Episode 18 Coaching Caregivers and Supporting Early Development with Social ABCs

In this episode, we’re joined by Dr. Jessica Brian, psychologist, senior clinician scientist at Holland Bloorview Kids Rehabilitation Hospital, and associate professor at the University of Toronto. A long-time champion of caregiver-mediated interventions, Dr. Brian shares her journey into Naturalistic Developmental Behavioral Interventions (NDBIs) and her leadership in developing the Social ABCs program. With decades of experience at the intersection of research and clinical practice, Dr. Brian highlights the power of empowering caregivers, listening to parents, and grounding early intervention in meaningful everyday interactions. Dr. Brian and her team continue refining Social ABCs, updating their website with new video content and caregiver-friendly summaries of the latest research. As they expand their reach, the core mission remains unchanged: to empower families, listen deeply to their insights, and support meaningful developmental outcomes through play and connection.

Transcript

SPEAKER_03 0:02

Hey everybody, welcome back. I am so excited to have Dr. Jessica Bryan here with us today, joining us from Canada, our neighbors up north. Dr. Jessica Bryan is a psychologist and senior clinician scientist. First that I've heard that. Congrats to you at Holland Blowerview Kids Rehab Hospital. And she's also an associate professor at the University of Toronto. And I got to meet Dr. Jessica Bryan last year through the NDBI Connections Conference, where she gave a very inspiring and informative talk about social ABCs, which falls under this NDBI umbrella. So, Jessica, thank you for coming. Thank you for being here.

SPEAKER_00 0:44

It's really an honor to be here.

SPEAKER_03 0:47

Thank you for the opportunity. I love it. Can you tell everyone a little bit about your journey into NDBI? Like how did we get there? Where did you start? What have you been up to over the past X amount of years that you've been doing this?

SPEAKER_00 1:02

It has been a lot of years. So we don't have to, we don't have to uh put a goal. I appreciate that. Um I was I was reflecting back, and honestly, my first kind of awareness of NDBIs came through while I was in grad school a long time ago. So we're talking, you know, a different century. So the late 1990s. We were um I was really starting to sort of hear about pivotal response uh training or treatment, you know, as and PRT really sort of caught my um attention because I was very interested in um working with kids with autism. Um I I wanted to think about sort of ways to support these kids that felt comfortable and natural. Um I just sort of around that same time I went to do my internship uh for my for my sort of as part of my doctoral work, and I ended up going to a place as a center essentially in um the States. So I was in New Jersey at PCDI.

SPEAKER_02 2:14

I have yes, incredible.

SPEAKER_00 2:16

Um so I got a lot of sort of really good grounding in kind of the fundamentals of the science of learning from PCDI. And then I was just really interested in exploring the idea of these more naturalistic approaches, particularly for the little ones. That's really kind of where it started for me. Um and I remember going to my supervisor with the the sort of hand printed manual from the Kegels lab and saying, I really like this approach. It feels really nice fit for these for these uh little kids that we're interested in. Um and then I sort of started early 2000, well, around 2007, started working on developing an intervention. So that's where the social ABCs really started to take hold. Um it's interesting looking back because they always talk about this 17-year span between developing something and kind of getting it out into the world. And it kind of has been about it has been about that long. Oh wow. So we we it's it's it's been a journey. Um, but really the social ABCs is grounded in PRT, which is one of the NDBI models. Um and and you know, I I I don't want to, I I I'll let you ask some some specific questions, but essentially, you know, we I've been working on that with my team since 2007. We've done various revisions and iterations, and we've done gotten a lot of feedback from the community and and it's helped us grow. Um, and sort of that's that's how it all got started for us.

SPEAKER_03 3:49

I love that. I love it. I was looking at the website, and your talk was again informative and inspiring. Those are the two I words that come to mind because it was just something I had never had on my radar before. And I am so excited to get you on here and to share this for people to learn more about the social ABCs and to get to know you and your colleagues and research and to really open up those doors to other potential avenues to supporting parents or caregivers, um, what you guys do in the model. And I know there's some differences in the US and Canada with early intervention, but it still tracks in terms of supporting caregivers. So, really thinking about how do we best do that and can we do that within the NDBI lens and having that. So that might be helpful to talk about what social ABCs might look like, or some of the characteristics or the parent kind of component and supporting them. What does it look like in practice? Might be a good place to start.

