Assistive, Augmentative, Alternative: Talking Tech with Jennifer Kraft (Part I)

ABA on Tap is proud to present Jennifer Kraft (Part 1 of 2):

AAC is everywhere right now, but too many people still treat it like a gadget instead of a voice. Mike and Dan sit down with Jennifer Kraft, a longtime special educator, assistive technology specialist, and BCBA, about what actually makes augmentative and alternative communication work in the real world and what goes wrong when devices get handed out without true assessment, training, or follow-through.

Jennifer shares a career journey that spans early intervention, life skills classrooms, ed tech facilitation, and behavioral health leadership in Pennsylvania’s evolving system (BHRS to IBHS). Along the way, she gets candid about the ethical pressure points in agency life, what it feels like to walk into a broken organization, and why protecting clients and clinicians sometimes means refusing to play along. That path ultimately leads her to launch her own practice, Krafted Care, and push through licensing and Medicaid barriers that can delay autism services for months.

Then we dig into practical AAC best practices: why AAC does not take away speech, how it can serve as a backup during stress or motor planning challenges, and why modeling matters more than “handing over the device.” We also cover device fit, customizing pages for real routines, separating entertainment screen time from the AAC system, and the nonnegotiable need for constant access and a charged battery.

If you care about ethical ABA, assistive technology, or helping kids and adults communicate with dignity, hit play. Subscribe, share this with your team, and leave a review with your biggest AAC question.

Transcript

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Welcome And Meet Jen Kraft

SPEAKER_01 0:01

Welcome to ABA on Tap.

SPEAKER_02 0:12

I'm Mike Rebio with Dan Lowry.

SPEAKER_01 0:26

So without further ado, sit back, relax, and always analyze responsibly.

SPEAKER_02 0:32

All right, all right. Welcome back to yet another installment of ABA on tap. I am your ever-grateful co-host, Mike Rubio. Always to my right side, Mr. Dan Lowry. Mr. Dan, second game, second part of a doubleheader. You ready for this?

SPEAKER_03 0:48

Ready for it. Excited. Excited to talk to Jencraft.

SPEAKER_02 0:51

Yeah, our guest today. You gave it away.

SPEAKER_03 0:54

Oh. Oops. That's okay.

SPEAKER_02 0:56

Spoiler alert. That's okay. Somebody who comes to us with a wealth of experience, speaks the language we like to speak in terms of assent-based approaches, taking the child's lead. Somebody who delivers services where it may not be very easy to deliver services. We always like talking to those folks in terms of their creativity and dedication to really get the job done, which sometimes is quite a logistical feat. So, although Dan's already given it away, without further ado, our special guest today is Jen Kraft. Jen, thank you so much for your time on a lovely Sunday. I don't know what the weather is like for you, but we'll get you back to your sunset. I guarantee that, and this will be over before you know it. How are you doing today?

SPEAKER_06 1:49

Doing well. Thank you for having me.

SPEAKER_02 1:51

You're very welcome. Thank you again for spending time with us. The usual format here is this is where we pass it right over to our guests and let them give us the origin story. Uh was it Lupe Casanierov recently said, How far back do you want me to go? We were like, go way back. He went back to elementary school and familial experiences he had, which have shaped his career. So if you have that question, Jen, go back as far as you like. The idea here is to give us all those experiences that have led you to where you are now. We find that everybody's got some relationship from the beginning to the current. So without further ado, tell us where it all started for you.

SPEAKER_06 2:26

Well,

Finding Autism Through Special Education

SPEAKER_06 2:27

my mom was a teacher. Um, she taught elementary school. She started in sixth grade and moved to fourth grade, where she taught for over 30 years in the same grade. And when it came time for me to decide what I was gonna do, I had made the decision to do a major in elementary and special ed. I had an excellent elementary education program that had all of our placements and observations done for us, but we had to get our own observations for special ed until our year block. And at that time, in her building, they had what was called a gateway class, and the gateway class was what we would call a multi-disability class or a life skills classroom today, and it was the first of its kind in our county. And I obviously did some observations in some of the learning disability classrooms, but she had said, I think you really need to observe this gateway classroom because it's different, and you might end up with some of these types of kids. So she talked to the teacher, and the teacher, of course, was like, Yeah, send her in, she can come and observe. And in that classroom, there was a young man with autism, a young man with fragilex, a little girl with downs, and a little boy with cerebral palsy and a seizure disorder. So it was a very small classroom, they all had paraprofessionals. The teacher was really great with them, and it was a really interesting experience because it was the first time I saw autism.

