SLP Toolkit Podcast, Episode 14, Transcript

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Lisa (00:42):

Well, hi. Sarah.

 

Sarah (00:43):

Hi, Lisa. How are you doing today?

 

Lisa (00:46):

I'm great. Thanks for asking.

 

Sarah (00:48):

I have nothing else.

 

Lisa (00:49):

That's all.

 

Sarah (00:50):

That's all under the table.

 

Lisa (00:51):

I know our introductions are always like really deep and profound.

 

Sarah (00:54):

Well, duh, because we're clearly deep and profound individuals.

 

Lisa (00:58):

Yes. So I have to say though, I am excited that today I don't just have to look and talk at you.

 

Lisa (01:03):

What?

 

Sarah (01:03):

Yeah, it's true.

 

Lisa (01:05):

I don't see anyone else in here.

 

Sarah (01:05):

Well, we have got a very special guest that is on our computer so nobody can see her, but you get to hear her. And we were really excited about doing this episode because it's a topic that I know is so important, but I don't think I have enough knowledge to be sharing it. And so we brought in somebody who's way more qualified to talk about a really important topic. She has a book and she has a blog and her name is Emily and she is coming from actually, I don't even know where you're at right now.

 

Emily (01:35):

I'm in Austin, Texas.

 

Sarah (01:37):

Austin, Texas. I did know that.

 

Lisa (01:38):

I know she's sitting in her new house.

 

Sarah (01:41):

Yes. She got a new house. And so she's on our computer, but we are so excited to have her. So Emily, tell us a little bit about yourself.

 

Emily (01:49):

Well, first of all, thank you guys for having me. I'm really excited to be here. Um, my name is Emily Cohen and I own a small private pediatric therapy practice in Austin, Texas called Tandem Speech Therapy. Um, I've been in SLP for.. It's my 10th year and previous to that, I was a special education teacher. Um, I'm originally from Michigan, so that's where I taught and went to grad school. And then I landed in Austin about nine years ago and here I am.

 

Sarah (02:16):

Well, we love Austin. We've had the opportunity to go a few times and we always think we're going to end up in Texas. We feel like we spend more time there probably than anywhere. Um, and it's a really cool place.

 

Emily (02:26):

Yeah. I love being here.

 

Lisa (02:28):

Were you a special education teacher in preschool? Or were you working with older students?

 

Emily (02:32):

No, I taught special ed for both elementary and middle school students. I actually taught two years in classrooms for kids with autism. Um, and that just didn't totally feel like my calling and had go back to grad school and, um, yeah, sort of found my love for working with the younger kiddos there and in my first job when I was a CF.

 

Lisa (02:56):

But that's really cool though, because I always think that gives you a better perspective of where you see kids, what they grow into. So even like, I think I worked primarily with elementary students in my school setting that I worked in, but when I got to go visit junior highs and high schools and look at what language impairments look like at that age and how social skills kind of evolve over the year for our kids. Um, even on the spectrum that have social impairment and maybe how I saw how it looked in elementary, but then seeing how it also presented in older grades really helped shape what I was doing when they were younger.

 

Emily (03:33):

Yeah. And I feel like for me also, um, I have, because I work with a lot of really young kids. I have a lot of kids that are going through that first assessment from the school district at three, you know, for what we call PPCD services here in Texas. Um, and so even though this was quite a long time ago that I was in a classroom, I feel like I can help the families I work with navigate that process a little bit.

 

Sarah (03:55):

Well, I have always said the best speech pathologists were teachers first. I really think there's a huge advantage because you own, you understand scope and sequence of instruction, but then, then you have an even more specific lens because it was special ed focused, so you understand differentiation of instruction. Um, and so then to add the background of communication and the brain and language and all of that into the mix, I just think it's a really great foundation, um, that, that some of us who don't have that experience, we have to go find it on our own.

 

Lisa (04:28):

Right.

 

Emily (04:30):

Yeah. And I think I've, I've worked with a really wide variety of kids, both, you know, in undergrad doing, you know, all my practicum work for special education and then in the very Ektron three different schools in three different years. Um, so yeah, I think it's been really good experience for me.

 

Sarah (04:45):

So the the private practice that you have are, are you doing EI mostly as a 0 to 3, or is this 3 to 5 or a combination?

 

Emily (04:55):

I have a combination. So, um, in Texas, early intervention is strictly through agencies. Um, and so while I do service some of that population, I also kind of, my practice is split 50/50. So I work with a lot of little ones in that, like 2 to 5 range that have a language delay, not necessarily because they have some other diagnosis, but sometimes because they do, and then I have sort of like more traditional school aged kids that have articulation and language goals. So I do a lot of articulation and phonology work with those kids, but my passion and my love is with the little ones.

