 Hi Kim. Can you hear me? I was having computer troubles and I thought, oh no, not today. No, no. My other computer, which will be fine as long as I don't unplug it. So anyway, I think we're good. So you want to do a little testing of some of the. Yeah, so I will do, I have two kinds of videos. One is embedded, or like some are embedded and some are through a YouTube link. So just want to make sure both work. They both work. And I got some stats that said 27 people watched the last, the recording of the last one. So that's great because I can listen to that. In addition to the important sound that we're on. That's fabulous. Yeah, I was really pleased. Wonderful. Let me see. I'm going to share. And I think in this case, I'm sharing my desktop, not my PowerPoint, because it will go online. So. Yeah. And if you show your, show your desktop, you can, then everything, right? Exactly. Yeah. Okay, so you see that. All right. Okay, so I will just, okay, here's a little guy online who's the cutest ever that it is actually time for us to begin. So I think I'll end the poll. I think we can see from the poll that we have quite a few SLPs and a couple of OTs, which is great, because this is certainly something that is that as everything is, it's combined work, but it's really nice to have that. So I'm going to get the poll out of the way and, oh, share the results. So there it is. Can everyone see the results of the poll? 72% SLP, 11% OT, 6% AT specialist and 11% other. Yeah. So 6% is one person. That is one person. Yeah, yeah. Which is great. All right. So, and some people in the chat are going to say who they are when they have groups of people together. So thank you all for attending again today. And certainly thank you to Kim and Kerry for continuing part two of this series for us. And I, for one, and I told I told Kim this as we were starting that I actually have actually started using their framework in meetings because it really helped people to think this through. So, which is why I guess I was so excited to have you talk to us. That's a practical thing. So welcome again. Kim is the SLP on the team. Kerry is the OT on the team. I'll let you guys talk a little bit more about yourselves. I'm hoping that everyone has watched part one, but if you haven't, you can go back and do that. And I guess with that in mind, I'm going to mute and I'll follow the chat and hand it over to you, Kim. Great. Thank you. Good afternoon, everybody. Welcome back or welcome for the first time. We are really going to be launching off of our first session. So we do a little recap, but if you're a little bit confused, just know what Kathy said. You can go back and watch session one and it should all make a little more sense. I am an SLP. My partner Kerry is an OT and we wrapped an assistive technology lab in Portland, Oregon as part of a nonprofit called community vision. So we've been working together for about 10 years. Yeah. And we have really been practicing this approach for many, many years, but just a few years ago, we were able to actually operationalize it into this training, which is really helpful way. Sometimes, you know, you practice things that sort of seem like the right thing or feel right, but not until you operationalize it, then can you sort of make it more understandable for others? So at the end of today, we're going to wrap up with a tool that can help you if you're working with families or teams to explain the approach and kind of organize your tools. So we're going to first do a quick review of the components. And then really today is about exploring some specific tools or ideas, both around participation and then access practice. And then we'll talk about supporting language development and just a little discussion about the benefits of light tech AAC. And then we'll wrap up with that handout for organizing the tools. So our quick review of session one is that for communicative competence, we all, whether we use AAC or not, have to have a knowledge of the language, so the words, vocabulary, grammar, et cetera. But we also need to have the ability to use it in real life. And that's sort of those social skills. But then for AAC, there are these extra external demands because it is an external tool. And so there's the visual motor operation of the device. And specifically, this approach talks about separating some of the goals between that access, visual load or access to a device and learning and developing the language and social tools. So just if you haven't seen it, the basics are the PAL stands for P is for participation and that's sort of targeting that social development. Access A is the access, the actual operation of the tools and then language is our knowledge of the words, grammar and meaning. And we separate all of these in the hopes that we will not overwhelm a child or a student because there's a lot to learn at the beginning, especially if you have some sensory and visual motor access challenges in addition to learning language. And so it's a journey and we are just separating out these ideas. And then our recap at the end of last session was just that engagement is really the key to begin the whole process. And that really is the way to build communication. And that participation, the P part of the approach, you can start from day one when you meet somebody. You don't have to, you know, there's some really simple tools and we're going to look at some of those today and you can literally just start that right away. And again, just separating those goals. So we are allocating our resources between access and language. And that access practice really needs to be fun. So you have positive experiences with technology. And then we want to start at least with modeling and supporting language development, because we don't want to wait for the access piece to get figured out before we begin any sort of exploring language tools. So we're going to just launch into some tools and examples. I know it's a little bit awkward on zoom to unmute or pop into chat. But like I said before, it's wonderful to be able to meet virtually. But the it can be a little intimidating to jump in. But I would like you to feel comfortable as you can to have other experiences or ideas around any of these tools we even love. So for young children and