SPEAKER_03 4:20

Okay.

SPEAKER_06 4:20

Um it's it was that was something new to me, and I I just was enthralled. I don't know, maybe that's a bad way to say it, but I was intrigued. I they had me hooked, and the the teacher was there was actually another student that she also had cerebral palsy, she was nonverbal, and she's important in my story because later that teacher was getting some devices, and she got an eye gaze system that she was going to try and calibrate for that young girl, and she invited me to be part of it, the testing, and that of course really hooked me. I had always been involved in technology, and you know, I went to elementary school in the days of the Commodore 64, the Commodore 128, and you know, basic programming and all of that. So seeing technology used in this different way, um it just really spoke to me. So I really leaned more into the special ed part of my dual degree. And when I graduated, I accepted a position as an early intervention teacher. So I started right away. I actually started in my classroom that I would take over as a paraprofessional until my certification came from the state. So I, you know, right away. And when it was time to start looking at master's programs, my mom had said, I think you need to get your master's in technology because Wilkes University had this technology program. She's like, the IUs, I'll teach it, you can go, that they'll pay for it, and it you'll just breeze through it because the content that they teach is all stuff that you know. And of course, me being me, who needs to have a challenge, I was like, I'll get my master's technology, but I'm gonna do it a different way. So I started looking into assistive technology programs, okay, and I found one at Johns Hopkins. Oh wow, and I have to say that it was one of the best things that I did. The things that we did, the things that we learned, there were so few of us in the program, and it was just really enlightening to see what was out there, and again, you know, this was 25 years ago, so the devices were the big clunky Dyno Boxes that were I remember static display, maybe still, you know, $25,000, pay weight, sure pounds, you know, and to see where they've come now is really amazing. So my first real life job was teaching three to five year olds in York, which is a small city in Pennsylvania, and was this funded through the uh school district? It was the intermediate unit. So I how do I explain an intermediate unit? The intermediate units are primarily county.

SPEAKER_03 7:58

Okay. In Sandy, in California, we have things called regional centers, it might be very similar to that.

SPEAKER_06 8:03

I would think it's like that. In New York, it's similar to what the Bose's.

SPEAKER_03 8:07

Okay, okay.

SPEAKER_06 8:09

So yeah. So I was my classroom was through the IU, but we were off-site in a church. So I it was a four-day a week program. Primarily, we would see the kids two to four days, and then we had what was called family involvement time, and they were it was half day sessions, so they either came in the morning or the afternoon, and then we would have to do a certain number of hours of family involvement, going out to their houses, having programs for them, or those types of things. And then our we went later in the school year, started earlier in August and had the ESY program. So it was kind of a like year-round.

SPEAKER_03 8:54

Okay.

SPEAKER_06 8:55

Have weeks off when regular schools would be in. So, like at Christmas, we'd have two weeks, we'd have a week off at President's Day, we'd have a week off kinds of things. So it was a really, really nice schedule. But once I got my master's, I decided that I wanted to kind of do something with it. And I started looking for something technology related, and I ended up at Kennedy Krieger, which is affiliated with Johns Hopkins, and they have a lot of autism-related things. But I didn't work with the autism programs, I worked at the high school, and I was the education technology facilitator. So, in that position, it was kind of a professional development role. So I would work with the teachers and integrate technology into their classrooms. I did a little bit of assistive technology, but there was an assistive technology person. I taught a keyboarding class to kids with traumatic brain injury. Oh, so had AAC devices, some of them were only one-handed typers. So that was really interesting to try and figure out how to do

Assistive Tech Training And Career Turns

SPEAKER_06 10:13

that. I taught a yearbook class, it was it was a really great experience. I really enjoyed my time there, but then I started having some health issues, and unfortunately, I had to make the decision to move back home because to be completely honest, we weren't sure if I was gonna be a functioning member of society again. Wow, because my health had taken that much of a hit. So came home, did some healing, and started getting back up on my feet, doing some long-term sub stuff, and this is kind of wild because you know, there I was, elementary, special ed, bachelor's, assistive technology, master's, and I taught I did a student in emotional support, and then I taught music for half a year.

SPEAKER_03 11:08

Oh wow, okay.

