Developing Competency in Self-Advocacy Skills for Complex Communicators

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Kate Grandbois: Welcome to SLP Nerdcast. We're so excited for today's episode.

We are here with Amanda Sheriff Hobson. Welcome, Amanda. 

Amanda Scheriff Hobson: Thank you. I'm so glad to be here. 

Amy Wonkka: Amanda, we're excited for today because you are here to discuss developing [00:02:00] competency and self advocacy skills for complex communicators. Uh, so I'm super pumped to talk to you about this topic, but before we get started, can you please tell us a little bit about yourself?

Amanda Scheriff Hobson: Absolutely. I'm excited to be here and share about this topic. Um, I am a school based speech therapist. I work in a collaborative school in Massachusetts where I am a SLP, but I'm also the speech therapy department head. Um, I've primarily always worked with students with complex communication needs as young as three years old up until the age of 15, working on developing, um, communication strategies and robust communication systems so that these students have access to language.

Um, so that has had me in private practice, home healthcare, um, and for the last nine years in the school setting. 

Kate Grandbois: So we're really excited for this, not only because it is of tremendous importance, but it also touches our personal clinical experience. And so it's, [00:03:00] I'm very excited for this conversation.

It's going to be great. Um, we need, do need to read our learning objectives and financial disclosures before we get into the fun stuff. So I will do that as quickly as I can. Learning objective number one, identify at least three skills to target to develop communication competency. Learning objective number two, identify at least three activities or tools for students to learn and practice self advocacy skills.

And learning objective number three, explain how to use coaching strategies to support communication partners. In utilizing skills explicitly taught during natural moments in the learning environment, disclosures, Amanda's financial disclosures, Amanda works for and receives a salary from a public school system.

Amanda also received an honorarium for participating in this course. Amanda's non financial disclosures. Amanda is a member of ASHA SIG 12. Kate, that's me. My financial disclosures. I am the owner and founder of Grand Bois Therapy and Consulting LLC and co [00:04:00] founder of SLP Nerdcast. My non financial disclosures.

I am a member of ASHA SIG 12 and I serve on the AAC Advisory Group for Massachusetts Advocates for Children. I'm also a member of the Berkshire Association for Behavior Analysis and Therapy. 

Amy Wonkka: Amy, that's me. My financial disclosures are that I'm an employee of a public school system and co founder of SLP Nerdcast, and my non financial disclosures are that I am a member of ASHA.

I'm part of Special Interest Group 12, and I participate in the AAC Advisory Group for Massachusetts Advocates for Children. All right, on to the good stuff. Amanda, why don't you start us off by just telling us a little bit about self advocacy? So what What is self advocacy and why is it so important?

Amanda Scheriff Hobson: Yeah. So I think this sort of started to become a focus area for me as I worked with more and more students with what again we're defining as these complex communication needs. Um, these students typically need a lot of interpretation around what their behavior means, what their communication styles [00:05:00] are.

And sometimes it felt like we weren't doing enough to make sure that their needs were being known. Um, in my role as both a direct therapist, working with the students, but also supervising other SLPs, this just seemed to be a theme that came up a lot. How can we do better? How can we assure that There's full autonomy, even as they're continuing to learn how to use language more effectively and efficiently, and so it really started this conversation of what could we do?

What kind of strategies can we use? What's out there in terms of self advocacy type curriculums? And of course, we quickly realized, That no big box curriculum is going to meet exactly what we're looking to teach. And so this is really combining a lot of different, uh, research pieces out there, different methodologies, different strategies.

And again, we quickly realized we can't just do the teaching. We also need to think about the environment. So we need to think about where students are communicating, who they're communicating with, and how to make sure that the [00:06:00] people who are receiving these messages are just as prepared as those who are.

And so when we're thinking about self advocacy, we're thinking about not just protesting and saying, if you don't want something, but we're thinking about how students can think about themselves and what they want to say and how to act on that. So we're really starting to think about what kind of changes to the environment need to happen.

What kind of opportunities do we need? And we really started to highlight and go back to the Communication Bill of Rights, and how this is really a resource that a lot of clinicians have used, um, and referenced when they're thinking about presumption of competence and access to communication. But we started to think, why don't our students use this?

Why aren't they learning about this resource just as we are? And how can we make that accessible? So sort of thinking about those 15 or 16 rights and saying, let's use this as our framework. Let's think about these things that we know our students should have access [00:07:00] to. And let's use that as our content and our skills that we're teaching, as well as what we're teaching the people who are working with our students.

That sort of became the framework for how we're thinking about this. And so a lot of the things that I'll share today are. Coming from a classroom of middle school students who are all complex communicators, they are using alternative access. You see, like, two step switch scanning or auditory only scanning.

They're also using direct selection. Um, some of them are very emergent in their communication skills, while some are more context dependent or transitional in their skills. Um, but there's still this constant need for interpretation from those who are working with them, and that's where we also start to think about the partner training to make sure that as we're teaching the skills to our students, we're also teaching skills to those around them.

Kate Grandbois: I know one of the first things that we want to do is have you talk to us a little bit about what self advocacy is by definition. Before we [00:08:00] get into that, I just want to make a quick comment, um, elaborating on something you said that I think is really important, is that out of the box curriculums, out of the box strategies are a slippery slope.

And I love that you've kind of described them as not a, One size fits all approach, and I think in a lot of instances, these curriculums, these packages of therapy materials are marketed as a blanket, a pro as a blanket approach to your clients or your students, and that's never good practice, right?

That's never a. Uh, an evidence based method of providing intervention, just taking, taking something straight out of the box and slapping it on or throwing it in the classroom, right? We always want to create customized interventions. Um, and I love that, that you've, you've set that up as a backdrop here for, for the important work that you're about to tell us.

I just wanted to kind of make a comment about that. 

Amanda Scheriff Hobson: Yeah, I appreciate that. I think, too, we, we noticed that, you know, they're [00:09:00] great. They're great foundations. They just need a lot of adaptation or modification to them to make them accessible for all students or for specific students, individual needs. Um, and oftentimes they were very pigeonholed into a specific skill, and we really wanted to highlight that there's a lot of skills that go into self advocacy.

