Episode 340: Sam Brydon: AAC Coaching Strategies for Parents, Teachers, and Staff

This week, we share Chris’s interview with Dr. Sam Brydon! Dr. Sam Brydon is a speech-language pathologist and researcher based in New Zealand who works with Torque Link, a nonprofit that conducts AAC assessments and provides support and training across the country. She balances this role with efforts to disseminate her doctoral research, which focuses on coaching and professional development for implementing AAC effectively!

Before the interview, Chris and Rachel dive into a great listener question. The listener has an 8-year-old child with cerebral palsy and cortical visual impairment who uses eye gaze to access his AAC device. They are considering adding more words to the device, but are unsure if this is a good idea. Chris and Rachel share why the family should follow their gut to push for more words on the device, highlighting the importance of presuming potential in every child.

Key Ideas This Week:

🔑 The Importance of Coaching in AAC Implementation: Dr. Brydon emphasizes that coaching, rather than simply delivering workshops or direct therapy, is crucial in supporting parents, teachers, and other communication partners to effectively implement Augmentative and Alternative Communication (AAC) strategies. Collaborative coaching that includes practice, feedback, and reflection is essential for lasting change.

🔑 Challenges and Solutions in AAC Adoption: She highlights barriers such as the misuse of AAC tools (e.g., as behavior management tools) and the difficulty communication partners face in mastering AAC strategies. Her research shows that success hinges on providing consistent, hands-on coaching to help partners integrate AAC into daily routines and interactions.

🔑 The Role of Motivation and Motor Planning: Dr. Brydon discusses the importance of ensuring AAC systems are motivating for children and that they utilize consistent motor planning. She notes that tools like core boards and approaches like LAMP (Language Acquisition through Motor Planning)   can enhance accessibility and engagement for users.

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 Talking With Tech. My name is Chris Bugaj and I'm here with Rachel Madel. What's going on, Rachel?

00:00:14 Rachel Madel
Chris, we have a question this week that we're gonna read from one of our Patreon members. So Stacy sent us a message and it's a good one, it's a long one, but I really feel like it's. It's something I want to talk about on the podcast, so I'm going to dive in. You ready?

00:00:32 Chris Bugaj
Yeah, of course. Is totally love that when people reach out to Patreon, we jump them right to the top of the list to talk about their questions. So I'm ready for it.

00:00:42 Rachel Madel
Okay. Hello, Chris and Rachel. I want to thank you for the years of podcasts that have launched my family into the world of aac. I was hoping that you might be able to help me. My oldest, Thomas, 8, is a kid who loves Winnie the Pooh roller coasters and jamming to his tunes. He has quad spastic cp, CVI and global developmental delays. He's been in therapy since he was three months old. Thomas has never had verbal speech, but has facial expressions that clearly indicate what's going on up there. His ability to sigh and eye roll puts any teenager to shame. I love this question already. He has been working with high tech AAC since the spring of 2020 and we've made some major changes over these four years. He began with core scanner on an accent 1400, first with one switch and then step scanning. This was difficult for a number of reasons, but he's super motivated by music and as soon as it clicked that he could say play to turn it on and go to skip to a different song. He found it useful enough to put in the effort. Just the ability for him to tell a stop or more was enough for us to be hooked on AAC for him. He still was only on the eight word page, but we wanted to move through the levels in Core scanner, though this required a lot of memorization since the program was not visually accessible. However, after returning to in school instruction in kindergarten, we saw a plateau instead of growth. It was clear that there was little buying in from his school team. They saw his hits more as random and said that he had not demonstrated that he knew cause and effect. After a separate issue of neglect in the school, we decided to put our energies into homeschooling. Fast forward to about a year and a half ago. His ability to use the switches was decreasing a bit with his massive growth spurts and spasticity and we were Getting worried. I was listening to Amanda Soper who you had on talking with Tech Speak on our weekly CBI support group call. She had talked about eye gaze, which with Thomas's visual impairments we had not considered. We trialed a device and were shocked to see how engaged he was. Now he has an accent 1400 with the eye gaze bar and is running in power 28 one hit with adapted symbols and coloring for his CVI. He does have a lot of seemingly random hits and is still learning many of the symbols, but when he's motivated she put an air in quotes. Watch Winnie the Pooh quote you stop bad, don't end quote and go home. It is very clear to us that he can do it in the right situations and settings as his parents were thrilled with the gains he's made and he's a happier kid with his device. But we feel like we're hitting a point where we need to make some decisions on what to do going forward. The goal was always to give him as robust a system as possible when it came to AAC and going to the 28 sequenced seemed to be the next step. Our SLP is so supportive of Thomas, but admits that CVI is not her strength. She was hesitant to move from one hit but told me that she will support whatever we think is best because we know Thomas best and we do our research. This scared me because while I do feel I know Thomas best, I still feel I know very little. My CVI call support group questioned why I would make the boards more difficult and if anything I should probably take words away on the main screen and give more access to quick phrases. While no one had said that Thomas won't be able to use the sequence board, they both pointed to the struggles he still has with the one hit. I feel like I have learned that giving more access to robust systems is always preferable, but the feedback I'm getting from others is that my son is an exception to this rule. He is a complex kid. I gaze while easier than switching at this point is still taxing. CVI makes his vision very dependent on his surroundings and his health. Still, I wonder if it is worth continuing with this level at 8 years old just to have to change up his system again and relearn. My husband and I have always been the ones to initiate any changes to a system and for the most part it has always worked out for Thomas. In the end, seeing this pushback on our idea for the next step forward, we're left wondering if we would be doing the right thing I think our question comes down to what do you look for to decide when to proceed to the next step? If we were to choose to move ahead, what should we be looking for to make sure it was the right choice and what is the appropriate amount of time to try it? Finally, I would ask if there are any cases when someone's disability really does make working with robust systems too difficult and it's more beneficial to just work with a pared down system. I got a little emotional at the end of this, Chris, because I feel like this is one a very common experience for families, unfortunately. And I think that Stacy is facing a lot of people who might not be presuming potential with Thomas. And so I just, yeah, was like choking up a little at the end because I feel like it's so. It's so hard to watch a family struggle and advocate for their child and to be met with some resistance. And I can totally see how Stacy might be feeling super conflicted about making these decisions because you know, ultimately when you have people, people who are saying no, we don't think this is a good idea, then of course you're going to start questioning things. So those are my initial thoughts, Chris, but I'm curious what your thoughts are.

00:05:45 Chris Bugaj
Well, no surprise you and I are on the same page. I also felt for this parent and got a little choked up reading or listening. Reading it the first time like when it came to our inbox and then you reading it aloud. There's one factoid in there that I want to hyper focus on that I think many people would gloss over. But it is a glaring fact that I think is the most important fact out of all of them that we're going to start to tease through. And here's what I heard. He's 8. He's not, he's not 28 or 38 or 48. Right. He's 8. Which means you've got tons of time in someone's life to always keep learning language and keep going and changing and growing and, and keep, and keep learning. Right there. It seems like what you said, people not presuming potential would be like. Well, you know, we've been at it for a couple years and we're not seeing the progress. But what are those milestones? I don't understand the progress. What do you need to make? I think that's what the parents asking, but that's what I just wanted to highlight first is that when we're talking about presuming potential, he's 8. So we've got time. We've got lots of time to continue to grow. I mean, he's got his whole life in front of him.

00:07:18 Rachel Madel
Yeah, and exactly. I thought, first thing when I thought, I said, wow, eight. Listen to all of the skills that this eight year old has. And you know, for someone who does this work and works with so many different students, having this level of skills as an eight year old is wildly impressive to me. So I just hope that Stacy, you're listening and you feel, you feel good about the progress that he's made because it can take a long time for students to learn alternative access and to learn language. And it sounds like he has made a lot of progress. Um, the one thing I wanted to call out, Chris, which I think is maybe the second most important sentence in this question, which is when he's motivated, he can say a lot. And so he and she gave specific examples, says, quote, he does have a lot of seemingly random hits and is still learning many of the symbols. But when he's motivated and she gives three phrases, watch Winnie the Pooh. You stop bad, don't and go home. And so we're listening to, to a student who is putting lots of ideas together and formulating a lots of ideas and you know, to the question of how do you know when the next step is, when you're ready for the next step. There's no like clear cut answer to that question. However, the things that I'm looking for is when they're motivated. Right. Because we know students will only show us their, you know, skills at the truest level when they're motivated. And it's, he, he's putting lots of ideas together, he's using lots of language. And so that was something else that really stood out to me is like, we're not talking about, you know, him only using single words or only using nouns. It's like, I see core language, I see, you know, using, don't. I mean, that's negation. So like, there's a lot of advanced language that I'm hearing here, which is even more reason than I think to lean into robust. The more robust the better. Because who knows what you would see again when motivated with a more robust system.

