This is a transcript from our podcast episode published December 13th, 2021. The podcast episode is offered for .1 ASHA CEU (introductory level, professional area). This transcript is made available as a course accommodation for and is supplementary to this episode / course. This transcript is not intended to be used in place of the podcast episode with the exception of course accommodation. Please note: This transcript was created by robots. We do our best to proof read but there is always a chance we miss something. Find a typo? Email us anytime.
A special thanks to our Contributing Editor, Caitlin Akier, for reviewing and editing drafts of our transcripts. Her work helps keep our material accessible.
[00:02:06] Kate Grandbois: We're so excited for today's episode today. I'm here by myself. My counterpart and copilot Amy is on vacation. Hi Amy. We miss you, but I do have an incredible guest that I'm so excited to welcome. So I'm not going to be lonely. We're really excited to have Tera Sumpter on the podcast today to discuss all things executive functioning.
Welcome Tera.
[00:02:28] Tera Sumpter: Thank you. Thank you. I'm so happy to be here.
[00:02:31] Kate Grandbois: I'm also so happy that you're here because we've had so many conversations leading up to this. So this is sort of like the pinnacle. This is a very exciting moment.
[00:02:41] Tera Sumpter: If only, we've been hitting, we’d hit record and hours ago.
[00:02:49] Kate Grandbois:Okay. So you're going to talk to us about executive functioning. And before we get started, I have to admit something which I've already admitted to you in private, but I'm going to now admit it in public because I don't know anything [00:03:00] about executive functioning. Um, and I think that's sort of related to the reason why we wanted to do this podcast and we'll get into the details of that later.
But essentially executive functioning is often sort of put on the shelf as this thing. And what we're going to talk about today is, is, or what you're going to teach me about today is how executive functioning is so closely related to so many things we do as speech and language pathologists, um, and how important it is for us to embrace it and understand it with a little bit of deeper meaning.
Um, but before we get into the fun stuff, I wonder if you could tell us a little bit about yourself.
[00:03:37] Tera Sumpter: I'm Tera Sumpter. I'm a speech language pathologist. Um, my background when I first got out of graduate school, um, my experience was in the medical field. So I did inpatient, outpatient. I did pediatric and adult care.
So I really saw the whole gamut. Um, I decided pretty early [00:04:00] on that when machines started beeping in the ICU that I was killing people. So I decided I should probably leave acute care because I freaked out and went to like a full,
[00:04:10] Kate Grandbois:I mean, that's reasonable. I think that sounds like a very scary and stressful environment
[00:04:13] Tera Sumpter: but I was not built for it.
Yeah. One of my coworkers would like dive in and start doing chest compressions CPR when someone coded. And I was like,
Kate Grandbois: we all have our strengths.
You do and you right away what mine was and what mine were not. So, um, we, as we kind of talked about earlier, before we hit record, you know, a love of mine has always been cognition and it was something that I was studying really in-depth even in graduate school on my own. And so when I say studying, I was finding that I had to go to other fields like neuroscience, like cognitive psychology liked, um, you know, developmental psychology so that there were other fields that were really studying [00:05:00] cognition, um, and how the brain functions really from a functional level.
Um, and that was what fascinated me. First time I heard the concept of neuro plasticity neuro-plasticity I was like, I'm in! Like game on and I just dove down the rabbit hole from there. Um, so I spent, well, gosh, the really the last 14 plus years. Really studying and learning from some of the best in these fields of neuroscience and neuropsychology.
And that's sort of, most of my continuing education has come from. So I'm a little bit different in that vein because I'm sort of this hybrid between what's happening in these other fields of psychology and neuroscience and, um, also the speech and language world. So I'm kind of trying to bridge this gap.
And as you can see with my work, it's, it's really sort of a hybrid
[00:05:57] Kate Grandbois: and I love that fresh perspective. I think that's so unique [00:06:00] because there's so much of what we do, um, that is siloed. And we're going to talk about that a little bit later in terms of, you know, we live on speech island, we work on speech island, we play on speech island, but there are other islands nearby that contributes so much to what we do. Bridging that gap is so important.
[00:06:13] Tera Sumpter: Yeah, the analogy. That's a great analogy. I never thought of it that way. I always talk about it like a lens, right? If we're only seeing things through one lens and that lens being the speech and language lens, it's a really, really narrow perspective on a lot of these topics because so many other fields are studying language just to, just to talk about one aspect, right?
Like really psychology studied it way before we did and how it develops and you know, what it comes from and where it comes from. All that, all that kind of stuff. There's so many different theories on it, but so many fields are studying these aspects of development that we are the ones treating. Right.
So if there's all of this [00:07:00] foundational research being done elsewhere, but we're the ones who have to pick up the ball and actually address it in therapy. Wow. Well, there's a whole lot of foundation that we can be learning from other places, not just, you know, through our one lens.
[00:07:15] Kate Grandbois: I can feel myself wanting to ask you a thousand more questions and I haven't even read the learning, learning objectives.
[00:07:21] Kate Grandbois: I have to be very careful. Um, but before we get into the learning objectives, you wrote a book on this.
[00:07:26] Tera Sumpter: I did, yes, I did. Well, I said, okay. So I forgot to tell you. So I was in the hospital for a couple of years, and then I started my private practice seeds of learning 10 years ago. Right. So that's, that's really where I took off and started doing very much my own thing.
I was able to branch out and be really independent. So with that came, um, I was attending lots of IEP meetings and things for children. And then I had somebody in a meeting, um, that kind of discovered this cognitive processing model that I had developed years ago, um, that I used for assessment and [00:08:00] treatment.
It's a very holistic approach. We're going to talk about it today. Um, and she said, I'm one of, I'm like on the board of this big organization here in Ohio, and I want you to come present this. This is brilliant. And I went, oh, okay. Because remember I've been living in a hole for most of my career studying from other fields.
So she's like, no, you really need to present to SLPs. So we started presenting conferences, organizations, um, kind of all over. And I would have SLP after SLP, after SLP saying, you need to write a book. This needs to be in a book. And I was like, when am I supposed to find the time to write a flipping book?
Like I have three children, I run a private practice. Like, so, um, anyways, I forced myself to get it done. It took away longer than I wanted, but I put the cognitive processing model got down on papers, everybody can access it. And it's been, it's like sold in almost 20 countries. It's [00:09:00] literally blown my mind.
[00:09:01] Kate Grandbois: That's amazing.
And I read it and it's very good. And we're going to talk a lot about the clinical content that you've put in this book. Um, and for anybody who is listening once we're finished and you want to dive a little bit deeper, there will be a link to the book in the show notes. Um, the title of the book is the seeds of learning.
