SLP Toolkit Podcast, Episode 32, Transcript

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Sarah (00:10): \ Well, hi, Lisa. \

Lisa (00:38): \ What up, Sarah? \

Sarah (00:41): \ I don’t know. All of a sudden there was like a loud bang and it distracted me. \

Lisa (00:43): \ It could be the hedgehog. She’s active in the cage right now. I hear her kind of crawling around right now. \

Sarah (00:47): \ I do. I hear Penny too, which is weird. It’s daytime. \

Lisa (00:50): \ Yeah, but we’re here. She feels our presence. \

Sarah (00:52): \ That’s true. \

Lisa (00:53): \ And she’s like, hey moms, what’s up? \

Sarah (00:55): \ I know, okay. Well, anyway, Penny, keep it down over there because we’re recording a podcast and we literally came into the office today because we also have dogs at home and it gets like crazy loud. \

Lisa (01:06): \ Yes. They’re very great companions when you’re working by yourself, but not when you have to do anything with any other people. \

Sarah (01:12): \ Exactly. \

Lisa (01:12): \ That’s when they’re the most needy, it’s like kids. \

Sarah (01:14): \ Right. And we’re really just trying to step up our game over here with our audio and tech for this podcast. So hopefully this sounds lovely right now. Anywho. Okay, so really excited to record this episode. The last podcast that we published was about oral mechs and what that looks like during teletherapy. Then we had the one before that with Emily Diaz, where we talked about all things secondary and what that looks like teletherapy. And so naturally this is just obviously turning into a lot of episodes about teletherapy, but with different spins because of different lenses and levels of experience. And so we just recently published a blog post for one of our content creators, Jesse Kleinman. And it just developed into some other conversations that we thought would be really valuable for an episode. So without further ado, we’d like to welcome Jesse into our confessional. \

Lisa (02:13): \ Welcome. \

Jesse (02:14): \ Hi. \

Lisa (02:16): \ Hi. So you are based out of Brooklyn, right? \

Jesse (02:20): \ Yes. So I’m working in Brooklyn but I’m living in New Jersey. \

Lisa (02:26): \ Okay. What’s kind of the pulse of how things are going there with therapy, schools. Like, are you in person, are you teletherapy? Are you a mix? \

Jesse (02:36): \ So we were teletherapy from March until late August. I went back in person for a little while. And as of today, I’m back doing teletherapy. \

Lisa (02:48): \ I think that’s probably going to be pretty common. So even people right now that think they’re going back, I don’t know how long it’s going to last. Even with my own daughter starting back in high school, in like a week or two. And I’m like, maybe we’ll see, see how it goes. \

Jesse (03:04): \ Yeah. It’s kind of all a waiting game. \

Sarah (03:06): \ I just saw something– it is, I mean, nobody knows what to expect since this is new and you know, the new word of 2020 “unprecedented.” I was like, everyone just wants to go back to being precedented. But I just saw something on Facebook today, an article about the new normal. And what does that look like? I think probably not ever– I mean, not anytime soon, going back to the way we know and think of things. \

Lisa (03:30): \ It looks like being flexible and yoga pants. \

Sarah (03:32): \ Yeah, true, good point. Good point. Okay. So Jesse, before we kind of get into the meat of the episode, will you just tell us a little bit about your background, the setting you work in kind of your passion areas or anything else that you think would be very valuable for listeners to know? \

Jesse (03:50): \ Sure. So currently I’m working in a private specialized school in Brooklyn. I work with students 5 to 21 with a variety of different complex needs, ranging from autism spectrum disorder to childhood apraxia of speech. And I recently started to get into the world of teletherapy, which kind of developed into me also helping other providers with teletherapy during this time. \

Sarah (04:20): \ And I love that. We were talking a little bit about that before. And I had asked you, is that always been something you’ve been interested and looking forward to it? Or is this new kind of level of support and education you’re providing because you were thrown into it? And you had said, no, I was thrown into it and I had to figure it out. But, you’ve always been a tech savvy person. And that gave you probably a bit of an advantage. \

Jesse (04:42): \ Yeah. I mean, I’m only three years out from grad school, but I’ve kind of always, self-taught different technology things. And I think I got lucky and I fared a little better when it came to teletherapy because of that. So I felt like I needed to help other people when they were struggling through all of this in whatever way I could. \

