OTS 131: The Correlation Between Speech and Sensory Challenges
- Jayson Davies
- Aug 21, 2023
- 3 min read
Updated: Apr 28, 2024
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Welcome to the show notes for Episode 131 of the OT Schoolhouse Podcast.
Curious to explore the world of Childhood Apraxia of Speech (CAS) and Sensory Processing Disorder(SPD)?
Join us on this episode where Kate Nealon, PhD, CCC-SLP, BC-CLS, and Zahava L. Friedman, PhD, OT, BCBA, delve into the fascinating interplay and coexistence of CAS and SPD. Gain insights into the significance of interdisciplinary collaboration between OTPs and SLPs in supporting children.
Tune in now to broaden your understanding of CAS and SPD!
Listen now to learn the following objectives:
Learners will identify the key components of the sensory processing cycle and how breakdowns at different stages can contribute to Sensory Processing Disorder (SPD)
Learners will identify the challenges in diagnosing children with mild to moderate Childhood Apraxia of Speech (CAS) and Specific Language Impairment (SLD)
The importance of early intervention and seeking support from a collaborative team of professionals when working with children with speech and sensory impairments.
Guests Bio
Dr. Kate Nealon is a licensed Speech-Language pathologist and Board-certified child language specialist. She is currently an assistant professor at Montclair State University, where her research focuses on the interaction of language and motor processes across the lifespan and the implementation of research into clinical practice.
Zahava L Friedman has trained countless occupational therapy students in her role as a fieldwork educator for OT and COTA programs throughout New York, New Jersey, Pennsylvania, and Connecticut. She has presented at many statewide and national conferences, such as AOTA, NJEA, in a variety of public/private school-based settings, and for special education non-profit organizations. She has worked as a pediatric occupational therapy clinician in both public and private school-based settings since 2007. Zahava also worked for the New York City Early Intervention system from 2008-2017, servicing children ages 0-3 in their homes. In 2014, Zahava completed courses and a practicum to achieve the Board Certified Behavior Analyst (BCBA) credential. In this capacity as OT and BCBA, she uses both sensory and behavioral frameworks in her practice. Zahava's research interests include interprofessional collaboration in schools, synergies between OT and ABA, and the creation of rigorous, engaging student learning experiences.
Quotes
“That is so key that we collaborate and build that rapport with other professionals.”
-Jayson Davies, MA, OTR/L
“We think of sensory processing as being a pure sensory framework, but there's the processing part that speaks to the adaptive response.”
-Zahava L. Friedman, PhD, OT, BCBA
“Childhood Apraxia speech is a relatively new diagnosis."
-Kate Nealon, PhD, CCC-SLP, BC-CLS
“You receive information through a variety of your senses. You want to make sense of it. You figure out what it means, and then you know what to do with it. Right? So sometimes in that cycle, depending on where the breakdown is, that's when you start to see an individual meeting criteria versus not meeting criteria.”
-Zahava L. Friedman, PhD, OT, BCBA
“The gross motor challenges that we see, the sensory processing challenges that we see, are all potentially impacting that child's ability to participate in treatment.”
-Kate Nealon, PhD, CCC-SLP, BC-CLS
Resources
Episode Transcript
Expand to view the full episode transcript.
Jayson Davies
Hello there and welcome back for episode 131 of the OT schoolhouse podcast. I am your host Jayson Davies. And I'm so happy to have you joining us here today. Today we are joined by both an occupational therapist as well as a speech therapist to talk about two terms, SPD and c a s. Now, I know you're a school based occupational therapist or school based occupational therapy assistant, you have probably heard and are very familiar with that term SPD sensory processing disorder, but I might have stumped you with C A S. Cas stands for childhood apraxia of speech. And you know, you hear that term apraxia And there we're talking about SPD today, you can kind of see how maybe this is going to go together. Now we are having on today Dr. Zahava, Friedman as well as Dr. Kate Nealon, who is our SLP guest today along with Dr. Friedman, who is an occupational therapist, and they're going to be discussing a recent journal article that they published together that talks about the comorbidity and the interconnectedness between not only CAS and SPD but that interconnectedness between occupational therapy and speech therapy and how we can work together to support students with SPD and cas. Dr. Friedman and Dr. Nealon are both joining us from the Kean University College of Health Professions and Human Services where they are both professors in their respective fields. You will quickly learn in this interview, how much chemistry they have together, they literally on day one of working at Kean University found each other and knew that they would be partners within some research. So you're about to hear a little bit about that story, as well as about the entire research article that they put together. And then some because not everything makes it into that published article. And as we dive into this interview with The Hobbit and Kate, I just wanted to let you know that for this particular podcast, you can earn a certificate of completion. As a member of the OT schoolhouse collaborative, all you have to do is listen to the episode, dive into your OT schoolhouse collaborative account, take a quick quiz, and boom, you'll have a certificate of completion. So let's go ahead and dive into our interview with Dr. Friedman and Dr. Nealon as we discuss sensory processing disorder and childhood apraxia of speech.
Amazing Narrator
Hello, and welcome to the OT schoolhouse podcast, your source for school based occupational therapy tips, interviews and professional development. Now to get the conversation started. Here's your host, Jayson Davies. Class is officially in session.
Jayson Davies
Kate and Zahava, welcome to the OT schoolhouse podcast. How are you doing today?
Kate Nealon
I'm great. Thank you so much for having us. I'm really excited to be here and to talk about this study and as speech language pathology in general.
Jayson Davies
Awesome, well, thank you so much for joining us, Kate and Zahava. How are you this morning? Or afternoon?
Zahava Friedman
All right. Yeah, it's actually afternoon, I mean, coming in from Michigan. So excited to be here. Great to see you. It's great to share that as something that I love and I'm passionate about. So I'm just excited.
Jayson Davies
Yeah, let's do it. You know, we are here to talk about an article that YouTube published to gather the title really quickly is siloed versus interprofessional. Approach speech language pathologist and occupational therapist perspectives on comorbidity of childhood apraxia of speech and sensory processing disorder. It's always a mouthful to read an article title. But you know, before we get into CAS and SPD, I would love for you both to share just a little bit about yourself and where you are in your careers. So Kate, why don't you go ahead and share with us where you are in your SLP career?
Kate Nealon
Absolutely. So I became a speech language pathologist about 15 years ago. So I went to the University of Virginia. And then I practiced in a pediatric inpatient children's hospital for about 10 years. And then I went back for my PhD at Teachers College, Columbia University, and have kind of entered the academic world. But childhood apraxia of speech is my passion. And I've continued to keep my hand in it slightly with a private practice. But I have entered the research realm of CAS.
Jayson Davies
Wow. And actually, was this your first published paper? Or do you have other published papers?
Kate Nealon
I have, I have other published papers. So I while speech language pathology exists in pediatric childhood apraxia of speech apraxia also exists in adults who have had strokes. So you can kind of have developmental and we'll talk more about that. But there's developmental apraxia as well as an acquired apraxia of speech. And so most of my previous publications are acquired.
Jayson Davies
Gotcha. So moving into the world of children, awesome.
Kate Nealon
Yeah.