really children of many ages, singing is a great way to participate. Children often love music and they love singing. It's a really big part of development. And I hear somebody is not muted. It's a little background noise. Yeah, I don't know. I'm working on it. Thank you. Okay, so singing is a really great tool. There's a little communication tool called the step by step. We talked about it during the last session a little bit. And it's just a little communicator where it's just digitized voice you just record. And there are single message buttons that look just like this. Those are called one steps. But we really love the step by step because you can do a single message but you also have the ability to do a whole series of messages. And I'm just going to share this awesome video of this little boy that we don't know. I literally just found this online and fell in love with it. His name is Lachlan. And he's a wee wee one. I'm guessing maybe 15 to 18 months. And he is using his step by step. I can watch the whole thing but we'll just get back into it. So really awesome timing. A fun way for him to participate. And you see a really simple tool where obviously it's not a really robust language system. But he already is, he's learned so much about those social skills about just timing and that back and forth reciprocity with his partner. So really can be a very powerful tool, the step by step. Here's another little girl that we work with. We were doing an AAC clinic at a camp. And again where you're going to see an example of another use of step by step. The kids were all making bottle rockets and they were doing various countdowns. So really quickly one of the SLP grad students was able to program a simple countdown. So she got to lead the group in the countdown. One of the things we love about this is just how quick it is. Same camp, different girl who, this little girl loved to tell jokes. So at the lunch table we programmed some jokes. And you will see, I'll explain our little series of jokes in just a second. And I might have to, it's hard to hear. And then I just wanted to say, I did not record this, I only recorded this with her with me. So she knew exactly what was on this button. Obviously, if you're programming a button like this, we're resusing it needs to know what the purpose of it is and what's on it. So I asked her if she wanted to do a joke and we figured out which one we wanted to do. And then I programmed it with her right there. So here we go. Who's there? It was more of an adult joke than a kid joke. And you'll see an example of what a kid joke looks like in the next slide. But you saw this little girl has rec syndrome and you could see from an axis standpoint, you know, she, her timing, if we, if I had just put the step by step there and let her have at it, she probably would have activated a little too quickly. And didn't wouldn't. So I gave her timing support. And that's partially because of her hand use with Rhett syndrome. And so at the beginning, especially if we're still working on access, even with a simple tool like this, we want to be successful because the point is the social interaction more than really getting the timing exactly right. And so because of her hand motion, the multiple taps, I just moved the step by step in and out to help with that timing. And then so what happened after this is a bunch of the kids were like, Hey, what is that thing? And so we ran around and we taught the kids how to program the step by step. And then a lot of them also wanted to tell jokes with it, which is awesome. We love that. And so here is a little girl who was working or who was at the table. And so she reported this joke. So hard to hear what it just says. So talk about timing, right? She didn't even wait for an answer. Her program was just not not who's there underpants. So we realized, of course, that our whole Dwayne the bathtub I'm drowning was just like way too adults. But they had fun just kind of going around the table and everyone programming those jokes. So just a really fun experience with the technology, getting a lot of that social interaction. And then we're big proponents of sharing the technology with all of the kids in the room to normalize that technology. So it's not just the one child who uses the strange, unknowable tool, but they all get used to it. And the benefits of that are the child not really feeling like they're sticking out like a sore thumb, but also the other children when they have experience programming and using devices to communicate or tell jokes or whatever. When the child who has complex communication needs uses those tools, they're going to naturally be more comfortable with how to respond because they will have used the tool as well. So it really has multiple benefits we have found. Here's another example of a little girl who this is quite a few years ago. She was just coming into our clinic and her mom was really great about figuring out what kind of news she wanted to share. So she came in, she also has RET syndrome. You'll see a little hand support there. Here we go. You look so excited. So you could say what? Oh, okay. I thought somebody was saying something. Well, thank you. She's adorable. And I love the way you have the step-by-step mounted there too. That's really a good thing. Yeah, yeah. So there's some kids who really like that, they would maybe go to school and they can have it mounted and they just, just to walk down the hall and be like, hey, hi, how are you? How's it going? Just, you know, a really nice way for them to participate in just walking down the hall. And like I said, it can help with timing, but we don't get too particular about it being like, no, no, no, it has to be exactly the right timing. You do whatever support she's figuring out her access. You'll see that she had a little bit some double hand motion with RET syndrome. She does have a splint, but she wasn't wearing it at the time. So I just held her hand naturally. And then it was a little easier for her to activate when she just had one hand kind of naturally restrained and the other freed the other one up to use the button a little more easily. And then also, if she wants to go through it a couple of times, we're like, yeah, we'll talk about it again. So we first time she's told