Well, some would refer to her as an SLP goddess. And when I say some, it means this is actual feedback from her course in when she presented at SLP summit in January, 2022. So, um, we are it ecstatic to have Cari Ebert in the confessional today.

Cari (00:01:25):

Hey. Hello? Hello? Hello.

Sarah (00:01:30):

Hi, welcome. We wish you were really in real life here. We need to meet.

Cari (00:01:35):

I would love that. I would love that. Yeah. Yeah, Cause you guys are what in Arizona. Yep, and I'm in Kansas city , and it is supposed to be spring and it is freezing. I'm sitting here with a blanket on my lap and I have my sweats on and I could use some gloves. I am frozen. It is so silly cold here.

Sarah (00:01:54):

Gosh, see, it's like, it is overcast here today, but it's like 77.

Cari (00:01:58):

Oh, I'm so jealous

Lisa (00:01:59):

Freezing. I had to put a jacket on look, jean jacket.

Cari (00:02:01):

70 is cold. It's like 31 degrees here. It's so dumb.

Lisa (00:02:06):

Yeah. So Kansas city. So, well, Jenny lived there. I know she's in Denver now, but did, did you guys know each other?

Cari (00:02:13):

Yeah. So Jenny, yeah, Jenny Beorum and I, um, so Kansas city, um, I don't know how much you know about your geography, but Kansas city is a two is a city too great for one state. So half of our city is in Missouri and half of our city is in Kansas. So Jenny Beorum, um, when she lived here, lived on the Kansas side and I live in the Missouri side. Okay. Uh, we both, uh, did early intervention birth to three for many, many years. And that's how I first met Jenny. Um, I actually went and did a presentation for her and all of her SLPs in her living room, uh, sat on the floor and did a two hour presentation on apraxia. And that's how we first met. And that was really, um, how her passion for Apraxia began. And so we have a really interesting, uh, kind of history together.

Sarah (00:02:58):

That's so cool. She's so much fun. We had the, um, opportunity. We met her first at Anasha. I'm sure. Just right away, like hit it off with her cuz you know, she, she's just,

Lisa (00:03:08):

it was her first Asha. She was at one of the member booths. Remember?

Sarah (00:03:10):

Yeah

Lisa (00:03:11):

Like, we, she had just launched her product, her um, Beorum speech junk cues. Yeah. Um,

Cari (00:03:17):

Yeah, she's, she's a hoot. How can you not love Jenny? So I miss having her in the Kansas city area, but we text, um, multiple times a week. Um, uh, so her and me, uh, and Amy Graham and her and I, we have a, a group chat. Um, I don't know what we call ourselves. The Apraxia nerds probably. I don't know something, but we talk Apraxia, um, as though, uh, like the way other people talk about like, you know, eating, eating tacos. I don't know. We just talk Apraxia all the time. So it's kind of our thing.

Lisa (00:03:46):

I think you need to rename yourselves to the goddesses because clearly I'm telling you the feedback. I did you have a chance to look at your feedback from the course

Cari (00:03:53):

Um to be honest with like, I probably didn't. I mean, I may have opened it. Who knows my life. You guys, if you had any idea, I don't know if I'm coming or going, like I have had to learn to say no because I literally, there are not enough hours in the day and there are not enough days in the week and I am always so far behind in getting presentations ready and that I just, so I hope it was good feedback.

Lisa (00:04:16):

There is not enough Carrie to go around there.

Cari (00:04:18):

There isn't there isn't I don't even know what to do you about that, but

Lisa (00:04:20):

No, I will say you can't possibly go through all of the feedback. Summit is such like a hugely attended event. I think I told Sarah when I went to print some of it, it was like 444 pages. So, you know, a little light reading, but I will say when I am, you know, going through, I always love to scan and it was stuff like people were like, oh my gosh, I, down to Cari, she's an SLP goddess. Um, a lot of feedback about how you're able to take a really complex topic and make it easy to understand. And, and not just that, but actionable the next day, which I mean, to me, that's probably the highest compliment in our speaking realm that you could get.

Cari (00:04:59):

Yeah, it absolutely is as a professional speaker. Uh, I think that has really become my superpower. I've been doing this since 2009 now. So I've been a professional speaker for over a decade and I have learned how to take a whole lot of words, um, that either Ashe said or that some research said or whatever it is. And I always challenge myself, how can I say the exact same thing in as few words as possible? So I have gotten really good at packing a punch with just a few words, but I want them to be meaningful words. I want parents to be able to understand them. I want new SLPs to be able to understand them and I want it to still be meaningful for seasoned SLP. So it really is, um, uh, you know, kind of my superpower hour being able to do that. And I take pride in that because I spend a lot of time, uh, getting my handouts ready and making sure they're they're usable.

Sarah (00:05:50):

Yeah, it was. And you're so lovely to listen to too. And so engaging and your energy is so good. Um, in fact, you've got the, the same background, um, right now that we're looking at, that you had in your summit. So even that, like, if you guys can't see, unfortunately you're listening right now, but it is a rainbow bookshelf and it just brings so much joy. And so it is, it's like everything about you is just like sunshine.

Cari (00:06:17):

You know, I really needed to hear that. I don't know if you, I really needed to hear that. I have had just a really stressful, um, couple of weeks. And so thank you for just making my day. My, this is my recording studio. We actually have two home offices, my husband and I, um, and, uh, so this is, I painted it pink because, uh, well, you can't really see the pink wall, but I'm a breast cancer survivor. So pink has, um, a lot of special meaning for me. And so I painted it pink and um, then I have my, my rainbow bookshelves. I have more bookshelves than this, but these are the ones that I could color coordinate. So my Roy G Biv as my son, Aaron calls it, he always walks in and goes, Roy G Biv.

Lisa (00:06:58):

So how did you make the transition you were talking earlier about, you started a lot in early intervention. How did you kind of make that shift? I know you're passionate about that still, but also Apraxia and autism. Um,

Cari (00:07:08):

Yep.

Lisa (00:07:09):

Tell us a little bit more about that.

Cari (00:07:11):

Sure. Well, um, gosh, where do I start? So when I first graduated in from grad school in 1995, uh, I thought I wanted to work with adults in long-term care and I was wrong. Uh, I did that for about three years and I thought I was gonna leave the profession because I, there was no joy in it for me. I mean, I really was struggling to find my purpose. And um, so, uh, not that we need to get political, but bill Clinton was in office and he, um, screwed Medicare and took a bunch of money away. And so my rehab company went under and it was the biggest blessing of my life because they gave us two weeks, um, notification, no severance or anything, and said the company's shutting down in two weeks. So I had to get outta long term care. And again, it was the best decision I ever made. Well, bill Clinton made it for me. Thank you, bill. Um, but I, um, went into pediatrics cuz I was like, I needed to, I knew I needed to make that shift and I just had a baby and I was pretty fascinated by this whole language development piece. And so started in peds and, um, worked in a clinic for about a year and then decided I needed to go younger. Um, and so I went into early intervention two decades ago and have never looked back, um, my passion for apraxia and autism pretty much stem from the fact that, um, I have a son and Aaron is autistic and he has apraxia. And so I had to learn everything I possibly could from a parent, uh, perspective. And that translated into my SLP world. And I've just never looked back. Aaron is now 17. And, um, he continues to teach me an awful lot about autism. I tell you,

Sarah (00:08:45):

Wow. Talking about real world experience. I was grateful that during grad school, I got to work and apply my knowledge. Um, you know, like during the day, cuz it just, the connection was so much stronger there. So to live with that is like, I mean, of course, no better expert than we could have to talk about this very topic.

