SLP & ABA: Better Together

Brittany: 00:00:00

That reminds me of something that I think about all the time at the clinic is people will often call us or even get a referral from a pediatrician and saying, you need speech therapy because the child's not talking. But what we know collaborating together is it's often speech pathology. They might not be ready for that yet, right? Hey, everyone.

I'm Brittany, speech language pathologist.

Shawna: 00:00:20

And I'm Shawna, behavior analyst.

Brittany: 00:00:22

And we're your hosts at Neurodiversally Speaking.

Shawna: 00:00:24

This is a podcast where we bridge the gap between research and practice, exploring autism and neurodiversity through the lens of speech and behavior.

Brittany: 00:00:31

Whether you're a parent or a professional, we'll give you practical tips to bring into your home or your next therapy session.

Shawna: 00:00:37

Let's get started.

Narrator: 00:00:38

Welcome to the Neurodiversally Speaking podcast with Brittany Clark and Shawna Fleming from lmno, brought to you by the Sensory Supply. While we aim to make Neurodiversally Speaking suitable for all audiences, mature subject matter can sometimes be discussed.

Suitable only for those over the age of 18.

If you're under the age of 18, please talk to your parent or guardian before listening to our show or listen together with them to stay up to date on new episode releases and show updates. Connect with us on Instagram @NeurodiversallySpeaking.

You can also send us listener questions to address on the show at hello@neurodiversallyyspeaking.com Neurodiversally Speaking starts now.

Brittany: 00:01:26

Hey, and welcome back to the podcast if you're listening today. Thanks so much for joining us. We're really excited.

This is episode two, and today seems natural that because this is so much of what we do and live and breathe, we're going to be talking about the collaboration between Speech Pathology and ABA and then also address all kinds of other collaborations between professionals.

Shawna: 00:01:48

Yeah. I'm so excited about this topic.

Certainly what we live and breathe every day is that collaborative practice and really believe in why collaborative practice is better. We're better together than we are apart. And so super excited to dive into that today.

Brittany: 00:02:02

Same. And it's not always easy. We're not saying it's all roses all the time, but it is pretty good. Like a. You know the tulips in the Netherlands?

It's very nice. Yes.

Shawna: 00:02:12

And I.

I think it flexes my professional muscles too, which I find keeps me really motivated to keep learning and identify some gaps in my own training too, the more that I collaborate with others. So.

Brittany: 00:02:22

Totally same same. So we're going to talk Today, all about what is aba? What is speech pathology? And define some of those.

Now, many of our listeners, this will be very familiar to you, but we want to start dispelling some of the myths as well about what ABA is not and what SLP is not. And we' about that in our next episode. But today, why don't we start with just what is aba?

Shawna: 00:02:44

Yeah, great question. And I think because ABA covers such a broad, such broad goals, it is hard to understand really what it is.

And so ABA stands for Applied Behavior Analysis. It's a science based approach. We're looking at how the environment is influencing others behaviors.

And I like to say it's like we're thinking about why people do what they do and then we use that knowledge to help them learn skills and improve really the quality of their daily life. And so it's not just about reducing behaviors that people don't want.

It's also about identifying what are some of the skills that you might benefit from learning and how would that add more value to your life?

Brittany: 00:03:27

I love that. And I think I'm gonna step back. We talked about aba, but we also didn't define like what is a bcba?

And I know that when we're on almost any intake call, we' say, okay, I'm the speech pathologist and then you're the behavior analyst. And they'll say, oh no, my son's not hitting, so we don't need you. Yes, exactly.

Shawna: 00:03:45

It's like in our title, right? Behavior analyst, an applied behavior analysis.

But I think it's really important to think like a personal pet peeve of mine is when people will say the kid had behavior. Because we all have behavior. Behavior is like everything that we do. And that's where I think ABA can be really hard to wrap your mind around.

And maybe where some of this collaborative practice becomes challenging is because we're really looking at a bunch of different aspects of behavior. Right. And so behavior could be talking, behavior is, could be doing up buttons. It could be so many things.

Brittany: 00:04:22

Right. What's that dead man example?

Shawna: 00:04:24

Oh yeah. In order for it to be behavior, it has to pass the dead man's test. So if a dead man can do it, then it's not a behavior.

Brittany: 00:04:31

And so what's an example of something a dead man can do?

Shawna: 00:04:35

Great question.

Brittany: 00:04:36

Lay down is still a behavior.

Shawna: 00:04:38

You, you could that one you can observe, but you couldn't observe anything. Like you couldn't move or anything beyond that.

Brittany: 00:04:44

Okay, so breathing is a behavior because he's not breathing.

Shawna: 00:04:47

Right?

Brittany: 00:04:48

Right.

Shawna: 00:04:48

And you can observe it thinking, not a behavior. You can't observe thinking.

Or I don't know, I could actually probably make an argument that you could observe thinking if you had the right definition.

Brittany: 00:05:00

You can't see me, but I'm like making a thinking pose, touching my chin. Okay, cool. So the dead man's test, essentially what you're trying to say is that everything that we do is a behavior.

I love the doing a button as an example. Right. Like we work with stroke individuals as well.

And that's commonly, well, where they will say, like, oh well, my husband's not hitting, so he doesn't need you, or like he doesn't have any behaviors. But then we do so much in that space that really benefits from the science of aba.

Shawna: 00:05:29

Yeah, exactly.

It's like we have some different ways of defining language and defining language goals, some different ways of looking at learning patterns and error patterns than other disciplines. And so can really look at what are those unique factors about how that person is learning to develop like a really individualized approach.

Brittany: 00:05:48

Okay, cool. So we've said that ABA is a science based approach. And then by definition then it's always evolving and changing as science does, right?

Shawna: 00:05:56

Yeah, exactly, exactly.

And like I think at the clinic that's something that we're really passionate about, is constantly evolving from both of our, like, from speech pathologies, literature and the literature in aba and the literature outside of our disciplines too. Right. We're always trying to do better.

And if really cool research comes out that's not in my ABA journals, I can still use that cool research and apply the principles that I know from behavior analysis.

Brittany: 00:06:21

So very cool. Okay, so on that note that ABA is a science based approach. Let's talk about some of the fears of like what aba.

Maybe some people think ABA is like turning everyone into a robot. Sorry, how do you say it? Exactly.