SPEAKER_06 11:10

Um, so your like lesser-known skills that you have sometimes get you thrown into places. Um so because I could play the piano, I ended up doing that for a while, um, which was a little random, and then I was a classroom to the future coach, which was kind of like the a tech facilitator role. So again, I was working with staff on integrating technology into the classrooms and things like that, and a lot of professional development, technology trainings, and those types of things. So I kind of got away from my roots, but it was okay because when I was doing the ed tech facilitator stuff, I got involved with the Discovery Educator Network and the smart exemplary educators and those kinds of things, and I really was learning those types of roles, and then I ended up in a life skills classroom, which was my first full-time, full-time job again. So I did that for a year, and then I got moved to the elementary computer teacher role, where I was for several years, and then I taught computers and gifted. So I've really taught three to 21, regular ed, special ed, and gifted. I've done it all, and that's okay because it's made me more well around it and given me a lot of experiences to bring to the behavioral health realm of things. And I think it really helps when I go into schools because I know what the teachers are struggling with, I know what it's like to have a classroom of 25 kids to 30 kids, and you have these kids with whatever diagnoses, and they just kind of throw them in your room, and you're like, How am I supposed to deal with them? and you have 10 other kids that probably should be diagnosed and don't have diagnose, don't have support, and no support, and no funding, and no, you're just at your wit's end because how are you supposed to meet the needs of all of those children? Yeah, and and it it really I've looked back on a lot of it and thought about what I would have done differently. Not that I could go back, but you know, it is what

Leaving Teaching For Behavioral Health ABA

SPEAKER_06 14:08

it is. So I left teaching and went into a TSS role, which Pennsylvania has their own language in ABA at that point. We were under BHRS, so I became a TSS, which is kind of along the same lines as as an RBT, okay, but not really. And it was entry level, and I did that for a while, but I could see that the tides were turning and that there was a need for ABA, and I kind of had a feeling that getting my BCBA was the right move. So I started working on that part of things, and I became a BSC, which is what was the the master's level position at that time. And lo and behold, the state of Pennsylvania had some law changes, and now we're under IBHS, which is um intensive behavioral health services, and the requirements have changed. So we actually have two lines of services we have ABA and then we have individual, and then we have a whole vocabulary that's different that goes with things. So it can be very convoluted, and I'm not gonna get into it, but it was the definite right move. I did go back to teaching for a while, a position I always said I'd go back to teaching if the right position opened up, and I had somebody that pretty much created a position for me to become a STEM teacher and it was at a behavioral school. The unfortunate thing was I started on Monday and the world shut down to COVID on that.

SPEAKER_02 16:07

Oh no, March of 2020.

SPEAKER_06 16:10

Yes, yes, so I thought they'd just get rid of me right then and there, but they didn't, they kept me on, and the following year the rumor started because the kids didn't come back and we just didn't have enough to really staff the school, so they told us to start getting our resumes ready. So I had still been working part-time because I at the company I had been working for, because I was working on my supervision hours for my BCBA. And when I told my supervisor what was going on, she's like, You need to come back and be a clinical director. So that was what I did. So I kind of immediately stepped right into a clinical director role on the ABA side of the service line.

SPEAKER_03 17:02

Wow, before you even got your BCBA, that's impressive.

SPEAKER_06 17:06

Yeah, yeah. And I I did, I guess that was April. I started that, and then July is when I took the test, is when I sat.

SPEAKER_02 17:16

Now you were a well-seasoned professional in a different field by this time. How often do we hear the same story? And it's somebody who's not so well experienced, but getting thrust. We just heard it earlier this today, but it's getting thrust into this clinical directorship position. So there's a whole slew of other things that you're now responsible for as you're getting your feet wet in ABA. So glad for your prior experience. I'll let you continue.

SPEAKER_06 17:44

Yeah, and I truly I don't think I would have taken the position if it weren't for the fact that I had 15 years in the classroom.

SPEAKER_04 17:54

Yeah. That that was running for it. Yeah.

SPEAKER_06 17:57

I had been in behavioral health for five years. Yeah. So like I felt confident enough, and IBHS had just started the clinical director role for everyone across the state of Pennsylvania had only started in January. So everybody was learning it. And it wasn't like a clinical director role, at least for our company. Some other companies might have had clinical directors, but it was new for us because that requirement wasn't there. So I stepped into that role, and I was there for three years, and then this is kind of where things kind of fall apart. My father took ill, so I start decided that even though there was a large telehealth component, the amount of time that I needed to be at home with him, or things would happen as I was trying to leave my house to go and see the few clients I had, it just wasn't okay. For me ethically, it was not okay. So I left that position after I found some telehealth work. One of the companies I worked with offered me a clinical director position, and I accepted it blindly, not knowing how unethical what kind of shape the company was truly in.

Audits Ethics And Going Independent

SPEAKER_06 19:54

I walked into a shit shell, we'll just say.

