Talking With Tech AAC Podcast

This week, Chris interviews Tami Altschuler, a medical-based SLP and graduate instructor who focuses on supporting AAC and communication in the hospital setting. She shares about her journey helping the doctors and nurses understand that communication is a medical necessity, and the patient and employee satisfaction improvements that have come from better supporting communication and AAC access for every patient that needs it. 

Before the interview, Rachel and Chris discuss one of Rachel’s clients who has optical nerve damage that makes visual processing difficult. The family is concerned that he is not able to access his coursework and reading materials due to his visual difficulties.  Rachel shares some of the assistive technology strategies she suggested, including voice typing in Google Docs, using Read & Write for Google Chrome, using text-to-voice using a camera, making text high contrast, and more! 

Key ideas this week: 

🔑 It was difficult to get initial buy in from physicians at her hospital to order SLP services for AAC and communication.Tami needs a doctor’s order to work with the patients - she can’t just work with a patient on her own initative. When Tami started at her hospital, the doctors didn’t know an SLP could help with a patient who can’t communicate (e.g. they are intubated). 

🔑 SLPs in the medical setting often focus more on feeding and swallowing than on AAC and communication. It took a lot of working through “barriers to participation” (Beukelman & Mirenda (2013)) - i.e. resources, attitude, skill, and knowledge. Had to break through those barriers to help the other medical SLPs understand the need to support AAC. 

🔑 The “Great Resignation” impacted the medical field in several ways, including the amount of knowledge nurses in Tami’s hospital have about AAC and communication. There was a mass exodus of pediatric nurses who had a lot of communication training, and the newer nurses were not as familiar. Tami’s hospital now has a process that trains nurses right away during new hire orientation about communication and AAC.

🔑 Writing a patient’s communication tools and strategies on the door outside the patient’s room can help the nurses know how a patient communicates before the enter the room. 

You can reach Tami on Twitter @tami_altschuler

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This week, we share Part 2 of TWT Live from Oregon! This week, Rachel and Chris talk with their audience about a range of topics, including getting buy in from teachers and staff and choosing which core words to start teaching!

Before the interview, Chris and Rachel answer a listener question, “Is putting a big poster with AAC symbols on the wall a good idea?” They point out the benefits of putting up AAC light-tech boards, and Chris describes why it is better to put up a poster of the kid’s core board than changing the symbols or moving them around.

Key ideas this week:

🔑 If an emergent communicator is struggling to learn how to use light-tech AAC, even with lots of modeling, you may want to try high-tech AAC. In some cases, using high-tech AAC can help him or her understand why and how we use AAC.

🔑 When dealing with a teacher or staff member who doesn’t want to use AAC, a “top down” approach that gets their administrator involved may cause push back in the long run and/or damage rapport. Try a “bottom up” approach first - ask probing questions to find out about that teacher’s challenges and point out where AAC can help (e.g. reducing difficult behaviors).

🔑 Celebrate the small wins for AAC users - if an emergent communicator make any progress towards independent communication, however small, make sure to celebrate and let everyone know! When someone makes a difference that impacts the life of another person, they are often inspired to do more!

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, we share Part 1 of a previously recorded Talking with Tech Live show with listeners from Oregon. This week, the listeners ask several questions related to conducting language and AAC assessments virtually, including how to make them more effective.

Before the interview, Chris and Rachel have a lively discussion about Gestalt Language Processing and how we can support AAC users who script. Rachel shares several ideas, including putting the student’s preferred scripts on their device as a way to make the device more interesting and motivating.

🔑 One tool that listeners suggested for virtual assessment is the Communication Matrix. https://communicationmatrix.org/ This assessment allows you to get input from caregivers through an online for. One benefit is it doesn’t require the chid to have to sit in front of a screen. 

🔑 When we are trying to observe a person’s communication skills virtually, it may be better to have the caregivers video the student at hoome communicating in the ways they normally communicate. It can be difficult to truely observe a child during Zoom sessions - the child may not communicate the same way on Zoom because there is greater pressure to “perform.” 