me the next time she told Carrie. And so really, we don't want to get too stuck on timing immediately. We really want it to be about that easy access and trying to figure it out. And really it's through using it that kids are going to have those experiences and learn the timing. Okay, so that was sort of like, so the step by step honestly can be used. I feel like we could, if we could have a step by step almost for every child with complex communication needs, that would be a potentially great tool. It really is limited only by our own imaginations and it's really quick to program. I will say on a side note, a sadness we have is there used to be an app called tap speak sequence. Some of you might have used it, but it was very much like a step by step. It was on an iPad and the benefit of it was because with the step by step, you know, let's say I did the countdown and then the next time I wanted to do the jokes, you rerecord over yourself. The tap speak sequence let you store, you know, you could have 20 jokes stored, you could have stories. And unfortunately, it hasn't been supported. I think the developer went out of business and it hasn't been supported for quite a few years, so it's not functional anymore. So that's, I want to find a developer to make another one, but if anyone here is of anything, let me know. So I'm going to just launch into some other ideas, unless anyone has anything they want to say. Good. Okay. Yeah, I'm just going to say again, I mean, these things, these tools have been around for a long time and it's great to see them. What I really again value is how you're using them without thinking about, you're using them for participation and being really honest, I guess about, I don't know, honest is the right word, but being really intentional about that. So I think that's really important too. Yeah, yeah. And I think on it, so I think a lot of you will see some tools where you're like, yeah, I know that I know that tool. It's a mind shift of thinking about the day, like how, what could we, and it doesn't have to be all day every day, but it's those little insertions throughout the day, like, hey, here's a time when you know, Ellie could, you know, ask the class questions or it's just sort of thinking about those opportunities scattered throughout a day or a week for a child. So in a classroom setting, of course, being able to do presentations or show and tell, etc., any sort of talking in front of the class, there's quite a few tools that you could use for this. One is Pigtello, which you may have heard of. It's by Assistiveware, the folks who do Proloquo2go. And it's basically a talking photo album. It has really high quality voices. You can do text to speech with the acapella voices. You can also record if there is a child who wanted to record for another child. Even children who, some students who maybe have speech, but when it comes to presenting in front of a whole class where they might be harder to understand or they get anxious, if they're able to record their own voices or do text to speech outside of the, and then do this as their presentation, it can really, it can even help with that. You can also embed videos in Pigtello. So it's a really nice way to do presentations. Last week, we showed you Weston's Teligami. That's where he did the hammerhead shark presentation, the hammerhead sharks. It's an avatar. So as we told you last week, Teligami is no longer supported. It's also a developer, I think, that stopped updating their app. And so you can't download it anymore. And I have been looking for a while for a replacement and haven't found one, but I just found one recently, this Vokey, V-O-K-I. And there is a free version and there's also a paid version. It's actually, from what I could tell, it's actually designed for classrooms. And then if you do a paid version in a classroom, there's just a lot more functionality in terms of the choice of avatar and the background and et cetera. So you can at least start free. So here's an example of doing a presentation on the solar system. Hello, I am presenting on our solar system. Our solar system is called the Milky Way. Our planet, Earth, is the third planet of... So anyways, we won't go through, but it was just a text-to-speech. This was the free version. I just did a little video capture of my Vokey, but that's an idea for presentations. And again, I'm going to talk about normalizing the technology. When we've gone into some classrooms and we introduce an avatar to do a presentation, do you want to guess how many kids would be interested in doing an avatar presentation? Pretty close to 100%. So some teachers have allowed any student, maybe not all the time, but maybe they at least get to do one avatar presentation in a year or semester, whatever they decide. And the kids love it. It's really fun. And again, it normalizes the technology. And so when the child who needs to use this technology uses it, it really helps the children have had experience with it. And then they can respond to it more naturally than if they don't know anything about the tool. Does that make sense? Yeah. Hello. And then I just wanted to highlight some kids. All these pieces have come together. They have their speech-generating device. They're doing great with their language and their access, but we can also remember that we wanted you programming with participation in mind on SGDs as well. So this little girl, Leanna, is going to do the Pledge of Allegiance. I apologize. This is a very American thing, but so here she is doing her, with her eye gaze device, her pledge. My name is Leanna. Please stand for the Pledge of Allegiance. I pledge allegiance to the flag of the United States of America and to the Republic for which it stands, one nation under God, indivisible, with liberty and justice for all. So that's it. Again, really simple, but just remembering that when children have speech-generating devices, sometimes we want to think about continuing that participation, those opportunities through their speech-generating device as well. All right. And then I just want to have a word about sequential scripts. Maybe many of you have done these already. So if you're telling news or a story, etc., there's just a few things that help sequential scripts be a little more successful. And