SPEAKER_00 4:49

Yeah, no, that's a great question. So, so it's very um, you know, we we fit into there are all these acronyms, right? So we we we do have we sort of think about ourselves as a naturalistic development intervention in MDBI. We also um another acronym that we often use is CMI or caregiver-mediated intervention. So the social ABCs is it really is designed to um is caregiver-mediated. So everything that we teach, we teach directly to the primary family caregiver. So mom or dad, sometimes grandma, sometimes aunt or uncle, whoever's really sort of the primary uh person in that toddler's life. We do mostly work with toddlers, um, and it's really designed thinking about that toddler age range. And we work on um, so we teach the parents skills that they can use then in their kind of day-to-day natural interactions with their toddler to enhance their sort of social development. Um, and we really, we really what we focus on a lot is keeping the sort of learning objectives quite narrow so that we're not asking parents to learn multiple different, many, many different things. We're really focusing on things that we think of as being pivotal. And again, that sort of speaks back to the PRT um lens that we come from, but really working on core um developmental goals that will have kind of wider impacts for the kids. So those goals for us are um so the social ABCs are things like um orienting your attention to the person that you're interacting with.

SPEAKER_01 6:36

Huge.

SPEAKER_00 6:37

And that, you know, in fact, all of our goals, um, our learning goals came out of research that we had done that showed these specific things to be more challenging for babies as they went on, as they sort of were evolved, sort of emergency as their autism was emerging. And I can talk about that in a second.

SPEAKER_01 6:54

Yeah.

SPEAKER_00 6:54

But essentially, we're working on kind of orienting to the person that you're interacting with.

SPEAKER_01 6:59

Yeah.

SPEAKER_00 6:59

We're working on um sharing enjoyment, so finding activities that parents and children will enjoy doing together.

SPEAKER_01 7:08

Yeah.

SPEAKER_00 7:08

Uh, and really a lot of that involves working through from the child's motivation. So helping parents notice what is it that motivates your child, what is it in the moment that motivates your child and why, like, is it the sound, is it the color, is it the feel of something? Like, what is it? Um, and then helping parents sort of build build those, build routines through their their child's motivation. And then the last sort of specific target or goal is um helping kids kind of learn to direct their communication to their uh whoever they're interacting with.

SPEAKER_03 7:45

I love that. And I can speak as a parent of a you know a neurodivergent kiddle, and we had EI come into the house and do this and you're gonna work on this, and there wasn't a lot of parent caregiver input, and they'd leave and we'd laugh and laugh, like we're not gonna do that. So the ability to push into a routine for a busy, already overwhelmed parent is just, I don't have 15 minutes to sit down and play, like in that context, versus let's make it meaningful for both this child and myself and build it into a routine and kind of back out of that and get the learning that so much more helpful. And and I really appreciate you saying those pivotal um things that are gonna have that most impact, right? Parents can be overwhelmed with learning a bunch of different things. What might be the most important pivotal triage? Just let me start here and get that ripple effect and then get some momentum, get some excitement, reinforcement, and then teach me another thing and teach me another one. And I love that about the model because it is overwhelming for the parent.

SPEAKER_00 8:45

Just honestly, this is this this a lot of this came out of work that uh my team and I have been doing with um younger baby siblings of children who have autism. So, so you know, with my colleagues in across Canada, we we were working again, starting in the late, very late 1990s, we were working with families who um had a child with autism and then they had a subsequent baby, and we were following those babies starting at six months of age uh to sort of see what are some of the earlier signs. We we knew that some of those babies would go on to have autism, and so what might be some of those early indicators. Um and that really informed the the things that we identified as learning priorities, um and also gave us a lot of insight, I think, into kind of just like you were saying, sort of that idea that families have a lot going on, and we cannot expect to it's just not fair to sort of expect a family to learn a million different things. Um, we get really, really high fidelity um sort of outcomes from families. So families learn the interventions really well, the intervention really well. They feel um, they tell us that they feel empowered, like I've learned this thing and I feel like it's making a difference, which is incredible. And they feel self-efficacious. So they tell us I'm feeling empowered and I feel like I know what I'm doing. And then of course we we look at and measure sort of child developmental gains as well. But hearing that from the parents about sort of um that impact that they now have with their little one and feeling like, I mean, we hear from parents who say, I wasn't really sure how to play with him before, and now, you know, he wants to play with me now, and and now I am the person that he comes to when he wants to interact, and just really um, really important sort of connect new connections that are being made between the the parent and the child, which are really important to us.

