Reducing Seclusion & Restraint in Autistic Students: Using CPS in Nonspeaking & Echolalic Kids

Reducing Seclusion and Restraint for Autistic Students: Using CPS with Nonspeaking and Echolalic Communicators with Stephanie Izzi and Sarah Hamel

Stephanie Izzi (she/they) is co-founder and Executive Director of Autism Included. An autistic adult herself, Stephanie uses her unique insight into neurodivergent communication and learning to support inclusion for autistic students. Stephanie works as a speech therapist, autistic inclusion specialist, and augmentative and alternative communication (AAC) expert. Her background as a research scientist provides a unique approach to their work, combining evidence-based practice and practice-based evidence to drive her workshops and practice. Stephanie completed their PhD in Genetics at Stony Brook University, and M.S. in Communication Sciences and Disorders from Massachusetts General Hospital IHP.

Sarah Hamel (she/her) is co-founder and Director of Strategic Initiatives at Autism Included, where she spends her time building a coalition of individuals and organizations passionate about inclusion for autistic students, particularly our youngest learners. She is always on the lookout for partnerships to expand the collective capacity for change. In addition, she continues to practice as a Speech Pathologist specializing in autistic learning and development including AAC. In her free time she enjoys making music, writing, and listening to funny podcasts

Transcript

Guy Stephens - 0:12  

Well, hello and welcome everybody. My name is Guy Stevens. I'm the founder and executive director of the alliance against seclusion restraint. And you are here for another ASR live our live video podcast series that we do. And we've got a exciting program in store for you today, as always, those of you that might not know who we are or who I am. The Alliance against seclusion and restrain is a nonprofit organization that we started about four and a half years ago, time flies. And we do a lot of work around punitive discipline around responses to behavior, while a work started really about things like restraint, seclusion, it's really broader than that. It's often about restraint, seclusion, suspension, expulsion, corporal punishment, very often the things that are being done to kids and youth often in the name of behavior. And we believe that we can do better. So, we do a lot of work about trying to highlight better ways of supporting kids and youth moving away from outdated behavioral and crisis management approaches that don't, aren't only not effective, but are often causing harm. So anyway, if you don't know more about us, and you'd like to learn more about us go to our website, which is an seclusion.org. And you can learn a lot more about who we are there. I do want to tell you a couple things about our show today. Of course, I say that I'm always excited. I’m always excited and have two really amazing guests with us today. So, you get two for the price of one here. You know, we've got two amazing guests. We have Stephanie Izzy and Sarah Hamill joining us today. And I should actually rephrase that and say, Dr. Stephanie is joining us and Sarah Hamel. And they're going to be talking a little bit about different approaches that they've been using to support and work with nonspeaking and echolalia communicators, they might talk a little bit about collaborative practice solutions, but other things that they're doing as well. This is a topic that I've been looking forward to, and I know a lot of other people have been looking forward to as well. And we're really excited to have them here today. So, I do want to let you know, and I see in the comments, we already have a couple of comments here. Somebody wants to learn more about joining we’ll certainly provide you information there. But if you are watching live right now, even if you aren't, I don't care, you can tell us anyway, I'd love to know who you are and where you're from in the chat. So, if you would go into the chat, tell me who you are, where you're from, and those of you that are regular followers of our show, if you're watching, you might notice that I am not in my regular place. I'm not in my home, I am not in my office. I'm actually right now in West Virginia, as I'm helping my son get moved into college. So, a lot of exciting things going on. But yes, that is a refrigerator behind me with an Alliance magnet on it. So, you know, we're in a totally different world right now. So great to see some people already joining in and telling us where they're from. And with that, I want to give you a couple announcements, and then we will introduce our guests, I do want to let you know, as always, we always record these programs. So, these programs go out live on YouTube, on LinkedIn, and on Facebook. But we also record them on all those platforms. So, you can go back, and you can watch them later. We also make it available as an audio podcast. So, if you want to listen on the go, it's easier while you're in your car, or you're working out. You can download our podcast on iTunes, Google Play, on Spotify, anywhere you get podcasts, you should be able to find it as well. And I will just take a moment to see that we have a couple of people that have checked in already. And it's great to see people checking in. Let's just take a look here. Neurodivergent by nature excited to be here from beautiful west coast of Canada. And I had the opportunity to be on the west coast of Canada a few months ago. Fantastic. Okay, fantastic. We've got somebody here from Rhode Island. Where else do we have people joining us from? self-advocate parent family coach and longtime follower here? Okay. Excellent. Ontario, Canada. We've got a lot of folks from Canada today. West Virginia University alumni here, awesome. So, we've got a lot of people joining in telling us who they are and where they're from. I've got a mother here who has a child with autism and a member of the advocacy group and we've got a Divina from Connecticut. So, we've got a lot of people joining us. So let's get to the exciting part I want to introduce to you today our very special guests and get to what you're really here for which is the here this amazing presentation you're going to hear. So let me begin and I'm going to give you a little secret. These two are related. These two are sisters, and I've had the chance to meet them, gosh, some time ago. I think it was a couple of years ago, you had connected through the alliance, and we talked and had a great conversation and have gotten to talk and try to collaborate ever since. And of course I'm always pointing people your direction. I'm saying, hey, I know these amazing sisters that are doing this incredible work. So, we'll talk a little bit about your background. So let me do your introduction here. And then we'll talk a little bit more. Dr. Stephanie Izzy is the co-founder and executive director of autism included and autistic adult, herself. Stephanie uses her unique insight into neurodivergent communication and learning to support inclusion for autistic students. Stephanie works as a speech therapist autistic inclusion specialist augmentative alternative communication, or AAC expert. Her background as a research scientist provides a unique approach to their work, combining evidence-based practice and practice-based evidence to drive her workshop and practice. Stephanie completed their PhD in genetics at Stony Brook University and MS in communication science, and disorders for Massachusetts General Hospital. We have Sarah Hamill is the co-founder and director of strategic initiatives at autism included, where she spends her time building a coalition of individuals and organizations passionate about inclusion for autistic students, particularly our youngest learners, she is always on the lookout for partnerships to expand the collective capacity for change. In addition, she continues to practice as a speech pathologist specializing in autistic learning and development including AAC. In her free time, it's hard to imagine you have any, she enjoys making music, writing and listening to funny podcasts. So, I've already learned something that I guess I knew about you but must have forgotten but so I didn't know that you made music or else I would have said you could have done a musical intro for us. Maybe it's not too late for that. So, we cannot always think about that. So, I want to first, welcome you both you are two amazing people that are doing I mean, I read your intro, but I know more. And I know like you've started a school and you're following something you're passionate about. And you're doing things and making change that I think is important this world. So, Stephanie Sarah, welcome. And thank you both for joining me today.

Sarah Izzi Hamel - 7:10  

Thank you so much for having us. I feel I in preparation, I went back and listened to the back catalogue of these. And I feel like I'm streaming among giants. This is such an incredible series that I'm just really excited to be a part of it. So, thank you for having us. Thank

Guy Stephens - 7:27  

You guys are giants to me. So, you know, you're in the company you belong in staffing and fantastic to have you here. I know for a fact that you are right now looking at your presentation because you can't see us. But we can see you but Stephanie, thank you so much for being here. And thank you for all you're doing.

Dr. Stephanie Izzi - 7:44  

We're really excited about this. Thanks. Me too.

