Greatest Hits - Express Yourself: Augmentative and Alternative Communication (AAC)

This summer, we're revisiting some of Hina and Marla's greatest hits from the first 11 seasons of The LowDOWN. On Season 4, Episode 7 of The LowDOWN: A Down Syndrome Podcast, Riley Rosebush and Marie-Elise Marcoux give us the lowdown on AAC communication.

Transcript

Today on the Lowdown A Down Syndrome podcast, Riley Rosebush and Marie Elise Marcoux give us the lowdown on AAC communication. Over to you, Hina and Marla. Hi there. This is Marla Folden, SLP and co-host of the Lowdown podcast. In the room with me here is Hina Mahmoud, co-host and fabulous OT. Hello, Hina. Hi, Marla. How are you? Oh, I'm doing I'm doing well. It's been a day, but here we are. Technology was giving us some troubles this morning. But, you know, that's the podcast life. Yeah. Yeah, exactly. Yeah. And before we get into the episode today, we would love for you to hit the subscribe button and leave a review of our podcast on whatever your chosen platform is. Um, remember to check out our episode pages for any additional resources. We always have some things that are extra with each episode, and you can follow the Dsph at w w w dot eff dot org and on Instagram and Twitter by following at Canada. Today we are chatting about something that I feel is a really misunderstood and hard to accept area of SLP, and that's using augmentative and assistive and alternative communication. Sometimes we call it AAC, and many people automatically think of using an iPad to communicate when they hear AAC. But as we'll talk about today, AAC is much, much, much broader in scope than that and offers the potential for communicating more effectively and efficiently with more people, which has a big impact on quality of life. And I'm really happy to bring this discussion to you today. Mhm. Absolutely. So joining us today, um, are Riley Rosebush and Mary Alice Marcotte. Um, both of them who are speech language pathologists. So Riley studied he she is one of our amazing SLPs at the DDS, and she studied psychology and linguistics before completing her master's degree in speech language pathology at the University of British Columbia. She has actually worked at the DSF since twenty twelve and has focused in on early intervention and feeding as part of her practice. Riley is passionate about early intervention for children with down syndrome, including optimizing feeding with a family centered approach. She has completed continuing education with Talk Tools, the SOS approach to feeding and breastfeeding support through Douglas College as an SLP. She believes that feeding and communication are important aspects of a child's development that impact their ability to participate and reach their full potential. Um, and our second guest today is Mary Ellis. She is a pediatric speech language pathologist with experience practicing in urban and rural settings from, um, specializing in supporting deaf and hard of hearing children to being a jack of all trades with special interest in AEC. So this is such a great pairing that we have today. She also is a mom to a little kiddo with down syndrome, um, who was born in twenty nineteen. So welcome both Riley and Marie Elise to the lowdown. So nice to have you guys. Thank you for having us. Yeah. Thank you. It's so nice to be here. All right. Awesome. So in the grand tradition of the lowdown podcast, we love to start off our interviews with five secret questions. So they're fun little icebreakers. No math involved, I promise. Um, so let's kind of jump right in. Uh, question number one. Uh, Maria, let's start with you. What are you looking forward to doing most post Covid? Like when it's like over, over for real, for real. Over. Over. Over. Um, we've been wanting to do, um, a bike tour trip with our son. Um, and I think we're kind of hoping that we'll be able to make it happen next summer. Um, we're planning on. I think the hope is to go to Sweden and tour around with our little guy and the buggy and, um. Yeah, that's. Yeah, I think I'm really looking forward to that. A actual like, I don't know where I live. It's like a wonderful vacation all the time. Um, I live in the Kootenays. Uh, but yeah, so it's been a while since we've left and yeah, it'd be really fun to go do that. Oh, that sounds really cool. Um, Riley, how about you? Um, similarly, I think I'd like to take a trip pretty soon. Um, I have a sister who lives in Switzerland, and she's never met my little boy who's eighteen months old. Eighteen months old. So, uh, it would be great to go over there and visit her. Yeah. Oh. So great. Okay. Question number two. If you could bring back any fashion trend, what would it be? Why don't we start with you on that one too? There's so many to choose from, you guys. The worst person to ask about fashion. Do you want any kind of trend? Oh my goodness. Um. Sweatpants and hoodies, which I guess have been brought back with Covid. So I'm living my best life at home. So. You just want that trend to continue. Love it. I'm not sad about that trend either. Really? Yeah. Work from home trend is okay. It's a whole thing now. Loungewear. People are capitalizing on it. So there's like sweatpants and hoodies everywhere. So I think it's here to stay for a while. Uh, um, really any, any trends you would love to bring back? You know, it's not, um, a time issue. It's more of a place issue, but I wish that a muumuse were much more accepted here on the West Coast. I think that's what I would like to wear from now on. Yeah. Yeah. Just comfortable. Sweatpants and hoodies are good too. But you know, that's two pieces of clothes. That's two pieces of clothing you have to put on. Oh, man. All right, third question. This one's fun. Um, so let's pretend you're chosen to compete representing Canada. What sport or activity would you like to represent Canada in. Let's say you're going to the Olympics or something else. Like what would you want to do to be really good at. And you don't have to practice. So we are assuming that we're actually good at it. Yes. Just magically you're representing Canada. You'll be the best. Oh of course. Yeah. Um, okay. I have two answers. Um, I was really excited about the new sport of rock climbing in the Olympics. I love outdoor rock climbing and indoor rock climbing, and so I was really excited for that. So that'd be pretty exciting. Would you want to do speed climbing? That stuff is no, no. I would like it to be separated and do like the bouldering and lead climbing and maybe avoid the speed climbing. Yeah. Um, but as a kid I dreamt of being an Olympic swimmer, so I guess, yeah, that would be fun. Those are very adrenaline packed races. They're really fun. Yeah. What about you, Riley? What would you want to represent Canada for? Um. Well, I guess if I'm just gonna pretend that I'd be suddenly really good at it, it'd be great to be, like, a women's hockey player or something. Yeah, yeah. Canada. Go. Canada. Yeah, yeah, I haven't given that one too much thought. Most people don't, but it's fun to imagine. Um, okay. Next question. If you had an unlimited supply of a food or drink, what would you like to choose? Mary Alice, I start with you. Sushi. Oh, that was very easy. It was very easy. I've thought about that one. Yeah, I would definitely go with pizza. Oh, okay. Both very classics. We get asked these types of questions all the time in our work. So it's so true. So true. Do you have good sushi sauce in the Kootenays? Um. It's okay. I tend to just avoid it and wait till I go to the coast. So it's like a special treat. And then I eat sushi every day that I'm on the coast. Gotcha. Makes sense. Yeah. Excellent. Okay. Um. All right, our last secret question, you guys, if you could teach one skill to everyone in the world, what would it be? I'm just going profound here with the last one. Yeah, I'm gonna end it on a deep level. Riley, you can go first. It could be a practical skill. It could be anything you would want everyone to know. Oh, well, it would be great, I guess, if everybody. I mean, I also don't know how to do this, but if everybody knew how to like farm and, you know, grow food and we could work on some of these hunger issues. Yeah. Yeah, that's very good. There we go. Yeah. What do you think? I feel like you guys need to answer these questions. You give us a hard one. I have I have my answer ready. Okay. What is. So it turns out most people tie their shoes wrong. Oh, the opposite way they don't untie. I learned this as an adult. So if you tie them like going forwards around, then it unties itself. But if you tie it the opposite way, it stays tied. Imagine how much time we'd all say, oh, how much less we trip. It was a life changing, really. Uh. I am stumped. But the thing that's sticking out to me, just because it's something I love doing at this time of the year, is kind of like Riley just mentioned, is, um, food preservation. I love food preservation at this time of the year. And this year I'm actually doing none because we've been sick all month. And so I'm just postponing. But, um, yeah, I've been kind of dreaming of it, but not doing pickles and all the good stuff. Yeah. Okay. I'll grow the food and you can preserve it. Excellent. I'll tie all the shoes and you can tie all the shoes. Perfect. Excellent. Okay, I have a little tidbit I want to share that I don't know if you both know, but Riley and I went to grad school together. Yes. So true. We totally forgot to tell everybody that you guys have. Yeah. So we're a long time friends, and. Yeah, we went to speech therapy together. I thought everybody would have just known