.

[0:06:43.7] FH: Thank you so much for having me. IÕm so honored to be here and so humbled by your wonderful introduction.

[0:06:50.1] MD: When you go out there and you are a change maker, you donÕt necessarily want to shine your own light. So, having somebody else toot your horn, yeah, we need that every once in a while because not everybody knows the hard walk it takes to get there, so.

[0:07:04.0] FH: So, itÕs been a journey. IÕm so excited to be here though. ItÕs nice to see the change thatÕs coming on from it.

[0:07:11.4] MD: Yes, hey, First Bite, thatÕs what we do. Okay. So, everybody has a back story and thatÕs one of my favorite things. For better, for worse, we all have our, ŅThis is how we got here,Ó So, can you take us from the top and tell us how did you become an SLP and then go into this little world of GLP because thatÕs like a subspecialty kind of like PFD. So, yeah.

[0:07:38.2] FH: And this is a subspecialty thatÕs just popping up, right? So, I graduated from the University of Texas at Dallas, with an undergraduate degree in speech-language pathology. I was the only clinician of color. I was in that program and that was one of the reasons why I chose it, because I wanted to do something different and I wanted to help as many people as I can, and I didnÕt see anybody that looked like me.

And I didnÕt see anybody that accepted anyone that was different. So, my entire life has been trying to fit in and trying to be like everybody else. I donÕt have the right hair color, I donÕt have the right skin color, I donÕt have the right way of speaking, walking, talking, dressing. So, I said, ŅYou know what? IÕm going to try something different and maybe this will help me get into medical school.Ó 

So, I did my undergraduate and decided I loved it. So, I got a job as an SLPA in the school system. I was working for a Title 1 school as an SLPA and my car was constantly getting keyed. Like, I was always getting written up for what I was wearing and I was wearing like a sweater dress in the long tights and boots and be like, ŅOh no, youÕre not doing it the way the other therapists are doing it. Why are you in the gym? Why are you doing it this way?Ó So, I said Š 

[0:09:01.2] MD: What did they want you to do? Sit at a table?

[0:09:03.7] FH: Yes. We needed to be sitting at a table and a chair and I needed to be wearing a two-piece sweater set and khaki pants.

[0:09:12.0] MD: Oh my God.

[0:09:13.0] FH: So Š

[0:09:13.8] MD: ThatÕs like Stepford Wives. IÕm sorry, thatÕs freaking scary and itÕs like Stepford Wives. Okay, yeah.

[0:09:19.4] FH: Well, I said, ŅAll right.:Ó My husbandÕs Š I got engaged and I was going to move to New Jersey and my husband said, ŅWhy donÕt you just apply to graduate school, apply to Columbia?Ó And I said, ŅI will never get in, are you kidding me? Like, IÕm a little brown girl that is just barely getting by.Ó He said, ŅJust do it.Ó So, I applied and I got in but I got declined everywhere else. 

Kean University, anywhere in New Jersey, New York, Connecticut area, and I was like, ŅWell, I guess this is where itÕs meant to be. This is where IÕm supposed to go because all the other doors had been closed.Ó So then, I went to Columbia for my graduate degree. During my graduate school, itÕs hard being a clinician with different mindsets, different cultural backgrounds. 

But this was the first place I got to see other clinicians that spoke more languages than English, that came from different environments and I was like, ŅWow, this is incredible.Ó When I submitted my paperwork, one day, I had to write, I was in a school system, they wanted me to write notes on how the kids progress did, the clinician, my graduate professor at the time, the clinician threw the papers at my face and said, ŅYouÕre a disgrace to Columbia University.Ó

[0:10:33.7] MD: Are you freaking kidding me?

[0:10:35.1] FH: So, I went crying to the clinic director and I said, ŅThis is what she said, I donÕt think this is the right setting for me. SheÕs very toxic.Ó She would be like, ŅYou better not be having children, you better not be getting like Š how are you already married? Like, what are you doing?Ó And she was like, ŅYou know what? ThereÕs no other spots available, you have to stick it out.Ó I said, ŅFine. IÕm going to stick it out.Ó

So, I stuck it out in all the other programs, just being the odd one out and having to conform. So, when I got my Cs, I was working for another private practice and said, ŅCan I have a supervisory role?Ó And theyÕd be like, ŅOh, you know what? You can be in charge of the fund committee.Ó I was like, ŅWhatÕs that?Ó TheyÕre like, ŅJust set up things that are fun for every other therapist and be in a medical setting.Ó 

And IÕd be like, ŅWell, theyÕd give me all the harder clients.Ó Because theyÕd be like, ŅWe donÕt want to do this, Farwa can take care of this.Ó And IÕd be like, ŅCan I have a full-time job here?Ó ŅOh, no, we donÕt have any openings.Ó Next week, they hire a white clinician to take over the caseload. So, I was burnt out, I was tired, I was done, and I said, ŅI donÕt think this is for me.Ó I took a long break from speech therapy, I didnÕt think I was going to come back. 

I had my children and I was on the opposite side of the waiting room. My kids were getting PT, OT, speech, and I didnÕt like how they came and talked to me, and they were telling me all the things that were wrong with my kid. IÕm like, ŅBut do you know the things he could do with the cardboard box? Did you just see how he created all that?Ó TheyÕre like, ŅNo, no, thatÕs not right.Ó And I was like, ŅSomethingÕs not right.Ó 

And I was like, ŅIÕm going to go back. I was like, T, I donÕt like people talking to my kids like that, I donÕt want this for other peopleÕs kids.Ó HeÕs my husband, heÕs like, "All right, go back to work.Ó So, I went back and I started working for someone else and I was getting talked to because the parents were hearing something different from me because I was saying, ŅYour child is amazing, theyÕre wonderful, letÕs focus on their strengths.Ó

And they were like, ŅBut thatÕs not what the other clinicians are saying. TheyÕre saying, we have to work on X, Y, and Z because theyÕre lacking the skills.Ó And I was like, ŅCan we work on the things that they like, and then all the other skills will fill in? I got the research articles for it.Ó TheyÕre like, ŅNo-no-no, why are you letting them stim?Ó IÕm like, ŅWhatÕs the problem?Ó And theyÕre like, I was like, ŅIÕm only seeing your child for 25 minutes.Ó 

ŅSo, for them to come in and for them to create safety for me to get anything done is this something that IÕm going to really choose? Like, I think I can work on something I know.Ó ŅFarwa, this kid is being pulled off your case, so the parents arenÕt happy.Ó I was like, ŅI need more time.Ó ŅYour running sessionÕs over.Ó IÕm like, ŅWhat? IÕm not getting much done in 25 minutes. IÕm coming back into the field because I want to create true change.Ó

ŅI want to just help one person. Let me just help one kiddo.Ó So, I could not last at that practice and I said, ŅIÕm going to do it on my own.Ó The clinic director said, ŅGood luck, you are never going to find another place and youÕre not going to be able to make it.Ó In the meantime, IÕve always done volunteer work. I was part of Morris County Speech and Hearing Association, theyÕre absolutely wonderful, they embrace me for who I was. 