Lisa (05:05): \ Well, and I think there’s different levels of comfort with technology from even like the perspective of how long people have– how old people are and how long they’ve been SLPs. Because, you know, you are of an age where technology has kind of always been around and accessible and that’s not the case for a lot of people. So it wasn’t even just the sort of switch from, I’m doing something familiar in person to going online, but then how do I even navigate online and how do I track my data? And how do I manage all of this? So it’s, it’s hard. I think the older you get, you feel like you’ve got something figured out, but I feel like in our field in general, there’s always something or someone who will show you, you don’t know crap about crap. And enter COVID. \

Jesse (05:50): \ Yeah. I think it’s been a very overwhelming time. And I was saying earlier, I’m in a lot of the Facebook groups and in those groups, I kind of saw there was a need for this support. People were nervous, they were struggling. They didn’t know what to expect, but if there’s one thing I’ve found, I think all speech therapists are really good at adapting and this wasn’t necessarily the way we wanted to adapt, but we’re figuring it out anyway. \

Lisa (06:16): \ Well, I think most people were in denial at first. I feel like it’s like the stages of grief or something, because I think this all hit us around March or whenever it was. And then things just shut down. And so people are just uncertain in every level of their lives, whether it be professional or personal and trying to figure out what this all means. So at first, even when there were resources out there, I think of even we put on SLP Telecon that ran through maybe like the first week of May. And so I think people thought like, oh, it’s just the summer is going to come and we’re going to get stuff figured out and then we’ll be back in the fall. And so now that that has happened for some people, but not for everyone, I do think that it’s that kind of okay, I’m going to accept this. That really nobody knows anything and that things can change day-to-day. So that’s a great space to be in for even problem solving and figuring out how to adapt either way, because like you said, I think we are actually as a profession, really good problem solvers and good at adapting for our students. I don’t know if that’s always the personality trait for applying to ourselves though. We’re good at being in that type A kind of personality type. \

Jesse (07:28): \ That’s exactly what I was thinking as you were saying that \

Lisa (07:31): \ Mapped and rigid and you know– so it is. And I think we’ve finally come to that point we’re like okay, maybe we just do have to go with the flow here and free fall for a little bit, but get it figured out. \

Jesse (07:42): \ Yeah. I think there was just a big adjustment period. And like you said, we don’t know how long this is really going to go on for. I think at this point I’ve kind of accepted I need to get used to teletherapy at least for the time being. And I actually really like it. I was worried with my caseload because it is so complex. I wasn’t sure that it was going to work for all my students, but it actually worked out surprisingly well, I don’t know if it was– \

Lisa (08:09): \ Are your parents involved? \

Jesse (08:09): \ Yes. \

Lisa (08:09): \ Have your parents been involved in the session? So that’s probably the big hurdle I think for a lot of people is if you could even get parent involvement to start because it all sort of will fall from there, whether you have somebody that’s there to kind of support you on the other end or not. \

Jesse (08:25): \ Right. So for a lot of my students– it’s different per student. I do have some older students that’ll sit there and be able to do the whole session without a parent there, but I think it’s really important to have the parents there because they get to see what you’re doing and then carry it over in different ways. Some of my students are on devices. They might not know how to necessarily prompt the appropriate way. They might be over prompting. So I think it’s really important to have them there. And parent coaching obviously is always super important, but I think it’s even more important now than it ever has been. \

Lisa (09:01): \ And usually parent coaching, we don’t have the opportunity to do it as much as we’d like. It’s like always great in theory, like, yes, I would love this device to go home and parents to be implementing it seamlessly throughout the home. And then it comes back to school and we’re all on the same page, but really that’s not always possible. But I think that is kind of what– if you look at the silver lining of this cloud, it’s we are getting to be in homes, working with parents, doing some training, and this is the same kind of training that really we should be doing with our instructional assistants, or paras that are supporting in the classroom and our teachers. And that we’re not just the only people that support this child with this device. It has to be throughout the day and consistent. \

Jesse (09:45): \ Yeah. And I think I’m also lucky I work in a very collaborative environment. So we do have a lot of that training for our parents and our one-to-ones. But with the parents, I don’t think we’ve ever had an experience like this where they’re there when we’re implementing therapy. And it was definitely nerve wracking at first. I mean, obviously I was a CF, I had my supervisor watching my sessions, but it’s a little different when it’s a parent and they’re watching everything you do. But I think it’s also a benefit, like you said, because they are able to carry it over and we’re training them in different techniques and strategies that they could use with their children. \

Sarah (10:23): \ Yeah. How did you get past that? Cause I have to tell you, I have a hard time with anybody supervising me \

