Beyond Bilingualism: Rebalancing the evidence-based practice triangle

This is a transcript from our podcast episode published November 28th, 2022. The podcast episode is offered for .1 ASHA CEU (intermediate level, related area). This transcript is made available as a course accommodation for and is supplementary to this episode / course. This transcript is not intended to be used in place of the podcast episode with the exception of course accommodation. Please note: This transcript was created by robots. We do our best to proof read but there is always a chance we miss something. Find a typo? Email us anytime.

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[00:00:00] Kate Grandbois: Welcome to SLP nerd cast the number one professional resource for evidence based practice in speech, language pathology. I'm Kate Grandbois 

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[00:01:43] Kate Grandbois: Hello, everyone. Welcome to today's episode. We are so excited to welcome back. Some of our favorite guests. Welcome back. Ingrid Owens-Gonzalez, Liza Selvarajah and Desi Pena. Welcome back. [00:02:00] 

[00:02:00] Liza Selvarajah: Thank you. We're so happy. 

[00:02:04] Amy Wonkka: We're so happy to see you here. Ingrid, Liza and Desi.

You are here to discuss issues related to culture bilingualism and speech language pathology. But before we get started, please tell us in our listeners a little bit yourselves. 

[00:02:20] Liza Selvarajah: Oh my goodness. I didn't know we were doing that again. Okay. um, I am a bilingual S L P French and English. Based in Montreal. Uh, let's say I have a private practice called Montreal speech therapy, and I just love, love, love, mentorship, and supporting just a multicultural way of thinking and working and learning.

[00:02:48] Desi Pena: I'll jump in. Um, so I'm Desi. And actually now that you mentioned your own private practice, I realize I never mentioned my own last time. Um, so I'm again, like I said, I'm Desi, uh, [00:03:00] Spanish, English, bilingual, SLP. Um, I also own a private practice here in Maine called Panorama speech therapy, LLC. Um, I'm still mostly contracting, um, with schools and agencies in the state of Maine.

Um, and I guess another fun fact about me is that I've lived all over the east coast. Um, but most recently landed in Maine. So I’ll hand it over to Ingrid. 

[00:03:27] Ingrid Owens-Gonzalez: Hi guys. Um, my name is Ingrid. I am a school based SLP, Spanish bilingual, I'm based out of Northern New Mexico. I'm first gen Mexican American. And, um, I just love working with kids.

I love working with multilingual multicultural kids, and I have a lot of things going on, um, that Kate will share with you on the disclosure section. But right now, uh, mentorship is really at the forefront of what I'm doing online. And I [00:04:00] just launched my speech place, LLC this summer. So

[00:04:04] Kate Grandbois: we're so glad to have you all back with us, and we're really excited to continue the conversation that we started with you during your last episode. Here with us. Um, and I wanted to take a minute before we start our conversation to read our learning objectives and our financial and non-financial disclosures.

So everyone bear with me. We will try to get through this part as quickly as possible. We've got five people here today, so it's a, it's a lot of disclosing, uh, but we're gonna get through it. Okay. Learning objective number one, describe the potential harms of over-relying on external evidence for multicultural and multilingual learners 

Learning objective number two, list at least two strategies to prevent harm in evaluations during the diagnostic process and learning objective number three, describe the importance of balancing the three pronged evidence based practice model when determining treatment. [00:05:00] 

Disclosures. Ingrid's financial disclosures.

Ingrid is the owner of my speech place, LLC. And is the employee of a public school. Ingrid also received an honorarium for participating in this course. Ingrid's non-financial disclosures. Ingrid is the co-founder of the bold SLP collective and the co-host of the bold SLP podcast. Ingrid is also the co-founder and lead mentor of the bilingual empowerment through allied mentorship program and an Asha step mentor.

Ingrid is also the mother of two bilingual and bicultural children. Liza's financial disclosures. Liza owns a private practice called Montreal speech therapy. Liza received an honorarium for participating in this course. Liza's non-financial disclosures. Liza is the co-founder of the bold SLP collective and the co-host of the bold SLP podcast, and is a mentor of the bilingual empowerment through allied mentorship program.

She is the mother of a bilingual and bicultural child. Desi's financial disclosures. Desi is the owner of Panorama speech therapy and [00:06:00] is faculty of the main New Hampshire leadership education and neurodevelopmental disabilities program. Desi also received an honorarium for participating in this course.

Desi's non-financial disclosures. Desi is the co-founder of the bold SLP collective and the co-host of the bold SLP podcast. She has a mentor of the bilingual empowerment through allied mentorship, and she is a child of Cuban exiles and is also raising a bilingual bicultural child. 

Kate Grandbois that's me, my financial disclosures.

I am the owner and founder of Grandbois therapy and consulting LLC, and the co-founder of SLP nerd. My non-financial disclosures. I'm a member of ASHA SIG 12, and serve on the AAC advisory group for Massachusetts advocates for children. I'm also a member of the Berkshire association for behavior analysis and therapy, the association for behavior analysis international and the corresponding speech pathology and applied behavior analysis, special interest group. I am a person of monolingual experience and a person of cultural privilege as a CIS white woman [00:07:00] in the United States of America. 

[00:07:02] Amy Wonkka: Amy that's me. My financial disclosures are that I am an employee of a public school system and co-founder of SLP nerd cast.

And my non-financial disclosures are that I'm a member of ASHA. I'm part of special interest group 12, and I serve on the AAC advisory group for Massachusetts advocates for children. I also come to this discussion as a person who's experienced cultural privilege, uh, being a white cisgender woman in the United States of America.

All right. We've made it through everybody's disclosures, learning objectives. Um, Ingrid Liza and Desi. Why don't you start us off with the first learning objective and talk to us about the potential harms of over-relying on external evidence for multilingual and multicultural clients. And maybe before we start just a little recap on external evidence, what is that

[00:07:50] Ingrid Owens-Gonzalez: you want me to jump in or Desi. 

[00:07:53] Desi Pena: You go first Ingrid you're up. okay. 

[00:07:58] Ingrid Owens-Gonzalez: So objective one [00:08:00] potential harms. I mean, they're really, truly immeasurable because you're impacting people's lives. So it's not something to look over. It really like sit in that word causing harm. Um, but external evidence is pretty much everything that is standardized or data driven outside of who you're looking at.

So all the things that have been done outside of the person that you're treating, uh, more formally, it would be like standardized assessment, criterion, uh, checklists, things like that. That really don't have anything to do with who you have in front of you. Um, so that, that's kind of what we're like talking about when we say external evidence.

And then as we know, we are very, very comfortable with that triangle. Uh that's. It irks me to see it written in black and white letters. It says that that's the best available information [00:09:00] gathered. Um, it's right on the ASHA website. And I know they're talking out about what the best available scientific evidence that's available, but just by putting that word right there, that's the best available information, then it makes it kind of imbalanced.

Right. And that's kind of like our whole goal with this conversation. Um, it is just available information. We don't have to call it the best. Um, but it's just data and, you know, there's other forms of data. Like the ones you collect from your client and from the family and their perspectives. 

[00:09:35] Desi Pena: Um, and I just.

