 if you know how to change the view so that we don't see the whiteboard so much, but we rather see the, oh, here we go, panels. Yeah, I don't do that. I wonder if I'm good. Oh, look, I don't think so, Kat. Okay. I know, but it's kind of designed for screen sharing, importantly. Yeah. Right? Yeah. Yeah. But, you know, I'll smooth a tiny bit while we're going. I just don't want to accidentally set the session down. I don't feel like that. No, no, no. I'm going, there's something, panels here. So, manage panels. Yeah, I don't think it changes that. It's just the things you can see at the top, the little one. Folks, I think we are going to get started. It is now four o'clock. I'm going to run through just a couple of little quick housekeeping things, and then I'm going to pass it over to Taffy, who's going to introduce our guest for today. So, just a reminder, for some of you who are maybe new to WebEx, because there are some new people joining us for the first time today, just a reminder to try and have your microphone muted. And muted means that the little microphone icon is red in color. Just so you know, if you accidentally leave it on, I'm going to sneak in from my end, because I can do that, and I might turn it off. So, your computer's not the best if you see it clicking on and off. It's just me turning it off for you. Just a reminder to people too, in case you're going to watch this session and you want to share it with people. You are recording it. It does take us a bit of time in order to get it converted into a more universal format, and then we will be posting it on the ERLT WebEx, and they are working really hard right now to actually develop a dedicated spot on their website under pdresources, just for low incidence webinars, and we're included in that group. So, something for you to watch for, but it is something that is on its way. Also, just a reminder that if you want to speak, and that's what we're hoping will happen a little bit today, you might want to throw your hand up, and then we'll just have an idea of who it is that wants to speak. You can also use the chat window, but in the chat window, probably best if you choose either all or the presenter. If you choose host, that's me, but then Jennifer won't see it. So, the best thing to choose is either all for the whole group or to send it to the presenter or find Jennifer's name specifically so that she makes sure she can see the question. All right, and Kat, with that, I'm going to hand it over to you to finish the introduction. Great. That's great. Jennifer, do you want to put your WebCat on for us so that we can see you? Please, if she comes, that's great. We're talking, though, Kathy, it's always your picture, so when Jennifer talks, then we'll see her. Yeah, that's perfect. Hey, I am delighted to be able to introduce Dr. Jennifer Gantz, who's a professor of special education at Texas A&M. I just love A&M University. That sounds, I don't know, a great ring to it. Jennifer also did her doctorate at the University of Kansas, and there's lots of great people out of the University of Kansas, so I'm sure that she's had the opportunity to work with some wonderful folks along the way. I first, and maybe I will do this now if it works. We'll see. I just got to meet Jennifer today, actually. I first came across Jennifer's work in a significant way when I used this book, and this is a bold advertisement for your book, Jennifer, which I know you did not ask me to do. It's called Aided Augmentative Communication for Individuals with Autism Spectrum Disorders. It's by Springer, and I used Jennifer's books, especially a couple of the chapters on more naturalistic interventions and peer supports or family supports in the AAC class that I taught, and I really think it's a nice, tight book that covers lots of important topics. Jennifer has written extensively, not only books, but certainly recently in the AAC Journal and other places about her research and some luck summaries, one of which we sent out to you about what's happening in the world of kids with autism spectrum disorder and complex communication needs. So I'm going to quit talking and Jennifer, introduce yourself to us, but I won't quit talking for a minute. The way this is going to work is a little different than the webinars that we've done and some webinars. For any of you who might remember, it's more like what we did with Joyce Abala, just a sort of fireside chat without the fire. So Jennifer's going to introduce herself. I'm going to throw some questions out. She's going to respond. We're hoping that perhaps you will have some questions as well. So this really will be a conversation with, to my mind, one of the permanent scholars in the area of ASD and complex communication needs. So Jennifer, welcome. Thank you very much for having me. I'm going to introduce you guys. I'm a little intimidated with Mixed Company because my background is in special education and in speech-language methodology. So I feel like I don't have all the answers. So I guess that's my caveat about coming to speak. I come from a classroom background and lots of experience working with autism and my focus has been on working with autism people to them and investigating the use of AAC with this population for, oh, let's see how long, 17, 17, 18, something like that, years. But again, I come from an SLP background, so be kind. So what else do you have teachers on board here today? Okay, good. Good. What else can I tell you about myself? Yeah, I grew up here in Texas. I hate to say I come from Texas. I've lived here for 30-something years of my life all together. I skated for a while and moved to Kansas, which actually was quite lovely. And then came back. I loved it so much. What else can I tell you? I have a couple kids. One has an IEP, not for autism. The other one has a 504 as well. Maybe I'm talking to Canadians. One has a special ed plan at school, and the other one has an accommodation plan. Neither have autism, but other kinds of behavior changes and emotional changes and so on. So do you want to just tell us a little bit about, you know, you talked a little bit about being in the classroom and what brought you to this, and maybe a little bit of some of your more