Episode 17: From Concern to Confidence: Parents' Journey with PACC

This episode features Tristan Feld and Natalie Wark, speech language pathologists who work in both public schools and the Clinic. They discuss their journeys into the profession and the PACC program—Parents and Children Communicating—aimed at parent education. The program, originally developed in the 1990s, provides services to families with children facing communication challenges. It includes parent education sessions while providing childcare, focusing on strategies for better communication. The program accommodates various caregivers and has had a significant positive impact on numerous families over the years. Tristan and Natalie share the rewarding experiences and challenges of their roles in both settings and express the importance of flexibility and collaboration in their work.

Transcript

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Hello and welcome to Hear Me Out, the official podcast of the Masonic Children's Clinic for Communication Disorders. This is the place where we dive into all things related to communication disorders and how we can best support the kids and families affected by them. We will be talking with speech language pathologists, clinic staff, families and donors to share stories, insights, and the impact of providing free speech, language and hearing services to children across our community. I'm Niki Lampi speech language pathologist and director of the clinic, And I'm Tamara Pogin, also a speech language pathologist with a focus on working with autistic children and their families. And we are your hosts. We're so glad you're here. welcome. Today we have Tristan Kerfeld and Natalie Wark here. They are speech language pathologists that work in the public schools, but also work for us. They run the PACC program, which is Parents and Children Communicating, which is a parent education group that we run here at the clinic. Welcome you guys. Hello. Thank you. Hello. So we would like to get to know you a little bit first. So Natalie, what brought you to Speech Language Pathology? Uh, it's been kind of a journey to get here. I started out thinking I needed to be a teacher, but that wasn't it. So I talked to my mom, she's a retired physical therapist, and she said speech language pathology. I was just a bit curious. I knew what it was, but I had never had experiences with it. So I shadowed Becky Leaf Custer, who's a speech language pathologist and loved it, fell in love, switched my career path, and here I am. Mm. There's been several, speech language pathologists that I talked to that they shadowed, and that was their big eyeopener. That's really interesting. Yeah. What about you Tristan, and what brought you to speech language pathology? Yeah. When it was time to go to college, I knew that I wanted to work with children. I knew I wanted to, work in some field that involved teaching children. But the being a classroom teacher just didn't speak to me. So I did some research and in my research I stumbled upon speech pathology, and it. Just drew me right in the ability to work with children, teach children, and then also the wide variety that comes with the field. Yeah, very interesting. That was more like me Too, where I just after some research said, oh yes. And um, yes and yes, like as I researched deeper into what speech language pathology offers. Yeah. So that's really neat. So like I've said in the intro, you guys are both speech language pathologists that work in the public schools. But Natalie, what was your journey to your current work setting, but also to the clinic here? Well, I started out in the skilled nursing facility and then I moved on to the medical setting where I was a float for about a year. And then I worked in acute care for a bit, found myself then going into private practice. In fact, with Becky Leaf Custer was the owner of the company. So that's kind of fun. Worked with their team. Contracting through schools and skilled nursing facility and then found myself because of family needing a, a move. And that's when I found Masonic Children's Clinic and have been here. And then again for family. I did join the public schools, but also got gifted with being able to stay here doing the PACCC program. Been quite a. And what about you, Tristan? I started in the public schools, right out of college and I also started here at the clinic working after school hours, to meet that need of the school aged children who needed the later timeframe for services. That's right. And you said that you started pre right out of college, that getting that job, and what was really neat is that Yes. So as a therapist. I worked here at the clinic from very part-time to full-time, but then as Those 4:00 PM 5:00 PM times is what a lot of people request for the afterschool kids. And so you, you and another therapist were really able to fill that need. And then that developed kind of into this opportunity to do the afterschool programs for PACC, correct? Right. Yep. I moved from seeing individual clients into helping run this program, which is geared towards parent education. So again, the, that after school, after work time, is the key time to offer that. So either of you, can you explain to me like what the PACC program is like, how it's structured, how it works? Mm-hmm. Yeah. The PACC program it's parents and kids communicating. That's what PACC stands for. Uh, the idea of the program is that we can find children at any time in their journey. It could be when they're on the wait list. It could be the first step to finding out what speech language pathology is. It could be families that are currently being seen in the schools. Anybody can come enjoy PACC. Our focused age group is typically between one and a half to five years old-ish. Whatever the developmental need of the child is, we can serve that. And we typically run about 5:00 PM