EPISODE 245

[OVERVIEW]

[00:00:00] MD: Okay, so continuing on our gratitude journey this year. One, I am grateful for summer vacations and Ð because they're like a fresh new start. So, I hope that you're listening to this episode, and are feeling relaxed and refreshed on your summer vacation, or I'm hoping that maybe if you're like in a year-round employment situation, you take a long weekend. But on that note, I am also grateful for this loving review from LizSLPToBe.

ÒThis is an amazing podcast. First Bite is always part of my week. I always learn something that I can use in therapy the next day, as a graduate clinician. I'm a better SLP because of this podcast.Ó Dog too, is a better SLP because of this podcast. She shared her happy shake in the background.

Folks, we love it when you let us know what we're doing to help y'all. That's what we're here for. WeÕre your bridge. WeÕll interview the experts and bring them to you so that we can hopefully expedite this research to practice and then give the feedback back because it's a two-way street. It's research to practice and practice and forming research as to what works and what doesn't work actually out in the field. Today's guest is Dr. Cheri Dodge Chin. Cheri, I'm so sorry, I butchered that. She is an amazing clinician as an AT lead, but she's also on her second doctorate and that's phenomenal. So, let's keep that ball rolling. Let's all aim for that level of joy and subject matter expertise and passion. Thank you for joining us and I hope you enjoy.

[INTRODUCTION]

[00:02:01] 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, early intervention right there with you. I run my own private practice, Heartwood Speech Therapy here in Columbia Town, South Carolina and I guest lecture nationwide on best practices for early intervention for the medically complex infant, toddler, and child. First BiteÕs mission is short and sweet, to bring light, hope, knowledge, and joy to the pediatric clinician, parent or advocate.

[00:02:48] EF: By way of a nerdy conversation, so thereÕs plenty of laughter too.

[00:02:52] MD: In this podcast, we cover everything from AAC to breastfeeding.

[00:02:56] EF: Ethics on how to run a private practice.

[00:02:59] MD: Pediatric dysphagia to clinical supervision.

[00:03:02] 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.

[00:03:12] MD: To break down the communication barriers so that we can access the knowledge of their fields.

[00:03:17] EF: Or as a close friend says, ÒTo build the bridge.Ó 

[00:03:21] 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.

[00:03:32] EF: Every fourth episode, I join them. 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 with experience in early intervention, pediatric acute care, and non-profit pediatric outpatient settings.

[00:03:52] MD: Sit back, relax, and watch out for all hearth's growth and enjoy this geeky gig brought to you by SpeechTherapyPD.com.

[DISCLOSURE]

[00:04:07] MD: Hey, this is Michelle Dawson, and I need to update my disclosure statements. 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, 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 SIG13, SCSHA, the Speech-Language-Hearing Association of Virginia, SHAV, a member of the National Black Speech Language Hearing Association in NBASLH, and Dysphagia Research Society, DRS.

Additionally, I volunteer with ASHA as the topic chair for the Pediatric Feeding Disorder Planning Committee for the ASHA 2023 Convention in Boston and I hope you make it out there.

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. 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. Those are my current disclosure statements. Thanks, guys.

[00:06:04] EF: The views and opinions expressed in today's podcast do not reflect the organizations associated with the speakers and are their views and opinions solely.

[INTERVIEW]

[00:06:13] MD: All right everybody, we have a treat, because we're deep diving into AAC, and this is like all off the cuff, honest answers because your lady here, the one and only Michelle Lynn Wood Dawson, dropped the ball on getting everything together in advance because y'all, it has been a month, so give grace. The one and only Dr. Cheri Dodge Chin who is an assistive technology consultant, and adjunct professor, and a published researcher. She focuses on AAC and bless her, she gave me grace. So, thank you very much for like completely bailing earlier this month when we went to record this.

But aside from her lovely extension of grace, y'all may know her from her blog. She is actually one of the original SLP bloggers and her blog is called Super Power Speech, and it has over 700 posts. She's the self-described organization queen, which I love, as I looked at the organization that was done in my house, and then two tiny humans came behind and like mauled. But she's here today to talk about AAC. Again, I do refer you back to her website and to her resources, because she currently has over 300 resources available. So, if you are a school speech-language pathologist, and you are tuning in on your summer break, one, thank you for joining us. Two, make sure you're listening to this on a beach or at I don't know, around an outdoor fire pit, underneath of a starry night. But also go check her out because she can fill your cup with something tangible after we're done talking.

Cheri, thank you so very much for coming on. Hi.

[00:08:04] CDC: Hi there. Thank you. That was quite the introduction.

[00:08:08] MD: Well, I'm honored to have you. You're like famous in the SLP world, also, [inaudible 00:08:13] loves you, and she was like, ÒShe's wonderful. Behave.Ó So, hi. YÕall, met like just minutes before we started recording and you are on West Coast. You're in Oregon, and Ð when I think of West Coast, I think of cold, rainy winters, but glorious summers. Am I correct? Is that a fair description?

[00:08:39] CDC: That used to be the case. Now, the summers are getting much more extreme. We had a couple of days of over 110 degrees last summer. The summer before, we got to about 118 at one point. The problem, of course, is that the homes here were not built for that, and so it is only newer homes that have air conditioning. So, that's been an interesting thing. The last 5 to 10 years is that our summers keep getting hotter and hotter.

[00:09:08] MD: Oh, my Lord. Well, do you have air conditioning?

[00:09:11] CDC: The upper floor of my home has air conditioning, but not the bottom floor.

[00:09:16] MD: Oof. And I feel like the kitchen is probably on the bottom floor.

[00:09:20] CDC: No, it's not. It's on the upper floor. We're okay.

[00:09:22] MD: You're okay. Okay, because thatÕs what Ð

[00:09:24] CDC: The kidsÕ rooms are on the bottom floor, so you know what, they can suffer.

[00:09:30] MD: Are they teenagers by any chance?

[00:09:33] CDC: Yeah, yes, yes, yes.

[00:09:35] MD: We were having the debate. I'm like, ÒI think I have to change my 10-year-oldÕs shampoo because it's not cutting it.Ó He's hit that little boy funk. And I'm like, ÒWhatever this is, is like, we need something stronger.Ó And my husband's like, ÒTrust me, it's going to get worse.Ó I was like, ÒReally? Really?Ó But oh boy, mom life is not for the faint of heart. Tell us about your beginning. What made you want to become a speech pathologist? Then how did you transition into AAC?