IÕm currently serving as president for that amazing organization and there have been members that have been part of the organization for 50 years. So, I was like, ŅThis is where I need to be because this is the environment I need.Ó And they said, ŅShark only grows as big as the tank that theyÕre in.Ó I was like, ŅMaybe itÕs my environment.Ó So, I was doing all the things that I thought I needed to do as a parent.

My son doesnÕt like haircuts, IÕm going to force him to have haircuts. He doesnÕt like wearing full pants, youÕre going to wear these full pants, and then finally, I was like, ŅYou know what? LetÕs just Š tell me what you want to do. Okay, you want to wear shorts in winter? Can you roll up your socks all the way up high? IÕm going to buy you some knee socks, and when you get to school, you can roll them down?Ó

Today, the teachers were having a hard time with him. HeÕs moving around too much, theyÕre constantly sending him out of the room, and I was like, ŅYou know what? I donÕt think itÕs you. LetÕs just help your environment, letÕs alter your environment to what you need.Ó IÕm going to do this thing for myself. So, I started my private practice and I was like, ŅIÕm just going to have one person. Like, I donÕt even need anything else, I just want to leave a mark in this world.Ó

So, I started with one, ended up being two, ended up being at a location and it ended up being my calling. My son currently just today got honor roll.

[0:15:10.0] MD: Yes.

[0:15:10.8] FH: So, thereÕs things that everybody said we couldnÕt do, weÕre doing and weÕre thriving. So, long story is that weÕre going to get hit with a lot of negativity, especially when weÕre trying something new and different and weÕre trying to change how people see things. Everybody was like, ŅOh, youÕre not doing evidence-based work.Ó IÕm like, ŅIÕm doing evidence-based work across multiple disciplines.Ó 

I was trying to piecemeal together different things. So, I was reading articles on physical therapy, occupational therapy, motor speech disorders, counseling, and spech pathology.

[0:15:47.6] MD: You were tying it together.

[0:15:49.4] FH: It was the whole child because I just wanted to help that one child. I started reaching out to every researcher that I could think of and be like, ŅCan you help me? What am I missing? What am I not doing right?Ó And it was always like, ŅWhat am I not doing right as a therapist?Ó Because itÕs not the child, itÕs the environment. So, when I came in and changed my mindset, it really moved mountains for the kids. 

It really made me a stronger clinician from it, because it's always me that's not doing it right. ŅLet me fix it for you, let me give you the right environment.Ó And then, the kids were making faster progress. The things that I could accomplish in six sessions, they hadnÕt had these gains in years. So, parents started talking, other clinicians started to ask me what I was doing. We ended up cocreating the Connect and Play program with Dr. Joni. 

SheÕs a physical therapist with occupational therapy where children are getting OTPT speech support, drumming, art, music, yoga. We go out to the farm and the kids last year, they were in the Connect and Play program for four weeks, have unbundled their language and off my caseload, and are getting off of their services. So, itÕs all about giving the children the right environment to thrive. 

And not just the children that moms get to connect, the parents get to connect, they feel safe but to get here has not been easy because weÕre here working against a system that thinks differently than us.
 
[0:17:32.1] MD: So, what you just highlighted was my favorite autumn T-shirt design that says, ŅMy favorite season of all is the fall of the patriarchy.Ó And itÕs got little fall leaves and bear in mind, IÕm a boy mom married to a white man and have two little white boys but weÕre feminist in our household and you can be a feminist and you can be pro-human and do it respectfully and thatÕs what your walk is literally a living breathing testament of you have an uncanny ability to see them where they are and see yourself where you are, and to thrive where you put yourself where you needed to be planted so that you could then fulfill your calling.

[0:18:30.1] FH: ItÕs so beautiful to see the transition thatÕs happened in the last 15 years because initially, parents have called and be like, ŅCan she speak English?Ó Because my name is different, itÕs Farwa Husain, right? Now, theyÕre calling me and be like, ŅDo you speak my language? Are you my people, do you have the same thoughts as me?Ó And thatÕs so powerful. I mean, it took time, right? To get here but now that weÕre here, I want to spread this information and knowledge and power other clinicians, which has led me to do a lot of community work.

[0:19:02.4] MD: Yes. Okay, so you say youÕre bilingual and IÕm curious, what languages do you speak?

[0:19:07.5] FH: So, I speak, Urdu and Hindi as well as English and IÕm interested in a lot of the South Asian dialects as well in languages.

[0:19:16.8] MD: We had our boys enrolled in a Mandarin school, so for four years, they were learning English and Mandarin. Oh, I miss it so much because half the day was taught in Mandarin and to have them immersed in a new culture like that and being exposed and now, we go to a different school because we moved from South Carolina to Virginia, their private school is housed on the Virginia School for The Deaf and Blind. 

So, they have immersive recess and they have Š with like the deaf school and they have choir and music with the blind school and so, weÕre getting in-depth play time and itÕs just Š I don't know, itÕs really, really cool to see Bear, you know because itÕs a small town and heÕs like, ŅMom, I know that. Should we play recess together? And she taught me.Ó And he starting to like, you know, show me the little signs that like his little friend taught him and Š but itÕs those little moments. 

Okay, so we went in a different route to open than what we actually are going to talk about over the course of today but it is of merit. Our profession is predominantly upper-class, middle-aged white women and thatÕs the gospel. I literally embody that even though IÕm a member of the Patowomeck tribe and have a little Cherokee amongst other in my bloodline but I know what I look like and I know that itÕs open doors for me and that there is power there to be an ally and to open doors for others.

And so, sometimes that means we have to advocate and be proactive when we join our stage associations when we join our local chapters, our county-wide associations. ThereÕs opportunities there to go immediately into high schools to raise awareness about what our field is, to go to the schools that might not otherwise have allied health reach out and say, ŅHey, have you heard about our profession?Ó

So, if youÕre listening and you want to be the source of change, may I recommend you volunteer a little time with your local associations, whether that be county or state in addition to ASHA but volunteer locally and letÕs raise awareness and open the doors for our field so that it becomes reflective of the beautiful melting pot that we all are because thereÕs power there. So, thereÕs my tiny soap box in really pretty pastel purple tennis shoes. 

So, on that note, GLPs, how Š is it gestalt? I don't know the first Š how you say the first word there appropriately, so make me better.

[0:21:55.0] FH: So, itÕs gestalt language processing.

[0:21:56.9] MD: Say this again.