Guy Stephens - 7:48  

I'm just going to look real quick and see that we have a couple more comments. It'll just mention before we get started. Adele’s parents, autistic kiddos and autistic SLP, from Memphis, Tennessee. We've got Tricia regular listener and community member here from Idaho. We've got Cassie Griffin Bennett, who I think you've both met and collaborated with autistic and ADH mom of autistic young kids, including nonspeaking, four-year-old who started on robust high tech AAC at the age of two in Washington. So, and also a Alliance volunteer. So, we've got some great people watching here live. And you've got an exciting presentation. So, what I'm going to do now is I'm going to bring your presentation up on the screen and the those of the rest of the world that's watching right now, they will see your presentation and they will see the three of us, you have agreed that you're happy to take questions during the presentation. And what that means is I'm going to hang around, but I'm going to be quiet, unless questions pop up. Or maybe there's a question that pops up in my mind. And if we have questions, I will bring those up on the screen. And I will give you an opportunity to respond to those. If we get to a point where we've got so many questions that you, We need to hit the pedal and metal and finished presentation, we can do that as well. You just let me know. But we're in for I think an hour or so have a fantastic presentation. I know, people have expressed a really strong interest in this topic. Because I think there's some gaps in information that are out there right now and, and people looking for information. So, with that, your slide deck is up and I'm going to be quiet and let you take it away. And I'll just break in every once in a while, as we have questions. And again, remind you that are that are listening or watching right now live. You can put questions in the chat at any time. And we'll try to get through those as we can. And of course, if you haven't already, introduce yourself, let us know who you are and where you're from. And with that, Sarah and Stephanie, take it away.

Dr. Stephanie Izzi - 9:49  

Thank you so much. And we had a great introduction from you. Just to say we started as a speech language pathologist in public schools and we're also with parents. So, we have a lot of different perspectives going into this. But we've seen kind of firsthand the seclusion and restraint that can happen in schools, particularly in the autistic population, and particularly in the non-speaking or regulate like autistic population. So, it's kind of personal and professional for us. We like I said, we have a lot of perspectives.

Sarah Izzi Hamel - 10:27  

So, when we think about, I just wanted to briefly touch on why as a as a group of people concerned with seclusion and restraint in general, why should we be especially concerned with seclusion, the use of these practices with the nonspeaking, and echolalic population. First of all, we know what's happening, seclusion and restraint, we also know it's chronically under reported. We know that it had these practices have the potential to cause very great harm that's long lasting, including physical harm, emotional harm, not that those are distinct necessarily from each other. And we also know that seclusion and restraint practices disproportionately affect children with disabilities, The figures are usually around 78 to 80% of seclusion and restraint events are toward a person with a disability. And oftentimes, those people are in segregated settings, and no one is able to report other than the staff. So, you kind of have an event happening to a child, that child can't report and none of the other kids can necessarily report either. So, relationships-based approaches like collaborative problem solving, are touted as one of the best ways to address challenging behaviors and that's been born out in research. Absolutely, they are very good effective approaches. But parents of nonspeaking and ecolodge children are left wondering where my child fits into this and if it's a technique that's relying on verbal communication? Can my child even participate in this? And that's where we saw the need in practice to have something overlaid onto these approaches. And we call it the autism included model. Oh, yes, sorry, that inhibition was supposed to come first can participate. Yes, they can.

Dr. Stephanie Izzi - 12:27  

Sorry, just to jump in and clarify. So, our approach is based on a lot of raw screens work with collaborative and proactive solutions. We're not, you know, trained practitioners of that particular approach. But we use a lot of that philosophy, and we'll talk about the other philosophies and foundations of the work we do around behavior, particularly in this population. But we do, as guy said, our introduction, we do have a school now, and we have children of our own, we have a school now, where we are working with students who fit that profile. And we use a lot of these philosophies as the foundation for our approach to what would be called behavior, right. And this might be familiar to a lot of you with the reframing of behavior that kids do when they can. So, shifting that mindset to kids or being defiant or lazy that they're having difficulty meeting expectations of adults, right. So, when there are stressors, you can reduce them, when there are unmet needs or lagging skills, or however you want to frame it. The child for whatever reason can't meet the adult’s expectation in the moment. So, they're demonstrating a behavior. The responsibility sort of shifts from the child to the adult. In that situation, what can the adult do to help the child meet expectations? So, some of the other things that are sort of supporting the approach that we have are neuroscience, and psychology of co-regulation. The fact that rewards and discipline a lot of the behavioral approaches don't necessarily work and don't generalize and don't work long term. I also check out the work of Amanda Dikeman, who has a low demand parenting

Sarah Izzi Hamel - 14:30  

I was just going to say we have to give a shout out to Cass in the chat, who was the one that introduced us to Amanda Dikeman’s work, and I felt like I had so many missing years. This is great. I love it. So, thank you

Dr. Stephanie Izzi - 14:41  

Really good and a great fellow on Facebook. Yet again, when you think about these approaches. We think of lagging skills and for children who are non-speaking or equally, like you'd probably put language is one of those lagging skills, I would say push back on that a little bit. But obviously, the communication that some of our children have or not is not effective in the moment, it's hard. And even for kids who have a lot of language skills, when they're in that situation where they're demonstrating a behavior, language isn't always accessible for them, right? So, language is one of those skills that you might identify as needing support. In that moment, there's a challenging behavior, and an expectation of the adult. So, the child is demonstrating some behavior, the adult has an expectation that isn't being met. The idea is that you're going to collaborate with your child, I'm coming up with a solution that's mutually agreed upon that works for to meet that expectation. So, we're bringing to this is that those solutions and how you get there, and it must be autism informed, and it has to use a total communication approach. So, we're really going to talk about what those two those are the two key pieces what that means. So first, I'm just going to go quickly through the differences between communication, language, and speech. So, we're talking about nonspeaking students echolalic students, everyone has communication, it's just sending messages that contain information. So, you can use behavior as communication, a facial expression, everyone communicates in a variety of ways, including these non-linguistic ways. So that's a clear expression of something's disgusting, someone takes a bite of something and makes that face, you kind of get that message. It requires no symbolism, no language. Language is a symbolic form of communication and involves social interactions. And you can have an emoji or written language or spoken language, a lot of AAC platforms are linguistic. So, there's symbols on a tablet that a child can touch, and it might say the word or pictures on a board. There's a lot of variations on that approach and that's the augmentative and alternative communication devices are not always but often linguistic. In that way, sign language is a language. and speech is a spoken form of language, right. So that requires everything to be working muscles and brain coordination to produce the speech sounds in the language that you're speaking. So those three things are different. And when you're collaborating with children who are non-speaking, who do not yet have a really robust language system, you're using all forms of communication, you can be speaking, you can be using your expressions, and your body language, positioning and posture, and all of these things to communicate. And so can the child that you're communicating with.

Sarah Izzi Hamel - 17:53  

I want to throw out there that all of us use all of these phones, we or I anyone uses non spoken communication, you write things, you're using symbols in your environment, we use, obviously nonverbal communication, totally nonlinguistic, non-symbolic communication. If I take a bite on there. You know what I mean? That's, that's nonverbal communication. Obviously, I'm a person that uses speech. But I should say, not all, most people will, will kind of seamlessly travel through all these forms of communication. So, it's not like we have to totally reinvent the wheel. When we're working with a child who primarily uses one of these modalities, it's something you already have the capacity to model for them, and engage with them in that place, because you're already doing it.

