FB 282 - AAC From Start to Finish in the Pediatric Outpatient Setting === [00:00:00] Michelle Dawson: ​Hi folks, and welcome to First Bite, Fed, Fun, and Functional, a speech therapy podcast sponsored by Speech Therapy. PD.com I am your host on this NerdVenture, Michelle Dawson, MS, CCC-SLP, CLC, The All Things Peds SLP. I am a colleague in the trenches of home health early intervention right there with you. I run my own private practice, Heartwood Speech Therapy, here in Cullatown, South Carolina. [00:00:48] Michelle Dawson: And a guest lecturer nationwide on best practices for early intervention for the Medically Complex Project. First Bite's mission is short and sweet, to bring light, [00:01:00] hope, knowledge, and joy to the pediatric clinician, parent, or advocate by way of a nerdy conversation. So there's plenty of laughter, too. In this podcast, we cover everything from AAC to breastfeeding, ethics on how to run a private practice. [00:01:17] Michelle Dawson: Pediatric dysphagia to clinical supervision 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. To break down the communication barriers so that we can access the knowledge of their fields. [00:01:35] Michelle Dawson: Or, as a close friend says, to build the bridge. 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. [00:01:50] Erin Forward: Every fourth episode, I join in. I'm Erin Forward, MSP, CCC-SLP. The Yankee Byway of Rochester, New York transplant, who actually inspired this [00:02:00] journey. [00:02:00] Erin Forward: I bring a different perspective, that of a new ish clinician, with experience in early intervention, pediatric acute care, and non profit pediatric outpatient settings. [00:02:10] Michelle Dawson: So sit back, relax, and watch out for all our stories. Hey, [00:02:25] Michelle Dawson: this is Michelle Dawson and I need to update my disclosure statements. So my non financial disclosures, I actively volunteer with feeding matters. National Foundation of Swallowing Disorders, NFOSD, Dysphagia Outreach Project, DOP. I am a former treasurer with the Council of State Association Presidents, CSAP. [00:02:49] Michelle Dawson: A past president of the South Carolina Speech Language and Hearing Association, SCESHA. A current board of trustees member with the Communication Disorders Foundation of Virginia. [00:03:00] And I am a current member of ASHA, ASHA SIG 13, SCISHA, the Speech Language Hearing Association of Virginia, SHAHB, a member of the National Black Speech Language Hearing Association in Basel, and Dysphagia Research Society, DRSA. [00:03:15] Michelle Dawson: 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 dysphagia, which is also a podcast with speechtherapypd. com. And I currently receive a stipend. Salary from the University of South Carolina in my work as adjunct professor and student services coordinator. [00:03:50] Michelle Dawson: And I received 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 [00:04:00] CEUs associated with it from speechtherapypd. com. So, those are my current disclosure statements. [00:04:09] Erin Forward: Hi, this is Erin Forward and these are my disclosure statements. I receive a salary from Cincinnati Children's Hospital Medical Center. I receive royalties from Speech Therapy PD 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 non financial disclosures. I am a member of ASHA and a member of Special Interest Group 13. [00:04:36] Erin Forward: I also am a volunteer for Feeding Matters. I am a contributor for the book Chasing the Swallow of Michelle Dawson, which I received no financial gain. I also am a member of the South Carolina Coalition Committee with ICDL DIF for a time. The views and opinions expressed in today's podcast do not reflect the organizations associated with the speakers and are their views and opinions [00:04:58] Michelle Dawson: Hello, everybody. [00:05:00] Y'all, we are in for a treat. We have a phenomenal speech pathologist joining us today that I am incredibly grateful that the good Lord blessed my stars. I got to meet her and see her in action. So we have none other than miss Claire Martin MEd, CCC-SLP. And she is the truly is a natural AAC SLP and her and I met two different ways. [00:05:28] Michelle Dawson: One, she's a speech language pathologist at the speech and language center in Harrisonburg, Virginia. And two, I met her through her project with the speech hearing association of Virginia through their leadership development program. And she is truly a ray of sunshine and only going to be a Claire Martin for a little bit more because she just got engaged to the man of her dreams in the Outer Banks. [00:05:54] Michelle Dawson: The pictures were adorable. And I'm also kind of geeking out, hoping that we can hear a little about wedding [00:06:00] planning. So AAC and wedding planning go team. Claire, thank you so much for coming on today and sharing your passion, but take us from the beginning. How did you become an SLP? [00:06:13] Claire Martin: Thank you so much for having me. [00:06:15] Claire Martin: I am so excited for this opportunity. Little JMU undergraduate me. It never probably thought I would be in this position. So I'm so excited about this. I went to James Madison University and graduated in 2016. And I kind of stumbled upon speech therapy by chance, I actually set out to be an athletic trainer and changed my path a little bit. [00:06:39] Claire Martin: I had some family friends that are speech language pathologists and I kind of questioned them and Just kind of took a leap of faith and changed my major freshman year and then loved it ever since. And I was grateful enough to have the opportunity to intern at the Speech and Language Center where I now currently work when I was an [00:07:00] undergrad. [00:07:00] Claire Martin: And then after that I went on to pursue my master's at the University of West Georgia in Carrollton, Georgia. And then I did an externship placement back at the Speech and Language Center and then I've been there now on and off for probably five ish or maybe four years. I took a little break and went to work for Harrisonburg City Schools for a couple of years, and then I came back about two years ago. [00:07:26] Claire Martin: But I have loved my journey. It's not been a seamless one, that's for sure. But I have, you know, Learned a lot along the way. [00:07:35] Michelle Dawson: Y'all, her project for the LDP program through SHAV culminated in an AAC meet and greet. And it was. When you come across like minded, passionate individuals that want to empower every tiny human that comes across their caseload, and sometimes not so tiny humans because let's face it, some of our kids have missed the [00:08:00] window on AAC and but claire set up this meet and greet full of like minded, passionate individuals all across the valley. You had a lot of SLC folks, you had some of the local school districts and it was Absolutely spectacular to we and Lorna Frizzle from JMU T TAC. She is Mrs. Frizzle come to life. And it was, it was, Amazing to see you create a safe space for us to talk about AAC, the challenges, solutions, all HIPAA compliant, and you fed us and gave us coffee. [00:08:35] Michelle Dawson: It was great. So thank you. [00:08:38] Claire Martin: Yeah. Well, coffee is always necessary for those conversations, but for any conversation. But no, it was really great to be able to do that. And we, I mean, as a private practice clinician and a former. school based therapist. I really saw the struggles with communication that we have some time or the obstacles that are there with. [00:09:00] AAC and just therapy in general about like, we don't have enough time, you know, we're, we're doing things to work towards IEP, or we're doing things to work for the parents, or, you know, we're doing these things and we really needed a space, like you said, a safe space to come together and have those conversations about what are, what are we doing? [00:09:17] Claire Martin: What's working? What's not working? What can we do better? And I was really so thankful to have that opportunity. And we definitely want to do more of this in the future. [00:09:25] Michelle Dawson: Yes, yes, and I will happily drive up from Stanton because I learned so much about like vendors and like who to contact if you needed help with this. [00:09:35] Michelle Dawson: I mean, being an outsider coming into the area that it was warm and inviting. So, thank