Wanted to jump in just quickly to say that, um, the reason that the data isn't necessarily the best for multilingual or multicultural learners is because a lot of the data is really centered or gathered from children of, uh, a white mainstream general American English background, um, children who are not exposed to more [00:10:00] than one culture.

And so it's the harmful piece about relying on that evidence is that you may be over or under diagnosing children with communication needs. Um, and what was really interesting, we recently. Recorded an episode, um, with Dr. V. Um, she's a professor at Howard and she really highlighted the point that, um, you know, everybody's comes from an individual place, right?

We, we say, you know, multilingual multicultural, it, it's not, there's no such thing as a monolith, right? Like each child has a certain dialect that they're exposed to, whether that's mainstream English, speakers, whether that's Spanish speakers, whether that's, you know, people who may speak, you know, one of the many languages and for example, India, right?

Like everyone has a dialect within a language. So it's something that, again, the external evidence isn't really accounting for [00:11:00] external evidence really looks at not so, so much like the granular details, pieces, but it looks at populations as a whole, which can be really harmful because then we're not individualizing our evaluation and our treatment, which is the whole point.

[00:11:16] Ingrid Owens-Gonzalez: So, well then you're looking at, if you're not represented in that external evidence, then it doesn't apply to you. Right. And so then. You get to the point where you're like, do I need to do research on every single population? It's like, no, you need to make smarter research. Mm-hmm that applies to every single population 

[00:11:36] Desi Pena: or be a better clinician, getting your clinical eye in tune with the fact that, oh, someone from the north of Mexico doesn't speak the same way as somebody from the south of Mexico, I should be accounting for the fact that there are dialectical differences and this happens to bilingual SLP all the time, too.

So, um, I think it's really important to sharpen your critical tool kit, you know, critical eye in your [00:12:00] critical thinking toolbox rather than assuming that the evidence is the best thing you can lean on. 

[00:12:07] Liza Selvarajah: Mm-hmm 

[00:12:08] Ingrid Owens-Gonzalez: mm-hmm and in terms of harm, um, I just wanted to highlight that I know that we're coming from a, um, pediatrics centered lens here, but when I was working with adults, Whenever you're using external evidence to make decisions about dysphagia and not making decisions based on the patient that's in front of you.

You can cause a lot of harm, not just physically, but also culturally to that family, putting a lot of undue burden for not considering their cultural practices. Um, you can cause a lot of harm if you're serving a family, um, who has a family member, who's had a TBI, and if you don't consider their cultural, uh, practices, then you make recommendations based on external evidence instead of what this family really needs or what this patient [00:13:00] really values.

Um, so it goes across, um, our scope, even though all three of us are now are more school based pediatric, but like relying on external evidence, like Desi said, um, can lead to over identification in the schools or under identification. And it's the same in outpatient. It's the same in acute care. It's the same, uh, in a SNF.

[00:13:27] Liza Selvarajah: I just think of who had access to education back in the day, who was all of this written for, who were the norms standardized on? What was one's best practice? What was one standard is no longer the standard. And if we could reflect on that and see that the standards themselves, the external evidence is no longer good.

What do we do? And how do we create these new ways of thinking? I, I was thinking how I was a little bit caught off guard at the beginning when I was asked to introduce myself thinking, oh, this is a [00:14:00] part two. I don't need to introduce myself. And I did. And my introduction was so different from the last time I introduced myself just one week ago and I am the same person.

And within a week I've evolved into something new and something different. And to compare me to like a little white kid is so different. So how can that be the standard? Um, I think of setting kids up for failure. This is what it feels like. You are setting them up for failure, testing them on things that they are not familiar with that are not part of their culture, not part of their background.

If you set them up for failure, then they will fail. And that is the harmful effect of it. Uh, effect of it. They're failing at something because we set them up to fail. 

[00:14:44] Kate Grandbois: I wanna piggyback on something that you said. So, if you're listening to this episode and you haven't yet gone back and listened to the first episode that we published with you all in that previous episode, we talked a lot about cultural [00:15:00] competency.

We talked a lot about, um, how you can do harm by not doing the work of cultural competency first, when working with children who are not monolingual, who are bilingual, who are multicultural. Um, so if you're listening, I just encourage you, today's episode. We are gonna be diving into the, the clinical application.

So please go back and listen to that. If you haven't. The second piece is I, I, as you were talking, as all of you were talking, I was reflecting on our jobs, which as I know a very general perspective, but we are trained as I'm putting this in air quotes experts, right? We are the commun. We are trained in communication, diagnosis, and intervention.

That is what we go to graduate school for. I don't believe in the term experts. So air quotes, but you get my flavor, right? And if we don't, what I'm hearing about this potential harm, I think it's, it's goes [00:16:00] without saying that many of us, most of us are taught in graduate school to rely on external evidence.

We are taught when we go through the evaluation process and we practice, sorry, I'm imagining myself as a grad student, I've got my easel, I've got my booklet. You know, I'm, I'm doing an evaluation for the first time and I am taught that assessment. Is a norm reference test. I am pretty confident that that is a standard experience.

And yet there are so many people, not at all represented in that test. That is in fact, not my understanding is that this not an accurate measurement. It has, maybe it has its place. But what I am appreciate so much about your perspective is not only is it not an accurate measurement, but it is harmful to rely on that as a measurement.

Um, Desi, I think, or Ingrid, I think you were the one who just mentioned the potential harm, not just of the over diagnosing and underdiagnosing, but the cultural harm, the emotional [00:17:00] harm. Uh, and that's what made me think of going back and really looking at this through the cultural competency piece, um, because the potential for harm is, is multifold.

[00:17:12] Desi Pena: I wanted to add on to that, that when in reading about, um, approaching evidence based practice from a, a legit three pronged approach. Um, and I know this is jumping into a different objective, so I'm gonna say it very quickly. Um, there is a standardization approach and that's a term from this one, um, article, uh, in social work that is linked in the show notes, I think, um, and just seeing standardization approach.

Oh, and this ties back to what I was thinking about. Um, seeing that, that written out, it kind of made me feel seen too in a way. Um, I think about this recent mentorship meeting, we were, um, meeting for the BSLP program. We met with students who are trying to enter the field of speech pathology [00:18:00] and they all had concerns about the GRE.

The GRE was not designed for any one of us. Um, you know, I was labeled as an English language learner when I entered school. Funny enough, I kind of questioned that now, if I should have even been labeled and received those services, um, You know, and I think that because of the fact that I'm bilingual, I just didn't, I'm not accurately represented those scores don't represent my actual abilities. And so I remember feeling that anxiety of I'm not gonna, I know I'm not gonna look good on paper, um, or on these standardized test scores. And it's because I'm not the standard. And I know that when those students brought those questions up to us, um, we all felt the same way.

We all felt seen. It, you know, these tests don't, don't act, don't accurately capture our abilities. And so it's really nerve wracking when it's part of an admissions process. Um, and I think that it's great that more [00:19:00] universities are moving away from those standardized tests, cuz they just don't really give you a sense at all of who that person is.

Um, when I taught, um, Uh, I, I did a master's degree in, in Spanish. Um, before I became a speech pathologist, um, I had a student who, um, they had to show proof of placement, right. That they could be placed in this, in this certain level of a Spanish course. And I had a student who showed me, uh, a copy of her SAT two scores, I think it was.

