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Kate Grandbois: Hello everyone. Welcome to SLP Nerd Cast. We are super pumped for today's episode. We've already had many minutes of giggling before we even hit the record button. We are here today to talk about a topic that we've covered on the podcast before, but we really are gonna do a little bit [00:02:00] more of a deeper dive today.
Um, it's a topic that we're really passionate about related to collaborating and collaboration skills. One of the reasons we're so passionate about this is because collaboration is really one of those skills that enables you to engage in person-centered care and focus on the person in front of you.
And we are here with not one, not two, but three special guests to help us unpack how collaboration intersects with supervision. So without further ado, I'm very excited to welcome Jamie Brandman, Jessica Nico, and Dr. Cindy. Go. Welcome Jamie, Jessica, and Cindy.
Dr. Cindy Gevarter: Thank you. Hello. We're excited to be here.
Amy Wonkka: Thank you so much. We're excited that you're sharing your time with us and our listeners today. We are here to discuss teaching interprofessional communication skills to supervisees.
But before we get started, could you tell us just a little bit about yourselves and maybe why this topic is so important or of interest to you? [00:03:00]
Dr. Cindy Gevarter: So I will start. I am an associate professor in a speech language pathology department at the University of New Mexico. But my background was actually first as a special education teacher and then I became a board certified behavioral analyst.
Worked in early intervention and then wound up teaching in a speech department. So inherently my whole background is interprofessional. Um, and so we were started a PhD program in our department a few years ago. And so I was very interested in recruiting students who have that same interest in interprofessional.
So my first PhD student, Jessica, allow to introduce herself.
Jessica Nico: Thank you Dr. G for that marvelous introduction. Pocus pocus. My name is Jessica Nico. She her, um, I'm going in, that's a classic. I'm going into my, uh, third year in our PhD program in communication sciences and Disorders. I'm studying under Dr. Sun Barter.
Um, as she mentioned, um, I was a practicing SLP, [00:04:00] uh, before I decided to come back and get my PhD. Um, I saw a big gap in, um, how we provide services to autistic kiddos. Um, specifically, uh, my interests are in echo and in neurodiversity social communication intervention. Um, and when I saw our program at UNM and I read about Dr.
Gobar, I was very motivated to meet with her. Excited, um, to discuss where we overlap, excited to see, uh, where we kind of diverge in our perspectives, but how we can again, come back together and, uh, do the best for our kids. Um, and next I'll pass it over to Jamie.
Jaime Branaman: Hi everybody. I'm Jamie. Um, she, they pronou.
I'm going into my second year here in the PhD program at UNM, uh, similarly to Jessica. I practiced for quite a few years in the field before returning, uh, in the field. I was lucky enough to work in school settings as well as early intervention, a BA setting. Um, so I had a lot of [00:05:00] hands-on direct experience with interprofessional collaboration.
So it's something that I was really passionate about, but noticed a lot of the gaps, like Jessica was saying. Um, my passion is also in a C specifically, so that definitely drew me to Dr. Coter, um, and I've loved learning from her thus far. Um, in addition to working towards my PhD in speech, I'm also working on my BCBA requirements, um, and working as an RBT.
Kate Grandbois: It's a great group. This is gonna be super fun. I'm very, I'm very much looking forward to this. Before we, uh, get into things, I do need to read our learning outcomes for the episode. So, uh, after completing this episode or listening to this episode, participants will be able to self-report knowledge gains related to interprofessional collaboration, competencies for board certified behavior, behavior analysts, and speech language pathologists.
Participants will also be able to self-report knowledge gains related to key components of interprofessional [00:06:00] communication when interacting with at least one other discipline, as well as reporting knowledge gains related to incorporating direct modeling role play, and in C two opportunities for supervisees.
To utilize interprofessional communication skills. If anyone listening is interested in learning more about the financial and non-financial relationships for this episode, those will be listed in the show notes as well as on the course landing page. This episode is also being offered for ASHA's eu, so if you are interested in earning Ash's CEUs after listening to this episode, please follow the link in your show notes that will also be listed on the episode landing page on our website.
Okay, now that we have gotten that behind us, let's jump into the good stuff. Where would you all like to start? It's such a party over there. You got three of you? I feel like I don't, I'm just gonna give you the mic. Go for it.
Jessica Nico: Awesome. Um, I think maybe where we wanna start is just going over expectations for both professions on interprofessional collaboration.[00:07:00]
Um, I can start from, you know, talking as an SLP specifically. So, ASHA has provided guidance to SLPs on, um, how important interprofessional collaboration is and servicing our clients. Um, and specifically for addressing the complex needs of individuals with severe disabilities, such as some autistic children.
You might notice me shifting back and forth, or all of us actively shifting back and forth between person first language and identity. First language person first, meaning person with autism or identity first, meaning autistic child. Um, there's just such a variety of perspectives, um, on person first versus identity, first language.
So we wanna be consciously shifting between that to respect all perspectives. Um, however, jumping back to, uh, interprofessional collaboration, Asha said it's the future of service delivery. Um, so we find that it's really important that we, um, instill this, uh, skillset within our. Current supervises in future SLPs, um, and Asha specifically, uh, principal four Rule A States individuals shall work [00:08:00] collaboratively with members of their own profession and or members of other professions when appropriate to deliver the highest quality of care.
Um, and in a professional collaboration is also recommended by, uh, IDEA as well as the American Ca Academy of Pediatrics, the World Health Organization, and various other, um, organizations. As well. So Cindy will now be talking about a little bit more from A, B, C, BA perspective.
Dr. Cindy Gevarter: Yeah, so those of you who might be listening who are BCAs know we have a very detailed ethical guideline.
Um, but I think one of the ones that often gets forgotten is 2.10. I had to look that one up to note number. Don't just know that off the top of my head. Um, but that focus is on the fact that BCBAs do need to collaborate with colleagues within our profession, but also from other professions and specifically with a focus on what is in the best interest of our clients and other interested parties like families.
Um, and one thing when I came back to rereading this code that I really liked and noticed was they emphasized specifically [00:09:00] compromise. Um, and using that compromise again to prioritize what is best for the client. Um, and then not surprisingly for anyone behavioral, um, we do have to also document our efforts, um, taken in terms of when we are collaborating or if there is conflict and when, uh, what the outcomes are.
Um, and one thing that I like to note here is I feel like this particular piece is often forgotten. And instead, people focus very frequently on, well, we can't do something that isn't backed by research. And kind of focusing on that one without thinking about how do we make those guidelines work together of, we do need to use evidence-based approaches, but we also need to collaborate.
Um, and Jamie's gonna talk a little bit more about a model, uh, for interprofessional, um, uh, communication and collaboration, um, that was actually developed by some dual certified SLP BCBAs.
Jaime Branaman: Yeah. So doctors [00:10:00] Lena Slim and Lili Ru developed a IPC competency Framework to help kind of guide like, what does interprofessional collaboration even mean?
What are those competencies that we need to be successful in this? Uh, so kind of breaks down into four main categories of these competencies. The first one is values and ethics. So the idea behind that is to have shared respect for each other, to have flexibility in our thinking and our actions. Actions.
And ultimately, like was mentioned at the beginning of the episode already is. Centering, really centering that client in everything, right? It's client-centered practice. So at the end of the day, doesn't matter who's in what field, right? The client's gonna come first. Uh, the next one is roles and responsibilities.
