Episode 323: Recast: Talking with Tech Roundtable: Early Intervention & AAC

This week, we present a Recast of a previous “roundtable discussion” between Rachel, Chris, and previous host Lucas Stuber on early intervention and AAC! (Note: Recast episodes are episodes from the early days of TWT that Chris and Rachel want to highlight again). In this episode, Rachel shares her experiences with using AAC with very young children and discusses the benefits and challenges with early AAC implementation. They explore the misconception that AAC might hinder verbal development, as well as parental concerns regarding AAC as “screen time”, the importance of multimodal communication options, and more!

Before the episode, Rachel shares that she no longer agrees with a position she shared on the podcast. In the roundtable, she shares that PECS can be a good option for learning initiation skills with AAC. Rachel no longer believes PECS is a good option for teaching language initiation to emergent communicators. Rachel clarifies that high-tech devices offer more robust and flexible communication options, which are usually more effective in supporting language development. She no longer suggests delaying the introduction of high-tech AAC if at all possible.

Key Ideas this Episode:

🔑 Rachel, Chris, and Lucas emphasized that introducing AAC early in a child's development does not hinder speech development, but rather supports and facilitates it. They advocate for starting AAC interventions as early as possible, even for very young children, to aid in their communication and language development.

🔑 Peers are a great option for modeling AAC. Involving peers, parents, paraprofessionals, and teachers provides lots of modeling opportunities, which helps integrate AAC into every interaction and makes it a more natural part of the child's communication.

🔑 The importance of multimodal communication is highlighted, where different methods such as signs, pictures, and high-tech AAC devices are used simultaneously to support both expressive and receptive language development. This approach ensures that children have multiple avenues to communicate their needs and wants

Transcript of the Episode

Please Note: This transcript was generated using speech recognition & AI tools; it may contain some grammatical and/or spelling errors.

00:00:08 Chris Bugaj
Welcome to this pre banter episode for a recast. We've never done this before, Rachel. So welcome to talking with tech. I'm here with Rachel Maddle. Rachel, let's talk about this particular episode.

00:00:20 Rachel Madel
Oh, Chris. Yes, let's talk about it. So I have to give a little bit of the backstory of this episode. We started doing recast episodes last summer, and the idea behind it is that we go back to the archives of talking with tech. We find episodes that we think were really powerful, and we reshare them because we realize we've been doing this podcast for six years, and there's been a lot of content, and we have new listeners who just started listening to the podcast. So in an attempt to recast old episodes that were powerful and also for our team to take a little breather over the summer, we introduced the idea of recast episodes. Part of what we do is go back and listen to the episodes. And, Chris, we each pick a specific number of episodes, and we each share them with each other, and we listen to the episodes to make, sure, you know, we feel good about them. And it is the content we want to share. Oftentimes, we're removing some of the ads that we had a long time ago. And this particular episode, I was listening back to it, and I remember exactly where I was as I was listening to it. I was on a walk, and I started listening. And the whole episode is about early intervention, and how do we start supporting students using AAC? And the reason we're coming on to do this banter is because I recognize, as I was listening, I had this pit in my stomach when I heard myself talking about picture exchange pecs. And as many of our listeners know, Chris and I have been pretty vocal about Pex not being an optimal AAC solution, not being robust. We've talked about it kind of at length on the podcast. But as I was listening to the episode that was recorded six years ago, I had this moment where I thought, oh, my gosh, like, I think I'm talking favorably about pecs. And the specific part is where I'm talking about Pex being a good way to teach initiation for communication, which, you know, as I was thinking about it, that was what I was taught in graduate school. It was like something that was drilled into my head, like, Pex is so good for initiation. And the reason that we're having this banter before the episode is because my first inclination was, oh, we can't air this. This is just not okay. I don't feel this way. And then I thought about it more, and I was like, it's the perfect opportunity to showcase what growth and evolution looks like. So I wanted to come on and clarify. One, I don't believe that Pecs is necessary for initiation. My thoughts and viewpoints have dramatically changed. And two, this is an opportunity to showcase learning and growth. And I wanted to be really vulnerable with you guys and share that. I said something six years ago on a podcast and aired it to the world. It's still in the archives of our podcast, and my viewpoints have completely shifted and changed. So hopefully that gives everyone else the same Grace. When we know better, we do better. And this is a perfect example of I had certain beliefs and viewpoints that have evolved over time. And so I wanted to just clarify, because as you guys are listening, if I didn't do this banter ahead of time, you might be like, what is she talking about? That conflicts with everything else I've heard from Rachel Madl. And so I wanted to come on and just showcase that and just showcase the growth and learning that's happened here.