Cari (00:09:02):

Yeah.

Sarah (00:09:03):

The whole view

Cari (00:09:06):

Yeah. What's so interesting is Apraxia was my original passion and I don't know, I just had an, a gift for working with children who understood everything, but couldn't talk to save their life. And so that, that humongous gap between that receptive and expressive language and I'm talking toddlers 18, 20, 22 month, 24 month old babies, and I was able to get 'em to talk. And so I started really trying to figure out what, what this was and what my strategies were. And when I first met with Jenny and all of her colleagues was the first time, or her staff was the first time I ever put it on paper, what my, you know, strategies were and how to support these kids who, um, were struggling to even turn their motor on, you know, to even get sound at all. And um, so Apraxia was my passion. Um, play-based learning, I'm very passionate about that. So I wrote a course on play-based learning as my second. It course never talked about autism and never even discussed. Um, on the speaking, uh, in the speaking world that I even had an autistic son and it was, um, just a few years ago that I really kind of opened up about that. And I realize in hindsight, I, um, wasn't ready, you know, um, when you live, um, uh, you know, when you're raising an autistic child and living it 24/7, um, and then, um, at work, you know, obviously I had autistic, you know, kids on my caseload. And so I basically had autism 24/7 and I was spent, I was, um, emotionally and, um, physically to some degree spent. So what I started doing was specializing in the apraxia instead of seeing autistic children. So I became kind of this person in the Kansas city area where everybody knew, oh, if, if you're suspecting apraxia of speech, give 'em to cari. So that way almost every child that I saw kind of fit that app Apraxia, uh, profile. And I wasn't, uh, uh, working with autistic at children. And I needed that. Um, at the time when Aaron was very young, um, if you've any of you have followed me on social media, I've, I've opened up a little bit about it, but he had, um, to say he had challenging behaviors as an understatement. Um, it was, um, very difficult. And I will just say since we're in the confessional, uh, that back then, so my husband, Jim and I, we have three kids have two neurotypical daughters. And then, uh, Aaron and, uh, what, what happened when Aaron was younger was Jim and the girls would live life. They would go to church, they would go to birthday parties. They would go to family events. They would, you know, go out to the zoo and Aaron and I would stay home because his sensory needs were so significant.

(00:11:36):

And he had such, um, severe meltdowns, um, out in public. And I, um, it was just easier. It was, I got so tired of being looked at as the mom who couldn't control her kid. Do you know what I mean by that? You know, those looks where people just look at you and, and, and you can see what's going through their head, if that were my child, you know, kind of a thing. So they, I felt very judged everywhere. I went, so Aarin and I stopped leaving the house and that's not good for anyone's mental health. Um, so these past few years, uh, that I have started opening up about autism and really listening to autistic adults, Aarin is now 17. And so it's been very important for me to me and my husband to kind of figure out what his next path is after high school, you know, where he is going. And so, um, I've become, um, a very strong advocate for the neurodiversity movement and really accepting autistic, uh, children for who they are. And instead of trying to change them, you know, really accepting them and building on their strengths, uh, instead of trying to fix deficits, like we were all trained to do in grad school, you know, under the medical model. So

Sarah (00:12:37):

Yep. We had, uh, Rachel Dorsey on a podcast. Oh, I think it was our last episode. And, um, at one point I actually got really emotional during the episode too, because she was sharing from her personal experience and, and just like, it was just a really powerful and, and vulnerable moment. It was so kind of her to share. And so I feel like that with you right now, too, that it, it is that's, you're putting yourself in that very vulnerable position to talk about such things, but you know, what a gift to us. Yeah.

Cari (00:13:04):

Yeah. Well, and Aaron is a blessing and I, I, I, I don't know. I do a lot of social media posts now almost every day. And I think the one I did cuz every Sunday I post on Sunday is, um, Sunday A day where I just talk about autism and it's just some random blathering of me. It's very therapeutic and cathartic for me to just have an avenue to just let it all out. And I basically talked about how Aaron is, um, he's my, why, you know why I do everything that I do, why I'm so passionate about what I do. Um, and I ended yesterday's post with, um, uh, something like, um, uh, Aaron is not an optional member of society and you know, that just, it's something that I think about a lot that, um, we don't get to pick and choose who, who we think is important in society.

(00:13:46):

Right. Everybody has their place. And so, um, I just want, you know, SLPs and, um, you know, other providers and ready to understand that autistic children are not mistakes. I mean, you know, they're blessings and we have to seek to understand them, not seek to change them. And so it has been a real, um, shift for me, you know, just these, the pandemic. I mean, you wanna talk about silver linings? I mean, the pandemic is the worst thing we probably, most of us have ever lived through, you know, as, as, I mean just how long it lasted and you know, what it did for us financially and emotionally and all of that. But what it allowed me to do, the silver lining for me is I went 570 days without leaving my house. Basically I didn't travel. And as somebody who travels about 45 weeks a year, um, and have been doing that for a decade, I'm telling you for 570 days, I was home and it allowed me to listen.

(00:14:39):

And I just got on social media and started listening to every autistic adult. I could find, I started reading everything that I could from autistic adults. And it was one of those moments where I was like, wow, I've been doing it all wrong. You know, I mean, in air quotes, wrong, like, you know, better, you do better. Right. And that's, that's where I think a lot of us are at now and I continue to change. Um, you know, during that time I, I wrote my, um, my, my book on, on autism on how to support very young children and their families. And I already need to update because I've continued to learn even since publishing that two years ago, you know? So, um, it's, it's a journey and I'm sure you guys feel that way too, you know, especially in your position, having all these speakers, you know, guests on and you learn from them and we start, I don't know the confessional, gosh, we've all been there. Right.

Lisa (00:15:29):

I think that was part of what we talked about with Rachel too, is that, you know, it has been so many ahas in the past couple of years, but particularly with, um, everything going on in the autistic community. And when you start to kind of analyze like, oh shit, I have done some things that I regret. And especially, I mean, I had shared too, my child is an adult diagnosed, um, autistic individual and I'm like, I did. So I created trauma for my own child and it like, it makes me sad, but you know, like you said, it, it was not done out of, you know, it was done out of ignorance, not out of, out of a bad place, but it's still happened.