Jayson Davies
All right, and Zahava, how are you doing today and share with us a little bit about your OT career?
Zahava Friedman
Sure, I'm doing well. I actually, the majority of my career has been in school based practice. So kind of me rewind a little bit earlier. So I'm a native of Brooklyn, New York. I'm a graduate of SUNY Downstate State University of New York for any new yorkers or Brooklyn errs. During the podcast, big shout out. I'm a New Yorker at heart, you can hear me speak, I speak very quickly. Being a New Yorker, I hold that badge, proudly. And right after attending my master's program, my first job was in a school, and I worked in school based practice full time for 14 years I adore working with children, and in particular, I love working in schools. Just fun fact about me, I'm a mom of five. So I always feel like development is in my mind, children. You know, since I've been an adult, I've been either a mother or practitioner or both. So I really, I use the skills of mothering in my practice. And I use what I know about development to support my family, my own biological children. And I primarily worked in schools, I also did some early intervention practice. In New York State, I worked in schools public school in New Jersey, private schools, in New Jersey, and I come to this research through the school based lens of working together with speech therapists at my school building really strong relationships with those speech therapists, and also through the sensory integration lens. So while I was a school based practitioner, a big sub specialty area that I utilized in my practice, in school based practice was in sensory integration in supporting children in classrooms for sensory integration. So I have done a lot of advanced training and practice in that area. And really, that's my passion, child development, and schools and collaboration. So everything about this research, in particular, which we're talking about today, has been, you know, like, deeply embedded in my soul for the past, you know, 15 to 20 years, I would say.
Jayson Davies
I love the passion, I love the passion that you have for school based occupational therapy and supporting the students that you work with. It's just, that's why we all do it, right. So yeah, now I gotta follow this up. Because it's not often that we have an OT and an SLP. On the podcast, it's happened two times, I think, in the past, but it's always fun to hear that story of how they came together to work together. And so who wants to take that one. And please share with us how you Kate and you Zahava came together to work on this project together,
Kate Nealon
I will take part of it because I have to say Zahava is a force of, of nature. And I am honored to be here today as the SLP kind of talking with occupational therapists and to be included, so thank you, but Zahava and I actually met at Kane University, as assistant professors kind of both starting our research careers, our clinical careers had been thriving for many years. But starting on this research career track, and both looking for support, the have a kind of just, we met, and that was it. We were like, obviously, we should be together. And obviously we should be doing research together. And from day one, that was it. And we kind of started talking and we both have such passion for pediatric practice and children in schools and children's and supporting the clinicians, because we're, we're coming from a clinician background. And so we both have the same passion for that. And as you talk to as I have a more today, you will find that her passion is just infectious. Like you just want to kind of be in the orbit because there's so much enthusiasm for the work.
Jayson Davies
Awesome. I love that that's exactly what we need for podcasts.
Zahava Friedman
I so appreciate that. I was going to add a drop of like color to the story. So like, fun story, literally our first you know, when you start as faculty, both Kate and I started in the same year, Kane University, we were invited to faculty orientation, which is like this crazy formal three day affair feels like a three day Indian or Jewish wedding. And we come to campus and it's the very first day the very first event of the first day and we're standing on the coffee line. I think Kate was in front of me, or was it that maybe Id line or something and I was like, Hi I'm Zahava occupational therapy, you know, new assistant professor. She introduced herself as new professor in the speech department. And literally in that first conversation on the coffee line, I said, she said, I study apraxia I said, it's so funny because I work with kids and a lot of what I do is sensory. And I always wondered if there was a connection, literally, within two minutes of us meeting. This is what we display. It was boring. Yeah. Yeah, we were nerds at heart. We couldn't help ourselves. It was a very, you know, most people have like a different type of origin story, but ours included research question.
Kate Nealon
There's like a notebook involved. or some sort of something. We're just kind of standing and we're like, absolutely need to do this work. Let's figure out how to make it happen.
Jayson Davies
Yeah, I feel like you were both just like on a high of having a brand new job in academia ready to dive into research. And so you're just ready to go. That's awesome.
Kate Nealon
Yes.
Jayson Davies
Awesome. All right. So, SPD occupational therapy practitioners, that's a common term Cas, maybe not as much for OT practitioners. So Kate, would you mind sharing with us, you've already mentioned child apraxia of speech. But dive into that a little bit more, what is child apraxia of speech?
Kate Nealon
Absolutely, and you may have heard or kind of It permeates some of our, of your practice in childhood apraxia speech was it's sort of like a buzzword right now. And we can talk more about that throughout the study. But childhood apraxia of speech, it affects about 1% of the pediatric population. And it's really about a child figuring out how to plan the motor movements, we the movements that are required for articulatory, like intelligible speech are so complex, the way that we organize our articulators, our our mouths, everything that's required to produce speech is hard. It's really, really difficult. And it happens really, really fast. And we don't make that many mistakes. And so these kids have a really hard time coordinating those movements that are required for speech. And so obviously, this can look like many other disorders, though, if any of the listeners are parents, that most of our children have some sort of phonological thing that happens at some point, we usually think it's cute, they substitute th they make it an F, they, you know, they produce something different, and that's phonological. And so a lot of times for practitioners distinguishing the what's phonological from what's motor? Because apraxia of speech at its heart is a motor. motor base disorder is tricky for kids who don't have a lot of output.
Jayson Davies
Yeah, and is there a specific criteria, whether it's in the DSM or somewhere else that kind of establishes CAS and what you're looking for, as a speech therapist?
Kate Nealon
Absolutely, what we're really looking for is in coordination, so a lack of coordination of those motor movements, as well as inconsistency. So if your child is making a phonological error, they're making that same error every time th is in the front of the word, they're saying an F, you know, for think they're saying think, every time and apraxia of speech, it's not that they can't get there, it's that they can't always get there. And they can't get there when they want to get there when it's really fast. And so for apraxia of speech, if the word is small, and like a three letter word like bed, they're more likely to produce it correctly than if it's elephant. Because now we put such complexity on it. And they have to kind of CO articulate so quickly. So we're looking really for that in coordination and the inconsistency of those errors.
Jayson Davies
Gotcha. Perfect. Thanks for sharing that I, I have a 16 month old right now. And so right now, you know, his favorite words, Mama. And he tries to say data a few times, you know, occasionally when he's when he's on like, Are you a bone? Yeah, yeah. And, you know, you can just, he's not a Praxic, or anything, at least as far as we know, right? You know, he's doing very well. But, you know, you can just see that brain turning, right. He's like, mama, mama, mama, dad. And they'll go back and forth a little bit. Yeah, take some time
Kate Nealon
And that repetition that we have those 16 month olds who are just learning how to produce all of these words, they repeat those words over and over and over again, and you can see them when they get a new word. And they say that word over and over. If you have apraxia of speech, you don't have those repetitions at your disposal. So you're not able to do that. So then as you know, as your son grows, and as now two, two and a half and he's putting words together and Mama go and car, truck run and whatever, that becomes increasingly difficult and so then you you lose out on so many of those linguistic opportunities.
