Geralyn Arango Deeley (00:12):
Daniel Webster once said, "If all my possessions were taken from me with one exception, I'd choose to keep the power of communication, for with it, I would soon regain all the rest." I love that quote.

(00:26):
Hello, and welcome to season four of Our Parallel Paths, A Future for My Loved One With a Disability... and For Me. I'm your host Gerry, Dr. Geralyn Arango Deeley. And this podcast is about just what the title says, the parallel paths of family members and their loved ones with intellectual disabilities. I'm a parent myself and I always have questions. Our Parallel Paths podcast is about nurturing and supporting ourselves as we nurture and support our loved ones with intellectual disabilities. Our roles as family members are ever- changing and evolving alongside our loved ones. So there's more than one path, more than one future to think about, and that's why we're here. I hope the stories and perspectives of my podcast guests and me give you hope, information, and ideas for your path.

(01:19):
So, holy cow, it's been quite a while since my last podcast episode. I feel bad about this gap in episodes because I love scripting the podcast. I love doing interviews with interesting people. And I love bringing Our Parallel Paths to you through Networks for Training and Development who sponsors our podcast. You know life gets crazy, but shame on me. Back to work. Lots to learn because our needs change. Our lives change, and our dreams and our visions evolve. And like I said, I have questions.

(01:58):
So family member, hey, let's talk about speech therapy for our adult loved ones on Our Parallel Paths. Let's talk about communication, helping people get better at it, our loved ones certainly, ourselves, and other communication partners in everyday life. And let's talk about it with speech and language pathologist, Patrice Gilbert.

(02:21):
So my son, Nic, started speech therapy when he came home from the hospital in 1998. He was about two weeks old, two weeks old. And so if you've walked the early intervention path, you know that speech services can begin that soon and that it matters that they do. Speech therapy helps a lot that develops what's needed for eventual speech. But even before that, there are concerns for the baby people. You know, like the ability to suck, get nourishment, to latch on, the ability to have breath strong enough to blow, to have lip closure. And I'm just speaking from memory, I'm not the expert here. And I know I haven't remembered everything that was worked on when Nic's speech therapist visited, but I know that her intense consistent support was essential to Nic working on expressing what he so wanted to say, and to eating and drinking safely as well.

(03:20):
I also remember that speech therapists were sometimes hard to find and we would go for stretches with no one, which made me nervous, and which I documented so we could try to get makeups when someone became available. 'Cause people of all ages can benefit from speech and language therapy, so a speech therapist may have a specialty and may be somewhere else altogether, like a rehab center or other healthcare providers, or of course in educational settings where likely we all found them.

(03:50):
Nic got speech therapy services all through school twice a week, which was more than most people we knew 'cause Nic had that level of need. Through the years, his IEP goals were to develop expressive language, to expand his MLU, his mien length of utterance, which was to say more, to address developmental apraxia of speech, which if I remember, was, and our guest will tell us more, was the brain and the mouth not working very well together. And we even tried a communication device, which didn't work out, but it was something that the team tried.

(04:28):
Then Nic graduated. And seemingly, that was that. He was working, living in the community. He had more going on than I do and still does. So weren't we done? At least until I started to notice that as wonderful as his job is, Nic doesn't have to talk that much at work. I started to notice that people, myself and other family, and friends included, were sometimes given to the, uh, smile and nod, "Ah," well we just couldn't understand what Nic wanted to say. And he really did have things to say. I started to notice that though Nic didn't seem to get frustrated when people didn't understand, it almost felt like he was trying less and less to be understood. And that bugged me.

(05:17):
I found Patrice Gilbert, our speech language therapist guest today, on a Facebook page just by putting the question out there. I had looked at other resources, but what she offered was what I got and closer to what I wanted for Nic. And so welcome. A little bit about our guest today, Patrice Gilbert. She's worked as a speech and language pathologist for almost 30 years, specializing in articulation, receptive and expressive language, and auditory processing and memory. And again, if you've had a speech therapist in your life, perhaps these are familiar terms. Patrice has in early intervention, in schools, in outpatient facilities and home care. She's certified as an autism spectrum disorder clinical specialist and is a children's book author as well. Plus, she and her 22-year-old daughter are also on the parallel path.

(06:15):
So welcome, Patrice Gilbert. Did I forget anything of your credentials (laughs)?

Patrice Gilbert (06:20):
I don't think so. Thank you so much. I'm happy to be here with you today.

Geralyn Arango Deeley (06:24):
Okay, great.

Patrice Gilbert (06:25):
Talking about speech therapy.

Geralyn Arango Deeley (06:28):
Okay. Because Nic and Patrice started out on Zoom every Friday-

Patrice Gilbert (06:30):
We did.

Geralyn Arango Deeley (06:31):
... which was really convenient for everyone. Uh, 'cause Friday was his day off from work, and it was a great startup 'cause we're kind of seeing if this is working. We set up instructional goals with Patrice just like back in the IEP team days. And I started to see progress. Nic seemed to have more to say. And we were understanding him better, which is so fun to watch and enjoy and, and celebrate. And if it feels that good for me, it's gotta feel good for Nic.

(06:57):
So I wanted to start a chat today with kind of a snapshot from Patrice of speech therapy for adults. What does it look like? And then maybe a little bit about Nic's sessions, but then also to find out about being better communication partners, and how we who understand our children, we always say we speak Nic, can coach and support others to be better communication partners too. So I'm, I wanna start out asking you, professionally and personally, your philosophy about speech therapy and its value for adults.

