Transcript for:
Multiple Oppositions Therapy Overview

hi everyone I'm just about to start my life chat with dr. Lynn Williams I'm just gonna wait for people to start joining in hello people are joining and then once Lynn joins in I'm gonna add her in and we'll start this chat so I've had so many questions maybe like over a hundred questions about multiple opposition's so there's so much out there that you guys want to know hi everyone thanks for joining and so I've kind of structured my chat I'm excited to Thanks I've kind of structured my chat so that we can hopefully answer everyone's questions but um there was just so much out there so we've kind of themed it I'm just watching everyone doing Ian's hello I'm just gonna wait for Lynn to pop up she's gonna come and watch and and then yeah and and then Lena actually has some pretty cool something pretty cool to tell you guys as well at the end thanks everyone for joining I'm just gonna scroll to see if Lynn's joined in yet multitasking he okay Oh says she's unable to join and it's gonna give her just a little bit I might say if I can add say if she can join that way um I also got out my ski app and things like I think it was in another chat me to Rebecca thank you you know I'm a big fan but my first ever ever client that I ever had when I was like a new graduate they had a severe phone in collapsed like everything was G and my clinic had and I honestly credit this book and this program to where I am today because I knew what to do and it worked actually wonderful stuff work so yeah this is like a really surreal for me and thanks so much for coming on my pleasure and I have to say I'm a big fan of yours too Rebecca I love your account now that actually was the manual that came with the skip software program which now is an app and so that manual is actually in the app now okay I just thought I'd give everyone an overview I know I quickly um let you know what we're going to do because I had over like a hundred questions I thought if we just like tackle the basics like a super quick overview and then I'm gonna have some real quick answers that I think you can probably answer in like a sentence or two and then we'll go through the roadblocks because the roadblock is I think the stuff that the people really want to know because they want to implement this approach but then they don't have like like a dial in SLP to say hey what we're doing great all right can you say in your head you'd be perfect for opposition's like is it that easy well you know it's kind of like anything the extremes are easy it's the ones that are kind of in the middle so you can tell oh you definitely are not you definitely are but those in the middle sometimes they're a little harder to figure out so as you were saying with your first client who had an extensive phoneme collapse when I see that as like oh yeah you would be perfect for this but what about a child who is more mild and and they have a few common types of error patterns then then I think you can say well minimal pairs might work well for that that child or maybe I want to try at multiple opposition's so I say that multiple opposition's is more for the children who have more sound errors who have also those children who have unusual kinds of sound errors and then I say on the extreme the ogk kids only God knows when when you're looking at it except I can't understand anything you're saying well I think a lot of people would go to cycles sometimes I guess when would you because in my head I I've only ever thought of model opposition's as a phoneme collapse so when I had a child and like everything is D or everything is H and everything is G I kind of feel like those are the ones I see a lot like the G is that yours yes yes yes yes yes and W I see a lot with W as well or final consonant deletion or initial consonant deletion so those also you're sayin with those with those other kids like potentially if they have like stop being fronting cluster reduction are you saying that you can also use that approach really yes yes so with multiple positions you can use that approach with to target sounds but four is the maximum yeah so you don't have to say oh they're not four targets from that phoneme collapse that I could choose so I can't do it you can do multiple positions if you have the child's error plus two target sounds yeah actually I've done that before with a child and it was like um I think it was maybe s and I contrasted don't see CH and SH it was those sound yes s SH and C hey something like that I know I've done it for a couple of those you know those small tiny ones yeah like like gliding where a child will produce w4l and are I've used multiple positions for that as well actually someone had as an example and I thought that would be a good one because instead of just targeting one and hoping that it will you know that rule would generalize across okay all right so then with cluster reduction I'm just thinking aloud because that's obviously very very common mm-hmm would that be easier if they are if it's an S cluster if it's like s versus like STF SL s and s W well you know well it depends on what's involved in that moaning cut collapse so if you're seeing that it's primarily s clusters then that might be where you'd focus on a lot of times like you said you'll see a T collapse a dam collapse something and then you'll have stop clusters you'll have our clusters you'll have s clusters so then you can get a variety of clusters in there and and that goes to the target selection and I know that there were some questions about target selection so I try to get the targets to be maximally different from each other so and and I use this target selection approach that I named the distance metric and what I mean by that is Phanatic distance how much phonetic distance is there between each of the targets as well as the phonetic distance between a target and the child's error production and the greater that phonetic distance is between their error and the target and across the target sounds the more salient that will be and therefore it should be more learn about but also it increases