you. But okay. One of the things that I'm in, forgive me if I'm being nosy, but how in the blue blazes, did you want to get into AAC? In general, because this is like a little niche pocket area of our field. So what piqued [00:10:00] your personal passion? [00:10:02] Claire Martin: Well, you're definitely right. It is definitely a niche area of our field, but it is growing and growing and growing and everybody definitely needs experience and ways to learn more about AAC. I actually, you already mentioned Lorna Frizzell. She is my AAC queen. She is not a speech language pathologist, but has such a great deal of AAC experience and knowledge and just wisdom. [00:10:31] Claire Martin: And so I worked with her in Harrisonburg city schools. Actually, we go to the gym together as well. But we we go to orange theory together. And so I kind of, Told her about the job with Harrisonburg city when she decided to take it. Ultimately, she kind of heard about it, but then she decided to take it. [00:10:49] Claire Martin: And she was like an AC kind of coordinator liaison for us, for Harrisonburg. And so she supported me in getting a device. [00:11:00] a patient who had lost vocal fold functioning due to a feeding tube issue and a lot of medical complexities going on there, but we ended up getting her device and I mean, it was phenomenal to see the things that she was able to say with her talker. [00:11:17] Claire Martin: Lorna also kind of was the one that, Taught me the word talker, which I now use regularly. So I don't, I typically try to stray away from using device or or iPad or a voice because it is something that talks for people and it doesn't replace like their natural voice or otherwise. But so she and I got this talker for this student and it was just, like I said, amazing to see the things that the student was then able to say and do after she had it. [00:11:48] Claire Martin: And that just really, I think, sparked my interest more. And I will add in that this student now has Full functioning of her vocal folds back. Yes, she's amazing. And one of our [00:12:00] speech therapists, Adrian is a or a vocal like guru at the SLC. And so she actually saw her and then now has full functioning of her vocal folds. [00:12:09] Claire Martin: So she's amazing. Adrian's amazing. But but yeah, so that I think was. And then just since then seeing so many patients connect with this access to visual supports and the speech generating devices and hearing their caregivers share success stories about their child using AAC at home. And, you know, just the access to the vocabulary that they had that they otherwise may not have. [00:12:35] Claire Martin: So that's how I got into it. Yeah. [00:12:38] Michelle Dawson: Nice. I got into it vicariously. I because most of the patients that need me for PFD are like really complex. So they tend to have delayed language acquisition. They may never have spoken language. So we need You know, to be able to communicate once need, joys, fears, life. [00:12:59] Michelle Dawson: And [00:13:00] it's always funny because my joke is as soon as you get to doing two word combinations on the device, I'm out. Dude, you don't need me as your AAC therapist. You need like the AAC therapist as your therapist. So that's what I'm like, tag, go to a guru. [00:13:15] Michelle Dawson: So I feel like my job is just to kind of get them started on their talkers to just kind of initiate the device process. [00:13:22] Michelle Dawson: But most of my tiny humans are tiny. Like I get twos, threes, fours, and fives. And so. We don't, very rarely am I beyond two to three word combos. Like it's, that's so listening to y'all talk about like sentence structure and like, like verb conjugation, I don't, this is over my head and not so y'all. I don't want you thinking I really know all of these things. [00:13:52] Michelle Dawson: I don't. I don't have to. It's my job to know the part that I know how to do to do that really well and grow there, [00:14:00] and then transition to gurus like Claire, who actually know about verb conjugation and like syntax or like how to even conjugate that word in various formats, because there's syntactical elements. [00:14:11] Michelle Dawson: I learned a bunch of new words last year at JMU and I'm like, Hmm, don't do that. . But all of that being said. When you get them kind of when you find a tiny human or not so tiny human that needs an AAC, what does your process look like? Like what, what's a normal caseload patient in your process? [00:14:35] Claire Martin: Well, I would think so some, some patients we get and again, I'm speaking to primarily pediatric patients. [00:14:43] Claire Martin: A lot of adults can and do use AAC, but I, I do have a few, but primarily I'm talking pediatric. And so I'm going to speak from experience on that. But thinking about like a patient that you might have an evaluation that you [00:15:00] might go ahead and introduce AAC to, or you might have a patient that you've been seeing for a little bit. [00:15:06] Claire Martin: You've been modeling a lot of verbal language and sign, and they just aren't imitating. You see that maybe they need those visual models. and speech output from a device. So really just kind of gauging it with your clinical experience and expertise. Like, is this something I want to go ahead and introduce to the patient? [00:15:29] Claire Martin: In an evaluation, or like I said, down the road in therapy, and then after that, really just talking to your patient's caregiver about this. What are the benefits of AAC? What, what does it do? What does it not do? Making sure they understand the AAC does not limit verbal language growth and Making sure, like I said, that they are on the same page with you talking about insurance funding, if that is something you need down the road having those discussions up front, because you do need to have them on [00:16:00] board with you otherwise. [00:16:01] Claire Martin: It's just not going to go anywhere. And then also collaborating with OTPT if you have it, ABA if they have it. And then if they're in school, the teachers or caregivers at a daycare or any other kind of, you know, Individuals that are really important to that child's life need to also be on board as well. [00:16:22] Claire Martin: So I think that those are pretty much the beginning stages, early starts. And then you might want to start thinking if you've got all that in place, thinking about programs, which is a whole other ballpark. There's so many. So there are, and you know, This is a pretty basic kind of overview of AC, but there's so many programs and companies that you can consider. [00:16:47] Claire Martin: Proloquo2go is a, an application. Toby Dynavox has applications and different page sets. PRC has different applications. There's, you know, lamp words for life, [00:17:00] touch chat, cough drop a vase grid three. There's. It's kind of mid tech like choice board applications that you can get. And then of course you also want to consider bilingual individuals. [00:17:12] Claire Martin: Does the application that you're considering support bilingualism in your patient? Does it have a Spanish feature and an English feature? How easy is it to toggle between the two? Do they have a different language, Mandarin per se, that they might need. So that's another consideration. [00:17:31] Michelle Dawson: This is, and y'all this, this doesn't all happen at once. [00:17:37] Michelle Dawson: That's the catch is this conversation is normally numerous conversations held over numerous sessions to lay the groundwork. And okay. So big picture. One of the biggest barriers I see in the private rehab world, right? Is one getting the devices in our clinics so that we [00:18:00] have something to practice with. Right. And so when she's naming all of these different companies, I'm If you're a private practice owner, I remember my first fear when I opened up my private practice was back in South Carolina was I can't afford them. [00:18:15] Michelle Dawson: I thought I had to buy these things. And I was like, there's no way I can pay like umpteen thousand dollars. I mean, I was a speech baby. I didn't know what I didn't know, but you can partner. With the different vendors to create long term loans for your clinic, as well as the individual loans for the patient or child that you're working with, but I am, and I'll admit where I screw up in South