When Plans Go South: Unexpected Moments in Therapy & At Home

Brittany: 00:00:00

With this guy, I wasn't able to even, like, jump into that conversation because already things were being thrown at the wall and my body and space was not safe kind of around him in that moment. And so the vibe was like, I'm gonna see what happens if I push every button here.

And so I had to kind of react quickly but also very calmly to figure out, like, what to do next. And so again, I knew that his nervous system was saying, like, I'm not unsafe right now or I'm not in control right now.

And, like, he was dysregulated. Hey, everyone, I'm Brittany, speech language pathologist.

Shawna: 00:00:30

And I'm Shawna, behavior analyst.

Brittany: 00:00:32

And we're your hosts at Neurodiversally Speaking.

Shawna: 00:00:34

This is a podcast where we bridge the gap between research and practice, exploring autism and neurodiversity through the lens of speech and behavior.

Brittany: 00:00:41

Whether you're a parent or a professional, we'll give you practical tips to bring into your home or your next therapy session.

Shawna: 00:00:47

Let's get started.

Narrator: 00:00:48

Welcome to the Neurodiversally Speaking podcast with Brittany Clark and Shauna Fleming from lmno, brought to you by the Sensory Supply.

While we aim to make neurodiversity speaking suitable for all audiences, mature subject matter can sometimes be discussed, suitable only for those over the age of 18.

If you're under the age of 18, please talk to your parent or guardian before listening to our show or listen together with him to stay up to date on new episode releases and show updates. Connect with us on Instagram eurodiversityspeaking.

You can also send us listener questions to address on the show at hello@NeurodiversallySpeaking.com Neurodiversally Speaking starts now.

Brittany: 00:01:37

Hey, everyone, it's Brittany. We're back on neurodiversity speaking.

Shawna: 00:01:40

And Shawna, I'm here too. Hey,

Brittany: 00:01:44

today we're talking about, have you ever walked into an assessment with a beautiful plan and within five minutes? Actually, sometimes not even five minutes, you're like, okay, cool. None of this is happening today. And it's never because you're not prepared.

It's because. And again, it's not because the child is like, not non compliant. We sort of hate that old term.

But because the expectations or the room or something about it is just like, not quite right or too much maybe for the child. Today we're going to be talking about what to do when that happens. So again, I'm the speech pathologist in our duo here.

I've learned a ton from you as a behavior analyst and from our shared mentors. But I want to talk today about what to do when behavior shows up real loud in an assessment.

How to keep everybody safe, and then how to still get meaningful information without forcing a kid through a plan that clearly isn't working.

Shawna: 00:02:38

Exactly. And so if you're an SLP listening, especially maybe a newer slp, this episode is basically, you're not failing. This is part of the work.

It's bound to happen.

And hopefully we're giving you some respectful and effective quick strategies that you can think of in those moments to help work through these more challenging assessments. At times.

Brittany: 00:03:00

Yeah. This episode is more like a nod to my former self. Like here, Brittany, if you.

Ten years ago, if you had had this, this is the stuff, I would have wanted you to know that. Now I know.

Shawna: 00:03:10

Yes, yes, exactly.

Brittany: 00:03:12

I did have a really challenging assessment this past week. And so, you know, I'm a speech pathologist. We're both owners in the clinic. We're both parents.

And that's really, truly shaped the way that we approach a lot of things that happen in the clinic, too. Because as moms, too, we know, like, lots of times you have things that just don't go as planned. And that can be like, small, little things.

Like this morning, my daughter really did not want to go to school. You know, she's neurotypical, but she had a big. And she kind of got stuck in her boots and, like, could not move forward.

I know I've actually probably told a similar story in the past. It just doesn't happen every day. But there are times, and I know that when that happens, she just, like, can't move through it on her own. Yeah.

And so she did, and we went to school and you and I chatted about it. But, you know, it's another one of those things.

Like, this morning was supposed to just be a normal morning where we go to school and it didn't go as planned. And so we both had to, like, kind of pivot. Co regulate and pivot. Exactly.

Shawna: 00:04:07

So today we're going to share a real or a version of a real scenario that happened at the clinic without any identifying details. Because it's not the point of this, like, one kid, Right. We're talking. It was like we were chuckling to ourselves sort of after.

Because this still happens. Right. And you're saying, like, 10 years in, sometimes I, like, came in with this really good plan.

I, like, touch chatted with mom, got the details, I got a good plan together. And then you get into the moment and have to, like we said, pivot right away.

And so the point of sharing it is not about this one kid, is that it happens to all of us. So hopefully you feel less alone. And then also, like I said, get those strategies to feel more prepared when it does happen, because it will happen.

Brittany: 00:04:50

Exactly. And it will happen to us again. You know, you and I have been through some really challenging assessments.

And by challenging, again, I don't mean necessarily what the child was or wasn't doing. Just like, oh, this is totally not what we expected and we're gonna have to pivot. And so we have to be really flexible in those moments.

And I also wanted to say, if you're a parent and you're listening and you're worried, like, what if my child's the kid who melts down in an assessment? Or like, I know parents say to me all the time, like, well, he's not gonna be the way he is at home.

Like, even yesterday I did an assessment and the child was, like, pretty quiet. He was just a little guy. And mom was like, he would be talking all the time if we were at home. And I said, yeah, no worries. Like, that's part of it.

And we kind of expect, yeah, they're not going to be the same that they are with you as they are with us in a brand new place with brand new people. So we totally expect that. And I also want. If you're a parent, I want you to hear this clearly. We're not judging families. We're not shaming kids.

You've heard us say this a hundred times. My mantra, and I feel like both of ours, is like, there are no bad kids.

And I know Shauna will always say, or you will always say, like, it's not about the organism, it's about the environment. Right. And so here we're talking about, like, the environment. The way we set it up that day was not ideal.

And so it's about how I respond and then how I can keep it safe and respectful for everybody.

Shawna: 00:06:07

I want to say, especially for us as clinicians, as cause we work together so often and do this collaborative practice. Actually, these types of assessments are things that fuel us.

We love them because they do keep us on our toes and make us think, like, oh, man, like, I should have thought of it from that perspective in the moment or gives us, like, good reflection and pushes us forward as clinicians. And so certainly not judging really a fact of what we do.

We meet with so many kids that are so unique that of course, sometimes the plan just isn't what we thought. Like, things didn't go as we thought they would because they're in a new environment with new people, with new demands and all that stuff. Right.

And so, as Brittany said, we're not judging anyone or shaming, just hoping to bring that real life lived experience to life.

Brittany: 00:06:51

All right, so here's the scenario again. I'm totally de identifying.

I'm going to change a couple of things because it's not about this one child, but after he left, I thought, we have to talk about this on the podcast because this is a real life scenario that all of you as clinicians will either have experienced at some point or will experiencing it in the future. So super real. All right. I had a client come in for a speech and literacy assessment. Going in. I knew a few things, like neurodivergent profile.

He had a history of some support, and I knew that he was in a school using some behavioral approaches from time to time. I also knew that there had been some. Some speech therapy in the past.

And on our end, we're a clinic that does speech and behavior support, and we do that collaboratively. And mom explicitly said, this is why I've come to you guys, which is like such a compliment.