that already. But you're right, I know, I just assume. Yeah. Um, and you guys both? Yeah. You guys both went to UBC and graduated in twenty twelve. So do you have a fun little story about your time together since you brought it up? Let's just go off on that tangent quickly before we get serious. Um, one of my two favorite memories of Riley in grad school I have thought of this is Riley would come to class with a giant clear Tupperware full of vegetables, either cut or uncut raw vegetables. And this is what she would eat throughout the day. And it brought so much joy to the rest of us. And then Riley is also a master doodler on her notes. And whenever I would borrow notes, if I had missed a class, I got bonus information. From having. Having had lunch with Riley for years and having attended a four day conference with her, I can attest to both of those things still happen. So nothing has changed. Perfect. No, I haven't changed. No. That's good. We love you for it. That's great. All right. Well, thank you guys for indulging us in that. I think it was a fun little walk down memory lane. And we learned a lot more about Mary Alice as well. So, um. All right, so let's kind of start with the basics. So what can you tell our listeners? Because I don't think a lot of them are familiar with, um, the term AEC. What it, what is it exactly? And can you give us some examples? Yeah. Um, so before I explain what AEC fits, I think it's good that we have a better understanding of what is communication. Mhm. So at its most basic communication is the sending and receiving of messages. Um why we communicate. There are tons of different reasons that we communicate. So it can be to argue, to ask a question for jokes, for connection, protesting, requesting, um, commenting. There's all sorts of reasons why we communicate and how we communicate. Um, typically the first thing that comes to mind is we communicate through talking through speech. But that's not the only way that we communicate. We communicate through, um, body language or facial expressions, gestures, um, texting, emails, writing all sorts of different ways. Which then brings me to ask, um, so AEC stands for augmentative and alternative communication. AEC can be tools, system devices or strategies. So augmentative communication is when you add something to your speech. So sign language pictures or a letter board, um, that can make your message clearer to your listener. An alternative communication is when you're not able to speak or you're, you're speaking is unreliable for you or difficult for others to understand. Mhm. So there's different types of Aki that we have. We can have unaided or aided Aki. So unaided would be examples like gestures um using sign language where I don't need anything additional than my body to communicate. And then aided is having something external to me. So a speech generating device like an iPad or, um, a book full of picture symbols or switches that when you activate the switch, a message is spoken. Um, we also want to think about our devices having different degrees of vocabulary. So we can have a robust system that has lots and lots of vocabulary to express lots of different functions of language. And then we can have systems that are less robust, like, say we had a switch that we recorded a single message in. It's not very robust that I can express many things with, but it serves a certain purpose. So these tools help a person communicate when they cannot rely on their speech. Um, so perhaps your child had not started talking or perhaps you lost your ability to talk. Um, it could also be that your speech comes and goes or is inconsistent or harder for others to understand. So if you think about it, we all use some forms of AEC every day. We're really good at texting and emails and we use gestures and sometimes we prefer one over another. So I know sometimes I much prefer doing emails back and forth with families than I would kind of jumping on the phone to do a phone call. Yeah. Yeah. And I think you brought up a couple of really good points with, I mean, there's a wide variety of AEC, and I like that you differentiated between assisted and an alternative because they do mean two different things. There's two different kinds. Um, so there is a wide variety, um, something for everybody that may need it. Um, and then I also love the fact that you, you said that even we, we use it every day. We just don't really think of, it, right? We do text, we do use gestures, you know, we use facial expressions. So it is a kind of a global thing that we are using it. So it's not just for a particular population, it is for everybody. So I think those two are really great points to hit home. Um yeah. So what why does AEC now if we kind of shift our focus towards our individuals with down syndrome, why does AEC play such an important role for people with down syndrome. So people have down syndrome like everyone else in the world want and deserve autonomous communication. So what I mean by autonomous communication. I'll kind of simplify that. It's basically say what I want to say to whoever I want to say it to. Whenever I want to say it, however I choose to say it. Um, and, but a person with down syndrome communication development isn't always straightforward to get to that, that desire, that autonomous communication. So there are many co-occurring conditions with down syndrome that can impact that journey to communication. So for example, um their hearing. So hearing can be impacted with different types of hearing loss that impact a child's ability to access spoken language and speech from their environment. Um, you can have speech sound disorders. So apraxia of speech, which I know Riley did an episode on at one point, um, that impacts a child's ability to plan their speech in a consistent manner, making it harder to talk and be understood by others. There's also low tone and craniofacial differences that can lead to reduced clarity of speech and voice differences. Um, another one that is common is a dual diagnosis of autism and down syndrome. So the interplay of autistic communication development paired with the characteristics of down syndrome communication can really create just kind of a whole new journey for communication. So AAC can help promote communication, development and build bridges to autonomous communication. Despite all these co-occurring conditions and from a strength based perspective. So not just kind of these co-occurring conditions, AAC plays to the visual processing strengths of people with down syndrome. Yeah. Um, many, most of the AEC systems out there are visually based. Um, and it really plays into our desire to want to communicate. So to have all these different tools that we can get messages across, um, is so powerful for a person with down syndrome. Yeah. And I think you started off with a really important point, which was the ability to do your communication independent of other people is a, it's a huge issue. And I think a lot of, a lot of times we kind of get into a trap where it's like, well, I understand what the child is saying, so I'll just translate for them. But what that does is make the child completely dependent on whoever's going to do the sort of translating or restating for them. And in the longer term, it really impacts that person's ability to be an independent communicator, which might even affect things like living on your own and getting a job. So these are skills that we want to have. Yeah, I'd like to think sometimes of it as like a social network. So at your smallest network, you have your familiar, um, listeners like your family, your siblings, um, but then you zoom out and you get your daycare providers, your teachers, and then further out, you get your community members and then further out you get dental medical professionals, the police, the, you know, whoever, strangers on the street. Um, and so you're going to want to find tools that help you communicate in all those different social networks that you might be encountering. So what works in the home may not be what is most effective in a broader social circle. But what is happening in a broader social circle? You may not need to use those tools across all your social networks. You might at home prefer to just use your speech because that's just what is easiest with family, right? And I mean, when you think about it, that makes complete sense because most people don't sit around the dinner table and text each other even though they could. Right? Yeah. We're talking to each other at home, but when we're out and we're talking with other people, clients, people of the community, we might email them or call them instead. So it's very normal to use different kinds of communication with different people in your social network. That is fine. And that's something that we all do. Um, many parents, I'm sure you guys all hear this often, um, have shared with me and kind of said in general that using AAC, they feel like they're giving up on their child communicating verbally. Have you heard these things before where they're like, I don't want to give up on speech by starting something like an arc. And what is what are your thoughts on that? Yeah. So I definitely hear this a lot. I think this is a common concern of a parent who's considering arc. Um, it's also a common myth of Arc. Yes. Um, so I want to kind of reframe that mindset through three different perspectives. So from a therapist's perspective, um, there is no known evidence that using Arc interferes with spoken language and speech development. In fact, there's actually several