Bec from Yarn Speech: Early Intervention in Speech Therapy

In this episode of PEADS Small Talk,  Grace discuss with Rebecca, a speech pathologist and current founder of Yarn Speech, the complexities and scope of speech pathology. 

They dive into the various roles of a speech pathologist across different life stages, the challenges of accessing speech therapy, especially in rural and remote areas, and practical tips for parents while waiting for professional intervention. 

Rebecca introduces Yarn Speech, an innovative app designed to support parents with evidence-based tasks to aid their child's communication development during long wait periods. 

The conversation also covers the critical importance of early intervention and offers guidance on recognising red flags in children's communication development.

Yarn Speech

Transcript

Speaker: 0:01

We acknowledge the traditional owners of the land and pay respects to elders past, present and emerging. We recognise their connection to country and their role in caring for and maintaining country over thousands of years. These stories are those of everyday heroes, of parents or siblings who go to extraordinary lengths to give their children a home in which they can not just survive, but thrive. We're so glad you're here with us to listen to Peeth's Small Talk.

Grace: 0:41

Hey Sarah,

Sarah: 0:41

how you going? Hello, grace. I'm good, thank you. Just busy as per usual. We have our be on the bedside conference coming up in October, so we are, in full swing, getting that organized, which is exciting.

Grace: 0:55

It is very exciting and every time we get another speaker who says yes that they wanna come along, I do a little happy dance. So, it's really nice to see how all of the time table is shaping up and yeah, I'm just really excited to see all the people who care about kids in the community come together and yeah, it'll be fun.

Sarah: 1:16

I'm excited whenever a new sponsor comes on board because I'm organizing the sponsors, so I have a little happy dance.

Grace: 1:22

Alright, so back to business. We are here for the podcast so my question for you this week is, what do you know about. Speech therapist or speech pathologist, either one. It's quite interchangeable. I actually don't know. I should have asked her what the difference is 'cause

Sarah: 1:38

yeah. Do you know when I actually had a, a sneaky little listen to this podcast and that was the very first question that popped into my mind was, what is actually the difference between a therapist and a pathologist? 'cause I do use them interchangeably and I don't think I should be doing that. Okay, so here's my. Very uneducated. Guess a pathologist is looking at the, maybe the formation of your sounds and your structures. So I'm thinking like, you know, swallowing and, and those sort of functions and therapy is the actual process of, learning. So learning the speech or learning the swallowing.

Grace: 2:21

I think it's interchangeable, so I didn't actually ask our guest what the difference was, and now I'm regretting it, but what does chat GPT say? The very evidence-based information.

Sarah: 2:35

All right. Ready? My quick typing with lots of spelling mistakes, they're used interchangeably. You are absolutely correct. Speech Pathologist is a formal professional title in Australia, the us, and many other countries. The correct title is Speech Language Pathologist. And a speech is a more informal or older term, often used by the general public. There you go.

Grace: 2:59

There you go. Oh, well we learn something new every day, don't you? GPT is correct. I had a really interesting talk with. Beck, who is a speech pathologist slash therapist, and, we got into the nuts and bolts of what do they do where you might encounter them, and also how, what she's doing to support some of our rural and remote communities, which, as anyone who listens to us would be aware that you and I are really passionate about supporting and getting that access out to them.

Sarah: 3:34

Yeah, absolutely. And especially with speech therapy, so many of our, clients in our complex care program absolutely struggle to get access. So we are hearing this all the time on the ground as well. As, you know, in hospital when they're visiting from or not visiting, when they're in patients from regional or rural areas, people don't tend to visit the hospital, do they? Not for fun. No, no. Only to visit other people. Yeah.

Grace: 3:57

Maybe to see the Meir cat sometimes at RCH. Beck, thank you so much for joining us today on the Peds Small Talk podcast. I'm really excited to chat to you. Usually we actually get our guests to introduce themselves, and the main reason that we do that is because I always find bio a little bit funny. It's something that you've written about yourself, that you get someone else to read it about you. Would love to get you to introduce yourself to our listeners and tell us a little bit about.

