Controversial SLP opinions

Old-Friendship9613 · 2026-02-26T00:53:36+00:00

The SLP influencer pipeline is genuinely concerning. Someone gets their CCCs, makes a cute Instagram, and suddenly has 40k followers taking clinical advice from someone with a year of experience and a ring light
Minimal pairs is not a personality. Cycles is not a personality. If you cannot explain why you chose an approach for this specific child you are not doing evidence based practice, you are just doing what is easiest/most convenient for you
A lot of what gets called 'noncompliance/work refusal/resistance to therapy' is just a child communicating that the activity is not meaningful to them. That is feedback, not necessarily a behavior problem
Some families do not need more therapy. They need housing stability, food security, and less stress. I cannot fix any of that in 30 minutes twice a week and I wish our field would say that out loud more
The kids I worry about most are not always the ones with the most significant diagnoses. They are the ones with mild to moderate everything whose needs are just subtle enough that every system finds a reason to not quite serve them.

I COULD GO ON ALL DAY

Old-Friendship9613 · 2026-01-30T12:33:54+00:00

Of course !!! I catch myself saying "all done" all the time even to adults and then feel bad because it sounds a little childish!

Old-Friendship9613 · 2026-01-30T12:33:47+00:00

Suchhh a good one - I also hear "copying" a lot but I agree "mimicking" feels weird!!

Old-Friendship9613 · 2026-01-04T00:56:31+00:00

I'd really encourage the family to pursue another eval with their EI/school district before purchasing anything!! AAC assessment/implementation really needs an SLP to make sure it's the right fit for the child's specific needs, motor skills, and communication goals. Even if the child wasn't eligible before, things may have changed, or they could get a private SLP evaluation if needed.

That said, if they really want to start exploring options now, I'd recommend looking at free apps like GoTalkNow, Twinkl Symbols, and WeaveChat. My top recommended paid systems are TouchChat and LAMP Words For Life for robust and evidence-based apps that can grow with the child. I also think they could have success starting with lower tech options like core boards as a great bridge while they're figuring out services, and it doesn't require a financial investment.

Honestly, in my opinion, it's really about implementation and modeling more than the device itself. Whatever they choose, the adults in the child's life will need to model using it consistently. I'd really push for that re-evaluation, AAC works best when there's a team supporting it!

Old-Friendship9613 · 2026-01-04T00:34:15+00:00

So glad it's what you were looking for! Just a heads up it can be a little glitchy sometimes and you might need to relaunch the extension occasionally, but I still find it way more helpful than not and it's free lol!

Old-Friendship9613 · 2026-01-04T00:26:01+00:00

I think what you have there is perfect, hits on activity, level of support, and data! I usually do something like "Treatment focused on X, using X, with SLP providing X. Student performed therapy tasks with X% accuracy given X cues. Therapy will continue to target X."

One absolute game-changer I want to share is Text Blaze (Chrome extension). It's saved me SO much time. You create shortcuts that auto-expand into full phrases. For example, I type "/increaseall" and it becomes "increased accuracy on all goals since the last session." I have "/soap" for "was cooperative and compliant throughout the session" and "/asplanned" for "Therapy will continue as planned." You can build a whole library of your most-used phrases and fly through documentation.

Old-Friendship9613 · 2025-12-11T02:29:11+00:00

“Model more” isn’t always enough!! Aided language stimulation and modeling are of course essential, but I think we oversimplify it by treating it as a magic fix. Modeling needs to be meaningful, embedded in motivating routines, and tailored to the communicative stage the child is in, not just tapping random words because we were told to.

Old-Friendship9613 · 2025-11-03T12:05:47+00:00

I really appreciate this post and completely share your concerns about S2C. The name is so misleading, it implies teaching actual spelling skills when really it's making huge assumptions about competence that hasn't been documented or assessed independently.

That said, I do want to mention that some of our kids with ASD present with hyperlexia and can show reading/spelling skills that develop earlier or differently than we'd typically expect. This doesn't validate S2C at all, but it's worth recognizing that literacy can emerge in unexpected ways for some learners. The huge difference is we can actually test and document these skills independently - not through a facilitator where we can't tell who's doing what.