so you want to think of your programming to reduce some of those if a person responds and then it's not programmed, so it kind of derails the direction of the script. There's things you can do to kind of lead. Like, guess what I did this weekend? You know, it's going to be pretty predictable that somebody's going to say, what? And then you say, well, I went to a birthday party and you'll never guess what happened. So you can do those leading things to help guide the the unknowing partner into what the, you know, the most predictable response would be in the script. And then, of course, it is really only good and pretty predictable interchanges or routines. And then when we're programming, you just kind of try to think about the natural flow of a conversation. And then we usually try to end it with some kind of a statement or question that is sort of a marker like, we're over now. And then we'll often program a blank hit in there just in case you do get a kiddo who hits it again by accident. It gives you a little clue like, oh, it's a blank one. We know we're at the end just to help it be more successful. And really, we've found this mostly to be great with, you know, looking, you know, helping give experience in that reciprocity and natural timing and just those social skills. So Carrie is going to talk about access, practice tools, unless anyone wants to chime in about participation so far. I'll just say, and I've got my grandson on my knee. And that, you know, one of the things that I found really helpful when I use this out in the world was to actually go through the child's day. And as you just said, figure out what are the times that it can purely be a participation activity, right? And so it really helps teams to think through some of these things. So as I said, right, I mean, take it and make it real practical for teams to think this through. So yeah, and just keeping in mind, it doesn't have to be a masterpiece. It can be the tiniest little like the step by step to say happy Halloween trick or treat when when a child is out. It can be super, super simple. And sometimes that's the that's when you can end up doing more things for a child when you don't have to, you know, worry about it being really complex or long. Okay, so here's Carrie. Hello, so Carrie, or here you be back. So as Kim mentioned, for that access practice piece, we really want to start with play based and fun activities, and thinking about what is that cognitive load. Thinking of all the visual skills that might be needed, the motor skills, the auditory skills, sensory regulation, pulling that cognitive piece out, pulling that language piece out, and really giving the child a chance to practice this motor piece, this body piece in a fun, maybe even errorless activity, where they're not having to think about all the language and other components. And it can take time for practice accuracy to be good enough that there's not that frustration. So again, starting in the beginning, really those fun activities. So we're going to see some examples in a moment and examples of tools. But first, I wanted to introduce you to a little guy, Kenny, and his journey with switch access. And so he was 18 months old in this video here. This is at a teaching hospital. And his team called us in to find out what could be the next step for him. They had gotten him an adaptive switch toy with one switch that he was able to activate with his hand and make the toy go. And they just didn't know where to go from there. Also with the mindset of what can we do now to set him up for access to augmentative communication. He has cerebral palsy and cortical vision impairment. And so they knew that switch access was likely going to be his method for communication. And they did note for us before we came in that when he hit his switch with his hand that his head would often drop. And so they just didn't know where to go next. So in this little video, we'll kind of show you within an hour, which was a long time for him. And he hung in there. We just had this one opportunity to come into the teaching hospital. Mom was totally on board and really excited to see what Kenny could do. So you'll see in the beginning that we start with a head switch that we fold up for little Kenny. And we found out from mom what is super motivating for him. And he loved to hear her sing. And she actually had some songs recorded on her phone, but we didn't bring an adapter with us. So we had to fudge it a little bit where, you know, when he activates his switch, we touched the phone and then the music plays. But it's kind of that early cause effect with mom singing. And we're holding that little head switch. She'll see him progress from a one switch to some two switch activities in a fairly short period of time. So we're going to watch this video on Kenny. By the end was doing some really cool problem solving. He had to start to figure out which switch activated which device. And he had never done a head switch or any other switch activity besides this one toy before that day. And within that short period of time, he's starting to figure out which switch activates which device. How do I move my head. But you can see in the beginning that we set him up to have a really positive interchange and experience with this technology. So we decided to just have him sit on the bench. We brought the switches to his head so that we were right there kind of at the ready. We could have had him in like a stroller and mounted a bunch of things. But because of his tone, you know, the switch could like hit him in the wrong place and he could have ended up frustrated. So in that very early kind of assessment period where you're just exposing a child to technology, we really like to be a smart partner and be there at the ready. So it's a successful experience for him. You also could see that we didn't use kind of the phrase like hit the switch, get the switch. It's really not about the switch. The switch is just a means to an end. So we might use phrases like, oh, more music. What happens next? To keep his focus on the activity. And just through practice, he started to learn where that switch was and what he needed to do to activate it. So in the next slide, I'm going to show you kind of where Kenny is today and how this