[00:00:00] 

Intro

Amy Wonkka: [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 

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

LP 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.slpnerdcast.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 

Amy Wonkka: to teach us. 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. Before we get 

Kate Grandbois: 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're both members of ASHA's State 12 and both serve on the a a C advisory group from 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.

Okie dokie, aim. What are we talking about today? 

Amy Wonkka: So today we are talking about communication partner instruction in a a c 

Kate Grandbois: and why are we talking about that? 

Amy Wonkka: Um, because we've heard a lot about partner training at conferences and through online groups. Communication involves more than one person. So we know that.

Is that 

Kate Grandbois: true? 

Amy Wonkka: Yes. It's that fake news. I think that's like a rule of communication. Um, typical interactions might look different for folks with complex communication needs and for their partners. 

Kate Grandbois: That's very true. Yeah. That's a big one, 

Amy Wonkka: right? So it's [00:03:00] not just about supporting the communicator. You have to support their partner too.

Um, two way street. Two way street. Yeah. Or if you're talking to more I do too, 

Kate Grandbois: baby. Come on, join in the fun. This is gonna be a good one. I can feel it. 

Amy Wonkka: Um, there are also some really great articles out there that explore the topic and we read several of them and wanted to share what we learned. 

Kate Grandbois: Well, you read them and then I tried to read them and I got very glassy eyes and then I skipped to the last two pages.

And then I asked you questions. But those, and I think this is an important thing to bring up, because reading literature is hard for some people. 

Amy Wonkka: It's, it's not the same as fiction. 

Kate Grandbois: It feels, it's Well, well, yes. I, I just think it's an, some of these, well, one of the articles that we read in particular was very heavy in [00:04:00] terminology, very heavy in statistics, very heavy in research and analytics.

And I think as a clinician, when we go to the literature, we are looking for evidence-based pieces that we can apply to our clinical practice. I would agree. Right. So, so we are going to try and take these two articles that we read that were very, very good and make them digestible. 

Amy Wonkka: Yes. There was a third one I snuck in there when you weren't looking.

Kate Grandbois: A third article. 

Amy Wonkka: Yeah. Oh, it's okay. We'll just talk about it. You're pulling 

Kate Grandbois: a fast one on me. Oh, yes, 

Amy Wonkka: we did. 

Kate Grandbois: You're sneaking up on me blonde. 

Amy Wonkka: I know. No, it'll be 

Kate Grandbois: fun. Don't worry guys. It's gonna be great. Okay. Okay. Um, so we have three learning objectives, three learning buckets if you will. So first we're gonna go over background information.

Uh, what is partner training? What does the literature say about it, and what kinds of partner training is out there. Mm-hmm. Um, what kind of partner training is out there? [00:05:00] Uh, learning bucket number two, objective number two, what does effective partner training include? Or what does it look like? And objective Number three, what are the hurdles to implementing partner training?

And what are some strategies to overcoming those hurdles? And I think that's a, I think personally that's a really big one in terms of implementation. Yeah. So first things first, bucket number one, learning objective. Number one, background information. What is partner training now? I had a, a few notes here for myself that I couldn't come up with a definition after reading these articles and that, that dissect could come up with is that partner training is training partners.

But I really don't think that that's a, a, a valid or fair definition. 

Amy Wonkka: No. I mean, I think in third grade they're like, you can't use the word in the definition of the word. 

Kate Grandbois: Are you saying that I have a third grade knowledge 

Amy Wonkka: of these articles? I'm a third grade definition test. 

Kate Grandbois: So in your educated, in your educated speech, what is a good [00:06:00] definition of partner training?

I actually 

Amy Wonkka: really like your definition. It just doesn't pass a 

Kate Grandbois: training partners. Should we just go with that? 

Amy Wonkka: I mean, I think it's, I think it's really working with communication partners to help understand what changes in their behavior will result in positive changes in specific behaviors for our communicator, and then helping those partners to change the way that they interact so that everybody feels more successful.

Kate Grandbois: Yep. That was much better said. 

Amy Wonkka: Yeah, but it's like the same words, 

Kate Grandbois: but it's like the same thing. It's like, so what does the literature say about it? Let's, let's do the deep dive into the, into the literature. Um, as you said, we read two articles, well, you read three and there are three available to our learners.

And I'm gonna, I'm gonna just drive blind. It's cool. I'm so prepared. So what does the literature say? 

Amy Wonkka: So a lot of what we'll talk about in this part today really comes from that one big article that, that made you feel excited and energized about learning. The last two 

Kate Grandbois: pages were really [00:07:00] good, 

Amy Wonkka: right? Like, like a lot of it was really good.

It's just you kind of have to. It's like the fourth and fifth book in wheel of Time. You just gotta get through it. You just gotta get through it. 

Kate Grandbois: Yes. That was book six and seven. Was it six and seven? Me, I think. Yes. For all of you. Wheel of Time fans out there. Yes. Yeah, I'm sure there's a bug. Shameless bug.

Um, so, so yes, the la there, but this was a really important article. Mm-hmm. Um, and it was a meta-analysis, which as you have said before, is one of our favorite kind of articles. 

Amy Wonkka: Yes. So, as a busy clinician who is not a researcher, um, I love a systematic review and meta-analysis. And this one comes to us from the Brains of Jennifer Kent Walsh at all.

And it was published in the Journal, augmentative and Alternative Communication in 2015. Um, and we love, we love articles like this, right? 

Kate Grandbois: Sure. Yep. Totally. Because. Because they do all the work for me. Yeah. And I don't have to read all the [00:08:00] articles. I just have to read one of them. 

Amy Wonkka: Right. And you read, 'cause 

Kate Grandbois: I'm a busy person.

I'm feeling like I have to defend myself. I think it's fair, you know, there's a lot of us out there who don't have time to get deep arm deep into the literature. And if we. Did, we would be researchers. Right? Right. So some of these meta-analysis articles can be extremely helpful and this is one of them.

Amy Wonkka: Oh, it's so good. And, and these people are fancier than we are. Right. So I also like that they use their fancy eyes and their fancy brains to read all of these different articles and synthesize the important information. Um, you know, as somebody who's not a researcher, I don't have the brain for statistics that I think all of these folks do.

So they list all their references in there, which is really helpful also. So if as you're reading through the article you're like, oh, I wanna learn more about this one thing, you could just look in their reference list without having to try and wade through all the articles that are out there and try and find one that answers your question.

Mm-hmm. 

Announcer: Um, 

Amy Wonkka: huge time saver. They make research more accessible to clinicians. Thank you, smart [00:09:00] people in academia. We appreciate it. Um, so this article really goes in depth explaining their approach to the review. They talk a lot about how they did it, how they picked the studies that went into it. Um, you know, you can, you can read all of those parts if you want to.