Lisa (10:30): \ I can second that. \

Sarah (10:32): \ Yeah Lisa was my supervisor. It always has made me uncomfortable. My principals, when they would come in and do the classroom observations, I kind of panicked, but even a parent more so than anyway– I feel like I probably want to impress a parent more than anyone. And so how do you kind of get over that idea? because– \

Lisa (10:51): \ getting over yourself. \

Sarah (10:51): \ Yeah. Because they’re there. You know what I mean? The principal only comes in once a year usually. But this is happening all the time now. So how did you get through that part of it? \

Jesse (11:01): \ You know, I think part of this climate was everyone adjusting to a lot of differences all at once. And I think the parents were very understanding and I got lucky again with my parents, that they wanted all of this information. They wanted to be able to help their children. So I think for me that made things a little bit easier, but I also just think it’s about the way that you’re delivering the strategies and techniques. So the parent– which is also a little bit challenging, you’re kind of walking a fine line. But I kind of just went with the flow and tried to let it do its thing there. \

Lisa (11:41): \ So are you doing more in the moment stuff? Are you spending– are you allocating certain times of the session to parent coaching? Do you wrap it up with just them or is the whole focus on the kids? Or do you have things that you’re sending home or emails? How how does this look in real life? Like what have you found to be the most successful way to do this with parents? \

Jesse (12:00): \ So when it comes to AAC, I think the prompting I typically do in the moment that also took some adjustment. I needed to make sure that I could see the device, that I could see the student’s hands and the parent’s hands, because sometimes you just hear the voice output and you don’t know who’s pressing what button. So I definitely needed to make sure that I could see the device. And I wanted to make sure that the parent understood the different levels of prompting and why it was important to provide less prompting during certain situations. But in addition to that, I definitely send a lot of materials home in regards to like the communication bill of rights and things like that, because I want them to understand the importance of having the device and using it throughout the day beyond just the levels of prompting. Also modeling without expectation and things like that. So it’s kind of a combination of things. If I have to, I will also do additional sessions to program devices or talk about other parent training techniques. \

Sarah (13:06): \ Have most of your sessions been individual or are you seeing any students in groups? \

Jesse (13:11): \ So I’m mostly individual, but I also was doing some groups. I ran a social thinking group in two different classrooms that I have. But for the most part they were individual. \

Sarah (13:23): \ Okay. Cause that’s the one thing I still don’t think I can quite wrap my head around. I was supporting my nephew while– they’re back in person right now, but I was supporting him for a little while and was able to be a fly on the wall when he was receiving his speech services and it was a group. But he’s got learning disabilities and things, but it’s a little different. There was no devices or anything like that, but it was just interesting to see watching her try to keep them all on task and take turns and make sure that they’re actually looking at the computer. I mean, they’re young. And so it was fascinating to see what this looks like. And so I’m curious and I– maybe we should take a poll or something. How many– because if you’ve got a really large caseload, I don’t know how you can avoid groups. \

Lisa (14:12): \ You’d be working all day, all night. \

Jesse (14:14): \ Yeah. I have a pretty small caseload, but the groups are definitely more challenging. I mean, I kind of had to mute students sometimes. They are with their parents. And the parents totally understand, I need each kid to have a turn, but for the most part, they were pretty engaged. This was with my older students. So it’s a little different, but yeah, the groups are definitely a challenge to navigate. \

Lisa (14:40): \ As an aside, have you ever considered moderating a presidential debate? You sound like you’re highly qualified. \

Sarah (14:54): \ That might’ve gone better. First thing out the gate– is Lisa and I are side texting for the whole thing. And the first thing out the gate I go why don’t they mute his mic? Why can’t they mute his mic? \

Jesse (15:02): \ I said the same thing. \

Sarah (15:05): \ Oh geez, it’s amazing. \

Lisa (15:05): \ Did I totally throw this off topic? Where were we? \

Sarah (15:14): \ Oh! One thing I meant to ask you back when we were really talking about the technology is are you guys using zoom or what is the platform you’re using to provide services? \

Jesse (15:22): \ Yeah, we’ve been using zoom. \

Sarah (15:24): \ Okay. Which I do think there’s a distinct advantage there. It makes me sad when I see that some school districts weren’t allowing the use of zoom. And so they’re using things like– I can’t even think, was it WebEx or something they were using? that doesn’t have the same functionality as Zoom \

