Latest / AAC Access All Areas / What does early AAC engagement look like?

Transcript

What does early AAC engagement look like? · AAC Access All Areas

• Ali Battye: Hello and welcome to AAC Access All Areas. I'm Ali Bhatti. Ruth Jones: I'm Ruth Jones, and today our question is what does early AAC engagement look like? Ali Battye: This is going to be a goodie, isn't it, Ruth? We've got lots of thoughts on this. Ruth Jones: I I think so. I think, you know, we just had our little quick pre pre session chat and I think it's really interesting because we get so many different kinds of profiles. So actually early AAC engagement can look really different for each individual. And you just used the term before we came on about the dream scenario. So I wonder if we should start talking about what does the dream scenario look like? You've introduced AAC. What's that like, you know, the absolute like this is It's going well and we know from day dot it's going well. Ali Battye: Yes. And I would like to caveat this with this is probably like 5 % of the children that I introduce AAC to. So this is quite an unusual scenario. But this is where you introduce an AAC system. Let's say it's an iPad with a robust vocabulary. You sort of like start modeling and the child instantly is drawn to it. Like it gets their attention instantly and they start sort to like pressing the buttons, they start exploring the more and the back and the clear buttons and they're just away with it. So this has happened recently to me. it also, you know, thinking about what helped with this, I think things that helped were parents were totally like on board with it. They were totally ready for this sort of journey, this adventure together. and just had it out all the time. ⁓ They were doing a little bit of modeling. I don't think they were sort of like really going for it in a really intense way. I think it was just out and they were playing around with it, letting the child play around with it. And also, this child is really lucky because they've got a really supportive TA in school who was also doing the same. ⁓ And so this dream scenario is that this child just explored, using it in their own time at home. Often I hear from parents that children will explore their AAC like in a quiet corner or before bedtime and so that's what this child was doing. And so I've probably done let's say five or six support visits since in school and every time I've just been blown away a by how well the child is using their AAC like that they're navigating and trying things out but b how well the ⁓ that ⁓ TA is able to switch between pages and clearly has that familiarity. And then I've had the odd WhatsApp message from parents to say, ⁓ guess what he just did. And then, so I did a home visit this week and this little boy went to something is wrong, something hurts and hand and his mom was able to say, ⁓ yeah, he hurt himself. finger yesterday. So I was like totally blown away by that, that already he's you know he's not not only using it for things like requesting but he's also able to tell a story, tell what's happened on it. Yeah so that's the dream scenario. Ruth Jones: That's so lovely. You know what I was thinking about as you were talking about dream scenarios, I was thinking, where are those moments in my time? And it actually took me back to quite a few years ago when I was working in a residential specialist school and I worked with an incredible team of therapy assistants and they would often go and deliver groups and sort of in-class support that was kind of I would guide the work they were doing, but they were going and they were so creative in how they could bring ideas and activities. And so I'd kind of like think about the goals and they'd just go off and create these activities. And we were in that phase where nearly every child at that school had a picture exchange communication system book. That's kind of what they'd been grounded in. And we were shifting away from PECs and using at that point in time the assistiveware ⁓ core word pages. So they had ⁓ which I think Assistive Worse they'll do on their website actually, they had like the core word classroom. And so it was a core word approach to single words. and there was a boy that they'd taken some activities that this particular child was interested in. We were sort of thinking they might be a good high tech candidate, but just exploring really how they would go. And they'd taken this to this group session, I think it was trains, it was a long time ago. But they'd kind of had a cordoard and they'd modelled ⁓ when the train and they'd been like, go, when the train had set off. And then, ⁓ more. And the train had like done, you know, they'd done something else. And they both came back from this session, the assistants, and were like, ⁓ you'll never guess what just happened. And within like moments of that little bit of modelling, want more he'd been saying, and like stop and go. And all of these things, yeah, on a paper-based Ali Battye: Wow. Ruth Jones: core board was what we saw with just that little bit of modelling and teaching. And this child I'm gonna say was probably 14 or 15 and so has had PECs for that whole 14 years of their life. And now they had access to words like stop and go and more and we're using them within moments, within a minor