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 Patina Eversum on the podcast. Patina works as a childcare worker at the Hermantown YMCA and is a mother of two daughters, both of whom are attending the Masonic Children's Clinic for their communication needs. Patina and her family have sought out a variety of services that fit each of their daughters' unique needs, one of which being here at the clinic. Hi, Patina. Hello. Hi. Hi. I was looking over Amelia's early paperwork and was very interested in how you initially found this clinic. You put down that it you were referred by Facebook moms. Can you explain more about that? Yes. So I am part of a Duluth moms community page, so initially- at her 12-month appointment, they were asking me how many words she was using at that time, and I was kind of like, "She's supposed to be saying words?" And they're like, "Yeah, she should have, you know, zero to five words by now. If she doesn't by the time she's 15 months, we're gonna put in a referral." So I put in a referral myself through the Help Me Grow program, as it inched closer to her 15-month, Checkup. Okay. Thank you. Because she still was only saying, like, one word at the time, or maybe she wasn't saying any. I can't remember anymore, but I put it in myself and, uh, so we could kind of get that going. And at that point, I wasn't sure what else to be doing, so when she got into school, I was like, "Gosh, is this enough?" And so as she got a little bit more into it, I didn't see the progress going as well as I had hoped. I was like, "Well, let's see what other help we can get for her." And so I had posted on this Facebook group what she was doing, what my concerns were, and a couple of parents who had gone through your program previously were like, "Oh, you should look into this one. They're great. We had a, so much success." Um, so I called and- Mm put my name down on a list, I guess. I can't remember exactly the initial steps of getting in, but- Yeah, usually what I think we did is y- um, any parent or caregiver can call, and we either schedule an evaluations that we kinda know where the kid is at, and then they usually have to go on a waiting list, you're right, and then we call when there's an opening for a therapist. And so I don't know how long Amelia was on the waiting list, but I do have records that we did see her for, a consultation, because we did know some of her needs already because she did have an IEP, um, was working with the Hermantown Public Schools. Yeah, and actually now that I think back on it, I think it was the second time I called Help Me Grow for her that I did all of this. 'Cause I think when she was- Little only little little, she was, um, she was progressing okay. It was slower than- But she- hoping but she caught up. She got words- Yes and things like that. And then they were also saying, like, "Oh, well now she's commensurate with her peers." Yes. And you were thinking, "But she's still hard to understand. She's still having issues." Well, she actually came to me after summer school and said, "I can't play with the kids. I can't talk." Mm. And, you know, as a mother, it broke my heart. I was like, "Okay, why do you think that?" And this was at three years old maybe, or four? That was, I think she had just turned four. Okay. And she, had done summer school through Hermantown, and I was like, "Oh, are the kids telling her she's not talking? What, what is this?" And I'm not sure exactly what made her say that, 'cause the teachers hadn't noticed anybody saying anything to her, but I called the Help Me Grow program again, and they were like, "Oh, well, it's summertime. She's over the age of three. We have to wait till school starts." So when school started, she was reevaluated for her speech- therapy. And they said, "You know, she's still hitting all of the markers for speech, however, we have some other concerns. Do you mind if we bring in a couple more people to evaluate her on our team?" So they brought in a school psychologist, and they brought in a couple other people who they said specialize more with autism, 'cause they said they wanted to just kind of have everything checked. And then when I went in to have my meeting with them when all of them finished their evaluations, they said, We're not sure what it is- Mm that we're looking at, but we know there's something." So they also s- And when they suggested, I said, "Oh, well, some other moms had suggested this for speech. Maybe that would be good to kind of pair it." So I called, and I think I called... It only took two or three months, I think, before you guys were able to call, and she came in and she had her initial evaluation with you. 'Cause if I remember correctly, we came in, like, in January. Mm-hmm. January, February, yeah. And that's really interesting, 'cause it is true. That's what's so nice about the, um, public school system and the Department of Education in Minnesota. They have from birth to six years, they just call it a developmental delay. Like, if we see a need, we are going to address it. We don't care about necessarily a, a specific label. And then as kids get older, they wanna know more of the, the specifics of where they fit and what their, their specific maybe disability category is. And that might be where it was happening with Amelia, where there's, they were noticing some social things, some anxiety things, some speech sound things, And she was doing well, but she was still struggling. And if she was self-identifying the struggle, I could definitely see you as a mama bear going, "I gotta do something." Yes. Yes. I'm very much let's take care of it- Yeah. So Amelia started, with the Masonic Children's Clinic in June 2024. So, she's definitely had, been around. In fact, by the time that this podcast comes out, she will