[0:21:58.1] FH: Gestalt.

[0:21:59.3] MD: Like, with the SH sound in the middle? 

[0:22:01.8] FH: Yes. ThatÕs how I say it but IÕve heard clinicians say gestalt.

[0:22:04.8] MD: ThatÕs like dysphagia and dysphagia. I am of the opinion itÕs like a potato and potato, like, tomato, tomato. So, like.

[0:22:11.7] FH: Pretty much. Pretty much and you know, the thing is, itÕs a German word that means ŅchunkÓ but it just sounds like chunk is scary and thatÕs not what itÕs supposed to be, right? ItÕs just like a fun phrase my kids are learning.

[0:22:27.1] MD: You said chunk and all I could think of, I was cursed this morning, almost blew chunks at the breakfast table [crosstalk 0:22:33.8]. You all, I promise the squirrel is worth it. So, we were sitting there eating breakfast and the nine-year-old tells the 11-year-old, my 11-year-old is my sensory kid probably on the spec. Well, we know on the spectrum and he goes, ŅDid you know thereÕs cowboy caviar in your French toast?Ó 

And I was like, ŅBobby, do you know what cowboy caviar is?Ó And he goes, ŅYeah, itÕs when the cowboy lays an egg.Ó Because he saw it on The Adventures of Gumball from Cartoon Network. I was like, ŅNo honey, thatÕs bullÕs testiclesÓ and so then Goose almost blew chunks at the table and I was like, "Yeah, there are no bulls' balls in your French toast sticks, bud. LetÕs keep eating breakfast.Ó But like Š 

[0:23:15.0] FH: That is so funny.

[0:23:16.7] MD: A boy mom for neurodiverse children is not for the faint of heart.

[0:23:22.4] FH: I agree. ItÕs a boy, so.

[0:23:27.1] MD: Yes, okay. So, gestalt means ŅchunkÓ and not to blow chunks, thatÕs a good starting point. Okay, weÕre going to go uphill from here. 

[0:23:36.6] FH: So, the research has been out about gestalt language processing since the 80s. Our field kind of just took a little turn and it got lost and now itÕs coming back from Š because of wonderful researchers like Marge Blanc and Alexandria Zackos and Barry Prizant and then Peter. Which is so great to see, like there's so much out there.

[0:23:57.8] MD: I remember coming through grad school and being taught not about gestalt. IÕm going to try to correct how I say this but about Echolalia and how Echolalia was a bad thing and thatÕs how it was presented to me was that if you have a child thatÕs presenting in Echolalia and that was the term even before scripting that it was bad that they might not ever learn standard English this way. 

And now, this many years later, IÕm like, their Echolalia is gestalt and thatÕs a script and that is them joyfully communicating. More than functional, itÕs joyful communication and I think Š

[0:24:39.2] FH: ItÕs meaningful, itÕs so wonderful. Yes. The first 10 years of my career, IÕve been trying to extinguish it. Then I became a mom and I realized, ŅI donÕt want this for my children, why would I extinguish it for your child?Ó

[0:24:50.0] MD: Yes, yes. Can you talk to us about like, what are the steps and stages of gestalt?

[0:24:57.6] FH: Sure. So, gestalt language processing follows a framework, which is called the natural language acquisition framework. It has been a seminal work by Marge Blanc, who built on Dr. Barry PrizantÕs work. Dr. Barry Prizant talked about the first four stages of gestalt language processing and then Marge Blanc landed on the last two. So, the first stage is Echolalia. 

So, these are children that have delayed echolalia and what delayed echolalia is theyÕre hearing something from their environment, reading it, looking at it, taking it, whether we Š from their body, their mouth words, or their actions and theyÕre recalling it at a later time. At a different time, in order to convey something meaningful to them. So, now, immediate echolalia is different. ThatÕs when we say something and they repeat it right back. 

ŅHow are you?Ó ŅHow are you?Ó No, thatÕs meaningful and purposeful too, is to hold the spot, turn-taking for conversational exchange to process language but the second youÕre holding it, storing it and recalling it at a different time, now, we're moving to the stages of gestalt language processing. So, the first stage is delayed echolalia, theyÕre holding it. Now, weÕre trying to stay away from the word echolalia because the whole goal is to make it positive. 

So, we're going to call it a gestalt. Scripting, gestalt, delayed echolalia, all mean the same thing but if we can give them that power back and say, ŅYou know what? This is cool, what youÕre doing, and itÕs natural.Ó It follows a framework, then parents are easy like it takes away that fear that the parents have. Like, ŅThereÕs something wrong with my child.Ó No, thatÕs just how they learn.

Many times, children will unbundle their language and be comparable to an analytic learner, which is what weÕre traditionally taught building by like, three and a half, four. So, thereÕs so many kids that donÕt even need our services and theyÕve unbundled it. The ones that show up on our caseload are kind of stuck in these earlier stages. So, stage two then is when theyÕre taking what theyÕve learned, theyÕre changing it. 

It could be theyÕre shortening it, theyÕre adding on to it, or theyÕre combining more than one thing that theyÕve already taken. So, thatÕs mitigation. Stage three is single-word isolation. At this point, theyÕve taken the soundtrack of their environments, everything that they learned, and theyÕre able to unbundle it, and now, theyÕre realizing that one word has one unit of meaning, and it means one thing. 

So, you're holding a teacup, teacup. It's a teacup. This stage is comparable to our first words children that are analytic learners learning their first word, and then combining on it because kids, what are taught? Kids learn a word, they put together a phrase, then they put sentences together. Those extra two stages are what gestalt language processors need to go through to get here, to stage three. 

Then four, five, and six are all about grammar. TheyÕre self-generating their own phrases, making complex sentences and theyÕre making new novel at around six.

[0:28:05.9] MD: That is literally a beautiful explanation. So, I start thinking back as youÕre describing this and thinking back of all the different tiny humans that I worked with over the years and like, where they were on the processes and there was this one little guy who was on my caseload and I started out as a speech teacher in the public schools a lifetime ago before they officially had SLPAs, it was like a precursor, right? 

