How To Help Your Toddler Talk! Hot Seat #4 with Elissa

Transcript for Podcast Episode: 167
How To Help Your Toddler Talk! Hot Seat #4 with Elissa
Hosted by: Dr. Mary Barbera
Guest: Elissa M.

Mary: You're listening to the Turn Autism Around podcast episode number one hundred and sixty seven. I'm your host, Dr. Mary Barbera, and today I am interviewing a mom named Elissa about her daughter, Lexi, who is just two and a half years old. This is hotseat number four. We are going to talk about getting started with a new diagnosis, and Elissa has read my book and now she has enrolled in my toddler course. So we talk about the differences between the book and the course. I give her some tips based on her one page assessment, one page plan and her language sample, which one of the tips I've never given before. Not really sure why, but it was full of hopefully great information for you that you can really move the needle, whether you are a parent of a child with autism or a professional. And I think it's a great episode. So let's get to this interview with Elissa.

Welcome to the Turn Autism Around podcast for both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host. Autism Mom, Behavior Analyst, and bestselling author, Dr. Mary Barbera.

Mary: Thank you so much for joining us today. I'm super excited to talk to you.

Elissa: Thank you for having me, I'm excited to be here.

Mary: Yeah, so why don't we start off? I don't know much about you at all, and I know our listeners know nothing about you. So why don't you start with your fall into the autism world?

Lexi’s Diagnosis

Elissa: So my fall into the autism world was with my daughter. Her name is Lexi. She is two and a half now and back, and it was April 30th, actually, that I just started to kind of put together that something wasn't quite right. She wasn't really responding to her name. She had a lot of regressions. And so at that point, we were on my way to actually visit my family and we went to the zoo with my brother. And he has three children, and his youngest child is six months younger than Lexi. And that was when I really, really noticed the big differences with Lexi's lack of progress and developmental milestones. And when we got home that weekend, the next day I called the doctor and we got her into an appointment and I had made a list of all the things that I had been noticing and the milestones that she was missing. And we just started rolling right off the bat from there, and the doctor got us in to have an evaluation. It wasn't until September, and at the evaluation, they did diagnose her with autism. It was a level two, level three needs. And they said we had in the meantime, also between going to the doctor in April and going to the neurodevelopmental specialist in September had gotten her into O T, P T and speech therapy. And they recommended also getting her into ABA, getting her into more speech because she isn't talking and. It's just there isn't availability is there's no availability, is there the speech they could only get us in the one time a week and then ABA, where we had looked into was a two year wait list. Wow. And two years...

Mary: You're in Ohio, you said? Yes. Okay. So your wait list for ABA to to even start is at a clinic or ?

Elissa: It is at a yes, it's at a facility. And all they do is focus on children who have autism and do ABA.

Mary: Is your early intervention? Is that in your home?

Elissa: Yes. So we do have early intervention in home and that's really, really helpful for my husband and I. We learn, we've learned a lot of like what we can do and how we can do things and get her progressing. But it just I felt I feel like it's just not enough for her. So and that's kind of how I found you in listening to your podcast. And then I had heard you talk about your book a lot. So I bought that. And then after reading your book, decided, All right, I think I'm going to try the class.

The Turn Autism Around Book Vs. the Toddler Course

Mary: You're in the toddler online course right now?

Elissa: Yes. Yes.

Mary: Been there for about a month.

Elissa: Yes.

Mary: OK, so we are going to go through your assessments and plans and everything. But I know many of our listeners, you know, have maybe read the book or read part of the book. The book is Turn Autism Around, an action guide for parents of young children with early signs of autism. It really does go hand in hand with the toddler course. So some people in the course are saying, Well, do I really need the book? And some people with the book are like, is the book enough? So since you're doing both or you did both or....

Elissa: Yeah.

Mary: Like how do they differ and and do people need both or how how would you recommend?

Elissa: I mean, I guess it all depends on like how far you want to dove into it. I think that if you want to read the book and go from there, you could. Or if you want to take the course and go from there, you could. I like both. I like knowing as much as I can about something with the. Of course, I do like being able to see the videos and the interactions and the examples. It's more detailed definitely than the book is, but the book was a great spot to start and having read the book before taking the course, I was prepared for it and able to apply it a little bit like I just I knew what was coming next, I guess.

Mary: Yeah, yeah. And the other nice thing and you're you're a big part of our online community is the community support. So..

Elissa: Yes, I love that.

Mary: You know, just chatting with other parents and early intervention professionals and, you know get stuck and that sort of thing. So that's thing that the book alone doesn't do.

Elissa: Yes, I do. I really, really love the online community.