have graduated. I know. That doesn't mean that all, you know, that she has no more communication needs or any social-emotional regulation needs, but we do offer two years at no cost to parents, as a way of kind of like a jumpstart, as a way of educating parents, educating the child, and then sending them out to, like, different resources. So she's definitely been through a few programs here. She's attended individual therapy services with myself, Tamara Pogin. Yay. I got to see her. And she worked on things like social communication, expressive and receptive language, especially, like, around language organization, like narrating a story or a sequence, figuring out categories and how to explain them and, understanding basic concepts where she could understand it and follow directions but maybe couldn't look at something and go, "It's behind the picture." And so we worked on that, and then also her certain speech sounds, which is what initially was some of the concerns. She also attended Buddy Group, which is our social language and emotional regulation group. But when she did that, we were talking before we were recording, kind of in a state of transition. We had just... We were moving from my long-term co-leaders of the program, speech pathologist Serena Larson and Dr. Susan Larson Kidd, who has a doctorate in education and behavior, um, had moved on to other things at that point, and so the speech pathologist, who also works here at the clinic, Jillian Little, and consultative occupational therapist Sarah Shepard, had stepped in to the, co-treatment and parent education role respectively. And so you kind of had a slightly different experience. You were the first group, um, when I say group is that we, we educate, four parents in an, education group, and then we have the, about three or four kids in the, in the group, upstairs at the same time. So, um, what were your, memories or experiences about, about that? Like, specifically, like, what, what you learned at the parent group versus what you saw Amelia learning as that progression went from very much, very much more structured with her peers in her group to then slowly, as the year went on, less and less structure? Well, I remember that not only was, uh, were your coworkers transitioning out, but we also had a lot of transitions within the group- We did throughout her three sessions of Buddy Group, because it started out with four children and four families. However, after a few weeks, one family ended up having to move out of, too far away to be- Yeah able to make it anymore. And then as it went on, you guys restructured it, and so it was just a pair, so she was there with one other child. I remember in the beginning Not knowing for sure if Amelia was getting much out of it, because of course, as children do, they don't behave for others like they do their parents. And she, in the beginning, was being quite regulated when other children weren't, and she was just kind of sitting there and watching other children being assisted, whereas she would just kind of sit there. And I'm like, "Is she getting anything out of this?" But then there were other times where she would, like, kind of not really have a meltdown, but she would kind of withdraw, and it was nice to see p- you know, people helping her realize how to get back into it. But yeah, as the time went, and then it was just her and another child, seeing the play that she was doing and the talking, and we're still actually friends with that family. We're seeing them this weekend at her birthday party, actually. That's exciting that's... Yeah, and like, she asks about her, and, "Oh, is she coming?" You know, so it's, it is kind of nice to see that a friendship developed out of it, um, and that they still play and everything. I really did like, the parent portion of it, because so often when people would take her to evaluate her, work with her, and all these other aspects that she does, whether it be at school or we'll talk later how she's had some assistance through Amber Wing as well. You know, I just get to sit in, like, a waiting room and not see how she's being directed or how they're helping her figure out what to do next sort of thing. So it was kind of nice to see, like, a little window. Like, so it wasn't, I wasn't there. She didn't see me. She didn't know I was seeing it, so she wasn't, like, performing for me. She was doing what she would normally do out in the world, but then I could see how someone reacted with her- Mm-hmm and helped her. Yeah, so what we typically do in Buddy Group is that we have, the ability to record the session. So we would record the sessions, and the kid's aware or not aware, you know, the different levels of awareness of being recorded. And then the next week, parents would get to watch that session. Sometimes the whole thing, usually just a curated part of the, um, of the parts that were interesting. And the parent educator would point it out, like, "Oh, look, this is what the speech pathologist was trying to get from one of these kids," or, "This is, this, Amelia was having a hard time here, and then she was given the words, or she was offered this solution." I do remember Amelia sometimes getting really, um- Her emotions got in the way of her language a little bit. She would get disappointed and then not know how to negotiate, or she would try to get a, a peer's attention and they wouldn't respond, and she didn't know how to try again. Mm-hmm. Or what if a peer did not agree with her suggestion? Like- Right, that's the big one that sticks out to me, is when they were doing cooperative artwork or something, and she had the picture in her mind- She had a plan this is how it should look. But of course, getting two to four children to all have the same plan pop up- Mm-hmm wasn't