And so it gave me the whole report, you know, what she got on her SATs. I mean, I don't, I'm not sure that that person broke 1000, um, you know, on the SATs, which back in the day, I don't know what, you know, what the numbers are now, but, you know, it was not a great score. Um, you know, it, in terms of like getting admitted to a university.

It just, it's something that really I held onto. She was my best student that semester. I mean, she just got like a 98 in the course [00:20:00] or something and she was super dedicated and it meant nothing to, you know, to see those numbers. Um, and it just made me so angry because of course she was a student of color.

Um, and. Sh, you know, again, like put her, put her on paper, she doesn't look that great. You put her in front of me. She's a wonderful student. It just, you know, I'm, I'm glad that she made it to that level of achievement. And I wasn't a barrier. Like thankfully her university saw something in her. Um, but it makes me angry at the same time.

So I think it's hard to remove that piece here. Right? Like it's not all it's, it's harm in the sense of emotional harm, um, cultural harm. But then we're also talking about harming people who may, you know, who, who are successful or who can be successful. And it really kills me, uh to bring this up. But I think it's also something that, um, is a necessary part of this conversation.

It goes beyond whatever [00:21:00] pathology, right? Air quotes, um, or disability like this affects people from all backgrounds, um, who may or may not have a disability. Yeah. 

[00:21:10] Ingrid Owens-Gonzalez: And to wrap up, um, learning objective one. I wanted to walk you through a scenario, uh, that I see in the schools a lot whenever, um, a bilingual S L P or any really bilingual professional is not involved.

Um, you see a student come in in kindergarten, who is coming from a bilingual home. They get screened right away. Uh, maybe they fail the kindergarten English screener. And so they get referred to the bilingual department or to the RTI department, whatever you call your RTI team at your school and your district.

Uh, and then they get further into their career kindergarten, first grade, and they're struggling to communicate. They're struggling to read, [00:22:00] and then you either can go one direction with it and say, oh, let's just wait, because he's bilingual. Or you can go the other direction with it and say, oh, we gotta put him, gotta test him, gotta test him.

They gotta be in, in special education. And so if you're over relying on these tests, how do you know which way is the right way? If you don't have the other two pieces of that triangle, if all you have is, oh, he didn't pass the kindergarten screener and oh, he's not doing well on insert, whatever standardized tests your school uses to measure reading.

You know, we used to use DIBELS and now we use, um, something station, you know, insert, whatever test. Um, how do you know what recommendation to make if all you have are numbers? Um, and so that's kind of what I wanted [00:23:00] to pause it to you guys in terms of harm. Um, If the student truly has a, a communication disorder, you have now waited two years to support them.

And if the student doesn't have a communication disorder and instead is, uh, emergent bilingual, you have now waited two years to support them in another capacity, right? Because we have systems in place to support English language learners, but you were just waiting, waiting for what, for him to fail another test, you know, when all that other piece of the triangle was there to begin with, you could have talked to the parent, looked at their language, history, uh, looked at their background.

Have they been to daycare? Have they been to preschool? Are they the youngest sibling? Are they the oldest sibling? Uh, is there a history of communication disorders in the family is their parent concern and [00:24:00] you just sitting there waiting. To find out. Um, so that's kind of where I'm coming from in terms of that learning objective.

And I hope that kind of wraps it up pretty well. And then we can go to learning objective number two. 

[00:24:17] Kate Grandbois: No, it does. And I just, for the sake of our listeners who we've been referencing, this triangle, we've called it a three pronged approach. Um, I was not aware that this was our, our, that our evidence based practice model was three pronged until pro, maybe it might have gotten shown to me in graduate school, but it wasn't the way I practiced.

Um, and so for anyone listening, if this is a novel concept to you, you are not alone. Um, I didn't learn about it in, in terms of embracing it as part of my practice until I had probably been practicing for a handful of years and for the sake of leveling the playing field and making sure everybody who's listening knows what we're talking about.

Our evidence based practice model and speech pathology [00:25:00] is three-pronged as a triangle. I bet you could have guessed that given that's what we, what we've been calling it so far. Um, and that triangle is made up of evidence, which is both internal and external evidence, cultural per, um, client perspectives and values and clinical judgment.

So again, often in speech pathology, we tend to think of quote, evidence as hard numbers research this component of external evidence. But that is one third, maybe even less than one third, because evidence is broken less than one third internal and external, right? So, so the, um, we really need to make sure that we are moving through evidence based practice as a process.

With equal reliance on at least three of those components and they influence one another. Um, for anybody who wants to learn more about that, we actually have an episode with, um, Dr. Mary Beth Schmidt who wrote the EBP, uh, briefs about this process. [00:26:00] Um, so if you wanna learn more about the evidence based practice process and speech pathology, I will, uh, link that episode in the show notes.

Anyway, carry on. I love that. 

[00:26:10] Ingrid Owens-Gonzalez: You said that like you haven't, you weren't trained in EBP and yet, you know, you weren't practicing at the beginning. I feel like none of us, well, maybe Desi, but, um, I went to grad school 11 years ago. I definitely was not trained on EBP. Yeah, I was. I think we don't talk about that enough.

Like you come out and you're still learning.

[00:26:28] Desi Pena: I think the, the problem. I went into the, my assessments in grad school, the same way. Carry in your kit, bring your protocol, come on down. You know, like I never felt like, I, I mean, I, I had a, I think a few nuanced evaluations, like they were very excited cuz they had a bilingual client for me to evaluate as my first client.

And it, it was a scramble. I mean, I don't mean to put down anyone from my program. They did the best they could. Um, [00:27:00] but I. I felt like my evaluations were test after test after test. Um, and I, you know, I know that we're, we read the manuals, we look at what evidence is in them that they'll work, you know, reliability, validity, sensitivity, specificity, but a lot of our instruments are not that great or robust even with the populations that form the standard sample.

So, you know, it's really disappointing, um, to over rely on them so much. And I feel like, you know, you're very kind and , I'm not saying that I got bad training, but I, I think that one of the things that happens when you're a bilingual speech pathologist is you quickly pivot away from that training you might have, or you might start questioning things.

Um, why is it this way? Why. Why are we using this as the baseline? When our [00:28:00] clients aren't in here, right? They're not, they're not represented here heavily. It's not super well designed or, you know, part of my diagnostic class was looking at sensitivity and specificity and reporting it out. We all had to do, take a test and, and spell it out.

Um, and I, it was shocking after weeks of talking about what is sensitivity, what is specificity? What is content validity? I feel like when we started looking at all of those different elements, we quickly realized, wait a minute, those aren't all spelled out in these manuals.

we were just like, oh, Hmm. So I wish my direct, my, I wish my professors had been like, Hey, they're not great. And I wish that that had been a conversation from the beginning, but it felt like the unspoken piece of grad school. 

[00:28:50] Liza Selvarajah: That's that's it right there, the unspoken piece. So no one ever said rely the most on the evidence, but that's what we saw.

So when I [00:29:00] think of the triangle and, and thinking back to grad school, to me, I was like, okay, again, we talked about me thinking in pictures. So I was like, okay, what does client values mean? What does clinical judgment mean? What does evidence based mean? Okay. To me client values, they filled out the intake.