00:09:43 Chris Bugaj
Let's talk about those mishits for a moment because it's really hard for me, listening to this story to know that they're mishits. Let's take away the cvi. Let's just say this particular student can see all the symbols. If this student is not reading, then what would a mishit look like? Because he might be trying to look at a particular symbol without the text underneath it. You don't know what that symbol necessarily means. So your eyes might go onto it and say, what is that again? Oh, okay. And you're listening to it. And so is it mishits or is it learning the system? Right? And then let's add CVI back into it. And now it's like, okay, now my brain has to really figure out what that symbol is and how it even maybe relates to what the word is that I'm. That I'm. That I'm hearing once it's being said out loud. And then what does that instruction look like to help me tie that? Like, what are the salient features of that symbol and how does it tie and tie to what I'm seeing and to the meaning of it? So there's a lot there that I wouldn't just be chalking it up to. Oh, they miss it. You know, it's not as simple as that.

00:10:54 Rachel Madel
To add to that, Chris, because I completely agree, when we have a student that has any type of visual impairment who's using aac, we have to be super cognizant of the fact that what feels like mishits is them actually figuring out where they are on their device. So I'll give a quick example. I was working with one of my students, and he seemed to be perseverating on acai. He would just say acai all the time, and it was just like, yeah, like, he loved acai bowl. So, like, that was something he was super motivated by. But then we realized it was at the top center of his device, and he would scan around until he found acai as an anchor, and then he would know exactly where he was on his device. So I would also encourage, you know, Stacy and your team to think about, really analyze these quote unquote mishits, because it could be Thomas navigating and figuring out where his anchor spot is. And if he doesn't have an anchor, maybe that's something you could explicitly teach for him so that he can figure out where he is. Again, we have to assume that he has. I mean, he has cvi, he has low vision. So we have to think through those strategies and give even more grace to him exploring. And again, this idea of quote unquote mishits.

00:12:25 Chris Bugaj
Totally, totally. A phrase that kept resonating in my head as I was listening to that story was make him prove that he can't, as opposed to make someone prove that they can. So my thought is, if they're Asking the question, should we go to sequence? I don't see a reason not to give it a try, you know? And again, with some explicit teaching around. Are you saying, like, you disagree or like.

00:12:52 Rachel Madel
No, I completely agree and have other things to say.

00:12:54 Chris Bugaj
No, please go ahead.

00:12:56 Rachel Madel
But, like, my other thought here is that I can understand how a family feels. Like this is such a huge decision because we're taking something that he knows and now we're progressing and maybe we're making the wrong decision. But when I'm working with complex cases, it doesn't hurt to start trying something. And it doesn't mean that you go from one hit and then we're at sequence and we're never going back to one hit. Like, it doesn't have to be this either, or black or white. It can be slowly over time. We're going to start when we know he's motivated. So like Winnie the Pooh, we're going to start trying sequenced, right? We're going to start trying to see what happens when we open up and create more robust opportunities. Can he sequence hits together? And then we can go back to the one hit because that's what he's most familiar with. Um, the transition doesn't have to be so stark and you just need to get information. Trying something like this, trying a more robust AAC is the least dangerous choice. Right. But it also gives us information. And to your point, Chris, like, let him prove that he can't do it over time.

00:14:05 Chris Bugaj
Yeah, I love what you're saying there, that it does often seem like once we make a decision, it's one or the other where you really can drift in and out. Same thing with, with masking, we often hear like, okay, do I mask or unmask? Well, leave it unmasked most of the time. And then if you want to explicitly teach, like, hey, you keep pushing this button and we're not sure you know what it means. Let's teach what that means. Like, and this is where we're going to talk about those salient features. And we're going to tell stories and sing songs and. And maybe tie it to some Winnie the Pooh story, whatever word they might be hitting. But you're going to teach that explicitly, maybe with less icons on the screen. When I say that, I mean the icon is in the same spot. They're masked. Right. For 10 minutes. And then you flip back to the other screen. That is. That's got everything unmasked. Right. So you can pick these moments to do. Very focused instruction to teach like this. This is how this goes, right?

00:15:04 Rachel Madel
Absolutely. And I just think that these nuances become really important when we're thinking especially about complex cases. And I think that, yeah, I just don't think it has to be this, like, either or decision. And it's like, I'm assuming there's no harm done. I'm always down for trying something if someone has an idea, especially if it's, let's, like, give more access to more robust aac. Like, what a great idea, right? But if someone has an idea, try it. Like, try it. And we're just getting information. I'm always saying that to my clinicians. I'm like, try it. Let's get information. I'm saying it to my families. Let's try it. Let's get information. Because the reason a case is complex is because we don't have enough information. Right? We don't know why he's, you know, not as, quote, unquote, successful or he's mishitting. But it's like, what's the roadblock?

00:15:58 Chris Bugaj
Is it vision?

00:15:58 Rachel Madel
Is it. You know, he's just not as practiced at targeting with eye gaze. Like, is it positioning? Like, there's so many different variables. And so when we have a lot of variables, we need to just start gathering information about those variables and trying different things to see what the roadblocks actually are so that we can come in and we can adapt based off of the information that we gain.

00:16:23 Chris Bugaj
I want to talk about the least dangerous assumption. So I heard in that story, the parents say that some people said, but your child's the exception to the rule. Like, we. We all agree that it should be more robust except for your child. And I hear that not just about vocabulary, but about kids in general, where it's like, yeah, but not my kid. Like, whenever we do a presentation and we're talking about, you know, the least dangerous assumption, or we're talking about the, you know, the who's. Who's a candidate. I'll put that in quotes for aac. And it's like, everybody, you know, what's the least dangerous assumption? There's. There. You can see it in some people's eyes. They think like, yeah, but, Chris, Rachel, you. You don't know. The kids that I work with, like, it's. They're the exception to the. There is no exception. There is none. There. There's not. Because that would be the more dangerous assumption. Right? So you can't go into any situation, any situation, thinking, but not this kid. Right? It's like, everybody gets It. It's figuring out how to do it right. So, yeah, I don't think. Parent speaking directly to you. I don't think your child's the exception. I think your child's probably exceptional. But look at those abilities and skills. Let's see how we grow on them. Don't let anyone say, oh, bother, when they talk to you about how you're. Do you see how I did there? That was a winning.

00:17:54 Rachel Madel
I saw it, Chris. I saw what you did there.

00:17:57 Chris Bugaj
Don't let anyone be the Eeyore to your piglet.

00:18:01 Rachel Madel
Wow, he's really coming full circle with the dad jokes intersecting with Winnie the Pooh. The last thing I'll say, Chris, is that I feel really strongly that families need to follow their intuition. Like, there's something in their gut that's saying, give him more, he can do more. And I really believe that families should follow that and everyone should follow that.

00:18:29 Chris Bugaj
I'm going to add to an extent to that, especially here, who. Someone's been at this for many, many years, has been listening to the podcast for many, many years, has been out there, and I'm going to put this in quotes, too, doing their research, because they didn't just go to a Facebook group and be like, I don't know, what app should I use? Right? And I just say that with. I want to add that, that, that qualifier to this. Because I've had parents that I've met that have been like, yeah, I opened this app and I didn't make sense to me, so I changed everything. I'm like, you did what? And then I. Yeah, my kid has motor planning difficulties, so I picked this thing. Like, but the thing you picked has many more hits than this other thing that you pick. Like, so. So, yes, trust your instincts. If you've been at it for a long time. If you're, you know, I don't know, three months, six months into this journey of aac, maybe listen to the podcast. Maybe listen to people who have spent their whole darn life trying to figure this out. Right? You don't know more than they do, necessarily. Yes, trust your gut, but especially in this case, parents. I love what Rachel's saying because you've been at it for so long, but if this is your first podcast episode that you're listening to and someone listened to it, you got to put more time in to start trusting your gut, because you might not know some of the rationale behind why we're choosing the things we're choosing. Is that fair?