And I wanted her to feel really that she could trust us and that we're not scared or worried or anything, like, sort of no matter what comes through the door. And like, if someone's dysregulated today, that I'm okay with that. And I'm not judging you or your child.

I'm just, like, going with it and know that we can get through anything here. So, yeah, right away on that day, I also had a student with me. So we are like a teaching center and a learning center, too.

And we love having master's level students or communication disorders, assistant students, behavior students. And so I had lots going on that day. And right away, there was a lot of adult energy in a very tiny room.

We picked a small room that day because that's all that was available. And so right away I noticed, okay, the environment is not set up ideally for this.

Shawna: 00:08:28

Yeah, exactly. Which is a lot for anyone, right? Like, all the adults, a new space. It is a lot to just walk into.

Brittany: 00:08:35

Yeah, exactly. And I felt that. And I instantly, like, we always say get curious.

And then I noticed right away that he was getting dysregulated and coming out, like, an interesting way is, like, kind of being quirky and fun and like, kind of testing my boundaries and sort of pushing a little bit. And so already I was like, okay, I'm getting curious here. And I feel like this environment is just, like, not set up the right way.

And so within the first minute, it was really clear that the kid was not here for my assessment plan. You know, I had a standardized assessment for language, I had a standardized assessment for speech. I had a spelling test ready to go.

And, you know, that just wasn't the plan that we were going to carry out. And so I'll tell my students that, like, sometimes I've got a plan, but that plan can quickly go out the window and you have to be able to pivot.

So, like, what are you going to do? Because you still have to do something.

Yeah, you got to figure out, like, ah, this parent is leaving today and I have to be able to get something, some sort of information. So with this guy, I saw some boundary testing big time. Kind of like seeing where, you know, you can push my buttons and see how I'll react.

Totally fair. Some big body movements, attempting to get my reaction for things.

And just also a lot of, like, nope energy, which is, like, tricky when you're trying to potentially go through an assessment plan.

So it was at that moment where I'm like, okay, we totally can't push through what I've planned and we need to pivot and also prioritize regulation and safety. So safety for myself, because like I said, there were some, like, big movements happening, but also.

Also prioritize regulation because I could tell that he was not feeling regulated in this moment. So I'll also be honest, about 40 minutes or so into this, it was one of those sessions where I did kind of need some backup.

I was like, I got Shauna in

Shawna: 00:10:22

my back pocket here.

Brittany: 00:10:23

Like, I know you're in your office.

And so not because I didn't know what I was doing, but because sometimes it's just needed, like, you needed another adult brain in the room who has, like, skills in behavior management. And so I did reach out to you and I was like, sos like, if you can come, that would be amazing.

Shawna: 00:10:39

And of course it's like, normal to call for support.

Brittany: 00:10:42

Right.

Shawna: 00:10:42

And that's what we're all about, is that holistic lens and not kind of sticking in your own silo and trying to work through something. And I think certainly in moments like this, right, where you're.

I don't want to say that you are frazzled, but you've got a lot kind of going on, right? You got someone who's like, holding on to you, you're trying to think of like, what's, what's next?

And then I also need to grab some stuff that might engage you other than my body. Yeah, right. I want to redirect you to something else cool that we can do. And that's like a lot of things for one person to be doing at a time.

Brittany: 00:11:11

Thank you.

Shawna: 00:11:12

And so I don't think that, like, I'm not. This is, I think, a misnomer too, about behavior analysts.

Like, I don't have a magic wand that I can just come in and turn off this maladaptive behavior that's happening right now.

Brittany: 00:11:24

I was hoping you would.

Shawna: 00:11:25

And that's sort of what I said to you. I'm like, I don't know, I'm here to help.

And like, I can grab stuff to, for you or like, let's redirect them to this and give some, like, hands on support for sure. But as a behavior analyst, I can't just come in and be like, oh, yep, here we go. And the behavior is gone. Right.

There's all this context before that that you want and then all these things that you'd want to sort of look at before figuring out what to do. And we wouldn't have had the opportunity to obviously have that conversation either.

Like I said, he's holding onto your arm and running around and that sort of thing. And so there's not an opportunity for us to be like, okay, so he really likes Pokemon.

Brittany: 00:11:58

Yeah, exactly.

Shawna: 00:11:59

And, and really talking about, like, what we could be doing here. And so instead we just have to work together and work with what we can see in that moment.

And really our strategy was just to help redirect him to something else.

Brittany: 00:12:08

Yeah, exactly. For sure. Yeah. But thank you for normalizing that for me. Yeah.

So the other piece is like, I could have called it immediately and just said like, yeah, this is not the day. Like, we can't do this. But I didn't want to the takeaway for mom to be like, we can't handle this or we can't, like, navigate through this.

And like I said before, like, she came specifically to us because we see autistic kids, we see neurodivergent kids, we see big feelings, and we're all, we're good with all of that. And we do have skills, I would say, like, specifically for myself.

I have so many more skills now 15 years in than I did, you know, starting in my career.

And so the goal for me became like, safety first, try to build a relationship and some trust because there was some boundary pushing and kind of Testing some of those things and then like, what data can I get from this that's meaningful so that I know like what my next steps are going to be.

Shawna: 00:13:01

Right? Exactly, exactly. That's perfect.

Brittany: 00:13:03

And so like, I want to talk about what I noticed clinically, like not what's like wrong with the child, that's not my way of thinking, but the situation and like what it was sort of asking of him. So like I already mentioned, like, new clinic for sure, new adults, new expectations and like, that's all already a lot.

He would have left school probably. And maybe he was doing something fun. Like I don't sort of know a lot about what happened just before he came in.

But like I mentioned, we were in like the.

We have some really nice big rooms in the clinic and then we have one that's like a little bit smaller that we sometimes use for parent meetings and stuff. And that was the only one that was available that day.

And I thought, okay, he's like a school age kid, you know, we can just sit at the table and all will be good. But then there was just like too many adults, too small of a room. It probably felt intense.

Even if we were all like really kind and like welcoming and caring or even if, like my student was pretty quiet, she was just watching. But it was like a lot of eyes, I feel like. And a lot of pressure probably, right?

Shawna: 00:14:01

Yeah, exactly. Even though it's meant to be supportive and kind, it can feel like pressure. And I think a lot of us can relate to that too. Right? I know.

This happened to us a couple weeks ago. We booked a meeting with a staff member to like tell them how awesome they were. But we didn't really put much in the meeting invite.

And then the staff member showed up thinking we were firing them. Yes, right. Like we thought, oh, this will be so nice in such a supportive meeting.

But because we're their boss, they sort of were like, oh goodness, my bosses want to meet with us. Right. So it was supposed to be supportive, but felt like pressure. Same for this dude, potentially. Right.

He came in, maybe didn't even know why he was coming in. I'm not sure. And then he's got three adults standing there and he's like, what is this place and what am I doing here exactly.

Brittany: 00:14:42

And I always wonder, like, do parents kind of explain. Explain to the kids before they come in?

And so usually I'll start my assessments, like, okay, did the mom chat with you about like why you came in today? And like, I'll throw out some scenarios like okay, well, some kids come to see me because they repeat their words when they talk.

Like, like, like, like this. Does that sound like you? And I'll like kind of wink at mom knowing, like, I know that's not why you come in.