Shawna: 00:06:36

No, it's not. I agree and I hear that criticism. Right. And it's valid. It's a huge concern. Historically, I think ABA wasn't a person centered approach.

I would probably argue that other therapies also had a different mindset approaching therapy. And so, and my other thought is like, as a society, we've changed our views really, if we even think about how we're parenting. Right.

My parents, what my parents did is not really what I'm doing as a mother.

Brittany: 00:07:03

Totally.

Shawna: 00:07:04

And so as a society, we've really shifted as well. We've got the neurodiversity movement that's informing treatment, moving more towards person centered or client focused. Care. Right.

Appreciating some of those nuances and uniqueness of the individual and a holistic approach. And so I think all of those things have sort of helped the science evolve beyond training robots.

Brittany: 00:07:30

Right. And it reminds me, even like mental health, we look at so differently now than we did even 10, but mostly like 30 years ago. So, so different.

All right, so ABA is a science. It's moving forward, which means it's always evolving, right?

Shawna: 00:07:44

Yeah, exactly. It is always changing. And things that we used to do, we're not doing anymore.

Similarly, I would say, though, to the way that society is changing, things that my parents did to me were well intended. I'm just not probably taking those same approaches with my kids. And so I totally hear the concerns.

I think ABA does have the ability to be compliance focused where you're training robots to do what they're told.

Brittany: 00:08:18

Right.

Shawna: 00:08:18

And I. That's not the. That's not what ABA is. Right. That's a bad clinician that doesn't know how to apply the science in a way that's person centered.

Brittany: 00:08:28

I love what you said there because I think you're right.

It's like we've got the science of aba and then there are the therapists that do aba and you could have a really wonderful therapist who's so person focused, so play makes learning fun. But then you can have a different ABA therapist that is more robotic or compliance based. Right. And I would say the same in every profession.

Like certainly in speech pathology, there are going to be really excellent speech pathologists out there and then there's ones that aren't really that good and you wouldn't want to send your child to. Right. And so we, you know, I think some of the criticisms out there are on the field as a whole, and that's just not fair.

Shawna: 00:09:03

Yeah, exactly. It's like a good BCBA isn't out there just giving out stickers and gold stars for compliance. Right.

And I think we do that at the clinic so well, we're looking at self advocacy, we're looking at communication skills. We're looking at helping this person navigate their own world in a meaningful way.

It's not about them identifying three pictures placed in front of them. It's not about them matching. Certainly these are things that we work on at the clinic, but that's not the focus.

For me, the focus is on making learning joyful. Right. Teaching that learning is fun.

Being together is fun and teaching them to advocate for what they want and certainly what they don't want too, in a way that their message is understood by other people.

Brittany: 00:09:50

Yeah, I love that. I love that.

And I think that's where there's some overlap too, because in speech pathology, our goal and our focus is to have meaningful goals that we're working on, something that's functional, that is going to help you in your everyday life. And that's certainly part of ABA as well.

Shawna: 00:10:06

Yeah, exactly. There is so much overlap between our fields. And I think as a behavior analyst, we have this across other fields too.

And then it can be challenging, certainly if you're a newer clinician, I think, to navigate some of those conversations and stay true to your science and what you were taught in your master's degree.

Brittany: 00:10:25

Yeah, totally. And so I think, would it be fair to say, you know, one of our mantras is like, we know better, we do better.

We say that all the time at the clinic at lmno. And I think that for SLP and I think that for ABA then too.

Shawna: 00:10:37

Yeah, exactly. I think anyone working in a helping profession should have that mentality. Right. We're all coming to work.

And I think the crux of our conversation today is really we all have the same goals for the client.

Brittany: 00:10:48

Right.

Shawna: 00:10:49

We all are doing this job because we love it and because we want to help others. And so everyone is well intended.

Brittany: 00:10:56

Yeah.

Shawna: 00:10:57

And that's where we, I think, can come from all together, really, is have those conversations from a humble spot.

Brittany: 00:11:03

And let's say it's the same for being moms. Right.

The way that maybe I parented my 18 month old to now, the way I think about things, like I'm changing because I know better and I do better and I'm like learning strategies all the time to help them when they're struggling. And that's such a big part of it too. Right. Like we're always just trying to do better.

Shawna: 00:11:22

Exactly, exactly. And like you try something and you see what works and what doesn't work. And I see this with my own kids. Right.

Like they're different and the strategies I'm using with them are different. And I'm doing the same thing with our clients. Right. We know what best practices are, are, and we know what the research is.

But I also know that this child really likes learning in this way. And so why would I not incorporate that into their therapy sessions too?

Brittany: 00:11:44

Totally. Okay. I love that. So we're really busting this myth that modern ABA isn't just about compliance.

It's really about teaching meaningful, specific skills that are going to help someone in their life.

Shawna: 00:11:55

Really.

Brittany: 00:11:55

We want them to be able to communicate. And I love that you said communicate their likes, so their wants and their needs, but also their dislikes.

We really think it's so important for someone to be able to self advocate and say no.

Shawna: 00:12:07

Exactly.

And that's really where we see in my world, I work a lot with autistic young children and that they might have a tantrum or end up banging their head on the floor or hitting themselves because they get so frustrated that they can't and they don't have another way to get that need met.

Brittany: 00:12:26

Right, right, exactly. And this is where, as a speech pathologist, I can't say we own communication because what you're just saying there is.

This child is so frustrated they can't communicate their wants or needs or preferences or dislikes that they're doing something else. And so we've got to collaborate on communication.

Shawna: 00:12:42

Yeah. For I think we both have so much value to add when we're looking at communication goals for the individuals that we're supporting. Right.

I'm looking at the environment and how all that might be contributing. And then speech pathology, really looking at what is a developmentally appropriate communication goal.

What are some of the things that would be an appropriate mode of communication. So there's so many aspects to speech pathology. So let's dive into that.

Brittany: 00:13:05

Nice. Thank you.

Shawna: 00:13:06

Yeah. Let's talk about what is speech pathology.

Brittany: 00:13:08

Exciting. This is my. My domain, of course. And so there are lots of things within our scope of practice as an slp.

So essentially we do everything from screenings, assessments and then treatment of communication disorders. If you're here in Canada with me, then, you know, we're not diagnosing. If you're in the us, then the diagnosis is part of it as well.