00:03:48 Chris Bugaj
Rachel, that's so awesome. So without further ado, let's get into episode 26, the recast of episode 26. When should we start using AAC?

00:04:03 Lucas Stuber
Welcome back once again to talking with tech. My name's Luca Stuber, joined today by Rachel Maddle. How are you?

00:04:09 Rachel Madel
I'm so good. How are you guys doing?

00:04:11 Lucas Stuber
I'm fantastic. And Chris begue. How are you?

00:04:14 Chris Bugaj
I'm here, too. I'm great. Can't wait to talk about what we're going to talk about today.

00:04:17 Lucas Stuber
Yeah, this is an exciting one. So we always really enjoy doing these roundtable discussions. And today we want to talk about early intervention. And we just happened to have somebody on the line here who is a specialist in early intervention. Right, Rachel?

00:04:31 Rachel Madel
Yes. I do a lot of work with emergent communicators, kids who are just starting to use single words or they're not using words. And it always lends itself to the question, when do you start using AAC? And how young is too young? And I get that question all the time, and it's a really interesting one. There was actually an article in the ASHA leader a few months ago, and it was talking about using AAC for kids as early as twelve months, which some speech therapists listening might be like, whoa, that's so young. It's really cool that they're starting to do research and seeing how effective AAC can be. I have an anecdote to share of a family that I worked with and the little boy was not talking, and he was about 14 months old. After a few weeks of trying to get him to imitate, you know, even just basic actions wasn't working. He was not approximating. He was having a really hard time imitating signs. It left me thinking, okay, now what? It felt like, whoa, this is so young to start using AAC, but at the same time, I can't in good faith keep trying to get a kid to imitate approximations and signs if it's just not working. And so I introduced pictures with them, and it was really effective. It really changed his ability to communicate, his basic wants and needs tantrums lesson, because able to communicate on a very basic level that it kind of lends itself to the question, when do you start using AAC?

00:05:59 Chris Bugaj
Hey, real, real quick, Rachel, let me ask you. When you say early intervention, do you mean birth to two or birth to three? Because I think, at least in the states, that's different. In different states. But what is it where you are?

00:06:10 Rachel Madel
Well, you know, what's interesting is that. So I don't work with a ton of kids that are birth to three, but I work with a lot of kids who aren't talking, and sometimes they come to me at four or five. So, you know, technically, it's not an early intervention per se, but, you know, when you're considering the kinds of skills that we're working on, you know, it's the same as I would be working on with sometimes a two year old.

00:06:32 Chris Bugaj
I hear exactly what you're saying language development wise, like how there's tons of kids that are at that age range.

00:06:40 Rachel Madel
Yeah, absolutely. And sometimes they're four or five years old, which is really unfortunate because it feels like so much time has been lost and so many supports could have been put in place so that we could have a very different child at four or five. And I think that just lends itself to supporting early intervention and AAC at a younger age, which I think is. It's hard. There's actually a quote that I love, and it talks about AAC not being a last resort, not looking at AAC as a last resort intervention, but instead really viewing it as a way to support language development. And I always kind of explain this to the parents that I work with and the teachers. Just because we use AAC doesn't mean we're giving up on verbal communication. We're not giving up on the signs that these kids already are using. It's really just a tool. It's a tool to kind of help facilitate language, help support expressive language and receptive language a lot of times. And there's no reason in my eyes to, you know, stunt expressive language development because a child's not able to communicate verbally. And I think that's what happens. We kind of push so hard for verbal, and then we get to a point where, wow, they're three and they're still not talking. I guess we should explore other options when my thought process is, don't wait that long. Don't wait until they're three or sometimes four years old to go to AAC options, whether that be low tech or high tech, we can start doing things so much sooner.

00:08:22 Chris Bugaj
AAC never hurts, right? So I think that's what the research shows, right? It never hurts. So another way to phrase that question would be, is it ever too early to start AAC? If not, do it as early as possible?