 

Lisa (05:31):

Yeah. That was my first job ever out of college as an SLP was early intervention. And they are, they're just, they're so awesome. And working with families is really great.

 

Emily (05:40):

Yeah. And that's really, that's where I came up with the name for my private practice when, um, so I founded my practice a little over a year ago and I was, you know, trying to come up with something that would encompass what I love. And I really loved that working together with parents, we were, I was trying to think of words that are synonyms for together. And we came up with tandem and then it snowballed.

 

Sarah (06:03):

When I was looking at your website, I pointed that out to Lisa right away. I caught that in the slogan of that. And I thought it was really powerful because that is kind of the advantage to what you're doing versus maybe some of those of us who were solely in the schools is we don't get that benefit of working with families as much as we probably would like to.

 

Lisa (06:23):

But we work collaboratively with other team members. So like with teachers and professionals. And so it's just working collaboratively in different ways.

 

Sarah (06:32):

Yeah. Yeah. That's true.

 

Emily (06:35):

Um, so I did, I'm Hanen trained and, um, that I got introduced to in my CS, so all of the other SLPs I worked with are all Hanen certified and It Takes Two to Talk Program. And we really only saw kids like two and three years old that in a private setting that were language delayed. Um, and so, yeah.

 

Sarah (06:54):

Will you tell us a little bit about, I am familiar with Hanen and I do have, um, uh, I didn't do the training, but I have some materials I have purchased from them, um, because of their, it's really great for those beginning talkers right, for expanding language. So will you tell us a little bit more about what that means to be Hanen trained and what that looks like?

 

Emily (07:13):

Yeah, so the Hanen Center there, their original program, and I think what they're most known for is a program called It Takes Two to Talk. So to back up a little bit, the Hanen Center is based out of Toronto, Canada. And so they, um, it was founded by SLPs pretty much solely for SLPs in there. It Takes Two to Talk program is designed for us as SLPs to teach and empower parents. Um, in all of their work is centered, they do tons of research on language intervention and play. And so, um, the training that you take as an SLP is a three-day program, and it goes through all of the strategies that are outlined in the It Takes Two to Talk book. Um, it teaches you how to teach the class. So It Takes Two to Talk program is for parents and caregivers. And it's like a one is, it's like an 8 to 10 week class that you teach. Um, and I've actually being Hanen trained. I've actually only taught the class one time. I taught it with a colleague who was also trained, um, and we taught it to a group of parents, but then I use all of the strategies, like every single time I interact with a child, whether it's like my own client's or my friend's kids or kids at the grocery store. It's just like always there in the back of my brain. So I think they're really good, easy to follow along strategies. Um, and one of the things I really love about the It Takes Two to Talk book and the other books from the Hanen, in some areas they're actually not designed for us as SLPs to read. They're written for parents and caregivers. So it's super user-friendly vocabulary. It spells things out really, really clearly and concisely. And I think it's really, um, it breaks it down in a way that's easy to implement. So it's less overwhelming.

 

Sarah (08:52):

Yeah. I think that's super important. And probably why I enjoyed it so much is because I think what happens, a lot of the materials we buy that are written by speech pathologists, for speech pathologists, they have some assumption of knowledge that I have the same theory and background and I don't always, and so then I have to do like, deciphering. Um, and I think then they, they almost don't want to spell things out because they, again assume that I don't need that level of spelling out. And most of the time I'm like, no, I do. I actually want you to spell it out for me. Step-by-step, right, you know.

 

Lisa (09:24):

It gives me the words too that, you know, part of our job, no matter what setting is communicating with others about what we're doing. And so when it's written in that kind of format, it makes it a lot easier that I can wrap my brain around it, have that user-friendly vocabulary and then share that with the people that I'm working with.

 

Sarah (09:39):

Right.

 

Lisa (09:40):

So I don't have to come up with that on the fly.

 

Sarah (09:41):

I think it's hard for us sometimes to not use jargon and terminology that only speech pathologists know I found, I found myself doing that in meetings with parents, making sure I'm using this like parent-centered language, you know? So, um, anyway, I think it's very, very cool and it leads us to really what we were, um, excited to talk to you about, which is this idea of play. And I know that your book and your blog are both entitled, um, the same thing, which is Playing With Purpose. Right?

 

Emily (10:14):

Right, yes.

 

Sarah (10:14):

And can you, so tell us a little bit about the background there and why that this is kind of your passion area, um, that you really focus on?