Book and Course Resources: Assessments

Mary: Yeah, that's awesome. OK, so let's we're going to make this kind of a hot seat. We've done a few hot seats. Is this hot seat number for our previous hot seats were a podcast 138 with mom of an early learner. Podcast 134 was a mom of an intermediate learner, and I can't remember what the first hot seat number was. That was kind of like a hot seat that I wasn't really prepared for. So it's a little it was a little iffy, but I think this hot seat will be great because we're going to talk about, you know, those really early intervention issues, the, you know, whether you just have the book because the book explains the one page assessment, the plan, you can get all the book resources. All these assessments, these plans for free and you can read Chapter one and listen to Chapter two on Audible with me reading the book, you can get all those book resources just by going to turnautismaround.com, so that's an excellent place to start. You may even want to go there and download those resources before you continue to listen, because we are literally going to go through Lexi, Elissa's daughter. We're going to go through her assessment and I'm going to go through her language sample, and I'm going to actually give some tips that I think will help Elissa and I think will help many of you as well. And Elissa is also very generous in the fact that she's going to share her assessment and her plan and her language sample. We're going to be able to put those right in the show notes. So those show notes. All right. MaryBarbera.com/167, which is going to be Elissa's podcast number. So Elissa did the assessment, the web page assessment. She did that at the end of January, when Lexi was two years five months old, so she's about two years, six months old at the time of this recording. And for those of you that don't know what the one page assessment is, it's literally just one page. And over a decade ago I created this and it's been revised many times and it's been revised most recently for the book, and we want this to be done as quickly as possible. I say it can take 10 minutes. I don't know Elissa, am I way off with that?

Elissa: No, it didn't take long at all it. It was an it was a fast assessment. It was great.

Mary: OK, yeah. And I think it's really good for the professionals out there, too. If you start the school year with eight kids or you get a new child into your classroom or you just want to like get a fresh start because whatever's happening in your classroom is not going the way you want it to go. I would really recommend having the parent and you, the parent really needs to have a heavy part in filling out this form. So even if they can fill out some of it or you can do it together on Zoom or online or in person to get your handle on, you might be like, Oh Mary, I have, you know, eight different assessments on Johnny. We don't with the last thing we need is another assessment. No, I think the best thing you can do, it's a one page assessment because, you know, Elissa, as a special teacher, you can have reams of data. But if there's not a good place to pull this in, it can be really problematic.

Elissa: Yes. Yes.

Mary: Yeah. OK, so she filled out this assessment, and I'm just going to start at the left hand column. She was diagnosed with ASD. She has no medication, no allergies, no special diet. She is unsafe around traffic and water. She does feed herself, which is going to become a strength on our plan. She does sleep through the night, another strength on our plan. She's not potty trained, but at two and a half that is really premature. We could talk about that, though, and grooming. She needs help, which is not that out of the question. One of the things that I didn't think. Up until right, this second is I know for the other hot seats, we did a self-care checklist. Did you happen to do a self-care checklist on Lexi?

Elissa: I had a looked at it. I had not filled it completely out.

Mary: OK, so that might be something after we record if you could fill it out and then send it back to us, and we'll include that in the show notes too. OK. Yeah. Well, you know, it's very common for two and a half year old to need help with grooming you guys saying, you know, those sorts of things. However, the self-care checklist developed by Dr. Mark Sundberg, which is included in my book and my courses, I really it's not just included. We use it to guide people, but you know, if she, for instance, isn't drinking out of an open cup and drinking from a straw in the feeding section. If she is not able to wash her hands with assistance or wipe her mouth with a napkin at certain ages, then we can kind of focus on those 18 months skills before we move into the two and three year old skills. So that's a good thing we should include. OK, then we'll get into the speaking expressive language part. She really just had some babbling, although we've made some progress and we're going to talk about that with the language sample. She, at the time a month ago could not request she would cry and grab instead and protecting. If I call out a picture on a page, she will point to it but cannot echo or say it. So she's having some better receptive language than she is expressive language.

Elissa: Yes, definitely.

Mary: Yeah. And then she at the time was not echoing anything. She wasn't filling in the blanks, doing any intraverbals. But her receptive language, she was almost always responding to her name, and sometimes she would follow directions without gestures. And if you tell her to clap her hands or stand up, she can do it without gestures. Usually, she can touch her nose as one body part. Imitation is a little iffy. Some imitation, some matching and then social concerns circle that apply. She has problems with greeting, sharing, pretend play and then problem behaviors. We're at the very end of the one page assessment, so you know, that didn't even take us five minutes to go over. But the problem behaviors include grabbing, cannot communicate. And then she has trouble with diaper changes. Can you tell us about that?

Elissa: Yeah, she struggles with being laid down on her back. So changing her diaper is, so she she does struggle when we lay her down on her back. She wants to kick her legs as she screams a little bit. We have been doing a little bit better in that regard. She's very into animals, so my husband discovered like if you start talking about animals and animal sounds, she is a little more relaxed. But, you know, even in one month, having done this and you are going through it, I like she has progressed in a lot of areas. I'm impressed.