Lisa (15:35): \ Chris Wenger talks about Canva. He put a whole course on how to present– which it’s not, that’s not a program that was designed for live instruction. It’s designed more for online instruction, meaning that self paced, sometimes we get together– \

Sarah (15:57): \ Oh Canvas. \

Lisa (15:59): \ Canvas. \

Sarah (15:59): \ I was like Canva that site we use for all our social media posts? \

Lisa (16:02): \ No, I’m sorry, Canvas, Canvas. But no. And I’ve used that a little bit, not for instruction, but when we worked in the school district, I had to do some professional development courses and try to design them on there. And I was like, no, I’m out. I’m not doing this, it’s too hard. \

Jesse (16:17): \ Yeah. Canvas is very complex. I used it in grad school, honestly, that’s the program they used. So I don’t really know how people are using it for teletherapy. \

Lisa (16:27): \ I know. \

Sarah (16:27): \ I know. And they’re being expected to adapt because that is the benefit of being able to use zoom. There’s just more features. I think it’s simpler. I noticed a lot of problems with watching these teachers trying to share their screen and doing some other things on WebEx that made me think, hey that is not a user-friendly program. That’s just a whole other hoop that you have to jump through. \

Lisa (16:52): \ and that’s even if you take out the pressure of doing your job, and trying to manage all of that. Even personally, I think about sometimes when I have an update on my iPhone, I’m like, well, crap, where do I find this now? So that’s the thing that I don’t think administration always thinks about is that this is a burden on– not that we can’t figure it out. Not that we won’t figure it out, but I always loved besides what’s going on now. But even in our school district that we worked in, things would just be new and people would just be like, well just figure it out. Like you’ll do it. And I’m like, okay, well you do it first. And then tell me how easy it is. \

Jesse (17:29): \ Yeah. And I think (simultaneous speakers) Oh, go ahead. \

Lisa (17:33): \ No, go ahead with your thought. \

Jesse (17:35): \ I was just going to say with zoom there’s screen-sharing, there’s annotate, all these extra features. There’s a laser pointer. Some of these apps– \

Lisa (17:43): \ to make it more engaging. \

Jesse (17:43): \ Yeah. And I would just circle things and wait for my students to realize that I’m circling something and then it would get their attention back. So I think there’s a give and take with different ones. There are definitely some benefits to Google Meet that Zoom doesn’t have, but each one has its own benefits and drawbacks. \

Sarah (18:07): \ I just like the backgrounds and the filters. They just added the new filters, like Snapchat filters. That’s engaging. That makes a student far more interested in staring at a screen when there’s something fun to look at you know? \

Jesse (18:21): \ Yeah. I love those filters. I actually showed up to a session, a few different sessions, one with the turtles on my head and my student was cracking up talking about turtles. And then another time I showed up as a pineapple, that one was a little scary. She didn’t love that. I love the pineapple. \

Lisa (18:41): \ Note to self: ditch the pineapple. \

Sarah (18:42): \ No more pineapples. \

Lisa (18:44): \ So you have talked a few different times about that your caseload ranges from 5 to 21 and that the majority of your caseload are students with complex communication needs. So how does that look from a therapeutic standpoint when you’re doing this via teletherapy? Where you do have to rely on parents or external cueing and maybe– I think even behavior is hard enough to manage when you’re in the same physical proximity, let alone if you’re separated by a computer. How does that work? \

Jesse (19:15): \ It’s definitely different than being in person. I have implemented different visual schedules, token boards, and some things that I’ve found or made myself. So I’ll kind of share my whole screen and have that open during the activity. And that’s worked pretty well. It’s pretty similar to what I would have done in person on a whiteboard if I was writing out their rules on the text. I’m basically doing an online version of that. And some of my parents have experience with dealing with the behaviors that they see with their child. So they also know how to redirect them, but it’s definitely been a challenge. There’s not really a getting around that. It’s different. But I think we also have to just think outside of the box and adapt and it’s implementing the same types of things we would be doing if we were in person, just in a different way. \

Lisa (20:13): \ So again, you’re talking about let’s get over ourselves because I think a lot of this stuff can be done, but it’s just how do I transfer this from this in-person, brick and mortar setting to tele-therapy? So I always think too, we are living in an age where if you are having trouble with something like that, follow people or get in those Facebook groups and ask how people are doing that. Because everybody’s in the same boat, everybody’s trying to figure it out and you know somebody has. So there’s just so many resources we can tap into now. \

