202. When AAC Feels Hard, It’s Working: What Effective Clinicians Do Differently

If you work with children who are minimally speaking with autism or you love a child who is minimally speaking, today’s episode matters. Over the past year, I’ve been doing something deeply intentional. I’ve been having long, honest conversations with speech pathologists and special education teachers who are truly effective with high-tech AAC. These weren’t quick chats. Each interview ran over an hour. I asked open-ended questions. I pushed for specifics. I wanted to know what is actually working for robust AAC systems with thousands of words. What I found surprised me. There was no magic training. No perfect certification. No secret setting hidden inside the device. What these highly effective professionals shared was something much more human. They believed in themselves enough to try. To fail. To troubleshoot. To look clumsy. To learn alongside the child. In this episode, I talk about why vulnerability is the real needle mover in AAC implementation. I share why modeling uncertainty, curiosity, and joy matters more than appearing fluent. Showing a child how you search for a word, celebrate finding it, or flexibly choose an alternative builds far more communication power than perfection ever could. We discuss treating AAC as play, not performance. About using devices the way we use books with young children as interactive tools meant to spark connection, not test correctness. I also connect what I’m seeing in my dissertation research to real-life practice. Across hours of transcripts and coding, the same theme kept surfacing. Fluency doesn’t come from training. It comes from hands-on experience. Repetition. Messy, imperfect action. This episode will challenge you to rethink comfort zones, to stop waiting until you feel ready, and to remember that communication growth begins when adults are willing to learn out loud. If AAC has ever felt overwhelming, intimidating, or like something you were supposed to already have mastered, this conversation is for you. And if you want ready-to-use, engaging, and effective activities that make AAC implementation doable in real sessions, join the SIS Membership. Weekly resources arrive in your inbox so you can spend less time prepping and more time modeling, exploring, and connecting with your kids. You can learn more and join at https://www.kellyvess.com/sis Thank you for being part of this work. Roll up your sleeves. Be vulnerable. And keep changing lives one child at a time.

If you work with children who have complex communication needs, you already know this truth: You cannot pour from an empty cup. In this episode, I share six realistic self-care swaps I use from morning to night to support energy, focus, and emotional regulation in the work we do. These are not trends. They are practical, research-informed adjustments that help me show up fully present in therapy sessions, even during long, demanding days. As winter approaches and energy dips, comfort-food cravings rise. Instead of relying on willpower, I build better systems. In this episode, I walk you through: • A caffeine swap that supports focus without crashes • A protein-rich breakfast that stabilizes blood sugar • A comfort-food lunch that doesn’t derail energy • A 4 p.m. strategy for end-of-day slumps • A clean popcorn hack that actually works • A dessert and sleep routine that supports recovery, not burnout Self-care isn’t indulgence. It’s infrastructure. When your body and brain are supported, you can stay responsive, regulated, and fully present with the children and families you serve. A note for SIS Members and those considering joining Inside the SIS Membership, I design therapy the same way I design my self-care: with systems that remove friction. Members receive weekly, done-for-you, research-informed activities so they can spend their energy where it matters most: interaction, responsiveness, and connection. No scrambling. No reinventing the wheel. Just showing up ready. If you are ready to reduce decision fatigue, protect your energy, and innovate your practice alongside a community of practitioners doing the work in real classrooms and therapy rooms, you can join us here: 👉 https://www.kellyvess.com/sis You deserve support that actually supports you. Thank you for joining me at today’s drawing board for a better tomorrow, 💚 Kelly

If you work with parents of children with special needs, this episode is non-negotiable. Instead of diving into research, we’re heading straight into a film that delivers the kind of uncomfortable clarity our field rarely gets. Today, we break down If I Had Legs, I’d Kick You—Mary Bronstein’s raw, emotionally accurate look into the lived experience of parenting a neurodivergent child—and why every SLP, special educator, and early-intervention professional needs to watch it. This movie exposes a blind spot in our practice: how we show up for families. And more importantly, how often we get it wrong. In this episode, you’ll learn: • Why judging parents instantly destroys trust • How our “professional persona” blocks genuine connection • The simple shift that makes parents feel heard instead of dismissed • When your “support” becomes a burden—and how to stop doing it • Why burnout in families is invisible until it explodes • How to rebuild capacity for parents and for yourself This is not a feel-good conversation. It’s a necessary recalibration for anyone who works with families navigating neurodivergence, chronic medical needs, and overwhelming daily demands. If you want to do better for the families you serve, start here. Feeling your own burnout creeping in? Stop white-knuckling it. The SIS Membership provides weekly, ready-to-use, universally designed literacy-movement activities that dramatically reduce your planning time while increasing engagement for every child on your caseload. Protect your capacity. Strengthen your practice. Join today at https://www.kellyvess.com/sis

