In this very special episode of the podcast, I talk with my wife, Lauren Schwabish, a speech-language pathologist who helps adults recover communication after stroke, traumatic brain injury, and other neurological conditions. We discuss person-centered care, translating medical jargon into plain language for patients and families, and the visual tools and assistive technology Lauren builds to help people with aphasia communicate — with real lessons for anyone designing data visualizations, dashboards, or reports for a broad audience.
Resources
Neuro Speech Services | @NeuroSpeechServices on Instagram | National Aphasia Association | Aphasia Access | BYU Aphasia-Friendly Research Resource | Stroke Association (UK) Aphasia-Friendly Guide
Guest Bio
Lauren Schwabish M.S., CCC-SLP is the owner of Neuro Speech Services, a private practice based in Northern Virginia, specializing in person-centered assessment and treatment of cognitive-communicative disorders related to stroke, acquired brain injury, mild cognitive impairment, ADHD, and other neurologic and neurodegenerative conditions. In addition to providing evaluation and treatment services, Lauren is a consultant with several non-profit organizations serving individuals with acquired brain injury, including Brain Injury Services and Can Do Multiple Sclerosis, and she is a volunteer group advisor for the National Aphasia Association’s Parenting with Aphasia group. Lauren received her Bachelor of Science degree with Honors in Communicative Disorders from the University of Wisconsin-Madison and holds a master’s degree in Communication Sciences from Hunter College of the City University of New York. She is licensed in the Commonwealth of Virginia, state of Maryland, and the District of Columbia, and is a certified member of the American Speech Language Hearing Association. She has over 26 years of experience working in hospitals and acute rehabilitation centers and is passionate about providing meaningful and accessible health education about the brain to patients, families, and health care professionals. Lauren is committed to empowering communities with evidence-based information and best practices in brain health behaviors.
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Transcript
00:01.76
Jon
Okay, we’re recording. Do you want to say hi to Scabbo before he has to edit all this?
00:07.28
Jon
You’re welcome.
00:08.08
Lauren Schwabish
Can you see me? Can you see me?
00:09.72
Jon
Well, he usually works with the audio. So, but Scabbo, if you look at the move file and you can see her talking, she’s making.
00:11.57
Lauren Schwabish
Oh.
00:16.63
Jon
Love hand gestures.
00:17.38
Lauren Schwabish
Love you, Scabbo.
00:18.41
Jon
Well that didn’t sound good.
00:18.75
Lauren Schwabish
This is the only time I will ever listen to this podcast.
00:22.52
Jon
She’s not even gonna listen to it. just gonna She’s gonna share it, but she won’t actually listen to it.
00:27.17
Lauren Schwabish
I want to see all the metrics here. I want to see reader listenership go sky high.
00:32.06
Jon
Scabbo doesn’t do that part. He edits the audio.
00:33.84
Lauren Schwabish
Scavo, run the n- Crunch the numbers, Scabbo.
00:36.68
Jon
He doesn’t do that.
00:37.14
Lauren Schwabish
Run the metrics, Scabbo.
00:38.34
Jon
He’s the audio guy. He wears all black when he does it. Peace. e He runs out. And he works on the thing and then he runs back off stage.
00:49.96
Jon
All right, Scabble. We got a special one for you. It’s just me and Lauren.
00:53.18
Lauren Schwabish
Yay! Yay!
00:54.40
Jon
Alright. Okay, you ready?
00:56.31
Lauren Schwabish
Yep.
00:57.23
Jon
Okay. I’m going to give us a few seconds here to pause and then we’ll we’ll start. Okay.
01:09.23
Jon
Well, hello
01:11.76
Lauren Schwabish
hi
01:11.83
Jon
fancy, fancy special guest on this one. What? I think it’s the first episode where I’ve been married to the guest.
01:21.25
Lauren Schwabish
First and only.
01:22.99
Jon
First and only. Um… Okay, this is going to be fun. A little bit different for people, I think, to listen to someone who’s not in the tech data field. but who helps people work with.
01:35.45
Jon
I guess data, and we’ll certainly work with tech.
01:37.81
Lauren Schwabish
Yeah, with information, certainly.
01:38.08
Jon
Um, Yeah. um and and from an accessibility perspective, which. is a big challenge for folks. So let’s start with. What?
01:48.86
Jon
is a speech language. of speech language pathologists and What do they or what do you do?
01:55.81
Lauren Schwabish
and So a speech-language pathologist. is a professional who supports… individuals. With. Any number of abilities so we can have speech pathologists who work from Cradle to grave.