Patrice Gilbert (07:34):
So I believe the, the most important thing is you have to develop a rapport with the person that you're working with. Because if they don't trust you and they're not comfortable with you, they're not gonna be able to learn from you. So when I say develop a rapport, I don't mean come in and do nothing and just get to know somebody. I start working on goals and documenting what I see that they need help with from the very first time that I meet them. Um, because I, as a parent, had a lot of people come in and say, "Oh, we're just gonna develop a rapport first. We're not gonna really work on anything." And I try to explain it doesn't work like that. You have to come in with the expectation, uh, of what she's gonna do with you and you're here. Um, you can't start with nothing and then think you're gonna be able to build from that. You have-

Geralyn Arango Deeley (08:26):
So like the developing rapport very per- like very intentional.

Patrice Gilbert (08:30):
Yes.

Geralyn Arango Deeley (08:31):
It's not, like, endless chit-chat. You're gathering information even as you're building the rapport.

Patrice Gilbert (08:35):
Right. And actually working on goals as well. They just don't know it 'cause it's the specific questions that I ask or the game that we play.

Geralyn Arango Deeley (08:44):
Mm-hmm.

Patrice Gilbert (08:44):
I choose things that will give me information and help the, the, um, adult who I'm working with.

Geralyn Arango Deeley (08:51):
So where do you generate the goals for, for an adult? Is it different in any way?

Patrice Gilbert (08:57):
It isn't really different. They might not have a current evaluation that I can look at-

Geralyn Arango Deeley (09:02):
Mm-hmm. Right. Nic didn't.

Patrice Gilbert (09:02):
Um, but I talk with the parents, the people who work with the adult, and, um, I talk with the adult themselves and just figure out, you know, a plan, sort of like an informal assessment. So just gather information and talk with the people and figure out what are their needs, how are they not able to communicate during the day, um, and what can we do to help them?

Geralyn Arango Deeley (09:33):
Yeah. Okay. Okay. And-

Patrice Gilbert (09:36):
So also, um, presuming competence, having high expectations, making the sessions individualized and making them fun. Um, nobody wants to sit there and just drill.

Geralyn Arango Deeley (09:50):
Mm-hmm.

Patrice Gilbert (09:51):
Like, Nic doesn't like to.

Geralyn Arango Deeley (09:52):
(laughs).

Patrice Gilbert (09:52):
He needs to work on specific sounds, but I can't just give him a list of words that start with an L and say, "We're gonna do these now."

Geralyn Arango Deeley (10:00):
Mm-hmm.

Patrice Gilbert (10:01):
I tried. It didn't work.

Geralyn Arango Deeley (10:02):
(laughs).

Patrice Gilbert (10:03):
So, um,-

Geralyn Arango Deeley (10:04):
And that, that's, that's okay. You tried and it didn't work.

Patrice Gilbert (10:07):
Right. (laughs)

Geralyn Arango Deeley (10:07):
So you don't say, "Well, you know what? He can't do that."

Patrice Gilbert (10:09):
Right.

Geralyn Arango Deeley (10:09):
You keep drilling in and looking for the, the answers.

Patrice Gilbert (10:12):
We just work on it on words that matter to him. So if-

Geralyn Arango Deeley (10:17):
Mm-hmm.

Patrice Gilbert (10:17):
... when we're having conversation, if he doesn't use a sound correctly, I will model the word for him, emphasize the sound. Um, he also benefits from hand signals or arm movements to help with the sound.

Geralyn Arango Deeley (10:38):
Mm-hmm.

Patrice Gilbert (10:38):
So we'll do-

Geralyn Arango Deeley (10:38):
I was gonna say, as soon as you said that, I was thinking about, um, one of his favorite terms as a Philly boy or outside of Philly boy, um, about the Eagles.

Patrice Gilbert (10:46):
Mm-hmm.

Geralyn Arango Deeley (10:46):
And so he's always talking about the Eagles, but not everybody knows how many, you know, sounds are in the word Eagles. And Patrice was using-

Patrice Gilbert (10:53):
Mm-hmm.

Geralyn Arango Deeley (10:55):
... a physical cue that Nic has picked up and gets a big kick out of doing.

Patrice Gilbert (11:00):
Right.

Geralyn Arango Deeley (11:00):
Um, and I can't, we can't sort of show it to you,-

Patrice Gilbert (11:02):
(laughs)

Geralyn Arango Deeley (11:03):
... but it's, it is involving his hands going where they need to be to remember to say that g in Eagles.

Patrice Gilbert (11:09):
Right. So we start with our arms out at the side, like we're flying like the Eagles.

Geralyn Arango Deeley (11:13):
(laughs).

Patrice Gilbert (11:14):
And then bring our right hand in, like to our throat for the G sound, and we just say, "E-gulls."

Geralyn Arango Deeley (11:21):
Gulls. (laughs).

Patrice Gilbert (11:22):
And, um, yesterday when I saw him, I got tears, and I'm getting tears now 'cause it makes me so happy (laughs) when the people I work with are able to use the strategies that I teach them. So yesterday he used that strategy of the arm movements on his own, said Eagles perfectly more than one time. And so now when he's talking about the Eagles, everybody will be able to know what he's saying.

Geralyn Arango Deeley (11:49):
Mm-hmm.

Patrice Gilbert (11:49):
Um, because I didn't even know what he was saying initially.

Geralyn Arango Deeley (11:52):
Yeah.