Bec: 4:30

Amazing. This will work really well of one of my own personal goals this year, which is to introduce myself as me, not as my job to start with. So my name is Rebecca. I am a golden retriever parent, of a beautiful 13-year-old. I live in Canberra and I love to be outside all of the time. And when I'm not outside or cooking or hanging out with my partner, I am usually, running a company called Yarn Speech, which is a tech company. In my former life, I was a speech pathologist for 10 years in rural and remote parts of the country. Now I work in tech, which is definitely not where I ever thought that I would end up.

Grace: 5:10

I love that and I love how versatile healthcare is as well. The way that you end up, you can end up in many different areas, if you are interested and passionate in that. I suppose the first one is, your formal life is a speech pathologist. What is a speech pathologist? I suppose first, like I know a lot of the kids that we go out and do education for, or that we look after in hospital, have seen a speech pathologist or are waiting to see a speech pathologist and yeah, I'd just really like to know a little bit more about what is that job? What does it entail?

Bec: 5:42

No, great question. it's something that I spend a lot of my time doing is explaining what actually is a speech pathologist and who do we really work with? the best way I always like to explain it is speech pathologists work across the entire age spectrum. So if you have a brand new baby. Maybe they're a little bit premature. Maybe they've been born with a bit of a complex medical history, maybe a cleft palate or something like that. speech pathologists work with babies in the hospital on feeding. So you might have lactation consultants who are specific to breastfeeding and that sort of feeding journey. But if that isn't working quite right and it's really quite complex. That's when your speech pathologist gets involved and we manage swallow function. I always think the best way to explain it to an adult is, you know when you drink water and it goes the wrong way and you cough and splutter and you like really can't cope. That's what our job is to try and stop. And for our little complex medical babies, often that's. Suck, swallow, breathe cycle of what they need to do in order to eat can be a little bit maybe uncoordinated, or if with a cleft there's a structural defect, so where is the milk going and what's going on. And so we help families to manage, swallow function in the littlest of people. So that's what we do at that point. And then as kids get a little bit older, they decide that they wanna start talking, which is sometimes a great thing for parents and sometimes an awful thing for parents. And that's when we get involved as well. And so at that point we work on speech sounds. So the sounds in words like ca at to for cat, or we work in language, which is using words together to form sentences. Actually understanding what someone is asking you and being able to follow those instructions. And so that's something we do as well. Once kids are a little bit older, then they get to about school age and we jump into literacy. And so now it's about putting the language and the speech sounds together in order to be able to read. And so teachers are obviously your core supports there, but speech pathologists come in and help when maybe there's a little bit of a challenge or a breakdown in that sort of reading journey. Then people get older. when we get into that older stage, we might start to see social communication things come out more. Our little people who are on the autism spectrum come in here as well. Any other sort of NDIS conditions? Down syndrome's, a really good example, low tone and using those words to communicate and how do we help there? That sort of disability sector is what we step into. And then only because we're on a PED podcast, I'll breeze through it, but we are going to adults. We work in stroke and neurodegenerative conditions are a big part of what we do. I spent a lot of time working in cancer, so oncology in the hospital was a big area that I loved and was very passionate about. And then we go all the way to palliative care and end of life care. So really it's communication and swallowing across the whole life journey is what we work on.

Grace: 8:24

Yeah, it's actually very broad, isn't it? And I can imagine that as a speech pathologist, you could choose to become a specialist in any one of those areas and really, become an expert in. Those parts of the lifespan, and that would be where you niche in and

Bec: 8:39

you sure can. Is that right? Yep. You can Or you pick what I did, which is rural generalism and kind of just be a little bit of everything all the time for whatever you need in your community.

Grace: 8:48

Yeah.

Bec: 8:49

Which I think when I, studied speech pathology at the start, I remember everyone was like, oh, you're gonna work with like lisps and stutters, and I was like, I think it's a little bit broader than that, which is definitely what

Grace: 9:02

What got you into, what drew you to speech pathology then? How did you end up there?