laid the foundation for his communication system and where he is now. So here, we've got a lot of tools up here, but I just wanted you to see kind of this multimodal communication approach that we had for Kenny. So over on the left, you see the step by step, which he's got one now. He's using it at home. He's using it in his preschool, just to participate in circle time, sing songs. And then underneath you can see some switch toys. He's actually starting some powered mobility trials. So he's about three years old now. So again, practicing that head switch access, even in a powered wheelchair, is kind of the ultimate play access practice, where you can just kind of wander around in a large space on a slow setting and just really get that practice of going between the two head switches. And at the top, you'll see he's got some apps on an iPad. These are the Big Bang series. So it's high contrast because he has that cortical vision. It's still good for him to practice his visual skills, and he has a vision specialist. So those are kind of his access tools, the step by step assist participation tool. And then over to the right, you can see he now has a light tech communication book, and it's got high contrast symbols for him. And then the way he's accessing this book right now is with a yes and no switch. And so it's that early auditory scanning through a list. And so here, his physical therapist is going through the book, he's got some play choices. And she holds the yes switch on one side and then switch on the other. And he's able to scan through a list of activities, like, you know, what should we do today? Should we play on the swing? Or on the slide? Do something else? So he's able to scan through an auditory list. That's kind of set the foundation for that communication piece. And so now he, the last we heard, he is doing some device trials now. Yeah, there was a question in the chat, whether that was in the same session. I'm thinking not. This was actually about a year later. That's a great question. We don't have a magic wand or magic carpet or anything like that. Yeah. So over after we had that session with the teaching at the teaching hospital, we were able to give his school early intervention teams some ideas and his private therapist ideas and mom's ideas that they kind of worked on those. And it led up to this about a year or so later. So thanks for the clarification there. And if there's any other questions, feel free to chime in. So here we're just going to run through some tool ideas, tools for working on that access piece, some play ideas and fun ideas. So for switch activities, you guys might have lots of ideas. There's a million out there. Some of the favorites we have are at the top on the left is a young lady with a power link. That's where you can have anything that plugs in. So here she's got a blender. You could have a fan, a lamp. And so she's able to help blend her smoothie with a switch. And down below and underneath in the middle is a spinner. And that's made by AbleNet. There's different spinners out there. And so you could put your own cards on the spinner. It could be part of the game. It could be, you know, maybe the students in the classroom and, you know, your the student could call out who, you know, the order of everyone to line up. So the possibilities are endless with spinners, but just a really fun way to some participation and then also working on if someone needs to work on that switch access piece. And then, I don't know if anyone has the switch adapted paint spinner, but that is a hit around here for all kids and not just kids that, you know, utilize the switches. But as Kim said, said really normalizing that technology and letting everyone to participate using these tools. So there's some switch ideas. And then on the iPad, there's tons of apps out there, but thinking about the layout of your apps and how someone could be working on their targeting practice with their finger. Again, not necessarily with a language system keeping that piece separate in the beginning of someone's really needing to practice on that targeting, the targeting piece with their finger or any of these apps can be switch adapted. So maybe they're using, you know, two switch steps scanning to go through their choices, but thinking about, you know, what are some fun motivating things you could program and then what the layout might be on whatever app that you're choosing. So these are just some free examples up here, some fun activities, making animal sounds, funny songs, or funny sounds, songs. Again, just keeping it really light and fun. And any of these can also have a key guard overlay on it. So plastic key guard could be made to fit any of these if that helps somebody with their targeting as well. And last month, we mentioned can tunes. That's a favorite around here made by University of Victoria. It's a free app that pulls music from your iTunes account. And there's different layouts. So I think it could have, I think it's could have two albums up, four, six, 12. So different layouts. And again, just that airless fun, you know, if someone likes music, just really so they can can work on their targeting practice. And this can also be switch adapted. And key guards. So I mentioned key guards, there's endless amounts of ways to make key guards so they can be custom ordered online. Or if you have access to a 3D printer, some people are starting to make their own, laser cut their own. So there's a lot of options either for a speech generating device or an iPad to have that key guard, or even a keyboard. So there are key guards that can go over a keyboard for typing that can help somebody get their finger in the right spot. So just to recap on some of those tools, both for participation and access, we talked about Pigtello. That's a great app. I think it's $18 and 20 bucks now. There's some free options that are similar talking photo albums, but we really do like Pigtello and how it works. It's really slick. And that also can be switch adapted. There's a free version of go talk now, sounding boards free, we talked about can tunes, bokeh is free. Of course, the step by step is such a great tool. And then animals is another free app that kind of has that grid layout and can face it out however you'd like. So