00:19:56 Rachel Madel
It's fair. Yeah. It's fair. I do think, though, that, like, when something's gnawing and it's different than. It's just like, I'm just gonna put this device on and I'm gonna program things that's different than, like, something that's like, keeping you up at night, being like, okay, like, something's not right here. Like, I feel like that is just an intuitive knowing that families can get. And I don't think someone's gonna have that when they just are like, I'm just gonna program this device and I'm just gonna do this thing. So I don't know. I.

00:20:24 Sam Brydon
We might.

00:20:24 Rachel Madel
Is this the first time we've ever disagreed, Chris? I don't know. Maybe.

00:20:27 Chris Bugaj
I can think of specific situations where parents have come up to me and they're like, but the symbols don't make any sense to me. And so I changed it because I know better than the people that put this app together. And it's like, but do you. How. How. What's the chances that you spending a few, I don't know, months thinking about aac? No more than people who've been working their entire lives in aac. Yes, your kid is unique. I get that. I can see the emails coming from all the parents. But just trust me when I say there are some people that know what they're doing. Spend your time figuring out who those people are and who to listen to. Because yes, there's plenty of speech therapists that don't, plenty of teachers that don't. Right. But if you can find. Spend more of your minutes rather than redesigning AAC and, and listening to your gut there, then listening to your gut that maybe, I don't know, and maybe I should be spending my time finding people who do. Is that fair?

00:21:25 Rachel Madel
It is fair. And I think, I think. I mean, I don't disagree with you in the sense that I think that following feedback from people who are very well versed and knowledgeable about a topic is important. Like, absolutely, I agree with that. I think that it's just someone thinking that the symbols don't make sense and changing things. That's not from an intuitive gut. I know in my gut that this is the right decision. And you're like, no, you disagree with that. I just, like, I haven't.

00:21:56 Chris Bugaj
Because intuitively you'd be like, you know what? I think we start with four cells because this kid has cvi. And so once they learn these four cells, these four large cells, intuitively that makes sense to me. And then it's in my gut that, you know, then once they learn this, 4, then we'll go to 8 and 8 to 16. And we know that doesn't work right. We've worked with so many kids. At least I know I have that. That never worked right. And so I could tell you, don't do that, because it might feel right in your gut to start with. 4. But I can tell you from experience, that doesn't work right. And you know. You know that, right? So there's this fine line, I think, between, like, following your gut versus knowing your kid, you know, and doing your. Spending your time seeking out those that. That. Okay, so, for instance, so maybe this is where we. We come together. Imagine someone going, yeah, it just didn't feel right to me that the symbols didn't feel right. So I said, I gotta change all the symbols. That's one option. Or. It just didn't feel right to me that the symbols didn't make any sense to me. So I did some homework to figure out what didn't I know. Why are these symbols the way they are? So I started looking for people that might be able to explain it to me. And I feel like that's. That's the line that we're talking here, is that I want people to do their. Through their due diligence when they have that inkling in their feeling that something's off before they go running with it. Is that. Is that fair?

00:23:23 Rachel Madel
Yeah, I think that's fair. I think that's fair. And yeah, I. I think it's like, I'm thinking more through, like, a. I think sometimes we. We have ideas in our mind, but, like, our body and our gut, like, doesn't lie to us. And so it's like, it's only these, like, big decisions that we have to make. Like, am I doing something wrong here? Like, am I with the wrong type of therapist? Is this, like, the wrong AAC system? Is that advice that someone gave me feel wrong in my body? Like, that's different than, like, what I'm learning in my mind and all the thoughts and all the things. And so I think that's the distinction that I'm making is, like, when something feels wrong in your body, like. Or like you're having a physical reaction to it. Like, follow that, because if you pull out that thread, oftentimes, you're, like, gonna make a different decision or you're gonna get the information that you need to make a more informed decision. And so I think that's kind of maybe full circle where we come together.

00:24:20 Chris Bugaj
Yeah, totally. Totally. Follow that gut. It's what you do with it afterwards, right? It's do I chase. I chase the evidence and make sure I'm listening to the right people, not necessarily follow my gut and make a decision based on that gut.

00:24:35 Rachel Madel
Yes, totally. And I think that's exactly what Stacy did. So we're really excited to have Stacy that you sent this message. I feel like it was such a good one to talk through on the podcast. And we're also super grateful, Stacy, to you and to all of our Patreon members. Patreon is what makes this, this podcast possible. And for all of our supporters, we're just so grateful that you have spent money to help support us. We have a team of people, Luke and Michaela, who help make this podcast possible. And without that support, we wouldn't be able to do it. And so we're super grateful. And Chris, we have some new Patreon members that I want to shout out since we're. We're talking all about the Patreon.

00:25:17 Chris Bugaj
Awesome.

00:25:18 Rachel Madel
We have Lynn and Amanda and Allison and Gemma and Kathleen and Holly. Thank you guys so much for becoming a part of our Patreon recently. And again, we are so grateful for your support. We really couldn't do it without you. If you guys are interested in becoming Patreon members, you get years at this point of behind the scenes content, extra bonus videos. I share a lot of my resources on there. I share discount codes to courses of mine, so there's lots of free perks. And if you want to be a part of our Patreon, you can go to patreon.com talkingwithtech and you can join us.

00:25:59 Chris Bugaj
All right, without further ado, let's listen to my interview today, which is with Dr. Sam Bryden from New Zealand. And guess what, Rachel? We're going to talk all about one of our favorite topics, coaching. If you enjoy talking with tech, we could use your help in spreading the word about the podcast. Please take a moment to leave us a review on itunes. The more positive reviews the podcast gets, the easier it becomes for others to find it. The more people who find the podcast, the more the word spreads about how to effectively consider and implement aac. And who doesn't want that? If that sounds good to you, please take a moment and give the podcast a quick review. We'd so very much appreciate it. Now let's get back into the episode. Welcome to the Talking with Tech podcast. My name is Chris Bugaj and today I am joined with Dr. Sam Brydon. Sam, how's it going. Can you tell us a little bit about who you are and what you do?

00:27:06 Sam Brydon
Hi, Chris. Yes, it's going really well. I'm a speech and language therapist and a researcher. I live in New Zealand. I emigrated here from Britain, so my accent doesn't match. I currently work for a charitable trust called Torque Link that covers the whole of New Zealand and carries out AAC assessments and also provides support and training around aac. And I only work for them three days a week because the rest of my time I am trying to disseminate my doctoral research, which I finished last year, through running professional development for other professionals who work in the field of aac.

00:27:55 Chris Bugaj
Wait, so your doctorate is all about teaching other people about aac?

00:28:02 Sam Brydon
Yes, my. My doctorate was, you know, how these things change as you go along. My doctorate was initially looking at an AAC system that's really popular here in New Zealand. I'm going to hold it up for you, but you'll have to maybe do some describing. So it's a 77 core board with what you'll see is a really extensive fringe vocabulary, attacks at the top. And over the last 15 years these have become really, really widely used. New Zealand, because New Zealand's a small country, you get a lot of consistency rather than, I know in other countries you get different systems all over the place. So although we use lots of different AAC systems in New Zealand, this was becoming really popular as a sort of starter system. And I know in a lot of special calls, staff wear them all the time. It's like the go to baseline system. So that's how my doctorate started. But as I was developing the research, I moved much more into actually what do communication partners need to be supported to use that system with children or any AAC system actually. So it morphed into that. So I focused on that. And now the professional development that I'm running is really looking at trying to change how people support communication partners so that they don't just do an info dump and run and trying sort of to tease out why AAC fails and is abandoned so frequently and the actual amount of support that communication partners need to make it successful.

00:29:55 Chris Bugaj
Oh, my goodness. Well, this is something that is near and dear to my heart, Sam, because what you just described is exactly my experience is that for the first number of years as a speech language pathologist, now I work as a in assistive technology and I support a team of people that, that fan out across our district. What you just described was the experience here in Northern Virginia, but across all The United States, I would argue, unless you had. You were very, very, very lucky. It was spend a lot of time doing an assessment to get the right thing, then you, or at least what you thought was the right thing, and then you maybe drop it off, give a little bit of training, but you had so much, so many other assessments to do. You're on. And I often felt like the training I did was awesome. I. Well, come on, I told you, model on the device and, and, and use core words, right? So just do that and you'll be fine. And I kept finding over and over again, like, what's the bottom line here? It's me. I like, they're not. Everyone's not doing what I'm telling them. I must be doing something wrong. And that led me to this idea of, well, actually, for me it was motivational interviewing that led to coaching. That was my sort of gateway, if you will. I know we're going to get there, I know we're going to talk about coaching. Let me just take us back about for you. How did you get interested in AAC in the first place?