So I've got their values right there on this piece of paper. So check, I did that part of the triangle, which is of course ridiculous. Now that I think about it, cuz it's so much deeper and a vested relationship is necessary and all these things. Anyway, so I checked off intake, got the client value. Then I was like clinical judgment.

I don't have any, I better go really hard on the external editing. 

[00:29:35]Kate Grandbois: I love that. I feels that way sometimes I'm laughing

[00:29:37] Desi Pena:. No, but. And you, they make you feel like you don't have any either. Sometimes, like not to, again, I'm not trying to crap on, like, 

[00:29:47] Ingrid Owens-Gonzalez: you didn't just finish a whole bachelor's degree on something else and pass the GREs and no.

[00:29:56] Liza Selvarajah: But here's, here's the crazy part. So I would like you have my whole kit read the [00:30:00] manual, like I'm so stressed about, did I turn the page at the right time? And am I reducing the validity? Because I oh yeah. Oh yeah. Teared the child down. Did I look at the answer? And that's why they pointed. I don't. So the stress was high.

[00:30:13] Kate Grandbois: It's so stressful. 

[00:30:15] Liza Selvarajah:And then this is, again, this is a grad school experience. Not today. Now I'm just like, yeah, flip it. It's all good. So, so then once I get all my data, my, uh, my excellent data from this child that it definitely was not normed on. Then I put in receptive skills, this based on the score, expressive skills, this, oh, there's my clinical judgment, severe diagnosis and check.

So I've got my three prong triangle, not realizing it's basically like a isosceles, you know, just like super heavy on this, these couple tests. 

[00:30:45] Desi Pena: Look that you're bringing out the geometry. I can't. 

[00:30:47] Liza Selvarajah: I had to look, I looked it up while you were talking

[00:30:48] Ingrid Owens-Gonzalez: what's the tangent, Liza. 

[00:30:55] Kate Grandbois: This is the first time geometry has made an experience on this show.[00:31:00] 

[00:31:00] Ingrid Owens-Gonzalez: why aren't we naing 

[00:31:01] Desi Pena: on the I'm sweating bullets a second. You say I saw solo. 

[00:31:04] Liza Selvarajah: So I brought up the isosceles triangle because the point to me was that it was so heavily based on external evidence.

And the other two were just little ch little ticks, little check boxes. They weren't actually equally being weighed. And when we talk about Bicultural bilingual kids, we actually have to weigh much, much more of it on the client values and our clinical judgment, because the external evidence doesn't match.

So that's yeah. That's why I brought up the new triangle. you're welcome.

[00:31:36] Ingrid Owens-Gonzalez: Love it. I just wanted to add that through that, like even within evidence, we tend to value external evidence over internal, and I kind of feel like we group internal evidence with. Client values, cultural values, further, you know, diminishing the importance [00:32:00] there, like, oh, what we see about their, their culture or their language is more important than what they're sharing with us.

So, yeah, it's the mess of a geometry. It's not a triangle. It should be, but it's not.

[00:32:12] Desi Pena: I was gonna say, and if we're trying to get to the second objective about naming solutions, um, I wanted to share one of the things that I use the most is, um, resources from the leaders project, which is through Columbia university.

It's run by Dr. Kate Crowley. Um, so website, it has free, um, CEUs, um, or continuing education on performing, um, reliable and, you know, balanced as possible, um, bilingual or multilingual evaluations. And one of the tools that's on there, um, is, and it is one of these interview. So again, I, I wouldn't necessarily call it like, you know, you download [00:33:00] this interview questionnaire and you're done.

Um, I would say that it's good to consult with. And one of my favorite questions on that form that is available through the leaders project is to ask parents to compare that child, to other children within their community, even amongst their own kids. And I recently mentioned this to, um, a special educator, you know, that I always ask to compare to other children. And she's like, oh, but we're always told never to compare. I'm like, no, like, it's so important because you know, if the parents have concerns, they're gonna tell you immediately, this is not like my other children. And that to me is a big red flag in terms of trying to balance this evidence based triangle, you know, evidence based decision making in an, an assessment.

If a parent tells me no, they're so different from my other children, I wanna know why that's my starting point in an evaluation. So I think it's really important to [00:34:00] list this solution, cuz I think this is a good starting point for anyone who may be wondering, where do I start these evaluations? You know, if, if we're not gonna weigh heavily, if we're not gonna lean it toward an isosceles triangle, how do I pivot it back toward the middle?

That might be a good starting point. 

[00:34:18] Liza Selvarajah: I just wanna jump on your, your word comparison, because I feel that we hide a lot of what we truly do with scientific jargon. So we tell teachers and parents don't compare, but when we put in a standardized score, what are we doing? We are comparing, we are comparing

[00:34:38] Kate Grandbois: that's exactly what I was just thinking.You're absolutely correct. It is like the whole point is comparison except, and I know we're going sort of back to this harm, but you're comparing it. It's apples and oranges. You cannot compare with a norm reference. It's not an appropriate comparison. Um, I love the, the concept of the leaders project and we'll link that in the show notes for anybody who's [00:35:00] listening.

Tell us more about what strategies we can use to not rely so heavily on the external, components of external evidence. 

[00:35:10] Ingrid Owens-Gonzalez: From the leaders project. I also use the non-word repetition tasks a lot. They have a lot of them free for you to look on there. Uh, they have 'em in English, in Spanish, in Mandarin, uh, and there's, um, several different versions of them, uh, depending on what your, uh, your age group is.

Um, so look into those, the non word repetition tasks on the leaders project, uh, that really kind of gives you another piece of the picture. It's not a whole picture, but it gives you another piece to add to your, uh, data to your portfolio on that child. If you're questioning some things, um, I always tend to use it, um, towards the end, if I'm still not sure with my other measures.

Um, but the, to get to the meat of [00:36:00] what we're here, um, the, my strategy is using dynamic assessment and I always like to joke and people are like, what is that? I'm like, it's not, not static and they just look at me like, okay, I need to, I need to know more. Um, but if I never learned about dynamic assessment in grad school, so I wanted to point that out because I hear a lot of SLPs kind of feel, not shame, but like a little bit embarrassed or I don't know if there's a better word cuz it's professional, but they feel a little bit less than if they've never heard it before.

And I wanted y'all to know, like I just started using that term four years ago and I don't even know if I even used it in the right context. Um, I used it, I heard it from, from uh, Dr. Edith Strand on her, [00:37:00] uh, childhood apraxia of speech course and free videos. She talks about, um, dynamic motor speech evaluation.

And I was like, oh, that's what I'm doing. Um, but I come from a psychology background and I learned about mediated learning in my undergrad and a little bit in grad school. So that's kind of my perspective of where I started. And of course it came from an area of, I needed to do something because all these tests were not, uh, working for my population, but that's where I come from.

So if you are feeling a certain way, because you've never heard of these things before, like, forget about that, that's just like we know about it now and we'll move forward. Um, because that's kind of how it happens for all of us. But, um, it really is just looking at a skill, figuring out where the student is at and then doing a little bit of teaching or support and then figuring out where the student [00:38:00] is at after.