But I'll say, like, sometimes that happens. And the kid will go, no, no, no, that's not me. And I'll be like, oh, yeah, no, okay, that's not it.

Or then I'll say, like, okay, sometimes kids will say. And I'll go through a couple scenarios, hopefully, either to like, let them know that, hey, I see all kinds of kids and like, I'm cool with whatever.

But then also to see if they're sort of have an inkling of maybe why they do need some extra support Anyway, with this guy, I wasn't able to even like, jump into that conversation. Cause already things were being thrown at the wall. And like, my body and space was not safe kind of around him in that moment.

And so again, like, no, I don't want to share any of the details, but the vibe was like, I'm gonna see what happens if I push every button here. And so I had to kind of react my to quickly, but also very calmly to figure out, like, what to do next.

And so again, I knew that, like, his nervous system was saying, like, I'm. I'm not in safe right now, or I'm not in control right now. And like, he was dysregulated.

Shawna: 00:15:58

Right, exactly. And when we see that, what we want to do is get curious, right?

And like, it could be like, I don't really trust you, and we don't know their learning history, or like, we don't know what's happened to them in their, like, previous interactions. Right. A lot of the kids that come to see us, maybe I've seen a lot of doctors, they've seen a lot of specialists.

And so they come into a clinic setting, right? And then they're already amped up and feeling unsafe because of past experiences that they've had. And obviously we're not going to be aware of that.

They're probably not even aware of it. Right. And so it's normal for that to come up. And then what we want to do is use that behavior as information.

And so in the moment, it's not my job to diagnose the function perfectly. Right.

Brittany: 00:16:39

But.

Shawna: 00:16:39

And in behavior analysis, we got those four functions. Sensory seeking behaviors, escape maintained behaviors, attention seeking behaviors, and access to tangibles.

And so sort of quickly coming into this space, you can sort of see he's kind of saying, like, get me out of here.

Brittany: 00:16:55

Yeah, right, right.

Shawna: 00:16:56

And so that would fall under our escape category. And so whenever. Once someone's trying to get out of something, my first thought is, why do they want to get out of this?

Why is this so terrible to them? And then how do I find a path back to connection so that they're not feeling like this is an unsafe space?

Which in his case, it sounded or it seemed like potentially. That was his interpretation.

Brittany: 00:17:15

Yeah, exactly. It makes me think of yesterday or the day before I took my eldest daughter to an appointment, and I was like, we got an appointment today.

And her instinct was like, am I getting a needle?

Shawna: 00:17:24

Right. Yes, exactly.

Brittany: 00:17:26

I just said, we're going to an appointment. And, like, the whole time she was obsessed. Like, okay, we went to, like, a pediatrician for some other things.

And she was like, but do they give needles there? And, like, the whole time. And then it was so funny. Like, the whole. She's like, my hands are sweating.

I said, I can't imagine any reason, like, if I literally cannot fathom why they would ever give you a needle. So, like, no, that's not the purpose of us going here. But still, in her mind, just, like, obsessed with that needle.

And so, you know, again, she's verbal. She's able to, like, tell me her thoughts. And she kind of noticed that that's what her brain was telling her.

And so for some kids, that's just, like, not possible to even know, like, why I'm being triggered or, like, what my. Our learning history is going to tell me about this for sure.

Shawna: 00:18:07

And actually going back to your other daughter with school this morning. Right. One of your strategies in that moment. Right. Was to clarify with her and help her label why she was acting the

Brittany: 00:18:17

way she was acting. Yeah.

Shawna: 00:18:18

Is it about this?

Brittany: 00:18:19

Yes.

Shawna: 00:18:20

Right.

And so that's a really nice strategy, if you happen to notice these patterns with your client or with your child, is that you can go in and sort of give them the language, too, because oftentimes these processes happen automatically in our body. Right. You're sort of. If you think about times where you felt.

Felt anxious, maybe you're not really realizing that you're anxious until your body's, like, super anxious. You know, you're not really realizing those, like, early signs.

Brittany: 00:18:44

Yeah.

Shawna: 00:18:45

And so our kid, like, kids are the same way. Of course. Their brains are still developing.

And so that can be a really nice strategy to go in and be like, hey, is this because we're going to another specialist appointment?

Brittany: 00:18:55

Yeah, yeah.

Shawna: 00:18:56

Exactly. Here, let's chat about what this specialist appointment is going to be like. And we certainly have families ask us that too.

Hey, like what can I say to my child before the appointment and sort of helping them to prepare for it. So that can be a nice strategy if you do notice your child has difficulty transitioning.

Brittany: 00:19:11

Totally. And that is exactly what happened this morning with my youngest.

Shawna: 00:19:14

You're right.

Brittany: 00:19:14

And I said, is it because of this? And she goes, well, yeah, it's a. Both. And I was like, okay, you don't want to go to school today and you're also worried about this other thing.

And she said, yeah. And then the tears started flowing and I was.

And then actually we were able to co regulate and I feel like that was the turning point when she was like, okay, like this has been named. We all acknowledge that. This is exactly why I feel the same.

Shawna: 00:19:33

Acknowledge my feelings. Links.

Brittany: 00:19:34

Yes, always. Yeah.

Shawna: 00:19:36

And so in this case, like when we look at the functions of behavior, right. Like I'm talking about something a little bit bigger than the function. Right. We're looking at those sort of setting events, we might call them.

So like going to a new place is a setting event.

Brittany: 00:19:52

Okay.

Shawna: 00:19:53

And then when we look at the functions like escape, access, tangible and sensory seeking behaviors, those are sort of more specific in the moment analysis that I might make.

Brittany: 00:20:03

Right.

Shawna: 00:20:04

And so in this case, we don't know, I don't know what the setting events were for this dude. Did he do something cool at school?

Brittany: 00:20:10

I don't know.

Shawna: 00:20:11

Does he hate going to the doctors? I don't know. Has he. I don't like, you know, we didn't. Did he sleep well? We don't know any of that information.

What we do know is that he's in this therapy room pretending to punch you and spinning around in circles and yelling like, I'm gonna put an ear quotes, like rude things.

Brittany: 00:20:27

Yeah.

Shawna: 00:20:29

And so I can't do like this full functional analysis.

Brittany: 00:20:33

No.

Shawna: 00:20:33

Yeah, but kind of taking a step back and I know you do this like kind of naturally now too, as a speech pathologist is take a step back and be like, okay, what's under this like antecedent category, you know, what's happened kind of before the behavior in this case, like really not a lot happened before.

And so it was pretty easy to boil it down to like we came into the room and in this case the parent wasn't there, which I do also think was probably a factor for him. But again, you would. This would be a setting event that you wouldn't have been able to predict that, like, if the parent doesn't come in, that.

That that's gonna be trickier for him.

Brittany: 00:21:04

Right, exactly. And mom had identified that later to say, like, yeah, sorry, I just really had to go to go to the bathroom.

Shawna: 00:21:11

Yeah, yeah.

Brittany: 00:21:11

And she was like, I'm sorry, I was gonna burst.

And I thought, like, he'd be fine for a minute, you know, and she was like, yeah, that probably wasn't the best thing, but I don't know what else I could have done. Right. And then he did come in with me, like, quite willingly into the room. And so. Yeah, you're right. And so I like that idea of like the.