We are more focused on the clinical application in this podcast. We're not gonna say a whole lot about that. Uh, but pages two, three, and four, they've got a lot of detailed stuff in there if you wanna read about how they made those decisions. Um, but when 

Kate Grandbois: Nope. Think 

Amy Wonkka: about, nope. Don't 

Kate Grandbois: wanna, don't wanna read those things.

Amy Wonkka: Nope. Nobody wants read those pages. Nope. So what's helpful in reading those pages? We'll talk a little bit about this. Kate and I have, have slightly different feelings, but we, like, what's helpful in reading those pages is it helps you to better understand when it's not just like, is this one thing evidence-based?

Right? Evidence-based is not like a, a constant. So you're trying to figure out is it evidence-based? And [00:10:00] if it is for who. Right, right. No 

Kate Grandbois: fair point. 

Amy Wonkka: Those little boring bits, kind of boring bits. They're important. Help us figure out how relevant is this for me, really as a clinician, right? If, if the, as a pediatric person, if the whole study was about people, you know, who had aphasia and, you know, we're, we're in a nursing home environment, it might be a very different, you know, it, it might still be helpful information that makes me think thoughts, but maybe not as potentially applicable to my current clients.

Kate Grandbois: Totally 

Amy Wonkka: cool. So they, they, they did all that stuff. They talked about that stuff and they found, at the end of the day, there were 17 studies that met their criteria and that included a group of 53 people with complex communication needs. And they ranged in age from two years, five months to 26 years old.

Um, but most of the people were in preschool or elementary age [00:11:00] people. So again, that just helps you as a clinician, like, all right, who is this really applying to? Mm-hmm. Um, similarly, most of the participants had a diagnosis of either autism spectrum disorder or intellectual slash developmental disabilities.

So again, just helps you put that in context. Um, they describe the partners, obviously, because these studies include partners and they were pretty diverse. The partners included caregivers, educational assistants, peers and teachers, and they really, and 

Kate Grandbois: I think that's such a good point, not to interrupt you, but I think, I think that the concept of communication partners gets thrown around a lot, and it's often pigeonholed as parents or maybe immediate family members, but you're talking about any individual that the.

A a c user is gonna be interacting with, the example I always give is the di the guy at the Dunkin Donuts counter, the person behind the deli at the grocery store is a communication partner. Right. The people, the [00:12:00] people in teachers aides, peers in the classroom, you know, these a, a c users go everywhere.

It's not just the immediate family. 

Amy Wonkka: No. No it's not. And I think when you think about all of the different types of communication, relationships that people have, um, there are different types of communication that you're more likely to have with those different people depending on their role as well. So in, in these studies, those people were anywhere from 11 years old to 64 years old.

So again, a pretty, a pretty diverse, a pretty diverse, it's a widespread It's, but back to the point that you were making, you know, there we all communicate with a pretty widespread of people usually. Lately it's, it's mostly just you and my husband and my dog. Right now 

Kate Grandbois: in the general, in the general scheme of things.

Mm-hmm. Communication partners are, are outside your house. 

Amy Wonkka: Yes. Most of the 

Kate Grandbois: time. 

Amy Wonkka: Yes. Um, so we also wanna look [00:13:00] at kind of back to the boring bits. Another helpful boring bit is to know, you know, what were the dependent variables? So what were the things that we anticipated might change as a result of the intervention?

Right? So again, as a clinician, that's helpful because you wanna know, not just partner training equals good. You wanna know if it does equal good in what way and for whom. So what they looked at in, in these different 17 studies were skills like. Pragmatic skills, like the intervals that included social interaction, uh, the proportion of communicative turns and initiations, and the frequency of communicative acts.

Kate Grandbois: And I think defining those things is really important because there are so many small components that go into a communication exchange. And I thought that that was really a, a helpful thing to read in this article. 

Amy Wonkka: I did too. And I think it's helpful, you know, thinking about applying this information clinically.

Mm-hmm. Because it again, helps bring you back to like, well, why would I do this? Like, what's the [00:14:00] point in doing this? What am I hoping to achieve for my client? By using an intervention like this. So some of the studies looked at that. Some of the studies looked at morpho syntax, right? So looking at multi symbol utterances, um, you know, are you including morphology in and using appropriate word order in your sentences?

So that's really different from the pragmatic piece that some other studies looked at. And then finally, other studies looked at, uh, the frequency of multimodal, communicative turns and semantic concepts. So basically how many different meanings are expressed and in what ways? Because as we talked in an earlier podcast, you know, there's, there's a difference between aided communication.

You need a thing external to your body, unaided communication. You're just using your body. And so for some of these studies, they looked at both of those things, right? They looked at aided communication like with a device or, you know, some external picture symbols or, um, something external to your [00:15:00] body as well as unaided.

Yep. Okay. Okay. So, so these exciting details are helpful because they help us. 

Kate Grandbois: Oh, that was very helpful. 

Amy Wonkka: Right? Like, because it helps, I didn't think 

Kate Grandbois: that that was a boring piece. 

Amy Wonkka: Okay. All right. I thought that was 

Kate Grandbois: a good piece. 

Amy Wonkka: That's exciting. That's, I'm, I'm glad to hear that. That's really good. 

Kate Grandbois: I'm engaged.

Amy Wonkka: Good. I'm glad. That's our plan. So why do you wanna do partner training? 

Kate Grandbois: As a human? As a, as a clinician, 

Amy Wonkka: right? As a clinician. Like, what's, why, 

Kate Grandbois: why do you wanna do? Because when you work with someone who has complex communication needs, they have a richer experience. When they have trained communication partners, it's better for your client is the very short answer.

Amy Wonkka: Yeah, I agree. Um. I think when we think about what things we might wanna change, it can be helpful [00:16:00] to think about what the communication looks like if people haven't received some support in that area. And I thought that that was a cool thing in the Kent Walsh at all article. 

Kate Grandbois: This was a sad thing to read, but it's true.

Amy Wonkka: It was. 

Kate Grandbois: It's reality, 

Amy Wonkka: right? And it's a nice description because from the description, you can pull right out of there and say like, okay, well these are things I might wanna change and move in the opposite direction. 

Kate Grandbois: And maybe this is a little pessimistic, but I feel like as clinicians we work so hard, uh, trying to achieve goals, right?

We're working so hard to move forward. And I think sometimes it's really hard to take a step back and remember that individuals with complex communication needs really do face these hurdles. In their everyday lives outside of the clinic. Outside of school. I mean, I know we know that in the back of our minds, but for me personally, reading it in an article, I, and I'll let you go through what these variables are and what these communication [00:17:00] experiences are, but it was, I guess what I, when I said it was sad, it's like, oh, all the students that I work with, all the clients that I love, they still experience this even though we've made so much progress, even though we've put so much time into therapy.

Does that make sense? Yeah. It's just reality. 

Amy Wonkka: And I think part of the reason that it's reality and one of the points that they raise in all of these articles that we read for this, um, is, is the fact that it's not, it's not really intuitive. Like we, there's a reason that we don't just hook somebody up with an aided a a c system and walk out the door and say, it was nice to meet you.