SPEAKER_03 10:52

Absolutely. I think sometimes providers forget that for parents, life keeps lifing. Like, I hear what you want me to do. Got a lot going on right now, and you're an expert and you know this. I'm learning this again, new skill, new context. Being able to step back and really support parents and caregivers in a way that is going to validate them and empower them and help them feel connected to their child is so impactful. And then on the flip side of that, I feel more confident, I feel like I'm having more fun, I feel really like in a great relationship with my kiddo where they might not have been there. Perhaps that stress and anxiety and overwhelm is kind of also diminishing a little bit, right? And that's an extra added benefit to really supporting caregivers. So, and then am I right? Is there a group, individual and a group?

SPEAKER_00 11:42

Yeah, so I I think I got a little bit off off tab off topic there, but you were asking kind of what does it look like? So essentially there are a couple of different models. So there's a model where that takes place over 12 weeks and it's one, it's fully one-to-one. So in that model, um, there's so we sort of have two main components. One is just learning some information, and we have a manual, and the coach goes over them the contents of the manual with the parents. Um, but then we really put a lot of emphasis on the in-the-moment coaching. So there's moment by moment coaching where you are playing with your child as a parent, you're playing with your child, and the coach is kind of just coaching you through those moments. Like, oh, I notice he's looking over at the ball. Why don't you go a little closer to the ball and see if you roll it to him? Like maybe it looks like he's interested in it. Let's see if he's interested. Those those kind of moments. Um, and that makes up the bulk of the the program is the coaching.

SPEAKER_01 12:38

12 weeks.

SPEAKER_00 12:39

So in the individual model, it's 12 weeks long, and there are sort of several. It actually starts with three sessions in the first week. Okay. And then we we we taper it down to two and and then down to one towards the end, and we we skip a week towards the end. So it's really kind of it fades out. We fade out as the parents, as the parents take over and become more proficient and come.

SPEAKER_03 13:00

It's also very intentional, I'm sure, and very helpful to back it out.

SPEAKER_00 13:03

Yeah, yeah, we intentionally do back out. Um, and remember, we're not we're never interacting directly with the child, so it's all coaching the parents as they interact with their child. Um, and then we do, we have a group model. So we were we were really excited by our individual model. We were seeing beautiful outcomes for the families and for the kids. Um, but we were also aware that I mean, you know, there are resource constraints everywhere, right? And and in Canada, we have an amazing healthcare system, but it's it's public healthcare, and and so there are you know resources can be slim. So we wanted to find a model that was a little more resource efficient. So we developed this group model where families meet together kind of in small groups um and learn. Do so it it's it's actually a hybrid model to be to be clear. It's not fully group. So all of the learning that's yeah, exactly. So all of the learning that's like content related takes place as a group, and then there's still one-to-one coaching. And we also pared it down so it's six weeks long now.

SPEAKER_03 14:07

I was just gonna ask, is that also 12 weeks? So it's six weeks. Six weeks. Yeah, yeah. That's exactly data research on that one too.

SPEAKER_00 14:18

Yeah, so we do. Um, so we we we had an RCT, a randomized control trial of the individual 12-week model. We've now published a pilot study from the group model with um just over 80 families. So it's a big, it's a big-ish pilot study. Um, and it was really the timing was very strange because we started the project just before COVID.

SPEAKER_02 14:44

Oh gosh, of course.

SPEAKER_00 14:45

But it's actually it ended up sort of working in our favor for the study anyway, um, which was that we had so families were coming into the clinic. So they were coming in, they were meeting as a group in person, and then they were coming into the clinic also for the coaching sessions, which may not have been the best plan, but that was that was our plan. So we we ran about we worked with about 40 families that way.

unknown 15:11

Okay.

SPEAKER_00 15:11

And then COVID hit, and my amazing coaches said to me, we could do this virtually. And honestly, I was like, I don't know, guys. This seems like this seems like a tall order. But my coaches are incredible, and they were like, I think we and the families were really also very game. They were like, let's try it. So, you know, like credit where credit is due. The families and the coaches were both ready to go. So we we pivoted really quickly to coaching virtually. So in a situation just like just like we're on today, we would be on a Zoom call and coaching the families, and the the group sessions were still taking place but over Zoom. So families were still meeting together in a small groups, like four, four to six families. Um, and then all the coaching was taking place virtually. And there's some things that made it possible because of this the way we do the social ABC. So we don't the coaches don't directly work with the kids, so we weren't losing that, right? And we don't do any modeling. So all of the learning takes place through coaching.

