#051: Tips and Tricks for Working with Early Learners with Autism

Marisha: Hi there and welcome to The SLP Now Podcast. I am incredibly excited to bring Rosemary Griffin back onto the podcast. If that name sounds familiar, she joined us on episode 13 and shared tons of tips for success with high school life skills. It was one of my favorite episodes. I was just telling Rose that I walked away wanting to work in a high school because she just shared so many amazing tips and made it feel so incredibly doable. I'm incredibly excited to have her on today to share that same caliber of tips and tricks, except focusing on early learners with autism.
And just a little bit about Rose. If you haven't met her, she is a little bit of a unicorn. She is at CCC-SLP, BCBA. She's ASTRA certified and also a Board Certified Behavior Analyst. She's also the founder of ABA Speech and is also an ASHA approved provider. And she's just an amazing resource Rose has presented at the national state and local level about helping students with autism develop a way to communicate with the world. And she also created some amazing products like the Action Builder Cards, the double up game all geared at helping students with autism increase their language skills. So without further ado, hello Rose.

Rose: Hi, glad to be back. Nice chatting with you today.

Marisha: I am very excited. And before we dive into all of your tips and tricks, because we have quite the agenda. I'm curious if you could just share a little bit about your experience. Last time you told us about working with older students. But I'm curious kind of what your path was and how you kind of built your expertise and all of that with the younger population, the early autism learners.

Rose: Yeah, absolutely. I've always had a passion for working with any age student with autism. That's kind of been always my life mission ever since I learned about what a speech therapist was and does. So I remember working even in my student teaching, that's what we call it here in Ohio with students with autism. And I remember we were working at the lower elementary grades and the speech therapist that I was working with was very seasoned and she had a lot of really great visuals we use with the students. And I just remember having some breakthrough moments, working with those students and thinking, Oh my gosh, this is really amazing. This student wasn't talking before and now they are. And it's just such a great experience to meet students who don't have any way to communicate and to see that growth.
I had one year early in my career. I'm reaching not at the 20 year Mark, but I'm kind of getting there. So one year I just did preschool. It was all preschool. And I really loved that age group as well because it's such a dynamic time for students. I remember meeting students and them not having any way to communicate. And then us working together as a team, myself, the special education teacher at that level, you really have a lot of access to parents. Parents are usually dropping off. And so you see the parents and I had one student in particular who had all these different medical complications from birth and we were working together at the preschool level. And I subsequently have seen this mom in the community. And now this student, many years after all this structured therapy is no longer on an IEP and doesn't even need speech therapy services.
And so that kind of joy of seeing a student who has no way to communicate and maybe is feeling frustrated and then working together collaboratively with a team and definitely keeping the parents in the loop. That is really what has sparked my desire to want to work with students who have autism. Just that kind of growth that you can have when you're working together as a team is really, as corny as it sounds it is why I wake up every single day excited to be a speech therapist. I really love what we do. And I say that we're always in, we're helping people increase their quality of life and being able to do that every day really means a lot to me.

Marisha: That's amazing. And your enthusiasm and excitement and all of those qualities definitely shine through and I've definitely been transferred some of those because you're just so awesome in what you do. Let's get into the good stuff then. A lot of us have these students coming up on our case load and we're just like, where in the world do we start? So what would you suggest, how do we know where to start in therapy for a student who's not yet communicating?

Rose: I think what's so very important. I really have these kind of different strategies that I try to use when I'm working with any type of student. But I think the first thing that's so very important when working with students with autism is that we take time to build rapport. I call it a therapeutic rapport. That's really just a term that I've kind of come up with over the years of doing presentations and talking to groups of staff. But I think that we have to take that time to really build rapport with our kids. And I think that, as speech therapists, we're very data driven and we want to make sure that we're getting data on different objectives and things like that.
And what I say when we first meet a new student, even if it's the start of the school year and the student is new to you, or maybe the student is completely new to the therapeutic setting is just taking, at least one session, but it may take a lot more for students who have autism and, or some behavioral problems and just kind of playing with the student and being in their space and sharing things with them and making sure that we don't always have to make every situation a very language enrich time. I think that's something that is hard to not do, but we don't want to bombard the student with a lot of different questions.
When I'm meeting a student who has autism and their younger and really across the board, I may just be talking about some of the things that I have. So if I have a farm toy, I may just say, Oh, I have the cow. And now the cow says moo. I want to try to be really excited and playful and I want to make sure that I'm not asking a whole lot of questions. I think that we tend to have a tendency to do that because we want to make sure that we have some social reciprocity where we talk and the student talks. But I think just being with the student and building rapport with the student is a really good place to start.
And so sometimes, in the behavioral world, we may call that pairing. You may hear that term. So the idea is that we're just pairing ourselves, the materials and the environment with good things. So we want to be the giver of good things. Because even if you're meeting a student and they're preschool age, that might be if they didn't have Help Me Grow or they didn't have home based services, that might be the first time that they're ever really meeting somebody. And that might be a really type of different dynamic for them. And so it's important that we are seen as the person who is the giver of good things and the person who is excited and has all the fun toys.
I have this funny story, I was an autism facilitator down in Austin, Texas, and I love that job so much. It really kind of foreshadowed what I do now with ABA Speech. We're talking on talking to groups of professionals, but I would work with the speech therapist there, they're a group of about 35 amazing speech therapists. And so once a month I would give a talk about a certain topic that they wanted to hear about and it always pertained to autism. And then I would go in to their different classes and campuses throughout the week. And I would help with students that were new or students that were not communicating. And I really love doing that. And so the one student that I met I had brought some toys because he was preschool. So you always have to have, no matter what the age, you have to have a lot of fun things. And so I had this little cat toy, I don't even know where I got this thing and it just, you press the top of it and it would move and it would make little noises.
And this student was essentially nonverbal at the time. And so he really didn't say much that day, but we interacted just what I'm telling you, you know what, I'm talking about, things that are going on, but not asking a lot of questions, kind of just in his space. And then I go back to my main office and I come out maybe a week or two later. And when he saw me, he didn't say hi and that's okay because I don't always work on greetings first, but he looked at me and he said cat. And so I thought, Oh wow, that's so exciting. He had this learning history of me being somebody who had something he loved and enjoyed. And that's really where it has to start. You have to build that rapport and you have to find out what your student really loves and enjoys. That's where you need to start.

