Present Notes:
Able to rethink every part you realize about teletherapy? 🎯 Be part of Hallie as she chats with Nanette Cote, M.S., CCC-SLP—a licensed speech-language pathologist with over 30 years of expertise specializing in Childhood Apraxia of Speech (CAS). Contemporary from presenting on the 2025 Nationwide Apraxia Convention, Nanette is on a mission to interrupt the stigma that speech remedy should occur in particular person. She’s flipping the script on digital speech remedy, exhibiting how teletherapy—when paired with research-based strategies like DTTC, Kaufman, and PROMPT-informed methods—might be equally (if no more!) efficient. When you’ve ever questioned whether or not teletherapy can actually ship outcomes, this passionate advocate for accessible care is about to alter your thoughts utterly!
Here is what we realized:
- Breaking the stigma that speech remedy should be in particular person—teletherapy might be equally efficient with analysis and caregiver assist.
- Highlights teletherapy advantages: accessibility, family-centered care, and versatile home-based studying.
- Creating programs for caregivers of children start–10 on speech and language growth and when to hunt assist.
- Programs give dad and mom data, methods, and steering to assist communication at residence.
- Goals to bridge the hole between skilled remedy and each day parenting routines.
- Urges SLPs to share programs with households as instruments to spice up progress between periods.
- Key message: caregivers don’t want a analysis to start out—data is step one.
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TRANSCRIPT
00:00:00 Hallie: Hey there SLP, I’ve a fast query for you. What should you might have only one e book in your shelf that truly will get the challenges of working with center faculty and highschool college students? Effectively, it is right here. Effectively, really the pre-order is right here, however hey, I am so excited to let you realize that my model new e book, The Secondary SLP Information is accessible for pre-order. And while you pre-order, you get an unique bonus that you simply will not wanna Miss. It’s filled with actual discuss methods, fast suggestions and inspiration that you should use along with your center faculty and highschool college students or all 12 months lengthy. That is the proper e book for a e book membership, a grad pupil group, or simply flipping by means of while you’re caught and in a IEP writing spiral.
00:00:51 Hallie: So head to speechtimefun.com/pre-order or head to my Instagram and ship me a DM with the phrase pre-order and I’ll ship you the hyperlink so you’ll be able to pre-order now and I can not wait so that you can get your arms on this e book in November however the sooner you seize it the higher the bonus.
00:01:17 Hallie: Welcome to SLP Espresso Discuss, the podcast designed completely for speech language pathologists who work with older college students, grades 4 by means of 12. I’m your host, Hallie Sherman, your SLP behind Speech Time Enjoyable, the Speech Retreat Convention, and the SLP Elevate Membership. And I am thrilled to convey you conversations, methods, and insights that provides you with the jolt of inspiration that you simply want. Whether or not you are tuning in throughout your morning commute, on a break in between periods, and even throughout a well-deserved leisure time. I’m right here for you every week. Let’s do that SLPs.
00:01:57 Hallie: Hey, hey, and welcome to a different episode of SLP Espresso Discuss. I do know loads of you might be fascinated with teletherapy, eager to dabble into teletherapy, wasn’t positive what sort of instances you’ll be able to and can’t have and the way do you contain dad and mom and caregivers into the speech remedy. I do know you will love this session, this subject I’ve as we speak with Nanette Coat. Welcome to the present.
00:02:23 Nanette: Thanks, Hallie. I’m so excited to be right here and I am simply honored that you simply invited me to have this dialog. It is a good subject.
00:02:32 Hallie: Inform everybody listening slightly bit about your self and the way you bought into this ardour of teletherapy, caregivers, all that stuff.