Bec: 9:08

When we were very young, I lived in this, rural farming community called Amply, which is in, rural New South Wales, near the Griffith and Hay region. we were out on the farm supporting my grandparents and my grandmother had cancer at the time, so we moved down as a family to the farm to help out. And, when my little sister was born, she didn't talk for a number of years. She has a very quiet little thing. Wasn't a big communicator. And we got to about three and she hadn't really spoken yet. And we were obviously a little bit worried as a family. Three is quite late. And so we tried to get her into a speech pathologist and it was really hard in the town, to now 29 years ago, so quite some time ago. And so that was my first interaction. I remember her going to the speech pathologist and I remember thinking, wow, this is so fun. This person plays games for a living. Which I now know is not quite the case. But when I was little, I thought it was the coolest job in the world. And then, as I got older, I went through. School I was leaning towards health generally. And as I guess most people in high school do, I was like, I'm gonna be a doctor 'cause that's what we all are told we should do. And then I did a work experience, in like year 10 where I shadowed, an occupational therapist and on one of the days she was like, oh, sorry, I'm like quite busy today. Can you just go hang out with my speechy friend for a few hours? And quite frankly, I really liked it. So I changed all my preferences and applied for speech pathology and was lucky enough to get in. And yeah, I've loved it ever since.

Grace: 10:30

So that's really interesting what you're chatting about in terms of, your experience with your sister as well something that we really commonly get asked by parents is, do you know a speech pathologist who hasn't got a wait list? And we get the requests from, the kids that we teach for in rural areas and regional areas and in metropolitan areas, although I've gotta say our rural areas that much more likely to reach out and say, who can we go to? But, there's a lot of really long wait lists in Australia for speech pathologists and probably all Allied health. In general, what are the risks for children if they're waiting too long for, if we focus on speech therapy, if they're waiting too long to get that support?

Bec: 11:15

Yeah, you are absolutely right. The wait list across the country are. Quite significant and, at least in my time working across the profession seemed to only be growing and not shrinking despite the fact that we're getting more and more speech pathologists out. There's a number of reasons why that happens. But the main point is we're out here trying to get to the kids who need it at that earliest point. And there's so much evidence that early intervention is critical. If we wanna have positive outcomes for children, in speech pathology, the things that we know is if we don't get to children by that critical early intervention window, they're five times more likely to end up in the justice system. They're more likely to end up with poor mental health. They're more likely to end up with poor literacy and numeracy skills during schooling. There's a lot of really, poor flow on effects and we can tie those back to not getting to kids by five. In some of the rural areas of Australia and some of the families we've spoken to, we've met families who've waited over five years to get access. And if you think you almost have to put your child. While they're in utero on a wait list so that you can get them in before they start school. Which is not that can't be the way that we go about things, and that's just not okay. The hard part is speech are doing their absolute best and there's so many of us trying so hard to work through that wait list. But the system is just so flooded by children who need support and one in four parents is worried about the communication skills of their child. So we need to come up with new solutions. So we're going to be in this si like cycle for a really long time.

Grace: 12:54

Yeah, that's actually really scary statistics, like listening to you say that sort of stuff and I just know also I'm thinking of parents who approach us like as you are speaking and they're trying really hard too, like they're trying. Really hard to get into, places to get into, be seen, using every avenue possible to try and make sure that their children have that intervention as early as possible.

Bec: 13:20

Can I just say that they're doing everything right? They are trying, they are putting their kids on wait list. They are calling around and it's just not landing.

Grace: 13:32

And so I suppose that's nerve wracking, sitting there with your child knowing that they need support and that you're wanting to give them the best chance to thrive and reach their full potential. And, there's a roadblock. Is there anything parents can do? If they, while they're waiting, like obviously we can't control some of these elements, like they're outside of Our circle of influence, as parents, but is there anything that parents can do in the meantime?