And so this is really key and I think there's a lot of breakdowns in our field, both fields I should say, in this. Um, in terms of understanding, respecting each other's expertise. I think that comes in understanding not just scope of practice, but go narrowing it to that scope of competence or that expertise, uh, so that we [00:11:00] can better collaborate.
The third one is teams and teamwork. And so having shared accountability and shared goal setting is really, really key. Uh, instead of working on things separately, we can definitely work together. And so having that idea of like, okay, what together can we do moving forward for this client? And then the one that we're gonna focus on a little bit more today is interprofessional communication.
Um, and so interprofessional communication as a whole should be bi-directional, uh, really respectful and have a lot of proactive dialogue. So you'll hear a lot of our strategies talking about next exceeds talking about proactive things that are gonna happen before the problem arises so that we can hopefully minimize those problems in the first place, but also have a framework set up so that if, if and when those happen, we know how to respond.
And so really that includes communicating in a way that allows that conflict resolution. Recognizing those values of each other, uh, encouraging others ideas. So not just being there for your own ideas, but recognizing [00:12:00] that other ideas, um, hold value as well. Um, receiving and giving feedback, that's just really, really key.
And I know it's something that I think, uh, everyone as a people probably struggles with to some extent. Identifying how you want to receive it or to provide it, um, and those, but those key, um, competencies are really, really key to be successful in collaborating.
Kate Grandbois: I wanna reflect a couple of things back to you about this, what you've just shared, which I, I first wanna point out the level of detail in the explicit.
Instructions for how, for how to be a good collaborator. Right. And then I think what I was reflecting on when I was listening to you is that that is in a lot of ways showing up to be a kind human being. And I don't wanna boil it down to its most simple parts because I think that the details and the instructions are important because these are things, these are skills that we need to acquire as [00:13:00] professionals.
Um, and if you are listening and you feel that you don't have the skills or you app you find in, in your self-reflection, that you're approaching a collaborative interaction with big feelings of the negative variety, you can rely on kindness and approaching a situation with kindness. So that's my first reflection.
My second reflection is I just, again, reiterating something that you said related to person-centered care and person-centered care. Is person centered care. The person that you are working with is the center of your decision making, right? Which means that, that trumps that is more important than your big, angry, grumpy feelings.
Not that everybody has big, angry, grumpy feelings. I'm making some assumptions, but if you are, if right, a lot of, some, a lot of times collaborative relationships can involve tension. They can involve disagreements, they can involve, um, especially with our more complex learners, they [00:14:00] can involve a lot of, you know, which direction do we go first?
Uh, you know, what are our next steps? What are the best interventions? Especially if you're in a place where. You've tried a bunch of things and you haven't seen success yet. Right. Um, and, and I just wanna reiterate that because I, I don't think it can be said enough. It's very easy for us as professionals.
I'm reflecting on my own experience at this point. It's really easy as a professional for me to let my feelings about how, where my scope is, take over. Right? Right. That's a natural human, inter a human reaction to wanting to do well. We all just wanna show up and do the right thing. Right. Um, so I'm sorry I, to steal the mic.
I just wanted to emphasize that because you, it is so important and it's simple, but not easy,
Dr. Cindy Gevarter: right? Mm-hmm. And I, I would just to piggy off, back off that kindness, I think the other part of it is showing up with, can you put your defensiveness on card for a second? Because I think that for me as A-B-C-B-A is some, is a skill that I've learned.
I would say really in the [00:15:00] last. Five years of, you know, that I know in my personal life I often wanna be, defend and say this is why. Right. And I think the kindness co kind of coupled with that of sort of my purpose here is not to defend why this is the most important, but to listen and hear and ultimately come back to that patient.
Announcer: Mm-hmm.
Amy Wonkka: You're here. I'm, you're here. I'm here, here with you. Um, and I, I just, as you guys were all speaking, I was thinking about how yes, we're here today and, and the focus of this talk, given everybody's background and the examples you're bringing up are, are around BCBA and SLP. But we are, you know, I am, I've worked in a lot of environments.
I've been in a school for a really long time now. Uh, and whether it's A, B, CBA or an OT or a PT or a family member or a teacher or a paraprofessional, like I, these skills are so pervasive and so important across so many areas of our work. Um, [00:16:00] that I think as people are listening, like, yes, some of these examples are gonna be sort of centered on, you know, these specific disciplines.
Uh, but I think the skills you're gonna cover and some of those key components of professional communication when we're working with people from other disciplines are, is going to be broadly applicable.
Announcer: Absolutely.
Jessica Nico: A hundred percent. Um, and I think that, you know, that's kind of why what brought us all together a little bit is that we've experienced unsuccessful collaboration and communication, um, within our professional lives.
And we've experienced successful collaboration and communication. And when putting this together and when putting some of our papers together in our talks together, it's, we kind of tried to identify what is it that we like? Yeah. What, what
Dr. Cindy Gevarter: feels work?
Jessica Nico: Yeah. Why did we work with all of our various backgrounds?
You know, how do we, how are we able to collaborate? How are we able to work together? And which is a strengths based approach, right? So like we're taking our own strengths and applying them to our own relationship and our own working relationship, which I think is really, really important. [00:17:00] Um, transitioning over to, uh, some key components for professional education.
Um, when I interact with other disciplines.
Jaime Branaman: So while what Amy was saying is a hundred percent right, you know, it's beyond just the professional realm of collaboration. Um, and same note rights across any sort of learner or client of any sort. Um, today we're really kind of focusing in a little bit on a SD 'cause that's where our little niche is.
Um, so diving into like, okay, so why are we gonna do it for autism specifically, why is this collaboration, um, really that important? Um, and ultimately for autistic individuals with communication disorders, there often is a multi multidisciplinary intervention team, right? It's gonna be very rare unless you're in a super rural, rural area.
And that's very unfortunate. And that's something else we're gonna mark on, does a different talk. But, um, you know, it's gonna be rare that you're gonna find, [00:18:00] uh, a learner with autism that has never encountered more than one profession. Right? Even if that's just like your medical professional and an SLP, right?
And so knowing that it's not just speech language therapy or knowing that it's not just a BA services that this learner is receiving is really, really key. Um, because that's how we can move forward in that child or that client centered way, um, to increase those outcomes really for that autistic client and their family.
Um, you know, most autism treatment is based, uh, evidence-based models are grounded in a, b, a and applied behavioral analysis. And so while we know this, we know that a lot of our principles are overlapping regardless of what discipline we're in. It's important to acknowledge that overlaps. So for an example, um, a BA therapists that are led by BCBAs, um, often do target functional communication skills, right?
And this is a very clear, I think the most like, salient example of an overlap that we get [00:19:00] with SLP spoke scope of practice. And I think in a lot of cases this might be where people first experience that challenge. Um. That's differing from another person. Um, and so I think it's really clear and important to recognize that both of these disciplines have value and both of them have input to this individual.
And so that's why that collaboration needs to happen, um, beyond just. The ethical mandate of the, you know, governing bodies of ASHA and the BACB saying like, Hey, you should do this, right, but how are we gonna do it? Right? And that's kind of what we're gonna dive into a little bit more.
Dr. Cindy Gevarter: Um, yeah. And just to expand, um, on, Jamie kind of talked a little bit about that scope of practice.
Um, and I think it's helpful, um, as a framework as we're diving into this to understand there really is overlap between scope of practice. Um, and then, um, Spencer ETL and colleagues, um, actually put out something for a BI one of the, uh, behavioral organizations [00:20:00] of looking at how can BCBAs collaborate with LPs.