🔑 If we are considering a virtual assessment, it is important to consider training communication partners on how to optimize the virtual assessment. Is the student seated in their chair? What is the background noise situation? Preparing in this way can help the assessment go more smoothy.

Emily Quinn’s webinar on the Communication Matrix from Echo Voices https://drive.google.com/file/d/1-S-rVgOrozwa36mGxaW0ZQcNob2brWTx/view

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, we present Part 2 of Chris and Rachel’s interview with Sean Sweeney! Sean is a Speech-Language Pathologist and founder of SpeechTechie.com, a website that focuses on the intersection of speech therapy and technology. This week, he discusses his “FIVES” pneumonic to help evaluate if a resource (e.g. an app) is a worthwhile investment of time and money. 

Before the interview, Chris and Rachel share about their recent trip to Montana to do a presentation, and some of the highlights of the trip. They also answer an excellent listener question that asks “Regarding the least-to-most prompting hierarchy, if the student is new to the board/device and we jump to the last step and model without expectation, how long do we stay at that level?”

Key ideas this week:

🔑 The least-to-most prompting hierarchy is related more to an individual words than to a particular student student. The amount of prompting that a student needs will depend on the word, so a student isn’t ever at a certain “level” of the hierarchy 

for every word.

🔑 The symbols or pictures on an AAC system give users way to recognize the word(s) they want to say. Without the visual, it can be harder for students to construct an effective spontaneous utterance. 

🔑 Sean came up who the pneumonic “FIVES” to help evaluate resources that he is considering using for therapy. FIVES stands for Fairly priced, Interactive (decision making, create narrative), Visual, Educationally relevant, and “Speechie” (i.e., the app can be used to target specific clinical objectives)

🔑 Sean likes to take materials and items from a student’s hobbies and use them to target his clinical objectives. For example, he has a student who loves Pokemon, so he pulls story grammar and vocabulary from a Pokemon comic to make the lesson more engaging and interactive.

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, we present Part 1 of Chris’s interview with Sean Sweeney! Sean is a Speech-Language Pathologist and founder of SpeechTechie.com, a website that focuses on the intersection of speech therapy and technology.  In Part 1 of this interview, Sean discusses his recent appearance on the game show Jeopardy and some of the insider information he got as a contestant!

Before the interview, Chris and Rachel make some connections between Sean’s appearance on Jeopardy, including the similarities between the Jeopardy committee that decides if a question was answered correctly and the need for a team based approach to assessment. Chris and Rachel also chat about the difference between an “AAC app” and an “AAC system”.

Key ideas this week:

🔑 Giving a quiz that is put up on the board in front of a group of people (e.g. kahoot.com, baamboozle.com, quizizz.com) is as much a measure of reading ability and fluency as it is a measure of knowledge. Just like Jeopardy, you can read the question out loud to the contestants before giving them a chance to answer, giving slower readers a chance to succeed. 

🔑 An “AAC system” is more than a particular app or tool. It is the combination of all the ways that a person communicates (e.g. low tech board, robust AAC app, and gestures) and often does not mean just one tool. There are circumstances (e.g. bath time) where a different tool, like a laminated core board, could be more effective than their primary app or tool.

🔑 It is common for people to not remember situations that required a lot of thinking, stress, and language analysis, such as going on a game show or giving a speech in public. This is, in part, because the brain is so focused on the immediate task that it isn’t committing things to memory in the way it normally would.

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, we present Part 2 of Chris’s conversation with Kim Hurley and Jessica Conrad about the Specific Language System First Approach! Kim Hurley is an SLP and AAC Specialist who is considering moving her district to the Specific Language System First Approach. Jessica Conrad is an SLP and AAC Specialist who works for the Indiana PATINS project supporting AAC users and their circle of support. In Part 2, Chris, Kim, and Jessica continue to breakdown some of Kim and Jessica’s concerns with implementing the Specific Language System Approach, including failing to notice when a student needs a more individualized AAC system (i.e. a “Tier 3” AAC student), as well as and the need to include families in the process of selecting the “Tier 1/2” AAC system.