02:10.26
Lauren Schwabish
as they say. There are speech pathologists who help babies in the NICU with feeding, and swallowing. There are obviously most people associate a speech pathologist as working with children. in rehab. or habilitation settings. So you could see a speech therapist in a school helping a child with their speech sounds, right? Saying their R’s, saying their S’s.
02:32.51
Lauren Schwabish
um But there’s a whole host of speech pathologists like me who are more medical speech pathologists who dedicate their careers to supporting adults with. speech and language issues and these are acquired. So this is not something that someone is born with, but typically something that someone may experience as a result of an accident or an injury.
02:51.96
Lauren Schwabish
So my area of specialty has always been working in. hospitals with individuals who have suffered some type of neurological injury so I’m Stroke. traumatic brain injury, brain tumor, maybe a complicated course after, let’s say, a surgery.
03:08.09
Lauren Schwabish
um My specialty is on cognitive. communication abilities, but I also help people with speech and I have a long history of helping people with swallowing as well.
03:20.37
Lauren Schwabish
So it is something that again, you could see in all ages. um And it is a profession that has a lot of flexibility. So I started out in hospitals.
03:32.08
Lauren Schwabish
working. with um you know medical professionals, nurses and physicians and other therapists. And now I work in the community as a private practitioner.
03:44.93
Jon
So worth knowing for people. for For listeners, the person who has the stroke, they go to the ER. They get admitted. They then… in many cases right go to a rehab hospital which is where you worked for many years
03:59.79
Lauren Schwabish
mm-hmm
04:00.24
Jon
and then eventually get discharged, but may need additional… therapy additional care. and depending on their age and their health insurance situation.
04:09.48
Lauren Schwabish
mm-hmm
04:09.56
Jon
They either work with the hospital or they work with someone like you.
04:12.89
Lauren Schwabish
Mhm.
04:13.12
Jon
Yeah. um Okay. But your work, both at the hospital and now for the last several years in your own practice. emphasizes person-centered therapy. um that’s built around the person’s goals and so
04:22.39
Lauren Schwabish
Mm-hmm.
04:25.59
Jon
um Can you talk a little bit about what that means and how you… translate their priority, like the individual’s priorities, and maybe that’s different from the family’s priorities, but how you translate their personal priorities into a treatment plan.
04:38.32
Lauren Schwabish
mm-hmm so first if we look at person-centered care it it kind of helps to compare it to what is the traditional medical model where the healthcare care professional is the expert.
04:48.90
Lauren Schwabish
And they… Perform diagnostic. tests. And they figure out what’s wrong with the person and they recommend a course of action. And this is traditional medical in all aspects, right? So a physician.
05:00.40
Lauren Schwabish
a you know an oncologist that expert is the one that’s making the decisions that has all the knowledge and basically the person the patient just goes along with it because they have this trust in the medical professional Person-centered care is different in that it understands really that the client, the person is their own expert.
05:19.02
Lauren Schwabish
And they have. obviously a lot of interests and they have priorities that are just as valuable. as the clinician’s knowledge. So person-centered care is a combination of standardized testing, which is useful, right? Like I have to diagnose the disorder.
05:36.61
Lauren Schwabish
um But I’ve chosen that. really almost in partnership with the person to say, hey, I noticed that you know you’re having some difficulty finding some words. I have a naming test. Let’s see if we can test that out.
05:47.44
Lauren Schwabish
And people are oftentimes receptive to that when it’s explained in that way.
05:51.28
Jon
Mm hmm.
05:51.28
Lauren Schwabish
But the big piece is about choosing. um other measures to understand someone’s disorder. So that might look like a patient reported outcome measure. uh which you and i collaborated on we could talk about that a little bit but it’s essentially like a questionnaire that says how is this particular situation affecting you.
06:02.46
Jon
mm-hmm
06:10.44
Lauren Schwabish
And then we come together and we say, well, here’s all the information we’ve gathered What matters most to you? What is your top priority? And what interventions are available that can help with that?
06:23.28
Lauren Schwabish
And so it’s very much a shared decision-making process. And that’s really what person-centered care is about. So it’s not necessarily improving someone’s accuracy on a test. Like if someone can name…
06:34.81
Lauren Schwabish
you know, only five out of 10 photos.
06:37.65
Jon
Mm hmm.