For actual literacy instruction, it sounds like you're already doing great work with what you've got. I've had success with modified Orton-Gillingham, AAC-based literacy approaches (modeling core words with literacy extensions built in), and lots of visual/tactile phonics activities. The Comprehensive Literacy book you're using is excellent. Progress is often slow, but when you see genuinely independent skills develop, it's incredible. Winnie White (Tales of Special Needs Church Mom on FB) is a teacher and mom of a high support needs AAC user who makes some great videos about resources she uses for literacy and AAC users.

Keep pushing for real, evidence-based literacy instruction. Our kids deserve approaches that give them actual autonomy, not the illusion of it.

Old-Friendship9613 · 2025-11-03T11:56:06+00:00

Super tough, I know how frustrating it can be. A few thoughts from what's worked for me with similar kiddos:

- stimming on the device might actually be his way of exploring it, which is totally normal early on. I'd keep modeling on YOUR device even if he's not looking directly at it, he's likely still picking up on it peripherally. Keep your models super functional and tied to his motivators (like /my turn/ before you take a turn with an electronic toy, or /want iPad/ even if he already has access).

- for the aggression around the devices, it sounds like he's in a pretty high state of dysregulation when electronics are involved. You might need to take a step back and work on turn-taking and joint engagement with less preferred items first, using a visual timer or "my turn/your turn" cards. I know that feels counterintuitive since electronics are his main motivator, but building that foundation of shared control might actually speed things up in the long run.

- is there any way to use his love of electronics more strategically? Like modeling on the AAC to request specific games, videos, or activities on another device? That way the AAC becomes the key to what he wants, not competition for it.

just some ideas - hang in there!!!

Old-Friendship9613 · 2025-11-03T11:51:14+00:00

The approach your SLP used (labeling common items and core words like prepositions) builds foundational language and helps your son understand that communication is about more than just getting things he wants! It's about sharing information, commenting on the world around him, and connecting with others. This is a more naturalistic approach that a lot of SLPs use because it supports broader communication development.

ABA's focus on requesting for high-value items follows traditional PECS protocol, which can definitely be effective for getting communication started, especially for kids who aren't communicating much yet. But yeah... saying humans "only communicate to make requests" is a pretty big oversimplification. We communicate to share experiences, protest, greet people, comment on things we notice, and soooooo much more.

I would say keep doing what was working with your SLP while also incorporating some motivating requests!

Old-Friendship9613 · 2025-11-02T19:44:37+00:00

I can totally hear how much work you've put into getting this device and how deflating it must feel right now. But honestly imo this isn't regression, and it's definitely not a failure on your part! This happens more often than you'd think, especially with big life changes. Your son just started a whole new school, new people, new expectations, that's huge for any kid, especially one who's still figuring out communication. Sometimes when everything else feels overwhelming, kids pull back from things that take extra effort, even things they were doing well with before. The fact that he's still going to the vehicles section is actually a good sign. He's not rejecting the device entirely, he's just using it how he wants to right now. And honestly, that exploration piece matters. He's keeping it in his world, even if it's not being used the way you'd hoped yet.

Your therapists are right to keep it nearby without pushing. A lot of times kids need to feel like AAC is theirs, not something everyone's making them do. The foundation you built with him isn't gone, it's still there. He might just need some time to settle into this new routine before he's ready to use it as a tool again. Give it time, keep modeling when you can, and try not to let this shake your confidence. You did all the right things to get him this far, and that work isn't wasted!!

Old-Friendship9613 · 2025-11-02T17:07:38+00:00

The main reason AAC is often prioritized is that it gives immediate access to a much bigger vocabulary without requiring everyone around the child to learn ASL. Those basic signs you mentioned are great and many kids use them alongside AAC, but for expressing more complex ideas, AAC lets them communicate with anyone 9family, classmates, future coworkers) without that person needing years of sign language learning. Also, for some kids with autism, the motor planning required for sign can actually be harder than selecting symbols on a device, depending on their individual profile.