Before the interview, Chris and Rachel chat about Rachel’s recent visit to a Jack Johnson concert in Hawaii and the importance of Jack’s music to Rachel when she was battling seasonal depression (i.e., Seasonal Affective Disorder) as a young woman.

Key ideas this week:

🔑 One concern Kim had was that the “best” AAC system for younger students might not be as useful for middle or high school students. Chris pointed out that there are robust language systems, like TouchChat, that are appropriate for children all the way through adulthood, and that is something we can consider when selecting our Tier 1 system.

🔑 The earlier you can involve parents in the process of selecting AAC for their student, the better. This can mean involvement with overall selection of the Tier 1 AAC system, as well as involvement with the considerations meeting you hold to determine if the student should be given AAC.

🔑 If you make sure administrators, teachers, aides, and families are involved with the selection of your Tier 1 AAC system, then there will be better buy-in overall. Plus, it will help retain knowledge about the process and the Tier 1 AAC decision, even if the AAC Specialist (or another trained team member) leaves the district.

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, we present Part 1 of Chris’s conversation with Kim Hurley and Jessica Conrad about the Specific Language System First Approach! Kim Hurley is an SLP and AAC Specialist who is considering moving her district to the Specific Language System First Approach. Jessica Conrad is an SLP and AAC Specialist who works for the Indiana PATINS project supporting AAC users and their circle of support. Chris, Kim, and Jessica explore some of Kim and Jessica’s concerns with moving towards a Specific Language System First Approach, and how those problems can be minimized or avoided.

Before the interview, Chris and Rachel chat about a recent visit to Arizona to teach a course on AAC and some of Chris’s previous encounters with Indiana’s PATINS project.

Key ideas this week:

🔑 One way to think about the Specific Language System First Approach is through Multi-Tiered Systems of Support. A Tier 1 support (i.e., support for almost everyone) would be the Specific Language System you give to almost everyone (e.g. a particular AAC app), while Tier 3 (individual support) would be for students that need a greater level of individual consideration for AAC (e.g. a student with CVI). 

🔑 If you use the Specific Language System First Approach, it is important to remember that there will always be students who need individualized consideration (e.g. students with access issues). One idea is to train team members on the kinds of students that may not be well suited for Tier 1 and what to do if you think a Tier 3 support is needed.

🔑 When choosing the system that will become the Tier 1 support for most students, you can invite admins, teachers, and parents to participate in the discussion about the needs of students and some of the features that would be needed for students to be successful, as well as how those needs are met by particular AAC systems. This can help increase buy-in and lead to better understanding of the needs of teachers and students.

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, we share Part 2 of Rachel's interview with Vicki Haddix and Janine Peca! Vicki Haddix is an AAC Specialist and Clinical Associate Professor at the University of Memphis who teaches their course on AAC for the Communication Sciences and Disorders program. Janine Peca is an autistic adult who recently went through Memphis’s CSD program and is now an SLP. Janice shares about a recent presentation she made about neuroaffirming practices, including a fascinating portion on what it feels like to be overstimulated. Vicki shares about how she improved her class design by giving choices to students whenever possible. 

Before the interview, Rachel and Chris talk about Rachel’s recent two-week vacation to Spain and France and Chris’s Roadtrip to ISTE! Rachel and Chris discuss using Google Translate to translate between languages in real time, scanning pictures for text translation and text to speech, the Wonderfully Inclusive Scavenger Hunt at ISTE, and more!

Key ideas this week:

🔑 Supporting sensory needs can be very motivating for AAC users, but are not always considered when deciding on motivating language for emergent communicators. Janine shares about the sensory strategy communication board she made for herself for when she feels overstimulated and has difficulty formulating language.

