[00:00:00] 

Intro

Kate Grandbois: [00:00:00] Welcome to SLP Nerd Cast. I'm Kate. And I'm Amy. And we appreciate you tuning in. In our podcast, we will review and provide commentary on resources, literature, and discussed issues related to the field of speech, language pathology. 

You can use this podcast for ASHA Professional Development. For more information about us and certification maintenance hours, go to our website www.slpnerdcast.com.

SLP nerd Cast is brought to you in part by listeners like you. You can support our work by going to our website or social media pages and contributing. You can also find permanent products, notes and other handouts, including a handout for this episode. Some items are free, others are not, but everything is always affordable.

Visit our website www.lpnerdcast.com to submit a call for [00:01:00] papers to come on the show and present with us. Contact us anytime on Facebook, Instagram, or at [email protected]. We love hearing from our listeners and we can't wait to learn what you have to teach us. 

Amy Wonkka: Just a quick disclaimer, the contents of this episode are not meant to replace clinical advice.

SLP Nerd Cast. Its hosts and its guests do not represent or endorse specific products or procedures mentioned during our episodes, unless otherwise stated. We are not PhDs, but we do research our material. We do our best to provide a thorough review and fair representation of each topic that we tackle.

That being said, it is always likely that there is an article we've missed or another perspective that isn't shared. If you have something to add to the conversation, please email us. We would love to hear from you 

Kate Grandbois: before we get started in today's episodes, financial and Non-Financial Disclosures. Um, I am the owner and founder of Grand Wa Therapy and Consulting, LLC and co-founder of SLP Nerd Cast.

Amy Wonka is an employee of a public school system and co-founder of [00:02:00] SLP Nerd Cast. Uh, we are both members of Asig 12 and both serve on the a a C Advisory Group for Massachusetts Advocates for Children. I am a member of the Berkshire Association for Behavior Analysis and Therapy, mass a BA, the Association for Behavior Analysis International and the corresponding Speech Language Pathology and Applied Behavior Analysis special interest group.

I literally, every single time I say that in show you wanna celebrate it, I wanna say hooray without fail. And if I, and then I stop myself from saying hooray, and then I wanna say Za, I don't know why. It's like this weird script that I have o off of a script. The problem, you just, you there chain those together.

I totally, I chain them together. If any listeners out there have any suggestions for other nonsense or silly words that I should or should not be saying after this intro. I would love your feedback. Okay, so what are we talking about 

Amy Wonkka: today? Uh, today we are [00:03:00] talking about applying aided language modeling interventions to your practice.

Kate Grandbois: So we have done one episode on aided language modeling already, um, to some of our listeners, uh, to our frequent listeners who may have already listened to that episode. This episode today is a little bit different, but it's gonna have some of the same information. So our original ADA language modeling episode, the, uh, purpose of that was.

To review, give a general overview of what aided language modeling is and what it isn't, and what the literature says about it. Today's episode is gonna contain a little bit more information and focus on how you actually implement aided language modeling in a treatment setting. There is gonna be some review of the information from the first episode, so bear with us while we go through that, but hopefully this will have a slightly different spin.

Yes. Yes. 

Amy Wonkka: Um, 

Kate Grandbois: so why did [00:04:00] we choose this topic? Why did we decide to do a deep dive into practical applications? So 

Amy Wonkka: this podcast kind of, uh, came about because we also wrote a blog post. We were guest bloggers. We got to be guest bloggers, which is super fun. Super fun. Um, it was really 

Kate Grandbois: cool. And we should do a public thank to Carol Zari who allowed us.

Gave us the great privilege of writing an article for her blog Practical A a C. It was very cool, which I have to say. 

Amy Wonkka: Practical. A a C is a, is a web resource that I direct people to all of the time. So to be able to be a part of that wealth of knowledge sharing that's happening thanks to Carol. Um, it was just super cool.

Super 

Kate Grandbois: cool. We love your website, Carol. Mm-hmm. We love practical a, a c. For any listeners out there who have not become familiar with this blog, um, it is an unbelievable wealth of resources and information. Related to AAC c. Um, it's practical. A-C-P-R-A-A-C-T-I-C-A-L aac [00:05:00] c.com. Is it a.com? 

Amy Wonkka: Uh, let's find out.

We're gonna ask the internet. Well, I'm asking the internet about that. I think one other thing I wanna share with you guys, our from the internet, our from the internet, 

Kate Grandbois: it's dot org. Oh, it's dot org so it's practical. A practical a a c spelled P-R-A-A-C-T-I-C-A-L. aac.org. 

Amy Wonkka: Dot org. And one other super cool thing about that resource is that not only are there text blogs, which, which was what Kate and I did, um, you know, she has videos on there.

There's all sorts of different types of multimedia. Resources that you can, you can check out. 

Kate Grandbois: And she, there are a lot of guest authors on there, so you really can search for a variety of different topics and different perspectives and viewpoints. So it's a, it's a multidimensional, um, well, of, of information.

Um, so once we had written that article for practical a, a c, we um, wanted to create an audio version so that, um, you know, not all of us have the luxury of like [00:06:00] sitting down and quietly reading an entire article at least. We, we've had this discussion many times before for the busy clinician or the working parent or you know, whatever your situation, if you don't have time to sit down and read.

Um, we wanted to make an easily accessible auditory. Compliment to that practical a, a c article. I mean, we've said enough about that. Let's just move on. Yeah. Okay. Moving on. What are our learning objectives, Kate? Okay. What are we learning about today? Diving right in. Okay. Uh, learning objectives today include, number one, define aided language modeling and review the evidence for it in the literature.

Number two, identify specific action steps to plan for aided language modeling within a treatment session. Number three, identify specific action steps for implementation and improving aided language modeling techniques within a treatment session. Exciting. It is exciting. Um, before we get into our learning objectives, we should probably, um, say a little bit about a, a c intervention strategies in general, wouldn't [00:07:00] you say?