00:02:42 Nanette: Okay, so the highlights. So this 12 months marks 30 years within the area for me. So I have been training, began as a speech assistant so I might work my manner by means of grad faculty. And it would not really feel like 30 years as a result of it appears like I am at all times studying one thing new and I nonetheless adore it. You recognize, I really like this job that we in some way receives a commission for too. It would not appear proper that we receives a commission for having such a tremendous expertise with altering lives the way in which that we’re in a position to. So I began a personal follow most likely now 12, 13 years in the past. And I used to be getting tons of calls about households actually needing a supplier for apraxia of speech, not one thing that many people get in our background in grad faculty and never one thing even actually acknowledged as a dysfunction that wanted to be handled otherwise till the final couple of a long time.
00:03:38 Nanette: So these calls received me considering, possibly on the time I used to be dwelling in Naperville, Illinois, I assumed, possibly I ought to begin wanting into some coursework. And I imply, the gorgeous factor in regards to the coursework for apraxia is I paid little or no for it. So, you realize, Dr. Strand has tons of digital trainings. then I received into, utilized and received into a sophisticated one in particular person in Chicago a few years again, all of it free, you realize, and it simply actually gave me a lot data and a lot hand-on follow to do these programs. So now I am, I believe 95 % of my caseload is youngsters with apraxia.
00:04:17 Nanette: And, you realize, over the previous couple of years since, you realize, having lived in Naperville, we moved to North Carolina. I’ve actually, actually develop into a teletherapist as a result of I had plenty of of us that had been working with me in particular person and wished to maintain the connection going. So we’re doing teletherapy and we’re doing it properly collectively, particularly for apraxia. So lately I offered on the Nationwide Apraxia Convention, which occurred to be all digital.
00:04:44 Nanette: And I coined this new time period, tele-apraxia, and sort of combining what I believe is the perfect of each worlds, teletherapy and treating youngsters with apraxia. Yeah, in order that’s sort of what introduced me right here as we speak, too. We had been speaking slightly bit about my expertise with apraxia and the way I actually really feel like teletherapy is a very nice match for teenagers with that exact analysis.
00:05:08 Hallie: So I am positive many individuals listening proper now are saying, however with apraxia, like, should not that be in particular person so you’ll be able to contact them and like assist them with their articulation and all that stuff. What would you say to that?
00:05:21 Nanette: So, I imply, that is typically, that is, there’s an enormous stigma about, oh, you realize, I’ve to have my youngster be seen in particular person. That is one of the best ways to assist them by means of this, you realize, explicit dysfunction. I am educated in immediate as properly. And after I was in particular person and utilizing immediate, it took some time to get my arms on these youngsters. And it’s totally invasive, know, it’s totally to the touch somebody’s face, even with morning, even with constructing as much as it. And it takes some time to construct that sort of belief and relationship.
00:05:54 Nanette: What I discovered is instructing the dad and mom the little methods is a little more properly acquired as a result of then, you realize, they’re acquainted with their dad and mom, they’re snug, they’re getting the assist they want. So I really feel like they sort of step in after which they know the immediate to make use of after we’re not in a speech session in order that they may help their youngsters out and alter that motor plan. As a result of if we, you realize, work for a pair hours per week and do the immediate and do all that additional assist to get them to the appropriate motor plan, it means nothing in the event that they’re spending one other hundred hours per week doing it unsuitable. It is not going to alter.
00:06:31 Nanette: So I believe instructing the dad and mom to get arms on has actually helped. And to be trustworthy, DTTC, the dynamic temporal and tactile cueing method, it begins with you working, speaking on the identical time with the kid. And I’ve seen this miracle occur the place, you realize, particularly on-line, the place I can simply sort of zoom in shut on my face. They will simply watch my lips transfer and the children can mirror up fairly properly. And it appears to work higher generally than touching them. In order that they get that focus. They do not have the distraction of, oh, let me take a look at that new toy on her shelf. You recognize, they can not see it.
00:07:07 Nanette: So I discovered loads of nice success with getting in shut, exhibiting them the visible. After which, you realize, they wish to be slightly impartial. So there is a huge stigma about, once more, like we must be there in particular person. And it is actually not one thing that I’ve seen make success occur sooner for these youngsters.