Jayson Davies
I'm glad I brought that up. That was I love that response. Thank you. All right, Zahava, again, occupational therapy providers. We are familiar with SPD but I want to give you an opportunity to kind of share the criteria for SPD that sometimes we don't often think about like we know SPD, but we don't often think about what the criteria for SPD actually is because you know, it's in a book somewhere put away. So I want to give you that opportunity to share the criteria for SPD.
Zahava Friedman
Um, yeah, so I think you know, there's different nomenclature, there's different classifications of different categories of SPD. But I'd like to start especially when I teach my students at the graduate level with the just the general cycle of understanding how we learn and how we produce responses and through understanding that cycle. You can understand we're in that cycle, the breakdown is and often were in the cycle, the breakdown. And this gives you the criteria for what SPD can be. So like, the cycle of sensory processing is, you know, receiving, understanding, that's the processing part and then adapting, right. So you receive information through a variety of your senses, you want you make sense of it, you figure out what it means, and then you know what to do with it. Right. So sometimes in that cycle, depending on where the breakdown is, that's when you start to see an individual meeting criteria versus not meeting criteria. So for an example, for some children, the break down can happen at the sensing stage, right. So like, either they're very sensitive, or they don't sense at all. So I have five children, biological children, some of my own children, like if they would fall down from the top of the playground, they wouldn't even cry. So that's a breakdown that's happening at the beginning at the sensing, and right, some of the children would feel it, but then they wouldn't know what to do like how to how to make sense of it happening at the middle of the cycle. And then some children, they fell down, they knew that hurt, but then they didn't know what that adaptive response would be like, should they adjust their posture, so they rub their foot, if it's if it feels like it's in pain, they couldn't actually produce that response. But I think, you know, even through this study, and through my work, like, what's the criteria for meeting the actual disorder is when an individual when it's impeding their function, to the extent that they cannot function in a given environment, or in a given occupation, or in a given stage of their life, the impeding of function is the most potent criteria that you look at. So, you know, three children can live in the same classroom and can listen to the same teacher, two out of three are responding to questions, following directions, making it through their day, putting on their coat, taking off their coats, but one of the three is not as functional, listening to the same direction of the teacher, take off your coat, put it on, can filter out that information, one of the children is being distracted by the cubby not being at the end of the row and can't find their coat. So I would say it's the function versus this function, and how, how functional how children's are they within that environment within that occupation, within that stage of life, that determines, you know, the criteria, but I want to go back to something that Kate said, when it comes to the motor aspect of apraxia. And I think this is at the core of sensory processing, you know, we think of sensory processing as being a pure sensory framework. But there's the processing part that speaks to the adaptive response. As soon as you have the word response, you have a motor output. And that's really what led us to this topic, which is like, it's not only sensing the information, it's moving your body in response to that information. So, you know, I think, you know, that's kind of a you have your basic, maybe definition and basic criteria is the function. But it gets tricky to understand is the function breaking down because of which part of the cycle? It's different than, like a checklist? I would say?
Jayson Davies
Yeah, absolutely. You know, they call it the SIPT, for a reason. It's not just the SIT. Right, sensory integration and praxis test, that practice is very important in there. So thanks for sharing that. All right, let's dive into the study. And the question, what was the key thing? And maybe this came up in that very first time we met? What was the key question that you wanted to answer with this study?
Zahava Friedman
Okay, you want to take that? Or should I?
Kate Nealon
Absolutely. I think that conceptualization of this study really came from our clinical backgrounds being clinicians with case loads that have either sensory processors, or apraxia on them, where, for myself, at least see us does not generally present idiopathicaly, it is not generally that this child has CAS and absolutely nothing else going on. So that child with CAS and that research is obviously ongoing, could have Autism Spectrum Disorder, auditory processing. But very often in my clinical practice and talking to my colleagues, they present with sensory challenges. But because I'm an SLP, I am not really treating those sensory challenges I am potentially referring, but I am not treating that sensory processing difficulty. But if that child is dysregulated, in some way, my apraxia treatment is not going to be as effective. And so but my clinical practice found that I was kind of trading over here and the OT was treating over here, and maybe we were chatting with each other but we weren't coordinating our treatment and we weren't as effectively and efficiently as we could have potentially. And so that sort of is where the conceptualization for me came from.
Jayson Davies
Perfect.
Zahava Friedman
Yeah. To add to that a drop, you know, we wanted to get We kind of want it to get the perspective separately of OTs and SLPs, without giving them are like without coloring it with our own experiences. As far as if you were working with a child with SPD, for example than it was OT or CIF as an SLP. What other things might you be seeing? That doesn't necessarily fall within the scope of your own practice? So that was one thing we wanted to see. A second thing we wanted to see within the study was like, if we want to move the needle forward, and improve practice for future generations of practitioners, what can we do to begin to move toward a unified approach? So we wanted number one, to gather from them what you're seeing individually, but number two, to put those pieces together as researchers, and also as people working with a future generation of OTs and SLPs, right, like we work in graduate programs, we're training students, but what can we do to better our education of the current generation of students to produce a future generation of practitioner that has a better understanding of what a unified approach might look like that understand that these things don't appear idiopathicaly, as opposed to discovering it five years or 10 years into practice? By mistake? So like, that was like two things that we were really aiming to do with our study.
Jayson Davies
Yeah, and I know that you ended up from reading your study, I know that you ended up using a focus group talking with some speech pathologist as well as some occupational therapy practitioners. But elaborate on that a little bit more. What did that specifically look like? No focus groups are not easy. So sure that,
Kate Nealon
Yeah, focus groups are not easy. We wanted to have a wide range also have SLPs and OTs, so not they didn't specifically have to be carrying a school caseload, they did have to have a certain, you know, inclusion criteria of amount of years of practice, and amount of licensure and things like that. But our focus groups were really were we wanted to look separately at those groups of practitioners. And I think that was kind of unique in looking at, what are they doing in their clinical practice today, because, you know, anecdotally, I know, from my own personal experience, what's happening with childhood apraxia of speech, how it is a buzzword, how some people are saying it's completely over diagnosed, and that it is, you know, kind of their diagnosing that instead of XY and Z. And so there are many different perspectives. And there's not a lot of lack of opinions in the SLP world about childhood apraxia of speech. So really finding out from SLPs that are in the trenches, what's going on, and what language they're using, and their diagnostic criteria and things like that.
Jayson Davies
And so use, you did two separate focus groups, right? Or were they all mixed into one group? Yeah,
Zahava Friedman
no, so I'll pick it up from where I left off. So we ran it in one evening, but two separate focus groups, we actually had a pair of co workers, one OT and one SLP. They, each one had heard about the study, I think the OT and had had and had recruited her co worker SLP. And they wanted to come to the others, the OT wanted to come to the SLP. And we were like, Nope, you're only going to the OT, we wanted it to kind of be putting brains together of different experts, or experienced SLPs and experienced OTs in a separate room, from different areas of practice, different ages, different, you know, different states, different trainings, you know, some had five years of experience, and were in their 20s, some had 20 years of experience, or 15 years of experience, and were in their 40s or even 50s. And we wanted to see, you know, putting the brains together of people over time, how has it shaped and what was your training, like, you know, kind of engaging them in the conversation and seeing what their experiences were across clinical settings, we aim to get five and five, five OTs, five, SLPs, we exceeded our numbers. I'm like, I'm shameful recruiter, just so you know, if you ever do research,
Kate Nealon
Really not quite impressive.