Um, so, like, you might have a program that really just teaches access to IEPs and making sure they're a participant in their IEP process, and that's a wonderful thing, but there's a lot of, uh, self advocacy that happens. Every day around them, not just that one time annual meeting, um, or thinking about being able to protest again.

That seems to be the first go to for a lot of, um, goal areas or focus areas. But it's also about acting on preferences and sharing opinions and making sure that students can do all of those skills. So really thinking more holistically about it. 

Amy Wonkka: Yeah, I, uh, I'm excited. I have the I have the good fortune of seeing the notes ahead of me.

So I know some of the topics that we're going to cover. I'm [00:10:00] excited to talk about those as well. But I do think it would be helpful for us to just talk a little bit like Amanda, you've said, self advocacy is not just protesting. It's not just Requesting your basic needs. It's not just attending your IEP meeting.

Um, so can you give us sort of a formal definition about what we're thinking about when we're thinking about this sort of all encompassing skill area? 

Amanda Scheriff Hobson: Yeah, absolutely. So we would define self advocacy as a set of skills and sub skills that engage that complex process of speaking on your own behalf, um, to share your needs, your beliefs, your opinions, your interests, desires, your protests, um, and you want to be thinking about also this concept of self determination within self advocacy.

So in order to do all of those things, you also need to know about yourself, um, and what kind of motivates you and interests you and drives you during the day. Um, so they kind of go hand in hand. The [00:11:00] self advocacy doesn't really exist without self determination, um, and so that really means it's like a metacognition.

task, right? You're doing this internal thinking about yourself. Um, you're learning about what you need, what your strengths are, what the areas you need support in, um, and also teaching value of who you are as an individual, um, so that you can engage in more of these meaningful tasks and motivating and within motivating context, um, to be able to self advocate.

Kate Grandbois: I loved when I was reading, um, your talking points, I loved reading that this was very much a metacognitive skill, meta, a metacognitive task. I'd never thought of it that way before, but you're absolutely right. And I think that's a really important lens to, to look at this through. 

Amanda Scheriff Hobson: Yeah, absolutely. And I think, you know, again, they go hand in hand.

We want our students to understand why they're saying no to something. We want them to understand why they're asking for something, why they are trying to engage with the people around them, and when and where they want to do that. [00:12:00] And in order to do that, they need to understand it. the, you know, we're going to get into skills here, but thinking about what are their communication strategies?

How do they communicate? Um, also including disability awareness, understanding who they are as learners and who their other classmates are as learners. And it's how it's okay to have differences. Um, thinking about accommodations that they need so that they can ask for them. They don't know what to ask for if they're not really aware of what their accommodations and learning needs.

are. Um, also understanding who these people are that are surrounding them, these teachers, these aides, these therapists, um, and how they are support people and not actually the people who are doing the speaking for them or they shouldn't be. Um, also going into things like personal preferences and motivation, um, thinking about this concept of public and private information, um, and how they have a right to say no to that, um, if they don't want to share certain pieces of information.

So we get into a lot of these like Big knowledge skills, right? Then we've talked about [00:13:00] disability awareness, accommodations, public and private. But then we also start to think about what do they do with that, right? Um, how do they use, um, a set of words, whether it's a pre stored phrase or an independent phrase to let somebody.

know that they don't know a thing, or that they want that word added into their device, um, or that they want to engage with a new peer in their classroom. Um, these are the things that we're thinking about for the knowledge and content, but then also how to use that knowledge and content to act on their skills.

Kate Grandbois: I think another really important, um, delineation for me reading through this is thinking about these things as skills. And I, I know conceptually we, you know, Oh, well, a student should have knowledge of their rights. A student should have knowledge of self and individual needs, but that's very different than, you know, having that conceptual framework of what we should be focusing on is very different than.

Well, let's actually target it as a skill, which I assume, [00:14:00] in your experience, translates into goals and targets and those kinds of things. That's very different than a philosophical framework of what we should be doing as therapists. Do you agree? 

Amanda Scheriff Hobson: Absolutely. I like that you're using that word should because this also challenges people to be a little bit, I guess, open and comfortable with the fact that we're asking them to do something different, right?

We kind of all come to the table with our own agendas and teachers and teacher aides, they know that there's a schedule, we need to follow it. And so if someone comes out and says, wait, I'm not ready to do that. We have to be okay with saying, okay, we'll wait. Right. We need to change the environment, um, to be open to the, the, the, I guess the opportunities that our students are going to hopefully act on, right?

If we're not willing to change, then some of these shoulds might not actually get those meaningful opportunities to happen. So that's why, again, that partner training is so important because they need to have the skills to act on. A student's advocacy in that [00:15:00] moment. And if we don't have that cause and effect, right, if we don't act on what they ask for, then they're not going to learn the power that self advocacy has.

Amy Wonkka: So just to say this back to you, and I think you'll talk more about the environment as we go through, but that implicit message that we're sending as communication partners and as staff in a school environment or some other environment, you know, when we don't listen and act on our students communication, when they are sharing these messages that are self advocacy, preference related, slash, you know, just Making their needs met.

We are sending that message that okay It doesn't matter. We just we just want you to follow. We just want you to follow the program The program is doing what I want. Not what you want 

Kate Grandbois: um 

Amy Wonkka: So i'm i'm excited to hear more and more about that because I think that must be a really big Paradigm shift for a lot of places and I think there's also got to be a place in the middle, [00:16:00] which is finding the balance too.

I mean, I, I work in schools as well. And there, you know, there is a schedule. So how do you help the communication partners to kind of find the times where, yes, you should definitely be mindful about supporting a student self advocacy versus, um, when you, when you really can't and what's the best way to do that.

Um, maybe you can talk to us a little bit about what some of your Skill learning activities might look like. 

Amanda Scheriff Hobson: Absolutely. Yeah. So when we're thinking about this, we actually run a self advocacy group weekly in our classroom that we, you know, again, I talked about using the communication bill of rights, sort of as our framework for thinking about what content we want to teach, but we also think about what's happening around them.

So for example, 

 A lot of our students, um, happen to have IEPs at the beginning of the school year. So we're going to use that maybe as a focus for the first four weeks or so, um, but what we're thinking about is what do we need our students to have in their, their [00:17:00] toolbox in order to participate in what's happening on their current schedule?