Dr. Stephanie Izzi - 18:46  

You might have heard the phrase behavior is a form of communication, and that is sometimes true. Sometimes, your child or you or whoever is doing a behavior that is intended to send a message. So, I think of things like a child takes a toy from the child they hit, you know, their kid that took their toy, they're angry, they're suppressing that, they're, they're mean to express it. And they're really clear about it. That's a form of communication. But sometimes it's just an indicator of something internal. Kids really excited and they do something or they're in pain, or they're hungry, and that's causing a behavior, it could be a reaction to something in the environment that's, causing a certain behavior to occur, the bright lights are distracting, or there's a noise that I hear that is causing me to do some behavior. But all these factors are interactive, and the behavior is the observable thing that's giving information, right? So that goes two ways I can provide information with my behavior, I can interpret behavior to kind of get at what the problem is, when we're talking about challenging behaviors.

Guy Stephens - 19:58  

 He said seven if I could just interject up in here real quick, kind of on that last slide. Of course, we've been hearing that a lot, the idea that behavior is communication. I also happen to be a big fan of search anchors work and research. One of the things that he says it's always resonated with me is the idea that, behaviors biology, right? You know, when we think about communication, sometimes we think very intentionally, you know, that people are trying to communicate something and when we think about behavior, being biology being its neurotransmitters, its hormones, it's our threat detection system. You know, we it takes away that fact that, you know, not all behavior, even though it may be communicating something, you know, I think people sometimes equate communication with an intent. I think it's really important to make that point with people that sometimes this is this bottom up, it's our body. It's our nervous system. It's happening on behalf of us. Anyway, I always love that thought I kind of curious to hear your take on that.

Dr. Stephanie Izzi - 20:56  

Yeah, I would say, you can try to teach Sarah, not to jump and scream, and she sees a spider. She's worked really hard on that. It happened like that is a startle, right. It's something that is kind of not the listener. So, I think that that is a really good point and what I'm trying to get at here is it's not always under the control of the person doing the behavior.

Sarah Izzi Hamel - 21:19  

It's not always what they wish were happening, or what they would want to be expressing in that moment. Like, I don't want to scream that way. But it's happening to you, it's coming through you really, and it's still valuable information. I think that piece of intent is so huge to recognize that while it's still important information, it's communicating something to us. Just because it's not intentional, doesn't mean it doesn't count.

Dr. Stephanie Izzi - 21:47  

This is that sort of drilling down into why a child is not meeting an expectation? Why are they doing that behavior and there's lots of ways of thinking about behavior, right? There's lots of ways to break it down and categorize it. I'm not really concerned about which way you're using, other than to be really broad about it, right? Like, it could be something going on inside of a child or something in the environment that's causing the behavior. A lot of it has to do with communication and relationships. A child who doesn't have other ways of expressing an adult who doesn't have other ways of expressing sometimes it's, you can't help but do the behavior and sometimes it is just this is the only way I have of expressing something or communicating something or it's what I want to do I need control over that thing. So, there's there are many ways of thinking about why a behavior might be occurring. That gets out this idea of when we're doing an approach that requires thinking about what are the skills that the child doesn't have to meet the expectation, right? What are the causes of the behavior? And how do we find a solution that's beneficial to both of us without necessarily a robust amount of language, we do something called co construction and that is sort of where we're starting. So, we form a hypothesis about why the behaviors occurring. Then we use autism informed and relationships-based communication approaches to co-construct the reason and the solution kind of at the same time, and this process is really responsive. So, it has to kind of occur in the moment usually or around a particular situation and we might be wrong. And it might take some back and forth with the child to collaborate on that solution.

Sarah Izzi Hamel - 23:42  

I was just going to jump in and say that's why I feel like the piece of responsiveness is so critical, because I feel like a lot of folks might feel like they can form a hypothesis, they can test the hypothesis. But if you're wrong, how do you recognize you're wrong? Will the behaviors be continuing? How were you able to pivot? I'm having that basis of understanding. We'll talk about the specific thinking and learning and communication differences with the autistic learner, or the narcissistic person, having that background allows you to make better informed hypotheses that are responsive to that particular child and what is going into that for them.

Dr. Stephanie Izzi - 24:28  

Involving the so-called instruction is a collaborative process. So, we're, we'll get into some examples. And it might make clear but you're not just saying like, oh, the child can't share their toys, I'm taking all the toys away. That's not that would be a hypothesis. You can test it that way. But that's what we're trying to do is use all those principles of respect and autonomy and all those relationships-based approaches to come up with a solution that we're really working with the child to implement. So, the point isn't to get a child to understand what your expectation is, that is not really the point, it's not to get them to accept your solution. It really is that collaborative process that involves both you and the child you're working with, and it's a relationship.

So, just to give an example where we kind of hypothesize that this was something going on internally with this student, we had a child who was throwing shoes. So, our expectation was okay, shoe stay on your feet. That was the expectation we had at the beginning.

Sarah Izzi Hamel - 25:48  

They were his shoes, just to clarify, he wasn't like going, taking shoes off.

Dr. Stephanie Izzi - 25:53  

This is in our classroom. So, okay, our first problem is, oh, he doesn't like his shoes on, or the shoe isn't on, right? Something's wrong. So, we're showing this child his shoes. I'm trying to see if we, he wants us to put them back on his feet, offering him a C-device with pictures of clothing items. So, we opened that up, and he would put shoes, and then sock shirt pants, you'd go through all the clothing. So, he's talking about clothing, like someone's going with the shoes. So okay, we're co constructing this solution. Let's say you don't have to wear your shoes right now. We'll put them in this cubby can't throw them, but we can put them over here. Anytime we'd go to put the shoes back on, he would throw them. So, like that wasn't quite it. He doesn't care about putting them in the cubby that didn't solve this problem. Do you not like these shoes. So, we worked with the student's family, and they got different shoes, they actually measured his foot when a size up. And we found there was a little mark on his toe and the shoes were pinching him that his foot hurt. So, this required a lot of back and forth. But the solution wasn't just to say, okay, you can't throw the shoes, I'm taking the shoes away. We are really it was a very collaborative process, and we ended up discovering that kids foot hurt, and then we can model that language, you can model language on top of it and see if you're correct. So, I think that was that process, it ended up being something going on, he was in pain and that was the way he was telling us. Another example was a student who was having meltdown behavior, just screaming and not wanting to go into the classroom and running away from the classroom, we would expect that this student would eventually go into the classroom. So, at first, we thought he just didn't want to leave his parent, which is not an uncommon thing for students who were like, Let's have the parent come in with the child to say goodbye and we'll see if that that helps. It really didn't struggle.

Sarah Izzi Hamel - 27:51  

That was very surprising for this particular student who we know very well, this particular morning, we just could not fathom what the problem could be, and everyone was scratching their heads because it the fact that they wouldn't transition in with mom, I was like, Oh, that's so I can't the wheels start going like why? What is going on? And then I literally slapped myself in the face when we finally got to it.

Dr. Stephanie Izzi - 28:22  

I think a lot of that is the curiosity piece too. So, like, not panicking, not saying we have to solve this behavior. It's very much like what is it? What can we do to help? So, we walked him outside, someone went back inside and tried to look around, and we ended up finding a vacuum cleaner. The second that moved, he got more upset when he saw it. So, we put that away, we showed him we were putting it away, and he was fine. You want to do the class, that was we didn't even notice it didn't see it in the classroom, it took a while to find out what was wrong. We tried a bunch of different things that ended up being the issue

Sarah Izzi Hamel - 28:56  

Just to throw out there to be kind to yourself, if you're also a neurodivergent person, it literally the problem was no one noticed a vacuum in the middle of the room. There was a vacuum there that wasn't there before, and I didn't notice it. Nobody noticed it kind of just blended.