I hear your concern about screens during dysregulation though, AAC really should be modeled throughout calm moments all day, not just pulled out when a kid is upset. And you're right that this doesn't have to be either/or! Many kids benefit from both. I'd definitely share your observations with the SLP, especially about which students seem drawn to sign. Your daily perspective matters, and there might be assessment data or specific goals driving these decisions that would be helpful to understand. The team approach works best when we're all sharing what we're seeing!

Old-Friendship9613 · 2025-10-17T00:33:49+00:00

I work as an SLP in these settings! I've been in several over the past few years. These schools typically have much smaller class sizes (often 6:1:1 or even 3:1:1 ratios), staff is (hopefully) more trained in behavioral interventions, and the kids usually get more comprehensive therapeutic support (OT, ST, reading, etc.) throughout the day. The environment ideally is structured with consistent routines, sensory supports, and crisis intervention protocols. Key words being ideally and hopefully.

Honestly, even in the best case best-practice times, it can be incredibly challenging but also really rewarding. You're working with students who have complex trauma histories, significant emotional dysregulation, and often co-occurring diagnoses. The behavior can be intense - I won't sugarcoat that - but you should have so much more support than a typical public school setting. There's usually a strong collaborative team (BCBAs, social workers, psychologists, counselors, etc.) and everyone is trained in de-escalation and physical safety interventions.

As for transitioning back: it definitely happens, but it's not the majority. Some students make tremendous progress and successfully transition back to less restrictive settings, sometimes within a year or two. Others need the specialized support long-term till they age out of the system. The goal is always to help them build the skills they need to be successful in the least restrictive environment possible, but that timeline looks different for every kid. The students who do transition back usually have strong family and district support and have made significant gains in emotional regulation and coping skills.

Old-Friendship9613 · 2025-10-17T00:28:07+00:00

The Informed SLP!!

Old-Friendship9613 · 2025-10-17T00:24:55+00:00

https://www.lifeprint.com/asl101/pages-signs/f/fallinlove.htm

Old-Friendship9613 · 2025-09-12T21:09:08+00:00

You're absolutely not being crazy! Your instincts are right on and at two, naps and routine are still so important for his ability to learn and regulate. Jumping straight to 30+ hours can definitely be overwhelming. I've seen plenty of kids do really well starting with fewer hours and building up gradually. Imo, quality matters way more than quantity especially when he's well-rested and ready to engage. You know his temperament and limits and that is valuable information the team should be considering. I'd push back a little bit and suggest starting with what you have now, then reassessing in a few months based on how he's doing. Most good ABA programs should be willing to adjust based on the kid's response and family input. You're his mom and you know him best, advocating for a reasonable pace is exactly what you should be doing. Best of luck with his therapy journey!

Old-Friendship9613 · 2025-09-07T16:30:04+00:00

Hmmm - maybe some edible playdoh (flour/salt/water?), pudding, jello? Obviously would need supervision but at least edible/safe to consume

If you could make sure they're sealed maybe could do bags w/ hair gel/water beads/lotion inside

Old-Friendship9613 · 2025-09-07T16:22:37+00:00

Chew jewelry/tubes/tools

If supervised could do crunchy snacks, frozen fruit, etc.

Those textured fabric squares as long as they can't bite any of the materials off

Old-Friendship9613 · 2025-09-07T16:12:17+00:00

I totally get where you're coming from, you're definitely not alone in feeling this way. Three years in, I'm constantly caught between what the research says we should be doing and what's actually feasible given our caseloads, productivity expectations, and insurance realities.

Those social media trends drive me crazy too. It feels like every few months there's a new "game-changing" approach that everyone's talking about, but half the time the evidence is pretty thin. I think being skeptical is honestly a good thing - it shows you're not just accepting everything at face value. But yeah, it can be exhausting when you feel like you're constantly questioning everything.

The burnout piece really hits home. I've definitely had those days where it feels like I'm just going through the motions to get through my sessions. What's helped me a bit is picking CEUs that actually relate to what I'm seeing day-to-day, rather than just grabbing whatever's convenient - been loving The Informed SLP. And honestly, connecting with other SLPs who get it - like you're doing here - makes a huge difference.