You called it a setting event. Yeah, setting event. And. But. But we don't know. There's a lot to it that we can infer. We can guess, maybe.

And so that getting curious is the first step. And I also want to say to newer clinicians and to myself, I'm not taking perfect ABC data in this moment or thinking about.

I am getting curious and thinking, is this for access or attention? And probably a little bit of both kind of thing. And then it is going to change my strategy potentially.

But I'm not going to my chart and sitting down and going, oh, oh, okay, here was the answer.

Shawna: 00:22:01

Let me grasp that.

Brittany: 00:22:02

Yeah, yeah, exactly. That's just like, not possible. Because in my.

In that moment, I had to, like, quickly triage work up, make sure we're both being safe, safety of my student as well, and like, keep everybody regulated. So I just kind of got to go with that next best step.

Shawna: 00:22:18

Right. Because that's what's going to stop things from escalating.

And that's certainly a value that we have at the clinic that I think old school ABA for sure didn't. You know, in my training, the purpose was you didn't want to reinforce a behavior because then it could, I don't know, stay forever.

Brittany: 00:22:33

Yeah.

Shawna: 00:22:34

And so, like, if these kids are having hard moments, we were like, sort of instructed to push through because you don't want them to learn that that works to escape.

Brittany: 00:22:42

Right.

Shawna: 00:22:43

That is never our mentality at the clinic. Right. Our mentality at the clinic is always happy, relaxed and engaged. How do I get you back to being that happy, relaxed and engaged person?

And then let's deal with this issue or this problem that came up and sort of understand it more. And then let's practice when you're regulated.

And then we'll work up to again, like, tolerating this with more pressure on it, you know, and so the same thing happens in the moment, right. My first instinct is, how do I turn this off?

Brittany: 00:23:12

Right?

Shawna: 00:23:12

How do I help this guy get back down so, like, we can get some stuff done today and we can have fun and end on a positive note, you know?

Brittany: 00:23:18

Exactly.

Shawna: 00:23:19

It's not that I'm trying to turn off his feelings, right? Or saying his feelings are invalid. What I'm seeing is, this can't feel good for you. It also is like, I feel a little bit nervous. Right.

I don't really know what you're gonna do next if you keep escalating. You're already punching me, you're already spinning.

What's sort of going to be that next thing that you do to see if that gets you out of it or if that escapes or if your body doesn't feel safe if I don't intervene, sort of, where are we gonna go? I can't wait for that. And so how do I bring us back to this point of happy, relaxed, engage, and connection?

Brittany: 00:23:55

Exactly. And so my first thought was, like, okay, perfect.

I knew to bring in a little bit of sensory toys, like some fidgets and stuff, which usually I have just on. On hand for any appointment. And so I brought over the bin of fidget toys, and I was like, I got some cool stuff here.

Like, do you want to see if one of these kind of feels good for you? And it instantly got thrown above my head against the wall, and I was like, okay, that didn't work. Pivot. And so here, let's talk about now.

Sort of like, what I did do that helped.

So the kind of getting into the practical part of this podcast, the very, very first thing I did, as I said, student, I'm sorry, I love you, but you gotta go. And I feel like she. It was just one too many sort of eyes and adults in the room, which I had identified.

And I said, yeah, maybe like, sit this one out and we'll chat about it later.

Shawna: 00:24:40

Right.

Brittany: 00:24:41

You know, good experience. But I thought she could learn more from me, sort of debriefing after the fact, because it was gonna help him regulate.

And that was the most important point for me. And then the next thing that I did was move, you know, and so we decided to move to more like our sensory space.

And so, you know, there's lots of little tips, and so I think we'll go through them kind of systematically. Like the things that I thought, okay, here's what I did first, and then here's what I did next.

So the first tip that I wanted to Share was like, don't sort of reinforce this, like, gotcha kind of behavior. So I could tell that he was getting, like, trying to get a big reaction from me. And honestly, like, my nervous system definitely wanted to respond.

Like, I think my brain was a little bit on fire in that moment. But if I react with that really big energy, then I am kind of telling him, yeah, maybe this works. And he's sort of pushing my buttons and getting it.

And so then I may be like, he may be looking for more attention then and continue that. So I tried to just go more so neutral. Definitely not cold, but more so, like, boring.

Like, just like, you're not going to get, like a big reaction from me for doing that.

Shawna: 00:25:49

That this is like a great tip for most things happening in your house. And I use this a lot. Like, if your kids swear, right. They say the number one thing you can do is like. Right, right.

And I certainly had my kids swear at home. My husband would give a big reaction. Yeah. It's like, ah, whatever.

Brittany: 00:26:04

Yeah.

Shawna: 00:26:04

You know.

Brittany: 00:26:05

Right.

Shawna: 00:26:05

And so anytime, really, that the kids are doing something that you don't want them to do again, or like, you think is like, wow, this isn't really ideal that you're doing this. Yeah, sure, there's lots of, like, teachable moments too, but it's nice to just sort of give that, like, cold. They're not cold.

That like, boring reaction so that they're like, oh, well, that wasn't really fun as I thought it was gonna be. Right, right, exactly.

Brittany: 00:26:24

And so in the moment, my little script in my head was like, I'm here to help. I. I'm gonna keep my body safe. And so like, yep, these are cool toys, but I gotta keep my body safe.

And so I just kept it really, like, cool as possible and not going in with like a big. Yeah, A big reaction. And again, it's not that I was ignoring him or, like, being rude or anything like that either.

I think, like me, 15 years ago, my. What I knew from ABA, which probably wasn't even accurate, or I don't know, would be like, ignore that behavior completely.

Shawna: 00:26:52

Right, exactly.

Brittany: 00:26:53

And just like, turn a blind eye. But in that moment, I feel like it would have looked rude if I was just like, ignoring him.

Shawna: 00:26:58

Right. And like, I think it could also be an escalating factor. Right.

Like, if no one's responding to me and if we, like, again, boil it down to these four functions and you think it's like, for attention and then no one's paying attention to me, what

Brittany: 00:27:11

do you think that does?

Shawna: 00:27:12

Right? Like.

Brittany: 00:27:12

Right.

Shawna: 00:27:13

Let me Annie that up and see if this works. Are you gonna give me attention now?

Brittany: 00:27:16

Yeah, fair.

Shawna: 00:27:17

Right. And so I think you're right. Old school ABA was more, ignore this, because if you reinforce it, it'll happen again in the future. Right, Right.

And it's not that I'm disagreeing with the science behind it, but these are humans and not rats. And so we need to respond to them in some way that's respectful of what you would do to another human.

Brittany: 00:27:40

Yeah, exactly. So then I would just say, like, I'm here to help, and this is not keeping my body safe, so we're gonna have to move on or whatever.

And so then the next tip that I have was I was trying to. To set really clear and simple boundaries, but also stick to them. So I didn't do any, like, long explanations with him.

I'm not sitting down and going in with a lesson about why we don't hit or why we don't throw or whatever, but because he knows that.

Shawna: 00:28:04

Oh, yeah, right. There's no he know. Like, he.

Brittany: 00:28:06

We.