the frame of learning that the child needs to achieve so a child who has a huge phone in collapsed I had a child who had a 1 to 23 collapsed phonemes and and consonant clusters and remember 4 is the maximum number of targets that you can choose out of that phone in collapsed so this child was was collapsing stops and fricatives and affricates and clusters and they were moist and voiceless and they were anterior and posterior so I wanted to select the targets with that maximum phonetic distance across the targets that I was choosing so that I'm enlarging the frame of learning that the child doesn't just need to learn stops doesn't just need to learn velar place of production doesn't just need to learn vocation doesn't just need to learn how to sequence consonants together so that is the principle behind the target selection with the distance metric do you because I know for me I use the placement of voice chart yes do you do you have I mean you probably this stuff is probably a bit more it comes naturally to you but for you know everyday practicing clinicians or you know SOPs that are new to all this do you have like is there a quick cheat sheet or a visual way like is this yes this doesn't have clusters but like is there another way that yes organize and see this yes so a couple things I want to say first of all I ain't glad that you're doing a place voice Manor analysis like that you know that came out even before phonological processes 1971 so it's been around for a long time but if it kind it got overshadowed by phonological processes and it'll give you a lot of the same information in less time and I'm all about working smarter not harder so first of all I wanted to say good on you that you're using a place voice manner analysis secondly to your question I did develop these phoneme collapse worksheets that part of my specs analysis inspect stands for systemic phonological analysis of child speech and I know that you and I were chatting earlier there's so much that first of all I'm just thrilled I'm over the moon happy to be here with you and thank you so much for inviting me and it's like I am so excited to have this opportunity to to talk to clinicians and I know that we won't get through all of this so I would like to go through and answer all the questions you said we've got over a hundred I'd like to answer those and send them back to you so you can post them and then also to send you the different resources so I'd like to send you that phone and collapse worksheet that you can look at and I'm happy to talk about it you know everybody's working remotely now I have not been in my office since March 23rd and so it's like oh I wish I could just pull this out of a file and show you here is the work sheep and and talk about it but I haven't organized it's very similar to a place voice Manor although you know how the place voice Manor is horizontally organized like yes so the phoneme collapse is vertically organized and and I just have it like a worksheet yeah and I have it organized by Manor so all of the stops all of the fricatives all the affricates the nasals the liquids the glides and then within each man are organized by place going from the most anterior to the most posterior place of production and then I have them categorized where you know that stops fricatives and affricates form the natural class of sound called AAB strengths there's nasals liquids and glides form the natural class of sounds called so neurons and then I have a section at the bottom for clusters so that when you are diagramming and you can you can do any kind of so you know I used the Goldman Frist Oh often it's very quick and easy and it's kind of like them even though it's a diagnostic test I use it it's like a screening tool but it it looks at every consonant initial medial and final and with multiple opposition's we're looking at initial and final because those are the most salient positions to train you and so I have these phoning collapse worksheets for initial position and then I have them for final position and you just go through and you say okay I'm looking down the column aboard initial targets on Goldman frist oh I'm seeing a lot of T's here so you know with phony and collapse it's a one-to-many correspondence so if I'm seeing a lot of T's over here under the child's column there's just one line for the one and I put a T and then I go through and check beside all of the sounds that I have written out old t / TT for DT for cake T fur ft 4 s etc and then all the way down to clusters of stt RK RK l etc and then I can so to me yeah yeah go yes yeah so instead of you know you having to write it out like that it's organized so then you get to see the order in the disorder so if you're not accustomed to write like you know speech is my life I do this I think this I dream this I eat it everything so I'm used to thinking you know stops and PBT dkg and fricatives theta MFP SCS you know but if you don't write it in that way you can miss patterns like oh my gosh it's only with the voiceless anterior sounds I think that's my ideas you know like I said the downfall this doesn't have clusters but I would get like a whiteboard marker and I will just do white green like the series that they do I'll color them in gray and then I'll do red even just like without just with the noise and sometimes just by color-coding like that you can go WOW yes by labels and it's like thinking big picture versus saying you need to learn the F sound you need to learn the s sound like it yes yes yes yes and and it's big picture too in terms of how we think about speech sound disorders that we don't think about it in terms of articulation and sound by sound but in it and it's even going beyond thinking of it in terms of patterns like fronting and stopping so for instance a child who's producing tea for K and T for cha and T for s and T for TR if I did a phonological process analysis I'd break that up into four different rules I'd say oh you're you're fronting you have the application you're stopping your you have cluster reduction whereas the phoneme collapse says wait a minute those aren't four