06:37.67
Lauren Schwabish
um The traditional medical model says, well, let’s just keep showing them photos of like random objects and see if they can name more of them. Whereas person centered care. says, hey, naming is an issue. What do you need to name in your day-to-day life?
06:50.18
Lauren Schwabish
What are the people? What are the objects? What are the places that you go? And how can we focus on strategies to make that more successful? And maybe their accuracy improves, but maybe it’s their confidence, or maybe it’s their participation.
07:03.69
Lauren Schwabish
So that’s really what person-centered care is about. It’s very art and science focused in terms of
07:08.37
Jon
Mm hmm.
07:09.59
Lauren Schwabish
Truly understanding the individual and then bringing Your science the technical knowledge that you have to them in a way that is understandable and approachable.
07:20.53
Jon
So to that end, on the technical knowledge, on the technical terms, on the jargon of which it’s a medical field. So there’s a lot. Your website, you talk about neuroplasticity on your site, but they’re like. you know your fields like everybody’s field has their own dark and how do you talk to patients and their families about the challenges that they’re facing in kind of a plain language, but still not dumbing it down.
07:47.16
Jon
for them.
07:47.88
Lauren Schwabish
Mm hmm.
07:48.17
Jon
um But like, how do you how do you? How do you have those conversations where they understand what you’re talking about? And then how, especially for the patients, and I guess I keep… coming back to the family sue how do they make it motivating to do the rehabilitation, do the therapy rather than being overwhelming and saying, this is just too much. I’m never going to get better.
08:10.90
Jon
You know and and sort of veer off into this into the sort of negative Thought space.
08:17.62
Lauren Schwabish
So. So one of the things that I always try to say is, what do you know? about your diagnosis you always have to meet the person where they are and you have to meet them where they are in terms of their health literacy and there’s a lot of best practices out there in terms of understanding health literacy just because someone is maybe like well educated and they have a lot of experience they may have a very low health literacy about their particular diagnosis.
08:24.02
Jon
Mm hmm.
08:41.43
Lauren Schwabish
And especially in my case, if I’m working with people who have had a stroke or a brain injury. When that was first diagnosed at the hospital, They may not have had the skill to be able to understand that.
08:54.69
Lauren Schwabish
So it doesn’t really matter if it’s a family member or if it’s a client. I always start by saying, tell me tell me tell me what you know, and I’ll fill in the missing pieces.
09:03.19
Jon
Mhm.
09:05.39
Lauren Schwabish
And then there’s a lot of um visual information, which you’ll see as a theme, probably between what you and I do, of being able to show people. what has happened. So if I talk about stroke,
09:17.25
Lauren Schwabish
I oftentimes will show them the brain and we talk about the parts of the brain just to see what they know. Sometimes people will use the terminology like ischemic or hemorrhagic, right? But sometimes people don’t know those words. So what I always say is our job is to build your knowledge base and we want to start with what feels comfortable.
09:35.43
Lauren Schwabish
And I only give small amounts of information at a time. And I always follow it with teach back. So. It’s not a test. It’s not a quiz. It’s not like they pass or fail, but my job is to explain it in a way that they understood so After we follow, we give some information, I might say, okay, just to make sure I did my job, tell me in your own words, what does that mean to you?
09:49.74
Jon
Mhm.
09:58.66
Lauren Schwabish
And then because a lot of my patients also have language or memory issues, we go ahead and we work on developing a place to store that information where they can find it. where they can understand it again where they can show it to somebody else so a lot of it is making sure that’s Part of the therapy itself is making sure we’re building systems where they can acquire information.
10:19.53
Lauren Schwabish
and and use it again, right? Whether they’re showing it to someone or they can reference it or they you know store it internally. um So it’s very customized to the individual, but we always want to ensure that.
10:33.58
Lauren Schwabish
um Our job is to make it. as plain language as possible. and um it’s incredible to see this because so many patients will discharge from the hospital and and I think doctors are not incentivized to communicate clearly um or they just don’t understand what that experience is like. Whereas I spend an hour with each.
10:54.75
Lauren Schwabish
patient that i have each session is an hour i can really see what goes well and what doesn’t go well for them so i modify my education accordingly
10:56.32
Jon
Mm hmm.
11:03.96
Lauren Schwabish
um but many people don’t do that and so part of our job is to empower the patients with the terminology that makes sense, but also to advocate that they need to request that. transparent communication everywhere they go.
11:17.92
Jon
So you mentioned a couple of things there that i want to I want to ask you about. you talked about visuals and then you talked about the tools that patients can use uh down the road to practice or when you’re not there to continue their skills.