bit of teaching. And so I think for me that's that like you say that dream early engagement scenario isn't it? We've given you a tool, we've just shown you a little bit of how it could work. Ali Battye: you Hmm Ruth Jones: and you're already using words that you haven't used before and you're saying words that we haven't haven't seen. And I think, like you say, it's not very often. And I think sometimes that's a common misconception, isn't it? That you could just give someone a device and they get to using it. And I think while we really have to hold on to presuming a child or an individual has potential to communicate those things, we also have to recognise that for some of our more complex communicators Ali Battye: Yay. Ruth Jones: They can have the potential, but they do still need teaching. And so it isn't necessarily going to be that situation where you give them a device and within a day, within a week, they're sharing lots of things that they are experiencing internally. Because for a lot of AAC users, it is a bit like teaching a foreign language, isn't it? You're teaching words for things that they might already have the experience of and therefore they do have potential to communicate, but until you teach them Ali Battye: Yeah. Thank you. Yeah. Ruth Jones: The words, which is why being attuned to your communication partners is so important, isn't it? Because actually you need to kind of have an idea of what they might be experiencing and thinking and wanting to say in order to show them and teach them where that vocabulary is. And I think that's where then we start with the modelling, don't we? And whether that's paper-based, device-based, you start with that kind of I can't I sort of say like little and often, so it's not necessarily Ali Battye: Mm. Ruth Jones: Really, you need to be going organs, blazing, modelling 500 times a day, but little bit now and again with throughout the day. Because I think sometimes that can be a bit of a if you don't get necessarily enough, sometimes that can impact the early engagement. But if you've got that little and often approach, I tend to think early engagement starts to look like I love it when a child bats your hand off their device, like. Ali Battye: more. Yes. Yeah. in the world. Yes. Ruth Jones: Even if they're not gonna say anything, but they're starting to recognise this is mine and I don't want you to say anything to me right now or I don't want to do this right now or I don't want you to use this right now. I think there's early signs of ownership. Ali Battye: Yes. Yes, yes, yes, that's that is a lovely point actually. ⁓ Yeah, and I was also going to come in on, because I really love your point about we're not bombarding them with AAC language. It's just a light sprinkling because so many of the children that I work with, they have like an extra sensory perception of when there is pressure, communication pressure, or when the adults around them have an agenda. And that automatically will trigger almost like a fight or flight or freeze response in them or it will just, you know, if it doesn't do that, then it just stops being fun. It might just be that it stops it being fun if they think that the adult wants them to do a particular thing, because then you haven't got any creativity with it. ⁓ And I think one of the real key things is to leave that door open for free expression, not sort of like having a predefined idea of what I want them to say using their AAC. ⁓ So yeah I think that's really good point. It's sort of like a sweet spot isn't it of like you say modeling enough and having it available but not sort of like giving them the sense of like you must use this and I'm only going to be pleased with you if you use this because that is an automatic kind of turn off I think for a lot of the children that we support. Ruth Jones: Yeah, and I think when we think about our kind of neuro affirming principles within AAC, you presume potential but also honouring all forms of communication. So it is kind of honouring the ways they're communicating at the moment while recognizing that in time having access to the robust language that high tech AAC can offer is going to enhance their communication skills and their communication capabilities. and I think it is Ali Battye: No. to sing along in air quotes functional language, are we, ⁓ in the early days? Because I think that can be the temptation of like, ⁓ we need to get some functional language. But what actually I think is more powerful is fun language in the early days, that they can just get a sense of, okay, this is for play. This is fun and playful and joyful, and it allows me to express myself. So in the scenario that I just described the dream scenario, this child absolutely loves spinning. So the pages that we modeled were around spinning or saying, this is fun, it's my favorite. So it was very much geared towards, let's start with what this child already finds delightful. Rather than, right, we need some functional communication. We want him to make requests. as soon as I hear ⁓ particularly sort of like teaching staff, hear this a lot, how do I get them to do X? Ruth Jones: On both. Ali Battye: That's a real like, okay, we're not gonna get them to do anything. That's a good way of putting a child off AAC. Let's frame it differently of like, let's see