Carolina. [00:18:43] Michelle Dawson: Talk to me technologies. That's the one that I always know. That's. The biggest vendor, you know, shout out to my peoples back in the Palmetto state. Like it was quick to get the contracts in and get the devices in. Right. Then I moved to Virginia and talk to me. [00:19:00] Technologies wasn't over in the Valley. Like they just didn't have as big a presence. [00:19:04] Michelle Dawson: But I met Jessica with Darcy Satillo, but my bias was, I knew that one company. But that didn't give my patients an opportunity to see the different tech out there. So at least now where I am now, we've got contracts with PRC Saltillo and with talk to me technologies, and I'm working to get Toby Dynavox. And so I have. A variety, but that's taken six weeks to get those set up. How about you? How have you, what process and what steps have you taken to get tech into your clinic? [00:19:42] Claire Martin: Yeah. So kind of same with you. I mean, you definitely get, and I'm very guilty of it, but you find the one that you like and you're like, we have this. [00:19:50] Claire Martin: And we're good. And we, we have very, we have a bunch of different apps on our iPads, which is really great. But sometimes as we talked about in [00:20:00] the presentation that I did with you for medically complex individuals, sometimes iPad isn't the way you can go and you need different access methods too. So that is definitely a whole different challenge as well. [00:20:12] Claire Martin: But we do have some Toby Dynovox loaner devices. And we do have, we have a we go from talk to be technologies and we have able net has been super great as well. And getting devices in our hands as soon as we need them. But as far as like having those devices in your clinic, just readily available is challenging. [00:20:32] Claire Martin: And then Having enough of them is challenging, too, because we have a lot of users of AC. And so then, you know, 1 clinician may be using it. Another clinician needs it. And, you know, we have 3 offices. We have 1 in Loudoun County and 2 in Harrisonburg. So, sharing them amongst the offices, just like sharing regular SLP assessments can be challenging too, because who [00:21:00] has the CELF 5? [00:21:03] Michelle Dawson: I'm just happy you said CELF 5 and those that shall not be named. Y'all, that was a Harry Potter joke. [00:21:14] Michelle Dawson: But also the key cards, like having the enough key cards, because I keep, I have broken more key cards sitting on them, which is really embarrassing to admit, but like they snap! And I have, mama got back, like there, it's thick back there. [00:21:34] Michelle Dawson: I will, like, You know, pull it off because we're trying something and then I'm running around the clinic having a field day chasing a tiny human on like a tricycle or like crawling in and out of a tent, and then I sit on the bloody things. So, I'm reassured that they are the least expensive things that if you have to break. [00:21:53] Claire Martin: Yeah, fortunately, it's just cloth. [00:21:55] Michelle Dawson: Yeah, goodbye. Yes, but also, Then we have, then there's the [00:22:00] outlier cases, right? Like, if I have a very medically complex case that I don't feel comfortable evaluating myself I'll reach out to Control Bionics or to Eye Gaze, and I will ask them to come and bring their trials with them. [00:22:17] Michelle Dawson: Right. And guys, when I say this, I don't get a script that says AAC, eval, and treat. Like oftentimes it's a language eval and treat. And then the family walks in or, you know, they will the tiny human. And you're like, Oh, this is not the trajectory that I thought it was going to go based off of the limit information on the script. [00:22:35] Michelle Dawson: So we schedule like a consult later on, but they bring their tech with them. And that to me, is Spectacular. Also, I don't want the financial responsibility of being responsible for like the 30, 000 tech. [00:22:48] Michelle Dawson: Yeah. That makes me anxious. [00:22:50] Claire Martin: Right. [00:22:51] Michelle Dawson: Yeah. [00:22:51] Claire Martin: No, yeah. They, the vendors are the way to go for sure when it's medically complex and they need a different [00:23:00] access method. [00:23:01] Claire Martin: Whether it's, you know, like you said, eye gaze or a switch or I had a former student that used a shoulder switch, you know, so any of those things, yeah, it was very, he was very impressive. But they, the vendors are definitely the way to go with that and contacting them and they are so accommodating and will come when your patient is in the room and will help with setup and getting the trial rolling and everything like that. So definitely. [00:23:30] Michelle Dawson: And that's free. What I wish I knew. Those consults are free. They come and they tie their services. I mean, you know, they want you to end up using their tech, but like that to me is a spectacular way to collaborate. And what's really cool is I'm old enough that I remember they all used to be sales people, but now they're actual SLPs or OTs, which is kind of cool. [00:23:50] Claire Martin: Yeah. Huh. Yeah, absolutely. They have some, at least have some knowledge of the field. [00:23:56] Michelle Dawson: That is beneficial. I squirreled, I got us excited. I'm [00:24:00] sorry. We were quoting fantastic songs and boobie lines over here. So. [00:24:08] Michelle Dawson: So when, when you're doing your evals and you've planted your seed, how do, how do you know when it's a right fit for a device and a program and the user? [00:24:24] Claire Martin: I feel like when they're able to communicate everything they need to communicate and all the settings that they need to communicate in. And yeah, yeah. [00:24:33] Claire Martin: When your parent or caregiver is on board for sure. And when I feel like you just, you know, you just know at that point when it feels like it's the right, the right thing for your patient, when they're independently, or maybe not yet independently able to, Request something that they really want, or they're able to tell you how they feel, or it feels like if they're not quite [00:25:00] there, they will get there. [00:25:01] Claire Martin: So going back to our discussion about medically complex. I have a little and again, I'm going to share a lot of anecdotal stories. Because that's just how I roll. I have a little one who we finally, we, we tried a lot of devices for her. And we finally found one that we felt like fit her. And was she independent with it? [00:25:21] Claire Martin: No. Is she independent with it now? No. But. Will she be? We felt like that was the best fit for her to grow with and to move forward with. And it took, like I said, a lot of trial and error, but when I felt like mom was comfortable with it and I felt comfortable with it, then we both were like, okay, this is the route we need to go. [00:25:42] Claire Martin: And we started out with her with eye gaze and ended up with, Direct access. So you just never know. Yeah. So you just never know. And she's amazing. She's the sweetest tiny little pumpkin. But you know, and then you just kind of, like you said, trial and [00:26:00] error and figuring out how, how to, Are they going to be able to communicate everything that they need and want to communicate and does that device allow them to customize things, add to what they want to add and Just, yeah, use it wherever they need to go. Do you have buy in from school? You know, things like that as well. [00:26:26] Michelle Dawson: One of my mentors, Dr. Carol Page from South Carolina. She always said start where you want to end. And I thought that was the most profound advice. And she's like, think about it, Michelle. She was like, normally insurance covers one every five years. [00:26:44] Michelle Dawson: And you, if you start where they're starting and you don't leave room for growth, you've, you've cut them off. And it blew my mind because it gave [00:27:00] for me clinically, it gave me a space to say, Hey, there Working at like maybe lamp at like the transition level, right? But we can build to the third level, or if it's at the third level, like the full, I can scale back all of those verb conjugations so that we can build into it as their language naturally grows and acquires, and it gave me permission to, I don't know, there's, there's an approach and feeding therapy where you anticipate and