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Episode
Kate Grandbois: Hello everyone. Welcome to SLP Nerd Cast. We are really excited. We're always excited for our episodes, uh, for our recordings. However, today's episode is about a topic that is very near and dear to, um, our hearts, both Amy and myself, [00:02:00] um, talking about working with complex communicators, um, as they. Go into their teen and adult years.
We are very excited to welcome a content expert here with us today to teach us everything she knows. Welcome Deirdre Flores. Hi. Thank you for having me on the podcast today.
Amy Wonkka: Thank you so much for sharing your time with us today. Uh, you're here to discuss empowering independence, teaching and fostering effective communication skills for adult success.
But before we get started on our topic, can you just tell us a little bit about yourself?
Deirdre Flores: Sure. So I am a speech pathologist in Westport, Connecticut, and I have worked with teens and young adults my whole career. So in public schools and in private practices. Um, I am the owner of a private practice called the teen, SLP, where we run groups, um, focused on the communication skills that teens and young adults need to be successful post-secondary.
Whether that is. After [00:03:00] high school, going to college, um, going to work, volunteer, going to a transition program. So what are the skills, communication and social skills that they need to be successful and independent in the adult world? Um, in 2021, I started my private practice 'cause I saw that after public schools, so either 18 or 22 years old.
When students leave the public schools, um, there's a big service gap, um, that they are expected to enter adulthood with these skills. Um, and if you think about it. The clients that we see, um, previously, like right when they're 18 in public schools, um, they have speech therapy because their language disability affects their ability to.
Get the language skills needed for those environments just by being in the environment or observations, right? They need explicit instruction, but once they exit [00:04:00] high school or they exit the public schools, it's expected of them to become an adult and then suddenly take on all the communication skills you need to be an adult.
Just by observing and being in the environment where we know as speech therapists that individuals with language disabilities really benefit with that explicit instruction. And I think, um, autism Speaks has a really staggering statistic where it's 50,000, um. Individuals with autism gr exit high school every year.
So that is a huge population and that's just autism, right? As speech therapists, we treat a variety of clients that have a variety of different diagnoses, whether that be auditory processing, pragmatic language, um, attention difficulties, um, social anxiety. And so there is a huge group of teens and young adults that benefit from.
Support and services so that they [00:05:00] can lead more independent and successful lives. And we as speech therapists have the tools that can help them. And so that is what I do at my practice.
Kate Grandbois: That's awesome. Thank you for sharing that. Um, we here in Massachusetts, just here in our, in Amy and our area, we see this a lot.
Um, just the lack of supports that are available for these families as they age. Everything from. They have access to residential access depending on what a family, you know, an individual family's values, goals, wishes are. Uh, so this is an incredibly important area. Um, the infrastructure unfortunately is just not what it needs to be, not what it should be for these families.
And I'm excited to learn about our role, uh, and what we can do as clinicians to help improve that. So. Um, I wanna start by reading our learning objectives. Uh, so for today, after listening to this episode, uh, participants will be able to self-report knowledge [00:06:00] gains related to client-driven goal setting and explaining its importance in fostering independence for neurodiverse.
Teens and young adults participants will also be able to self-report knowledge gains related to social and communication skills essential for success in adulthood, including self-advocacy and perspective taking. Participants finally will be able to self-report knowledge gains related to tools and strategies for implementing effective group therapy sessions for neurodiverse.
Teens and young adults, uh, anyone who is interested in learning about or reading about all of the financial and non-financial disclosures for this course. That information is located in the show notes as well as on our website. If you are interested in earning Asha CEUs for listening today, the link for that will also be in the show notes and on our website.
Um, and without further ado, I am excited to kind of get into, get into the, the meat of this.
Deirdre Flores: Yes. So the [00:07:00] number one thing that's important when working with young adults is that they wanna be there, right? So I feel like for their whole lives they've gone to speech therapy, either because they've had an IEP or their parents say This is really important.
But now as a young adult, it is important that they want to show up, that they are identifying that this is an area that I wanna improve on. Um, self-determination. Is a research has shown is one of the key factors to show that, um, predicts if you're gonna be successful as a young adult, right? To make your own goals, to figure out a way to achieve them and to work on them.
Um, a lot of my clients are referred to by their parents or outside providers, but where it starts is like my intake process. So. I start off with a conversation with a young adult and we kind of go through like a checklist of communication skills that you need to be a young adult. So like we were saying before, problem solving, self [00:08:00] advocating conversations, which leads into friendship skills.