SPEAKER_02 20:00

You're being very diplomatic, Jen. I appreciate that, but go ahead.

SPEAKER_06 20:04

So, you know, I I started to clean things up, and about a month after I took the role, we got audited by the state. The audit obviously didn't go very well. The the person that was auditing was very frank with me and said that you know there were people who wouldn't even come because of the boss because they were afraid of for their license. And I spent the entire day, my assistant and I spent the entire day explaining everything that we were doing to fix the situation. And at the end, the boss comes in, and within five minutes, she undid everything we spent all day doing because she just knew I stayed on for a while because I wanted to protect the clients and the clinicians that were really working hard because somebody had to do it. It didn't matter within like three months, she fired me.

SPEAKER_02 21:14

You knew too much.

SPEAKER_06 21:17

Well, because I wouldn't, I wasn't a yes person.

SPEAKER_02 21:19

Yeah, yeah. Well, and yep.

SPEAKER_06 21:21

Like I literally sent her an email at one point telling her that if she did something while we didn't have an actual license, she would break 13 ethics codes, and she didn't like that.

SPEAKER_05 21:34

She didn't like that exactly my app at that point.

SPEAKER_06 21:37

So it was at that point that I decided that I'm gonna go out on my own. And I had been talking to somebody like a year prior at one of the MSOs, and I talked to that person again. We signed a contract we started things so this was this was two years ago and we started working with you know all the hope in the world that this was gonna come through and 18 months later I still didn't have numbers that I needed to be able to get in network with Medicaid in Pennsylvania if you have an autism diagnosis you qualify for Medicaid you need that number like you you need to and I just was not heard I had so many pieces of documentation of like this wasn't done this wasn't done this wasn't done so I broke that contract and last November I started over again on creating crafted care so thankfully last week I started working with our first client congratulations thank you we're still not we still we have a Medicaid number now for Southeast we're still waiting on the Medicaid number for Northeast but you know it's been a labor of love clearly it's yeah incredibly stressful cutting through red tape it is not for the faint hearted at all and again you know if anyone is listening and you are from Pennsylvania and you are considering your own ABA practice we are different not only in our vocabulary and how we do things but the licensing that is required and we have regions and you need a license for each region that you're gonna practice in and those the what you will go through for each region will differ it is it's the most bizarre thing in the entire world that you will attempt to do there there's no rhyme or reason so you just kind of have to make sure that you can take very good notes and make sure that you are in contact with your senator or congressperson and have them on call to help you push things along but it it's gonna be a process to really get through but I'm glad that we're finally in the home stretch and we're actually going to I'm actually able to go out and do my job again. So that is my origin story. It is convoluted and I've done a lot of things and I'm glad that I've done a lot of things I'm glad that I've done a lot of things and have had the experiences that I've had I'm glad that I I've done the technology stuff that I've I've done I've done a lot of traveling because of it I've done a lot of presentations all over because of it. I went to South Africa because of it so like it it served me well and it every little bit of it helps me make helps make me the practitioner that I am and helps me do what I do well this is a super comprehensive or story.

SPEAKER_02 25:53

We really appreciate it Dan is a master at asking questions so he's got a list of at least 200 that he's generated here we're gonna need to schedule a four hour block I'm kidding what a trip what a wealth of experience you've got one of the things that I've always said as a practitioner when I consult with schools and one of the things I say to our staff when we train is I'm really good at the individual contingencies. But group contingencies are a whole other level of of artistry and expertise. So you had that before you moved into the more individualized game and you've kind of played back and forth between that and having to consider somebody's need for assistive technology as an individual but if it's going to be effective it has to fit into the greater environment every time. So what a I mean again what a wealth of experience I'm I'm sure it was a lot of it was happenstance which is what I love about these stories. But uh it's all sort of culminated like you said it this all culminates and stays relevant to what you're doing now.

SPEAKER_06 26:54

It absolutely does and some of it's coming back.