 

Emily (10:24):

Yeah, so I think, um, like I was saying, in my CF, I really learned a lot about these strategies and I saw the other SLPs I've worked with using these strategies with kids in their one-on-one sessions, but then also teaching parents how to do the work outside of the therapy setting. So whether we're at school or private practice, you know, I always described to parents, you know, so I have 40 minutes with your child a week and there are 40,000 other minutes that you interact with them, or they have outside of this, this interaction with me. Um, and so it's really important for us to, um, teach parents and caregivers, how to do the work outside of the therapy setting. And so I actually, I have to give my husband credit cause he came up with the term "playing with purpose". Um, and we were like talking one night with a friend of ours who has a little one who's like two and a half now. And she was like, "Oh, you always give me these great ideas to use with, um, my son, why not do one of those subscription boxes?" And that didn't really speak to me personally, but I think there's lots of great ones out there. Um, and so it was kind of trying to discern that and make that more manageable. And I had been thinking about starting a blog with starting my practice. And so it kind of came from there. So what I do is I either picked individual toys or activities that I like to use in therapy with my clients or that I see families interacting with their own children, um, either in play or stuff the parents asked me about. And so I take each activity and I kind of break it down and I talk about specific tasks that you can do with the child and what skills that you're addressing. So if you're a parent and you're, maybe you're working with an SLP, um, because your child is having trouble following directions, you would be able to go to the post on Mr. Potato Head. And I would give you an idea of what you can do with your son or daughter while you're playing with them.

 

Lisa (12:26):

What's so great about that is I think that's the direction EI has gone in general, even the specialized training that has to occur where you're working collaboratively, having those carry over steps. And so to help people—that is really tricky that, you know, we sometimes get stuck in that mode of I, all my time is spent going from child to child or traveling or writing reports or whatever. And then to add that component to of these are some follow-up things that need to be done. It gets hard to kind of map all of those out. So it's, it would be really amazing to say, Hey, we played with this, send them to this post that's already created. And I would love that. That'd be amazing.

 

Emily (13:06):

Yeah. That too. So in the table of contents for the book, you know, it's all, it's like any other ebook, it's very, um, navigational. I can't think of it easy to, easy to use to navigate. So you can say, Oh, my kid's really into playing with bubbles this week, click, you're on the bubbles page, and you know what to do.

 

Sarah (13:27):

And so it has just as a list of activities and things that they can do. So when they're playing with bubbles, here's some things you can target. Here's some maybe words you should use that kind of thing.

 

Emily (13:36):

Yeah. So like, I'm trying to think of what we just talked about with bubbles. So it talks about vocabulary that, um, is great. Especially if you're working with little ones who are just developing words. So vocabulary, um, I talk a little bit about like breath support, um, and how that's important for speech and phonation. Um, who would other things, I think in the bubbles, cause they talk about turn-taking um, and how you can work on that social skill with kids. Um, yeah. So, and I try to kind of vary it through all the different, all the different toys and activities. So there's lots of different things. And even if I write about it just for bubbles, there are ways to apply it to other toys and activities, of course.

 

Sarah (14:18):

Yeah. And then by skill area, you said also. Like if I specifically know I want to work on following directions or maybe who questions or whatever the skill is, then there's something, an activity that, that helps you to target that skill.

 

Emily (14:33):

So not every single point, every single activity has all, but you know, there's whatever millions of skills we can work on with kids. So I would say each toy or activity has five to six things that you can do, um, for, and each of the five or six things targets a different skill.

 

Sarah (14:47):

Yeah. Yeah. Which I think is so cool because one thing about speech therapists, I think we are really great problem solvers in the sense of, we can take something, I could literally take this pen and turn it into therapy if I need to. Um, but that being said, there are moments where I'm just like, I'm done. Like I can't come up with anything. I'm not sure the direction I should go. You know, how can I take this pen and do something with it today? So I love ideas of something I can do with the pen and the object of choice right now, um, that I may not have thought about my own.

 

Lisa (15:18):

But not just that. I think like you can say that from your perspective now with 10 years under your belt. But I remember being in grad school and being told we had a materials closet and there was this one clinical director that was like, you should be able to pick up anything in there and provide treatment and work on any goal. And we were like petrified, terrified to have her send it because we were spending all of our time looking at the, you know, the, the limited clients were exposed to in school and trying to laminate and make things perfect and individualized for every student versus then with some experience under your belt after time, I feel like I could do that now, but as a new therapist, I think it's more as a new therapist where maybe you don't have enough of that under your belt. So it would be an awesome tool for that. But then it gets into, then even if I had 10 years of experience or 20 years, and I know how to use these things, it makes it a lot easier to have that kind of scaffolded for me. So I don't have to rethink about all of that. I can just click in and get it. So it's more about access and, um, the organization of it and making it easy on me. So I can really focus on the kid, but new therapists—

 

Sarah (16:26):

I know I'm missing things. I know I'm missing huge opportunities to really be impactful. Um, because it, you know, I just, my perspective, you know, impacts, you know, my ideas and what I come up with. So having somebody else say, you know, here's what I can do. I can take that and then I can transfer it to anything.