Dr. Stephanie Izzi - 29:11  

In non-vacuum blinds at that point. It wasn't on so we would have thought the sound we would have kind of noticed more often but it wasn't on but that was still really upsetting and we modeled language around that but, the more you do this, you're building a relationship of trust with whoever you're working with or living with or whoever it is and it's communication, right? They're communicating something to you you're communicating it to them and you're trying different things and it's again very collaborative and we shift the focus to shift is on the adult right like that we're going to try a different thing, we'll figure this out.

Guy Stephens - 29:54  

I had to interrupt for one second, I mean the onus is shift is on the adult, like underlying multiple times it's such an important point. Because so often we look at the onus being on the child, like the child has to be the one to change, when in fact, in so many of these conversations, it really is about the adult. Anyway, I'm sorry to interrupt.

Dr. Stephanie Izzi - 30:14  

It is because my assumption isn't not only does this child not able to do this, but there's a reason they're not able to do it and we can help find out what that reason is and maybe it's an unrealistic expectation, we'll get into that in a minute. But, some of these things we have to do, and some we don't, but the onus is definitely on the adult, why is this not working? Why is what I'm doing not working? Why don't you understand all these things. So, another one that's not uncommon is hitting people and in this case, hitting people and then laughing about it. This one may or may not have been my own, that's different, and other kids we've worked with. So, the expectation is you can phrase this however you'd like. It's a safety issue. You can't hit people, that's an expectation, I wouldn't let someone hit you all those things. You can phrase that however you would like, but you can't hit people. So, our first hypothesis is it sensory? Does this child need to hit things? Is this fun? are they getting sensory input? So, let's demonstrate other things you can hit, you can hit the couch, we have lots of things to hit and throw and jump a lot of things available to kids for that sensory piece. But that didn't quite work. It was really just, we want to hit the adult, in this case, really funny about it. So maybe what I'm communicating with that is, it's really funny. So does this kid think it's really funny. So there's a couple of ways you can approach that. But I think another thing we'll talk about with is like autism informed responsiveness and neuro divergence, informed responsiveness. You can try to teach a child that it isn't funny, but it is to this. Right? So, like, that's, we didn't go that route, we made a game where we taught, the reaction is what's funny, right? So really drilling down into what is exactly the thing that this kid's getting out of this and it's the reaction. So, when this child was hitting, and it was surprising, and you get a big reaction, and then then often it would be like, no, a really stern reaction, which was also really funny. So, we made a game out of getting a big reaction with a gentle tap, not a hit, like not hitting someone said, hurt them. We also work around consent. So, I'm not doing this with everyone just doing it with people who are inviting you to play this game. So that works really well. The hitting, slapping straight across the face went away. And it sounds as game that we can kind of engage in with consent from both people, that is still really funny. Um, so that gets us to our other two really big key takeaways, that any expectation and adult has to be meaningful to the child, particularly with neurodivergent. Kids. They have to understand why in some way, they don't have to be able to verbalize it, they don't have to be able to express why but they have to have some, it has to be a functional reason for them and any interpretation of a message or solution has to be autism informed and that can look different.

Sarah Izzi Hamel - 33:36  

I would say it has to be autism informed, or it's very unlikely you're going to get it right. I mean, that's just the fact of the matter.

Dr. Stephanie Izzi - 33:45  

So, we'll talk about what those two things mean. So, we had an expectation at a school we were working in, that a child would do writing homework, and it was this kid can't spell, can't spell, can't spell, can't spell, doesn't do writing homework just wants to do whatever they want, and they just like to do what they want. So, the kid drew a picture, and I was like, what's that a picture of? I wonder is that a cat and I just listed things and then they just wrote this on their own, and then signed it after their name. So, you can do different things. When you sit down with writing homework, and the student didn't understand why they were doing his homework. It's very unlikely that I'm going to be motivated to do it. But we expect kids to do that a lot. So, tying the reason for the expectation to the child in some way is really important. We'll have a lot of examples.

Guy Stephens - 34:44  

Some of that, I mean, just treating kids like they're human. I mean, you know, if it would be hard for us, we can't expect it to be easy for kids, right.

Sarah Izzi Hamel - 34:58  

I think it's this thought of Like I, what I've heard a lot I'm sure many people in this space have heard a lot is like, oh, well, they have to learn that life is terrible and you have to do stuff you don't want to do a lot, which is not true in my life. Like, I don't generally do a ton of that. It's some things. Absolutely,  that seems to be like your parent or your teacher, I have to instill that in you, rather than just letting you kind of in a supported way absorb the natural consequences of the world we try to advocate.

Dr. Stephanie Izzi - 35:33  

We’ll talk about that. There are always times that you have to do things you don't want to do and there are ways to support both adults and kids through that.

Guy Stephens - 35:45  

But we also live in a world where you don't always have to do things you don't want to, I mean, I've heard many things and IEP meetings given as examples of like, the real world. I mean, even things like if it's very hard for you to be around a lot of people, well, what about the real world? Well, right now you can get on Instacart and have your groceries delivered to your house. I mean, there are things that we can do, and there are solutions, and sometimes we force things, anyway, I did want to get to a couple of comments here real quick just to share as we're going, let's say diviner says, reminds me of what we used to do with crime infant, trying to determine all the issues, it's trial and error. Right? You try things. Another great comment here and I love the combination words here. Yes, the persistence and curiosity as to what the reason, that's it, it's about being curious. Being curious means so much as an adult caregiver, right?

Dr. Stephanie Izzi - 36:41  

It's really the crux of it, right? Like, instead of reacting, and I'm a parent, also, that panic, I won't call it panic even but like the reaction, you're human to, right? the adult in this situation is also human. So, your reactions are always perfectly curious and not detached through all emotion, It's hard. But I think that the curiosity driving your interactions with these students and a respect for them as humans, and if a love for your children in whatever form that takes.

Sarah Izzi Hamel - 37:16  

It’s like operating under the assumption that you have a reason I don't understand. There's a reason I don't understand. I want to just that just if the child believes you have a desire for understanding, I think that's a tremendous propeller of progress. It's like they will hang with you longer, if you've demonstrated to them over time. I don't get this, but I'm trying even if you're not successful with some of these things, that the effort matters, like it does register, that's been my clinical experience. It matters tremendously.

Guy Stephens - 37:57  

It matters to all of us, right? It matters to us as adults, and it matters to everyone, that's the thing. I think, also, assumptions, oh, Sarah, disappear. Keep trying. It's all good. When we make assumptions and there's a lot of assumptions like about behavior, whether they're seeking attention, they're doing this, they're doing that and curiosity, in my opinion, goes a lot further than making assumptions and assuming intent, and sometimes intent that, isn't there, right?

Dr. Stephanie Izzi - 38:33  

Yes.

Sarah Izzi Hamel - 38:34  

I think we're going to talk about autism informed, like, what does that mean, next, but the thing I think I didn't realize people in general don't realize is that, especially if you're not an autistic person, yourself, the assumptions you're making, like, if you look at a situation and you're taking something out of you're wrong a lot. That's just like I learned of myself. I was like, oh, wow, I was very wrong. It's just you can't fathom what's going on in there sometimes until you learn until you do the work, you can't, you're not going to come up with it yourself.