studies that have shown that Arc supports language and speech development. So when we establish a strong foundation in communication, it promotes development of other aspects of communication skills such as your grammar sense and building, meaning of words, speech, etc. one can have both goals to improve spoken language and speech and also multimodal communication. It doesn't have to be one or the other. Yeah. Um, from a parent perspective, I want to reframe my mindset to thinking about putting myself in my child's shoes. So not being able to talk reliably, effortlessly or at all must be really stressful. So what can I do now to help reduce that stress while we work on those other skills? And this is kind of like a, I have a bit of an analogy, um, to switch gears from communication to another aspect of development. It's not the perfect analogy, but um, my son is not yet walking and I know he will likely walk at some day, but in the meantime, we use different devices to help him get around. So we have a stroller. He has a manual wheelchair, a trike, he has a gait trainer. So these devices don't interfere with his walking development. They give him instead an alternative way to explore his surroundings, gain independence and motivation to be mobile, and chances are he's going to want to keep some of these devices like a bike, even though he can walk, because it could be more fun and efficient to get around in certain contexts. And then my third perspective I want to draw attention to is from the arc users perspective. Um, so listening to the stories and the perspective of AC users, a big theme that comes through is having a means to express themselves and what is most important. It's not speech. Many AAC users are either full time or part time AAC users because their speech is either not present, unreliable, effortful, or less effective, and it finds it stressful when more work is placed on speech than on their AAC. Mhm. Um, yeah. So it's really, I think that's been one of the most powerful things for me is to learn from their experiences. And they're coming from all sorts of different backgrounds, but, um, yeah, to kind of see the way that they see the world, perceive their communication methods and how really I think there needs to be a shift there that we value all forms of communication, not just speech. Yeah. Mhm. I think sometimes people assume that just because you don't have the verbal speech that you because they say my child is non-verbal, but they're trying to say that they're not communicating like there's a, a disconnect because just because you're not able to say something verbally doesn't mean that you cannot communicate. Right? So there's that distinction has to be made as well sometimes. Yeah. So there's a shift towards using non-speaking rather than non-verbal because non-verbal signals that you don't have these ideas of language. The thoughts um non-speaking is more to do with that. The, the motor articulation of like putting out the sounds, um, which could be again, unreliable comes and goes or not present for you. Um, or just not reliable. and so non-speaking signals that, yes, I still have intent to communicate and language in me. I just need a different avenue to express it. Mhm. And I think there's a there's a sort of side aspect to, to some of this, which is if we insist, which is not something that SLPs would do. But if people insist that someone try their voice repeatedly and repeatedly, and then it doesn't result in success for the person being understood, then eventually what happens is the motivation to speak at all goes down because it doesn't work. Right. And so, I mean, how many times do we expect somebody to try and try and try and try? And actually our students have astounding perseverance, I would say, because I don't think that I would try as much and as regularly as they do to communicate clearly. Um, but by providing other ways for their message to be understood more effectively and efficiently, we can keep motivation sort of across the board because they they have a reliable backup if they do want to try speech. So they might be willing to try their communication more frequently if that makes. Yeah. And keep motivation up and decrease stress, frustration. Isolation. Yeah. Mhm. Okay. So I want to shift gears a little bit and start talking about the mechanics, if you will, of how we get going with a C or just Nonspeech communication for children with down syndrome. So what age when you're thinking about these questions, what age do you like to start? Is there a too young. Is there a too old. What do you like to start with? Mhm. So I like to say that it's never too late or never too early to start a good answer. Um, does it always look the same? So, you know, if we're starting with a ten month old, it's not going to be the same thing as a thirty year old. It's definitely um, so yeah, you can never start too late or never start too early. Um, you can be a newborn and exposed to early multiple ways of communicating like signs and pictures and speech and spoken language. So the, the systems or tools that you're choosing to use might vary. Then say an adult who might be literate and might want to use a written AAC as a communication. Um, and again, like, so if you were an aging adult with down syndrome who maybe didn't need AAC earlier in life, they might be looking for something to augment that communication as they're aging, um, just to support them. Um, and that again, might look like a different system than what you would have used, say, with a, like a symbol based system with a little child. Mhm. Yeah. And what kind of signs do you look for to think that like, oh, I think AAC could help in this in that situation? Are you looking at frustration levels? Are you looking at expanding vocabulary, accessing a visual learning system? What kind of things do you consider when debating yes. No on starting some AC. Mhm. So I'm going to kind of run through some some signs that I might look for kind of across the lifespan. So this one might sound a little silly, but getting a diagnosis of down syndrome is really get us thinking about multimodal communication from the get go, that this might be something we want to consider and look at those different options and have exposure to them really early on, um, co-occurring diagnoses, like I talked a little bit about them before. I'm a quiet child who isn't engaging in vocal play or babbling communication through concerning behaviors. So if a child is, um, behaviors are communication. So if a child is using behaviors that are challenging parents, um, or like, like, I don't know, Pulling hair or pushing like physical communication. Physical communication. Um, that's a good signal that we might want to support this child's communication because the tools they're having right now are not being as effective for them. So let's find some tools that will be more effective. Um, again, frustration and communication difficulty being understood by not just unfamiliar listeners, but also familiar listeners, um, noticing signs of isolation. So if they're starting to just withdraw, like we know they really enjoy being with people and connecting. So if we're noticing them doing the kind of the opposite, that might be a signal that there's something missing there that's helping them maintain those connections. So either there's a communication breakdown happening or it's just something. Yeah, something's just amiss for them, um, seeking more independence in the community. So again, as we're getting, transitioning into adulthood and wanting more independence, we might need some extra tools to support us. Um, and then as we age, we might acquire health concerns that impact our speech as well, that, um, aren't necessarily down syndrome related, but could be happening to someone with down syndrome. And again, aging and Alzheimer's would be another factor that we want to consider as maybe we need to supplement their communication with some other tools. Yeah. So yeah, lots of science, lots of things, lots of science and throughout the lifespan. So if you, you know, look at your child or the child that you support maybe in a school and you say, actually, I think they're engaged, they're able to communicate effectively with all the people around them. We don't need it right now. That doesn't mean you don't ask the same question next year or, you know, when they change from elementary to high school, etc.. These are questions we keep asking. And we also maybe need to keep adjusting their system that they do have to fit with their communication needs. Mhm. Yeah. It's ever evolving. It is. It is like anybody's communication. Yeah. Yeah, definitely. You know, we didn't all used to rely on text messages. Exactly. So you know, it just evolves. It evolves. Um, so Mary Alice, you use a C with your son and how did you decide, you know, that you were going to start doing that and when and kind of give us the picture, what did it look like? Yeah. So, um, we got a birth diagnosis and, um, you know, being that I am a speech therapist, I actually had quite a bit of knowledge around communication and down syndrome. So from the get go, I really wanted to make sure my child had exposure to lots of different communication modalities for a few different reasons. I wanted to support his communication development. Um, I wanted to give him options and see what he is drawn to. Um, I wanted to follow his lead, um, because I didn't know what his communication might look like as he gets older. I didn't know if he was developing, going to develop hearing loss. I don't know if