happening. Yeah. So we used... So we went from very highly structured things to very unstructured. So what you're talking about is the more highly structured way, that they were doing something called Dots and Lines. And so some child would be like, "Okay, I want you to draw three red dots." And in Amelia's head, she might have think, "Well, the three red dots are gonna go across the top of the page." And then a child maybe did a vertical three dots, and you ha- and that's like an emotional regulation thing. Like, okay, this is a collaborative thing. We're gonna see what it ends up like. We're gonna give everybody two turns and, this is a group project versus this is my idea. And that, that was a progression, and I think she did get used to it, and then they kinda got into like, "Oh, we made a rollercoaster" or, or, "No, it could be..." That's the other thing, that shared imagination. "No, it, it could be a rollercoaster, but it also looks a lot like a field of flowers." You're like, "It can be both a rollercoaster and a field of flowers?" Yes. Yes, it can with these girls. They were very imaginative. And then we went to collaborative play, where we did, um, when it was just one other peer, they did stuff like a lemonade, a pretend lemonade stand, pretend donut shop, I think. I think there was probably a flower stand in there too. Yep, I think there was a flower stand too. And so there was that customer-worker kind of dynamic, and they had to really get each other's attention. I also remember that, Amelia is very much of a impulsive thinker. And so she would try to share ideas, but she wouldn't necessarily be able to, her peer is the same way. They wouldn't necessarily look at one another or say or give anybody a heads-up that they have this new great idea, or that they were wanting to talk about the weekend and getting to go to the water park. And so that was just some, some different things that we were doing that I think the educator in the groups highlighted, like, "Oh, Amelia, say your peer's name and then launch. You don't necessarily have to stick to the eye contact and glue your eyeballs to each other, but you're giving that person a heads-up that, 'Hey, I'm sharing something that I want you to know.'" And, um, that was a, a, a good learning curve, and I think that was one of the main things that with, conversational skills that I thought was a good missing piece for both of them because they both had pretty good conversational skills with adults because you think about an adult, you do a lot of that recasting, like, "Oh, this is what you mean." Following their lead, maybe even talking about what they wanna talk about. Whereas maybe a peer is like I wanna talk about Pokémon. And you're like, "Uh-oh" you know, so we gotta figure something out. So yeah. So that was... I'm glad that you, that you guys got to go through all that with, with buddy group, for sure. She still loves the Three Little Pigs. We read- Three Little Fish and the Big Bad Shark yesterday. Yeah. And she was like, "We did that in group. Do you remember when w- Mm-hmm you know, I picked it?" 'Cause when you guys did the pretend, "Oh, what do you wanna have your three littles and your big bad?" Mm-hmm. And she was like, "Oh, she did that one." That is true. So- I'm like, "Wow, you remember that?" And that's that repeated practice. So what we did is we took the original story of The Three Little Pigs, and then we let the kids act it out. And then we made slight changes. So we first did The Three Little Pigs and the Big Bad Wolf, and then we're like, "Well, what if we had a different big, bad character? What would it be?" I've been, I've been, been doing this group probably since like 2017 in this way, and we've had Tasmanian devils, we've had big, bad dogs, we've had big, bad pirates, we've had big, bad sharks, like The Three Little Fish and the Big Bad Shark. And then, so then we're like, "Well, what about the three littles?" And I think at least, I don't know if it was Amelia, but the three little kittens and the big, bad dog. Does that sound familiar? I don't remember. There's also some birds in there, too. Oh, I mean, she's usually birds, but Yeah, I think there was a three little birds and the big, bad something. And so yeah, I'd have to go back and look because it's just so versatile because, again, we have that structure. And so the kids kind of know what to expect, but then we're just changing it a little bit, and then they have that agency to share their vision. And everybody's like, "Well, okay, so Amelia's sharing her vision, but then I get to share mine," and, and it's that g- nice give and take. And so I'm glad that she enjoyed it. So yeah. So she remembered it. Yes. And yeah, 'cause we read many versions of The Three Little Pigs. We read... Let's see, we read The Three Little Fish and the, and the Big Bad Shark. We read, like, The Three Little Javelinas, which are like- Yep, and we got that one- Mm-hmm from the library back then. And we also have at our house The Three Little Unicorns and the Big Bad Dragon. That's amazing. I feel like we also rented something about, like, three little ninjas. Yep. Um- I think there was that. And then somebody also found, like, we read The Three Little Aliens and the Big Bad Robot. We have that here. So just different things that, just to grab different kids' attention. Um, well, that's really cool. So that, she definitely had... Like, I think you're right. I think some of her triumphs were her initiations of wanting to be social with people, and the peers, and wanting to understand them. Um, and some of her things that she worked through, I think, were that idea of, that collaborative idea of we're working together. It won't always be my idea, but we'll do a little give a take. It'll be my turn, then your turn, and