separate rules and for this child in their language it is one rule and it makes sense that there's this phonetic resemblance between what the child is doing and those target sounds they're all voiceless yep they are all obstinance for stop cluster and the child's error is T which is a voiceless stop abstract and so it's so exciting you know when I see that when I start thinking okay you've got lots of processes that's like usually my first like clue that all payers probably won't be enough like because you know you'd pick like the front in aspect of something so usually when I see kids and there's like you're starting to tally up all those patterns I'm like okay I'm gonna have to choose an approach that thinks that's going to make the bigger bigger yeah and it really is a paradigm shift that moves us from more of a fragmented analysis to a holistic so whereas I would say you know this many times fronting this many times stopping this many times cluster reduction etc that I look at it more holistically and say it's one rule and it makes sense so those are the two critical things is that you can economize that you're looking at it holistically and the other thing is is it's it makes sense so that's kind of the two ways that we evaluate the the adequacy or their power of an analysis it doesn't have descriptive power and and you know phonological processes definitely has descriptive power but does it have its planetory power yeah why are they doing what they're doing yeah am I kind of right just people like familiar with this approach and I'm going to be honest when I was at university I don't even I don't even know if I I don't remember I don't remember learning if I did it was like 10 minutes and I think it's okay I think there's so much out there that it's yes and and that's not the only class you're taking no minimal pairs the way I think of it is that multiple opposition's it's like minimal pairs but just with an extra target or two yes you know and more yes and okay so it is very very similar to minimal pairs and in that you are directly addressing hamana me you are contrasting the child's Aerith error with the target sound and even though you have multiple targets you're always doing the one-to-one contrast within that larger treatment set here's the and part that makes it bigger that it's it's looking at the child system differently the minimal pairs and that's that fragmented versus holistic so with the phoneme collapses and in saying hey that's not for different error patterns that's one rule that I can explain why the child is doing what they're doing it's like saying that the child speech sound disorder is their native language and you're wanting them to learn to speak the ambient language which for us is English and so what we're doing is we're treating this child like a second language learner and we're taking their language and mapping it on to English and that's what the phoneme collapses are doing right yeah so it it's like minimal pairs in those ways but it is different because you're thinking about them differently that make sense yeah so when just for a quick overview for people then so let's say we've got like I think a common one is D so let's say we have like deep chip keep and flip I know that that's a common one I've seen in textbook this is what people want to know I we do it like deep in chip like are we just doing those two kind of like minimal pairs and then and then you do is that what it looks like yes right so you're always contrasting it back to the child's error and it's just like the way that I even like to lay out the cards either on the table or on the screen if I'm working from the app is that way where you have the child's the error and then the targets and then I bring it up and I'm contrasting air target next one error target next one error target because what you're doing is you're confronting that hamana me yeah would you do a couple of trials like would you do deep cheap and then kick deep and then dip dip like would you do you know like a couple of trials and then you move on to the next one you know I don't I run through the whole rhyming pair set and then go to the next one yes yeah so dip chip dip dip dip kill okay and then go to the next one deep deep sea deep cheap go to the next one and and this was another thing that I saw and the questions that you shared with me and that I saw posted on to your account a lot of questions about dosage and intensity so in answering your question you know would you do stay with that and get a couple of responses well you could certainly build up the intensity that way but here's the thing with phonology there is duality and learning so you'd have to learn the rule and you have to learn the execution you know you can't learn one without the other and it's like articulation is here how do you place the articulator x' to produce the sound and phonology is up here this is the rule you need to learn okay we have to put both of those together we can't if we work on this one without this one it takes them a lot longer in therapy these kids are in therapy for five to six years yeah like like barber Hudson talked about if we do just this without supporting this the child's going to get frustrated yes and this is where I see where a lot of people were saying you know how long do you stay with that if the child is not stimuli so right and what's interesting and this was another question that I saw Rebecca that people were saying how do you start what's your criteria and when when do you move on when do you add another sound I have a treatment paradigm that that I have described and it's in that that book which like I said is now on the skip app yeah that's it that's it yeah yes this this is what made me confident because I had something to go by and I think like a diagram like it is it is so I have I have republished this a number of times and and it's in my book that I have with Sharon McLeod another Aussie and I brought I brought it just to show you yeah by the way these are my two daughters it was a Christmas photo I took years ago but yeah so it's it's in a lot of different places yes