And then consultation and parent education, educating other professionals, etc, so there's lots. Our scope is very broad, but we're focused on speech delays and disorders like articulation, phonology and motor speech communication disorders.

So sometimes related to developmental delays, sometimes with autism, learning disabilities, but also stroke and brain injury, cognitive disorders. I feel like I'm getting out of breath. There's so many things in our scope of practice, progressive neurological disorders.

And then we can also do reading and writing. I love working on literacy goals across all ages. Stuttering, augmentative and alternative communications.

Then it also includes swallowing and voice and resonance. So all this to say is that SLPs, we actually have such a wide scope of practice and we can really work with people of all ages.

And, you know, you and I often talk about how when I Do lit reviews. It could be on any one of those topics. And then for a variety of populations.

And the professional development opportunities that I might take are so broad. And so I might be doing some on AAC and then on some on literacy, but the populations that the, you know, the populations might be different.

Whereas you are almost always reading something about autism.

Shawna: 00:14:49

Yeah, exactly. And, like, that's where most behavior analysts are working is in the autism space. And so that was all of my training in my undergrad.

All of my supervised work hours were in that. Like, everything was in autism. And then there's tons of literature, of course, out there in ABA about autism.

Brittany: 00:15:09

Right, right. And so when we come together and collaborate, that's, again, where there's so much value into, you know, bringing our worlds together.

Because in my Masters, I think I had, like, maybe one really good lecture.

Shawna: 00:15:22

Right. Wow.

Brittany: 00:15:23

On autism.

Shawna: 00:15:24

And not even a full course.

Brittany: 00:15:26

It was like part of a longer course on just language development, I think, and social development.

And so I was actually very disappointed at the lack of content on autism because I'd been working in the field a little bit before I did my master's and had such a strong mentor who was an SLP and bcba, and she taught me everything I knew about autism. And I was so grateful to have that. But it certainly didn't come from my coursework.

Shawna: 00:15:51

Right.

Brittany: 00:15:52

And it's really not coming from my professional development. Like, it's not. I mean, I do that personally, but it's not like there's a sole focus on that.

Shawna: 00:16:00

Yeah, exactly. And I do think in the last, even, like five years, maybe 10 years, some really cutting edge research has come out related to autism that.

That you'd have to be doing so much professional development to really be able to wrap your brain around some of these nuances that we're discovering or the research is showing are critical parts of treatment that are unique to individuals that are autistic versus individuals with other kind of communication or language delays.

Brittany: 00:16:30

Yeah, absolutely. And so another reason why we do professional developments together. And I remember the very first one that we did, the Espinosa training.

If you don't know, look it up. She's incredible. But it was on the ebic, and I remember.

Remember, we had to pause it so many times because I'd be like, wait, what are we talking about right now? Yes.

Shawna: 00:16:49

The researcher is Francesca Deglia Espinosa, and I saw her speak for the first time probably ten years ago, and in my mind, really has changed the way that we do a lot of language Approaches for autistic individuals. And. But she is very brilliant. And so even as a behavior analyst, digesting her content is dead.

And so we would watch it together at night, like we put our kids to bed and then we would watch it. She would. Brittany would be at her house and I'd be at my house and virtually we would watch and then we would pause, chat about it, press play.

Yeah, pause, chat about it, press play.

Brittany: 00:17:25

Those are good times in our early days. Awesome. So coming back to then, like back to speech pathology and defining what we do, just a little bit about the training and who provides it.

You need to have a master's degree to work as a speech pathologist in Ontario and in Canada, where we are. And then you also need a license. So I have a license, for example, with caslpo.

And then depending on where you're located, you need to be licensed in order to use that title and then do that work.

And then, you know how speech pathology is different maybe from some other professions as well, is that we often use standardized assessment measures.

I know from working together that we are often trained in speech pathology to use standardized assessment measures, whereas in the ABA world it's often a little bit more like a curriculum based assessment.

Shawna: 00:18:10

We just say, yeah, exactly. Curriculum or criterion referenced assessments are really common in our world.

But I so appreciate the value of these standardized assessments at certain points along the therapy journey.

Brittany: 00:18:25

Right.

And I remember when I first started working a lot more with you and in autism, kind of being worried because a lot of our autistic children just can't sit and do a standardized language assessment. Like we. I just did one today with a learner who's five and she's been at the clinic with us now for a couple.

And today was the first standardized assessment that she's ever been able to do. And she did so well. She was amazing.

But two years ago, like, we just, we can't go into an assessment assuming that everyone's going to be able to do that, sit down at the table and point to this picture and answer those questions. Right.

Shawna: 00:18:58

No. And like, it wouldn't be the right place either. Right. Like, I find the times that we find doing them in treatment really useful.

Sometimes at the beginning.

Brittany: 00:19:05

Right.

Shawna: 00:19:06

If they don't have a diagnosis of something, trying to figure out like, why is this language delay occurring? What are some of the questions I should ask? Right. Really helpful then.

And then in that case, they're like really nice when they're school age and looking at where aspects of the curriculum might be challenging or even updating their criterion referenced assessments and stuff that we're doing. A lot of them have language milestones and the standardized assessments can be really helpful to inform that too.

Brittany: 00:19:33

So that reminds me of something that we, I think about all the time at the clinic is people will often call us or even get a referral from a pediatrician and saying, you need speech therapy because the child's not talking. But what we know collaborating together is it's often speech pathology. They might not be ready for that yet. Right.

Like, they might not have the learner readiness skills to look at my face and attend to my speech models or even repeat what I'm saying. And that might be not the best next step for that person or that client. Right?

Shawna: 00:20:01

Yeah, exactly. We've got all different sort of collaborative models that we run depending on the unique profile of the individual in front of us.

At our clinic, we see a lot of autistic individuals. Brittany and I in particular, are passionate about early intervention.

And so the kids that are coming in the door, what we're looking for is that social communication skills. Right. And where do they land with all these little pieces that contribute to a robust social communication repertoire?

And if they're missing some of those skills or most of those skills.

Brittany: 00:20:36

Right.

Shawna: 00:20:36

Then ABA can be a really nice, nice way to establish joint attention and shared enjoyment and focus and staying with an activity or understanding what imitation is and the expectations and helping to encourage vocal communication. And then we can switch over to maybe either speech pathology only and the child's ready for that at the clinic.