Patrice Gilbert (11:53):
But I knew what we were talking about. So just helping him be able to communicate better is gonna help him just across the board in his life. And it just makes me so happy that he's starting to use the strategies independently.

Geralyn Arango Deeley (12:08):
Mm-hmm. And, and he certainly gets a kick out of it. One of our other goals-

Patrice Gilbert (12:13):
Yeah.

Geralyn Arango Deeley (12:13):
... was to get him to not call you Trice.

Patrice Gilbert (12:15):
Yeah.

Geralyn Arango Deeley (12:16):
And so he will very proudly, like,-

Patrice Gilbert (12:18):
(laughs).

Geralyn Arango Deeley (12:18):
... make a point of saying, "Pa-trice."

Patrice Gilbert (12:19):
He does.

Geralyn Arango Deeley (12:22):
You know, it's a little slow, but it's there.

Patrice Gilbert (12:23):
Yeah.

Geralyn Arango Deeley (12:24):
Um, so what are all those things called in speech pathologist terms? 'Cause like, I'm thinking about what areas of need do you address in adults, and I suppose is it anything necessarily different or what are the terms we are still using as parents of adults?

Patrice Gilbert (12:42):
So it, it really isn't that different. A lot of adults might have the same difficulties they had when they were children. So like with Nic, we're, we're working on our articulation still and his intelligibility so that everybody can understand him. Um, we're working on receptive and expressive language, uh, which I also do with, you know, children who-

Geralyn Arango Deeley (13:04):
Mm-hmm.

Patrice Gilbert (13:04):
... I work with, but adults still could have trouble with that too, the auditory processing piece.

Geralyn Arango Deeley (13:10):
And I mean, that's really about practice, isn't it?

Patrice Gilbert (13:12):
It is.

Geralyn Arango Deeley (13:12):
Yeah. Because-

Patrice Gilbert (13:12):
It is.

Geralyn Arango Deeley (13:14):
... although it may be challenged, it's like, well, if you never have to really think about it, you're not gonna get any better at it or even maintain-

Patrice Gilbert (13:23):
Right.

Geralyn Arango Deeley (13:23):
... your skills. And that's this distressing part for a parent is watching s- the gains disappear.

Patrice Gilbert (13:30):
Right. And we don't want that. And I don't really believe they actually disappear-

Geralyn Arango Deeley (13:36):
Okay.

Patrice Gilbert (13:36):
... or that a person regresses.

Geralyn Arango Deeley (13:39):
Mm-hmm.

Patrice Gilbert (13:39):
I think that they're just not with people anymore who are expecting maybe what the therapist was expecting. So if they know, if somebody knows that they can get away with just saying a couple words like a telegram instead of using a whole sentence, like we're humans, everybody's-

Geralyn Arango Deeley (13:58):
Mm-hmm. The path of least resistance.

Patrice Gilbert (13:58):
... gonna take the easiest path. Right.

Geralyn Arango Deeley (14:00):
Yup.

Patrice Gilbert (14:01):
So-

Geralyn Arango Deeley (14:03):
Yeah. Um, I mean, I remember my, my brother long ago, who's very frank and always has a comment to, to add to the situation, and it was a real one, he sort of said, "I noticed that you guys explain everything. Nic will say a word and everybody else translates for him."

Patrice Gilbert (14:17):
Right.

Geralyn Arango Deeley (14:17):
And I was like, yeah, it's good and it's bad.

Patrice Gilbert (14:21):
Right.

Geralyn Arango Deeley (14:21):
Because he's understood, but he's not d... I'm doing all the work, his sister's doing all the work, his dad's doing all the work.

Patrice Gilbert (14:27):
Right.

Geralyn Arango Deeley (14:27):
And he's getting the message across, but he's not, there's no growth there for him.

Patrice Gilbert (14:33):
Right. So that's why speech therapy and adults can be helpful because we're not always gonna be there to translate for our children. So we want them to be able to be intelligible to anybody who's listening. We don't wanna have to translate. Um, and they don't probably want us to translate. I mean, they're adults now.

Geralyn Arango Deeley (14:54):
Yeah.

Patrice Gilbert (14:55):
And how would you feel if somebody had to-

Geralyn Arango Deeley (14:57):
Yeah.

Patrice Gilbert (14:57):
... reiterate what you were saying or let somebody know what you were saying, so.

Geralyn Arango Deeley (15:01):
All the time.

Patrice Gilbert (15:01):
Right.

Geralyn Arango Deeley (15:01):
Yeah.

Patrice Gilbert (15:01):
Right.

Geralyn Arango Deeley (15:04):
I mean, so often with the challenges, I think, how would it feel to be, or how would it feel if I had to do whatever?

Patrice Gilbert (15:12):
Right.

Geralyn Arango Deeley (15:12):
Wouldn't I want to yell at somebody who just wasn't trying to understand what I was gonna say? Like, uh, here I'm trying to-

Patrice Gilbert (15:22):
Right.

Geralyn Arango Deeley (15:22):
... tell you, you know?

Patrice Gilbert (15:23):
Right.

Geralyn Arango Deeley (15:24):
We know what that feels like as typical folk. And so, you know,-

Patrice Gilbert (15:28):
Right.

Geralyn Arango Deeley (15:28):
... the smile and a nod, people think, "Well, at least he's... you know, I, I'm trying to be polite," but it's like, can we do better?

Patrice Gilbert (15:34):
Right.