Isn't that right? So the title of the book is the seeds of learning. Um, and you also have an online community where people can go to learn more. Isn't that right?
[00:09:27] Tera Sumpter: I do. I created a community called the Seeds of Learning. Um, it's on the mighty networks platform. Um, it's, it's a private community, it's an educational community.
And the reason why I started that again, it was because people kept asking for professional development. And what I was finding from years of presenting is that we get done with the presentation, we get done with the seminar and everybody says, I need more. I need to put this into practice and then I need to come back and I need to help.
I need to problem solve this with you. And so that was why I created the community so that every week we get together on zoom, [00:10:00] um, everyone brings their questions. We talk about the things that we did over the week. Problem solving errors that we had issues that we had in therapy. It's on going education and you have access to me all week long.
You have me face to face on zoom. Um, and there's self study material that I put out. We go through individual topics of executive functioning, um, and there's lots of self study material. People can get CMHs for it. So, but I went in the community and to everyone learns from each other. So we see, like we see things through one lens.
Right. Like, I I've been sitting executive functioning for so long, but I still see it through my eyes. I still see it through my lens. And there's so much value to me presenting what I might experience and the studying that I've done in the therapy that I've created, um, to other people, but then other therapists going, oh, wait, now I see it through this lens.
And they teach all of us. So it's really this community, um, has, it's just [00:11:00] been wonderful. Literally the zooms are the highlight of my day
[00:11:03] Kate Grandbois: awesome. So for everybody listening, as we sort of get into the meat of this material, if you are finding yourself wanting to learn more, there will be additional resources listed, and this will be one of them.
Okay. So let's get through the boring stuff so that we can get to the fun stuff. Sometimes people write in and ask me to skip this part. I can't ASHA makes me. So please bear with us. I'm going to read our learning objectives and our financial and nonfinancial disclosures, and then we'll get into it. Learning objective number one, define executive functioning and describe its relationship to learning. Learning objective number two, define the cognitive processes model and how it relates to speech and language pathology. And learning objective number three, identify at least two strategies for supporting executive functioning and speech and language. Disclosures Trra Sumpter's financial disclosures. Tera receives royalties from ELH publishing for her book, the seeds of learning, a cognitive processing model for speech, language literacy, and executive functioning.
Tera Sumpter's nonfinancial disclosures. Tera does not [00:12:00] have any non-financial relationships to disclose Kate that's me. I'm the owner and founder of grandbois therapy and consulting and co-founder of SLP nerd cast my nonfinancial disclosures. I'm a member of SIG 12 and serve on the AAC advisory group for Massachusetts advocates for children.
I'm also a member of the Berkshire association for behavior analysis and therapy Mass ABA the association for behavior analysis international and the corresponding speech pathology and applied behavior analysis, special interest group.
Tera Sumpter's financial disclosures. Tera receives royalties from ELH publishing for her book, the Seeds of Learning, a cognitive processing model for speech, language literacy, and executive functioning. She's also the owner of a private practice seeds of learning, LLC. Tera Sumpter's nonfinancial disclosure.
Tera does not have any non-financial relationships to disclose. Okay, we got that done. It was super boring. Let's get into the fun stuff. So I want to start off by sort of looking at some larger concept questions and I have to thank a friend, [00:13:00] an educator friend who brought this to my attention. Shout out to you, Liz.
Thank you so much for being my friend and teaching me things. If you read your book and, um, she works in a general education setting with individuals who are, um, struggling with literacy and it blew her mind and she came to me as the speech pathologist, and said, she had all these questions and I could answer none of her questions.
And the reality is that as speech and language pathologists, our scopes of practice are very, very large. Yes. A very, very wide, I guess I should say. And when I was in graduate school, which granted was a long time ago, I was sort of taught or given the impression that executive functioning is something that you do with someone who has a TBI or someone who has a neurological deficit.
And then when you're done working on those skills, you sort of put it up on the shelf. You don't, you know, you only address it when you need it. Um, but one of the things that my friend helped [00:14:00] that Liz again, thank you Liz, helped me reflect on and something that I learned when I did read your book is that executive functioning is more of a cornerstone that really needs to be considered and addressed throughout all of communication.
And I wonder if you could tell us a little bit, a little bit more about that as a deeper concept.
[00:14:17] Tera Sumpter: Absolutely. So executive functioning is really the foundation, the cognitive foundation for all learning. And so speech and language is just, those are a couple in literacy and right, all of these other types of, um, skills, this large scope of practice that we have, these become types of learning that we undergo from the time that we're born, but found, but the foundation, what has to be in place before we can learn cognitively is the executive functioning.
In short, we can say that executive functioning is self-regulation. So that's the shortest, shortest example or shortest definition of executive functioning would be self-regulation. Um, [00:15:00] we can think of, uh, executive functioning, that system is being like the boss of the brain, um, where, you know, it's sort of the, the one that's in charge.
We'll talk about this, maybe a little bit more in detail, um, but in charge of. Workers. So we have the workers, the some systems of technician doing the work, but then you have to have the manager, you have to have the boss who has to tell them when to do the work and how to do the work and at what pace to do the work.
Right? So all of these types of skills. So the, the executive functioning system is really that boss, the manager. And I also like to think of the executive functioning system kind of like a conductor of an orchestra. So it's also, the system has to, has to make sure that all of the workers work together in this sort of harmonious fashion so that we have this beautiful harmonious output.
Right. And so when we talking about output, you know, when we see executive [00:16:00] dysfunction and there's a problem within the executive functioning system, the deficits that we see are performance deficit, That's how they're defined. They're defined as it is a performance based deficit, because it's what we see is a difficulty producing, whatever it is that we're being asked to do, because the system isn't queuing the workers.
So getting back to your original question of like, what, um, you know, how, what exactly is the executive functioning system? Why is this something that's so foundational to learning? Why is this something that we should be involved in what we do as SLPs with children, not just TBI patients? Well executive functioning, the system is responsible for making sure that we are aware of our environment. We are cognitively connected to those around us. That's how we implicitly learn and speech and language development for that early, you know, birth to three. [00:17:00] We know that that's such a critical period of development. It's all implicit.
We don't directly instruct children. The quote unquote normal development don't know who that kid is yet. I haven't met them. There were a lot of air quotes happening there, but you guys couldn't see my air quotes, but I'm always like whoever that is, don't know who that is. But in the literature we talk about the quote unquote, typical, you know, um, control group, whatever.
So, um, but, but yes, so we have to, you know, this quote unquote typical child develops implicitly by soaking up like osmosis, right? Just being a part of this language rich environment. But the language rich environment is not enough because the child has to be connected and has to have awareness of that language rich environment.
That makes sense?