We find what we do a lot of is the kids are getting some ABA and some speech one on one. And we're all working on similar goals. Many goals are the same. And then we might have our unique goals as well that are separate.

So something like an articulation goal is going to be during the speech sessions. And then during the ABA sessions, we might be collecting some more data around eye tracking or some of those other.

How much time is spent in an activity or something like that.

Brittany: 00:21:32

Yeah, I love that. And like some people listening to this may think, oh my gosh, all your early intervention, you kind of push towards the aba.

But no, we're still saying we do it really collaboratively. And even our most senior ABA therapists at the clinic have been trained by both of us.

Shawna: 00:21:45

Yeah.

Brittany: 00:21:46

So they're.

I, I like to say sometimes that if you came into like one of the top senior therapists that I'm thinking of, if you came into her session as an outsider, you wouldn't necessarily know if she's a speech pathologist or a behavior analyst or, like, what team she's on.

Shawna: 00:21:59

Right.

Brittany: 00:22:00

Living and breathing all of those good things from both sides.

Shawna: 00:22:03

Exactly. And, like, really bringing together both. Right. It's like.

And actually it's almost not even bringing together, like, separately, we have the same goals. Right.

And that's what we're realizing is, you know, I actually think the child needs these five things, and I think the child needs these five things, and we might call it something slightly different. And I really think that's where you and I excel. Because we've worked together for so long, we don't call it something different anymore.

We'll just say the same five things, and they fall in both of our domains. And so then we look at our team and who's available and what training they have and are really able to customize to the individual in front of us.

Brittany: 00:22:38

Yeah, you're right. Right. And I wanted to come back to that speech pathology. We're actually trained a lot to do a lot of things that are sort of ABA principles. Right.

Like modeling, prompting, the things we do in parent coaching or parent empowerment sessions. Like, a lot of that is actually coming from the principles and the science of aba.

Shawna: 00:22:54

Yeah, exactly.

And then what a behavior analyst is very skilled at would be helping you figure out how you're fading those things out or what are some data that you might collect to track progress over time.

Like something that sometimes I'll come across when I'm consulting with other professionals, panels, is there's not a lot of data over time, taking data in this session. But as a behavior analyst, I really want to see if that be data is improving or decreasing from one session to the next.

And as a clinician in another field, certainly you're thinking about that and keeping it at the top of your mind. But there's no, or often not a visual representation for that. And so I think as behavior analysts, we really can help come in.

In and see, like, oh, it's not really actually making progress the way that we would expect. Yeah. I wonder what kind of change we should make. And that's where we could come together about what that change is. Right. I don't.

As a behavior analyst, I might not know what the change is, but I'm like, okay, maybe consider this. Is it at the beginning of your instruction, or consider this at the end of the individual's response.

And what are some of those factors that you might consider?

Brittany: 00:23:59

Yeah, I think until we started working together, I would have never graphed my data and now I can't imagine, not like even outside of autism. I work with some kids and motor speech and phonology and we started graphing some of our phonology stuff and it is so cool.

And I just did a discharge report for this client who's done so well and showed all of his phonological processes. Just the graphs just looked amazing and like showed the amazing work that we did, which was so cool. But I wouldn't have done it that way before.

Shawna: 00:24:28

Right?

Brittany: 00:24:28

Yeah.

Shawna: 00:24:29

What an amazing tool to have right at discharge. As a clinician, I feel really good letting you fly. I see all of this data. I can see that the increasing trend as a behavior analyst.

Always very exciting.

Brittany: 00:24:39

Yeah. I was thinking just now too, I wonder if in some things, not everything, but some things in speech pathology are like always built upon.

Like one thing is built upon the next. So if I'm teaching literacy skills to a client, like we're every session we're building on things that we've already learned and something.

I don't know, maybe something like that, it might be harder to graph. But no, I think you would probably.

Shawna: 00:25:01

Argue we can grab anything. Yes. You just have to think about it in the right way. And some things don't make.

Makes sense to have a number assigned to them and be on a visual graph.

But I would certainly want to track progress in a different way then or be having some pre post probes or monthly probes or something like that where I'm expecting to see some sort of improvement from my intervention that I should be able to measure.

Brittany: 00:25:23

I love that because again, in speech pathology, some clinicians kind of say, hey, we're always making steps forward, but do you have the data behind it to prove. To kind of prove it and show what you're working on, anything. Like I said, I wouldn't go back now to doing it any different way.

I love seeing the graphs and it helps me in my supervision too.

If I'm going in and looking at a speech pathology assistant or a CDA and seeing how treatment is going, then I can look at the graphs rather than kind of weeding back through all the different chart notes.

Shawna: 00:25:49

Yeah, that as a behavior analyst seems insane to me. I can't even imagine going back through all the chart notes.

And I think as behavior analysts, there's some misconceptions too about speech pathologists where we think like, oh, speech pathologists just help speech sounds right.

And certainly that is something that I would rely on a speech pathologist for always, like, you've taught me so many things about how our mouth moves and makes noises that I, I've learned a lot with my own children that I can apply then.

Brittany: 00:26:15

Right.

Shawna: 00:26:16

But I wouldn't obviously apply treatment to a, a client. Right. And so speech pathologists can also help inform so many things related to language development.

And I think things that we're missing as behavior analysts. Developmental milestones. Not a part of my education at all.

Brittany: 00:26:32

Right.

Shawna: 00:26:33

I don't think it ever came up.

And so like those are things that are really, really important when, when we're programming things is certainly when we're looking at like social, pragmatic language, there's certain milestones that you need to meet in order to acquire some of those skills. And so working on perspective taking with a three year old or something. Right. Might not be, that might not be beneficial.

And as a behavior analyst, I might not have the skills in my tool belt to know that that's not a good target.

Brittany: 00:27:01

Right.

Shawna: 00:27:01

And so again that collaborative practice on the curriculum development and the therapy plans can be really helpful.

Brittany: 00:27:07

Yeah. And we both want treatment to be like functional and relevant to the client, but also efficient.

Shawna: 00:27:12

Yes.

Brittany: 00:27:12

So if I'm working on something that's way out of range for that person or like out of their current ability, then it's not going to be as efficient. It's going to take a lot longer.

Shawna: 00:27:21

Right.

Brittany: 00:27:21

When maybe we should take it a couple steps back.

Shawna: 00:27:23

Yeah, exactly.