00:08:37 Lucas Stuber
One question I wonder, when you talk about this, you know, twelve month intervention student, how do we define AAC? Are we talking about signing here? I mean, are we talking about any other modality?

00:08:46 Rachel Madel
Well, you know, that's really interesting is because I know that the definitions are kind of unclear, right. Some people are like, oh, approximations can be considered AAC, which I don't agree with that. Sign language can be a very no tech AAC, if you will, personally, in my own experience, and we can kind of get into pecs and picture exchange and how we utilize those or don't utilize those and our thoughts on that. But I think a really easy way is to just start incorporating more visual support. I think that, that a lot of times can be so beneficial to kids as a quick and easy way to really understand how to get their needs met without having the requirement of an approximation that maybe a lot of people aren't understanding or a sign. A lot of times I work with kids and their signs are approximations of signs. You know, sign language isn't universal. Not everybody understands sign language, but then on top of it, you have kids who are approximating signs, which is even harder. It's like, oh, that's his version of Eat. Like, okay, well, I'm happy you told me that, but I would have never known. So I think that using sign language and using just basic pictures is a really good place to start.

00:09:57 Lucas Stuber
Well, and that's, I mean, you hit on something that we deal with, with older age too, right? Using signs in this, in the supermarket when you're lost isn't as universally comprehensible as necessarily having an AAC device that's going to you know, provide comprehensible english output, you know, to the. To that listener that may not have ever learned sign language. You know, I guess one of the questions I always have is, like, say we're working on with a student that's just turned two, you know, has the classic regression sort of profile that we would expect in Asdev. Maybe had a few basic words that, you know, now are sort of not being used as much and some approximated signs. So what do we do? Do we, do we reinforce those signs and their ability to communicate with their family, especially that this is, you know, an early intervention standpoint where they probably are interacting primarily with their family and try to use that to cascade symbolic knowledge, you know, for the next little period of time? Or do we get started with symbolic, you know, with picture exchange or with some sort of basic ac? It's obvious that we need to get started doing something. But what?

00:10:50 Rachel Madel
One thing that I like to look at when I'm considering a child who's signing is how consistent are they using those signs and are they actually intentional signs? Because what I see a lot is a child will do the sign for more, and if they don't get the desired outcome, they'll then sign eat, and they'll kind of go rapid fire, go through all the signs that they know, which is a potential indicator that they don't understand. So they don't actually have that symbolic knowledge that the sign for more is different than the sign for eat, which is different than all done. So that's a big indicator to me. If a child is using signs very consistently and accurately, then I'm happy to kind of keep supporting that. But I think that it's really important to really piece out, is it intentional and do they actually understand, or they're just kind of, they've memorized these actions that they do that will eventually get them what they want. Because a lot of the kids I work with, especially with autism, they don't understand the differences between these signs. So I don't think it's necessarily doing them justice to keep having them sign when they don't truly understand the difference. And that's where the visual support can come in. You can sign more, show them that sign, and then show them the icon for more and keep building out that visual support with photos or on a device. And I think you can compare them really nicely together.

00:12:14 Lucas Stuber
Perfect. I agree.

00:12:15 Chris Bugaj
Yeah. I think it's kind of interesting because somehow that child that you described did learn the signs in some way. Right? Even if they don't have that symbolic representation for what each one means. And so that makes me question. I'll ask it right from the very beginning. Where are we going with that? Where are we heading with sign? Are we going to have even more signs? Is that going to be the student's primary form of expression, or should we be moving to something else as quickly as possible? And at some point, you have to make that decision. And so if the question is, the question is how early is too early? And the answer is, it's never too early, then maybe you should be looking at it at a device as early as. Yeah, two years. Why not? What would be the possible reason not to do that?

00:13:07 Rachel Madel
Yeah, that's a good point. I'm trying to think of a potential reason not to do it. And we're also, you know, I think, biased. We are on a podcast talking about AAC all the time and how much we love it. So, you know, I think that the biggest roadblock, potentially, is that parents sometimes have a really hard time with adopting this idea that their child will be talking through a device, especially in the beginning stages. It's hard. We introduce a device, parents kind of give up hope that spoken communication is going to come, whereas I think when we introduce signs, it's kind of like we can use these signs while the words are coming. We kind of transition from, verbal approximations aren't working. You know, we transition to signs. It's like, you know, we're just gonna give them some signs so that we can have their needs be met while the words come. Then you introduce a device, and parents are like, whoa, I still want them to talk. Which just goes back to this myth that we. We know is not true, that we introduce a device and the child will stop talking, or it will prevent spoken communication, which we know research disproves.