what we can find out about this child by using AAC as a support and allowing them to kind of show us things that might be in their head through AAC. Ruth Jones: Yeah, definitely. I think that's a really lovely way to frame it. And I think a lot of that is grounded in historical, isn't it? The focus on children being compliant with adult led, you know, stuff. And I think whenever I see, you know, in education, education staff trying to integrate symbols and sort of basic AAC into lessons and those kinds of things. And often it ends up in hand over hand prompting, which we don't want to encourage because Ali Battye: you Ruth Jones: For all sorts of reasons, we should probably have that as a question one time, but I think you end up with that because actually it's just not interesting. Kids don't want to say if it's a square or a triangle, or if you know there's like more or less, or I don't know how many things are in a what's it. I just think it's not it's not fun and it's not interesting. And so we sort of can I think sometimes put children off using symbols because we focus on it being that. Ali Battye: Yes. Ruth Jones: functional thing for education based or very specific, you know, we've got a core board for the meal and so they have to ask for I want my lunchbox, even when somebody stood there with the lunchbox in their hand, or you know, they've got to kind of ask for help in order to get and and they are important functions of communication. So we do want to think about it, but when we're first introducing it and we're looking for those signs of early engagement. Ali Battye: and Ruth Jones: so boring let's think about what what would really entice you know I think a bit about is it the curiosity approach talk about an irresistible invitation and I think that's what's really nice with AAC is like we want to be offering something that's irresistibly inviting and actually just asking for help is not or you know like asking something that you can see already that that's not irresistible like it's very resistible. so I think those like lovely Ali Battye: Yeah. Yes. Starting with a page of say, I'm thinking of another child that I'm supporting at the moment. ⁓ One that he finds absolutely delightful is he absolutely adores Peppa Pig. So a page of Peppa Pig characters to him has been one of the things that he has absolutely loved exploring, just going through all of the characters. And you can see that he's got his favorite characters through that. Like that he often like really goes for Daddy Pig and Danny Dog are the two on one page. And then on the second page, it's Grant. So yeah, it can be a little, I suppose, window into what that child loves and what they're thinking, which can be just really interesting to find that out. Ruth Jones: Mm. Certainly. And I think what's really what's really important is thinking about that big picture communication because you might know a child loves Pepper Pig because they always play with their Peppa Pig toys. They always want to watch Pepper Pig. They always want to read the Pepper Pig stories. But it's not just Pepper Pig, is it? There's so much language associated with that, even in just those characters. Suddenly a child can talk about the different characters with ease. And I think that's the thing, isn't it? It's about Ali Battye: Yeah. Ruth Jones: How do you offer space for talking about things that are interesting? Because that's where you're going to see that early stage exploration with children. And I think sometimes I don't even expect navigation. I might even navigate through to a page and just be like, here's some vocabulary, let's see what happens. And I think I suppose I'm also thinking back to talking about ownership over a device. Ali Battye: it. Yeah. Ruth Jones: Is there are certain signs I think even before a child would start pressing any buttons on AAC, you know, where you might start to see those bits of like starting to carry it places, even if they're not using it particularly, that little bit of ownership like batting away. ⁓ and another one I think is when you're modeling, they just start to look a little bit more, they just start to notice. Ali Battye: Yeah. Yes. and stop, stop what they're doing. Yeah, because it can be really subtle, can't it? Those little glances or, you know, like the side eye thing. Because I sometimes will model almost like out of reach of a child. If I'm really trying to give them the idea that I'm not demanding that you do anything with this AAC, I might be modeling like it's not in front of them, it's actually in front of me. But because I work mainly with autistic children, I know that they often use peripheral vision and it has amazed me at how much they can pick up from peripheral vision like passcodes and things like that. But I then will sort of like just see them glance at it quickly. And I think as visual processing can be really strong in for some autistic individuals, ⁓ I have been amazed at how quickly they can sometimes pick up the things that I've been modeling when I haven't actually Ruth Jones: No, no me. Yeah. Ali Battye: actually being aware that they were paying any attention at all. I mean, just an example of the visual processing strengths of some children. I had a child come into my therapy room and I'd got like a little, it's like a little shape