11:28.70
Lauren Schwabish
Okay.
11:30.84
Jon
So I want to talk about both of those. I also want to ask about empowering patients. What happens when you have a case where what the patient wants. or their goals don’t match with the families or other caregivers.
11:46.84
Jon
goals or expectations like how do you You know pull those together.
11:51.96
Lauren Schwabish
Mm hmm. Well, some is some is targeting caregivers, right, specifically.
11:56.37
Jon
Yeah.
11:56.15
Lauren Schwabish
So there’s some tools that I mentioned, the patient-reported outcome measures. There’s some questionnaires that look at care partner burden. that are really useful. And so helping.
12:07.96
Lauren Schwabish
I need to understand where the partner is coming from. Like they may be, let’s say in charge of finances where they were never in charge of finances.
12:10.72
Jon
Mm hmm.
12:15.78
Lauren Schwabish
Maybe the, my patient was the one that was solely responsible for that. And so the care partner might say, I need him to pay our bills again. Right. I need, I don’t know where anything is.
12:23.72
Jon
Right.
12:24.82
Lauren Schwabish
He has to get better so he can handle that again. And that might be born out of the fact that this person doesn’t have experience or they’re very overwhelmed, which is really what this is about.
12:35.63
Jon
Mm hmm.
12:36.44
Lauren Schwabish
So a survey that allows me to understand the caregiver burden might help us to figure out.
12:36.67
Jon
Yeah.
12:41.52
Lauren Schwabish
you know do we really need to make sure this patient can pay the bills again? That might be his goal. If that’s his goal and that’s her goal, we can tackle the. you know the skills related to that. But sometimes it’s also about pulling in more caregiver support.
12:55.69
Lauren Schwabish
So a lot of times my job is to not only. work on the individual’s goals, but to connect them to other support communities. And so I always am looking for care partners, support groups, client support groups.
13:08.13
Jon
Mm hmm.
13:08.42
Lauren Schwabish
um There’s a diagnosis. I don’t know if we’ve used the word yet, but aphasia, which is an acquired language disorder due to stroke that can affect reading, writing, speaking, listening.
13:18.94
Lauren Schwabish
That’s one of my sort of areas of specialty. And there’s a whole community. out there online virtually that is there to support the individuals. So usually it’s about trying to understand each person’s perspective.
13:31.50
Lauren Schwabish
um I really want people to feel successful. So if there’s a real discrepancy in the goals, I might try to find a middle ground where maybe we’re talking about. um vocabulary related to finances so we’re not doing the cognitive load of having to pay the bills but more using words related to that.
13:50.33
Lauren Schwabish
Or maybe we create a visual or we create time and a schedule where people can sit down and look at the information together.
13:50.92
Jon
Mm hmm.
13:56.91
Lauren Schwabish
But it’s really trying to make sure that that care partner and that family’s expectations and needs are addressed. as well as my client.
14:05.78
Jon
Right. Okay, so let’s talk about the visuals and then I want to talk about the tools.
14:09.74
Lauren Schwabish
Mhm.
14:09.70
Jon
so um when you’re working with someone, let’s say someone with aphasia, because that’s that’s where you’re focusing most of the time. Um, What do the visual tools?
14:21.50
Jon
that you use in therapy look like? Where are you getting them from? How are you? building them like Take us through. or take people. people through Let me pause here because I think, I think just so. so you know I said this in the intro, and just so people have their head around why I think this this conversation is important for people who are data communicators, is everything that you’re talking about is thinking about who is…
14:47.89
Jon
in in my jargon, right? It would be, who is the audience? Who is the person that you’re talking to?
14:50.71
Lauren Schwabish
Mm-hmm.
14:52.03
Jon
And it’s still person centered, right? You’re not going to give. a talk on how to code in Python to the CEO of some… You know company because they’re not coding in Python right so so when it comes to now we get into the visuals and the tools when you are working with someone like where are the visuals that you’re getting like walk us through what a therapy session will look like
15:16.04
Jon
When you are presenting someone who is recovering from stroke, who has aphasia, what are those visuals? look like? What are the tools that you’re using?
15:25.05
Lauren Schwabish
Got it. So maybe we can start by sort of some good resources to guide this audience into what that looks like.
15:28.96
Jon
Yeah. Yeah.
15:31.07
Lauren Schwabish
And so we’re looking at accessibility.
15:33.97
Jon
Mm-hmm.