Bec: 13:55

Yeah, there's a few things I think, I have always said to all families, put your name on every wait list you can find. The worst thing that will happen is by the time you get the phone call, you won't need them anymore. And you'll be like, thank you for the call. As a speechie, I'm gonna be like, cool wellness family on my loose. Great it doesn't upset us. I think don't feel like you're gonna disappoint clinicians if you don't end up going with their services. That's wonderful. That's what we're all looking to do. So always make sure you call around and put yourself on every wait list, whether that's the public wait list, whether that's private wait list, whatever works for you and your family is what you need to do. Then look for other things to do in the meantime. And we'll go in a little bit to do with, yarn and what we've built. 'cause this is exactly where we work. We work on this wait list solution. So there is stuff out there and there's stuff that we're trying to build to support this in the meantime. But the main tip I always say to families is keep talking to your children. I think something that we, forget is that kids learn of what they watch of us. And so if we're quiet and we're just doing the dishes and not talking to our kid in that time, your child isn't learning. So tell 'em, it sounds so weird and it sounds so funny, but talk about everything you're doing all the time. So if I'm washing the dishes and my nephews are around, I'm like, oh, I've got a white plate goes in the water, like scrub, and then I'm drying the plate. Like they've just had so many different language interactions on something I was already gonna be doing anyway. So make sure you're always talking. 'Cause that's super, super critical. But back to what we're doing, 'cause I think this is also super exciting is, yeah, we started a company called Yarn Speech. And the reason we went about this is exactly this reason here, the amount of families I met that. Needed something and wanted something to do, but I didn't have the capacity as a clinician to provide that service because on my wait list, I'm only up to the point with the kid who got on there three years ago, not the kid who's here in front of me right now. And after years of kind of giving families the letter that said really sorry, here's our wait list. Here's two tips for you to do at home. I'll see you in three years time. Hope the problem's not so bad then, which made me feel awful. And I don't like that as a clinician nor to any of our other clinicians, but also that's not helpful to this parent. So at Yarn, what we've built is, we're building a series of platforms that support parents while they're waiting. So our first product was for like talking kids. And every day we give you three different evidence-based research back tasks for you to do at home with your child so that you always have new things to be doing while you're waiting. And so we try and I guess activate that waiting period. So you as a parent, feel like you can support your child and not only are you supporting them, but you're supporting them with clinically built evidence-based stuff while you're waiting to get in. And so by the time you get to me, you're a rock star, you know what you're doing, your kid's like probably going really well, and I don't have to worry so much about, the basics of getting them going. It's more those really nitty gritty niche sort of areas of things to do.

Grace: 17:00

Yeah, I can imagine how much of a game changer that would be to feel like, okay, at least I'm doing something, we are still working on this while we're waiting to be seen more definitively. So I suppose like the other question is, how would people get access to this? If you're on the NDIS that people could access through that? If you're not on the NDIS, can you access it as well? how do they get access?

Bec: 17:28

Yeah, so I guess there's two sides to this. If you're not on the NDIS, that's fine. Our app is available to anyone at any time. It's just in the app store. You come on down, you download our app, you get a seven day free trial so you can see if it works for you and your family which is great. And then you subscribe on. We deliberately made it a subscription service because we don't want you to hang around as a company, and I'm sure you're great and your child is wonderful, but we're trying to just get you ready to go and support parents to just understand what are the things that they need to be able to do to support their child in this waiting phase. So we don't want you to be with us for years and years. Having said that, we do have some families who are on the NDIS who are with us for years. So we have this beautiful mom who was a huge part of helping us build our platform, and her son is nonverbal and it's on the NDIS at the moment. she was so pivotal for us in the way that we picked certain things that went into the app because for her she was like, I spend my whole day worrying about my child. My whole day, every single moment of my day is worrying about his wellbeing and how I can make his life better and to support him. Coming up with things to do is actually genuinely exhausting, like having to come up with just tasks. And games and things that you know are gonna help is hard work on top of general care needs already, especially if you're managing tubes, if you're managing secretions, if you're managing all the other things that come with complex children. Then coming up with the things that also help them developmentally learn is hard work. And so for her, she's on our app and continues to be on our app. Because it gives her ideas of things to do at home that she doesn't have to think of. She goes log in the morning and we're like, Hey, today you're gonna do this. And she's great. Today I'm gonna do that. Thank you for that. Quick two second thing. And we've taken the burden of coming up with tasks. Off her for that day. And so that for us is another huge part of what we do and something that we really care about in regards to being involved in the NDIS. So yeah, we are a we're a clinical app, we're something that you can get written into your plan. We work with speech pathologists, so if your speech, he loves what we're doing tell 'em about us. And if they do like it, they might put it in as well. But it's something you can definitely work in.