Marisha: Oh, that is such a cool story. I love that.

Rose: Yeah. Definitely.

Marisha: It's definitely great illustration of that concept too. Awesome. We spend some time establishing rapport, we're really focusing on finding what the student is interested in doing and what they'll enjoy, kind of just pairing in that way. Do you have any suggestions, especially as a newer clinician, I would be preparing for these sessions, I'd be like, what in the world do I prepare? So do you have a strategy? Do you have a ton of different toys? How do you organize the room and kind of select things to set yourself up for success to establish that rapport and do that pairing?

Rose: Yeah, that's a great question. I think the one of the first things too, and after we kind of build rapport, we definitely need to discuss assessment. I know that assessment is something that's very, very important. And usually if you're a school based therapist, the kids might be coming in from a home program or they might already be, they may be coming in from home for an evaluation. And so it is a really delicate balance when you're first meeting students of wanting to be this person who has all the really wonderful things, but you also need to probably do an assessment. Especially when students are younger, you may be part of an assessment team and you may be looking at, does this student really qualify for services? And so oftentimes it can be really difficult to test students with autism or more complex needs because they may not get a standard score on the PLS or they may not be able to sit through the testing.
And so I think it's good to have some things that are readily available, just like you would with younger students, maybe you have different play sets like a kitchen set up and some of those more traditional type things. But you also want to make sure that you have some reinforcers that might be really special that you kind of keep in your own possession as the speech therapist, because you can kind of use those things if the student like bubbles. Let's just say, because I don't know if I've met a child even with severe autism that did not like bubbles and it's kind of a fun toy. So making sure that you kind of have those in your possession. Maybe if you're doing an assessment you're able to have the student do some of the different test items, and then you're able to do some type of reinforcement that you have in your possession so that you could do a little bit of play. And then you could try to go back to testing.
And that's kind of a delicate balance. It's going to be hard for kids. And a lot of times when you're working with somebody who's really little, it really depends on your kind of methodology and also where you're working, but you may have the parent come back. If the student isn't able to answer all the questions, you're going to get a lot of good talk time with the parent, with the family. And you really want to know how the student is talking right then or communicating right then, is that really across the board? How they're communicating in the home environment. I think that's important too. That assessment piece is really important. So obviously if you have students who are younger, you may be able to use the PLS, which is a really, really nice assessment because it looks at all the different pieces and parts, is the student able to request things they want, can they receptively Id things? Are they able to label, what types of words can they say? Those are all really important.
Also, the functional communication profile, is really nice for assessment as well, because it's more open ended. And so it looks at different pieces and parts as far as can they take turns? That social kind of pragmatic pieces on there as well. And so I think those are the types of things that when we're first meeting a student, we want to make sure that we're building that rapport, that therapeutic rapport, and then really the next step is to really get a good assessment because that assessment is really going to help us have a scope and sequence of what we should work on an intervention. And I think when I was starting to work with students with autism, it was hard for me because I was working with younger students in a more year-round kind of ABA type school. And I just remember thinking these students are not getting a standardized score on the tests that I'm giving them.
There's just so many things that these learners could not do. That was really hard for me to know, what are my next steps? And so another test that I've talked a little bit about probably before too it's called the VB-MAPP. And so that test is really nice if you have access to it, if you're working in more of a specialized program, if you're not working a specialized programming, you've never heard of it. It's good just to kind of hear a little bit about it, because you might be getting outside evaluations where somebody has given the VB-MAPP. And so really what that looks at is different parts of communication. It looks at why is a student communicating? It looks at, is the student requesting, are they able to do that independently? Is the student labeling? What can they label, is the student playing with others? Is the student able to be in a group setting which is really, really important information at that age as well, because oftentimes when a student, every student is different.
I've had worked with students before who were essentially nonverbal, but I would tell the parent, your child is very social. They want to be around other people. But it's really good for us to get that complete snapshot of a learner because then we can say, okay, these are the exact goals that really need to be addressed for your student. And I'm a big proponent of making sure that communication is embedded across a student's day two. So rarely am I working on something that the team is not working on as well. I definitely take time to train everybody on how to embed communication opportunities during the day that are meaningful because we can't do it alone. You know what I mean? It's really important for these students that they have that type of intervention across their entire day.