Jesse (20:47): \ Yeah. And I think– \

Lisa (20:52): \ What was your most– what was the thing you struggled with the most when you first made that transition where you were like, oh, I didn’t even expect that, now I’ve got to figure this one out. \

Jesse (21:00): \ I really think just getting used to tele-therapy in general. Obviously I had some no shows in the beginning. I think just getting used to the fact that this was unfortunately our new normal, and once I adapted to that, I was able to kind of just run with it. Like we said earlier, I’ve kind of always had a knack for technology so it’s actually been fun for me to do the research and find different things and even going on those Facebook pages and just asking, hey, does anyone have resources for answering why questions? And then I’ll get 10 comments of different speech therapists telling me, hey, this is a great resource for that. So I think also using that community to your advantage is really helpful. \

Lisa (21:44): \ Yeah. And we’ll share in our, in our resource part of the podcast episode any of those Facebook groups that are awesome for tele-therapy. And then you also have created a Facebook group specific to building that community to help with supporting the service professionals. Correct? \

Jesse (22:03): \ Yeah. So when I was in these Facebook groups, I kind of saw a need. Different educators and speech therapists were kind of just struggling and I felt like with my love for technology and the fact that I had been doing teletherapy, I wanted to try to support them however I could. So I created this tele-therapy materials for speech therapists. I also created a YouTube channel doing some tutorials, using different apps and things like that. And then I’m also doing one-on-one support for people who need extra tele-therapy support. So I’ve kind of spent quarantine doing some of that. As I was learning, I was also able to support other therapists, which I thought was really cool. \

Lisa (22:52): \ That is, that’s amazing. \

Sarah (22:52): \ I think so too. I think obviously we have created something that was built on a problem that we personally had. We created a solution for that. And so one; we always love to see other people doing that. Recognizing there’s an issue and trying to figure out how they can help solve it. But I also think– and this goes back to Lisa and I have been very open with this, hence the reason we have a podcast called True Confessions. Is we are not always confident in our knowledge and areas of expertise in all areas. And some of the ones that we spend the most time talking about are not areas that I would have ever considered myself an expert in. And we had to get past that because I think when you’re really close to something and it’s personally affecting you, I think you have a lot to offer. And so I love that it’s not like you’ve had years and years of running a tele-therapy practice and then now you’re going to come out and tell everybody just how easy it is, and look, I’ve been doing it this long and this is what it looks like. You are a school-based SLP who has taken– had been literally thrown into this headfirst. \

Lisa (23:59): \ Two and a half years out of school. \

Sarah (24:03): \ Right. So I think you’re the perfect person to help provide that support because you’re in it and you are working through it yourself. And so I love that you’re offering that support. I’ll put a reference to your group and YouTube channel as well, so people can check that out. \

Jesse (24:18): \ Yeah. At first, honestly, I didn’t know what it was going to turn into and it is a very small support group, but I do think that it’s a great thing that I’m able to use this knowledge to be able to help other people. Because I know it’s a hard time for everyone and anything that I can do to try to make it a little easier, then I definitely want to do that. \

Lisa (24:40): \ Is it just speech therapists in that support group? Or are you also supporting parents and teachers and other related professionals? \

Jesse (24:46): \ So it just so happens that it’s all speech therapists, but I kind of put it out there to other educators. There are some specific rules for posting in some of these Facebook pages, especially if there’s like a monthly membership fee. So I had to be careful about where I was putting it out there, but I would definitely welcome educators or parents if they were interested as well. \

Sarah (25:07): \ Yeah. That’s super cool. I love stuff like this. It made me think of one other thing too, when we were talking about the kinds of supports people need. So we talked about the technology, we talked about the getting over the problem with having parents present and watching you. We talked about the behavior challenges we are experiencing via the screen. What about materials? And adapting the things that you’re using and what do you find yourself using a lot that you’re able to share with other therapists? \

Jesse (25:47): \ Yeah, so I keep saying that YouTube is one of the best resources out there. You can find so many read alouds. There are teachers who have created full lessons about problem and solution and inferencing and things like that. So I’ve definitely would go to YouTube first and then kind of go from there. I always start with a YouTube video, whether it’s a hello song and then we go to a read aloud, and then maybe a boom learning activity. But typically I’m on YouTube, Epic, Vooks or boom learning. That’s pretty much where I find most of my resources. And then again, from the speech therapy community. Whether that’s on Instagram or Facebook, I get so many ideas because so many people are going through this collective trauma at the same time. And I think everybody kind of wants to help everyone else if they can. So I would definitely look to the community also for extra resources, but starting with YouTube is definitely a good place to start. \