Grace: 19:45

Yeah, that's great to know. That would help thinking about the cognitive burden and cognitive load of parents who are juggling multiple, departments that they're going to with their kids for appointments and medications and regimes that they need to do throughout the day. Especially if you combine that with physio and other, treatments that they're needing to do. It sounds really helpful and really exciting and a great solution, for a problem that's not gonna go away very quickly, being our wait list, sadly

Bec: 20:14

it is not.

Grace: 20:16

So I suppose is there any time in which, parents who are on the wait list with their kids, you're saying put your name around everywhere and be on a wait list, but is there any red flags which parents should be aware of that they can advocate? Are there some things professional opinion that are just like definite, you need to push hard and really advocate if you're seeing these signs.

Bec: 20:35

Yeah, let's start with the swallowing side of things. If there's something going wrong with feeding and there's any sort of instances of choking or coughing or concerns with that sort of, that feeding side of things with children and they aren't seeing a speech pathologist or haven't before that is super, super important to get in. We triage those patients at a higher risk triage as a clinician, so you will get in quicker. The reason we say that is you get in quicker because we are worried about the, like general health of your child. Aspiration is the thing that maybe some of your families know about. It's when food or fluids could even be just your own saliva, goes the wrong way into your lungs and you can throw in pneumonia and get very unwell. We don't want that. That's not good. And so those kids go to to the top of our wait list. So if there's any sort of instance with feeding or choking or coughing or anything with food, shout it from the rooftops. Tell everyone you'll get seen quickly and you should be. So that's one corner. If you're worried about the communication side of things, there are definitely certain things that, will throw flags at different points. And communication and learning. Communication is a journey. Everyone who has a little person will know, like the first words are at a certain point and the. 27 sentences that end with why are at a different point. And so along that spectrum, there's different red flags very early on. There's certain things that we wanna look out for. Responsiveness. Are they looking at you when you are, speaking to them? Is there eye contact? Are kid's responding to their name? Can they follow simple instructions? And when I say simple, get the ball, not get the ball, put it in the basket, put your shoes on, and then let's go outside because there's a lot going on there. And I think sometimes we forget that, processing all those little bits of information is hard in a little brain that's trying to learn 24 7. So be kind to your kids. But yeah, I think some of the things that are really important are eye contact and, tracking when you're little. Once they're expected to talk. And the way I always think about it is you should have one word at one. Whether that's mom, go more a basic sort of word you want about one word at one. And then you want two words together at two. So blue ball, I'll go mom, come. And then three words at three, like it grows is like a nice way to think about it. But if you don't have words at one, like why? What's going on? And I will comfortably say there's some kids that are just a little bit slower to talk and that's also okay. I think something we're really passionate about at yarn is not being alarmist. But if you are there and you're a little bit like all the other kids in my mom's group aren't talking quite yet, or their nieces and nephews seem to be a little bit ahead, it's always better to go and get some help and check, and make sure, to know that there's not something else going on. So they're probably a few of the little things that I guess spring to my mind.

Grace: 23:24

Yeah, no, they make sense. And you know what, I've gotta say we often will get asked, when we run health awareness, education and first aid education for new parents around that aspiration, because it's probably worthwhile defining that, it can be normal for children to occasionally swallow things. And that to go the wrong way. Yeah, and like all of us, we can have those instances where we are like drinking a cup of water and we accidentally do a little tongue, little aspiration. And then and that's fine. I suppose it's more about if you're constantly seeing that happening or if it's quite large amounts and it's causing lung infections or they're getting recurrent, pneumonias or bronchiolitis or different things like that. That's what you are talking about, isn't it, in terms of that aspiration. But the little ones are not,

Bec: 24:11

we all have moments, right?

Grace: 24:12

We all have moments.