Marisha: Yeah, that's perfect. I actually got to use the VB-MAPP a little bit. I worked in an autism program for a couple of years and it was super helpful.

Rose: Oh, that's great. I think it really breaks things down. Don't you think that we wouldn't necessarily be able to do on a standardized speech therapy test, so that's great.

Marisha: Yeah. And it was a nice way because the special education teacher used it too. And so it helped us have a common language and a common lens around what we were looking at, which is super interesting. I'm curious, we're pulling these pieces from the different assessments that you mentioned, we're observing, the students were getting feedback from the parents and the teachers, we're putting that all together. When we're piecing all of these things together and we have our whole list of things that we could focus on, do you have any strategies for navigating through that or do you have some kind of insight on maybe the most important areas to focus on in therapy? How do you know how do that?

Rose: That's a really good question. I actually have this gosh, it's been so popular. It has been downloaded by just thousands of people. It's called an autism IEP goal bank, which you can find at abcspeech.org, but what I've tried to do with that goal bank, and really what I try to do with any student who's not communicating. I'll have some main skills and really these main skills, you would obviously base them on each individual student in your assessment. But they're kind of, when I first started working with students I used to work at the Cleveland Clinic Center for Autism. And we were a separate program for students that was their least restrictive environment. So it was oftentimes students who had problem behavior that was a barrier to their learning. And I just remember working with these students and thinking just like you said, where do I even begin?
Sometimes it's hard to see that path that we need to take to help the student, have a response form, have a way to communicate. It's hard to know how do I help this student have spontaneous communication? I think that's just really hard sometimes when you're first working with these students. And there's a lot of noise out there too, everyone's going to have a different way that they approach this type of learner. Right. Some people may say, well, I always work on these types of words and I always work on these types of words and what I would say to you. If you're just beginning or there's a lot of noise out there on what you should do is whatever approach you end up taking. And however you're going to set your goals is that you take data and you analyze that data. Because oftentimes we might be on a team where, you said you worked in autism program, you may not always have the same philosophical idea about what you should work on with students.
And so I say, we don't always have to agree on everything, but I'll tell you what, when we take data and we analyze data on our goals and how we're doing things, that really takes a lot of the anxand the kind of upset that we may have when we kind of disagree with people. I would just let you know that going ahead. But there are absolutely different skills that I always try to make sure that we're incorporating and they really come from things like the PLS, from the VB-MAPP. And it's just kind of a culmination of what is appropriate for your learner. But I always kind of talk about these skills as learning readiness skills.
I don't know if you've worked with students in preschool, I'm sure that you have, but oftentimes it's hard for them to sit at a table or it's hard for them to attend so we might use more play-based therapy, which is definitely fine if we're able to teach things directly. But some of the things that I think are so very important for students are gross motor imitation skills. Gross motor imitation skills are going to teach the students. An example of that would be if I said, okay, do this one and I clap, and then I have the student clap after me. So we're teaching them how to learn. We're teaching them how to attend. So there's so many different pieces and parts just in that one little exercise that we're doing with gross motor imitation. Gross motor imitation too, can also be generalized to things like GoNoodle. I love GoNoodle, actually Koo Koo Kangaroo, which is one of my favorite groups from GoNoodle, which gonoodle.com is a free website.
If you've never been to it, it's absolutely amazing. And there's lots of different songs and dances. And what's really cool at that age is you can show students those videos and they have a lot of different imitation skills. So they may have people that are doing dances and the students can try to do the dances too. And so it's really working on that student's ability to attend. If they're with a group, it's working on their ability to engage with others. And it's a really nice kind of play-based way, maybe you're working on that gross motor imitation with the student directly and the teacher's also working on it, but then maybe you do a circle time. And part of it is to watch a song from GoNoodle. And so then you're embedding that ability to generalize into a classroom setting with other peers and things like that. I'd say gross motor imitation is definitely one of those.
Another thing that's really, really important for students is to work on matching. So matching picture to picture or object to object, we have that whole hierarchy that we learn about in graduate school. And so wherever the learner is at with that, I think that's really important. And really that matching is so very key to also work on engaging. You can definitely work on... I had a student who, Oh gosh, they were just not attending. They were at the picture level, okay. We were not using objects. They were able to do pictures, but they really were not having consistent success with some of the pictures that we were using. I was kind of using what I had in my therapy room as far as some picture cards and kind of repurposing some artic cards for that purpose. And the student really was not loving it.
I knew the student really loved and enjoyed watching Daniel the tiger. And so what I did is, we have a copy center. I work three days a week at a public school. And so we can get color copies, but we have to send away for them, which is fine. I'm just happy to get them. And so what I did is I sent a copy center. I went on Google images and I created these picture cards. They were all the same size. So the student wasn't matching based on size. And they were all of Daniel the tiger. Daniel the tiger birthday cake, Daniel the tiger with friends, Daniel the tiger on the show, Daniel the tiger by himself.
And so we worked on matching and something I think so important about that is that, if you're working in something that's more of a structured program, we might put out three different pictures. And so two of those pictures might be distractor pictures, not the targeted picture that we're working on. And one might be that picture we want them to match. We give the student the picture we want them to match. And then we say, match Daniel or match Daniel and his friends. And then the student has to scan, which is such a great skill to work on. And then they have to place it down on the correct picture. And so you're teaching the student, okay, these are the things, these are the foundational skills that are going to help you learn more in a least restrictive environment. If you have some direct instruction and then we go to morning circle, you will be able to attend better in that setting. We're trying to set that student to have a learning history of attending, working on academic tasks for a little bit longer and things like that.
And then the other one that I always like to start with is following one step directions. And I can tell you as a mom of three, my kids have trouble with one step directions on the daily. But that is really important for parents who are autism parents who are affected as a family by autism, just the things that we take for granted, for our kids. I may tell my kids, okay, get your shoes on or get your shoes. My kids may just be delaying because they're watching the iPad or doing whatever and not attending. But for our learners who have autism and are iddy biddies, those types of things are going to be really important because I always talk about the fact that our therapy, it's not just us and the student. We can get really kind of in this almost like, some days I feel like I'm really helping other people. And then other days you might have a therapy session and feel like, what am I even doing here?
But knowing that the work that you do every single day with that student, you might be working on a one step direction, like get your shoes right before they got out to play or whatever. And you may think like, Oh my gosh, this is so hard, or this is so repetitive. But you have to think about the big picture, how it's a ripple effect. So it's like, okay, I'm going to work on these early learning skills like this one step direction, get your shoes. And that, maybe it's going to take this student who has severe needs three or four weeks to learn that one step direction without any prompting, but me I'm when they learn it and you can share that with the parent and they can then embed that into their home environment.
You have to think about what effect that's going to have on that family. That family could say, okay Tom, get your shoes. And he gets his shoes and he's ready to go out for the day. And I just know that when we're working day to day, we can kind of get in this. You know, it's hard to see really what the big picture is, but it's always really important to know that you can embed those things into the home environment and how much our therapy, our daily therapy and what we do everyday for our kids is going to have an effect on their home life and how they're communicating in the home environment. Those are definitely some things I love to start with.