sort of set and part of the shapes, it's like a garden one, part of the shapes are these little worms, like quite small worms and there's two of each color. And this child had just glanced at this set and could instantly see that one of the pink worms was missing. and there was only one and then dived under my trampoline and pulled it out. Like somehow this child within about 10 seconds of entering my room had done this scan of the room and been able to find that pink worm and that's not the first time that's happened. A very similar thing has happened before so I just think some autistic children just have the most amazing visual processing and they are picking things up from a distance or using their peripheral Ruth Jones: Yeah. Mm-hmm. Yeah. Ali Battye: vision that we just didn't know that they were. So just almost modelling sometimes, ⁓ not out of reach so that we don't want them to be able to reach it. But for those children who might be ⁓ sensitive to demands, I think that can be quite a nice strategy to really demonstrate. I'm not demanding that you're doing anything here. I'm just going to show you what's on here, offer this language and see what happens. you Ruth Jones: Yeah, definitely. And in fact, just as you were talking, I was thinking about a little one that I've been working with where ⁓ at home they've got an iPad and they've put some vocabulary on it. But we started with a communication book that was kind of GLP with a bit of a core page on it for their preferred ⁓ TV programmes. So I think there's like six or eight pages on there for different functions with some phrases. And this child I've been working for a long time now, like Ali Battye: No, no, no. Ruth Jones: couple of years and the book's been in place, they're in school and I'm sort of seeing them checking in half termly. So in school they've got a book and they've got other core boards that they use just school sort of things. And then at home they've got the book but they've also got the iPad that the family are kind of doing bits of modelling on. ⁓ and the first stage that we noticed with this child with early engagement was that they would come home and sit and just flick through their book. Ali Battye: you Ruth Jones: They weren't necessarily pointing, they weren't necessarily doing anything. They would just flick through the book. And actually I got a WhatsApp message the other day from their mum saying that they'd come home at the end of half term, gone to their book, flicked through and said, I need a break. And it was the I need a break. And I just thought like and and that's a child who we still haven't got the iPad in place consistently. You know, they're still we're still modelling. Ali Battye: Wow. Okay. Ruth Jones: So I would class that as early engagement because they aren't ⁓ kind of you wouldn't necessarily have them down on paper as a full AAC user, but they are non speaking. and so they've just got access to different tools at the minute. We're still in that teaching and modelling phase, but I need a break was what they said. And I just thought Ali Battye: Yes. Yes. Good night. Amazing. And it's a nice thing about a book actually isn't it? I'm often an advocate for iPad based AAC early on but one nice thing about communication books is that a child can easily kind of see how much is on there and how it's laid out whereas an iPad app is really difficult to know how much, how many words are in this thing and how do all of the pages link to each other so sometimes it can be very individual and I do have the odd chance Ruth Jones: Mm-hmm. Ali Battye: where the iPad is just a bit overwhelming for them ⁓ initially and having a book, it's a bit like the difference between a Kindle and a paperback, I think, because I went through a phase of reading on a Kindle and I've actually gone back to paperbacks because I really like to see where I am in the book and I really like to be able to like refer back to bits and I have more of a sense with a physical book where it came in the book. And so I think if you've got a child who you saw Ruth Jones: Yeah. Ali Battye: of like intuitively feel like this iPad app is maybe a bit overwhelming for them. You could just compare that with offering a communication book to see whether they are exploring that more readily. And I think that example that you gave is a lovely example of a child who could sort of like explore the whole book and really kind of like start to ⁓ get an idea of all the vocabulary that was in the book. So, yeah, sometimes there are exceptions to the rule, and sometimes their paper base can be really powerful. Ruth Jones: Yeah. Yeah, and what's been really lovely is that where for that particular child at home, they've done some programming, we've then done a screenshot and printed out a single page and sent it to school. So while the iPad's sort of at home and is been introduced, then tentatively there's a bit of modelling and sort of a bit of support going on at home. We've been able to those particular pages that that child is really enjoying using at home around like preferred songs and that sort of stuff, we've then had access to that paper based. Ali Battye: Hmm. Hmm. Hmm. Ruth Jones: at school as well. I'm going in next this half term to see how that's going on. So it'd interesting to see if they've noticed any