And they really laid out, um, the overlap between scope of practice, scope of confidence that we typically see between LPs and bcs. But what I really liked that they did too is they outlined relative strengths of each, um, and then like areas for. Uh, that are really, uh, particularly good opportunities for collaboration.
So for example, um, in terms of strengths, uh, language structure, swallowing, feeding, that might be more on the SLP side versus data collection. Um, single case design research preference assessment. That might be more the BCDA. But then when we come into something like, um, augmented and alternative communication, right?
Um, our different strengths are actually going to come together. Um, but in order to identify that those strengths can come together, we have to communicate. Mm-hmm. And that's why we really wanted to focus on that topic, because before we can ever get to that collaboration, we need to have those conversations.
Jessica Nico: Mm-hmm.
Dr. Cindy Gevarter: Um, and [00:21:00] discussions. And unfortunately, there's a lot of. Barriers, which Jessica is gonna get into a little bit more.
Jessica Nico: Yeah. So there's a lot of strengths like, uh, Dr. G said a lot of opportunity. However, um, according to some research in the literature, specifically afters 2024 school survey, um, there's specific challenges in limited time for collaboration as reported by SLPs as well as, as well as the limited understanding of the role by others.
And that's on both ends of the spectrum, right? Um, I think in the literature people say that, you know, there's poor incentives to collaborate, there's hubris, there's pride involved, there's a lack of understanding. Um, there's a lack of theoretical understanding as well as practical understanding of, okay, what are the theoretical philosophies versus like, what are their hands on doing?
I don't understand what's happening. Um, as well as just a preference for one way of thinking. So in order for there to be effective interprofessional collaboration, as Cindy said, there has to be effective interprofessional communication, which starts with [00:22:00] shifting our mindsets around. Working with another person.
Um, it starts with professional humility. Um, and it starts with co cultivating mutual respect, um, while withholding, upholding shared ethical values in order to fulfill, you know, our role within a team-based approach. So some solutions that we kind of put forward based on our own conversations and based on how we've interacted with each other is kind of just a structured dialogue framework, um, for you to approach interacting, uh, with another professional.
Whether you've been working with them for almost three years, like Cindy and I, uh, two years, what is math? Um, or somebody that is now joining on the team, right? Um, uh, whether or not you have an existing history with that person, that might be. Or not so great. Um, but, you know, uh, taking a step back and regrouping and coming back together, um, to talk in a more effective way, right?
So to give examples of this where, um, we wanna provide examples of [00:23:00] communicating in a way that allows for conflict, conflict resolution, should it arise when it arises, um, and we're, we're gonna be talking specifically about a case-based role play scenario that Cindy and I practiced, um, specifically about a child who uses e to communicate.
Um, that way we can share a model of successful, effective interprofessional communication for our SLP supervisees in the future. So the first step that we kind of recommend is just getting on the same page. A lot of the literature and, um, SLPs perspectives on the topic reveal just a lack of understanding of roles.
So coming together, um, with this antecedent based approach, right? Behavior, setting the tone and getting ahead of that potential conflict. Right? Um, so some, um, what that would look like due to some concerns and confusion about the rules is explicitly defining your role, um, saying that other person might not know your history, they might not know your education, your background, right?
Um, so you wanna set the [00:24:00] tone for openness in discussing, you know, this is what I bring to the table, this is my educational background, this is my, uh, practical background, right? Um, introducing yourselves. And, you know, this kind of looked like for us, me sharing my experience coming from a more social interactionist floor timey, play-based clinical education and practice, um, and my history and interest with providing strengths-based neurodiversity affirming services, autistic clients who use a lillia.
And although Cindy comes from a behavioral background, she hide where we aligned, right? She highlighted where we aligned our alignment of our methods and our approaches, um, such as her use of NDBI, such as her use of naturalistic n um, and strengths based neurodiversity affirming approaches. So, while expressing her own professional experience and my own personal professional experience, we both aim to demonstrate professional humility, um, and avoid power dynamics, right?
And treating each other as equals and experts within our own fields. Um. Because, you know, within community-based research [00:25:00] specifically, we all have expertise, right? We all come to the table with something, and that's always an opportunity for us to learn.
Dr. Cindy Gevarter: And I just wanna point out, like within that conversation, like listening and then again, trying to actively reflect back like where those similarities were, right?
Mm-hmm. So I didn't just start with like, I'm a BA trained. I was like, oh, I love natural approaches too that, you know, like thinking about where you can, from the beginning again, this step is get on the same page, like mm-hmm. Tell your history and your story, but look for the, like, where do we have those similarities?
Yeah. And even like the most. Behavioral and the most social, I think you can find those, right? Mm-hmm. If you're coming in at it from like that approach of mm-hmm. Let's, my goal is not to defend a BA, my goal is not to convince you to become an slp. Mm-hmm. It's how do we get on the same page and understand each other's role.
Experience.
Kate Grandbois: Mm-hmm. I wanna kind of unpack some of this in terms of how this extends to people in a non-professional [00:26:00] context. And I think one of the things you're getting at that I, I love and value so much is that perspective taking of what someone else's lived experiences, what someone else's bringing to the table, right?
Just like you said, using our own strengths based model and applying it to our peers. Right? We meet, we've, we've learned to do this for our clients. Why aren't we doing it for other people? Right. Adults are learners too. Okay. So louder for the people in the back. Right. Right. So what I, what I, what I am hearing that I appreciate so much is, is applying that to other collaborators on the team.
Like families, we don't know what their home life is like. We don't know what their lived experience as care partners is like extending that to our clients. Again, person-centered, right? What are their values? What are our clients' values? Um, and then trying to unpack and dismantle a little bit. What biases we're bringing to the table in terms of if it's with a family, what power diff, what power position are we in, what's the power differential there in terms of hierarchy?
How are we approaching that [00:27:00] relationship with humility? Um, and with any professional? I learned a term a few years ago, it was one of my favorite terms, and you may have already mentioned it, or it might be coming up later, which is the concept of disciplinary centrism, which is pervasive across of all of medicine, which is the idea that your discipline is better than everybody else's, right?
Mm-hmm. And that is like a cultural phenomenon that we all carry, right? Uh, and I, I think that the idea of unpacking that within ourselves first. And then communicating that explicitly to others is so powerful. Uh, and again, I just love the, the step-by-step instructions that you're providing because it is, I think about myself as a clinician when I was first in the field, and it is like, as my 11-year-old would say, extra cringe, mom.
It's just extra, extra cringe. These are things that you develop and that you learn. Um, and I think that the, the specific points you're making are incredibly helpful.
Dr. Cindy Gevarter: Yeah. I, I love that extension that yeah, it [00:28:00] applies beyond just input, but absolutely. The whole team, which includes families, the autistic individuals themselves, and learning their learned history.
And even, you know, Jessica and I, when we modeled this. Had some of an experience, but I, I wanna say our very first conversation, uh, we're also just very candid about positive and negative experiences. Mm-hmm. With collaboration. Mm-hmm. To, to point out, again, that lived experience of like, I wanna be honest, I've bad interactions with.
Mm-hmm. Or, you know, so that like we're stating I'm open and I wanna learn, but also like getting an idea of the framework or the big feelings someone might be coming in with mm-hmm. I think is also helpful to just be honest about and identify. And I, I think that can help build that, that first stage, um, too.