 

Lisa (16:46):

Well, and one of the things I think that can go to the wayside when you're practicing and seeing a ton of students is that whole component of lesson planning. So that's really what if you're giving an activity and you're thinking about all the ways it can be used in all of these different contexts, that's a lesson plan,

 

Sarah (17:00):

Right.

 

Lisa (17:00):

So even if it's not lesson planning in terms of teachers in a school, it's still thinking about what you want to do in your therapy session and mapping that out. So that's mapped out for me, sweet. I will walk in and rock it and do amazing work with that kid. So that's what I love, is anything that helps me like takes that kind of pressure off. Because we get into this space where we feel like we have to do everything, and we know why. We know a lesson plan is best practice, so you can target everything and you can have all of that pre-mapped out before you encounter it with a child, but then real life hits you upside the head and some things start to slip.

 

Sarah (17:36):

So, and that's what I, that actually was leading me into. My next question is, um, when you're doing play-based therapy, really, for the most part, do you have a plan? Like, do you know what it is you're going to go in and target, or is it really child centered in the fact that I'm just gonna follow his lead and I'm gonna see where this takes me?

 

Emily (17:52):

I think it's a combination because even in play-based therapy, like we still have, I still have goals for my clients that I write for private practice, just like you have for your school kids with their IEP and their arts. So I always have, okay, these are the four things that I really want to work on with this child. And I do a lot of times, I bring something with me just in case, especially like when I'm going to a new family's house, because I just never know what I'm going to walk into. Um, but there are, and I always have like a general plan in my head of what I want to accomplish, but I think you bring up a great point. Like childhood play is hugely important, follow a filing a child's lead that comes straight—that terminology is exactly in the Hanen and It Takes Two to Talk program. Um, and I actually think that's one of the hardest things to teach parents to do. Um, uh, I see this all the time, you know, um, I think we see parents, I see parents often, "Oh, tell miss Emily what, this is, tell miss Emily, what that is." And you really have to coach parents on using language in a natural environment and model tons of following the child's lead and really, um, just kind of rolling with the punches of whatever happens that day.

 

Sarah (19:09):

Yeah. Yeah. And that's what I was, I was wondering about is, is that balance of, um, I've got these goals and I have these targets I need to hit. And so, you know, I needed to focus them with this activity and here's the toy that's going to get me what I mean, um, versus, you know, how often are, should we be using their own materials in their home? You know, that kind of thing. So just, is it just a balance?

 

Emily (19:32):

Yeah. I think it's a balance, even when I'm following a child's lead and doing childhood play, there is so much of it that I'm still in control of. So one of the things that I love about kids' toys, and I talk about this on the blog and in the book, um, you know, lots of kids' toys have tons of parts. And so there are ways for a child to feel like they are in control and getting to play with their Legos, how they want, where I'm actually really controlling the interaction and providing them lots of opportunities for requesting or labeling or things like that. Because I get, I can control a lot of the pieces of the toy and give them sort of access to them one by one, which provides lots of that repetition. Um, and then those are the kinds of things that I like to model for parents so that they can see how they can be in control while their child is still getting to do what they want to do.

 

Lisa (20:27):

Well. And I think that's one of those things that we overlook as adults is that these little children are little people and that whole idea of choices, we like that even as an adult. And so when we try to force a child into a situation that is not something they want to do, they just, they won't do it just like we don't as grownups. And that power choice, like, I mean, it's still, you're leading them into choices that make sense for us as therapists and get what we want out of the activity, but it's still it's. That was one of those things. Even working in preschool and early intervention, working with older students, they want choices, too, choices over their learning. It's just a little bit, you know, with the younger ones, it is so play-based, and they can't, I mean, their attention span, even too, it could be that I'm into the Legos right now and then swing my head, I'm into Potato Head. So that whole flexibility piece as a grownup where you can't be on your own agenda is huge too.

 

Emily (21:22):

I think that's like, that makes me think about how I also help parents sort of control the environment. So, um, because kids do have a really short attention span, but we can do little things to kind of prolong it. So I kind of, um, one of the things that I help parents do a lot in my private practice when you come into their home is kind of control the environment a little bit more, um, so that we can keep kids' attention for just a little bit longer. Cause like 30 extra seconds of them attending to one activity with us gives us so many more opportunities.

 

Lisa (21:52):

What would be an example of what that would look like?

 

Emily (21:55):

Um, I think we all do this to keep ourselves organized, but, and I'm sure y'all do this in your classrooms as well, but I have all of, almost all my toys and, you know, like clear plastic bins. So that helps us stay organized and keep everything in track and helps parents stay organized and teaches kids how to clean up, which is like a good organizational skill, um, for them. But then it allows us to control the interaction. So, and I also try and help parents kind of like pare down what's going on in the playroom. So I encourage parents to keep like four to five toys out at a time, um, and to put everything else away. So there's a whole idea of like a toy rotation, which you can read lots about. Um, uh, and I also kinda like help, um, we try to like keep some things up out of a child's reach, so that encourages them to request things. So some things that they have access to all the time, some things that are enticing, but are out of their reach. So they're kind of forced for lack of a better word into requesting things that they want to do.