Why AAC Fit And Training Matter

SPEAKER_06 26:59

So like stepping away from the assistive tech stuff and now being able to step back into it that's one of the things that I'm really excited about to get back into that world of assistive technology and the AAC I did a preschool summit that Autistic Little Learners did last week or the week before and this woman has built this business on creating materials for preschool preschoolers with autism and everything that I watched so far I sat and just shook my head and I was like I was doing this stuff 20 years ago like this is these are she was making adaptive books and I was like I didn't I did that I even went as far as like adding textures to my books and everything else and and it I don't what's the word I have a horrible word finding sometimes that's okay it's your time it validate it. What you had done prior yeah well just you know going through this process having all of this happening again I was really starting to doubt myself I almost canceled her today because I was like just in that very questioning of why am I doing this? Should I be doing this? Do I have the right knowledge like am I going to be able to do this with everything that's going on in ABA right now? Do I have the ability to run a company? Am I gonna get the staffing that I need you know I'm not the best with research and uh quoting like what evidence-based practice I'm using just because I go off of the experience that I have and what's worked could I find go and find the journal that matches what I'm doing absolutely but I I don't I this is what I do this is what we're gonna do it and it'll work just trust me but having that validation and seeing that yeah it was like yeah you can do this it's gonna take a bit to get back into that routine of doing it but you're there you're you're it's gonna come back going to closing the gap I don't know if you've heard of that conference no no have not tell us about it closing the gap is like the premier assistive technology conference okay it's it's a resource on all things assistive technology so it's not just AAC it's wheelchairs mobility aids anything assistive technology again back in the day they used to have a big not a magazine but a big resource that would come out and you would be able to flip through it and like look and see what you know I need this and you would go through now it's online which obviously is a hundred times better but I'm going and I'm presenting and that was like one of my goals for this year like I want to go I'm gonna present on something at Closing in the Gap because it's been a a goal of mine for my entire life so one of the things that really bothers me is when kids are giving it AAC and there's an organization here in Pennsylvania that is really good about getting AAC into the devices into the hands of kids but they don't really assess what device what program they should get so there's literally a shelf at the IU with like 10 devices that are just sitting there because they weren't paired with the child.

SPEAKER_02 31:20

And it's great that they're willing to get the AAC into the hands of the kids but you have to take that step to do the assessment and to talk to the speech therapist that works with the child and to really talk and explain to the parents that yeah they might be able to go to McDonald's and order something but you have to work with the child and the speech therapist has to be on board with this as well and there it you have to make sure that you have the right program for your child because I worked with one little girl who she had a program that you could only put a limited number of pictures on the screen and her sister had like an unlimited version and it they opposite so you know there's a lot of devices that get given to kids and there's no explanation there's no training there's no fit and that's an important part of AAC yeah it's not just here take this well it's a it's a very convenient very fancy very sign of the times so to your point if we go back to you know early 2000s it's a big clunky expensive there's going to be a deterrent for families to try and get that it's not very attractive but now it's almost a little sexy oh AAC device I and I don't know enough so I'm really glad to be learning from you today but I've certainly been in circumstances where you know maybe a child I'm doing early intervention they're about to turn three and maybe as part of our intervention or at least during our our sessions we've seen an increase in verbal behavior and echoics and some of the operants are coming online the child's talking and then the notion comes up oh yeah they're getting evaluated they're gonna get an AAC device and some parents are very willing and very interested others are is this going to take their voice away all the questions I'm sure you've heard let me pass it back to you and let's talk about that doubt or or the

AAC Myths Modeling And Exploration

SPEAKER_02 33:35

need. When is an AAC appropriate and for what reasons and then how does that start? I think a lot of people because of the ergonomics because of tech being so user friendly and self-guided these days the idea is yeah you give it to your child and of course they're gonna start they're gonna understand the semantic categorization setup of this thing and they're gonna start pushing buttons and no that's far from the truth. In fact as a parent as a professional you're probably spending a lot more time modeling the use of that device in the beginning than anything else.

SPEAKER_06 34:07

I've thrown a lot at you unpack it for us so I mean obviously you want to talk to a speech therapist because it's yeah and they're gonna argue with me and there's a bunch of schools of thought on it. You know I could say one thing and five people can come on here and start attacking me and saying well first of all you're a BCBA you have no right to say this and I my whole thing with that always was I'm a teacher I'm with the child more I see all of the the domains not just speech but that's a whole nother soapbox that I could get on the AAC is never gonna take language away from a child that is like that's proven there are multiple resources and studies out on that. That's the augmentative part it's augmentative right so like it's not gonna take it away it is there to support the child there's a young man who had dyspraxia has de dyspraxia who talks about the fact that and there's it's not just one person there are several people in their 20s who have dyspraxia who have devices some of them have to use them all the time some of them are some users sometimes and they will all talk about the fact that the one nice thing about AAC is that if they're having a tough time like and and this is not a great example but for example I know that I have issues with word findings sometimes they obviously have it at a much more severe level than I ever do but that it they're able to find their voice with their device when needed. So it's their backup when they're having when they're having in a stressful situation. So like if they're in a new situation where there's a lot of stress and they're just really having trouble getting their words out they can resort back to their AAC and now they're able to communicate their wants their needs their thoughts because that device is there. So I think that's been the new way that I think of it that and I try to explain it to parents that yes we want them to be able to communicate with their own voice but there's going to be times where they may struggle and if they learn with this device they're always going to have their voice and they're always going to be able to communicate that's a great example because we we immediately or those parents who are immediately thinking about I guess more of the cognitive part of linguistics and and knowing the words and what your explanation says is this is a this is a concern sometimes in coordinating all of it.