And, um, yeah. I think Jessica's gonna talk a little bit too more then about sort of our next step of just building into, now that we've introduced ourselves, how does that relate to the actual client that we're working with? Mm-hmm.
Jessica Nico: So as we, as you mentioned, everybody comes to the table with their own expertise, right?
[00:29:00] The client themselves, the family members, the caregivers, um, all the related services, right? So it's important that we create space. For the team members to share their own perspectives on the case. Um, because if we're looking at my water bottle, right? And I have blue glasses on, this looks bluish greenish, right?
But Cindy comes to the water bottle and Cindy has purple. 'cause Cindy has purple, purple glasses on. It looks purpleish greenish, right? We're both looking at the same thing. We both have different perspectives on the same thing, which is influenced by our glasses, how we see the world, how we were trained, how we were educated, right?
So making sure that, um, we acknowledge that we're all looking at one slice of the, of the child, in our case 'cause we work in peds, but acknowledging that together we can create a whole picture of that person based on our own perspectives, right? So sharing our perspectives of the case from my SLP social Interactionist.
Glasses from Cindy's [00:30:00] behaviorist. Glasses Bring your own clinical observations and judgements to make sure that, um, we're serving the client from, you know, each of our perspectives and creating a whole person. Right. Um, and sharing, you know, what has been a challenge from your perspective, but really focusing on what has been working right.
Um, and when sharing challenges, being curious as to how the other person kind of, kind of fill that gap. Being curious to kind of like, I'm having a challenge with this child. I wonder if Cindy, how Cindy could, because she could definitely support there. Right. Um, so sharing what's been challenging, what's going well, um, so like, one of the strategies is using reflective questions as Kate, you've been doing throughout the entirety of the podcast. So checking in with, this is how I'm perceiving the thing that you're saying with my glasses. Right. Um, and reflecting back and asking, is this what you mean? Is this how you, um, meant to say it?
Is this accurate that I'm receiving? Right. Um, and if, if something that you don't understand or if there is a miscommunication or a lack of understanding, asking questions for [00:31:00] clarity, but also out of curiosity rather than judgment. And then again, reflecting back what you're hearing, um, and checking for a shared understanding.
Dr. Cindy Gevarter: And so in this like practice role play, which our intentional we'll talk about later is we're going to actually share this as a model for our graduate students. Um, but again, we came at it of, from a real actual case, but Jessica played SLP very hearing a lot about GLP and I was sort of behaviorist like, Ooh, what?
And Gestalt language processor is GLP, which is a topic that, um, hot button topic right now. Mm-hmm. Um, so we had Jessica like throw out that term and instead of being like, Ugh, that's not evidence-based, right? Mm-hmm. Myron was like, so tell me what you mean by that. Mm-hmm. What, you know, for me as a behaviorist, like what does that look like?
Mm-hmm. So that I could understand, oh, okay, she's telling me they're using, um, whole phrases, pull phrases, and they're responding to intro verbals. Right. More than initiating mans. Right. So again, I put my defensiveness aside and was like. Tell me more about what that looks like when [00:32:00] you say that, right?
Mm-hmm. I'm focused on that side, so again, I'm being humble and not trying to come at as like my way is the right way, right? Mm-hmm. Um, and through that, like naturally, Jessica just gave me a lot of valuable information that I could then kind of translate into my head and also be like, oh, I, I know that profile of child she's talking about, right?
Like, even if I'm not using that term, this aligns right, but constantly again, reflecting. Back those, those questions. Right. Um, and I did a lot of like, oh, this is how I would, like, does that align with what you're saying? Right. To keep making, um, that connection.
Announcer: Mm-hmm.
Dr. Cindy Gevarter: Um, and then that piece of the conversation then led into our, our step three, which is the way we kind of describe that as like finding the Venn diagram, right?
Mm-hmm. As like as we want to start thinking about goals and we talked about earlier the importance of shared goals, um, trying to figure out can we create those shared goals and where might we need to do [00:33:00] things differently? So again, that Venn diagram. Um, so this really focuses on, again, that, um, IPC value of recognizing values and what we each bring to the table.
Um, and really again, focus on that. What are the similarities that we can come here? Um, so there were simple things in our conversation where, for example, Jessica would say, you know, initially I might accept if he used this scripted phrase, even though it doesn't exactly, exactly match the context. And then over time, if he started using it more this way, then I would respond to that.
And I was like, oh, that's something we call shaping. Mm-hmm. Let's talk to you about, right. So that we're also introducing the different terminology. Mm-hmm. Rather than just being like, oh, you're using shaping, that's a behavioral principle, right? Like, oh, I'm, does that make sense? Oh. And then I was like, that's very cool that you're doing this thing that I would do.
Right. Of just like. Bringing it back to what we share. Um, I think that's the piece I again mentioned earlier. I've heard from a lot of BCBAs, the, [00:34:00] but we can't do anything with GLP because it's not evidence-based. And that goes against our ethic guidelines versus. In this conversation, looking for moments where I can say, oh God, shaping, I can do shaping.
Mm-hmm. Right? Like, what are the behavioral components where I really can, um, collaborate, right? Mm-hmm. Um, so really looking for those similarities at first. Um, and then as we get into thinking about goals, you know, before we have goals or if there again, if this was a previous existing relationship, coming back to those goals.
Um, just going back to assessment and what we can each bring to the table. Um, so in this, again, roleplay scenario, Jessica talked about language samples and all the different, and, uh, she provided me examples of some of, um, the scripted phrases the child was using and I asked her more about the context and she, um, then I asked follow up questions like, um, you know, do you notice differences in they're using it in this context?
And she started mentioning, um, some [00:35:00] moments of. Again, terminology differences, but dysregulation or challenging behaviors. Right. Um, and then I was able to follow up of, oh, do you think they're using this phrase in this way? Which led me to basically a kind of suggesting and, and Jessica kind of actually almost suggesting in me using the term, oh, I could do a functional behavior analysis of how they're using these scripts in different contexts.
Mm-hmm. And then we talked about that piece. Mm-hmm. Right. So we were able to come and say, these are the strengths you are bringing. Here's some things I could add to it. Um, and then as working on goals, same thing where Jessica might be able to, um, maybe have a stronger sense of. Developmental appropriate, uh, what in terms of next steps, and maybe I'm coming in and offering more support on measurement and data collection, right?
Um, and then the key next step from there is seeing can we have shared goals, right? Mm-hmm. What is something that we can both work on or more than one thing? And this is where [00:36:00] that, um, IPC piece of openness for ideas, right? Mm-hmm. So you're starting to build, you're on the same page. You're talking about assessment, but then you're like, I think we should do this, right?
And they're like, well, and the i, the goal here is the goal of the goals, right? Is the goal here is ultimately you want shared goals. Mm-hmm. And so to have those shared goals, there might be a little bit of compromise on both sides. Mm-hmm. Right? Of, okay, I can change this a little bit, but it still meets my ethics and it aligns with what I'm thinking from my scope of practice, right?
Mm-hmm. Um, but allowing that for their shared goals. Then also recognizing that there's sometimes just things that it's okay to have unique goals. Mm-hmm. And it's okay to say, I'm gonna focus on this and you're going to focus on this. Mm-hmm. And how are we gonna talk to the family and how are they gonna support each one of these and understand how they integrate.
Um, and then really when we do have those different goals, the key part of the discussion there is to just talk about any concerns we might have [00:37:00] about our goals conflicting, right? Mm-hmm. So someone's like, well, if you're doing that, that's going to disrupt what I'm doing. Right? And so breaking it down and problem solving, right.