I'm actually thinking about this is years ago, but when I was a direct therapist, one of the lines on our assessment, the Abel's assessment was fine motor imitation. So they could do 10 different fine motor targets.

Brittany: 00:27:37

Right.

Shawna: 00:27:38

And so back in the, when I was a direct therapist, we just taught them at this invitation at the table so we could check it off the assessment. And so we would teach these two year olds to be doing like make a two and make a three and do. Okay.

And then now that I have my own children, I see that that was like an unrealistic milestone for them. Like they just like shouldn't have even had the muscles to do those things.

And had we had an OT come in and consult that could have fixed this poor child that we then probably did so many trials of to teach this skill when it really like he didn't need to make two with his fingers. We should have skipped that part of the assessment.

Brittany: 00:28:17

Yeah, exactly.

Shawna: 00:28:18

So I think so much value in collaborative practice.

Brittany: 00:28:22

Totally. Yeah. And so we're trying to highlight here the things that we can learn and, and that we do learn from each Other.

So for speech pathology, I think we can learn from Aba and BCBAs having efficient sessions, data tracking like we talked about, prompt fading. Like, we know different prompting and we're talking about queuing hierarchies and that kind of thing.

But we often don't systematically prompt fade like you've taught me or I still consult you to get your help with. And then let's also be on AS behavior management strategies.

And so if a child is running all around the room, like, I'm going to look to you, like, how do I need your help? Because again, like I remember we did, we got no training about what to do if your child doesn't want to come and sit at the table.

So if you've got a little one who can come and color and listen and look up at you, then great. You know, you're smooth sailing. But not every child is going to be like that.

Shawna: 00:29:11

Exactly. And a big part of our learning is on motivation and understanding motivation, how to be a detective about the motivation of others.

And there's some very cool research coming out from the ABA side. She's actually duly certified at bcba. Slp. Tamara Casper.

Love her coming up with some really cool stuff using the principles of behavior analysis for early communication, shaping and teaching. And so I think that, like, there's some really cool ways that we can bridge that gap and bring the sciences together.

Brittany: 00:29:45

For sure. Yeah. A lot of our mentors and people we look up to in the field are actually SLP. BCBAs. They call them unicorns.

And a lot of them are part of this special interest group that we love. And we're so glad to be connected with them and learning from them.

Shawna: 00:29:59

Yeah. If anyone is looking for extra resources, I would always check out the Speech Pathology. Behavior. No, ABA spa. Basic Speech Pathology.

ABA Special Interest Group.

Brittany: 00:30:09

There we go.

Shawna: 00:30:11

On Facebook. They. It's such a wealth of information. They have so many members now. It is an ABA Special interest group like abai.

Brittany: 00:30:21

Right.

Shawna: 00:30:21

And so it started out that way. So probably more behavior analysts in there maybe. Actually, I don't know. I would recommend it.

Brittany: 00:30:26

It's a nice mix. Yeah, for sure. Yeah, I recommend that one. And then also SLPs against pseudoscience if we're going down that path.

Shawna: 00:30:35

I wasn't.

Brittany: 00:30:36

That'll be like a whole other episode about pseudoscience. Okay. I wanted to circle back again.

We've both talked about kind of what our fields are, field of study and then the type of professionals that we need to be. Like, we both have master's degrees, etc, but I wanted to talk about scope of practice versus scope of competency.

So we both gave examples of things that are out in our scope and out of our scope of practice and competency. But what is that mean?

And so scope of practice, like I mentioned, when I was talking about speech pathologists and I got out of breath, I was like, there is so much in our scope of practice, I. E.

As coming out as a speech pathologist, I could do swallowing, I could do voice therapy, I could do stuttering and work with autistic individuals and people with cognitive disorders. Doesn't mean that I'm competent to work with all of those individuals.

And so it's really based on the training that I have, the experience that I have, the amount of professional development I do after my degree in those. Those things, to become competent in that area. And so, for example, I don't see people.

Someone asked me today, she's a singer and she's losing her voice. And I referred on, of course, it's just not within my scope of competency, even though it's in my scope of practice.

Shawna: 00:31:47

Right, yeah, great point. And I think certainly early career professionals, it's a really important distinction to be aware of and know what you don't know.

I always felt like that was a strength of mine when I was an early career professional is like being pretty humble and knowing. Like, I don't know that.

Brittany: 00:32:04

Yeah, exactly.

Shawna: 00:32:06

And I think sometimes professional interprofessional practice can really push our comfortability in that something that we feel is we're competent in. And then you're collaborating with someone who doesn't speak your language. And I think that can really highlight how competent you are in that skill.

Brittany: 00:32:22

Yeah, that's true. And like you said, we're always learning. And so sometimes I'll think, ah, I thought I knew this, and I don't, or I need to brush up on my skills.

And so that's like another thing about collaboration. We love just like continually learning, for sure.

So let's talk then about if we're meeting a family for the first time and they want to know, okay, what's the difference between the two of you? We like to say sort of like the. The how and the what or the what and the how.

Shawna: 00:32:47

Right.

Brittany: 00:32:47

Do you want to explain that?

Shawna: 00:32:48

Yeah, I think what we often will say to make it easy to digest, there's certainly so much nuance to this is that the SLP provides a really great theoretical framework for what to teach.

So the vocabulary words, what are those steps and grammar, they're Looking at the developmental sequencing and then the BCBA is really able to come in and refine how to teach it to the learner.

And I think something for sure that I value from speech pathology is like, what types of materials are even great for teaching this skill or like reading. What's the progression for that? Y. I've worked with SLPs for a long time now, and so I feel pretty good about teaching reading skills. Skills.

But mo Again, most behavior analysts, you're not taught the progression of how reading develops and the complexities of reading and literacy and reading comprehension. And so I really couldn't determine what.

Brittany: 00:33:41

The goal should be.

Shawna: 00:33:43

You could tell me a goal, though, and I can definitely break that down and figure out what are the sort of best practices before your instruction, what should your instruction maybe look like, and what's a good consequence strategy along your teaching journey or like at the clinic speaking about reading, sometimes we'll use the teacher child to read in 100 easy lessons. Great book for teaching reading, but very dry.

Brittany: 00:34:05

Yeah. It's not my favorite for that reason to be so dynamic and. Yes.

Shawna: 00:34:10

And so it can be really good if, like a behavior tag is teaching reading gives them, like, a very simple script to follow.