Yeah, just like where aided language modeling falls in the, in the continuum. 

Amy Wonkka: Yes. I think that we should, and I think that we should say, you know, one of the first things that you'll find about aided modeling interventions is that they're called like 15 different things. So you may have heard aided language modeling, you may have heard aided language stimulation, you may have heard system for augmenting language.

Like there are a lot of different, um. Terms that are used to kind of refer broadly to this, not very well-defined and sort of nebulous construct of like, I'm gonna provide you some type of input using an aided tool. So something external to my body, um, as I'm speaking to the, to the communicator. 

Kate Grandbois: Yes. And I think another perspective about aided language modeling that's interesting is that it's super popular.

And, um, when I say super popular, I mean, you know, it's well documented in the literature. I'm not at all referring to it as like a fad. I [00:08:00] mean that if you are a clinician, um, who is a career launcher, you're maybe, you know, graduated a handful of years ago, or maybe you're a seasoned clinician, but you're just starting to tip your, you know, dip your toe in the waters of a, a c aided language modeling is likely an intervention strategy that you have come across.

It's often presented at. When you go to conferences, there are lots of presentations about it. There is information about it. Much social media. Yeah. Like you'll 

Amy Wonkka: see the, you know, information, you'll see it discussed in Facebook groups about a, a C, um, right. So it's out there. 

Kate Grandbois: Right. Um, and I think once you, you know, understand what it is, it can be a little bit difficult.

To implement it because it is not just, oh, I'm gonna touch the buttons on Johnny's device. There's, there are a lot of different moving parts, and it's a little bit more of a dynamic process. So just because it's a really, um, popular or commonly used intervention doesn't necessarily mean that it looks the [00:09:00] same for everyone or that, um, you know, you do it just one way and it's not a, it's not a program, it's not a procedure.

Um. And 

Amy Wonkka: I think when we look at the literature, we see that, you know, of course within the context of a research study, the people who are running the study are, are generating operational definitions and describing what their intervention procedures are. Uh, but that doesn't. Often I find when I read research, it doesn't really directly translate to what I do as a clinician, you know, in my clinical practice.

So that's true for aided modeling. Um, and it's true for other interventions also. So, you know, there are, I think it's worth mentioning that although we're focusing on aided modeling today. There are a lot of other interventions that you may have heard of, you know, things like discrete trial chain training or behavior chaining, or you know, a lot of different type prompting procedures that kind of combine together to create your treatment prac your treatment package.

[00:10:00] Um, when we think about aided modeling. Just like any other element of that treatment package, you're going to wanna think about your individual variables in your treatment environment with your communicator, with their communication partners. So it's something that involves planning, should involve planning, which we'll talk more about Exactly.

Kate Grandbois: Um, well said. So let's get into some of the underpinnings of objective learning. Objective number one, define aided language modeling and review the evidence for it in the literature. So tell me, Amy, what is it? Repeated language modeling. 

Amy Wonkka: What is it? Great question. Um, I think, I think you, as the clinician to some extent, are defining what it is for each individual, you know, and each team that you're supporting.

Broadly aided modeling interventions include all of these different approaches. You know, like we had said, it could be system for augmenting language, augmented input, aided language stimulation. Language [00:11:00] modeling, natural language modeling. Those are all terms that you can find in the literature, and they refer broadly to the idea of as the communication partner, when I'm speaking to the communicator and supporting them in learning how to navigate and access their communication device, learning the vocabulary, I am modeling those keywords on the device to talk to the person.

In the context of sort of just our natural exchanges with one another, and I think the big distinction for me between. Modeling and a different intervention approach such as prompting, is that in the case of modeling, it's me as the communication partner using the device to talk. I'm not using the device with the, you know, agenda of like providing a cue for what I want the communicator to say to me.

I'm not prompting, um, I'm just using it to talk to the person in a naturalistic environment to sort of provide that immersion. 

Kate Grandbois: And when we were preparing for this episode, we had a [00:12:00] really interesting. Discussion about this concept between what is a model and what is a prompt. And I think that it's a really important discussion.

It's a question that I get asked all the time. Um, particularly if you work in an a, b, a setting. Um, I, I, which I do, I work in an a, b, a setting. I'm, I'm a dually certified BCBA. Um, and modeling is. A prompting strategy that is very commonly used in an a, b, A setting and a variety of other settings. So I get asked the question all the time, well, I'm not gonna model on the device because then I'm just prompting him and I want them to do it independently.

So how, tell us, Amy, how would you, how would you answer that question for our listeners who get that question? 

Amy Wonkka: So if you are getting that question or maybe you have that question yourself, I would point you toward an article by Senate L and McNaughton in 2016, and we'll have that citation up on our website.

And they do a really nice job in, in their article, just [00:13:00] distinguishing the difference between a, a c modeling what they call a a c modeling and what they call instructional modeling. So that's really what Kate's talking about is instructional modeling. So, so you're Yes, I'm modeling just like if I want you.

You know, to, to do a silly dance. I might do that silly dance myself. I, I wouldn't, I can't dance. 

Kate Grandbois: Anybody who does me does can't dance. Those are beautiful. Who can't see Amy right now? I was trying to do, she's doing a little shimmy. 

Amy Wonkka: That's lovely. So in that context, you know, I am providing a model, um, of this silly dance because I want you to do the silly dance.

That's not, you want me to imitate your silly dance right now, I want you to imitate me. Yes. That is really different than what they're talking about in a a c modeling. Which they define as a naturalistic communication interaction, which is a dynamic process between at least two people, highly interactive, bi-directional, multimodal, and occurs naturally.

Right? So that's super different. And I think when we think about really structured prompting [00:14:00] hierarchies, like the example that you gave, um, Kate. So let's say maybe I want you to say juice and I'm gonna hold my finger over the buttons for the icon sequence that you might need to press to say juice.