Dr. Stephanie Izzi - 39:12  

We’re making this really clinical, but it's also the basis of relationships, right? Like, I'm serious, and I care about you. But we will talk about autistic behavior specifically and I just love like this cartoon just illustrate the fact that we're kind of making all these assumptions about the purpose of these behaviors and just reinforcing them by saying, okay, you did the behavior. Therefore, I was right about all of my assumptions about, all of this.

Guy Stephens - 39:41  

I like the cartoon too.

Dr. Stephanie Izzi - 39:45  

So, that's where we get into all these barriers. Like I want to do all of these collaborative approaches with my students or my child, but they don't have the language to understand me, and they can't express all of these things and they're too inflexible and they're just stuck in these loops or whatever it is. All these professionals have told me that my child, my autistic child can only learn by these highly structured rewards and punishments, right. So, that becomes this huge barrier and our whole idea is that we have a speech therapy clinic, and we don't have any treatments for autism. We don't believe autism is an issue at all. But it's important for a variety of reasons to understand the differences in how autistic children, individuals might communicate, learn and connect with other people and that'll solve a lot of your problem. So, there are some things we have this on our website. So, we'll go through it briefly. Different ways of thinking about autism and neuro divergence that might help kind of start a journey on understanding how autistic brains might work differently than other brains. One is this idea of monotropism, which is that this idea that autistic brains tend to focus on a small number of really internally driven interests at a time. So, shifting attention is really uncomfortable, and sometimes almost impossible. There's this drive to focus on. Interest is the word that is used in a lot of these papers, but it's like a focus. So, we talked about like a flashlight of attention and it's hard to shift outside of the beam of the flashlight.

Sarah Izzi Hamel - 41:40  

What I always tell people is like, what we're always trying to do is rather than so yeah, think about their attention stream as the light, like you're in a dark room, the light that's created by your flashlight is their attention stream, don't try to wrestle the flashlight out of their hand, try to get in the light. That is how having an understanding of how their brain is working is going to help you because trying to get the attention away from them, is it feels like trying to move the Earth. It's sometimes like that. But it's not impossible to get in there, you get in there and the other thing I would point out, I see your asterisk. It's not just interest, like what that means is you can have someone a person who is their monitropism is showing up as a really focused deep attention to a topic. But it can also be like our friends who might really like intensely visually inspect something or be very focused on a detail or a feature of a physical thing. It's the same idea. It's that manotropic sort of attention stream, and it's not a problem. It's just something to know something you have to know about them to teach that person effectively.

Dr. Stephanie Izzi - 42:56  

The other really big ideas that what's called the double empathy problem, which is really just describing describing how autistic and often neurodivergent people are often seen as being unable to communicate or having struggles with communication. But a lot of research is showing that they can communicate pretty well with other autistic people. It's just that when neurotypical and autistic people are trying to communicate with one another, that there's a breakdown in communication, which just highlights the fact that it's not just on the autistic person to resolve these issues, right to fix the communication or to meet the expectation, it's really important to emphasize it in two ways. So, I just had this little slideshow like the two neurotypical brains totally fine communicating with one another. To autistic brains also totally fine communicating with one another often those messages are sent, I don't know, how many studies have been done, specifically in non-speaking autistic populations, but often, I would think that that is similar, there's just a way of interpreting these communicative messages, however they're sent that like, it's almost like a culture, right? So, like your cultural expectations are, are similar if you're autistic, and so you can kind of pick up on the nuances better. But when if you're kind of living in another culture, it's harder. There are these unspoken things that you're just not aware of. But the culture is mostly neurotypical. So, it does make it seem like the problem is with the autistic brain, but it's not really. Couple of other things is really good pattern recognition. So that quick, making connections, sometimes connections that you wouldn't expect. Autistic brains can sometimes generate patterns that you wouldn't expect and process patterns in a different way. So, they're making a lot of connections sometimes and then the sensory process and interoception considerations. So, you might have people that are under oversensitive to sensory states or have difficulty perceiving when they're hungry or when they're hurt. There is evidence that they're highly susceptible to forms of anxiety that are often overlooked in autistic students and then you get into communication with autistic individuals. A lot of language development is what's called Gestalt or echo Blaylock. This is often meaningful, alternate path of language development. So, you can look up these stages of language development for echolalic autistic students are children. It's often leads to really meaningful language acquisition, but it's hard to interpret in the moment. So, you have kids that are scripting or using Gestalt these like long phrases, that don't always mean what they seem to me and right. That can be used for a variety of communicative or non-communicative purposes. So that can be hard to and then apraxia of speech. So, childhood apraxia of speech has been shown to be an appropriate diagnosis and as many as two thirds of autistic children. That is a motor speech difficulty where the brain and the articulators that we use are really smooth process and a really quick process that has to be automatic. Someone with apraxia, it's not and so their brain and their articulators their mouth aren't communicating with each other to form words. So that can be an underlying cause of why some autistic children and adults are not speaking. But if you overlay that on a difference in language, and a difference in communication, and all these other differences, it can look really different. So that's some of the things that inform for those who are autistic naturally, it can inform your interpretation of autistic behavior. So, an example of autism informed communication through a behavior lens is where we are working with a child who was just attacking a radiator a lot of the time. So, a lot of our hypotheses around, there's some radiators making a sound, we liked the sound that it makes when we hit the radiator. It's also we just get drum kits in because we didn't want this child to get burned on a radiator. So, we got drum kits in, we got other things to hit, none of it worked. We're like, oh, wow, this is really interesting, and this gets that kind of a whole picture where you're really looking at observing and being curious, and asking other people and maybe looking at different times of the day. So, this kid was yelling, and hitting this radiator looks really angry. So we thought it was a negative and then we're like, maybe it's we like hitting it, maybe it's musical, we're all these hypotheses going on and none of them worked. So, we're thinking about, okay, what is what are you doing? Where does this occur? Have I seen this before. We're like, I've seen this before, over and over, I'm just watching. And I'm like, I've seen this before.

The kid like to watch this clip, which is a clip from singing in the rain, where someone's hitting a piano with a hat and it makes a kind of similar sound to when he was hitting the radiator. It took a while to make that connection, to be honest, because we weren't saying words, it wasn't exactly the same. But that was the connection that this child had made, and we brought in a bunch of hats and something that made a similar sound just to the radiator and that worked to replace that behavior.

Sarah Izzi Hamel - 49:12  

It also turned something that previously much like a slap in the face. It turned something that was previously problematic into something productive, because now it is reciprocal. Now I'm in on it and now I can talk about it and now we can talk about like, and it's not just language based. I know that's like where I go, but it becomes an opportunity. It goes from a problem to an opportunity. The other thing I would just highlight about this example is we're leveraging it, whatever the problem behavior is, look at all of the stuff you can leverage. You can leverage your knowledge of the child; you can leverage your knowledge of who's in that child’s Life and you can leverage knowledge of what you know about autistic brains. Anytime thinking about, it’s going to sound funny, but I can't I have lost track of how many times I've been observing a behavior and being like, Wow, I wonder why and it is related to something the child has seen, which just goes to show you, like many children, like most children, they are learning from their environment, they're absorbing information and play schemes up there. They're just doing kid stuff, they're just doing it kind of in a different looking way.

Guy Stephens - 50:41  

That brings up concerns around like when we model things like corporal punishment, or restraint or seclusion, the things that kids will pick up as solutions.