Shawna: 00:28:07

Or we think he's trying to push our buttons. This guy was older, and so definitely knows not to hit people. And so me explaining that is redundant and unnecessary because he already knows not to.

To punch the air or not to do whatever he's doing. Right, Right. And so that's where you want to just keep your language simple in the moment, like you said.

Brittany: 00:28:27

Yeah. And so my scripts that I kind of had in my mind were like, yep, that would hurt. I'm moving my body back.

Or like, I gotta keep my body safe or I can't let you throw that. You can hold it, or I'm gonna have to put those away. And that is what I ended up doing with a lot of the sensory tools. I give them that one chance.

It didn't work. And so I just said, I can't let you do that. That's gotta go away right now.

Shawna: 00:28:49

Right. Which is a natural consequence.

Brittany: 00:28:51

Yeah, exactly. Like, keep everybody safe, myself included and him. Yeah.

So then, yeah, just, like, keep those kind of scripts in your mind about holding, like, having that simple boundary and then sticking firm to it in a, like, very kind and respectful way.

Shawna: 00:29:07

All right.

Brittany: 00:29:07

The next tip that I have that I sort of drew on was, like, changing the environment, not the child. I think you said this in a meeting already this morning.

Shawna: 00:29:15

My number one mantra.

Brittany: 00:29:17

Yeah, right. And I know I said it already here. Like, the. Can you say it in behavior analysis,

Shawna: 00:29:22

we don't blame the Organism. We blame the environment.

Brittany: 00:29:24

There you go. Thank you. I know you say it more eloquently. And so, yeah, we had to change the environment. Not the child here again, there's no bad kids.

He wasn't like, I believe his body was so dysregulated or whatever you want to call it. His mind was dysregulated. And so he wasn't, like, choosing to, you know, be, like, rude or mean or anything. It was the environment.

The way that it was set up was, like, not ideal for him on that day.

Shawna: 00:29:48

And that's what we know with neurodivergent children. Right. Is that their brain. Brains are. It is harder for them to regulate.

Certainly once it's already sort of heightened, we might see that heightened happens faster than typically developing children. You're right. And often takes longer to come down.

Brittany: 00:30:04

Yeah.

Shawna: 00:30:04

Right. And so in this case, like, this is something that we're used to seeing at the clinic, is that.

That you need to kind of come up with some sort of switch or something to help change, because it's harder for their brains to do it on their own.

Brittany: 00:30:19

Yeah, totally. And actually, you're right, because I saw that in the assessment, too, was like, a little fidget toy is not going to fix everything.

Shawna: 00:30:24

Yeah, yeah.

Brittany: 00:30:25

Like, here, spin. This wasn't like, oh, okay, now I feel good.

Shawna: 00:30:28

Right? Yeah.

Brittany: 00:30:29

Needed a bigger change on my part. So we changed the environment. And so, like I mentioned, we ended up moving to a space. So I know I said this.

We were, like, in a pretty small room with, like, lots of chairs and stuff because there were too many adults. And so I was like, hey, hey. You know what I think is going to feel good for both of us? Let's go down the hall.

I've got, like, a room where we have a lot more space, and we've got some cool sensory stuff. Do you want to come with me? And he was like, yeah, let's do it. And so the room felt less tight. And that was, like, good for all of us.

I feel like it was good for me also to get out of that room and just, like, take a minute and a breather down while we were walking down the hall.

Shawna: 00:31:04

For sure. Yeah. And I think that's another important consideration. Right.

I think with behavior management, sometimes we often sit in the consequence category, so we think about reinforcing or punishing things, sort of what we're going to do after the behavior. But there's also a lot of things that we can do in behavior analysis. We call them antecedents, sort of before the behavior happens.

In this case, he was already dysregulated. So this is a consequence strategy because you're already in the space where he's dysregulated.

But in the future, if he was going to come back for an assessment or something like that.

Brittany: 00:31:36

Right.

Shawna: 00:31:37

Then we might set this strategy up right from the beginning.

Brittany: 00:31:39

Right.

Shawna: 00:31:39

Let's look at the environment. We did way better. When there is more space, he could move his body easier. We had access to way more things. You could see the cool toys we had.

And so things just, like, went better from there. Totally.

And so I think it's an important consideration when we're looking at behavior support and how we can support it so much more than just punishing something.

Brittany: 00:31:58

Oh, yeah, yeah, for sure, for sure. Exactly.

Shawna: 00:32:01

All right.

Brittany: 00:32:01

The next tip that I have is I really focused on regulation first, then data. So when we moved down the hallway, I did not bring my. I think I had the deep, like, a standardized articulation test.

Shawna: 00:32:13

Wait, throw that on the garbage.

Brittany: 00:32:15

You know, I did not bring really anything with me but my clipboard and a pen and a paper that I could quickly grab on my way out the door and knew that there were going to be some cooler stuff that maybe we could do to pivot both of us in the sensory room. So administering the test did not happen. And so I knew that potentially I could get, like, a speech sample through play.

If I got him regulated first, then I could start taking some data objectively. So we ended up in there and having, like, a little bit of a conversation and back and forth. And I was able to get.

Once he was regulated, I was actually able to. To see his way of communicating, and his whole sort of demeanor changed.

Like, his whole tone of voice even came down to a more, like, regulated level. And, like, we were talking about roadblocks and, like, having a more normal conversation.

And I was like, ah, okay, now here's where I hear that, like, f for th substitution or like, some of those things that I was kind of looking for in my standardized assessment, But I was able to get it in a more naturalistic sample that truthfully felt so much better to both of us.

It wasn't what I went in with in my plan, and I. I can't get a standardized score for that, But I can say, like, okay, here's some sounds that I identified in a much more, like, natural way.

Shawna: 00:33:28

Right, exactly, exactly. And of course, the assessment, if the child's, like, dysregulated, you're not going to get anything accurate.

Brittany: 00:33:34

From them anyways.

Shawna: 00:33:35

Right. It's like a measure, a useless measure, even if you did run it, you know?

Brittany: 00:33:38

Yeah, true. Yeah, exactly. And it's as if there's any speech pathologist listening, you know, it's kind of boring to do a standardized assessment. Or it can be.

For sure.

Shawna: 00:33:47

For sure.

Brittany: 00:33:47

What is this?

Shawna: 00:33:48

What is this?

Brittany: 00:33:48

Flipping my book here. So certainly not bringing in the joy. So that actually leads into. My next tip, is, like, strategically bring in the joy.

And so I used some distraction, some novelty, and some, like, different movements of fun. Not as bribery, but, like, my focus was bring some joy.

Start building a trusting relationship where I can trust a little bit more what you're gonna do a little bit more predictably. But you can also trust me that I am a safe person and that I can, like, we're here to have fun and, like, get to know each other.

There's no needles like my daughter would be worried about. Or, like, you know, there's not, like, really, hopefully scary about this appointment. And so, you know, what did I do?

Is, like, I, you know, said like, hey, what if we do this, like, kind of silly thing? I'm trying to think of the activities that I'm offering out.

And so, honestly, I offered out, like, three or four things, and he was like, nope, the first couple of times. Okay, fine. And, you know, in our sensory room, we do have these, like, long sticks with balls.