recent work in that? So actually, when I was, well, I actually started teaching gel education and then because, as we're seeing, we are having this increase in numbers of people with autism, the one classroom we had that was dedicated to kiddos that those characteristics was getting so large, they asked me if I would take it on. And I was already certified in teaching special ed, and I had been working with one young child in his home. So I said, absolutely, yes, I'm up to the challenge. Let's do it. And I avoid it because the particular that I first started working with, I was impressed at the amount of progress that he would make with the kind of intensive, you know, small group of one-on-one interventions. So when I started teaching this class, I had younger children, kinder, pre-school age children, so children who were somewhat newly diagnosed. Some of them didn't speak, or didn't speak in a manner that was understandable to most people. And so, you know, throughout my training, I did start to learn about exchange-based programs and that kind of thing. And this was in, let me see, 1997-ish. And however, and I was seeing in my classroom, I was seeing great progress with kids, being able to communicate better, fewer problem behaviors. Some kids starting to talk as they were learning how to use AAC. But I met with, I had a lot of resistance from certain parents. They were worried, I'm sure you've heard this from folks who work with. You know, they were worried that they'd use it as a crutch, right? So using the crutch, my kid won't talk if he has access to AAC. So I was pretty convinced that that wasn't the case. That wasn't what I was seeing. However, at the time, there wasn't a whole lot of research to support that idea with this population. And so, when I had school at Kansas, that was what I wanted to investigate. So kind of how I got started, I was interested. First, of course, in giving these kids a way to communicate that was effective for them. But also wanted to determine, well, this is true, that speech would be inhibited. And guess what? It wasn't true. You know, so I did some work in there. Other people have done work in that area. And I'm sure you've heard of it. No, that's not true. So that's where I got started. And since then, I've been interested. In the beginning, it was more like, how active is this and what is it relate to speech? I've moved on a little bit. Right now, what I'm most interested in is this problem that I'm seeing. And then I'm sure that many of you probably also see. I used to go into the consultant when I was in grad school later into people's classrooms and teach them how to use AAC with children. And I would walk away, come back, and they were using it at snacktime and put the communication book away. Okay, time again. Yeah, we'll pull that out and earn lunchtime. You know, these one or two times a day, it was communication time, which doesn't make any sense to me. Of course, communication is ubiquitous disease at all the time in all different settings. But even seeing that, we started an autism clinic. There wasn't anything like that here. I live in College Station. It's pretty much a college town. And there weren't behavioral services for this population here. There weren't diagnostic services. So myself and some others from the university, we collaborated with people in the community to start this clinic. And even there, I was training my own graduate students. I was there, you know, every week, a couple of days a week, training the students how to use it, emphasizing that they incorporate communication instruction across natural all kinds of activities, everything that they're doing. And I would still see the same things, even though I, you know, over and over again, coaching them, giving them examples, talking through it, and I was seeing the same thing. So this is really where my focus is right now. And I think some of the questions haven't been answered. I don't think. But there's a lot of research to support, in particular, exchange based systems of this population. And much of this work has been done with recent implementers, people who are pretty well trained, with very controlled settings with very limited vocabulary. So this is my big concern right now. How can we go about teaching, not AC, but whatever communication is working for that particular activity, a more multimodal approach to teaching communication, including AC for those who need it, but involving natural communicative partners from the get-go. So making sure that it's implemented across kinds of contexts, across setting, different settings, different communicative partners, lots of vocabulary. So that is what I'm doing right now. We were lucky and received some funding from the state of Texas for a couple of projects. And one of them is focused on the required projects that involve parent-directed training. And so that we added that our focus would be on communication. So that's what we're doing now. We're really in the very early stages, early on in the cafe. After we're done with this, a half an hour later, we're giving our first online training to parents. So we're trying to reach throughout the state, which is a challenge because it's a large state. We are using distance technology. First, to do large trainings on our basic kind of framework, so we do this. And then they will work with, I guess, therapists for lack of a better word, the work one-on-one, the parents will work one-on-one with therapists to try to implement this in a way that is meeting the needs of their individual children and their families. What are their priorities for communication? What are the major barriers? That's what I'm doing right now. Yeah, that's really exciting work. And I mean, one of the things that drew me, as I said, to your work is the fact that you, number one, did some real investigation on the various modalities, whether it's on-aided, so sign language modalities or the exchange or having a voice or all of those things. But I mean, at the end of the day, that piece of the work, I think everybody, and I'm sure there's lots of people online that would agree, that's the thing. How do we help people to do this with the tech, or a research word with the day, right? How