some etiologies and disorders, you know, that there's going to be penetration, right? Like you, you know, like, you know, there's going to be some level of aspiration because this is what's going on, but that doesn't mean that they have to be 100 percent NPO. [00:27:52] Michelle Dawson: You can work in the gray, which I don't like gray. I want it, yes or no, black or white. But with [00:28:00] her statement, it gave me wiggle room to work in the gray and AAC. And I didn't have an AAC grad class. I had an undergrad class that they like cleared for grad school, but I graduated a little bit before you, cause I am old. So I [00:28:15] Claire Martin: No you're not, [00:28:17] Michelle Dawson: yes, this is all Botox. I graduated in 09, so I'm like, hi, I'm rocking that 41, but like, that's. And I have devices have changed and programs have changed. Like I haven't had a chance to work with cough drop. Like I don't know anything about it. I see it. And I'm like, okay, I do not emotionally have the bandwidth to learn a new program right now, but eventually I want to sit down with it, but that's part of our growth. [00:28:49] Michelle Dawson: Okay. Wait on that note, where do you learn about the new AAC? How, what makes you grow? [00:28:55] Claire Martin: Yeah. I, well, so our our clinic [00:29:00] Cicero therapies they do a really good job of having clinical round tables once a month. And they have mentorship programs, which Michelle, you are one of those. But so they have some opportunities for us within our practice. [00:29:12] Claire Martin: But also I, I Like I tell my grad students, and I've trained a couple of SLPAs as well. The best way to figure it out is just to do it. Because you're not going to learn without trial and error, without making mistakes. And it's the same way for our AAC users. They just have to do it and figure out where things are and how to do it on their own. [00:29:33] Claire Martin: And then, you know, reaching out to, like you talked about reaching out to vendors. If you're at a private practice, you're out of school, taking that initiative and reaching out and having a representative come and teach you about what they have to offer and doing that with lots of companies so that you are able to see what is out there and learn the new products and learn you know, new programs and things like that as well. [00:29:57] Claire Martin: Like they're always coming out with new [00:30:00] things. Like you said, it changes so rapidly. Another thing I really like to do in terms of like AAC use and therapy and just tidbits to share with families and things like that is to follow Instagram accounts of really good AAC promoting therapists or just therapists that use a lot of AAC in their practice as well. And to get those tidbits. [00:30:21] Michelle Dawson: Yes. And, and the trick is she said really good. So she follows highly reputable colleagues because there are those on Instagram, man, that want to be the Instagram famous. And so, which is a thing that blows my mind because I am that old. But it's like the Blippi. Like, like the YouTuber or yeah, whatever. [00:30:42] Michelle Dawson: I don't also do, and then Mr. Beast, I don't know how that man made money to give away stuff like that, but that's a thing. Yeah, you, cause she shared her resources with me and you've got some like all star AAC SLPs that you, you've learned from. So who are some of the folks that like [00:31:00] inspire you? [00:31:01] Claire Martin: Oh, goodness. Well, I, so. I will say the list that I shared with you, we actually have a whole list of broken down by category like AAC, articulation, language therapy, Instagram handles to share with our families and our clinic. And so I kind of pulled from that. But I really like the Rachel Madle. I don't know if I'm saying her last name right. [00:31:24] Claire Martin: She has a really good list of resources and just things you can pull from there. I also love Ms. Speech EP. She's not in the ones that I sent you, but she is really great. For, I mean, a whole different side of this, but autism and neurodiversity affirming practices and things like that. She's really great. [00:31:42] Claire Martin: But it's just nice when you're doing your mindless scrolling that all of us do to, you know, You know, you're just scrolling, you're scrolling. And then, Oh, I see that. And that's just a quick way of getting something that you can take in your practice rather than sitting down to read like a 10 page article, you know, you just be like, Oh, okay yeah, that makes [00:32:00] sense. Or that's something that I can implement tomorrow or something like that, rather than being something very time consuming. [00:32:07] Michelle Dawson: Yes. It's making it functional. So, Dr. Michelle Theron out of Florida State University, she's the ASHA topic chair co chair for AAC this year. Her research is on how to make a friend if you're an AAC user. [00:32:24] Claire Martin: I love that. [00:32:25] Michelle Dawson: Like it's all about being a friend and like, how do you play when you're an AAC user? And like, I love listening to her talk. I love watching her present because she's talking about joy, about life, about what it like at the end of the day, like the thing that it is that like adds meaning to a kid's world is, Hey, I played with a friend at recess today. [00:32:50] Michelle Dawson: Like that's when goose comes home from school. It's who'd you sit with at lunch today? What did you guys talk about? Like, give me the deets, right? Like, oh, nobody says that. [00:33:00] [00:33:01] Michelle Dawson: I need the tea. Is that still a thing? [00:33:04] Michelle Dawson: I don't know, maybe. But he's a boy, so like, But like, Those are, like, those are the things that, like, I want to know about. [00:33:13] Michelle Dawson: Like, Bear, did you talk to somebody this morning in school? Because he has social anxiety. [00:33:18] Michelle Dawson: And like, so like, different conversations that as a caregiver you have with your, your kids. But as a, as a, as a AAC promoter and champion. I want to make sure that we're, we're empowering and we're uplifting them. So I love the references that she gave. [00:33:42] Claire Martin: Good. I'm glad. Yeah. [00:33:44] Michelle Dawson: So I love that you give resources to the caregivers, but when you're doing therapy and this is the same when I was down back old home, this is the same that I've noticed being up here in the valley is there's the obvious concern that if we [00:34:00] pull in a device or a talker that the child won't speak. [00:34:03] Michelle Dawson: And then there's also, I have families that have a steep learning curve because they're not tech savvy. And even more than that health literacy. Right? That's a huge component to to what I'm encountering. [00:34:21] Michelle Dawson: I love that you go through and you talk about establishing the trust Like it could be that first eval, but sometimes you have to create the partnership before you pull the device in. [00:34:35] Michelle Dawson: But what about for the challenging kiddos that you know, it'll be great if we can get them in, but they don't appear interested in it or they're they want it to play like their videos or their music. What, what are your strategies? [00:34:52] Claire Martin: We definitely see those same things as well, and I think, like I said, starting from the very beginning with those con open [00:35:00] conversations of this is what we want to do. And this is what I think is a good idea. Here's why I think it's a good idea. And I think part of that is having that relationship with your family. [00:35:13] Claire Martin: And that's why I kind of said sometimes you introduce it in the evaluation and sometimes you don't. Because sometimes you do need that relationship with the family first. To where they're trusting your professional and clinical opinion. And then, a lot of times, if you do have that rapport with your family, they're going to say, Oh, okay, well, yeah, like, you're the professional, I trust that, I trust what you're saying. [00:35:33] Claire Martin: And maybe they'll be more open to it then. Because, like, we know it doesn't discourage verbal communication, and I have seen it. [00:35:42] Michelle Dawson: I love that you go through and you talk about establishing the trust. Like, it could be that first eval, but sometimes you have to create the partnership before you pull the device in. But [00:36:00] what about for the challenging kiddos that you know it'll be great if we can get them in, but they don't? [00:36:07] Michelle Dawson: don't appear interested in it or their they want it to play like their videos or their music. What, what are your strategies? Because I'll be honest, I sometimes still struggle with that. [00:36:18] Claire Martin: Yeah, it is. I mean, Oh, that is so challenging. I, we really, those are the ones that were like, we need our occupational therapist. [00:36:27] Claire Martin: We need to work on attention. We need to work on engagement. But having really preferred Activities or objects in the talker that they can request that they and then modeling, I mean, model, model, model without expectation. Absolutely. 