before we launch into the language part of PAL, or if there's any questions about anything at all, happy to answer. I have a question. Sure. I was just curious. So whenever you're using like the go talk now app, do you have a switch interface that you recommend that's easy to set up and train parents on? Yeah, that's a great question. So there's a couple of different interfaces that will work on the iPad for any app. So the able net hook, we use a lot. And then able net also makes the Bluetooth. And is there any other words? Pretorian inclusive technology. So those are the three that we know of. Have you used an interface before? I have. And when I tried the hook, I had I did iOS settings, and I made it switch accessible. But then it messed up like within the go talk app. I also I forgot to turn on the switches. So it was kind of it was a training piece. And I kind of failed as far as like training the parents. And we know we know how that goes with technology. Yeah, so the right now they have the applicator. So I'm exploring that. And it seems to be easy connectivity, but difficult, like just figuring out which mode to set it on. And yes. And the Pretorian is the that's the applicator is Pretorian. Yeah. So we'll save Kim as a tip because I know what you're talking about. So there's a funny thing that happened on iPad. I think it was when we went to 11. It used to be all switch interfaces had keyboard commands. So, you know, space and enter or one and two, etc. And so when people first started doing iPad interfaces, it was very app specific. So go talk now, because they were, you know, an 80 focused developer, they made switch accessibility within their app that would have been that kind of like space and enter based technology. But then when iPad itself became switch accessible through the actual iOS, it did not use keyboard commands. It uses iPad specific commands. So something like tap the screen, or you can tell it to swipe, or you can tell it to move to the next item, or make a selection. And so it was very specific commands. And so you can actually get a little messed up by going into the iOS and making it switch accessible and then going into the program itself and turning on the switch accessibility, they end up fighting each other. So I don't know if that is what happened or if that kind of makes sense of maybe why things didn't work out very well. Yes, yeah, that ended up that's exactly what happened. So I'm still, I'm in this, you know, operational, trying to figure out the operational use of hooking up the switch interfaces and probably not part of this training, but definitely looking for help in some of those operational things when it comes to setting up switch interfaces with switches, depending on if it's a switch accessible app versus what. Right. Yes, exactly. If you ever want to just like email or call us, we'd be happy to like just talk through some of that stuff too. It does seem like we should have some sort of a, I don't know if hands on is very good via Zoom, but it's like multiple people, I think would like to dig into some of the iPad setup things, because once you've got it going, it works really nicely. But there's a lot of, like you can put one little setting wrong and things will not work very well. So this is a future session guys. I'm really loving it. Thank you. Thanks for that question. Yeah. Great. And then I was going to also say about the key guards, Carrie and I sometimes you don't have, like you don't have the special key guard that you need. And we've literally taken some phone for and made, you know, took a screenshot and then cut out our pattern. And then just how did we attach that? I think it was just with some kind of elastic band thing. So you can do some makeshift stuff too, if you think a key guard is going to be helpful for that targeting practice. Yeah. Yeah, for trials. Yeah, not permanently. Okay. So I will just talk a little bit about language development unless there's anything else we don't want to rush you guys. So anything else about the access piece? Nope. Okay. So language development and just supporting. I am probably preaching to the choir here about modeling. But modeling is sometimes called aided language stimulation. So for those of you who haven't heard of that term before aided language is any sort of an AAC tool that uses external, whether it's a symbol or device external tools. And so it's really language stimulation but using aided language. And then just pointing out that AAC is obviously an expressive tool. But for some children, it can help with their receptive language to just having that visual support. So even if they're not ready to use the system, us using the system to talk to them can be really helpful. And then like tech has easier access. And we'll dig into that a little bit in a second. And then we're going to talk a little bit about smart partners. So here's just a little graphic about modeling. Just to remind ourselves that really whatever we're hoping for the output of a child in terms of communication, they really need that for input. So we speak to our babies and our children with the idea that they will acquire language and speak. But if that for some reason is not going to happen, and then we think we want AAC, if we just give them spoken language, it's confusing for them to then figure out an AAC system all on their own. So we really want that input to be AAC so that they know how to use the AAC. And then sometimes we think about how much modeling, because sometimes it feels like we model a lot and we still don't see any results from an expressive standpoint. And we get maybe we wonder if we're on the right track. But I like to think not just about the amount of time, like sometimes we'll be like a year. But if you really think about how much speech a baby hears before their competent communicators, so like not just the time, but like mom talks, dad talks, grandma, grandpa, aunt, uncle, neighbor, Amazon delivery person, person at the grocery store, the TV, there's speech all around us. And so learning AAC, right in a non AAC world can take quite a bit of time. There's lots of speech around us and very little AAC. And I like, I found this graphic that I really like, I've heard this, I don't know, who's, oh yeah, Jane Corston, who came