things like that, for sure. One thing with the buddy group too is that, Sarah Shepherd also educated parents in the group on emotional regulation and sensory differences, and then into offshoots of each participant's individual needs. Can you talk about the natural progression of how that happened in the group dynamic with parents? I remember especially in the last two blocks of the sessions, like even like parents were starting to use each other as resources as well. The main things that I remember taking away from some of the observations for the occupational therapy portion were some of the things Amelia still utilizes a lot at home, like trying to remember that just because they're fidgeting or not looking doesn't mean they're not paying attention. Amelia does have... She does make eye contact, but sometimes she has trouble keeping eye contact, and she likes to color while she's listening when stories are being read. And before, I would've been like, "You're not paying attention. Please look at me," or, "Please look at the book." But that wouldn't have made her focus any- anymore. But when she's coloring, sh- she'll ask questions about what I'm reading, and we'll talk about it while she's coloring. Or she has some fidgets that she's allowed to use at school and, and she came away with different ideas to help her when she's getting anxious doing worksheets or playing board games, 'cause like in buddy group they did a lot of board games and then you guys could see when she was amping up because she'd start to rock or she would start to do something. So they gave her like the TheraBands and the wiggle seats, just different things to help her because sitting still is not- It's its own skill. Yes. And it's never been one that she has really had. Even when she was little, she wouldn't sit to eat. She had to stand to eat, so she had one of those helper stands at the counter, and I'd put her food on the counter on a plate, and she would stand up there, and she could eat fine standing. But sitting down, she would take a bite and she'd run away. And then 10 minutes later, she'd come back, take a bite, and run away. So just the m- the movement helps, helps her focus, helps her concentrate, whereas before I thought it was a beha- behavior issue. Mm. Where really it was a I need this to help me focus. Right. So you were, you were figuring out the differences to actually what she needs to do what we actually want her to do, and it might look different than maybe some other child, but you're saying, "Oh, we want you to listen? Well, then we have to give you something for your hands," or, "We want you to be able to finish this worksheet. We have to make time for you to get up and move around." Yeah. Something like that. And so Sarah was big about that. And so it was from Sarah's observations from those videos, I think, that kind of, led you to some other referrals. I think we were t- you alluded to that a little bit earlier, So first, first Sarah Shepherd did an, uh, con- consultation of occupational therapy evaluation here at the clinic, and so kinda gave you some of those home programming ideas and things like that. So when Sarah did her evaluations, it was to figure out whether or not Amelia had praxis- Mm-hmm which deals with her executive functioning and her working memory- Mm-hmm to see, about those things. And then it kind of- 'Cause she noticed that Amelia would wanna do things but then get stuck or paralyzed in, like, initiating something, and she's like, "Is that the i- the executive functioning of ideation? Is that actually having trouble," m- even though she doesn't have any physical disabilities, about difficulty planning the motor activity that she needs, sequencing it out? Like, "What do I need to do first, second, third?" 'Cause that's what I notice a lot, is, like, the sequencing part was a, is always been a, uh, kind of hard for her. She's like, I know the end result," but she would do, wanna just do A, E or A, Q, E, and we're like, "Oh, let's do A, B, C, D, E," and she's like, "I missed a part in there." Yeah. Right. And to be kind of funny, I tell her father that all the time. "You jump from A to Z, but we still have to do B, C, D, E," you know, "to get there." And he's like, "Oh, yeah." So it's kind of funny how I've try, I try... It's harder to remember with him than it is with her, but you try to remember, "Okay, take a step back. Let them think about it." Mm-hmm. Um, but, yeah, 'cause, sometimes you've gotta learn then with that, that I can ask her something, but then you have to, like, give her time to think about it. 'Cause she's visually picturing it in her head. Since she's such a visual learner, it's much better to, show her what you're asking for, because before you'd ask, you're not answering. Well, ask again. Ask again. And then it's, like, overwhelming because now you've, you're sounding like you're, bombarding her with questions when really she's, just needing to think about it. Right, and that's, like, that processing, that working memory, being able to hold everything in her brain to be able to know what it means, and if we keep going and going, it just starts to be wah, wah, wah, wah, wah, wah, wah, wah, wah. Mm-hmm. And, and so you said, like, adding a picture, so that it can be a reminder to be like, "Oh yeah, this is what we're doing. This is what we need to accomplish." 