particular engagement with the paper based version of the iPad page. but I do think, you know Ali Battye: Yes, and I'm still an idea. pod training Ruth, have you ever done pod training? Yeah because I really like the idea of ⁓ you suggest that the adults just stick with the first two pages of a pod book first knowing that they will inevitably start to explore other pages but I like that because sort of thinking about why don't you just explore and it might be two pages, it might be six pages and you might Ruth Jones: I years ago. Ali Battye: make some suggestions, know, so the things that that child absolutely loves. So why don't you just explore the bubbles page, the ball page, the play-doh page, maybe snacks, for example. And that feels more manageable, I think, for an adult who is completely new to AAC. ⁓ And also, if they go slightly beyond that, if their curiosity sort of like gets the better of them and they go slightly beyond that, they end up feeling really good about that. Whereas, you know, if the opposite happened and you said, just explore the whole package, and if they explored like six pages, they might feel as though they were not doing very well and they'd be doing exactly the same thing, but it would just be what the expectations were at the start that would be the difference. Ruth Jones: Yeah, I think like it's interesting, isn't it? Because we're kind of talking a bit about early engagement for the AAC user, but you've also got that engagement. What does early engagement look like for the communication partners? And how do you make that early experience one that boosts confidence and is something for them to build on rather than is maybe something that can create a bit of overwhelm and a bit of stress? Because I think that engagement from communication partners, particularly for those Ali Battye: No. Ruth Jones: you know, the ninety-five percent of children who aren't going to be the dream scenario, the communication partner is actually almost more important than the child's engagement. And so kind of how do you make that early experience for the communication partners an irresistible invite to use the device and and when are you going to use it? And I often find myself doing the same, like program one page, practice adding Ali Battye: Yes. Yeah. Ruth Jones: vocabulary to that one page and sort of I often go to because I'm a big super core, ⁓ a lot of my users are supercore users is I'll say focus on like a preferred page and then the messages page because I think messages is generic and once people get to grips with the messages page there's so much vocabulary that's applicable to everything. And then you have something that's quite like meaningful and maybe a bit irresistible for the child as well. And I think they can be quite nice. Ali Battye: Yeah. Yeah. Ruth Jones: places just to start 'cause I think it has to be manageable for communication partners because if their engagement drops off, the device then ends up in a cupboard or it's on a shelf. We've it's kind of out, but we're not really using it. And when we think about teaching a language, it does have to be that little and often practice. And so if it's not really happening Ali Battye: Yeah. Yeah. Yeah. Yeah. Ruth Jones: you know, when we think about like speech therapy, there's a quote somewhere, isn't there? And can't remember the numbers of it, but it's like if you've got two thirty minute AAC sessions a week, there's like ten thousand three hundred minutes when that's happening if AAC exposure is only in your therapy session. So we need to be making sure that the engagement early engagement from adults is is kind of as Ali Battye: Mm. Yeah. Yeah. Ruth Jones: as maximized as possible. And I suppose for me, when I'm thinking about what does that look like, it's when I go in for a visit, people know where it is and people have questions. Like we tried to do this, but we didn't know how. ⁓ it might be that if it's a paper based tool, it looks a bit ropey, you know, because actually you've seen it it's been used around a bit and bent corners. but I think also people that know, so when I ask how's it going, they don't kind of go, ⁓ Ali Battye: Yes. Yes. Yes. Yeah, in pages. Ruth Jones: Because I think well you're not engaging with that then. So it is it is kind of you do get little signs, don't you, about which communication partners are more engaged with AAC teaching. And I think I often hear, ⁓ well, they don't really use it, so we've left it over there. And I think that is one of the biggest frustrations as an AAC therapist because I'm like, but they won't use it if they're not that five percent dream scenario. They won't be using it if you don't teach them how. Ali Battye: I don't I don't know. Yes. Yes. Yes. Absolutely, and I think children are so sensitive to attitudes towards AAC. So sometimes ⁓ if I hear that, they don't really like it, what I think is beneath that is I don't really like it or it makes me feel uncomfortable. And the child has really picked up on that. you know, I notice a lot. Children will use the modalities of communication that they know the people around them are comfortable with. Ruth Jones: Yeah. Ali Battye: So if, you know, like with Makaton signing, they'll use Makaton signing with the people that they know use Makaton signing. They'll use their