Geralyn Arango Deeley (15:34):
And so the other piece of this is that you communicate with the person on the other side of it, communication's always a two-way street. And so those of us,-

Patrice Gilbert (15:48):
Right.

Geralyn Arango Deeley (15:48):
... you know, in my case who speak Nic, we still struggle.

Patrice Gilbert (15:50):
(laughs)

Geralyn Arango Deeley (15:51):
But how, how can we become better communication partners and how can we model for others? Because-

Patrice Gilbert (16:00):
Right.

Geralyn Arango Deeley (16:01):
... I think people are well intended, but-

Patrice Gilbert (16:04):
I think so.

Geralyn Arango Deeley (16:04):
... they get to a point where, "don't know what he's saying."

Patrice Gilbert (16:07):
Right.

Geralyn Arango Deeley (16:08):
You know? Or somebody says, "Oh, how old is he?" And he's standing right there.

Patrice Gilbert (16:13):
Right.

Geralyn Arango Deeley (16:14):
And it's like, ask him.

Patrice Gilbert (16:14):
So talk directly (laughs) to him.

Geralyn Arango Deeley (16:16):
Yeah.

Patrice Gilbert (16:16):
Right.

Geralyn Arango Deeley (16:17):
So what are some thoughts about that?

Patrice Gilbert (16:20):
So I think, um, think about what you're doing and what you're saying and would you like it if somebody was doing or saying that to you?

Geralyn Arango Deeley (16:28):
Yeah. Always.

Patrice Gilbert (16:28):
So that's what I tell people. So I think that training staff and adults who interact with the person-

Geralyn Arango Deeley (16:35):
Mm-hmm.

Patrice Gilbert (16:35):
... is really important to let them know the strategies we're using in speech therapy that help, and just to explain to people how the person communicates, what helps them, what doesn't help them, and what they can do. Um, if you're talking with someone - anyone - and you don't understand what they're saying, what do you do?

Geralyn Arango Deeley (16:59):
Yeah.

Patrice Gilbert (17:00):
Do you nod and smile and act like you know? Or-

Geralyn Arango Deeley (17:04):
Yeah.

Patrice Gilbert (17:04):
... do you say, "I'm sorry, I didn't understand that. Will you say it again please?"

Geralyn Arango Deeley (17:08):
Mm-hmm.

Patrice Gilbert (17:10):
It's the same with a person with disabilities. You just, they're humans first, just like everybody. So just, you know, ask them to repeat it.

Geralyn Arango Deeley (17:21):
Mm-hmm.

Patrice Gilbert (17:22):
You still don't understand it, you know, "I'm sorry, I don't understand what you're saying. Is it okay if I ask your mom? Or is it okay if I ask"-

Geralyn Arango Deeley (17:30):
Well, that's... Ah, I like that.

Patrice Gilbert (17:31):
... "your job coach? Is it okay if I ask the other adult who's with you"-

Geralyn Arango Deeley (17:35):
Mm-hmm.

Patrice Gilbert (17:37):
... "if they know what you said?"

Geralyn Arango Deeley (17:38):
That's cool. Because what that's saying is, yeah, if I'm really at a point where I don't get it or I need more than you're giving me, may I?

Patrice Gilbert (17:45):
Mm-hmm.

Geralyn Arango Deeley (17:46):
I'm not turning away from you, I'm asking you for permission-

Patrice Gilbert (17:50):
Right.

Geralyn Arango Deeley (17:50):
... to get more information.

Patrice Gilbert (17:52):
Right.

Geralyn Arango Deeley (17:52):
And that's important because it still gives a person a little sense of, "Okay, yes, you may," or, uh,-

Patrice Gilbert (17:58):
Right.

Geralyn Arango Deeley (17:58):
... you know,-

Patrice Gilbert (17:58):
Right.

Geralyn Arango Deeley (17:59):
... whatever, they respond.

Patrice Gilbert (18:00):
Right.

Geralyn Arango Deeley (18:00):
How respectful?

Patrice Gilbert (18:01):
Because yeah, we want them to know that we do respect them.

Geralyn Arango Deeley (18:05):
Mm-hmm.

Patrice Gilbert (18:06):
And we're not just gonna say, "Well, I don't understand you, I'm just gonna talk to this other person instead," because nobody would like. That made me sad to even say. Nobody wants that.

Speaker 1 (18:16):
Mm-hmm.

Patrice Gilbert (18:17):
So ask for more information, ask them specific questions. Um, don't pretend to understand what they're saying. If you really don't, it's okay to let somebody know "I'm sorry, I don't understand what you're saying."

Geralyn Arango Deeley (18:29):
Yeah. And sometimes I think about the fact that I have good number of people who are my staff, or Nic's staff, sorry. Um, and they have things to tell us.

Patrice Gilbert (18:41):
Mm-hmm.

Geralyn Arango Deeley (18:41):
And so, you know, we have our service notes and things like that, that are helpful to that process. But when I can catch up with a staff in-person, sometimes they're seeing things that I don't see, or that you know it ... And I ... For good and for bad because sometimes it's like, "Oh, yeah, Nic was so great about, you know, taking care of something out in the community." And it's like, "[inaudible 00:19:04] Yay! That's the good news." Or sometimes "Wow. He really struggled with ..." So that's the other piece is to let people be our partners, I think too.

Patrice Gilbert (19:13):
Right.

Geralyn Arango Deeley (19:14):
To say, "Hey, so how's it going for you?" You know, when you go to the supermarket with him, is he talking, is he greeting people? Is he doing whatever?