to 7:00 PM. What else? Tristan? we have a five to six week session. Okay. Right now they've most typically been five week sessions. Yep. And then with the design is kind of with the parents come, there's free childcare for siblings and for the full family. So you can come attend. You could be a grandparent, you could be a parent, you could be caregiver of any sort. Anybody that's communicating with the child could come and join us for the session. We separate from children and do a discussion portion about strategies and then the families. And the child go to a therapy room and at the clinic here, there's a two-way mirror. So the family starts by playing and practicing strategies for about 15 minutes, and then Tristan and I will come in and discuss the play, give you some feedback, what's going well, maybe something that you could practice. And then we say goodbye for the night and there's dinner. That's what I was gonna say. Our timeframe is that five to seven time, which we understand, is dinner time and sometimes bedtime for these young ones. but we try to provide, ways around some of the barriers for families. So we understand families might just be getting off work, picking up their kid from childcare. Um, and so we provide dinner. We start our evening with a dinner all together and. That can help families just come straight from work and childcare, not worry about that dinner in between. So we start with dinner. like Natalie said, we offer childcare, so siblings are welcome to come and attend the whole night. We will always have childcare available for them. And so then after the dinner, then is the parents only learning time and then you go on. That's really exciting that that works. And like you said, like trying to remove some barriers and so there's that group learning time where you're just giving the strategies and like kind of throwing out ideas. And then there's that individualized time where they get to practice, but also you get the individualized feedback, right. What's the history of PACC here at the clinic? Yeah. This program was developed back in the 1990s by Carol Roberts and Levon Lever. Um, it was developed up at UMD and at that time the program was called Interact. Uh, Natalie and I had the privilege of being students at UMD and got to be a part of interact. Woo. Woo. And then in nine, like 19 98, 19 99, when the clinic moved downtown, that interact program was still being run up at UMD, but Carol Roberts brought that program down to the clinic as well. And then we had two areas to offer the service. And at that time, the one at the clinic was renamed parents and children communicating. So PACC. I know that you guys typically see what, two to four families per PACCk session? Yeah. Two to four families per session. So if you think of two to four families, three to four PACCk sessions a year since 1999. Oh man. It's a lot of families. that's a lot of families that's getting that education to help their kids, when they're at home, when they're doing their everyday activities, versus just waiting for. The speech language pathology, like I like that's important. Therapy's important, but then they're at home so much more with their kids than when they get to come to therapy. So that's really interesting to be able to have that. Yeah, we have a graphic that we share the first week, and it's a pie chart and it shows the parents, how much time they're. Child would be spending with a therapist, which is, you know, a little sliver in the pie. And then maybe how much time they're with a caregiver or preschool teacher, which is a little bit bigger of the pie. But the majority of the pie is parents. So giving them these tools, to use because they are with their children, they're helping them develop that communication. Mm-hmm. Okay. And since you guys have been doing the PACC program for several years, do you have any stories about the impact, that PACC has had on either parents or the children communicating, and sometimes like to call them aha moments that parents might have? I feel like we have so many stories and mostly we love to see when both parents can make it to a PACC session and it makes a huge difference for the child and the parents. We had our, one of the last couple sessions, and both parents made it and. They come into the group and we're able to share the strategies that they practice for the week. And my goodness, it made such a difference for this little guy's communication system that they had heard one word come out from that time that they had left to the time that had they had come back, and it was so imPACCtful. The whole group was so happy for the family, and it all had to do with the way that they played, the way they approached communication with their child. It was great. Yeah, I think that's my favorite part of the program is we start each week asking, how the week went. Any, thing they practiced, any new skills. And I love hearing the families share with us, the skills they used or the new things they saw their child doing, and whether that's their child gained a new skill or they understood their communication in a different way. I think that's very impactful each week that each family has something to share. Often when they're leaving, you just see that twinkle in the parents' eyes and the kids looking up at them. And just that alone, it's priceless. also the one-on-one time in the therapy room when parents have one-on-one time with their child away from a sibling, I think that opens a lot of eyes to. It's a magical moment. Mm-hmm. It really is. So one thing that you shared before was it is not just for parents that it can be, any caregiver that, spends significant amount of time with the child, have, have come to PACC. Can you talk more about that? Yeah. We had a family come through. Both mom and dad came, um, they used a lot of the strategies and. We're just so, thankful for the