And I think it's okay to have both to say, let's aim for shared goals, but if we're really struggling, what do we need to do to kind of separate this out and say, how do we still work together professionally and just make sure that we're not causing issues for each other. Mm-hmm. And I've had a mix of both.
I've had some where it's primarily shared, some where it's primarily, ideally I like to, when you can get to that point where you have more shared because. There's just more intervention and, um, consistency and generalization, which we know, um, is important for that. Um, we do have one more step, but I just wanna, I know we, I talk a lot, so I'm gonna pause and see if any questions about that, you know,
Kate Grandbois: that I'm like chomping at the bits to say something.
Yes. This apparently you're in, you're in good company. I'm not the
Dr. Cindy Gevarter: best at giving that pause,
Kate Grandbois: so I'm gonna No, no, no. You're in good company. [00:38:00] I, I just wanna point out, again, reflecting back a few things I'm hearing that are really resonating with me, um, as a person who really values collaboration is this idea of translating.
Yes. And we do this in our heads when we collaborate with any professional, right? So we listen to families and they tell us about their concerns. They tell us about what life is like at home. They're using very plain language, and we're translating that in our heads to disordered language or using medical model language or.
You know, translating this into things that we can use to guide our therapy. We might do this with occupational therapy if there's a, a shared scope. What is particularly interesting about behavior analysis is that there is an ent, the, the semantics and the vocabulary that is used is a particularly grouchy flavor of, of, of barrier in terms of collaboration.
Um, because of, and there's a lot of history there. Um, and we're not here to talk about that, but, you know, the, the component of [00:39:00] translating is pervasive across collaboration. And I think it's a, again, an important exercise to kind of reflect on what kind of mental translating you're doing so that you can code switch in your mind when you're talking to families and not use a lot of jargon.
Right. The other point I wanted to make is something that you brought up about. Evidence. And I, in my experience, my, I have, um, noticed over the years that different individuals and different professions appraise evidence differently. And that is also really, really important. And there are components of scientific, fields of scientific study that debate, you know, is qualitative better than quantitative is, you know, is case study better than, you know, randomized control trials?
That is, that is not the level of detail that we're working in as clinicians, but there are other. Professionals who may have a different definition than you about what is considered quote unquote evidence. And again, [00:40:00] behavior analysis kind of lives on their own island here. Uh, you know, with a, with a slightly different definition of what, what would be considered evidence as an extreme example that I'll give, I was told once by a behavior analyst, I was promoting for a client of mine, uh, to an a a C user to use aided language stimulation and to use aided language modeling.
Um, and I was, this was a behavior analyst that was providing services in the home. I was working as part of the school system as a contractor. Uh, and I was talking about how supporting mom, uh, the family at home using aided language modeling in some capacity in the home, embedded icons or what have you.
And the behavior analyst told me, and I am, this is a true story, that unless I could produce an article from Java, which is the Journal of Applied Behavior Analysis, they would not do it. Their definition of evidence was not the many years of peer reviewed research that we had in our field. It had to be out of a behavioral analytic journal.
Announcer: Yep.
Kate Grandbois: Which, and this was about 8, 9, 10 [00:41:00] years ago. I'm pretty sure there's evidence in there now, just in case anybody gets that question. But I think it's important, again, with this perspective taking, thinking about what other professionals are bringing to the table. And I love what you said about approaching it with curiosity and finding that common ground of, okay, I, my, my definition is of evidence is different.
But what is here that I can move forward with? What is here in this conversation that I can ask more about, that I can learn more about? Because maybe we are talking using the same words, but we have different definitions of these words. And if I approach this with curiosity and ask more questions. That facilitates finding that common ground, releasing some of that tension, and again, holding your client at the center of what you're doing, because that is the point.
Now I've gone off on a tangent. I'm sorry. I, Amy, I, I also feel like you're chomping at the bit, and I'm just gonna mute myself.
Amy Wonkka: No, all of your tangents are good. I appreciate them all. I do think, you know, all of those points that you raised [00:42:00] were, were. Very helpful. I wonder too about when I think in your example that you, in your case study that you've talked through, like that's an example of it working really well.
Mm-hmm. Um, I think Kate's example is a, is an example of it not working really well. Right. Um, I think many of us, and maybe some of the listeners feel like you've had more experiences maybe in the middle, right? Where Okay, if I, maybe if I just had the time and time we talked about a little bit earlier on.
Maybe if I just had the time to sit down with this person, we would come to a nice meeting in the middle and we could be a little bit more collaborative. But in real life, I'm sending some emails really quickly. Um, and I didn't know if you had any tips for SLPs or other listeners, especially around written communication.
Mm-hmm. So you don't necessarily have the time in your day to sit down and do all of that sharing. Um, right. Are there tips for when you get the email and you're like, ah, that word, you know, and then you had this big reaction. Where do you [00:43:00] go from there? How do you salvage that?
Dr. Cindy Gevarter: Jamie, I'm wondering if you, Jamie's had some recent, uh, and again, she's an SLP from behavioral, but had some recent, and again, we're gonna get into the supervised, but mm-hmm.
Had some negative experiences in front of students. Mm-hmm. And probably in both written them, uh, Forbes.
Jaime Branaman: Mm-hmm. Um, I mean, I think in general, when you get that email, my best tip is don't respond right away to start with. Um, I know that's something that all of us have been practicing a little extra lately, um, and is like taking a second to think through it.
Um, I think that recentering on what the goal is for the client is gonna be really, really key of like, okay, what is the outcome that we're trying to get to? Right. Um, and from that goal, we can, it sometimes will help shape that response, um, to hopefully guide whatever. Um. I mean, it's definitely really challenging and I recognize that time is not [00:44:00] on our side most days.
Um, so that we don't have that. Um, but I do think that, um. Recognizing things. And even if it takes from your perspective, then trying to apply it the other person's language even about it, right? Mm-hmm. Maybe bridging that, do you doing some of that work bridge that gap can be helpful versus, you know, always not always waiting for the other person to translate it.
Mm-hmm. Um, another thing that I like got clarification on recently, which I think it could be a really helpful tip, is that, um, interpreting and translating are two very different things. Um mm-hmm. And a interpreter made sure to clarify this to me one time at a ac about recently actually. Um, but the idea that, you know, when we're translating, we're trying to word for word, and I think that actually might be where a lot of us are getting stuck, right?
Mm-hmm. Is that maybe there's not an exact equivalence of something. Mm-hmm. And so instead, if we can figure out how to interpret it into our own world, then sometimes that can kind of help break down [00:45:00] some of those barriers, um, and kind of give that little clarification.
Jessica Nico: I wanna say what an excellent example of collaboration, interpreter, another person that we often work with, right?
Um, and how Jamie came to that space with like, wow, I have something to learn here. Right? I have something to learn and apply moving forward.
Dr. Cindy Gevarter: Yeah. Right. And I just wanted to
Jessica Nico: highlight that
Dr. Cindy Gevarter: it really goes, again, back to that humility, right? Of you get this email, and to Jamie's point, can you pause, take that?
Like, if I respond right now, it's not gonna be humble, it's gonna be defensive, right? Um, and then I, I do think it's a really good point, right? Of the, like, some of the steps we're, we're outlining, we were saying we're trying to do it as an Anna Cino approach, but you might be in a context where you can't start with like, hey, but even as simple as that first email communication, I think I wanted you to tell you a little bit about myself, right?