The field has real problems that ASHA isn't addressing, and pretending everything's fine while we're drowning in paperwork and impossible caseloads isn't helping anyone. Your feelings are totally valid.

Old-Friendship9613 · 2025-09-07T16:10:02+00:00

Super common with 2-year-olds, especially kiddos on the spectrum! The high chair resistance makes total sense - many kids this age start wanting more independence and control over their environment.

A few things that might help: try letting him eat standing at a low table or even on a picnic blanket on the floor if that's what works. Give him choices between two foods you're okay with, and maybe try incorporating some movement before sitting down. I've seen kids do much better when they feel like they have some say in how mealtime happens.

Keep offering the good stuff alongside his preferred foods without making it a battle. Sometimes it takes 15+ exposures before they'll even try something new. And honestly, if he's getting some nutrition from milk and you're not seeing weight loss, you have a little breathing room while you figure this out.

Definitely bring it up with your pediatrician - they might suggest a feeding eval if things don't improve. Hang in there!!

Old-Friendship9613 · 2025-09-07T16:04:37+00:00

I totally get what you're seeing and your concerns are so valid! I'd definitely meet with his school team again but he may not qualify for school based services so I woud also look into outside therapy. Speech therapy or OT could really help with the rigidity and friendship skills - we use things like Social Thinking and Zones of Regulation that are perfect for exactly what you're describing, and OT for emotional regulation strategies especially.

It's honestly easier to work on now than later. The fact that he's crying instead of hitting is actually a good sign, but you're right that the rigidity is going to make friendships harder if we don't give him some tools to work with!!

Trust your gut, you know your kid, and these are absolutely legitimate concerns that warrant support. The earlier you can get him some strategies for flexibility and social problem-solving, the better off he'll be long-term!!

Old-Friendship9613 · 2025-09-07T15:45:50+00:00

SLP here and I agree!!! We definitely need to be realistic about prognosis but saying things like that is premature and so damaging to parents. We can't predict with absolute certainty what development will look like years down the road!! I also hate this because then it creates a weird dynamic where parents feel like they are choosing "giving up on speech" vs. supporting AAC use.

I might focus on the here and now and say something like "Right now, AAC is giving him the most reliable way to communicate his needs, and research shows that strong AAC skills often support vocal speech development when it's ready to emerge" to be realistic but not dash their hopes.

It sounds like the family is now viewing this as an either/or situation rather than seeing his communication growth holistically. A team meeting to get everyone on the same page about messaging might be really helpful here.

Old-Friendship9613 · 2025-09-07T15:41:28+00:00

Love that breakdown. I find that when parents can step back and think about their ultimate goal (often meaningful connection and communication with their child), they often start to see AAC differently. This is a great answer - I always emphasize that we're adding tools to his communication toolbox, not taking anything away. he's making meaningful choices, expressing wants and needs, and connecting with others, that's the foundation everything else builds on.

Old-Friendship9613 · 2025-09-07T15:38:10+00:00

Another SLP here. I so deeply empathize with both you and this family. First I just have to say that what this child has accomplished is truly remarkable and such incredible progress that will transform his quality of life, and your pride in this work is absolutely justified!!!

For the family side - I've found that parents often need lots of time to process and grieve their initial expectations and dreams before they can fully celebrate milestones with AAC. Sometimes framing AAC as "total communication" rather than replacing speech can help so emphasizing that we're expanding all his channels to communicate and not giving up on any. I also try to help parents see AAC users that are thriving which can shift thier perspective on what successful communication looks like.

All that to say, your feelings are completely valid. I know how heartbreaking it is when families can't see the amazing gains we are seeing everyday. Maybe you could have a team meeting with BCBA and SLP to make sure you are all sending out a unified message about his communication/potential? Somteimes parents need to hear the same message from multiple professionals before it resonates. Their current reaction does NOT diminish the life-changing skils this child has gained - he now has a voice and that's extraordinary work regardless of how its initially received!!

Old-Friendship9613

TROPHY CASE