Dr. Stephanie Izzi - 50:55  

I think that's hugely important. One of our overall messages is, don't panic. It is important, it is very important that a child not touch a radiator, that's hot, right? That's important and It's important that your kids aren't hitting injuring themselves and others, that's very important. But the solutions that you come up with, when you're in a state of fear, when you're having a fight or flight response, are not going to be your best approach to the situation.

Sarah Izzi Hamel - 51:27  

I know for myself, your mind starts going of what if like, having been in the classroom, like, it's impossible, I'm a human being, your mind starts to go, what if I can't get this under control? What if I can't teach them how to not do it, and when your brain is in that state, as you know, everyone's familiar with, you're not making good decisions when you're stressed. So, no matter what this thing, what the thing is, no matter what the kid is doing, if your goal is to do everything in your power, do your absolute best to support them to something that is positive and helping them learn the skill. Calmness as your friend.

Dr. Stephanie Izzi - 52:11  

I think that the question of that we always hear is like, but how do we prepare them? But how do we teach them to be adults in the world, and it gets back to your point about, you can't always get what you want in, in life when you're an adult? Well, first of all, these were, I'm working with children mostly. But second of all, it is what it is right? Like these are, we can only do what we can do. So, I think that we have seen much more generalization of skills, when we use this approach than one or the other approaches because it becomes their learning, right? It's a learning rather than a training, if that makes sense. So, like you're internalizing these messages that you're sending to the child that you're working with, it's really, it's much more rewarding for me, and it's also teaching these principles, like you said, we're not modeling punishment, we're not modeling these things that we wouldn't want the child to do. So that I think is just important.

Guy Stephens - 53:24  

I was using to bring a comment from a viewer that said, knowing when the moment isn't the time to learn the expected skill is also important.

Dr. Stephanie Izzi - 53:34  

Yes, it is critical. I think that's, that is one of the trickier things about what we're doing is that there does come a time, right, if a child's very upset, there is a point in time where they're not learning. We'll talk a little bit about that, might as well now of how you arranged the environment and set up. I don't like doing things artificially, right? So, we don't set up situations where we're testing a kid or, making like, I'm not going to wheel the vacuum into the environment to or a picture of a vacuum to get a child used to vacuums, right. Like it's how do you teach in the moment? And how do you, like expose the child or catch the child in a moment where they're not so upset? Or doing a behavior where they learn?

Sarah Izzi Hamel - 54:27  

That's the art form honestly.

Dr. Stephanie Izzi - 54:30  

So sometimes that is challenging and honestly, the first step is always to reduce that stress because you can't teach in that moment. Like that's not that's not when you do it. There is arranging the environment and reducing stressors and having plans ABCDEF, all of these things that it takes time, and it takes effort, and it is really response piece of it. When can you teach vs when do you have to just resolve a situation. But yeah, these are examples of how we're doing, how we think to hypotheses, and alternative hypotheses about a behavior.

So it could be, these are we're framing it as messages because we do this for language acquisition too. So, if someone's yelling at the fridge, do they want something in the fridge, they want to play with the door of the fridge. Really, it's really granular.

These are all real activities that we have worked with. This is a little bit of interpretation. In the moment, testing the hypothesis and then if you're wrong, trying it again, and testing out your other hypothesis and providing other opportunities. That's the back and forth. You're overlaying all of these things, I'm using my behavior to communicate. We do this a lot with turn taking, because we're going to school. So, a child's getting upset and trying to take a toy from another child, I help, we have things that we're like, you can't play with this right now, I'm sitting between the two kids who are trying to get out each other, let one child play with the toys, then give it to the other child who's waiting their turn, and who's really upset, but then they get it after a while. So over time, that message does get through, I'm using language, but I'm also using my body positioning and my literal objects that a child wants to like you have to come up with creative ways of getting your message across. Sometimes the expectation isn't. Sometimes I just give up on the expectation, right? So, if it's a safety issue, that's not an option. Often, if it's an equity issue, it's not an option. But sometimes, the kid doesn't have to keep his shoes on, right? You can have your shoes in a cubby. I don't care about that. Is that important? Does the kid have to be sitting often, it's just getting rid of adult expectations, which I think is hard. Right? It's hard.

We have a lot of these are often language based. So, this was a child who was banging on the back door. So, we have pictures. So, you can use language, provide these things. Okay, here are all the things in the yard that you might want. What is it? Nope, that didn't work. You started the guards does. That didn't work. I'm watching for a reaction, and then reacting to it. Okay, so you're pulling me, let me show me, I'm goanna go with you. Let's see what happens when we open the door. So, I want to go for a walk. So, we've gotten that far. This kid is getting in a stroller saying I'm goanna go for a walk, pulling, pulling and pulling. But then we have another behavior kind of throwing, having unexpected behavior or yelling or throwing a fit or whatever it is. So, you're trying something I want to walk this way I want to walk that way letting the child leave you when it when it's possible. It's not always possible.

Sarah Izzi Hamel - 58:36  

I was just going to say going back to that example, I find a lot of times if you're envisioning, okay, you're in your house, your kids pulling you to the door, and then you walk one way and they're like, I'm kind of mad and I'm expressing that. So, you go the other way. Sometimes an outside observer might be like, you're letting this kid run your life, you're letting them tell you what to do. You're not You're having a conversation, that is if you have a child who communicates largely nonverbally, without linguistic units they are commute in that way. That is how they are communicating they are saying something to you. By dragging you then they're saying something else, and you're changing your behavior. That's the back and forth. That's the work you're supposed to be doing and it's not wrong or bad. I just wanted to throw that out there.

Dr. Stephanie Izzi - 59:35  

That gets back to the co-regulation piece and all of those really great neurobiology. The fight or flight was like understanding all of those things and being able to co regulate. Sometimes the answer is going to be upsetting. I mean, sometimes you can't solve the problem and so we need to work through bad feelings and feelings that are not even bad but no negative feelings that are I'm upset, I'm frustrated. That's okay. It still helps to reduce what are these like problematic or challenging behaviors, right?

Sarah Izzi Hamel - 1:00:12  

It’s not about the aesthetic is just what I would say. Sometimes the aesthetic is going to be off, and it's going to look like you're acquiescing to something, or you've given up on an expectation and others might think that's a failure, that you're not doing good behavior management. I think that's not helpful necessarily as a perspective.

Guy Stephens - 1:00:34  

But, when you look at this, I mean, isn't a certain amount of this about, kind of attunement with a child. I mean, isn't, I have to, as I look through what you're presenting here, thinking about a setting, like your school, as you've gone through this process, this construction process and work through really solving problems, your understanding and getting to know, I mean, you're becoming more attuned, you're building relationship. I mean, isn't that really what it's all about? I mean, it's almost putting a priority on us being able to understand communication, that may not be our own. Right. I mean, isn't that harder of it is a kind of that attune co-regulated?

Dr. Stephanie Izzi - 1:01:23  

Yeah, it is truly letting go. It sounds like I mean, a lot of this is repetitive, because the ideas are all good and we can all agree on the ideas. But what this looks like in practice, is when you really just let go of this idea that you have to be in control at every moment, everyone has to be safe. That is true. Everyone has to essentially have equity and not be treated badly. It's not everyone gets the same thing, but everyone gets what they need. Right. But other than that, the expectations are all kind of just, what can I do in the moment? How can I best serve this child in the moment?

Guy Stephens - 1:02:02  

Maybe even a pinch of acknowledging that neurotypical expectations aren't the only expectations, right? That the idea here is not to have everybody meeting what is a standard neurotypical expectation.