SPEAKER_02 16:20

I love that.

SPEAKER_00 16:21

So it's it really worked well virtually, and just by happenstance, we had about half of our sample, or you know, our half our participants got the program in person and about half of them got it virtually due to COVID. So it wasn't randomized. Um, but we have really nice outcomes showing that very, very similar outcomes for families, regardless of which whether they received the program virtually or in person. There was one sort of hint of a difference, which I thought was very cool, which was which is that for the in-person model, when families were meeting with other families in person, the reduction in stress was a little bit better. So there was something very special about not surprising, but very special about meeting in person with other families.

SPEAKER_02 17:15

Like community sense of not being alone and exactly.

SPEAKER_00 17:21

Yeah. And it and you know, it'd be interesting to look at we are looking at it now, but interesting to know whether um so stress was very high in the co in the virtual group, but co it was just the beginning of COVID. So it's understandable that stress was high. We now we're now just finishing another randomized control trial looking at just the virtual group model compared to a control uh condition. And so we'll have more information fairly soon about how that looks in terms of uh reduced stress as well for them, as well as child outcomes and all the standard things we've been looking at.

SPEAKER_03 18:00

I appreciate so much that it's just parent-mediated, not just parent-mediated, that it is parent-mediated and that you guys aren't on the floor modeling it. So prior to my NDBI exposure and previous old school ABA days, so NDBI about a decade now, get on the floor, show them how to do it. They can't do it, coach them. And it just again, now as a parent, I think back to, yeah, that probably wasn't very helpful. They probably felt very discouraged. And so I'm moving into more of a parent-mediated approach where I am actively coaching the parent to coach the parent, where I don't want to be that model because I know it might look better with me than them. That's not fair, right? I'm on chapter 30 of my practice journey here. They're just starting out learning how to help support their child. And I also find it to be really incredibly beneficial for my coaching skills. Like I can't get it in model, I can't go through the Zoom, right? I have to think about how to coach in a way that can support that without relying on jumping in and showing. And that has changed how I support parents tremendously because you have to be creative and you have to think about that. So I don't know if you encounter that as well.

SPEAKER_00 19:10

Yeah, I mean, I I absolutely hear that from my coaches that it it there's nothing that hones your coaching skills like coaching over Zoom. Like that is just the best way to become a really, really skilled coach. Um, and yeah, like certainly that temptation to be like, oh, let me just show you, is it's just not there anymore, right? And we, you know, I exact I think you really hit the nail on the head in terms of thinking about why we might have made that decision to not model. And and exactly as you say, we don't, we didn't, we felt very strongly after working so closely with families early in their autism journey with with us with their babies, yeah. We were so like so aware of how parents are feeling often during that period, and we wanted to do everything in our power to not make them feel like they weren't doing the, you know, doing as well as they would like to be doing. So we felt very strongly, as you say, like it's not fair to have an ex, we didn't feel that it was fair to have an expert come in and do the things, and the child's gonna love playing with you, and then the parent may not get the same reaction that didn't feel right. We also feel very strongly that um we didn't want parents to watch a therapist and copy that therapist style. We wanted the interaction to be genuine for how you interact with your baby as a parent and not to be like, I'm I'm I'm acting like the therapist that my baby that my child really likes. Like we we really wanted to avoid that as well. So there there really were two reasons that we avoid that that kind of model. And then the other thing is because of how young these kids are, they're gonna want the parent. First of all, they'll want the parent, and and we want them to want their parents. Really, we want them to want their parents. But also, like, imagine if you're in a session where it's the first time the child reaches out, or the first time they make a sound, or the first time they say mama, and it's to the therapist and not to the parent. Like that is not, we just did not think that would be okay. So, so really there were lots of reasons to do it the way we did it.