100%. So we're just every time they're requesting it or reaching for it or playing with it. [00:36:47] Claire Martin: We're modeling that. But sometimes it's still not enough. Because sometimes you still don't have that attention and engagement. One of my friends friend and colleague that you also know, Michelle is [00:37:00] Alex Machonsky and she has done something really recently that I've loved and she's recorded part of a song to put into the talker so that when you, they hit the button, it sings part of the song or it, you know, requests part of the song or things like that, especially for GLPs that love song and dance and videos and they can then engage with the device a little bit to get down on their level and kind of Peak their interest a little bit more. [00:37:28] Claire Martin: So, but those are not you know, Full, fail proof. So, we, you know, We just kind of take it as it comes And take it case by case. [00:37:37] Michelle Dawson: So, I I have a kiddo on my caseload right now who definitely a Gestalt language processor level two was at a different program. We have a diagnosis of ASD, but we also have a genetic condition, which is the causal factor for, ASD for this [00:38:00] tiny human neurogenic etiologies in addition to everything else that's going on. [00:38:04] Michelle Dawson: And the mom came and she was really candid that she had had an Eval and attempted therapy for their son, but was told there's nothing we can do with them because he won't listen. And what I'm gathering is that they went to a, uh, to therapy where the child was tasked with sitting at a table and imitating and accessing the device upon presentation. [00:38:36] Michelle Dawson: And hear me when I say this, folks, that is how we were taught. That is how I was taught. I know that's what my therapy looked like back in the day, right? There's times. Yeah. [00:38:51] Claire Martin: Oh yeah. I mean, even with mine five years ago, I mean, [00:38:55] Michelle Dawson: you know, but that's, that's just it. But you [00:39:00] said model without expectation. And that is a phrase that when you're going through and you're doing the AAC eval part and you have a child that isn't comfortable with tech right out the gate, right? Like they just don't want to engage with it. Model, model, model. We got to keep presenting it and presenting it in a fun way such that they want to. See it. They want to check it out. [00:39:27] Michelle Dawson: They want to, I mean, one little guy that sniffed and licked all things cause that's where he was developmentally and the mom was like, he won't electrocute himself, will he? And I was like, I. Don't think that he'll electrocute himself looking the twice, but like, I mean, uh, he did not. [00:39:45] Claire Martin: That was his way to learn what it was. [00:39:46] Michelle Dawson: Yes, but it was, that was, that's, he was still at the mouthing phase, right? I mean, he was like almost three, but we were still at the mouth. But like, developmentally, that tracked, right? But, I say this because, For those of us that were [00:40:00] taught therapy happens at the table. We have to first learn to let that piece go. [00:40:05] Michelle Dawson: Therapy doesn't have to have a table, have, you don't have to have a table in a therapy room and then not even for feeding therapy, the hill I will die on. And then to model without the expectation, because this is huge, huge. But when you said that, I was like, Oh yeah, yes, [00:40:23] Claire Martin: presumed competence and model without expectation there. Yeah. The, my Roman empires for, for the Gen Z, [00:40:31] Michelle Dawson: I'm so old. I'm like geriatric millennial over here. Yay. [00:40:38] Claire Martin: I heard that term earlier today for the first time. It's, no, it was elderly [00:40:45] Michelle Dawson: geriatric. Come on, man. I sneeze pee after two kids. That's even with pelvic floor therapy, but they there was a, uh, Yeah. , an elder millennial was those that had the one computer in the classroom. And I'm like, this is [00:41:00] why AAC is so hard for us because I, you'll get dysentery and die in pixelated form, crossing the Oregon trail. So like, we need to, [00:41:13] Claire Martin: you did not make it to the end of the Oregon trail. [00:41:17] Michelle Dawson: No, I did not. Oh god. That's great. But that's, but for. Let's be honest. We're treating kids of caregivers that were also elder millennials. That this is overwhelming. The tech is scary. And we want, I, as a mom, I want, when my child is exposed to something, I want them to catch on to it naturally and quickly, but that is not necessarily going to be it for AAC users. And that's okay. So yeah, [00:41:52] Claire Martin: yeah, no, I'm, I'm with you there. Those conversations, like you said earlier, happen over weeks at a time, multiple sessions [00:42:00] at a time and they just that constant reassurance. I think our families need sometimes of this is not something that we're expecting them to pick up overnight. This is not something that they're going to just pick up. Pick up the device and just start creating full sentences. This is not something that we, you know, sometimes even expect them to, to get in months, periods at a time. [00:42:23] Claire Martin: But just needing to give our families. That comfort and that safe space to problem solve with you and to learn and to grow alongside them and ask them openly, like, what do you like about this? What do you not like about this? Like, is this something you see yourself using at home? And then also When they're learning something, holding them accountable. [00:42:46] Claire Martin: I have a family that wanted me to make a goal to do like a weekly checklist at home. Like this is where we modeled the device this week. This is how he responded this week and things like that because they want to be held [00:43:00] accountable as well because they know oftentimes after you get to that point where they do see success at home, they want To continue to see that success as well. [00:43:08] Claire Martin: And so, being there with them just to, to support them and encourage them and to provide all the resources that you can to our caregivers is huge. And, and resources that make sense and are not above their head, you know, are, you know, like just things that are. Visually appealing and, and things that you can go over with them as well can help them a lot. [00:43:38] Michelle Dawson: One of the things that I struggle with clinically is, especially for feeding, like I'll get in my head and like, it makes sense in Michelle land, but translating an outside of Michelle land and putting it into layman's terms. And so I always joke with my families and I'll say, okay, I got to go nerd first. [00:43:59] Michelle Dawson: Because my [00:44:00] neurodivergence, my ADHD, I am a very visual person and I have to talk it out, but I have to talk it out with my hands, which is stupid. And I look like, I mean, I know it's an interesting combination, but so I explained to them, look, I'm going to go nerd first and then I'll translate. And when I explain it like that, so the caregivers understand, this is just my thought process. [00:44:23] Michelle Dawson: It's really cool to see us establish the trust in the relationship. And then hold a really in depth conversation about something huge and easy to format snippets. Right? And so with AAC, I find myself, because I am not a robot, like most of my caseload uses it, but not. In the level to which my other AAC user friends like yourself use, right? [00:44:55] Michelle Dawson: Like where the baby steps. And so just explaining it to them in a [00:45:00] non