Marisha: Perfect. That's super helpful. And then, so let's say we've established the rapport, we have our assessment. We figured out which areas we want to focus on in therapy. So what would the actual session look like once we dive into therapy?

Rose: Oh yeah. Okay. That's a great question too. I think that's really important. I definitely always love to start working on requesting. I think that's just so very important oftentimes when we're working with students who are younger, they may not have any way to tell us that they want the things that they love and enjoy. I always start my sessions with requesting. In the behavioral world, you might hear that term as manding. And so that's kind of a jargon type term, but a lot of people oftentimes a speech therapist, myself included as a school based therapist, even though I'm a BCBA, when I'm working in a school, I'm employed as the speech therapist I'm definitely doing speech therapy kind of through a behavioral lens, but I'm absolutely 100% collaborating with other BCBAs.
And so even if we're never going to use those terms, I think it's really important to understand what they mean so that... you talked about Marisha, how you used the VB-MAPP and you felt you were able to get on kind of the same working level with the teacher. And I think sometimes those words that we kind of talk about when we don't understand a term, I know that sometimes I get defensive. I've been with other people before, and they've said a term and I act like I'd completely understand that term. And then after I leave the meeting or sign off the Zoom call I'm googling it and whatever. I always start with manding or requesting, I kind of use those interchangeably because that's kind of telling the student, these are the things you love and enjoy, and this is what we're going to start with today. And so that's really, what's going to help our students find a way to communicate with the world.
And something that I think is so important is, oftentimes our students might have really limited things they love and enjoy. So as part of that assessment, or when we start kind of getting in the groove of therapy is doing a preference assessment. And so a preference assessment is something that, I don't like to send them home. I know sometimes teachers do that kind of at the start of the school year. And I think that's fine, but you can just Google preference assessment. I definitely have one at ABA Speech. And so it's really just a list of potential reinforcers. And so that's going to be really powerful information because we want to make sure that our sessions are embedded with things that our student really loves and enjoys.
So no matter the age of the student, but especially for our little ones, we want to make sure that we're starting our sessions with them requesting their very favorite things. I went back to the cat story, the kid who really loved the cat. So when we worked with him, we made sure that we had the cat toy. And we made sure that we had all those really fun toys because we want to spend, let's say that we have a 30 minute session and that's the thing to talk about too, is that the things I'm talking about today might be the very gold standard. I absolutely understand that a lot of speech therapists are not able to see kids individually. I don't want people to think, Oh my gosh, everything she's saying is only if you're working with students individually. I realized that that is not always the case.
Just know that the things I'm talking about, if you're not able to see students individually, things to kind of think about can you have a paraprofessional come to offer some help? Because students may leave the teaching area, get into something different, have trouble attending. And it's really important to kind of have that support when you're doing your sessions. And what's really amazing about building a rapport with paraprofessionals as well, or one on one assistance or whatever you're calling them in your workplace is that when you're working with a student with more complex needs or autism and you have team members present you're really modeling. You're really modeling like this is how we embed communication. This is how we should respond to maybe a behavior that kind of gets in the way of instruction.
And so I think that's important to talk about because sometimes when I'm talking, I do talk about seeing students kind of individually. And I know that that's really not always the case. So just know that there are ways to get around that creative scheduling. Sometimes I've seen students where I'll see them for 15 minutes on one day and 15 minutes on another day, or maybe I'll see students in a dyad, meaning it's just me and I have two students or it's just me and I have two students, but there's one assistant. And then when I'm working with the one student on a skill than the other student, maybe he's engaged in a puzzle or some type of task that the student can do with minimal prompts.
I just want to talk about that because I realized that we don't always have the luxury to be able to see the students in a one on one setting before I get too entrenched here. Okay. So requesting, I think requesting is super important because that's how our student's going to find their voice. I often say that's kind of my personal mission is to make sure that every single student that I come into contact with and hopefully every single student that anybody who kind of listens to ABA Speech will come into contact, we'll have a way to communicate with the world. And so I think that is really, really important. And so during that manding time or that requesting time, you're going to have things that the student really loves and enjoys. And you're going to work on them requesting those things.
I think what's so important about that too, is to remember that we want to work on them requesting very specific things. Let's say that your student really loves puzzles and really loves bubbles and really loves Pete the cat. You're going to have those things present and then you're going to help the student. And if they need help, I'm requesting those things. You're going to help them request those things. And once they do, then you're going to give them that item and they're going to play with it. And then we don't take that item away because we don't want to take things away. That can cause problem behavior, because I don't know about you, but I don't like when people touch my things. And then I'm going to show them something else they might really love and enjoy. I'm going to show them the Pete the cat book, and maybe they see the book and they say, Pete, and then I read the book to them or however we interact with the book.