Have a great life. You know that we need training on the part of the client. Typically, you need to learn your system, you need to learn strategies. Perhaps you're still learning the, the content that goes with it. And then it makes sense that it would be something that partners needs to learn too. Right.

Kate Grandbois: Um, 

Amy Wonkka: it's, 

Kate Grandbois: but I think I got ahead of you. So what are the, what are the experiences that commun complex communication users or a, a c users experience? What are those things? 

Amy Wonkka: So, [00:18:00] so in that article where they reviewed these 17 other articles, they said, you know, the patterns that they see with a, a c users are that a a c users tend to take relatively few conversational turns.

They have lower rates of initiation and lower rates of responding, and they are asking few questions and generally have really restricted linguistic forms. So those are all things that, you know, are, are opportunities to. To change those things, right? Those are all opportunities for us to better support the communicator and their partners and, and switch that stuff around.

Kate Grandbois: Uh, and I think that the article also made a really good point that all of those variables combined or separately are what often lead to, and this is almost a direct quote, abandonment device. Abandonment. Yeah. And I know that, that, when I read that word, it just was like a stake through the heart. 'cause that's it, it just was very final and very, I don't know, just very real.

[00:19:00] So I think sort of looping back to that question, why partner training? This is why the reason that we do partner training is to try and mitigate some of those variables to make sure that devices don't get abandoned. To make sure that those, you know, those experiences are improved and that human connection is maintained through communication for immediate family members, for community members, and for, you know, staff and schools.

Amy Wonkka: Yes. And, and when we, you know, when we add. An aided tool to somebody's communication system. The intent is that that makes all of their communication better, not that it's some extra thing. And when we see device abandonment, it tells us that something went wrong. You know, something went wrong in that process.

Because similar to, you know, people who have concerns about if you introduce an aided a a C support, will the person stop using their oral speech or will they not develop oral speech? We're all gonna do whatever is easiest and most effective for us. [00:20:00] So if somebody, the path 

Kate Grandbois: of least resistance is what I always say.

Yeah. And if someone response effort is what A, BC. BA would say in case you ever need to have this conversation with the BCBA, you need a low response effort for the parents and or, and here I go saying parents communication partners. 

Amy Wonkka: And what is that? What is response Effort. Response effort. Don't make 

Kate Grandbois: me define that.

I wouldn't butcher it. No. It's the effort that you put into responding 

Amy Wonkka: being a battered dear friend. 

Kate Grandbois: I didn't bring my dictionary, sorry. 

Amy Wonkka: No, but I get what you're saying, right? Like if something is hard, you're less likely to do it. 

Kate Grandbois: Yeah. I don't like to do things that are hard. 

Amy Wonkka: No thanks. I don't like to do things that are hard either does wine, not unless you're 

Kate Grandbois: gonna tell me I can have wine when I'm done.

That's I need reinforcement. Everybody needs reinforcement. 

Amy Wonkka: Yeah. Yeah. No. Um, so we talked about the communicators, but there, there are things that, there are differences we see in the partners as well. So back to, you know, why would we do a partner based intervention when we look at partners? [00:21:00] I say we, I mean the authors of this study, when they looked at all of the research that they, you know, sifted through to write this meta-analysis, they found in partners, the partners of people who have complex communication needs, those guys tend to provide few opportunities for communication.

Announcer: Mm-hmm. 

Amy Wonkka: They're taking the majority of conversational turns. They're asking a disproportionate number of yes no questions. Lots and lots of yes no questions. So those again, are, are because communication is relational and involves another person, it's, it's not just one person changing. Both people need to change in order to change that dynamic.

Kate Grandbois: Um, I think that's an understated point. I think that's just hugely important. And as clinicians, we put so much emphasis on. Having the communication skills of our clients change, but it is the two way street. It takes two, right? That's the theme. Maybe that should be the theme [00:22:00] song for this. I'm still dancing it around even though I'm not singing.

So I feel like it does take two. And that is the take home. That's the take home is that it's really, really important to make sure that you're including some component of partner training when you are, when you are, when you have a, a c users in your practice or you're doing a, a c treatment. 

Amy Wonkka: Yeah. And that was one of the big takeaways that, I mean, spoiler alert, that's, that's one of the things they recommended in this article.

Kate Grandbois: Stop it. Yeah. You're joking. 

Amy Wonkka: Not at all. Um, so, so something that's really cool is they've, they've done, there's been a fair amount of research that's been done in this area. And so the authors, you know, look through all of these different things, um, and what they found was that. The research has focused on teaching partners a lot of different things in a lot of different ways, right?

So some of the research has focused on setting up communication opportunities [00:23:00] or providing models, um, or asking questions. But I think, you know, when we think about partner training or partner instruction or partner coaching or whatever, you know, terminology you wanna use, I think there's the piece where you're providing information so they can change some communication behaviors, but also I think it just helps people feel more comfortable.

Um, you know, especially people who are new to A A CI. I think that that's true even for having worked with people who are complex, uh, communicators for quite a while. I think that's true for educators too. That's true for any, doing things that are new can be uncomfortable. Mm-hmm. And so I think, you know, just getting a little bit of support around that can be helpful in its own right.

Kate Grandbois: Definitely. Um, and I think you made a good point earlier when we were talking about how a lot of times partner, partner training can feel like it's just a focus on [00:24:00] the technical aspect. And I see that a lot in the places where I consult in the teams I work with, and I have been victim of doing this myself.

Like a, a parent will ask a, I really wanna meet with you because I wanna learn how to, you know, to program the device and we spend all of our time talking about the mask or vocabulary builder, or how to edit a page or how to make a macro or blah, blah, blah, whatever it is. And then I walk away having not talked on any of these other things, I've missed my opportunity.

So I feel like that's also another important piece is that partner training should not just be a focus on the logistical and technical aspects or the operational aspects as, as you've said. 

Amy Wonkka: Yeah, no, I, I totally, I totally agree with that. And I think part of why we do that, 'cause I do the same thing and part of why we do that is because those, and as we'll talk later in the, later in the talk, later in the podcast, um, you know what the, what the authors are recommending really [00:25:00] is kind of a very structured approach to partner coaching or instruction.

And I think part of why a lot of us go to those operational skills is because they are the most procedural and concrete and formulaic that you can get. I can print out a sheet for you and I can print out a sheet that says, here you go. Here's the 10 steps for how you program a button. Here's the 14 steps for how it 

Kate Grandbois: feels so easy.

You don't have to talk to them about their behavior. You don't have to make, make suggestions about how they're doing things. How they should be doing things differently. I feel like it, it does feel much more comfortable. 

Amy Wonkka: Well, it's also, it's, it's also like a higher rate of success, right? Like you can, you can both follow this little recipe together and we can go through the recipe and look at all the steps of the recipe and I can model how to do it, and then I can give you the recipe and you can sit down and try and follow the recipe and do the same thing.