Mary: OK. All right. So, yeah, well, why don't you tell our our listeners, what has she progressed in?

Elissa: So some of the things that she has progressed in is that she still isn't dressing herself, but she is starting to want to brush her own teeth. So I'll do it first. And then when I'm finished doing it, she'll brush her teeth. So she's been more into that. And then also hand-washing. She's become she actually really likes hand-washing now, and she enjoys that. The babbling, she's still babbles a lot, but she's really, really trying to mimic sounds. So that's been a huge help. She's starting to do more of the greetings. She's getting more high buy in. It's hard to understand. I can understand it, but I'm hearing it, which is exciting. She's starting to know more body parts as well. And when we first started, she only knew nose she was really proud of that. But now she's getting head, she's getting eyes and belly, which I think has to do with the table time and Mr. Potato Head and...

Mary: Mr. Potato Head. Yes, actually, it's a big part of our program. We do have we put in the show notes, we do have blogs on hand-washing, I believe and greetings. We also have bonus videos. Did you see the bonus video yet within that toddler course, I think there's one on greetings in there.

Elissa: Yes, I did. I did, and that's what got us into doing some more greeting stuff.

Mary: So yeah, so I can put the the video blogs about greetings and handwashing in the show notes if we have those. OK, so as I say in my book and in the course is you take the one page assessment and you go down the left hand column first and the first need we get to is safety awareness. And so for two and a half year old, it's not that unusual to be unsafe around water and cars, but you know, it is something we have to keep them safe. And I've done a lot of work on safety, safety, bonus video safety podcast safety chapter of my book. So the first need that Elissa wrote down is unsafe, around water and traffic. But then, as I pointed out, as I was reading some of the assessment is the strengths. Column includes feeds self sleeps through the night, can point to objects in a book if verbalized, and almost always responds to her name, which is great. And now, a month later, and I recommend doing this assessment, updating it every three to four months. But if you make really great gains, you can update it even more frequently. You can update the plan more frequently if needed. But usually, three or four months is a good timeframe to reevaluate. And then your needs are, you know, not potty trained and needs help with grooming and dressing, not requesting, cannot sing songs, inconsistent with following directions, inconsistent with imitation and matching, poor social skills, and the problem behavior. So those are the strengths and needs at the bottom. We have a plan which is just basically work on requesting, manding, tacting, echoics, imitation, and matching. And that may sound like overwhelming, but through the course through my book, we combine all that into easy activities at the table. So can you talk about you have a special ED background too? Is it is it? I know it's unusual for early intervention practitioners to be focused on the table. But what? What was your reaction when you started reading that? And what is your reaction now?

Table Time in the Turn Autism Around Approach

Elissa: When we first started table time?

Mary: Like when you first heard me going, Hey, get them to the table and stuff. Because early intervention is like all floor anf follow the child.

Elissa: It was a definitely a different approach than what we had been taking prior to it. So I was a little skeptical, but it really she we did spend a lot of time just preparing the table and she does like it. Like, I'm if I say, Lexi, let's go play at the table. She runs to the room where table time is and we actually now we changed the doorknob. We put a lock on it because we would just find her in there like ready. She'd just be sitting at the table, tappin on the table, like, OK, I'm ready. So. Yeah, she loves it, and I wasn't sure if she would go for it or not. She's just super squirmy and fidgety. I am too, though, so I'm OK with that. But she does love it. She likes doing puzzles. She loves Potato Head, she loves it. We have pictures of all of our family that she sees regularly, that she puts into the shoebox. She loves that she is able to match up items that she likes balls, cups. But yeah, she I wasn't sure if it would go well, but it really, really has. And it's definitely showing improvements.

Mary: Yeah, yeah. So I did do a video blog. I think about table time and why my approach definitely includes Table. There are some in my book about why I am big on table time, and I do think it's easier. You have a background, but just say you didn't have a special background, it's really easier, easier to train yourself or others at a table. I think because you can get more trials and especially if the child likes the table, then it's easier to transfer those skills to other people.

Elissa: Yes, definitely. I do notice that when I would follow her around, it was hard to keep her interest in something. And she is a child who if there's a lot of objects like her stim as to just like, gather up all of those objects and then hold them. And then it's just kind of like, All right, well, now I can't get you to do anything at all because you're just holding all of these pieces. And so getting her to do things for me outside of stationed spot was really hard, and with table time, I'm I'm the one in control of the pieces are so it defintely helped.