I call it a rotating array of reinforcement. So that's really how I like to start the session because I'm starting with this things that the student really loves and enjoys. I'm making sure that I have those really amazing things in my possession. And I'm helping the student when needed if they need help requesting those things. And then I'm taking data on that. I want to know, it's kind of like this idea of what are you into today? I'm a creature of habit. I just recently changed my Starbucks order. For the past year, I've had this crazy order. I got a mocha, but it was more complicated than that. I'm not going to get into it because I'm kind of a coffee nerd. And then one day I tried something new.
I go back the next day and the lady goes, Oh, so you liked that drink. I'm like, Oh my gosh, is this good? This lady knows my drink. I think I have a Starbucks problem, but it's kind of like, that's what we're saying to our kids. We're not really saying, what are you into today? What do you want to play with today? You might say that because they're little, but we're kind of analyzing and we're kind of the behavioral detectives. We're thinking like, Oh, when I saw him last week, he really loved that puzzle. I'm going to make sure I have that zoo puzzle that makes the sounds. Or maybe you see him the next week and he really doesn't love that anymore. So you have to have a lot of different things ready to go.
And so I think that working on requesting is the most important thing. And then that's going to kind of give us that behavioral momentum, where the student sees that you have the things they love and enjoy. They're working on requesting them with whatever response form they use. If they're using pictures or their voice. And so that's going to build this history of, Oh, I love going to Miss Rose's room because she has, the bubbles and the cat toy and all the things I really love and enjoy. Sure, it's speech time. I'm ready. And so that's really what we want to start with. And then we want to have a running list. I kind of every year kind of change and modify the way I'm taking data a little bit here and there. And so I always have for each of my students a data sheet that would have, in essence, it's kind of my therapy plan. I'd have the different things we were going to work on.
And so then let's say we do requesting, and I write down the student really wanted to request puzzles and bubbles. They did that on their own, maybe 10 times, and then they wanted the iPad, but I had to prompt them to request that. I make sure that I note all of that information on my data sheet and then I might move into something like working on the gross motor imitation. So I might say, okay, do this one. And maybe I jump. And I think that's important too. You don't have to just work on one target within these different skill areas, but it is important to note exactly what target you're working on.
Let's say that we're working on gross motor imitation and I'm going to do a jump and I want the student to do that after me. I definitely want to make sure that I write that down on my data sheet. And then I know, did the student need prompting to do the skill? Did the student do the skill on their own? And then we obviously want to make sure, especially with our little guys that we're taking time to do play-based things. So maybe we do work for five minutes and then the student takes a little break. Maybe we do some part of our session at the table and some part of the session is maybe in their classroom or it's in a play area, in your clinic, wherever you're servicing the child. I think that's very important because we want to make sure that we're kind of analyzing too, especially with really little kids.
Number one, is it appropriate for them to even come to the table? That's important to think about is the student going to work better on the floor? Where is the student going to work best that's important. And I think too, especially when I'm working with little students gosh, and even my students who are older, I get bored sitting in the same place for 30 minutes. I always try to kind of vary, like okay, first we're going to work at the table and we're going to do requesting and then we're going to do a little labeling and then maybe we're going to go for a walk. And maybe when I was doing just preschool, we had a little gym right across the hall from the therapy room. So we would go over there and shoot a couple of baskets and then we would come back. We had a kitchen area right in our little therapy room, so we would work at the table and then we would go in the kitchen.
And make sure it's kind of this fluid kind of dance that I feel like once you get more accustomed to working with students with more complex needs, it just kind of becomes easier as time goes. And so those are some important things. I might also work on the one step directions like we talked about, intersperse some work on matching. One skill that we haven't talked about yet is labeling. I think labeling for students, if that's what your assessment says to work on is very important. And I think what's so important when we work on labeling. I had a student who I met him in, was he, he was preschool. I met him, I was working in a specialized program with housed within a public school. And I met this little guy who came to us and they said, he's not talking, he has a device. But it was the cutest thing.
I would work really closely with the teacher and I worked on his goals and we would use his device. He didn't really like to use his device and he was trying to talk and he would say little things. And then when he started talking, we just worked really collaboratively. Me and the teacher on all these early learner things, he started talking and you could understand everything he said. And that's one of the things that's so amazing about working with younger students is that level of growth in such a short time which you don't always get that kind of success with older students. It was amazing. He started talking.