And we both feel successful because we're really clear on exactly what steps you need to do and how you need to do it. And when I think about a lot of my training, especially before I [00:26:00] started reading the work of these guys, but even now in revisiting it, I'm like, oh, I need to tweak stuff again. Um, you know, when we talk about skills, we don't tend to do that, or I don't tend to do that.

I tend to be like, aided language stimulation. Let me tell you all about it. Oh yeah, that's 

Kate Grandbois: totally me. 

Amy Wonkka: But, but it's not procedural like that. It's like a lecture, like in college. Mm-hmm. And, and what these guys were finding is they're finding, you know, that's not. There's a reason that we like the procedural stuff, and it's because it works.

It's more effective, it makes it real concrete. 

Kate Grandbois: Um, so, so we've established that partner training is important mm-hmm. Because of the enrichment that it provides our clients and that it's a two-way street. I won't sing the song. I won't control myself. Um. But what kind of partner, so what kind of partner training is out there?

What does it, what, what it, what other, what kind of training is out there? 

Amy Wonkka: So, good question. What they found in their, like 17 included studies was that there were really two big groups [00:27:00] and one the authors called strategy instructions. So that's where the partner or the partners are taught a really specific multi-step sequence of communication skills.

Um, the other big group, what they labeled individual skill training. And in those trainings, the partner or the partners are taught to use a specific communication skill individually or to use a number of separate skills in a less structured situation. Um, so, so what that looked like was variable, depending on the different studies that were in this big meta analysis.

But they all included somewhere between two and five of the following, you know, methods. Um, so one of those types of methods was like a descriptive overview of the skills or strategies. This is like. My go-to for a lot of stuff. Right? So I'm gonna explain the reasoning behind using this strategy or skill.

I'm gonna tell you about the potential benefits. Um, so like for an example, we did a podcast a few weeks ago on aided language stimulation. 

Announcer: Mm-hmm. 

Amy Wonkka: You know, as an a a C strategy, we might wanna train a partner to [00:28:00] use. And so my descriptive overview would be like explaining that, you know, when I say a key word aloud, I'm also going to slowly activate each button in the icon sequence on the client's device.

And I'll model that word on the device. And I'll also use my oral speech and I'm not gonna have any expectation that they do anything that, that client do anything other than listen. And some potential benefits of this might be, you know, I might use a slower rate of speech as this, as a communication partner.

Um, you know, it's a naturalistic opportunity to model the tool. It increases my familiarity with the a EC system as a partner. I do a bunch of these trainings, right? I bring people in, I lecture them on this. Um. And that 

Kate Grandbois: this is called a descriptive overview of this, of target skills. 

Amy Wonkka: Yeah. And I just survey recap.

I don't know about you, but like I feel like a lot of my training kind of stops right there. And that's unfortunate. 

Kate Grandbois: I am gonna admit that. I agree. And then in front of anyone who is listening. Yeah. I feel like, I mean this is, [00:29:00] again, I think every time we read an article I'm like, Ooh, I, I really should be doing this a lot better than I'm actually doing it this, but we're learning.

Amy Wonkka: Yeah. Well and that, that's 

Kate Grandbois: good. 

Amy Wonkka: Like making yourself way through the details a little bit. 'cause it does, yeah. You reflect as a clinician. 

Kate Grandbois: Mm-hmm. Um, so, so after descriptive, um, yeah, after the descriptive overview, there's providing instructor models or demonstration. 

Amy Wonkka: So can you, like what would that, with the aided language stimulation, what's that?

Kate Grandbois: Um. Well, it would be demonstrating aided language simulation. I'm being, so I don't have any words. It's, it's, it's demonstration, right? It's demonstrating the skill. So using the same example of aided language simulation. You describe it and then you do it. 

Amy Wonkka: Yes. And to be fair to both of us, I think a lot of our trainings are actually a smooshy together of both of those.

Right. A smooch, I'm gonna tell you about it. Do all this stuff. Look, watch me do it. 

Kate Grandbois: It's a smooshy. 

Amy Wonkka: This is a piece that when I was rereading these articles, this [00:30:00] next one, that I was like, oh, I don't think about this. 

Kate Grandbois: Verbal rehearsal. 

Amy Wonkka: Verbal rehearsal, verbal rehearsal of this sequential steps to be implemented.

And this connects with the articles we'll talk about later, um, that come from Jennifer Kent Walsh and Kathy Binger, um, and their impact program. But they've done a lot. Uh, they, yeah. I'm 

Kate Grandbois: excited to get to that. I really liked that one. 

Amy Wonkka: No, it's so good. We'll, we're gonna get there. Um, they do a lot anchored to shared storybook reading, and they have a really specific set of skills that they want the partner to execute in a very specific way.

And they even have little like acronyms that go with it. Like one of them is the wrap, like RA. A a p or A-R-A-P-P, uh, but they want the partner through the training to like, know what those acronyms are and be able to say them out loud. Um, this, my interpretation is that it could also be something like, if we're gonna do it, anchor it to a different activity, like blowing [00:31:00] bubbles.

I have a lot of clients who are real deep into bubbles. So this might be something like, step one, I make sure I have the client's device in the bubbles. Step two, I'm gonna ensure that the client is engaging in, you know, a reciprocal interaction with me. Step three, I'm gonna say blow with oral speech, I'm gonna activate the sequence for blow on the device.

Step four, I'm gonna blow a bubble. So this 

Kate Grandbois: is like a, just a very specific set of directions. 

Amy Wonkka: It's my takeaway from this and. My, my takeaway from the meta-analysis in the, in the work of ER and Count Walsh, it's like very specific to their programs, but I think as a general Clinician, clinician, what I take away is that this is a piece I should be adding in, even if it's not like the directions, a specific program, like the wrap.

And it would be something like, all right, for the bubbles routine, I want the, you know, the paraprofessional and the mom and the special educator to all know, like, these are the steps in the routine. And they know them so well. They can say them out loud. 

Kate Grandbois: And if you are talking to [00:32:00] A, B, C, B, A, this is called a task analysis, right?

So you are, you know, you, this is something that you could maybe. When collaborating develop with other professionals in terms of staff training. So just sort of moving along and recapping in terms of the different kinds of partner training. We've gone over the descriptive overview of skills. We've gone over providing instructor models or demonstrations using verbal rehearsals, which is the, I don't wanna say to-do list, but Yeah.

Specific sequence of skills. It's your to-do list, make sure you have all these things, and do this, do this, do this. Um, and then there's providing opportunities for the communication partner to practice the targeted skills in role plays with the instructor. Now is this like an I do you do we do kind of model?