And we kind of go through all of these and the young adult will say like, yes, I, I do wanna work on that area. Or no, I'm good with that. And then from there I'm like, okay, great. So I either have a group or we can work individually and I could help you with those skills. Um, that is really important. One, because of motivation.
Right now they wanna come see me 'cause they see the value of it. Um, if they're going to be in a group, it's really important then that they're an active participant. I always link it to when we wanna be healthy and we go to, let's say, a trainer and you meet with that trainer for a half hour a week, and if you're really not bought in and then you don't do anything, then you meet with them again the next week.
You don't really improve. You don't practice outside. If you really are motivated and this is your goal, you're gonna meet with that trainer, then maybe you're gonna go to the gym the next day and practice what they taught you, and then you're gonna start to see improvements. And so the same with like speech therapy, especially as an [00:09:00] adult.
You go in, you meet with me, we meet, we come up with a plan, and then they, they carry over those skills outside of therapy. And I think that's the number one thing as a young adult like. Let's be bought in and I will help you with tools and strategies, and then you practice outside and that's how this is gonna be successful.
And again, that ties into that self-determination, the goal, making a plan, and then following through
Kate Grandbois: in order to get there with your clients and get that sense of buy-in. I have to assume that you're spending some time establishing trust.
Deirdre Flores: Yes. Yes. So establishing trust. Even just going through conversations around these skills, you really get to know their thought processes and, um, they do become really vulnerable with you, right?
And, um, that you are like, I can help you. I have some concrete skills that's gonna help you feel more independent and help you feel more successful.
Kate Grandbois: How do you navigate instances [00:10:00] where. You're working with a client, you're going through this checklist. You're really trying to learn about their individualized values, their individualized goals, and you hear the voice of their parents sneaking, sneaking in, right? They might, um, may not have spent the time thinking about what they want because they've kind of been constructed to think, oh, well, you're, you, should I, this is one of my new favorite phrases.
Nobody likes to be should on. Okay. Right. So, so how do you navigate it when you get the impression that they are shoulding, right? Like they should do this and they should do that, and, and there's the voice of the expectation, societal expectation or parent parental expectation on their future goals. How do you navigate that?
Yes.
Deirdre Flores: So. A lot of it isn't just like, do you wanna work on this skill? It's, I also present it as like thought processes. So I, sometimes I think, or sometimes I feel really nervous when I go into a new situation and I can't start a conversation, [00:11:00] so I don't present it just like I have a hard time starting conversation.
It's, I think this, sometimes I think this to myself and I feel like they connect a lot more. With when you put out, are you thinking this, is this, is this a thought process? Um. Also, I will put it back on them of like, oh yeah, I should do this. Okay, so explain to me what will that look like? And, you know, what will that do for you?
How would that make you feel? You feel happy. So kind of bringing it back to them and the value that it is for them. Sometimes they'll say, oh, I don't know. And like, okay, not as, not as valuable for you as maybe for your parent. And if you're coming to see me, I wanna know what's valuable for you. Um, you know what's really interesting is.
A piece of being an adult is dating. Right? Making connections is really important. It's one of my favorite pieces of, um, running groups. So I have like a specific group on dating and I have an adulting group that we go over dating. And a lot of parents, when I talk to 'em on the phone, they're like, oh no, my son's [00:12:00] definitely not interested in it.
And they'll tell you, nine times out of 10 I go into the dating piece and they're like, yep, that's exact. And then all of a sudden you see them. Yep. I wanna be able to have a conversation with someone. I don't know. I wanna be able to ask 'em for their phone number. Plan a hangout, right? Um, understand nonverbal body cues, like dating is all communication.
And so it's like, that's it. That's exactly how we're gonna, that's what we're gonna work on. Because that's what important to you.
Amy Wonkka: Can you talk
Kate Grandbois: to us?
Amy Wonkka: Sorry Kate, I'm
Kate Grandbois: jumping in. No, all I was gonna say was the audience can't see me like beaming from ear to ear with smiles over the idea of working on dating.
Yes. I just love that because. Love is. Love is love, and how wonderful to give someone access to, to experiencing that as a young adult and, you know, making sure that that opportunity is there for them. I just, it just, that was all I was gonna say was just joy. That's it.
Amy Wonkka: Thank you for sharing your joy.
You're welcome. [00:13:00] I had a question thinking, 'cause you said, um, the relationship section and I was wondering if you could talk us through a little bit, kind of more about the structure of what that intake looks like. Is that something that you've designed yourself? Is that something that is like commercially available for SLPs who might be listening?