[00:17:53] Kate Grandbois: It makes a lot of, and I love the imagery that you're using, especially the conductor. I think that, you know, just the concept of [00:18:00] all of these parts. Working together. And I think, at least for me hearing you talk about this and reflecting on my own caseload or my own clinical experience, it it's one of those things that, well, yeah, it makes a lot of sense, but because we're not necessarily as speech pathologists trained to specifically address the executive functioning, we're sort of only, we're sort of working on, it feels like we're working sort of on the surface without considering, you know, some of these deeper concepts or the roots, if you will.
Um, I wonder if you could just to start off with some basics, outline some, some specific components of executive functioning. So off the top of my head, I'm just thinking about what you've said. I would say attention is likely one of them. Yeah, so I could be wrong. Cause again, I don't, a disclaim her. I don't know what I'm saying, but you're teaching me.
It's fine. I'm fine. I'm fine. It's comfortable. I'm comfortable with it.
[00:18:57] Kate Grandbois: Aside from attention. What are some of the other components of [00:19:00] executive functioning that are, are relevant to, um, what we need to know as SLPs?
[00:19:04] Tera Sumpter: Well, there are a bunch right? There are a ton based on the research that you read, everybody defines it slightly differently.
Some people, researchers tend to have like a smaller view, others like a really broader view with a lot more skills. I personally, with my experience, I've found that the broader view where I can really, I guess it's more of a detailed view where there are more skills that I can analyze the better I feel like I can target my treatment.
So what are some of those skills? Attention and perception of the environment awareness right, of environment and self are absolutely the foundation. Right? Then we have another big one: inhibition. Opposite of impulsivity, right? Can we inhibit ourselves so that we can allow our partner to take a turn
[00:19:51] Kate Grandbois: That gets me in trouble sometimes. That can be a human condition across, across everyone, right.
[00:19:56] Tera Sumpter: A hundred percent. Right. [00:20:00] Um, that is something that we all have to develop and struggle to develop at times. Right. Um, things like energy. Do we have the right amount of energy for a task? Do we have too much energy or are we too lethargic?
How about initiation? Just getting started, right? How about those procrastinators?
[00:20:20] Kate Grandbois: I sit down a basket of laundry and just get my phone out. I'm not folding that laundry, cause I don't want to initiate the task because I hate it.
[00:20:25] Tera Sumpter: Right. And so that's, I mean, that gets starts getting into therapy, but that's absolutely right.
You've set yourself too large of a goal that seems really undesirable. And so we have to somehow shorten that up. I'm going to fold two towels. Then I get to choose you.
Kate Grandbois:Write me a task analysis.
Tera Sumpter: Well, we'll create a treatment plan later. There you go. There you go. I need one. How about stopping? You know, we say it's time to turn off the TV and go to bed or it's time to do this and go to bed.
How's the stopping, right? Anybody has. A five-year-old or
Kate Grandbois:I was just about to [00:21:00] say, that's my son, just yes,
Tera Sumpter: Flexibility. And so when we think about flexibility and usually we're talking about mental flexibility and that can be seen in ways of stopping and doing something else, right. When we have to transition from classes, it could be that way, but another way, um, you know, in terms of assessment and when I see mental flexibility are in those types of language questions where a child has to give me two correct answers, they have to mentally be flexible enough to not just think rigidly about one, you know, or concretely about just one answer.
Well, now you have to provide me with another way to say it. That is mental flexibility. So often we think of these as strictly language type tasks, when really there's a lot of executive functioning involved. Okay. How about self monitoring? Can you take inventory of your own actions and your responses and with self-monitoring, if we can self-monitor then we can self-correct, [00:22:00] self-correct then. Just because the child can catch their errors doesn't mean they're going to fix them.
And a lot of times we lump these together. They might see that they made a mistake, but they don't take the extra step of self-correcting. All of those are, um, executive functioning. Self-modulation is a big one being able to, again, um, use the right intensity or frequency. How about those kiddos who are really loud and can't modulate their loudness level?
Kate Grandbois: Also me, It's fine.
Tera Sumpter: Yes. I have a child who's very, very loud. Yes. And, um, I kept hoping she'll grow out of it and I'm like, Nope, she's not growing out of it. But also like how about physically, when, when we're interacting with our peers, do we push too hard? Right? Do we get too close? All of those things, do we know our own strength in a sense?
And can we, can we modulate that. um, balancing multiple demands. Right. That's something I, when I work with my college students, we work with balancing a lot that becomes something hard. Sense of time and pacing [00:23:00] yourself. Right. Time has a feeling to it, knowing that you're going to have to listen to my presentation for 30 minutes versus having to sit in a presentation for five hours feels different.
You're like, yes, I can do 30 minutes. And when I say, oh, you're going to have to give Tera something for five hours. You're like, oh gosh,
[00:23:19] Kate Grandbois: you bring snacks, maybe a secret Sudoku puzzle. Not when we're listening to you.
[00:23:26] Tera Sumpter: That's been the hardest part with COVID and the zoom presentations, because I'm so interactive.
Like I sit on your lap and I'm like all over the place. Like I literally sit on people's laps. I'm all over the place. So like the time is, and it's so much fun. It was so taxing. That, one day we’ll make it happen, done done and done. Sequencing, um, executing a task, uh, working memory. We have to talk about that today.
Working memory is massive. Working memory [00:24:00] is holding and manipulating information and being able to recall and pull up information from long-term memory and use it within this, uh, inner immediate type of operation working memory is an executive functioning skill. Anticipating, engaging, analyzing, comparing and contrasting, generating of ideas, associating, prioritizing planning, organizing. decision-making just you executive functioning.
[00:24:30] Kate Grandbois: That's a lot more than I was expecting. I was expecting like 5. Not a joke.
[00:24:34] Tera Sumpter: And Tera is still talking
[00:24:38] Kate Grandbois: I haven't gotten my Sudoku puzzles out yet. Don't worry. And I'm fully present, fully present. No, but that's a, that's a lot. That's a lot. And I think when you, when you reflect back on that long list and how many of those components are direct influences on language, language use, word choice, attending to your [00:25:00] communication partner, using working memory to, you know, I can't even list all the things you said because there were so many, but every single one of them is related.
Um, making me feel like the spokes on a wheel with the center being language, or it's somewhere on the wheel and all of those things, they're all connected.
[00:25:16] Tera Sumpter: They're all connected and they're all necessary for any kind of learning. And it's not just, not just speech and language
[00:25:27] Kate Grandbois: before we talk about the cognitive processes model and how it relates to speech and language pathology.
I have a couple of smaller related questions that, um, about things that you mentioned in your book that I think will give us a nice backdrop. You mentioned in the book about the pluses and minuses of getting a diagnosis and, and how we as SLPs, okay. So I'm just trying to pull this all together here. We have that long list of executive functioning of things that we're not really necessarily addressing in our speech therapy sessions, where we have the skills and the content [00:26:00] knowledge to maybe address some things on the surface.