AAC with the people that they know are comfortable with AAC. They'll use hand pulling, hand leading with, you know, with people that they know respond to that. So I think it's really important that, like you say, the engagement of the adults is equally important, if not more. Ruth Jones: Mm-hmm. Ali Battye: important isn't it just to reassure as well that yeah this is all very typical in the early stages so it's very very typical for a child's interest to come and go a bit for them to maybe be interested in two pages maybe able to navigate to those two pages but not to be particularly interested in other pages that's all really really typical it's really Ruth Jones: No. Ali Battye: typical for children to, in air quotes, like stim on their device, like to press it over and over and over again. We get very excited when we see that because that is engagement with the AAC. They get, learning that power of having a voice and to be able to play with sound or speech sound. So sometimes when it's a, you know, say a child is, is repeat pressing, ⁓ tomato, tomato, tomato, tomato. They are doing all of that play that their speaking peers have been able to do. And ⁓ it's delightful to be able to play with sounds and play with words in that way, play with the rhythm of language. So I'm always delighted when people say they're just pressing buttons or they're just exploring or they're just doing it randomly because that is absolutely what early engagement looks Ruth Jones: Yeah. Ali Battye: like. Ruth Jones: Yeah. And I think some of those attitudes towards that early engagement are when we really need to support the adult communication partners to question their values and attitudes and their presumptions around an AAC user. So if they're not really using it, we might notice, ⁓ well they don't really use it. You're not presuming that they have potential, you're kind of just expecting them to just start talking with it. Which actually isn't the case, we need to teach it. And I think things like that repetitive like, ⁓ they're just is what we hear so often, isn't it? ⁓ they're just repeating the same thing, so we took it away, or so we muted it, or so we did you know, and I think often we have to really think about what values and attitudes underpin the comments that people make around AAC users, because I think if If they're saying, like, ⁓ well, they don't really use it, so we've given it someone else, so we've passed on the device to trial, or you know, we we we've not bothered really using it, the message to that individual is basically you're presuming that they don't need access to words. And we really have to respect the process of teaching language takes time. And I know any of Ali Battye: Yeah, yes, yeah. Yes, and just in the last... in language as well. you know, like we don't expect a child to come out of the womb and start talking in fully formed sentences and making sense. It takes a child at least a year and, you know, five years really to reach conversational ⁓ level. And so we need to offer the same grace to children who are using AAC. They do need to be immersed in AAC language and to be, you know, hearing the people around them. offering that language. they're building up a really sort of like rich picture of what language can ⁓ do. Language is so complicated, isn't it? Like, you know, when you start to think about, you know, language is made up of vocabulary. There's so many different words and concepts in our language that children have to be exposed to. So, you know, when I was taught, I don't know how accurate this is, I might be way out of date, but I was always taught a child has might have to hear a word like a hundred times or Ruth Jones: No, no. Ali Battye: 200 times to build up a picture of what it means and depending on how complex and abstract that word is, it might be more than that for them to build up like a picture of how that word is a ambulance, it's distinct from a police car or something like that. They just need to sort of like hear that over and over again. So that's vocabulary. Then we bring grammar into it. So it's how words can be combined and in what order. So, you know, like the word order ⁓ can change the meaning completely. If you think about like a phrase like big car versus the car is big, like the meaning is the same, but it takes a while for a child to be able to work out those words in that order. What does it mean? Verb tenses are really complex, so the difference between dancing and danced and was dancing or multiple people were dancing, like that takes Ruth Jones: No. Ali Battye: a long time for children to listen to the patterns of language and work it all out. So we've got vocabulary, we've got grammar, we've got like the use of language or the pragmatics, all the different reasons why we communicate and that is immense as well. So and then adding you know that knowledge of the world that children have to sort of know okay what do I say in what situation. It's huge work that these children are doing. Sorry that was my phone making a noise if the, I've just turned it to silent now so it shouldn't do that again. But you know I'm sure we've used this analogy before, we don't put a child in front of a piano and expect them to be a concert pianist straight away and it's the same with AAC, they are going to need to be immersed