15:34.46
Lauren Schwabish
accessibility when it comes to aphasia means modifying the language. so that it is Simple.
15:45.58
Lauren Schwabish
clear and direct. And one resource that I think is really wonderful, just even if there are folks out here who are trying to create accessible information is just.
15:55.84
Jon
Mm-hmm.
15:56.91
Lauren Schwabish
taking a look at a guy that Do you have show notes? How do you share information with the people?
16:01.47
Jon
I have show notes.
16:01.21
Lauren Schwabish
You’ll post it.
16:02.34
Jon
I have show notes.
16:02.78
Lauren Schwabish
Who knows? Okay.
16:03.54
Jon
It’s like, you know, we’ve been married for like 400 years and you’d like you’ve never listened to the show.
16:03.89
Lauren Schwabish
no
16:08.12
Jon
You’ve never, and you’re a big podcast listener.
16:08.28
Lauren Schwabish
Not a one. Not. Love them.
16:10.97
Jon
And you’ve never listened to the show.
16:12.54
Lauren Schwabish
Never, never not once.
16:13.36
Jon
this is this is where this episode starts to go off the rails where people just listen to us but People just listen to us fight. And it’s just, the just. Just marital strife.
16:24.22
Jon
On iTunes. No.
16:25.98
Lauren Schwabish
Not true.
16:26.21
Jon
Okay.
16:26.72
Lauren Schwabish
Never not.
16:26.73
Jon
All right. Okay.
16:27.05
Lauren Schwabish
true Okay.
16:28.16
Jon
So visuals.
16:28.28
Lauren Schwabish
So.
16:29.05
Jon
Yes.
16:29.32
Lauren Schwabish
The visual.
16:29.13
Jon
so I have show notes. I have show notes and I will, I will share, I will share these links.
16:31.30
Lauren Schwabish
Great. You’ll put it in the show notes. Okay.
16:32.97
Jon
Yes. Okay.
16:33.88
Lauren Schwabish
So one really helpful resource is one put out by Stroke Org UK, which is in England and Wales. And they have a booklet that talks about. how to make mostly health education, but really any information accessible for someone with aphasia. So one thing to know is that.
16:52.80
Lauren Schwabish
The length. and complexity of written language especially, but also spoken language really needs to be adjusted. So instead of having multiple paragraphs of text, we really want to boil that down to the most essential information. So it might look like for someone who’s very impaired, we may be looking at a single word.
17:16.24
Jon
Mm hmm.
17:15.98
Lauren Schwabish
um Or we may be looking at maybe some keywords. or a simple sentence And we think about font, right? We think about font size.
17:26.91
Lauren Schwabish
I know you’re a huge font fan, right? So we’re looking at enlarged font or bolded font.
17:30.19
Jon
i know
17:33.16
Lauren Schwabish
We’re taking out the serifs and the flourishes and all the fanciness, right?
17:36.44
Jon
Mm hmm.
17:37.99
Lauren Schwabish
And then we’re pairing that information.
17:38.03
Jon
Right.
17:40.58
Lauren Schwabish
with a non-language based symbol. So that could look like. an icon, black and white icon.
17:47.27
Jon
Mm hmm.
17:48.29
Lauren Schwabish
That could look like a photo. And of course, in person-centered care, we always want a photo that is recognizable. So a big part of what I do is build person-centered communication tools. Those can be both low-tech, like a binder notebook with pages that have a photo of a family member plus their name.
18:09.69
Lauren Schwabish
That’s something that we would you know doing powerpoint we’re using the iphone you know we’re we’re using tools that are recognized and available
18:12.87
Jon
Mm hmm. Mm hmm.
18:17.26
Lauren Schwabish
um or we’re using a high-tech tool so in my industry we have a few different companies that have tablet-based or app-based what we call high-tech aac which is um augmentative alternative communication these are essentially iPads, tablets that have pictures.
18:38.11
Lauren Schwabish
that can have a single word and then we can also layer in a recorded word or recorded sentence.
18:43.38
Jon
Mm hmm.
18:44.56
Lauren Schwabish
um When I’m pulling together visuals, I also think about emojis. I think about things that they may have seen conventionally, you know, sort of in their day to day. I worked with a gentleman earlier today who has.
18:54.30
Jon
Mm hmm.
18:57.39
Lauren Schwabish
language changes due to dementia. And he worked for a major corporation. And so I’ll pull the logo. of that corporation onto the page so that he can see not just the word of where he worked, but he can also recognize that logo, which is highly familiar.