If you love weaving books into speech and language therapy, this episode is absolutely your lane. In this conversation, Kelly breaks down a 2025 scoping review on early language development and reading aloud, then translates it into five practical literacy “hacks” you can use with preschool and early elementary students starting tomorrow. She pulls zero punches about the study design: you’ll hear exactly what a scoping review is (and isn’t), why it doesn’t carry the same weight as a systematic review or meta-analysis, and how to use it wisely as an “idea generator” rather than gospel. From there, she layers in two decades of clinical experience and walks through the habits that actually move the needle in real therapy rooms. You’ll hear about: Why this 2025 scoping review on reading aloud and early language is best viewed as an “idea article” How the authors used PCC (Population, Context, Concept) to narrow 1,000+ studies down to 106 Why repetitive, predictable books (like The Gingerbread Man or Brown Bear, Brown Bear) allow diverse learners to participate at a higher level How to rethink “social stories” using a Brown Bear-style repetitive frame and a child’s favorite characters for more powerful behavior change What Universal Design for Learning actually looks like in speech therapy when you go all-in on multimodal cueing How multisensory, multimodal activities (print, props, movement, AAC, writing) especially support autistic students and kids with attention and motor planning challenges Why connecting books to real-world roles and prior knowledge (“You’re the zookeeper…”) drives deeper language and thinking than fact-based WH questions Simple language shifts that move you away from quizzing (“What color is…?”) toward higher-level thinking (“I wonder why…”, “Tell me about a time…”) How predictable literacy routines reduce cognitive load and move kids out of fight/flight and into learning Why the interaction itself matters more than any single treatment target or book choice How prepping rich, ready-to-go materials frees you to be fully present in the interaction (where the real “magic” happens) By the end, you’ll walk away with five concrete literacy routines you can plug into your week and a much clearer lens for judging research quality while still using it creatively. Want these literacy hacks done for you every week? If you’re ready to stop reinventing the wheel and want literacy-based, movement-rich activities that already embed these principles, join the SIS Membership. Inside SIS, you get: Weekly Google Slides decks built around repetitive, predictable books Multimodal, multisensory activities (movement, props, print, AAC, writing) you can use with your entire caseload Treatment targets that are already leveled and ready to go, so you can focus on the interaction instead of scrambling for materials Join SIS here and grab everything instantly: 👉 https://www.kellyvess.com/sis   Annika, A., & Johanna, L. (2025). Early language development and reading aloud with children: A scoping review and content analysis. International Journal of Educational Research Open, 9, 100508.

Children who speak freely at home but shut down in public aren’t being stubborn. Their capacity is getting crushed by the demands of new people, new settings, and unpredictable routines. In this episode, we break down how to build capacity using the PRIDE approach—adapted specifically for reluctant speakers and children with selective mutism. You’ll hear how to shift out of “thermostat mode” and into “mime mode,” using 10 minutes a day of pure responsiveness to lower pressure, increase connection, and support communication in high-stress seasons like the holidays. We walk through exactly how to use each part of PRIDE—objective encouragement, reflection, imitation, description, and enjoyment—without adding demands, without pushing speech, and without triggering shutdown. This is the blueprint for helping sensitive, cautious, or selectively mute children communicate more confidently when the world gets loud. In this episode, you’ll learn: • How the Demands–Capacity Model explains shutdowns in public or group settings • Why holiday routines, unfamiliar people, and novel activities increase mutism • How to adapt each PRIDE element for reluctant speakers (no expansions, no recasts) • What 10 minutes of daily “mime time” does to build capacity fast • The specific social and communication behaviors that improve when capacity increases • How SLPs can coach families through this process during high-stress seasons If you work with children who freeze, whisper, avoid, or stop speaking outside the home, this episode gives you a concrete plan you can use immediately. Want ready-to-use activities that make your therapy educationally rich without adding demands? Join the SIS Membership and get weekly materials designed to support speech, language, and social-emotional foundations—especially for sensitive and reluctant communicators. 👉 https://www.kellyvess.com/sis