in that language and be hearing the richness and the variety, you know and it's gradually going to build up a bit like a mosaic or a jigsaw puzzle, like it's a 2,000 piece jigsaw puzzle, it's probably a million piece jigsaw puzzle. So they're just going to like get little bits at a time ⁓ and we just want to be observing those bits and just noting ⁓ they just did that that's amazing whether it was a glance or whether it was a press the button or press the button 5 000 times we just want to be noticing that and and you know celebrating that start of that journey. Ruth Jones: Mm. Think so, don't you? And ⁓ it's really struck me just listening to the way that you talk about it, is that if you really think about learning a language, that even for us an adult, if you suddenly decide, right, I am going to learn a foreign language, and you download one of those popular apps, you might be doing 20 minutes a day for how long before you are using that language usefully and interactively, and I think we need to think about it being such a long time. So if you are a parent or you are a teacher and you've got a child and the speech therapist or somebody is saying, We're gonna put in a device and you're going, What? And then you're going, but they're not using it, which is almost proving your what question, just challenge yourself. Just notice that showing up and saying, But actually, how long does it take to teach language? Because we're not teaching that behavioral pattern of request reward, request reward. We are teaching language, and language takes time. and not like months time, sometimes years time. So we really do need to give everybody the grace and the pause to really sit and and notice that. And the other thing that I just was also thinking about is that that's if you're thinking about a Ali Battye: is, yeah. Yes. Ruth Jones: child who is not autistic, not learning disabled, learning language via the kind of typical pathways, if you add in autism or a learning disability where there is, you know, cognitive difference, there might be extra processing, lots of extra kind of sensory noise that their bodies are dealing with. Ali Battye: you Ruth Jones: that might make it even longer because their capacity to learn language might be reduced because they're processing so much else from the environment around them and that kind of baseline anxiety, that nervous system, all of that sort of holistic stuff that we consider in speech and language therapy and AAC use, we also need to consider. So I think noticing those really early engagement pieces, but also if even if you're not noticing them, Ali Battye: Yeah. Ruth Jones: sticking with it and believing that children have capacity and have potential to use language. We just need to find the way to teach it and know that that might take time. Ali Battye: Yes, yes. And you know, I've had so many children that I've worked with where it has taken months of us modeling. ⁓ In my training, I always give the example of a child who I've probably been working with for nine months. And we were just lightly offering paper-based AAC. ⁓ And there was just one day in the therapy room that he suddenly like was like, ⁓ hang on. So he was sitting on this table that I'm sitting at and he touched the radiator and I modeled on his communication book. Ruth Jones: Mm. Ali Battye: it's hot and then he kept taking my hand putting it on the radiator getting me to point it's hot and it was just like a really lovely moment but it had been nine months to that first engagement me and me and his parents had been just lightly offering phrases from that communication book up until that time and then just one day something clicked and he was like right okay i know what this can do for me now i'm interested i'm in and Another example that I always like to give is another child that I'm still supporting actually. But she ⁓ is largely speaking, so we were introducing AAC just as a sort of like option. And again, she had a phrase based book and occasionally she would take my hand and get me to point to different messages and kind of listen to what I said. But we'd sort of gone off the boil with it a little bit. And then one day her mum just texted me to say, ⁓ she just went upstairs and got the communication book, brought it down and said, it's my favourite about what they were doing at the time, they were baking. And so those two scenarios just, I always think of, because they just remind me it can take months, it can feel like you are modelling like into the ether and it's not going anywhere, but you just have to keep the faith that it is going somewhere. because children are attending even when they don't look like they're attending. Ruth Jones: Yeah, absolutely. And I think now feels sensible to shift a little into our our glimmers. Although we've shared quite a few little examples, haven't we, today? Have you got a particular glimmer that you want to kind of think about from we've not had a a little chat for a while, so you might have a something from even, I don't know, a few weeks back. Ali Battye: Yeah, no, well, can't. My memory ⁓ for like two days ago is not great, Ruth. So I'm just going to pull from today. So ⁓ this morning I was in a school and I think this is a nice example because it's a multimodal communication example. So this is a child