00:31:21 Sam Brydon
Well, I used to be an early intervention speech and language therapist back in the uk and when I moved to New Zealand, I worked for the Ministry of Education here for a couple of years while I just found my feet in New Zealand. And then what year was it? It was about 2009 when I started working in a specialist school in Hamilton here, the North Island. And that's when I really started to become passionate about aac. When I first arrived at the specialist school, they had put heaps of funding into PECs and there were PECS folders everywhere in that school. Everyone had had training. The PECS folders mostly sat on high shelves so that they didn't get in the way. And for the first two years that I worked there, I just felt like it was my job to go around and get folders off shelves and try and make people use them, but it just wasn't really going anywhere. And I knew something wasn't working, but I didn't have a clue how to fix it. And the thing that was really transformative for me was going to Gail Porter's POD training. She came to New Zealand for the first time. I think it was 2011. And it was like a sort of moment for me. I just sat there thinking, yes, yes, naturalistic. Oh, modeling, yes. Surrounding them by the language. Yes. Robust vocabulary. Oh, just everything. It just blew my mind. And, and that there was. I think there was three of us at the training from my school, all speech and language therapists. And we drove back in the car going, what, what are we going to do? How are we going to change everything at school? And we'd already kind of worked out that making. I think our school had 150 students at the time, probably 80 of those needed to use AAC. And we had already realized that 80 pod books, 80 personalised pod books was probably not going to be possible. So we were trying to think of something that was going to work as kind of a base system. And that's where we came up with the core board that I showed you. And the idea that we could have a base system across the school with everybody, all the staff, including the admin staff, the teachers, teaching assistants, modeling all the time and making a really aided language enriched environment. And then we could do sort of individual assessments to look at what different students needed on top of that. And that was like. It became, I get a bee in my bonnet about things and then I just can't. Like, I was dreaming about it. I constantly dreaming about it. I still have the occasional dream where I'm wearing a core board and trying to demonstrate how to use it to people, but someone's moved all the symbols around.

00:34:13 Chris Bugaj
Ah, a nightmare, you mean.

00:34:16 Sam Brydon
I'm so annoyed. In my dream I'm like, you can't do that because of the motor glass.

00:34:21 Chris Bugaj
Yes.

00:34:21 Sam Brydon
Like a constant dream for me anyway, I was on, like, I was on one. Me and the other speech and language therapists we presented to the management team. We got the management team on board and we sort of slowly changed things around and became just. Our school really had a focus on aided language modeling and having robust vocabulary systems and. And it's all gone from there, really. I just got more and more passionate because what we started to see was real change then instead of like children tiredly handing over a symbol so that they could ask for their lunchbox, they were starting to get excited about communication and they were running up to us and grabbing the core board to tell us something that they wanted or something that they'd. It wasn't, you know, obviously it wasn't perfect and it was, it was a rocky road, but I was just seeing how much difference it could make and how exciting it was when it made a difference. And that's, that's how I landed up being this passionate about aac.

00:35:24 Chris Bugaj
Awesome. That's so exciting. So it really sounds like. I don't know if you're familiar, but I am really a champion for. And I think I've Maybe. How do I put this? I came up with this phrase called the specific language system first approach. But it's maybe that's putting language on something you are already doing, which is, we've got a thing. Let's use this as our tier one. We know it's not going to work for everybody, but we're going to scale it up from there. We're going to build a culture around it. And so you did. So you're building a culture around it. What did the training slash professional learning look like for the people that were implementing the tools? Sure.

00:36:05 Sam Brydon
Well, this is where I got my first inkling into, into how information dumping doesn't work and how difficult aided how difficult AAC actually is to implement if it's not something that you're immersed in, in your brain. So we may. I, me and my team of SLTs developed some lovely workshops. Like really, really. We thought we'd done a great job. And they, they had practices, they had brainstorms, they had group discussions and when we were running them, so we ran them for teachers, we ran them for teacher aids and we started to run them more widely for the area around because people were starting to hear about, oh, they're doing this. And some people traveled in, other professionals, other schools started to travel in. And while we were running them, we definitely had amazing engagement. People are excited, they liked the workshops. But what we found was that apart from for a few, really people who really had communication at their heart, there wasn't carryover over time. You know, we would then be going, still not doing it. They're still not modelling, they're still missing opportunities. They're using their core boards to sit on when the grass is wet, they're using them to fan their faces when they're too hot, but they're not. Or something else we saw was that they started to replace the visual supports for behavior, which was another unintended consequence because the teachers realized they didn't have to wear those little lollipop round, stop, listen, sit. Because they had it all, they had all that vocabulary there on this board. And so it was starting to become an agent of control rather than that sort of modeling that's comments and questions and funny things and you're being silly. Ha. That kind of thing. It was, you know, it just wasn't. We also ran parent workshops and again, you know, we weren't even able to give that support in the home environment because the way our service is set up when we work in specialist schools is we're meant to deliver our Service in the school. So the parents would come into the school, have the workshop, and then go home and struggle. Goodness knows what that looked like for them. Poor things.

00:38:31 Chris Bugaj
Sam, the way you say that, it reminds me or analogy that I like to use is like, hey, you came to this concert and I taught you how. I showed you how to play a piano. And then, okay, now you're supposed to play the piano in concerts yourself, and you're supposed to play it at home. And. And it's like, well, I just watched a video of someone playing a piano and maybe learned the theory about playing the piano, but I didn't actually get to practice playing the piano.

00:38:57 Sam Brydon
Yeah.

00:38:58 Chris Bugaj
Is that fair?

00:39:00 Sam Brydon
Yes. And like this. These aren't easy skills, I don't think. I think we as speech and language therapists forget how difficult this stuff is. Like, when you talk about aided language modeling, you're like, just point to the symbols and say the words. Easy peasy. Or. But it's way more than that as well. It's not just aided language modeling. It's setting up the right environment. It's engaging the child in fun activities. It's using really sensitive prompts and encouragements to get them interested. It's responding in the right way at the right time. There's like a whole set of skills that are not intuitive, that don't. You don't naturally know that then have to be applied to an incredibly complex child who probably is not really delighted by the change you've made in their life. Like, I know some children grasp their AAC system with delight and go, I've been waiting for this my whole life. But I would say the majority of children don't. They're, like, not sure about this. I've been getting along. Been getting along perfectly all right, thank you. Helping myself to everything. This just looks like a extra layer of difficulty.

00:40:11 Chris Bugaj
Yeah, for sure. For sure. So recognizing that people were fanning themselves and they were using it as. Like you said. I love how you put that, like an agent of control. Like, oh, I need a way to tell kids what to do. And now I can point to this board to tell them what to do. These are things that are problematic. What changed?

00:40:33 Sam Brydon
I mean, we never totally nailed it. And I think that's what led to me changing the direction of my research, because I was aware that I. Any skilled speech and language therapist or professional that's been working with AAC for a long time knows that they can usually, within 10 minutes, get a child using AAC successfully. Like, you find out what really floats Their boat. You set up the funnest game in the world. You take a few turns, you do a bit of modeling, then you wait. Child usually usually points to the symbol that you were hoping they were going to point to. You can usually get things happening really fast and everyone's like, wow. But the carryover was just this endless, endless conundrum for me at the school. It was like, why isn't this working? Or why is it working in some classes? And then the child moves to the next class and it's completely abandoned and it doesn't work. And why is it so hard for our parents to do what's happening at school? And it just consumed my life, really. So it's what I decided to focus on in my research. But I don't think I ever really fixed it. While I was working at the school, I think we started to make changes and we did bring in more of a coaching approach, but we weren't. By the time I left working at the school, there was still so much more work to be done.