Mm-hmm. Like some of these things that if you set that from the beginning can be done versus, you know, I, as a special ed teacher, I remember one of my [00:46:00] professors like telling me the best thing you could do. You're like. Early years of teaching, if you got everything else wrong, was to call parents and to tell them something good.
Right? So that you're not communicating for the first time when something bad happens, right? Mm-hmm. So the same thing if you know you're gonna be collaborating someone where you're like, oh, I'm not gonna see them all the time there. I'm worried there might be conflict because we like just start off with like, I'm excited to just work with you.
Here's my prior, I've had, I love working with SLPs. Here's my prior experience. Like if you set it at the positive, then when that negative comes in Yeah, there's like a little bit of rapport. Yeah, rapport and just sort of like, um, space for the other person.
Jaime Branaman: I think that really reduces the risks, um, maybe of.
Drawing those like false assumptions right, of other people. Um, the number of times that I've heard about IEP meetings where, you know, the SLP right off the bat goes to the BCA and says, well, you're BCBA, so I know that you're not gonna [00:47:00] do this, or I know you don't do it this way, right? And so if we're in that space, we're able to create that relationship separate, right?
Mm-hmm. It's gonna potentially set us up for a lot more success because we don't have that false assumption coming in.
Dr. Cindy Gevarter: Um, I was gonna just take us back a little bit to, uh, just because I do wanna get into what we're actually doing and how we're doing this with supervisees. Um, so our last sort of step in that sort of, um, framework for dialogue, right?
And this again aligns with some of what's in the, the BCBA in terms of this of really setting collaboration norms and kind of data sharing processes and how are we coming back to this? Because you can have this great conversation and walk out feeling, yay, old stuffy Duffy, it's gonna work great. And then if you don't follow up that does, and then someone gets defensive again, right?
Um, so I've listened to one of your previous podcasts on, um, implementation plans, and that's something in the a c world that I think we need to be translating as a whole for many [00:48:00] clients, but specifically de definitely for kids with, um, autism. Um, and thinking about laying out clearly who's working, what are our shared goals?
What are we working on separately? How are we sharing data? Is it through a shared. Secure file or do we wanna set up a meeting again? Um, and then one of the pieces in that IPC model is that idea of receiving and giving feedback is hard, right? Mm-hmm. So at this stage, how do we come back if something's not going as we planned, right?
And we wanna give that feedback. So, um, again, just coming from a. Taking those patient-centered and strength-based approach with our colleagues. Mm-hmm. How do you like to receive feedback? Right? If I, if there's a challenge, do you want me to write you an email or would you prefer a call? Right? What does that look like?
Um, and then having that supportive by taking actual in the implementation plan. Here's the data I'm gonna take, here's the data you are gonna take so we can come back and look at that objectively of it is working or it's not working, or we need to adjust this. [00:49:00] Right. Um, and then just yeah. Really thinking about how do we regularly check in and make sure that, and not just assume everything is going great because we have this one meeting.
Right. Um, it's the idea of that ongoing process, just again, everything we're talking about now, you mentioned adult learning. It's the same processes we use Right. With children and, and our clients that we're thinking we have to come back here. Um, so that's kind of the framework. We, um, have made some efforts to start integrating more, um, with our students in our clinical education program here, and we also have some upcoming things.
So we were gonna spend some time talking about some of the things that, how are we gonna teach this mm-hmm. In clinical education.
Amy Wonkka: Mm-hmm. Yeah. Also hooray for teaching it in clinical education. Yes. Talk about an antecedent intervention right there.
Jaime Branaman: For sure. So Jessica and I, as part of our graduate assistantships, have both served as clinical instructors in U N's speech and hearing [00:50:00] clinic.
So we've got an opportunity to work with graduate students at different levels of their education for their masters. Um, ultimately when we think about our graduate programs, the focus is really building that workforce to go out and support our individuals with communication challenges. Right. Um, and I think, you know, it's no secret that, uh, everyone in our field are down on clinicians and we're, you know, it's something that's really a big area of need.
Um, so one of the things that's really important to like consider when we're thinking about how we're gonna, how we're gonna fix this communication problem, right, is to make sure we're setting it up from the beginning. So some of the problems that we see within the graduate programs often is that, um, our programs or our clinical supervision is often really silos.
So there's some form of specialization. Um, however it's different than specialization, right? Because specialization. Implies that we have a specific set of knowledge, but that we are still opening open to and still accepting other knowledge while siloing [00:51:00] is kind of closing us off from that. So what's happening is we're getting more, that specialization is turning into more siloization and kind of closing off, um, students from additional opportunities that are really key to their future as professionals.
Um, there's also just a lack of interprofessional training and modeling. Um, I know that we have some ongoing, uh, attempts to bring in, you know, like a PA students into our speech clinic or OT students, um, but are faced with a lot of limitations, unfortunately sometimes due to insurance and other like requirements, certification requirements.
But in general, I think that, you know. It's not set up to serve that way. Um, and what we're noticing from that, um, according to Asha, only half of SLPs have helped prepare to lead or engage in IPC teams. Um, so that is a huge, huge issue, um, followed by, in BCBA training programs, um, only 67% are receiving formal training on collaboration or didn't receive 60% [00:52:00] that I did the stat wrong.
, 67% receive no formal training. And I will also know on that note, as someone who is actively in a training program, um, the training that is received also is very. Varied in that the, you know, the extent isn't necessarily there either. So the course may include, include some level of collaboration, but not quite what we need.
There's no like explicit training opportunities. Um, and so really what we're seeing right, is the supervisors are playing a critical role in building those skills early. If we can get those skills early, then we can really build towards those competence and not just throw clinicians out into the wild and expect them to like, okay, now collaborate.
You've never seen another professional, but now collaborate, do it. You know, like that's ridiculous. Um. So a lot of that for us has looked like, um, moving beyond just that observation, actually embedding real world collaboration opportunities for students. Um, so for [00:53:00] example, we have developed an a a C evaluation clinic here at UNM.
Um, and through that, um, we've gotten a lot of referrals from local a BA clinics, um, and lo and. Providers. And so that's been a really, really key opportunity to start setting up these opportunities for practice. Um, so I've been able to practice this with BCBAs that I already have relationships with, as well as B CBAs that I do not have relationships with and have our students join.
And we really had that mixed bag experience, which I think has been really, really important to truly teaching. Um, so, you know, one of the things that happens is, you know, you have some of these spas that are like, uh, they really need a device and we'll do anything. You know, and they're really gung-ho on whatever our recommendations are.
And then I've had others that maybe get a little bit of defense defensive that like. They weren't able to do whatever. Um, and in this one particular instance when I have had a negative, uh, kind of reaction from the BBA I've, I had [00:54:00] two graduate clinicians with me. And the really, really important part of that interaction was the debrief that came after it.
Right. So it wasn't just have this interaction and let them walk away and be like, okay, I don't like BBAs now. Right, right.
In this situation, you know, afterwards, prior a debrief was talking about like, okay, here's why I asked the question the way I did. Right. And like explaining to them how the conversation went. You know, they, they left it with, they have no prior knowledge really of a DA and they left, you know, being like that felt icky, but not knowing why.
And so being able to talk with them like, why, what didn't go right and how can we change this for next time? Or how can we shape this? And so a lot of it was just being able to model like.