I think we all need these be kind of neat I know it's a bit hard for people to see but I see well I can send I can send this to you - I'm gonna try to just send you a whole bunch of stuff that you can you can share with others but so going back to the to the question about yes I think I lost it how the power to start how long to be open the duality that's where I was going with this that in those earlier phases your your emphasis and treatment is more at this level but it doesn't mean that you're not addressing this one and then that focus starts to shift where it's like oh it's more up here so phase 2 imitation boom you're here even even though you're still working on contrasting the rule but phase 2 spontaneous you're having more focus up here on the rule phase three where you're you're playing games with the child with the contrast you're all the way up here and what's really interesting is I have in that treatment paradigm you are measuring generalization freak like now you don't have to do it a sprinkler so you don't have and in people can change it I did that for research purposes because I wanted to really track that change but what's really cool about this is you you start to see you know you have your data on how they're doing in treatment and then every third session I'm measuring generalization and again I want to mention there are two measures of generalization and narrow measure of generalization and a broad measure of generalization the narrow measure is probe words of the target sound in untrained words and and I have a 90 percent criterion level very high but I don't feel comfortable saying oh you've met that and we're gonna stop training because at such a narrow measure it's only words it's only ten words per target sound in the target position and and you're getting this every third treatment session so there's a learning effect there with the probe so I just use that as a gateway to say well when do I want to do the broad measure of generalization which is conversational speech and this is where we really want to note you know oh it's the kid getting this and I don't want to have to do that language sample too often because it takes time and and so that narrow measure is the gatekeeper and it tells me oh you hit 90% there get a conversational sample and Faye has said mark Faye has said if the child is producing the target at least 50% of the time and spontaneous connected speech then it's likely that they will it'll continue to emerge on its own so that's not fog this is where I think people can get what I would get a bit confused that's only for that's not for articulation we can't think about you know for like exactly exactly it's family exactly yes yes say you know phonology yes knowledge yes not our teacher yes so if you have a child who's lisping no you have to have very yes yes yes so anyway what I was gonna say about that as I'm collecting my treatment data I'm collecting this narrow measure of generalization and I can start to see the interaction between what they're doing and the treatment words and when generalization starting to occur and you know when you start to see the blips and the light bulb going off the little blips coming up is when you're in phase two spontaneous because that's when you're really starting to shift from this level to this level and then once you get to phase three boom that light bulb goes off and you see wow they've met that narrow measure of generalization I'm going to do the conversational sample and see if they've met that broader measure of generalization and I published a study and I think it was in 2000 that looked at the treatment history of ten kids and just saying you know let treat my paradigm you know how long did it take them to get through and when two children generalize out well out of the ten kids I believe it was six generalize out at phase three but there are some kids who they're totally great on those contrasts even in you know more communicative scenarios and they're doing great on that narrow measure of generalization but on that broad measure of generalization it's like they're just not there they're like maybe 30% 40% yeah I use an app by smarties to do cuz I like that it's very digital and it produces graphs for me and this is like yeah I've cut the kid's name this is like one of the sample so that 61% is the phone in collapse the substitution and so forty-nine personal forty nine percent of the errors were forty nine percent in their phone in color and they have to see just six weeks of doing multiple opposition's you know that went down to 31 percent yeah yeah that's an overall and I was like wow like in six weeks of multiple opposition like you know pretty much yeah that phoneme collapse it kind of like hard and yeah you know you know like yes yes yeah yeah yeah because because you're treating it systemically you're treating the sound system you're not treating an air pattern you're then that's the thing between processes and phoneme collapses and we were saying it's broader your your shifting your thinking to a system to a language of their own and and and so you do see that system ship and and you'll see it quantitatively in terms of you know while you went from a 1 to 23 phoneme collapse to I 1 to 8 own name collapse but you also see it qualitatively where the the kid might have had some really unusual errors like h40 and now they're having more developmental kinds of errors like yeah yeah I love that I'm gonna fire some great questions that you know you can do it initially and finally so a child who has final consonant deletion sometimes you'll see a a one to seven phoneme collapse of several stops fricatives affricates to null okay so that's your collapse to know what's the articles but what's the minimum dose of minimum practice trials that were aiming for in one session so it depends on whether you are working individually or in a group but I say that you would want to shoot pour fifty to sixty trials in a thirty minute individual therapy session minimum minimum is 100 there's this whole idea of got to get a hundred go to get a hundred and I think people are getting