19:12.20
Jon
okay
19:12.15
Lauren Schwabish
Similarly, if I’m making a page for someone who wants to talk about going out to eat or where they like to go shopping. I’m going to pull either a photo of the storefront which is really easy on google you just steal the photos, right?
19:24.24
Jon
Yeah.
19:25.30
Lauren Schwabish
Or I go to the places and I snap a photo of the… You don’t like it when I steal things. um When I take a photo of a place, let’s say it’s their house or it’s their local pharmacy so that there’s an instant familiarity.
19:30.37
Jon
man
19:39.40
Lauren Schwabish
with that. image or like the icon right so it’s the trader joe sign or it’s the home depot sign and when people see
19:45.66
Jon
mm-hmm
19:48.62
Lauren Schwabish
That. visual and they see the language. It’s very often easy for them to read it out loud. which means they can incorporate it into their verbal communication.
19:58.74
Jon
Mm hmm.
19:59.05
Lauren Schwabish
um I love the noun project, which you introduced to me, but that’s a really nice way to…
20:03.40
Jon
Mm hmm.
20:06.46
Lauren Schwabish
engage someone in developing a visual tool. So a lot of times if photos might be, if someone’s had any type of visual field cut. where maybe half of their visual field in each eye.
20:17.96
Lauren Schwabish
is missing or they have vision changes as a result of their injury. We may not want to go with a detailed photograph. We may want to go more basic with a black and white icon. And so what’s fun about the noun project is I might type in.
20:33.27
Lauren Schwabish
um let’s say hamburger And the nature of those icons is that they’re, you know, They vary in how abstract they are. And so I’ll have the person tell me which one they want when they can scan and look. And they’re they’re sort of selecting and choosing the symbol that.
20:49.98
Lauren Schwabish
really represents the idea.
20:52.36
Jon
Right. Can you… Can we can we you mentioned visual field cut? and Can you talk just for a second about the different types of vision impairments that your patients have had? Because I think in the data viz field, there’s…
21:08.67
Jon
a bit of an obsession with color vision deficiency, which is not the only visual impairment out there. So can you describe a little bit more before we get into the tools part?
21:15.27
Lauren Schwabish
Mm hmm.
21:18.20
Jon
But because you mentioned that that phrase visual field cut, can you talk a little bit about the sorts of visual impairments that people have?
21:24.70
Lauren Schwabish
Sure, and this is like this is gonna be the real 101 version because this is ah this is its own unique specialty and there’s
21:29.40
Jon
Yeah.
21:31.87
Jon
Its own thing. Right.
21:33.26
Lauren Schwabish
professionals, neuro-optometrists, neuro-ophthalmologists, occupational therapists who really specialize in vision and vision changes after brain injury.
21:40.45
Jon
Mm hmm.
21:40.60
Lauren Schwabish
But we should also remember that um Sudden change in vision. is a sign of stroke. So we always want to educate the people, right? Be fast, right?
21:49.64
Jon
We do. Be fast.
21:51.04
Lauren Schwabish
Balance eyes. E is for eyes. So a sudden change in vision. can look like Missing vision in either one eye. or part of each eye, depending on what part of the vision system has been injured.
22:05.92
Lauren Schwabish
Um, In terms of the accessibility, we’re really looking at visual information processing. in addition to acuity. So acuity is like, you know, I’m getting older. I have to wear my readers all the time when I’m looking at fine print, right?
22:20.67
Lauren Schwabish
Vision changes associated with a stroke is almost as if. that visual field, what the brain can actually see. is missing.
22:31.39
Jon
Mm hmm.
22:31.39
Lauren Schwabish
So I’ve had clients that describe it like I can see I can’t see I can see I can’t see so it’s kind of like this interrupted
22:36.82
Jon
Mm.
22:38.63
Lauren Schwabish
visual field where you have to move your head to get your vision in the right place.
22:43.88
Jon
mm-hmm
22:44.21
Lauren Schwabish
There’s also when people have a injury specifically on the right side of their brain. there’s a spatial inattention or a visual inattention. where the eyes are working.
22:56.04
Lauren Schwabish
And the brain can see information, but the attention system is impaired. where they may be hyper attentive to stimuli on one side and their brain does not see.
23:08.27
Lauren Schwabish
It could be their body that they don’t see.
23:08.100
Jon
Mm.
23:11.48
Jon
Hmm.
23:11.25
Lauren Schwabish
It could be the room they don’t see. and their brain is. able to see it when you direct their attention, but it’s really an attention system. problem.