Um, we want to move away from hypothetical and we want to really move into realistic. Um, and so we're thinking about. Content teaching and so content teaching can be really challenging. Um, it could be boring. Um, but we want to really try to make it as, um, functional as possible. So one thing that we'll do is when we set our, our main topic is we'll think about creating some type of custom.

Um, this way we can really pull in realistic scenarios that our students will be part of, and this is used to provide examples of the skill that we're going to be teaching, provide vocabulary that we're going to be targeting, um, trying to use real pictures of the students, maybe in the settings that they're going to be practicing their skill in, examples we've had, let's go to an IEP meeting and we're going through that process in that building, um, my accessible school and we're walking around and looking at pictures of them.

Things that are in the school that make it accessible for students to participate and learn in. [00:18:00] Um, and so once we have that type of narrative to introduce the topic, we're using a lot of explicit vocabulary instruction routines to really make sure that our students are learning about these higher level vocabulary, um, in a meaningful way.

And using the words that they have access to. So, like I said earlier, a lot of our students are at various levels of learning to use a robust language system, but they all have access to robust language systems. And so we want to use the words that are in their devices to be able to identify, define, understand these higher level.

Tier two and three words that we're targeting. Um, so for example, um, we looked, um, at the word accessible. And so that is probably a tier two or three word. They probably don't have it in their devices, but they do need to understand what it means to have something be accessible to them. And so we've used core words like accessible.

It means to get what you need. It means to help you to go into this place. Um, and those are [00:19:00] words that live in their device, help, go, get, need. Um, and we really emphasize that as we're teaching the definition. Um, we do other activities that fall under these explicit vocabulary instruction routines, such as examples and non examples.

Once we've understood that word accessible, we're going to look at some pictures of things that they've experienced and determine, is this an example of something that's accessible or is it not? So we might see a big staircase walking up to the building. Is that accessible for you if you're in a wheelchair?

No. Um, is this elevator something that makes the school accessible? Yes. Um, we'll also generate situations, right? What kind of places are you going to be? to be accessible, um, and kind of go through and make lists that way. Um, we'll also do some word associations, reading aloud different sentences, um, such as, Amanda went to the bathroom with just one aide to change their clothes.

Is that an example of something that's private or public? Right? As we're getting into different [00:20:00] vocabulary words. Um, I went to a busy mall. Is that a private place or is that a public place? Right? So again, we're thinking about these different ways to go through these routines to make sure that students are understanding the words that we're teaching before we're asking them to act on it.

Kate Grandbois: I also love, uh, one, just want to comment. I love the way you're describing these activities. It sounds like some of them are really experiential learning. So going with the student into the hallway. To the stairs and having a conversation about the accessibility or inaccessibility of of that physical environment, which is a very different learning experience than just conceptually learning about in the in the classroom.

And I have to imagine that that is a really powerful learning experience. 

Amanda Scheriff Hobson: Absolutely. They recently did a scavenger hunt to go through the building, sort of like what you're talking about to find and they had, they had a list of all these places that are on their schedule. Go find something that's accessible.

Go find something that's not. Take a picture of it. [00:21:00] But we're also putting language on that with their, their aid. So tell your aid when you're ready to take the picture. the picture, tell them yes or no, if this is the place that you want to take the picture of. So there's so much language opportunity on top of these content pieces, um, and again, to provide the autonomy around, um, being able to say, yes, I want to do this.

No, I don't. Um, and it's a really good practice opportunity for the aides that are working with the students. 

Amy Wonkka: And I just want to reiterate for the listeners that you just gave such a nice example of some of that environmental difference, right? So in. Instead of going somewhere, finding that it's private, having the aide tell you to take a picture, you're having the student direct the adult.

And I think also for so many of our learners, they're going to have a paid caregiver who's supporting them, um, throughout mo most of their life, all of their life. So being able to give those directions to other people is not only a self-advocacy skill, but it's a, it's a long life skill. Um, so that's just one nice example of how.

[00:22:00] That environmental piece might look a little different. It's not a huge change. It's easily doable. Um, but building in those opportunities for students to give directions to adults. 

Amanda Scheriff Hobson: Yeah, absolutely. We really want to, again, make it functional and make it meaningful, right? Learning to give these directions is not something that's just going to happen in isolation in this activity.

We're hoping that with repetitive practice, this is something that they can learn to do with a variety of communication partners. 

Amy Wonkka: I know you had a couple of more activities. Yeah, absolutely. You let it 

Amanda Scheriff Hobson: go through. Um, so yeah, after we get through some of these explicit vocabulary instruction routines, um, we're thinking about looking at, okay, so you have this comprehension.

Now what are we going to do with it? We'll use this tool, Talking Maths, which is another way to look at Students being able to have autonomy when they're sharing their preferences. Um, TalkingMats could be a low tech or a high tech tool, um, they have an app now that you can use. A lot of our students need things that are large to accommodate for a CVI, um, so we'll often do these on large poster [00:23:00] boards where they can have symbols representing the words that we're talking about.

But when you're using a tool like this, you really want to set the topic of what you're about to ask opinions around. And then again, thinking about the function of it after they share all these opinions. what are you going to do with it? Um, so, for example, um, last summer, we got ready for field trips, and the teacher committed to the students sharing their opinions about different field trip options, and based on the results of the classroom, those were the field trips they were going to go on.

So they did some virtual field trips of looking at different field trips. Things in the Boston area that they could go to, um, she made sure they were realistic options. Um, and after, you know, all the students got to say, I like it, I don't like it, or a very popular phrase for the middle schoolers is whatever.

I don't care. Um, and that's kind of our center column. So you have it. That's amazing. Yeah, it's very, uh, very into the age group, um, and a lot of them really like that word, um, so we hear that a lot, um, but [00:24:00] it's a good way to know, you know, sometimes we don't have opinions either way on something, so we want to, we don't want to pigeonhole into either the I like it or don't like it.

So after these virtual field trips and these, um, ways to watch videos and think about what they were about to share their opinion on, they sorted those field trip options into those three categories. Um, they looked at which one had the majority and that's where they went. Um, so again, it kind of ties in building up the idea of that was the unit around preference.