SPEAKER_03 21:28

Ugh, I appreciate that as a uh I didn't even think about that, but appreciate that let the parent have the win, let them celebrate those first, and you are facilitating it or mediating it, but you're not kind of in the way, then having to try to transfer it back over. And also kind of thinking about that therapist style. Like if it's not genuine, it won't sustain and maintain over time because it's not you. And then parents stop doing it, it's not working, and then we get into the I don't know how to help my child. So I appreciate the intentional thoughtfulness of the Model with the coaching that you've done. I don't know a lot of models that have really spelled it out that way, which is incredible to listen to and to really be mindful of the parents, the target population who you're servicing, the parents and the caregivers, grandmas and aunts, to really empower them and to help those connections establish, which is what, again, social orienting, social engagement, social enjoyment, helping to get directed communication, those three things. I wanted to circle back. You had said something about those early indicator behaviors from the little ones. Can you list a couple of those? So if you can think of the top of your head, that kind of influenced where social ABC's targets are coming from. So the little ones you had talked about, those early concerns or early indicators.

SPEAKER_00 22:47

Yeah. So this was work. This was led by some of my colleagues in Canada. So Susan Bryson, Lonnie Zwegenbaum, there might, they might be names that you that you know. And really we were looking, as I said, we were we were working with babies who had an older sibling with autism. So we knew that they might also end up with, you know, with the diagnosis themselves or with similar kinds of um profiles. And what we know what we found in that research essentially was a couple of interesting things. So one is that around 12 months of age, you can see differences in the babies who go on to have autism, to be diagnosed with autism. You see differences in their um sort of visual attention skills. So their ability to kind of orient, move their attention in space from one thing to another, shift their attention, remove their attention or disengage their attention from something in order to look somewhere else. So attention was a really big one. Um and the kids who had who ended up at age three with a diagnosis were having more difficulty with that attention when they were 12 months old. We also saw differences in smiling. So the kids who ended up getting a diagnosis at three were less smiley than the other kids. So we felt there was something, so that's where that sort of shared enjoyment uh came from. You know, and then you know, it's not surprising sort of difficulties with um social commun communication or directing communication to a partner. That that would be a more probably a familiar one for for lots of people. Um but really those were the three things we we saw as as a like when we were working directly with the children, with the babies, and we had developed a measure called the um AOC, which lots of research sites are still using. Yes. That was that was like a direct assessment to look for those, to look for those signs. Interestingly, when we when we were working, say clinically with the babies looking for those signs, we the the most informative age was around 12 months for us. The earliest most informative age was around 12 months. But when we asked parents, yeah, if you're if you are concerned, they their reports earlier were even earlier, were good predictors of kids who ended up with a diagnosis.

SPEAKER_01 25:17

So not surprising, right?

SPEAKER_00 25:20

So around nine months, parents were very good at at sort of detecting those things that ended up uh leading to a diagnosis, you know, predicting a that a child would have a diagnosis.

SPEAKER_03 25:32

Yeah, and I feel like that tracks like with Liam's journey, little baby blob, right? Looking sensory social routines, looking, playing, people play. As soon as those kind of objects came into play, and he could army crawl and start clutching things and never seemed to let them go and had a real hard time shifting back to our little games that we used to play. It's around six months that I was like, oh, some of this stuff looks real familiar for what I do for a living. And and then by nine months, absolutely certain, 11 months started the evaluative process of, hey, this is pretty much tracking with what I see. Um, just very blessed to do this for so long, to kind of watch for that on the radar to really help support parents that have concerns to not get dismissed. That no, there really is a difference between what he used to do, look at me and coo, right, and now he isn't doing as much. And oh, he's a boy. No, that that's a concern that should be validated and incredible research you have to kind of say that early to hear parents and just to kind of have it on the radar of getting that support as needed. Um, that's so powerful and it's so, you know, thinking about all that stuff that's going on from brain development within that time frame and that range of we want to get in there. And sometimes kids get diagnosed at four or five still in the States. I'm not sure how it is up north. That gap is closed.

SPEAKER_00 26:55

And honestly, you know, like the the the whole, I would say the the the motivator that really got this whole body work going from our group was that we were hearing from fam when we were in so many of us were are also clinicians, right? So we you know, I still I still have clinic one day a week. My colleagues are clinicians as well as researchers. So what we were hearing from families when we diagnose a kid at age four, parents are were often saying to us, I've been wondering about this for many years. I started wondering around one, just like just like the story you shared. I started wondering around nine months, I started wondering around one. My doctor said he's a boy, let's wait. And of course it's true, children develop at different age, at different paces, like all of that we we need to be thinking about too. But I think the bottom line message for us, and in fact, this has now been worked into the Canadian Pediatric Society guidelines. So we have a we have a list of like early signs that community doctors should be thinking about. And one of them that we have in writing in the guidelines is listen to parents. Like if parents have concerns, this is something we need to be to be thinking about and to be taken seriously.