Sarah Izzi Hamel - 1:02:20  

That is a piece we didn't talk a ton about it. But depending on who you are, as a consumer of this information, some people have really had to do a lot of soul searching about what actually they care about, what is actually unacceptable to me, what is actually unavailable to this.

Dr. Stephanie Izzi - 1:02:40  

This goes back, you should be able to explain why to your child?

Sarah Izzi Hamel - 1:02:48  

You goanna have problems? If you can't really explain it? I think oh, and I just wanted to throw out there, too, I saw in the chat, moats place, said that just agreeing something is not optional, is validating and it can be almost a comfort, it allows the child to get over it, because we're not doing this back and forth. But that requires me to know what I will never ever, and they can sense that, and you won't have to do it for that long. Once that kid knows, okay, six times later, this just is not going to happen. The meltdowns become less frequent, less intense, shorter in duration, you see it over time. It's not to say you can't be flexible, you certainly can't be though you have to be, but when it's a no, just say it, and they're goanna scream and cry. The point isn't for your kid to be happy all the time. You know what I mean? Like there are going to be upsetting things in this world. And I'm here to help you through it.

Dr. Stephanie Izzi - 1:03:56  

But right now, the world is the world for them. It's not the world that I don't like living in the future. Now that you never consider it. But they are not adults. And they're not operating in the world.

Sarah Izzi Hamel - 1:04:09  

But you can't run around with a knife. You can't, right? I can’t let you. Because I love you.

Dr. Stephanie Izzi - 1:04:13  

But a preschooler can or someone who isn't, doing a neurosurgeon or whatever, you can't do certain things when you're performing a particular job or whatever. But, someone who's at home can have their shoes off. That's okay. Whatever their age, whatever the issue is, someone needs time. Yes, they can jump on a trampoline, while they're learning math or whatever it is, like these are things that we can all Yeah, I never say never do things, but we try not we don't do physical prompting or withholding items just because I take away things that aren't safe, but I give them back often. So again, at home and in the classroom. If someone's using something in an unsafe way, I might run Remove the item if it's an immediate danger, right? But I don't remove it forever and I don't say you can't get this back until you can show me a different skill. It's a that back and forth is much more like, I'm going to take the scissors because you are cutting another child's hair with or whatever it is, then I will give them back and show you what you can cut right here, you can cut paper, you can cut this and then I give them back and if they go and we have a lot of boxes with stab marks in them, because kids like using scissors and if it's safe, if it's acceptable in the setting, it's fine. Like, we pick our battles, I never would demand a particular communication modality or attempted director shape play those expectations are neurotypical and they don't work, you're never goanna be able to answer why do I have to put the doll in the chair and feed it? Why? I don't have an answer to that, and I will engage with you. But those things are just not anything.

Sarah Izzi Hamel - 1:06:01  

Great check. Like if you can't explain it

Dr. Stephanie Izzi - 1:06:06  

Without tying yourself in pretzels, these performative tasks that don't mean anything I would get rid of. And we don't use a lot of rewards. Again, these principles are not things that most people argue about, but like children should not have to be said, but often has to be said deserve autonomy and control over what they can have autonomy and control over. We should consider how the kid learns best how they communicate what their interests and presuming competence, not defiance. Again, if a strategy you're using isn't working, what can you the adult do to change it. We use a lot of different modalities, including behavior. This life again, just to reiterate, we do think about the future we do think about having kids become independent and be able to regulate better all of these things we want for our children, obviously, but the starting point is to form those relationships and trust. It's not that some kids might to some degree rely on other people for regulation into adulthood, that's just true. Right now, all you can do is support them and try to provide that space for them to regulate and be able to communicate more effectively.

Sarah Izzi Hamel - 1:07:27  

I think sometimes we get so focused on like, looking at the peak of the mountain like adulthood and perfect functionality and totally independent. We forget, we're down at the bottom. And that what we need to be thinking about is the next step, like you'll never get there, if you're focused up here and just operating like forgetting everything that has to come in between and to move towards. I don't know, if folks are familiar with that idea of gradual release of responsibility, it's essentially an idea in developmental practice, that it's going to unfold as it will over time and that we can't force development and we can't strong arm development. It is through acquisition, especially of language at its core is always social, it's going to unfold as it will naturally over time for your child and every child. And the way to get from here to there is through your relationship, because it truly the only control you have.

Dr. Stephanie Izzi - 1:08:33  

Providing the supports and the scaffolding that the child needs. But a lot of this, I think comes down to having unrealistic expectations. So, this is what we use at our school, our school is essentially a different environment. Right? We both came from public schools and use a lot of these methods in a public school. But that is an environment that is it's an institution that's steeped in behaviorism, to be honest, and so this isn't always, the optimal setting isn't always where your child is, right? So, we just had this slide to kind of talk around things you can do, and you have a lot of resources about this guy. So, this is just to add to that. What we tell our families to look for a school where a child can't report what's happening to them.

Sarah Izzi Hamel - 1:09:27  

Anytime, we're talking to an audience of people who might have nonspeaking or got I feel like we could do a whole other hour on like the language considerations for these populations and the language considerations for equity like kids in particular, but with any child just because they have language doesn't mean it's there when I need it. So if you have a child that has unreliable communication, and they are in a setting that's not optimal, I just always would want to tell people there are things you can do to protect your child, I would emphasize that it's not sufficient just to understand the district's policy on seclusion and restraint, because there's often such a cavernous gap between the policy and the reality for those kids, or of what's going on in the school. Be sure you clearly understand how your child's particular setting is defining seclusion and restraint in a functional way. That was a problem we would see oftentimes is that we'd see you know, a tremendous number of instances of seclusion and restraint, and bring it up and people would in the school would be like, I don't know what you're talking about, we've never restrained a child, not recognizing a rift and chair is a restraint. I know that sounds crazy when I'm saying it, it happens, people are horrified.

Dr. Stephanie Izzi - 1:10:54  

It's a restraint. If it's used to restrain someone, not that the child needs it to sit up straight.

Sarah Izzi Hamel - 1:11:01  

But the thing is familiar with Rifken chairs, they're the wooden, they're usually used in early or with littler kids because they don't make them bigger. Larger children are obviously harder to restrain but a rift in chairs, a chair simply with a strap or a bar that comes down across they were designed. This is a sad statement, the riften company has put out a statement, please stop putting autistic kids in these chairs. They were designed for children with cerebral palsy, who required them for physical support to remain upright in a chair because of low muscle tone. That's what these are for.

Dr. Stephanie Izzi - 1:11:36  

They are often used to restrain autistic children who don't need them to sit in a chair, but just don't sit in the chair, they don't want to sit in the chair. So that is something to look for rooms that, have restraints that are reflection rooms or calm down rooms or quiet rooms often will be used. So, asking those questions and looking for those types of things are things we would always kind of advocate. We just have one more example from a school because it's a great example. But we had a student who wouldn't do anything but write numbers and the expectation of the school was that he would complete his spelling homework. So we're like, Well, maybe he just likes math. We'll let him write numbers on the spelling homework and we would do math, and then spelling, we did all these things. Then observing this child, just writing all of these numbers, someone finally figured out, he had an alphanumeric code that he was using to do his spelling homework. Using these numbers, I just thought that was so wild.

Sarah Izzi Hamel - 1:12:41  

This is an example I never would have thought to do that something in all my life I probably would ever think was a fun thing to do. Let me come up with an alphanumeric code to write sentences. The non-autistic brains just probably not going to do though. You can understand you can start. Awesome.