[00:10:06] CDC: I have had lots of different dreams. I was going to be a marine biologist, of course, like many people of my generation. But the other dream that I had when I was growing up was to be an educator for the deaf because although I didn't know anyone who was deaf or hard of hearing, I just fell in love with sign language when I was very young, like second grade. Then, that kind of fizzled away as I got older, and I went back into the Marine Biology idea. But education was always something that I was really interested in. So, I ended up graduating from college with a degree in biology, but also getting my teaching certificate. I was a high school teacher, high school biology teacher in an urban school near where I graduated for one horrific year.

And I can't Ð teachers are just amazing. I can't believe that people do this, day in and day out, for 30-plus years. I barely made it through that year. Then, I was like, ÒI have to do something else.Ó Back when I was getting my college degree, my father had had a massive stroke, and he was profoundly Ð his communication was profoundly impacted. So, when I was rethinking my career choice during that terrible teaching year, my mother said, ÒI think you would like the speech therapy thing that dad had because I remember the speech therapist has signed language books on her bookshelf.Ó

[00:11:38] MD: I love that she remembered that that was your love from when you were little. 
[00:11:42] CDC: Yes. She did. So, I said, ÒWell, is it teaching? No? Great. I'm going to sign up and do that.Ó I got into a program and I focused on adult communication because I was going to work with people like my dad that had aphasia and were post-stroke. I graduated, and I couldn't find a job. I looked around, I was looking at rehab clinics, I couldn't find a job. There was one job opening I could find, and very Ironically, it was in the exact school districts that I had left kicking and screaming two and a half years before.

[00:12:22] MD: I'm sorry, that's a God moment right there, just saying.

[00:12:26] CDC: I took it because, in the middle the year, I was a December grad. So, I took that job and it was much better than being the high school teacher where I had 150 kids a day, and I looked like I was 17 teaching 17-year-olds.

But one of the classrooms that I served while I was in that first job was a classroom of kids with very severe to profound physical, cognitive, and communication needs. I looked at these kids, and I said, ÒI have no idea what I'm supposed to do here. Nothing had prepared me for this.Ó I'd never heard of augmentative communication. I don't know how many schools were talking about it in the late nineties, but mine definitely was not. 

That interested me. I was like, ÒWell, how can I help these kids?Ó Then, a professor from my grad school was like, ÒWell, hey, I know of an internship you could do all the way out in Oregon.Ó I was going to school on the east coast. So, this was kind of a big deal. But I was actually raised in California. It was going to get me back closer to my family. I said, ÒOkay, well, that sounds kind of interesting.Ó We were ready to have a change, so I applied for this internship, and I got it and I moved across the country. I spent a year with some of the most incredible researchers at the time in AAC, and it was a really good experience. Then, when it was done, there wasn't really any other AAC opportunities. So, I was like, ÒYou know, I think I'm going to go back into the schools.Ó I like school schedule. I like having summers off. So, I found a job in the schools in the Portland, Oregon area.

Actually, originally, I was just in two elementary schools. I was just your run-of-the-mill, regular speech path that works in elementary schools. But within a couple of months, the speech path that was serving the one classroom with students with complex needs had to move on. There was some kind of transition. They said, ÒWell, Cheri, you know some stuff about working with people with complex needs. Do you want to take over these classrooms?Ó And I said, ÒSure.Ó So, for the next 18 and a half years, I was your general speech path in the schools, but I also had these classrooms with students with complex needs, and many of whom relied on some kind of augmentative communication, whether it be white tech or mid-tech, and a few high-tech over the years. That's how I got into it.

[00:15:08] MD: Nice. Now, you're the division lead, right?

[00:15:12] CDC: Well, there's only one of me. So, my district has a position. Some districts in our area have this, some do not. My district has a position of Assistive Technology Consultant. The person, the amazing person who had this job before me decided she wanted to move on, and so I took the job. I have been doing this for a year and a half, and I focus on Ð primarily, I focus on aug comm, but I also, and my big learning curve has been focusing a lot also on switch use, access to technology, reading and writing assistive technology, and helping our students who have needs besides just verbal communication needs. So, that has been a big learning curve and I expect I will continue working on that for quite some time.

[00:16:09] MD: Amazing. Our backstory on our guest, so you know where we've kind of gone as a podcast for different topics. We've had Dr. Carol Page, who is the South Carolina Ð she just retired. Actually, she retired last year. She was the South Carolina Assistive Technology Lead for the entire state. She's come on a couple of times and talked about one of them, my favorite one that she did was on cortical visual impairment and how that can impact access and selection and materials. But not necessarily like exclude eye gaze, which was an eye opening, literally like it just kind of blew my mind episode.

We've had Stephen Kneece on a few times. He has speech on language songs on Instagram and on Facebook, and he is an assistive tech lead for Ð or was. He has left his school district. Now, he's full-time faculty at Columbia College. But he's come on and talked about access and point of access, which was really, really cool. And who else have we had on? We've had Lane Rials with Control Bionics on, talking about the EMG signal and the access that they have through the neural node. Nod. Node. I always get that word wrong.

[00:17:25] CDC: Not sure.

[00:17:26] MD: Yes. Which was very cool. And then Michelle Ð oh, God, Dr. Michelle Therrien. ItÕs French. I can't say it correct. She's at Florida State University and her research, she's not actually a speech pathologist. She came at it from a computer linguistics degree background and her focus is on relationship building through AAC. Like how kids make friends on AAC devices. That's like the coolest research ever. Like I want to go study how to make a friend when you're communicating via AAC.

So, that's Ð I know I'm forgetting some. We've had Wyatt Franken on. Oh, my God, I'm blanking. We've had Ð oh, my God, I can see her face, beautiful brunette. Actually, y'all could be sisters. She's come on and talked about LAMP Words for Life. So, we've talked about a couple of Ð we have a history here is what I'm trying to get at, just so you know. But we haven't talked about the process and the role and responsibilities of a school, like a school lead. What does that look like? And how Ð I'm kind of thinking, how do people access you to get supports for their students, and how does that culminate in a successful trial, and then a very beautiful detailed report because I want to go there? Because I like Ð we were talking about that before. He made a joke about her OCV reports. No, I love that because you should read my PFD reports. They are slightly anal-retentive in their beautifulness.