For that student, he was requesting, he was talking and one of the things we worked on him with is labeling. And so it was really important that we started work on labeling things that were preferred. So basically just working on things that the student loves and enjoys. If the student really loves the iPad, we're going to work on iPad. Oftentimes that's one of the first labeling targets I work on because a lot of kids love their iPad. Or maybe it's a movie, maybe they really love that, or maybe they really love going to grandma's house. And so we label grandma. So making sure that we're going to start work on labeling things thing that are preferred. Because labeling can be so very hard for our students with more complex needs. We want to make sure that it's not a program or it's not a skill that they don't like working on. And so I always make sure that I'm picking targets that the student really loves and enjoys.
And then I always tend to start working with some nouns, start working on labeling some nouns and then phasing in some preferred actions as well. And then another thing to really think about is making sure that we're showing the student multiple pictures of whatever it is that we're labeling. Let's say that we're labeling horse, and so we have maybe a real life picture of a horse. Maybe we have the object of a horse and maybe we have a picture book that has the horse. Or maybe we just have three pictures of horse. Whatever's going to work for your setup, for your student. And that really, when we show a student three different examples, we're helping plan for that generalization piece, which I've talked about before. And we have to make sure that we're thinking about that when we're planning our intervention. That's so very important for our scope and sequence.
Another thing that's super important is play, which obviously for our little ones, but even for older students, play is so very important. A skill that I really love to use and strategy that has so much research behind it is video modeling. And so I had a student, this is actually the coolest thing. So when I was down in Austin, I heard this lady talk about this language program she kind of had developed. And so loosely based on this talk I heard, I wrote a grant for our teachers and speech therapists and we got all this money, which was awesome. And so what it bought us were some toys and it bought us color copiers. And it was a really cool program, we had it a little, one of the kids, they were in kindergarten and so it was a gas station toy. And so you get the gas, the car pulls up, there's so much language that goes into that.
So what the speech therapist and I was kind of supporting as an administrator, I would go, she would take this toy to a regular kindergarten classroom with typical peers and she would take a very loose kind of language sample about how the kids were, what were they saying when they played with the toy. Then our speech therapist would create a story with real pictures about the toy and the words that the kids were using. And then she would read this story with her kids with autism, pretty severe autism. And then she would also show them a video model of typical peers playing with the toy. And then she would have all kids with more complex needs play with the toy as well.
And we took data on it, we presented about it in the district, but it was really amazing to see when we have that direct instruction with play. A lot of times our students may just have really limited play skills because, maybe number one, they don't really love and enjoy a whole lot of things. Or number two, maybe they would love and enjoy things, but they're just not sure how to interact with them. These video models really show them like, okay, the one we did for the car, it was like, Oh, here comes the car and the car goes vroom and now I'm going to put gas in the car. It was really cool to be able to show them that video, then have them play with it and then reinforce them for using those different types of words. Obviously play is so important.
And then, cooperative play with others. I do a lot of talk about modified leisure skills. And so something that I love, love, love for students at that age is to do modified. Simon says. It's just always, Simon says, so it's kind of like we're working on engagement, we're working on gross motor imitation, we're working on attending. Simon says touch your head, Simon says touch your knees, Simon says do a twist. And those types of things can be really, really fun for the students. So making sure to embed those opportunities. What's so cool about something like Simon says or another game I've done with my students is modified musical chairs, really iddy-biddy.
What's fun about that is you put the chairs out. Let's say we have three students, we put out three chairs and then the only rules are when the music's on you walk and when the music is done, you sit down and that's how you modify it. You don't ever take a chair away because I don't know who came up with that anyway. It's kind of torturous. And so that's how you modify it. You can use whatever songs the kids love and enjoy. You can use whatever is like the hot movie at the time. And then what's nice is if you do have a para pro or two to help you with that, that's cool because then they can help generalize that potentially to the classroom. So let's say here in Ohio, we might have indoor recess more than maybe where you guys live in Arizona. And so during that time the kids may play games in the classroom and so it gives them a time to kind of practice those skills outside of the speech session.
Then the only other thing that I try to think about, especially at this age range too, is we call them intraverbals in the behavioral world, but it would just be kind of like filling in the blank. Filling in the blank for common phrases, is often a kind of a prerequisite to being able to answer some more complex WH- questions. And so I might say ready, set and the student says go. Or one, two, and the student says three. And it's really working on social reciprocity. I say something, you say something and we're engaging together. So that kind of in a nutshell, if you were to kind of take a camera crew and kind of come and see how I do therapy, that would be what you would kind of see.