stress like well but I can't get a hundred trials yeah lots of ideas you know what if you can't get that just try to meet that minimum I yeah right right and that's another thing that I'd like to share with you is a data sheet that I have made for multiple opposition's you know one of the things is when you're wanting to implement a new approach if you don't have the tools to implement it it makes it really hard to do that so it is kind of like if you were going to to clean your floors but you didn't have a broom or a mop and you don't want to have to get down on your knees with paper towels and try to do it and I feel like that's what we're saying to clinicians oh here's this approach go do it here's what's involved but we don't give you the tools to do it and that was the whole rationale for developing the Skip app this is what I didn't really be like when I was doing it I really but I'm sorry my mum joke I didn't feel - and I don't have to put my faith but it was going to work and follows but quickly people are just asking about like how frequently so it is one 30-minute session enough to make change okay there's actually some data out there there was this randomized control trial an RCT that was done and I can't remember exactly when it was maybe 2014 something like that by Melissa Allen and and she looked at the the dosage and she was finding that you know obviously the greatest amount of change that you're going to get is if it's three times a week so that's not realistic and I know in Australia your health care system is different and and it's not mandated in all of the states in Australia that you provide services in the schools so so I don't know if you knew this but I was an honorary professor at the University of Sydney for a few years and have worked and collaborated quite a bit with the lease baker and so she put me on a dissertation committee with one of her doc students Ellie Sugden and that might be a name that a lot of year yes so I yeah yeah so this article is fabulous and and she asked that question if you know you can't get the dosage what what else can we do and so her whole study was how do we train parents to implement and specifically multiple opposition's and so I know that there were some questions about you know parent training materials Ali did a wonderful job this was just published in 2019 in the American Journal of speech-language pathology and it has a whole supplemental materials and it's open access that's right that's right so she did such a beautiful job in making it very explicit and and I have done a lot of parent training I've done parent training not only in terms of phonology but also language and working on morphology and and also literacy and how do you work with parents and you know a lot of the literature you talk that you read that involves parents say that well the compliance is very low and and so what I found is the more explicit your training is and again giving them the tools to be able to implement it at home and and so that's what Ellie did in her study is she was very explicit in training the parents and and and she collected data not only on the child outcomes but she also collected parent data and asking them you know how confident did you feel delivering therapy and she she asked them to complete the scale at the beginning of therapy and then at the end and all of the parents there their confidence increased significantly as going to try to see if I could find it here quickly I may not be able to put my hands on it but I think it's like 80 some percent we're saying they felt calm confident that ideal in practice what about schools okay well and when I think about schools in the u.s. that that is a concern it's really hard to contact parents it's hard to set up meetings with parents much less do the training I don't have a good answer for that one of the things that that we did is we made parent training videos we and you know I would work with small groups of parents who could come in I provided childcare because a lot of them you know it's like well I can come but I am NOT going to be able to focus on what you're saying because I'm running around the room after my four year old so you know that's a question that I I think we don't have a good answer for but I'm always and and just like you Australians are so clever at coming up with creative ways how do we handle this roadblock so I don't want to give up I do acknowledge that it's hard and I do acknowledge I don't have the answer that would address all parent when I did this approach I actually I just gave the cards to the teacher's aide and every single day this is why I think that child makes so much progress every day that teacher's aide actually just went through like went through the targets with the child so that's one thing that I did I also worked in America so I know what it's like to be in the schools and I'm gonna be honest here I found it very hard because I like speech so much I personally felt like I wasn't as effective like I was like really yes honestly I would make like a little black three-minute video on my phone and I would email you know text that video I did a parent just to show them all right quickly come on and like make a video of okay mom like what I'd like you to do is I'd like you to do this and that one I felt like that was easier some I mean written communications great but a videos Hey oh yeah yeah I like a little kind of like the RTI I would do that as well with mice to be kids I'd see them every day for five minutes because I felt that that was easier like yes manage my time because I couldn't see them I you know it just wasn't effective so those little things the best-case scenario but they're little things I've done that do make a difference yeah it might not be the ideal where you're saying oh I want you one-on-one for 30 minutes yeah but what can I do you know so sometimes just seeing a child for 10 minutes one-on-one instead of 30 minutes with fora you know three other kids are there poor kids might be better and it's interesting my dance that's the thing yeah yeah yeah yeah yeah you and I have a mind meld