up with the statistics that by 18 months babies have heard, on average, 4,380 hours of spoken language. And we still don't expect them to be fluent speakers. And if we use that amount for our AAC learners who are seeing their AAC systems used, let's say twice weekly for 20 to 30 minutes, it would take 84 years for them to have the same amount of input. So we just have to remember that, obviously, we, you know, even if they don't get the same amount, remembering that it's important to do it as much as we can. Some of you have probably heard this statistic before, it's rather shocking. So I just want to talk a little bit about what a smart partner is. And just remembering that we are smarter than technology, we don't always feel that way. But if you slide your finger across a screen on an iPad to land somewhere, that iPad or that device is not going to know that you didn't intend that first touch. And you were really going for that final touch. So we, but we can see that. So we are smarter than technology. And that smart partners can support access, as I was talking, but also can support memory and staying on task. And for those early attempts, we can make meaning from those attempts, we can go with the flow and try to form meaning. And we'll look at a couple of examples in a second. And of course, we're really engaging too. We're fun. So here's an example of Linda Burkhart talking with a little girl with Rett syndrome. And you will see that she is giving access support. She's scanning and turning the pages. But also, and she's engaging. And also she is making a little bit of meaning. And we'll talk about that in just a second. Yes. Something's wrong thinking question. One of those. Yes. Okay. Something's wrong. Yes. Something's wrong. Oh no. Something's wrong. Something's wrong. Tired, hurt, uncomfortable. One of those. Tired, hurt, uncomfortable. Yes. Oh my goodness. Tired. Tired. Oh, you think you're tired, huh? I'll tell you what I think. Go back. Go back. More to say. I think, I think you are silly. I think you're silly. You just took a nap. You just took a nap. I think you're silly. You tell me you're tired. I think you're silly. So you can see the little girl did end up saying yes to the first item on the list. And maybe she intended that and maybe she didn't. We don't know if she's just in the exploration mode. But Linda kept it engaging and that virtue is forming the meaning in that she just kept going with it, took it, and then made her own comments about how silly it was that she would be tired. So smart partners can really take those early attempts and make them meaningful and engaging, which really builds on the sort of language experience of a child learning those early skills. And of course, we're there for access support. Smart partners. Here's a young man who has a book and he knows his book. It's like it's newish, but he knows it fairly well. And we were working on developing a yes-no here. And so you'll see some head switches. Our school choices are swing, rocking chair, read a book, sing a song, watch a video, or something, rocking chair. It's a great idea. So we'll figure it out. So yeah, he was just working on that head development. So I'm there for access support. You can see I can read his body movements and then I would just activate. The point wasn't for him to actually hit those switches, but just to develop that head movement in a response to scanning through a list. Here is a young boy using his pod book and he's a direct selector. And I just want you to look at the sort of fineness of how his finger goes. And then you'll see at the end when they're on the TV page, he actually rests his hand on the paper. So even for direct selectors, access can be a work in progress, but he's still got lots to say. More to say. And mom is filming and being partner. So it's a little wonky in the video. More to say, I want, I want, right here, watch TV. Here they were. You'll see his hand wrap change the channel here. Okay. So we change the channel. And I like that one too, because clearly there's something really boring on TV. And so here he has access to a lot of language. It's not just a request. It's getting down to some fine detail about actually wanting to change the channel. And you could see a little bit of the finger movement and then his hand rested on the page as he touched, changed the channel. And so just that light tech option, if that had been on a dynamic screen, there probably would have been lots of errors in that navigation. So the partner, smart partner is there both to turn the pages, but also to see what his targets were. So there's not just pod books. There's lots of variations of light tech books. This is a Spanish English core board with some fringe vocabulary that we developed here at the lab. And then there's lots of light tech alternative access. All of these are pod examples. And the reason is because there's actually templates for these, but you could make any light tech system alternative access, whether it's an eye gaze board or high contrast and an auditory scanning book, or the one in the bottom left corner is actually maybe somebody who could do just like an eye gaze or a gross hit to a quadrant. And then you could just scan the four cells in the quadrant. So a little bit of access shortcut. I'm going to put in a little bit of a comment here, though, because I would never be able to create a light tech system that comes anywhere close to the thinking that get a quarter dead. And at the end today, I'm going to, if those of you who aren't, are still around and don't know, we are going to do a two day pod in Edmonton in March. So it's kind of a nice segue to thinking about why, and I'm not even, I'm trying not to call it light tech and hard tech. I'm trying a non-electronic system might be a really valid approach. So I love that you guys are doing this. And yeah, and again, just a shout out, I guess, to Gail Porter that I couldn't, the thought that's gone into that those pod systems is amazing. It's very phenomenal. And I just, I only say that as a caveat. So people don't think I'm just, you know, trying to sell a pod, but she has put a ton of thought into it. And when you hear her present, you realize like there's even more thought than you could possibly imagine. And you're