Cari (00:16:09):

Yeah. And it's hard, it's hard. And we, we grow and I think that's what we all, we always have. We have give ourselves grace and, um, we have to acknowledge that, um, we're all growing, we're all learning. And as, um, an SLP who's been in the field for 26 years, I would never claim to know it all. And that's why when people say, oh, Cari she's whatever. I'm like, yeah. But I'm still human. And you know, it's just that I being in either practice, I'm allowed to specialize. If you work in the schools, you can't really specialize. And so you have to be a Jack of all trades. Um, I'm not a good Jack of all trades, which is why I left the stability of having a full-time job with a company who offers PTO and pays my insurance. And, you know, I've none of that, I've none of that stability whatsoever because, um, I'm self-employed, but what it allows me to do is to hyper focus on apraxia and autism, which are the two things that I am absolutely the most passionate about. So, you know, um, again, we all, we all have different things that we bring to the SLP table, right? Yeah.

Sarah (00:17:09):

And I think for so long, I think we do, you know, as, as school based SLP and we always say we're generalists, you know, we have to know something about everything. Um, and we do beat ourselves up a lot because, you know, we, we just cannot obviously be experts in all areas.

Lisa (00:17:25):

And, and, you know, typically I wanna say maybe I had in 10 years, one or two children who crossed my path with Apriaxa. Right. And we don't see it that often. And until you do, you know, you don't have to

(00:17:38):

Really, You know, go and, and really learn all of that. And so some was a great way for us to be able to like, just focus on something super practical that like would in like, hopefully motivate you and inspire you. But also like that grace, like make convince you like, it's okay. Like you, we are not expected to know everything doesn't mean you're a bad SLP.

Sarah (00:18:00):

Right.

Lisa (00:18:00):

Um, you know, take this and grow and, and, and become a better person, you know, and therapist,

Cari (00:18:05):

You know, I have a solution for, um, if, if you wanna me to, I'd like to solve some world problems. Okay. Absolutely. SLP world. Okay. For school-based SLP, I have a solution because I don't know how you guys do what you do. I honestly don't. I mean, I just, the thought of having to treat one child, you know, who maybe stutters and another child who has a phonological disorder and another child, you know, I mean, I'm just like, how, how can you go and bounce from two child to child? So here's, um, something that is happening in a school district in California. I'm not gonna get super specific because I don't need to, but, um, I love their models. So they have, um, like one SLP in their school district is super trained in childhood Apraxia of speech. And she goes to every single, uh, course there is on a Apraxia.

(00:18:51):

They buy her every Apraxia product, anything she wants, she wants every Beorum speech sound queue, man. She gets it. She wants cari's silly sound card, man. She gets it. She wants to go to the app, Apraxia kids' bootcamp, webinar, whatever she gets it. Right. So then there's that person. So she carries a regular caseload and goes to her school's, you know, two days a week. But the other three days she's available as a resource to every other SLP in the district. And so they can use her in any way they want. Right. Whether she helps with evaluations helps write goals, helps, um, create, um, a treatment plan, whatever, in the same district, there's also a fluency specialist. So there's an SLP who gets to go to every single possible thing. There is on fluency. You would ever need to know there are several SLPs, um, who can support, uh, autistic students.

(00:19:37):

Right. Then there's, Thelp, you know, we need one, who's a dysarthria specialist. And I don't know any SLPs who are dysarthria specialists. We need a couple of those in the world. Right. And so if we, within school districts had access to SLPs who wanted to specialize, meaning it was their choice, meaning I'm super passionate about X, Y, or Z, please train me. And then I also have good colleague to colleague coaching skills. Right. Where, I mean, I play nice with others. Cause that's an important skill. It can't just be, I know a lot. It has to be, I know a lot. And I love to great and partner with other, my other colleagues. Right.

Lisa (00:20:14):

And People don't wanna punch me in the face when I speak. Yes,

Cari (00:20:16):

Exactly. I've worked those before. Yeah. Well being able to play nice with others, would you guys agree that as a life skill right. And that,

Sarah (00:20:24):

And not a lot of SLPs can

Cari (00:20:26):

No. And isn't that crazy we're the communication specialist, I know yet we don't all, you know, play nice with others

Sarah (00:20:31):

Well, and there's this funny thing. We've talked about this in several episodes. Like we had the AAC specialist and he was lovely and I loved him, but I was so embarrassed by my lack of knowledge that I never utilized him. Like I should, because I was too embarrassed to admit that I like, I didn't even know what to ask. And so we've gotta get past that too. It's the dumbest thing. It's literally only hurting me that I am not saying, I don't know. I don't even know where to start. I don't even know what to ask. Help me literally from the beginning. But yes. I think every district should have one we've talked to Nina Reeves, um, is that's what she does. She works for a school district and her entire caseload is all of the, the students, um, was with its fluency was stuttering.

Cari (00:21:15):

It's amazing. Isn't it? Yeah. Yeah. And I just feel like every district could do that. I mean, of course I, because you would find SLP who have that passion, there has to be self motivation. You know what I mean? It has to be intrinsic. It can't be like, that's one of the things about me being self-employed is I don't have someone saying Cari, you gotta get your progress notes done. Gotta get your work. Like there's nobody, I've just got the lists. I have you. I mean, in my working office, um, it's crazy, but I'm like, I'm very much intrinsically motivated. I love my job. I'm very passionate about my job. And for me being, self-employed untrue for those of you who work in schools, the more I work, the more I get paid. So, you know, there is that, um, motivation, financial for me as well.

(00:21:57):

Right. That, um, unfortunately if you work in a clinic, you work in a school, you get paid the same amount, no matter how many kids you see. Right. So right. Um, um, but anyways, that, that intrinsic motivation important. And if we could allow our school districts to have SLPs who specialize, right. And then they are accessed, they're available to the entire district. I mean, I just feel like we're gonna have to start using, um, more of an expertise model because the field of speech language pathology has grown too large. And there is no way one SLP can be expected to know everything and to know not only how, you know, therapy, strategies and evaluation tools, but how about evidence based information, right. You have to stay on top of the most recent information and, and, and make sure you're providing evidence based practice. I just think we are, and

Sarah (00:22:48):

Really just trying to is stay on top of my paperwork. Right. I'm just trying to get to four o'clock today. Right?