Mary: At the same time. She's running to the table. She's happy. She wants to do it. And that, you know, table time that doesn't look like that. I mean, you don't have to be that enthusiastic about table time, but you definitely want the child to want to do it. And if they're not wanting to do it, it is. It's not your fault. But you don't have the reinforcement, right? The demands are too high. Reinforcements too low. And there's never a time when you can't repair anything. Pair up repair. So. And don't just get like, Well, I'm going to let them stand at the table will just do it in the high chair or we'll just have to do it on the floor. Because if they're not running to the table, they're not going to be running to the toilet to potty train. They're not going to be running to the bathtub to learn how to get a shower. They're not going to be running to get a haircut. All of these things are hard and potentially hard for kids, and we're not where we're wanting them to really want to be with us, to want to learn, to want to accept reinforcement. And so it's not a control thing. It's just this is the most expedited way I know how to get children to increase talking and decrease problem behaviors. And that's the way we can work on requesting, tacting, echoics, immitation, matching all at the same time is through these early learning programs like the The Shoe Box and Potato Head, et cetera. So also, you're going to use or have been using the one word times three strategy. Why don't you tell our listeners? I'm sure some of them have heard of that.

Elissa: Yes. So we will. When I'm doing things with her or show her a picture of mommy and I'll hold it up and tell her, Mommy, Mommy, mommy. And then she'll take my picture and she'll insert it in the shoe box. And we I do it all day long. I I find myself saying things three times, even with my students at work now. And it's it. I do feel like it's definitely paying off and it's so easy to just implement. It's just whatever we're doing with her. We just say it three times when it's time to eat. Lexi, let's eat, eat. And she comes running to the table to eat now.

Mary: And so and she's starting to even echo sometimes. Yes, if she does echo, I just want to point out the child does echo. If you say eat. And she says, eat. You don't say it three times. You just say that once and then you make a big deal out of that. So yeah, so one word up to three times. And then you also said you are using the Shush and gives technique throughout the day. Can you tell our listeners about that?

The Shush and Give Method

Elissa: Yes, I do have a harder time with that one. Yeah. She I'll tell her sh then give it to her. And I'm never quite sure because she doesn't always stop the fussing. So I don't know. Like, OK, well, she's still crying. Do I still give it or? So that would be something great for you to help me out with.

Mary: OK, so the shushing give is when the child is whining, crying, having problem behaviors and they want something, but you can't just give it to them. So say the child is wanting water and saying wah wah grabbing. And you know, it's important to get the child quiet, at least for a couple of seconds before you deliver the water. So this is a very, very simple kind of count mand procedure for those professionals out there that know what a count mand is. So Dr. Vincent Carbon's came up with the strategy, and it used to be like, OK, now you have to be quiet, you have to be quiet for a count of 10, and you can imagine how much tantrum goes on with trying to get a child to quiet down for a full 10 seconds and out loud count. It was just like, this is not working, especially for little kids, but even for older kids. If they have language delays, you want to get them the reinforcement, but you want to get it when they're quiet. So. So say she's waaaaa, sshhhhh. And you know what you just said is like, it's hard to know when to give it to her. And I often describe this as like a jump rope, like you got to make a decision. And sometimes it's wrong as you go in and you're like, Oh my gosh, she just let out a yelp in between me saying shush and giving it. And now she just got reinforced but quiet down as much as possible. She. Even if it goes from a cry to like a whimper and it doesn't have to be like within 10 seconds or 30 seconds or a minute, you could just, you know, put the water aside gently, let's calm down. Let's take some deep breaths. Good. Good. Good. OK, now let's have some water. So it doesn't have to be this whole. Like, we want to be gentle. We want to be, you know, help the child calm down. And if they are wanting something that they can't have. So and that that's a struggle, too. So say they want a French fry from another another person at a restaurant from their plate, and they can't have that. Their food's not ready. You know, you can't do a shush and give them that try. So it's more of an accepting no kind of thing, but you can do the same kind of gentle techniques. Let's quiet down show. Can I just take some deep breaths and a deep breaths are actually good? You know, let's calm your hands down. Let's like squeeze your hands together less and then they can't have the fry from the neighbors table. But OK, I have my iPhone or I have a cracker that I keep in my bag or here. Let's have some crayons. But the important thing about a shush and give or calm down procedure or, you know, that sort of thing is that we don't want to give the child an item during crying or whining or whatever, because that's going to increase it. So I think what you're describing is kind of lower that jump rope like you're not quite sure if you're doing it right, but over time, you don't have to worry about the Yelper. I reinforce a little early or late because over time, you're just going to want to get her happier and happier.

Elissa: Yes. Yes, that's it. Good to know because I think you're right with the description of the jump rope like I, I am always just like, Oh, when do I jump in? What do I give it to?