We all have preferences. We understood what that word meant. Then we got to practice acting on it. And the environment followed through, right? There was a cause and effect to completing that activity. Um, similarly, we've used this tool for IEP participation. Um, so looking at our schedules and thinking about the different classes that we attend, and we know that there are classes you just have to attend when you're a student, um, but you still can have an opinion about them.

Um, so being able to sort that and then present it at an IEP meeting, um, share it with the families and the team members [00:25:00] so that they can see what your preferences are. And I think a tool like this is going to be very helpful. Um, Massachusetts recently changed their IEP format, and I think all schools will be rolling that out next year.

Um, and there is a new section around student, um, student, uh, vision students, uh, what they want to learn about and what they like and their future goals at major transitions. Elementary, middle school and high school, and there's feedback around. How do we get somebody with maybe complex communication needs or an emergent communication level?

How will they do this? How are we going to integrate that in? And I think it's important to think about some of these tools that can help meet a student where they are, but still give them the autonomy to share their opinion.

Amy Wonkka: I was so excited to read this whole piece about Talking Mats because I think that it's such a helpful tool for people, for listeners who may not be familiar with Talking Mats. It actually comes to us out of Scotland. Is that right, Amanda? Scotland? I think you're right. Yes. Yeah. [00:26:00] And I heard that this year they may be offering online trainings.

At times that are USA friendly, um, so I'm pretty excited about that. I love the idea of using it for the new IEP, um, because I do think that is a challenge, um, for getting authentic participation. And I, I had a question for you just about using TalkingMaths as a tool. How, how early are you introducing something like this with your students?

How young are you introducing the idea of sharing preferences like this and kind of grading your preferences between not just like, I want this, and I don't want this, but this is something I like, this is something, whatever, I don't care, and this is something I don't like. 

Amanda Scheriff Hobson: So I recently started thinking about this at even as my young as my preschool classes, right, because it's one of the early things that I'm hearing our aides model when they're introducing robust language, [00:27:00] because verbal referencing or being able to say what you see when you're noticing a student communicate and maybe what we would consider an unconventional way.

Um, it's very easy to notice. Sometimes attach meaning to that, right? If someone's laying on the floor and they didn't like that fidget tool that they just selected, you can say, Oh, it looks like you don't like that one. But now to add another level to that, being able to maybe make a chart of fidget tools for students and saying, you know, every time you grab that brush, you seem to end up on the floor, right?

It doesn't seem to be something that you like. So maybe we put it here for now. You could always change it. Um, it's not a permanent board by any means, um, that you could be able to think about Providing them some concrete visual that shows what they like and what they don't like. And it also then becomes a tool for the classroom.

Um, you might have subs coming in every once in a while or every day. Um, and they might be able to look at a tool like that and say, Oh, okay, when I'm working with this kid, now I understand those things that they like or don't like. Um, music is very big in the younger classrooms, and I feel like we often [00:28:00] jump to nursery rhymes.

Um, but nursery rhymes are not the only thing that we listen to. I have a two and a half year old who loves to listen to Mamma Mia the soundtrack, right? But that's not typically something that you would introduce until you knew. And so as you're doing a lot of experiencing and thinking about, Oh, okay, I'm noticing that they're getting very excited when they hear this.

We can add that into their I like column. And I think that again, it's, it's not permanent by any means, but it does. Provide an Understanding where, um, the students are at. 

Kate Grandbois: And I, I think everybody listening, presuming most of our audience is speech language pathologists, most of us are familiar with the concept that visuals are a really powerful teaching tool for language.

But, one of, another really important thing that you've brought up here is the power of visuals for the culture of your classroom. The power of visuals for the culture of your workplace environment and for communication partners because when you have that permanent product, like you said, you know, you have a sub coming in or you have a new aid or there are [00:29:00] other kids in the classroom that might, you know, really benefit from this kind of approach.

You've, you're, you're tying it all together with this visual. I just, I just love that suggestion. I love it. 

Amanda Scheriff Hobson: Yeah, and we've used it in general education classrooms as well. So we have our students who are being pushed into their same age peers, seventh grade social studies, seventh grade math, things like that.

And we recently had students, um, in those levels, um, the general education students fill out a survey telling us about the words they're using. Um, because again, we, the, that word, you know, uh, whatever really comes from what we're hearing other seventh grade students saying. Um, and it also seemed to be the most, uh, kosher, I guess, you know, we could use that word, um, but, you know, when we're thinking about it, we wanted to make sure that we're thinking about, okay, these are the words that other seventh grade students are using.

That doesn't automatically mean those are the words that are seventh grade. Students should use, but we want them to know about them. So after we had the general ed students fill out the [00:30:00] survey about, you know, what are the words you can't live without? Or when you're turning on your iPhone, what's the first app you're going into?

Um, trying to get a survey about what, you know, we're, we're old, we're, we don't know what's happening, . Um, so when we got that feedback, we went through and we said, okay, here's some slang words that you know, some of your peers are using. That's sick. Drip row, no cap. Yeah. That's what my son always says. I don't even know what it 

Kate Grandbois: means.

Amanda Scheriff Hobson: Exactly. We did have to do some looking up to understand what some of these words meant, but once we got them, we did some of those explicit vocabulary routines to teach them what the words meant, and then they got to decide, yes, I like that word. I should add it to my device. No, I don't like that word because.

Who knows what it means or I'm never going to use it. I'm not, I don't want that in my device. And we showed it to the peers. We said, thanks so much for filling this out. Look what we did with it. And now it's another like, uh, socialization, social communication opportunity for our students to connect with their same age peers.

Amy Wonkka: Love it. 

Amanda Scheriff Hobson: And so that jumps [00:31:00] into, you know, thinking about phrasing phrases that we're teaching and programming. We're really shifting to including our students in that opportunity. So as we're learning those new phrases for self advocacy, right, we're balancing having students be able to use words to make their own.

You know, snug, spontaneous novel utterance generation, being able to say exactly what they want to say, but sometimes self advocacy has to happen really fast, and so we also want to teach them that there's a fast way to use a phrase. Or I don't like that, or that's private information. We want to have that as a pre programmed phrase so that they can have the ability to say that quickly.