with that I don't do chutes and ladders in hi-ho cheerio or any of those other things because then I'm always redirecting the child back to the task but I try to make it so engaging and that they want to work with me and this is another thing you know my husband is a counselor and he and I for many many years co-taught and counseling and communication disorders of course and one of the things that we would spend time on is how to understand children's behavior and misbehavior and and how to get how to motivate children to work with you in therapy and in and so it's like you have to build a relationship with them and then you know they want to work with you and it's kind of like I'm running I'm running you got to catch up with me and I know that that doesn't fit for all the kids but I like to start on the level and assume that they'll do that and then you know take off with the kids and then if it doesn't work back up and then see well what other strategy do I need to do well I think this is a great way to talk about the biggest roadblock okay it is not stimula before a sound what do you do and I think this is where I know it's so easy just to lose faith and just going up like they're not getting it yeah when I read that study and just to let everyone know cuz people are like you showing me all these apps and books I will make I'm gonna I'm gonna make the least I'll make a list you know we're just chatting I'll make a list get it together and all the information will be there but what was interesting I read in that article for 2019 article you said it was it showed how you individualize multiple years yes yes okay and for those children who were not stimula ball you started the session with 20 C V consonant vowel articulation articulation yes yes yes yes and and that I love this Ally actually Elian and Elise actually found the this term and where this has been used in other approaches intervention tailoring so you tailored the intervention for the child now that does not mean be eclectic just do whatever works it it means that you are adapting what you're doing and so what you described with le when she pulled it out and she did 20 CV repetitions articulation then she put it back in multiple positions okay so when we look at these approaches on paper it's it feels from a clinician point of view it feels like you've got to do it this way and when there's no you're not sure if you know you're going off on a tangent or if you're doing the wrong thing and then I feel like it can be too easy just to veer off and just okay we're going to be writing and then you get I love that well and and you know you're talking about the different parts that make up an intervention approach and so my colleagues Elise Baker Sharon McCloud and Rebecca McCauley who is from Ohio State and I we've worked for a decade in developing a taxonomy of phonological intervention and and just really kind of looking under the hood of all these phonological intervention approaches to say what are the elements or the ingredients that make up an approach and one of the things that that I've been looking at is how do we teach students how to do clinicians learn new approaches and one of the things it's one thing to sit and listen to something and you can go yeah yeah that makes sense and then you go to do it and you have a thousand questions so one of the things that is coming out of the psychology literature early childhood education literature is talking about fidelity rating checklist and so I have developed one for multiple opposition's and and it goes according to like this is for the phase two so we were talking about the treatment paradigm and you're looking to say you know did I pair the target and comparison sound together for each contrast did I include a metaphor for the target did I include a gesture for the target these are all the components yeah so yeah so I think that yeah we should we're sure we've done we've done some you know presentations that after the past couple years on this intervention taxonomy and when everything everybody had to ship to online all the universities I took a couple of those presentations that put them together and and made a free two-hour lecture on the phonological intervention taxonomy so that's out there I can send you the link for that I could actually I could talk it feels like it's only been about 10 minutes yes oh she's fabulous yes we've got to talk about who is that can you swap a new one in and replace it with another sound that's a great question so again thinking systemically you have picked these four targets based on the distance metric and so what you're you're counting on is this generalization across the untrained sounds because you has strategically selected these targets to represent the different aspects of learning that the child needs to achieve so if a child generalizes out on one of the targets I throw it out now instead of one to four contrast I've got a one two three contrast so I generally do not put one in because I'm looking to see are you generalizing across the other sounds that are not trained and that's what you hope will occur okay I'm gonna show people who aren't just super quickly who aren't familiar with the skip app oh good had a CD and I think do you know I think that one of the reasons why I used all of these approaches is because I've had this and and it was easy yeah I never had to see it like fifty ten minutes and go you know for me I actually I bought this program and I've got the app as well and so I know it's a little bit backwards for people but for the app you you can literally plug in like let's say it's D is our targets out there air our sound and then you can plug in you know I'm just gonna do some random little things here you can just plug the mean and then it comes up with all your word lists so you don't have to kind of sit and think and then this is what you choose and then what I love about it let me just select that one sorry I've got a really old iPad and that looks like and you can choose whether you have photographs like what you have here or illustrations I really like illustrations better