Mary: Yeah. And when you're using a shushing, give remember it's a reactive strategy. OK, so we want to spend ninety five percent of our time preventing problem behaviors. So even if you have a nightmare situation at the restaurant with the neighbors French Fry, you're going to be the Monday morning quarterback. Next time you go to a restaurant, you're going to have snacks, you're going to have crayons, you're going to have whatever, and you're going to prevent that problem behavior next time. So even if you're using this shush and give and it doesn't go well. Think about how you can prevent next time. Yes. OK, so then ABC or calendar data on problem behaviors? I did do a video blog we can include in the show notes here 167 on calendar data. Are you taking calendar data now?

Elissa: So I haven't done calendar, but I have done to ABC and it's usually a lot of the problem. Behaviors we were seeing were stemming from her having items that she wasn't supposed to have and then getting her to give up those items. And to be honest, a lot of the time, if we just ignored her within about two minutes, she's over it and moves on. So but it's one of those things like I didn't realize that prior to doing that that's what was causing some of it.

Pairing Potty Training

Mary: So yeah, I think ABC data definitely helps. And again, if you're doing ABC data and you're looking at crying and other problem behaviors, then you're looking at reactive. So taking ABC data or calendar data helps you think about how can I prevent this next time? How can I be more proactive and preventative? And then the last thing you have on the plan is pair sitting on potty one time per day. And one of the things I would say is, you know, when you described her having problem behaviors laying on her back for diaper changes, I'm assuming she lays on her back to sleep without a problem.

Elissa: She is actually a stomach sleeper. OK? She always has been. She just she's usually sitting up looking at a book, and then she just like folds. Right in half, she almost sits sitting Indian style, and then she'll eventually in the middle of the night, wiggle to her tummy.

Mary: OK? And then the other question I would have is she's not constipated is she?

Elissa: She is not.

Mary: Ok because I just did a podcast interview with a potty training guru, Dr. Stephen Hodges, who, you know, really said like peeing and pooping and, you know, kind of getting a weird positions can be. Sign of constipation, but a couple of things, diaper changes, I would I would be preventative and like your husband, kind of discovered the whole if you talk to her about animals or whatever. If she could hold something while she's laying on her back, that's super fun. If she could get a special treat for, you know, doing a diaper change, something that she really loves that she doesn't get a lot, if you could pair that up so that it was more doable and I would. I mean, she's two and a half. Will she sit on the potty?

Elissa: She will. She's she's a funny little girl. She likes chairs, so she, when she does it, sit on that like, I've only done it with her a couple of times. Night times get crazy. So and I I don't feel like there's a lot of potty training readiness there yet. So I've only done it a couple of times. And both times she thought it was silly and then she would just straighten her legs and straighten her back and then just kind of like, push herself off. So I've kind of. Held back on that a little bit more recently.

Mary: OK, so I would, you know, I wouldn't wait too long to pair up the potty or the toilet, like maybe diaper changes if she has bowel movement, maybe show her in the in the regular toilet, maybe get a seat for the regular toilet. And you know, they have contraptions where there see the little stairs, you know, she could really like like that or just a little Fisher-Price potty that she could sit on. I would do it more, not less like I wouldn't do it once a night. Even then, or I would do it like three times a day like, this is potty time. This is practice. But I wouldn't wait for like potty signs. I wouldn't do anything intensive, but I think the better she can get it just sitting and maybe she'll be. I always like to do it first thing in the morning because that's the highest probability time that she has to pee. So I even made up a song with Lucas like first thing in the morning. When you wake up, you go pee on the potty and it's from like wiggles or something. But that became part of our routine. So morning, night before you go on a trip before she goes to school, whatever. But you don't want her squirming in, you know, so you're going to have to think about strong reinforcement. Maybe a special potty seat, maybe would would kind of.

Elissa: Yeah. And we even have in the basement from our other daughter, her little tiny potty. And as much as Lexi loves little chairs, I'm surprised that I haven't thought to bring that up and get it cleaned off and ready. So that's definitely something that I will do.

Mary: Yeah, I think the mistake people make is like only getting the potty chair or potty seat out when those three, when they're like, OK, it's time, you know, get it out sooner and pair it up. And I also have, you know, a potty chapter in my book, a potty podcast, a couple of potty podcasts we can link in, the show notes. OK, so the other thing you wrote down here in the corner of your plan is reinforcement will smile and be happy when she gets it. A duck, and book and mom.

Elissa: MnMs

Mary: OK, yeah, sorry. MnMs.

Elissa: OK, I'm not that special.