Um, because as someone who works in the school system. You know, my older students, I'm, I'm always on the hunt for nice assessment tools that help us look at all of those components, um, of social communication in particular, and like adult communication skills. So I just was hoping to learn a little more about that.
Deirdre Flores: Yes. So it's actually, I created it myself based on like a whole bunch of different research and books that I've, I've, um, read and went through. And again, from. From the speech side and then a little bit through the psychological side, right? So you are going through the thought processes, um, and I break it down into the areas of being an adult.
So problem solving, perspective taking [00:14:00] self-advocacy, job skills, um, higher level language, and then dating. And then when you're thinking of a young adult, you also need to think of like the different environments that they're gonna be in. So. Environment could be work or volunteering, right? One or the other.
Um, school, if they're still going to, if they're going to college or if they are going to a transition program, there still is a little bit of school environment in there. Um, a big piece we talk about is dynamics within families because they are wanting independence, so that self-advocacy may be advocating to their parents that they now want to choose when they're going to the dentist and, and make that, um, phone call.
Um. So, and then in the community, so driving and problem solving, I just. A little piece of my groups too is we do, um, outings. We go out and go in the community, and just recently we went out to, um, the mall and it's a really big mall and there's all these different entrances. And I [00:15:00] had a client that drove himself and he just parked came, met us, and then he totally forgot where he parked his car.
And so we talked about that kind of problem solving. So if you, and that's like problem solving within the community. And then when you can't find your car. Right there, it's communicating. Um, so it is looking at the different areas of communication as an adult and then the different environments that young adults are in.
Kate Grandbois: I wonder, I mean, as you were talking, I was thinking about just the family systems piece and how counseling, I mean, we talk about counseling. I think every single episode on this podcast, counseling touches everything we do in speech pathology. Um, but when you are thinking about, or talking about advocating to their own parents, you're really starting to, especially if they're.
Technically a minor still, right? So if you're working with someone who's maybe 17, uh, or someone who's over 18, but there's maybe questions of guardianship or you know, independent living, then the parents are gonna be involved. So how do you navigate that from a [00:16:00] counseling and family systems aspect in working with the whole, with the whole unit, the whole family unit?
Deirdre Flores: Yes. So every month I, along with billing, right? I send an email to the parents about what we've been working on. So I might send a visual of a strategy we're working on, and then I, I talk to them how their young adult is doing. Um, that is where I can say, Hey, Sarah has been working on. Really self advocating for herself or planning, and she really needs to choose at least two appointments.
She's gonna call and plan for herself. Um, I know that she gets her nails done every month and she has to go. She said she has to go to the dentist. Can you please like, you can support her, but she really needs to do this, this month. I have parents come up to me and said, that is the, I needed that. I needed you to tell me to back away.
And so kind of using it as she needs to practice this in real life, and [00:17:00] please let her do that. I'm here to support her, but I need you to take a step back. And so I use that opportunity to say like, kind of like the homework piece, right? Um. But I, I can't imagine parents, it must be so hard. You have, uh, somebody with a disability that's navigating adulthood and you are so nervous.
This is new for you too. And so it is nice that we get to be that role of don't worry, let her be a little bit more independent. I'm a stop gate and then somebody else, then you, you know, we could call you in when we need it, but she can practice this on her own.
Kate Grandbois: I was just gonna do a little, I was smiling while you were talking because a lot of this resonates with me personally as a parent.
Maybe this is an overshare, but it is hard to be a parent. It's extremely hard. I'm a parent of, uh, a teenager. As a matter of fact, today is her 14th birthday, so happy birthday to my child. Um, but it's really hard to let go as they get older. So these parents that you're working with are also wanting.
Personal [00:18:00] journey of their own parenting experience. Mm-hmm. And their own parenthood. And it's hard to let go as your kids get older. And I, it's even harder, I would imagine, if you've given, you know, if you've had extra anxiety and extra worry about making sure that they have everything that they need, that they're gonna be okay, that they can do things on their own.
So there's a whole complexity of individual journey and growth there just for the parent. And I, I think it's worth pointing out mostly because as therapists, it's really important to take the lived experience into consideration when we're putting our counseling hat on, right? Mm-hmm. And, and I think I'm reflecting on myself as a younger therapist, it's so easy to be like, well, just don't do that or do your homework, or just go, go take this and do it without consideration of what that family system feels like for the parent and the care partners.
Deirdre Flores: Yes. And to go back, right? Think about they went through school and they were taught how to school, [00:19:00] and there had, there isn't really explicit instruction in how to be an adult. So the parents often are teaching them how to be adult, right? To make those phone calls or to navigate and they've a lot on their plate.