And we have a person in front of us. Your book is mainly focused in pediatrics. So we're going to use pediatric examples through the process of, or through the course of this talk, this conversation, you have a small person in front of you this child in front of you, who may or may not have a diagnosis, but has been flagged or referred.
And I'm thinking about my friend, who's in the general education environment right now, trying to support learners, um, because this doesn't necessarily affect just SLPs. And I wonder if you can talk to us a little bit about this concept of diagnosis and how it fits into this larger puzzle.
[00:26:41] Tera Sumpter: Yeah. So this, this gets controversial and it's interesting because I'll have people on social media really, really argue with me about this.
Um, I, I believe that we're very label happy in our society. We want, we think that once we've found a diagnosis, [00:27:00] I'm using air quotes, again, a quote unquote diagnosis that then we've found the answer. Right. Like, oh yes, the child has DLD or, oh yes. The child has, you know, whatever it, whatever it is, it's like the whole alphabet soup of, of what we give to children,
Kate Grandbois: what acronym.Right.
Tera Sumpter: Yeah, exactly. So, um, and I would argue that a diagnosis can do one of two things. It can point us in the right direction, or it can point us in the wrong direction and in terms of how to create treatment and how to help the child. And so I think we have to be really careful about putting all of our eggs in the diagnosis basket, because if we're so focused on the diagnosis and what we think are the, what that diagnosis is supposed to mean, we might not see all of these other,[00:28:00] um, you know, symptoms or issues that might be presenting itself that might be able to provide us with the knowledge for better treatment plan for that child. So I think, and this is, you know, what I'm finding is that the really good therapists are already doing this, right. We're looking at the symptoms, we're looking at how the child presents functionally within their environment.
And I always say, to me, the diagnosis doesn't matter. It really doesn't matter unless the child needs services other than, and I'm in private practice. Right. So I know it's a totally different ballgame in other settings. Um, but for me, when I have a child in front of me, all I need to do is I need to look through how they're processing information and that's going to give me the best picture of this kiddo, whether or not I give it the label of, you know, DLD or autism or, you know, whatever the diagnostic [00:29:00] code is to me as the practitioner. And that child’s therapist, it doesn't matter because I'm meeting the child where they are based on how they're presenting, you know, across settings.
[00:29:11] Kate Grandbois: The reason why I think it's so important to, to talk about this is because before we talk about the treatment model is because I think as clinicians, we get the tiny person or the child in front of us and we read their intake forms and we look for a diagnosis.
And that gives us an idea of what it is we're going to do that day or what assessment materials we might need. It's like you said, it points us in the right direction or the wrong direction points us in some direction. But what I think is important to highlight is that as clinicians we're there to, for person centered care, we're there to treat a child or a human or a person, however old they are. And in order to engage in person centered care, we really need to support the person [00:30:00] and the quote symptoms. And I'm using air quotes, of the diagnosis and not just the diagnosis itself. So before we started talking, and I also want to say that there are funding components related to this too.
So a lot of people get a diagnosis. Because we have to based on our healthcare system to get funding. So I think it's important to keep that as a backdrop in our minds, as we start talking about treatment approaches, and I know we're going to talk a lot more about the cognitive processes model, um, but there are other variables and other factors that we really have to consider in our treatment room besides the diagnosis.
And I love the point that you made in your book. And I just wanted to highlight that for a second.
[00:30:39] Tera Sumpter: Oh no. Can we get something to that? Um, you know, I think I I've spent my whole career really intimately with families being in private practice. That's a beautiful part of private practice is that we really become part of that family.
Um, and so I've really watched a lot of them go on this journey of trying to help find [00:31:00] help for their children. And one of the things that I've heard time and time again, is that we lost so many years of good help because it's therapy for the child because they were everyone, they were chasing a diagnosis, right.
They were like, well then there was this diagnosis and there was this diagnosis and there was this diagnosis, but nobody was putting it together and trying to piece it together and just looking at how is the symptoms presenting. And so that's, that's one thing where I feel like if we're focusing on that diagnosis, we can end up barking up the wrong trees for too long, as opposed to just looking at the child in front of us.
And the other thing too, is I think it's so important to remember is that no two diagnoses present the same, right. We can have two kiddos with dyslexia in front of us. And they're going to look very different, right?
Kate Grandbois: Because they're two different people, and no two people are the same!
Tera Sumpter: but I feel like we get stuck on the diagnosis and we're like, [00:32:00] well, they have dyslexia. And because they have dyslexia, this is what we do. Boom, boom, boom, boom, boom. Instead of really looking at how does the child present? What are their mistakes? When I talk about, when I work with therapists on assessment, right?
I always say, forget the numbers, forget the percentiles, forget the standardized scores. Those tell you nothing other than that the child is having trouble. That's the only thing they're going to tell you where you're going to get the most information about that child, how they process information and what you as the therapist need to do about it is in the errors that the child makes.
We spend hours at my private practice combing through the data that we get in an assessment at every single, um, stimulus, right. Here's the word was pat and they said, pitt, what was the error? And then once we have all of those, you know, the errors mapped out, then we're looking for the patterns. What are the patterns within this processing?
That's where the information is, [00:33:00] on how a child is struggling and how they're processing information. And I feel like we lose that when we focus on the diagnosis.
[00:33:07] Kate Grandbois: This is a great segue into our second learning objective,
[00:33:10] Tera Sumpter: stop talking Tera...
[00:33:14] Kate Grandbois: no, because you're starting to talk about some of these fundamental components of analysis.
And I think that there are components of that in the cognitive processes model. And I, and I want to, I want to give you a chance to tell us about the cognitive processes model. First of all, what is it and how is it related to speech and language pathology? I know that's a loaded two parter question.
[00:33:34] Tera Sumpter: Yeah. Yeah. Remind me about the second part. Once I am part way through my
Kate Grandbois: that's what I'm here for. I can do that.
Tera Sumpter: That's reminders. So the cognitive processing model, it is, um, it's, uh, a model of looking at the components necessary for learning, particularly academic learning. And I spent years developing this based on [00:34:00] studying right loads and loads and loads of reading of research what's involved with what, what correlates with what, um, and you can see in the book, the actual diagram and how I use the diagram to plop in information.
But it's really looking at these different components, everything from speech processing to language processing, to pulling out phonological processing, um, visual word form area, which the visual word form area for literacy is the part of the brain that visualizes symbols, numbers, letters, um, and then how that correlates to math.