do we help them to be able to do it across all of these and use these systems across all of these different clients? But as I said, your book chapters on the naturalistic support, I think were really lovely for me, because as I've seen, in my opinion, in the world of autism, that much of this has been very didactic, very prescriptive, very rigidly done. And while that can work in that particular context, how do we take it and move it beyond that? Better comment? No, I agree. And the picture in the book was, since there isn't literature specifically on this, I had to draw from literature on naturalistic construction in general, or for communication, but not necessarily for AAC. That's really the problem. And I don't think I have all the answers, and I'm hoping that maybe some of the participants have. If you're meeting people who do this on a day-to-day basis, have some insight. In fact, I'm going to take minutes if they do. Have some insight, because we're just at the beginning of trying to figure out how to do this, and I agree. I come from, well, I was an educator more generally first. I take an eclectic approach, but I am a behavior analyst. I also, along the way, became a certified behavior analyst. And it's true. The research, most of it comes out of single-case research, which comes with applied behavior analysis. And so that's what we do really well. We do things in a very controlled way. You know, very black-and-white, and it is. It's very didactic. And you say, here, this is an evidence-based practice, but it was implemented in such limited ways. I don't know that it's accurate to present it that way. Yeah. I'm going to pause for a minute and see if anyone else has anything to add in, or any comments for Jennifer based on her, I guess, invitation to us to talk about experiences. Seeing her now, which is a lot of fun. If you think of something, put it in the chat as well. I'm going to follow up on that with the last article that you provided to us, which is sort of a state of the practice in terms of autism and AAC. Autism, CCN, and AAC. Would you mind, because a lot of people probably haven't had a chance to read it or even had a chance, maybe even to know that it's there yet, to just talk about sort of some of the differences in what the research has said and understandably that it's limited on things like using sound. I'm particularly going to ask you a particular question about text training, but sort of in the few, you know, breathing, do you want to just sort of summarize that chapter and what we know or what we're leaning to what are evidence-based practices or what are promising practices for kids with autism spectrum? It's been a while since I wrote it. Let's see. So first about time. Okay, sure. So sign language, and I hope I, well, I probably will step on some changes with what I say. I've done it myself in this moment. So, you know, I keep saying, but you all probably know. It's a controversial issue, this question of using A to A-C with generating devices or picture exchange kinds of systems versus using sign language. When I first started hearing about this idea, it was in a very educational manner almost because I think it was just a conference talking to a parent who was sitting next to me who was asking me if I had heard about, this is probably 20, maybe more years ago because I'm a teacher then, or maybe 18, but she was asking me what I do and I was telling her about using techs often in my classroom. That was the first time of A-C I was ever introduced to. Much of my early research was specific techs. But she was asking me if I had heard of applied verbal behavior and Vince Carbone and all these people and basically telling me that techs was horrible. Exchange-based communication, A communication was horrible and sign language was the way to go and it was effective and so on. This idea really hasn't gone away and so I did include in the book, I included a chapter specifically on this controversy, on sign language and partly because from what I knew at the time before I wrote the chapter, there wasn't a whole lot of research and so I wanted to support sign language for people with autism. And so I wanted to into that a little bit more in-depth and see, try to pull every article I could find that every research article that I could find that related to these sign language. And so what I found was, and I don't use sign language, we can talk if we want maybe in a bit about why I prefer A to A-C, but what I found in the literature was that there is some for art, but most of it's anecdotal. Most of it's just a kid study where they're reporting, here's what happened. When they do report data, most of the articles report very limited vocabulary, very lengthy, the amount of time that it takes to teach the children this very limited vocabulary is basically it. There weren't enough studies, there weren't a whole lot of well-designed studies. That's the part of the sign language. On the other hand, particularly for PECS, has probably been researched more than maybe anything else for use with kids with autism in terms of A to A-C. There was a lot of support. There's a lot of support for PECS and other exchange-based systems and a lot for the use of speech-generating devices. And so that's kind of the bottom line for me. I wouldn't say absolutely don't use sign language, oh, somebody who's using sign language successfully, that's wrong, don't do that. I certainly think that in A-CAN, there are probably individuals for whom sign language works really well. But I haven't missed them. That wouldn't be my first go-to. And again, and I'll give you a little conversation, one of the challenges that I would have with that is if you're going to do sign language, the child should be immersed in the sign language environment. It's a very atypical for kids with communication needs to be immersed in a language environment that would give them the richness of the language and not just the language. So for me, your research was helpful because I guess you like research that confirms your biases, but it also just makes a linguist as a... It makes sense that people actually... And there's a comment from Jasmine. Ross, can you see it in the chat? Yeah, no, I