Zahava Friedman
Like, if you if I like you will probably be recruited into a future study Jayson. So just be aware, it will happen, it would be ready to repay the paintwork. So it will happen. And anyway. So like if I've ever met you, I've laid eyes on you, if I've seen your LinkedIn account, or I know your sister, or if I knew someone who knew you the state you lived in whatever, like I will probably reach out you don't have to participate. But I will read that for a class that we were able to recruit a nice group, I would say like a healthy mix of ages and practice areas. And we we wanted to engage them in conversation. And for you know, it was interesting, because in the beginning of each focus group, these are things that don't make it to the article, by the way. So if you've ever read this article, you won't see this there but we can give you some color that doesn't always make it to a peer reviewed article. In the beginning we had a lot of like the veteran older practitioners have a very loud voice And slowly, we would, I noticed that like, the younger ones are less experienced were gaining, you know, competence and were able to share their perspectives. And it was interesting to see both what people saw having been in practice for 20 years versus five years in the private practice, private school, public school, you know, older younger, we started to see a clinical picture that seems to saturate throughout the group to be able to paint a more complete picture of what OTs and SLPs clinically, out there in the field might see with a child with SPD or with cas.
Kate Nealon
And that's particularly important for the SLPs, because childhood apraxia of speech is a relatively new diagnosis or a relatively new area, you know, the American Speech Language and Hearing Association only kind of came out with their technical report in 2007, that really defined what childhood apraxia of speech is, and really, you know, kind of allowed it to be supported by insurance and things like that, and really legitimize the childhood apraxia of speech. So for individuals who maybe have been practicing for 30 years, 25 years, even for myself, who graduated from graduate school in 2008, what you were learning in graduates graduate school about childhood apraxia of speech is very different. So this land is really, really continues to be very dynamic. And so newer grads have a very different take than than older ones.
Jayson Davies
Great, great. Well, now I'm excited for the data part, because focus groups typically, you know, we don't need to get into all the details. But with a focus group, you're transcribing the entire conversation, and you're looking to code that. And so I guess, first of all, just, if really quickly, were there some key questions that you were really looking forward to asking these participants, and then just kind of, I guess, start to talk about some of that data that came out of it. So I don't know who wants to talk about two or three questions that you were really excited for?
Kate Nealon
For me, it was really looking at how do you define conceptualize what, what do you have to see in a child to start thinking further childhood apraxia of speech bells to go off, rather than a phonological impairment or just an articulation error. And while many of them talked about prosody, and so for, for listeners out there who may not be completely familiar with prosody, it's really just the rising and falling and that intonation in our speech. And so when you're asking a question, and your intonation goes up, it gives, it gives your listener a lot of information about what you're talking about, whether you're super passionate, whether you're super kind of you know, listless, those kinds of things. But when you're just focusing on getting it out, and making an intelligible prosody goes by the wayside a lot of times because you're focusing on production. And so a lot of times in childhood apraxia of speech, and in general, we see impaired prosody. And so I was excited to hear that a lot of our SLP is cited, impair prosody, if we start seeing, you know, a lack of the that rising action, a lot of kind of the general rise and fall that we associate with intact language and speech production, that that alarm bell starts going off.
Jayson Davies
I love that. That's a great, that's a great explanation of that. And I didn't know what that terminology was, or that term was thanks for sharing.
Kate Nealon
Most don't, you know, we're XOP nerds, I'm sure you guys have many terms that I'm just gonna, you know, kind of be in the chat. Like, let's find that one.
Jayson Davies
Yeah, definitely. All right. So what was one or two questions that you were super excited about? And what was some of the responses you got?
Zahava Friedman
You know, it's very interesting. We were more concerned, like Kate said, with the conceptualization of the therapist, how did they conceptualize a child meeting criteria? We were not as concerned with treatment planning or what you do as much as like, what you see with this, like with the symptoms or with the signs of someone who would meet criteria. I mean, we we basically took almost an identical list of questions for the OTs and SLPs. And just ask them in separate rooms. So like for the OTs, it was a lot of SPD questions. And for the SLPs it was a lot of CAS questions without leading them down the road of if you see it together, because we didn't want to skew the results or lead them in any direction. What I do have to say was OTs, hopefully you won't be insulted by this was the SLP is really good like direction followers like if Kate asked the question they were all on topic, like she said, what's the definition and the OTs if I asked the question about SPD, one would be like well I have a beef with and it would be marginally related to SPD but not completely.
Kate Nealon
We are Type A, we are we are here for a goal we are we are goal oriented I don't know why draws us to the profession.
Zahava Friedman
When very tangential a little bit but but even the tangential parts of the conversation that we had about SPD I think, as we get into the results, you'll see they really, it was interesting how despite the fact that the SLP conversation was so question answer question answer staying on the script of what is the definition of and what are assessment tools and what other disciplines might be seeing this child, which we are both groups of professionals, and the OTs will deviate from those, the point driven by both add a common thread, which came out in the themes across both across both focus groups, which was a very interesting thing. I don't know if you want us to get into results yet. But the nature the quality of the focus groups were different, depending on the professional membership. But the results were not that different. You know,
Jayson Davies
Gotcha. No, I think it's perfect timing to dive into the results a little bit. So if you want to continue on that route, go ahead.
Zahava Friedman
Kate, do you want to start or?
Kate Nealon
I don't know, you can go.
Zahava Friedman
Okay. So I think, you know, one similarity that we saw is that both disciplines saw their respective, you know, diagnosis or set of conditions as being on a continuum. I think for the for the speech therapists they saw CAS has been on a continuum. Same thing with the OTs, right, you know, you have a child with someone in tact, sensory processing, but some things are breaking down. And then you have moving along that continuum, a child that is that is really not well modulated. And there's very, there's several models that I'm sure you're familiar with that them you know, Lucy James Miller's is one of them within the OT realm that we have, like a nomenclature breakdown or classification. And the OTs alluded to that in a similar way to the SLPs, alluding to that in CAS, so like where they spoke about, for the OTs listening, you may not be familiar with, right, but in the SLP world, Kate, please correct me if I'm wrong, like you'll have a child with completely intact articulation. And then you'll have a child with somewhat intact articulation and some articulation anomalies. And then you'll have all the way along the continuum, a child with CAS, like what Kate described earlier, a child with articulation challenges will have a consistency to the to the missed articulations like our will always be all, but a child with apraxia or childhood apraxia of speech, our will be all will be I will be different every single time. And that was all. And there was a similarity to the way that OTs described that continuum, where a child with someone intact sensory processing is functional some of the time so like, they're able to get themselves dressed, but the buttons are misaligned, versus a child with completely, you know, sensory processing disorder all the way down the continuum, can't get themselves dressed, can't find their shirt, get make it through the morning routine. So it was like interesting to see that.