And then we see in the model, how executive functioning has to reguluate all of it. So, um, it's just a broader, more holistic approach of looking at assessment, right? That's, that's primarily how I use it. Um, but the assessment drives treatment, right? So if you have a good assessment, it's going to drive, gonna drive treatment.
So, um, we do a really detailed assessment based on this model of looking at each individual component. [00:35:00] And how does that relate to speech and language was the second that
[00:35:04] Kate Grandbois: See you remembered that was such good executive functioning
[00:35:05] Tera Sumpter: and working really good working memory. That was really good working on the question.
[00:35:12] Kate Grandbois: Well, and the reason that I want to unpack it and make this connection is because, you know, we are SLPs and often we work in a siloed environment, right? We work on, um, I think we talked about this maybe before we started recording, we work on SLP island right here by ourselves. We don't work. We work here, we play here and there's other islands nearby that may contribute to our work.
But for the most part, we stay on SLP island. And what you're getting into with the cognitive processes model is a little bit of an edge or going into some of these other areas. And I, I think because we've, you've already outlined how critical executive functioning is for so much of what we do. I think it's really important to point out specifically what the cognitive processes model has to do with speech and language pathology in the first place.
[00:35:59] Tera Sumpter: [00:36:00] Yeah, absolutely. And I think to you with. This is what I'm. What I tried to do with this cognitive processing model is offer us a really tangible way of showing how speech and language development is the foundation for so much of our other learning.
Right? And we know that as SLPs, we know without speech and language, we're really going to struggle with literacy, right? If we have holes there, well, I'm going to show you how it's also related to math. And I'm also going to show you how all of these components of the processing are needed for learning another language, or doing well in social studies or science, right?
What is it that we're accessing for all of this other language and speech and language from a subset, um, processing component, you know, a factor. It is a foundation, but seeing also that the executive functioning is the bigger picture of what has to regulate. [00:37:00] Sort of all of these, sub systems. So it's a lot of what we, we already know.
And I've had so many SLPs who read the book, reach out to me and say, you know, like, oh my gosh, this is, this is what I've been feeling for so long, but I didn't know how to organize it. I didn't know how to put this into words, like, because we know that these components, speech, language, right, phonology, some of these things are foundational for the learning that takes place in the classroom.
You know, we know that a child's going to have trouble with reading comprehension if they have deficits in language comprehension. Right? Why is that? Because oral language becomes the foundation for these other aspects of a child, can't understand struggling with oral language comprehension, they're going to have a hard time sitting through a lecture and understand what's happening in social studies or science, right?
So it does become these components necessary for all learning. And that's what I'm trying to show with this model. Um, but the bigger picture being that yes, speech and language a hundred percent are a massive [00:38:00] foundation, but there's even more that has to happen before that. And that's the executive functioning component that it is, it is truly the root here.
[00:38:10] Kate Grandbois: And everybody who is listening, who has listened to our podcast before knows that we're massive, massive proponents of collaboration and a lot of what you're saying, and this imagery we've sort of touched on about these neighboring islands in our field. A lot of what you're saying. There is overlap here with other professionals.
Um, and I wondered, I wondered if you could tell us a little bit about that overlap, particularly with our school psychology counterparts or our neuro-psych counterparts or our psychology counterparts, um, or even our general education counterparts when they're in the classroom and don't have access to an executive functioning specialist, but are turning to the speech pathologist, trying to facilitate more growth in a general education classroom.
What, what, what does that look like for you?
[00:38:56] Tera Sumpter: Well, I just want to start by saying, you know, [00:39:00] with that question, if we, if we think that there's no overlap to all of these fields, we're as dumb as they come listen, the brain is,
[00:39:14] Kate Grandbois: can you tell me what you really think? Just real quick?
[00:39:15] Tera Sumpter: Am I allowed to swear? How many expletives are you allowed to bleep out in when a guest ASHA's not going to like that?
[00:39:26] Kate Grandbois: I don't think they would have it's okay. If this wasn't public, I'd say I wouldn't tell, but it's fine.
[00:39:29] Tera Sumpter: So, so if all of learning whether or not we're talking about the field of education or psychology or SLP world, or OT or PT, whatever it is. All of this stuff is mediated by the brain and the brain is interconnected.
It is all connected. There is no way to differentiate between this processing and that processing. I mean, it's fascinating to see how [00:40:00] quickly the brain will shift, you know, based on that's a whole, that we can’t talk about that. Okay. That's going to get into a whole other topic that was not on an objective, but it's really fascinating research by David Eagleman.
If anybody's interested with his book, Livewired, it's amazing.
[00:40:13] Kate Grandbois: The link in the show notes, just in case,
[00:40:15] Tera Sumpter: oh my God. He's, he's a neuroscientist. He's, he's brilliant. Um, but, but everything is interconnected and everything is working together. So there is no way for us to say as SLPs that we don't need OT.
There's no way that we can say we don't need the psychologist or that we don't need the educators or that we don't need the vision specialists because it takes all of it for a brain to learn. Right. So, um, I feel like it's, I feel like it's sort of a no brainer.
Kate Grandbois: Pun intended.
Tera Sumpter: Yeah, that was good. That was real though, for a Friday to Katie, Katie, that was impressive.
So no brainer. I mean, we, we have to see [00:41:00] all of this as interconnected. We have to see the, that all of us need to be working together and why it all blends so much together. And one of the things that I hear a lot from professionals, particularly SLPs when I present is that they hear from other fields, particularly a lot of times the school psychologist will tell them, stay in your lane.
Yeah. I I've heard that a lot over the years that they will hear from school psychologist, executive functioning is their domain. Executive functioning is not your domain. Stay in your lane.
[00:41:30] Kate Grandbois: I recently heard a term for this: disciplinary centrism. So when you think that your field knows better or does better than other fields, disciplinary centrism is a rampant problem across all of medicine, across all of allied health.
Every, every discipline has a flavor of disciplinary centrism. And when you start talking about and looking at disciplinary centrism, you start to see a lot of individual variables like ego. [00:42:00] And I think that there are a lot of barriers there. Um, that we, as people, can't control other people, but we can control ourselves.
And there's a lot of work you can do to build, to bridge these gaps related to reflecting implicit bias, thinking about your own ego, defining your scope of competence. What do you know and what do you not know? Because you're going to have a much better chance of making a good relationship or smooth, smoothing things over with the grouchy pants down the hall who told you to stay in your lane.
If you acknowledge that you can learn from them and ask them and ask them questions and create a relationship. And as we, we literally make a mug with this on it, be a person, not a jerk. So there's a lot of things that you can do to improve some of that inter collaborative relationship. Um, and that's a, not to steal mic from you, but disciplinary centrism is a, is a real thing.
I mean, that's why they have a fancy word for it.