 

Lisa (22:59):

And motivated to request them.

 

Sarah (23:03):

The art of sabotage. Yeah.

 

Emily (23:06):

Yeah. But I think a lot of it is just helping parents like really pare down and, um, not—especially for our kids that are language delayed—um, you know, kind of do to decrease that distraction so that they can attend for a little longer.

 

Sarah (23:21):

So I know we talked about, um, requesting and labeling and, um, what was some of the other things I'm just thinking like the buzzwords that we've just talked about, what you can do with activities, but what, what else do we get? You know, what else does the play-based approach benefit us? What else can we do with it?

 

Emily (23:39):

Well, so I think just in general, we know that kids learn through play. So it's going to be, those really little ones, it's going to be the quickest avenue to them learning a new skill or, um, being more proficient with a skill that we want them to do. So in, in toys and books, and, you know, I consider books, a toy are just, there's so many opportunities for vocabulary. Um, and we can teach kids, you know, vocabulary and context through play, which is really important, you know, kids have to learn vocabulary and context to be able to continue to use it, um, in their expressive speech. Um, and it's just engaging, like when I sit on the floor and play with my fines and um, silly or make funny sounds, like they're super engaged and interested in what I'm doing and the longer that kids are engaged, the more opportunities we have to teach them. So I think it's just really about that engagement and prolonging the engagement with them.

 

Sarah (24:41):

It was interesting. I worked in a preschool and, um, the teacher, that's always an interesting dynamic first and foremost, to go into somebody else's classroom and to be truly inclusive in my therapy with that, it, with the teacher and the whole class as a whole. And uh, so we had some different ideas about lots of things, but one of them being play and very early on, I noticed that all of the amazing toys specifically like the kitchen and things like that were always locked up and out of the way. Everything was kind of off limits. And so I would bring that up, you know, like, you know, can we get the kitchen out? Can we do these play things? Oh, it's so distracting that just distracts them from all the learning we need to do today. And you know, we'll set aside some time, maybe this month, you know, to get the kitchen out for a special treat, you know, so I had to do it to try to do a lot of convincing and advocating about play and the benefits of it. Um, and it, it was a hard sale, which I was so surprised by because when it, when we finally would have that opportunity, when she would open up the kitchen and she could see the language that was happening in this very authentic natural way, I thought that should do enough. That should do it, right? Like that's going to show her, look at these kids who are talking and saying things and engaging and sharing. And turn-taking, and all of these skills that are happening while we play. And it just, that, that, that wasn't the case. She, she had, she hated the mess. She hated the noise.

 

Lisa (26:04):

And the lack of control. Then it's out of her--It gets more into what's going on kind of naturally versus whatever she had planned for that day.

 

Sarah (26:13):

Yeah. I think we do a lot of convincing with teachers in general about the benefits of play. I mean, it, I think more specifically, I'm thinking of older students, you know, where they're like, "all you have to do over there is playing games all day", you know, in a negative light. Um, so have you had any experiences with work with working with other members of the team and trying to encourage why play is beneficial?

 

Emily (26:34):

Um, I mean I think a lot of, I think, I think I see the same kinds of things you're talking about with teachers, with parents. I think as adults, we really forget how to play. Um, I think like my personal experience with my caseload is, um, and working with more parents, so I'm 38 and I work with a lot of parents that are my age and have little ones, so we're that much further away from our own childhoods. Um, and so I think a lot of it is about like getting, like I talked to parents all the time about getting down on the floor, getting down on your kid's level and just like remembering in calling up that child version of yourself, um, so that the kids are really engaged in interacting with us.

 

Sarah (27:25):

Yeah.

 

Lisa (27:26):

And that's hard because we're on our schedules.

 

Sarah (27:26):

It was really very funny cause I have my own children. And can I tell you I was terrible at playing with my own children? Terrible. I didn't enjoy it. I didn't want to do it. I'm really great with playing with other people's kids. Um, but I don't think that comes naturally to everybody.

 

Lisa (27:40):

Not only naturally but I think too, like I remember working with birth to three and preschool and then having my own kids and thinking back at that time, trying to implement the strategies that I was telling other parents to implement that seemed so kind of no brainer and easy, but then when you're in that situation, I remember thinking, wow, I feel like I'm talking a lot. I feel like I'm doing this, I'm doing that. It felt a lot different being on that flip side. Um, and then also to somebody that there's less, um, tolerance from kids, if they think that it's not just pure play, if they think you're trying to like coerce them as a parent, they sometimes they were like, no, I don't want anything from you. I just want a hug right now. And so there's the kind of the parent dynamic that can shift things a little bit sometimes.