Cari (00:22:53):

Exactly. Let alone worried about, am I doing best practice? Right? Because there, there comes a point where the load being placed on us is just far too big. It's just, it's not even manageable at some point

Lisa (00:23:04):

When I it's hard too. I, in the district where Sarah and I worked together, there was the AAC specialist and there was a TBI specialist, both SLPs that, um, worked with sped teachers and kind of collaborative teams. And I'm curious though, I, I don't, it was never really adopted that it would be on other kind of low incidents, like within the field of speech pathology alone, to have those, we tried at one point to do, uh, a dysphasia expert, um, that was an SLP and did that whole thing, but the process in our district, because it was a big district. It just, I mean, you know how it is like changing anything in like the us government, like it's, it's so difficult. So maybe first looking at the size of your district and the control you have, and then looking at baby steps within there. But, well,

Cari (00:23:52):

Absolutely because honestly, in a big district, it would have to be region. It'd have to be, we have one Apraxia specialist in, you know, the east region. We have one in the, we, I mean, you you'd have to, you know, there's no way even one SLP for a huge school district, you know, would be, would be, would be feasible. So

Lisa (00:24:09):

Well, I think one of the issues that I, it happens probably in a lot of school districts, we talk about it even it's one of our core values at SLP toolkit is to be proactive versus reactive. But when you're struggling to even, you know, manage your day to day, that's when it ends up being a lot of active. But with school districts, I mean, I've sat in a lot of those fun meetings where they end up paying so much money. If you know, they don't have, um, documentation, evidence based practice in place, they'll go and pay a clinic to do all of that. And,

Cari (00:24:41):

And think it would be a lot more, um, cost effective to simply train your own staff. And to, if you, if you have an SLP is super passionate about autism or super passionate about apraxia, it's gonna keep that SLP happy and keep 'em at their job. Right. Rather than having to be a Jack of all trades and say, I have to know a little bit about everything, but I don't get to specialize in the one thing you know, that I am most passionate about. So I think there's there's work to be done obviously. Um, but again, our field just continues to grow. And I, I think we're gonna have to have, I mean, again, if I ran the world, I would change a lot of things, but I think we need SLP who are actually autism specialists who really, um, are doing due diligence and understanding, um, the social model of disability versus the medical of disability.

(00:25:28):

I think it's a, kinda a, a travesty that we are all trained under the medical model. And yet when you work in pediatrics, most of our kids, um, they're developmental issues. They're not because of a traumatic brain injury. They're not a loss of skill, you know, so we, um, in pediatrics we should be doing habilitative therapy, but yet we're trained to do rehabilitative therapy and it just all does all pieces don't fit, you know? And so I think there's, um, some restructuring that, that, that would be amazing, but the likelihood of us seeing it in our lifetime probably isn't very good.

Sarah (00:25:59):

Well, we're gonna vote for you in 2024.

Cari (00:26:02):

Excellent. Excellent. I would like run the world at least one small part of it. Now. Here's how I, here's how I'd really love to run the world is. Um, and I don't know if it's okay if I say this, but I'm gonna say it. Education is broken. Education has been broken for a long time. And I think what we need to do is for special education, I think we really need to get, um, uh, a PTOTSLP and a special education teacher. Those four people collaboratively need to run the special education department. We need to get people in there who actually understand not only child development, but who understand brain development. And I think we are so far away from developmentally appropriate practice in, especially in early childhood. And I mean, you look at pre-K kindergarten, first grade, second grade, it's insane. I just consulted with the school district again, out west, and I won't even label the state, but, um, uh, they, um, are using a program in kindergarten. Um, and the kids were learning about Ben Franklin and the kindergartners had to write, um, a paragraph about Ben Franklin. This is what they were tested on. They had to have an introductory sentence, two detailed sentences and a conclusion sentence kindergarten. These are five, these are five year old babies. And this is, this is part of the curriculum

Sarah (00:27:13):

Where I learned how to tie my shoes in kindergarten. I took naps, right?

Cari (00:27:18):

Kindergarten used to be

Sarah (00:27:19):

On the kitchen.

Cari (00:27:20):

Yeah. Remember kindergarten. We used to go half day, we have a little mat`. We used to take a rest and it used to be play based. And we basically went to kindergarten to learn the social rules, how, of how to survive in a group setting. Um, and today, kindergarten is the new second grade and our babies are suffering. And, you know, so, I mean, we have five year olds uttering, the three worst words you could ever hear a student utter, I hate school. And they say it when they're five, I mean, what are we doing? You know? So yeah, we could work on education. Um, I'm, I'm all in for that one too.

Sarah (00:27:53):

I mean, gosh, it's one, it's no wonder that you don't have time, you know, I know enough time in your day.

Cari (00:27:58):

Yeah. The, the number of topics, you know, I have, like, I think I just counted. I have 15 i have 15 different seminars that I do. Okay. 15 topics. I mean, that's insane, you know, so I have like five different apraxia courses. I have a play-based learning course. I have my sign language course. I have a literacy based course because, you know, SLP, we all use books for language therapy, but I use books for speech therapy. I mean, I do talk about how to use it, to build, you know, to work on speech sound disorders. Like that's my real love. Yeah. With my passion for children's books. Um, uh, you know, I have my building executive function skills through play-based learning for preschool. I mean, it's just, you know, I have all these different topics and I can't, every time I have my sensory for the SLP course, like every time I write a course, I'm like, oh, that would lead to, I don't know enough about this. So I would research that and then I'd be like, oh, well now I need to research this. So I feel like I'm, I'm finally building this, this, this, um, I don't know, plethora courses topics, you know, that covers like all of child development and maybe I'll be done soon. I don't know, but I just keep down writing new courses, writing new courses, writing new courses. So,

Sarah (00:29:05):

And we'll link to those in the, the show notes.

Cari (00:29:07):

Um, oh, awesome.

Sarah (00:29:08):

Yeah. We were so excited when you agreed to do summit because you're, we, you know, we always ask our feedback and we want people share like their favorite presenters or whatever, and people have been like dying for you.

Cari (00:29:18):

Well, I'm so grateful that you asked. I mean, I, um, like I said, I need to start saying no, but to you guys, I was never gonna say no to you guys. So I appreciate you asked it was an honor.

Sarah (00:29:27):

Thank you. Because it was, it was just like such a great course and it was packed with so much. And I feel like this ties kind of into like what we were just talking about, um, with meeting like experts, you know, specialized people to work with these, these individuals. And in this course, you primarily talked about, um, uh, motor based learning. Right. Right. And I love, you started out by talking about like, we have to know the diagnosis so that we can give the appropriate treatment. And that was like, what'd you call it something about the bus.

Cari (00:29:56):

Yeah. I say you, um, the, the, uh, diagnosis drives the treatment bus. That's it? So, yeah. Yeah. You have, you don't know the right diagnosis. Yeah. You can't, there's no way you can plan. And I don't remember in grad school, anybody talking to me about the treatment bus, you know what I mean? It was like, I needed somebody to just, you know, tell me specifically, and if it's a, if it's artic you use this, if it's phono, you do this. If it's apraxia you do this, if it's desarthria for you do this. And then the one thing nobody ever told me, or maybe I skipped this day in college, but nobody ever told me there could be a mixed speech sound disorder and a kid could have all of those. And therefore you better have goals to support all of the core, you know, the impairments. And I was like, wow, I really missed that in grad school. So that has been huge for me, 100 percent, um, to recognize you can have a child with CAS who also has final Conant deletion and cluster reduction. Right. So they also have phonological, uh, impairment. And we need to make sure that we're addressing all of the issues that are affecting intelligibility.