But like, yes, hi. Let's do all the things.

[00:19:10] CDC: Okay, there was so many things there you just said. Can you back up to the first question?

[00:19:17] MD: Okay, so back up to the start. You mean, I didn't tell you how bad my ADHD was. I have not gone running today. I should have done that. Let's start with what does your job actually look like as the lead assistive tech person? Like what is your Monday through Friday look like?

[00:19:33] CDC: Well, I'm still figuring that out. I haven't figured that out quite yet. So, I will tell you what my ideal will be at some point and I will get there. I'm just not totally there yet. Ideally, I will be on Tuesday, Wednesday, and Thursday. I will spend the first half of the day at one of my schools and then and go back to my office and deal with the paperwork for all the things that I dealt with at the schools.

The reason that I have not gotten to that point and may never truly get to that point is because I start by going to a school and then I ended up getting crisis calls, or IEP meetings at three other schools for the same day. Then, I end up everywhere. So, for example, yesterday, I was at seven buildings.

[00:20:32] MD: Oh, my Lord.

[00:20:33] CDC: Right. And that's not my ideal at all.

[00:20:37] MD: No.

[00:20:38] CDC: Then, I really, ideally also, would like to have Monday and Friday, where I'm just at my home base, and I'm not visiting any schools, so that I can deal with programming devices, working on our comm reports, or getting things ready, and getting inventories. We just got a whole bunch of iPads in my district, thankfully, for loaners, for students, and hopefully for SLPs as well. We haven't quite gotten that far yet, but inventory them all and keeping track of where they all are is been a challenge. So, I definitely need lots of time, during the week to deal with that.

[00:21:16] MD: Yes. Do you actually bill when you're programming?

[00:21:22] CDC: No, I do not at this point. I may at some point. Right now, I do not.

[00:21:26] MD: Okay. Because that's something that I've noticed that I've gotten pushback on, not Ð sometimes Ð I've gotten pushback on it from managers, not from colleagues, so I need to specify where that comes from. But I've heard managers say, ÒWell, we don't have time to pay people to program these devices when they're worried about their productivity numbers. 
Instead, I come back with, but have you actually assessed the ASHA superbill to find out that that's actually a billable CPT code. But you have to advocate for advocacy because normally, that's not one of the codes. Like a lot of people use Fusion or ClinicSource to do their billing, and you have to plug into those programs what CPT codes you want your employees to have access to. And if that's Ð so, folks, if you're listening, and you're getting pushback on your billing times, share the ASHA superbill with your managers, with your Ð whoever's in charge of your Medicaid or insurance billing at your school or at your private practice, because there are codes specific for that.

Okay, so you have a dream of getting the balance. But while it's still in a mess, what do you mean, emergency IEP meetings? What's happening? No, not emergency IEP meetings, just IEP Ð well, actually, sometimes they are emergency.

[00:22:50] CDC: Yes. I tend to be forgotten. ItÕs a forgotten role. So, on a regular basis, I get notified that an IEP is happening that day, by teams. Sometimes these were meetings that were scheduled way in advance, and they just forgot about me, and then the OT happened to look at the invitation. It was like, ÒAh, Cheri really needs to be here.Ó Or other times, it's I'm like triple booked on a regular basis, I'm triple booked for IEP meetings, and then I'll finish one early, and then I'll try to get on another, which has been great when they are being held virtually. But not all of them are being held virtually.

So, some of these meetings are kind of emergency or last-minute behavior planning meetings. I've had some of those recently that have just come out like literally the day of Ð

[00:23:46] MD: I mean, I get stuck in emergency IFSP meetings when the service coordinator forgets the plan is about to lapse every six months, which is kind of surprising. Because they're good for six months. But I can commiserate with that company right there.

Now, when you're doing your site visits, probably not the word to use, but when you're going to work in an individual's classroom. Can you walk us through what is your Ð what is your process? Do you have the time to build into your schedule to deep dive the IEP and find out where that child is? Do you bring devices with you to trial? What does that look like?

[00:24:26] CDC: A lot of times I'm just in there putting out fires. They'll hand be like four devices and say, ÒAll of these need updating.Ó Or, ÒSo and sos device isn't working.Ó Or, ÒThe kickstandÓ Ð yesterday and I was at a school and I was like, ÒOh, my gosh, this device doesn't have a kickstand.Ó IÕm like, ÒHow long has this kickstand been missing?Ó They're like, ÒI don't know.Ó Or, ÒWhere's the case on this device?Ó TheyÕre like, ÒOh, I don't know.Ó

Just trying to put out a lot of fires. Sometimes I'm able to go in and actually model for staff so that I can kind of show the staff how to model on an aug comm system. A lot of times I am just trying to help kids based on whatever the teacher needs help with at that particular moment. Ideally, I would like to get to a place where I'm doing a lot more coaching within the classroom. Right now, that's not happening for a couple of reasons. One is, the fact that I don't have a regular schedule. And then the other big reason that it's not happening is because I don't feel like the most the classrooms are in a space yet where they feel like they want this person that they haven't necessarily known that long to come in and be offering coaching.

[00:25:44] MD: Yes, you're in the storming, norming, and forming stage of leaderships of team building.

[00:25:53] CDC: Well, now you have to explain what all that means.

[00:25:53] MD: Oh, okay. Yes. So, there's cycles of a team when you go through team building programs, and like leadership development. I went through that ASHA Leadership Development Program a lifetime ago, pre-wrinkles and pimples, which is weird, because now that I'm turning 40, pimples are back. I don't know how that happened. But like, my body got to pick a struggle. I can't Botox, dye my hair, and require pimple pads. I digress.

But there's a storming, forming, and norming stage so that when there's a new person on the team, there's that little bit of a storm. It's not like a bad storm, it's just that everybody's trying to figure out how they work together and how to support each other. Then, there's that forming stage where, ÒOh, this works for us in our communication style. This still needs to be developed.Ó And then there's the norming stage where you have a nice rhythm and a balance and a rate. Storming, forming norming. And that can take time because it depends on the other communication partners, their stakeholder buy-in.

It's really cool to watch. And I have to remind myself, whenever I'm new to a situation, that being new is going to rock the boat, hence the term storming. It's not always bad. It's just what happens. This is a part of human nature.

[00:27:13] CDC: Yes, that's a good point, because a lot of our teams are not stable. We have a lot of fluctuation in terms of our educational assistants, and even our teachers. So, even if I'm not the new person, like somewhat Ð there's always someone that's new.