he'd get a diagnosis of autism. So I just wanted to have kind of all the options on the table for us. Um, I also wanted my son to see that all modes of communication are worthy, have equal worth and um, yeah, get exposure to that at a really early age and put in an action myself and us as a family. Um, did you find that difficult? Um, because we tell people to do this all the time, but doing it in your own home, did you find it harder than expected? Yeah, sure. Definitely. Um, you know, it's one. Yeah, I'll be real. It was really challenging. Um, there's a lot of, you know, I, I kept thinking like, yes, as a therapist, this is what I recommend. And then here I am as a parent and trying to implement this. And, um, you know, that I think many parents can attest to that first year being really overwhelming. Um, because not only am I thinking about communication, I'm thinking about gross motor development, fine motor development, array of medical things that we are investigating or dealing with. So, um, our resources are parents are warranted in, um, in that first year. And then of course, just, um, you know, postpartum and everything else, all the baggage of that first year is a lot. So, um, I, it was really hard. It's intimidating. I think I had, um, ideals of what I thought my capacity was to do it and I had to keep myself in check and be kind to myself. And um, rather than think I was going to do it all, I might just, you know, start with this little piece at first and then kind of add something along and there'd be periods where I wouldn't be doing any because there was too many other things happening at once. But as you keep it going and kind of reintroduce it and keep up with it. It starts to become second nature. Mhm. And so it becomes less work and becomes enjoyable. And I think what was a big turning point too, is when your child actually starts engaging with you in a EC. Um, in the same way that like when we talk to our newborn child that we are expecting, we'll learn to talk because there's no other reason why they shouldn't be. Um, and then that moment where they start to actually like babble back to you or give you that they motivate you, they give you that feedback to keep going. Um, so, um, that was really powerful too when you start seeing it working. Like they're absorbing this information, they're understanding these different modalities and now they're using them. And that really kind of drives that motivation for a parent to keep going. Absolutely. And I think there's a secret point hidden in there, which is that you have to do quite a lot at the beginning before you can expect that your child is going to give it back to you. Yeah. In in responding. And, you know, just as we would with any little baby who we expect will be able to speak verbally without too much challenge. We talk to them for six, nine, twelve months before they're really responding and starting to use their first words. Right. So it's, it's kind of the same, right? And you there's this period of time in there where if you're using an AAC system where you might question and that would be understandable, like, is this working? You know, I've been doing this for a couple of months now and they're not doing it yet. Um, but that would be a normal part of development and learning. Mhm. Um, so let's talk specifically about the system or systems that you're using. So the choice between sort of high tech, low tech combination of them, one or the other is a really complex process, and we go through a lot of steps with the family. When we think about choosing something to start with, you know, what would work well for the family. So how did you go about choosing your early systems? What did you choose? And sort of why if you want to get into. So, um, the first one that I chose was supported sign. Sign supported speech. So using signs borrowed from American Sign Language to augment my speech, my communication with my son. Um, I picked that because it's unaided, so I didn't need extra things around. I could do it on the go. I could do it anywhere. I was, um, without having to remember to bring something with me. Um, a third arm to carry things when you already have the baby going. Yeah. That's a real concern because a lot of parents tell me like I have it, but I don't have it because it's not like attached to me. So yeah, yeah. I think another thing that's nice with the The sign language is. It's become a bit mainstream. Parents are just everyone's kind of picking up signs and using them. Everybody's doing it. So, um, I think in terms of comfort of other people seeing you using signs, there's just this general acceptance of like, oh yeah, this mum's just signing with her baby. So there's a little less kind of other factors to consider there. Um, and, and I also know that again, one of the strengths of children with down syndrome is that visual and kind of picking up gestures and that gestures emerge before our spoken language does. So I kind of really wanted to tap into that for him. Um, and it was also something easy to teach other family members and friends to use as well. Um, by bit the little, you know, oh, here's the sign for apple. And then, you know, if they don't remember it, not a huge deal, but then they can use it in that moment and it's approachable. Yeah. Um, other, so I there's a kind of three main AEC tools strategies that I used in the early days. Um, another one was, um, I had a pod book. So a pod book is a low tech aided communication device. Um, it's a pretty thick book, um, with about twelve pictures per page. And um, I am the voice. So I point to the pictures and speak the words or the phrases that I want to say. And I really wanted to, um, use this system with him because I wanted to get him exposure to a symbol based system. Um, I also thought that from using a symbol based system, he would also learn other skills like learning to point, um, learning to kind of attribute. Yeah. More gestures, attribute meaning to symbols. And um, it also really helped that he wasn't mobile. So it was kind of easier to kind of model on that. So I myself wanted to practice early on and kind of get the hang of it. Um, so that if we did need to continue on with this, he would already understand the goal and the purpose of the system and be have like the attachment to it. Um, I'm what was nice with a pod book is they have kind of themed pages, so I was often drawn towards doing some of those. So they have like the bubbles page and it had about twelve um symbol pictures, um, paired with that activity. So it would be words like big, more bubbles pop. Wow. Again. And so we would blow bubbles and I would kind of point use the pictures available to communicate ideas to him. And then, um, another one that I used was, uh, an aided, uh, device, Um, that I use as a transitional tool. So it's not something that I would continue to use with him. Mhm. Um, but this tool really helped kind of bridge that gap, that build that connection of like, not only can he receive messages, but now he has the power to send a message. So, um, what I use is called a big Mac and it's a, a big red button switch that you can press. And, um, what I would do is record a message in the Big Mac. And so when he presses it, it would speak that message. So you have an example of your son using. Yeah. And I think it would be easier. Yeah. It'd be easier to kind of explain it just by hearing it. Let's do it. So what you'll hear first in the video is, um, me reading a story with my son and I. The book is called Chicka Chicka Boom Boom. And what I recorded on the device is boom boom. So every time I would say chicka chicka. I would then wait and he would. Then he would boom. Press the button and go boom, boom. Um, so what you'll hear is me saying it first and then modeling to him. So I'm pressing the button so he kind of knows, oh, okay. When this button is pushed, it says that word, and then the rest of the video is him actually activating the switch. And then you'll notice at one point he accidentally makes it activate at the wrong time, and then he gets really excited and starts just pressing the button and we just go with it. And then we continue. So, but yeah, the video really kind of showcases the use of that device. All right, let's hear it. Chicka chicka. Boom boom. Boom boom boom boom. A told B and B told C. I'll meet you up top of the coconut tree. We said d to e f g. I'll beat you to the top of the coconut tree. Chicka chicka boom boom. Will there be enough room? Here comes H up the coconut tree and I and J and Tagalong K all on their way up the coconut tree. Chicka chicka boom boom. Will there be enough room? Boom boom boom boom boom boom. Look who's coming. L m n o p and q r s and t u v still more w and x y z. The whole alphabet up there. Oh, no. Chicka chicka. Boom boom. Okay. That was gorgeous. I loved it. Um, that was wonderful. And, oh, there's. I could talk about that all day. Um, there was such beautiful anticipation there. He knew where his spot was. Yeah. He got to participate. It was awesome. That was a favorite book of his. So he knew that book by heart already. So he knew what was coming. Um. Mhm. And that him using that, um, well, it came at a time where he was not yet using any gestures, spoken word signs. Um, but I knew he had so much he wanted to communicate, but he wasn't yet kind of sending intentional messages to me. And this like was like an aha moment for him. That was our first time using it. And, um, yeah, it was just like, yeah, really cool to see bridging that gap for him. I feel like the smile that he had basically comes