I had this one little boy on my caseload because I was working full-time and going to grad school full-time at night. So, that was intense and whenever there was a assembly in the auditorium, he would get really nervous and youÕd see him rocking and he would start narrating the animal planetÕs top 10 deadliest countdown. His memory. I wondered if heÕs got to be at this stage of the game, probably in college age now because how many Š 

Oh, I just made myself very old but you could tell he was upset because it was the script that he picked was the deadliest countdown, and if he was really happy, we would marry and script different top 10 countdowns but that was indicative of the mood in the environment but Bobby would script like the entire episode and just rock, and that was how he processed what was going on, and the sounds and the sights and too many humans and Š 

[0:29:42.6] FH: [inaudible 0:29:42.3] himself and Š 

[0:29:43.9] MD: Yes, yes, and I just let him do it and then would ask questions and say, ŅWhat about the tarantula?Ó And then, you know, he would script more about like a set of spider. I hate spiders, so kudos to me for even asking about the spider but Š 

[0:29:58.8] FH: IsnÕt it incredible as clinicians that we carry these kids with us in our hearts? Like, when I started learning about gestalt language processing, I had one friend that kept coming to mind. IÕm like, ŅOoh, I didnÕt do right by him. I didnÕt do right by him. Why didnÕt I? Why didnÕt I know this?Ó So, I called up Mom and I said, ŅHey, can I give you a scholarship? Like, I donÕt need anything from you.Ó 

HeÕs 26 now, when he came to me a few years ago and I started my private practice. I said, ŅJust Š this is more for me than it is for you. Let me just do this.Ó He saw my face and he said, ŅNo speech? No speech? No speech?Ó I said, ŅNo-no-no. Please, this is going to be totally different. This is not what we do at that. I get it, I get it. IÕm not going to sit at a table with you, letÕs just hang out.Ó 

So now, he calls it ŅFun with FarwaÓ and at 26, he just got his AAC System. At 26, it was the first time in his life that he requested something that he wanted. ŅBike. Bike. Walmart, bike.Ó Putting him in stage three because before, it was just scripting and it was all scripts of, "Don't do that, don't touch this, sit down, quiet hands, sit down, quiet hands, sit down, quiet hands.Ó And thatÕs powerful. IÕm like, ŅYou donÕt realize the things that you, coming here is not therapy for you, itÕs for me because I feel like as a clinician, I didnÕt do right by you.Ó

[0:31:33.5] MD: We did as best we could with the knowledge that we had.

[0:31:36.9] FH: I agree. Yes.

[0:31:37.4] MD: And that is why we engage in lifelong learning to evolve our skillset. If I practice the way I was taught 15 years ago, I would take a piece of plastic and shove it in every kidÕs mouth and we would work on mastication patterns. Thank the Lord, I know and have read Dr. Georgia Malandraki and her wife, Dr. Jaime Bauer, her out of Purdue I-EaTs, that we know rotary chew patterns donÕt evolve until 12 and tonal implications. 

We donÕt need to use things that vibrate in hard plastic but like, Michelle practicing today versus Michelle practicing in 2009, those are two different MichelleÕs. thank goodness for that.

[0:32:22.0] FH: Yeah, and thank goodness for autistic adults and voices coming out to help this neurodiversity-affirming movement because thatÕs who IÕm going to. ŅTell me your experience, tell me how I can help support the next generation of children.Ó

[0:32:35.9] MD: Okay, so you talked about AAC and I love AAC. After PFD, AAC is like my next big love just because so many tiny humans that I have worked with over the years had multiple etiologies, like multiple things going on, and so we had delayed spoken language because of you know, X, Y, and Z, maybe traches. Who knows? lots of causal factors. I have seen this pop up in debates, and not like public debates but like in chat forums. 

With respect to the AAC, when we are setting up initial programming, do we program with their current GLP? Do we program with their target GL? Like the next level, do we program individual words like lamp? Do we do chunks of phrases on the device? And it seems, from what I have seen, itÕs kind of all over the place but I feel like we have to tailor it to each child, but what is your thought process and resources and make us better?

[0:33:37.5] FH: A hundred percent, AAC needs to be customized to the child. Now, that any and all of the AAC systems out there are designed for an analytic language processor. So, we do need to customize it for a gestalt language processor.

[0:33:52.3] MD: Can you explain the difference between the two processors for those that arenÕt familiar with that analytic language processing term?

[0:33:58.9] FH: Sure. So, analytic language processing is what weÕre traditionally taught as children learning language. I want you to think of it as Legos. So, when we are building, weÕre going to put the Legos together and weÕre going to build on top one word at a time. So, it would be, ŅMama, weÕre going to eat pizza.Ó So, now, IÕve created a phrase, which is a new sentence, right? ItÕs a black word, plus word, plus word. ThatÕs analytic language learning.

So, when weÕre thinking about gestalt language processing, I want you to think of a tower already built and a few other towers. So, we have these longer scripts, it could be, ŅRain, rain, go away, come again another day.Ó A full phrase, and then, ŅLetÕs get out of here.Ó So Š and then the children are going to take these phrases and these longer chunks that have one unit of meaning because they havenÕt broken it apart just yet, and theyÕre going to mix and match it. 

And then theyÕre going to come down to their single words, and then theyÕre going to build on this tower. So, analytic language processing traditionally may work with a child, word, phrase, sentence generation. For gestalt language processors, they learn in bigger chunks and they unbundle it to single words, and then they build back up on it. So, when we come to AAC use, and for many years, I have avoided AAC because I thought and I was taught that mouth words were the way to go.

You know what? WeÕre just going to force them to talk, I donÕt need to give them this multi-model support, AAC evaluation is only for the specialist. That is not for you, you are just a generalist. So, IÕve avoided it, and then I realized that there was something missing because most of our children have some kind of underlying motor difficulties that are not being talked about, right?

And I think the latest research said up to 90% of neurodivergent autistic children have sensory differences as well as physical gross motor differences. So, even if they have mouthwords, thereÕs days where they donÕt have access to. There might be days or times where theyÕre dysregulated but they canÕt access that. So, I want to give them the support that they need. So, when it comes to AAC, weÕre thinking about, ŅWhat supports can I give you on those days that you donÕt have access to it?Ó

ŅWhat supports can I give you if you donÕt have mouth words at any given time?Ó Because communication is whatÕs important, right? So, how I start with them, it depends on the stage that theyÕre in because there are six stages. Usually, the younger the better and I always want to set up as, ŅWeÕre never taking away how the system is set up. IÕm not deleting the homepage, IÕm not taking away icons because itÕs also part of mode of planning.Ó

We want our children to get to the point where theyÕre self-generating and using it as itÕs meant to be but in the initial stages, I might have a phrase page and IÕll put communication functions that are important to the child and the gestalts that are important. So, I have a little friend that likes to communicate with Bubble Guppy videos. So, IÕm going to put this Bubble Guppy videos. 

[0:36:57.2] MD: I love Bubble Guppies, yes. 

[0:36:58.7] FH: Yeah. I have another friend that communicates via voices from YouTube like Bear Hunt and a lot of different songs. One likes Taylor Swift, so weÕre going to put Taylor on there. ThereÕs so many beautiful things that come from musical lyrics, so why not use them? But we also, along with that, need to put the power phrases. ŅI need some space, I donÕt like that, this is fun, letÕs do it together.Ó

So, I always have a phrases page in there and then weÕre going to work out a bit, theyÕre in stage two, then leave it, that icon hits and goes to another page because then theyÕre mitigating because then, ŅLetÕs go to school. LetÕs go to home. LetÕs go out of here.Ó And then stage three is your single words, so you are going back to your core word section in those pages and four, five, and six are all about that self-generation. 