I don't know how to describe that, but you, like, build your own, like, fort again, essentially. And I was like, oh, gosh. Okay, what are we gonna do with the long, long sticks and these? Is this gonna be safe?

And, you know, I'm, like, constantly assessing the environment, too, to be like, is this a good distraction? Is this gonna keep everybody safe? And he was like, I'm gonna make a sword. But we ended, and I gave my calm script again.

I was like, okay, we can make swords, but we gotta keep each other safe. So that's my rule here. Or these go away. So we made some, like, swords again. Like, here. I'm using air quotes. Some swords, obviously, not really.

Shawna: 00:35:19

They're just.

Brittany: 00:35:20

Just, like, these toys. But then I started to see the joy come out.

And so when I did, like, hold my boundary about safety but then give a little, like, oh, wow, your sword has so many spikes. And, like, kind of go that way. Then he was like, I could feel again his energy kind of come down in, like, a calm, regulated way.

And he was like, yeah, and my sword has, like, all. I don't know. He's talking about the spikes on his sword and, like, how cool that would be if this was upside down or that was this way.

And I was like, here we're now getting somewhere because we've got an activity, as long as everybody's safe that he's, like, talking and he's, like, really interested in. And so I found something that kind of is going to work here in this moment.

Shawna: 00:36:00

Right. I was thinking while you're saying that you are super flexible in that moment too. Right. You probably didn't really want him to

Brittany: 00:36:06

make a sword because.

Shawna: 00:36:09

Feeling a bit nervous. Right. And so in his case, like, we know that he was saying things to sort of test your boundaries before.

I wonder if he was sort of like, this person's gonna say no to the sword. Right? And if you had have said no, I bet you things would have escalated up again. Right. And so because you said yes, he's like, oh, all right.

I could get into this. You know, like I said, you probably were like, I wish you said anything but a sword right now. But you're like, okay, you know what?

I can make that work. Right. And I think oftentimes as parents and as clinicians, you're forced to be flexible.

Brittany: 00:36:44

Yes.

Shawna: 00:36:44

And I would say, actually, one of the number one arguments me and my husband have is I find that he's quite rig and wants, like, the kids to just do what he thinks they should do and not have any autonomy. Whereas I'm like, I don't know, like, would it hurt you that much if they, I don't know, colored the sheet of paper with, like, purple?

Brittany: 00:37:00

Yeah.

Shawna: 00:37:00

Like, it's just garbage anyways. Like, I don't. Should they be coloring on a flyer? I don't know. It doesn't really hurt me. Yeah. So let's just say yes.

Brittany: 00:37:07

No worries.

Shawna: 00:37:07

He's like, no, no. We color on only construction paper.

Brittany: 00:37:10

Right. I don't.

Shawna: 00:37:11

I don't know. That's like, a silly example. But I find as parents, if we can be flexible, that that can also make a big change in the moment. Or clinicians, too.

But anyways, so good job on you for being fle.

Brittany: 00:37:21

Thank you.

Shawna: 00:37:22

Because I do think it was potentially an area where he was maybe testing that boundary. And if your answer had have been different, then I think your assessment also might have gone differently. Right. So true.

Brittany: 00:37:31

And at that moment, he was building his sword, and I did take a minute. That's when I literally stepped back with my body and, like, took a step back, and I was like, yes. Took a couple deep breaths for myself.

While he was building this like intricate. It was one ball with like 80, like 80 spikes on it.

Shawna: 00:37:45

Right.

Brittany: 00:37:45

And I'm like, okay, I'm gonna keep that as a step back to keep my body safe, but also like let you go with this. But you're right. Thank you. And so in those moments too, I was also trying to consciously give him some choice.

Because in these times we wonder, you know, as I'm getting curious, like, do you want to have some control over this situation that really you have no control over? Like you've been brought to this place, I'm telling you kind of what to do. And so that's where something else I'm doing is like cool.

Like, and not with this guy specifically, but sometimes I'll be like, hey, do you want to practice our speech sounds on the floor or on the chair, you know? Or like, hey, do you want to do this coloring activity like on the

Shawna: 00:38:20

purple people or on the newspaper or whatever, you know?

Brittany: 00:38:22

And I'm like giving like throwing out some elements where you get to decide. Even if I'm still creating like the, the scenario, I'm really like, I'm fine with either option.

Shawna: 00:38:31

Right.

Brittany: 00:38:31

I'm giving you just like that little bit of element of control. And I feel like we do talk about that a little bit of like bedtime struggles even.

Shawna: 00:38:37

Right.

Brittany: 00:38:37

Like, do you want this book or this book or like, do you want the water to be bath. Bath water to be bubbly or not bubbly?

Shawna: 00:38:42

Right.

Brittany: 00:38:43

You're like giving some control.

Shawna: 00:38:44

Yeah. I had a friend come over and, and we had all of our kids together and she said to me, she's like, it's funny how many choices you offer.

Like, I would never even think to offer those things to my kids. Cuz I was like, I don't know, what plates do you guys want? What cups do you want?

Like everything that I was offering them, I was just like, give them like fixed choices. Like I've only got four plates, so yeah, gotta kind of live within my boundaries here.

Brittany: 00:39:04

Yeah, yeah.

Shawna: 00:39:05

But she was saying she's like, I just would never have even thought I would have just like put the food on the plate, you know, like, who cares? And so that was something that sort of stuck with me too. Like I didn't even realize that I was. How often I was really offering those plates choices.

But certainly is a really great behavior strategy.

Brittany: 00:39:20

And again, the, the behavior strategy behind it, you would say, is like giving a little bit so that they like feel like you're a little bit more in control. Or what would you call it?

Shawna: 00:39:29

Yeah, it does obviously give them a sense of control, which is like a human need.

Brittany: 00:39:32

Yeah.

Shawna: 00:39:33

And then we know, certainly with children, this idea of having they have so little control in their lives, you know, most of their lives are dictated to them. And this is again, something that I like to remind people too. Like, we don't really like to be told what to. Neither do kids.

And so nice way of balancing sort of those must dos with some also leeway where it's appropriate.

Brittany: 00:39:57

Yeah, nice. Okay. So we talked about there, like, me sort of giving in a little bit and letting him do the sword holding my boundary, that we were all safe.

And then I gave him some fixed choices so that he felt like a little bit of control around the scenario. All right, the next tip that I have, I'm going to call, like, offload what you can.

And actually, this is a moment where you came in too, and you're like, okay, maybe we can get someone else to kind of help with this. So I had a number of different things that I wanted to achieve in that session. Like I said, it came in for some speech stuff and some literacy stuff.

And so there was a spelling inventory that I wanted to give. And I think when the moment you came in, you were like, hey, what if we give the spelling inventory to the school?

Because not because we're like, offloading because we don't want to do it or we think we can't. It was around the fact that you were like, I think he's going to be more regulated. Yes. In the school. Exactly. This is where he's comfortable.

Shawna: 00:40:49

He's used to being asked to do stuff like this.

Brittany: 00:40:52

Yeah.

Shawna: 00:40:52

And these people are used to working with him on those things. Right. And so, yeah, let's get a really accurate presentation of his spelling instead of sort of what he's going to do today or even in a future.

Like, let's say he came back. Right. Like, you might get the same responses, but the responses might be different. And the school, when they're administering, will also know. Right.