And so it's kind of like, Hey, I'm here. I, I will. She's going to learn this skill explicitly through right. We, she knows how to do it. We have practice in a safe place. She can do it, and I think it is, it's a lot on parents' plate, but to offer these groups really helps those parents. Realize, like yes, they have been taught and they have the skills and they practice these adult skills to be independent and to be successful.
So that's why it's so important that we do provide these services.
Amy Wonkka: Well, we've been talking a lot about this, the skills and the counseling dynamic. I wonder if you could tell us a little bit more about. The process of setting the goals themselves, right? Obviously a lot of that comes from your intake and going through those different category areas, but once you've done [00:20:00] that with a client, what does that process look like in terms of collaborating together to come up with goals that are gonna be meaningful for them, um, and impactful for them?
Deirdre Flores: Yes. So from that intake, um, we talk about, we kind of prioritize which three to four are the most important. Now, that's like if I was doing individual therapy, I offer a lot of groups and so. One of my most popular groups is called Adulting. And the first session of the group, um, I've done it a variety of different ways.
I've handed out kind of checklists of these are the areas that I wanna work on. Um, we've done something fun like a Kahoot, and we've taken a survey. So like, here are the areas, which ones are we gonna work on first? You know, and it is within the areas. It's a 12 week group. So we, we target each skill, but which one is prioritizing?
Like, which one should we go first? Um. So then from there, right, we wanna work on conver almost always is [00:21:00] conversation skills first. 'cause they're always like, I don't know what to talk to people about. So let's say we do conversation skills. We'll work on those. Strategies and within, I don't just put conversation skills.
I'll break it into, you know, starting a conversation with somebody you don't know, keeping the conversation going, you know, um, asking someone for their phone number. So I'll break it down into skills. They'll identify which ones are important to them to work on, and then we'll work on those skills for, let's say three to four sessions.
Then I'll reenter that, intake that checklist again, and then say, okay, let's realign. What do we wanna work on? And they will then mark off what they wanna work on. And what is really cool is that they'll see that from three, four weeks ago, they really wanted to work on, let's say, starting conversations.
And now they're like, no, I got it. So now let's move on to asking someone their phone number or advocating for myself. Um. Again, going back to like the gym [00:22:00] analogy, it's like when you first start working with your trainer and you're like, I just wanna run for a mile, and then you're working on it and then like four weeks later he checks in and he's like, all right, run a mile.
And you do it and it's easy. So that's why like, it's like those check marks. So then by the end of the group, hopefully we have gone through all of the skills or we have addressed a lot, and now they have identified, yeah, you're right. I can start these conversations by myself. I am advocating a lot more at work by my, you know, on my own.
Um. So the goals are in a group are kind of ever changing, um, individualized in the part of, let's say we all say we wanna work on starting conversation or maintaining conversation, different strategies. One person may always need to look at the visual. One person may need a little bit more prompting. Uh, one person can, might be able to do it.
Right away, but they, let's see if they could, you know, change the topic mid-conversation. So that is [00:23:00] where the individualization comes in. So it's like one strategy kind of, could be the umbrella, and then how each individual is able to achieve the overall goal through that strategy based on like queuing and what supports they.
Kate Grandbois: You had just touched on a question I was gonna ask, which is around group cohesion. Mm-hmm. In my, I'm like thinking back to my outpatient days more than 15 years ago at this point, and thinking about the challenge of. Creating groups that are a good, that are a good fit, where there's good, I use, I already used the word cohesion, but there's a good vibe in the group, right?
Everybody's getting something out of it. What strategies do you use to facilitate cohesion? Is it, is it selection or, you know, uh, intentional people, choosing people intentionally for a group. How do you go about navigating that?
Deirdre Flores: So the number one thing is the intake, is that they're motivated to be there.
So they all want to work on this skill, [00:24:00] right? So you're showing up. I also tell parents, I'm not a friendship maker. I'm not a matchmaker. I'm here to teach them a skill. We will practice and then hopefully they'll apply it. My groups have turned into friendships. Almost all of them. There's group chats, they hang out outside, but that is not my number one.
That is just a bonus that happens. Um, so they're motivated to be there is number one then, right? The first one or two sessions, you can see people have walls up because this is hard. Um, I often start off with a. I'd say like a social opener. It's almost like a conversation opener, but they don't know it's a conversation opener.
So like a would you rather, um, let's say it's, it's summer right now when we're, um, and so would you rather go on a rollercoaster or a water slide and then, you know, they all share and then it's like, oh, have you ever been to, and I might. Share a water, um, park in Connecticut, and then start the conversation and see who has something, you know, [00:25:00] that they share in common.