Here's their response. We don't like that response. How can we respond? You know? So like they're saying, this kid isn't motivated to request anything, and we know that that's not actually how motivation works. We know that that's actually just, they're not giving them things that they want. Right? They know that they're, but you know, we can't be like, well, it's your fault, right?
In that moment. Instead we can be like, here's what we see in our session. [00:55:00] You know, that works for them. Or the other thing you know, is just like when vocab happens in that moment, stopping, um.
There was a few, and, and part of this might be because I disclosed that I am working towards my certification as well. So, you know, part of it could be that they were like, alright, we're gonna switch to verbal behavioral language. Um, but part of that, that meeting was being able to stop and be like, actually my students don't have experience our language.
Can you explain to them what that means? And modeling like, I don't understand this. Explain it. It's okay. And it's okay to say that. Yeah. Modeling that for
Dr. Cindy Gevarter: students is important. Yeah. And
Jaime Branaman: even from the beginning, oftentimes I always try to start at the beginning of meetings with our BBAs and asking us, what is your experience with a, a c?
You know, what, where do you come from? Yeah. Do I need to start from the beginning? And make sure that you understand like what the role is, what is the, what is the purpose? Or have you already had seven clients on touch chat and you just need help getting access to this device? Because SLPs are still the only ones that can prescribe them, you know?
So that's really, really huge, is being able to navigate that and being able [00:56:00] to model for them those conversations, how to respond to those conversations and how to continue to facilitate that relationship.
Kate Grandbois: You've said so many things. I'm gonna have to, I'm gonna have to like pick and choose how, you know, of all of the things that you said.
I wanna comment on all of them. Um, and I think one of the things I'm thinking about is when you do find yourself in these really prickly moments, so some of the extreme examples that, that we've talked about, um, hitting you over the head with this verbal behavior lens.
Um, or the example I gave about, well, I'll do it when you show me a published article in a at at JABA, you know, before things get tense. I think again, just bringing that kindness to the forefront and developing trust and developing trust with another person can take so many different. Formats, so many different forms.
Um, I was mentoring someone once and I was trying to explain this to them and she said to me, I don't wanna be friends with them. And I was like, oh, that's a good [00:57:00] comment. I don't, I don't know how to explain how this is different than friendship. And now I've done a little bit more reading and self-education and I know that that is not, you don't have to be friends, but you have to develop, you have to put in emotional e energy.
To cultivate trust. And when you have that trust, you can approach some of these difficult conversations with a little bit more sensitivity and maybe not get your head bitten off. Right? It's that concept of like, you know, you're laying on your horn and throwing your middle fingers at the stranger on the highway, but if you looked and you saw was your mom, you'd be like, oh, sorry, mom.
You okay? You know what I mean? Context really, really matters. And how we approach these kinds of conflicts really, really matter. Um, that was kind of a weird analogy. I hope everybody followed me down the rabbit hole. Yeah.
Jessica Nico: Yeah. We
Jaime Branaman: got it. Like we we're there. We're with you. Yes, yes. No, but definitely I definitely see how, you know, that it's so key to like put that in everything in context and build that trust.
And I think another way of like modeling, like how to build that trust too. You know, another example, and this is [00:58:00] kind of on the roles and responsibilities, um, competency that I know we're not focused on, but still key in this, is that, you know, in those meetings also just like setting someone who's gonna take priority and you know, in this meeting, even in this meeting, that like I didn't feel was going well, was being able to be like.
Humble enough to know that, like I see this kid in our clinic one time a week and she goes to aba mm-hmm. Every single day. Mm-hmm. For 35 hours. It's gonna make way more sense if I have them take, take lead on programming this device, right? Mm-hmm. Even, even if I'm not so certain about where we are in our, in our collaboration, right?
Mm-hmm. And so it's being able to make those decisions and model those decisions for our clinicians to see like. Hey, here's what's happening. And then if they program the device in a way we don't necessarily agree with, we can train them more on that. Right. And so that's having other meetings with them to explain like, here's why we do this.
Right. And given that explanation, I think that why goes a long way. Yeah.
Dr. Cindy Gevarter: Like giving
Jaime Branaman: them like
Dr. Cindy Gevarter: the sense that you do, again, it goes back to respecting their values mm-hmm. And trust and giving them the opportunity to say [00:59:00] like, I believe you have the expertise. Mm-hmm. I'll support you on it. Right? Mm-hmm.
Um, we're gonna talk a little bit more too about a couple upcoming things and ongoing things that we've also done.
Jessica Nico: So in, you know, trying to find a positive path through and forward because at the end of the day, the client is gonna continue receiving services from everyone, right? We're gonna continue and it's better to try our best to be on the same page than just abandon ship completely.
Right? Um, so in addition to like guided clinical practice and incorporating these, um, opportunities within their clinical instruction, bridging the gap, I think within, um, our academic contexts, specifically within a graduate clinic. And providing explicit instruction within our classrooms on opportunities for collaboration, as well as within workshops as well as within, um, tailored design classes to work on co communication and collaboration, um, is really, really important for that explicit instruction piece.
Um, so something that we've developed over the course of the last semester and in the summer [01:00:00] is our SLP two B series, um, gotten from a hashtag on Instagram hashtag SLP two B, um, and that we're using this existing infrastructure in which we provided trainings on data collection between the two of us, right?
And how data collection can look different across disciplines and how, um. Behavior, be socially, emotionally informed behavior approaches, right? Um, and we provide explicit instruction on those topics. And we're also expanding that to interprofessional collaboration and interprofessional communication. Um, specifically because students ask, students ask for support and how to talk to other key parties such as caregivers.
They need help. Code switching between how do I talk to a caregiver, how do I talk to, um, a related service provider? How do I talk to a medical professional? They need those tools and we need to provide explicit instruction in those tools within our classrooms, as well as carry over into the clinical context, um, through guided supervision.
Um, and we're also developing another course called core functions in which we provide continue to provide explicit instruction on these soft skills. [01:01:00] Um, because at the end of the day, we are professionals providing these services, um, and we need to be providing, um, students with, uh. Kind of the skills within that hidden curriculum.
Um, Cindy?
Dr. Cindy Gevarter: Yeah. And I was gonna say part of what, um, our goal with that, the SLP to B series, um, in the fall is to take, for example, the, the role play that Jessica and I were talking about and like play some clips of like what worked well in here, but then also give them some more challenging ones. Mm-hmm.
Like some of the ones you both mentioned. Right. And we all have those examples of like, now you role play, how could you use these? Um, and so we have some incentives matter for students if you're doing things outside of class. Mm-hmm. Um, UNM, uh, our program does, um, the university has an IP, um, certification that we're gonna work with, um, to see if we can make it a requirement for that or an option for that.
And then what I was gonna lead into talking, we've also had some success with training grants. Um, that allow us to specifically bring [01:02:00] in interprofessional and opportunities with, um, other departments. So, um, I had a grant called Project Scenes that was in collaboration with our special ed department, many of whom have more of a behavioral background and training.
Um, and we actually, because it was a research partnership, Jamie mentioned some of the, our clinic has some issues sometimes of we can't bring in OT students because of insurance, but if we do it under research, we can. Um, so we've actually for the last three years had an autism clinic that is part SLP students, part part special ed students.
Announcer: Mm-hmm. We
Dr. Cindy Gevarter: have them take classes in both departments. Um, they have debriefs at the end of a session to talk about what looked. Good. What, what would they change? And that, um, Mary Hartley is an SLP with like 35 years experience working with kids with autism. She's our current clinic director. Um, and she and I run that together.