And then, I have to say meaningful speech has an AAC course. Emily Diaz is launching an ACC, an introduction to GLP course next week. So, thereÕs a lot of fantastic amazing clinicians that are doing the research and putting that information out there. So, I highly recommend you follow them. 

[0:38:10.4] MD: Yes, and folks, OSU, the Ohio State University has some absolutely brilliant researchers. Dr. Allison Bean, she is doing a ton of stuff on AAC. Dr. Michelle Therrien, who is the current ASHA topic chair for AACU, she is out of Florida State University and her research is on how to make a friend if you use an AAC device but like at the end of the day, isnÕt that kind of what we want? 

We want connection and whether you use mouth words or which is another term that we can use for spoken language instead of as a field, we're moving away from verbal and nonverbal because there is implications on intelligence and ablism behind those words. So, mouth words is the phrase that, if we listen to our autistic adults and teens, that they identify that they feel more comfortable using that phrase. 

Also like spoken language for Š so, just as a frame of reference for if youÕre unfamiliar with the term mouth words, there is also another organization out there that I would recommend everybody go check out. ItÕs, see if I can get the acronym right, USAAC, and this organization trains individuals in how to train first responders to communicate with users of AAC and why AAC is important as part of a Š if thereÕs an emergency and theyÕre being rescued, why that AAC should also be rescued. 

You know, itÕs like an extension of that human, like a wheelchair or a crutch or a cane and so, itÕs that and that entity is a nonprofit and they tithe of their time and train folks on how to train first responders, which I feel like if we did more training there could prevent catastrophic communication breakdowns in the future. Yes, segue back over. 

[0:40:17.7] FH: But if you have to say the positive things that are coming about with the iPad is that the stigma of a self-generated voice device, output device has been gone. Like, my parents are like, ŅOh, itÕs just nap.Ó IÕm like, ŅYes, itÕs nap. We got this, we can do this. We can skip all those extra steps.Ó We trial and do all the things but itÕs not as scary anymore because now, everybody is carrying on a phone. 

Everybody has a device, you know? Everybody is texting, everybody is like, ŅWhoÕs on the phone anymore?Ó 

[0:40:46.8] MD: Yes. Actually, I saw an article last week that in Northern California, up in the mountainous terrain area, they were contemplating getting rid of landlines altogether because everybodyÕs gone digital, right? But itÕs so rugged and rural up there in that particular local that they canÕt get cell service and so they were like, ŅIf you take our landlines, you know if something happens, we canÕt communicate out.Ó

And I was like, I forget because we live, I mean, where I live thatÕs a non-issue but there are pockets of even this country where we donÕt have digital access and it just Š I donÕt know, itÕs a refresher that like, ŅNot everybody has, do better Michelle, do better.Ó Okay, so I appreciate your explanation on how to consider programming the devices because thatÕs trying to guide students through those clinical decision-making processes on, and trying to train students and how to train caregivers. 

It can be very challenging when you have a young adult that youÕre training who is not a caregiver themselves and like coaching them there. Do you have any advice for that? 

[0:42:00.5] FH: Yeah, a lot of it is bringing them in and letting them program themselves. Like, for my 26-year-old friend, I started putting in phrases and then I was like, "Wait, you can do it yourself." And I handed it over and he did it and I said, "I just put you in a box. I am so sorry for that. I'm so sorry for not thinking you couldn't do this." And be like, "Do you want to put them in?" "Yeah." "Do you want to record your own voice on there?" "No." 

And then before you even start, many of our gestalt language processors are very musically inclined and take in the environmental sounds. So, the first thing I do is let them choose the voice, let them choose the pitch, the rate of speech. A lot of times, we need to increase the rate of speech for them because theyÕre picking up the soundtrack first, the intonation patterns first. So, when we slow it down too much, youÕre breaking up that sound, it doesnÕt sound so good. 

IÕll have Mom or Dad or their sibling record themselves on there because that sounds much better than a boy robot. Those are very important considerations and even if they donÕt have verbal output of speech, they will let you know with their body when they donÕt like it. TheyÕll cover their ears and say, ŅI donÕt like this voice. I donÕt want to do this.Ó YouÕll see them light up when they do find a voice that they like. 

Put the power in their hands, itÕs their talker, itÕs their device. ThatÕs where IÕm starting and IÕm starting from, ŅLetÕs figure this out together because this is yours.Ó ThatÕs been really powerful for the families and for the young adults.

[0:43:33.9] MD: I learned that trial by fire a few years ago, probably two summers ago now. I worked with a little girl who was diagnosed with autism and it was very difficult for the family because of Š and the mom was very candid, her family had in their culture felt a certain way about a diagnosis of autism, and this little girl, she was brilliant. SheÕs freaking brilliant. She saw me enter the passcode on her device one time. 

I didnÕt think any of it because she was sitting right next to me. As her mom described it, she hacked into her device and added a bunch of phrases after you know, the session. She goes, ŅMichelle, she came to me on Saturday morning and said, ŅMy name is X. I donÕt want to hear no. I want blueberries and Doritos now, please.Ó

[0:44:23.9] FH: Oh my gosh. 

[0:44:24.5] MD: I know, itÕs sonic. 

[0:44:25.6] FH: Standing ovation to you. 

[0:44:28.2] MD: ItÕs like, yes but she figured out how to add Doritos and blueberries and I mean, I had already put her name in there because you know, like we need it but like, that one child changed my perception, and because I assumed, I assumed, you hear the words IÕm using, I assumed that at four she was unable to explain her autonomy and IÕm a mom of children. I should have known better because I know how fiercely independent my children were at four. 

But wow, just wow, and after that, it just kind of, it made me reassess my view of an AAC device and its role. I will never forget that and she was also the same child that changed her strap, like instead of the strap that came with the device, she would use her mother's and her grandmother's scarves so that they matched her outfit because it all had to match, and like I appreciate that. 

[0:45:30.9] FH: I love that. I love that and I have to say IÕve been starting kids as early as two that are starting with me and itÕs Š parents are like, ŅNo, I donÕt know.Ó Oh, itÕs incredible the things that theyÕre doing. I have my little friend whoÕs two, as went up having a bad day, ŅSomethingÕs bothering me, I want to go home. Like, I donÕt feel good.Ó Like, that communication could have been lost with a meltdown and a tantrum. 