SPEAKER_03 28:17

Yeah, and they might be bringing these types of concerns to you, and this should be on your radar, not maybe what you might not know about autism. And um, that is really impactful to have that there and a document that they have to look at and they should be reading and and implementing and really supporting the families. And it's hard. Boys talk late, like you hear it all, and I just think how many times do the families that I support from around the world, doesn't matter if I'm here, when I lived in England, when I lived in Albania, it's the same story that I hear from caregivers told to wait, it's okay. And I don't know if it's because they're looking for more really overt kind of autism signs, symptoms versus some of the more subtle things that you can pick up and detect a little bit earlier. Or again, that parent is telling you there's a shift or a difference that they're noticing that's concerning them from a social perspective that they might not even know it's autism. Usually it's like that language delay, but some parents pick up on there's something before that even happens. That engagement, that disengagement, that smiling, right? All that pre-linguistic an avenue to helping a kiddle get a diagnosis to get the treatment, to get the services that parent can help support them for. I feel like that tracks around the globe. And you guys have some stuff in is it India, Goa? Yes, yeah. Okay, looking on the website.

SPEAKER_00 29:40

Yeah, we we trained a group in Goa in southern India. Yeah, yeah.

SPEAKER_03 29:44

I was like, where to find us, yeah, or in the states or across Canada. So, what would that look like for practitioners who might be listening? Like, oh my gosh, I want to learn this model, I want to get trained in the model. They just reach out to the social ABC's website and then go through that process.

SPEAKER_00 30:01

Yeah, yeah, we have exactly so the social ABC's website is easy to remember at socialabcs.ca. It's um, yeah, and then we do have a sort of um uh a form that people can fill out that gives us a sense of kind of whether your program might be a fit. Obviously, we we still need to meet with the program and really understand, but we want to make sure that you um, you know, you work with toddlers and you have a good, a good sort of um understanding of toddler development, um, and sort of just some of the the things that have to be in place are we just ask you to fill in in a form and it gives us a sense of where to start. And then someone from my team would get that.

SPEAKER_03 30:39

Okay, and then what would be the age range? Sorry, if they were listening, age range for zero to two, one to two, two to four, kind of what's that age range for yeah?

SPEAKER_00 30:48

So it is small, and and we're a little bit strict because we really don't recommend using the program outside of what the research has has shown. So we the program really is designed for kids starting as young as 12 months and going up to 42 months. 42. Okay, got it.

SPEAKER_03 31:08

Thank you.

SPEAKER_02 31:09

Um and that kind of helps.

SPEAKER_00 31:11

And we actually have I have an amazing um colleague who's working again with with Lonnie Zwegenbaum, who I mentioned earlier, um, and another colleague, Isabel Smith, who's a psychologist in in the Maritimes, um, working on uh, and so the my my colleague, her name is Erin Dowds, and she's actually working on developing a baby version of the social ABCs for six to 12 months, six to fifteen months. We're doing a little bit of overlap. We're gonna we're gonna see which which model works best for that 12 to 15 month um group. But she's been really working on refining the the approach for really, really, really uh little ones.

SPEAKER_03 31:51

I love it. I love it. I feel like you should have you have social ABCs and capital. The baby one should be lowercase ABC, like yours for the baby version with lowercase.

SPEAKER_00 32:01

That's too that's actually very cute. We jokingly, I don't know if this is a if this only works with if you know French, but we do sometimes call it the Babcs, like B apostrophe ABCs, but that kind of works. Oh well it translates what we'll call it. I like the the lowercase.