Um, often they're around the same ages, and so I love nostalgia. That is like, right. You bring up nostalgia. Somebody's walls just break down and they wanna talk about their childhood. Right? What makes you so happy? Like the toys you played with, the, the cartoons you watch, so. I will find like on YouTube, like a like name that cartoon and I'll put the years that they were born, I just had a high school group and they were born in 2010.
Oh my gosh. So nostalgia. This is
Kate Grandbois: horrifying to me.
Deirdre Flores: I know. So nostalgia of 2010 and so you could just see the wall. Oh my gosh. I love that video game. I love that cartoon. Me too. Uh, by the second, third session, we are all on the same playing field. We are talking, we found out things that people have in common and that's a part of my role as a facilitator, right?
To, oh my, you both play video games, right? Have you played this one or that one? And [00:26:00] so that is a little bit part of the, um, role that the speech therapist plays to make sure everyone makes these connections, but involving some fun interactive activities like that really helps mesh group.
Amy Wonkka: Do you also tend to select groups based on sort of, we talked a little bit earlier, you were talking about the different environments that people are in.
So do you have different groupings based on like students who might be in their early twenties but are still attending school versus people who or who are attending? Their high school versus students who are in their twenties and are attending college or working at a job site. Uh, do you try and pick like, like environments?
Deirdre Flores: Yes. So before the intake is the conversation with either the parent or the provider that's referring them. And I will typically describe. The, um, participant that might be in my adulting group. So in my adulting group, often they'll drive [00:27:00] themselves, right? They might be volunteering or have a part-time job.
Um, they are looking for friends actively they are saying, you know, I'm lonely. I want friends. Um, I have a mastering conversation group where it might be for someone that needs more prompting just to engage in conversation. Um, so there's a different profile of. Clients and I will direct them to which group is appropriate.
I run a group that's called, um. Campus ready. And so it's for, um, seniors going into onto the campus and they're just working. So they've been accepted to college, right? They're graduating and we're just working on how do you problem solve with your roommate? How do you self-advocate for those accommodations?
Um, so I do, I guess before the intake, it is the conversation with the parents or the um, provider to then say what is appropriate for them.
Amy Wonkka: That makes a lot of sense. I wonder if you can tell us a little bit about how the skills that you target for, in [00:28:00] conjunction with your clients, um, might look a little different depending on those different groups. And so thinking about the difference between those clients who might be, you know, still attending, they might be in their early twenties or late teens, they're still attending their public school, uh, versus those who are attending, you know, uh, going, getting ready to go off to college or working at a job.
I was wondering if you could tell us a little bit, um, more, and give us an example. Of how, you know, we might work on skills like self-advocacy or perspective taking and how that might look different across the different groups that you're running.
Deirdre Flores: Yes. So perspective taking. So in my conversation group, we use a lot of perspective taking about how you might start a conversation based on somebody you know, right?
So you stop and you think about that person. What's a topic we share in common? And I might bring that up. Um, perspective taking in the college. Group may be tied to problem solving, so it might be, what do you do when your [00:29:00] roommate is bringing people over and late and you wanna go, you wanna study, or you, maybe it's reverse.
Maybe you are having, you have the lights on, you're playing video games till late at night, and your room. Is trying to go to bed. That's perspective take. Um, I do a lot on problem solving, perspective taking together, kind of using I statements. And the first is recognize their feelings. So I realize that you are frustrated that I'm staying up till two in the morning playing video games, but I need to, right?
And then to advocate for their needs. Um. In the adulting perspective taking, we talk a lot about perspective taking via text messages. So how would the other person feel if they got that text message? So right tone of voice. We add emojis all the time for um, tone. And so how might that other person receive that text?
Um. Then also we, a big [00:30:00] piece is ghosting. My clients don't mean to ghost their friends on texting, but they just don't know how to keep the conversation going. So I give a strategy of like send a meme or a picture of something that's, you know, that you two share in common or you know that they will think it's funny and they'll be like, well that's, I feel uncomfortable doing that.
And then I'm like, think about it. If you received that text, you would be like, oh my gosh, this is so funny. I love this. You. So the perspective taking isn't always that you did something wrong. It's like it, well, what you're doing will also make somebody else happy. And so that's why we, you know, we'll continue the conversation through sending a meme or a picture or checking in, Hey, how is that interview you went on?
Um, so perspective taking is a skill that we do all throughout the ages and all throughout different levels.