[00:27:30] MD: Yes. But when that happens and thereÕs that high turnover rate, your team stays in the storm stage, and can't really progress back, or move forward to the forming stage. But then it also puts an at-risk child at risk further, right? Because the ability to communicate of where was the charger? Where do we keep this? And that would explain why nobody could tell you where a kickstand was. Or how long it had been gone.

Also, I got to be honest, I can't tell you how many times I've taken off the keycard of a lamp to subsequently sit on it and crack it. Because I have a bodacious booty and those keycards don't hold very well.

[00:28:18] CDC: Yes. I have not broken a keycard. But that was one of the things that came up yesterday was someone was like, ÒWhere's this kid's keycard?Ó I'm like, ÒHow am I supposed to know where the keycard is?Ó

[00:28:31] MD: This is legit the most honest real insight that we have ever done, and I freaking love it with my whole soul. Thank you so much.

Okay, so then tell us how Ð what is your plan in place to get where you want to be?

[00:28:48] CDC: I don't yet have a plan. I am still working on that. I think a lot of it is going to have to do with setting up better boundaries. For example, the very tentative schedule I have is that I'm going to be in the certain classroom every other week, and I need to try really hard to make sure that if that teacher was like, ÒOh, can you just come over here and do this really quick for this kid?Ó Or, ÒCome in and work with me on thisÓ, that I actually Ð I stick with the pre-arranged dates that I have so that I'm not running around the district as much. Because we know so much of Ð there's just so much wasted time as you drive from location to location, to location, and not all these things can be done remotely. I can't fix a kid's device remotely. So, just trying to streamline and be more efficient with my time I think is going to make a really big difference.

[00:29:51] MD: Yes. One of the barriers for AAC on my end is one, trying to establish buy-in from colleagues that in the framework of early intervention, children are capable of doing this with respect to high-tech. Right?

[00:30:11] CDC: Mm-hmm.

[00:30:13] MD: That's a big barrier. Another one is the fact that trying to encourage that, yes, we can do high-tech AAC devices with little ones, because it's not Ð because I hear the screen time, but they're not supposed to have screen time.

[00:30:31] CDC: Right. I'm sure with early intervention, you must hear that all the time.

[00:30:34] MD: Oh, God, yes. And I'm like, ÒYes.Ó But you see them navigating their iPad over there, or how they're playing on your phone, or the TV that is on every time I come to your home, it's already occurring, right? Like we're already there with their screen time. But let's give them the opportunity to have a communicative outlet, trying to navigate that conversation.

But another barrier I get is making that transition to the LEA and the school SLP, not the team lead, but the school SLP not having access to the devices, so they're uncomfortable when I do get each kid set ready, approved by insurance. They're going to it early childhood special education classroom, where their incoming team may not have prior exposure. Does that make sense?

[00:31:31] CDC: That totally makes sense. Something similar has been a challenge for us. So, around 2012, maybe, we got some kind of grant. The school district got a grant and all the speech paths got an iPad, and we were able to ask for AAC apps as needed. I mean, it wasn't very many. But every once in a while, the people who had students that needed AAC were able to get the apps that they needed. For example, I was. Then, a lot of the speech paths never needed any apps, and so they just used their iPad for you know, activities, speech activities, and things like that.

What happened was, we, speech paths left, iPads broke, et cetera, and every time a new speech path would come in, or a device would break, we would say, ÒOkay, we need a new iPadÓ, and the district with look at us funny, because we hadn't realized that that was never part of the budget. It was a one-time grant and they had not Ð

[00:32:32] MD: Oh, my Lord.

[00:32:34] CDC: Ð planned for iPads to be replaced. So, now 2023, these iPads are completely not functional, which means that basically, no one has an iPad for modeling on. That has been a really big issue and something that my predecessor, and then myself have worked really hard on trying to get functioning iPads for the speech paths to be modeling with, and we're almost there.

We have Ð we got Ð the iPads, they were distributed from another department that didn't need them anymore. So, we got the iPads, and then we got a grant for cases, because the iPad without a case is pretty useless, right? Especially when you have kids that throw things. So now, we are just at the point that we're going to start putting those cases on the iPads and distributing them to speech paths.

The hard thing is that because it is a limited number, we still need to take into account all the kids that need access to and the aug comm. The kids are going to have to take priority over the speech paths, and the speech paths are going to kind of get the leftover remaining, and we're just going to cross our fingers and hope that it's enough.

[00:33:46] MD: Yes. So, one of the things that we did, and I don't know if they have vendors or supports out there, one of the steps that we took is that we partnered with, and I say we, the university where I was the clinic coordinator, and then the subsequent private practices that I've worked at. We've partnered with Talk To Me Technologies and Control Bionics and set up long-term loans, and those were free. So, folks, if you're listening and you live in a region where you have access to those organizations, I know there's other ones out there. Those are just the two that are here locally for my neck of the woods.

[00:34:27] CDC: I have a question about that. Were individual speech paths able to get those long-term loans?

[00:34:34] MD: Yes, individual speech paths. So, that was the thing because what Darlington School District, I think it was Darlington School District, and we set it up with all the SLPs in the private practices, and we had two or three at the university because we had two clinical educators and myself. So, there was three at the university. We had one fancy one with Control Bionics for the eye gaze. Lane, I know you're listening. Don't kill me. I don't remember what it's called. But it was like the really, really fancy one with the neural note. It's gone. It's there. It's gone. But we set those up so that it was to the person, and they had access to that for an extended period of time. And what was cool was, I was even able to take it a step further, and for the individual student or patient that needed the trial, we set them up with their own individual, I say, long-term loan, but it's for like four to six weeks, which 50% of the time is enough to give me Ð 33% of the time, it's enough to give me the data that I need. For the remaining cases, I've either had to completely change and go a different route, which is fine. 

Folks, if you're listening, the first one you give the kid may not work. The first communication app may not work, and that's okay. We set it up for ongoing ones, and then sometimes the kids just ended up not needing it. They had the trial and then spoken language evolved, and they discontinued the trial. But yes, that's how Ð that was one of our solutions and workarounds. But we haven't been able to push that out statewide to all districts. But that's a dream that I have. 

[00:36:25] CDC: Yes, and four to six weeks is a great amount for a long-term loan. I know that some companies will only send it for one or two weeks, which just is not enough time.