Mary: OK, so those are kind of clues. OK. And let's just talk about your language sample quickly, and we're going to post this in the show notes to. Hopefully this is helpful for everybody, but I do want to get to a couple tips that I saw. Just part of it was those reinforcement, a duck, a book, an MnM. And part of it is from her language sample on 119 and 120. She really just had a couple ha or gaga. You know, the kind of just sounds and high-pitched laughs and a pretend cough, which is good, a lip smack, which is good with one of my little clients, Jacob, who's in the course he when I got there, the family had kind of taught him to go, take his finger and make his lips go funny. And even though that's not usually the imitation we start with, it was an imitative skill that we could get under our control pretty quickly so that fake cough and lip smacking might be things that you can get her to do and saying, go like this (lip smacking) or go like this (fake coughing). And even those two things are kind of like oral mode. They're definitely oral motor imitation, but they're they're getting to echoics as well. And then so on two nine, you did another language sample and these language samples are 10 minutes, 20 minutes. Doesn't matter whatever you do, just pick the time, set the timer and be there for any kind of words. So she said Cuh for Cup and P for Pizza both looking at pictures.

Elissa: During the table time. That's my shorthand. My TT is my table time.

Mary: OK, great. And then Baba, when she saw a picture of a sheet mama doing table time and lots of babbling in between. And then you say, in three weeks, I went from just tracking sounds to tracking Echoics, which is amazing. I would keep language sample like once a week. And yeah, I don't know if you're OK, but you know, I think it's for some kids. We keep it every day. We tally and we, you know, write down every new word we hear, every word we hear. You can get a, you know, it's probably going to be time for you to get a clicker like this and keep track of words heard during table time. And then you can say, OK in 15 minutes or 30 minutes or an hour, we got five words. And so whatever you measure will increase like so. And it sounds like the floodgates are just about ready to open here.

Elissa: Yeah, I feel like they are. It's coming and it's coming fast. I'm excited about it.

Expanding Language at Table Time

Mary: Yeah. So a couple of things I saw. Now there's four steps to the turn autism around approach assessment, which we just went over the one page assessment and the language sample, and you're going to send us a self care assessment. Those are the big, the big ones to start with the plan, we just went over. And now the third step of the turn autism around approach is intervention or teaching. And I just want to talk to you just a couple of things that I saw that were clues in the assessment that might help with the teaching. You already said she loves table. She loves the early learning materials, which is just amazing, right? So. OK, so the shoe box, I would if you don't have it, I would I would gather pictures of actually I would get double pictures because we can always use these for matching two of pizza cup. Mama, M&M sheep and we can call the sheep, Baba, just because we normally we'd want to call the sheep sheep, but since she's the Echo or she's saying Baba, we can. The goal here really is to get echoics, because once you get echoics and she starts saying everything you're saying, then the floodgates are open. So also with a puzzle, make sure you have an animal puzzle that has both a sheep and a duck, also, which I don't think I've ever given this this guidance before in the course or in any podcast. But you can also get another container like an oatmeal container or a shoe box or something with a lid and make that the 3D shoe box. So you can have 3D figurines like farm animals like a sheep and a dog. And you can have food, fake food like a little pizza, a little dollhouse cup.

Elissa: That's a great idea. I like that

Mary: You're taking notes.

Elissa: I am. I totally am.

Mary: You totally shoud. And I, you know, and that can just be like the special other shoe box. You know, that's the other that's, you know, and I do like the idea of like having like an oatmeal container or something where, you know, it's a bigger, bigger slit. It's a different thing, but it's important for it to get kids to label objects and not just pictures, too. So that goes hand in hand. You can also then take your pictures and your little 3D items, and you can do 3D due to 2Dthe match.

Elissa: That's a yes. I like that idea.

Mary: Lexi's, not going to know what hit her.

Elissa: I know you're right.

Mary: Woah new materials, OK? I already talked to you about the imitation, like the sounds, the popping sound or the the coughing, the fake coughing you can. I would totally mix those in with clapping, patting on the table, doing those easy imitation skills too. And if she stops like responding to popping or coughing, that's not something you could make like you can't physically help her do so, you know, as long as she's doing it. But if you're like, do this and it takes you like 10 times, so she does it, then stop doing it because we don't want to give kids directions that they can't easily follow and we have no way to prompt them. That's why I'm not a big proponent on sending kids down and trying to do echoics. Now we're going to go in the back door. We're going to get them excited about labeling the nose and the and the potato head and labeling the sheep for the puzzle. We're we're going to get them just excited about being there and listening, and then we're going to get them excited about actually trying to say it. But it's going to be on their terms and when they're ready and once the floodgates open, it's going to be fun for her to talk more. OK. And I already gave you the ideas about the problem behaviors, the diaper change. And then so that's all teaching and intervention. Do you have any questions? We're going to get to the fourth step of the turn on autism, an approach which is data collection. But do you have any questions while we're at the teaching?

Incorporating Family in Interventions

Elissa: So. Yeah, I do. We have another daughter who's four years old. She's going to be five soon, and I know that she is really into helping Lexi. And if you had any suggestions on how to kind of get her engaged into the teaching process or I don't really know how to incorporate her, but I know that there's got to be a way.