 

Emily (28:25):

Yeah. I mean, I think it's, it's really hard for me. It is not my natural personality. I tend to be a more quiet, reserved, like more regimented person. So it's like I have to call, I have to do the same things that I'm telling parents to do for myself. So it's stepping outside of my comfort zone, um, a lot to, to get down on the floor.

 

Lisa (28:47):

Well, and even as parents, sometimes we're like, "I just need to cook dinner." Like they can play with their ball while I cook dinner. So sometimes life kind of gets in the way too where that's like, "Oh, I just schedule time to play." And so it is, it's like kind of a shift in mindset of the importance of it, that it's not just playing, it's developing those communication skills, the bonding that comes out of that.

 

Emily (29:12):

Yeah. And like once, so one little tweak that I was talking to really cause you were talking about being in the kitchen and cooking. So I encouraged one of the moms that I work with to bring some of her daughter, just like a small box of her daughter's own play kitchen stuff into their own kitchen.

 

Lisa (29:28):

Oh cute!

 

Emily (29:28):

So the little roleplays on the floor while the mom is cooking and she is able to kind of like, you know, the, mom's able to divide her attention and interact with her daughter while she's playing on the floor while she's cooking in the kitchen. And then there's like vocabulary tenfold, because she's talking about what she sees her daughter doing. She's talking about what she's doing, it's on a natural context and it's like this great green opportunity.

 

Sarah (29:51):

Yes. And that's one thing I was thinking of, you know, talking about scope and sequence of instruction earlier. Is there, um, I think this is where I kind of struggle sometimes, especially when I'm working with students that have more complex needs, um, or you know, very limited, limited language, you know, where do we, I guess what— actually, let me go back a second. In the pediatric SLP Facebook group, I saw a comment in and the student had a lot going on, but what stuck out to me first and foremost was no, no joint attention, no shared enjoyment, no, none of these very limited skills. And so I thought: there's gotta be a kind of a starting point, right? I'm not going to get any language until I can actually get this child to have some attention, joining attention with me or, or some kind of shared engagement. Um, so is there kind of a sequence to play?

 

Lisa (30:39):

There's a hierarchy to play.

 

Emily (30:41):

Yeah, definitely. That is the first thing is interaction. You have to establish some kind of interaction. And so in the Hanenburg and they talk a lot about establishing interaction first and then you can establish a back and forth interaction and then everything sort of builds from there. So that's exactly where child led play comes in. So you have to find, it could be like one teeny tiny little thing, but you have to find that one thing that's going to start the interaction and spark the interaction for the child and it builds from there. So yeah, I think eye contact and joint attention, are hugely hugely important. And those are for some of the, yeah, some of the lower kids, those are the first things that we're working on because you know, that has to happen before we can even begin to teach them or play skill or, um, you know, hope that they imitate a sound from us or something like that.

 

Sarah (31:39):

So how are we finding out, obviously we need something that's highly engaging for them to be able to have that, um, even interest at all?

 

Lisa (31:48):

So an inventory, maybe?

 

Sarah (31:48):

What's our best way to be able to find those resources?

 

Emily (31:52):

So a lot of times they do an inventory. Um, so in my like, first visits with a family, so I'd like to watch them interact with their child, but we also talk a lot about, you know, like what, what are the things that you're, you see your child naturally gravitating towards? Um, and I don't have any like, formal, you know, form or anything that I do that with. Um, I also just kind of look around and see what is there at the house. Um, cause those are often going to be the things that the kids are most interested in. Um, sometimes I come, I go into houses and there aren't a lot of toys. And so that's when I bring, you know, a lot of my own things in. Um, but some of the things that like I find, um, are super engaging for kids. Initially we talked about this earlier, bubbles. Um, I think like I don't see those a lot in kids' homes, so that's a great, um, I use those a lot actually for establishing joint attention. So I'll blow the bubbles, I'll try and catch a bubble on the end of the wand, which can be easier said than done. And I use that to build some engagement and attention and joint attention and eye contact, um, stuff like that. Yeah. But a lot of it is just kind of observing what's happening in the home already and talking to the parents and getting a sense of what does their day look like, what things their child seems to be most interested in and then working from there.

 

Sarah (33:13):

Do you have any—so I know you said bubbles is a favorite go-to. Um, what, uh, what other things are you, if I have a tool kit of the best engaging things, do you have recommendations for that?

 

Emily (33:25):

So I think bubbles are great. I love ball poppers are great. And a lot of times kids have never seen them before. So I think things that like have a reaction, you know, think about like those cause and effect toys that we use with kids. So I have, you know, the really simple cause effect toy that just has the five doors with the different switches. Those are really great for, um, little ones. Mr. Potato Head is like, my all-time, all-time, all-time favorite toy.