And weÕre trying to figure out whatÕs going on with you but now, youÕre able to advocate for yourself. So, weÕre giving you that ability and weÕre building your confidence because one thing that a lot of research says is many of our neurodivergent and autistic children and adults end up being bullied, they end up having a higher rate of suicide. If we can just empower them, think about all that struggle that theyÕve Š weÕve been able to avoid and thatÕs important. 

So, as clinicians, we need to think about not just three-month goals, not just six-month goals but what is our goal for them in their lifetime. What is their goal? I guess parents and I think one thing that really changed how I practice is being a mom. Like, I see the kids as what I would want for my children and I have an open conversation with the parents and be like, ŅWhat are your goals? Like, what is your ultimate goal for your child?Ó 

And it is always the same, we want safety, we want connection, we want our children to be loved, we want them to be able to advocate for themselves, we want them to live healthy happy lives. Why would I do anything to take away from that? I just want to support you. I want to support your family. 

[0:47:09.3] MD: I have a special needs autistic brother-in-law. He is about to turn 46 and cognitively developmentally, we have microcephaly cortical vision impairment, CP, ASD, thyroid condition, all of Š heÕs got a little bit of everything, right? Matty has a passion for underground and garage radio on satellite. So, if anybody listens to the Satellite Series FM, like underground and garage bands are MattyÕs specialty. 

He also can tell you any single fact about Paw Patrol that you could possibly want to know. The band knows what he is about and it also included Power Rangers and Hot Wheels cars, right? Like, we know but it's interesting to see having an adult autistic brother-in-law putting that perspective, life goals, it brings home in a way that I could not convey otherwise, what long-term plans look like. Dr. Carol Page was one of my mentors. 

She was the director of the South Carolina Assistive Technology Program and she always told me, ŅStart where you want to end.Ó And I thought that was so powerful because I made Mathew the end because he can do so much and lives his life to the fullest and his life looks different than another individualÕs but thatÕs his life and he has joy there but he scripts, we marry. I mean, he would be a stage six because I mean, we have our scripts. 

But we break it down and we build it up and grammar sometimes we have some irregular pronouns or irregular past tense verbs will throw him but they also do my youngest, who didnÕt hear for the first two years, right? It does put a challenge on us when weÕre working with children to go to the darker scarier places of choosing vocabulary that might challenge our preconceived notions and our biases because bad things happen to some of MathewÕs classmates. 

Like, their sexual assault occurs in high school and being able to empower our GLP communicators with negations, with, ŅNo, donÕt do that.Ó Having that vocabulary and modeling that vocabulary now prevent and save horrible things from happening and thatÕs really uncomfortable to talk about as a mom and as a sister-in-law but something that we have to talk about as professionals. 

[0:49:56.5] FH: And something Š this is a really good point but we also have to have that open dialogue with the family. One of the phrases that I was trying to give an adult was, ŅDonÕt shoot.Ó Because this is a colored adult and thatÕs something thatÕs important because thereÕs much things in the media about our disabled black individuals, right? And one of my presentations, I was in a school and I showed that video. 

All the therapists felt very uneasy but it was a topic. We need to feel that because that is how weÕre going to grow. So, that is important to the family, that is important to me. ŅDonÕt shoot.Ó Yes, I will give it, that is something we can model because itÕs important to you and your lifestyle. 

[0:50:47.1] MD: You have to brave enough to acknowledge that that is the elephant in the room that we have to actually go there and talk about and body vocabulary, putting body vocabulary on an AAC device, that can be really uncomfortable for some caregivers but just because an individual is not speaking doesnÕt mean that they donÕt want to have sex. So, letÕs clarify that for the room because I have had adults, a lifetime ago I worked with adults. 

And I will never forget my one favorite couple would come in and they were so mad when they walked in the door and I was like, ŅWhat happened?Ó Because he had a stroke and he has anomia and he was like, ŅI Š what Š hoo, hoo.Ó And I was like, you all could have see the gesture and I was like, ŅI am a little uncomfortable right now.Ó So, the wife told me. She was like, ŅI didnÕt know what he was trying to tell me and he goosed me.Ó 

But it was you know, so I ended up having to call the PT in and then we ended up having to talk about the Ņhoo-hooÓ and yeah, but like Š 

[0:51:49.3] FH: ItÕs part of communication. 

[0:51:51.4] MD: ItÕs part of the communication but he had paresis on the right side of his body, so they had to strategize how to physically make the Ņhoo-hooÓ happen and then we had to come up with word retrieval so that we could communicate that but the same happens for our teens and our young adults and adults that are GLP learners. So, letÕs Š while thereÕs also the scary bad part, thereÕs also the really fun part. 

And I donÕt know about you but that is kind of fun and so, thereÕs that. Who knew we were going to talk about sex being fun today when we talk about this stuff? 

[0:52:28.0] FH: I literally was just thinking this. I was like, ŅHow did we end up here?Ó but I like it. I mean, weÕre safe. This is a safe space. 

[0:52:36.2] MD: This is a safe space. I had a really good cup of coffee and a cup of tea already this morning, so huzzah, but okay. So, what resources, for those of us that were taught one way and we're learning about gestalt, do you have like a favorite spreadsheet? What resources do you have for those of us that are learning it as the clinician versus resources for the caregiver or the individual? 

[0:53:03.7] FH: Yeah. So, thereÕs four main courses out there right now on gestalt language processing. If you are looking for free resources, Marge Blanc made this all this available on her website, which is the communicationdevelopmentcenter.com website. You can find all the latest research, articles, and even have access to her as well. The courses out there are The Meaningful Speech course. 

There is a directory that you can go and find clinicians, if you're a parent, that you can find clinicians that are in LA-trained. There is the Northern Speech Services course, which is a three-part course. It's more of a college-level course and by Marge Blanc. There is a Dr. Amanda Blackwell, Paulina Elias, and Marge Blanc have a course in Spanish, which is the Communication Natural course. 

Communication Natural or Natural Communication, it is also in Spanish and in English for both families and that's at a better price point and it's easy access, and they have monthly meetups for parents. And then if you're a South Asian clinician, there is a course out of India called Uncleft for Clinicians in Hindi. Now, if you have a desire to learn about music and gestalt language processing because there is a lot of music involved in what we do, Corinne Zmoos has a course as well. 

[0:54:26.0] MD: I love her, IÕve had her on the podcast, she is a delight, yes. 

[0:54:30.3] FH: She has a music and gestalt language processing course as well. So, where would you start? The places I would guide you would be Dr. Amanda BlackwellÕs one-hour free webinar and then choose the courses that you would Š that bring you joy. Meaningful speech is wonderful, Dr. Amanda Blackwell and Marge Blanc's courses are wonderful as a starter. Then you go on the research and then you dive in. 

It's like, give a mouse a cookie, once you start, you just want all that information, and then check out that communication development center. 

[0:55:02.8] MD: Now, wait, donÕt you host support groups, and what support meetups? Talk to me about that. 