Mary: Yeah, yeah, that's a great question. So in the verbal behavior bundle, which you'll hopefully go to next. So people start out with the toddler. And then if you have an older child or your professional working with older children, you just start out at the verbal behavior bundle. But in that course, we do have videos of Jacob, which I talked about with the with the lip and the finger movement. His older brother is Scotty. He was. He was just two years old. They're like, like, your daughters are two years apart in age, and he was about the same age. So Jacob was two and three, and Scotty was four and five. And I went there weekly for a while years, actually. So when Scotty was there, they were being watched by their grandmother and we would do practice circle time with the therapists and the grandma. So they read the book and they'd ask Scotty to do a couple of the, Oh, what's what color is this? And that sort of thing for him? And then they'd say, touch the sheep and they'd pull it over for, you know, your daughter to to respond to. So you get active responding for both of them. We also would have we trained Scotty, and I think there might be a a video in the verbal behavior bundle where we we literally sat next to Scotty. He held up the the sheep, or he held up the banana and said, Banana, banana, banana. And you know, she can learn how to do those things. I wouldn't have them do it on their own, but you sitting next to her, she can become like a little junior therapist. And some people might think thoughts. Yeah, she's only four or five. Why put this on her? No, this is just active engagement, you know, like little kids like to play teacher. Mm. Yes. So she can be your little junior teacher, right? Yes. Yeah. I think I think Scotty, I think they even got him a shirt that said junior therapist or something. Yeah. And he was always really proud of it. And I know with my kids, with Spencer, he was 18 months younger. But by the time Lucas started therapy and you know, Spencer was. And Lucas was five and a half, but Spencer was very much like, Look at the moon and you know, he'd keep an eye on on on Lucas. If we were out, he would, you know, he still does. And I don't know if you listen to the podcast with Spencer, my typically developing son, but it's a great podcast. And, you know, kids with siblings. On the spectrum are very special and many times just so resilient and so exceptional that so I think those are good things to me. She could model sitting on the potty. She could model laying on her back, you know, for diaper change or she could lay with her. And that's good. I think it's a diaper change and they both get reinforcement. So you see, I use her for modeling for activity. I also have a video in the Verbal Behavior Bundle with Jenna with her kids. Cody and Ava and Ava was two years younger, and so Cody was four and Ava was two, and Ava was not on the spectrum. So but she would have them both at the table just to kind of keep them both busy.

Elissa: OK, so that's a yeah, that does. And I think that she would really enjoy getting to be a part of table time too, because when I'm in there with Lexi, she'll kind of crack the door and peek in. She wants to know what's going on. She always has some reason that she needs something. She needs to ask something because I think that she just wants to like, What are you guys doing?

Mary: Yeah, she's getting your undivided attention. Yes, maybe you need to have just like, OK, we're going to set a timer. You know, this is this is Lexi and your other daughter's name time. Like, OK, when the timer rings, then you're going to go into the other room and you're going to do X, Y and Z, which is fine. But, you know, maybe set set a timer for some limits so that you can just get out without impeding of the whole lesson.

Elissa: Yes, that's a good idea.

Mary: Yeah. OK, do you have any other questions about that step?

Elissa: I think that that was my biggest one there. OK.

Mary: Did you also have like, do you have extended family that you also want to?

Elissa: Yes. Oh yes, definitely. So we actually live on across the street from my brothers, not my brothers, my husband's sister and her family. And then also across the street and down just a little bit is my mother and father in law. So everyone just has a hand in Lexi's progress and what we're doing. So I didn't know if there are ways to kind of incorporate them or things to let them know to keep things. So any advice that you have on that?

Mary: Yeah. I mean, if they would be willing to read my book or have you just explain to them, I mean, you could even do a video and you could just say, this is what we're doing. Here's a little table time. Here's the early learning materials. You know, if Lexi cries and whines, you know, we don't want to give her things right that second, we want to try to calm her down. We want to spend 95 percent of our time preventing, you know, show them if they're around and you are going to do table time, you know, show them, show them how you say a word three times and you're, you know, I don't know. I think just keeping them in the loop and educating them might be good. They can listen to this. Watch this podcast and get, you know, just some tips.

Elissa: Yeah, they are excited that I'm doing a podcast with you, and my mother in law actually has read your book. I shared mine with her when I was done with it, and she is excited to come and see what table time looks like and jump in and help out.

Mary: We have so many grandmothers within our course. I did a podcast with Grandma Diane and a couple of years ago and it is one of my absolute favorite so we can link them on the show notes. But grandmothers, most of the time as grandmothers, as a few been a few have been grandfathers or we've had aunts and we've had, you know, certainly parents and guardians. So the more people you can get to do this to expand, the better. Let's talk quickly about just the last step is is data collection. I would say keep going with the ABC data if when you have big problem behaviors and then also the calendar system might be helpful in terms of just keeping track of anything major. But you know, I think it seems like things are really going well. Now you had said there's a two year waitlist for ABA. Are you going to be able to get ABA? Are you going to just how or what? What's going to happen?