through in the audio. You're like, yeah, I was Delighted that he was getting his message across. Oh, that was so wonderful. Um, one of the things that you did, which I think is super important to point out for families, is that not only did you try multiple things at once, and that's okay to try. If you feel like you have the energy to do that kind of thing, but also that you're picking specific activities, you know, the pod book goes really well with the bubbles activity. There's no pressure to, okay, this is it, and we're going to carry it around all day. And we're going to do pointing out symbols all day from the get go because that amount of pressure is huge. Um, so starting in the right moment with the right dose is it's okay, it's okay to do that. Um, did you, you talked a little bit about finding what was the right amount for you? Um, how did, how did that go? Did you sometimes do it a little bit more and other times a bit less depending on because you know, kids with down syndrome are also they have a lot of other health things, so they're not always feeling well enough to jump on board with trying out new things either. Definitely. It definitely had. I had many things going at once and it was definitely a lot and overwhelming at times. Um, and what I ended up currently what we're really focusing on is sign supported speech, because he's now using gestures and has really picked up on that. And so I'm following his lead. This is really our most effective and efficient communication that we have. Mhm. Um, the switch we use sometimes for fun. So I think I really like that you brought up the how I chose specific activities to do it. And I really focused on the activities being fun and about connection, not about teaching words and language. To him, it was about building connection and having this tool to kind of support fostering that connection with him. Um, I really wanted to focus not on like business talk like. Come here. Stop. Wait, I wanted to yeah, I want to do things like boom, boom and stinky and like, sit on a whoopee cushion and like, have that say switch, say stinky. Yeah. Um, making it fun. Um, that being said, um, when it came to building signs into my day, I really focused on routines. Um, so for example, I had about a list of signs that I would use every time I did diaper change routine. So it would be like change dry, wet diaper, all done stinky poopy. I would sign these things during that routine. Now, those are not necessarily the most exciting words for him to want to express back to me, but what he got in those routines is a mom who was practicing using her signs that happened multiple times a day, so I got more used to it. They were predictable. So he kind of learnt to understand what those words meant. And then I would take those signs that were maybe less fun in that context and bring them in a fun context. So I would read opposites book and we would do wet and dry or do stinky on a whoopee cushion. So all done at every time we're done reading our books. So I would pull those less exciting signs in that routine and then kind of have them fit in into fun activities with him. And you're building this sort of what we call like sound symbol correspondence or visual audio correspondence. So that when I hear this, it means this and they're actually the same thing. And that's an important skill. One of the fundamental skills of using AC takes a long time sometimes to learn that skill. So consistency, it's very helpful. And I also, even though like I already had like a base knowledge of science, I still used reminders. Like I would have like a sticky note by my diaper changing pad and being like signs like think about your size or like having them in the bathroom or a dinner time for meal time routine or bath time routine. So I still benefited from having visual supports for me to help cue me, remind me to kind of use my signs. Mhm. Mhm. Um, do you have any examples about so you gave us a beautiful example of your son using a C at home, but what about at school? Because there's a huge role for a C in school as well. And can you talk a little bit about how that can fit in? Mhm. Um, here is where I might also ask Riley to join in. This is one of my questions. I was like, Riley can help me with this one. Riley. Do you have anything you want to say first? Um, I feel kind of stunned by this one because it's such a daunting. I know it's a whole episode on its own. Yeah. And still in daycare, so is still in daycare. And I've never worked in this school. So I have very like this like narrow minded like in home arc use. Um, but Riley and I briefly talked about it, so maybe Riley would just like briefly have a little chat. Yeah, absolutely. Yeah. Because we do deal with, um, uh, lots of schools and school teams and, uh, trying to help, you know, the school teams incorporate a student's arc during their day. So, you know, it's something that we do work on here at the Dzf. Um, so what we try to do is really encourage, like, you know, both the families and the schools to think of the students kind of larger communication and participation goals first. So think about, you know, similar to what you said about, um, you know, where the student might be struggling to send their messages clearly and effectively, like how are they struggling to or when are they struggling to participate fully in activities at school or when is there communication? Um, just not meeting all of their needs during the day and, and thinking of Arc as a strategy to help them meet those larger communication goals rather than, you know, kind of the other way around where you think primarily of, hey, we're using this arc, we're, you know, we're focusing on this like, no, we're still focusing on the student, the individual and their participation in, in class with their peers. Um, you know, just as one example, uh, lots of school teams and families as well are thinking about, um, kind of enhancing, uh, social communication skills. It tends to be a really common goal that we see. So social communication skills and also just social participation overall. So being able to interact with peers and take turns with peers and, um, you know, like conversational terms and things like that. So, um, you know, we might set up activities where, uh, you know, students pick a kind of shared interest activities and then maybe the supporter, like an EA or somebody can help them, you know, model how to navigate to the page that includes that vocabulary. So if it's something like a pod book like Morelli's and Loic used, you know, let's navigate to that page with that activity we both enjoy. Or if it's a higher tech device, you know, finding that vocabulary page and, and let the students, um, you know, have their interaction. Luckily, because they're most systems are picture based, the students who don't have down syndrome can also quickly figure out, you know, what the buttons mean and you know, what messages might be in there. So you can let the students model, um, as well and, and see where that interaction goes. Um, another fun way that it can be incorporated. Um, you know, lots of devices, especially the higher tech devices allow for pictures, like photos to be added and also kind of some longer messages too. So there's lots of opportunities for building things like presentation skills or, you know, talking about my family or things that I've done before. By, you know, kind of really harnessing the technology that a student might have to enhance their ability to, to stay more than they might be able to in like a presentation situation on their own or sharing situation. Um, so yeah, lots, lots of fun ideas. Mhm. And when in doubt, snack on it is kind of my, my motto, which is like, you don't have to go on your first day and use it all day, just little bit by bit, try and include it. Um, keeping in mind your student's goal, right? So that's why we're, that's why we're using this. That's why we're aiming in that direction. They want to communicate more with peers. So that's going to be when we're going to snack on this device and try it out is in those moments where it could help our student reach their communication goals. So many parents sort of have told me that they they have a system and for some reason it's not working for them or they're not using it. And a lot of times when it comes down to it seems to be is that it's intimidating and they don't want to do it wrong. Sort of in my air quotes on on audio. Um, have you either of you run across this same sort of phenomenon, which is like, I don't want to, you know, especially with some of the iPad stuff, they're like afraid of either breaking the app or accidentally deleting things or maybe, you know, they can't find the word that they're looking for. And that could feel embarrassing or just overall stressful and intimidating. So it doesn't come out and it doesn't get used. Um, has this happened to you guys? Yes, yes, this has definitely happened. This has happened with me too, where I felt limited by, by the pod book. And I was like, ah, like I, but I want to say this, but this is what I have. And then I feel like I'm fumbling around trying to find what I actually want to say. And then I feel like I lost that connection. So there's a real, real worries. And like it is, it is definitely intimidating. So I think, um, the first thing would be, again, I'm happy that parents are approaching their therapists and airing these, these frustrations, these concerns that they're having, and not just like shelving the device, um, and expressing like something is just, just not working for