[00:36:36] MD: You can't collect Ð that is not enough time.

[00:36:39] CDC: I'm going to tell you a story about that. So, I recently got a device that was on loan for part of a trial with a company, and we had one to two Ð we had two weeks with the device for that child. But, first, I always have devices delivered to me, because if they get delivered home, I just don't know what's going to happen. So, I have devices delivered to me. And then I can't always program them the first day I get them. Then, I have to drive them over to wherever they need to go, and then I need to train the family and the speech path on it. Then, in this particular circumstance, after we did all of that, which took several days of our limited two-week time, the whole family got COVID.

So, the child never came in for speech during those two weeks, had no schooling during those two weeks, and then the device was due back and we had to return it to the company. Luckily, I pleaded my case and they sent me a new one recently so that this child can have another trial. But that just is kind of showing like the whole two weeks is just not enough time.

[00:37:51] MD: Yes, but it's not. Sometimes I feel like that were four weeks, because Ð so, the patients that I normally see are typically pretty medically complex. They've got surgeries, we've got follow-ups, we've got Ðso even with the four to six weeks, I mean, they could Ð we're probably going to have to miss at least one session because they've got a GI consult, or they've got something going on. Honestly, I got to say, they've been Ð the tech team and the trials departments have been really, really good with both organizations to allow for some extensions and to put the kid back in the queue at an expedited rate.

Like if we have to send it back and do like a second trial, there's probably a three to five-week period in between where they don't have any device. But I'm at least bringing mine in so we can practice during that time and coach the caregiver. Or another carryover strategy that I've used up, I've screenshot, what is this app called, CamScan? IÕve CamScanned the surface of like the pages so they at least have like a laminated low-tech version for that four-week interim. It's not pretty, it's not ideal, but like, it's a patch job until we get it back to continue and pick up where we left off, if that makes sense.

[00:39:14] CDC: Yes, that does make sense. I have certainly done the equivalent of that low-tech version.

[00:39:22] MD: That always makes me feel great. But I got to be honest, you used a word earlier that scared the bejesus out of me. The switch, the scanning with the switch. That makes me nervous. I don't know how to do that. When like a patient has a high-tech communication device, and they have to Ð they utilize it by switch access, like to communicate when it picks up and it lands on the right iconography and communication, that makes me nervous because I don't know how to do that.

[00:39:51] CDC: I know how to set it up. I have a student that I want to try it with. She's currently using eye gaze but I want to give her a second access method for her device, and so I have played around with it, but I have not yet Ð I'm still new enough to all this that I have not yet successfully used it with a student. I am doing, I am trying to get teams, I should say, to do more partner-assisted scanning right now. That has been one of my big push areas this year is to get teams on board for partner-assisted scanning, not only for kids who may be high-tech is just not the most appropriate communication option for them. Or also, for kids, that is a great option for them, but you can't always have this huge eye gaze device mounted to your wheelchair. There's other times in life when you need to have a communication partner scanning through your choices. So, thatÕs been something else.

[00:40:46] MD: Can you expand on that? I don't know. I have a vague idea of what partner assisted communication scanning looks like. But can you explain that for us, like paint a picture? 

[00:40:57] CDC: Sure. Partner-assisted scanning means that the partner, whether that be the speech path, the teacher, the parent, the friend, the sister, the brother, is the one who's pretending to be the scanner. So, they're going to follow a very regimented, predictable pattern of words. Maybe they start with, I'm just going to give an example, this kind of like a pod-type example. But you're like, is it a core word? Then, you teach the aug comm user to indicate, yes, when you get to the one you want. Some individuals can indicate no as well, but many canÕt. So, youÕre waiting for some kind of yes.

Is it a core word? And if they don't respond, you go on to the next one. Do you want something? They don't respond, you go to the next choice. These are like categories, in this case, that I've given the example. Is something wrong? Then, let's say that that individual raises their eyebrows, and then you interpret that as meaningful. You're like, ÒOh, something's wrong. Okay.Ó Then, you have a set list of what you're going to go through in terms of what might be wrong. Are you positioned wrong? Do you hurt? Do you feel sick? You have five different things. And if they don't choose, your last choice is always going to be is it something else, because of course, there's lots of things that we're not going to get to in a list. And then if they don't indicate, then you go back, and you start over, just like a scanning machine, we just start over from the top.

That gives our individuals with pretty complex needs the opportunity to participate expressively to the best of their ability, and in a way where it is memorized, and they know what's coming next. So, we're starting to use this with this one young lady I have who is blind because she doesn't need to see anything that the partner goes through the choices, and we're trying to teach her, she doesn't yet know the order. But we're hoping after several thousand repetitions, she'll know after core words, they're always going to ask me if I want something. And that's what I'm going to indicate yes. A lot of it is learning how to be a good interpreter of body movements or small noises, by assigning meaning to things just the same way that you would assign meaning to an infant, as they are learning how to communicate with their communication partners.

[00:43:20] MD: Yes. Also, teaching the communication partners how to read those. That's the same like when I'm working on a latch. I'm also a CLC. So, when I have a mom, that's learning how to read her newborn, and they're still learning each other's nonverbal communication, I mean, at that stage of the game, I'm talking like four, six, eight-week-old, and she's trying to recognize those first emerging hunger cue signs, that takes time. But it's the constant repetition because a breastfed baby will feed 16 to 25 times a day. So, they have that Ð that adds up to the thousands very quickly.

Also, I'm so grateful that you said that, because some of the feedback that I get is, ÒWell, we went over that. We've gone over that a couple of times.Ó IÕm like, ÒNo, no, no, no, it's not a couple. This is a muscle memory.Ó It's going to take so many presentations, and I always tell my families, you need to drive the device upside down. They're like, ÒWhat do you mean?Ó I'm like, don't hold it so that up here while you're standing, hovering over your toddler, you need to bend over so that it's in their line of sight with their orientation upright. So, you drive it upside down so that they can see it.

[00:44:41] CDC: I like that. I've never thought of that. But you're absolutely right. Yes.

[00:44:45] MD: Yes, you got to drive it upside down. It's backwards, but it works for them. So now, I am so good at driving upside down, that if I go forward, then I'm like, ÒOh, I have no idea where anything is because my muscle memory is for upside down.Ó So, that's great. That's like with all things, do it backwards, Michelle. But that works and that's been Ð that's a great strategy folks, drive upside down, but just not a vehicle.