[00:42:53] Tera Sumpter: Yeah, that's brilliant. And it's so important. I mean, we can go into the whole, like philosophy of why that exists [00:43:00] straight from an evolutionary standpoint, we're all trying to survive. Right. It's either eat or get eaten. And so I think that's maybe where a lot of that comes from.
Yeah. But I think that when we realize that in our field, in the field of medicine and when we're trying to help other people that this sort of sense of ego and self has to be set aside because it's not about us. It's about the patient in front of us, the client in front of us, the student in front of us.
Um, and realizing that we are better together as a team because we're all going to support that system. And that is so critical. Um, I mean, we refer, we are so collaborative, um, within our private practice where we need all of these other people on the team, but that's essentially where I was, what I was trying to offer with this cognitive processing model is that, this isn't just speech and language. And if we are only looking through that micro lens, we're missing a whole lot of other pieces to [00:44:00] this puzzle.
[00:44:01] Kate Grandbois: Not only that, but let's think about the things from the client's perspective and looking at it through the lens of person centered care. An individual; presumably if you're listening to this, you're interested in learning more about executive functioning. So you may or may not have someone on your caseload who has some who need some supports for executive functioning that individual may have other people on their team. They have other stakeholders, they have friends, they have parents, they have, they have other people in their environment.
So if you make it just about speech and language, you're not going to create a long-term supportive environment, or you're not going to facilitate that long term supportive environment because we're transient. We have our clients for an hour, a week, two times 30. I don't know whatever your workplace workplace setting is or whatever your service delivery model is, but it's never just about speech and language.
It touches so many other things, and there are a million reasons for that outside of um, math and social studies [00:45:00] and the academic pieces, there are social emotional components to this too.
[00:45:03] Tera Sumpter: 100%. Yeah, that was something I actually didn't talk about. That's very interesting is that, you know, executive functioning is a really, really broad umbrella that regulates many what we call arenas of involvement.
So it's going to regulate the emotional arena. And so it's, you know, emotional, really our perceptions, our thoughts, our actions. And it's really fascinating because we get kiddos and they come to us again, going back to the diagnosis, um, conversation with a million diagnoses, right. They have oppositional defiance and they have, you know, sensory processing disorder and they have, um, you know, all of these different diagnoses, but that's really because ultimately with these kiddos, the deficit is in the root.
The root of that is executive functioning and the executive functioning isn't regulating all of these pieces and parts, they're not, they're struggling to regulate their emotions. They're struggling to regulate their actions. They're struggling, [00:46:00] struggling to regulate their perceptions and their thoughts.
So it is a really broad, broad arena. And that's why, you know, working with allied professionals is so, so, so key. Um, having somebody who specifically targets the emotional, if we need that and the sensory, I mean, you can't do executive functioning work without a sensory OT. Just can't do it. It's, I always say executive functioning and sensory processing go together like peanut butter and jelly.
And you can't separate the two. They have to, you've got to address the sensory system as well.
[00:46:34] Kate Grandbois: I love that. Do you have any, for those people who are listening, who maybe have been told to stay in their lane or experiencing a prickly pear, a prickly professional, or some other, you know, unfortunate interaction or where they're not really sure where to get information for how to get, how to make those relationships better.
Do you have any practical suggestions for improving those relationships?
[00:46:56] Tera Sumpter: Absolutely. You just have to educate yourself. [00:47:00] You have to arm yourself with information. When people realize that you know what you're talking about and you can cite sources, then you know, people start to listen. Um, I was asked about a year ago to present to a local group of school psychologists. There were like 70 or 80 school psychologists. It was all on Zoom. Yeah, I know. Well, usually it's, it was a lot of people, but, um, I mean, I was, I was shocked in a way. I mean, it was honored obviously, but, but in my head I think of like, oh wow, the school psychologists are asking me to educate them on executive functioning.
Why did that happen? Because they know that I know a lot about it, right? You just have to present yourself. I know a lot about it. You have to learn about it. My favorite places to go to there's a book that everybody needs to buy. You have to put this in your show notes. It's by George McCloskey. If you follow me on Instagram, you know, I reference him a lot.
George McCloskey. Lisa Perkins, Bob Diviner is [00:48:00] the book is by, um, called assessment and intervention for executive function difficulties. It is a fantastic book loaded with so much information. I will warn you. It is not an easy read, but it is worth every moment of energy that you put into it. Um, another really good one by Russell Barkley, he's better known.
He's kind of like the godfather or the executive functioning. Um, he has a book called just executive functions, executive functions, what they are, how they work and how they evolve. That's a really, really awesome, um, book as well, Dawson and Guare have some good things out there. There's a lot of people and this is where it gets tricky.
Right? There are a lot of people out there writing about this topic now, but there's some heavy hitters who've been in this field for a long time. Um, you can't go wrong with Barkley. You can't go wrong with McCloskey. Um, and, uh, I do like, I like Dawson and Guare too. I [00:49:00] don't like their working memory stuff, but other than that,
[00:49:03] Kate Grandbois: I will link all of those in the show notes so that everybody listening can have those, uh, as a, as a quick and easy access.
Um, in our last 10, 15 minutes, I wanted to transition over to our third learning objective, um, and talk about implementation. So in other words, now that you've told us a little bit about the importance of executive functioning, how it's related to speech and language pathology, what the cognitive process model is.
And some of the barriers such as interprofessional collaboration and those kinds of things, what are some things that we can do about it? What are some things that people that are listening can do in their therapy rooms or, um, even additional resources to improve our ability as SLPs to do more than just the surface work of addressing speech and language.
[00:49:54] Tera Sumpter: Okay. I'm going to talk about two key components that I think should be a part of everybody's [00:50:00] therapy that's going to target executive functioning. Okay. The first thing that we have to do is we have to increase a child or adult, but in my, you know, in a child's awareness around their deficits, we can't change what we're not aware of.
And the, an incredible technique for doing this. It's called reflexive questioning. This is something I talk about a ton. Reflexive questioning is responding to a child's response when there's an error. So for example, um, if a child says, I'm gonna use the literacy example, cause we do this across the board, you can apply it to anything.
So, um, if the word is “bat” and the child says “bit”, I'm going to respond to bit. And I'm going to say, when you say bit, what would be the [00:51:00] second letter that you would see? B-i- I it would be I you're right. Does it match? And I'm going to point them back to the original stimulus. And they can say, no, it doesn't match.
And I can say you're right again. You've been twice Right. Good job. Let's see. What's the second letter that you use. It's an a, oh my goodness. You're right. Again. You're so smart. What does A say? Oh my gosh, smart again. I went to word say that nice job. What I've done is I've increased that child's awareness around the mistake that they make when we just give the child an answer.