did. So can you... I don't know if everyone saw it, but... I wouldn't say everyone, so everybody should be seeing us. Okay, so I think that that's it. Those are some other important things that we need to think about now. That leads me then to my next question. Before we move on to another comment also, just to me it looks like from Amy, who noted that the commitment and cost to staff here, parent training is huge, and it goes along with what you're saying, Kathy, that without that kind of commitment for everybody to be using sign language, then you don't have that rich language environment and modeling going on. Yeah, absolutely. So that goes to my next question, and I'm almost... I often hear and I know... I believe in... Well, I probably know that they're right, that PEX is really the only evidence base, the only practice that has a solid evidence base. So yeah, so I like your face. Tell me about this and talk about it, because I know you're the girl that's gone into the research more than the person that's gone into the research in Syria more than anyone else I know. So can you talk about that a little bit? Sure. Yeah, thanks. Yeah, I like that. I'm in my mid-40s, but sure, call me girl. Let's talk about PEX. So I was really... I don't know if Ann Amherd with PEX is the right word, but as I said, that was the first real exposure I had to AAC. And as I said, I was seeing a lot of progress in the kids I was working with on night, had been exposed to... And I kind of came again, I came into this field, it's through the back door, right? I didn't come studying AAC and figuring out what works for particular kids. I came in by first being introduced to PEX. I'm not sure if I'm doing well. And as many of the children started talking as a result, or not, I don't know, as a result, along with learning to use it, they were beginning to speak as well, at least to some limited degree challenges I was talking about earlier. And I started to realize, too, that, you know, say they were implementing PEX, but they really weren't implementing it broadly, as I was talking about, but they also weren't implementing it with fidelity, which is something you mentioned. The web was developed... It was developed in a research context. And I'm friendly with Andy Bondi and Lori Frost, and they've been very helpful. They, in fact, for my dissertation, gave me all the materials. I was going to buy them from them, and they gave them to me. They've been very supportive and very helpful, so I'm not trying to best... But it was developed in more of an educational context, you know, looking at the different components. That said, much of it is based in behavioral strategies, which do have a lot of research support. These problems with implementation, given the problem that in the early phases of PEX, it requires two trainers. This ability seems to be a real problem. So I wouldn't say don't use it. A way to exchange space is not the way to go, but at that point, how many years ago, maybe five, six, seven years ago, I started really expanding what was invigorating the PEX, looking more into FGDs and other things because of their limitations. And particularly, five, six years ago is when we started seeing all these use of mobile technology really explode. They used these apps, which in terms of feasibility, they seem to be effective. Another, besides the issue with parents worrying about speech being inhibited, I would also hear from parents that they didn't want to be lugging around this communication book because it made their kids look, you know, weird or odd. They weren't concerned about that. But I've had tablets that are everywhere, iPhones, seen everywhere. So it doesn't look as unusual. It also gives you, I think Janice likes, they talk about just in time, you know, vocabulary. They give you that opportunity where you don't have to spend all the time up front, necessarily, preparing for those or you do spend time preparing, but then you can add on the vocabulary that you need right then and there at that moment. So there are a lot of things that I think are attractive about using these technologies. But again, I wouldn't necessarily say use them for everything. There are going to be times where a gesture is much easier and quick and a head nod or, you know, using a picture point or an exchange-based system in this particular context, even though this child does have access to an FGD, that may be more appropriate. Now I'm trying to remember where the question, what the actual question was now that I think I went down the rabbit hole. So you went exactly where I wanted you to go. That's great. And I will continue that. That's all great. If not, we'll come out and bring it forward. But can you talk about, I mean, so the question is that, you know, Pets is the only one that's there. Uh-oh. And I talked about maybe the evidence base and maybe some of the things that you've seen there and that you've written about that I've read about the benefits that occur from having a voice or having a speech-generating device. Like an audible voice, right? Okay, so I don't know. Pets certainly, I think, as a package, has more research support for this population than other things. That was hesitation because there's a lot of research on using FGDs. But the thing is, there's a big difference between talking about Pets and talking about FGDs because Pets is this protocol, right? It's an instructional protocol. I made this mistake. When I first met an analysis I did on AAC, I made this mistake of kind of consuming the center. But really, it has a lot more to do with the practices that you use to teach it. And there is a lot of literature to support the use of FGDs. And I guess the question isn't something, actually, we're conducting in that, we're wrapping up a meta-analysis now, looking at high-tech AAC and looking specifically at the using strategies that are being used. Most of them are behaviorally based, which, again, we have a lot of support for these behaviorally based strategies. But we're trying to look at how effective they are when it comes to using high-tech AAC. This is kind of part of the issue when you're looking at this literature base is you have one protocol well-developed that you're