Lisa (00:30:55):

Yes. And I, until we worked with Jenny, when was that two or three years ago, we worked with Jenny Beorum to create some kind of an informal screening tool for SLP toolkit because that we had, I think she had just presented and really talked about the importance of understanding exactly what was going on, because if it's motor based, the treatment approach is very, very different.

Cari (00:31:13):

Its so different,

Lisa (00:31:14):

It's literally the first time I'd ever heard it. And this is like 12 years in. And I was like, what the heck?

Cari (00:31:20):

Yeah. Yeah. When I wrote my, the book, the SLPs guide in treating childhood apraxia of speech with the amazing Dave hammer. So he is, he retired in 2019. So he has been in the field, gosh, you know, 25, 30 years longer than I have. So when he asked me to co-author this book with him, I was like over the moon. But, um, it was just so, um, crazy how much I learned from him. And I considered myself an, apraxia specialist already. Do you know what I mean? But just learning from him. I was like, wow, like, um, he was the first one that really introduced me to the term mixed speech sound disorder. And I was like, that sounds like something important that an SLP should know that, you know, that speech sound disorders don't fit in boxes that it's not like a child either has Arctic or has phono, or has CAS, or has Dysarthria guess what? They can have some of each, you know, and nobody, I don't remember ever taking a course on how to treat mixed speech sound disorders. Did you guys, I

Lisa (00:32:14):

Don't know. I didn't even really remember any treatment courses. I got treatment guidelines through both my internships at the clinic or externships at private practice or whatever

Cari (00:32:27):

And how scary is that?

Sarah (00:32:28):

Yeah. And this is forever ago, I remember the first time I realized that there was a difference even in the approach for articulation versus chronological processes. Right. I remember like I was actively working and I went right.

(00:32:38):

Huh?

Cari (00:32:41):

Yeah, I mean, think about this when you, uh, you know, so like phonological is a linguistically based speech sound disorder that just blows my mind that you there it's, it's linguistically based. Right. So, whereas Apraxia and, um, CAS are motor based, but phonological has nothing to do with motor at all. It is the child has not yet learned the rules for the spoken language. They haven't learned the rules. I mean, it's amazing that it's linguistically based. And again, I get so excited about weird stuff like this when I do my seminar, because I'm like, these were those, you know, mind blowing moments where as a practicing SLP, I was like, that seems important, you know what I mean? It seems really important to know that that is

Sarah (00:33:23):

its pretty Important.

Cari (00:33:23):

Yeah.

Lisa (00:33:26):

It's funny that, you know, they don't know the rules for spoken language, but they can write an intro sentence to details in a conclusion, So that's... With looking at the questions from your course. I, I do feel a, a few of them came from school based SLPs that were like, but I work in a school, we work on eligibility, not diagnosis. So how does that work? And then what do I use to diagnose? Or what do I use to determine the differences? And then how do I, um, write goals for that? And it's like all the same questions. I'm sure you get at all of your courses.

Cari (00:33:59):

Um, Yeah. Even without a diagnosis. I mean, CAS, it's just that the SLP needs to know the diagnosis. You don't have to put it on a piece of paper. The point is the diagnosis drives the treatment bus. So you need to know if the child has, um, speech, motor planning difficulties. Then what you're getting at as the SLP is that the child has difficulty moving between sounds, syllables and words. This is a problem with movement with co articulatory transitions. So it's not that the child can't make the B sound or can't make the S sound. It has nothing to do with what sounds they can make it's that they can't move between sounds so like kids with Apraxia little ones that i see, they might be able to say, mm. And they might be able to say E, but they can't say me, which requires them to move between those sounds. Right. So it's about the movement patterns. Okay. Um, and so whether you call it CAS or not, you, you still wouldn't re, and I know in the schools, there's probably an eligibility of, um, you know, I don't even know what is speech,

Lisa (00:35:03):

Speech, language, impairment,

Cari (00:35:04):

Speech, language impairment. Thank you. So of course, CAS is gonna fall under that, right? We're not gonna, you don't have to call it that, but you can say in your wording that the child has difficulty moving between sound syllables and words. And what you're saying then is I'm going to be using principles of motor learning during my treatment. Right. It doesn't matter if you call it that it's, that, you know, you have to be using a movement approach. So apraxia, the root word is Praxis. Praxis is a Greek word. That means movement. When, you know, entomology of words, it helps you design your treatment program, right? So you have to be working on movement patterns. So the problem I have is when, you know, as an SLP um, uh, goals are written that the child will produce bilabials in the initial position of words that has nothing to do with movement patterns, nothing whatsoever.

(00:35:52):

I don't even, I don't, I'm not even interested in you talking about, you know, really specific sounds. We need to be working at the word level. We need to always be working at the word level and be working, um, on, um, moving between those sounds. So, uh, Jenny, I know Beorum, you know, talks about this a lot too, but you need to pick target words that are relevant, meaningful, and they better darn well be high frequency words. So I always joke, you know, leave your multisyllabic word cards in the super duper box. Like we aren't, I don't need to teach certificate and transportation. Like how many times a day does a kid say those words? You know,

Sarah (00:36:28):

I think you used the, the example too, kaleidoscope, kaleidoscope,

Cari (00:36:31):

Isn't that fabulous, like

(00:36:32):

Let's spend all your mental energy, trying to motor plan a multisyllabic word that you're never gonna say again, ever under any circumstance. You're never gonna say so let's spend all of our time and energy on that. So it's really important that we're picking target words. And when that's the number one strategy, I'll just leave with all your listeners is if you would just work, fix five target words or target phrases at a time I'm telling you you'll make such functional progress. I don't care if they're artic, if they're phono, if they're CAS target word therapy is in my very humble opinion, the most effective way to go. And so I always ask parents or teachers for a wish list of words and phrases. I wanna know what would make your life easier. What would make the child's life easier? If they could say approximations of, you know, these words or phrases, and don't shy away from phrases, I wanna go, I wanna eat.

(00:37:24):

I wanna, I wanna don't teach a robot. I want to, I wanna is a really powerful, you know, way for children to let you know what they want to do or what they want to have, what they wanna play. Right? Wanna wanna wanna. Yeah. So, um, um, I I'm otherwise, I mean, I don't love, I mean, there's so many other carrier phrases, but you know, we wanna not only teach that one, but don't teach, I want to eat. I want to play. I want to, I mean, get away from the robotics. So co articulation, right? So I always joke, like my mother-in-law's name is not pat ty her name is Patty. So teach kids to talk the way we actually say the word don't break things. When you segment right into, into word sounds and syllables, it ends up sounding very forced and very robotic and very choppy. So, um, it's about movement co articulatory transitions. That should be your favorite phrase. You should say it frequently. Write it frequently. It's about movement, right? Yeah.

Sarah (00:38:25):

I love it. You talked about too, the, the frequency of practice, um, In your presentation.