SPEAKER_02 37:16

So if we can just have the the words are there it's how they get them out that's the problem and that's where this device comes in. I think that's a really important nuance you just communicated there which I will certainly adapt and start using when I try to chime in on these situations I I'm not a content expert so I by and large stay out of it as much as hey how you know hey SLP or person in charge how is it you would want to see us as ABA professionals engaging and moving this in parallel to you so I always you know lean on them but I like that distinction in terms of now AAC devices maybe being overprescribed as it were is that something that is also a concern and and why or why not I don't know that they're being overprescribed is anything that's going to support or bring on language going to be overprescribed? Interesting. So even if it's even if in this case then now it's it's sort of interface that a child is engaging with to play around and look at the different categorization. I mean there's a lot of semantic processing involved in these devices which is super important to learning.

SPEAKER_06 38:30

So even in just engaging the system like any other tech device you're saying the learning value is inherent I I I'll give you an example in my first classroom they when I started the a uh my AT program they gave me all the devices that kind of worked but didn't work so they couldn't give them to kids to use and I had this old dynamite like the small version of the dynamox. Yeah um and I had this little guy and and he I love this child he I I his speech was unintelligible but he tried to talk and when he would have free time I just had this device sitting in one of the centers he would go over and he would pull it down and he would sit there and push buttons and sit there and continually repeat the sounds the words so you know when you have these kids that yeah you want to model and you want them to use it appropriately but you also want them let them explore yeah and to find like let them go through and go through the pages and see where things are because modeling works yes we need to do it but they also need to be able to explore and see where things are and see what's on it and see what's not on it. So when they're you know it's like anything even if you have like a PEX book and they're going through and they're looking for something and they're looking to you like if they want to say giraffe because they went to the zoo over the weekend and you ask them what did you see and they're going through and they're going to their animals and they're looking to you because they're not going to spell giraffe at age three most children but they know they saw the giraffe and they know it's an animal and they go to the animal page and they're looking at you you know like those are those that communicative intent of I know this is where this should be and you know that's we're communicating with the parents so much and making sure that the parents are trained in the device so that the parent can then know that like okay we're going to the zoo I need to put a zoo folder on and need to put like the animals that we went and saw so that if the kid goes to school they can talk about going to the zoo or I was just working on I we went shopping yesterday and I got a couple board books. So I was taking the adapted book idea and was going through and creating the pictures to go with the book and I will be creating displays for my client's device so that we can have a display a page that goes along with the book so that she can learn to start pairing things. So there's a lot that that goes with it and there's all kinds of arguments and research on whether you should have core words and how you make the pages within the device and I don't know what the the right way is it it I think each child is different and each child you kind of have to individualize it for that child based on how they go through it. But I don't think that you're gonna hinder a child or overprescribe something that is only going to give them another way to communicate and to learn.

SPEAKER_02 42:13

And that that really communicates or suggests the idea that as listeners we it behooves us to be open-minded about that sort of hybrid form of maybe I'm gesturing maybe I'm pointing maybe I'm pushing this button maybe I'm making sounds that are somewhat intelligible but as listeners then we really have to prepare ourselves to be ready to to listen in that format.

SPEAKER_06 42:39

And that's what it's all about like you know these kids are communicating in so many ways with us yeah whether it's a touch of a face or it's a stroke of a hand whether it's a sound whether it's a look it's not just we miss so much of their communication sometimes that and I don't know maybe it's because I'm somebody who likes to sit back and observe and I tell my the people that I work with like it may look like I'm sitting and doing nothing but I can assure you I'm sitting and I'm watching because I'm looking for those nuances because those are the important things that other people aren't picking up on that kid is putting out and those are things that we can build on.