Patrice Gilbert (19:23):
Right.

Geralyn Arango Deeley (19:23):
Because I notice it too, Wednesday is half-price Sushi Day a giant.

Patrice Gilbert (19:27):
Yeah. And oh, is that why he talks about sushi on Wednesdays?

Geralyn Arango Deeley (19:31):
Oh yeah, because when [inaudible 00:19:32] he sees you. He's that sushi.

Patrice Gilbert (19:34):
That's too funny. I didn't know that. See?

Geralyn Arango Deeley (19:37):
Yeah. But I try to kind of step back and watch the whole process.

Patrice Gilbert (19:41):
Yes.

Geralyn Arango Deeley (19:42):
He'll ... You know, it's like really cool that he does greet the person who's paying. He does ... When they chit-chat with him, he chit-chats back in his way. Um, and when they say, "Oh, have a good day," he's like, "Hey, you too." You know?

Patrice Gilbert (19:53):
Yeah.

Geralyn Arango Deeley (19:53):
And it's like, that's what people do.

Patrice Gilbert (19:56):
Right.

Geralyn Arango Deeley (19:56):
And those natural circumstances, that's when I should step back. And if he- if he does mess it up or something, or forget something, I'm there or your staff is there, but it's like, you know what, here's that presuming competence.

Patrice Gilbert (20:09):
Exactly.

Geralyn Arango Deeley (20:10):
Yeah. Of saying, you know what, he could probably do this.

Patrice Gilbert (20:14):
Right.

Geralyn Arango Deeley (20:14):
And you know, he's still gonna ... The main idea here is to get the sushi, but it's also to say hi and say thank you and have a good day and all that.

Patrice Gilbert (20:20):
Right.

Geralyn Arango Deeley (20:21):
And he got his sushi. So it's rewarding in that way.

Patrice Gilbert (20:23):
Yes.

Geralyn Arango Deeley (20:23):
But we're presuming the competence when I, when I do try to step back and sort of asking my staff to find that balance of "Don't talk for him."

Patrice Gilbert (20:32):
Right.

Geralyn Arango Deeley (20:32):
"Help him." You know?

Patrice Gilbert (20:34):
Right. See what he can do.

Geralyn Arango Deeley (20:36):
Yeah.

Patrice Gilbert (20:37):
Just let him do what he's gonna do first and then if he needs help and he says it's okay for you to help-

Geralyn Arango Deeley (20:43):
I like that piece. That's important.

Patrice Gilbert (20:45):
Then he can ... Then he can help.

Geralyn Arango Deeley (20:46):
Yes. Yes. You mind if I, you know, mind if I answer this question for you, Nic?

Patrice Gilbert (20:50):
Mm-hmm.

Geralyn Arango Deeley (20:51):
You know, um, because the other piece of it embarrassed somebody and-

Patrice Gilbert (20:57):
Right.

Geralyn Arango Deeley (20:58):
And that's a piece that leads to, to someone's frustration. You know, everything that I think we do is to also keep people from getting frustrated 'cause I know when I get frustrated, I get kind of cussy, you know?

Patrice Gilbert (21:13):
Right.

Geralyn Arango Deeley (21:13):
I'm not gonna break anything, but I'm gonna get like [inaudible 00:21:16]. And so ...

Patrice Gilbert (21:17):
Yeah. Our language isn't as acceptable when we're angry sometimes.

Geralyn Arango Deeley (21:21):
Yeah. Yeah. You know.

Patrice Gilbert (21:22):
Just like, you know, with anybody.

Geralyn Arango Deeley (21:24):
Right. And we have to realize that sometimes people with disabilities are already, you know, stigmatized by the people who don't have to think about this stuff and who may really assume like, "You know what they're like?" And it's like, "No, you don't know what they're like" 'cause there's no they.

Patrice Gilbert (21:37):
Right.

Geralyn Arango Deeley (21:38):
So-

Patrice Gilbert (21:38):
Everybody's an individual.

Geralyn Arango Deeley (21:40):
Yeah.

Patrice Gilbert (21:41):
That's why everything is individualized for them.

Geralyn Arango Deeley (21:43):
Mm-hmm.

Patrice Gilbert (21:44):
To help them succeed.

Geralyn Arango Deeley (21:46):
And that we can help support them in different ways.

Patrice Gilbert (21:49):
Mm-hmm.

Geralyn Arango Deeley (21:50):
As communication partners to work on their articulation and all the speech pathologists kinds of areas that I need to say to you, like, "How's it going?"

Patrice Gilbert (21:58):
Mm-hmm.

Geralyn Arango Deeley (21:59):
What are we ... "What should I be looking for or working on?"

Patrice Gilbert (22:02):
Right.

Geralyn Arango Deeley (22:03):
Um, and then if it's not a good fit, you are free to move on.

Patrice Gilbert (22:09):
Yes.

Geralyn Arango Deeley (22:09):
Somebody did mention that to me and I thought, "Well, if- when the day Nic says he doesn't want to do this anymore, then we'll revisit it."

Patrice Gilbert (22:15):
Right.

Geralyn Arango Deeley (22:16):
Right now he is quite enjoying the experience. And I think he really is showing improvement and more intentionality in what he wants to say. And he's pretty funny. Mm-hmm. So that's kind of nice too.

Patrice Gilbert (22:29):
Yeah, I, I agree. He's, he's shown a lot of progress. When I first started working with Nic, just attention to task and focusing on what my goals were, was, was a challenge. He likes to talk about what he likes to talk about.