threatening non Oh, what's the word condescending approach. And that's, and that's Trixie. Very technical word, Trixie, but it's, it's it's important that we're creating that safe space for them to feel comfortable to ask the questions because when you do encounter subject matter expert, it can be embarrassing when you say, I don't know how to do that. [00:45:24] Michelle Dawson: And, and that's, that's okay. Y'all, we, I am not subject matter expert on AAC or feeding, but I know the person to connect you to. And that's, that's what I'll tell my caregivers. So yeah. [00:45:41] Claire Martin: And I have even, you know, kind of going out that route have been approached with questions about the tech from parents that are just way more intuitive than I am. [00:45:50] Claire Martin: And then they're like, well, how can we do this? Or, you know, what could we do to make this happen? And I'm like, You know what? I have no idea. Let's ask the device representative, [00:46:00] because, because I know, like, I'm like, I know this part about the communication piece. And then some of these other cool features, I have no idea. [00:46:09] Claire Martin: So that's where other people come in handy, too. But like you said, like, being able to be vulnerable enough to say, like, I don't know that, or I realize that. You know, that's something that I need to go and reach out to somebody else. [00:46:23] Michelle Dawson: Uh, Jessica with PRC Saltillo, she's the regional rep for our side of the mountain. [00:46:28] Michelle Dawson: She came over to the clinic a couple of Fridays ago and I was like, she was talking about unity words for life and the secret bar under the bar at the top that can like save phrases. I didn't know this thing existed. Holy cats! So freaking cool, man. And so She was showing me how to program this and then how to change like the grid size so that the grid is the same, but the icons are a little bit smaller so you can [00:47:00] put like a larger background. [00:47:01] Michelle Dawson: Like I didn't know that all of that was embedded within Unity, right? Cause I've used PRC Sotelo lamp and I've used words for life, but not the Unity board because it's. It's a different setup on talk to me. And it was, I was like, all right, you have to show it to me again. And it was cool to watch her drive the device upside down. [00:47:23] Michelle Dawson: So it was like facing me and she's, and I mean, she is an ATP, like she's literally like, yeah. Assistive technology person, what is professional? It's Professional. It's the certificate that you can like. Professional sounds better. The person, Jessica, we love you. But it was so mind blowing and humbling. [00:47:47] Michelle Dawson: But I love that moment because she taught me and then, don't you know, the following Monday or Tuesday, I had a tiny human come in with the unity words for life and I understood [00:48:00] and I, and so the mom was like, well, I don't remember how to add this vocabulary word. And I was like, I think it's this way. And her and I troubleshooted it together. [00:48:09] Michelle Dawson: And it was comforting to be a hot mess express with the mother because with like pulling from the information that had just been imparted on me, but it, I don't know, it's, it's, Yeah. Y'all we can shine in our career. [00:48:23] Claire Martin: And I think there's something so valuable about that, like troubleshooting alongside them because they're like, Hey, we're learning together, you know, and that continues to build that rapport with the family as well. [00:48:34] Michelle Dawson: Yes, it does. Oh, yeah. Okay. So. We've squirrel. So you have them come in? We do the ev, do d, adhd, I guess my pslp win. They, they come in and they do the eval either right out the gate with the tech or you plant the seeds and you get it in what, when you find the device and the program, because those are two separate [00:49:00] things. Right? But when you Mm-Hmm. find the device, the program, and the access methodology that works for the child. What are your steps with insurance and report writing? Like what are all those behind the scenes things that I didn't know needed to be done the first time I, I went into this world. So can you illuminate us there? [00:49:25] Claire Martin: I have recently learned these things as well because prior to working at the Speech and Language Center, again, two years ago, I had not, done that either. Lorna was so gracious to walk me through that very first AAC evaluation report. Being her non SLP self, she knew way more about it than I did. And so I have gone through that as well. [00:49:48] Claire Martin: But yeah, so you've gotten You've gotten your formal trial done. And so now you're working with the, the vendor to request the actual insurance funded device. So it kind of [00:50:00] depends on the companies. Some will get the insurance information for you. Some want you to kind of do the legwork for that. [00:50:08] Claire Martin: But getting that report written is obviously key and making it for you. So, and I say making it, not making it, but just providing that data that you have to show that this device is necessary, medically necessary for your patient to have in order to essentially leave. Function and day to day living and with day to day activities they love insurance, love to see that they are able to communicate medically necessary information as well. [00:50:39] Claire Martin: Emotions such as like, you know, when they're in pain or when they're hurt. So those are things that oftentimes your auditor might send back like, Hey, could we add in a little bit more about how you saw this patient able to, or you saw this patient communicating Medical information that is something that [00:51:00] we do get back. [00:51:01] Claire Martin: But so once you send your report, the auditor will take a look at it and then send it back to you for edits if needed. And then you send it off. And then the waiting game begins in terms of waiting to see if insurance approves. We have had. Some more denials lately than, than there were before. I think that's just kind of with the insurance world changing a little bit. [00:51:25] Claire Martin: But yeah, and then hopefully it's approved. And then once you get it approved, they'll mail the device to the patient typically. And then the vendor representative can help set it up or you can help set it up and then you can kind of get the ball rolling from there in terms of that being there. [00:51:46] Claire Martin: dedicated speech generating device to have for likely the next five years. [00:51:52] Michelle Dawson: I, I had a colleague ask me one time, and I'll admit [00:52:00] I was a little frustrated in general but we had a crucial conversation about why not just stick with the iPad. Why, why, the school's giving them an iPad, why do you actually have to get a device? [00:52:12] Michelle Dawson: I'm like, I, so, this, this is the why. School districts are responsible for offering devices, right, like, we, we know this, they have to offer it, however, those devices are owned by the school oftentimes, more often than not. I see the devices not go home at the end of the school day. They don't go home at the summer. [00:52:37] Michelle Dawson: It is just for while they are in school. So step one, we're taking something that should be theirs to communicate basic once life's needs at bare minimum, and then all of the joy on top of that. And they don't have full access to it. But also what I have found is by going through with the vendors, They do a really good [00:53:00] job of securing the script from the pediatrician and a letter of medical necessity, which they To my life. [00:53:05] Michelle Dawson: I've never actually seen a letter of medical necessity, but the vendors get that right. And they send that off with the insurance. But also if that child breaks the device in those five years, if that child if the family needs help training and. You and I both had this happen in our worlds where our colleagues set up a device, but then their husbands get transferred or deployed, or they go on maternity leave and they're not there when they come back. [00:53:32] Michelle Dawson: The vendors also have 1 800 phone numbers where you can set up one to one trainings because, I mean, my therapy sessions are 30 minutes now. I don't know if you're running 30 minutes or an hour. Yeah. 25 to 30. We can only do so much