[0:55:08.6] FH: Yes. So, for me, it was very important to create a community, not just a community for parents but a community for clinicians. When I started in my area, I was the only one doing this exclusively, the only neurodiversity-affirming clinician and that was hard because everywhere was, ŅNo, youÕre not doing it right.Ó So, I started having clinicians that had the same mindset as me come join me. 

Like, ŅLetÕs hang out together, letÕs just talk, letÕs just connect.Ó And it was open to everybody and it really caught on because clinicians need a support group ourselves. We need somebody to connect with, we need somebody to talk to, especially about gestalt language processing because it is newer, it is uncomfortable. ItÕs really hard when youÕve done things a certain way your entire career and then all of a sudden, ŅWhat do you mean child let play based?Ó 

ŅWhat do you mean neurodiversity-affirming? What do you mean IÕm just going to let them script? What does that look like?Ó Well, let me show you because we canÕt come into any environment and say, ŅI know better than you. You know what? YouÕre doing it wrong.Ó No-no-no-no, weÕre not creating change that way. IÕm going to come in and meet you where youÕre at and let me guide you. 

So, we just recently did a meetup this weekend. I hosted it in my office and I did a sound bath for clinicians. So, thatÕs when we had wonderful, one of our enrichment leaders, Alex Gonzales, came in and we have different sound drums that will light up, and he creates music inside the drums while we lay down on the yoga mats and clear our minds. The vibration of those drums helps and it moves the cells in our bodies and it helps us relax and it helps reduce anxiety. 

It was the coolest experience and I wanted the clinicians to experience something different, something thatÕs been around for thousands of years, and say, ŅWait, if I am enjoying this and this is something different, I can try something new in my therapy sessions.Ó We want to open up their world from a place of working together and a place of community. So, I host in-person meetups that are at no cost to clinicians. 

I also do free webinars for families, my most recent one is going to be next week on creating authentic friendships. ItÕs not about gatekeeping the information. The more we talk about it, the more awareness that we have on it, the more change that we can create, the more positive experiences that could come from it, and thatÕs how families find me. TheyÕre like, ŅOh my gosh, so and so told me about this. This is so cool, let me learn more.Ó 

ŅLet me learn from you.Ó And then even the clinicians will be in a different state and be like, ŅI saw you do that Farwa, that was really cool. IÕm going to do it in my state.Ó But one thing that we did, Dr. Joni Redlich, sheÕs a phenomenal physical therapist and sheÕs world-renowned in her TMR approach, which is total motion release. ItÕs a strength-based approach on working with the body. 

Her and I created the Connect and Play program, which is about giving children positive experiences to connect with their body, their sensory systems, and their communication. We have drumming circle part of it, we have yoga, art, music. One of the parents that I spoke to in Pakistan, which is across the world, ended up hosting a drumming circle for her child, her autistic child from the school because sheÕs like, ŅYouÕre doing something really cool, I want to do it.Ó 

So, it's all about sparking change, innovation that's going to have this ripple effect throughout the world, so Š 

[0:58:59.9] MD: Yes. 

[0:59:00.9] FH: So, one thing that is very, very important for me is to set the foundation and pioneer the way for the next generation of clinicians because being the change maker is hard but weÕre here to do it together. ItÕs such a wonderful change thatÕs happening in the neck, in the last few years. Now, instead of clinicians turning their backs on me or clinicians saying, ŅThis is not right.Ó I feel like, ŅCan you help me? Can we learn together?Ó 

ŅIs this right?Ó IÕm like, ŅYeah, you know what? The fact that youÕre here and youÕre wanting to learn, youÕre doing it right. Just do it scared.Ó 

[0:59:40.1] MD: Just do it, period. Now, he knew what they were doing with that phrase, by the way, just do it but it is and I am incredibly grateful that you chose our field. Yeah, I am incredibly grateful that you chose our field to go into because you hit it on the head. It is very scary to take the leap of faith and to do something new. Have you heard The Man in the Arena quote by Teddy Roosevelt? 

Oy vey, when I was writing the book, I was going to walk away from it because I wanted to write a book for PFD that gave case scenarios, real-life honest case scenarios, and then tied it into, ŅThis is why I engage interprofessional education.Ó And I got to a point where I couldnÕt do it. I talked to different publishers and they want to price point at such an astronomical rate and thatÕs cost prohibitive. 

I wanted to, knowledge should be shared and shouldnÕt be hoarded, and I want to dismantle the notion of an ivory tower and take it apart brick by brick and build a road, right? So, my husband sat me down, actually, he goes, ŅWoman, I will hog tie you if you donÕt sit still.Ó So, we curled up in bed and watched one of Brene BrownÕs TED Talk where she quoted Teddy RooseveltÕs, The Man in the Arena. 

And itÕs all about when youÕre brave enough to stand there essentially in the muck, in the mire, with the dust, the tears, and the blood on your face. We did that so that we can create the space for the future, right? And oh my God, did I ugly cry. I just wept because it was so very, very raw, right? But I wanted to make it different and it is my understanding that you too have stood in an arena and made something different and I want to hear about what it is that youÕve made, your third baby if you will. 

[1:01:45.5] FH: My third baby is a baby because itÕs labor, so much love and a labor of a lot of clinical experience. So, I am launching a first phrases card deck. Now, these cards are powerful phrases that every child should need across 11 communication functions. When we think about communication, weÕre thinking about giving them purposeful phrases that they are going to need no matter your language learning style. 

So, every child should be able to advocate for themselves, they should be able to protest, they should be able to express in new situations. So, these phrases are Š IÕll let you know the communication functions, the 11 communication functions because when weÕre thinking about gestalt language processors, we want to give them lots of phrases and that they are going to pick up these gestalts. 

When weÕre thinking about analytic language learners, weÕre thinking about enriching their environment. So, what was happening was a lot of clinicians were saying, ŅWell, Farwa, where do I start?Ó IÕm like, ŅWell, we have to model language across communication functions.Ó And theyÕre like, ŅWhat does that even mean? Like youÕre saying that IÕm just supposed to talk?Ó IÕm like, ŅNo, no, no, everything has to be purposeful.Ó 

Yes, weÕre talking to our children, weÕre making natural communication but we want to make sure that we have a place to start and I wanted to create a bridge for clinicians that have only done medical modeled-based services where itÕs all deficit-based because you canÕt throw someone in the ocean and tell them to swim. We have to find the bridge between it, right? So, these are flashcards across 11 communication functions. 

So, they are commenting, help, daily activities, transition, protests, shared joy, sensory, new situations, self-advocacy, empowerment, request, and on the cards in very big bold letters, it has the phrase written, it has an image, and then it has a QR code. Children can scan the QR code, and it has voicing of my children and my niece and other children saying these phrases. So, we are enriching their environment by creating an opportunity for them to read, see, hear those phrases. 