Lisa (26:57): \ How has this impacted your opinion of when you do go back in person again? The next time? Will you be incorporating these same sorts of activities or are you feeling like this is more specific to just your role in tele-therapy? \

Jesse (27:12): \ So, because I’ve actually already been back, I can tell you that I have used some of the materials during my sessions. I definitely don’t use them every session. I have paper materials that I’ll use or laminated materials, but I’ve used a lot of the boom learning activities. I’ll just have an iPad. And also that way I’m able to sit a little bit further from my students. So I’ll have the iPad on the table and just let them answer the questions during those activities. I’ve definitely still used YouTube videos, but I think more so that’s a teletherapy thing rather than I would use it in person. I do use some of the books on Epic and things like that, just so that I don’t have so many hands on all the physical materials. And I think that’s another key thing there. If you want less touched surfaces, keep everything on the iPad. And it’s definitely still a thing you can use during in-person sessions. \

Lisa (28:08): \ Well, and even it’s funny, I have a daughter who’s a junior in high school and she was talking about going back. And one of the things that she’s going to miss is she likes the digital presentation of materials, or even like in a math class, being able to just grab something out that she says, if I do this on the computer it takes me seconds versus if I do this in class, I’ve got to draw everything and it takes so much more time. So she’s like, I wish they’d just let us bring our laptops and use these like we’re using them in these online classes. And I think that parallels to even with SLPs, the materials that we’re using. There’s so much cool digital things that it doesn’t have to be that you’re using it just because you’re in tele-therapy. And even YouTube. I used to love YouTube for even pulling up commercials like the Geico commercials. And you can work on all of the different figurative language in those, and the jokes and everything. Or I love if you have a book that you want to go over and you don’t have a physical copy in stock, there are so many people that just read books on YouTube. So flip through the pages and you can stop and you can talk and you can analyze, and you don’t have to have a physical copy of the book. So I am one that I’ve always, I love digital stuff. I hate paper so much. So much. \

Jesse (29:24): \ And something else that I thought of when you were saying that, I love using Pixar shorts. They’re really good for problem solving, inferencing. The kids think they’re really funny. There’s one, I think it’s called Ormy the pig and the pig’s trying to get a cookie, the top of the fridge. And he tries to do all these crazy things to get the cookie. And he ends up with a cookie jar stuck over his head and he can’t eat the cookie. So there’s a lot of fun videos like that. And those are all wordless. So you can kind of pause and say, what do you think is going to happen next? And then you’re working on predicting, and then there’s different ways you can incorporate inferencing. And I’ve always kind of used YouTube videos that way. So it was kind of an easy transition when I went to tele-therapy, but I’m still incorporating some of those factors into my in-person sessions definitely. \

Lisa (30:16): \ Yeah the kids love it. Kids, even when you think about videos, that is their preferred format for learning. And so when we put worksheets in front of them, it’s not always something that they relate to, but they’ll get engaged in a video in two seconds. \

Jesse (30:33): \ Yeah. And I think that’s, what’s so good about the boom learning activities because when you get it right, they get a bing and then when they get it wrong it goes whoops. And they think it’s really funny. One of my students kept pressing the wrong answer because he just wanted to hear the whoops and he just kept laughing. So I had to have him tell me the answer. And then we went back to the activity so that he could click all the wrong answers and press whoops. But yeah, they’re really fun. It gives them the positive feedback right away, and that’s a great thing you can still use in person if and when you transitioned back to that. \

Sarah (31:12): \ What about with your students with more complex communication needs, I know you said we talked a little bit about AAC and what that looks like as far as parent modeling and prompting and things like that. But what does a normal or a typical session look like? \

Lisa (31:24): \ And what kind of activities are you doing via teletherapy? \

Sarah (31:26): \ I imagine you’re kind of focused maybe on just like one target or and like how long are you doing that? Is it 20 minutes? One on one with that child? What does that look like? \