Um, when there's like an urgency involved into the self, uh, self advocacy. Um, but again, you know, Historically, and I still have them, you know, we have a lot of sheets around the classrooms of aides and teachers writing down programming needs, but we're also including our students in that we want them to tell us what they want added to their device.

So almost all of them have buttons that say, [00:32:00] add that word to my device in their chat words or quick, quick words folder. Um, in the case that, you know, we're in a classroom and they hear somebody say something, then we could add that in. So they're learning to advocate for that. But we'll do explicit teaching of that while we're learning new words.

So in a unit around public and private information, when we're learning, that's private, or don't talk about me, or let's change the topic, we'll go through and say, which of these phrases do you want us to add to your device? And where? Um, a lot of them have a self advocacy quickfire. Folder page in their device where they can access it pretty quickly with the least amount of navigational demands.

But sometimes they want it something in a different place. I've had students say, I want that under, something's wrong because they feel like maybe that it is a, something's wrong phrase when someone's talking about me, um, and so we give them the autonomy to think about that and that is where we program it and then aids know where it's living so that they can model as time goes on.

Amy Wonkka: I think it's really great because it's a good [00:33:00] example of how you're making these small changes in your environment that aren't impossible, don't feel super daunting, but are still sending that message about Both you and the student being equal partners, uh, in the communication exchange.

Um, and I think it's also, it's, it's really great to think about similar to directing other people's behavior. Just thinking about if you're somebody who's using a high tech tool, you are likely going to continue using that high tech tool, at least in some capacity for many years to come. And so being able to take ownership and direct other people to make that tool the way that you need it to be is just such an important.

Not only immediate self advocacy scale, but such an important, like, long term life skill. It's, it's really great. 

Amanda Scheriff Hobson: Yeah, absolutely. And I think that leads into, like, one more activity, but also kind of ties into the environment piece of thinking about communication planning tools. Again, historically, you'll often see speech therapists making them with a team, um, so [00:34:00] that, you know, you've heard communication passports, so communication passports has been historically something that, you know, speech therapists will make to share with a team or make with a team.

Um, and it's a great. tool to have so that everybody knows how somebody communicates, what their communication strategies are, um, and how to support them as a communication aid. But we're starting to pull that back into using the, having the student be part of that team conversation, um, so that they can co plan or co construct some of the narrative around it.

Thank you. Why they're communicating, how they're communicating, and how somebody can help them. We'll also shift that into, like, I need, I do, you can charts. So, you know, if we're thinking about, you know, in the summer, we go swimming. A high tech device doesn't really mesh with being in the swimming pool. So, what do you need when you're in an environment like this?

that and we'll talk through some low tech options and why low tech is the better solution in that scenario, um, what that person [00:35:00] might do, that student might do when they need access to it. So what are their unaided communication strategies? I yell, I move my hands, I start shaking my head, um, and then what you can do as the communication partner, you can.

Get my device. You can model some phrases for me. Um, and that's been really helpful because again, uh, summertime, especially you meet a lot of different communication partners, you see some lifeguards, some swim instructors, instructors, that's something that you can do and show to them, but it was co created by the student.

They sort of signed off on what they want to be able to share with those partners who are reading those tools. 

Kate Grandbois: I just love the word co constructed. I think that's a great theme of almost everything you've said so far is just this underlying, um, just centering the student throughout every single decision that is made and not just in concept, but in participation.

I just think it's so great. 

Amanda Scheriff Hobson: Yeah, and I, it's really, it goes [00:36:00] into then that environmental piece of working with the partners, the partners are part of it, they're not the ones who are thinking about what they think is important, it's sort of, um, you know, important to, important for conversations, um, is it important to the student or for them?

And, and it's both, right? We know that communication tools are important for them, but what's important to them to share? Um, and so we want to make sure that that's being, um, included, um, in that con kind of conversation. Similarly, we're thinking about when I do, it means, so when I shake my head, that means no, that means I don't like it, right?

They get to decide what they're trying to communicate in that moment. Um, and again, we're working with students with a variety of communication skills and a variety of communi So we're thinking about how we're presenting those choices to them. There might be a closed set of choices of, you know, if I'm shaking my head, here are three options of what I could be saying.

But there's also always a way out of that. Um, usually it's a symbol for, I have [00:37:00] something different to say, or a symbol for their device that says, get my device, I have something different to say. Um, because again, we don't want to lead them to an answer, but we do want to work with the level of support that they need.

Kate Grandbois: So, throughout everything that you've mentioned, it sounds like not only is the student participating and being centered in, in each decision, but we've already talked about the importance of the environment, but we've danced around this very important role of communication partners and communication partner training.

And I wonder if you could, just in our last section of the episode, just talk to us about The role of the communication partner, how important it is and how we might refocus our lens to train communication partners. 

Amanda Scheriff Hobson: Yeah, absolutely. We, um, use and, uh, the teacher I work with coined this, this phrase of communication ally.

We really shift to, from partner to ally. Um, she'll often say things like, be the microphone, not the actual speaker. Um, right? We want to make our [00:38:00] students voices louder so that everybody's hearing them but not do the speaking for them. And so this idea of communication ally looks at more of like this partnership and this companionship as opposed to like a helper or someone who's there to guide you to what you should be doing.

And so when we thought about self advocacy at the beginning, we really said that we know we can teach content and skills. But in order for it to stick and to generalize and to be understood at an even higher level, we need those things around the student to change too. Um, and so we also know that with the varying levels of communication strategies in a complex communicator, that there is a large need for interpretation of what students are saying or trying to say.

And that could be really risky because you want to be able to interpret. So that you can understand and attach meaning, but you don't want to cause harm by [00:39:00] interpreting it in the wrong way. So we really need to support communication partners and feeling, um, confident and having a really strong set of tools in their toolbox so that they can follow through on these skills with fidelity.

Um, and it, it means that there's a lot of time that is needed. for this training that I will say in those schools, you don't always have. And so when we thought about running this group, we really thought about doing it with all of our aides. It's not a break time for the classroom. It's for everybody to be part of the group so that we are.