If that's his usual sort of spelling skills or if it's an off day. Like, you know, they might say, like, you know what? We did it today. Yeah, but he seemed really unfocused today. I don't know why.

And then it turned out he didn't sleep, you know, or something like that.

Brittany: 00:41:23

Right.

Shawna: 00:41:23

And then they could flag like, oh, I'd actually do this again, if that's okay with you. And then you could look at the test and let them Know whether it's appropriate to readminister or not.

But yeah, I think you're just getting a way more accurate.

Brittany: 00:41:33

Yeah. And I love that. I was like, okay, that's a good suggestion that I needed in that moment.

Because I was trying to think like, okay, we got a little bit of a speech sample in play, but now how am I gonna get to those other things? So I appreciated that, like kind of other someone else's brain just thinking about, like, how we can get some more information in that moment.

And I do feel like it wasn't us, like, giving up at all. It was more just like using a smart way around this that's gonna be better for me and for the kid here.

Shawna: 00:41:57

Exactly.

Brittany: 00:41:58

And so I remember thinking, like, for the mom. I was like, I'll give you this piece of paper. If that's easy. You can put it in his backpack. I can also PDF this to you in an email.

Like, let's make this really easy for you. Cause I don't wanna put a burden on the parent.

Shawna: 00:42:09

But like.

Brittany: 00:42:09

Or I'm happy to set up a meeting with the teacher myself. Like, I'll go around this any other way. That's gonna kind of make this successful for this. This guy.

Shawna: 00:42:16

Exactly. And I think that's like your kind of final tip here. Call in for backup or bringing in another. Not even backup. Just like a second regulated adult.

Because in those moments, of course, your stress response is heightened. Oh, yeah, right. And so just bringing in another regulated adult, you can help make sure, like, safety and help with that decision making too.

Like you said, not even if you were like fully regulated. You and I often have different ideas or opinions. Lots of them are the same too. But it's just sort of nice to get a second opinion. Okay.

I came in with this plan. I've already pivoted and done this. What do you think?

Brittany: 00:42:54

You know? Yeah, exactly.

Shawna: 00:42:55

And so just getting those second opinions isn't a failure.

Brittany: 00:42:57

No.

Shawna: 00:42:57

Is actually like smart clinical thinking. Yeah. And one of my things to young clinicians is often like, don't be afraid of what you don't know and don't be afraid of saying that.

Brittany: 00:43:06

Yeah, totally.

I was telling my student yesterday, like, if you get into a job where you're doing like at home therapy and sort of doing therapy out of your car can be really hard, especially as a new grad.

But I said, honestly, even today, like, so many years in, I wouldn't want to do it because then I'm like, isolated in this environment and I can't get Anyone else's, like, clinical judgment. And I said, how many times, you know, even today have we said, like, hey, what do you think about this? Or, like, can I get your opinion on this?

So I think, like, I just love working on an interprofessional team. For sure. Sure. Because then we do sometimes combat things from, like, a different lens.

But also just having another, like, adult around in another brain can be really helpful in so many, so many different ways. All right. Another thing that I wanted to chat about was this sort of, like, bucket analogy. This came from you, actually. I feel like you.

Shawna: 00:43:54

It's a book, really.

Brittany: 00:43:55

I'll take any credit.

Shawna: 00:43:56

Okay. How full is your bucket?

Brittany: 00:43:57

Yeah. Right. And is it the. Have you filled a bucket today? That book or no, I thought it's

Shawna: 00:44:01

called how full is your bucket? But truthfully, it's been a while since I read the book. But the analogy lives on for I bring it into almost every session.

Brittany: 00:44:08

Oh, can you share a little bit about that?

Shawna: 00:44:09

Sure. Everyone has this, like, invisible, invisible bucket over their head.

And then throughout the day, it gets, like, drops of water added from stressors, you know, or things that come up throughout the day. And it might start in the morning with the morning routine of getting dressed. I hate getting dressed.

There's like, three drops of water in there, you know, and then the bucket gets fuller and fuller. And then sometimes we do things that take water out. Right. Like maybe we get to do something that we really love.

Or spending some time in a sensory room at school can help take some of that water out so that then we're ready for the next lesson in. And then.

But once the bucket gets full, it's gonna tip over and water's gonna go everywhere, you know, and the tip over point is where we see those meltdowns, tantrums, big emotions, or sometimes the reverse, we see that shut down, where you don't get anything anymore. Right. The brain is just. My other analogy is that the brain is on fire. And so when the bucket is full, the brain has gone into fire mode.

And our job is to really help put that fire out.

Brittany: 00:45:04

Yeah, for sure. And on a day like that, for me too, my brain was on fire.

I knew I had to come home and, like, sit in my driveway for, like, 20 minutes just to kind of decompress.

Shawna: 00:45:12

Exactly.

Brittany: 00:45:13

But why we're talking about this for this assessment was his bucket was definitely, like, overflowing. He just, like, couldn't use those calm down strategies. So we'll say this all the time too, is like, often the kids sort of know what to do.

Like, they will know that. You know, the school's taught them the zones of regulation.

Or somebody's taught them, like, take a deep breath, you know, and like, he would know that. But if your bucket is, like, overflowing in that moment, then you just, like, there's no way you can just like, automatically use.

Use those coping strategies.

Shawna: 00:45:41

Exactly, exactly.

And similarly, like, we see, like, some of those common traps, you know, they think or you think they're like, a good idea in the moment, but they actually end up making things worse.

Brittany: 00:45:54

Yeah, for sure. So let's talk about some of those

Shawna: 00:45:57

one we talked about. Right. Over talking or explaining. Just keep it simple. What should they be doing? I don't say things like, don't hit. Stop hitting.

Brittany: 00:46:04

Right.

Shawna: 00:46:05

What can we be doing? Is the really important thing to say. Right. Or explaining like, I'm keeping my body safe, I'm moving over here.

Brittany: 00:46:12

Yeah, exactly. Yep. I like that. Like, keep it simple. Another one is like, endless sort of negotiation. Like, I didn't go into any sort of negotiation with him.

I set my boundaries. I said, this is like, what we can do with this. If not, it's like kind of going away and kept it that way.

Shawna: 00:46:26

Exactly. Yep.

Taking name calling personally, again, this comes up at the clinic sometimes, certainly with our youth and teen clients, where they might say something. It's like, unkind. We had a guy that, I don't know if he was watching Love is Love island or just found it on YouTube.

And so he had learned some really colorful language. And I'm sure it gets, like, quite the reaction at times.

And then his family, of course, like, so embarrassed if they'd bring him out and he would say these things sort of thing. And so the biggest thing is, like, don't take it personally. You know, it's usually a means to get attention.

Brittany: 00:47:00

Y.

Shawna: 00:47:02

Actually, even when any of us do it, it really is. It fall under that attention bucket for sure. And then not to take it personally,

Brittany: 00:47:08

like, and this is.

Shawna: 00:47:09

I think he was calling them, like, fat or something.

Brittany: 00:47:12

Yeah.

Shawna: 00:47:12

Fatty, maybe. I can't remember. Anyways, it's like, he doesn't actually think you're fat.

Brittany: 00:47:16

Right.