SPEAKER_03 32:21

Yeah, it kind of tracks at the baby. That's fantastic, and then you have this incredible um foundation to lead up to if they are done with baby, right? Like, oh, feel confident, got what you need, great. If not, they could just morph right into the bigger ABCs and kind of continue the program designed for the 12 to the 42-month old kiddos. And what a nice trajectory to support them. Maybe some parents jump off before then, and some people might still need that uh ongoing support that just kind of continues through that kid's development. I'm very excited about that because the little ones again, like you see, like you kind of see the patterns and the siblings, and you just kind of like just be prepared or just get those resources available. It can't hurt, right? To get that there. So if a if a staff professional community provider wanted to do social ABCs, they would work with you all to get up to speed training, a fidelity certification if there's a process for that. And then they would be able to then coach the parents one-to-one or have a group format and have resources to guide them on that. Is that kind of how it works?

SPEAKER_00 33:27

Yeah, so we we have been fairly again, strict. We're we're easygoing people, but we're strict about our social ABCs. Quality controls we've been strict about sort of what it what it takes to become a social ABC's coach. So we we an individual can become a coach so far, it's usually through an organization. So you would be a provider within a particular organization. That organization would would be backing your interest in becoming a coach. Um, and usually the organization so far has has paid for the training. Um, but yes, then and there's a fairly rigorous process where we work with the coaches. Um it's about a six-month period for the training. Um and I was gonna say but, but I'll say and during that six months, you're already working with families who are on your caseload or who are part of your organization. So our our trainers will train coaches with the coaches' family, like the families that they would be working with anyway. Um and then we have lots of sort of um video check-ins, and we people do have to meet credentials in terms of coaching credentials, and we do then certify people. Um, we do also have a yearly re-like. It's not really a re-certification, but it's sort of a refresher. Like show us, send us a video where you think you're doing things well, and we'll we'll see that you're still doing things well. And we do kind of make sure that people keep up their skill set. We have some requirements about um, you know, not kind of taking too much time off between, you know, the the last video we saw in the next video, because we do think that as with many things we practice, sort of keeping keeping fresh is is really helpful. Obviously, in Canada, we have long maternity leave, so that's okay. People will go away for a year of maternity leave. But when they come back, we just might do a refresher just to sort of make sure they're they're back up to speed. And we give lots of support. We have a big community of practice. We have about 60 coaches now in across Canada and um you know, in with some of our partners, we have partners in India and Israel now, and they they meet um regularly, kind of as a as a large group to to talk about the social APCs and get support.

SPEAKER_03 35:53

I love that. You're gonna have a partner in the US, somebody's gonna listen to this and they're gonna reach out and they're gonna want to do that. And I am fully supportive of that. I've got one in mind. We would love that. Incredible, cross the border and come down here and to think about the organizations and how to support the parents. And yeah, I am very grateful for a lot of connections that I have and really thinking about um that age range that you guys are supporting and potentially the babies coming soon, really getting into some nonprofit places I can think of the top of my head that I think would be 100% on board to do something with this pilot partner research and to bring that down here. Um that's incredible that it's an Indian Israel. And I'm like, we have some I states, Iowa, Illinois, Indiana. Let's bring to keep the eyes going, just bring it down to one of them.

SPEAKER_00 36:41

I'll tell you too, like we have we have sort of different um ways in which, so even across Canada, so because the provinces are really where where the funding comes for each service agent for the services. Um, so in, for example, in Ontario where I am, families can receive the social ABCs once they have a diagnosis. So once they're in the system in the autism system. So they still have to get diagnosed young enough to be eligible. It's working, it's working well, but it's you know, there's a there's a tight timeline. In a different province, so there's a we have a province called Prince Edward Island, which also has an I in it, PEI. Um that's what I mean. Another, and in PEI, what they're doing is they're providing the social ABCs while families are on a waiting list for their autism assessment. And this is like a beautiful model because we know that some many kids won't get their diagnosis early enough to sort of be in the prop in that age range. And families are looking for something to do while they're waiting. Our waiting list can be really long in Canada. Yeah. Um, so it's really a nice way to support families while they're waiting.

SPEAKER_03 37:51

Do you think that model of supporting the families on the wait list would uptake in Ontario at some point?

SPEAKER_00 37:58

That that might be So we are trying, we have a really strong um infant development network, and I know you guys too, like zero to three kinds of like services. Um, and we do have some partners already in the infant development um sphere who are a couple of whom are trained in the social ABCs. So we're some families are starting to get it that way. We actually just received funding from a granting agency that is going to um where we're gonna look exactly at that. Like, can we bring the social ABCs into sort of more generic infant development um spheres and and see if we can get to kids earlier?