00:07:24 Hallie: That is so fascinating. And I really like that you simply talked about like utilizing the dad and mom as a part of the remedy. Are you able to discuss extra about incorporating and involving these caregivers and the way helpful it’s?
00:07:35 Nanette: Yeah, so we at all times have them within the session, proper? So even after I had my workplace periods, I at all times had dad and mom within the workplace and it virtually felt like slightly extra of a distraction in that setting as a result of youngsters would retreat. They do not need to work on the exhausting stuff. None of us actually do. They’d retreat to the father or mother. We lose time within the transition. We attempt to get again on monitor.
00:07:57 Nanette: Effectively, I imply, if the father or mother’s sitting proper subsequent to them then on on digital camera, it simply it provides them the protection web that they want and reduces all these transitions to sort of get them again on monitor. After which I test in with the dad and mom. So normally at first, we test in and speak about how have issues been going or through the session. If a baby says one thing out of context and I am not acquainted with it, the father or mother will chime in and assist make the communication higher by letting me know what they had been speaking about. After which on the finish, we normally test in once more.
00:08:26 Nanette: And fogeys are very, they’re lively individuals as a result of they’re ensuring the connection remains to be robust. They’re sitting there actually attending properly to the session. After which I usually use father or mother suggestions for what targets we ought to be engaged on subsequent. So I need to choose the significant targets for them and ones that they are saying very often that I am lacking as a result of we’re in a really drill particular sort of session. So I do not get, oh, that they are saying the phrase favourite 100 occasions a day, you realize, as a result of it is not out of context after we’re working collectively. So having them there and actually, I really feel after we’re in tele-therapy, the dad and mom much more engaged.
00:09:04 Nanette: Once more, they need to ensure that the expertise is working properly and that their youngster stays seated, however they’re lively individuals slightly extra so, which is ironic since we’re nowhere close to bodily one another.
00:09:15 Hallie: I really like that. And earlier than we hit document, you had been telling me a narrative about while you had been presenting nearly on the Apraxia Convention. Are you able to inform what you talked about earlier than about one of many dad and mom? That occurred in–
00:09:27 Nanette: You had been main me in and I missed that assembly. So, yeah, so we did the convention all nearly after which there have been completely different breakout rooms we might pop into simply to sort of join with different dad and mom, different professionals. So I occurred to be in a small group and there was a mother within the group and we had been speaking about, was really one other mother within the group who had a newly identified youngster with apraxia, like actually the day earlier than.
00:09:51 Nanette: And he or she was already stressing out about, my gosh, we do not have anyone anyplace close to us to offer remedy. You recognize, we’re not less than an hour, two hours away from the closest therapist who’s been educated. And so she was stressing out. So I chimed in with, hey, you realize, I occur to have completed this presentation on how I exploit teletherapy very efficiently with treating apraxia. After which one other mother chimed in and mentioned, properly, I watched that. And I need to thanks as a result of I’ve really been utilizing teletherapy with my son and it is going rather well, however nonetheless felt like possibly, you realize, we ought to be in particular person with this therapist.
00:10:31 Nanette: Perhaps I ought to be promoting my home. Perhaps we should always transfer. And he or she thanked me. She mentioned, thanks for giving me that, you realize, sort of aid in I am not doing a disservice to my youngster by having him take part in teletherapy. would not must be proper there, proper down the road. So sure, she simply felt like I can breathe, it is going properly, I acknowledge it is going properly. And I’m doing every part I can for him, even when we’re not in the identical room with a therapist.
00:10:58 Hallie: I really like that as a result of so typically we promote ourselves brief ourselves that we are able to present enough remedy and be impactful if it is digital. And that is so not true.
00:11:12 Nanette: Yeah. And folks say too, you realize, like, it should be exhausting to not have the ability to like give a excessive 5. Effectively, we nonetheless get excessive fives in teletherapy and I nonetheless get to know the children. I discuss with the dad and mom about what do they like? So I construct in little reward movies that I imply, and the children love that they love a video far more than sitting and enjoying one other recreation that is going to be exhausting for them to speak by means of. In order that they like that little break of, I get to observe slightly Lego interactive. You recognize, that is enjoyable.