So whether you look at it from a lens of mediated learning, like, uh, Vygotsky, Zone of proximal development, or whether you look at it from a lens of, uh, dynamic assessment and levels of prompting, uh, it's all just, Hey, what can this child actually dowhen I help 'em or when I remove an obstacle, um, and for me and bicultural, bilingual children, a lot of the times is what can this child do if I just explain this in their home language, or what can this child do if I take this really, uh, niche, vocabulary word, like s'mores, you know, that maybe not culturally appropriate to their life, what if I substitute s'mores for something that's culturally appropriate for them and see if they can make me that sentence?

Um, so that's what dynamic assessment looks like. [00:39:00] And that's been my biggest tool for becoming, uh, more culturally competent in my evaluations. But I feel like a lot of people look it up and they see mediated learning and test retest through all of these big words. And they're like, I don't have time for that.

Um, I would say to them just, um, I think we linked it to the BIS examples on what to do. You can do it so quickly, just on a couple of items on the owls, say that a student had a hard time on a couple of items on the owls and you're done. And you did your clinician thing, your ones and zeros, which my favorite thing that I learned from Dr.

Strand on that video was free on YouTube. Uh, she says we are clinicians, not technicians. And I, I always, I love that because you need to look be beyond all those ones and. So I will go to those zeros and figure out like, okay, if I [00:40:00] let them hear it one more time, does that help? If I, you know, say it in Spanish, does it help?

If I provide pictures, does it help? And yes, I'm taking a little bit more time to do these things, but it makes my report writing that much easier. It makes my goal writing that much easier. My present levels writing, uh, even just your justification on eligibility forms, you have more than numbers to give.

Uh, and I think we had that conversation yesterday with Dr. V as well. You have an actual, really good picture of the student and parents really connect to that when they feel like you really got to know that child, when you give an example of a response they gave and they're like, oh yeah, that sounds like my child.

You really dug in there. I feel like I find more buy in anyway. Cause they're like, oh, you really are giving me the best picture of my kid. Um, so that's kind [00:41:00] of where I wanted to start off the discussion. 

[00:41:01] Amy Wonkka: I have a comment and a question.

[00:41:03] Ingrid Owens-Gonzalez: Yeah. 

[00:41:05] Amy Wonkka: Comment is that it sounds like you are being so thoughtful and that the example you gave with owls was really helpful for me.

And you're being so thoughtful in asking further questions about, okay. So before, when I was being a technician, maybe I'm like, plus minus saying, going through and saying, these are the minuses, and you're asking more questions about why are these minuses? Are there things that I could change that would make them no longer be minuses.

And so my comment with that is that any of that information you find out as a school based person, I think is also awesome stuff to put in the accommodation section of the IEP, if your state has an accommodation section. Um, and I guess a question I had that that may not be super answerable in this modality, but if somebody's used to kind of relying on that more technician type approach and saying like, okay, here are [00:42:00] the pluses, the minuses I've identified the deficits.

Um, are there, are there helpful tips about the types of questions we might wanna ask as clinicians to dig a little bit more deeply? And then also how, how we can think about interpreting the information that we get. So if I haven't done this before and I feel a little uncomfortable, but I, I know I wanna start doing incorporating dynamic assessment more into my work.

Um, are there patterns I look for? And that might make me think, okay, this, this is sort of tipping the scale for me in terms of. I I'm more likely to make this client be eligible for services versus, oh, no, actually I don't really think this person, um, should be receiving services. I didn't know if you, if you could talk us through a little bit of that.

[00:42:45] Ingrid Owens-Gonzalez: I can, unless Liza, Desi 

[00:42:48] Desi Pena: I can jump in. I wanted to add before we get a little bit too far, so. Part of this, um, objective that we're reviewing today, we actually covered in the first episode as well, when we talked [00:43:00] about ethnographic interviewing. So hopefully in your ethnographic interview, you've gotten some information from the parent valuable information, unbiased information.

The whole idea with dynamic assessment also is it's an unbiased approach. So you've hopefully already gotten from them a sense of whether they're concerned or not. So I would say start there if the parent is concerned and they're saying, yeah, you know what? This kid is just not like my other kids, you know, they're highly distractable or I don't understand them or yeah, whenever we go to Abuelita's house, like nobody really understands what message they're trying to share with anybody.

Right? Like you already have that in the background. Right? So then you go into your test and let's say, um, let's say the parent isn't concerned. And then you go run into this question with the s'more. I love that example. Right? So you run into this question with the s'more and you're like, okay, well really we're talking about like in this subtest they didn't [00:44:00] understand this question and there's a s'more they didn't understand this question. And it's about going to the veterinarian. They didn't understand this question. And it's about, um, uh, swimming in a, in the ocean, right? Well, maybe they don't have a pet. I mean, I know that in my family, like having pets, my family thinks pets are gross. Like, it just, you know what I mean? Like, I, it might be something worth asking yourself like, Hey, do you guys have a pet?

Do you know anybody who has a pet? Do you know what a veterinarian is? Like, that's a new term for my son, cuz we don't have a pet. Right. Um, thinking about, okay, maybe they don't swim. Maybe culturally there is a boundary, like some swimming isn't part of something that they do. Maybe they've never been to the beach.

Right. We're looking at what experiences they may have had and may have not had. Right. So I'd say that that's really important, especially if the parent's not concerned. Um, And I don't know, you guys can back me up on this or shoot me down.

Um, but I feel like that's when I would start saying what's the [00:45:00] cultural load in these questions that they missed. So looking specifically at the ones that they didn't get, what is the cultural load? What's the cultural exposure they would need to those concepts to get those questions right. Um, so I don't know.

Do you guys have an opinion on anything I've said? I don't. I also don't wanna, 

[00:45:19] Liza Selvarajah: I support everything you're saying. Um, I'm thinking about food. Food is a big cultural thing. 

[00:45:25] Desi Pena: Food is big

[00:45:27] Liza Selvarajah: and in our initial interviews with the parents. I wanna know what kind of food your child eats that way. I'm not using a standardized test with cultural food from, you know, Canada, America, that this child is not exposed to.

Cuz let's say the goal with this kiddo is intelligibility, but they're out here trying to say smore, but you're trying to find an SM blend in a word that they've never heard. Now I'm here trying to teach vocabulary that's irrelevant to their life. And then pronunciation, when I could be targeting words that are meaningful to them, that [00:46:00] they want to be requesting at home and that parents understand.

So I'm thinking about, um, Amy your question about like a, a data driven kind of clinician, which is what we were taught to be. And if you get a list from home of what the child eats and you find pictures, like you're even developing that relationship with the family and the child, I care about you and what your life is like.

I'm not trying to pull you into mind. I'm here to support you, not fix you. . So all of that in there just plays into the relationship, which builds stronger communication skills. Cuz how much stronger are we as communicators when we feel a connection with the person that we're talking to. So I know I'm jumping into a lot of different things here, but to go back to the original question, I would get a list from the parents of food that the child eats.

And I would show them that food and have them label the food as I would on a standardized test, but now more cater to this child. Um, and then from there we could, we could write up some goals. 

[00:46:56] Desi Pena: And I was gonna say, this is a nice thing too, like for a [00:47:00] private practitioner or somebody works outpatient, you can have them do this at home.