comparing to things that are not as well-defined. Much of the work, you know, Jeff said this in those folks, much of the work on FGDs comes out of their research group. So, you know, you can be pretty confident that they're doing similar things and they are behaviorist. So, you know, they are using these behavioral strategies. But it's still one of those things where you have a teacher who feels like you suggest they implement something like a visual schedule and they put it up on the wall and say, okay, here. And then you come back when they're like, it didn't work. And it turns out they didn't teach the children how to use it. And it's the same kind of thing. You can't just hand somebody, you all know the sensitivity to the choir, I guess. But you can't just hand a child an iPad and that's it. It fixes communication, switching how to use it and modeling and so on. So, I'm sort of hearing you say that really what maybe we're missing is some of those more help protocols. Yeah. There's a question from the chat that asked about, you know, are there some basically partner protocols? She talked about the impact model. Jennifer Kent Walsh from a few years ago. Are some protocols that you've uncovered or are we still in that development stage of that kind of thing? Well, you know, this is that point at which I admit what I don't know, right? So, I am not as well read on AC more generally outside of the use particularly with people's autism. That's probably something that I need to do in my free time. Take the time to read more because I'm not, I can't really comment on better or the lamp model. I mean, I'm aware these models exist. I haven't taken the, well, I mean, I do, I will look at those things. I guess the thing is that it is something that I'm trying to do at least a framework for a lot of the approaches that I've seen that there are more general approaches for a broader AC kind of audience. And I think some of it can apply. Like I do like a lot of the work at Penn State that is more naturalistic and considering developmental appropriateness and that kind of thing. Some of the folks that they're working with have maybe intellectual disabilities or physical impairments, but they're not awesome. And autism is so different with that so it's more difficult, I think, to teach communication because they're often not even, this is a flyer, because they're not tuned in. Somebody with Down syndrome who can't talk because there's more of a motor issue, that person may be more tuned in and more able to imitate and kind of get it, okay, well, you've taught me to use it here now. I can generalize it to use with somebody else or with another context. And the instructional practices, I think, have to be perhaps tweaked and manage more behavioral strategies with this population. So I don't think we're really well-developed. And like I said, I'm not as read on the broader... It's fair enough. And I think that the other piece that I think that most people in the audience know is that this still is an emerging field and we're still trying to figure out a whole bunch of things. And then you say when you've got kids whose major priority perhaps is not communicating and being interactive with other people, there's another whole layer that goes on top of that for sure. Actually, that's a good... That's another thing that I'm really struggling with, actually, is this issue of how to teach these more socially-oriented kind of communication. I don't have a good answer. We conducted a study in the spring with a little girl with complex communication needs, and her aunt was a primary caregiver, and so we'd work with her in her home. And we were trying to just teach just very kind of very simple social, more learning, talking about the things that she liked to play with, and that was a huge struggle. We were using these techniques that we know to be effective. We didn't want to introduce a researcher that wasn't related to what we were doing, and it was a gift of course. We were not very successful. It's one of the things that maybe we'll have more informative, but it's not... We didn't have good results. So again, if anybody has insight about some strategies to get at those more socially-oriented communication skills, it's something that's cracked yet, not even closed. So the question from the audience was about Joanne... I don't ever know how to say Joanne's name. Joanne Catherill's work. Yes. She was so interacted by email. Okay, good. Yeah, me too. Yeah, yeah, yeah. So any thoughts... I mean, she's done... Again, she's kind of been the practical guru, I suppose, in the Autumn AAC world, and she does have some approaches to these things, any comments, any thoughts about some of the things that she's doing? Or maybe you don't want to know? No, I don't have any comments. Actually, I'm working on an edited book with Rich Simpson. We're co-editing it, and she's writing a chapter. I'm trying to remember what chapter it is she's writing. So I'm really looking forward to reading her chapter, and then maybe I could talk a little bit more to it. Okay, that's great, actually. That's something to look forward to for sure. I know, in my point of view, from reading some of your stuff and your book and even the article that you sent out, I think one of the things that really stands out for me is that sometimes we don't work together in teams well enough. So clearly, functional behavior analysis, well done, and done to figure out what she was trying to tell us. And then thinking about things. So it's a great time to model or to give them another way with the corollary or whatever we do. But oftentimes, it seems that we're not really working... So here's the things that I've heard at first hand. We'll get the behavior under control, and then we'll worry about AAC. And I put it as one of the myths, but I think it's because we don't talk to each other enough and we don't understand the value of having a well done functional behavior assessment. And what I particularly liked about your chapter is there's some... I'm wondering, it's not really quick and dirty, but the... There's some quick and dirty things you can do. Or you can get down and get dirty and find out, really, what is that child really trying to