23:19.55
Jon
Right.
23:20.22
Lauren Schwabish
Right?
23:20.43
Jon
Right.
23:20.58
Lauren Schwabish
Okay. um and then you can combine that with any one of existing problems so if someone has a color blindness issue
23:25.73
Jon
Mm hmm.
23:28.47
Lauren Schwabish
That’s not going away. It’s just one facet. of vision. So many people who have a brain injury will have to wear prism glasses. That helps the visual field to kind of align again.
23:38.77
Jon
Mm hmm.
23:38.91
Lauren Schwabish
um But our job in the speech pathology world is to figure out what. you know, what is most accessible to you. And then sometimes it’s actually bypassing the visual system. So let’s say reading.
23:52.81
Jon
Mm hmm.
23:52.89
Lauren Schwabish
people love to read and when they have a field cut or they have some sort of blurry vision or sometimes fatigue can affect your vision how well you recruit your vision sometimes the best strategy is to use
24:02.02
Jon
Mm-hmm.
24:06.92
Lauren Schwabish
Text to speech. where we’re having them highlight text. through their phone or we’re having a maybe there’s a platform that they can upload a document and they can read it by listening.
24:19.99
Jon
Mm-hmm.
24:20.19
Lauren Schwabish
or they can see the word scan and being read out loud while they’re also sort of, so they’re sort of dual tasking it. They’re using their visual system, but their auditory system as well.
24:30.85
Jon
Right.
24:31.04
Lauren Schwabish
So we always need to think about the sensory inputs. because that’s what feeds. the rest of the brain. So what can they see? What can they hear? What are they able to perceive in their environment?
24:43.46
Jon
Um. Okay, so you just mentioned… phones, computers, auditory. tools that people can use. So can you talk about how you have helped people use Those types of tools. I mean we don’t need to get into the guts of the of the iPhone like accessibility menu, but you have.
25:01.61
Lauren Schwabish
Okay.
25:03.44
Jon
you have discovered, I mean, not discovered, but you have found things in the iPhone settings that have helped a lot of people use. the phone in a post stroke or post.
25:15.06
Jon
concussion TBI world.
25:16.28
Lauren Schwabish
Mhm.
25:16.26
Jon
so Can you talk a little bit about the tools and technologies that you helped your patients. use to communicate.
25:26.28
Lauren Schwabish
Mhm. Yeah, I think. obviously the ubiquity of phones now um and and tablets and computers and you know technology is is something that when i was first doing this it was like the younger people would it would be more intuitive and we were going more low tech with older people and now everybody
25:40.10
Jon
Mm hmm.
25:43.27
Lauren Schwabish
um has tools sometimes people will have a stroke and then their family members are well-meaning and they’re like oh i just got dad an apple watch so you know we know how he’s doing and can you teach him how to use the apple watch and i’m like You know, it’s.
25:57.09
Lauren Schwabish
It’s a new process. It’s a new system. It’s not that accessible if you’ve never used it before. But for people who are customary phone users, the best place to situate.
26:02.74
Jon
Right.
26:08.08
Lauren Schwabish
um language and cognitive supports is in the tool that they always know where it is. And almost everybody, I mean, if you don’t know where your phone is, you’ve got your own, you know, that’s its own strategy.
26:17.20
Jon
Yeah.
26:17.92
Lauren Schwabish
But most people have their phone.
26:17.74
Jon
yeah yeah
26:19.35
Lauren Schwabish
and so um One of the things I always like to do is look at photos, right? Because that’s how we all share information about, you know, what we’ve done recently. And so a good example of a way that we might strategize around photo storage would be.
26:33.80
Lauren Schwabish
um to create albums. so that we can… find the photos quickly when we want to share information we can categorize them this is my family these are the foods i like this is vacations that i’ve taken
26:38.18
Jon
Mm hmm.
26:41.01
Jon
Mm hmm.
26:46.72
Lauren Schwabish
And then within those photos, we can use the, I’m just speaking as an iPhone user because it’s the one that I think is the most accessible. We can use the markup feature.
26:53.81
Jon
mm-hmm
26:55.78
Lauren Schwabish
which is to add language to a photo so if i have a photo of someone’s face i can add their name somewhere in that photo again pairing that visual with that language and that’s really wonderful
27:06.79
Jon
Right.
27:08.67
Lauren Schwabish
You can also do that in the caption feature. So that’s really nice if you want someone to be able to talk about the photos and they need assistance with word retrieval, you can have them write it in. It’s also good writing practice if that’s something they’re able to do independently.