me, um, and validating their feelings. So as a therapist, I really want to validate where they're coming from. This is so foreign and new and a whole new way to communicate. But I think it's also important to take time to unclamp what it means by doing it wrong and what is intimidating, because there could be several unsolved problems or emotions attached to that, um, that we really need to kind of lay out. Um, and kind of prioritize which ones will be most helpful to problem solve together to kind of get to solutions. And Marla, you touched on this earlier on, but helping to identify realistic goals and expectations, which will vary. Yeah. Which will vary from parent to parent. Um, so we're all going to make mistakes. Um, but that's actually the beauty of using a C is making mistakes and using the a C to like talk about the fact that I made a mistake. Oops. I pressed the wrong button. And you can show your child how to correct and erase and go back and try again. Or search for a word like I can't find what I'm saying. Maybe if I look here. So you're actually teaching your child lots of important functions of using an AAC device, which is navigating it, figuring out, um, how to delete, how to go back to the home page. Um, so you're actually go through your mistakes teaching really valuable lessons to yourself, how to navigate the device and to your child, how to do that as well when they're learning. Um, and we want our students to feel empowered to be able to make mistakes as well when they're trying it out and feel confident that if they, if a mistake happens and they do that, I know how to fix this. You know, I can delete it, I can start over. And, you know, it's not a problem to have that issue. Um, and that's, that's hugely important because otherwise our students don't want to use it either if they're expected to be perfect at it. I often talk to parents here about the importance of building what we call operational competence, which is that, you know, navigating, turning it on, oh, it's not loud enough. Turn up the volume. And, you know, as you say while you're learning it, you're being the teacher for those operational functions that we hope that the student will over time, learn to so that they can be truly independent using their advice at their device. So it's certainly, um, you know, take it all as a learning moment and, and, and be that good model because we're not just modeling language. We're modeling the AAC device as a system. And then also that strategic competence, which is, you know, my, as robust as the system might be, I might have, you know, a few thousand words, but it's still never going to be all the words that a person might want to say. So how can I still send that message or get that message across with the limited words I have? An example I sometimes give is, is like, you know, you want a cookie, but you really want like an Oreo cookie, but Oreo isn't in your device. So, you know, can we find the word cookie? And then maybe add like the words black and white or something like that so that, you know, we can still send the message, which is the most important thing even if the specific vocabulary is missing. That's what I love of AEC is this ability to be, to think outside the box and get so creative and thinking of like new and fun ways to say the same thing, but in a, in a C language. Um, one of the things that I like to do is and this and kind of falls into this question is let parents take time exploring the device or the size of the symbol books on their own time without the pressure of like trying to connect and build that interaction with your child. Do it with your, your spouse or a friend. Um, and also turn your voice off and really shift your lens from expressing yourself through speech and to expressing yourself through AAC. Um, it's just a really powerful, it's a, it's a, it's a different language modality. Um, and so it needs to be approached that way doing, trying to like think speech and EC at the same time takes a lot of our energy. Um, so yeah, just sometimes shifting and really seeing how could I say this without my words? Um, is kind of a fun exercise to do. Yeah. That being said, one of the things that I sometimes will we'll recommend to adults who feel like they're making too many mistakes is to say out loud what you're doing and what you're looking for, so that you don't feel pressured by this awkward pause because you're teaching in that moment, like, oh, there's no sound, and then you're monkeying around looking for the volume button or like, where is that word? And so you're taking it from like a silent pause where the pressure is increasing on you and you're like, I can't find it to making it something that like the student can see, oh, this is what we're doing. We're problem solving right now. And that makes it a learning moment for both of you instead of a panicked moment just for the hour. Yeah, definitely. I also like to kind of help parents track their achievements, big or small and the achievement, like it's not a sprint, it's a marathon. Like the, um, the big ultimate goal of using arc independently. Like there's a lot of little steps. And as parents raising children with down syndrome. We're really good at celebrating our children's inch stones to get to those bigger milestones, like we see all these little intricate steps to get to those bigger milestones, and we celebrate them big. And so we should give ourselves the same grace and celebrate our own little inch stone. So it could be maybe my goal is simply to like, carry the device with me everywhere, not even turn it on. It could be like I brought it to the store. I brought it to the bathroom. I placed it in a way that we could see it. And that could be your starting point, is just knowing how to use your device, like bring your device around and have it be visible. And then it could be okay. I turn it on and we just had the screen on. So me and my child can just see that front screen while we're doing an activity and kind of just really slowly build up on your skills and your confidence with that device. Um, without it being the end goal of I'm communicating everything on this device with my child. Right? And the biggest barrier is usually getting it out of the bag. Yeah, really is just having it in the room where people know that it's there and people can see it. Um, so that is a huge, it's a huge deal to get past that first big sort of jump. And so that it's with you. Um, so that is a valid goal. That's a, that's an important thing to start with. Um, another one that I encourage is, um, joining, joining some Facebook groups. So, um, joining ABC parent Facebook groups where you'll have new parents who are just starting to explore this. And then seasoned parents who have a child who is beginning to be not just an emergent ABC user, but like, um, an independent ABC user and learn from their experiences. They're so helpful at helping you troubleshoot devices. Any questions you might have? Um, I've learned so much from those groups. Um, and these groups have a lot of them also have professionals in there that kind of give that professional lens. Um, but parents have so much knowledge that they gain. And then another one is seeking um, groups of AAC users, because they also come with a wealth of lived experience using AAC and troubleshooting their devices and figuring out how to say certain things, um, a certain way and how to organize your folders. Like everyone eventually modifies them in their own way. Um, yeah. So yeah, there's, there's a lot of supports out there to help. This runs right into Hannah's next question. Well, actually, before I kind of jump into my question, I also being the OT listening to you fabulous SLPs talk, I'm learning so much, but I'm also seeing a really big opportunity for collaboration as well, because so many of our kiddos with down syndrome are seeing multiple therapists. So, you know, at the DSF, we have teachers, we have the OTS. And, um, and I think I personally love when a shared client of ours is using an AEC and I say, please bring the iPad in or whatever system it is a core board, whatever, because I want to use it as well. Because why should the communication practice only stop at the SLB session? Right? Like it needs to be consistent across environments. But for the OTS at least I can speak to that listening out there. There's so many things that we could work on to help improve AAC usage as well. Like, you know, working on visual tracking, working on targeting some of the fine motor stuff, some of the color recognition. So I know that Riley and I shared a client where she was having a really hard time even looking at an AAC page. So we, I blew up like three or four. I want symbols on the wall. And we practice her, you know, tracking and targeting the symbols. So there's a really great opportunity for helping build those foundational skills. But then also we need to welcome these devices into our sessions. Um, and when you guys were talking about making it successful in the school, unfortunately, there's have been many, many instances where I've heard EA say it's too hard for us to use, so we're not going to use it literally like so. To me, that seems some form of like a human rights violation. I'm like, this is this person's ability to communicate and you're taking it away from them. So I love how you have broken it down in a way where it really does seem manageable, not only for parents, I'm sure, but even for us professionals that are like, okay, I actually can just have it in the room, you know, build one activity around it or so many