Brittany: 00:34:17

True.

Shawna: 00:34:18

But they're not going to know how to go outside of that script. And what are some fun ways that we can bring reading alive? Right. And that's where, again, I would defer to the speech pathologist.

And then I myself can give the therapist strategies for how to make this activity at least motivating to complete. You know, like, not everything we do in life has to be like, the most joyful. Yeah, yeah.

But we should make it more palatable for the people that are experiencing these lessons. So really great curriculum. Dry. We can come together and improve its use.

Brittany: 00:34:48

I remember the last time we had that as part of the curriculum. The behavior therapist came, like, screaming over to me and was like, I don't know how to say this sound. And it was just a letter A.

And he was like, how do I say this? I'm teaching reading. And I was like, oh, let me break this down for you. This is such a good question.

Because you're not just going to say a if it is short vowel or a long vowel and what's your context? And I was like, I can't just answer this in a one word or a one sound thing.

Shawna: 00:35:12

Right.

Brittany: 00:35:12

So I sent him a whole sound bite.

Shawna: 00:35:14

Perfect. And again, as a behavior analyst, if I was getting ready to write that program might never even cross my mind to think about that. Right.

Like long versus short vowel sounds or like, what are the reading rules? And how do you make that digestible to a learner with a language delay? Right, right. And.

And so there's certainly so many nuances to all the skills that we're teaching. Yeah. And we, as a single professional, can certainly not know it all.

Brittany: 00:35:39

Exactly. All right, well, that leads us nicely into collaboration.

We've talked so much about that already in this episode, but we wanted to address, like, what are those barriers? Because it. We've made it seem, like, really easy and really nice, and certainly most days it is, and it's so much better together.

But there are barriers. And not everyone owns a practice like we do. And, like, so true.

Our desks, literally, we look at each other, you know, when we're writing programs, we can just ask each other questions. And that's certainly not the norm. And so I think a lot of people might struggle because you're on different teams.

Like a speech pathologist coordinating with the BCBA at the school.

Shawna: 00:36:13

Yeah, exactly. I think there's so many big picture variables that can make collaboration challenging at a systemic level. Right.

Are saying, time, who's paying for this? How do I fit this in my already so busy day? Some of those things.

But then we also have some, like, interpersonal barriers that make collaboration challenging. And there's some, like, turf wars a little bit over who owns what and who's gonna provide the treatment for that.

But I think it really often comes down to us not speaking the same language and misunderstanding what we're trying to say.

Brittany: 00:36:50

Definitely, definitely, definitely.

Shawna: 00:36:51

And like we said, like, all of us are doing this because we love it. Right. No one's doing this job if they don't like it. It's too. It's a very challenging job with a lot of moving pieces.

And so the more that we can figure out, like, what are the philosophies or what is the foundational principles of speech pathology or occupational therapy. It makes us stronger as clinicians, the more we can understand about other fields.

Brittany: 00:37:18

Totally. And like you said, we all want the same thing. We all want our clients to. To flourish. Right.

And whether that's with communication or play or just learning in general, we want them all to thrive, and that's why we're all here.

Shawna: 00:37:31

Exactly.

Brittany: 00:37:32

So, again, we've talked about, like, the benefits of collaboration, the challenges, but what about the risks of poor collaboration? Yeah.

Shawna: 00:37:41

I think for me, as a professional, all the biggest reason that I want to collaborate is that I want to provide the best service to the person. Right. Like, they're. In our case, we are in private practice, so people are paying us a lot of money for our services. Yeah.

We're often with the kids when they're little, you know, there's like only so much time. And so I think the biggest risk to me is that ineffective treatment or a redundant treatment where. Yes.

Where they're going to see a speech pathology who's working on communication in one way, and then they're coming to see us as ABA therapists and we're have introduced a picture system or something, you know, and so that's not fair to the individual and it's not fair to the parent.

Brittany: 00:38:28

Yeah, exactly.

Shawna: 00:38:29

They don't know what. How to navigate whether they should be doing a picture system or what the speech pathologist is doing. And if we. Yeah. If we had.

Have just collaborated.

Brittany: 00:38:38

Yeah, yeah. It's so true. And so we've seen clients like that. Right.

Where a client is given, like a speech generating device or an iPad to use for communicating at the school, but then it has to say at the school and it belongs to the school. So then what happens at home? Like, the family is kind of doesn't have that same system.

And then they might go to private therapy and might be given a completely separate system.

Shawna: 00:38:59

Right.

Brittany: 00:39:00

How confusing for that poor child.

Shawna: 00:39:02

Exactly, exactly. And so I. To me, the risks of poor collaboration are ineffective treatment, we're wasting time for the client, we're wasting money of that family.

Families. And as a professional as well, their risk, of course, is that I don't know everything and I can't know everything.

And so of course I should consult other people and get them to. That are already with that child to help me fill in those gaps.

Brittany: 00:39:28

Right, yeah, exactly. So people ask us sometimes, how do we do it? And I. I would say we're not perfect either, for sure.

And we're always striving to learn better, know better, do better, and like, learn, learn together is I think, what I'm trying to say.

Shawna: 00:39:41

Yeah, exactly. I think we both really respect the experience, education and personal views of the other one.

Brittany: 00:39:50

Yeah.

Shawna: 00:39:51

And we have, I think, a really unique perspective because we're moms of young children, we're clinicians, and we've had some really awesome mentors.

Brittany: 00:40:00

Yes.

Shawna: 00:40:01

And are both so passionate about what we do.

Brittany: 00:40:03

Yeah.

Shawna: 00:40:04

And that then we are able to then find a gap and be willing to work together to solve that gap in communication or overcome. I think in speech pathology, they say the progression is this. And then I might say, oh, you know what in my background, like, this is what I've seen.

And then we're able to close that gap because the communication can stay respectful instead of shutting it down or being like, you don't believe in this, so I can't even talk to you about it.

Brittany: 00:40:28

Yeah, exactly. And I certainly. There's been like imposter syndrome times as well.

Like I said, like, my training on autism was so itty bitty in my masters that I feel like I can still never learn enough.

And like, sometimes I'll think, oh, well, you just obviously know more about this one specific thing because it wasn't always a core part of my training. Whereas then, like something different I might feel really confident in. And so we, you know, again, just try to take what we know and go from it.