Geralyn Arango Deeley (22:48):
Elvis and hair.

Patrice Gilbert (22:48):
Um, yes, yes.

Geralyn Arango Deeley (22:51):
Diamond. You have Nic. Sorry about that.

Patrice Gilbert (22:54):
And, you know, and sports, um.

Geralyn Arango Deeley (22:56):
He goals.

Patrice Gilbert (22:57):
But he has significantly increased his attention to task. He, um, needs less redirection when we're doing the activities. I think some of that is because I, I adapted and if what I was doing wasn't working, then like ... He likes to be social, so we do a lot of conversation, but it's like specific conversation. So he can talk about what he wants to order from Pat's pizza or he can talk about camp, but then I have specific questions that I'm asking him to target certain sounds or to see if he'll answer a certain type of question. So even though to somebody who doesn't understand what I'm- what the therapeutic activities are, it might look like, oh, they're just talking. They're not doing speech therapy. Oh, they're just playing a game. They're not ... you know, she's not really on anything with me. That is never true.

Geralyn Arango Deeley (24:01):
It's always intentional.

Patrice Gilbert (24:02):
Because I'm always working on something. Even if we're just having a conversation, they're benefiting from learning how to have a give-and-take conversation. Um, Nic went from just talking about his thing and me trying to interject and not being successful to now he asks me questions. Also-

Geralyn Arango Deeley (24:23):
And others too. Others too, it's so cool.

Patrice Gilbert (24:24):
Like, "What do you like to eat?" What do you ... What are you gonna do tonight?

Geralyn Arango Deeley (24:27):
Yep.

Patrice Gilbert (24:27):
And he's asking me the questions that I was asking him. So modeling-

Geralyn Arango Deeley (24:34):
Mm-hmm.

Patrice Gilbert (24:34):
Is huge.

Geralyn Arango Deeley (24:36):
Yeah.

Patrice Gilbert (24:36):
So just having those conversations and modeling the language that the person should be using or could be using.

Geralyn Arango Deeley (24:44):
Mm-hmm.

Patrice Gilbert (24:45):
And one day they will. That's just what I always tell people.

Geralyn Arango Deeley (24:49):
Yes.

Patrice Gilbert (24:49):
"I know."

Geralyn Arango Deeley (24:51):
Yeah. I mean, he's asking other people.

Patrice Gilbert (24:53):
That's great.

Geralyn Arango Deeley (24:53):
Questions that are just not like, "Here's what I'm doing today." It's like, "No, no, no. How are you? What's going on?" You know, he'll ask other people and create conversation and that gets me all happy.

Patrice Gilbert (25:04):
Me too.

Geralyn Arango Deeley (25:04):
And it's, it's a work in progress all the time. And, you know, regression is real, but it's like, you know what, here we are and we're doing something.

Patrice Gilbert (25:11):
Right.

Geralyn Arango Deeley (25:12):
And you know, his job isn't the talkiest job. They're lovely, but he doesn't really have to ... He's not really front-facing in a place where pret- pretty much almost no one's totally front-facing.

Patrice Gilbert (25:23):
Right.

Geralyn Arango Deeley (25:23):
Um, so where are the other opportunities? With friends, at his classes, at stuff like that. And it's like, well then let's talk about it using it there.

Patrice Gilbert (25:32):
Right.

Geralyn Arango Deeley (25:32):
And saying to your boxing coach, "Hey, how are you doing tonight?"

Patrice Gilbert (25:35):
Right.

Geralyn Arango Deeley (25:35):
"What's going, what are we doing tonight?" Stuff like that. That's just ... yeah. Conversation's a two-way street, Nic.

Patrice Gilbert (25:40):
Right.

Geralyn Arango Deeley (25:41):
And you're practicing, but you're taking it out there 'cause the generalizing is, is-

Patrice Gilbert (25:45):
Right.

Geralyn Arango Deeley (25:45):
The challenge.

Patrice Gilbert (25:46):
And he started generalizing on his own.

Geralyn Arango Deeley (25:49):
Yeah. Because he wants-

Patrice Gilbert (25:50):
Which is super exciting.

Geralyn Arango Deeley (25:51):
He's got communicative, communicative intent.

Patrice Gilbert (25:54):
Definitely.

Geralyn Arango Deeley (25:54):
Tons and tons.

Patrice Gilbert (25:56):
Definitely.

Geralyn Arango Deeley (25:57):
The other thing I wanted to sort of say we're just touching on now, which was kind of fun, is that Nic likes- his ... texts some strange things. And so it was something that we're gonna- we're starting to work on, which is using his texting feature, his speech-to-text. Um, and he's really motivated to talk into his phone. He's really motivated to talk into the creepy Alexa thing we have.

Patrice Gilbert (26:23):
Right.

Geralyn Arango Deeley (26:24):
And it's 'cause it is creepy, I think it's watching us. But, um, he's, he's motivated and so you're starting to work with him like a bit on his phone to say, "You know, text, um, speech- what- speech to text the message and let's see if it comes out and you can press the actual message and get it spoken back so you can hear it."

Patrice Gilbert (26:45):
Right.

Geralyn Arango Deeley (26:45):
But that to be understood in that way is something really that is something to run with for him because he wants it.

Patrice Gilbert (26:53):
Yeah. That's important to him. So, we'll ... He'll be motivated to work on his speech intelligibility. And

Patrice Gilbert (27:00):
... he'll be motivated to work on the sounds that he needs to produce.