Shawna: 00:47:17

And I think for some clinicians, that could be really triggering too. Right. And so being aware of your own sort of biases with the name calling can be really helpful.

And then to have a counselor or someone that you're talking to, if someone is using sort of rude names is like, you probably, like, you might need to chat with someone about it.

You know, if you Worry about being fat and that sort of thing, and someone's calling you that, of course that's going to be triggering to, you know that it's not personal. But I also appreciate it's not as easy as being like, I'm just not fat.

Brittany: 00:47:46

Yeah, yeah, right.

Shawna: 00:47:47

Practical strategy.

Brittany: 00:47:48

And that was a word that was used to me. And I was like, okay. Like, I know this isn't personal. And I remember the mom said, like, oh, he says that to everyone. And I was like, it's all good.

Like, I'm not taking this personally at all, actually, but I also, like, feel pretty good in my skin right now, you know, like, again, younger self, I might have thought, like, that was really horrifying and, like, maybe take a little bit personally, but I know, and, like, that's why I have to have. Have this, like, in my head all the time. There's no bad kids. Like, he doesn't mean to say this.

And I have learned that as a mom, because sometimes my kids will be like, I hate you. Like, it hasn't happened often, but, you know, like, they'll say, I hate you. And we know they don't hate us.

Like, that is actually not what they're trying to say at all. And so if you take it personally and internalize that, then you're gonna, like, react and punish and shame or whatever.

Like, you know, that's also not what they need in that moment.

Shawna: 00:48:35

Exactly.

Brittany: 00:48:35

And so know that it's not personal. But also, like, when we're so dysregulated, sometimes we'll say things that we don't mean. And as adults, we do that, too. Yeah, yeah.

Shawna: 00:48:44

And then I think the sort of final tips here are, like, to not be rigid, like we were saying. You know, you come in with a plan, you have an idea, or maybe you've even, like, you set a boundary early on, you know, you can't just keep.

And again, old school aba, we just, like, hold that boundary and like, yeah, yeah, yeah, I will wait you out, you know, and that was our mentality. And sometimes, like, there's a time and a place to let someone, like, calm down, you know, or, like, to take some space for sure, yeah.

But that we're not just, like, continuing to say, nope, point to the cat point.

Brittany: 00:49:15

Yeah.

Shawna: 00:49:15

Like, that is so annoying. So don't do that. Don't keep adding demand. Don't be afraid to pivot.

Brittany: 00:49:21

Right.

Shawna: 00:49:22

You start in one room, let's move to another room. Or let's play with swords, I guess. And then trying to kind of Follow through. Like, don't be rigid to your plan either.

Don't keep trying to follow through with your original plan. It's not the child's fault that you plan seven things for them to do today, you know, so be flexible and come up with some.

What's going to work in the moment today?

Brittany: 00:49:42

Yeah, exactly. And then the last thing is, like, when to know how to call it or like, when to stop.

And I did appreciate having you in the in there, too, because I didn't want to. I mean, again, like, even as an experienced clinician, I didn't want to feel like a failure, like, I couldn't do this.

And the mom was like, this is why I came to you, you know, So I didn't want to feel guilty that I, like, cut it too early.

But it was important to call it, like, if my safety was compromised or, like, you know, it just was if we were constantly going back of different, like, escalation and dysregulation. Like, no one feels good in that mom. And so again, my focus was like, how do I get you back to that? Happy, relaxed, and engaged?

How do I, like, build a trusting relationship if I can? And I, like, proud to say, we did get there and we did end on a really, like, more positive note.

But I was able to say to the mom, like, we're going to pause more to the more formal part of the assessment today. What I'm seeing is, like, the environment just, like, isn't the right match for him today. I want to keep everything really safe and positive.

And so when I did get out a good language sample and a little, like, speech sample, it was five minutes, like, nothing really long by the time we got to that. Then I said, you know what? I think we'll, like, call it for today. We've gotten some good information.

We've got a plan, like, with the spelling assessment going to the school. And I want to leave on a really good note, I want to end this now when things are, like, really positive.

Shawna: 00:50:59

Exactly. And I think that was the right call in that moment for everyone involved. You know, it's like, we want this kid to want to come back to us. Of course.

Brittany: 00:51:06

Yeah.

Shawna: 00:51:07

But then you also were able to get some pieces of information. And I think we also learned some really valuable strategies for next time. In this case, this guy mom ended up using a first then strategy eventually.

And that was really helpful for him. He was like, oh, okay, I see what. What this day looks like now.

Brittany: 00:51:25

Yes.

Shawna: 00:51:26

And so we know when he comes next time. Okay, great.

Let's talk about what your day's been and what it looks like moving forward so that you're not sort of lost in, like, this weird space that you've been dropped off in.

Brittany: 00:51:36

Yeah, yeah, exact. And, like, I know now, too, if he were to come back to the clinic, like, fewer adults in the room, like, maybe he's not the client.

Where my student's gonna learn from in the moment. I could probably debrief her after, but that's just, like, not gonna feel good for him.

Shawna: 00:51:49

Exactly.

Brittany: 00:51:51

Yeah. Yeah. And then I did.

As we were sort of troubleshooting at the end, my brain was, like, going a mile a minute trying to think, what should I recommend for the next steps for this mom? And I was thinking, like, a joint session with ABA and SLP might be, like, a great place to stay.

So sometimes we say, like, speech therapy may be a goal, but if we don't have those sort of learner readiness skills, or if, like, our body's not ready to, like, sit and watch my face and imitate me and take feedback and stuff, then sometimes that's where I'll draw on the ABA team to, like, build some of those. Some more foundation skills.

Shawna: 00:52:23

Right. Yeah.

We've done a lot of assessments together, and then sometimes, really my job is to take a step back and sort of catch those moments really quickly. Right. See when that behavior is shifting and come in with a strategy right away before it escalates too far.

And so sometimes those joint sessions can be really helpful.

Brittany: 00:52:40

Yes. And I would have definitely loved that.

You know, often we do do the assessments together, and this is one of those ones where I was like, why don't we do this podcast one together? But if you're an SLP and you've had a session like this, I want you to hear you're not alone and you're not doing a bad job.

Sometimes the most clinically skilled thing you can do is just, like, be flexible and pay pivot.

Shawna: 00:53:03

And if you're a parent, the right team's not going to shame you. We're going to problem solve the environment, the demands and the support, and come up with something customized and flexible to your child.

Brittany: 00:53:13

Yeah. So if you're looking for a neuro affirming speech and behavior, come check us out. We're at Elemento.

We love talking about our experiences on the podcast. So please, you know, like, or share or subscribe or send us a note if there's something else you want us to touch on.

Neurodiversityspeaking.com or send us a message. We'd love to hear from you.

Shawna: 00:53:34

Thanks everyone.

Brittany: 00:53:34

Thanks. Before we go, we want to remind our listeners the topics we discuss in the podcast are not a replacement for professional medical advice.

Please contact a professional if you have questions.

Shawna: 00:53:46

And just a heads up, we'll use both identity first and person first language to respect different preferences. We'll also see treatment and therapy since we come from a clinical space, but we'll always with respect and a focus on what works for each person.

Brittany: 00:53:58

See you next time.

Shawna: 00:53:59

Bye.