That would be instructional modeling. I'm, I'm giving you, you know, visual supports or I guess I'm providing the model. Maybe first I show you how to say juice and then I want you to say juice in that same manner. That's instructional. It's more structured. It might still take place in kind of a naturalistic environment.

Maybe it is snack or we're drinking juice and you know, so I provided a model for juice and then you said juice. Um, and I think. When we think about aided modeling, it's, it's less structured than that. And the ultimate goal is not that I have Kate say juice just like I did, it's that I'm just providing her visual supports in this same modality.

Kate Grandbois: So to use that same example of juice and aided language modeling approach would maybe. Sitting with the communicator, you're both having snack together and you're commenting on your own delicious juice. 

Amy Wonkka: Mm-hmm. [00:15:00] And 

Kate Grandbois: you're talking about. Whatever it is that you're talking about. And the, the intent is a social exchange.

The intent is not, I'm gonna say juice so that you say juice. Correct. So if I, so my, my grape juice is delicious, but I really wish I had, I was about to say strawberry juice. I've never even heard of strawberry juice, but I really wish I, I really wish I had apple juice or. My juice is really, really warm.

Gross. I really wanted to go get an ice cube. These examples are so absurd, warm juice. But in that example, I'm maybe modeling the word juice as I have a social exchange talking about. My juice. Your juice. 

Amy Wonkka: Or you could say, you know, this is delicious juice. And depending upon your communicator's level, like you might, you might model both the word delicious and the word juice on the system while saying this juice is delicious example.

And also drinking delicious juice and delicious. You drink the [00:16:00] delicious juice and then your communicator might say, mine too. Right. So the ultimate goal is that we have a reciprocal social interaction that not that like I then want you, Kate, to imitate 

Kate Grandbois: that this is delicious juice. Right? So, um, the, in the, and again, this is a really great article.

Um, when we were having this discussion, the, uh, verbiage in this article and how this article describes the difference between a, a c modeling and instructional modeling, I found really helpful Senate light and McNaughton. 2016, the references on our website, go look it up, if you would like to read more about that.

Um, but I do think that it's an important distinction and it's a, I don't know if you get this question a lot in your part. I get this question all the time. 

Amy Wonkka: I think the reason that it's a, an important distinction as a clinician is less about like, oh, I need to be very clear on what type of modeling I'm doing.

And I think it's more just. Being conscious about, including, about [00:17:00] not just doing directive instructional modeling, right? Mm-hmm. If, if that's appropriate, and we'll, we'll get into some of these factors later and we'll share some, some planning forms that, you know, we kind of have up on the practical AC website and up on our website that you're welcome to use.

Um, so because if you have a client. Who you feel like you wanna be using aided modeling interventions as part of your treatment package, and you think that? This is an effective tool for them. You wanna be conscious yourself and aware that you're not just using modeling in the context of instructional opportunities, directives.

You really wanna be aware that you're identifying and then taking advantage of the opportunities that are occurring incidentally throughout the day. I think that that's like the most important reason to be aware of kind of. The, the different pieces there. 

Kate Grandbois: No, and I, and I, this is just me and my experience.

I find that that is unbelievably, it's very, it's crucial and also [00:18:00] requires a lot more resources in terms of staff training. Yeah. And, um, partner, um, communication, partner education and training in general to capitalize on those, on those natural communication opportunities and, and exchanges. 

Amy Wonkka: Well, and I think it's, it for a lot of people, it's a shift from.

A highly directive interaction style. Yes. To a more reciprocal interaction style. Mm-hmm. And I think that when you hear, you know, when you go to a conference. And you sit in a session and you hear about aided language interventions. Sometimes that's stated explicitly and sometimes it's not. But I think that, that to me, when I, you know, when I've sat in these sessions and, and thought about what the speaker was saying, those are pieces that I take away, right.

Is the idea that, you know, kind of. Along with an aided modeling intervention is the idea that it's, it's less directive. Mm-hmm. You, you're building this different kind of incidental, reciprocal. [00:19:00] Communication style and, and we tend to be really directive often. Mm-hmm. Communication partners with especially younger children in general.

Um, so just being aware of that and being aware of modeling multiple types of communication. 

Kate Grandbois: I think that's such a good point. So now that we have a little bit of the lay of the land in terms of aided language modeling and what it is and what the literature says, um. I think it's would be a good idea to start talking about and thinking about, um, what things you need to consider when you are interested in introducing aided language modeling into your clinical work.

Um. 

Amy Wonkka: Right, because we talked about how, you know, it's, it's not, I think that's another piece too that makes it a little bit harder than instructional modeling, right? Mm-hmm. When you're, when you're thinking like, I just want Kate to say delicious juice. That's all I need to think about because with what my agenda isn't, 'cause delicious 

Kate Grandbois: is my target word in my IP objective, and that's right.

I need to make sure that you have met this [00:20:00] objective before my meeting with the parents, right. In a couple of weeks. 

Amy Wonkka: Right. That's, that's not the excuse, right? Correct. So, so when you're thinking more naturalistic and more global and less directive, then you need to think about more variables. 

Kate Grandbois: Right, exactly.

And there are so many variables. So, um, in terms of trying to unpack what a naturalistic communication exchange is and all the things that you would need to consider when. You know, thinking about how to create and embrace more of these naturalistic communication exchanges, this sounds so simple, but thinking about what your client or student is, is interested in.

Yes. Uh, you know, what, what are, what are they interested in? Um, and I think this is an even more important one. And maybe less obvious to a lot of people, but what routines happen frequently? Right. So, you know, and, and this I think also goes back to, to choosing communication targets. Like, it's great if the word [00:21:00] delicious is a target and you think that that word is an important word for them to have, but how many opportunities do you have to use the word delicious throughout the day?