different ways. So I do love that that you had that idea to do that. So yeah, yeah. Um, okay. So throughout this episode, you've shared so many great ways, um, of how to make an, a C system successful. Can we, let's kind of maybe summarize for our listeners. So some, some of your top, you can make it a top five or top three tips for those listening out there in how we can help make an AAC system successful for a student and their family. Yeah. Um, I think a big piece for us is to shift our lens on how we perceive AEC and to really embrace it, um, and to not see it as a barrier, but rather opening doors for our children. Um, and so yeah, I think that's the biggest kind of foundational thing. We really want to shift our lens on AEC. I think another one is having fun with it. So even if you're not using it throughout the day, all day long, find an activity that's enjoyable for your child. If it's reading a book, if it's singing a song, if it's having a snack and pick a few words that you can model like, like I did for my Big Mac switch, I had like different songs, different books. I would record a particular message in and use it that way. Um, so yeah, have fun. Use it to foster connection, um, model without expectation. So what I mean by that is, Um, let's, uh, model without expectation. I want parents to use the devices to connect to model language on it without asking them, their child, to copy what they said or like making it like this teaching tool of like, okay, now you taught them. Yeah, don't test them. Don't make them work for something. Because then you lose the fun in communication. Um, we just want to model language and they will then follow our lead because we made it fun and enjoyable and they'll see the power of it. Yeah. Um, yeah. And, um, don't reinvent the wheel. There are people, professionals who are out there building these systems for you, who have put a lot of time and energy and research into setting up systems. Um, so use what is already made. Um, your therapist will have access to lots of these tools. Um, and then you can modify to fit your needs from there. So don't feel like you need to kind of make your own page sets all the time. Um, there are tons of systems already out there to match with you and your child's needs. So that's a really big one. Um, and don't forget to honor all modes of communication. So even though you might be focusing on modeling a say on an iPad or signs that your child may prefer in a particular context to say more or sign more rather than say, more on the device because it's more effective and efficient for them. And so let's just honor all the different ways that we can communicate and not just insist in a particular modality for them. Mhm. Yeah, I fully agree. Four hundred percent with everything Maria Lee said. Uh, but the only one I would add is to really think about investing the time in communication partner training. So that includes like parents and also, um, you know, trying to think about those Communication networks that Morales mentioned and who is going to be your child's. Um, like most important or more frequent, um, communication partners who are going to help them learn the system and be modeling for them and be interpreting what they say. And can we all, like, team up and get together and talk about, uh, some of the strategies and, you know, some of the background and, you know, and things like that. I think that's a huge reason why, um, you know, we have some of those problems that Hannah mentioned where, uh, teams will, uh, really doubt or give up on or just feel defeated by the introduction of an a C system because they just don't have the specific training or background information that they need. And, you know, it does take, it does take time and it takes resources and it takes our attention and a lot of planning. But if we can do it, um, you know, in the beginning and, and kind of front load ourselves with that knowledge. You know, the kids are off to the races and and it can be a lot more successful and people feel a lot more confident. And like having observed you guys work at the DSO, if you guys go through multiple different testing periods of different systems. So it doesn't always have to be just, you know, the one and done. Like I've seen Riley and I share a client where you're going to two or three different things to try out what works best for the client, but also something that would, you know, help the families be more independent and more on board. Right? Yeah, yeah. Another thing I want to add, um, that kind of ties into what Riley was just saying is oftentimes people ask us like, well, what skills does a person need to start a, E, C? And there are no prerequisites to learning. AEC what makes someone a successful AEC user or learner is all those things Riley just mentioned. So finding the best match to meet that person's communication needs. Communication partners dedicated to modeling their AEC communication partners focused on connection and interaction with AEC and communication partners who presume potential to learn AEC. And really, that might seem like a daunting task for all the people in that person's life. But those are all intuitive things that we all know to do. This is all how we learn language. So you could take AEC out of those four points and add English or whatever is your home language. And these are all the ingredients that we needed to be where we are today when we're speaking our languages and have mastered them and become autonomous communicators. So we intuitively know how to teach language. Um, and so it's the same with AEC. There's no prereqs we just need dedicated communication partners. And yes, there are skills to develop because AEC is different. Um, and not familiar to everyone, but it's the, it's just opens up all these doors. And, you know, there's one side thing that I want to bring up, which is There certainly are floating around on the internet sort of unrealistic stories, anecdotes from families who say, you know, I just had my computer and one day my child, who never said anything before, sat down and wrote a novel. Um, and what can happen in my experience is families will read a couple of these and say, okay, we're getting this a system, a system, exactly this one. And I'm just going to leave it in front of my kid and then they're going to write a novel. And that is not our expectation as SLPs that that would happen ever. Um, that doesn't follow how language develops and how communication develops. So if it takes longer, that doesn't mean that anybody's failed at learning to use an AAC system or incorporate it in their life. Um, I guess I'm saying be wary of these sort of stories that are floating around that, you know, if you pay money, there's always money, pay money to, you know, get this or that or something that it's going to be sort of the magical fix and your child's going to start using that exclusively and fluently overnight. That doesn't happen in my clinical ever. I don't know about yours. Maybe you've had that, but I've never seen it. No. You know, there's a lot of kind of snake oil buyer beware situations. Yeah. Um, so before you shell out a lot of money on a system, I would talk to somebody and make realistic goals. Yeah. Yeah. Those stories don't always share the full picture. Mhm. Always. Right. No. Yeah. Yeah. What that person's journey was. Yeah, exactly. Um, so on the flip side of all this, all these great things to kind of keep in mind to help make it successful, what are some of the common mistakes in your experiences that people make when trying to implement AEC and something that they can try to avoid? Mhm. Um, I guess I feel like I kind of touched some of those. Reinventing the wheel don't reinvent the wheel. Um, modeling with expectations. So really insisting that this is the best way and quickest way we're going to learn is by you like, doing what I just did and insisting on it. Um, really think of it as not a sprint, but a marathon. We're on a long journey together, just like we were learning language ourselves. Um, took us many, many, many months of our parents talking to us to get to where we are, um, making it, uh, feel like work. So keeping it authentic fun, um, focused on connection and, uh, um, and interactions, um, giving up too soon. Honestly, I think that would be one of the biggest ones and is, um, giving up too soon and thinking that your child is just not interested. Um, we got to explore that a bit more and spend more time. Yeah. Yeah. Um, a wise SLP friend of mine told me when Loic was born, um, she said, oh, look at you. You are like, been freed of milestones and societal expectations. You get to just do what you want and let Loic be who he will be. And, um, somehow this is really freeing that you could just journey how you want and learn language, how you want. And I think that was like, although a hard piece of advice to take at first. Yeah. I'm like, wait a minute. What do you mean? But also really freeing to see that we are on our own journey and our own path, and we can do it however we want. Um, and AEC fits perfectly in on that journey for us. Yeah. I think also maybe add thinking that one way will work for you the whole time. So a lot of families start using sign at home, which works really well in the home. Um, maybe with some friends and at daycare, but over time, not everyone is going to be familiar with your signs. And it would be amazing if we lived in a world where everyone was just picking up sign language. In fact, when you mentioned, um, your question around like, what would be something you'd want the whole world