00:14:07 Chris Bugaj
Is it sort of like an anti vaxxing sort of concept? Like, the research supports vaccination. So the research supports is your child is if your child, if it's in your cards for your child to talk, this is going to help them talk faster, as opposed to let's wait and see. And because your fear is getting in the way of actually supporting the student's language, let's focus on the research. Am I. Is that a bad analogy?

00:14:34 Rachel Madel
Like, yeah, no, I totally think you're right. I think that it's the fear, to be fair, I think that parents have a lot of decisions to make when it comes to a child with special needs, and they always have that fear that they're doing something wrong. And they're not supporting their child the best way they can. And, you know, we kind of, as clinicians, we try to, you know, show them all the options. But a lot of times I feel like parents are just, like, overwhelmed with decisions to make. They don't know what the right step is. But I do think that it's fear. It is a fear based decision when you're not supporting it, something that could potentially make a world of difference.

00:15:12 Chris Bugaj
You know, I have definitely had parents or even paraprofessionals. She's like, yeah, I don't think she needs that device. This is a middle school student, because she can talk. Like, yeah, but she's not talking and she's not using it. And so I had to go through the research and kind of explain the same analogy like this. If she's going to be more verbal, this helps her become more verbal. And so I find that I don't run into it as often as, as other people. I seem to find. I just wonder what the percentage is out there. Most of the parents, when I do explain it to them, like, yep, your kid's not talking right now. And if they're going to, this is going to help them, they're like, okay, let's. Let's do whatever it takes. You know, I wonder if that's becoming smaller over the years, the percentage of people that have that fear. I don't know. I don't know.

00:15:55 Rachel Madel
Yeah. And I think that just technology is everywhere now. People are a lot more comfortable with technology, I think, than they used to be because we all have cell phones and tablets and all these things. And so I do think that's helping. That's helping the high tech AAC cause. But, yeah, I don't know. That's a good question. I'm wondering if there's other experiences with parent pushback that you guys have besides just, they won't talk. Are there any other things that you come into contact with?

00:16:27 Chris Bugaj
Well, much more frequently. Is that implementing it successfully? You know, I know you told me to model all the time, and I think we've covered that in previous podcasts, but not an outright rejection. I don't want to use this because I'm afraid they're going to talk. There's so much more connectivity out there where you can connect with other parents who have had similar experiences. Like, yeah, listen to them. We had that same thought. You know, we, we listened to the speech therapist when they were saying we should get a device. And we got back in the car afterwards and we're like, honey, do you think that we should do this? Yeah, they're saying, you should do it. And then two years later, we were turning the device back in because, you know what? It's completely verbal now, you know? Thank you very much. He's saying his ings, and he's adding Ed and he's adding plural s, and he's got hundreds of words that he's using, combining them all over the place, and we're turning that sucker back in. We don't need it anymore. But thank you for giving it to us, because we don't know if we'd be here if we didn't have it in the first place, you know? So connecting stories, I think, of other parents helps.

00:17:27 Rachel Madel
Absolutely. And I always tell that story to parents that have that exact fear. And I have a client that I work with right now, and he started, and he was using a dynavox, and he's literally talking so much that we were working on now, social language. And I'm like, we can't be talking right now. So it's just like, it's so crazy, though, because he's so verbal and he so communicative, and it's crazy. It would be hard for a lot of people to know that he used a device to communicate when he was, you know, three and four years old. So I just think you're right. We have to tell those stories, and I definitely tell them to parents who are kind of struggling with this idea. But I think that that story needs to be told more often. We all have those stories as clinicians, but it's kind of like, oh, you know, they've graduated. They don't need their device. But I think that it would help a lot of parents to see, look what this device, how this device launched this child's communication skills and how helpful it was. It didn't detract from verbal. It aided it and helped it.