(00:38:30):

So I'm gonna pick the five target words and phrases preferably. So these things are gonna be

Cari (00:38:36):

Meaningful

Sarah (00:38:37):

Most function are meaningful. Yes. How, and then what am I like? We're just doing a hundred repetitions.

Cari (00:38:44):

Well, that's the goal, you know, that the whole point of repetitive speech practice, which is the only way to help kids with apraxia and become intelligible is repetitive speech practice, but I am anti-drill work. Um, Jenny Beorum I know is too, I am not interested in sitting with little flashcards and having him say, you know, words, um, over and over, but we have, um, you know, uh, uh, identified fun and meaningful ways. So like connect four there's 42 checkers. I know because I use it all the time. So that's 42 repetitions, very rapid repetitions of whatever the target word or phrase is. It doesn't have anything to do with the game. It might be the child's favorite food pizza, or it might be his favorite bluey character, or it might be, I don't know what your target order or phrase is. The point is, um, kids love to drop checkers into connect four because at the end they get to slide the lever and all 42 checkers come raining down, make a ruckus on, on the table.

(00:39:36):

They laugh, they think it's fabulous and they wanna do it again. So that's a really the muffin tin is what I use with toddlers. I can get kids love to put in, dump out and do it again. So we pick our target words. And as they're putting things in, we're saying, you know, the word or, you know, something related to it, um, uh, an Abacus has a hundred, um, beads. Don't know why little kids love moving beads across, and you can get 'em to say their target words over and over. I don't know why, but they love it. Right? So it's little things like that. Pop up pirate. How many, how many, um, swords does he have? That's how many repetitions you're gonna get? Um, what's in Ned's head take all the weird stuff out of that weird game and put, um, toys that are relevant, meaningful to the child, you know, all their favorite toys.

(00:40:19):

So when the child reaches in and he pulls something out, it's guaranteed to be a target word, you know? And so, um, one of the things Dave hammer said about, um, what's in Ned's head is it's pretty gross that you reach in his ear or up his nose. So add Ew to the beginning of everything. So Ew, chew you, Ew ball, Ew. You know, whatever it is. So adding ew, you get to work on prosody, but it just adds another syllable, right. To that, um, uh, practice. So, um, I think the reason, um, Jenny and I both why we love doing apraxia therapy so much is it is very rapid. Um, this is, remember speech is rapid and accurate alternating movements of the articulators. So it's about speed and agility. So the movement, we need that motor plan to be very rapid, right? And so we just keep going.

(00:41:09):

You, you know, we give them lots of cues and we'll use, um, you know, um, simultaneous productions and we'll slow down the word if we need to, to get all the pieces, you know, in there, but then we have to speed it back up. I mean, speech is rapid, right? Speech is fast. And so you get to do tons and tons of reps and you get to follow the child's lead. And I just, I think we, most of us in grad school were trained to do kind of boring drill work type speech therapy. And if, if you're bored, you know, the kids bored. If you've ever watched Jenny beorum do therapy, her kids are never bored. I mean, you know, Jenny doesnt

Lisa (00:41:45):

Wrapped up in tape. I wanna see a therapy off, I wanna see a therapy off of Carrie and Jenny, same kid in a room and see

Cari (00:41:54):

Notes. Yeah. Really

Sarah (00:41:56):

Super fun

Cari (00:41:57):

In my, in my, I just did, um, a course for SLPs down in Brazil on Saturday. And I had just gotten done doing an intensive with a little guy, a little three and a half year old. And so I had some brand new video of me engaging with the child. And it was so fun for me to sit back and watch. Cause I had, haven't really spent a lot of time reviewing the video yet, but, um, he's having the time of his life. I mean, I look like a goon, but you know, I mean, we're both having fun. Everybody's laughing. And when he is treating SLP afterwards said, I've never heard him that verbal in my life. Usually he's throwing screaming and head banging and we had no challenging behaviors. So the power of child led play child led therapy. I mean, Hmm it's it's something else, everything, when you,

Sarah (00:42:39):

So you talked about that the very first piece being attention and motivation

Cari (00:42:42):

You're spining your wheels.

(00:42:44):

Yeah. Without it you're spinning your wheels. Absolutely. So yeah, those prerequisites attention motivation, and there has to be imitation if a child can't attempt verbal immatation again, what are you doing in speech therapy? I mean, you have to go back and pick up what I call foundation skills. Um, uh, in, when you look at principles of motor learning, the technical term is pre-practice, which means you have to make sure the learner is ready for the practice session. So if you don't have the child's attention, if they're not intrinsically motivated to practice talking, and if they don't have verbal limitation, you are wasting valuable time stop working on speech, right. There's no point. And that's where I think some SLP get frustrated. And so here's what happens. Gosh, I can't get 'em to talk. So what I'm gonna do is work on play skills and like receptive language. And so what happens is this gap just gets bigger and bigger, receptive language keeps growing and speech. Each never moves, right. It never changes because we can't get him to turn his voice on, you know, because we don't kind of have those foundation skills in place yet.

Lisa (00:43:45):

Well, I, we did get questions on that too, in, in about your course about like what happens if the child is not verbal yet, what do you work on? Or we also got a lot of questions about co morbidity. So if you have a student that is Apraxic and has down syndrome or Apraxic, and is also, um, autistic, Some things to take into consideration.

Cari (00:44:05):

Yeah. So you always have to remember that you've got a primary diagnosis and CAS is the secondary diagnosis in that point. And so, um, language trumps speech every day of the week. So you better be starting with AAC. I'm not interested in talking to any SLP, um, about difficulty, um, getting a child to talk until AAC, robust AAC, um, unrestricted access to aided language goals, better be in there and better be the emphasis. And once we have language and communication, then I am more than happy to start talking about speech. Um, I just did a consult on a six year old down syndrome, um, uh, and uh, suspected CAS, right? So same thing. I mean this little guy, um, has, um, great attention, you know, um, kids with down syndrome tend to love to watch our faces, right. So he is got great attention, but absolutely no imitation, right.

(00:44:55):

None whatsoever. So we have to make sure we're building those foundation skills first. Um, so AAC has got to be, again, I think there's been a shift, um, I'm 26 years out of grad school when I was in grad school. AAC was nobody said this, but it was considered last resort, meaning we certainly would never start speech therapy with AAC because that would indicate we've given up already. Right. It was this idea that AAC means he's never gonna talk. We now know there's nothing to substantiate that in the research or the evidence. So, um, language before speech, that's kind of my new motto language before speech. Right. Um, we need to make sure

Lisa (00:45:32):

We do get questions on that too. About like when do we introduce AAC or, um, how do you deal with if a child is breaking down in their, um,

Cari (00:45:40):

Yep. Yep. How in my, in my apraxia, of course my full one where we do assessment differential diagnosis and treatment, and I go through my therapy bowls and the first one is always AAC. I, I mean, we don't move forward until we have AAC in place because language trumps, um, uh, speech. And if you're dealing with an autistic child, um, we know from the research that 25 to 30% of autistic children will never develop, um, complex speech. So knowing that one fourth to one third will never develop complex speech. We darn well better or start with AAC. Cause we can't decide, you know, we don't have a crystal ball to know which autistic children will become verbal and which ones, you know, will likely not, um, develop that complex speech. And so we need to make sure that as a field, as a profession that we honor, um, all communication as being valid, that we don't place, um, more of an importance on spoken language, over other forms of communication.