[00:45:16] CDC: Not a motor vehicle.

[00:45:17] MD: Not a motor vehicle. Oh, my goodness. Okay, so have you Ð I know you're taking on the world out there. But with respect to your resources that you've got available, do you have resources available to guide clinicians in this step? Or if, say they're the solo SLP who doesn't have quick access to their AT team lead, how can we set that person for success if they're listening?

[00:45:46] CDC: I know I have at least one blog post about partner-assisted scanning, and I even, I think this was during the pandemic, so I was like all gung ho, and I even created a video of a sampling of what that might look like. I know that that's one thing you can do.

For my own teams, and sorry, guys, this isn't public, this is just for my school district. But I ended up, as part of my role, I took it on myself to create a whole web page using Google Sites, which is very easy to do, and putting all the things, and all the videos, and all the links in there. So, even if you don't know how to do this, if you have someone who's kind of in charge, and you ask them, can you compile these into a really easy presentation method that we can access at any point? That would be really super helpful.

Then, I always love going to kind of those websites that just have everything, like praacticalaac.com for example, where if you just put in the search terms, you can find like six different blog posts about it as well as articles and videos and things like that.

[00:46:57] MD: What was that website?

[00:46:59] CDC: Practical, P-R-A-A-C-T-I-C-A-L.

[00:47:04] MD: I have never heard this.

[00:47:04] CDC: Praacticalaac.com. Really, it was created by Carole Zangari out of Florida, and it is mostly just a compilation Ð I mean, she writes some of the posts but a lot of them are things from guest posters or she links to other people's posts and this has been going on. She's had this for over 10 years.

[00:47:27] MD: I've literally never seen this before.

[00:47:28] CDC: Very well-established blog.

[00:47:32] MD: Oh, my Lord. So, itÕs got the tree. Sorry. My family, that's our crest. The Wood family is the oak tree and like that circular pattern, so all of us Ð all of my family have the oak tree tattoo somewhere on our bodies. There it is folks.

Okay, so what other resources or practical day-to-day stuff that do you wish that folks knew because my biggie is please don't put the device away. Please keep it out. Please keep it charged. I know like I say that on like repeat and we see that again and again. But what are there things that you wish that could happen in a classroom that would help ease everybody's storming, forming, norming?

[00:48:25] CDC: The see me, see my AAC. The idea of like don't put the AAC away in a shelf. If I come in and it's still in the kid's backpack, that's not a good sign. I actually created a wanted, one of those like old western wanted posters using Canva and I put the kiddoÕs photo in it, and you could see her speech-generating device in it, and then it's in this wanted thing. Then, I put it on the door to the classroom, and it said something like, ÒWanted. Have you seen my talker? I'm not supposed to leave this room without my talker.Ó Because she was going to her specials.

So, she's in a wheelchair and she will Ð they'll put her talker on her desk for use in the classroom. But then when she goes to her specials like PE or lunch or whatever, she needs the staff to put the mount on and put the talker on the mount, and it wasn't happening. She was only using her talker in the classroom and she is completely non-speaking and very social. So, I was like, ÒWell, how is she supposed to communicate during all those times, especially like lunch, because she doesn't eat orally, right? So, what does she got to do during that time?Ó Well, hopefully, it's communicate with her friends and her peers but that's really hard when she doesn't have her talker.

All that to say, I made a wanted poster and put it on the door and everyone thought it was funny. I'm not sure if it actually worked.

[00:49:56] MD: I think it's funny, but hopefully it worked. But also, you brought up lunch, and I have a research idea that I would love to see come to fruition for kiddos for AAC for lunch. So, like, can I speak that into the universe? Like, maybe we could like big dreams there? Is that okay?

[00:50:13] CDC: Sure.

[00:50:14] MD: Okay. I want somebody to do research where they put a voice recorder on, for children that are typically developing. And I don't like that phrase, but there we are. And I want it to go, like, let's actually get a wide variety of participants from across the continental United States, suburbs, inner cities, rural, and age norm this. But I want the language that's utilized around the lunch table. Then, I would like is to somehow come back, and like the whole lunch experience from walking into the cafeteria, going through the lunch line, making the selections. And then I would like to go through and have universal access set up for our non-speakers that maybe they can't get through the lunch line with their eye gaze device on. Because I mean, some of those cafeterias, those hallways to get into like the lunch line are very narrow, and wheelchairs might not be able to fit there. But I would love to have universal access for communication there.

Michelle Therrien, when we were talking, we were talking about like, wouldn't it be great to have a communication board as a playground, itÕs great. But then you have to stop what you're doing, go all the way back to the communication board, and then come back. But what if we did a research analysis about what are those kids saying when they're hanging out at the top of the slide? And then putting that vocabulary universally accessible right there, even to the point that it's got braille on it, and some way that a child that's non-speaking, could communicate, ÒMove, get out of my way. Go faster. Don't push me. Slow down. Knock it off. I love you.Ó I mean, I'm just thinking about, like, my youngest was definitely afraid of slides. So, I'd always be like, ÒI love you. You're going to make it man.Ó

[00:52:07] CDC: So, it would be like language samples in all those different environments combined with surveys from probably adults, because probably the kids aren't going to answer the survey. But they could be interviewed to do interviews, to compile that information.

[00:52:22] MD: Yes. Then, build that in. IÕm like laying on top of my microphone. I'm so excited. But then built that into Ð someone said there's like placards or something that's permanent that won't move that's also latex-free, because I have too many kids, that I work with that have latex allergies. And imagine the amount of independence that will occur for these little ones. That just Ð somebody somewhere, please research that. Let's make that happen. Yes. I don't have time. I can just dream the ideas, but I can't do all the ideas.

[00:53:02] CDC: Yes, even as it is, I can't keep up with current Ð one of the vocabulary systems that we use a lot where I am is the WordPower 60 and they have the social phrases, and you go in there and they're fine. That's awesome. That's great. How are you? But I'm pretty sure most of them were put together in the late nineties, early 2000s. So, some of them, I just look at them, like, ÒDo people still Ð I know I say that. But do people still say that?Ó So, I actually had to go and I had to ask my son, who's a Ð he's a college sophomore. I was like, ÒWould this be so weird if a kid was saying, that's awesome.Ó He was okay with it. He was like, ÒNo, it would still be okay. It might not be the most up-to-date terms, but it's not irrelevant at this point.Ó

So, even having a list of all the ongoing and updated list of the slang and lingo and idioms that are being used, that alone would be very helpful.