Kate Grandbois: I love the idea of a, what did you call it? A gif? Gif. I never know how to say that. Yes, I know, I don't. I'm, I'm dating myself here. I've already disclosed I have a teenage child and now I dunno how to say or [00:31:00] describe modern technology.
That's fine. We're gonna move on. But I love the idea of that, um, because as we know, visuals are powerful in therapy. How else do you incorporate visuals in your sessions, in your groups?
Deirdre Flores: All the time. So when I talk about strategies, there's always a visual that's attached to my strategy. So it's broken down and it's a visual, so that, again, like I said, if I have to scaffold within a group.
One person may have the visual in front of them that has step by step, um, so that they just breaking it down, taking the mystery out of right. If you're self advocating, I have the three step process of, you know, state your problem, how you've tried to solve it, how the other person can help you. Um, so we use visuals there.
Um. Other visuals. Like I was saying, when we start out, I do those activities of would you rather, or kinda watching the video of nostalgia. Um, it visuals just drive right, like [00:32:00] people are really motivated with visuals. Um, sometimes I'll pull up some clips I find on YouTube. Um. This, the generations that we are treating, they go to YouTube all the time.
So that's motivating to watch a quick clip on somebody, you know, doing something on YouTube, maybe teaching how to start a conversation on YouTube and I'll, I'll use those kind small clips as well.
Kate Grandbois: What other, I mean, I'm just thinking about how this is similar, but very, but different than our traditional speech therapy session.
Right? So in a traditional speech therapy session, we would use visual supports as you're describing, but there are other. Strategies we might use as well, like prompting or modeling. How else, what other like classic therapeutic strategies are you bringing into these groups?
Deirdre Flores: Yes. So like I said, the visual, um, prompting, we could have the visual down on the table and I'm just pointing to the next step that they need to do.
Um, I, if we do role play, [00:33:00] sometimes we coach the other person with. Giving cues for nonverbal so that they can respond to those nonverbal cues. Um, so it's kind of scaffolding, um, different, pulling away the scaffolding, but in a naturalistic way. Um, one strategy, and I guess it's kind of like prompting, is that a lot of the young adults will then bring in experiences that they're having outside of group to bring to group and ask questions.
How would they deal with and, um. I see that as like you've tried it independently and now you're coming here and we're gonna break it down and, and, um, practice within here within a safe situation. Um, for example. I had a client that met up with a friend for lunch. She was going an Uber home. The other friend was driving themselves.
She went and waited for her Uber. Her other friend left. Just so happened that Uber took 30 minutes and she felt really nervous. Um. That she was left alone for 30 minutes in a place [00:34:00] she might not have known as well. And so she brought that to group. And so if you think about it, right, that's like the independent try.
She tried that independently, she brought it down to group and now we scaffold it. We talk about perspective taking, we talk about problem solving. Um, so it is a little bit less of like the traditional go from a visual to a verbal to a nonverbal and more of like. As an adult, you've tried it on your own.
Here are some supports and here are some strategies you can use.
Amy Wonkka: Okay. I wondered if you could talk to us just a little bit about, I know we had chatted a little bit, you shared some notes with us in advance just regarding some of that shift in responsibility back. Um, so we talked about the shift where, you know, you may give somebody homework to make some of those appointments on their own.
Is, is that also true for how they interact with you in terms of like their appointments or any of that? Like is that also an opportunity to work on some of that independence?
Deirdre Flores: Yes, so my number one thing [00:35:00] is right, I, I have the initial phone call with the parent often. Then from there, within the conversation, I say, please share my phone number with the client.
They need to. Call or text me if they're not going to make group, um, if they're gonna be late, if they need directions. Um, right now bosses and supervisors give out their phone numbers all the time. So texting now has not only become that you're doing it with friends and family, you're doing it with bosses.
Um, I know like some doctors, doctor's offices, you're texting. So texting now is more formal, right? And you're texting with a variety of different people. Um. In my group, I have tried group chats as well as there's an app called Team Reach that we have used too to, um, do text messaging. And there I have gotten a lot of practice, like they have gotten a lot of practice on using strategies that we've talked about.
So [00:36:00] sending a picture of your dog, right, and to initiate the conversation with everybody. Um, so. In that piece that you can model, what's a group chat and how do you respond? Um, and then what's really cool is a lot of my clients within the groups have then gone to other group chats and created their own and then initiated hangouts outside.
Amy Wonkka: No, that's awesome. And that's, that's such a good point about texting. It really has become, I mean, I, I literally just this morning got a text from my dentist about scheduling my dentist appointment. Um, and the group chat and connected with that, like group emails are such a workplace piece as well. Like, do you reply all?