that I've been supporting for quite some time, actually. And it's a good example of ⁓ we have tried a few different things with AAC. He currently doesn't have consistent Ruth Jones: Yeah. Ali Battye: access to an iPad because his iPad broke and we're sort of exploring different pathways to getting an iPad like charity funding or maybe school loaning one. So he has a communication book at the moment and then in our sessions I'm taking in my iPad. But my glimmer today was nothing really to do with AAC, it was more that multimodal communication. So ⁓ you know how some days children are just full of mischief? He was just full of mischief today. in a totally delightful way. I just only had to go into the classroom and he started giggling. And that was like a real, ⁓ you know, set the tone for our session. So he finished his skips because he likes his skips. And then we got up and he went the wrong way down the corridor. He knows exactly where the therapy room is, but he decided he was going to run the wrong way. So I like ran ahead of him and did a big stop, like in a fun way, not in a Shout away. Which he also found hilarious. ⁓ And then later in our session he'd got this activity cube which he'd been exploring. He'd looked at me and sort of like licked it. was really looking for that reaction of like, ⁓ no, we can't lick it. And then he looked at me and dropped it into the bin and looked for a response for that. So, and then lovely giggles and lovely vocalizations and his face was just so animated, some really fun sounds we had. So yeah, just that would be my glimmer that sometimes it's not about the AAC at all. Sometimes it's just about that connection piece. Ruth Jones: Yeah. Ali Battye: and all the different modes of communication that children communicate with. Ruth Jones: ⁓ I love that. Like anyone watching this on YouTube will be able to see the giant smile on my face. But if somebody's listening to this, that has just brought such a big smile because I think just joyful interactions are what life's about, isn't it? And sometimes we can get a bit bogged down in like the educational element of therapy. And actually, like that fun is just so central, isn't it, to having, you know, meaningful communication. My glimmer that I'm thinking about actually is a little Boy that I went to see this week in school, and I've been working with him for a long time, and we've been doing lots of light touch modelling. And I would say he is that kind of child where you're like constantly going, Are we getting this right? Is this the right mode? Like, because it's not that there isn't progress, but it just feels like we're still in early engagement phase, even though we've been doing this for a while, and we have kind of adapted and done things a bit differently for him, and more recently moved his voco chat onto the high contrast. Because we were wondering about the visual sensory element. So there's no cognitive visual impairment, but his visual sensory system processes things differently, and we're kind of wondering, and we're seeing more engagement. So that's been like really exciting, seeing more engagement with the high contrast symbols. But what I saw this week when I went into class was normally when I get there, his class group have transitioned off to sensory circuits, and he and I get a bit of kind of quiet time in the classroom. ⁓ but they I don't know if I was early or their their schedule was a little bit late, but they were just finishing up their kind of morning routine and they asked how they're feeling, because you know, we do that in circle time stuff, don't we? But he had his AAC in front of him and he said, Really sad, and then he looked and then deleted it and went really happy. And I just was like, that was the first time that I'd seen him using AAC in sort of the classroom environment because normally when I'm there we've kind of been like I'm in the class but it's me and him rather than like the whole group and it was just so lovely and the way the TA responded was like, ⁓ you're sa ⁓ you're happy. Like and it was just such like a natural interaction and the TA's ⁓ response and the way that they just supported him as they would have done if he'd have said that with his own Ali Battye: Yes. Ruth Jones: spoken speech which was so lovely and really valuing and really meaningful. So yeah, that's my that my glimmer this week is nothing to do with me and all to do with this fabulous little boy and his TA having a really meaningful interaction. So yeah. Ali Battye: and And it's just nice to be witness to that, isn't it? Like to be able to be part of that when we're seeing those flourishing relationships and flourishing communication between people. Ruth Jones: Yeah, it really is. It really is. so I feel like that's a really lovely way to end our conversation on early engagement. it's been really nice 'cause we've had a bit of a break and I've really missed you and missed seeing this, so Ali Battye: I texted Ruth last week to say I've been missing a Friday catch-up so yeah it's nice to have one, I've been looking forward to it. Ruth Jones: Yeah, and we've got a few more books before we have a break for the summer holiday. So, ⁓ yeah, we'll be back with another episode in a couple of weeks. Ali Battye: Yes, thank you everybody, take care. Ruth Jones: Sang bye.