So if I would've just said, no, it's not bit it's bat. There is absolutely no processing that takes place for that child. It's completely passive. I'm giving them a response, but the child's brain isn't actively have to get engaged in fixing their own mistake.
[00:51:56] Kate Grandbois: Not only that, but it's punishing and it doesn’t feel good
[00:51:57] Tera Sumpter: and it doesn't feel good, [00:52:00]
[00:52:00] Kate Grandbois: creating a positive learning environment.
You're not associating yourself with anything that is empowering. All of those good feels that we all feel when we do something hard, but feel like, okay, I can do this, that inner loop, that inner self-talk, you're not going to get any of that momentum. If you're just sitting there going, Nope, it's bit not bat or bat, whatever.
If you're just sitting there correcting them, you're not going to get any positive momentum in terms of rapport any of that stuff.
[00:52:25] Tera Sumpter: Exactly. It's a very positive environment when you bring in the reflective questioning. Um, the other thing too, you know, a lot of times we'll just have them like, oh no, that wasn't right.
Do it again. But that'll be the way that we would address the kind of an error, just, okay, we'll try it again. Well, they might get it right the next time, but there's been no reflection. No self-evaluation no awareness on the child's part of how they erred the first time. And it's the increase in awareness that is gold.
It's the secret sauce to changing how that child is going to process their [00:53:00] environment. What would this look like for a straight up, you know, executive functioning example? Let's say we have a kiddo. Um, let's say that we have a kiddo who is looking out the window, right. And they're distracted by something going on outside the window, instead of paying attention to the teacher.
How might I handle that with reflexive questioning? I may say, Hey Johnny, where are our thoughts right now? Is that important? Is what's outside important right now. Oh, no, it's not. You're right. I'd be like, I hear it too. I always tell the kids like, trust me, I hear it too. I could probably get an ADHD diagnosis myself, but like, I hear it too.
Is that important right now? You're like, no, what's important right now? The teacher talking. That's right. What should we be focusing on? What should we have our thoughts on? Where should our thoughts be? They should be on the teacher. You're right. Good job. Can you show me? Yes. Awesome. Great. So using it that way, instead of like stop paying attention outside, Johnny, you're not listening, right.
There's a way to do this that increases [00:54:00] the child's awareness. And with repetition, reflexive questioning ends up wiring the child's self-talk. So they start asking themselves the same questions. Am I doing what I'm supposed to be doing? Are my thoughts where they're supposed to be. Um, those that match,
[00:54:20] Kate Grandbois: which is an executive functioning skill. That's self-reflection.
[00:54:22] Tera Sumpter: A hundred percent.
That's why we do reflective questioning. It's full circle. We're getting the child to self evaluate and to be able to self monitor and to self correct. I mean, let me, let me ask you this. So if you have, um, if you have somebody coming over to your house, right, who is coming over for dinner and they call you on the phone and they're like, oh my God, Kate, I'm lost.
What's the first thing you ask them?
Kate Grandbois: where [00:55:00] are you?
Tera Sumpter:Great. Right.
Kate Grandbois :Is that the right answer?
Tera Sumpter: You say, where are you? That's what we need to be doing with our children. We need to be saying, where are you? Let me meet you, where you are at your response. And let me help guide you to the.
[00:55:20] Kate Grandbois: I love that analogy with all my human self, because the analogy is where, cause you you're lost.
Oh, well you're lost. And then hanging stuff, just telling them that they're lost telling them what they already know.
[00:55:35] Tera Sumpter: Yeah. Or try again. Sorry. I know you're lost, but try it again. Try it again. Right. Geez. It's so beneficial. We would, we have to meet them where they are and we in the, where they are is at their mistake.
I do this with speech too. I mean, you know, if the child is using the wrong sound, right, I'm going to meet them at the wrong sound and we're going to analyze [00:56:00] the air and sound and I'm going to raise awareness around their aired sound and then ask them if it matches. Right? So I'm increasing awareness around the ears that they're producing so that then they can see the distinguished does this, the distinction between theirs and min.
[00:56:16] Kate Grandbois: I have to assume that this also requires some nuance and finesse and rapport and counseling skills, because I'm imagining myself as a, as a more green clinician. I'm old and crusty now I've been doing this for too long, but you know, I, once upon a time as a new grad, I think back on the things I did and I just absolutely cringe.
But you know, I think that I could see my younger self, maybe trying to apply some of these techniques too harshly or without the right dose of support. Do you feel that that's true, that there needs to be some nuance around counseling and positive report to do this reflective questioning well?
[00:56:58] Tera Sumpter: Well, for sure, like, don't be a [00:57:00] jerk look I'm telling you it'd be a person that.
Yeah. I mean, you're not gonna be like, Johnny, are you paying attention? You know? And, and I think always bringing it back to, um, we all experience these kinds of errors and meeting them at that human level of, I get distracted too. Or, you know, sometimes I make mistakes when I read too, or sometimes I'm, disfluent when I talk too, right.
Like whatever, whatever it is, we can all meet them there. And that's the beauty of reflective questioning is that you're meeting them there. You're meeting them where they are instead of standing in your spot firmly and saying, get here and get here now. Right where we're walking over to them. And we're saying, we're holding hands with them.
And we're saying, I see you and I see where you are and I see your struggle. And we're going to walk together and
[00:57:53] Kate Grandbois: It’s so validating. Everybody wants to be validated and heard.
[00:57:55] Tera Sumpter: Yeah, it's so validating. So like my I've worked with all [00:58:00] ages throughout my entire career, but now. I'm old and crotchety, like you were saying.
Um, you know, I don't quite have the energy for the littles that I used to have now that I'm in my forties. So I really loved the high school and college aged kids. And I can't tell you like these high school boys, like, I can't get them out of my office. Like they come for therapy and then they won't leave and they're like, give him material.
We just like being here. They love being there because they know there's really never a wrong answer. It's supportive. They feel successful. And I'm telling you, it is all because of the reflexive questioning and how we can take a mistake and turn it into a positive and walk them to the right answer. But they can see it themselves.
I always tell when I do full like big day trainings and all, everything, I always tell people if there's anything you take away from today, please take reflective questioning. It is an absolute game changer. Oh, I know. I have a quick example too. [00:59:00] So in my mighty networks community, one of the members, Jean, who's amazing.
She's, she's more seasoned than we are Kate. She said, I didn't, it wasn't quite sure but I bought into this reflexive questioning. She goes, oh my god, it worked so well. I couldn't believe it. She was like, I asked these little five-year-olds who were squirrely all over the place. Is that what we're supposed to be doing?
Where are our body's supposed to be right now? And they're all like, oh, oh no, it's not what we're supposed to be doing. And they got to where they're supposed to be doing just like good job. She was like, I couldn’t believe it worked! And I said, it works.