imparting of the wisdom with the caregivers in that timeline, but we can in that timeline, walk them through the resources available to them such that they can [00:54:00] on their time when they have the headspace. [00:54:03] Michelle Dawson: And let's be honest to all of the working caregivers in the world, having headspace is a lovely place to be. Schedule those consultations and to get that mentorship. And, and that's. To me, those are the bigger, but yes, we want them to have a device with a program, but all of that extra support is. well worth the what it costs insurance to pay. [00:54:34] Michelle Dawson: So, yeah, there's a couple of insurances. I would love to talk to you after hours, but we'll talk after hours about, [00:54:41] Claire Martin: yes. I'm with you there. So the hot gossip of our office. Yeah. Change topics. Sorry. [00:54:56] Claire Martin: No, but you're, you're totally right. I mean, [00:55:00] having the parent feeling empowered in terms of if something breaks, like you said, or if something glitches and who can they contact at, you know, six o'clock on a Saturday evening in terms of, oh, my child's talker won't turn on. [00:55:16] Claire Martin: So knowing that they have the resources for those things is. Very beneficial and crucial in terms of, if you're comparing it to just having an iPad not to mention it's a dedicated device then and not just a, an iPad that they can go back and forth between their speech application and [00:55:34] Michelle Dawson: yes, yes, I had a, I have a kiddo that I've been working with off and on for the past couple months, and the device came home from the school and the mom was like, well we have two programs on this one, and then at this other place we're getting therapy, we have two programs on this device that they're trying. So the child has two devices with a total of four devices. [00:55:58] Michelle Dawson: different AAC [00:56:00] programs. And you know, what he has learned is he can triple click to get out because we have memorized passcodes and get into uh, Some of the video games in there and I'm like, mm hmm. Also. Wow, you're really smart. You've learned guided access [00:56:20] Claire Martin: Yeah, yeah And they do they learn that [00:56:27] Michelle Dawson: But that was that to me Bigger picture was a breakdown in communication between the team that we had two devices with four different programs going on and different people responsible for programming vocabulary on the different devices. [00:56:45] Michelle Dawson: And I was like, let's put a fork in all of the above and try just 1 and yeah, and that is a, where I feel like the private practice SLP has the ability [00:57:00] to kind of be the bridge for the team, whereas sometimes the school SLP's hands are tied. Is that, is that a fair, like, does that make sense? [00:57:11] Claire Martin: Yeah. I feel like that is a fair assumption. A lot of times too, I mean, the school SLPs are so tied to what they have access to or what they're being told to do based off the IEP and things like that. So no, I I definitely think that's a fair assumption, but, and as long as that collaboration, I mean, just like we did with the breakfast, as long as that collaboration is going on, then hopefully you won't have situations like that, where you're doing a bunch of different things. [00:57:42] Claire Martin: Inevitably, maybe sometimes you will, but that collaboration is so crucial. Otherwise you will end up with that, or the child shows up to school with a talker and the school SLP or the teacher is like, Where'd this come from? So, or they'd never get it [00:58:00] out of the backpack. [00:58:02] Michelle Dawson: Yeah. I always, I always knew I was in trouble when I'd show up to a house for home health and it would be covered in a layer of this week's dust sitting on a counter. And I was like, Oh, Yeah. Yeah. [00:58:16] Michelle Dawson: Yeah. That made me sick. [00:58:17] Claire Martin: That or it shows up dead. I'm like, is it dead because we didn't use it? Like we didn't know it was dead? Or is it dead because we have been using it so much? [00:58:26] Michelle Dawson: Cause that could go either way. Yeah. It could go either way. You're right. Yes. [00:58:32] Michelle Dawson: So, so if somebody is listening and they want to start incorporating AAC trials in their therapeutic practice, one of had this question posed to me this week and it was a actually two weeks ago and it was a really good question. [00:58:52] Michelle Dawson: And she said okay, but Michelle, how do, how do we know which patients need AAC? Like, what am I looking [00:59:00] for on a script? Like, what are we looking for when the referral comes in? And I was like, oh, that's, that's a good question. So I would, let me pose that to you. What are you looking for as a potential AAC user? [00:59:17] Claire Martin: I think, so I've talked a little bit about like, when do you introduce it? I think Anytime I suspect apraxia, I almost always am going to suggest AAC. And almost anytime there is like an expressive delay anytime you feel like the receptive vocabulary is higher than the expressive vocabulary, I feel like the, uh, I mean, again, we presume competence, right? [00:59:44] Claire Martin: But also thinking that they probably are going to pick up a C pretty quickly then. But also, I mean, us as adults, especially ADHD, like, you know, neurodivergent adults, we can benefit from visual support. So [01:00:00] why would we think that a child learning language that doesn't have expressive language could also not benefit from visual support? [01:00:07] Claire Martin: So having that AAC to just provide that extra support that they might need, I You cannot go wrong. It's not going to hurt anything to introduce or try a C. And if you, you do it for a while and it doesn't, you know, again, then you kind of get into that, like, well, you got to continue to do it and you've got to continue to introduce it and the, in the context, but you can't hurt anything by going ahead and trying it and seeing how the patient does with it. [01:00:38] Michelle Dawson: I have one little girl in my caseload who is. Wide open. That child reminds me of my niece. She is piss, fire, and vinegar, and joy the entire time, but she keeps me on my toes. And we're working on Am. She, cause she'll say I, and then whatever it is. I happy. I hungry. I, and we added in [01:01:00] Am, and she's like, you go get that tablet. And I was like, yes, I'll go get my tablet. And then she'd say, I am, and she slid her button on it and she, and she scrunches her little nose at me. Now, here's what I have learned. She is pulling my leg. She'll say, am, if I pulled out a tablet, if the tablet's not there, she will scrunch her nose and defiance and not say, and But she, she's at least starting to do it. [01:01:30] Michelle Dawson: And if she's doing it out of I don't know if she's doing it out of spite or because she can she's going to grow up and become an attorney one day. I am convinced she will be an amazing attorney one day. But she'll know how to say But the, the mom asked me, the caregiver asked me, she was like, do you think this is holding her back? [01:01:52] Michelle Dawson: I'm like, no, because it's the visual, because we're, we're getting that literacy piece. So she's learning the word [01:02:00] and, uh, now do I think she needs a permanent device? Honestly, right now I don't think because she's going through like this rapid language explosion, but as a tool in therapy, it's, it's huge. Sometimes we just need an aid to get us there, right? It's like our team needs like a walker and an adaptive tool. [01:02:27] Claire Martin: And that's a really good point that you brought up because sometimes not everybody will need a permanent device, but will it be a good therapy tool? A lot of times it will. Absolutely. Yes, because they just need, it's no, you know, it's just a little bit higher tech than printing out a picture of the word am right. [01:02:45] Claire Martin: Like, like it's just, you know, it's easier. It's, it's. It's right beside you and you can grab it and, and it has that speech output too, which sometimes they love. I mean, it's just like an articulation app. The kids love to click the picture and it [01:03:00] say the word for them. Like, [01:03:01] Michelle Dawson: Oh, yeah, we did that with bear. My, my youngest son, he had , He was born, , pastor here, born