So it's not just doing the content teaching for students, but it's really also content teaching for staff, and then providing some of these opportunities that are more hands on and practice in a safe space, so when they go out into the larger setting of the school or in the community, they're carrying the skills with them. 

Amy Wonkka: I love that. I think that, you know, you, you make such a good point in terms of, you know, the interpretation [00:40:00] piece is not necessarily easy. And even if you're someone who's been working with a student for a long time, there's a lot of, um, risk, like you said, in.

Potentially misinterpreting or putting words in their mouth. And that, you know, also isn't what we want to be doing. We don't want to be telling the student what their message is, um, and, and interpreting it incorrectly. Um, so I think the, the scaffolding and the support that you talked about providing to the communication allies, um, I also really like that term is, is really a helpful, like sort of emotional piece underneath it.

Um, in terms of the skills, when you're Doing your self advocacy groups, and that's a, sounds like it's a great opportunity, like you said, to teach the skills to the student, but also the partners. How explicit do you get with supporting the partners in that environment, where you're sort of doing that skills instruction?

What does that look like? 

Amanda Scheriff Hobson: Yeah, [00:41:00] we usually are pretty explicit, right? We want to know exactly, um, what we're teaching our students and what exactly we're trying to teach the staff and we want them to know on the receiving end as well. Um, and so we'll use a lot of repetitive skills, I would say that really are just going to help with all communication.

So we're really emphasizing. presentation skills. What does it mean to be partner assisted scanning? Um, to just be the scanner, not the questioner. Um, we're really thinking about what is wait time and how do we do that and start to feel comfortable with it. So we'll do a lot of explicit coaching of I'm going to ask a question and I'm going to wait silently for 10 seconds.

And then based on that time, I'm going to do this because I'm noticing this. Um, so a lot of that, like, uh, self talk and self modeling, um, during the opportunity to practice. Um, we're also just recognizing then, like, some of those higher level skills of thinking about different response strategies and variation of response.

[00:42:00] Um, I talked a little bit earlier about verbal referencing, um, thinking about being able to say what we see to attach meaning to that for the student, but we're really also teaching the power of maybe. Right? Again, we're doing interpreting in that scenario, but we want to be cautious about telling a student that that's what they are doing.

So instead of saying, I'm noticing you're, um, you're laughing during this comment, you might think that what your student or your classmate just said is funny. Um, we might be saying things like, maybe you think they're funny, or maybe you thought that was a good joke, or maybe you just liked it. Um, but maybe you're thinking about something else.

Right. We don't know. Um, so rather than saying you think it's funny, we're changing that to maybe you think it's funny. Um, so that we're not telling the students exactly how they feel. Um, and we're thinking about, like, again, going back to some of those general strategies, least to most prompting, um, but one that has been really nice, um, this is from somebody who put out in a thesis, [00:43:00] um, and it's in print, um, but it's called SNAP, um, and it stands for Stop Stop.

Notify, await, acknowledge, and proceed, and it really does a nice job of encompassing, like, a lot of different partner, um, strategies that are out there, um, but it's, we've been using it a lot for making sure that there's autonomy for our students as well. even on the things that are scheduled. So we talked about schedules earlier, but for example, a lot of our students receive g tube feeds, uh, medication.

Um, they need to, they hear the bell ring, they need to go to their next class. These are things that we know have to happen, but we can still go through the snap process by letting them know what's happening. So we're stopping and notifying. Um, we're waiting to see if they respond. So that might be unconventional strategies, like Looking up and making eye contact, um, it might be looking away and shaking your head no, right, to indicate you're not ready, um, it may be using symbolic communication that's a little bit more clear, [00:44:00] like, okay, thanks for telling me, right, um, and then once you get that acknowledgement from the student, whether you're ready to do it or not, then you can proceed, um, but what has been a shift on that is when What happens when a student says no, what happens when they're like, no, I'm not ready for that YouTube feed or I don't want to go to social studies today.

And so we've been allowing teaching and providing tools for these communication allies to be able to say, okay, I'm going to set a two minute timer and then I can come back. And then we will unfortunately have to do that feed because it has to happen within this window, but I'm okay waiting a few minutes or okay, I'll go let your social studies teacher know that you're going to be a little late today.

Come back. Make sure you have what you need. And then we can go to class. Um, if it's something that's optional. You know, sometimes they have allied arts classes or things that they're just not feeling that day, we can say, okay, let's look at a different part of your schedule that we can do right now. That might help you get back to the schedule for your day.

[00:45:00] Um, but that's a shift, that's a big change for teachers and staff to feel comfortable with just because it seems like they're deviating from that expectation that they should be following. 

Kate Grandbois: I was just about to say this is a really important nuanced shift because, and I think it touches on something you mentioned earlier, which is just, you know, as the professional in the classroom who might be focused on student rights and self advocacy, working with an aid or working with a teacher or working with another individual in the classroom who is maybe new to this concept or reframing things for the first time, I can only imagine when they are Encounter an activity that is mandatory, like social studies or, you know, a J tube feed for nutrition.

You know, these are really important things. And I think this is, I guess, maybe just a cultural thing of this note. Well, sorry, too bad. You got to go. You know, that's kind of how we treat children in general. Um, but making space for some [00:46:00] flexibility, creating, seeing it as a learning opportunity for those self advocacy sales and that wiggle room.

So important. So nuanced, and I have to imagine that this is going to intersect with the relationships that you have with the other people in the classroom, the professional culture that you're in, in your workplace in general, um, the groundwork that you've put in with these other professionals in terms of Explaining the importance of these things, taking the time to, I don't know, Amy and I have talked about this on the podcast a lot before, just creating a nice professional relationship of kindness so that when you remind them, Hey, you know, they did, they did say that they didn't want to go.

Would you mind just shifting your perspective? It's not perceived as harsh criticism or direction. You know, you have that nice collaborative relationship to begin with. It's just so important. 

Amanda Scheriff Hobson: Yeah, and, and like you said, the foundation had to be built, right? This didn't happen overnight. The first time it happened, it was like, wait, what, what do you mean I [00:47:00] have to wait to give a g tube feed?