If you serve young children with behavior challenges, this episode delivers a framework you can put to work immediately. Today, we break down the PRIDE skills: five evidence-based behavior strategies drawn from Parent-Child Interaction Therapy (PCIT) and Teacher-Child Interaction Training (TCIT). These methods have more than 50 years of empirical support and consistently improve behavior, engagement, emotional regulation, and communication across diverse populations. You’ll learn how to use objective praise, reflection, imitation, description, and genuine enjoyment to build connection—not compliance. This child-directed interaction approach has been shown to make meaningful gains for children with autism, ADHD, selective mutism, developmental language disorders, trauma histories, hearing differences, anxiety, and disruptive or externalizing behaviors. The research is broad. The effect sizes are large. And the application is simple. We dig into how PRIDE skills strengthen executive function, expressive language, joint attention, and emotional resilience—and why these strategies are essential for SLPs, early childhood educators, and anyone working in preschool or early elementary settings. When you have educationally rich activities prepared, you can stay fully present and implement PRIDE with intention, clarity, and consistency. If you want treatment plans that allow you to focus on relationships, responsiveness, and evidence-based connection strategies that actually change behavior, the SIS Membership is designed for you. Each week, you receive educationally rich activities that treat the whole child—speech, language, literacy, executive function, and motor foundations—so you can implement PRIDE seamlessly without scrambling for materials. Join the SIS Membership and make your therapy easier, richer, and more effective: https://www.kellyvess.com/sis Let’s build capacity, connection, and better outcomes—one child at a time.💚Kelly

If you treat speech sound disorders (SSD) and you’re not seeing the gains you expect, this episode is your playbook. We cut through the noise and name the 10 research-informed predictors of slower progress—attention/self-monitoring limits, sensitive temperament, co-occurring language/working-memory load, hearing impairment (fricatives/affricates), motor speech factors, structural constraints (e.g., open bite), low stimulability, later start to intervention, low therapy intensity/irregular attendance, and environmental barriers. Then we pivot hard into the three levers that consistently move outcomes: choosing complex, maximally distinct targets (e.g., SW-blends), delivering dynamic temporal tactile cueing (DTTC-style), and holding the ~80% challenge point to avoid reinforcing error patterns. Concrete therapy examples, parent carryover, and generalization strategies included. What you’ll learn: 📈How attention and self-monitoring mask progress until generalization “pops” 📈Why a sensitive temperament demands predictability and a responsive start 📈How co-occurring language and limited verbal working memory can look like CAS—but aren’t 📈What hearing loss really means for fricatives/affricates and consonant deletion patterns 📈Practical expectations for motor speech and structural constraints (e.g., open bite) 📈How stimulability with maximal cueing informs prognosis 📈Why start age and habit strength matter for entrenched /r/ and /s/ errors 📈Why frequency > duration for home practice, and how to embed one daily rep 📈The “no-data-during-DTTC” mindset: probe quickly, cue deeply, fade fast The 3 levers (non-negotiables): 📈Target selection: Complex, maximally distinct clusters (SW > ST/SP/SK) to drive system-wide change. 📈Delivery: DTTC-style, moment-to-moment cueing (choral → fade), with brief probes to verify learning. 📈Challenge point: Keep accuracy near ~80%—high enough to learn, low enough to adapt. If you’re reinforcing errors, pivot. 00:00 Why progress “flatlines” then explodes 03:10 Predictor #1: Attention/self-monitoring 06:20 #2: Sensitive temperament & predictable routines 10:00 #3: Language/working memory vs. “looks like CAS” 14:15 #4: Hearing impairment (HF cues, fricatives/affricates) 17:10 #5: Motor speech considerations 20:05 #6: Structural constraints (open bite, dental) 22:40 #7: Stimulability with maximal cueing 25:00 #8: Older start age, entrenched habits 27:10 #9: Intensity/attendance 28:45 #10: Environmental barriers 30:45 The 3 levers: complex targets, DTTC, 80% challenge point 38:00 One-rep-a-day home carryover that actually sticks Call to action: Stop reinventing materials. Make your work easy with effective, educationally-rich SSD tools at your fingertips—complex target sentence strips, paragraphs, and movement-literacy activities ready so you can focus on cueing, not prep. 👉 Join the SIS Membership: https://www.kellyvess.com/sis