newborn hearing screen, and then didn't hear for two years and change. So we did articulation station and God help us. If I went to correct his speech sound, he would say, no, you not Dr. Angela. And I was like, okay, I'm not Dr. Angela, dr. Angela, she's a goddess. There's no way I could be Dr. Angela, but like he wouldn't do speech therapy with mommy, unless it was with articulation station. I owe them. Oh, my God. But that was, that was his tool to get him over the hump and the hurdle. And then he was riding his reign. Yeah. Yeah, but no, that's, and, and I, I love the continuum of like you giving the example of like low tech, like we've done construction paper. [01:03:53] Michelle Dawson: I've done dry erase boards. I have low tech laminated boards that I will send them home with that are like [01:04:00] snapshots or like scans of whatever we've programmed on the device and for them to like carry over if we don't think that they need it at home, but That's the, the beauty and the power of AAC is it doesn't just have to be all in high, high tech. [01:04:17] Michelle Dawson: Like you talked about the eye gaze down to like, you know, direct access for that one time and that that was, it's, this is such a cool thing that we get to do professionally. [01:04:32] Claire Martin: It is very cool. And even like the mid tech, you know, with switches and, and things like that. And I mean, yeah, we have, We have it all. [01:04:42] Claire Martin: And Lorna actually shared a resource with me about like tangible, tangible, like AC as well. And with those that are visually impaired, like switches that have switches that have like tangible symbols on top of them that they can feel [01:05:00] like what it is, is, I mean, that's just another, you know, like you said, continuum of AC, another option too. So there's, there's all kinds of options and there's definitely not a one size fits all, for sure. [01:05:12] Michelle Dawson: So what is, what is your advice for the person that wants to get into this? What would you fill their cup with? [01:05:21] Claire Martin: I I would say, I mean, just get your feet wet and try out an app that you've heard about, or you've seen somebody using, or you've seen another therapist using and just try it out and see what you think or see what your patient thinks. [01:05:37] Claire Martin: And don't be afraid to mess up. I mean, like I've said before, with my graduate students and SLPAs, they're like, Oh, I missed that opportunity to model better. I missed that. No, no, you didn't like do it anyway and, or get it next time. And, There's nothing you can't go wrong with it. I think that learning by trial and error is definitely the way to go. And. [01:06:00] that'll increase your confidence with it over time. [01:06:03] Michelle Dawson: Yeah. I'd say have fun. [01:06:06] Michelle Dawson: That's yes. [01:06:08] Claire Martin: You're, you're giving, you're potentially giving somebody a way to communicate that they may not otherwise have. So have fun with that and know that you're making a difference either way [01:06:20] Michelle Dawson: and allow them to tell, you know, and to bugger off because that's huge. [01:06:25] Claire Martin: Yes. Right. Oh yeah. All the time. I mean, we. Termination and denial is one of the functions of communication. So all the time we're like, Oh, stop. Okay. You want me to stop? [01:06:42] Claire Martin: Or no, or like you said, stop or no, or added some of this fun phrases, like no way or go away. [01:06:48] Michelle Dawson: I have one little one whose mom would always say no, thank you for like polite manners, it might be Southern wind and the child would go, no. Thank you! And I was like, TWO MORE DEAD [01:07:00] eARTHS! [01:07:01] Claire Martin: Love it. Love to see that. That's great. Oh, [01:07:04] Michelle Dawson: okay. Oh my god, I love you. You're so delightful and authentically you and approachable. Y'all Claire is genuinely this much fun in person. So, if you're a tiny human looking for a [01:07:19] Michelle Dawson: practicum site, my, I recommend her as a,, clinical soup or CF mentor. Hit, hit yes, but if folks want to learn more from you, how do they reach you? [01:07:31] Claire Martin: Yeah. So you can definitely email me my email and maybe Michelle, you have a way to put this in the description as well, but my email is C L A I R E at S L C cares. com. And I do have an Instagram. It's not like a SLP Instagram by any means, but you can reach out to me there as well. My username is C N Martin C [01:07:57] Michelle Dawson: I feel like, is that going to change when you [01:08:00] get married? This is very exciting. I [01:08:02] Claire Martin: guess. I mean, I guess people do that, right? I'll be a deploy. So we'll have to switch it up or a Siri likes just Siri likes to say it's before it's not actually pronounced that way. [01:08:20] Michelle Dawson: My ex husband's last name was Schwartz and all my speech babies called me Ms. Like I should have known then. Shoulda known. [01:08:30] Claire Martin: Yeah. Martin's a little easier to say. So if you ask me, I say it's DuPuy. If you ask my fiance, who has very strong West Virginia roots, it's DuPuy. But that just reminds me of Home Depot. So I don't know. [01:08:48] Michelle Dawson: Well, God save you. Let's be figuring that one out, honey. Yeah, right. [01:08:53] Claire Martin: We'll just, either way, you know, either way. [01:08:55] Michelle Dawson: Okay, so then the final question of the hour is, if somebody's listening and [01:09:00] they got a little bit of love money, as my grandma would say, is there a scholarship or a fundraiser or an organization where somebody can make a donation? [01:09:09] Claire Martin: Yes, absolutely. So one of the local area organizations that we actually have gotten a lot of devices through that when insurance doesn't approve it, or maybe it's not even a device. [01:09:23] Claire Martin: Maybe it's just assistive tech in another fashion is Shenandoah Valley Autism Partnership. SBAP as we like to call it here they are phenomenal. They we write a little scholarship recommendation letter and they nine times out of 10 approve it right away. For our families that need it and maybe cannot get it otherwise. [01:09:41] Claire Martin: So Shenandoah Valley Autism Partnership would be phenomenal. I know they'd appreciate it. [01:09:46] Michelle Dawson: Awesome. Well, thank you. Everybody, if you're listening, you know where to find us. I'm sure by now, , first night podcasts on Instagram. And, , if you have an idea or a topic request for an upcoming episode , just let us know, [01:10:00] send us an Instagram message. [01:10:01] Michelle Dawson: Erin is much, much better at answering them than I, but eventually I come up for air and do that part too. So go team. And, , Claire, thank you so much for coming on today. This was truly joyful. [01:10:13] Claire Martin: Thank you for having me. This was so fun [01:10:15] Michelle Dawson: thank you. [01:10:16] Announcer: Thank you for joining us for today's 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. [01:10:39] Announcer: Please allow one to two months from the completion date for your CEUs to reflect on your 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. [01:10:55] Michelle Dawson: Feeding Matters guides system wide changes [01:11:00] by uniting caregivers, professionals, and community partners under the Pediatric Feeding Disorder Alliance. [01:11:06] Michelle Dawson: So what is this alliance? The alliance is an open access collaborative community focused on achieving strategic goals within three focus areas, education, Advocacy and research. So who is the Alliance? It's you. The Alliance is open to any person passionate about improving care for children with a pediatric feeding disorder. [01:11:28] Michelle Dawson: 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. That's a wrap, folks. Once again, thank you for listening to First Bite, Fed, Fun, and Functional. [01:11:55] Michelle Dawson: I'm your humble but yet sassy host, Michelle Dawson, the all things [01:12:00] PEDS SLP. This podcast is part of a course offered for continuing education through SpeechTherapyPD.com. Please check out the website if you'd like to learn more about CEU opportunities for this episode, as well as the ones that are archived. [01:12:14] Michelle Dawson: And as always, remember, feed your mind, feed your soul, be kind and feed those babies.