00:18:34 Lucas Stuber
One argument that it was made to me recently, which I thought was interesting, was the idea that taking a two year old and giving them a device almost violates the concept of presumption of competence, because we need to assume at that age that the child is still going to develop language. The obvious, I think, response to that is we have a lot of evidence that multimodal communication is great all around, whether that's just bilingualism or it's using AAC and signs and oral language simultaneously. I think one thing that we need to really hit home, though, is that we do want to honor all modalities. If you want oral language to continue developing. Then when there is input orally, you honor it that you respect that as language just as much as the use of the device would be. One of the other complaints that I get is concerns about screen time.

00:19:18 Rachel Madel
Yeah, no, I get that a lot, actually. I think because I'm in LA and everybody's all about screen time, but yeah, it's like, especially with those young kids. I mean, I go into households and they have a zero tolerance policy with screens, so kids aren't able to watch any shows, play any games at a very young age. That's definitely a concern of a lot of parents, is we know screen time is not good for our kids, so why would we put a screen in front of them? I'm hoping to have a good friend of mine, Stacey Lindenberg. I'm hoping to have her on the podcast because she knows everything about screen time and how it can affect speech and language development. It's really interesting because I feel very conflicted because I see, you know, how sometimes too much screen time absolutely can be detrimental to speech and language development. But I also specialize in technology, so, and I know how powerful these devices can be for children who don't have the ability to use spoken communication or aren't able to utilize sign language. I think that it's kind of a tough decision that we have to make, but if approximations aren't working, we have to do something else. And I think that's where low tech AAC can come in as a stepping stone. Once we see how effective a communication board can be or a picture exchange system, then it's like, okay, well, I can't possibly print, cut, and laminate all these pictures that your child could potentially want to say. So that's where technology comes in. We can easily add a button on a device, and I think that's the cell that I typically do to parents. And where low tech AAC is kind of invaluable for those parents that are like, no, no, no, it's a really good stepping stone.

00:21:00 Chris Bugaj
So if you had to use that as a stepping stone, I would totally agree. Otherwise, I would go right to the device. Because how else do you model the ing? How else do you model the plural s? How else do you model ed? Typically, those things are not on your communication board. So I can see it, like strategically, like, okay, these parents, I've pitched the device to them and they are not going for it. Okay, then I'll take a step back. But otherwise I'd be trying to model on those, on that system. Because how do you put the little grains of sand in the sand timer for those morphological structures? Also, back on screen time for a second. I think we say screen time, but I really think there's two forms of screen time. There's active screen time and passive screen time. What I mean by that is, you know, my daughter will sit and just watch Netflix, and you should just sitting and chilling and watching, you know, some little mermaid or something. That is passive, which is, I think, is a totally different concern, that when she's playing Minecraft and her, she's actively engaging her brain to build things and solve problems, and maybe she's playing with somebody else, and when she's playing with somebody else, she's communicating with them. And so I think it's a real problem that anytime we have a conversation about screen time, we just call it screen time, when really there are two forms of it, and. And they should be maybe studied separately. You know, putting a communication device is not just saying screen time. It's. This is active screen time, and you're communicating. You're doing it with somebody else, you know, so the social. It's a social part as well.

00:22:33 Rachel Madel
I have one kind of question to pose to you guys, because I often get questions about pecs, and do you use pecs? And what about pecs? And you go straight to a device. And one reason that I like pecs, there's a few reasons that I'm not the biggest fan of Pex, but one reason I really like it is that it teaches initiation, and it teaches that communication is reciprocal. And I think that we can start a child on a device, but they can be in a room by themselves, hitting iPad, iPad, iPad, all day long, not understanding that somebody has to receive that message. And so I do think one of the benefits of pecs is it teaches that initiation piece. You know, you have to take a picture, and you have to give it to somebody. Now, I think we get stuck, right? I don't want. I don't want kids to get stuck in pecs because I don't think it's a robust system. Like you said, chris, the Ing endings and all those morphological endings, that's so important to start teaching at a really young age and start modeling. But I do think that initiation pieces is useful. So is there anything that you guys do to support that with going straight to a device?

00:23:44 Chris Bugaj
Well, I think if you have a device, it's still reciprocal, right? I mean, so saying want and handing over a piece of paper that has want on it or pressing want on a communication device. And the voice saying want is. It's the same sort of situation if a student is sitting in a room pressing want, want, want, and nothing happens. That is also a learning experience. Geez, I'm pressing want. No one's here. I'm not getting what I want. Yeah, you're right, you're not. It'd be just like that person ripping off the card for want and throwing it across the room, you know?