Bec: 24:13

if it's something that's consistently occurring, if you're noticing that your child is clearly uncomfortable when they're eating what's going on? Let's just get it checked out. Make sure there's nothing else happening. I still remember times where. We've been referred babies that were just not gaining weight, and we're all like, what's going on here? And then we're finding clefts, like submucosal clefts that are hidden up the back, that no one's come across before because no one ever really looks in someone's mouth. There's stuff that might be going on that we just don't know yet. So you might as well give it a check and see if it's fine. But yeah, there's definitely a spectrum of normal. I cough and slaughter all the time. I'm a disaster with a cup of water sometimes,

Grace: 24:51

yeah, no, absolutely. Those are really useful I think. Tangible things that. People can think about and take away, and it sounds like what you're also emphasizing is you know, that you know your child and you know what their patterns are. if you've got those concerns, and you don't feel that they've been, appropriately addressed that first time around, go and get a second opinion. Trust that in strength, trust, trust your gut feeling. It's never gonna hurt to have another appointment and ask the question. If you are not worried, can you tell me why you aren't worried and when I should be worried?

Bec: 25:25

Helpful. And to build on that, I think, something that I find is really important in this space, and especially when we're talking about complex medical children, is, because there are wait lists. I think sometimes we think like I finally got in, so I have to stay with this clinician forever. And I think this across all clinicians, this is not unique to speech pathology. And I often think about when we used to have to go to the checkout at Woolies, I know now we can all go to the self-service if we just wanna get through. But remember, you used to have to pick a lane, right? And once you got in that line, you were like, this is my line, I'm here now. And then it was, they would start doing your groceries and it just took forever. And you're watching all the other lanes move really fast and things are going well, and you're like, why didn't I pick that lane? But you never go back to that slow lane again. The same thing happens when it comes to choosing your providers to support your children. If you are unhappy with the service and you don't think it's meeting the things that you want it to meet, pick another lane and that's okay. And you will eventually find someone who is the perfect fit for your care team. And this isn't to say that your slower lane isn't the right fit for someone else's care team. Someone might love that more gentle pace. And that's perfect for their child and their community. But if that's not for you, go to the next one. And don't feel like just 'cause you got through a wait list, you have to stay with someone forever.

Grace: 26:45

This is a relationship that you need to build as well. You want to be able to get to know that person for them to get to know your child, and for them to also be able to pick up on those patterns eventually as well. So you need that to be a relationship that you enjoy.

Bec: 26:59

With them for the many years you're gonna be together.

Grace: 27:02

All right, this has been so helpful. I've learned so much chatting to you, Beck. I would love to finish it off with just hearing, what your hope. Is for the future of speech pathology, especially for kids in Australia, if you have one.

Bec: 27:15

I have so many dreams. Look, I will not rest until children who deserve access to early intervention get access to early intervention. I think what we're trying to do and it's not just me, I think it's several people across the allied health spectrum. We're trying to systemically change the way that we support children. I think we need to think bigger, and we need to go how do we help? The whole system to better fit, to better support the children who need support at that earliest point in the journey so that we set kids up for success in the long run. It might mean I never sleep again, but I'm excited to keep working on it, for many years to come.

Grace: 27:57

That's amazing. And it's incredible the work that you're doing advocating for early intervention and particularly, thinking about our underserved areas, which are our rural and remote areas in particular. Such a vast country that we live in and every kid deserves to have access to healthcare, no matter where they live. So yeah, thank you for all the work that you're doing and, thank you for coming on the podcast today too. I think it's been really helpful and hopefully. Those people who are listening have gotten some useful information around, what a speech pathologist does, if they've got kids. They're on the waiting list at the moment, what they can do. And also they know about yarn now as well. So checking that out if, you've got something now that you can do while you're waiting. This has been such a great chat. Thank you for coming on Beck.

Bec: 28:41

Thank you for having me, grace. I love the work that you do as well.

Speaker: 28:53

Hello listener. That's the end of that episode, but I just wanted to jump on quickly to let you know that in case you're wondering, Sarah and I are caffeine fueled moms and business owners that really love to highlight the stories of children with complex medical needs. In this podcast, we do this for free, but if you are willing and able to fuel our caffeine addiction so we can continue to. Bring these stories to life. Now is your chance. Linked in the show notes is a way that you can support us by buying us a coffee. So check it out and then we can continue to tell these stories. Well, everyone, that's it for today. Thank you so much for tuning in to another episode of Pete's Small Talk. If you love this episode, we'd be so grateful if you left a review, subscribe to our podcast, and follow us on social media, where you are guaranteed to find life saving tips and tricks for keeping your little ones safe. See you next time.