Marisha: That's amazing. I love all of the examples and ideas and just a really nice overview of all the things. That's awesome. Just a couple of followup questions. In terms of managing the materials, especially with more of the initial phases where we're really working on what the students are interested in, because I know I definitely had pretty poor management of that in the beginning. I would just try and have all of these things ready to go and I don't know. I'm curious what you agree with them. Do you leave your materials all around the therapy room so the student can move around? Or do you kind of put them in the cabinet and grab them as you need them? How do you maintain control of the session and manage those pieces while still kind of keeping the student engaged? Because sometimes they'll have such short attention spans where they quickly go off from one thing to the other. I'm just super curious.

Rose: Yeah, that's a great question. I always kind of talk about that too is that, these aren't the type of students that I'm kind of talking about today where you can just say, Oh, hold on one second, I have to grab that particular flashcard it's in my cabinet because we might just lose that student. And then we might spend the rest of the session trying to get behaviorally back on track to a level of engagement. So that's a great question. I definitely, when I was working in more of an ABA type program that was a year round program for students with most moderate to severe autism, every single student. And it kind of varied by the year, as the program progressed. That clinic has been around for about 12 years now. But we would just start out where the students would have their own organizers, their own kind of like tub of materials, if you will. And so in there would be like their specific picture cards that they're working on, their specific toys that they like to use for requesting.
And that kind of gets hard because sometimes you might have another student who really loves and enjoys that and that's okay too. I don't think you have to have everything together, but you are absolutely right in the fact that you need to be on your A+ game with organization when you're working with students who have trouble engaging because we know what it's like to have good working rapport with a student. And then if you have to grab something or somebody comes into your therapy room to talk to you or something, that you could just lose them. And then you feel like the session is kind of, then you're just kind of getting back to a level of engagement. So really what I would suggest just as a starter is if you could just have a bin for that student and maybe in that bin you would put the different cards they're working on, different maybe you just have like a data sheet in there too that's kind of like that all in one place.
Every place is going to kind of have their own way that they're taking data and things like that. And oftentimes I actually really take data in the classroom binders because the classroom staff is really working on communication goals when I'm not present or when I don't see the kids for therapy. But I think it's a really nice way to start. I would just say one little bin. And then you would put in exactly what you need for that student in their data sheets. So it's all right there and it's ready to go.

Marisha: I love that idea. And I think that even if we don't have the ability to create a tub or a bin for each student, there's going to be a lot of overlap in the types of materials and in between sessions we could switch things out or whatever. That makes a lot of sense. I love that. And then it's kind of nice too, because a tub is something that typically only we can open. So it still gives us that control. And if it's like kind of, I don't know we could see, what students respond best to, whether it's transparent or not. But if it is, that could be a good opportunity to work on some requesting in.

Rose: True. They might see something that they really like in that bin and they might say open or they might say the name of the toy, that's a good way to work on student motivation. We kind of talk about those communicative temptations and that would just be one that inherently, if the student cared enough, to look and see what's in there. And if you're picking out things they might love and enjoy, that would absolutely be another way to kind of incidentally work on communication, which is great.

Marisha: Awesome. And then another followup question. We don't have time to dive into a ton of detail, but any quick tips on data collection because this type of therapy looks very different than our articulation therapy or just anything. I don't know, in the beginning it can feel less structured I think. So do you have any tips on kind of wrapping our heads around that and coming up with a good strategy for data?