That's my job. I'm the classroom nurse. Um, and that's, they're right. That is their job. They have an order. They need to do it. Um, and so that's like opening up that conversation of, okay, let's talk about it. Is there any flexibility? What is this window where it has to happen? Um, we know you have other kids that you need to feed or give meds to, like really, truly, what is our window here?

We want to be realistic about it, but if there is a window. We want to be able to honor that piece. Um, and I think once we had some of those collaborative conversations, the foundation just got stronger to be able to do that. And a lot of this, the snap, this stop, notify, wait, acknowledge, proceed. That's something that carries and goes through so many different advocacy skills, but it was taught in our like, ask me first unit, right?

Rather than just. moving my chair, or moving my body, or bringing me to the next part of my schedule, or putting me in a place that I'm not really sure about, make sure you're asking me. Um, and it's as little as simple things like, do you want to [00:48:00] read this book right now during your choice time, up into the big things of, do you want to go to this class?

Um, or do you want your G tube feed right now? But we felt like it was important to make sure that we taught the skills to the staff and taught them why. Right? Um, as well as then give the skills to our students who now love to remind us to ask me first, um, constantly. And, and we call it out when it happens too, right?

Um, as a speech therapist, I'm doing programming on devices. Sometimes I'm removing a device and I, I forgot to ask first. And so, you know, we acknowledge, oh man, you're right. I forgot to ask you first. Let's go back and do this because that modeling from me as that person who is a leader in the classroom, Also helps the aides who are learning this to realize I'm not just setting an expectation for them.

It's really just a whole classroom, um, expectation. And then thinking about other activities too, right?

These are all practiced in role play scenarios. So, again, I feel silly. We're asking people to be on the spot. Um, But it is really important for [00:49:00] staff to practice this in a safe space before they go do it in a more, I guess, uncontrolled space, right? When they're in larger community settings, there's a lot of more unpredictability around what's going to happen.

Um, and so now that we do it regularly, I would say that people are more engaged with it. Um, but we'll have, you know, a role play where we go back to those co constructed scripts. So we might set a scenario, um, where we say, okay, um, you're in class and you hear somebody say to your teacher, Oh, why are they using that device?

Or what's that thing hanging out of their belly? Um, and we want to think, okay, what are you going to say? And so we have the teacher kind of act it out, the teacher aid act out that scenario and the student thinks about some of their self advocacy phrases that they learned that they could say, and then they come up and practice it in front of the class.

We'll sometimes tie that into a you be the judge activity where they. purposefully choose maybe something that we wouldn't expect to happen or that we [00:50:00] wouldn't want to happen, um, for thinking back to those explicit instruction routines of examples and non examples so that they're not always practicing it the perfect way.

They're also practicing it when it might happen. Um, and sometimes it's also like a more of a communication ally focus thing, right? Like what if, um, somebody comes up to you and speaks to you in a baby voice? What would you do, um, as a communication ally, how would you be the microphone for that student to really amplify, um, what they are trying to communicate?

If their face is grimacing because they don't really like it, rather than speaking for them as the communication ally, what kind of strategy could you use? to help that person understand why maybe that's not working for the student. Um, and so a lot of these activities allow it to be a safe space to practice, um, and to think about, okay, when I, I experience this now in the real world, I'll have a better, um, idea of how to respond.

Kate Grandbois: I'm wondering if you have any suggestions for any professionals who are listening [00:51:00] who are really inspired by everything that you're saying, but also looking at their current work environment, their current classroom, their current collaborators feeling a little overwhelmed or realizing how much work there actually is to do to shift this balance and work on some of these nuanced perspective shifts.

What would be, do you have any suggestions for just a good place to start? 

Amanda Scheriff Hobson: Yeah, I would start by thinking about your environment and thinking about what you're noticing and seeing happening around you and what would be one thing you might want to change, whether it's small or big, starting with one explicit area, and maybe thinking about Tying it back to that content piece of the Communication Bill of Rights, which right may or may not be violated, um, which area should you do more education around for students and staff so that there is this, uh, this foundation set of why we're doing this.

I think when our staff really understood why we [00:52:00] were doing this. It's not just to be those annoying professionals who are trying to embark on a change journey, um, but that, oh, wow, this thing really exists and it says this and it's a human right. And now I understand why we're doing it. Um, and then once you learn about it.

and have the skills to do it. A lot of it is confidence building. Um, and so something too that we do that's pretty simple is we do self advocacy shout outs. Um, at the start of every self advocacy group, we have a little jar that we can add post its to during the week of like noticing when somebody is doing a really great.

Job self advocating, whether it's a student, but oftentimes it's staff that we're writing down exactly what staff did. Um, and then we're calling it out, um, at the start of group and applauding really their, their change, um, their action that had a better benefit. then maybe doing the alternative prior to self advocacy group.

Um, so, you know, you'll see things like, oh, uh, Ms. So and so did a really nice job asking first [00:53:00] before she went and took the student to the bathroom, or, um, the student did a nice job saying, don't talk about me when they heard somebody talking about them in social studies. Um, so it's student and staff alike, and I think it's built a really nice camaraderie because now staff are writing about each other, um, positive things, obviously, um, but they're trying to reward and really call out that positivity.

And I think that helps with the culture piece and is also helped with the, the confidence piece and the overwhelmingness, right? We're noticing when people are doing things and we want to tell them about it. 

Amy Wonkka: Yeah, I think that's super, um, That's a, that's a super helpful example and something that feels actionable and like you could start it and do it and, and move forward from there.

I know I had a question just about some of your actual units that you teach in your group. So I know one of the units you referenced was ask me first, are there any other kind of core units that might be a [00:54:00] good starting point? For people who might be listening and feeling very excited about wanting to go back and do this.

Are there other units similar to Ask Me First that might be a good starting point? 

Amanda Scheriff Hobson: Yeah, so we've done Ask Me First, which again was wonderful for just like being able to say yes or no to things. Um, but we're also this summer doing, we're actually going back to do it again. We have some new students coming in.

We're doing a whole unit on preferences and choice making. And choice making being beyond just saying what book you want to read or what song you want to do, but meaningful choices that happen during the day. Um, and so, you know, we have. Students to prepare. We had our older students, um, take pictures of the choices they make during their day.