SPEAKER_02 43:30

Yeah yeah that's it's it's uh it's so interesting it just to share to share something quickly that that I shifted over to a few years back and to to your point of all the things that are being communicated that maybe we're missing because we've envisioned communication a certain way already in terms of vocal verbal behavior. But joint attention is one of my favorite things with early intervention the idea that kids looking at something and and it really Shifted my thought process in terms of the idea of eye contact, which was always always rubbed me the wrong way a little bit. I mean, yes, it's got its place and its time and place, but I always felt like we over-scrutinized it. And now we join attention the idea that you were saying it earlier, the idea that a learner might shift their gaze from something they're looking at over to me and then back to this. There is so much being communicated there in terms of some sort of listener response then now to say, are you tacting that and showing it to me? Or did are you manning it? You want me to give it to you? All of these things that are now contingent on my response to something that I may not have paid attention to if not for saying, hey, just listen to all these gestures and to the whole hand leading behavior, for example, which I think is almost treated more diagnostically as a trait than anything else. Sometimes it's like, hey, that child's sitting there. They thought of something that they're not seeing in that moment that's in that cabinet, and realize that only you could reach it for them, so they went and they got you. That really opens up that communicative effort much more and much further beyond some developmental piece that's maybe frozen in time, and now we're looking at as a delay or as a diagnostic trait. So I really appreciate the way you're putting that, especially the the idea that tech is here, tech is here to stay. And if it's going to help a child communicate through play, even, you know, knowing that, and and we'll talk about this later in terms of the idea of screen time and how this fits in to these devices now, or whether or not it fits in. But in a culture that's now concerned about over tech use, which kind of goes back to the origin of my question, I like the way you frame it. It's no, no, wait, this is gonna help a child uh communicate, engage with their world a little bit more, especially if the rest of us are approaching it the same way.

Access Battery Low Tech And Teamwork

SPEAKER_06 45:55

Yeah, and uh like I I'm a firm believer in separating like their fun tech from their AAC tech.

SPEAKER_02 46:04

Very good. Okay, that's a great tip right there.

SPEAKER_06 46:06

Like this is this is your you know you can have my phone to watch Miss Rachel, but this is your device because that device has to be accessible to them all the time, and the program should be up and it should be sitting somewhere where they can get at it and they can grab it, and they shouldn't have to switch between pages to get at it. And there still are actual ablenet has their device that looks like an iPad, but it's not an iPad, and well, maybe it is an iPad at its face, I'm not sure. Um, but you know, the Quick Talker is a device. When I looked at the back, it looked different, maybe because it has like a battery pack built in, so that it has more battery cover. I have to get it a little bit closer, but you know, that device needs to be their device there because it is their voice, and and that's another battle that I like yeah, I have with anyone that is with a child that has an AAC device, they need to have access to that. Do we what happens if we lose our voice? We're hoarse.

SPEAKER_02 47:20

That's a struggle. That's a that's annoying, that's frustrating.

SPEAKER_03 47:23

Yep, can't communicate effectively anymore.

SPEAKER_06 47:26

Exactly. So if you have a child who has a device and actually uses their device and it's out of battery, how frustrating is it going to be for them? And if they're learning how to use it, how can they learn to use it if it's not accessible to them? Oh, here's your device, you have access to it at school, but now you're at it at home and it's in the book bag, or vice versa, your parents are really on top of things and you have access to it all the time, but now you go to school and they don't take it out of the book bag because they don't have sports staff to work with you with it, and they don't realize that you know you're using it, or that you just need support to have it. That's it's not fair to take the child's voice away from them and their way to communicate because let's face it, how much of the maladaptive behaviors that we deal with are because of inability to communicate.

SPEAKER_02 48:27

Fair amount, good percentage, fair amount. And if it's the inability to be to express yourself, it might be on the other end, these adults just aren't listening. I said it in the wrong tone, so now they're correcting me, or you know, some other aspect of rightfully so, things that we're trying to shape. But yeah, it's one of my pet peeves, and you know, it's a beautiful phrase, use your words, and then so many times I'm looking at situations and going, Oh, they've communicated just fine. I I think we're not listening, is the problem.

SPEAKER_06 48:58

Yeah, yeah. So, you know, to and and when you have that device where it's it's their device and their play toy, they're gonna drain that battery right away, and then they don't really understand that this is my play thing, and this is my this is my voice, because I'm just gonna continue to call it my voice, yeah. You know, I think that there needs to be that distinction, and I think in this day and age, especially the pricing has come down on the AAC programs and everything, on iPads, on on tablets, on whatever. So it is more attainable through insurance, through organizations, through grants to get devices for kids. Whereas, you know, back in the early 2000s, you're looking at 10, 20,000, $30,000, depending on what device you want. Whereas now some of them are two, three hundred dollars for the software and uh a tablet and the case.