Jesse (31:35): \ So typically, yeah. Yeah. They’re typically 30 minutes. I do a combination of things. There’s actually a lot of really good resources on YouTube, again. There’s some AAC read aloud videos and then there’s AAC sing along. So I usually start with like some type of AAC sing along and then I’ll either do an AAC so you read aloud or just a regular read aloud and I’ll create a topic board or some type of visual support with all the key verbs and adjectives and nouns that I want to focus on for that session. And I’ll have the topic board or the visual supports open alongside the book and I’ll share my whole screen. And then I’ll use that laser tool or draw a circle around the word as we go through it. And also on boom learning, there’s a lot of core vocabulary activities. So if I was focusing on “go” for an entire activity, I would try to make sure that my first song had the word go in it. And then maybe I would read a book that had a lot of go in it. And then we would do an activity on Boom where they would have to go through all the pages. So there’s definitely some focus on core vocabulary, but I’m still incorporating fringe also. And then again, with the parent coaching, I’ve sent home a lot of strategies and ideas for things they can do during daily routine things like laundry and cooking and things that they can focus on with using the device during those activities so that they understand the importance of that. And modeling as well. \

Lisa (33:12): \ You’ve talked a lot about your support within working with parents. How is this looking for related professionals and teachers? Are you able to do any cooperative– not even just sessions, but how are you having meetings? How are you getting IEPs done? How is everyone coordinating this to make this kind of less painful? It’s hard enough when you’re in person to coordinate. \

Jesse (33:33): \ Yeah. I definitely am in contact with my BCBA at my school and the OT. It’s definitely more challenging when we’re not in person. We were having zoom meetings once a week to kind of go through things. But for the most part, like I said, when I’m in person it’s pretty collaborative. So if I had a question or wanted to collaborate about something and reached out to a related service professional, they would always be willing to help. I’m definitely lucky in that respect. But it’s definitely harder over teletherapy. I think everybody needs to make that extra effort. And when everybody’s already so drained from doing teletherapy, it’s not necessarily the first thing on the agenda, but I do think it is important just to make sure everyone’s on the same page \

Lisa (34:20): \ Well drained from not just teletherapy, but life and the circumstances around us. This is a really heavy year on so many levels. There’s a lot of stuff going on. And so I think we tend to forget that and how that can trickle down and impact even our working relationships and getting stuff done for students. \

Jesse (34:40): \ Yeah. And I think I’ve tried to focus on the positives during this time. It’s definitely harder. But for me, I feel like it’s been a time for me to start this teletherapy support group. I actually started my private practice also during this time. So it wasn’t just me doing teletherapy. I feel like I was able to focus on other things that were important to me, that I actually didn’t have time for before. So I think there’s a lot of positives that can come from this time. It’s more a matter of changing our mindset and what we give power to has power over us. So what we focus on expands, so I think if we try to see the light at the end of the tunnel and try to see the positive, there are some benefits that can come from this. It’s just a matter of getting over that really hard hump. \

Sarah (35:35): \ Yes, you nailed it on the head. You nailed it on the head. \

Lisa (35:40): \ You hit the nail on the head. \

Sarah (35:42): \ Oh my gosh, who knows? \

Lisa (35:43): \ You nailed it into the door. \

Sarah (35:47): \ Anyway, I really appreciate your point because that is something we talk about all the time is mindset and what you choose to focus on, and so I love that you said that because now more than ever before, we’ve got to be able to spend what energy we have trying to just make the best out of this crap situation. And you know, this is tough for a lot of people, but Emily Diaz– what was the quote from their district that we love so much? Compassion over compliance. And I love that the district had that attitude because it’s one thing for all of us service providers to provide grace for ourselves and the families that we’re working with. But then we still have this fun level of administration and other compliance issues hanging over our head. Lisa had asked a little bit about this, but as far as writing the IEP and determining goals and stuff, are you finding an effective way to be able to assess students’ current needs and help identify goals for the next annual review over tele-therapy? \

Jesse (36:57): \ Yeah, it’s definitely a challenge. I think that for the most part, when my students join my sessions, which is the most important part, I’m still able to determine whether or not they’re meeting their goals and then try to think about the next step from that goal. But again, it depends. If your students aren’t showing up to your sessions, it’s a little bit of a challenge. But yeah– \

Sarah (37:22): \ Yeah, what’s happened in that case when you’re not meeting their service minutes as far as your district? \

Jesse (37:29): \ Yeah. So I’m a private school, so it’s a little bit different. We were also kind of changing around the minutes and we were also providing a lot of pre-recorded materials, so that also worked into their schedules. So instead of doing the full 45 minute sessions, however many times they had a week, we were doing some pre-recorded stuff that could be anywhere from five to 25 minutes. And they might have prerecorded speech materials a few times a week. So they’re getting a lot of speech therapy materials outside of the live sessions if for whatever reason they can attend. A lot of these families have multiple students that are home and they need to do zoom sessions for all of their children, maybe at the same time. So it’s definitely, like you said, compassion over compliance there too. I think it’s just an adjustment for all of us and we have to just kind of figure out the best way to navigate it, however we can. \