00:42:08 Chris Bugaj
So let's talk about that. You said we started to bring in a coaching approach. Like I said, I turned the camera on myself and said, something I'm doing is not working because I'm seeing such parallel stories. And so I went out and did research on my own. How do people change and adopt new things and learn things? And I came across this term motivational interviewing, where it was in psychology, it's someone goes to get help from a psychologist. And that psychologist doesn't go, oh, you want to quit smoking? Here I have it. Quit smoking. Well, it doesn't work that way. You can't just tell someone what to do. You ask them questions and they reflect on those questions, and then you summarize what you think they heard or what you think you heard. And I was like, oh, oh, oh, this is a whole thing I haven't even tried. And. And then that led, like I said, gateway to even more studies. So that was my story. What was your story? How did you go about, okay, I know this isn't working. You mentioned you eventually went to coaching. What was the bridge in between?

00:43:11 Sam Brydon
I think it was in the early days of my doctoral research. I. I started to think about. When I was starting to think about what experimental design I wanted to use. I had these early ideas that were completely unethical about sort of having 10 children in one room who get older systems. 10 children in a room with, like, more robust vocabulary and speech and language therapists. And then I thought, thought, this is rubbish. Well, my supervisors said, this is rubbish. My supervisors at Massey University, I should say, who were constantly having to redirect me onto the right track. And I started to think, none of this really matters. When I was trying to compare the difference between text and what we were using now. And looking at the research, I realized that hex research is quite solid because it's able to look at cause and effect. It's able to look at, you set up a situation, they have a motivator, they exchange a symbol. Boom, you can count that. But what I was trying to capture with this more robust system with aided language modeling and with far more vocabulary available is that it wasn't just about that. It was about the children were using more communicative functions, they were doing things more spontaneously, it was getting used across more environments and I was getting greater buy in. And when I started to pull all that apart, I just couldn't find a research design that would really capture all of that. And then it became more and more evident to me that it didn't really matter what I could make children do. It mattered more what other people, the people who actually matter to the children, the communication partners. Partners, the family, the teacher aides, the people that they spend all their time with. It mattered what they could do. And that's when I really started to think about, well, what's worked for me in the past. And when I was an early intervention speech and language therapist before I came to aac, I had done lots of Hannon training. And so my main focus was on parent child interaction or teacher child interaction. And I was running more than words courses. And the thing that I knew worked when I was a Hanon trainer was not the workshops, it was the coaching. The parents. Whoever came on my Hannon workshops always said the thing that really worked for us is when you came into our home and then we practiced and then you told us how we were doing and we talked it through and we problem solved. That that's the feedback we always used to get. And that's where I started to think, well, my research is going to need to include a large element of coaching, because that's really what works. And I don't know why I hadn't thought of that more before. I think it's because the way your life is set up as a speech and language therapist in a school is not geared towards coaching. People always want you to deliver workshops. It's seen as time efficient. It's seen as getting lots of people to do something at once. So. So I think the Idea of. Especially the idea of doing one to one sessions with parents but also finding time to do a coaching approach with teachers or teacher aides is challenging.

00:46:53 Chris Bugaj
Well, a couple comments. The first one is in our neck of the woods. A problem that I see is that a lot of people use the word coaching as a synonym them for helping and it's sort of an umbrella term. So let's start there. Which. Or let's. Maybe that's the next thing is we've got a tool, we've got training. Like you said, maybe I can you come to this thing and I created slides that go behind me and I'm telling you this thing. What is coaching? How is that different? How do you define it?

00:47:27 Sam Brydon
I think it's really important to define coaching because I think there's a real tendency at the moment coaching is a real buzzword here. I don't know if it is. Oh yeah, here think people say they're doing coaching. I've got the words of my. One of my supervisors, Tara McLaughlin in my head here that there's a real risk that in 10 years time people are going to say oh I tried coaching and it didn't work. And I think it's because there's a lot of stuff that happens when people say they're coaching that isn't the bit that makes the difference. So for me coaching is collaborative. You come together both with skills and knowledge. In terms of aac, I see it as I have skills and knowledge around AAC strategies. But the person I'm coaching brings their knowledge of the child, their knowledge of the routines that matter to that child and that matter to them and how they're going to make it work for them and their underlying skills with that child and helping the child to manage, to regulate and what the child loves. All of that comes together. So it's completely collaborative. It's agreed from the start but fundamentally it involves opportunities for the coachee to practice the skills, to receive feedback on what I've observed, what the coach has observed about them practicing the skills to be able to reflect on that and do problem solving and then plan moving forward which bits are going to change what they're going to try next.

00:49:12 Chris Bugaj
We've had a couple episodes now about coaching and one of the ones that stands out to me is in our neck of the woods we had some colleagues from neighboring school district and they. Dr. Lauren Kravitz Bonnet is her name and she was saying there's actually kind of a model for this already and that is an early intervention model. Is often working like with parents. Like at least in the. In. In the United States it would. We would go to the home, we might show the parents something, but then the parents would do something and we'd work with them to give them feedback. And so it's. And then that model immediately stops when you go off to school and it's like, well, what happened to the parents? And how do you. When they're the. They're going to be the through line in somebody's life. Where in the United States you might have. In your. In your public school school experience. I don't know, seven different therapists, you know, 75 different teachers, you know, okay, that's an exaggeration. But maybe 12, you know, so. So it makes a lot of sense to keep that model going. Is that a fair analogy? Do you have that there in England and New Zealand where it's an early intervention model is like that. It's like, could we just sort of remember what we were doing there? Let's extend that here.

00:50:29 Sam Brydon
Yes. Yes, it's. I think there is not a great deal of that model. Coach. Coaching model going on in schools here. I think it is a model that is used in early intervention, but not so much for AAC practice. I think the ministry of education here are using a. Routines. I can't remember the exact term of it, but it's actually come from America routines. I can't remember it. But anyway, they are using a coaching model in early intervention that is really collaborative and helps parents to set goals around different routines for their child. But I know for a fact that there is a lot of. Here's a core board point to the symbols. Let's see how you get on going on. So it's not carried over so much to introducing and implementing AAC in early intervention patient. Although I've been doing. I've been. I'm running a lot of PD around the country this year and I think it is definitely becoming a model that is. That is recognized as important. But yes, then when it gets to school, it gets even harder. Yeah. Yeah.

00:51:52 Chris Bugaj
Tell us a little bit about the research that you've been doing around coaching.

00:51:56 Sam Brydon
So what I ended up doing was a multiple case study study where I took six families who had a child who was between three and four years of age and was essentially not talking or had very few words. I had the cutoff point as 10 words. A bit arbitrary, but that's where I decided to have the cutoff point. So I took six families off the waiting list that we have here. For speech and language therapy services. And luckily it was a nice big waiting list. So I had lots of choices and I took six families because that is far too many for multiple case study. But I was absolutely certain that probably only two would turn up to the first session and I'd be lucky if I finished with any because I planned to do work over a year. So I planned to work with these families for a year and I designed a program that I called Empowering parents for aac and it still had workshops in it because I couldn't think of a way to deliver all the information. So I had four group workshops that the parents came on. In fact, I only had one parent from each family attend because I was doing quite a lot of quantitative data collection as well as qualitative data collection. And I just didn't feel I could manage to do that across both parents. So obviously that's not a good practice model. But for the sake of my research, I just had one parent from each family. So they attended four group workshops where they learned about different AAC strategies, which I did aided language modeling as the first one, I did creating opportunities for communication as the second. And then I did a session on prompting and a session on responding. So they came to those four group workshops, but in between the workshops. So after each workshop they then had a coaching session in the home where we focused on the strategy that they had learned and did the full coaching on model. So that whole process, workshop coach, workshop coach for four times, took nine weeks to complete. And we were really lucky because it fell in 2020. But here in New Zealand, we managed to eradicate Covid and while the rest of the world was locked down, we were acting like nothing was happening. We had finger foods at the workshops and everything, but obviously it was. We had our borders shut and it all went to custard after that. But I was very lucky in terms of being able to do the research. So as well as them coming to the workshops and having the coaching in the home, I was also taking quantitative data in the form of 10 minute videos in the home, which was a separate visit where I was. They played with some toys and some snack foods and I was looking for what changes could I see in the parents in terms of were they using the strategies they'd been taught and what changes could I see in the children in terms of were they starting to use the AAC and was there any talking happening? And then after that nine week period, we did a long maintenance phase because from my research into the literature, I could See that a lot of AAC studies don't really have much maintenance data. And I know we all know that it drops off. Once you stop putting support in, it's likely to drop off. So I carried on doing coaching in the home once every two months to the end of a year and I carried on doing data collection until the end of a year. And I was also taking qualitative data because we had a survey at the end of the initial stage where they did the workshops and we had a long interview at the end of the whole year and I took a lot of other notes throughout the year. So they essentially got a sort of program of workshop coach, workshop coach and. And then some support going ongoing for the rest of the year.