'Cause you went through several iterations of things she, she doesn't really need anymore, but maybe when she was four and a half years old, you needed, like, a, a clear visual schedule for nighttime because- Yes she was like, "But my toy is right over there, Mama." And you're like, "Yes, it is, but we are brushing your teeth, and then we are getting our pajamas on." Yes, yes. I made visual morning reminders- Yeah of what all the steps we do be- to get out the door in the morning and visual bedtime reminders, which is funny 'cause her younger sister didn't really need it, but she saw that Amelia had it, so now we've got two big bedtime reminders that- They look at once in a while, but yeah, they don't really need anymore. They've kind of got it down. Mm-hmm. But they like to look back at it. And also, that's a thing too, is that experts have said you don't necessarily remove the visuals, once they seem to have mastered the skill, because maybe there's a night that if they do glance at it, or maybe that, you can add things to it where they're using just the picture to help, and it was full-time mom assistance, like, "Let's go to the schedule, and let's look at it, and let's say that it's done." And now you can be, "Where are you in the..." Start talking about very sequential language. "Well, you just brushed your teeth, so what do we do next?" And so you can make it more verbal, and she's like, "Well, that picture's, like, embedded in my head. I know what I do next." And so that's, that's super helpful. I thought that was really helpful for, for Amelia. And like you said, and it didn't harm Pippa at all. Right. It it helped her out too, just like she maybe caught onto it at, at a different pace. So the other thing that happened was, during the process of Buddy Group and think- thinking about it, and also having A- Amelia's reevaluation in the school process somewhere in that time period, and they're saying, "Well, it's something." You, heard about Dr. Elizabeth Carver from Amber Wing, who is a developmental psychiatrist. Yes, and I actually was referred to her by Jillian. Yes. Um, because she could see a lot of issues that her children had in Amelia. And just like when I talked to Sarah, she's like, "Oh, she's just like my daughter. This is..." 'Cause she's got a lim- a lot of similarities there too. So in that way, I think we were very lucky, because to me, all of this is just how four-year-olds must be, five-year-olds must be, when really they saw some of the emerging things that it could've been, like anxiety, was the big one that we started to see Dr. Carver with originally. And when she finished that program, Dr. Carver also gave her an evaluation for ADHD that she Ended up having. Yeah. And so that's true. So, like, I think Sara Shepard and Jillian Little, they have, you know, neurodivergent experiences with their children, and they were just seeing that, but also just being aware of the other resources out there. 'Cause y- I don't think you'd heard about Amber Wing. No. And, and Dr. Elizabeth Carver is a huge resource in our community, where she serves kids birth to s- first grade, so, like, seven years old. And, so she has a very high parent focus, where she does a, about 10 to 12 visits consultatively, kind of figuring out what the child's needs are, especially if they have social-emotional issues or anxiety issues, trying to, like, tease that out. Is it autism? Is it ADHD? Is it a combo? Is it something else? Because sometimes it starts feeling like alphabet soup that people can be throwing at you. Is it OCD? Is it... And you're like, "Okay, somebody help me," you know? And so it was nice that, um, she was able to help with that And so Amelia has an ADHD diagnosis and- And anxiety, yes and a, um, non- like, a non-specified anxiety- Yes yeah, mm-hmm, disorder. And so it's stuff that you were seeing, but it's nice to be like, "Oh, okay." Right. So now we can... Now that we have that diagnosis, you can then advocate for her, and I think that's really, as you've been getting, closer to her end of time here, that's really what I've have heard you doing is you're like, "Well, where do we go next, and how do we advocate for, an IEP that will support her needs?" Right. I was gonna say, and it's been big having you guys as a resource because Amelia did come up on her IEP reevaluation, because turning seven, the category she was under before- No longer exists no longer exists. And they were contemplating if she fit under a different category or if she no longer was eligible to be on an IEP. So it was really nice to have you guys to come back and talk to, and for Jillian, who's done all this process with IEPs before, to give me feedback in what I should be looking for and asking for. That really helped, when I had questions on what to ask them to make sure she could stay on her IEP- Mm-hmm for next year. Yeah, and a lot of it is accommodations-heavy because she is doing really well in her kindergarten program right now. But there's definitely still some things. I know that she's working on reading, and she still has a few speech sounds and, and also just for her mental health. Y- she, we've talked about how her low frustration tolerance, you know, she might have some negative self-talk that we wanna nip in the bud so that... 'Cause she's so smart, but she sometimes doesn't always feel that. Right. And so she's got a long school career ahead of her, so we don't want that to be a pattern. Exactly. Yeah. So, like we said, Amelia's almost done here and will be by the end of the time this podcast airs. So, uh, what things do you think Amelia will remember about her time at the clinic? Well, evidently the three little pigs. I think so. Uh, it was very interesting. Uh, we had been trying to talk and make a plan, 'cause that's something that we're, we work on with Amelia, is, like, making a plan and verbalizing it for what she wants her last couple of sessions to be. And some things surprised me, some things didn't. Like, she mentioned something that we just did last week. Well, that makes sense, it's fresh in her mind. But then she mentioned some things like, she didn't know what to call it, but we did some baking soda and vinegar experiments where we we put