SPEAKER_02 50:07

Would it be fair to say that, and I'm gonna over-generalize here, so please fine-tune the question, but it would be fair to say that any child with a expressive communication delay would benefit from an AAC, or is that way too general a premise?

SPEAKER_06 50:27

I mean, I I would think I'm sure somebody would be able to come on and say it's overgeneralized, but I I don't see why it wouldn't support anyone with any kind of expressive disorder. And they're and they're not for everybody, because you know, you then have to look at the cognitive level. Okay, can they make do they need a button to go with it? Like, do they need to scan if they have some kind of physical disability or other things? But there are other ways to be able to access those things. There's head switches, there's tongue switches, there's yeah, all kinds of things. But so that's why you know, having an evaluation done to really truly determine what's the correct software so that you're or device to make sure that you're really setting the kid up for success or the person. But I don't see why, if somebody's having issues expressing themselves, it wouldn't support them.

SPEAKER_02 51:38

It reminds me of even more low-tech devices that Dan. I gotta pass it over to you. I've been monopolizing this whole conversation.

SPEAKER_01 51:44

Oh, good.

SPEAKER_02 51:45

Past couple years, I spent some time doing some direct work with a student that was rather impacted in high school. And yeah, the team decided, you know, various components of the team decided, a very low-tech, big red button. I'm sure you know the device, record your voice onto it. One one ten-second stream of voice recording. And to the outside observer, that may seem you know very minimal. And then to the lot of us who had taken this kid, you know, over the past two years from highly aggressive behavior to now that moment of five seconds at the beginning of the day where we were crafty enough to record our voice and say good morning into it, and then have the teacher greet him and have him push that button as a response. That was monumental. I mean, that was huge. Uh, to your point, a much more dynamic device, like a screen with semantically categorized words and phrases. I mean, that the sky's the limit there, given the exposure and then the reinforcement from the environment as a result of this button push.

SPEAKER_06 52:51

Yeah, and and you know, it it doesn't you always back in the day it was you always start with low-tech. So you start with the pictures for the picture exchange. We I used to rip apart, you know, the the books that sing that have like books that the ones that you could re-record, I rip those apart and I'd re-record things on those. Oh wow, getting a five uh five choice thing. There were some photo albums that would talk. You could rip those apart and put those together to make boards that could again same premise as a Big Mac.

SPEAKER_02 53:35

Big Mac. There it is.

SPEAKER_06 53:37

Yeah, yeah. Um, so it doesn't have to be a high-tech AAC device, you know. You really have to look at each individual child and decide, but it doesn't mean that there's not something out there that can give them some sort of what voice.

SPEAKER_05 53:58

Yeah, yeah.

SPEAKER_06 54:00

You know, you talk we talked about when I was in my ABA program, we talked about deciding what's gonna work best for the child when you're looking at AAC. And is it PECS? Is it sign language? Is it an AAC device? Because which one of those is the person going to have with them at all times? You're gonna have sign language all the time, but is your communication partner always gonna understand sign language? You're not gonna be able to walk into every store, every restaurant, and order something with sign language because not everybody's gonna understand if you have a picture exchange book to have your entire vocabulary, that's gonna be a heavy book, depending on what your vocabulary might be. I remember those books exactly, it may work for some kids, and some kids do still carry those around. Yeah, yeah, and as a starter tool, it's great. And if that's what works for the kid, then that's what's that's that's what's gonna work, and you gotta deal with it. That's their voice, but yeah, and that's their voice, and that's what that's a person can still go someplace and pull pictures for Big Mac French fries and a Coke and hand it to somebody, and hopefully they'll figure it out and be able to figure their order out. An AC device tends to be something that everybody's gonna understand. And it it's kind of like the middle ground, you know, and it's more accessible. Again, I'm not saying which one is right for every child, you have to work with the family, you have to work with the team, and it has to be the team. You can't make the decision as the BCBA, you can't make the decision as the SLP, you can't make the decision as the OT, you can't make the decision as the doctor, and you really can't make the decision or shouldn't make the decision alone as the parent. Everybody needs to work together and have a discussion about what's best for the kid and why or the client, not just child. Sure, it could be any age, and I think that's a piece that we're missing as well.

SPEAKER_01 56:34

And this is a good place to stop, but make sure you return so you're not missing part two and always analyze responsibly.

SPEAKER_00 56:44

ABA on tap is recorded live and unfiltered. We're done for today. You don't have to go home, but you can't stay here. See you next time.