program, thankful for the communication. It opened up between their family that, after their session they called the clinic back and they asked if, both of their moms, so the kids' grandmas, two grandmas could come. And. Go through the program, also learn the same things that the parents had learned. Practice it. It was fantastic. It was extending beyond just the family in the home. It was extending to that extended family, those people who are also spending time with the child. That was a really fun, really fun session. And we can take the strategies that grandparents and parents are seeing and individualize it when we come in at the end to discuss at the end of our session what's going well and what we can practice a little bit more on. And I feel like there's kids that we see come through that maybe toys aren't their thing. So then we switch gears and have parents try some movement with them and wow, look at that communication starting, and that communication can look different. Maybe someone's seen. Three word sentences and maybe another child is, reaching for something to show that they're communicating. So it's fun to individualize therapy. Well, indirectly watching parents and give them feedback with those strategies that they might be able to try. Mm-hmm. And also helping parents let go of their ideas of what Play should look like. Oh. And uh, so that you're talking about maybe they wanna be more movement based or people games is what I like to call them. Yes. Mm-hmm. Or removing the pressure you talked about. Yes. Can you talk a little bit more about that? Like the, say this, say this, right. So many times there's so much pressure, you're comparing what your child's doing to what someone else is doing. Each of us are individual in our communication and putting a child out there and, oh, they're not talking. They're not. Saying words, they're not doing this. But then when you step back and look at what your child is doing and appreciate how you can get on that level makes all the difference. Mm-hmm. So we talk about that as the communication is not just the speaking words, right? It's the, all the communication intentions that you were referring to, Natalie, the reaching, the, the twinkle in their eye, the vocalizations, the word approximations, that. We might not be 100% sure what they're trying to say, but in context we can then model, you know? Right. And, and then kinda give them that success. And that's, it's all about success and communication and interaction and that connection. Yeah. One of our weeks we talk about books and music and so many times it's hard to get those parents to just not read all the words on the page. Right. Yeah. Yeah. It's okay to skip pages. It's okay to just point. It's okay to say what you see. It's okay to. It's okay to follow the kids lead. Right. And just kind of be like, yeah, maybe they only wanna talk about the cow on the page. It's all right, Moo. We get it. Let sing a song. Yeah. That's interesting. One thing that, Nikki, our director here, has talked about when she gets feedback from the PACC program or pretty much any kind of parent education group that we have here. So we also have the autism education, parent groups and parents talk about. That feeling of not being alone, like that, being able to grab that community and learn together is so validating for them because maybe they think that it's only their child that has some struggles, and so they're focusing on the struggles, and then they can, like you said, focus on the successes that they're getting from the program. Right. Yeah. Part of our sharing at the beginning, is the families supporting each other or comparing stories of what their children are doing and how they're communicating. And I do think it's very powerful to have, a group of parents together to see that they're going through things together, they're learning things at the same rate, and their kids are doing similar thing. So, are there any future developments for PACC? Any changes or, or new information? Well, there are a couple things that have been developing. Tristan and I were asked by the director of our program here, Nikki. LampI, she had asked if we could develop a fluency program and we just got done running that in the last five weeks and it went really well. Gave us opportunity to use a format that was similar to PACC and place it into, working with families of kids who stutter. So that was one adventure we've been on. Yeah, that was fun to follow the same model, but with a different mode of communication. Mm-hmm. And then we're hoping to also, within the next six months-ish, I've been trained in the More Than Words program by Hannon. We're hoping to roll that out for the clinic and provide that for families. It would be for families of autistic children, ages around two to five, but it's focused on communication and how to play with your child and foster. Connection. That's exciting for me to hear. Um, and we only have so many clients that we can see in a day. And so as those kids are waiting on the waiting list, what we like here, and this is for PACC, for if they're concerned about autism or if they're concerned about their language delays or if their fluency. We don't need to have a diagnosis for them to come. No. And so often parents are like, the kids are one and a half or two, or even younger, and they're going, something's not right. Or, I'm concerned about my child's development. They can call here and they can get these strategies and learn about it so that even when people are saying, oh, just wait, or, we'll look at this in six months But it's nice to know that they can call here and be like, well, let's get these skills and then see if things change. Not just wait and see, but let's do some things and then see if it changes. Yeah. So that's nice. And we have had a couple, stories like that where, maybe they had their assessment done here, but there was a long waiting list. And they came through the program and when their name came up on the waiting list, just through. The skills that the parents were able to implement at home, their language had, started exploding and parents' concerns had dropped down and that the need for direct therapy at that time wasn't needed. So, yeah, that is exciting. And it also kind of comes the other way too. 