Kate Nealon
Absolutely. And I think what we also saw with the practitioners is that for kids who were either very, very mild in terms of their CAS and SPD, or very severe, those were easy diagnoses, you know, those it was really those kids that were more in that mild to moderate range, those ones that are really difficult for clinicians that maybe present one way one day, and then the next year, like, oh, maybe no, actually, maybe they aren't a sensory processor. I you know, maybe it was just that one day, they were you know, they just come from something where they had to sit for a long time. And you know, that that kind of mild to moderate presentation is really difficult. And I think that was sort of what we were looking for was like, How can we support those clinicians? Who are having those mild to moderate children? And what does the other? What does the other individuals see? Like? What do the OTs see in our children with childhood apraxia of speech? Are they seeing these inconsistent errors? Or are they just seeing a kid who isn't intelligible and is subsequently really frustrated and is non compliant? And I can't understand what they're saying. And maybe they need an augmentative device? What if you're not the SLP? who's living in this land? What are you seeing? And alternatively, if you're the OT, what are you seeing, you know, are you are you seeing in terms of the sensory processing? A kid who just can't sit still a kid who may be out they don't like speech? What whatever we're kind of saying, what is the what is the perception of those practitioners of those alternative diagnoses that we're not as familiar with?
Jayson Davies
Yeah, so I just want to clarify or just wrap my head around everything. You primarily asked OTs about SPD primarily asked the SOPs about Cas, but did you kind of mix in the CAS with OTs and SPD with the SOPs? Or did you really keep a separate?
Kate Nealon
We ask them what comorbid diagnoses they often see with you know, let's say you have a child with sensory processing disorder on your caseload. What are they also often present? Continuing with, you know, not leading them. But you know, we got Autism Spectrum Disorder, we got articulation delays, we got communication impairments, auditory processing, all you know, depending on cognitive communication impairments, all kinds of things. So asking them what in their practice, do they often see these children off? Also presenting with?
Jayson Davies
Gotcha. And so I'm just going to kind of put my little hypothesis hat on and say, I would assume that the SLPs mentioned SPD as a comorbidity to CAS, but I'm not sure the other way around would have come up, at least not specifically CS, they might have talked about speech impairment, but did CAS come up at all? directly from the OTs?
Zahava Friedman
Yeah, that's a great question. Um, I'm gonna take that one such a great question. Okay. So sensory is a buzzword, right? Every OT, you know, understand no sensory is trained in school. Just as an aside, when I was graduating school, which was 2006, it was like, it was more of an emerging area of practice. But nowadays, it's a given. And that's how I trained my students. It was not surprising to me that most of the SLPs did mention sensory independently on their own. Um, first of all, I was an OT, and I was also reading the study together with Kate So like, you know, just see the face of an OT and your mind goes to sensory maybe, I don't know, it's, it's definitely highly popularized. I mean, you know, again, we can go into whether it's being overused in the in the general population, currently, you know, you walk into Target Walmart, every toy, you sensory, there's weighted blankets all over the place, so you can't miss it. Exactly, exactly. I knew it was going to be. And the OTs also had that reaction, because this was the sensory based focus group. So like the overuse of sensory is a totally time for another, another podcast and another time, but it came up a lot by the SLPs. By the OTs. We got to this was one of the tangential pieces that I kind of alluded to, but we got into a sidebar topic. I don't know if you remember this case, they spoke about apraxia and dyspraxia. And it came up with general apraxia and dyspraxia and every you know, everyone uses the term differently. I'm not here to define it. I think it's also like waving a red flag in front of a bowl. If I work there, there are experts out there.
Jayson Davies
I actually do want you to define it though I want you to because for people listening, just just you don't have to go like in depth super in depth, but what is the difference?
Zahava Friedman
I will I mean, I'll do it. I definitely know some people will even disagree with my definition, but I'll do it. So, um, you know, I think the consensus within that focus group, and I think this is kind of how I define it, as well as a, you know, when you hear the word, the prefix A is like absence of, and this is, you know, just a challenge to so does praxis challenge to praxis, which is you know, motor coordination or motor planning, a Praxic, no motor planning. And I think, you know, in my mind again, apraxia would be a total lack of dyspraxia would be a challenge to the coordination. That's the differentiation to it. And I think again, there's still within our world some conversation around what's the correct term, and how we use it and if generalized to motor movements, movements, but we you know, I guess my point was, is
Jayson Davies
that alright, catch you off the topic or the question here was our OTs recognizing CAS when they see SPD, really,
Zahava Friedman
they are recognizing a general movement challenge when they see SPD. I think some of them are recognizing that the speech therapists struggle with the same children and the same movement challenges in speech. I don't think they had the language of CAS in the same way that the speech therapist had sensory at their fingertips maybe the definition of sensory wasn't from wasn't what an OT would, you know, define it as because it's not as deeply in the scope of practice of a speech and language pathologist. But that language was at their fingertips. For the OTs, the language of CHF, the language of apraxia, the language of dyspraxia was not as much as at their fingertips, but they did recognize that there was a movement aspect when there was a child with an SPD challenge.
Kate Nealon
Gotcha. Okay. Cool. Absolutely. They just kind of defined it more as a communication impairment. They weren't separating out what speech and what's language, you know, that's that's the nerdiness of us. But they were certainly saying that for, you know, some kids who had SPD and they were seeing, they were also presenting with a communication impairment or they were also seeing an SLP but maybe couldn't tell you what they were seeing the SLP for. So there was a there was a general awareness, but they know no one said absolutely. It often I'm with CES and that is XYZ.
Jayson Davies
Yeah, and I'm assuming that this is kind of what you're expecting. I can't imagine that you were expecting OTs to know exactly what CES was. And SLP used to know exactly what SPD was correct?
Kate Nealon
No, and that was really, absolutely, we didn't expect them to know that. And that was really one of the catalysts for this study, because they need to start knowing this because a lot of these kids are presenting with this. And we're losing time. Because if a child is presenting with CAS and SPD, and I am not incorporating components of an SPD treatment plan into my treatment plan, I am not serving that child as efficiently and as well as I could. And so I need that OT language. And I need that OT knowledge knowledge in order to have a better treatment approach.
Jayson Davies
Gotcha.
Zahava Friedman
Yeah, I want to add something, Jason, it's been on my mind just listening to your questions like sparking a lot of memories from these focus groups. But one of the participants, I think this was like a breakthrough moment, was an OT. And she was describing how the SLP was working with a child who was communication impaired. And I still remember her her words, I think we just did an article she said he was communication impaired because of the motor impairments. She said he was, he was a Praxic, because of the motor breakdown, where she put the pieces together. And she said, the communication was impaired, because motor wise, he couldn't get out the speech. And she was seeing the motor output from a sensory perspective. But you realize that it came out from an SLP perspective in the speech domain, which I feel like was a breakthrough moment. It was one of the more veteran OTs speaking, but you could see heads nodding. And that was a moment where they were like, oh, that's why it helps somebody work together. Because this person who had worked across time with many children and with many SLPs had had that breakthrough moment, where they said the communication with impairment was there because of the motor.
Jayson Davies
yeah, and shout out to Fran actually, it was able to find that quote, really quickly, word for word, she said that, what I find is that the speech therapists are saying that children have apraxia, but once the children begin to make words, then their language impaired and their language impaired because of the dyspraxia. So
Zahava Friedman
Exactly, exactly. Exactly. That was.