Go with that.

Shawna: 00:40:54

Yeah, exactly. I think we're looking at.

I'm thinking of an example where in speech pathology they might have an approach for reading, for example, something you would have learned a lot about and know a lot, lot about. And then I got no instruction at all on reading.

Brittany: 00:41:11

Right.

Shawna: 00:41:12

And then I've got a minimally vocal autistic learner who is reading on his own. Right. So he hasn't followed the regular developmental trajectory. But what I can then do is I can observe his current skills. Right.

And kind of report back to you and be like, okay, this is where he's at. He's can read 400 words. What should we do? Right, right. And then it's not that I need.

I'm going to follow maybe exactly developmental sequence from speech pathology, but I'm going to then chat with you about what is that sequence and which gaps might this learner have that I should then be considering for treatment?

Brittany: 00:41:48

Yeah, exactly. I love that. I think that was really well said. Thank you.

And so again, like, coming back to what we do, we both own a practice, then we work there every day together. And so our practice is multidisciplinary or interprofessional. And that's the approach that we use.

There's a fantastic article by Lena Slim and Lilith Reuter Yule, sorry, Lilith. That talks all about interprofessional collaboration and the different types.

But what we feel like we do really well together in this multidisciplinary approach is right away when the clients call us, we take the calls together. And so we're trying to get the different aspects of learning and communication and play right from that intake call.

We do the assessments together and we do those collaborative assessments. And I love doing that. You know, you're chatting with the parent while I'm on the ground playing with the child.

And then we swap and we're both looking for sometimes the same thing and sometimes very different things. Like I'll be taking a speech sample and a language sample, and then you'll be saying, can they match or can they imitate or can they. Like, how. What.

What do I do if I disrupt the routine and what happens? Right.

Shawna: 00:42:50

Yeah, exactly.

I think exactly like you said, we're looking at sometimes the same thing, but usually some different things or slight nuances to this skill where we're both still adding a lot of value to that collabor.

Brittany: 00:42:59

Yeah. And this is an interprofessional approach that we use.

And so we're doing those assessments together, we write the report together, we have the family discussion, and then we often break off and we'll say, okay, now, ABA might take on most of the programming, but I'm going to consult to it.

So I'll give you the verbs and the nouns that I think we should work on, or I'll give you the vocabulary, and then I'll be in regularly supervising or consulting.

Shawna: 00:43:22

Yeah, exactly. That's what we've found works extremely well. Some of the things that we find are challenging. Challenging can be.

If we're meeting with other service providers outside of the clinic, it can be hard for them to understand, like, what you do versus what I do. And so, like, if it's like a daycare support worker, they're not sure which one of us to meet with.

Brittany: 00:43:46

And parents, too. That happens all the time.

Shawna: 00:43:48

Yes, exactly. And I do think it's because we have so much overlap.

Brittany: 00:43:51

Yeah.

Shawna: 00:43:52

In our scopes of practice that then we really. It could be either one of us is fine, but then some parents will.

Brittany: 00:43:59

Come to me and say, what do I do about this? And I'll say, oh, my gosh, that's definitely a Shauna. We'll pull her in. Because that's definitely more your domain.

And like, I think that's a good point too, is we kind of, I wouldn't say know our lanes because there's so much overlap, but we know where. Like, again, coming back to that scope of competency versus practice, like, I know I'm not competent if this. They say, like, what do I do? He's.

He's hitting his sister. That's not going to be my domain.

Shawna: 00:44:21

Yeah, yeah, true.

Brittany: 00:44:22

All right, well, we're wrapping up for the second episode. We wanted to just give some practical tips for professional professionals, whether you're in speech pathology.

ABA or occupational therapy, Psychotherapy. Like, there's different ways that we all really can collaborate. So we wanted to leave with some tips.

Shawna: 00:44:38

Yeah.

I think what we were talking about is like, we've got a model, but we are also the owners of that clinic and we can sort of design a world that works for us. And most people are probably not living in that world.

Brittany: 00:44:50

Right.

Shawna: 00:44:51

I was reading a couple blogs before preparing for this and saw one that talked about an expert mindset versus client centered therapy. And I thought that's such a nice way of sort of wrapping things up. Is years ago, I think we all thought of an expert mindset.

You go to the doctor, the doctor tells you what you need. You go see a psychologist, the psychologist tells you what you should do. You see a psychiatrist, they give you medication. Right.

Whereas I think in society now it's a much more whole holistic approach.

And so we should all leave that expert mindset behind and be coming in knowing kind of where we can add value to this individual's life and certainly advocating for those benefits that we think we can provide. Right.

But understanding that the individual and their family know really what's going on every single day and have the best understanding of what will work.

And so while, I don't know, maybe I use the picture exchange communication system is my most often AAC model model, I shouldn't come in and then say, that's the only way to do things. Right?

Brittany: 00:45:57

Yeah, for sure.

Shawna: 00:45:57

And so I think getting rid of that expert mindset and coming in with this idea that our goal is to help this child thrive.

Brittany: 00:46:04

Totally. Yeah, totally.

And I think we always say too, like, if you've had experience with speech pathology or ABA in the past, it doesn't mean that the type of professional that you saw is what we do as well. Like, we all have our own different styles and unique way of doing things, and ours just happens to be really cool. Collaborative.

Shawna: 00:46:20

Exactly. And so I think, like, leaving your ego behind, coming ready to be humble and respectful to the other professionals and what they might try to do.

Something that I'll try to do for sure in the autism world is look at sort of some of these buzzwords and themes in autism treatment prior to a collaborative meeting with an outside professional. So if I'm meeting with an ot, I want to know, like, what are some of the common approaches they're doing?

And so I'm going to look to the OT literature for that. Or in speech pathology, what are some of the common approaches we're seeing in the speech pathology?

Litter so that I'm already primed on what language. By language, I mean terminology they might be using in our meeting, so that I can quickly and easily reinterpret that.

Brittany: 00:47:05

I love that. But that's rare. Most people aren't coming in saying, oh, I read all these OT vlogs last night.

Shawna: 00:47:10

I do love my work.

Brittany: 00:47:12

But that's so cool.

Shawna: 00:47:14

Right.

Brittany: 00:47:14

And that is a nice way to. Into a meeting. Yeah.