And for parents, it gives them something tangible. ŅOkay, this week, IÕm going to pull the cards that are protest and I know how to model it. Oh, IÕm going to do empowerment. Now, IÕm doing shared joy.Ó And before you know it, they have this huge library to go to. The card deck is big, itÕs a hundred-card deck, so thereÕs 87 phrases and then thereÕs some blank cards on there that you can use a dry-erase marker to write because we also want individualized language to your environment. 

So, say if the kid says, doesnÕt like, ŅDonÕt touch me.Ó And they want to say something else for it, you can write it down yourself. So, weÕre making sure that we are giving the parents and the clinicians the opportunity to thrive and to empower them and be like, ŅOh, I got this. I can do this.Ó So, thatÕs how I came up Š about the last few years, IÕve been writing down all the phrases that IÕve been giving the kids and all the phrases that theyÕve been saying and logging it. 

So, itÕs some of the favorites that the kids have needed and one thing thatÕs very important thatÕs not talked about as much is the communication function of empowerment. ŅI can do this. IÕm strong. IÕm brave.Ó Because now, weÕre giving them the self-talk. Now, weÕre giving them the executive functioning skills for them to be successful academically down the road. So, I want to put that to the families, to the clinicians to give them an opportunity to support their children. 

And say if you are an AAC specialist, you'll know, "Okay, on my system, I have request but I don't have anything for commenting." Because for me, and what the research has shown is, if children don't have commenting, then when they get to stage four, they tend to regress back to their original stages because then they can't create those new novel phrases. When they don't have all these communication functions [inaudible1:05:47.5] plateau because they don't know where to do. 

So, we want to create and enrich the childÕs language in the best way that they can, and on the market, I was looking everywhere is words. ItÕs all first words, itÕs all first words, thereÕs no phrases, which led me to announce like, ŅAll right, letÕs just do this. LetÕs create something.Ó 

[1:06:09.7] MD: I identified it, now letÕs fill the void, yes. 

[1:06:13.1] FH: And thatÕs how the Connect and Play program came. We looked at each other and weÕre like, we keep trying to piecemeal and send people to so many different places, letÕs just do it ourselves and then these first phrases, I was like, ŅIÕm already sending all these phrases to all the clinicians that are asking. I think I just need to put it out there.Ó And IÕm just doing it scared and hoping that we can support as many families and clinicians as I can. 

[1:06:39.5] MD: YouÕre doing it bold and brave and beautiful. So, I mean, it might be scared but hell, youÕre showing up and youÕre leading this forward. So, thank you. Seriously, thank you. Okay, I want to buy a set for my clinic. Where do I go? 

[1:06:59.1] FH: Yes. So, we are going to officially launch at NBASLH in April this year, 2024. You can go to gestaltgoodness.com website and I do have a freebie that I will be sending out that for those that are listening can download it, and thereÕs a few cards that you get a good idea on where you can start and itÕs Š one thing thatÕs very important is we are not using this to drill language. 

None of this is about taught language, we are not using this as traditional flashcards, and if youÕre thinking this is going to help your child speak, no. What we are doing is we are enriching their environment and the first thing you should do is get the child a dynamic AAC system. The first thing you should do is enrich their environment but this is a support to enrich their environment. 

[1:07:46.8] MD: Yes. Okay, Farwa, if somebody wants to follow you or reach out to you, how do they find you? 

[1:07:53.8] FH: Sure. So, you can find me on Instagram @oneononespeechtherapy and my website is oneononespeechtherapy.com and then if you are looking for the flashcards, itÕs gestaltgoodness.com. 

[1:08:05.1] MD: And itÕs my understanding that you also have webinars with SpeechTherapyPD? 

[1:08:09.2] FH: I do. Yep, I will be speaking at the upcoming spring conference at SpeechTherapyPD and I do have a few courses already on there. 

[1:08:18.4] MD: Yay, okay. I cannot express my gratitude for you enough. So, with my whole heart, IÕm really glad that our paths crossed at ASHA and that I am truly in awe of what youÕre doing. So, thank you. 

[1:08:35.5] FH: Thank you so much for having me. ItÕs clinicians like you that inspired me, so thank you. 

[1:08:42.2] MD: Now, IÕm going to cry. Okay, everybody, come check us out next month at NBASLH. If you havenÕt registered yet, itÕs in Raleigh and it truly is like one of my favorite conferences to go to every single year. YouÕre going to meet just the most amazing people and the lectures are just bloody brilliant so Š oh, and then the gala. The gala is a blast, they had the thing that you do like you stand and then the cameras zoom around you with pictures. 

[1:09:08.1] FH: ThatÕs fun. IÕm actually speaking at NBASLH too on holistic treatment for autistic children and where to start and IÕll be at the gala, so I canÕt wait. 

[1:09:17.2] MD: And if you come through, IÕm doing one on feeding tubes and why feeding tubes can be friends and not foes. So, we hope to see you there at NBASLH. Thank you for being you. 

[END OF INTERVIEW]

[1:09:29.7] ANNOUNCER: Thank you for joining us for todayÕs course. To complete the course, you must log into your account and complete the quiz and the survey. If you have indicated that you are part of the ASHA Registry and entered both your ASHA number and a complete mailing address in your account profile, prior to course completion, we will submit earned CEUs to ASHA.

Please allow one to two months from the completion date for your CEUS to reflect on ASHA transcript. Please note that if this information is missing, we cannot submit to ASHA on your behalf. Thanks again for joining us, we hope to see you next time.

[1:10:10.5] MD: Feeding Matters guides system-wide changes by uniting caregivers, professionals, and community partners under the Pediatric Feeding Disorder Alliance. So, what is this Alliance? The Alliance is an open-access collaborative community focused on achieving strategic goals within three focused areas, education, advocacy, and research. 

So, who is the Alliance? ItÕs you, the Alliance is open to any person passionate about improving care for children with a pediatric feeding disorder. To date, 187 professionals, caregivers, and partners have joined the Alliance. You can join today by visiting the Feeding Matters website at www.feedingmatters.org. Click on PFD Alliance tab and sign up today. Change is possible when we work together. 

[OUTRO]

[1:11:02.8] MD: ThatÕs a wrap, folks. Once again, thank you for listening to First Bite, Fed, Fun, and Functional. I am your humble but yet sassy host, Michelle Dawson, the all things PEDs SLP. This podcast is part of a course offered for continuing education through SpeechTherapyPD.com. Please, check out the website if youÕd like to learn more about CEU opportunities for this episode as well as the ones that are achieved, and as always, remember, feed your mind, feed your soul, be kind, and feed those babies. 

[END] 


FBP 27400Transcript



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