right to get a robust system and to create it from scratch in an alternative access kind of way is would be incredibly time consuming. So and so I just want to say that around to continue what you're saying, Kathy is those light tech supports. A are really important in a multimodal system. If you're outside and it's sunny, or it's too cold, or it's raining, or it's just too glaring, and you can't see your screen, you need to have another option. Also, we know that technology always fails or the battery runs out just when you need it. So it's also good for a backup system. But really, when we are talking about separating out some of these skills, it can really be more efficient for early language learners and anybody who has difficult access, even once they're really, you know, they're a little more dialed in with their electronic system, having a light tech backup system, or for some things where they just they need their partner to help them because they're tired or whatever. It's really important to we I think sometimes poo poo we say light tech is at a low tech just because low sounds like it's, you know, lower rung on the ladder. But yeah, non-electronic or light tech, it's just it's a really good option. And remembering that it's not always about what's easier for us, but sometimes it's easier for the child to not underestimate the power of a system like this too. Okay, so I know we're almost at a time. I don't want to there's a handout that you would have gotten called communication tools and strategies and what it does is just a little chart that separates out participation access and language because as we are going along this journey, you may have different tools that you use at different times and it can get really confusing. And so to be able to kind of put them in a column like, Oh, we're doing, you know, step by step for, you know, this kind of stuff and here's some of the access things we're doing and this is what we're doing for language. It just helps organize, but it also helps families and teams understand why like why don't you just get this child a dino box or whatever they understand what the the process is. And so I think we have found this tool to be really helpful. So I'm just going to we're going to show you an example of one and I'm going to do a quick intro of Ellie. She's using her step by step here. And she's just singing, she's figuring out her access is really early. And she was having some issues staying in her chair. So we got her out on the swing and she's just singing. She loves music too. And she's pretty significant seizures, cerebral palsy, cortical vision impairment, and some hearing impairment as well. So she was doing her step by step for her participation. She had some fun, those Big Bang patterns that Carrie was talking about on the iPad with switch access. Meanwhile, we were looking on her vision and refining her yes no, figuring out her seating and what kind of mounting. She we started with a very early pod auditory scan that was modeling first. And so this is what her handout look like for preschools a couple of years ago, right? So we just have that step by step for singing simple stories and preschool activities. And then some simple auditory scan for just directing activities. And then her access tools, her apps, she had one switch and she had some two switch activities. And then some two switch play things that she liked adaptive toys and a massager and fan. Plus she had some mylar objects and shapes that she was working on with vision therapy. And for language, she had her pod book and that was mostly being modeled and then some auditory scanning. And then we also because we were not exactly sure it was going on with her hearing, we did do some touch cues as well that we were experimenting with. And then we were experimenting with some mylar symbols as well. So this is just kind of organizing the tools and then everyone can kind of see, oh, this is why we're doing, you know, this app with this switch. And this is why we're using the step by step and oh, we have found it really just a helpful way to get everyone on the same page and understand why we're doing certain things. And today she has a go talk now programmed with sort of the beginnings of the pod with high contrast that she is using to scan sometimes. But when she has difficulty, her caregivers are at least using it to model with her as well. So sorry to kind of rush at the end there, but I want to be respectful of everyone's time. I don't know if there's any questions. Yeah, that's great. I know it's so much to talk about in so little time as almost the voice is the case. And I'm going to just say, oh, yeah, I should, this is my grandson. Hi, buddy. You want to say hi, Logan? You're going to say hi. We'll stop with this for a little minute. Anyway, what I was going to say is, you know, your form is a really great place to start. And then I would encourage people to go through and take those pieces that you have in your form and say, and so when are we going to be intentional about doing this, right? And what do we need to do? I just think it is, I'm going to say in some ways it's just total common sense. But on the other hand, it's like all common sense that's not really common. We have to think about doing it that way. So anyway, and taking it apart to put it back together as you guys say. All right. So some other folks are saying people have to go. So anyway, thank you very much on behalf of all of us. And there's your contact information. I'm assuming that you're, we probably won't be able to drop in. No, I realize. Feel free to email if you have just any follow up questions that need to do any sort of follow up. Thank you. All right. Thank you very much. I appreciate it. And I know everyone else did too. And again, if people you can email them, or if you have questions or comments, you can email me and I know where to find them. So thank you again for these two vote very practical sessions. It was lovely to have this very practical conversation. And again, it sounds like there'll be some more practical sessions that will follow up on this one. So thank you both. Go up and enjoy. I don't know, it's sunshiney here. I hope it's sunshiney where you all are. And we will talk soon. And take care. Bye bye. Okay, bye.