Finding ABA Resources

Elissa: So there is a couple ABA options around here. So the one that would be the it would it would essentially be like her full time school, which is the ABA that has the two year waitlist and we've gone. She really, really gets a lot from social interaction with peers. So because it's all children who are on the spectrum, I just I don't know what the right thing to do is. And then also knowing it's a two year wait list, I just don't know. And then there's another ABA facility near us, and I'm skeptical about it. And then I there's a third option and when I called it to try to get Lexi on the wait list for them. They said that because we're currently getting EI services that we wouldn't we can't double dip into the county's disabilities assistance and funding. Yeah. So and that one would have been a free resource, but working in special education and knowing that there is a BCBA at our school that works for that third option, which I was told I couldn't have because of it, I was like, I'm just going to ask her, like, what? What's the deal with that? And so I actually recently spoke with her about it, and she said that they can offer if you have the right insurance they can offer you like in their facility, some help. So she I did get her into that. I don't know what it's going to look like yet. She has her intake on Thursday, so I'm excited to see how that goes. I just know that I feel like I need to be doing more. And she's right now, just she. I can tell that she's just a ready. And so I just I'm desperate for resources and so...

Mary: And, you know, I think a lot of people get to your point too to this point where you know you are seeing gains. And one of the big things that I warn people is no matter what services you're looking at, if you're looking at eBay or you're looking at speech or tea or whatever, is that? I have a very different system. I have a very different approach. And you know, one example one mom had was making all kind of gains kind of. At this point, child was starting to talk, was happy with the table, loved it and she got to the front of the line for this ABA to be in the home. And they came and they were like, We're going to, you know, take him in his bedroom, shut the door. You're going to hear a lot of crying. That's not, you know. And you are special ed background. You know that you're not going to, you know, do that. You know what? This family did kind of just deal with it. And I don't know how you know what their circumstances were. Or maybe it was just bad in the very, very beginning. But still, we don't want kids to have any trauma, any crying. And if people, if you the parent, have found a way, whatever you call it, x y z method and working that the child is running to the table and learning and starting to echo, you know, that needs to keep going. And that whole philosophy needs to keep going. So it sounds like you're in the right direction. Your eyes are wide open, but yes. And the other thing is, I did do a video blog on how to pick ABA and ABA School, Home vs. school ABA, which I think is important. But we also did a recent podcast with Michelle C and her daughter, Alaina. And we did a case study white paper that we could link in the show notes. And, you know, her daughter was similar. She liked the social. She didn't like the social, but the the mom one really wanted her to socialize and everything, and she got very social when she went to an ABA school. But eventually he became to like conversational, and she really didn't need it. So she was discharged. And now she's in typically typically developing school. But I know for Lucas, he always went to typical preschool, and that can have really good effects with good role modeling. And so, you know, I think with your background, with the courses, you could come up with a home program or clinic program, but that would involve some part time preschool that is with typically developing peers. Yeah, at least at some point, yes. Yeah.

Elissa: Oh, I I guess we'll see what happens on Thursday, but I am going to I'm hopeful that all goes well. I'm hopeful that. Their approach is similar to yours in that it stays positive and keeps her excited, I mean, she is she's a happy little girl, so I'm, if anything starts to show red flags of a displeased towards it. I'm not going to be afraid to pull her, though.

Elissa on the Turn Autism Around Podcast

Mary: Well, it sounds like you're doing great. We are going to wrap it up. But before I let you go, I always like to end this way. Part of my podcast goals are really not to just help the kids, but also help the parents and professionals listening to be less stressed and lead happier lives. So do you have any self-care tips or stress reduction tools that you use that you recommend?

Elissa: Yes. Listening to your podcast, I was ready for that one. It's so night time when my husband and I get our girls into bed a couple nights a week. We just like to come back downstairs and have a glass of wine together and just have time together without hectic ness and interruptions from children. So that's kind of our unwind time together and us getting to communicate and just child free time.

Mary: Yeah, I love that. Love that. So thank you so much. I think this hotseat is going to be very beneficial to our listeners. Hopefully it was helpful to you. I know I loved this story and I'm excited for the progress that Lexi is going to continue to make. So hang in there. Keep us posted within our online community. And good luck to you.

Elissa: Yes, thank you so much. I really appreciate it. I feel honored that I got to sit with you.

Mary: If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at MaryBarbera.com/workshop, where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism. And you can learn more about joining my online course and community at a very special discount. Once again, go to MaryBarbera.com/workshop for all the details, I hope to see you there.