Like this is like the intake call when you're calling them to get a sense of what's going on. These are all things that the parents can just prepare and bring. And, you know, in the two weeks before they come to your evaluation and hopefully you've explained to them the value of doing it. And so they, therefore they bring it.

It's not to say that they will cuz sometimes it doesn't happen. But, um, you know, I think that there's so much, uh, again, value in giving them, let, letting them know that collaborative, Hey, I need to know what you culturally value, bring it with you. Don't leave it out. Like I know that that's the, the, the general feeling, right?

That that's, that's separate. It's not, it's essential. 

[00:47:48] Liza Selvarajah:  I have a quick story to share and I, I may have shared it on the last episode. So you could take it out if I'm repeating myself, but during COVID when we started zooming in with the families and seeing kind of like the home [00:48:00] life, it really broke that barrier of like professional in school.

And it wasn't just a progress report the parent was getting or, or an evaluation. They were really like there for the sessions. And one big thing when I, it was really eye opening for me, I was doing, um, a little standard test with a kiddo and the parent was like, oh, they don't know that. We don't eat that at home.

Just putting it out there. And I, I can imagine myself in grad school being like, well, this is the test, please be quiet. you know, and like trying to really meet this like experimental type of, uh, controlled. I wanna, I would want it to control every variable so that I have like the most reliable data back in the day.

Now I'm like, you're so right. I turned off, I like stopped sharing screen. And I was like, why don't you open your fridge and tell me what's in there. 

And she really pulled up her kid and her kid started labeling different things. And then she said, oh, she never says milk because I don't know that word is hard for her.

Like, it was [00:49:00] so much easier for me to draw these, like, um, I wanna say a treatment plan, but draw goals and objectives. Very measurable ones right there in front of me all because we just broke that whole evidence based. I need all this external, I need to test it this way. And yeah. 

[00:49:18] Kate Grandbois: And just for the sake of coming full circle and moving into our third learning objective, I just wanna point out how in that story in, in most of what, what you all said is really focusing on client perspectives and values, client perspective, caregiver values, which is evidence based practice.

So again, we think so often in our, in our professional culture, how we are, you know, the messages we receive and how we approach an evaluation or how we approach the story that you just told of, of assessing someone over zoom, um, and relying on this component of external evidence, but taking the child and lifting them into the, using the [00:50:00] vocabulary.

That's evidence based practice because it is patient centered client centered care. Um, before we talk more about our final learning objective, I just wanted to go back quickly to the concept of dynamic assessment. And piggyback a little bit on something. You said Ingrid about how dynamic assessment can feel like a very intimidating term, because it's not necessarily something that we've taught.

It feels very elusive, sort of like, oh, this mysterious assessment that I've never, cuz it's not a, it's not a test booklet necessarily. It's not something that you buy. There's no directions that you follow. It's not, it doesn't live in a box. Right. And in the assessment world, sometimes we feel more comfortable in a box with our directions.

And what, and what have you. Um, I, we had, we've interviewed some researchers on dynamic assessment on the podcast before, so we can link some references in the show notes to talk a little bit more about what dynamic assessment is. It's a whole field of study. We're never gonna cover it in the context of this episode, but I wonder [00:51:00] if you could tell us for our listeners who might not be as familiar, what does dynamic assessment look like for you?

If someone is listening and thinking, okay, now I know I need to do dynamic assessment or rely on that as a strategy. What's next? What does that mean? Like what does it, what does it look like? 

[00:51:18] Ingrid Owens-Gonzalez: I'll answer your question by answering Amy's because, oh, this is interesting. My grad, my graduate students and, um, that I've supervised and clinical fellows that I've supervised.

Whenever I talk about dynamic assessment, they get that we have to do ethnographic interviews that we have to balance the triangle, um, that we still have to do some, um, standardized assessments because of the. You know, field that we're in because of, uh, the setting that we're in. Um, and then they stare at me and they're like, well, then now what?

Um, so Amy, my answer to your question, and hopefully Kate's is, start with a test that you're comfortable with. [00:52:00] So we'll go with the owls example you gave the owls, you did perfect, totally controlled everything, you know, perfectly chef's kiss. Uh, the authors would be so proud and then you go back and you look just, they have it for you.

They have the patterns for you in the back, what each one in zero meets. And I think a lot of people don't go back there to see what does this zero in question number 33 mean, oh, it's about syntax. What does the zero in question number 63 mean? Oh, it's about synonyms, uh, or 45 is about opposites. And you start there, you build that pattern.

If you're not comfortable with gleaning information from a family interview, uh, gleaning information from their work samples or from their teacher, um, observations, start there, start with the test and then go see the [00:53:00] patterns. And from there you see what tasks is this student having a hard time with?

And those are the tasks that you go back to, whatever framework you prefer. I like the test. You already did it right. Then go to their teach and then retest or teach retest. So test retest, I'm getting all confused. Test, test, teach, teach retest test. So you already tested and you already found some patterns and you wanna go back and see if with some support.

Visual support, explaining it a different way. Uh, maybe in a different modality with some manipulatives, if they can get that concept, all dynamic assessment is, is taking away the bias of learning because you're not testing learning, we're not psychologists, we're testing language. So that's what I would say to my [00:54:00] students.

Go to what you already have, what you're already comfortable with, what was drilled to you in grad school yeah. And then leave up behind and trust in your clinical experience because it's not ephemeral like clinical experience is just what it is. You've learned patterns from living through different sessions, different meetings, different clients, different CEU providers, speaking to other professionals. You're just picking up information, just like we pick up everything else. Um, you know, we all get better and better at driving somehow and we never take a driving class again. so that's kind of how I look at it.

and I hope that I answered the question, Kate and Amy, 

Kate Grandbois:you did. 

[00:54:48] Desi Pena: I was gonna say, I was gonna say the really cool thing too. I don't actually use the owls, but I use the CELF, um, unfortunately, um, but I use it, um, and I do the [00:55:00] same thing. I just literally see which ones they got wrong. So like on the CELF preschool, if anyone, you know, has access to the protocol or can think of the protocol, it has like a little box, a little grid at the bottom right hand.

I just circle the ones they got wrong. And that's where I start looking for those patterns. Oh, it's always, when there's a descriptor, you know, on adjective use in the sentence. Oh, it's always when or when it's an ordinal concept, right? Like I start there and think. Oh, okay. Let me go back. And, and it's that, it's that teaching phase that is the most important part of a dynamic assessment.

Okay. You got it wrong. Let me teach you how many times do I have to teach you? What visual, you know, am I using visual supports? What kind of queuing, how much queuing, how accurate are you after I remove all those cues and prompts? Um, and that's I, and I, I think what's also fascinating about this conversation is I think we should, we should already be doing this.

Like, I, I think [00:56:00] that the thing that's shocking to people is the name dynamic assessment, but we should be doing this. Like I think about, um, testing articulation. Well, I wanna know how stimulable they are. Right. So I'm gonna go through my Goldman Fristo for anybody, everybody, right? Like, let's just say it's somebody who is a general American English speaker.

Right. And there's no other culture. There's no other language. I'm gonna go through and say, wow, they got all those words with final consonants wrong. Okay. I'm gonna probe for, uh, final consonant deletion as a chronological process.