some vinegar on the baking p- baking soda... I don't know, was it egg or something? It was a snowman that, for- A snowman, yeah for winter, yes. Yeah. And, and then it melted the snowman, and she's like, "I wanna do that again." And so we're like, okay, so that strong cause and effect, it was fun. She had a lot of control over it. It, it smelled. Everything. It was, like, involved so many senses. So I think that's something to kinda remember too, is like, as therapists, it's like we think... It was a hunk of baking soda- I know. with a couple foam pieces in it. And to be honest, we do baking soda and vinegar stuff at home- Mm-hmm but it's more of a volcano-y look inside- Yeah different kinds of test tubes- It's not frozen first and yeah, in different test tubes and styled cups and stuff. So I mean, the fact that it was a shape and she got to melt it was- Yes kinda cool. So I'll have to get that- It's a- recipe from Andrea. Yes, Andrea Th- Andrea Theon, our therapy assistant who makes a lot of the crafts or preps a lot of the crafts, she took a cupcake tin and filled it with baking soda and water, and we froze it, and then she put, um, like, little eyeballs and little carrot noses and different things on the top of the white blob. And then inside was a surprise, and I think that was also something that was interesting. She's very much into those mystery things, yes. Yes, yes. So that is, that's really cool. And then we kind of talked about it a little bit, but is there anything else that, like, what your main takeaways were from Amelia's time here that your recollections would wanna be? You know, I think just, I feel like l- all the stuff that I learned through buddy group and through my weeks here, it, it really does give me more patience with my children than I feel like I had before. And I f- kind of felt like I had decent patience before too, but also since I work with children, I c- I see things in other kids that I've actually feel like I take to work with me, and I can talk to them in different ways. Um, I've actually seen a couple of children I've worked with who are here, and so I'm like, "Oh, good, other people know resources," and I've actually, in those same mothers groups that I was talking about when I heard about you guys originally, if, when people bring up questions similar to what I had couple years ago, I also refer you guys to people. And I talk about PACER to people that talk about IEPs since I found out about them. And, uh- Have also brought up Amber Wing and different resources that you guys have offered. And I know that just because my children are about to be done here and graduating doesn't mean I can't call. Nope, that is true. Doesn't mean I can't ask, doesn't mean I can't, you know, use you guys as a resource forward, so. Yes. That's- 'Cause that's true, 'cause even though Amelia's, uh, s- time, uh, is approaching graduation, um, we, Pippa has just a few more months here. She started a little bit- Yes later and I just wanna talk about how, um... So, like, how was Pippa's, um, entrance into the clinic, uh, slightly different from Amelia's since you already had a experience here? You know, I was trying to remember why I originally... Pippa had even less words than Amelia did. Mm-hmm. And that I can remember, and poor Pippa, child number two, always the forgotten child. Um, I just remember she had even less words by the time she was... I think she started closer to, like, 18 months or 2 years when I put her down on the list- Mm-hmm for here, because she was still not really saying anything, and it was just, I kind of was like, "Okay, can I put her on a list?" Because she's not, she's not gaining anything with just help through the Help Me Grow program with school. Mm-hmm. And because- And you started the Help Me Grow around 15, 18 months too? I believe we started her around the 15 months as well because she just wasn't- Mm-hmm doing the words. but sh- Pippa was at a different developmental stage when she started coming here to the clinic. Um, I believe she didn't have very many intelligible words at all, whereas Amelia when she started coming, she had some speech sound errors and things like that, but she was a communicator 'cause she'd done that work through schools and, and things like that. So what were some of the, strategies you observed or n- education given from Pippa's needs that were different? Um, so Nancy Johnston is Pippa's therapist. What were those different kinds of things that maybe Pippa was doing or that Nancy was educating you about? Again, my memory. Trying to remember Pippa's starting here is hard, but I know for like the past year or so it has been more articulation sounds- Mm-hmm because once she started talking, she talks- And then- a lot. And then you were, and then Nancy and you guys are working on shaping it into something- Mm-hmm easier to understand. Yes, yes, because that's where her frustration level was happening. She was saying words, and you could tell she was telling you everything she wanted to say, but understanding what those words were was very hit or miss, and that was where her frustration levels were and, would cause... And at first she would repeat herself over and over, but then as time went on she got to the point where sh- it was like, "Why don't you understand me?" And so we've worked for quite a while now on articulation with just focusing on singular, sounds and sometimes combinations. I can't think off the top of my head what you guys call 'em. I, like blends. Yeah, blends. Like the S-H and- Yep, clusters, yeah. Yep. So we've been doing a lot of that where Amelia's been working with like the T-H- Yep and stuff with you now, but we didn't, I don't feel like we had to do that kind of thing nearly as much for her. Mm-hmm. And it is, it is helping Pippa, as