say? And your example in your book is lovely about the little guy who was saying, don't touch my stuff, right? So... But it took a while to figure that out, and then you give him, you know, don't touch as a voice output on his eyes, and he wanted to say it, and he said it by screaming. So I just want to talk a little bit about that. Is that something about... I guess I'm asking a couple things about teeming and about, you know, doing... getting on and getting dirty with functional behavior analysis for these kids. Teeming... Yeah, I don't know that I have good answers for that. I think that takes a lot of effort and takes a lot of commitment on the part of all of members of the team to want to do it. It's a challenge that I've... I've pulled a heck of a lot of success in pulling people together. Again, though, my political experience is limited, and then at the office and clinic, I'm not the person who's there every day who's working with a face. So the things that I read are more theoretical and hopeful, I guess, about how important it is to get everybody involved in doing behavioral efforts. As far as using means of determining the purposes behind the behavior, you said something about the distance that behavior has to be control before we sign. I agree with you. That's safe. So all of the time when we're implementing... We've seen it. When we're implementing AAC with kids who do have challenging behavior, we never even see the behaviors. It's so rewarding. They don't have any need to age in those behaviors. That's been my experience. That said, with more severe behaviors, if that's not really clear from the get-go, what is that in behind that behavior? And I'll give you maybe an example in a minute trying to remember something we were talking about today with my team. But in other cases, I think... Now, I wouldn't wait to implement AAC, implement it in other contexts, and perhaps use it as a tool once you have figured out why that behavior is occurring. I'm going to figure out why that behavior is occurring. There are some checklists out there on the market. Again, this project that I have where I'm finally able to do a lot more implementation of these things that I've been talking about is just brand new. I'm hoping that we can use some of these checklists successfully. There are some that are supposed to have good reliability, that are supposed to be accurate in terms of them mapping what comes out of more experimental approaches to determining the functions, the reasons behind the behavior. So that would be easiest on everybody. If you have a quick checklist you can do, then do that. If not, I don't know. There is some research out there on teaching parents to conduct functional analyses, experimental functional analyses, and ways to make that easy to do versus the agactic approaches in a quiet, small office. Some of you don't have to go too far, but that is in the back of our heads. We were talking about it today in the back of our heads that if we aren't successful with using the checklists and figuring out the reasons behind the behavior that way, then we may have to take it another step. Oh, this is what we were talking about today. So my great assistance are just getting started talking to the parents of the kids that they're going to start working with in a couple of weeks. And this is an example of, I think it was a teenager who has complex communication needs and who would, how about when they get to the store, for example, and wouldn't go to the store and would run away. So this is problematic. It's not clear yet based on the interview that you had with the parent what causing that. But certainly, if we could find out the reasoning behind what is it that is aversive about this particular environment, then perhaps we could teach him to communicate something that at least for the time being, we could teach him some way of asking not to do X and they could come up with some solutions to ask for, you know, if it's too noisy, to ask for headphones or something along those lines so that they can go about, you know, child out in the community about having these kinds of health downs. But again, we'll see how that goes. If the checklist is enough, gives us enough information that we can then take care of. For me, it's really powerful research to say because doing the experimental, you know, try to just try that, try that, and that takes an awful lot of effort. And in my experience, it doesn't really happen. But one of the things that I, from your discussion, is one of the things that our talking kids, kids, my children who are now adults and then some, they didn't want to go somewhere and they had a meltdown, you'd say, use your words, right? Use your words. Or they would negotiate with me. I don't want to go to the store. I want to go there. And so, you know, I think, which is really potentially powerful as we think about how can we let our kids with complex needs, including those that have autism, to have those negotiations, those negotiation opportunities. As you said, I'll go in there, but you better give me some headphones because I hate the noise, right? So that's really, I think that's really fascinating. So the challenge, though, we were talking about this today, the challenge will be convincing the parents that it may start out with no door. And having to respect that situation in the beginning every time is purpose-setting up situations where you can get at and then leave him with go on and you go or, you know, that'll be a challenge. It's all exactly it. So I'm going to pause again. Anything on the chat or anybody else have any questions or thoughts based on sort of where the conversation has gone so far? I know there's also great people there on the list that try a lot in doing an interesting and informative thing. Oh, so many. I know. Oh, Todd's going to add something. Okay, she's going to type again. Awesome. So Todd's going to just wait for you to do that and maybe give other folks some questions or some opportunity because just like we need to pause for our kids. Okay. Okay, so here's one from Amber. We struggle to think to have behavior therapist supported language approach. Do you have any advice for these instances? Oh, that's interesting. So