00:11:41 Nanette: So yeah, I believe there’s simply loads of issues that we miss in assuming you’ll be able to’t construct an important relationship in tele-therapy and you actually can. So I imply, I’ve received youngsters that I’ve by no means even met in individual that I am seeing nearly and the bond is simply as robust as these youngsters that I have been sitting in the identical room with.
00:12:01 Hallie: I really like that. You talked about earlier than I like zooming in and getting your self nearer to the digital camera as one of many methods for working with the scholars. Are you able to share one other one which is perhaps assist to somebody listening that’s questioning how do I work with these youngsters?
00:12:15 Nanette: Yeah, yeah. So I’m pulling up my little slides right here from the presentation itself so I do not miss something. Yeah, so an enormous a part of what I do within the apraxia remedy is absolutely primarily based on DTTC and loads of that’s constructing by means of ranges of assist for imitation after which spontaneous manufacturing. So we do not use toys. We do not need the children to have toys to be trustworthy, which is one thing that I used to be slightly stunned to listen to after I went to the trainings as a result of I imply, 30 years, I exploit toys. Like that is, that is my jam, you realize? And the way do you get a child to have interaction with you? Like, how is that any enjoyable?
00:12:53 Nanette: Effectively, it’s enjoyable. And the toy within the hand is distracting them from the motor level they must deal with. It is like yet another factor that they are targeted on that can most likely forestall them from imitating the sound the appropriate manner, as a result of they’re not likely 100 % there with you. once more, like in teletherapy, it is simply me and the digital camera after which just like the little rewards, like I mentioned. In order that half is actually wonderful as a result of I haven’t got youngsters once more that I’ve to redirect and transition again as a result of, oh, they noticed the bubbles that had been on the market and so they need to go play with that, you realize.
00:13:30 Nanette: I really like the zooming in, particularly within the very starting, as a result of it takes away from anything that may very well be searching on me, like my eyes and making an attempt to interpret that nonverbal. I simply get shut sufficient to my lips to allow them to actually simply see the motion. And it is wonderful how properly they’ll sort of seize that. Almost about evaluations, the good factor is I haven’t got to arrange an iPad or hand… father or mother an iPad to document the session. So I can return and play it once more. I simply click on document.
00:14:00 Nanette: So, you realize, after which you must like preserve the child in that very same spot or dad and mom operating across the room with them, audios reducing out. And in order that half I really like as a result of I am simply click on and now I’ve received it recorded so can return and take a look at it once more later. A number of the different issues that I really like are the annotation options. So I’ve received some youngsters who’re nice at studying their targets. So I will like put out an inventory of phrases that we’ll follow. Generally I will use wheel of names in order that they spin it, they love that. Like they get to spin the wheel to select the subsequent phrase for follow.
00:14:34 Nanette: After which I will both, you realize, generally I put the phrase on the display that we’re training in order that they’ll see it, make a connection. Generally I do not need the phrase, so I simply use a fast annotation to erase it. It is simply, it is good. I exploit a mouse to rapidly navigate by means of these issues. If I really need them to deal with one thing, can spotlight the phrase.
00:14:55 Nanette: I can transfer to the subsequent degree. So if abruptly I am like, oh, I believe they might deal with like placing a number of extra phrases collectively than that only one phrase, I can sort it in. So there is not any delay. After which you do not lose consideration since you’ve received their focus already. And it is like a mini second to, mini second is not actually even a phrase, however it’s a mini second to sort of get them to the subsequent degree actually rapidly. After which past that, simply the wonderful capability to not must drive your child to a remedy session, you realize, and to simply save all that point, particularly for these households who’re, really feel so dangerous, like driving an hour one technique to get to a therapist when we’re additionally asking them to do this two or thrice per week as a result of the motor plan goes to make a greater change should you meet in shorter segments than one lengthy one.