🔑 Labeling certain behaviors as a “meltdown” or “tantrum” carry the implicit meaning that it is done for attention. When an autistic person reacts to overstimulation with a particular behavior, we should consider that this behavior may be physically necessary for them at that moment.

🔑 During a period of overstimulation, we can connect with an autistic person in a neuroaffirming way to find out if there is something we can do to help, such as saying, “I notice you are doing a lot of hand flapping, and I wonder if you are feeling a lot of stimulation. Is there anything I can do to help?” 

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, we share Rachel's interview with Vicki Haddix and Janine Peca! Vicki Haddix is an AAC Specialist and Clinical Associate Professor at the University of Memphis who teaches their course on AAC for the Communication Sciences and Disorders program. Janine Peca is an autistic adult who recently went through Memphis’s CSD program and is now an SLP. Vicki shares about making pre-service education more interesting and engaging, and the need for increasing mentorship for recent graduates. Janine shares some of her experiences as an autistic adult, including some of the ways neurodiversity was and was not supported during her undergraduate and graduate experience. 

Key ideas this week:

🔑 Even with with the best AAC pre-service prep for students, we will need mentors after graduate school for new SLPs to lean on, especially for initial AAC device selection and implementation.

🔑 One part of a being a good mentor is leading others to where the good resources are (e.g., podcasts, webinars, articles). One way we can do that is giving them a “curated” list of resources to review before you meet together. Once they have gone through those resources, you can discuss them in-person. This can reduce the time spent going over basic information and increase the value of your discussion together.

🔑 New SLPs may also feel lost on how to evaluate and treat non-symbolic communicators who may only have emergent intentionality.  They may write goals and use materials for more advanced communicators that are not appropriate yet. We can direct them to focus instead on establishing foundational communication skills, including initiation and understanding symbolic representation.

🔑 When someone asks Vicki to explain AAC to them, she will point them to praacticalaac.com, AAC in the Cloud (aacconference.com), and the Talking with Tech podcast (talkingwithtech.org - thanks Vicki ☺️). This gives people something to read, something to watch, and something to listen to, depending upon how they learn best.

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!

This week, Chris interviews Shelley Anderson! Shelley is a music therapist who works for a private practice in Ft Wayne, IN and runs a business, Notes 2 Live By, that teaches basic communication through sign language and, more recently, through assistive technology. Shelley shares about the ways that music can be used to teach language to everyone, including AAC users, including how music can be used in unique ways to teach core language concepts. 

Before the interview, Chris chats with his son Tucker and daughter Maggie about current slang that you may want to consider adding to AAC devices. They talk about slang such as “slay”, “queen”, “give me the tea”, “fit”, “choogie”, and more! 

Key ideas this week:

🔑 It can be very motivating to start singing a song and to then stop it at a point that makes the listener want to keep singing. An AAC user can add a word from their device to the song you are singing in the same way, such as us singing “Because I’m” and having them say “happy” to the tune of “Happy” by Pharrell.

🔑 When using music to teach language, it is better if you sing acapella or play an instrument. That way, we can slow down the pace to meet their needs, which  is more effective than pausing the music on a pre-recorded track. 

🔑 We can use music to teach a particular core word, such as playing “Wake Me Up Before You Go Go” by WHAM! to teach “Go”. You can also contrast the different meanings of a core word using different songs (e.g. “Can’t Stop This Feeling” by Justin Timberlake and “This Train Don't Stop There Anymore” by Elton John).

🔑 If you are using music in therapy, make sure not to overuse a particular song (e.g. play the same song they like every week for months), as this can effect how motivating it is.

Visit talkingwithtech.org to access previous episodes, resources, and CEU credits that you can earn for listening to TWT episodes!

Help us develop new content and keep the podcast going strong! Support our podcast at patreon.com/talkingwithtech!