00:56:07 Chris Bugaj
Okay, I have a couple follow up questions about that before we get to the results. So when they came to the sessions that were the workshops, how long were those sessions?

00:56:18 Sam Brydon
The first one was quite a long one. It was two and a half hours. There was a lot of introductions, getting to know each other. Parents absolutely love being able to be with other parents who had children who weren't talking because it feels like a really unusual disability. People aren't aware of it and so they just loved meeting each other and they got to know each other. And also I had quite a lot to introduce in that first session about. I was telling them about what the coaching would look like and we did our first action plans there. But after that they got shorter each time. The second one was two hours and then the last two were about an hour and a half each. Each.

00:56:54 Chris Bugaj
Okay, and you said the first session was about aided language stimulation. Were you introducing any sort of acronym to help them learn? Like Jill center and Matt Bod have s'mores. Tabby Jones Willibers has Tabby Jones Williber has Master Pal. Or was it just. It wasn't. There wasn't anything. There wasn't anything like that that they were using?

00:57:18 Sam Brydon
No. I talked to them about core and fringe and explained find that in for the purposes of this core board where the fringe is actually quite difficult to access.

00:57:31 Chris Bugaj
That's the flip book at the top.

00:57:35 Sam Brydon
It's going to be most useful to model core in the first instance because it's going to be easier for them to do. And I also talk to them. I don't know if this is terminology I've made up or not, but I talk to them about targeted and general aided language modeling. And targeted being where they just watch their child think, what word would my child say right now if they could and then point to that symbol and name it for them. As opposed to general where you do lots of chit chat, comments, questions. Because I think one of my core beliefs is that for people to have success with AAC and to keep going with it, they need to feel successful straight away. They need to have some early successes. And I think targeted modeling is both easier to do for people when they're just starting out with modelling and it's more likely to engage the child and get some results. And I wanted them to get early results because I know that that is a real reinforcer for carrying on. So I really encouraged them to do more targeted modelling initially than general modelling. We talked about what it was and then we, at the end of that first session we planned. And they each planned a couple of activities to do at home that would work for, for them. And we thought about exactly what the targeted models might be. Quite often words like more or finished or help or open, you know, ones that really get a quick response and fit with the activity. And then I encourage them to not try and model all the time. Encourage them to just pick a few words, stick to those, stick to the activities and get some success with those. So they would build their confidence up rather than just go out there and model, model, model, which I just think is just way too hard. Hard.

00:59:22 Chris Bugaj
Yep, yep. Do you do. Was there any sort of metrics for the student like you said you were going to measure language growth or I think maybe you said just AAC use. Right. Did you, was there any baseline data that you were trying to collect there and then to measure that growth?

00:59:37 Sam Brydon
Yes, I did a baseline data collection before they came to the workshops where I did a 10 minute video which was basically the first time they'd ever seen a core board. Each of these families. And I said, oh, here are the, here's the toys and the snacks. Just play for 10 minutes with your child. The core board's there. Use it or don't use it. They, they all six families completely ignored it. They just sort of. I had these boxes of toys and they went through them and explored them and they didn't touch the core board at all. And, and that core board was there for every data collection ongoing and it was obviously much more used. And then I had a large part of the early days of my research was designing actually with the speech and language therapists that I worked with at school because we were all stuck in the first COVID lockdown. This is when I made my coding, my manual for how to code the data Collection. So I had a set of codes for parent behaviours and a set of codes for the child behaviours. And the child behaviours were about the number of symbols. They pointed to, the communicative functions that they were expressing, whether it was prompted or spontaneous, whether they put symbols together, linked symbols together. There was a whole range of, of codes for that that I was looking for. And also were they using any spoken words?

01:00:55 Chris Bugaj
Gotcha. Which you, you discounted or you counted?

01:01:00 Sam Brydon
We just counted. I only counted the spoken words. I didn't do any more work with that data.

01:01:05 Chris Bugaj
Gotcha. Gotcha. And then the follow up coaching was that also how long were each of those sessions?

01:01:14 Sam Brydon
That was really variable and one parent did comment in the survey that she thought they were a bit. But I'd say that in the early coaching sessions they were often over an hour, sometimes even longer. And as the year went on they got much quicker. We really fell into a groove. They knew what to expect. They had the activities ready and quite often they would have the video ready for me as well, which I loved because a large part of the early coaching sessions was just trying to get their child into the room. Room? Yeah, like they were at home. But the child had worked out that something was going on and like zoom off to the garden or whatever. And, and so, you know, there was a lot of work in those early days just building up confidence to play with their child.

01:02:01 Chris Bugaj
So they recorded their sessions and then you looked at those sessions together. That was part of the coaching, right?

01:02:06 Sam Brydon
Yes, the coach. The coaching sessions were video based so we would do a quick observation and if that was really stressful, I would sit and do guided practice. I would do guided practice with feedback. We'd set up the activity together and then when things were going well, I just popped, I just pop my phone out and go take a little bit here because it's going really well. And I would just, I just needed like 40 seconds to 2 minutes max of video for us to then analyze and do some pitching conversation around.

01:02:35 Chris Bugaj
Yeah, awesome. Awesome. Okay, so let's talk about the results. So at the end you've got quantitative and qualitative feedback. What did you learn?

01:02:46 Sam Brydon
Oh my goodness. The results were amazing. It makes me tear up now. So had no idea how this was going to go because I'd never implemented an AAC system without being quite involved in the start. Something I used to do at the school was I would try stuff out with the parents permission and then I would present it to parents and say, I think this is going to work. I'd even have some video to show them, but I'd already done quite a bit of work on it. And so the idea of like just implementing an AAC system and being completely hands off, and I was completely hands off because I didn't even do any hands on assessment at baseline. I just did it all on parental report because I didn't want to go in there and be the big expert and do some assessments that made me look good, if you know what I mean. I wanted them to feel that they were the ones that were doing this. So I really had no idea how it was going to go. And I also didn't know whether anyone would stay with it. And all, all six parents stayed with it. Like it was amazing. They, they, they all. One family had to leave at eight months because they had a whole series of things happen and then all caught Covid and were very ill with it. But I ended up with five right at the end of the year. But I had all six to eight months, which I thought was incredible. So that was the first thing. Then the next thing was the parents learned the strategy to the point where they started to look like speech and language therapists. They were incredible. I've got so much video evidence and it's just like when I show it now when I'm running my PDs for other professionals, like people GASP it's like, it's amazing how good these parents got at supporting their children to use aac. The children all started to use the core board. So five of the six children didn't just start to use the core board. They were like, they were sequencing three and four symbols together to make sentences, which is, I think it's unheard of, of with a core board which doesn't have voice output and isn't terribly motivating. Yeah, they were incredible. And four of the six children started to talk. Who of the children? Probably three of the children probably didn't need to use aac. By the end of the year, two of them were still difficult to understand but could talk in sentences. One was talking completely fine, didn't need anything. Probably didn't even need any more speech and language that therapy. And all of the children were becoming competent AAC users. Yeah, it was amazing.

01:05:23 Chris Bugaj
That's amazing. Okay, so do you have some numbers that you could share with us? Can you tell us more about like, you know, a story about one? No one was touching the core board at the beginning, but by the end, like you said, well, I knew things.