[00:54:01] MD: My stepmom still says cool beans and it cracks me up every time. SheÕs like, ÒCool beans. I'll make it happen.Ó But she'll text it to me, and I'm like, ÒOh, my God, that's so adorable and precious and I don't want to tell my stepmom that like Ð I mean, I know we don't say cool beans anymore. But now it's like family lexicon. But my eight-year-old had to translate, ÒThat susÓ, and I was like, ÒWhat are you saying? That's not a word? What is this, that's sus?Ó I now know. That means itÕs suspicious, but like, I had no idea the words that were falling out of his mouth until he translated.

But that's right. But like having that Ðbut that gets back to building friendships and relationships. This is more than just utilizing an AAC device to check a box for meeting academic goals, right? There's more to life than that. We've got to equip and empower so that the users of these devices can live their life, and I feel like that gets lost sometimes.

[00:55:03] CDC: Right. One of the interesting things about this new job, in the past I was always working with elementary, and now I'm working with K through age 21. So, I'm starting to really think about not just, how can we help them to read and write in elementary but how can we prepare them for life as independent as possible? I know one way that comes up is when teachers want to do kind of drill and kill vocabulary. Vocab is important, and I get that. But let's just assume that 15 years from now, they've made progress, but it's not super significant compared to their peers for progress. What do we really want them to know? Do we want them to know all this kind of tier two and tier three vocabulary? Or do we want them to be able to express their wants and needs and protests and basic social back-and-forth friendships?

It's kind of one of my big rants that I go on all the time, that not enough time is spent on communication, when communicate to me, and someone's going to prove me wrong, and then I'll change my tune. I'm fine with changing my mind. But right now, my current rah-rah is that communication and self-regulation, and shoot, there was a third one. But those are the three main things we should be focusing especially on our kids who have developmental delays. There's a lot out there at school that I'm like that's later in the pyramid. First, let's get down these basics so that we can function and feel safe and have control over our bodies and communicate with others.

[00:56:49] MD: Yes. My very dear friend, Erin, her focus is on Ð she has her DIRFloortime certification, a couple of different levels and she also has her trauma Ð I can't remember what it is. But she's gone through the trauma relationship certification as well. So, she talks about trauma-informed care, and how we have to focus on building and maintaining those meaningful relationships for trust and everything is centered around trust, and setting these children up for Ð I don't Ð it goes scary quick, but bodily autonomy and the ability to say no. That's scary, because a lot of these children probably had like direct hand-over-hand forced on them, or they don't have the ability to say, ÒStop, let me do this.Ó But if they can't say, ÒStop, periodÓ, because they're so used to being forced to accept hand over hand, then we have created scenarios where a vulnerable child is at Ð their at risk for very bad choice-making adults. You see what IÕm saying?

[00:58:09] CDC: Yes. Well, and the other thing, this reminds me of I was listening to a podcast, and they were talking about body parts and teaching our kids body parts. I went on and I went to all three major vocabulary apps that we typically use in my school district, not a single one had those body parts on there. I had to look Ð I have to go in. I remember to go in and add private parts, except I actually label them and I'm like, ÒYou know what, if someone doesn't like that, that's too bad.Ó 

[00:58:44] MD: I laughed because the boys call their business a tallywhacker and the girl's business a tooty ta, and like outside of our family, that doesn't make sense, but that's literally what my family grew up calling them. You got tallywhacker or a tooty ta, and then there's that song, ÒOh, Tooty Ta. Oh, Tooty Ta. Oh, Tooty Ta-Ta.Ó And my boys thought they were singing about a vagina. So, like that got complicated.

[00:59:08] CDC: But I just find it so frustrating when I've got like, high schoolers that I'm giving a device to and like the word like penis and testicles aren't on there. I'm like, well, we just got them this device saying that it was for health and safety needs.

[00:59:21] MD: We should have that on there.

[00:59:25] CDC: Yes. I mean, hopefully, the kids aren't going to be using it inappropriately, but at the same time, if they are that's pretty age appropriate too.

[00:59:32] MD: Yes, it is. Oh, God help us. Yes, it is. That started in our house. Oh, my God. Boys are so gross. Do you have two sons? One son?

[00:59:42] CDC: No, one son.

[00:59:43] MD: One son?

[00:59:45] CDC: He's actually not Ð he's not that. No one in my family. We don't do body humor, so Ð

[00:59:50] MD: But we were getting ready this morning Ð no, it was yesterday morning at breakfast and I was laying out the itinerary for the day, and the little one was like, ÒMom, I don't understand what you're saying. You're not speaking my language.Ó Goose was like, ÒYou have to translate it into fart and poop and PJs.Ó So, I would say something and then the tango would go, fart, fart, toot, toot, pee, pee. And then my husband, my husband would go, ÒNo, that's not how you pronounce it. It's fart, poop, pee, pee, poop.Ó And like that went on for all of breakfast yesterday morning. I'm like, ÒThis is Ð what is this? This is normal. This is our normal.Ó ItÕs so gross. I love it.

But that gets me back to the vocabulary for our family is fringe. We live in our fringe and it works for us. Are we recognizing those vocabularies outside of tallywhacker and tooty ta and putting that on their devices so that they can thrive in their neurodiversity if they want to info dump on their favorite topic. I had a child one time his favorite topic was vacuum cleaners. This is very hard to program vacuum cleaners, especially the different types, but if that's meaningful to them Ð

[01:01:01] CDC: So, what I just did, this was so fun. It's the first time I've done this. I had a student who is Ð she's speaking but she's very, she's like, less than 50% intelligible. Her thing is wolves. She loves wolves. We have a trial device for her right now. What I did is I made like seven different questions about wolves, so she could engage her communication partner. ÒHey, did you know that a wolf has 43 teeth?Ó Seven different questions like that, and then some wolf-specific vocabulary. Then, the idea being if we decide we do want to go through insurance funding for a talker for her, that we can add even more things on there. But she was just so thrilled to have her vocab page that was just Ð it was individual vocab words as well as pre-formed questions. So, the quick access so she can engage other people in her topic of interest.