Dr. Stephanie Izzi - 1:13:04  

I was like, Cool. So that was someone who thinks maybe a little differently figured that out. But if the answer for this child was just can't write numbers anymore, we can't let him write numbers, which was the answer the school wanted to use. He is reading, like this is you're missing a lot. Again, every kid is different, every kid's going to be different. But like, why do you need to do it not an alphanumeric code. Like that's just like, it was a great solution to that problem and so now he can write in both letters and alphanumeric code. But that took some time, and he thought it was funny. So that, you're assuming that everything is a really serious behavior that's communicating something serious, a lot of the time, some of the most pervasive behaviors that are hardest to get rid of often it's a humor, like, there's humor in there, too. Not to forget that not everything is this like, yeah, he likes numbers. But it wasn't this, everyone assumed that it was, oh, he's only focused on numbers, and he can't not focus on numbers. He thought this was really funny. When someone figured it out. He thought it was great and funny and that's the relationships piece, right? Like, it is funny, and it's awesome. So, I don't know. It's just not taking everything so seriously, all the time to there are some serious behaviors that you do have to take seriously. But that's not necessarily one of them. Letting some of that go. I think that's it. If there are any questions.

Guy Stephens - 1:14:43  

All right, well, fantastic. What I can do is I'm goanna make your slides go away and you can actually join us back on the screen and hopefully see us and if anybody has any questions, we are close to our time here. But if anybody has any final questions, we'll let you put those in the chat now, and we're getting a couple comments here, so eye opening. We've got a thank you all, I do want to ask you. So going back to this idea that you started a school, tell him tell us a little bit about the school you started and why you started it.

Dr. Stephanie Izzi - 1:15:20  

So right now, we're actually operating a therapeutic program. We're looking for a facility a physical space to open an inclusive classroom. We started it actually in collaboration with a parent of an autistic preschooler who just was disappointed in the options that there were for her child's in in public school settings. Like we said, we had tried to, the varying degrees of success use this with individual students in individual classrooms. We brought all these ideas into different settings. But we really wanted to just kind of do it that the way we wanted to do it.

Sarah Izzi Hamel - 1:16:06  

I think there's a tremendous failure of imagination. I don't know who I stole that phrase from, I know, it's stolen from somewhere, but there is of what autistic students are capable of. Even our youngest learners are most different thinkers. We just felt so strongly if you could create an environment that again, would allow for the natural unfolding without force of that child's developmental trajectory, how can I like any child support you to develop as you will? What would that look like? And it's been tremendous, the most exciting work we've ever done, I think.

Dr. Stephanie Izzi - 1:16:48  

Our school the name of the school is the Oregon Montessori Center for Inclusive Education, which is in Rhode Island. So, we collaborated with a Montessori primary program, so it's ages three to six right now. Our hope is that eventually will expand and open up new classrooms. And we're really, excited about it. So, this was our first year and our facility was flooded. So now we're looking for a new facility, but we have one for at least next year. So, we're still rolling.

Guy Stephens - 1:17:20  

I appreciate that. I know that there are probably a lot of obstacles. I know from talking to you that there have been obstacles that continue to pop up to make this one.

Dr. Stephanie Izzi - 1:17:30  

Our students are doing great. It's been so exciting to just see what happens when you have, honestly a nerve divergent led program. With all of these principles really kind of at the way we envision the marketing

Sarah Izzi Hamel - 1:17:48  

Just as we're wrapping up, we took kids who had been not all of our kids, but in probably 40% of our kids had been asked to leave at least one other place. These are failures. These are kids that could not be served in public settings. They made tremendous, meaningful progress quickly. It was really cool and exciting to see. It's like if you do all that stuff that we said, it really does work, if you can do it.

Dr. Stephanie Izzi - 1:18:23  

It starts good learning at their own pace. Really, I mean, it's been really great to see every single one of our students.

Sarah Izzi Hamel - 1:18:30  

What I wished we could have done, what I wished I could have done was put together like a cookie cutter a prepackaged, like here are some activities, or this is the x and do why, I can't say that because with each and every one of those kids, it was like, I don't know.

Dr. Stephanie Izzi - 1:18:49  

It's very individual. So, we had guiding principles, and then you have to individualize. So that's the harder part, I think it does work if you do it. And that's really the great news is that it can really work.

Guy Stephens - 1:19:03  

That's fantastic. So, I'm goanna give each an opportunity to leave us with some final thoughts here as we wrap up. Sarah, I'm goanna start with you. What are your final thoughts or anything you want to leave people with? Or any just kind of your final thought of wisdom for the day? What do you have to share?

Sarah Izzi Hamel - 1:19:21  

The only thing I can think of is, first of all, Steph, Steph and I are both on Facebook. We would love to connect with any of you and hear from you and get your feedback would be absolutely fantastic. Because we're really passionate about sharing these ideas and empowering parents to go a different way and travel their own path out there in autism land, which is crazy. But just to also through this, be kind to yourself, too. I know that every day was not perfect is not perfect. How do I overreact sometimes? I sure do. Am I calm always? Nope. But you can model self-compassion for your kids too. Just my last thing that I always tell people is like, What's the smart thing I could say? I know, if you are withholding and not using language with the kid because you don't think they'll understand it, I would challenge that thought by saying, If you don't, they'll never understand it. That’s my co-construction.

Dr. Stephanie Izzi - 1:20:33  

I would just be saying hi to people in the comments. Renee and Maureen, Maureen is an awesome parent and Renee knows from, or someone who's from Rhode Island who was involved with spear, which is an excellent organization too. So just a shout out to those too. Just try it just put on the lower X, low demand and collaborative and proactive glasses and try it for a bit and see if that can work for you. Because it really has, it really has been very successful for us. So, I think that's great.

Guy Stephens - 1:21:09  

Yeah, and I get back to one of the comments earlier about, persistent curiosity, right. Yeah, connection, curiosity those things are so critical. A couple final comments here to share love you girls, and we were thankful for the work that we're doing in this community. Great job, ladies. I enjoyed the presentation. Wonderful. What's your Facebook page?

Dr. Stephanie Izzi - 1:21:28  

So, we're at AAU included, I believe on Facebook, if you search for autism included, you will find our Facebook page with our logo. It is also linked on our website.

Guy Stephens - 1:21:40  

So, you said AAU included?

Dr. Stephanie Izzi - 1:21:44  

Yes, I believe that autism included was taken. But I will double check that and put the right app on there. But it is linked on our website.

Guy Stephens - 1:21:51  

I just grabbed it as well, just to put it in the chat. So, I'll put it in the chat. It does look like autism included. So hopefully, I got it right, the wrong weekend here. So, if you suddenly realize I got it wrong, but it looks like you. So, I'll put that in the chat here. I want to thank you both for spending the last hour and 20 some minutes with us today. Really appreciate the work that you do. I know thinking about kind of the work that you do and the things that you're bringing to the conversation. I'm always, periodically thinking about people to connect with you. I know recently it was somebody talking about starting school. I'm like, you've got to talk to Sarah and Stephanie. You guys are doing great stuff. I appreciate you coming on to share this and for everybody else. Just want to thank them for joining us today. We will wrap up Stephanie and Sarah, you can hang out for one second. We'll catch you after we say goodbye to everybody. And thank you everybody for joining us today.

Sarah Izzi Hamel - 1:22:52  

Thank you all so much.

Guy Stephens - 1:22:54  

Bye bye

Transcribed by https://otter.ai