00:24:20 Lucas Stuber
Right. How often do you hear typically developing children, you know, making noises and saying random things in other rooms? So, yeah, a lot of those things. Absolutely. What about one of the other barriers that I hear about often, which is just cost of low tech relative to high tech AAC? Maybe that doesn't come up as much in LA.

00:24:40 Rachel Madel
Very true. No, but it's a very good consideration, and I think that it's something that we can start right away. I think sometimes the AAC, the high tech AAC process can sometimes be long and arduous, which we've talked about on other podcasts about how it doesn't necessarily need to be. But we're kind of really heavy a lot of times on the assessment piece and figuring out what system and what device and all these things. So what I like about low tech is that I can bring it back the next session and I can start using it, you know, and it's cheap. You don't have to worry about recommending, you know, an iPad, and then you have to buy a $300 app, because the worst thing in the world is to recommend a high tech system, have a family pay for it, and then it's abandoned. You know, I never want to see that. So I think it, it's kind of a nice stepping stone. I feel like I keep saying that. I keep circling back to the stepping stone with the low tech, but it can be really useful, I think, to warming up to the idea of high tech AaC.

00:25:44 Lucas Stuber
Well, and I would just chime in too, and say that it's becoming less expensive, too. I mean, even with a kid's Kindle or an Android tablet, it can get a quote unquote high tech device in the 30 or $40 range. And I'm not saying that that's going to be a robust system to last forever, but it's something that you can.

00:26:00 Chris Bugaj
Trial, you know, even go back, what, seven years. Augmented communication was outrageously expensive for anybody, right? And so to think, geez, you can get a robust language system for under $800. Maybe now it comes from a place of privilege, but I think there are so many different avenues for how to get $800. You know, I can go to volunteers. I can do fundraisers. I can go find school districts that are getting rid of their old iPads and getting new iPads. You know, there are so many resources available, like finding an iPad. It's very possible. I don't want to use the excuse of I can't afford it to say that you can't. You're sorry. Sorry. Your child doesn't get the robust language. They don't get to put the little grains of sand in their. In their sand timer because, I'm sorry, we just can't afford it. We can't figure it out. I often fear, Rachel, that people will lean on that light tech because of that. Instead of taking the time to try and brainstorm, how are we going to get high tech AAC? I also feel because people are more comfortable with it and they're not using it as a stepping stone.

00:27:05 Rachel Madel
Yes. I couldn't agree more. And I think that's where I have a huge problem with the low tech, because you're right. People stay within their comfort zone. They're like, I know pecs. I've been doing pecs for 20 years. I got this. And it really is limiting a child's abilities, and it's not helping in every way possible, which is slps. That's what we should be doing is giving every child the opportunity to expand to their, you know, their potential. And I think that a lot of practitioners and ABA therapists and teachers, they feel comfortable with pecs, and that's what they do. I just had a kid, you know, I've been seeing him for about six months. We started a system with him, and he's not using it as consistently as school would like, and so they want to go back to pecs. And I was like, what? No, absolutely not. It just like, there's never a situation that I can think of where I would ever want to go back to Pex. You know, it's just like. And it's just one of those things. Would you keep going back to that? If this is sometimes a long game?

00:28:14 Chris Bugaj
It's so ingrained in people to, well, we'll just change the tool, right? If they can't read this book, we'll read a different book and we can't read that book, we'll read a different book. No, you have to teach them differently to read. Same thing with the. You have to change your intervention strategy, not change the tool.

00:28:29 Rachel Madel
Absolutely.

00:28:30 Chris Bugaj
I feel like I'm going to get a lot of hate email this time.

00:28:33 Rachel Madel
This is a contentious one.

00:28:36 Chris Bugaj
And the reason I have such kind of strong feelings about this is not because it's just my opinion, and that's because I've read the research, and the research seems to suggest that the earlier we start with these sorts of interventions, the the better off students will do. So what's that one from Romsky? Early intervention in AAC. What a difference 30 years makes, right? And then there was that Esha leader article, AAC with energy from Beth Davidoff. And so they point to this idea that we need to start as early as possible. And I almost wish that the research would take it to the next level and say, because when you say AAC, that does include the low tech, it does include hex as a system. So could we look at the difference between low tech and high tech early? I wonder if that would be another research article or research any PhD students out there that want to do that? It would probably be great. I'd love to read it.