Um, and you know, there's this focus on core vocabulary. Yes. All of that is true, but there are some core vocabulary words that might happen more frequently than others for different students or communicators, depending on their interests, depending on their school day, depending on, um, stakeholder input.

Um, and I think that those are, those, those two things, general interests and frequent routines and frequent opportunity are two really important things, um, to consider when planning for an aided language modeling exchange. 

Amy Wonkka: And when we think about aided language modeling it. It also is an intervention that has multiple elements of communication that it supports, right?

So we are providing, you know, contextual models of expressive communication, but you also might be helping to support expressive, or, excuse me, [00:22:00] receptive communication. Mm-hmm. By pairing, you know, a more consistent visual symbol with your auditory oral output. Um, so when we're thinking about. You know, you could model, you might wanna model specific functions of communication that you're not seeing that often in your, in your, uh, client.

Um, so thinking about that as you're keeping in mind, okay, so where are their interests? Where do their interests lie? And where are those frequent opportunities for communication? So, so just to connect to the idea of pragmatic functions. To different interaction styles. One thing that we see a lot when you have a very highly directive style is we tend to ask a lot of questions, give a lot of directions, but make very few comments, right?

Mm-hmm. So just being aware of that and being aware that you are. Possibly targeting things that maybe your client isn't using at all, but someday you would like them to use. So we're gonna provide many, many examples of how those words could be used [00:23:00] naturally in natural, functional, meaningful, and hopefully enjoyable and super fun activities.

Kate Grandbois: Um, so sort of taking a step back, we have talked about what it is some with the different names that it goes under, some things that the literature says. What does it look like? So we had mentioned this in our previous episode about the, you know, this concept of aided language modeling as a general description of, of interaction and reciprocal exchange.

That is a pretty. Big gray area, right? I mean, that could look a million different ways for a million different people. So my, in my experience, when clinicians are just starting to practice aided language modeling with their commu, with their aided communicators, there can be some, not necessarily confusion, but question about, okay, well how, how many times should I.

Should I, you know, select the target icon [00:24:00] And should I talk while I, I get these questions from parents too. Should I be silent? Should I only verbally repeat the icon that I'm selecting? Should I say a whole sentence and just communicate naturally? You know, what, what do I do just to, you know, to be pretty simple about it?

What do I do? Um, and I think, you know, it's a, the answer to all of those questions can differ a lot depending on the profile of the communicator. 

Amy Wonkka: Yeah, and I, and I think it should be individualized also. I think that, you know, we'll, when we read through the research, you see. Some very specific things, right?

Like the Dragger Etal article 2006, they gave this like very specific criteria they used in their study about, you know, when you point to a symbol, you point to a reference. You don't want more than a two second delay. Um, you know, you're trying to provide, we had an article we read by Binger and Light in 2007 where they're saying, you know, you wanna try and get you, you have the dosage of 30 models in a 15 minute [00:25:00] session.

As you read through the literature, these are good things to put in your brain and think about, but it doesn't mean that that's the only right way to do it, and it doesn't mean that that's the right approach for your specific client. I think that what is the right approach kind of universally is to be thoughtful about it and to be clear about what you are doing and why you're doing it for your particular client, and then be constantly considering that again and making revisions as necessary.

You know, I mean, I know like personally for me, sorry. Personally for me, I think about the kind of zone of proximal development for both my client and my communication partner. Mm-hmm. So what, you know, what is their length of utterance right now? How many words are there? Are they using primarily single words and they're using maybe 20 different single words expressively?

Then, you know, maybe my big focus is just on building that single word vocabulary. So most of my modeling is. Single words on the tool doesn't mean, I'm just gonna say single words with oral speech, unless I have unique [00:26:00] client factors that make me make that choice clinically, which I might do. Um, are people use, you know, do I have a communicator who's starting to use some two word combinations?

Then I might, you know, encourage partners to use two to three word combinations. They're just like. You know right where they are and one step beyond. Uh, however, sometimes you have a partner who's brand new to the system, and so we also want them to feel successful. So it's a bit of a balance. You know, you might just ask the partner to do a lot of single words until they feel comfortable and then kind of bring them back up to.

The, the communicator's zone. 

Kate Grandbois: I think that the, considering the, you know, it's probably not too much of a leap to say consider the zone of proximal development of your communicator, your aided communicator, because that's our job. You know, your is to work within the zone of proximal development, but the idea of the zone of proximal development of your communication partner is, I think.

It's tremendously important. Um, you know, I think for a lot of our [00:27:00] parents and a lot of communication partners working with a, a c is novel. It's, you know, intimidating. It's, if you're not tech savvy, it's, and, you know, and, and it's, and it's a high tech tool that can be a whole other component. Um, so, you know, going back to that literature by, um, binger and Light in 2007, about this recommended dosage of 30 models in 15 minutes.

That's a pretty big ask for someone who is maybe not comfortable with the tool, hasn't had any training with the tool. You know, maybe you don't have the buy-in that you need to have. Or even if you're a clinician and you hear those 30 models in 15 minutes and you're thinking to yourself, right, well that's great, but I have to keep this kid engaged.

I have to hold a clipboard. I'm trying to take data. I'm trying to be social and, and engaging and high energy. How can I possibly try and, um, do all of this at once? I think that, you know, yes, it's a bumper in the road, but. Considering yourself in, in your own zone of proximal development and the zone of proximal development of your communication partners is [00:28:00] super important.

Amy Wonkka: Well, and I think too, what we found, it's something that was really interesting for me when we did the Aided Modeling podcast. First podcast, the episode. Yeah. Yeah. In, in reading through that literature, some of the research that's been done on modeling interventions are also done on populations who are very different from the clients that I may be working with.