well. You can definitely hear some of those sounds come out. Sometimes I think it's gone a lot slower with her catching onto that than I feel Amelia picked it up pretty quick when she was doing things. This T-H is taking a little bit, but other things that we've done I could see the progress. Mm-hmm. Whereas with Pippa it's still lots of reminders. And I know it takes lots of time. They need lots of practice, and- And I think- a lot of these words we don't necessarily say on a daily basis, so it's kind of easy- Yeah to be like. And, and I love that because, you're just seeing that, oh, your two daughters are different. And also I think Pippa is working at this at a much younger age- Yes, yes. She definitely was than Amelia. So when Amelia hit it she's like, "Okay, I understand what you want me to do." And, and we still make, you know, try to make it fun and things like that, and I also think that, um, the, as a speech pathologist we like, try to go in an organized way. Like, "No, we're not gonna get every sound correct every single time we talk about it, so what's the most bang for our buck? Where are we gonna get the most sounds the where she so that the, um, intelligibility improves quickly?" But it's still not all the sounds are right. Right. And, and so sometimes, 'cause how old is Pippa now? She just turned four? She just turned four. Yeah, she just turned four. So, I mean, I do have to remind myself, you know, 'cause when she's here I'm hearing her work with Nancy and it's great, and I do see some progress at home, but then she's still at home for mom- Yeah when she's talking and I'm like, "What was that? Can you say it again?" Mm-hmm. Breakdown, you know Yeah "What? I already said it." I'm like, "I know." And sometimes I just didn't hear her. It's not even she wasn't I couldn't understand her. It's like, "Sweetie, no, I didn't hear you." Yeah, it's- To her, that's the same thing. You're asking me to repeat at this point. Yeah, and then that's true too. Sometimes we, we've all done this as therapists, and you can do this as a parent too, you know, blame your ears. Like, "Oh, my ears didn't hear it," you know, or, or, "Oh, make sure you're looking at me so that I can figure it out, 'cause sometimes I don't always get it." And, um, because those are, you know, additional communication strategies, especially for someone who is either hard of hearing or has some intelligibility issues. So yeah, that's But she So she's still working through it, and she has a few more months- Yes, yes at the clinic, 'cause she started just, like, about four or five months after Amelia, I think. Yes. Well, you know, and sometimes as Mom, seeing them every single day, it's hard to see the growth- Mm-hmm because she also goes to Head Start this She's been going to Head Start this year, and at her evaluations with her speech teacher there and her classroom teachers, they're always like, "Wow, she's, like, gained so much confidence this year. She's talking so much." Where at the beginning of the year, they couldn't get her to play with other kids, to talk. She'd sit at l- the table and just, like, stare at everyone. Where now they're like, if a teacher sits next to her, she's talking the entire lunchtime, and she's singing the songs at group time now, and they're not having as much issues understanding her as they had in the beginning of the year, because, they don't see her- Yeah, but that's nice to hear every day. So it's nice feedback, 'cause yeah, 'cause just like when they're itty-bitty babies, you don't notice this. They get taller and taller, and one day you're like, "Wait a second- They're in the next size how are you in the next size clothes already?" You know, it's sort of like that to me, is I don't see necessarily the improvements every day. Mm-hmm. But those that don't see her every day see huge improvements. I definitely see that, so not being the, the therapist that works with her and then just hearing her in the waiting room as we, like, start to separate between, um, you know, with Pippa and with Amelia. It's like, "Oh yeah, look at that," and she's able to come out and be like, "I made I don't know. I made a pancake," you know? That pancake craft that they just recently did, and I'm like, "Yeah, you did? That's amazing." And again, that's the same thing, where there are, developmental norms for speech sounds, and that's why Amelia's working on those, what we call, like, the later developing sounds, the TH and the L and the b- well, we worked on the L, and now it's just the TH. And, and so that's, like, one of the few errors that she has left, whereas Pippa has some delays, but there are some sounds that kids usually get by four, and then get by six, and then get by eight. And so even though she still has some speech errors, there's some what they call developmentally normal errors, and so she has those plus the ones that she hasn't caught up with her peers yet. So I think that can be, too, where we're figuring that out as she'll grow and, and probably continue to need some, uh, articulation therapy when she leaves here, but she's got a really good start. And even it's just sometimes, like, learning how to be an okay and work through that, uh, miscommunication, right, um, communication repair, and how can I do that, and how can I make it easier on myself and easier for my peers? And so I'm glad that she's had some success with peers this, this year, and she will continue preschool next year. Yes. Yep, she's doing full-time preschool next year, and she also has an IEP for her speech. And Nancy's been really good about contacting the school and talking with her therapist there about keeping their plans kind of not exactly the same, but in sync- Mm-hmm so that she's, she's kinda working on the same style things and- That's cool. Yes. And