than yourself yeah and you can lose that one up so that they're next to each other yeah yeah and then and then you see they the the plus and minus so it keeps data for you and you can also switch the order of Equus not acquisition to order a presentation so there you go yeah well first of all let me do a disclosure that I did develop this app with NIH funding the National Institutes of Health so it really has a rigorous theoretical background and we had to do national test sites and developing this program and so anyway I do I do receive royalties off of this but so EBS healthcare actually converted it from the DVD that was what you had to the app and they're the ones who sell the and I was playing with my skin pap today when I was reading the questions and like there was this great one about this child who produces FW 4sw clusters and BR clusters and so I wanted to get on my skip app and I was having some problems so I called the programmer at EBS and he was excited that we were doing this and he said Lin I will give you ten promotional codes for skip that you can give out so I've seen all of those to you Rebecca and you can distribute those ten anyway that you can actually do multiple opposition's minimal pairs empty set maximal opposition's in Bower contrasts so for me when that when there are those strange little areas this generates it straight away and something gets done I'm not sure how you feel about this project sometimes when I've done the multiple actually non-words people have asked can you use non yes yes yes so this this has a huge database it has over 2,000 real words it has over 6,000 nonsense words so it was interesting like I said the person who had asked the question about the f/w for the SW and BR that I we don't we didn't have a way that you could let me just get on here that you could have a nonsense error you know so like fw is not a cluster in english and so I had to trick I had the trick skip into doing that so the person who asked the question was named Sam so I put I put Sam in as one of my students and so I'm going to click on Sam and since there wasn't a a nonsense for fw to put in for the child's error I just put F and then I wanted to have all of my f words be nonsense so I don't know if you can see this but I've got fat sweat and breaths okay so since fw does not make a word I just made nonsense words so we just say you know when when you make that those two sounds together it doesn't make a word it's silly it's just like this funny picture here and and I'm going to contrast it with each one of these sweat Brett so when the child when they trying to say Brett says sweat you'll say sweat that's a silly word they could point to this and then you go up to the next one and then you go to the next contrast so this is things swing and bring okay so I just wanted to show even though I didn't have a way that skip didn't have that nonsense option for the child's target that I tricked it into doing it just so people can sorry I don't know if that's oh it gives for yours yes yes but you can see you've got multiple opposition's minimal pairs empty set and I like that you've you've kind of given an example so when you do go into multiple opposition's you do give it a description and you want a video treatment example yes yeah and I'm glad you mentioned that because someone was saying do you have some video tutorials and they're loaded into the app yeah so then it really is a simple sorry my app is my iPad is like ten years old and it's still surviving this is what it would look like yeah and then you even kind of got in the app what you would choose and how you would choose it yeah yeah and and one of the things that I wanted to design and I mean when you get a million dollars grant you can you can build in all the bells and whistles that you want and I want to just in time support so anytime on any screen that you're doing something I tried to put what I thought would be questions that you would have so you'll see ten word sets were included now choose include non words and the ten word sets will go yeah so ten word sets this one I think I picked a funny I think that it should because it it would there it goes 157 yeah and then you just click on it how many words set so basically so dojo slow that's one word set correct set should we be choosing for our kids well I always start with five and and people say well what what are you basing that on there's not a whole lot of evidence I mean a lot of people haven't said well let's study this but there was a study that was done several years ago by my mentor Mary Elbert and and then a couple of the students in the program there at Indiana University Tom Powell and Paula Swartz Lander and and they they looked at what if we start out with three and we measure generalization and then if they haven't achieved generalization then we go up to five and and if they didn't achieve generalization we go up to ten and what they found this most of the children achieve generalization at five and so that's where I came up with that and sometimes people will say well well if you've got ten word sets why not use all ten of them and and that's kind of the the example of more it's not always better yeah and a couple things I want to mention before I forget that there were some questions about group therapy and seconds remaining before okay okay okay okay that's all right but I just wanted to say you can do group therapy you can set it up on the Skip app that way I'm gonna have to get you back on live again we have to have another focus wonderful I just don't what yeah I've got lots of work to do because we've been talking articles I will make up a fresh new Instagram post to give away those 10 apps because like I said I think it's going to change people's oh and I want I want to just say that you can use the the app on Zoom and doing teletherapy yes definitely awesome well I'm gonna say wrap up and say thank you so so so much I've just learned so much new stuff and I've got so much clarity you've just been so generous with your time oh there Becca thank you thank you so much for having me and I love all that you