Kate Nealon
I was sort of like silently clapping there with my video off when that happened. But I mean, I think an important thing to note here is that this is this study is really step one. And so figuring out what clinicians are doing currently, so that the next step can be the education around. Here's what this is for both SLPs and OTs. For here's what these are, here's how they can present. Here's how if you have a child with CAS and SPD, here's what your treatment plan could look like. Here's how to collaboratively work together, which I think has been missing up until now.
Jayson Davies
Yeah, yeah. All right. Well, we've talked a lot about kind of your results, but I know you had three specific themes that kind of came out of all the results when you put them all together, so I'm just gonna read them off really quickly. We've kind of touched on some of them, we haven't so I'm just gonna let you dive into it right after I read them off. But clinical conceptualization for CAS and Kate I think you talked a little bit about that. The same thing clinical conceptualization for SPD, and and Zahava. I think you've talked a little bit about that one as well. But we haven't used the term from the third one soft landing of CAS slash SPD, as acceptable replacement diagnosis for neurological global disorder, that one I really want to dive into because there's two terms that we haven't mentioned yet soft landing and neurological global disorder. So let's discuss.
Zahava Friedman
Okay, I'm gonna let you take that one.
Kate Nealon
Okay. So as we've kind of known, have discussed a little bit, oftentimes, CAS and SPD do not present by themselves. They're not idiopathic disorders, they're often kind of with something else. Not always, but they can be. And for CAS that can often be Autism Spectrum Disorder, as we said, it can often be a larger kind of global, either genetic variant or more of a global developmental disorder that has a cognitive component. It can be a lot of different things. And I think, you know, and this is my personal opinion from, from my experience, that what we're seeing as CAS has become a buzzword is because Cas is more treatable. And so for parents who are potentially facing larger diagnoses that are potentially more life disrupting and a little bit more nerve wracking for them. That CAS is one that they can kind of see the treatment plan, see how this see a potential beginning and an end to this treatment in the beginning. And so I think that has contributed to becoming a potentially over diagnosed disorder currently. But this comorbid presentation that often happens, sometimes one is diagnosed versus versus another NCDs can be kind of the first presentation or because, you know, for a 16 month old child or a 24 month old child, what you're seeing generally is their speech, you know, when you're talking about milestones and things like that, certainly there's, you know, more gross motor milestones, but that's what you're seeing. And so that's impaired. That's where parents are most concerned about, they're going to the pediatrician, and they're saying, they're not talking, I went to the park with so and so's dad. And their child was saying two word sentences and their child was really intelligible, and their child, whatever it is, that's what first goes off for a parent is really the speech. And and so it's often the first thing that that's kind of identified and subsequently treated.
Jayson Davies
Gotcha. So then, I guess for maybe this is more for the EI OTs and SLPs, as opposed to school based? What should they make of that when they're seeing the kids, whether it be you know, early intervention or in school based? I guess that they're seeing that CAS should they automatically think hey, I need to get the OT involved or vice versa for OTC is SPD? Should they think maybe I need to, to get the SLP involved? Or what should they make of it when they see these diagnoses?
Kate Nealon
For an SLP? If you're seeing say, yes, absolutely, I would get the OT involved for an evaluation because either the gross motor and potentially PT at that point, but like the gross motor challenges that we see the sensory processing challenges that we see are all potentially impacting that child's ability to participate in treatment. Another kind of piece with childhood apraxia treatment is that because it's a motor based disorder, the treatment is repetitive. I mean, and the same as you know, if you were trying to teach me to do a cartwheel and to motor plan how to do a cartwheel, the first step is to do 700, cartwheels. And for you to continue to you know, move your leg, move your arm do this, it's the same with apraxia treatment. So for those kids, there's not a lot of three year old two and a half year old kids who want to sit there and do 50 repetitions of be in the initial position of the word, alright, we're gonna say bed, all this time, you're gonna put your lips together. That's a hard, it's a hard sell for us. So if those children are dysregulated, or aren't able to participate with us, we're losing out on so much on so much opportunity for success.
Jayson Davies
That's interesting, because when I think of praxis in the OT world, there's a few. I'm just gonna kind of, you know, there's a few ways to kind of think about practice, there's kind of the sensory side of saying, Okay, I see the praxis difficulty, I'm going to come at it from a sensory lens. So I'm going to work on sensory integration with the all the other senses a little bit to help the praxis side of things. The other way to come about is like what you mentioned, right? Do the same thing 700 times. And so you kind of have two camps, if you want to call it one person is going to do it 700 times the other person can work on the quote unquote, underlying skills that might impact praxis. You're saying in speech, it's more of the 700 times as opposed to working on the underlining practices currently, but I think you're kind of alluding to in the future, that's why we bring in the ote potentially to help with some of those other sides of things.
Kate Nealon
Absolutely. And I should clarify that it's 700 times, but it's 700 Correct times. So if you are not doing it correctly, I am giving you tons of feedback and make you know, because 700 Incorrect. cartwheels does not produce an amazing cartwheel at the end. It's two cartwheels and a ton of feedback and a ton of changes and all that and then continuing on. So it's 700 Correct productions. But yes, yes. That is the potentially that is generally the treatment.
Jayson Davies
Perfect. So now let's kind of dive into the Okay, now what type of situation for this? Like? What should SLPs? What should OTs take away from this research? Is there one key thing? Are there multiple key things? What is your hope? Or maybe what even you're doing right now as a result of this paper that you wrote together? What is your takeaway for everyone that's read or listening today?
Zahava Friedman
I'll take that one. Yeah. Okay. So I'm going to reiterate it About what Kate said, but then I'll go a little bit more practical. So like we mentioned before, you know, collaborate. Okay, that's been said 1000 times. But I think what came out of this study, I'm going to quote another participant was something that they said was like, it's a different trajectory. One of the participants described for for these individuals who are showing CDs or SPD are both, they have a different developmental trajectory, where one may be seen with the other or with many other comorbidities. So from the get go with your parent, or if your SLP, or OT, working in a school system, where you see the speech is incredibly impaired, or from a sensory perspective, you're seeing above and beyond what you would expect even to see, consider that it might be a different trajectory for that child, and consider opening the door to a full blown collaborative effort at the school level. So there, you know, I worked at a school for 14 years, there were times that I saw a child. And like after a couple of weeks, I'd call in the PT. And I'd say calm, let's have a look, see, and try to see if we should request a PT evaluation for this child, right. But there are some children where I don't even wait a few weeks, it takes two to three sessions. And instead of just calling in the PT, I'm like, we have to have meeting now pronto. Like are we considering a full blown classroom change with all three therapies. And if you see one of these things, especially like beyond the scope of what you have seen, consider it all earlier and quicker. Ask the team for help. And if you're not comfortable asking everyone, go to your one go to person, whether you're really good friends with a PT or with an SLP, with a child, study team member, but go early and understand that the trajectory might be different. It might not be OT on schedule for six months, and then maybe considering PT, it might be more. And I think you know, you know, like I mentioned a mom of five, Kate has two gorgeous girls. We're both parents. And I think, you know, as parents, sometimes we we see these things with our children. And what I say might sound like, it's a little contradictory to what you might do as a practitioner, but it's really not, I think, when you see some of these signs, don't be afraid to ask and to pursue as early as possible support for your child. And until you reach a practitioner that you feel is matching that need or a series of practitioners or an agency, you know, go for what you can if you see a child that has this area of challenge till you get to the bottom of what you think it is. So at this, you know, as a parent, I would definitely say, if you're seeing one, try to ask the question of is there a bigger picture here that we have to understand, but also give yourself a break as a parent, like, understand that some of these things are a different trajectory. And I take that phrase as a parent to say like, I'm in for the long term, my trajectory with my child might be a longer one. And I could be kind to myself pursue as much as they can, but also know that I'm just doing my best. So if you're a practitioner, school based practitioner, hearing this, go ask your friends for help. Ask your collaborative team. And if you're a parent, hearing this, do as much as you can, but forgive yourself, if you sometimes feel like you're not doing enough, because there's so much on our plates as parents, that trajectory is long, and keep your energy up and try to do as much as you can without, you know, burning yourself out as a parent.