00:15:47 Nanette: So households are driving and so they’re like, properly, we’re right here. Let’s get in so long as we are able to. That one hour session is not going to do as properly for these youngsters who might get possibly two or three periods damaged down, like 20 minute blocks. That is going to make the larger change. That is backed by analysis. So, gosh, I do know there’s like one million different little advantages. Oh, so it additionally, the caregiver involvement.
00:16:12 Nanette: So I’ve at all times received a father or mother there. They are not in a ready room. They’re proper within the session and so they must be shut by as a result of once more, like, and it rarely occurs. I give plenty of tidbits about how we are able to preserve a connection robust. In order that they normally do not lose the connection, however the child might navigate to one thing and click on, and the father or mother desires to verify, nope, we’re proper right here. We’re gonna keep right here. I can even disengage their mouse in order that they can not begin doing what they need to do as a substitute of what we’re purported to be engaged on. So yeah, I believe these are the biggies. These are my prime causes to like Teletherapy. Plus I am saving some huge cash not shopping for toys anymore, know, simply preserving it.
00:16:54 Hallie: And the advantage of doing it, you are able to do it again to again, versus if it was in particular person, you is perhaps driving home to accommodate, otherwise you might need… I do know after I was in a clinic setting, I had so many cancellations. I really feel like after they must go to you, they only cancel. That simply occurs extra typically.
00:17:10 Nanette: Effectively, no, imply, whether or not or a sibling sick and so they cannot are available, like all of that is averted by. imply, I do see much more attendance with teletherapy as properly. That is an important level. I completely forgot about that one, particularly if, you realize, they must convey a sibling alongside to the session after they’re driving to you and that sibling’s not feeling too properly. You recognize, we will not actually threat having that child be current on this session along with your consumer. So it is quite a bit simpler to simply say, oh, simply go within the different room and activate the pc. I received you.
00:17:43 Hallie: Immune system as properly.
00:17:48 Nanette: Proper. True. True.
00:17:50 Hallie: I adore it. I adore it. Effectively, that is so, so useful. Thanks a lot. And like, I really like listening to that it’s attainable to have impactful remedy, to nonetheless make these connections, nonetheless have that rapport and nonetheless be so, like wonderful that you’re along with your shoppers by way of teletherapy. Are you able to inform everybody listening slightly extra the place they’ll study extra about you and study extra from you?
00:18:16 Nanette: Oh, yeah. Yeah, thanks. So I am within the technique of rebranding in my classes and speech web site and reaching out extra to caregivers about this subject and plenty of others. So I really feel for these households that come to me and I begin working with them and so they say, you realize, I want I knew what was anticipated at this degree, this age. I want I knew who I ought to have gone to for early intervention, who I ought to have talked to about that. And I imply, I believe we’re in it, proper? Like we’re within the thick of it and we simply overlook generally that, oh yeah, you enroll right here for early intervention otherwise you go right here for this.
00:18:57 Nanette:So I am making an attempt to coach households extra. And my hope is earlier than the tip of this 12 months to launch a number of programs. And my first couple of programs will all be about what to anticipate at completely different ages of growth. So I’ll begin at start and I’ll go all over 10 years previous to assist speak about, oh so, you realize, now you’ve got received an early elementary age youngster, what is the expectation for communication? Not simply, you realize, what sort of sentences they need to be placing collectively, like what’s their play appear like? What’s their social language purported to appear like?
00:19:27 Nanette: So I’ve spent an enormous a part of my profession in early intervention and now with my personal follow, that is sort of my area of interest too, the early age youngsters. However I’ve additionally labored within the faculty programs. I’ve labored with youngsters from kindergarten, preschool, all the way in which as much as highschool. So I’ve received like a bunch of expertise to have the ability to relate to households like, properly, here is what is going on on in an IEP and right here is the place you get began with remedy and right here is the place you carry your youngster by means of remedy. So my hope is to be e a bridge for these households to grasp slightly extra what to anticipate and the place to get the assets and assist that they want for his or her youngster. I do not need to substitute remedy.