So that's just something else to keep in mind as you are reading through the literature or you're reading through, you know, ASHA's practice portal or some of these other statements or some of these other resources that sort of synthesize the literature. Be aware of, you know, did they do this intervention with a lot of people who were, you know, one standard deviation below the mean on the receptive language, but had, you know, intact sensory and motor systems.

So there are a lot of things that should come into play when you're making determinations about what's best for your clients and you just wanna individualize it. 

Kate Grandbois: Right. And you know, I think, I think at the, one of the big takeaways there is that it's okay if the way you are modeling with your [00:29:00] client or student looks differently than a colleague or the way you do it with a different student.

I mean, you'll develop your own, I guess you could say style, but rhythm and, you know, sort of communication style through aided means based on. All of those other contextual and environmental factors, 

Amy Wonkka: but by planning for your intervention in advance, which we'll talk more about in a little bit, it helps you be really mindful about the why you're doing it so you're not just doing it.

Because in this moment with this one toy that that was the word you could find, you're making a conscious decision to kind of consider those unique client variables. And then hopefully you're also collecting data as you're using the intervention and determining, okay, does this feel like the right amount of modeling?

Um, do I need to troubleshoot some element of this environment or this type of modeling? So it should, while it's gonna be very individualized, it should be informed by. Your client needs and the needs of their [00:30:00] communication partners and a lot of different variables. 

Kate Grandbois: Doable. Wait, let, let's u Yeah, let's use that as a segue into learning objective number two.

So identify specific action steps to plan for aided language modeling within a treatment session. This sort of subheading we had for this was what do, what do I do next? Right? So you know what it is. You know that there are these bumpers in the road of, you know, quote unquote dosage, that it needs to be customized.

But how do you customize it? How do you go about doing that? Um, and in general, if you break that down into smaller parts, it's, it's a little less intimidating and feels more doable and just like everything else we do, it should be no surprise that one of the first things that you should be doing is considering your client's overall strengths and areas of need.

And, you know, considering all of the different components of, you know, what they bring to the table, what's their attention? Like, what is their receptive and expressive language like? Do we, do they present with sensory needs [00:31:00] and what are their access methods? 

Amy Wonkka: Yeah. These, these are all really important variables and as you work with your clients, you will probably find other categories that you can insert in there as well.

Um, if you look at the planning form that's up on our website, uh, you can, you can use that form, you can tweak that form. It's really just there for you to get you thinking about what are different systems that you should be like. Considering about, not, not a EC systems, but like components of your client that you should be thinking about.

It's not just receptive and expressive language. I guess that's the big takeaway, right? Right. 

Kate Grandbois: That's the big takeaway. And we do have a form, um, we'll talk about that form in a second. That's a, a planning form, sort of a graphic organizer. It's table. 

Amy Wonkka: I mean, this is the table. I love a table to 

Kate Grandbois: help you sort of plan and think through all these things.

And I think for me, um, one of the biggest things that I, I see, I guess, overlooked, so I think most clinicians. Consider receptive and expressive language. Most SLPs, you know, that's [00:32:00] sort of our whole purpose of existing on the team, is to consider receptive and expressive language. But some of these other components have a huge impact on aided language modeling interventions, and they might not.

Be front and center, but maybe they should be. The one that jumps out to me the most is attention. Um, so in my practice I have, I've seen this a lot. You know, I did a, a team training. We talk about aided language modeling. I educate the team on what it is. Um, you know, I, I maybe even show them a little bit, and then I walk by the classroom.

Or I pop in, you know, getting ready to do my consult, and the staff member or teacher is modeling away and it looks beautiful, except Johnny's eyes are out the window. You know, the attention is, is not, is not a factor. 

Amy Wonkka: And I think, you know, and another important point to make is that. Eyes on doesn't necessarily mean attention.

And attention doesn't necessarily mean [00:33:00] eyes on. Right. So those also aren't synonymous. That's true, and that's another piece that's important to remember for each individual client. You need to know your client and know what that means. I have some students who, you know, pay the best attention when they're not looking.

That's true. And other people who, that's not the case at all. So use your. Individual knowledge, your individual clinical knowledge. Very true, yes. To make these decisions on a, on a customized basis. But 

Kate Grandbois: yes, I made Johnny and his poor teacher sound like they were really, or that I was making a poor assessment.

Um, I, I think, I think the takeaway is that, you know, just. You know, again, just to really hammer it home, consider things outside of just receptive and expressive language skills and attention. Sensory needs and access methods are all gonna be important components to an aided language modeling strategy.

Amy Wonkka: Well, and just, I'm sorry, just one more attention piece. Oh no, but when you think about using an aided tool, the joint attention demands for that are actually quite high. So joint attention [00:34:00] can be a challenge for many of our clients who are emergent communicators. So the ability to, you know, share, share gaze with somebody, or reciprocal gaze, then share gaze to a reference, then back to the person.

That's actually, that's a lot, that's a lot of load there. And then when we add in an additional tool, so there are also things that you can do. You know, are there things that you can do with your body and your positioning? To help mitigate some of those challenges for your client. Those are all considerations, and sometimes while it's not like under the research umbrella of aided language modeling, I think there are also times when the aided tool might become a gesture, an unaided support.

So it's, again, it's a communication system. It's not just because you have an a, a C device. That has to be the only way that you're allowed to communicate. Mm-hmm. All of us use multimodal communication. So a lot of variables in the attention bucket. 

Kate Grandbois: This is one of those things that Amy reminds me of on a regular basis when we brainstorm clinical issues.

It's a system, it's system not just one tool. I think it's a [00:35:00] good takeaway. Um, and there are other things that I think are, are really important things to consider, like the. Social targets or the pragmatic targets that you, you know, or the pragmatic, I guess exchanges is a better word, where you would like to see these kinds of things like, um, reciprocating a greeting at circle time or saying that's mine to appear?