Amy Wonkka: I think so, right. Okay. So I have, you know, I've, let's say I've talked to you about it. We've gone through the to-do list and now we're gonna try it, but I'm not gonna expect you to do it with the client. I'm first gonna have you try it with me, so it's a little bit less [00:33:00] stressful. We're gonna try it together.

Um, yeah. 

Kate Grandbois: And then the last one you have listed here is. Guided practice opportunities. 

Amy Wonkka: Mm-hmm. So the shift here, as I was reading it, was that in the opportunities for us to practice, we're practicing together. Right? You are, you are giving me the partner instruction. I'm the partner, we're practicing it together in this guided practice.

I am, I am now using those skills with the person who's using a, a, C, but you are still there to give me support. So you're pro, 

Kate Grandbois: and this is like a, so basically coaching. 

Amy Wonkka: Mm-hmm. 

Kate Grandbois: So like the mom, if I'm the clinician and I'm working with my client and the parent is the partner that I'm training. Yep. So they're, they're together.

We're doing an activity. I'm still there, but just providing a little bit of feedback to shape the communication partner's behavior. Yeah. And 

Amy Wonkka: similar to what we do with our clients, you're trying to fade that, fade your prompts. So 

Kate Grandbois: ultimately this is a very [00:34:00] rich set of tools. Yeah. And it's way more than I'm currently doing.

So I am excited to have this. Well, and I, I know we're gonna talk about barriers later on, but I think it's nice to know that there are a variety of other partner training strategies out there outside of the ones that you're using. But also there may be some that are more or less possible within your setting.

'cause there are a lot of barriers too, and I know we're gonna get there, but, um, in other words, these are all great, but if you don't use all of them at the same time, I think that's a realistic, that's a realistic possibility that you're not gonna be using all of these. Wouldn't you agree? I think just based on time, 

Amy Wonkka: I think the big piece, and like you said, like we'll talk a bit about this at the end.

I think the big piece is just to be aware and remind yourself as somebody who's, who you know, professionally stalked some of these ladies for a while. Conferences, um, you know, I, in case anyone 

Kate Grandbois: didn't catch that, Amy just admitted that she stalks these people at [00:35:00] conferences. 

Amy Wonkka: Well, 

Kate Grandbois: making sure that was clear.

Amy Wonkka: Go on. No, I am like, yeah, I'm, I'm into, you're deep 

Kate Grandbois: in, I'm into it. I support your choices. 

Amy Wonkka: Um, I feel like when you, when you read something like this, even if you read it, like I read these articles back when they came out in like 20 13, 20 12, like the ones that we'll get to later and now read you the 

Kate Grandbois: OG fan, 

Amy Wonkka: right?

OG reading them now, like eight years later, I feel like it's still a good reminder. So it's a good, definitely reminder to, to, to connect back to it. Anyway, the last thing they do mention in the meta analysis is just materials focused instruction, like following a workbook. I don't, I don't really, I've never done that, but, 

Kate Grandbois: so again, just recapping partner training is super important.

We have reviewed a handful of different kinds of partner training, but in terms of the literature, is it effective? Is it evidence-based? Does it have actual positive outcomes for your clients? 

Amy Wonkka: Important question. [00:36:00] Very does it. Important question, 

Kate Grandbois: cliffhanger. 

Amy Wonkka: So, so, but we teased it at the beginning so that you guys already know the answer.

Uh, so when Kent Washlet etal did their big review of the literature, they did find, and I'm gonna quote page 2 79 of the article. Uh, but the central finding of this review is that a body of evidence consistently indicates that communication partner instruction has positive effects on communication performance of individuals using a a C.

So in other words, including communication, partner instruction with a a c intervention plans will likely assist in yielding improvements in the communication skills of individuals with complex communication needs. So in, in short answer 

Kate Grandbois: is yes, yes, it's, yes it is effective and yes, you should be doing it correct.

And it is documented in the literature and it is evidence-based practice. 

Amy Wonkka: Yes. And I think it's important to note, so back when we were talking about kind of the little boring like details at the beginning, they do make the point that. When we look [00:37:00] at the A a C, um, partner interventions, there were some differences that they saw.

So they did see a notable difference for individuals with autism spectrum disorders. I thought that 

Kate Grandbois: was so interesting. 

Amy Wonkka: Yeah. Yeah. So in, what was interesting was that for this group, which was a significant portion of the overall, you know, people in the study, they found a moderate effect size for partner instruction interventions compared with a very large effect size.

For everybody else. 

Kate Grandbois: So what does that say in regular person words? So 

Amy Wonkka: in regular person words, talk to 

Kate Grandbois: me, talk to me like you, like I need to understand that 

Amy Wonkka: I'm, I'm this level weird all time. No. So when, when, when I read that, my takeaway is that I know that there was some effect there, but it was less compared to everybody else.

Kate Grandbois: Right, 

Amy Wonkka: right. So, and, and 

Kate Grandbois: isn't it, didn't I read it correctly that they attributed that to the decreased social motivation? Mm-hmm. And social connect, I don't [00:38:00] wanna know if I should say social connectedness, but, um, queuing into salient social features in terms of partner communication. Well, so there was less of that in the, generally speaking, there is less of that for autism given that it's one of the diagnostic criteria.

So they made the assumption that that was a likely contributing factor. Right. To which not having been as successful in that population. 

Amy Wonkka: Correct. They also made the point though that it, it didn't mean it shouldn't be considered a possible intervention component for, for this group of people. 

Kate Grandbois: Actually, that brings me to something that I was gonna read that really struck me, and it's like the shortest sentence, but also super, I felt that it was super powerful.

Partner instruction should be viewed as an integral, integral part of a, a c assessment and intervention. Mm-hmm. And I feel like so often it is not an integral part. It is. Are you laughing me? Am I saying that word wrong? Nevermind taking the dog out for me. Oh, [00:39:00] that's good. Go for a walk doggie. Um, so partner instruction should be viewed as an integral part of a, a c assessment and intervention.

And I feel like so often it is not an integral part. It's an asterisk. Yeah. Like it's, it's, oh, I have time. Or Oh, this parent is asking me so I have to meet with them. Or it, you know, it's very rarely. Written into objectives. It's very rarely documented as a requirement. I mean, I think I've seen a handful of a, a c evals where it lists it, but I mean, full disclosure, it's not a boilerplate item in a lot of my a a C evals, which it will be from moving from, hence fourth, from March 26th, 2020.

It will be in all of my a c documentation. Right. But it's, it's not an integral part. Um, in, so across the board, I think, well, I guess I shouldn't say that, but in my experience, 

Amy Wonkka: and they talk about that too. I mean, they talk [00:40:00] about in the barriers, like they do talk about. The need for people, like fancier people than us in research, when they're generating policy statements and recommendations, they, that should be reflected in there.

Mm-hmm. And that comes back to all of these other things we'll get more into later, but, you know, funding is a real issue. Is there funding for it? Um, I think part of what was exciting for me in reading through these articles was that I think there are a lot of ways that we can embed it into what we're already doing.