01:05:37 Sam Brydon
Were going to really. You remember the first data collection I went to. So I'd done the baseline data collection collections, which everybody found very painful because this strange woman videoing them, box of toys, some of them had said, never really played with my child like this before. They didn't know what to do with the core board. But I went to my first data collection after the first workshop and coach and. And the little boy ran up to me. I was wearing a core board because I always made a point of wearing a corboard to arrive. And he pointed to. To me and then fast and then ran off around the room to show me that he was running really fast. And that was the first thing he did when I walked into the room and I was like, this is incredible. Like, five of the children started using the core board straight away, right from the outset. And it just blossomed from there. Now, there was one child on the research who. I think the core board was not the ideal aac. I mean, I don't think the core board is an ideal AAC solution for anyone. It's a starter system. It gets you off. It gets you off the ground. And it's. It's relatively cheap to make. I don't think it's. I'm not saying it's a great system, but there was one child for whom it was visually complex and she was struggling with motor skills in terms of. Of pointing and discriminating and finding what she needed to say. And her family had some very complex feelings around aac. It turned out that they were on the research more because they wanted something. They didn't want aac, but they wanted something. And for a while she didn't make any progress at all. In fact, she got to the point where she was like sort of throwing it away. And I knew, the parents told me they weren't using it at all outside of coaching sessions and data collection sessions. They were actually hiding it from people. People. They felt quite a lot of shame about it. But then six months in, they had an incident where she was at the mall and she was crying and she couldn't make herself understood. And I think this is probably the first time they really didn't know what she wanted because at home she could always. They could always guess. They could. She could show them. And they were absolutely distraught about this. And after that, they came much more on board with trying to use it. And then we started to get change for her as well. She never reached the same level of competency as the other two children, but she was starting to point to symbols with meaning. She was taking turns in games. She was finding people that she knew on the fringe strip because we'd personalized all the fringe strips. She was finding family members and pointing to them to ask where they were and stuff like that. So all of the children, but for five of the children, they started to make progress within two weeks. Like quite exceptional progress. And the ones that were going to talk, they all, they three of them started talking within two weeks. Like they started to come out with the words that their parents were targeting for modeling. So that was the first words that you were starting to hear the children.

01:08:44 Chris Bugaj
Say, oh, how exciting. That's awesome. And it's not surprising to me because like I said, we've done a lot of work in this area in my neck of the woods with coaching and when the mostly with educators. We are moving into, into exploring how we can do it more with more fidelity with parents. But the idea of coaching a teacher and we've done this, it doesn't take long to see those gains because they start to realize why I'm being supported to. I'm getting better. Like I can actually see my skills getting better because from my first video I didn't know what I was doing. But by my last video, oh my gosh. You know, and that the, the comparison assistance help. Can we. Let me ask you about the videos. So you'd watch, you record a little video. You'd watch that video with the, with the parents and then you'd say things like, so what'd you see there? Like what would you differently as opposed to give it more wait time. Remember how we talked about wait time? I'm guessing, is that fair or did you bounce back and forth with both those?

01:09:45 Sam Brydon
Yes, it was quite organic. I don't think I'm a terribly good. I know I'm not a very good coach. Right. I always, always tell some people this. I think, and I think this is really important for people to hear because I'm not being self effacing. I am, I am not a very good coach. I tend to see a problem, think I know what the problem is and want to tell people what to do. So not the ideal personality type for a coach by any means. And I, I really realize that. But the parents still said they found it incredibly helpful. So if people worry that they're not going to be good at coaching, they need to hang on to that. But yes, mostly I wanted to draw it out of them through a process of reflection. But there was also an element in my coaching model that was giving supportive feedback and constructive feedback. So sometimes I would say, here I see you waiting and I know previously you've really like jumped in there, I can see you waiting and look what happened. He did this. Or I would say, I noticed that you used three prompts in a row there. Do you remember how we talked about, you know, maybe just using one prompt and then moving on? So, yes, there was some feedback that was specific and wasn't just about drawing it out of them. And also some parents struggled more with the reflective process than others. And a clear really asked for and appreciated the more sort of specific feedback.

01:11:21 Chris Bugaj
Something that we're doing that's a little bit different than you're doing, and I'd just love to pick your brain for a second on that is we've specifically targeted aided language stimulation and we have ideas of moving to other skills like descriptive teaching. You mentioned prompting, least to most prompting. And we've only dabbled a little bit bit in that. So we take a teacher through six sessions all about aided language stimulation. And the way your design was, it was one aided language stimulation, one on prompting, one on. What did you say?

01:12:01 Sam Brydon
One on creating communication opportunities and one on responding what to do when they do use the aac. Yeah, yeah, I covered all of those.

01:12:11 Chris Bugaj
So what are your thoughts on that prompting?

01:12:13 Sam Brydon
Well, I don't think I should have. I regretted separating them out and doing them two weeks apart because actually they all work together. And what happened was most of the parents. This is what I find universally, if you don't talk about prompting, people will do it anyway and they won't do it in a sensitive and respectful way all the time. Whereas if you talk about prompting and how it can be used and I think of it more as encouraging rather than prompting, then. And they. Then you're more likely to get it done in a sensitive and respectful way. And I think prompting has become a bit of a controversial topic. Everybody who works in AAC has seen some hideous prompting that has made them feel really uncomfortable. But the fact is that prompting is a natural thing that we do in conversation all the time when we're asking people how their holiday was or whatever. It is something that we do. And I think it's something that people will always try to do when they are implementing aac. And if we don't do it, if we don't. This is something that I did more coaching on than anything else because it needs. It's something that you can really pick apart when you watch a video back and someone has used the wrong prompt at the wrong Time, you can really go back through that and go, oh, look what happened here? What do you think he's thinking? Why do you think he runs off there? And it's something that you can really coach on. And the parents developed really sensitive ways of using or not using prompts at the right moment. And I think that's because it was coached on. But the early videos, before I'd introduced prompting, there was some really, really difficult prompting. There was some really repetitive. So in one communication turn, in one data collection session, there were 22 prompts. And the child was very, very put off the idea of going anywhere near that core board for a couple of weeks after that. So that's something that I feel does need to be tackled and talked through. And we ignore, ignore it at our peril, really.

01:14:26 Chris Bugaj
I. I just love how you put all that. I mean, I love the idea of changing the word from prompting to encouraging. I'm going to encourage, encourage this way, encourage this way, encourage this other way, Encourage this other way. Okay, all that. Now I'm going to demonstrate some options that you could potentially do and then cycle that back. All right, now I'm going to encourage again, encourage again, and maybe remove that prompting so it removes that switch of stigma. And then that story, I can hear it. I can hear the parent going, show me on the board. Show me. You should. It's your turn. Show me, show me. I. I know exactly, but.

01:15:00 Sam Brydon
And she's an amazing parent. Yeah, but. But it's a data collection session. She wants to show me that her child's been using the core board.

01:15:10 Chris Bugaj
Yes. It's a very natural thing, too, in that how many parents do that when they see grandma and they've seen the kid do something before? Tell grandma. Tell grand grandma he's not gonna do it. Right? Yeah. Okay.

01:15:24 Sam Brydon
And I did talk to my parents. Sorry, just on prompting. It's a bit of a passion of mine, actually. Encouraging, I call it now. But everyone, you know, we need to be honest that it is still thought of as prompting. I don't say do least to most or most to least. I actually think that no prompt is good or bad. I just think that it's the right prompt at the right time for that child and that you're making it based on a whole range of things that you need to be aware, like the child's mood, the child's personality. What they did last time, did they know their AAC system well? Are they familiar with this activity? What's the environment like? There's a whole range of things going on in the background that help you make a decision in the moment about what type of encouraging things will I use here? Do I need to use one at all? I know that they've used that symbol before. I know they know this activity. So maybe I can just hang on back.

01:16:17 Chris Bugaj
Yeah, that, that makes a lot of sense that especially as you get skilled at it, right. And you can kind of feel it out because at the beginning I think you're trying to consciously pay attention to all those different variables that you just mentioned. And after a while I just know how to throw the football. Right. I don't have to think about where my arm is and where my hand is and how fast do I throw it. All that stuff just gels after a while. So tell me, with the research that you've done, what advice would you give? Like what do you think the practical takeaways are for people listening right now going, well, I work with people, parents and I work with teachers. And yeah, you're right, about 95% of my stuff I do direct therapy to the kid. What, what would be some of the takeaways? You would, you would hope people would look at this research and go, oh well, here's something I can adopt and do.

01:17:03 Sam Brydon
Well, it's absolutely cemented for me that our role as a therapist is not to be doing the AAC implementation. It's to be supporting others, the most important people in the child, child's life, to be doing the AAC implementation. And it's an incredibly complex skill that you're asking them to do. And so you're going to need to use a coaching approach. There's absolutely no doubt in my mind that what worked about my research was the coaching. It wasn't the workshops. The parents often didn't remember much from the workshops at all, apart from how nice the cheese was and how well they got on with the other parents. What they said in the survey after the first stage, that the coaching was what they appreciated the most. And I think it's the reason they stayed with the research for so long because it was supportive and collaborative and they felt like they were having as much input into it as I was. And it's really the only way, it's the only way to make AAC successful. And we might as well not be wasting our time anymore with one to one therapy and information dumps. We really need to shift to this. It's not, I believe that parents and family are the most important people in the child's life and the ones that are going to Stay the most constant and advocate for them at school. But I also think this approach needs to be used with early years educators and school teams. And it can be done. It is harder. It is harder finding time and changing people's mindsets, but it can be done. And it is the only thing. It's the only thing, because this communication system cord, I'm holding it up now is not a very. It's not a very fancy system. It's not something that most children love, and yet children learned to use it really competently, and they won't even get any voice out. It's not very motivating. You know, it's not great. But they all learned to use it really well, and it had a lot of benefit. And I don't. You know, I don't think it's about RAACD tools. I think it's about what we're doing to support communication partners.