Um, I think this is sort of getting back to us being very instruction driven. Mm-hmm. Um, that we tend to, and this is a blanket statement, but at least in my, my personal experience, tend to. Not think of those incidental opportunity communication exchanges as opportunities to embed aided language modeling.

Amy Wonkka: And I mean, we're like instruction's, not bad. Instruction's not a dirty word. There's a reason we all go to school. You know, I mean, I think that instruction is, instruction is 

Kate Grandbois: not a 

Amy Wonkka: dirty word, right? It's, it's not. And we put that on a 

Kate Grandbois: mug. Oh my 

Amy Wonkka: God. But I, but I think it's, it's, it's when it's, when it gets lost, right?

When all the other things get [00:36:00] lost and we don't want that to happen. So that's very important. So, so far we're thinking about client variables, like their attention, receptive, expressive language, sensory needs, access methods. We're thinking about the tasks like Kate was saying. So we're thinking about what is it that we actually want the person to do?

And thinking again, not just about, you know, vocabulary syntax, grammar, morphology, but also thinking about the pragmatic component of it too. Maybe we want you to participate, like just take a social turn and it's not about what you say, it's about taking your turn and that level of independence. So that's where kind of the, the speech and language skills.

Target is, is embedded, is in that part. 

Kate Grandbois: And I think there's a lot to say about how to, you know, choosing the targets in terms of, you know, the social application, the, how motivating the student motivated the student is, um, you know, whether, what their interest level is. But the environmental considerations I think are also really important.

Amy Wonkka: [00:37:00] Yes, definitely important because to get back to when we've identified the client's needs as far as attention and we've identified what our goal tasks are for them to accomplish, that could look very different mm-hmm. In different environments. Uh, having worked outpatient, I was very aware as an outpatient clinician that my outpatient environment, which was a relatively neutral room, I didn't really have a lot up on the walls.

I had like. Total control of all the fun things, right? They were in a bin, you know, that's, that's not real life. That might be a great opportunity to acquire some initial skills, but that doesn't mean that when my client goes home, they're going to use those same skills in a really busy environment.

Mm-hmm. Where they don't actually, like, they have free access to these different things. There's not kind of that contrived communication environment. So just being aware. Of variables in the environment. And again, for some people, if you have chall, like I personally don't do well with a lot of background noise, it's a challenge for me to keep my focus.

It's a [00:38:00] challenge for me to pay attention. That is a challenge for you. It's so, if you have, you should see I have a shared office and I like have these giant, I'm also that person pros that I'm playing. Like MI can't 

Kate Grandbois: but, but do you play music in your headphones? 

Amy Wonkka: I 

Kate Grandbois: play, I play 

Amy Wonkka: classical music. 'cause 

Kate Grandbois: I can't play music with yours that demands all of my attention.

I It's white noise or nothing. Or silence. Oh 

Amy Wonkka: yeah. So see. Different. Here we are, two different people, people, I'm the same with two different environmental needs. So just be aware of considering that, that that's a factor for your clients also, just like it's a factor for you. 

Kate Grandbois: So in thinking about all of the things that we just said, mm-hmm.

Which is a whole, a lot of things, thought of things, okay, I gotta pick a target, I gotta consider, you know, all, all these things. All I have to consider, all the things. Amy and I, as we were discussing this, really agreed that the best way to tackle all of that is to write it down. Yeah, everything is more manageable on paper.

Um, and writing and organizing all of these different variables and [00:39:00] specifying how they, how they pertain to your client or student can really help you plan and consider each individual factor and also figure out how those individual factors influence each other. Um. So, you know, writing down the specific presentation of your client and their strengths and needs, writing down the targets, writing down descriptions of the environment and maybe ways that you could modify the environment, noting different concerns that you have.

Um, making a list of the different ACOM accommodations that you might be able to make ahead of time, including, you know, maybe giving a little bit of extra training to a communication partner, an aid, or someone who is going to be in that environment on a regular basis. Um, and. Making another list of potential unaided or concrete aided supports, which are objects.

Amy put that in parentheses for me. When she wrote Concrete aided supports, I was like, oh man, what is that? It's an object. It's a tiny object. I should have just said things you could have just said. Thanks. Um. [00:40:00] But you know, back to Amy's point and something that she says to me all the time, it is a, it's a system.

You people don't just communicate with one way all the time. So making a list of some of those unaided or concrete aided supports, objects that you might wanna incorporate if you're maybe in a setting where the device isn't reasonable or appropriate, um, or maybe it's a different goal and objective that you're working on.

Amy Wonkka: And, and you don't, you certainly don't have to use a planning form all the time, but I think that what's helpful about some type of planning form, and you can also Google them. There's a lot of them on the, um, on the web. You can find like different. Uh, intervention planning forms. I wanna say that Gail Van Tno has a bunch of great stuff on our website, even if she doesn't have, she has so much great stuff on her website, a planning form for this.

You should. Hi. Hi, Gail. Hi. Thank you for sharing all your great forms. We love your website. Yeah, so she's got great things that you should check out. Um, but it's, it's just a helpful exercise. I think the first, if you're feeling like it's too much [00:41:00] to. To manage to think about all these variables. I think having a planning form can help The first few times you try and do it to just wrap your head around that thinking process could not anymore.

Um, and don't feel like you have to do all the activities at once. Pick one or two things and like fill it out for that. See how those go and, and then, then add to it, keep it manageable for yourself as well. 

Kate Grandbois: To sort of recap the action plan for. Planning is to write it down, but I think that's a good segue into our final learning objective.

Identify specific action steps for implementing and improving aided language modeling techniques and within a treatment session so we know what it is. We've talked about all the different things that you need to consider and. One specific concrete thing that you can do to plan for it. Now let's talk about what specific action steps you can take for implementing and improving aided language modeling in an actual, um, session.[00:42:00] 

So I think I. Casually, the first thing that you should do is try it. You've planned it, you've thought about it. Um, you don't know what will work until you give it a try and note your successes, and then try to reflect on your failures. Um, if you've gone through the procedure of thinking things through and considering all of the really important variables, um, you know.