Mm-hmm. Just by being more mindful about it and a bit more explicit about it. 

Kate Grandbois: So, learning bucket number one. Learning objective number one, the, what is it? What does the literature say? What kinds of partner training are there? I feel like that is a very robust and super important. Body of of information, but what does it look like?

We've talked about this a little bit already, but I sort of wanted to get into the other article that we read, the Impact [00:41:00] program. Yeah. I like, I like this article a lot. Yeah. I thought I It was very not dense. What's the opposite of dense? It was very accessible. It, it was very accessible. That's a great word.

It was a very accessible article and I felt like it was just full of good nuggets. It's of things that you can take away. 

Amy Wonkka: This is why I'm so into these ladies and their work, but I mean, when I first read this article, I was like, oh geez, I can go do something kind of like this. And I did. I mean, I tried to like, I basically did a not very good version of their rap program for a bunch of my students and it felt like it was so helpful in, in mm-hmm.

By using their existing structure. It let me. Fuss around with it from my work environment and like the particular variables unique to my job. Um, but it was so helpful and, and I feel like it made my partner support so much better, right? It made it more like following that recipe for how [00:42:00] to program a button and less like, let me come up here and lecture you all about it, language simulation and how it's important.

Not like a 90-year-old when you Right, right. Like, because that's how all the people felt when they were listening to me and they were like, she is boring and Okay. Right. So what they talk about. So, so this next section, this next big bucket, talking about it, we're gonna talk really about the work of Jennifer Kent Walsh and Kathy Banger.

Um, there are two articles I snuck one in on Kate. It's cool that, that were published in 2012 and 2013, uh, in perspectives on a a c, which is a plug for SIG 12 memberships through Asha. There's a lot of great stuff there. You get access to their perspectives journal. Um, SIG 12 is the ac, special interest group, which might be called, are they called?

Different things now? I still call 'em, I don't know. I don't know, but 12. That's what you want. Um, so this article, the 2013 article really focuses on an intervention they call the Impact Program. So step [00:43:00] one, like how do I do it? Step one, step one, read their 2012 article that Kate didn't get a chance to read.

I'm sorry. 

Kate Grandbois: So Step, this is the Cliff Notes version. 

Amy Wonkka: This is the Cliff Notes version, right? So step one, you need to identify your instructional goals, right? So what mm-hmm specifically do you want the partner to be able to do? Um, definitely check out their 2012 Perspectives article. It's titled Selecting Skills to Teach Communication Partners.

Where do I Start? Such a good article, 

Kate Grandbois: and that sounds like a great article. 

Amy Wonkka: Yeah, it's really, it's really, really, why didn't you give this to me before we recorded this? I wanna read this article. I would in the folder. I, that's not fair. It was one of those times where I read an article and then I had to read another article.

Um, yeah. So, so it's great. It's accessible, it's easy to read, you read it and you feel like you can do things with it, right? But some very brief key takeaways for me when I read it were, don't focus on what the partner's doing wrong, right? So a lot of times we'll watch a [00:44:00] communication partner. You know, Kate and I both work at sort of a, a c specialist.

We're using air quotes, but quote 

Kate Grandbois: unquote 

Amy Wonkka: a a c specialist roles. Um, so, you know, you come in, you do an observation, you can see some things that you wish people were doing differently. Don't focus on that. Nobody likes when they're like, oh, you're doing it, but you're doing all these things wrong. So don't do that.

Um, don't try and don't be 

Kate Grandbois: mean. Don't be mean, 

Amy Wonkka: don't be mean, don't be mean. But this 

Kate Grandbois: next one I do all the time. I'm guilty of this aggressively. Yes. 

Amy Wonkka: And this is part of what I love about these guys. Don't try and teach too many things at once. 

Kate Grandbois: Oh my gosh. That's me. 

Amy Wonkka: Mm-hmm. 

Kate Grandbois: I am always, I'm like, well, you wanna try and do a language simulation and you also wanna, you know, do the expect and pause and you also wanna blah, blah, blah.

And it's hard. 

Amy Wonkka: Well, and it's true for partners and a a c users, right? I want you to build your vocabulary. I want you to make more requests. I'd like you to ask a question. It's, they're saying that's a lot. Don't do that. 

Kate Grandbois: Um, well, and I think this is [00:45:00] maybe just reframing it in a way that, you know, as clinicians, we do it all the time.

Think of the communication partner as your client and working in their zone of proximal development. Mm-hmm. So you drop a breadcrumb, you would never take on a client, be like, we're gonna fix all your communication problems right away. No. You would pick one thing, you would work towards it slowly. It would be something that's close to where, you know, where they are, um, in terms of development.

And it's the same here. I mean, we know how to teach things right. But applying those skills in a different setting, I think it's hard to switch your hat or not switch your hat, I guess. 

Amy Wonkka: And it's hard to forget, you know, in the case of speech pathologists who might be listening, sometimes it's hard to forget that we went to years and years of school and had hundreds of clinically supervised hours and a CFY before we became clinicians.

Right. So we need to like. Dial back our expectations a little bit because there was a lot of training that went into becoming automatic with these different things. Um, [00:46:00] so big takeaways. Don't focus on what the partner's doing wrong. Don't try and teach too many things at once. Don't try and change too many partner or a c user behaviors in lots of different places or situations.

At the same time, don't forget to connect the changes in partner behavior to meaningful changes in the a c user's performance, right? So we're always bringing it back to we're not just doing this training for you, we're really doing it for the clients. Um, right. So connected with that, they give you four guidelines and they describe each one in a lot of detail.

I definitely recommend checking out this article. Um, but their, their big four guidelines are, you know, number one, you wanna identify the partner behaviors that can result in desired client skills, and that they're currently linked to the changes we all wanna see for the client. Um, you're selecting really well-defined client and partner skills that can change quickly.

They're easy to identify, they're easy to quantify. So this goes back to, you know, don't just do that big descriptive lecture. Like be very [00:47:00] specific, be very specific about things that are kind of a small change for people and you're, you're easily able to like, agree on what that change looks like. Um.

Practice the selected techniques with the client before teaching it to the partners. I think this is really important. This is a big takeaway for me. Make sure this stuff works yourself, right? Mm-hmm. If I wanna do shared reading and I wanna train maybe mom to do shared reading with you, I need to make sure I try it and that this is successful.

I don't wanna bring mom in and teacher to do something that it turns out isn't a helpful and effective strategy for the client, right? Mm-hmm. That's two thumbs down. Um, start small, that, that is huge and expand after achieving initial success. So build up, which is 

Kate Grandbois: again, what we do so much as therapists, naturally anyway, it's just a matter of reframing it to the learning skills of the communication partner.