(00:46:38):

And that's where I think, um, we have to, you know, check ourselves sometimes and make sure that we don't have this, um, kind of bias, you know, in our field that says spoken language, trumps everything else. Um, so that's where I too, I, I would say I've had a, a big shift, you know, um, um, these past couple years in really acknowledging that I am not an AAC specialist, but boy, I follow some doozies on Instagram and I feel like I am in a continuing ed course every day when I read their posts. And I'm always like mind blown, you know, the mind blown emoji over and over. And I'm like, don't you think they should teach that in grad school? Probably. You know, like I say that all the time

Lisa (00:47:14):

Education nowadays is bananas in the best of ways. I mean, we have talked about like even the invention of Instagram stories and watching therapists in real time.

Cari (00:47:26):

It's Phenomenal

Lisa (00:47:27):

It's amazing. Yep. We did get some questions about, you know, that you talked about the shift in the past couple of years, that masks, um, oh, how does that come into play? If you have therapists that are still required to wear a mask during therapy when clearly those kids need to be seeing your mouth

Cari (00:47:46):

Yeah. Visual cues. Um, the ability to visualize movement. Now we do know that blind children learn to talk. So, you know, we have to be careful to not put all our eggs in one basket and assume that without vision you couldn't learn to speak. Right. We know that there are obviously probably, I mean, I never worked with one, but there's gotta be a blind child who has childhood apraxia of speech. So, you know, I, I am not a, a, um, a vision impaired specialists, but I will say that the visual cues, um, are, and I think Jenny and I would agree on this visual cues, uh, are absolutely essential for, you know, most of our, of our kids. Um, that is why, I mean, the clear masks are obviously a way to go. If you can find a way to get the barrier, you know, and remove the masks.

(00:48:29):

So, you know, you can have that. The other thing would be to record yourself on your phone or on your iPad. And so you may be saying it, but the child is watching you say it on an iPad. We live in the digital age. You guys, I mean, we gotta stop, like trying to make excuses, just record yourself, doing X, Y, and Z. That's why even say about parent coaching. Oh, the parent can't be there for therapy. Good news. We live in the digital age, you know, zoom with 'em or record yourself and send home teacher. Oh yeah. Well, the teacher needs to know how you cue the child. So send a video, everybody likes, videos, you just said, isn't it amazing to watch somebody else do therapy? Well, as we're coaching, um, other colleagues or parents or teachers or paras on the cues that we're using, why wouldn't we put it in video format?

(00:49:12):

It is so much more effective. So we have huge advantages to living in the digital age. It's creating issues. I think in early childhood with excessive screen time interfering with play-based movement. So, you know, and I have a whole course on that. I mean, that is a huge issue, but there are advantages and disadvantages to everything in the world. Is that fair to say? So, I mean, we just have to understand that there are ways we should be using technology, um, to coach and to educate others. And, um, it's, it's pretty amazing that we have the ability to do that even in a pandemic. Yeah.

Sarah (00:49:46):

I love my, one of my favorite things to say all the time is be a problem solver. I say it's Lisa and my children on a regular basis

Lisa (00:49:51):

see her husband and the children. But even when you just, when you just said that I went, oh, duh, like that would never have even crossed my mind. But again, that's the beauty of, if you are a lifelong learner, which in this field, you have to be, but really life, you have to be period, but that there is no excuse anymore. There's no excuse, to not hear something, watch something. I mean, there are people with ideas or even I think of the Facebook groups of, Hey, I'm having a challenge. How do I incorporate verbal, you know, visual cues of if kids see in my mouth when I'm doing or artic therapy or, um, motor learn or motor therapy for CAS, and there will be people that have answers. Yeah. Like there's no excuse not to have answers to all of our questions

Cari (00:50:37):

And that's why we need to always collaborate. And we need to come into every day, um, as, um, willing to learn as acknowledging that we don't have all the answers. There is no one person who has all the answers, Jenny, Amy Graham. And I, we always, we learn from each other. I mean, we pick each other's brain and you know, we're constantly learning and, um, you know, so it's, it's a, it's a wonderful field to be in. And there are always gonna be challenges. If it's not a pandemic and masks, it's gonna be something else. So don't allow that to, you know, disrupt, um, you know, flip over whatever you call it, the apple cart. What's that saying? Upset the apple cart. I mean, something's gonna upset your dang apple cart every freaking day. So you better get used to it

(00:51:16):

Right. And you better just learn to deal with it. I'm working with my son on idioms. So I, I have all these idioms in my head. Oh, I gotta greatest book on idioms. I know your listeners, can't can't see, but my son also loves animals. And so this is called, there's a frog in my throat, 440 sayings, a little bird told me it is the most amazing book on idioms. Cause it's all in cartoon format, you know, like

Lisa (00:51:39):

I have that, that is a fantastic book.

Cari (00:51:42):

I love it. But so I have idioms on the brain cause he, he's always asking that when we use an idiom, his favorite thing is he, is that literal or non literal. I'll be like, let's think about it, buddy. Do cats and dogs really fall from the sky and he'll be like, Hmm, I think that is non literal.

Lisa (00:51:57):

I'm like if they're in a tree and in a, in a gust of wind comes like, this is where I feel like the conversations would go to, like it could happen.

Cari (00:52:05):

Yep. Yep. Yep. Isn't that funny? I love it

Sarah (00:52:08):

That's so good. I think we could talk to Cari all day, but we're not gonna,

Lisa (00:52:12):

can I sneak in one more because I did see a few people ask this and this is always a question that I did too older students with apraxia that came up a lot. Where the heck do we start? Especially

Cari (00:52:22):

So older, the

Lisa (00:52:23):

Moment where I'm like, I've had that older kid who probably didn't get great therapy this time now what?

Cari (00:52:30):

Okay, so here's the deal guys for older students, they should be choosing their own targets a hundred percent. What do you wanna be able to say clear, maybe it's Minecraft people, things, maybe it's video, it's gonna be related to video games or related, you know, what are their, their friends names, their teachers names. So you wanna make sure what are their favorite players in sports? You know, who are their favorite basketball players, which teams, I mean, so you really have to make sure that you're getting at relevant, meaningful, functional, right. I also would encourage older students to be bringing in their homework. Um, they need to be, you need to be working on words directly and phrases directly from the curriculum. So go to the, um, language arts, bring your language arts homework, bring your, you know, whatever you should, if he has a book report due or a PowerPoint presentation or a, you know, whatever it is that he has to do, that's what you should be working on in speech.