So let me pull out these few words. Let me teach the child. Hey, you know what? This word has a tail or this word. Um, you know what I hear at the end, I hear this sound and see if they can do it alone, or if they need more support from me. So I feel like, you know, again, not to make anyone feel uncomfortable or like this is super basic and what are you doing?

No, no, no, no, no. [00:57:00] Like let's undress the term because the more we undress it, the more we understand, oh, this is just probing. Like we're just taking a treatment target and trying it out. That's essentially what dynamic assessment is. And it's so important for multilingual, um, students, multicultural students, because they're at an unfair disadvantage when we lean so heavily on those standardized assessments that were not based on them.

[00:57:30] Kate Grandbois: That was so well said. I love the term undressing. Um, and, and just breaking it down, demystifying it so that it's not as intimidating so that clinicians can apply this, um, and be more effective in their, in, in their assessments. Um, in our last couple of minutes, I know we've, we've woven conversations about the three-pronged evidence based practice model throughout this conversation, but I just wanted to wrap up by, you know, really taking a minute to talk [00:58:00] about the importance of balancing those three components and what that feels like. I know in a lot of the stories that you've told you've illustrated, what balance feels like in terms of integrating, um, client perspectives and values with maybe, uh, with maybe the external evidence that you need to take.

So, um, in some of our previous coursework on assessment, we acknowledge that in some instances, you, in some instances, instances, you have to conduct a norm referenced assessment because insurance will require it or your state requires it for eligibility. Um, so I, I love the term balancing in the subjective because it does encompass how you can move through this experience with prioritizing what you need to prioritize, to do an effective, uh, to conduct an effective comprehensive assessment.

So what can you tell us about, um, the balancing act that clinicians may need to do when, when moving through this experience, 

[00:58:58] Liza Selvarajah: I think not being afraid [00:59:00] to firstly, the dynamic assessment just , it makes me laugh because every case becomes a complex case when they don't fit our usual way of testing. So if you run into a complex case, which is basically everyone, now you have to dynamically assess. So that's just,

[

[00:59:17] Kate Grandbois:  I wanna some air quotes happening here for lots of air quotes. Sorry, lots of air quotes

[00:59:22] Kate Grandbois: No, no, no, it's fine. But you know, but you're right. Any quote complex, um, situation is, is, is not necessarily complex. 

[00:59:32] Liza Selvarajah: So now that, so now that we're dynamically assessing, there's a lot of teaching happening within the dynamic assessment and that's where I feel the client values and, um, our clinical judgment comes in and I feel that's where the balancing act is.

If you do appropriate. Assessment. So within it, if you're teaching, if you're listening to parent feedback, you know, not being so, um, sciencey about it, I think we're really trying to [01:00:00] turn these kids into tiny little science experiments, where you got this score. Therefore you fall into this category, therefore this is your diagnosis, but it isn't like that.

So if you really wanna balance that triangle, it all starts with like an appropriate assessment. 

[01:00:16] Desi Pena: And I was thinking, cuz I know you guys, you Kate and Amy do a lot of AAC evaluations, right? Those are complex. Let's put the air quotes in there. You know, you can't necessarily give a full standardized speaking language assessment to children who are non-speaking, 

[01:00:39] Amy Wonkka:who are also not in the norms, usually correct. Captured in the normative sample. Right. 

[01:00:44] Desi Pena: So maybe if that maybe if we tie it back to that, um, you know, again, in, in, in the hopes of demystifying this whole process, right? Like. It's the same exact process, right? If you're confronted with a child who is exposed to [01:01:00] general American English, and they are, um, you know, monocultural, I'm trying to think of a they're, they're only exposed to one culture, right?

Um, it's the same process, right? Just to, I, it, this is out of your comfort level, um, potentially because of what we discussed in the first episode of this series. Let's try to think of it this way. Maybe if it's harnessed this way, it will feel a little bit less complex to per se. But I think that, um, you know, really going back to the idea of, okay, this tool, isn't giving me the information I need.

Uh, so what Liza was saying, right? This tool, isn't giving me the information I need. What is the information I need? And just asking yourself that question and then trying to balance it out. Okay. I've not had this situation before, but I am a clinician. I've not had this situation before, I have, but I have this parent, how can I level these two things?

How can [01:02:00] I operationalize these two things so that I can move toward a better decision making process? Cuz that's what, you know, again, we, we talked about this very briefly, but evidence based practice is a process. So even if you have to like sketch this out, you know what I mean? Like I, I feel like again, If you can find, um, if you can find or advocate for yourself as a clinician for more time for these evaluations, I think that's another piece too, you know, as another solution or strategy, you know, say, Hey, this isn't straightforward.

I need to do my ethical best by this child. If you expect me to take on a complex evaluation, uh, for example, for a non-speaking child and use X amount of time, this is this, this should be dedicated and we should really be spending a lot more time in making sure that we get this right for this family, for this culture, for this community.

Um, so that's something else to consider adding to your [01:03:00] toolkit. Um, it's really the idea of how do I peel back the layers of my cultural discomfort and enter this space to do right by this child and this family. 

[01:03:11] Amy Wonkka: I just wanna say I 1000% agree. That's all. Thank you.

[01:03:14] Liza Selvarajah: Just listening, just really just listening to the kid, not through your lens, but through theirs, going back to the interview process, we talked about last time, last time on the CELF, there is a question with a banana and an apple and a glass of milk.

And the child is meant to say apple and banana, uh, because that's the fruit and my kiddo said banana milk. And I said, why did you say that? And he said, every morning I have a glass of milk with a banana. That is correct to me, that is clinical judgment. That is a clear explanation to how those two went together.

And if you're stuck in, but the norm and the standard says that only fruit should be placed together. That to me is a dynamic assessment, even though you're [01:04:00] using a standardized tool, 

[01:04:03] Kate Grandbois: that's such a great story and such a great point. Um, and I know as clinicians, you know, when we are experiencing, are going to write these up, right.

And going to explain the findings of our assessment, and maybe we're in a situation where we had to use that assessment and we had to score it. But then just being able to explain that those scores don't represent the child's actual functional skill, because that is not the point of a norm reference assessment, norm reference assessment don't measure idiosyncratic skill changes.

They don't, they don't account for, for personal experience or, or culture. That's not, that's not what they're there for. So even if you are and listening, and you're in a situation where in that exact story you felt even, you know, reflecting back on a choice you made you've, you did score that as quote, wrong.

You can still use narrative and clinical judgment. Again, balancing this triangle to explain that score to [01:05:00] diminish that score, to put context around that score. Um, and of course, if you're in a position where you don't have to use that score, don't use it because it's not accurate, valid and reliable measurement.

[01:05:11] Desi Pena: Yes. That's it. I mean, yeah. Why use something that you don't need? Um, again, I feel like we're gonna we should like link this episode to the episode we just did with Dr. V's because she said the same thing use a checklist. Why are, why are you using like use an observational checklist go to that child's classroom?

Ask the teacher, like, why are we relying on, you know, can they repeat this sentence about a nurse? Right? Like, this is one of the questions on the CELF, 

[01:05:44] Ingrid Owens-Gonzalez: my mom is a nurse at the community clinic. 