SPEAKER_03 38:36

Yes, you can. Yes, you can.

SPEAKER_00 38:39

And it also gives us more reach, right? Because a lot of the kids, like if you think of kids who are marginalized or who don't come to to the centers to get a to get an assessment as early, this would also, these these infant development programs are very good at catching all the kids who have any developmental concerns. So it I I'm thinking it will help us reach out to kids who might get missed otherwise.

SPEAKER_03 39:05

That's fantastic. And then across the different provinces, because Canada is quite spread out. Are there the coaches could support the families that are in more rural or kind of like I'm just talking with Regine, thinking again, like some parents might drive two hours just to get to the doctor's appointment, depending on where they're at in the provinces. So that kind of coaching remotely sounds like a wonderful resource to be able to access, get families access to intervention and support where they might not physically be able to even get anything. Isn't kind of exactly.

SPEAKER_00 39:37

I mean, we um yeah, I mean, that's a big plus of the virtual care. So now our model is what we're testing right now is completely virtual. So we could theoretically see families. I mean, Ontario is massive. So if you we talked about like northern Ontario, it's like how many hours? Hours and hours and hours of driving to get to the north. I think Ontario's, I was just looking this up for a different thing, but Ontario is like the geographic space of Ontario is about a million square kilometers.

SPEAKER_02 40:10

Wow, that's big.

SPEAKER_00 40:12

It's just massive. So this would be a really nice way to reach families who would otherwise have to drive hours and hours.

SPEAKER_03 40:19

Yes, and I think moving everything kind of moving online and kind of digital help support and getting people to get access to things, it's becoming since COVID, more and more. I think more and more families are more comfortable with that in terms of support and consultation coaching. So it's great to then think about the families that are more comfortable and more aware and open to that if they have an internet connection and people have a smartphone of some type that they could get some support in their very remote hours north region or hours west to wherever it is that they're going to be ticket from. So just access to intervention and then being able to support the families. If people wanted to learn more about social ABCs, we have the website link that we'll put in the show notes. Any other resources that you can think of that would be great? YouTube videos. I'm trying to think like where they could learn more about social ABCs on a link to the video.

SPEAKER_00 41:13

Oh, it's a great question. I mean, we, as we learned before we started recording, our website needs is is in the midst of being updated and it will be updated um soon. So I think that we one of the things that we're motivated to do is to put more sort of um video resources up there. So right now we have a lot, we have our publications, which I know are not always digestible to everybody. Um, our plan is to create some, we were going to do some lay summaries, but you're making me think as we talk that maybe lay videos would be a nice, a nice approach to just talking about like what did this study find? What are we looking for? And um, so I think we, you know, that that's a nice goal for us. We do have some we have some funding from um our foundation from a very generous donor here who is supporting some of this like digital or like increasing our digital um footprint here. So we will be we will be doing more. Honestly, for now, the place to start is the website. So even as we create videos and stuff, they will all be there will be links to them on the website or they'll be housed on the website. So that's the place to go for more information.

SPEAKER_03 42:28

I love that. I'm gonna circle back. We had um, I do some volunteer work for the NDBI special interest group for ABAI here, uh social media stuff. And one of the things that I've been talking about with Mindy and Brooke and Gersal and some other big NDBI researchers is how to translate this incredible work that they're doing into TikTok length reels, short video, um, short picture things on Instagram, carousels, so infographics on Canva created. So if that's something you're interested in, we have a little group of undergrad students that are interested in social media. So we're trying to think about what would a template look like for a study to translate it into the younger generation from not the background words, to to get it in a to get it in their hands where they can digest it, get interested, and maybe want to learn more. So that's one of the next Q2 missions I have is to how do we take that and get it out there? And I am also from the 1900s, so I'm not a TikToker and not Instagram carousel real. I don't know what any of that means other than the words. So, but we have a team of students who are really excited to volunteer their time to do that. So perhaps. Oh my god, this has been incredible. I think you so much for your time, Jessica. This has just been again informative, insightful, engaging, and I can't wait for more people to learn about social ABCs. It's amazing.

SPEAKER_00 43:55

I I Jamie, you you're amazing. I love your enthusiasm, and I really love uh I love the opportunity to to chat with you and, you know, happy to participate in any way that's helpful.

SPEAKER_03 44:05

Thank you so much. And thanks for being here. You're welcome.