(00:53:16):

I, I hope I have time. I just wanna share. And if I shared this during the training, I, I don't think I did, but I remember being in my son's IEP meeting a few years ago and the, um, science teacher was in there because he went to regular ed science with his para. He was in special ed classes the rest of the day, but he really loves facts. So he loves science because there's no, there's no make believe. There's no imagination. He likes ,he's a straight shooter. Right? So he likes facts. So he loves science. And the science teacher popped into the IEP meeting. Aaron is really struggling with, um, the vocabulary. We're doing something that was with water. So he is struggling with, you know, condensation and evaporation and those multisyllabic words, he was struggling even saying 'em, but he was really struggling with the vocabulary and understanding 'em.

(00:53:59):

So the science teacher leaves SLP comes in, gives me her spiel and she has a vocabulary goal on the IEP. So I said, great. I'm so glad you have a vocabulary goal. Are you working on vocabulary from science? And she looked at me like I had a horn growing out of my head and said, oh no, I wouldn't have any idea what they're working on in science. And I said, well, here's the thing. Um, you know, um, he's in science class, the science teacher was just in here and said, he's struggling with science vocabulary. I'd love if you could address that. And she said to me, straight up, if I, I, would've no way of knowing what every student is working on in every class. So I, I just work on vocabulary, you know, based on the topic that I pick, I have a real issue with that because the SLP, um, should be there to support the curriculum.

(00:54:41):

Anything that we're doing, if you want it to be educationally relevant, everything you do should be drawn directly from the curriculum. So if you're looking for that's why, oh, and I did see how I'm rambling, but I did a post on this a while ago and I know I ruffled some feathers. I'm not a big fan of thematic speech therapy. Like, oh, I'm gonna do apples in every session, you know, take your apples and shove them because I mean, my kid doesn't care about your damn apples. And so if you're gonna try to make him talk about apple and you know, do all this stuff, my son is going to disengage. You're gonna write that he was non-compliant they refused to participate. I I'm so against thematic based speech therapy, cuz how is that individualized? You're supposed to be pulling every child's goals. It should be in support of the curriculum and support of what skills they need to be successful in that in educational environment.

(00:55:28):

So I, I, older students should be selecting their own target words and phrases and they should be drawn from homework, um, from, you know, class assignments when you write goals, um, like I'll just read you a couple of the goals. I pulled out my hand out from my course motor planning goal examples for the more verbal child. Right. So, uh, um, let's see here. Um, child will accurately plan and sequence 25 target words, uh, during, um, it could be structured play time if it's like, you know, a kindergartner or something, um, with no more than one cue from the SLP child will accurately plan and sequence 20 different two word phrases that are intelligible to a familiar listener. When provided with no more than, and one queue from the SLP. child will accurately plan and sequence 20. Um, let's see, uh, 20 target words using three different prosodic variations child will produce plan and sequence, um, uh, uh, three to five word intelligible utterances here.

(00:56:23):

It is accurately planning and sequencing all syllables when provided the point is you should always have plan and sequence plan and sequence. That's how I know I'm writing a motor goal is if they will plan and sequence, right. So I always try to that way, I know that's my motor speech goal, and then you might have an Arctic goal, right? Child will produce L in the initial medial final position of, of target words or whatever. And you could have a phono goal, child will, um, um, uh, you know, produce clusters in target word. You know, so I, the point is you're probably gonna have more than just apraxia goals for older kids, I'm assuming. Um, but that, hopefully that's helpful. It's just really about, um, um, planning and sequencing those movements for speech.

Sarah (00:57:06):

I think the biggest takeaway, and, and you've said several times throughout this conversation is it's the relevant, meaningful, um, informal. Yeah.

Cari (00:57:14):

That's it so important? I mean,

Sarah (00:57:15):

Yeah, yeah. I mean, that's not, it it's very complicated.

Cari (00:57:19):

Well, thats most of it <laughs>

Lisa (00:57:20):

And we're done and we're done. No, and actually, Cari, I, people said this about your courses too. We literally could sit here and talk to you all day, but clearly that we can't do that. We can't all just today, but, um, can you share how people can follow you and get more information about what you're doing?

Cari (00:57:39):

Sure. Um, go to my website. So it's Cari Ebert seminars. Um, I'm sure you guys will put the link in there. Cause my spell, my name is spelled weird, C A R I Cari Ebert seminars.com. So you can check out my products. All of my, asha approved self study courses are on there, um, along with all my products. Uh, and then I'd invite you to follow me on Instagram, Cari Ebert seminars, I'm most active on there. It does cross post to facebook, but I'm sort of over Facebook. So I do most of my posting on Instagram. Um, so those are the two best ways to, um, engage with me. And um, yeah, so I appreciate you guys so much.

Lisa (00:58:15):

And if you, if anyone has questions about thematic units, uh, <chuckles> and especially with the Cari express please DM her <chortles> at Cari Ebert seminars on Instagram, not us,

Cari (00:58:28):

if you know, and I, I just wanna say, I know I probably shouldn't have said that. It's just my one pet peeve. We all have our pet peeves. Right. And for me it's that my son

Sarah (00:58:37):

I do love the younger grades though. Cuz like you can still do penguins when they're doing like they're penguin unit. Like I do. I, but I'm

Cari (00:58:45):

Because if it, it they're doing in the classroom doing by all means you can do it. Absolutely. Absolutely. It's when you have a six grader and you're like, oh

Lisa (00:58:52):

It's, I think you can individualize it. But that's where people can get stuck is they just do a thematic unit unit that one size fits all. But maybe even like with your son, if I know he loves facts, then what we're pulling out of this unit is all the factual stuff. And then we can put a skin on it,

Cari (00:59:07):

Please. This won't make him color an apple because he would rather stick himself in the eye with a pencil than color anything. Okay. So that's, to me where, when you get into arts and crafts, my son despises arts and crafts and I'm sure there are some neurotypical kids who do too, right? I think most little kids like it, but again, individualized means you should know what gives every child, their brain tingles. And every child is gonna be reinforced and motivated by different things. And so, um, we just have to make sure we're not doing it because we think it's cool, right?

Lisa (00:59:36):

Yes. Oh Cari, Cari Ebert sermon, not a seminar. That's amazing could say amen. Amen.

Cari (00:59:44):

I am very preachy. So I apologize to your listeners. I do get very preachy at times.

Sarah (00:59:49):

No I like it. I feel like with you and Jenny both, I'm just like, yes ma'am okay. Somebody after Jenny presented every, I had a friend that DMed me and she goes, wow. I felt like she was a driller and I wanna do everything she tells me and I go, yep. You're welcome.

Cari (01:00:02):

You're welcome. I love it. I love

Lisa (01:00:04):

All right.

Cari (01:00:05):

Best.

Lisa (01:00:06):

Thank you much for your time today.

Cari (01:00:10):

Yeah, this was a blast. I love it. You guys take care. Okay.

Sarah (01:00:13):

You too