'cause sometimes, parents might get offered PACC and then. It doesn't work with their schedule or whatever. So maybe they get called for individual therapy. Then the therapist starts to see the parents and the client and they're like, have you thought of PACC? Especially when there's a really busy kiddo, PACC gives parents that time and that permission to learn and sit and learn from each other, in a way that doesn't always happen in a traditional therapy because we're focused on the child, right? And so you can focus on the parents first, and then of course you did. Then switch and focus on the child. So that's really neat about the program as well, right? Yep. I like both aspects of it. I like that we're kind of that bridge between when you're on the waiting list, waiting for therapy. But also, yes, like you said, that time for the parents to focus on them and their skills. When their child is receiving direct therapy. And I think too, Tristan and I feel pretty lucky to be running the program right now, but there have been many therapists before us. Oh yes. Right. Yeah. Yep. This program. Yeah. I did one or two sessions. See? See, it's been the labor of everyone's hard work. It sure has. It's something that we wanna keep going. For sure. Yeah. Wonderful program. Yeah, that makes sense. How long have you guys done it together? Uh, this is our third year together. Right. Come see us. We're great. And then you said that you've been doing it since, I've been doing this program, I believe for nine years. Yeah. Okay. So that leaves a lot of years between the other therapists. I've done this. That's true. That's true. Mm-hmm. That's true. How does it work to having two different therapists or two therapists working with the PACC program? Yeah, we, Natalie and I recently were talking about this and how much we appreciate each other and being able to, do this program together. I think we are learning from each other. Just as much as the parents are learning from us, it's it's an all around learning community. Natalie's got really good ideas and as she's talking and answering questions, things are. Pinging in my brain and vice versa. Um, so we work well together. We do, we have a lot of fun and I don't know how many of the audience members have met SLPs before, but I don't think one of us is alike. But we all come together for the, for the child. I think that's what we're all here for. But it's really nice to work with someone and respect what they're doing and come up with ideas together and share that with the families. It's kind of the best scenario. Yeah. And in our model, as we mentioned before, we can have anywhere from two to four families. So when we have those groups of four families, it's also very helpful to have each other. because at the end, as Natalie was talking, it's the more individualized, time where we go in and talk with families, answer any questions, can model things for them. And when there's two of us, it allows us to, break that work up so that. No family staying here late into the evening. But also it allows us to switch up which families we go to each week so the families are getting, both of our brains using, picking both of our brains working together. But going back to, your current work settings, like what do you find like the most rewarding and the most challenging in your current positions? Either at the public schools or here at the clinic? Um, I would say the most rewarding thing for me, being a school-based SLP is that you are working in the child's natural environment. So you are seen on a daily basis, how their communication directly imPACCts them and you can use that information to shape your therapy, really individualize all your therapy to students' specific needs and then also help them. In that environment, you can be right in the lunchroom with them. You can be in the specialist class with them. You can be where they need you at that moment. And I could speak to some being in the public schools, challenges could be at times the, all those successes that the child's having in school. There can be a barrier sometimes talking with parents. I know that a lot of SLPs have, are very diligent and have good communication going at all times. I can find it challenging to fit that into the workday sometimes. So there's that. But I think right now with the way that communication is set up for emails, for texting and apps out there galore so that, um, working through what your method is, one challenge for me is keeping parents in the loop and then when you have higher case loads, that can be a challenge to do that. The second thing I would say is scheduling. That's a big one. Scheduling is tough. Be tough. Yeah. And it's changing throughout. The reason it's tough is that these kids have core classes that they're not allowed to be pulled from. They're specialists. They're not allowed to be pulled out from for therapy. So that kinda leaves small amounts of the day. And once you know it, everybody has the same time that they can be pulled out. So you can't take all of your caseload at the same time. So being creative, there's another. Another moment where we get to be flexible as therapists. More flexibility. Yes. And thank goodness for teachers. I feel like they're patient. Yes. 