 

Lisa (33:50):

Windup toys. I love windup toys at home.

 

Emily (33:54):

Things that, things that have that cause and effect thing, um, like there, there are the other ball popper toys, the one there's like one where the ball sit on top and you have the hammer and then it kind of goes down like, a crack. Um, so things like that. So like, I like toys where the child has to do most of the work. Um, so I try to steer away from, yeah, like the battery powered stuff, although the windup toys are a little different in that regard. Um, so those are, I think those are a few of my go-to. And then books also. So like books with flats for the little ones are really great for engagement as well.

 

Sarah (34:34):

Yeah. I love books. I, it probably was my 90% of my therapy with always involved a book of some sort, just because you can do so much with one book. I could make a book last for a month if I wanted to.

 

Emily (34:47):

Yeah. I can use it with my articulation kids, with my language kids, and with my little, the little ones too.

 

Sarah (34:54):

So when do we stop playing? Is this only for our two to five year olds? Or is it something that we should be doing with our, you know, should we be introducing more play opportunities in elementary school, even?

 

Emily (35:08):

I think it's super, super critical for language development for kids up until, you know, or before five. But I play all the time with my articulation, my, you know, elementary aged kids that we're working on just strict, you know, really rudimentary articulation goals. Um, you know, if you think about the vocabulary that you use with individual toys, um, so like I was playing chutes and ladders the other day with my client who was working on his L sound. Um, and we've, you know, there's just a lot of words that are super great for lots of things. Cause there's all kinds of stuff that you can describe. Um, we talked about going up the ladder and down the ladder. And he went, um, before the ladder and after the ladder. So there were just lots of opportunities for him to target that L sound. Um, so in, I mean, in general, because I'm so play-based most of my caseload, um, my case would kind of tapers off those kids at an early elementary age, but I think there's lots of applications for play, you know, through the elementary years for kids.

 

Sarah (36:10):

I'm glad you said because Lisa, if anybody listening knows Lisa and I, we still haven't stopped playing and I'll be 40 this year. So I think there is always room for that. And I do, we, you know, we do joke a lot about how teachers—that's what'd you do today in speech, let me guess you played. And I just, I always will defend it to my last breath, uh, because that obviously the value we get from that engagement and the fact that we are targeting communication skills, you know, it all needs to be around kind of this idea and the memory and the attention and all the other factors that are involved with play. Those kids learn more when they're interested and excited and engaged. And so, you know, I don't feel like we needed to do any kind of like, argument as to why this is a good approach. Um, amongst therapists. I think we know that I think we do have to do some advocating though when we're working with other team members.

 

Lisa (37:09):

Well, and having the basis of understanding for ourselves and relaying this to our students to: why are we playing? Because when they're little, they don't necessarily need to know the why, but as they get older, I don't want them to leave the speech room in sixth grade and just say, "all we did today is play a game." We're using a game, either it's a reward, it's so some sort of generic reinforcer of turn-taking and opportunities and whatever, but I still want them to know their goals. Why are they coming in there? Or there are those games that you can incorporate language based skills within that activity. But again, I want them to know that we're not here because you're here to play. What is the one, Kaboo? Is that the one?

 

Sarah (37:50):

Caribou? Caribou, the SLP's most cherished game.

 

Lisa (37:53):

I know, the cherished Caribou.

 

Emily (37:57):

Miss Emily, did you bring the treasure game?

 

Lisa (38:02):

So that's the kind of stuff I think as my kids got older, there's always a place for fun and everybody works for different motivators. And I think sometimes too, we think that that when kids hit middle school or high school, that they also don't want to play. And that's so not true, just because they're coming a bigger package, they're still kids and they love it.

 

Emily (38:22):

Yeah. I used to joke with people that like, when people say, what do you, what's the speech therapist or what do you do? Oh, I get, I get paid to play. And then I was like, no, really. I'm super lucky. I get paid to play all day, but it's also really beneficial for your children, so.

 

Sarah (38:38):

And that's, I think that's what stuck out to me the most about the title of the book and the blog is the playing with purpose. And I think that's the key to the whole thing. Is it like in like what Lisa was just talking about too? I'm not just playing Caribou because it's my favorite game and I enjoy it. There's a purpose to it and there's a lot we can get from it. And so that piece that you get to have the benefit of educating parents on is huge. Um, and then we just need to do more advocating with our team members at our level, um, about the benefits of it.

 

Emily (39:09):

Yeah, I think the book is really to help like raise awareness so that people, parents and us as SLPs, anybody can be just like a little bit more intentional or know why they're doing the things that they're doing.