00:20:08 Nanette: That is not my intent. It is extra about like how I can higher assist households perceive what is going on on of their kid’s growth. After which in the event that they are eligible for providers, you realize, what helps they’re getting within the faculty, what these appear like, what they imply, as a result of I’ve seen throughout this profession that the extra you may get households educated and concerned of their kid’s work. I imply, you may most likely know that youngster much less. You will not see them for a few years to return.
00:20:37 Nanette: They’ll make an even bigger stride when your dad and mom are on board. They actually perceive what is going on on. It empowers them to be higher advocates for his or her youngster too. In order that’s my hope is that simply preserve empowering households to be a powerful advocate and to discover a place to show the place they do not know the place to get began. imply, particularly, apraxia is a really small p.c of our inhabitants, possibly as a result of not as many youngsters are being examined to establish them.
00:21:03 Nanette: However so a lot of these households actually, you realize, at all times come ahead and say, like, I spent years not understanding why my youngster wasn’t making any enchancment in conventional speech remedy, as a result of it’s a very completely different method to remedy. So I really feel for them. I want that any individual mentioned, hey, know, faucet them on the shoulder like, what about this? You recognize? And so I need to be that particular person tapping them on the shoulder saying, hmm, have you considered this? And possibly ask any individual and go right here to seek out you, proper, assist. In order that’s my mission in life. Once more, I hope to get that out on my web site within the subsequent few months.
00:21:40 Hallie: Adore it. And we’ll have hyperlinks within the present notes, everybody, so that you guys can share these assets with the shoppers, dad and mom that you simply’re working with, share it with, you realize, pediatricians to allow them to share it with their households, all that stuff. So thanks so, a lot, Nanette. I at all times finish my episodes with a joke, since jokes construct rapport and so they’re very language-based. And so since this episode is airing within the fall, I assumed this one could be acceptable. How do you get a squirrel to love you?
00:22:11 Nanette: I do not know, I am afraid of squirrels, so I normally run from them.
00:22:16 Hallie: Act like a nut. Like corny dad jokes guys are right here each week so you’ll be able to steal them and use them along with your college students to once more construct rapport and have loads of enjoyable. And hey, there are some R sounds in that one squirrel. So why not? You need to use that one as properly. So thanks so, a lot. We’ll hyperlink all the data within the present notes guys. So test it out. And till subsequent week, everybody, keep out of bother. Thanks so, a lot, Nanette.
00:22:45 Nanette: Thanks. You are the perfect, Hallie. Thanks.
00:22:53 Hallie: Thanks a lot for tuning in to a different episode of SLP Espresso Discuss. It means the world to me that you simply’re tuning in every week and getting the jolt of inspiration you want. Yow will discover the entire hyperlinks and data talked about on this episode at my web site, speechtimefun.com. Do not forget to comply with the present so you do not miss any future episodes. And when you’re there, it might imply the world to me should you would take a number of seconds and depart me an trustworthy overview. See you subsequent week with one other episode stuffed with enjoyable and inspiration from one SLP to a different. Have enjoyable guys!
00:23:34 Hallie: Hey there SLP, I’ve a fast query for you. What should you might have only one e book in your shelf that truly will get the challenges of working with center faculty and highschool college students? Effectively, it is right here. Effectively, really the pre-order is right here, however hey, I am so excited to let you realize that my model new e book, The Secondary SLP Information is accessible for pre-order. And while you pre-order, you get an unique bonus that you simply will not wanna Miss. It’s filled with actual discuss methods, fast suggestions and inspiration that you should use along with your center faculty and highschool college students or all 12 months lengthy. That is the proper e book for a e book membership, a grad pupil group, or simply flipping by means of while you’re caught and in a IEP writing spiral. So head to speechtimefun.com/pre-order or head to my Instagram and ship me a DM with the phrase pre-order and I’ll ship you the hyperlink so you’ll be able to pre-order now and I can not wait so that you can get your arms on this e book in November however the sooner you seize it the higher the bonus.
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