'cause we're constantly coming. Or if you have to change your timeframe or it all works out though. But that would be a challenge. Yeah. And I also remember when you're doing your best to pick the right time for each child, but then it's also matching like the different needs of the kids to make the ages, the ranges. Oh my goodness. The needs.. Yeah. Piggybacking on Natalie's challenge in the school of that parent communication, I would say that is something that's rewarding on this side of things at the clinic. The clinic is very, very family focused, very parent focused, and our whole program is parent education focused. So we deal with that challenge in the schools, but then we come here and that side of it is the rewarding side. So we see both sides of it. So true. I can see that. Mm-hmm. We have a very supportive director too, that supports this program, fosters new programs coming along. I think that's also a reward of being in this setting. Mm-hmm. And collaboration. I feel like, my goodness, you walk through the door and you get so many SLPs to talk to. Oh, reward. That is something that you miss in the schools. Right? On SLP collaboration. Mm-hmm. And we couldn't do our job as well without you guys, because you guys are coming in at that later time, after we've, been here from like eight to five and then you guys are starting here. Mm. And so you're making that sacrifice. To come in at a later time and for the parents to be able to come and they can come together, like the two parent or the, or multiple caregivers or whatever. And so we invite everyone, everybody's welcome. And that really makes a difference as well. Yeah, I would, I would say that, Natalie and I, coming in those after hours just speaks to how rewarding the program is because you know, that to me, that is not. An extra sacrifice. That's not extra work. This is coming into a rewarding, program, right on those after hour times. It really is a privilege, and I know the listeners might think it's five weeks. It's truly five weeks of really intentional time together, and it does make a difference. It is very rewarding. You're right, each family that comes through and each child that comes through, it's really fun to get to know everybody. In fact, there were some kids that liked dinosaurs. And Tristan and I got dinosaur shirts just for dinosaur shirts. Now that sounds fun. Oh. So if, uh, parents, or any listeners that are interested in PACC, they can contact the clinic, with. Masonic children's clinic.org. Or they can call and find out and say that they're interested in the PACC program for their young children who are, have communication delays or they might fill out an intake and talk about the child's needs, and then. They might get flagged for the possibility for the PACC program. So we appreciate that. And you guys coming in and, and doing that. For us and for the clients. 'cause it was interesting, we were trying to say, we, I couldn't do the math. Before we were on, on recording, we said, how many families would that be? Oh, if it started in like 1999 and it's about two to four families, three to four times a year. That's a lot of families that have been imPACCted by PACC. That's a lot of families. So many. Yeah. Could be the the start to their journey could be PACC. Yeah. So we appreciate that you are continuing that and taking the banner and keeping it running. We appreciate that. And we love being here. Yes, we do. So, I was also saying before we were recording that you guys, when we talk about you, you know, we're, we're in a staff meeting and so that's during the day, and so you're not here. And we're like, and Tristan and that and you know, it's like the, there's this person, this person, and did, did anybody tell Tristan Nat. We gotta tell Tristan and Nat. Good deal. We're never apart. Never apart, at least in our brain. But we even do the podcast together. Exactly. So we appreciate that you came out and shared your stories about PACC and about yourselves and, what's happening here at the clinic. So thank you very much. Thanks, Tamara. So we usually like to end our sessions when we have speech language pathologists with us with a question. What is your favorite go-to activity or toy? I. do you, Natalie, have any, can't live without like therapy item or activity that you like to do With your clients, either at your school job or here. You know, my favorites are whatever the child likes, I follow their lead. Whatever it is that they're into, I'm into it. So I know there's different things that a child might like. I would print out pictures and put 'em around, or I'd hold them by me or, uh, whatever their favorite thing is in the room. If it's my coffee cup, we'll do therapy. Mm-hmm. Whatever it might be. That's kind of my. My favorite thing, whatever they love, I love. Yep. I agree with Natalie. Not, not any one set therapy item, but being able to turn all things into. A therapy session. That makes a lot of sense. And I would say that tells a lot about your guys', uh, years of experience that you can do that, that you can think about, oh, what is the child interested in? But then also what are the goals and objectives and how to work that into whatever you're doing and make. Enjoyable, functional, and keep your data. Take your data. Exactly. Maybe all at once. So that, that is, that is a challenge. And then that's the thing about speech language pathology. It's never the same because every kid is individual and has different needs. It sure is. Mm-hmm. It makes sense. Being flexible. Flexible. Yep. Thank you. That wraps up this episode of Hear Me Out. Thanks so much for listening. Be sure to subscribe, share the podcast with others, and join us next time as we continue learning from the professionals, parents and donors who make this work possible and celebrate the amazing kids we serve. To learn more about the Masonic Children's Clinic or to support our mission of providing free speech, language and hearing services, visit our website and consider making a donation. Every gift helps us give children the voice they deserve. Visit us at masonic children's clinic.org.