again, behavior therapist are not on board with a language approach. So any questions? Behavior therapist, if they're certified behavior therapist, they are supposed to be well-versed on the literature. And they should be implementing practices that have evidence behind them. So... Did you read your article that we sent out to her? Sure. Well, I don't know about mine, but providing literature, pointing to articles in their own literature base, and there's lots of behaviorally based support for using speech-generating devices. You know, there's an entity in Lori Frost had written articles about the fact that text is based in behavioral strategies. So it's hot because... I don't know what it is. I don't know what it is with behaviorists. I hate to sometimes hate to say I am a behaviorist because of this, but I've run into many behaviors that are really hard as. It's... Narrow? Was that...? Narrow? Narrow? Narrow? I mean, they're manualized, maybe? Manualized. They do things the way they do them. And that's what behaviorism is supposed to be. We're supposed to be evaluating the situation and then determining if what we're doing is working, and if not, then we need to make some changes. They should be open to that, and they should be open to looking at your does or doesn't support. And, you know, my article, other people with articles that are... or other literature that shows that using... you can... you could use these behavioral strategies to implement A to D, A, C, and that sign language just... it just doesn't have the support. The problem is... it's like proof, do you want to listen to because the applied verbal behavior... the applied verbal behavior people will say over and over again that there is research to support sign language. And, yeah, there's some, but there's really too much comparison. The way the evidence, the performance of evidence, it doesn't stand up, yeah. So, another question, and it kind of fits into one of the questions that I had, which is, you know, looking at the variety of different aids, which might be, again, it might be beyond what you've actually looked at, or beyond what the research suggests. I don't know, but someone asked about POD and Prognetic Organizing, yeah. And I know... Not that I know of. Yeah. And, yeah, she's not there, right? It's just... Yeah, because it's really new, because I haven't seen it in dark. Like I said, we're conducting a metamorphosis now, so we've put a lot of literature that's pretty... at least in the last year. Yeah. And so someone is also, Casey is also saying, can we salvage the component packs, which gets, you know, and she's saying, captures key social interactions. I think, and I know, again, from reading your stuff and from reading other people's texts, the research doesn't really go beyond requesting what they've shown it, but... Yes, it's another limitation, yes. Yeah. And so, is there something there that we should pay attention to in the text recall that we shouldn't walk away from when we're looking at all of these other... Absolutely. Yeah. No, I'm... Like I said, it's all based in behavioral strategies that have a lot of support. And I've seen people who are pretty successful with using text, but again, yeah, more often I see these limitations. They only get to requesting, they request very limited vocabulary and are very flexible. But, yeah, that issue, that's one thing that it is a particular strength of pecs is that the focus from the beginning is on getting somebody's attention to communicate directly to that person. I think that is absolutely a strength. And something that we'll have to really attend to when using other kinds of Aided AACs, especially speech-generating devices, because you don't necessarily have to get up and walk to the person that you're trying to communicate with. But there's not much research on... I don't even know if there's any research. I could be wrong, but I don't have my head know of research with speech-generating devices that even addresses that. Most of the research, including the other people's research that I've seen being conducted, it's sitting at a table communicating about things that are right here in front of us, even sitting on the floor, but still the things are right here versus getting up and walking to somebody to get their attention. And there isn't... Absolutely, there are definitely strengths of pecs. And if someone wants to... If someone worked on the issue of implementing with fidelity, implementing across different contexts, past, past phase, you know, the, I want phases, the great thing is, you know, I don't necessarily blame pecs for that because requesting is relatively easy to teach and those others more complex, more socially-oriented skills are really, really difficult with this population and I don't know how to do it yet. So how that we're working on it. Good. So I think this is... I mean, again, in your work and different things, you talked about multimodal and I think that that's part of the piece. And I see that we're running out of time and you want to get to your next... But I'm going to have you finish off talking about the chapters of your book just, I love, which is that naturalistic support and using peers and those folks. Do you want to just finish off a little bit talking about what you've learned about that? And maybe I'll even ask you, again, if somebody particularly Barry presents and sort of the certain kind of model, those kinds of intentions and how we can think about bringing AAC into those. So, Brett, I asked you and go with whatever part you want to. Sorry, I had something in mind and I lost it. What was it? Yeah, the idea. And there are a couple studies about using... I'm not using that. But I think peers and siblings be aided in the group of natural communication partners that you're trying to emulate the intervention with. I didn't see that as a whole lot. That's something that for us is probably the next step. First, we're starting with parents and then later on, you need to move on to peers and first, classroom teachers. And I hate to say classroom teachers are less important, but, you know, the family members are the ones who are with these guys more hours of the week than anybody else. It