So we did a predictable chart of I can make choices about and they wrote down things that they make choices about during their day, like, um, where they want to sit. During independent work time, what fidget or sensory tool they need access to, which teachers they want to work with during individual work time, and then they went to those meaningful [00:55:00] places, took the picture with the tool, and now they've made a book to introduce to the new students who are coming in this summer, um, and that will go into teaching the word.

preference. Um, this idea of being able to make a choice or say what you want is sort of our core word definition. It will go into the different types of choices that we can make, and then how we make choices, like the communication tools that we use to make choices, and then what staff should do when there are choices to be made, um, and what staff should do to provide more opportunities for choice making during the day.

Um, we also this year did a big unit on respect, um, to talk about how people talk to us, um, what kind of information. So this tied in public and private information, um, and how that addresses respect and dignity. Um, and it also tied in, um, thinking about, like, how people communicate with us too. tone of voice, um, and being able to think about baby voices or talking to us in a respectful tone, especially at that middle school [00:56:00] level.

Um, it went into body autonomy, not touching just because I'm in a chair. You shouldn't touch my chair. That's actually an extension of me. Um, and Even devices, right? I gave an example earlier about ask me first before you take a device to program. Um, so all of those pieces were tied in, um, and we ended that with like an acceptance unit, um, doing a little bit of disability awareness, watching videos of other AAC users.

I believe this was during April when we had like Neurodiversity Awareness Month and Autism Acceptance Month. And so they ended the unit by co constructing a script, uh, a narrative around what acceptance means to them. Um, and so we had a narrative that we heard somebody say, we took and filled in some blanks and they use some of their vocabulary to fill in those blanks or their devices.

to create this their own narrative around acceptance, which was nice. We try to end all the units with like a very permanent product or something that kind of ties it all together. So again, there's meaning to what we did. [00:57:00] Um, so like for summer that I just Talk about for preferences and choice making.

They're going to be working towards making sure choice making boards are available in the classroom or tools are available in spots that you often make choices, um, and get to practice those and have a say of where they go, um, to again, get their classroom ready for the traditional school year.

Amy Wonkka: I love that. I was hoping you could talk to us just a little bit. You did at the end. But just for people listening, when you're talking about your units that you're running with your students, this is not like a, like a one, we did one 50 minute block and then it's done and we move on to another unit.

This is something that's stretching multiple weeks, right? 

Amanda Scheriff Hobson: Yes, this is, um, I'll, uh, thank the teacher that I work with on this who has the organizational skills of what a really nice lesson plan looks like, not that we're not lesson planners or speech therapists, but I think this goes into the more academic level.

We usually try to complete those when we're thinking about the unit. We've identified either the problem or the thing we want our students to do, [00:58:00] and then we name that unit. Um, we'll identify what vocabulary words that, that tier two or tier three level, um, what words we're targeting, and then think about our core word definition so that it's consistent across all weeks.

Um, we'll jump into the different activities that we want to do to explicitly teach the vocabulary, have them practice the vocabulary, do more of those hands on activities. We're also thinking about the goal for this. The communication allies. What do we want them to leave the unit with? Um, and then usually we're trying to identify some type of permanent product, which sometimes is a little bit more concrete than others.

Um, so like I said, that acceptance narrative at the end that they got to videotape and send home to families. Um, maybe it's a communication passport that they're figuring out to share with, um, you know, other communication partners. And sometimes it's a little bit more abstract, like getting the environment ready for the next school year.

Um, but that kind of gives us a flow so that we are typically doing a unit anywhere from four to nine weeks, right? It might be a [00:59:00] whole quarter. Respect was a large majority of the year because there were so many different areas that we can go into. We're also tying it into the Communication Bill of Rights that kind of fits into that unit.

Um, we have a dictionary of the Communication Bill of Rights. that has all of the pictures representing the rights. Um, we use a lot of Boardmaker symbols, but we've identified which, uh, PCS Boardmaker symbol to represent that right, what core words are used to define the more abstract right or the abstract definition, and then this can get referenced as well.

So we try to have some continuity and things that are set up in advance, but there's a lot of planning unit to unit too. 

Kate Grandbois: Everything that you've just described is so robust and well thought out and planned. I, I am very inspired. I don't even have a classroom to go to, but I, I just feel like. This is a really critically important and I have to assume somewhat overlooked and missing piece of curriculum.

Um, [01:00:00] particularly when it comes to the nuance of some of this and the staff relationships. I wonder if in our last couple of minutes you have any final parting words of wisdom or, you know, action steps that we haven't gone over that you want to share with our audience. 

Amanda Scheriff Hobson: Yeah, I think I would be to highlight sort of what Amy brought up around if you're overwhelmed and you don't know where to start, what should you do?

Um, and I think it's really to just do an environmental observation. Think about what you're noticing in the spaces that your students are spending the most time in. in, and is there this tangible change that you're looking for? Is there something that you think you're doing, but it's not working or it's not generalizing?

And start from there. And really thinking about self advocacy with that self determination lens. Thinking about how to teach the student to act on it because they understand themselves and their desires and their motivation. And trying to empower them to [01:01:00] learn this skill, um, is definitely going to be, I think, your key in, um, and also recognizing that doing change is hard and it doesn't happen overnight.

I'm talking through a lens of we've done this now for two full school years, and we still have areas where we're like, we could make this better, we can make a lot of change in this area. Um, and so it doesn't happen overnight and it's hard. It's not instant gratification, but I will say thinking back to two years ago before we did this, it's hard to even imagine because our students didn't have some of these skills or they weren't even being highlighted.

And I think again, going back to the school setting, training partners is hard, mostly from those time restraints as a barrier. So thinking about a way to make that inclusive into some of the student teaching will help maybe going back to that original overwhelm. 

Kate Grandbois: Thank you so much for sharing all of this.

This was so eye opening, so inspiring, really [01:02:00] just a wonderful in depth insight into the quality of this work and how it could be done. You've given us so many action steps, so many ideas. We really appreciate your time. Thank you so much for being here with us today. Of 

Amanda Scheriff Hobson: course. I'm so happy to be here and share just a little insight into what we're doing.

Thank you so much. 

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

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

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

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