 

Sarah (39:22):

Yeah. Yeah. Is there, I feel like, I know I like, of course had all these questions and things I wanted to ask you. Um, is there anything else that we didn't touch on that you think would be important or our listeners might want to know

 

Emily (39:35):

I think one of the other, the other like single most important thing that I talk to parents and caregivers a lot about, and we're doing it right now, even though we are, um, on the computer with each other, but I talk a lot about the importance of face-to-face interaction. So I think it's important. I think we were just, I was just talking about being intentional. So, um, there are two really big reasons why it's so important that we spend time interacting with kids face to face. And so the two first ways that kids learn speech and language skills is by seeing and by hearing. And we know that his SLP speech and language pathologists, it's part of our title. But, um, when we interact in that face-to-face, um, way with kids, we really set them up for success for all of that learning that they're going to do.

 

Sarah (40:23):

I love that. I think that's a really powerful and something that gets overlooked, I think. And I think that's the other benefit. I mean, not only are you teaching these families how to play and interact with their children, which is again, such a strange concept that we have to learn how to do that, but we do, but the, um, attention and bonding and relationships that they're, they're creating with their kids, they may not have otherwise been doing. Yeah.

 

Emily (40:51):

You know, it's even when you're interacting with your two months old and you're holding them and you're feeding them and you're looking at them, you know, in their face and in their eyes, you're setting them up for all of that learning that's going to happen. And we use those skills as adults, we interact with each other and we do our best to look at each other and pay attention to each other and give each other that attention in that respect. So I think it's important.

 

Sarah (41:12):

Yeah. It's so interesting. Cause I, you know, my kids, um, are talkers like their mother, they are my children. Um, and they've always had pretty decent vocabularies and there are, I think they're very articulate children. They are no, by no means, you know, exceptional learners, you know, in comparison, but to other like genius level kids, I mean, they're smart. They're going to hear this and they're going to like, "Thanks, Mom." My point is, I don't think that they are geniuses, but their language is really good. And I know it's because of all the talking I did, which naturally just came to me, but I was always saying, look at this, Oh my gosh, can you believe, look what I'm doing, now I'm going to take this and I'm going to, I was always talking, you know, and I, and I didn't realize it until I worked in a school with, um, low economic, um, kind of status and, and working with really young, young kids. But I didn't realize that that's not natural for all people, all cultures, they don't maybe talk as much and engage. And so the program that we were doing, it was really teaching families how to be, um, having this, you know, parallel talk while they're with their kids and, and, and what kind of questions to be asking. And, um, it was, it was interesting because I, I just did that naturally.

 

Lisa (42:23):

I think I have a word inventory that I took with my first child. You know, you don't do that kind of stuff with your second kid, but when she was 10 months old, the words that she could say. It's somewhere. So, but that was one of those things too. Same thing. I was really honing in on her language use. It's so fascinating to learn about it and then actually have your little babies in front of you see how they develop.

 

Emily (42:46):

Yeah. And we talk to parents about, sometimes I hear people say, you know, you're the weather man. You're the sportscaster, you're the narrator, whatever word you want to use, but yeah, it's just about, yeah. I teach parents all the time. You just have to talk all the time.

 

Sarah (43:00):

Yeah. I like that. The narrator or the sportscaster. It's a good analogy of what it is that you're doing.

 

Lisa (43:05):

It feels awkward though.

 

Sarah (43:06):

It does feel awkward. Yeah. I do to my dogs though, too.

 

Lisa (43:11):

Can you demonstrate?

 

Sarah (43:12):

No.

 

Lisa (43:13):

I want to hear the pitch.

 

Sarah (43:16):

This is so good. Thank you so much for taking time to do this. Um, and talk about this topic. I, like I said, I don't think this is one that we naturally would have come up with. Um, but when you're super interested about, and so when it was a great opportunity to be able to collaborate with you and learn more about what it is you do. And I think there's gonna be a lot of interest, um, from our audience and it just opened up the door to, I think we tend to focus on school based because it's what we know. It's our comfort zone. So I love that we just opened this up to an even greater audience, um, of SLPs who are working with EI or that preschool population.

 

Emily (43:53):

Yeah. I appreciate the opportunity because I love talking about it. So thank you for letting me share.

 

Sarah (43:59):

Yes. And I'm going to attach resources too. I'll share your book and your blog. And if you have anything else, um, that we can share with our five listeners, um.

 

Lisa (44:07):

I told you six. Someone emailed this week.

 

Sarah (44:07):

Oh, Lisa says we're up to six. Um, if there's anything else that we can share, I will attach that to this episode. Um, so if we refer to anything that you can think of, then let us know and we'll make sure that, um, our listeners have access to that too.

 

Emily (44:21):

And I'm going to give you a discount code. So if anybody listening to us all today, wants one…

 

Sarah (44:29):

That's awesome. Thank you for that. That's very nice. All right. Take care. Thanks Emily.