[00:59:32] Kate Grandbois: It was one of the most, one of the most important things that I'm hearing about this is that it's done again, just to sort of reflect this back to you. It's done in a positive, supportive, comfortable, and safe therapeutic environment. And yet nobody can learn and grow when they’re being criticized when they need to be validated when they're feeling anxious, no learning is going to happen as a human experience.
You are not going to learn [01:00:00] something if you're in fight or flight, or if you're nervous or if you don't have a good relationship. And I love that you're describing this in such a way where you're meeting someone where they are full of support. Okay.
[01:00:10] Tera Sumpter: So second, second, one second strategy. That is so key is the implementation of visualization into our therapy sessions.
So, um, and this is key for both executive functioning and language, because this is really the foundation for what we call nonverbal working memory, which is really this imagination part of our executive functioning system that's necessary for language. So, um, what is visualization? It's this ability to create mental representations within the brain, right?
It's if I say, think about the best vacation that you ever went on, what happens in your brain.
[01:00:49] Kate Grandbois: I actually, I think, I think I might have an executive function disorder.
[01:00:51] Tera Sumpter: Oh no you don’t see anything?
[01:00:56] Kate Grandbois: I have concepts, but I am my visual. [01:01:00] My visual spatial abilities are lacking. It's okay. I'm cool with it.
[01:01:04] Tera Sumpter: We can work on that. Non-verbal working memory becomes a foundation for our ability to have foresight and hindsight. So the only place that the future and the past exists is in our mind, it only exists in our ability to create a representation.
So I can't plan for the future. If I can't project myself mentally into the future, I can't self evaluate the past and the mistakes that I made. If I can't see what happened and role play it again in my head, in the past.
[01:01:59] Kate Grandbois: That's powerful just as like a [01:02:00] person. I mean, if you're thinking, you know, that you that's applicable to everybody all the time.
[01:02:04] Tera Sumpter: Correct. And that's why so many people have executive functioning issues and they can't do this. You have to be, so when it comes to working memory, we have working memory for images, non-durable working memory. We have working memory for sound, phonological working memory, right. We have these two components.
And so we can't our concepts and our language are going to be, um, really, you know, conceptually are going to be, uh, what's the word I'm looking for? You know, the non-verbal working memory is what houses these concepts. Right? And so if we can't see ourself moving through the world in our mind, or if we can't see a potential interaction happen with a peer before it happens that if I say this or do this, they might be upset with me.
So therefore I need to check [01:03:00] myself and self monitor. Right? All of that requires this ability to visualize and have mental representations either into the future for planning purposes and for self-monitoring and for self-correcting, but also for the really important skills of self-evaluation, which takes place in the past and learning from mistakes so that we don't repeat them again.
Right. We took it when I hear parents say all the time, like they keep making, doing the same thing over and over and over again. Why aren't they learning that if they do this, it's not going to work for them. Well, because they're not, self-evaluating, they're not replaying the error over and over again in their mind, trying to self monitor it and fix things, and self-evaluate it. Right. That all requires visualization. So, um, in short, I mean, gosh, I could, I could talk for days about visualization and how we address it and all of that. That's going to be my third book, third book,[01:04:00] second book, which is in the process of being written right now is, um, my executive functioning therapy.
And then I think my plan that I have sort of outlined in my head is a third book, which will be language through an executive functioning lens. Yeah. So, but I'll be dead by the time I can get all this it's all in my brain. I just have to get it out.
[01:04:25] Kate Grandbois: I, this was especially that last one. I feel like so much of what you've said is, and shared is not only applicable, but critical to the work we do in speech and language pathology across so many different components of our scope and so many different apps of that, aspects of, of what we do.
Um,
[01:04:44] Tera Sumpter: and I want something, oh, sorry. That's something that's so fascinating within my mighty networks community is because these therapists are always bringing different, you know, they'll say I had a question last week, Tera, what about, how does executive functioning relate to disfluencies? How does it relate to this population and [01:05:00] this population?
Right. And so there, we get to really problem solve with all of these different types of populations that we work with. That's awesome.
[01:05:09] Kate Grandbois: That's awesome. Well, to anyone who is listening, who, if this is their, you know, either first pass at learning more about executive functioning or if they're, you know, knee deep in it, but when I continue their journey, do you have any words of inspiration or wisdom for those, for those folks who are listening?
[01:05:28] Tera Sumpter: Oh my gosh, you should have prepped me for this question. Any words,
[01:05:33] Kate Grandbois: Amy always does, and I forgot because Amy’s not here.
[01:05:38] Tera Sumpter: Sorry. Do I have any words of wisdom? Um, I would say just keep reading, keep reading, keep challenging. Um, progress is not made without resistance. And so just because it's always been [01:06:00] done one way doesn't mean that that's the right way.
And so if we really want to move our field forward, if we really want to not feel like we're lost in therapy and that we're really reaching these kiddos and helping them, we have to keep asking the questions. We have to keep reading. We have to keep challenging. Why, why, why are we doing what we're doing?
Why are we seeing what we're seeing? If you can't answer the why keep digging.
[01:06:29] Kate Grandbois: Well, I can't say anything to follow that up, so that's just, I have nothing to contribute.
[01:06:36] Tera Sumpter: Oh, I'm glad that it was good.
Oh, thanks. Okay.
[01:06:43] Kate Grandbois: I am so grateful for your time and I'm so glad that we got to share this with everybody listening. Thank you so much for coming on here and teaching me everything ,
[01:06:52] Tera Sumpter: Thank you for having me
[01:06:54] Kate Grandbois: and to anybody's who's listening. All of the resources that we mentioned will be in the show notes [01:07:00] and, you know, contact us any time.
If you have questions, I don't want to speak for you, but you've been so generous with answering questions through your different channels, social media, people can find you through your mighty networks. Um, there's lots more, lots more.
[01:07:13] Tera Sumpter: Yeah. Instagram I'm on Instagram every day I post and then get off.
Cause I don't want social media drama, so, but I do post and get off. Um, but I do answer DMs. I try to get to a lot of the comments. Um, so you can, a lot of people do reach me through Instagram too, but my email is in the book. You can find me. I mean, you can find me on my website, so I'm not hard to find.
That's awesome. Feel free to reach out.
[01:07:37] Kate Grandbois: Wonderful. Thank you so much again for being here and we hope everybody learned something today.
[01:07:42] Tera Sumpter: I hope everybody learns something too. And I really appreciate you having me. This was so much fun.
[01:07:47] Kate Grandbois: Open-door policy for you. Anytime. Anytime.
[01:07:50] Tera Sumpter: Thank you. You guys are the best.
Comments