00:29:28 Rachel Madel
Yeah. And then another thing that I really liked from those articles that you mentioned, Chris, they talked about the effects of peer modeling and how absolutely amazing it can be. And it's just really interesting. I've done a lot of work in the classrooms, and kids are very interested. Kids who don't have devices are very interested in the kid that does have the device, and they're constantly trying to touch it. And a lot of times teachers are like, no, don't touch his device. That's his, that's his words. And my take on it is that it doesn't have to be all these rules surrounding the device necessarily. And what I've done with some kids is shown the peers how to model on the device. And a lot of times that's way more effective. As we know, peers are way more influential than adults could ever hope to be. And so if we can start incorporating those peers and saying, you know, well, let's say go and show them how to model the same way I would. First of all, it's less work on the paraprofessionals and the teachers, but it's also more effective because then we have that peer engagement, and I think that's such a. Such a great thing.

00:30:32 Chris Bugaj
Yeah, absolutely. I think we even had some episodes about that. Right? The whole Eric Inger episode about where you just provide a system for students, and now that all the students are having it, and then everyone else in the environment begins to use it even more, including the paraprofessionals. So you got the peers, the paraprofessionals, the teachers, everyone using it. And, you know, I think we've even shared stories where, like, take a kindergarten classroom, the teacher just uses the system to teach the reading, you know, because they're the big overlap between the sight words and early reading words with core vocabulary. And so, yeah, let's get the peers using it and more people using everyone should be using it.

00:31:11 Rachel Madel
Yes, that's the takeaway. Everybody should be using AAC as early as possible.

00:31:18 Lucas Stuber
So it sounds like we have a couple of different takeaways here. One of the things to touch on is probably the biggest thing is that ase intervention does not inhibit the development of speech, that it can facilitate all these other things through multimodal communication. For that reason, there's really no reason not to get started if it is a two year old. There might be considerations about low tech versus high tech or what that might look like, but there's no harm in facilitating augmented communication as early as possible. You know, a second piece is, you know, this concept of other people learning the AC strategies, right? So whether that's peer modeling, whether that's treating parents and not just paras, getting the whole team involved is fantastic. And then this, the low tech versus high tech piece, right? The pecs can be a very important step, you know, in terms of scaffolding up to the higher level. But, you know, an actual high tech speech generating device is going to be a lot more robust. It's going to facilitate all this morphology stuff, you know, which is foundational developmental literacy, and just overall is more flexible and, you know, also can be really engaging for the students.

00:32:20 Chris Bugaj
I just want to reiterate there, I'm not sure that's my scene takeaway about sex. So I started thinking, like, okay, in the 1950s, we had interventions that we used, and we don't use those interventions anymore. And I just wonder if pecs is.

00:32:37 Rachel Madel
In that same camp like anything else. There's always a transition period, right? So I think that that's kind of what we're seeing right now. We're transitioning to a different medium and a different way of doing things. And there's always going to be early adopters, Chris, and late adopters. I mean, I guess we're all early adopters, but I think that for those people who are late to adopt, I guess it can be a stepping stone. But let's not get stuck there.

00:33:02 Lucas Stuber
There's always considerations, right? There's always exceptions to the rule. But as a general principle, I agree, Chris. I think that especially as costs come down there really isn't any reason to not make the jump sooner. On that note, we are curious to hear what you think, and we may very well hear a fair amount of it. But come track us down on Facebook, talking with tech. There's a group and a page. Come join the group. We'd love to have the conversation there. Also, please do subscribe to the podcast on your medium of choice, whether that's Stitcher or the iTunes app, whatever that might be. That helps people to find us, which we really appreciate. And then one last note is that we are actually going to alter our production schedule a little tiny bit. And I want to give a shout out real quick here to our awesome producer, Luke Padgett, who's been with us here for a while. Right, Luke, thank you. So he's been giving us a ton of help and support and guidance for the last few months here. And then he's also going to be helping out or getting some assistance from a new helper named Mikayla, which we also really appreciate. And for that reason, we're going to take a little pause to rejigger our production. So we will be back with you all in June, so not very far away. And in the meantime, we hope to hear from you. For Rachel and for Chris, this is Lucas Duber. We'll talk to you all soon.