Lisa (38:31): \ Can we just tell that to the attorneys too, that are suing districts? Like, dude, compassion over compliance man. \

Sarah (38:37): \ Are there lawsuits? \

Lisa (38:38): \ No, I think there’s going to be. \

Jesse (38:40): \ I think there probably will be. \

Lisa (38:41): \ I bet there are practices that are specifically looking at how to maximize their profits based on current circumstances. But I think for me, what I don’t really understand when it comes to that is if a student is not fully accessing their curriculum then the needs change, right? So if you have a kid that was in person, 30-35 hours a week, and now is getting some prerecorded stuff and maybe an hour a day or something, then we also can shift our supports because really everything we do should be about access to curriculum according to IDEA. We’ll see how that plays out. \

Jesse (39:23): \ With the access to curriculum, I mean, if they’re not joining those zoom sessions then they obviously don’t have access to the curriculum. So I know a lot of my friends have had issues with their students just not showing up whether you send three or four reminders, but again, some of these families have three or four kids at home and they might not be able to have their student join the zoom session at that time. So also making adjustments in that end. If you have to make changes to your schedule so that it works better for the family, definitely have to look into that in some cases as well. \

Sarah (39:58): \ Oh, it’s going to be so interesting to see how this plays out. I don’t know– again, just with my own family and children and nephew and everybody else, I’m seeing this kind of different perspective on– of course I worry. I worry about my little nephew being able to come back from not being in school since March. And he’s got all of these special needs and things, but at the same time kids are resilient. And, again, I think it’s the idea of how do we take this? What do we learn from it? How do we make improvements in the future? Even if everything does go back to quote normal, come January will we be better prepared in the future for something like this? And so anyway, any other things that you would want to share with listeners who are having these same kind of struggles? I feel like we just covered so much. \

Jesse (40:54): \ Yeah. I would just say, honestly, stick with it. I know it’s a really challenging time for all of us, but like I said, try to focus on the positive and if you want to reach out to me for extra support on here, and there’s a lot of great free resources online that you can use during your sessions. And definitely look into those Facebook support groups. Everybody’s kind of going through this collective thing at one time. And I think it’s the first time that the whole world has been kind of experiencing such a difficult thing all at once. So there’s other people that you can vent to and talk to about this. So don’t feel like you’re alone. We’re all going through it and we’re all kind of in it together. \

Sarah (41:39): \ Yeah. I love that because you’re right. I’m in a lot of those tele-therapy groups and the tone is just different and I say that because Lisa and I have been very honest about not all Facebook groups are so lovely. And you’re almost afraid to ask a question because you’re going to get attacked for being stupid or not using evidence. And so the tele-therapy groups are lovely because I do think everybody’s like, yeah, we get it. This is hard, and I figured it out and let me share it with you versus how do you not know this? So it’s nice. \

Lisa (42:10): \ And I love the perspective it’s given to people that would never have given the respect to the work that tele therapists are doing out there and being able to experience it and see how that’s working with students. And that it’s just as valuable of service delivery as in-person. \

Jesse (42:32): \ Yeah. And I was just going to say, I think also make sure you’re taking care of yourself, whatever that looks like for you. If that means taking a bath or having a glass of wine or doing a spin class or doing some yoga, make sure that you’re taking care of you and not spending all day on work and looking for materials. You deserve your life too, everything isn’t just work. \

Sarah (42:57): \ Yes. Well said. \

Lisa (43:01): \ Well said, Jesse Kleinman. \

Jesse (43:03): \ Thank you. \

Sarah (43:04): \ Thank you so much for having this conversation. Again, we really love when we can chat with somebody who’s in the trenches and is experiencing this and is taking it and how you’re able to learn from it, and grow, and now support other people. So we really appreciate you. This has been a great conversation. \

Jesse (43:22): \ Yeah. Thank you guys for having me. This was great. \

Lisa (43:25): \ And we appreciate you, our listeners as well. If you are loving what you’re hearing, please take a second to rate and review us. It helps other people find the podcast, which is awesome. \

Sarah (43:35): \ If you don’t have anything nice to say, just keep it to yourself. \

Lisa (43:37): \ Yeah, and rave review only. And by that I mean give us five stars and talk about how lovely we are. \

Sarah (43:45): \ Bye. \

Jesse (43:46): \ bye.