Rose: I think data is very important. I think that on abaspeech.org if you just put data sheets in, I think last school year I put together the data sheets that I used for my binder. And really what I like to do is just list each skill that we're working on for the student. And then I list the specific target. So if it's gross motor imitation and we're working on jumping, I list that if it's a one-step direction and it's get shoes, I list that whatever we're working on labeling, I have all that there. And then really what I've been doing is more sometimes we call it cold probe or first trial data.
I just take and I circle a plus or a minus for the first time that we work on that skill. And so that gives me a running record of how the student is doing. And I try to always make my data functional so it gives me good information, but I try to make it really, really easy for me because I'm a school based therapist, I see a lot of different kids. So I want to make sure that it's a system that's going to work for me, that's easy, that isn't taxing. And I'm always kind of refining. I definitely have some free data sheets on that @abaspeech.org as well.

Marisha: That is super helpful and I love just your quick practical tips on that one and that was brilliant. I think this'll be the last question that we dive into. But I think that, because you mentioned the team being so incredibly important and especially when it comes to parents when we're working with the early learners, this is all very new to them and I bet that it's pretty scary and overwhelming for a lot of them. What advice do you give to your parents and how can SLPs effectively communicate in this particular stage of things?

Rose: Yeah, I just try to let parents know that I'm there to support them. I think ongoing communication for all parents is very, very important. Parents want to know what's going on. Parents usually want to know what can they do at home to help supplement what's going on in therapy. I try to be very specific on progress reports and if I'm working in a place where I can talk to parents when they pick up their child, I try to always be really specific about what we worked on. And I try to just not overwhelm parents. I am a parent of three and so I know what it's like to be completely overwhelmed and to feel you're not doing enough ever for any child, especially a child who has significant needs. And I think it's just important for them to know, Hey, I really love working with your child. I'm here to support them.
Because a lot of the times parents who have kids with autism, they may not have those warm fuzzy feelings from being in IEP meetings. That's scary. I've definitely seen parents at the preschool level cry when their child is diagnosed with a disability. It's hard for everybody. And just knowing that you can be there to support them, you can be a sounding board and just trying to be really positive. And to relay really specific information so that they know exactly what's going on in therapy, I think is key.

Marisha: That's perfect. Because I feel like especially in the IEP meetings, there's so much information being shared and do you ever have any handouts or visuals or anything that you like to share? Do you have any go tos for that or do you find that just like the specific progress reports and little verbal communication here and there?

Rose: Yeah, I think that that ongoing communication is really what's so important. And definitely just with our IEPs, we meet together as a team. We send a draft home. I think sending a draft home with ample time so that parents can ask questions, get feedback. Oftentimes with your students with autism, they might already have a whole team of people working with the student in the home environment. If you're a school based therapist, they might want to show it to their home team and get input. And I think I try to really take all that in. And then I just try to always kind of think about the parent's perspective. And sometimes it's hard. We might have parents that might seem difficult to work with. But I think those parents really challenge us and I always just think they want what's best for their child. I think that's what's important to remember too, because sometimes we can get into these meetings that are contentious and that's just kind of the nature of special education, unfortunately.
But I just always want parents to know that I'm here to support your child's communication. This is my main focus and my professional career. And that I think when you kind of show that kind of positivity and optimism even if you kind of have those trials and tribulations with advocates and 20 people in IEP meeting we always just have to be really focused and this is their baby. We need to do what's best for the child because sometimes we have those meetings that they make everybody a little nervous. So just kind of remembering where this parents is coming from I think is really, really important.

Marisha: Yeah, that was definitely a huge takeaway for me after my first couple challenging meetings because ultimately, everyone just wants what they think is best for the child. If we can communicate with that as the focus, I feel it becomes much less contentious and we can just really focus on the child, which is the goal. And I think the tips that you gave and I love some of the phrases you use, like I'm here to support your child. And I think backing that up by sharing when you do see the parent, giving them updates and just being present in whichever way we can, even if it's just in the IEP meeting. Sharing specific examples or specific stories I think just really helps illustrate that point. I'm supporting your child, I am here for them, I'm showing up. And all of that I think is huge. And I loved your other phrases of I'm here to support, I'm a sounding board. Those are all really great. Yeah, really great tips. Okay, awesome. So any closing words of advice or just maybe your biggest takeaway. If you could take one thing from the top what do you think would help the most.

Rose: Yes. I would just say when you're working with students with autism, try to find out what they really love and enjoy. When you first meet them, just be in their space and find out what they love if they're not able to communicate on their own to make sure that you do work on direct instruction with requesting that that's a goal on the IEP and that the things that you're working on are very specific to what they love. Bubbles, puzzle, jump run, things like that. That's really what's going to help our students understand that their communication is powerful and it's going to help really strengthen their overall communication skills.

Marisha: Okay. That's perfect. If we can take away one thing, just really focusing on our students' interests and what they love and leveraging that for some awesome therapy sessions.

Rose: Sounds great.

Marisha: Love it. Well, thank you again for sharing your amazing experience and I just loved your stories and really specific tips and strategies. Thank you again. I super appreciate it.

Rose: Yeah, great to be here.

Marisha: And then you also shared a bunch of different links. For the listeners, if you want to go to slpnow.com/52, I'll share the links to all of the autism goal bank and the data sheets and all of that good stuff so you can easily access that as well.

Rose: Great. Perfect.

Marisha: Thank you.