Amy Wonkka: Yeah. Yeah. And, and you know, nobody, nobody wants to feel like they're doing a bad job. Nobody wants to feel like they're getting picked on. Everybody wants to help this person, you know, [00:48:00] optimize their communication. So let's acknowledge that. Um, they say that clinicians should ask the. Three questions. What is the partner currently doing or not doing that is failing to facilitate the communication.

So if you're not clear about exactly what skill you need to work on and you're trying to figure it out, guiding question number one, like what are they doing or not doing? You can ask yourself, what is the 

Kate Grandbois: communication partner doing or not doing? 

Amy Wonkka: Right? So you can ask yourself in your head, you can identify like that they're doing it wrong, but you're not using that as your driving force.

So I come in, you know, Kate comes in and she sees me with a client, and I'm just asking question after question after question yes, no questions all the time. She's gonna say, all right, Amy needs to shift from asking all these yes no questions. Um, what exactly could the partner do instead? That would be more facilitative.

Maybe it would be asking replacement 

Kate Grandbois: behavior. 

Amy Wonkka: Yeah. And then what client behaviors would result from these changes? We [00:49:00] think that the client would use more robust communication because they'd be being asked wh questions. 

Kate Grandbois: And you have listed here that, um, the augmentative and alternative communication profile from Tracy Kovac is, has a partner skills inventory in it, doesn't it?

And I think that that's tremendously helpful. Yeah. If you don't already use it, bringing that into the fold as part of your assessment materials. Because if you do an a a C assessment or even if you have somebody who's looking for more instruction, um, you can, you know, use that. Just pull it out of your back pocket to use it even as a guided interview.

Amy Wonkka: Yes. And that resource is listed on our website so you guys can check it out. 

Kate Grandbois: Excellent. Um, 

Amy Wonkka: when we. Think about step two. Step two is the implementation. So now we're into their 2013 article. We're into the Impact program and the impact program. I really 

Kate Grandbois: liked this article. 

Amy Wonkka: So good. It's so good. It targets five different prompting skills, which effectively are like a most to least [00:50:00] hierarchy.

So, you know, step one, their teaching people A to C modeling, expect and delay wh question asking, verbal prompting. And then their kind of fifth skill is contingent responding, which is just meant to increase the likelihood that the a a C user is going to continue to communicate in the future because somebody's responding to them.

Mm-hmm. And obviously you want to do that. Um. 

Kate Grandbois: And I feel like when I read this, I thought, oh, I do all those things, but I don't do them as a package. Yeah. And I think that was a big takeaway for me is that I have, I have recommended aided a, a c modeling, I have recommended an expected delay. I have recommended wh question asking and contingent responding, but I have never looked at it as a whole treatment package for the partner.

And I think that's a really important com. I think that's a really important piece. 

Amy Wonkka: And they're all about like, conceptualizing it as a, as a structured package, right? Like it's a structured sequence of Yeah. 

Kate Grandbois: This [00:51:00] is, this is a great article. 

Amy Wonkka: Um, worth reading out 

Kate Grandbois: there. 

Amy Wonkka: It really, yeah, it's really good. They, and they, they kind of anchor onto, in a lot of their research, they do anchor onto, you know, shared reading.

They, there are a couple of different activities too, but the shared reading is a nice close-ended task. Um. Their training approach takes anywhere from one and a half to six hours of total time, one to six training sessions. So it's not like a huge time suck. Like it feels doable. You could do it, I think, as part of a lot of your ongoing service anyway.

Mm-hmm. And it focuses on five components including video review, modeling, role play, verbal rehearsal, and coach practice, which we've talked about earlier in the podcast. If you look, 

Kate Grandbois: go ahead. 

Amy Wonkka: Yep, yep, yep. Doing, doing this remotely, friends, just a reminder. Weird. You go. You do do it socially distancing. Um.

I was just gonna say, if you, if you look in table two of their [00:52:00] 2013 article, it gives a really nice breakdown of that, those five instructional components, which they teach across eight different instructional steps, and they give really nice examples of what that looks like. So for more detail, you can see the article.

Kate Grandbois: And that's exactly what I was gonna say. I interrupted you for nothing. I, I think for, if, for no other reason, the re the reason to have this article on hand, just to have it at your desk or have it in your file is because it, it has these really nice tables where you can quickly reference, oh, I, Joey's mom asked me for more information about blah, blah, blah.

I, what was that thing? I, you just pull it out and the table's right there. It gives you lots of really great information in a flash, I think is really helpful. Well, I feel like since we all know that I cut all the corners when it comes to reading 

Amy Wonkka: literature. Well, no, because life, life is real. We, we, I'm busy, man.

Yeah, it's hard. But I want no judgment. No, no judgment. Judgment. No judgment. Um, I think [00:53:00] when we, when we look at this really structured approach, and when you look at that table. In their 2013 article and when you read about their application of the WRAP program, it does also help you like you can do what I did and just kind of take that and shift it a little bit and try it out yourself and see how it goes.

And it's a nice structure to kind of attach onto before you try and branch out in your own. Maybe you do have a student who really loves bubbles and you wanna kind of use that same structure for training around a bubble blowing activity. That's great. You get to try it out here and then kind of slowly expand.

Um. As an aside real quickly, when I reread these articles to prepare for this podcast, I made a connection to a totally different podcast that I listened to you kind of recently. Um, I don't know if anybody listens to The Hidden Brain. 

Kate Grandbois: Never heard of it. It's a 

Amy Wonkka: podcast from NPR and they have an episode called When Everything Clicks, the Power of Judgment Free Learning.

And they tell this story about how Dr. Martin Levy, who's an orthopedic surgeon in New York, how he trains new surgeons and he trains them [00:54:00] like using clicker training like you would for a dog. Really? So the whole podcast is, is super interesting. I loved it. But he uses a variation of these same super explicit techniques, right?

So he breaks down all the pieces into these very tiny steps. He has the people, the surgeons like verbally rehearse the steps, so they're like not over, like rope over, left, blah, blah, blah rope. And he gives like repeated practice, like all of these same components and it was just oh, interesting. 

Kate Grandbois: I'll have to tag him somehow, or her, I, Martin, I guess it's a man.

Put the 

Amy Wonkka: reference on the, on the reference sheet. We will. 

Kate Grandbois: Yes, we will. We'll, we'll put a link up there. 

Amy Wonkka: Yeah. So anyway, that's, that's just like an interesting thing to think about, kind of this exact same approach to instruction for adults, but like in a completely different discipline. 

Kate Grandbois: Well, it just shows that it's an effective learning strategy.

It's being repurposed and replicated across different disciplines and different skill sets. Right? 

Amy Wonkka: Yeah, it was very cool. Anyway, 

Kate Grandbois: that's very cool. So looking again, the 30,000 foot view, [00:55:00] we've talked about background information, we've talked about, you know, what it, what it looks like. This impact program is very cool.

There's two research, there's two articles out there that describe the different. Um, actual applications of partner training. And finally, our last learning objective of our last learning bucket, hurdles, hurdles and strategies. So each work environment has its own set of restrictions in terms of time, finance, um, you know, budget, et cetera, et cetera.