Geralyn Arango Deeley (27:04):
Yeah.

Patrice Gilbert (27:04):
So that the speech to text thing can understand what he's saying. Because I think the problem is they don't, it doesn't understand-

Geralyn Arango Deeley (27:12):
Right.

Patrice Gilbert (27:14):
... what he's saying. 'Cause he doesn't say the words as clearly as we do.

Geralyn Arango Deeley (27:17):
Right.

Patrice Gilbert (27:17):
But that's why you don't have to sit and drill. If you can make it functional and important to the person, then the intrinsic motivation comes into play and yeah.

Geralyn Arango Deeley (27:29):
It's so exciting to see that too.

Patrice Gilbert (27:30):
It is. It'll be great.

Geralyn Arango Deeley (27:32):
So what have I forgotten? What, what would you wanna add? Because I think my questions, oh, I know money. How does this get paid for? We started out private pay and not my preferred way to go, but I really wanted what I wanted for him. And when he, when I saw him working with you, it was like, he wants this too.

Patrice Gilbert (27:48):
Right.

Geralyn Arango Deeley (27:48):
This is, this seems like a good match. We don't wanna pay for it. That's all. And then we got interesting again. So how does somebody make, you know, acquire these services for, as an adult?

Patrice Gilbert (28:01):
So it, it is challenging, it's more challenging to find services for an adult-

Geralyn Arango Deeley (28:07):
Mm-hmm.

Patrice Gilbert (28:08):
... Um, with learning disabilities, who still needs help with their language and all of these things. So, you know, reaching out in Facebook groups.

Geralyn Arango Deeley (28:16):
Yeah.

Patrice Gilbert (28:16):
Talking to people in the community.

Geralyn Arango Deeley (28:18):
Mm-hmm.

Patrice Gilbert (28:19):
Um, private pay is one way to go. Um, finding a place that will take insurance is another, but again, that's hard to find.

Geralyn Arango Deeley (28:28):
That's hard. Yeah.

Patrice Gilbert (28:29):
Uh, for our kids. Uh, waiver funding.

Geralyn Arango Deeley (28:32):
Mm-hmm. That's how we ended up-

Patrice Gilbert (28:34):
So yes.

Geralyn Arango Deeley (28:34):
... doing this.

Patrice Gilbert (28:36):
And then I've had people apply for grants before too.

Geralyn Arango Deeley (28:40):
Wow.

Patrice Gilbert (28:40):
It, it, it covers a certain number of sessions, but, you know, it's better than nothing.

Geralyn Arango Deeley (28:47):
Sure. Sure.

Patrice Gilbert (28:48):
And it helps the parents out financially.

Geralyn Arango Deeley (28:50):
Okay. Okay, because that's the other piece of this is, okay, how do I do this? You know, and how do I pay for it? So it's, it's an open-ended question, but it's definitely one to ask. You know, not to say, well-

Patrice Gilbert (29:03):
It is.

Geralyn Arango Deeley (29:04):
... You know, he is not in school anymore, so I guess you can't get speech therapy. It's like, well, you know, you may have to call your insurance company. You may have to-

Patrice Gilbert (29:10):
Right.

Geralyn Arango Deeley (29:10):
Put something out on Facebook, you know?

Patrice Gilbert (29:12):
Right. And we can figure out a solution.

Geralyn Arango Deeley (29:16):
Right.

Patrice Gilbert (29:16):
You know, a lot of, I know a lot of people want speech therapy for their child, but they can't find a place that takes their insurance and they can't afford to private pay.

Geralyn Arango Deeley (29:24):
Mm-hmm.

Patrice Gilbert (29:24):
And, um, you know, if they're still school age, you can always talk with the school.

Geralyn Arango Deeley (29:31):
Right.

Patrice Gilbert (29:31):
And see if they'll help in any way.

Geralyn Arango Deeley (29:33):
Right.

Patrice Gilbert (29:33):
Um, so just use whatever resources you have available to you.

Geralyn Arango Deeley (29:38):
Yeah. Keep plugging away at it. 'Cause that's-

Patrice Gilbert (29:40):
Right.

Geralyn Arango Deeley (29:41):
You know, we ended up using our waiver and that was great, but it wasn't a, it wasn't a, a slam dunk. It was a bit of like, all right, how do we do this? And, and so using our supports coordinator and using you and, and we were able to make it happen. But it wasn't a, it was not a slam dunk. It took some work, but so worth it. So worth it. What else? Did I forget anything?

Patrice Gilbert (30:01):
I think, yeah. One thing I would like to address is the whole assessment piece.

Geralyn Arango Deeley (30:06):
Okay.

Patrice Gilbert (30:07):
Um, because I've talked with, um, quite a few parents who they just, their child is struggling at school. They know that something's wrong. They do an evalu- you know, the school does an evaluation and says they're fine, but the parent knows they're not fine. So if that is happening to you, it could mean that the proper assessment tool wasn't used to show the difficulty that your child is having. It could just mean the assessment they used is what your child's strengths are, but it did not show what their needs are.

Geralyn Arango Deeley (30:49):
Needs are. Yep.

Patrice Gilbert (30:50):
So, you know, the parents are, are right. If they think their child is struggling, then the child is struggling. So I've helped parents, I've talked with parents and listened to them say what difficulties their child was having, read the report, saw what evaluation tools were used. And I said, from what you're describing, these evaluation tools aren't gonna show what you're talking about. I make recommendations.