Kate Nealon
And in my perspective, yeah, absolutely. And so my perspective would be more would be a little bit more clinical. So as an SLP, I would hope that what they would get from this article is really more of the language that they can put to what they're seeing. So if they're seeing these kinds of sensory components that we all kind of, you know, that's your buzz word, like the sensory, that's certainly the one SLPs know, what does that mean? What What are is the what are the terms now that you can bring to that OT, instead of saying, they're having trouble with sensory instead say, this individual is or is really seeking a lot of aural input, this individual is, you know, really seeking a lot of input on their body, when I'm trying to, you know, do treatment, whatever their specific SPD components are, because, you know, like we said in the article, these kids didn't read our textbooks, they're not going to present with all of the symptoms simultaneously, that would be wonderful, but they don't. And so whatever they're presenting symptom, ology is taking that to the OT, and as I have said, not being intimidated by it, because we all kind of think that we should be these experts of everything. And the reality is that SLPs and OTs are kind of jack of all trades, you know, while while some SLP might be a swallowing expert, they might not know a lot about apraxia of speech or something in an OT land. So it's not to be intimidated by the other practitioner. That and to start Developing these relationships, it would be my hope that as we go on a childhood apraxia of speech diagnosis or someone saying that they have, you know, suspected, immediately triggers an OT evaluation, and subsequently the same thing. So for OTs
Jayson Davies
All right, I had a question and this is the perfect time to ask it, it's off script. So I hope you don't mind. But expecially in school based occupational therapy, there has been a lot of debate about speech and language only kids, kids who have an IEP specifically for speech and language, but they don't have an IEP for academics, no sai no special day classroom, they have only been identified by the speech therapist. Now, over the 10 year of my career, 10 years it used to be that was perfectly fine. If a student had s li speech and language impairment, they could refer out to occupational therapy for an OT eval, no questions asked. However, over the last decade that has kind of turned around and districts are starting to say, hold up. The SLI first needs to make a referral to the psychologist to determine if there's a specific learning disability, autism something else before going to the OT. And what I'm hearing you say today kind of says that that's wrong, like that should not be the case. Because Absolutely, if a student has Cas, then there is likely a SPD concern going on that should at least be evaluated. Okay, maybe we rule it out. But it should at least be evaluated, did anything that I just said, not make sense?
Kate Nealon
Not at all. And what you're explaining is now putting another individual, a psychologist who may not also be able to identify these kinds of components in this this kind of soup as well now. And so what we need is to have practitioners that are trained in cross trained basically, in these kinds of components, do I have to be an OT? No, but I could certainly as an SLP be very much aware of what sensory processing disorder is what it looks like how its treated. Same thing with a lot of, you know, in the pediatric feeding realm, you know, is often a place where SLP and OTs overlap. So certainly I should have a working knowledge of all of that of all of those diagnoses and terminology and all that so that I could and then I should also be trusted to be the practitioner who makes the referral, who doesn't have to jump, you know, for other practitioners to get there.
Jayson Davies
I 100% agree. I've had a lot of conversations with her about this topic. Most of them have been private, this one obviously is now going to be public that I have seen districts do this. And I truly do believe that a lot of districts are doing that, in order to make OT more difficult to get. I see the the use of a psychological evaluation as a barrier to OT because of the growing OT caseload. It works and I don't think that that should be the case, I think that the SLP should absolutely be able to say hey, I'm seeing sensory I'm seeing something even. I mean SLPs are very smart people they can see fine motor, they can see sensory, they can see Visual motor, they can see a lot of things, and they should have that ability to just say, Hey, I see this, I believe that it is probably impacting academics, let's or just even functional skills in the school. Let's bring though tn so yeah, the hobby.
Zahava Friedman
Yeah, I have some data. That's why I was a school based practitioner for 14 years. So in the state of New Jersey, when you have a speech on the IEP, it's called ESLs eligible for speech and language services. And my, one of my closest friends was the speech and language, you know, pathologist in the school, and she would have like, probably 10 to 20% of her caseload was ESLs kids run there is run there's an ESL a child with with a speech on the IEP, the speech therapist operates as the case manager. So it doesn't make sense to bring in another case manager, so maybe the IEP changes categories, or maybe the child receives OT under a 504 plan. That's actually what would have been tradition, tradition under my school. But I also feel like a lot of these things happen when the groundwork hasn't been laid for strong relationships among the professionals in the school, we set up roadblocks for children to receive services as opposed to opening bridges between each other and communicating that directly. But when there's a strong goalkeeper, a petitioner a strong SLP and they have strong relationships, then these things will happen more naturally, as opposed to having to set up procedure, procedure, procedure procedure and stop the services from happening. Even within my school district. Very often, you know, if I was operating in a school where I had been there for 10 years and a new OT, you know, maybe contract person was coming in another school. They were not Getting 504 plans in that other school in my school, you could get OTs through a 504 plan, because there was tradition in our school of me being there. So I think, you know, your mileage may vary, state. States may vary, districts may vary, things are different pay to state, but relationships underpin it all. If you're there for your collaborative counterparts, and you lay the groundwork, well, then the knowledge can flow much better. Like if you if you care about them in there, as human beings and as professionals, then it will be obvious that a person who was working with Cas, as the work of the person was working with a child who has like, it's, um, it's more natural flow, when the relationship is at the core of practice, I would say, you know?
Jayson Davies
Yeah, I mean, that was a big part of my practice, right? Like just educating other professionals and learning from them, right? Like, I worked in a place where I didn't have another occupational therapist until I hired them. And so my mentors were a lot of speech pathologist and psychologists and I learned so much from them about speech and psychology, and went like, what, what a specific learning disability even is like, right, you learned so much from them, and they also learn from you and helping them to understand when to make that referral, or helping them understand what is sensory, how sensory impacts behavior and so forth, right? So that is so key that we collaborate and build that rapport with other professionals. So yeah, I have a challenge. And I don't know, maybe it's for one or both of you. But if you're not already, like repeating the study, I think you should with like teachers to kind of do a similar thing where it's like, SLI specific or not SLI but SL, specific learning disability, SLD and SPD. Like, What do teachers think about SPD? And what do therapists think about SLP? Too many acronyms are getting confused. But anyways, I think that would be like just doing something similar, except with teachers and OTs, or SLPs. And teachers and psychologists, like, there's so much language, it's kind of a barrier in a way, like, right, we're, we're both speaking English, but we're using completely different terms, and it can be a barrier. So yeah, that'd be fun.