What do you put in your reply all message are? How do you double check to make sure that you're not replying all if you don't intend to? Um. Um, and please
Deirdre Flores: put a subject line in your email. And I always think right when they are younger, we talk about what's the main idea. And that's all I say is like the subject line of your email is the main idea.
So it is very speech [00:37:00] tied. It's just all practical pieces. Yeah. It's like, what's the main idea? Put that as their subject line. You need to greet somebody, you the three pieces of a email. Yeah,
Kate Grandbois: I didn't, I guess I had never really considered the power of text in a professional setting until you said it, but I'm thinking like Slack or, you know, Google Chat.
I mean, I can't remember the last time. And there's so much remote work that's happening. Mm-hmm. That and the nuance that goes into that from a written language perspective.
Deirdre Flores: Yes, yes. That's huge. And the keeping a conversation going via text messages and what do you do? And, um, I, another piece is when you meet two people, right?
And a lot of my clients are looking for friends, I have modeled how to initiate a group text. So I might say he's Sarah, this is Kelsey. I wanted you two to meet. And then, um, so I'll have a text where they meet each other and then they might have their own text. Then a client came to me and said, I did [00:38:00] it.
I did exactly what you did. I hung out with like, so and so from one group and another from my, my like house. And I, I did the text just like you did, and I introduced them and then we all hung out and I'm like, yes. That's amazing. Yes. Yeah. So it's like real life, practical social skills, but it's on a device.
Amy Wonkka: Yeah, I love it. And it's like technology is such a ubiquitous part of our life now, and that is how that, that is how we connect with other people and being able to make those connections is the first step of having that relationship. Um, I think this sort of ties in nicely into another piece. Uh, that you do in your work, which is work in the community.
I know you mentioned the trip to the mall. Um, but being able to practice those skills, so, okay, so I've connected with my group and we are gonna make a plan, but knowing how to sort of execute that plan, uh, I was wondering if you could talk us through the steps that you might use to teach, depending any of your groups, but how, how your level of support may [00:39:00] look as the SLP who's facilitating the group.
Um, yeah. When you're doing these types of community experiences.
Deirdre Flores: Yes. And so when we talk about prompt level, right? My, my planning of these community events goes from me doing the most amount of work, so the most prompting to the least. So as the group goes on, I'm doing the least amount of work. So that's kind of like the prompting right there.
So in the beginning we talk about friendships are based on shared. Interest. So we talk about in the group what does everybody like and let's say trivia night, we went out to one night for a trivia night, but I brought it and said, Hey. This place is trivia night on Wednesday. Would you guys like to go?
Okay. So here and again, I followed up with it in a text message so they could see how you invite. Um, I planned what time, what day, where we're going. Then the next, a lot of times in my adulting group, we start off with what's going on in your communities. They're from different towns. Um. Just looking [00:40:00] up, what, what's going on?
What would you be interested in? Um, some of them are into meetups, some are not. But the commun, there's so much going on, right? As a young adult, you could find based on your interests. So then I will maybe give three options. Which one should we do? And then they'll choose. By the end of the group, it is them sending out at least one of them, sending out a text message in the group saying what, you know, giving an option and asking, you know, do you wanna do Saturday or Sunday?
And what time works best? Um, I have, I have had one session where there were two clients that were able to make the group and three that weren't for some reason. And they were doing real-time texting, oh, what should I say? Okay, I'm gonna text. Oh, she responded, what do I say back? And so you're able to kind of coach them along with planning a hangout that way.
But yes, so it goes from me planning it every detail to then at least then, then planning it on their [00:41:00] own.
Kate Grandbois: So we've talked a lot about texting the role of technology.
We, uh, you know how technology is just an, it's an integrated part of our lives. How else are you embracing technology in a way that facilitates social interaction instead of. You know what I'm always telling my kids? Like, get off your phone, put your te, put your technology away. Call your friends. You know, how are you integrating technology in a way that facilitates social interaction as opposed to inhibiting social interaction?
Deirdre Flores: So I actually, it's really exciting. I have been using a lot of virtual reality and AI tools for role play within my sessions. So these young adults often have had speech therapy for many, many years and it gets boring, right? And so how do you keep it fresh and new for the young adults? And so I have been working, um, some are kind of like prepackaged.
Um, prepackaged scenarios. Some [00:42:00] are that I am able to create them and it's much more tailored to the specific client. Um, so interacting with avatars, some are just on the computer, some are actually on the Oculus. Um. And interacting with ai. And what I really like the ai, I guess you could call them chatbots or avatars, is they have real naturalistic back and forth conversations compared to when you're role playing statically in a therapy room.