So we just wanted to end the episode quickly with a review of identifying what those hurdles are and then talking a little bit about strategies that you can use to overcome those hurdles. 

Amy Wonkka: Yeah, so when we look, I mean, I think you named them all right, funding, privacy time. Um, I think these are all things that Privacy.

Yeah. Privacy I feel like is an issue with the video component. That's why I've never used that word. Ah, so when they [00:56:00] do, if you look at their 2013 article, like step one of training day one is to use a video to kind of show an example of somebody, not that client, but a different client. To show an example of that person communicating when this, when the partner is using the strategies and when they're not.

And 

Kate Grandbois: it's a great idea. I guess it's easier if you're in private practice or depending on what your work setting is, if you can get that permission. Yes. To use, I mean, training hospitals do this all the time. You know, you sign the waiver, can we use, can we record you? Can we use it for, I mean, sometimes it's promotional purposes, but a lot of times it's educational purposes.

Um, so that would be something to consider. 'cause it's a great idea. It's also something that saves with time because if you have a video and you're able to share it through some sort of HIPAA or FERPA compliant means you can send it to them. You know, not on YouTube, but you can send it to them and say, watch this video before you come into my session or watch this video before you come in for your.

Parent meeting or conference or whatever. 

Amy Wonkka: Well, and I think [00:57:00] in the way that they did it in their research, they were doing it together. Sort of like anybody who's ever done, you know, any of the handin trainings or anything like that. Like they were doing it more as like a coaching, like, we're gonna watch this together and talk through the differences.

Kate Grandbois: Mm-hmm. 

Amy Wonkka: Um, 

Kate Grandbois: in that's also a great idea. 

Amy Wonkka: It's such a good idea. I know it's such a, I have like video envy, but, so depending upon where you work, right, that may or may not an option for you. Um, so that's the privacy piece. And then I think the bigger, more universal barriers are probably around funding and time.

And those are kind of the same things. 'cause time is money. Um, but, you know, is there a way for this to be included as part of your therapy potentially, right? If you're, you know, just 

Kate Grandbois: because I'm in private practice, I, you know, looking at all of these things with like a lens of how I could work it in my setting.

Um. And I think you could, you could bundle it in terms of like a fee for service kind of thing and not charge as much as you would for therapy if you, I don't know what the privacy implications could be, but you could do [00:58:00] a group, you know, you could do group therapy with, you know, I wanna say wine and cheese, maybe that's not professional.

Have some sort of like evening where you have a group of parents come who have signed a waiver to share and you're talking about it more generally instead of, you know, with, you know, related to the specific students. Um, and the video thing. I feel like that's just such a great idea. 

Amy Wonkka: I feel like Kate's more fun than me.

She's gonna have wine and cheese training. That's 

Kate Grandbois: cool. I had a, I had a case of wine delivered today. Hashtag COVID-19. That's why it's downstairs. That's why I'm thinking about it. And it's, it's five o'clock and just a few minutes here, so, no, 

Amy Wonkka: it's cool. It's cool. Um, so I'm so professional. No, I think those are, those are like, those are exactly the types of things, right?

Like, so think about all the components that go with it. Think about the barriers that could connect to it. I think when we reflect back on. The different components of the training that they talked about. You know, the video review, the modeling, the role play together with the [00:59:00] partner, I think would be the harder pieces to cover from a funding standpoint.

When you get into the coach practice actually working with the client, I think that those are the times that that could easily just be incorporated as part of your session. A barrier for me as someone who's been in the public schools is just access to the people who I want to train as partners. And a lot of time that comes in the form of like, you have this aggregate group of, you know, 50 paraprofessionals and two hours to train them.

And so, you know, that's not ideal because you're not gonna get the individualized time that you want. But you know, just for me reflecting like I should do less lecture and more, you know, small group. 

Kate Grandbois: Right. 

Amy Wonkka: Just being a little bit flexible about how you think about that. 

Kate Grandbois: Right. Um, 

Amy Wonkka: one other, I also 

Kate Grandbois: like that you have here, you know, consider using the tools that you already have, like the A A CP, you know, just making it.

Did you, did you say that already? Yeah. Just like making it more efficient. Right. Um, you know, don't reinvent the wheel. All of that kind of stuff. And I think depending on where [01:00:00] you work, talk to your administrators, right. You know, talk to the people running your clinic or, and this is evidence-based practice.

This is, I mean, goes just go back to that quote. It is an integral part of a c assessment and intervention. Correct. Um, so I think a little bit of advocacy might also be able to go a long way. 

Amy Wonkka: Well, and even, you know, one last out kind of outside the box thing is, is think about other, you know, can you make some depersonalized training modules, right?

If you don't use the client's name, if you don't use any identifiers, are you able to make a couple of short, like packaged. Pieces of content that you can share with lots of people, which will take more time at first. But then once you've made that, it's available and you can share it, you know, infinitely.

Kate Grandbois: Well, I think that we covered a lot of material today. A lot of 

Amy Wonkka: stuff. Thanks for hanging in. 

Kate Grandbois: That was, that was deep. That was deep. So we reviewed the importance of partner training, partner training, um, that they have a really important role in the success of an aided communication exchange. We reviewed [01:01:00] the different patterns that we see in partners, um, with who are communicating with aided communicators and the different kinds of partner training that are out there, um, and how we can shift the results in a positive way, um, across.

Pragmatic morpho, syntactic, semantic domains. Um, I think that those are all really important points and everyone should consider reading at least one of these articles. 

Amy Wonkka: Yeah, and I think, you know, the big takeaway too is just using that specific structured instruction and incorporating really specific concrete, manageable, a sequential approach to training is, is a big piece of it.

So if you're just going to read one article, I would say read two articles. But if you're just gonna read one, read that 2013, um, Jennifer Kawa, Kent Walsh and Kathy Binger article, the 2012 is really helpful too. And like Kate said, like they're, they're pretty accessible. They don't feel like the meta-analysis that we talked about, they don't feel 

Kate Grandbois: Yeah, yeah.

There's no eye glazing. No, [01:02:00] I really, I really enjoyed them. And you as always, you guys can get more information on our website, www.slpnerdcast.com. All of the references for the articles will be there. Any additional resources we discussed will be there. Um, you can use this podcast for ASHA Professional Development.

Just go to our professional development page or read more about it on the episode page. And I think that's, that wraps us up for the day. Shameless plug. We have some exciting episodes coming up. We're gonna be publishing an episode on stress management with using acceptance commitment therapy with, uh, a fellow BCBA, which is gonna be super interesting.

Yes, feeding and swallowing in schools Yep. Is coming up still too. And maybe verbal behavior, maybe. We'll stay tuned. Maybe we'll see. Stay tuned. All right, everybody, have a wonderful evening and we will see you here again [01:03:00] soon.