Shawna: 00:47:17

And I think it also makes me obviously, a much stronger clinician. And obviously we're not going to chat about this right now, but Gestalt language processing is like a big buzzword. Right.

And so if I'm going into a meeting with a speech pathologist, I should assume that word's going to come up.

And as a behavior analyst, I should also feel confident that I know the literature behind that, I can talk about it, and I'm able to be a good advocate for the family, whichever my stance is.

Brittany: 00:47:44

Yeah, I love that. Yeah, we'll talk about that later. Yeah, definitely be a topic.

But I like how we also say, like, we don't want to put the parents in an awkward position or the client where they aren't like, the referee between the two professionals. We've been in those meetings where it's heated across professionals and it's just not nice. It's not fun at all.

Shawna: 00:48:00

Exactly. I find it so frustrating. And I feel for the parents. Right. Like, as a parent myself, I want someone to tell me what to do.

I want to do what's best for my child.

Brittany: 00:48:08

Exactly.

Shawna: 00:48:08

And so if the professionals are giving me different advice, how challenging is that for me to figure out?

Brittany: 00:48:12

Right. And that's one thing, again, I love about our practice is I know if.

If you're giving advice to a family, like, it's likely going to be so similar to what I'm saying, if it's about our shared domains. And then we've certainly been in parent meetings where I'm like, oh, I think we should do this.

And you'll say, actually, like, let's maybe tweak it a little bit differently or something. And vice versa. And I love that too, where we're not shy to say, like, oh, actually, you know what?

From my perspective, I think we should wait on that and, like, do this first. And I'll say, oh, yeah, you're probably right.

Shawna: 00:48:36

Right. Yeah, something. Or I'm thinking if you gave a suggestion for something that sometimes I might say, you might also consider adding this on.

Brittany: 00:48:44

Yeah, yeah.

Shawna: 00:48:45

Or like, how to bring kind of two strategies into.

Brittany: 00:48:48

Right.

Shawna: 00:48:48

Right, yeah. And so for parents so challenging, right? You've already got a lot on your plate. You've got a.

Probably a neurodiverse individual that you're supporting. And so how can you be that champion? And you're to bring all of these different pieces together.

Brittany: 00:49:07

And I would say we've coached parents, especially around, like, August, right? When in Canada, schools start again in September. And we're saying to them, book a meeting, right? And they'll say, like, oh, I don't know, should I?

And we're often saying, hey, you gotta be that advocate for your child and, like, boosting their confidence around it is what I'm trying to say.

Shawna: 00:49:23

Right.

Brittany: 00:49:24

And saying, hey, book that school meeting and we're gonna be there with you. We got your back. And, like, we're not.

Not that there's, like, a reason to have that, but, you know, we wanna make sure that everyone's coming together for the purpose of that child. And so we're often saying to the parents, yeah, like, have a team meeting. But. And not all of our clients do that.

It's really the one, like the parents who kind of speak up and say, hey, I'd like to book a team meeting with everybody coming together. And sometimes it's like, all we have is five minutes. We've had those. Or sometimes we have an hour.

But we really need to come together and at least share here some of the joys that we see at the clinic and ways we're working on something. And then what are the challenges you're having at school? Because we can work on that, too.

Shawna: 00:49:57

Yeah, exactly. And I think as a parent, like, appreciating sort of some of these systemic and other barriers that we've highlighted today for the professionals.

Right. And so for you to be that person that keeps everyone together, unfortunately, is another job for you.

But you could always talk to the professionals you're working with and set up some sort of consistent cadence. Like, we all get together every six weeks and we spend 30 minutes talking about my child or something like that.

Brittany: 00:50:27

Right. And then if time is such a barrier, we do have clients who have, like, a book, Right. Or a binder that goes in their backpack.

And I'll write something from my session, you'll write something from your session. And then the teacher or the EA is also giving some information about what happens happen that day.

Shawna: 00:50:39

Yes, exactly. Getting creative around collaboration can be super helpful.

Sharing reports that you get from one provider to the next and being appreciative that the professionals that are collaborating probably don't have the time.

You know, we're lucky because we get to create the environment that we work in, but most people are not that lucky and so are probably putting in those extra hours outside of their paid time.

Brittany: 00:51:05

Yeah, for sure. And so if you're doing that, we see you. We've been there for sure. It's why we designed our practice together. But I think it's so important.

And if you're listening to this episode, you also value that collaboration. So kudos to you. Keep doing it, even if it's challenging. You will see such a benefit to collaborating.

And like we always say, it's just like, the best for the client and it makes our work environment better too. So remember that too. It's not just for the client. It's actually nicer for us when there's a shared, shared goal for the client.

Shawna: 00:51:35

Exactly. And professionally, I've learned so much from collaborating with others.

I remember when I first became a behavior analyst, one of our competencies is on interprofessional collaboration. And I would just be like, I don't know how to collaborate with a speech pathologist. I. And I was trained from a BCBA slp.

She was probably a little bit more ABA leaning. And so I would go to these meetings and just feel like I was banging my head against the wall.

Like, I just couldn't figure out, like, I was trying my best, and I just felt like I couldn't come out the other side. And. And then finally, I think from working with you more, I was like, oh, my gosh, we are saying the exact same thing.

We are just speaking a different language.

And so what I've really found as a behavior analyst is if I speak speech pathology, then people like me a little bit more and get a little bit more buy in about my approach or that I'm not just coming in saying, no core boards, no this, no that. You know, I really am like, I'm trying to keep up with your lingo and what you are saying. Yeah.

And it took me probably five, six years after becoming a behavior analyst to really, like, put two and two together and realize where that gap was.

Brittany: 00:52:42

Oh, same. Absolutely. And now I can throw a man intact. And at a dinner party.

Shawna: 00:52:48

We go to very exciting dinner parties.

Brittany: 00:52:51

Oh, yes. Awesome. So thanks so much for listening, everyone.

Shawna: 00:52:56

Thank you.

Brittany: 00:52:58

Before we go, we want to remind our listeners that topics we discuss in the podcast are not a replacement for professional medical advice. Please contact a professional if you have questions.

Shawna: 00:53:07

And just a heads up, we'll use both identity first and person first. Language to respect different preferences.

We'll also say treatment and therapy, since we come from a clinical space, but always with respect and a focus on what works for each person.

Brittany: 00:53:19

See you next time.

Shawna: 00:53:20

Bye.