She runs the program, but I come in and out and I'm doing research and we model that, right? So like, Mary will say something and then she'll be like, Cindy, what do [01:03:00] you think about that? And I would, you know, we model what it looks like as we collaborate very well together and give them that, and then they get practice doing that with each other.
Mm-hmm. Um, all of our students in these training programs also do lend, um, which a lot of universities have, which is a, uh, leadership, I always forget the acronym leadership in. Something, I'm gonna get it wrong. We can look this one up afterwards. Um, it's leadership in neurodevelopmental, well, you're gonna pull it up for me.
Uh, leadership education in neurodevelopmental and related, uh, disabilities. So, um, many universities have these lend programs that are interprofessional in nature and, um, our students have worked with OT students and PT students. Um, and then we also have done things like bringing in, um, panels where we had an, an early intervention panel that was an et uh, or, sorry, a pt, an ot.
An SLP and a developmental specialist, right? And then again, they just see that model of how are they communicating and what does that look like and what questions [01:04:00] do I want to ask them. Um, we do have an upcoming grant that is similar, that is just in our department, but we're gonna spend a whole semesters in a mentorship series focusing on professional collaboration.
We're planning on working to see if we can get OT to come into our clinic more in this. So, um, really for anyone who listening who might be in, um, a position where there are like looking into how, um, sometimes these training grants and research experiences allow you to build that collaboration more intentionally and remove some of the barriers you might face in other contexts.
So, mm-hmm. Yeah, I think that's just a start of some of the ways we've been thinking about how do we do this more?
Kate Grandbois: I love this and I, I wonder it just in our last couple of minutes, for anyone listening who is. Maybe not in a university center setting, but supervising CFS or supervising departments and is reflecting on inter collab, you know, [01:05:00] interprofessional collaboration skills that could be worked on.
What, um, recommendations do you have to get started? So, things that a clinician listening could try and implement? You know, Monday morning,
Jessica Nico: I, um, think personally we work in an imperfect system, right? So we work in, um, the medical field, the educational field. We work across, um, settings. So it's, it's, I don't, you know, we have to individualize a little bit more than one broad recommendation, but I do think that.
In general, we have to acknowledge that we work in an imperfect system and that we are doing the best with what we have at any point in time. And one step in the right direction is better than no steps in the right direction. Um, so if we talk about setting, thank you. Setting short-term goals for our clients and long-term goals for our clients, right?
We should be setting the same things for us where I specifically use a session goal [01:06:00] framework. When I teach my students what do I want my client to do today, it's not their short-term objective, what they're gonna do in six months, but it's something that they can work on today that builds up to that short-term objective that builds up to that long-term goal.
So I think sitting down from an administrative standpoint and saying, okay, we're not gonna fix all of our interprofessional collaboration problems today. We're not gonna fix them in a year because of all these external barriers. Uh, but there are things that we can do today to take a small step forward.
That's what I would say. Just sitting down within your. Specific field I add and a specific workplace.
Dr. Cindy Gevarter: I was gonna add to you just to build off, um, you know, when Jamie said she developed this a a c eval clinic and then she said, we're getting a lot, lot of referrals from a BA, that's because Jamie has put in the work
Announcer: mm-hmm.
To
Dr. Cindy Gevarter: get a lot of referrals from a BI. Mm-hmm. So I would say again, also just starting, you know, if you wanna do it, you supervises to do it more. You need to do it more. Mm-hmm. And you need to model it more. And who can you reach out to to start providing those opportunities? And it doesn't have to be everyone.
You [01:07:00] might, you know, know, oh, I worked well with this person in the past. Mm-hmm. Let's see if there's ways that we can start working together. Mm-hmm. Because I think that's, we wouldn't have that level of referral from a BA if JB wasn't reaching out and saying, Hey, we're a BA friendly S-L-P-A-C valve clinic.
So I would say that would be my other piece there. Yeah.
Jessica Nico: That's a vulnerable place to be too. Yeah. To try to try is
Dr. Cindy Gevarter: to be vulnerable, you know, like building those relationships.
Jaime Branaman: I think at the end of the day, like you're not gonna know what you don't know, right? Mm-hmm. It's always, that's I think something I learned very early in grad school I learned that I needed to ask more questions. Mm-hmm. And so I think just like start by asking a question.
Yeah. Mm-hmm. Pick one thing. It doesn't even have to be client specific. You know, maybe there's a term that you heard at your last IEP meeting. If you work in a school setting, you're like, I have no idea what their this is, right? Mm-hmm. Maybe it's acknowledging like, Hey, I can't do my speech session. If the kid's not regulated, I should talk to the ot.
Or, Hey, this kid is engaging in some high rates of aggression and [01:08:00] I don't know how to respond. Maybe I can talk to the BCBA. Right? There's so many different things, and I think also like. Learning within your context what that looks like. What is, because like, I dunno, I've worked in schools, right? When these VAs I feel like, often get siloed in schools into like their just behavior, but remembering that like our scopes are not just limited to like the one setting we're in.
Jessica Nico: Mm-hmm. I wanna piggyback off that and then I'll stop. But I do think that something that we, Jamie and I and Cindy strive to instill within our students and within our graduate students, clinician is a growth mindset. Um, and we model that ourselves knowing mess, there's continuing mess. We expect you to mess up, we expect you not to know things, right?
There's continuing education for professionals as a reason. We are con we, we are called to continuously learn. And for students to see that and, and for us to acknowledge and welcome their questions and say, wow, I had no idea you didn't know that, that's on me. I didn't teach you that. You can't know things.
You dunno. So as cis and people just accepting that students don't know and, [01:09:00] and modeling that we don't have things. Yeah.
Jaime Branaman: And one fun quote to end on because we have a giant, you can't see it. We have a giant quote board behind us, but, um, from Lin Pla and Dower in 2019, presumed potential, but teach to competence.
And I think that can be applied to everything can be applied to our clients, it can be applied to our coworkers, like always presume that there's potential for that relationship, and then figure out where they are and from that competency level, build from there.
Kate Grandbois: Thank you so much for this. This is that.
This has been really, really wonderful. You brought up so many great points. The explicit and, you know, the, just the, the specific skill sets that we need and the detail that you went into was really, really great. Um, I also really appreciate the lens of helping our newer clinicians acquire these skills and the ripple effect that that has and how important it is for our field as a whole.
So, thank you again so much for being [01:10:00] here. We really appreciate your time. To anyone who is listening to this episode who would like to earn Ash's eu, please follow the link in your show notes. Find us on Instagram, send us an email. We love to hear from our listeners. Um, a quick thank you to our production team, Dr.
Anna Paula Mui, who makes our Ashes EU possible. Tegan Ahern, our production manager who keeps the project alive. Darren Lopez, our production assistant who produces all of our course materials and web production. Tracy Callahan and Dr. Marybeth Schmidt, who assist with managing our advisory board and our peer review process.
Uh, and last but last not least, our advisory board who, um, helps to review our content and elevate the quality of our material. Actually, I should say the last but not least, is you all. Thank you so much for being here as our guest today. This was really, really great.
Dr. Cindy Gevarter: Thank you for having us. Yeah, this was fun.
Yeah, ended the day. Wonderful. Yeah.
Sponsor 2Outro
Kate Grandbois: Thank you so much for joining us in today's episode, as [01:11:00] 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]
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