I think Pippa enjoys coming here, too. I, I've seen Both of your girls are so crafty. Like- you h- you provide so much materials for inspiration for them. Um, you know. You can't see our kitchen. Every counter, every cupboard, both tables- Yeah, but- covered. But, but paint and- Yep um, pretend play and Play-Doh and, you know, books and things like that. They are very creative kids, and they, um, love making projects. And, and so it's, it's That's very rich, too, because you can When you're doing all that hands-on, which I know Amelia really loves, there's so much to talk about. How did you do that? What'd you think about that? How did that feel? All those things are just coming out, and so it's a lot to talk about. So I, I really like that you get to do that. But because you said, like, how your house is full to overflowing- you've blessed us a few times with, um, donating some toys and materials, um, to the clinic, and so we really appreciate that. Well, yeah. Not that often, though. No. I think you guys have definitely given me more things to take to work with me- Yes than I've brought to you guys, but it's Kind of nice to know Yeah. We try to do, like, uh, sometimes people wanna donate stuff to the Masonic Children's Clinic, and we are always open to that, but sometimes it's stuff that we either don't need or already have. Like, somebody donated a beautiful train table to us, and we're like, "Well, we already have two train tables, so who else could benefit?" And so we thought about you, and specifically the childcare program at the YMCA, and you brought it to the staff there, and they're like, "Yes, please." And so you were the, kind of the go-between, and I think we've done that a couple times for some bigger things. Yeah, Emily's given me a few boxes of books or games that are too old for the children that are typically here, and whatever we can't use at work, um, as far as the books go, I've been putting on, like, those big red bookshelves- Mm-hmm that you can find. The give-away? Yes. Yeah, that's- So they're still being distributed to people that would like 'em, so. We appreciate that, because it is true. Like, everybody wants it to go to a place that it's gonna be used. And so whether it's here or the Y or, well, yeah, the little red bookshelves, we definitely wanna keep giving back to the community. So we appreciate that you've done that with us. It's kinda like it was a group project a little bit. Yeah. I guess the only other thing that we really did was when Amelia first started here, Pippa was, you know, doing the childcare and stuff like that, so she's kind of- Oh, yes, the sibling care the sibling care, for sure. So she definitely, got to play with Emily at the front desk, and Andrea. Yes. And, um- Yes, and they both are kind of angry at me all the time that they're not coming with each other. 'Cause when, when Pippa started, we were both, they were both- At the same time scheduled at the same time. But- Schooling d- threw that out the window schooling threw that out the window, which I know it's extra driving for me, but I actually prefer them not at the same time, because I like to be able to sit in with both girls. Uh-huh. Whereas before when they were at the same time- We had to switch off I always had to go in with Pippa for the most part because she couldn't give Nancy the answers she needed- Yeah about what's been going on. Whereas Amelia could kinda tell you what's happening- Mm-hmm or you could figure it out. So it's kinda nice that I can sit in with both girls. For this past school year Mm-hmm So that I didn't have to pick and choose. I know Amelia's kind of excited. I think she's gonna be excited and disappointed and excited and disappointed about this summer because Pippa's still gonna be getting therapy and Amelia's gonna transition into receiving childcare services. Right. Which she's also kind of fine with 'cause she- Yeah always wants to play- She always wants to color with the toys in color. She always wants to color. She always wants to play with the toys in the waiting room. She'll still get to go to on our field trips. Um, but we also are hoping that she'll be able to, um, at least be evaluated for our auditory processing program that Dr. Kelsey Putvin, our clinical audiologist, just brought in called Feather Squadron. And so we know that Amelia has difficulties with working memory. We don't think she has any actual hearing acuity problems but, Auditory processing is something that an audiologist can work on and there's this program that we hope that she may be able to do some of the time that she's here and it's, um, an iPad-based program. It's like 20 minutes at a time and so if it's, so she could still be here and still benefit from some of our programs even though she's not on my caseload anymore she might like, if, if she qualifies she'll just be like, "Come on over here to Dr. Kelsey for some times," and that could be fun too. So we'll see how that develops. That's a relatively new program but I definitely thought of Amelia, and that can help with some of the reading things and, you know, 'cause that's processing, blending, segmenting sounds, learning new words, how to figure out word attack and some of the things that, happen with working memory 'cause you have to be able to hold all those different sounds in your head and how they move together. So I'm looking forward to hearing if she qualifies for that in the future. And like you said before, you was like, "You know that it's not the end and we can still connect- Yes and things like that" and I just look forward to that in the future. So thanks for coming on. Yeah. And, uh- You're welcome. It was great listening to the story and reminiscing with you. Thank you. You too. 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.