[01:05:47] Desi Pena: Oh, my word, right? Um, no, maybe my mom, I maybe, I don't know what a community clinic is. Um, but 

[01:05:56] Ingrid Owens-Gonzalez: I think it says my mom is the nurse at the community clinic.

I'm like, [01:06:00] who talks like that? 

[01:06:01] Desi Pena: The nurse. Wow. Yes. Is it really the nurse? Okay, well, um, . Yeah, but I, you know, I think that we've come to this point where it's really crucial to set standards for ourselves, um, and to make sure that we are carrying out these evaluations also, just so we can make good treatment decisions too.

Um, you know, obviously we wanna rule in and rule out, but no standardized tests and unfortunately I've seen this way too much, but no standardized tests should be dictating your goals. I've seen it way too often. 

Kate Grandbois: Here here 

[01:06:40] Ingrid Owens-Gonzalez: standard. We get a little, 

[01:06:43] Liza Selvarajah: yeah. 

[01:06:45] Desi Pena: Yeah, pricing. One more goal about adjectives and a verbs.

I'm gonna lose it. 

[01:06:51] Kate Grandbois: we, we, we, and there are lots of references for that. There that's been well documented in the literature that writing goals and objectives based on scores of a test [01:07:00] is inappropriate for a whole host of reasons that we obviously do not have time to get into, but we can link some of those previous episodes we've done.

And some other additional literature in the show notes for anybody who does wanna learn more about that relationship. Um, 

[01:07:14] Ingrid Owens-Gonzalez: yeah, I just wanted to add to that last objective. I always go back to my question from last episode, who are you doing this for? Who are you doing all of these batteries for? Um, it's not gonna help the parents understand the teachers, understand it's not gonna help you understand.

It's just gonna, what make it easy to fill in some boxes on your report template? I know it seems daunting, but really whenever you do dynamic assessment, the reports write themselves when you have all this information. And the thing that I like to tell my students, whenever they're like, oh, it's, it's more time.

I'm like, not really. You're giving yourself credit for things that you already do. You're just putting them on your report so people can see [01:08:00] all the things that go into you making this recommendation. And even as an 11 year old veteran yesterday, I learned a new thing that I need to give myself credit for, that I never have before from Dr.V she talked about portfolio. Um, what was the word she used portfolio review assessment or review? Yeah, maybe portfolio review. I'm like I do that all the time. I don't receive a referral and that's credit to our, um, counselors and educational diagnosticians in my district is not coming from me, but my referral packets always include work samples and I always review them.

And I always use them to inform what I'm doing, and I've never known how to give myself credit for that until Dr. V yesterday gave me the words for it. And so if you're looking at this, this is new, this is different. This is daunting. I really urge you and challenge you to twist that lens back and say, I already am great at this.

I already did this master's degree. I already have all these years under my belt or [01:09:00] even months under my belt. And I already think about all of these things when I'm making these choices. And I want to give myself credit for them.

[01:09:08] Desi Pena: Yeah. Be a clinician, not a technician. 

[01:09:14] Kate Grandbois: it's a great quote. It's a really, really great quote. 

[01:09:17] Ingrid Owens-Gonzalez:Yeah. That's  all Dr. Strand. Yeah. It's on the YouTube

[01:09:19] Kate Grandbois: and we we'll link we'll link all of the link, all of the references and resources. We've mentioned a lot  throughout the course of, of this episode.

[01:09:26] Ingrid Owens-Gonzalez: I need to give you more links.

[01:09:29] Kate Grandbois: Yes. Yes, we will. We will get them. Don't worry. In our, before we say goodbye, do you all have any advice for any of our listeners who maybe would like to learn more if this is their first, um, time coming in contact with these concepts of evidence based practice, balancing the three-pronged approach, dynamic assessment, potential harm of norm reference tests?

What, what final parting words of wisdom can you, can you leave our audience with 

[01:09:55] Desi Pena: this isn't wisdom? But DM us, send us a message on Instagram. [01:10:00] Um, listened to our podcast, shameless plug, shameless plug. Um, I just think that the conversation shouldn't stop here. And if you're at the point where this is an uncomfortable topic and you're still like, wait a minute, what, please reach out.

Um, we always try to respond to DMS. Um, and you know, the three of us are open to connecting. Um, So I think and finding a mentor. That's the other thing I don't know. I know that Ingrid and, uh, Liza mentioned mentorship, but it's so important, especially if you're navigating new waters. So I'll let you guys,Yeah. If you have anything else to add, 

[01:10:44] Liza Selvarajah: I get DMs on TikTok and Montreal speech therapy, and I just like tell a story so that everyone can hear it. So they get the question and the story so that I could support a lot of other SLPs out there. 

Uh, but there's a quote I saw [01:11:00] on JRC, the SLPs, Instagram, uh, connection over data collection.

So that's what I hold true 

[01:11:07] Desi Pena: here. I think Ingrid came up with that, right? Mm-hmm 

[01:11:11] Liza Selvarajah: stop. 

[01:11:13] Ingrid Owens-Gonzalez: I was so proud whenever she DMed me and she said, do you mind if I print this? But mine's a little different cuz I did connection. And then I did the greater than yeah. Back to my math nerdiness. I did connection greater than data collection and

[01:11:31] Liza Selvarajah:oh my gosh, Ingrid, look at that. And I was like, there was a quote  that Ingrid came up with 

[01:11:35] Kate Grandbois: no cause connection is greater than I love it. Yes. Yes. 

[01:11:39] Ingrid Owens-Gonzalez: Oh, I love, I love Jordan. Uh, my last word as we do on our podcast, I think my last thing would be don't confuse internal evidence with client perspectives and culture. The triangle's already heavy on the evidence and then we're adding a whole nother wrench in the system.

[01:12:00] Uh, I think that that happens a lot more than we think, like Liza was saying. Um, so that would be mine. And then give yourself credit. I think you're already doing a lot of these things. You just don't know how to write them down. 

[01:12:14] Kate Grandbois: That's awesome. Those were great. So good. As you say, the last words, those were great last words. Thank you all so much for joining us today, having you here is always such a treat we've learned so much from you. Um, as I mentioned, we will link all of the resources in the show notes. We will put a link to the bold SLP collective and podcast. Um, I can confirm everyone here on this panel is so friendly and so warm and so open to conversation.

So if you are listening and you have additional questions or you wanna reach out, please don't hesitate. This is a, a very welcoming and curious and wonderful group of women. Um, Thank you again so much for being here. We're so grateful for [01:13:00] your time and I am a hundred percent sure we will find a way to collaborate with you again soon.

So thanks so much for being here.

[01:13:07] Desi Pena: Thank you.

[01:13:13] Kate Grandbois: Thank you so much for joining us in today's episode, as always, you can use this episode for ASHA CEUs. You can also potentially use this episode for other credits, depending on the regulations of your governing body. To determine if this episode will count towards professional development in your area of study.

Please check in with your governing bodies or you can go to our website, www.slpnerdcast.com all of the references and information listed throughout the course of the episode will be listed in the show notes. And as always, if you have any questions, please email us at info@slpnerdcast.com

Thank you so much for joining us and we hope to welcome you back here again soon.

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