seems like that would be the right place to start. I'm just trying to just see how... And I did write about it, but again, it was drawing on other literature that doesn't necessarily come from the AAC, but it comes from other kinds of, you know, permeated interventions. So, I think it remains to be seen, kind of what are the differences in providing instruction to parents. Parents, it's a little bit more challenging, too, to work with parents than even... Okay, so we have, you know, most of these studies are with researchers implementing. We have some studies with teachers implementing. And teachers tend to be pretty well-educated. And then parents... I think there are a few with parents. Parents' parents, of course, come from a wide range of backgrounds. So there's some challenge there in designing, changing their international, you know, common strategies for this very diverse group. But then there's even more when we're talking about with children. So I'm interested to see what kind of modifications we can ask to make. As it is, I already feel like the changes that we're going to do for the parents are even more than probably what is manageable. Like, we aim to kind of keep it pretty simple, but as we do this, it's become... What about this? Well, we need to talk about this more and more, like, pieces of the net on. So I think, I mean, these are, to me, kind of fun challenges. I used to feel like the AARP list, a student was asking me in class the other day about this. We have this list of what we call evidence-based practices for autism, the AARP list, but we haven't really done the work of integrating all the different contexts and for all the different individuals and characteristics, their characteristics for what is actually effective. As you might say broadly, it's effective for people with autism, but we don't know... Was all these studies done with young children? Were any studies done with adults or adolescents? Very few. In most cases, very few. No matter what intervention this is, we're talking about. So I think I feel like we've come a long way, but we still have all of these questions. And of course for me, my interest in AAC, that's what I'm the piece of me to figure out. But it's true really across the board for all these interventions. I don't, I'm not aware of literature. I really like re-imprisoned work and in fact some of the stuff I'm going to talk about with the parents tonight is relating to their communicative conditions, you know, some opportunities for teaching communication so as far as a package, like for certs, I don't know that there's a literature base submitting it. Well, I haven't seen it, but I also know that I've not been in the literature at this literature to the degree that you have. But I think it's, again, this is in these early days. We're in the early days of this work. And so while that's frustrating, it's also exciting. There is... Exciting for me. So if you'll bear... Now you can tell me if you need to go, you need to go. There... Yes, you need to go. You have... Just a couple of minutes since it's 6.30, and I have a couple of things I need to do before that. There's one question that I think, and this will be our final comment, which is that much of the AAC world is talking about aided language stimulation and a lot of modeling. And so if you want to talk just in your closing remarks about what you've read about that, what you... Maybe even your practice. So... Yeah, sure. Sure. I'll go real quick. That's something that we're... Like I said, I'm really interested in these approaches that are coming from more of a developmental perspective. What's developmentally appropriate? How do people, typically developing children, learn language? They don't learn it from somebody prompting them to use... Say such-and-such now. Say such-and-such. And so I like this idea. It's really appealing, the idea that in addition to expecting kids to use... Not just kids, but individuals lift them to use AAC expressively. We also need to model more for them how to use it because it's a lot more similar to how they actually have people typically learn. We're incorporating this framework that we're using, modeling, as well as more behaviorally-based strategies that are more directives. You know, I don't know yet what kind of success we'll have. I really have to draw from the modeling for this formulation. I don't think it's going to be enough. It's not been my experience that it's enough. In fact, the kid I was talking about that we worked with in the spring, that's where we started with modeling, and we didn't make any... So again, though, we were talking about kind of more socially oriented skills, kind of conversional talking about what we're doing versus making requests. Maybe it would work better with requests. I don't know. But I think it has a place in how communication is a door on my street. Great. So that's it. Thank you. That was great. This was very much fun. Thank you. Yeah, for me, too. We'll go for it now. And here's what I'm going to say to you, Jennifer, is that any year from now, I hope we can maybe touch base again, and you can update us on some of your research. That'd be fun. I think you're really trying to put this all together. And going deep. And it is a deep area. Thank you for spending time with us. Yeah. And thanks for those of you who timed in. That's a question that makes me so happy. And there's some folks saying thank you. And so we're going to let you go off and get onto that research project. So thank you. Thank you, Kay. Thanks for having me. Okay, great. Okay. Okay, everyone. I'm going to say this little quick thing for those of you who want to hang out for a minute. We're going to do a lunch and learn tomorrow that the one that didn't happen because of technical challenges on the communication matrix and some of the other kinds of ways we keep that in practice. But Ross is going to send something out about that. First thing tomorrow morning. First thing tomorrow morning. Thank you all. The participation was really great. And I hope you enjoyed this conversation with Jennifer as much as I did. We want to keep track of her for sure. So thanks all. Have a great evening. And that's it. Good night, everybody.