Geralyn Arango Deeley (31:18):
Okay.

Patrice Gilbert (31:19):
About you might wanna ask for these specific tests.

Geralyn Arango Deeley (31:23):
Okay.

Patrice Gilbert (31:24):
And it has never failed. They ask for those tests, they get done, and then the parents are like, "Thank you so much. You know, now we know where the areas of need are and how we can help him or her."

Geralyn Arango Deeley (31:38):
'Cause we still have to remember that, you know, parents are experts on their children.

Patrice Gilbert (31:42):
Right.

Geralyn Arango Deeley (31:43):
You know, and that everybody else is a member of the team and the child is the ultimate expert on themselves. But we are not to discount the fact that, you know, families and schools have things to offer one another.

Patrice Gilbert (31:55):
Right. Definitely.

Geralyn Arango Deeley (31:56):
And it needs to be respected on both ends.

Patrice Gilbert (31:58):
Yes.

Geralyn Arango Deeley (31:59):
And so, rrr.

Patrice Gilbert (32:00):
And reach out. Like parents, don't be afraid to reach out for help. Don't be afraid to ask whoever you can.

Geralyn Arango Deeley (32:06):
Mm-hmm.

Patrice Gilbert (32:07):
For help. The worst that happens is you end off where you were and you don't have the help. But if you don't ask, you don't know (laughs).

Geralyn Arango Deeley (32:15):
(laughs).

Patrice Gilbert (32:15):
So I ask a lot of questions.

Geralyn Arango Deeley (32:18):
Yeah, me too. (laughs) That's why you're here. And I'm so glad you're here. Anything else?

Patrice Gilbert (32:23):
Thank you. I am happy to be here. I think I just wanna like reiterate.

Geralyn Arango Deeley (32:29):
Mm-hmm?

Patrice Gilbert (32:30):
Presume competence, high expectations.

Geralyn Arango Deeley (32:34):
Yep.

Patrice Gilbert (32:34):
I, I come in and whatever the ultimate goal is, I start at the top.

Geralyn Arango Deeley (32:39):
Okay.

Patrice Gilbert (32:39):
And then work our way back to see how much help does the person actually need.

Geralyn Arango Deeley (32:44):
Mm-hmm.

Patrice Gilbert (32:44):
Um, as opposed to a lot of people who give the max cues to start, but then you can't know what a person really can do on their own. Um, so high expectations, here's what I want you to do. Let's see how you can do it.

Geralyn Arango Deeley (32:56):
All right.

Patrice Gilbert (32:57):
Um, and then if you need some help, I'll give it to you to get you up to that point. Um.

Geralyn Arango Deeley (33:02):
Okay.

Patrice Gilbert (33:02):
And for those just wanna maybe define presume competence. That just means assume that children can learn or adults can learn. We all learn throughout our-

Geralyn Arango Deeley (33:13):
Through our lives.

Patrice Gilbert (33:13):
... whole life.

Geralyn Arango Deeley (33:13):
Yeah.

Patrice Gilbert (33:15):
So they can't learn what they're not exposed to. They can't learn what they're not taught.

Geralyn Arango Deeley (33:20):
Yeah.

Patrice Gilbert (33:21):
So I think it is just really important to presume competence. Um, high expectations. Believe in their potential to meet their goals and support them in getting there and the individualized attention and develop that rapport. If you don't have that rapport and they're not comfortable with you-

Geralyn Arango Deeley (33:39):
Yep.

Patrice Gilbert (33:40):
It won't be successful. Um, and that, you know-

Geralyn Arango Deeley (33:44):
Yeah.

Patrice Gilbert (33:44):
It doesn't mean you're a bad therapist, it doesn't mean, you know-

Geralyn Arango Deeley (33:48):
Yeah.

Patrice Gilbert (33:48):
That the child can't be helped. It just means it's not the right person.

Geralyn Arango Deeley (33:52):
Mm-hmm.

Patrice Gilbert (33:53):
Because you have to be comfortable with anybody. Like, that's how we choose our friends.

Geralyn Arango Deeley (33:56):
Yeah. I was gonna say, that's kind of a life thing, isn't it?

Patrice Gilbert (33:59):
(laughs) So, right.

Geralyn Arango Deeley (33:59):
Don't gravitate toward people you're not comfortable with.

Patrice Gilbert (34:01):
Right.

Geralyn Arango Deeley (34:02):
And that goes in this professional, you know, developmental setting as well. And so, huh. So much good stuff. So much good stuff. I'm so glad you were here today.

Patrice Gilbert (34:13):
Thank you. Me too.

Geralyn Arango Deeley (34:14):
Yay. Yay. And you, listeners, thanks so much for spending time with us on today's episode with speech language pathologist Patrice Gilbert on Our Parallel Paths. Speech therapy is for adults with intellectual disabilities too, for all the reasons Patrice shared and all the philosophy that Patrice shared. That makes it a good experience. And hopefully some of you have experienced all of these good things on your own. Um, speech therapy for Nic has really been very helpful all through and even as an adult. And I do think it's enhancing his communication. He has a lot to say. And I hope today you found some information you can use on your path.

(34:58):
And listeners, I hope you'll follow our podcast. I hope you'll share it with family and friends. And I really hope you'll return to listen and learn for more stories of people like you and me and our loved one with an intellectual disability on Our Parallel Paths. You're not alone. I'd love to hear from you. Feel free to comment, to rate the podcast and to join our Facebook group. I will see you next time. Take care.