I'm very nice. I might not give in, but for example, we were doing a role play, a problem solving role play for my campus ready group, and we were saying, okay. The avatar is your roommate and you are telling him he's bringing people over all the time, and you, you need your time that he's not bringing people to the room.
Well, I'll tell you that Avatar did not give up and was pushing back, pushing back, and I was able to coach my client to speak up for himself and really engage in that conversation and really engage in that problem [00:43:00] solving and self-advocacy. Um, and they really enjoy these. Um, role plays. There are some virtual reality and AI scenarios that assist therapists can really control.
Um, like the rubric that the client is being scored on, um, can really give them direct feedback. You can, they could use this at home to practice their conversation skills and it's really motivating. Um. And to add on, like how do you take this outside of the therapy room? Actually yesterday I went to the mall with my, one of my groups and we went to one of those virtual reality experience, um, places in the mall.
And we, we, um, engaged there and then we went bowling and had. Um, dinner, but it's a way that you take from the therapy room, you're practicing a real life skill. They're not just playing a game on virtual reality, but they are engaged and I'm seeing much more [00:44:00] dynamic conversation than just with role play with myself or somebody else in the group.
And then we're also using. To then hang out outside. So we're, we're not just stuck in the metaverse or the virtual world. We are then having face-to-face conversations and they see how you can use that interest to then hang out with friends.
Amy Wonkka: Okay. This is probably a silly question, but I'm gonna preface it by saying I'm medium old.
So I'm asking this for any of the medium old SLPs out there who might be listening and aren't. Super familiar with what's available in virtual reality. Mm-hmm. Like, are you, like, what are you actually using? Are you using like a computer that you guys are typing into? Are people wearing headsets in your office?
Like I literally don't Yes. Know how to, I'm take a picture in
Deirdre Flores: my mind for
Amy Wonkka: this.
Deirdre Flores: I'm using all of that, so I am using where you could just talk into the computer and the computer talks back to you. There's no visual I am using where there's an avatar on your computer screen and you are talking to them and they're talking back.
Also using [00:45:00] where you put on the. The headset and you were fully immersed and you were inside and talking to other avatars, and you could look and you're in a total different room. So you might be in the cafe or you're at the table with your boss and you're advocating for accommodations. Um, but in all of those scenarios, it is AI that is talking to you back and forth.
What makes it therapeutic is that I have on the other end, I have control over, um, what the scenario is, what is being measured, and um, how the AI chat bot is interacting. 'cause I don't know if you've done it, but AI chat bots are very nice. And they'll keep the conversation going. Um, so as a therapist you can really manipulate exactly how that chat bot is reacting to, um, the conversation so that you can target very specific skills.
All right. That's super fascinating and
Amy Wonkka: you're blowing my mind a little bit. [00:46:00] It's so cool. SLPs out there, definitely check out these, these tools that are available because I grew up in the day of like flashcards and a tin. Um, so it's just amazing how far some of our resources have come. Mm-hmm. Um, that we're able to use with our clients.
In our last few minutes, I didn't know if you wanted to share a few parting words of wisdom or tips for an SLP who's been listening to this conversation and is now really excited to go out and either try some of these like. Like shared goal writing or some of these, um, role play opportunities to work on skills for, you know, their adulting environments.
Deirdre Flores: Yes. So. I want really to hit home that these clients, 18 to 30, there's a really big service gap, right? They're leaving public schools where they have had a lot of explicit instruction in how to be a student. Then we ex, we kind of throw them into this [00:47:00] adult world where we just expect them to learn these skills kind of through osmosis and they need our help.
We as speech therapists have the tools and the ability. To make somebody's life independent, fulfilling, and successful. There's no better feeling than somebody coming, a young adult coming in and saying that they hung out with somebody, um, outside a group and they wanna come back and tell you how happy they are.
Or they advocated at work and they resolved a situation on their own. So being an adult is all communication and we are the ones that can really help. Make sure that these neurodiverse young adults have a successful experience of being an adult and then, um, that they have fulfilling lives, which is our main purpose.
Amy Wonkka: Deirdre, thank you so much for sharing your time with us and all of your information. I'm very inspired to go out and learn more about virtual reality. [00:48:00] Um, thank you so much. Thank you so much for having
Deirdre Flores: me.
Amy Wonkka: It's pleasure.
Outro
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 [email protected]
thank you so much for joining us and we hope to welcome you back here again soon.
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