Make a plan for when you're gonna try it. Bring your graphic organizer, bring your notes, bring your table, bring your sheet, bring whatever it is that you made, um, and maybe take a little of ex, take a little bit of extra time to modify the environment ahead of time so that you feel more comfortable and you feel set up for success within your session.

Um, you can try and you can, oh, go ahead. 

Amy Wonkka: Oh, you and, and you don't have to take. Really rigid data, like you just, just think about it and be mindful about what you're doing and what you feel like is working well and not well in the moment. [00:43:00] 

Kate Grandbois: Yes. Um, and the infographic that we have on our website has a place where you can take data within your graphic organizer, which might give you a nice way to sort of reflect on all of these different variables and which components worked well and which didn't.

But you don't have to take data on the same sheet. We personally feel like it's what you know. Why, why reinvent? Why reinvent the wheel? Um, and, you know, have multiple pieces of paper that you can't, you know, make, you know, you've got your data on one pink sticky note and you've got all these five other handouts.

Try and making it, uh, make it more of a cohesive, um, tool for you. Might be a really nice way to reflect on what went well, what didn't go well, so that you can make tweaks moving forward. 

Amy Wonkka: And you might find back to some of. Client factors you might find when you're in your session. Oh, there's this other thing that I didn't even think about that I should have thought about, right?

So you can make a note on your form. 

Kate Grandbois: Write it down, [00:44:00] write it down, write it down, make a note. So one of the final things that you could do is what we call, review, revise, and repeat, sort of similar to what we were just saying. Looking at your data, reflecting on your data, what worked, what didn't work, make some slight changes and tweaks to that and, you know, try it again.

Um, we both feel pretty strongly about data if anybody's listened to this pod, this podcast before, but data doesn't necessarily just mean tally marks, right? Qualitative data is also really important. So maybe you scribbled that. You know, Johnny seemed bored. I don't know. Something really casual. That is really good.

Information. It, it does. I, my point being, it's a weird example. My point being, it doesn't have to be Italian mark. It doesn't have to be mathematical. Qualitative data in these situations can be really helpful when you're reflecting to improve upon, uh, aided language, you know, your intervention strategy.

Amy Wonkka: Well, and when you think about the data that you're collecting, it's not just about your client, it can also be about yourself, [00:45:00] right? Right. So one thing that makes modeling intervention challenging, I think, is that you have an extra thing with you. So maybe it's really hard to manipulate all these different things that you wanna troubleshoot that, and you might just let you know, like, remind yourself this was really hard.

This was really hard, and I think that this thing, this aspect of the interaction is what made it hard. 

Kate Grandbois: So, review, revise, repeat, consider your qualitative data. Consider, consider your quantitative data. Let it guide your decision making. Reflect afterwards. Do a little journal on your, on your planning work.

Amy Wonkka: And know that you might end up deciding that some interventions are a better fit for certain targets and environments than others. Like that's okay too. You don't have to say the one right way to model the one right way for me to model when I'm talking to Kate is no, it might be, you know, when we're one-on-one in a quiet environment, I do these things right when we're doing something different and she's not super into the activity.

I do this other stuff, 

Kate Grandbois: the the final [00:46:00] step. In the action plan for impro, for implementing and actually improving your aided language modeling interventions. We've sort of, we, we had the review, re review, revise, repeat, and the final step would be share it, review it, revise it, repeat it. So once you have a little formula that you.

Think has been working. You've tried it, you've reflected, you've taken data, you've, you've revised it, you tried it again, you took data, you reflected, you revised it. And you have a system. You have a, maybe this takes, depending on how often you're seeing your student or client. Maybe this takes a week, maybe it takes a month.

Um, but you've. You've gotten down to a little bit of a science. You're in your comfort zone. You know which components work, you know which variables were more salient or less salient. You've thought about what was motivating your client, what was interesting, the frequency with which those targets and why you chose them.

It's really important to share it with the other communication partners and stakeholders in that student or client's life [00:47:00] because aided language modeling is an evidence-based practice that is. Should be what ideally would be pervasive across communication partners. 

Amy Wonkka: Right. And I think when, regardless of your work environment that's relevant.

So you know, I think back to when I worked outpatient. When you're outpatient, you have a lot of contact with the parent and guardian. How great to help them become an. Integral part of this intervention in real life, naturalistic, meaningful, functional opportunities across the home. So how do you do that though, right?

Because we just like talked through kind of a multi-component process where we were constantly thinking about how it felt for us as the clinician kind of developing this implementation approach. We should probably also get similar feedback as we're sharing it with others. 

Kate Grandbois: Right? So, and I think this is also [00:48:00] piggybacked onto an issue we've talked about in previous episodes related to collaboration.

Getting that feedback can be hard. You don't necessarily have time in your day. You don't necessarily have contact with those other professionals or communication partners. So actually the physical components, the actual contact, you know, not everybody has the privilege of sitting down and being like, so I had this great session, this series of great sessions.

I really feel like I've figured something out. It's working well. I'd love to talk to you about it. You don't necessarily have that. The other communication partners. Um, undivided attention for a a period of time. If you do in your work setting, that's great for you. And we're, yeah, we jealous. Take advantage of that.

We have jealous feelings because that's not how I think a lot of work settings operate. Um, we really recommend, we highly recommend. Creating handouts or permanent products, tables and infographics that you can distribute to communication partners as a general visual support for that environment. This could be things that you're hanging up on [00:49:00] a tag board in.

It's it called a tag board, right? I, I don't call anything that 

Amy Wonkka: you've never heard of a tag bullet, a bulletin board. 