[01:01:54] MD: I love that. I love that. Okay, I was at a conference Ð I was at OSSPEAC. Hi OSSPEAC. Ohio School Based Ð Ohio School Speech Pathology Educational Association. I butchered it. I'm sorry, ladies and gents. But they had a dynamic presentation on AAC, and one of the speakers there was asked by a member in the group, ÒDo you program gestalt language scripts into the device?Ó It was very interesting because those are Ð that child's unique scripts, right? Do you program that into the device or do you edit away? And my thought process was where are they on that level of gestalt, right? Are they at the one word? Or are we working on like two and three-word comm? You see what I'm saying? What is your thoughts on this?

[01:02:48] CDC: I'm still wrapping my brain around that, especially for the kids who can verbally speak their gestalt. I'm not at the point right now that I feel like if they can speak it, I'm not at the point that I want to also put it on their aug comm device. But I know there's definitely people who would say that you should. So, I'm not married to that idea yet. That's just kind of where I am right now. I'm like they have a Ð itÕs one of those, they have a functional way to communicate this. We don't need to force it in a different modality as well.

[01:03:23] MD: Yes. My thought process is if the program that I'm working on has word chunks, or like sentences and phrases Ð I'm sorry, Chewbacca came inside and is drowning a bowl of water and now eating so please Ð he's got cancer. So, we kind of give him a little bit Ð oh, he's, I know. My dog has metastatic melanoma on the surface of his tongue and they wanted to do Ð

[01:03:49] CDC: On his tongue?

[01:03:50] MD: On his tongue, because of course he does. And they wanted to do a partial glossectomy with the chance he might need a feeding tube. I was like, ÒI'm sorry. Do I? No, thank you.Ó I'm not doing that to a dog. Then, it was the oncology vet, and my vet was like, ÒYou don't understand what Miss Dawson does for Ð a partial glossectomy with a feeding tube.Ó But yes, of course, that's my family. That's my dog.

But I'm of the opinion if the device that I'm working on has the option for some longer scripts in it, and that's where that child is with their needs. Then if they're only scripting through spoken language, and one word, and I know what it is that they're scripting, I would add that in there for them. But again Ð

[01:04:41] CDC: That makes sense.

[01:04:42] MD: Yes, but if they have spoken language, and they're giving me the full script, then I don't think that I need to add the full thing. You see what I'm saying? 

[01:04:50] CDC: I see what you're saying.

[01:04:53] MD: That's how I rationalize it in my thought, but I also feel like this whole concept of gestalt language processing is only hitting mainstream within like the last maybe five years, and we need more research here to kind of drive which way we go.

[01:05:09] CDC: Yes. But I mean, we've been using Ð it's actually interesting because I feel like when I first started aug comm, it was all gestalt-type things like pre-programmed full messages. Maybe not gestalt, like not the individualized gestalts of the kids. It wasn't that, but it was not core based, it was full phrase-based, and then we shifted towards only core. Well, no, first we had to go into the PECS realm. No, first of all, is the PECS realm, right with only fringe. Then, we had the full phrases. Then, we had the only core. Then, then we had the core plus fringe. And now we have the core plus fringe plus the phrases. That's been the last 20 years in a nutshell.

[01:05:58] MD: Oh, my, how the times have changed.

[01:06:03] CDC: But in some ways, it hasn't, though. Because in some ways, we're circling back around. I'd like to think that we're learning more and doing better, but lots of history and lots of theories kind of go in cycles like that. I know, educational theory, just has a long history of doing that. Just cycling through like, what's best practice?

[01:06:23] MD: Yes, that's all right. Tongue ties are there, and right now the pendulum is swung that everybody in their mother has a tongue tie. Oh, by the way, if you're an adult, and you get your tongue tie fixed, I've even read on the wild world, it'll fix an orgasm. You just kind of got to take this in stride. But like, when the research that is currently available, does not support severing a lingual frenulum. And there's no such thing as a buccal tie or labial tie. Oh, by the way, the National Academy of Otolaryngologist don't even have a concise definition on what a tie is. Casual, just casual. PFD rant. This is one of my soap boxes.

[01:07:05] CDC: Interesting. I didn't know that. That is clearly not my area.

[01:07:08] MD: No, this is the world I live in. Okay, we have joyfully gone over. We didn't even get to the reports. But we'll have to redo this again. Because I would love to have one come out again, in the future with you when Ð the floor is yours. The microphone is yours. I am so grateful for your time and your expertise. Is there anything that we didn't cover that you want to cover? 

[01:07:33] CDC: Not right now, I don't think. I'm just kind of, like I said, even though I've been in this job for a year and a half, I'm still just kind of figuring it out and trying to come up with a schedule and looking at what an ideal day and an ideal week would look like, and maybe when I actually achieve some of those goals, it would be great to check in again and talk about how they went.

[01:07:58] MD: I love that. Yes. Because that would be a great model for those that are like I am right there with you. I don't know what my schedule looks like. So yes, we will claim that in the universe. Well, if folks want to reach you, or they want to follow you, how can they reach you and follow you?

[01:08:11] CDC: You can find me, I will admit I have been slacking off on social media because I'm halfway through another doctorate degree.

[01:08:21] MD: A second one?

[01:08:22] CDC: A second one, yes.

[01:08:24] MD: Nice.

[01:08:25] CDC: So, social media has kind of gone by the wayside. But you can see all my previous posts at Super Power Speech, like on Instagram or Facebook. Then, then you can always look on my blog with all my blog posts, superpowerspeech.com. And then you could contact me directly via email that I'm very good about checking and that is cheri@superpowerspeech.com.

[01:08:49] MD: Beautiful. Thank you so very much. Y'all, thank you for tuning in. We love it when you hit us up on First Bite Podcast on Instagram. We have a First Bite Podcast Facebook page, as well as when you give us a loving kind review, that always makes our day on the Apple Podcast. So, hit us up with your five stars. Tell us what you love. And if there is a topic you want covered, message us, let us know. We'll go there. Cheri, thank you so much for coming on.

[01:09:19] CDC: Well, thank you for having me.

[END OF INTERVIEW]

[01:09:23] 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 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.

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]

[01:10:15] MD: That's a wrap, folks. Once again, thank you for listening to First Bite: Fed, Fun, and Functional. I'm 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 you'd like to learn more about CEU opportunities for this episode as well as the ones that are archived. As always, remember, feed your mind, feed your soul, be kind, and feed those babies.

[END]
FBP 245		Transcript

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