If you work with children with autism who are minimally speaking, this episode is a must-listen. We’re breaking down why the “Look at” sentence strip has been a total game-changer in my therapy room—and why it consistently helps children begin to speak, connect, and comment on the world around them. After 25 years of practice, I can tell you this tool does more than encourage speech—it builds neurological pathways for speech to flow. You’ll learn: ✅ The neuroscience behind why repetition and motor consistency matter ✅ How DTTC and “look at” work hand-in-hand to build automaticity ✅ Why “look at” is far more powerful than “I want” for developing joint attention ✅ How to pair high-tech AAC with low-tech sentence strips for best outcomes ✅ The 10 reasons this strip transforms therapy for children with autism. This episode is full of practical insight, real-world examples from my SIS members’ “back porches,” and evidence-based strategies that rewire how we think about early speech intervention. 🎧 Tune in, and then grab your own Look at sentence strip and watch your minimally speaking students light up the room. 💫 Join the SIS Membership today for access to the weekly movement- and literacy-based therapy materials that pair perfectly with this episode—complete with parent emails and ready-to-go Google Slides for your whole group sessions. 👉 https://www.kellyvess.com/sis Thanks for joining me at today’s drawing board for a better tomorrow, 💚Kelly

Discover how a 2025 Nature autism study transforms early intervention in speech language pathology. Learn how family history, genetics, and executive function shape assessment, therapy planning, and lifelong communication outcomes. If you work with children with autism, this episode will change how you think about early intervention forever. A major 2025 study published in Nature titled Polygenic and developmental profiles of autism differ by age of diagnosis has revealed that early onset autism and later developing autism are not the same. This is one of the largest autism studies ever conducted, examining more than 47,000 individuals around the world. The results reshape how we understand autism heritability, family psychiatric history, and executive function development. In this episode, you will learn: ✅ Why early autism diagnosed before age three is genetically distinct from later developing autism that emerges in middle childhood or adolescence ✅ How family psychiatric history, including ADHD, anxiety, depression, bipolar disorder, and substance use predicts later developing autism ✅ Why the DSM 5 removal of the age three cutoff was not only progressive but empirically supported ✅ How this research should change your parent input forms and follow up recommendations ✅ Why executive function including attention, cognitive flexibility, and self regulation is the bridge between prevention and intervention This study confirms that autism can emerge at any point in development when social and academic demands exceed a child’s executive function capacity. That finding changes everything about how we evaluate, how we plan early intervention, and how we empower families. If you are ready to move beyond reactive labels toward proactive, capacity-building intervention, this episode will show you how to do exactly that. 💡 Join the SIS Membership at https://www.kellyvess.com/sis to access weekly movement-based literacy and language activities that build executive function, the foundation for lifelong communication, learning, and independence. Source: Zhang, Y., et al. (2025). Polygenic and developmental profiles of autism differ by age of diagnosis. Nature, 631(8046), 455–468. https://pubmed.ncbi.nlm.nih.gov/41034588/ Note: The diagnosis of Autism is an interdisciplinary process. In the U.S. public school system, a psychologist, social worker, and SLP are minimally required. In private settings, most insurers require a psychologist, MD, or psychiatrist with an allied health professional, such as an SLP.   

If you work with minimally speaking children or children with autism, this episode is a must-listen. Speech-language pathologist Kelly Vess takes on the five biggest myths about high-tech AAC (augmentative and alternative communication)—and backs every point with current peer-reviewed research. Learn why high-tech AAC devices: ✅ Do not require self-regulation or joint attention first ✅ Are not too complex for preschoolers ✅ Increase social interaction rather than limit it ✅ Should not be constantly customized ✅ Must be provided—and supported—by public schools under IDEA and ADA Kelly breaks down each misconception, explains how to blend high-tech and low-tech AAC for multimodal communication, and challenges you to D.S.D.—Do Something Different—instead of waiting 17 years for “research-to-practice.” It’s time to empower our minimally speaking students with robust, research-driven voices. Whether you’re an SLP, special educator, or early-childhood professional, you’ll walk away ready to advocate for access, staff training, and parent coaching in AAC implementation. 👉 Join today at www.kellyvess.com/sis