01:19:17 Chris Bugaj
One, maybe. Maybe the whole thing is a big mix and it's how much time we're spending, because maybe there's a little bit about some. Like, there's some aspects of.

01:19:25 Sam Brydon
I mean, obviously the tools do matter.

01:19:26 Chris Bugaj
Yes. But maybe it's not as much. Like I said at the beginning, I was spending so much time choosing the right tool that nobody ever used that I was putting all my minutes in that bucket where maybe I don't need. I could put a little bit of, you know, and more minutes into teaching people what to do. And when I say teaching, I mean that's a combination of. I wonder what it would have been like if you didn't do your workshops, even though the parents said that. That. That they maybe didn't remember, and that's not the part they appreciated. I wonder what stuck so that. And I wonder how many times you might have said, like, remember how we talked about. Or when I talked about. And that draws it back. And again, all of that. This. This pie chart. How do the. How does it work for each individual family? About how many minutes and how much percentage do you have to put in all of those? And then. Right. Is that. Is that a fair way to think about it?

01:20:21 Sam Brydon
Yes, because it would have been difficult to not do the workshops because the passing of information in the situation in the home where there's often more than one child and the TV might be on or whatever is tricky. And at least it gave me time. Time where they could give their brain. Their brain space to thinking about aac. And some of it did stick. Not. Not much. Not as much as I wanted, but it was there to hang the coaching sessions onto. So I don't, I don't regret doing the workshops but I know it's the coaching that made them start to do it.

01:20:54 Chris Bugaj
Yeah, I think that's where most people live is they're spending most of the time doing workshops but not having that follow up of coaching afterwards. And you, you ought something else you said that I just want to expand upon. I wonder what this means for universities and how they might be thinking about their, their pre service model. Because you, you said you, I think you put it as your personality and maybe but I, I, I tend to see the, what you're describing as your personality as a therapist. Personality is like oh, I went to university, university. I learned what to do and now I tell people what to do. I don't know that's a personality trait. Maybe it is part of it but I feel like that's what you learn to do. Right. That's how the, that's how training is designed. That's how the university is designed. That's how it's been for eons. I don't know, maybe that's an exaggeration but it's now been for a long time. And so what you're advocating for now is a change in that where it's yeah, you got to know, you still need to know. But this, it's a whole nother skill set that we're really not touching in the pre service model which is I'm going to do this coaching part and it's, you got to have all three, you got to know about the tool and the, the, the interventions. You got to know about the, the how to do an effective training. But then I also have to be able to coach the follow up. Is that all fair way to think about it?

01:22:17 Sam Brydon
Yes, yes, definitely. And it's not a skill that people are getting at university at the moment. Well, I don't know whether it's, they're not even getting a great deal of information about aac so it's, that can be quite new to them. But in terms of like coaching parents I think that seems absolutely terrifying to new graduates.

01:22:38 Chris Bugaj
I would also say this is interesting. I don't know if you collected any data on this but I'd be curious to get your impression. A lot of the every move you've ever seen about speech therapy, not that there's tons but the public perception is therapy means you go this place and the kid does something not so in the way that were talking about prompting maybe needs to change. I wonder if therapy Needs to change. You know, as a, as a word that we use. What are your thoughts about that? Because I think a parent would have to come in and go, oh, it's me, I have to do. I'm the one that has to learn the skills. Right?

01:23:16 Sam Brydon
Yes. We could be called communication coaches, couldn't we? Something like that would be more accurate for what I really do now because even in my talk link role I start coaching from the very first minute of assessment. Like I don't see the point of trialing a device if you haven't coached the people around to know what to do with it. I mean, how can it be successful if they don't know what they're doing? So I start coaching now from the first moment I meet people.

01:23:47 Chris Bugaj
Yeah, a thousand percent. So what happens next? Now that you've got this research? Are you working on the next version of it or just trying to amplify it or what's. I'll just, I'll stop there. What's next for you?

01:24:00 Sam Brydon
Well, I, I don't think I have it in me to do further research. It really, it, it was. I'm a really practical person. I like to be doing things. I absolutely loved the year of the, of the actual data collection. The year where I was running the workshops, doing the coaching. That was my happy time. But everything else about it I found enormously stressful and I had levels of procrastination I just didn't know I had in me and I just, I can't really face going back and doing it again. I have, I've been working on an article for AAC and it's been going, the AAC journal has been going back and forth and I'm still waiting to hear and that, that has also been incredibly painful process. So what I think I seem to have settled into is trying to share what I've learned with other people working in this space. So I've got a two day workshop I'm running. I mean I hate the fact that I'm doing a workshop which is essentially an info dump, but I try to make it as absolutely practical as possible. And I have had feedback from people that they have gone away and changed their practice and it's all around sort of what are the strategies we need to hang our coaching on? What are the AAC strategies that people need to know about? How do we break those down for people and make them really simple and then how do we implement it in a coaching model? So it's a two day workshop and they really focus on Coaching on the second day, doing loads and loads of practices. They get. They become immune to it by the end. And yeah, I've mostly been running that in New Zealand. I've done a couple in the UK and a couple in Australia and that's. I think that really sort of meets my. I need to be quite pragmatic and practical. I can't face doing more research. But it is still sort of based in the research. It's very much about what I've discovered and it hangs itself on a lot of videos that I got from my research, which my lovely parents have allowed me to share.

01:26:12 Chris Bugaj
Awesome. Awesome. I like to end the interviews asking this sort of a similar question, which is in the world of aac, clearly you're excited about coaching. You see where it goes. What else? What if it's got you either curious or excited? What do you questing after? What's. What's like floating your boat recently?

01:26:32 Sam Brydon
Well, my other, really the other area that I am most excited by because right through my professional career I've always worked with autistic children more than any other group. And I have recently become the lamp trainer for New Zealand. And I absolutely, absolutely love the Lamp therapeutic approach and the app. I just think it makes complete sense from a motor planning point of view. So that is something else that I'm kind of developing and working on and really feel excited about.

01:27:08 Chris Bugaj
Yeah, awesome. Awesome. Yeah, that approach. The lamp approach. So again, not the app, but the approach. I feel like it doesn't get enough amplification. Right. And people talk, talking about the approach. Right. Because it often is conflated with the app. I mean, I like to think that motor planning is something that is some. It's universally something we need to be considering with regardless of the tool. So part of our consideration process, we talk about how many hits does it take, how complex are the motor plans to get to the words? So the fact that you're so excited about that gets me excited about.

01:27:46 Sam Brydon
Yes. Like motor planning is where it's at. We. We need to think about it so much more. I'm now working with clients who are eye gaze and I see that the eye gaze systems haven't. A lot of what we're using haven't really caught on to the idea of motor planning so much and I've really noticed that motor planning is still a thing when you're using eye gaze. If you move things around, it's incredibly difficult for them. It's incredibly difficult for people to learn those new motor plans. It's just it makes AAC so much easier when you've got really consistent motor plans.

01:28:18 Chris Bugaj
Yeah. For the user and for the communication partner. Because I know I'm. I'm trying to think what message, and I'm trying to think of that skill and how I'm supposed to. And now I also got to try and find the word, and the word's not in the place that was last time. All of that becomes very. I. I mean, near impossible to. To do. Yeah. Well, I'm excited for you. Thank you for taking the time. Let me apologize on air that I. I got caught up in a meeting, and I wasn't able to get home in time to record this, and you were patient enough to. To wait and to be flexible with that. So I. I so appreciate your flexibility and. And that I'm so glad we got to do this and it didn't get pushed off even further because I'm so excited about having met you. Thank you, Leanna Fox, for putting us together and for setting this up and for participating in this. You're just. Really appreciate it.

01:29:13 Sam Brydon
Thank you.

01:29:15 Chris Bugaj
All right, talk to you later.