Kate Nealon
And we're both sort of, you know, we're all sort of, oh, all of the education, academic education happens there, all of the, you know, sensory regulation, what happens in OT, I'm going to be responsible for all of communication, that's, it's just not possible. And so when we're all using, you know, a shared vocabulary, and we're all coming at it from from the same place, then we serve the kids so much better, but I think, you know, and that goes back to our, to our very complex title. But we exist in silos very often, you know, and I kind of live over in my speech and language land and, and then I, you know, the expectation is in 45 minutes a week or 15 minutes, you know, three times a week, or what have you, you're going to somehow fix the dysregulation, and then, and I'm going to also fix all of the communication and make this like, it's impossible, obviously. And so we have to become more collaborative and have more of a knowledge of each other's professions. And, and what have you.
Jayson Davies
Yeah, what was that chuckle for? Zahaba?
Zahava Friedman
Yeah, no, I was laughing. Because when you were reading the title earlier, when we submitted this title, we actually abbreviated in the original submissions, you remember that Kate?
Kate Nealon
Yeah.
Zahava Friedman
And, and we're very grateful we we got accepted in the first trial with very minor revisions of the first time ever for us. But the one revision one, one of the few revisions that was asked for was please do not abbreviate in the title. And it makes it very long and impossible to read. But just fun tidbit all the behind the scenes stuff you don't know that happens when you see something in print, you know,
Jayson Davies
so I'm assuming you had abbreviated SLP OT CAS and SLP or SPD.
Zahava Friedman
It was that I think CAS and SPD were abbreviated and original version.
Jayson Davies
Those are both really long one. So yeah. Fun fact, you only learn it by listening to the podcast. All right. Well, first of all, thank you so much for both of you being here Kate, and Zahava. But before I let you go, I do want to just kind of let you share one final takeaway, if there's just one thing that a listener is getting from this episode from this podcast, what is it that you want them to take away?
Kate Nealon
For me, I know most of your listeners are OTs, but I'm going to just assume that there are SLPs out there that are listening as well for for childhood apraxia of speech. If you're seeing a child on your caseload, who is presenting with this, you know, in coordination and the inconsistency of errors and the impaired porosity, seek out your occupational therapist, develop a relationship with them and really ask them to come to come see that child, because more than likely they are going to see pieces of that child that maybe you haven't seen, or you just can't put words to, that are going to help the overall outcomes that you're going to get in treatment?
Jayson Davies
Yeah, what about you Zahava? One thing that you add?
Zahava Friedman
Yeah, it's not, it's not too different. I guess me and Kate are good friends, because our minds always think alike. But, you know, I once had a group of students who also asked me like, how do you have so many SLP friends and I love to collaborate across many professions. It's really something, it's like, it adds so much flavor and life to my work. And I told my students, the simplest thing, but I'm gonna say this here, the best way to collaborate is to make friends go make a friends in another profession. Just find one person who you who you enjoy talking to or schmoozing with, just make a friend. If you develop a friendship with someone, then you can also work together like don't only see it as purely professional, but look to build each other up across the professions. So that's my advice, go make friends in another profession, you will be surprised by how much you learn.
Jayson Davies
And if you need help finding a friend, call Zahava, she will help you
Kate Nealon
100%
Jayson Davies
You'll have five friends by the end of the week.
Kate Nealon
collaborative relationships,
Zahava Friedman
I'll recruit friends for every single person on the market.
Jayson Davies
All right. Is email. I know you both work at a college is a college email, the best way for anyone to potentially reach out to you if they have questions or LinkedIn better. What's the best way to get in touch and learn more about this?
Kate Nealon
Absolutely. For me, my email, I can provide it for you in the show notes. Okay, perfect. My email address is the best way to get in touch with me. I'm on email constantly, as I'm sure most of us are. And I would love to hear from anyone. Yes.
Zahava Friedman
Yes, me as well. I mean, I'm very active on LinkedIn, but I prefer email. And I'm very responsive. And I would love to hear ideas, collaboration, ideas, stories, anything that happened in your school districts, I just love to hear from people. So definitely reach out, email me. And you'll probably hear back. I respond back very quickly.
Kate Nealon
Very quickly, three in the morning, I do not understand how Zahava parent five children and also responds to my every text and email immediately.
Jayson Davies
I'm more of the type of person where like, I'll read it and then I'll mark it as unread. So I can think about it and then respond. So I'm very, I have a love hate relationship with you people that can just respond so quickly. Yep. All right. Well, thank you both so much for being here. I really appreciate it. And I also look forward to all the collaborations, all the research articles that continue to come from both of you. I'm sure there will be more in the future. So thank you so much.
Kate Nealon
Thank you.
Zahava Friedman
Thank you, Jayson. It's been a pleasure. Thank you so much.
Jayson Davies
All right. And that is going to wrap up episode number 131 of the OT schoolhouse podcast. Thank you so much for tuning in. And I hope this episode kind of inspired you to maybe go out, reach out to the SLP or maybe the SLP a at your school site and get to know them a little bit better, and say, hey, you know, I listened to a podcast and had a speech therapist talking about CES on it. And I just wanted to get your perspective on CIS. And you know, I work with kids with SPD, maybe we should be collaborating a little bit more. If you don't get anything else from this podcast. I hope that you get that out of here. Heck, you could even email them a link to this episode and say, Hey, you might enjoy this episode too. So yeah, thank you so much for listening. And again, if you are a member of the OT schoolhouse collaborative, you can go ahead and sign into your account, find this episode within our podcasts that you use, and take a quick quiz to earn your certificate of completion. Oh, and one more thing. We don't typically have something at the very end of our episode. But after we stopped recording, Zahava had one more thing to share that was super insightful. So I wanted to let that play at the end of the episode. So in just a few seconds, you're gonna hear one last clip from Dr. Friedman. I hope you enjoy it. Take care.
Amazing Narrator
Thank you for listening to the OT schoolhouse podcast for more ways to help you and your students succeed right now. Head on over to OT schoolhouse.com Until next time, class is dismissed.
Zahava Friedman
Okay, there's another thing that didn't come out of the article. Okay, you probably remember it. But um, you know, it was a very interesting thing across both groups of SLPs. And OTs in particular, I would say more with OTs. They were describing the type of child that had a sensory processing disorder where there were also emotional aspects to it. And that almost being seen as like a criteria or very often aligning with the sensory processing disorder and also the with childhood apraxia came out in the social right case like they were the speech therapists were just speech language pathologists were describing the type of child with challenge to their social skills were because they because the words didn't come quickly and they took a longer time at a time they hit middle school, they presented with social emotional challenges, and it was an interesting symmetry across both professional groups pertaining to the emotional area.
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