Kate Grandbois: I've heard of a bulletin board. Bullet. A tag board. Is that because I'm from south of the Mason Dixon line and I have a different vernacular? 

Amy Wonkka: I think so I, I'm 

Kate Grandbois: gonna, I'm gonna ask the internet that question.

What 

Amy Wonkka: do you call the sandwich that you get at a pizza shop? 

Kate Grandbois: Ooh, off topic, but a very good question. I grew up calling it a sub. My husband calls it a hogie. 

Amy Wonkka: I call it a sub. When I went to college, 

Kate Grandbois: it was a grinder. 

Amy Wonkka: Grinder. I'm also grinder. Yeah. Sub grinder. Hogie. Never hogie. 

Kate Grandbois: Hogie. Never. 

Amy Wonkka: Hogie, never Hogie.

No. 

Kate Grandbois: Oh, that's interesting. I dunno. 

Amy Wonkka: All right. We, we digress anyway. Tag board, tag board or tag board if you have one or bulletin board or a bulletin 

Kate Grandbois: board or cork board or whatever you call it. Wherever you are in the, in the country. Um, the, um. My train of thought now. 'cause all I'm thinking about is the fact that I said I was, I think you 

Amy Wonkka: were saying that you can share, [00:50:00] oh God, you can share visual supports about the modeling intervention in the places to help remind people kind of the key considerations for when they're implementing those supports.

Kate Grandbois: Right. And I think it's, you know, really important if you do have an opportunity to check in with the communication partners, make sure that they know how important their feedback. Actually is if you have an opportunity to get feedback from them about their concerns or issues or what's working well for them and what's not working well for them so that they can participate in ADA language modeling in their environments, that is huge.

So, but that gives you another hurdle. How do you do that? Right? Um, there are probably a lot of barriers, like we said, to getting that kind of feedback, scheduling conflicts. Bandwidth productivity standards, you know, all time in general. Um, so there are a couple of different ways that you can get that information outside of a conversation, and we would highly recommend a checklist.

Yep. We have one on our website that is free that you can download. [00:51:00] Um, you could also do a more formal data collection process if you have that available to you. But either way, we highly recommend that you gather this information and collective feedback from stakeholders and then reintroduce it into the review.

Revise, repeat. So if the classroom teacher or some other communication partner has given you the feedback that's. Certain variables or components are either irrelevant or more relevant. Um, attention shifts in different places, or, you know, aided strategies are working more or less well in different places.

You know, our unaided strategies working more or less well in different places. Take all of that feedback and review it and revise it, and then try it, repeat it so that you can try and improve the aided language modeling experiences across those different environments. 

Amy Wonkka: Yeah, so that all of the communication partners are feeling successful in implementing the intervention because people will only try so many times something that feels very unsuccessful.[00:52:00] 

That's true. So by helping make sure that all the communication partners recognize that their input is valid and could lead to modifications of the recommendations in that environment. So it's really important. That you're conveying to the communication partners that their input really is important and meaningful, and that they know something about the interaction in that environment that you don't.

So again, if you're outpatient and you're trying to extend some of these modeling interventions into the home with the family, make it clear to them that you are. Not judging their ability to implement the right way. You can't see my air quotes. There's no right way. Um, there's no right way. And so help helping make it clear to all of the people that you're working with to support the communicator.

That their input is going to help shape what is the right way for them in that moment, in that environment, and that the [00:53:00] right way. Air quotes can't see 'em. It's a podcast, um, that's gonna change over time, but that their input is crucial to collaboratively developing what that is together as a team. 

Kate Grandbois: That is so well said.

And here, here I, of course, I 10000% agree, but I think, you know, communication partners, because we tend to be, um, I guess depending on your work environment, you may or may not have a lot of access to different communication partners, but this is really a huge piece and corner, you know, fundamental piece of success for, um, for communicators in general as particularly, you know, aided communicators.

Um. Communication partners have so many different experiences with, with an aided communicator. They have different environments that they communicate in. Um, they are, you know, they use different vernacular, probably they are more or less aware of different targets that may or may not be relevant. Um, they might use different morphological or syntactic [00:54:00] syntactic structures based on, um.

Their communication history with that individual. So it's just so unbelievably important, um, to get that input. Um, so I think that sort of wraps us up. I hate to, I mean, we just said a, a whole lot of things. I think the takeaways are, um. That you should not be intimidated by using aided language modeling strategies.

If you are, if now that you have a good understanding of what it is, we encourage you to think really hard about all the different variables that influence aided language modeling. Write it down. Use the wor, use a worksheet, use a graphic organizer. We have one for free on our website. Try it, revise it.

Figure out what works. You know, keep what worked. Scrap what didn't work. Tweak it. Do it again. Get into a groove and then share it. Share it with the communication partners, conduct interviews if you can, you know, have conversations. If you can get the feedback from communication partners if you are not able [00:55:00] to do that because of, um, if you're not able to do that because of.

Work restrictions or issues with your schedule or time? Give them a permanent product. Um, you know, put something in their mailbox, use a table, use a, you know, a hand, a written document. We have an example of that, um, on our website as well that is free and available for download. Um. And Al as always, data, data, data.

Use your data qualitative and quantitative, reflect on it and use it to change and tweak your, um, intervention to make it more successful. So I think that's it. That was a whole lot. Thank you everyone so much for joining us. Cruise on over to our website, www.lpnerdcast.com. If you'd like to purchase a certificate of attendance for Asha Cmhs, uh, if you'd like a handout.

Handouts are available as well. If you listened while you were driving or doing dishes or [00:56:00] going for a run or whatever. Um, and we also have some free downloads available for, um, graphic organizers and, and permanent product for interviewing communication partners if anyone is interested in using them. So we love hearing from you.

Leave us a review, send us an email, um, and we hope to hear from you soon.