to know? One of my thoughts was like, everyone should know American or not just American Sign Language, but a sign language. Yeah. Because how amazing would that be? Access for everyone. Um, so yeah, kind of think about that. That would be like this ideal world of mine, but we might have to be rethinking when we're entering school. Depending where you're located, you may not have access to ese who have signing experience. So you may want to reevaluate what your AAC systems are for entering school. And a symbol based one can be fantastic because it is a bit more universal. The device speaks for you or the symbols have the words written on it as well. So, um, everyone can kind of understand what it is. I want to point out really, really importantly, that if you do change systems from sign to something simple base, picture, symbol, it was not a waste. It was not. You did not waste your time in learning sign at all because your child learned language, which is the underlying thing more so than the hand movements. It's how to put words together. What do words mean? And that they take with them the next system. And they can still use their signs in that home context or, you know, in the context where it is effective and efficient for them. Um, it doesn't have to be let go and put to the side and off we go. We don't sign anymore. Um, and there's also kind of a, you can use it as a transitional tool as well to once you're, until you're established with a new system. Um. Yeah. Yeah. I also add one more common mistake. Yeah. I think, um, and this is kind of a PSA to anybody who has a higher tech device at home right now is to back it up because it's really discouraging when. When your system that you've developed over time gets accidentally deleted or the iPad, you know, goes for a bath or something. So, you know, learn to back it up and make that a part of your routine. Yeah. So important. Um, when, when you were talking about, you know, like you would love for everyone to learn, um, some form of sign language, which just kind of brought me to, um, during an IEP meeting, a parent once said that, you know, the onus shouldn't always be on her child to communicate the way the rest of the class wants. Like they, so this is, um, a fabulous school with an awesome resource teacher who then said, well, we're going to teach our other students that do not have down syndrome how to communicate using sign language is also they just made it a whole like course of like, okay, everyone is like a grade, I think grade four or five or whatever, but everyone's going to learn ASL. So yeah. Like, why does it, why can we also not, you know, teach everyone else if we're going towards more inclusive education, then these kind of things need to be thought of as well, that it can't always be on, on the shoulders of the person with down syndrome to do all the work, to communicate. If we can somehow meet them halfway as well. Yeah, I know the change doesn't have to fall on the disabled individuals and needs to be shift that from like, oh, you can't talk. Therefore, we need you to learn all these new things and learn how to talk because this is how we're going to do it. It's really change should be on the shoulders of the community. Society really to adapt and change and be inclusive of everyone. Yeah. Awesome. Um, so with all three brilliant SLP minds here, do you have any resources you would like to share with our parents? Because I'm sure there's, you know, a multitude of apps for AC. There's lots of different books out there. Articles, blogs. Um, Marie Alice, would you like to start and let us. Yes. So many resources to share. Um, I first want to draw attention to families that twice a year, um, there are sales on apps that go on sale in October for eco awareness month. There's a bunch of sales and then in April there's Autism Awareness Month and all the apps go on sale as well. So that's kind of a nice time to keep in mind if you're thinking about getting an app. And I know they're pretty expensive, um, but to kind of purchase them twice throughout the year, this is when they come around. Um, maybe ask first. Yes, yes. Um, if you have an SLP on your team, check in with them before you spend your money on something that might not be a super awesome fit, because there are lots and lots and lots of apps to choose from. And they don't, they're not all the same. Yes. So have a little check in. Have maybe multiple chats. And a lot of times SLPs have the apps already. So you can see and try before you buy. That is good. Yeah. I love that. So you try before you buy. Um, another one that I really love is following the Arc coach on Instagram or Facebook. She's an SLP dedicated to supporting therapists and parents on their journey to Arc. And she has like the most amazing visuals that. Yeah. Inform parents so clearly and precisely. Um, couple of Facebook groups. So arc through motivate model and move out of the way is one that has therapists, teachers, e s parents. Um, it's just like this wealth of information. Isn't that Kate Ahern? Aaron. Yeah. I'm not quite sure how you pronounce her last name, but yeah, she is. Yeah. The moderator of that group. Um, another one that I like on Facebook and Instagram is we speak pod. So spot pod is a cymbals Paiste cymbals based communication device. And um, this is a family who uses pod with, they have several children with different types of disabilities and they use pod in their home. And she makes these wonderful videos of how she models pod. She shows videos of them making mistakes and going all wrong and kind of what she learned from them. Um, so I've learned a lot from watching her videos. Um, this was a recommendation from Riley to me and I was so thrilled to have found pod. Um, another one that I, uh, encourage is ask me, I'm an AAC user. It's a Facebook group where you can go and learn and listen from AAC users. So you can ask a question. But I, I generally would encourage families just to go and listen and maybe search. If you have a question, search in the bar to see if someone else has asked this question first and really listen and read the comments. Read the questions to get a feel of the group and the perspective that they're coming from. Um, they share lots of resources to go and follow and, uh, yeah, learn some more about arc and implementation. Um, and a lot about advocacy around Arc. Um, what else? So many assistive wear is a wonderful website that has wonderful webinars to help ease teachers, um, daycare providers, parents, um, where they go through what is modeling and how to model, um, what is programming? How can we program things into your device? Um, how can you implement it in a lesson? Um, which is like, yeah, just a wonderful resource. They have also lots of core boards, which are, um, symbol boards that you can use a particular type of vocabulary, core vocabulary that you can print and use in your classroom that are free for those who are wanting to venture more into sign supported speech. Um, there's tons of resources, but I really love signing time and really following, um, even Rachel Coleman, who is the creator of Signing Time, listening to some of her, um, presentations that she does because she, she's very about inclusive signing. So her daughter was born deaf and so she said, well, then everyone's going to have to learn signs. So she went in the daycare and taught everyone sign and went to the soccer field and taught the families and the children's signs. So for her, this was her child's modality. This is how she was born. And she really wanted just everyone to accept that and learn alongside them. So yeah, I think she's her stories are really motivating and inspiring. And then the product she created, signing Time is fantastic. But anyway, that's a few of many that I could list that I think are important to share. Yeah, I also enjoy those resources. And one other that I'll add is that if you're, you know, trying out a system, especially a higher tech system and you're feeling stumped, um, and you don't have your, a, your SLP, AAC specialist living next door to ask, try the company's website. They have a lot of free video resources or step by step guides for problem solving or, or figuring out how to do some of those things. So if you're not sure how to like add a button or delete something or you deleted something by accident, um, a lot of people don't know that you can basically Google it and often find a step by step guide and that's really helpful. And, um, you know, you can learn to learn to do it all yourself. Yeah. A lot of them have trouble now. Yeah. And a lot of them have Facebook groups too, that you can be like, this is the touch chat Facebook group, and you can go in and then just get users. And there's usually a moderator who's like a tech of touch chat. Um, so yeah, most of most programs have kind of their own group to where you can seek advice, get feedback right away on the weekend, at midnight when something happened, you're not going to see your therapist for another week. Um, yeah. Mhm. Awesome. Well, thank you so much for sharing those great resources. So we will have them on our episode page. Um, so everyone can have a look at that. Um, Maria and Riley, we want to thank you so much. I learned a lot today. Uh, I know this is like old hat to you guys, but I think lots of people that are listening are gonna learn and hopefully become a little bit more, you know, a little less stressed about going into the AEC journey. So thank you so much for, for joining us today. You're welcome. Thank you for having me. Thank you so much. Thanks for coming.