27:21.38
Jon
Mm hmm.
27:21.93
Lauren Schwabish
um The iPhone has a cognitive, it’s called assistive access feature where you can actually create a very simplified version of their phone. So this is really for that individual who’s not using their phone at all. And maybe they just need to restore like functionality to call someone.
27:41.15
Lauren Schwabish
or to send a text or to see what the weather is where when you get into assistive access you can create as few as you know, one or two icons that are super big
27:41.37
Jon
Mm hmm.
27:52.86
Lauren Schwabish
um Which really allows someone again low vision, but even just cognition or communication so you can modify the visual field how much they’re looking for um Similarly, I like to go in and just help people delete.
28:08.85
Lauren Schwabish
unnecessary apps move apps where they need to see them take away background photos because that’s another layer of visual information they have to search through so if someone has like a photo of their grandkids and then they can’t see the apps that they need because that’s a lot of
28:17.79
Jon
Mm hmm.
28:23.52
Lauren Schwabish
visual color and text and fonts. what we’ll do is we’ll create a black or you know a dark screen um and just have no image in the wallpaper so that the icons that are the most significant will be.
28:40.17
Lauren Schwabish
more available. Another thing that I really like to do is switch into like voice assistant. So we may say this is really helpful for people who have working memory demands.
28:50.85
Lauren Schwabish
um So for example, I heard something I think is really important and I want to write it down. And working memory is this temporary holding space, right, where we have an idea or a piece of information just a little bit long enough to do something that’s higher level with it.
29:05.93
Lauren Schwabish
so People who maybe have an idea or they want to remember something um that’s a piece of information by the time they open up their phone maybe they saw a text message and now they’re suddenly you know responding to that and that original intention is gone So helping people to be able to use a voice command to say, hey, remind me to pick up milk at 5 p .m.
29:23.48
Jon
Mm hmm.
29:31.47
Lauren Schwabish
That’s a good example of a way to adjust. the usage of something and then getting those visual reminders, right? So a lot of the sort of, we consider it to be. more cognitive assessment a cognitive tools assistance um can be very useful.
29:49.16
Lauren Schwabish
And then again, the accessibility features. So for information dense, you know, let’s say someone wants to read an article in the Washington Post or the New York Times actually has a listen feature.
29:58.49
Jon
Mm hmm.
29:58.49
Lauren Schwabish
But there’s apps like Natural Reader or the the native phone native accessibility settings where you can highlight text and hear it read out loud, but also watch and see where it’s scanning. So it’s really trying to figure out, A, what does the person want to do?
30:13.55
Lauren Schwabish
be what is the tool that they’ve been the most familiar with.
30:13.50
Jon
Yeah.
30:17.79
Lauren Schwabish
uh see how can we modify it and then how can we practice sequences that might be new or might be different so that they can use that in an everyday situation.
30:27.93
Jon
and And you’ve got you work with people who have. Okay. I don’t know if this is right, but three maybe buckets of impairments. So physical impairments, which I guess I would put. i ah put vision in the physical impairments so that might be in an iphone world like
30:43.30
Jon
Maybe they have weakness on one side or they have a field cut or a vision impairment. And then you’ve got people who have cognitive impairments and then you’ve got aphasia with the language impairments. And I’m guessing that for each one of those buckets, and I’m sure there’s overlap and people who have multiple.
30:58.88
Jon
uh impairments I’m guessing you’re thinking pretty carefully about which features work with which type of… Oh. impairment. It’s alright.
31:09.84
Lauren Schwabish
Yes. I mean, if you if you just open up your phone and you look at the accessibility menu, you’ll see there’s some for vision, for touch, et cetera.
31:14.90
Jon
Mm hmm. Mhm.
31:17.18
Lauren Schwabish
I mean, more sophisticated technology that’s dedicated to people with impairments could be, let’s say, someone with ALS, right, where we have voice banking and now we have all of this AI voice generation that that can be done.
31:28.38
Lauren Schwabish
People who lose all motor function might be able to use eye gaze. or pillow switches where maybe the residual movement that they have in their finger and their head, they can access, you know, some type of screen to help come up with a message, speech generating devices.
31:42.11
Lauren Schwabish
So, yeah, I mean, a thorough assessment by a speech pathologist.
31:42.29
Jon
Mm-hmm.
31:46.38
Lauren Schwabish
We’ll figure out. what is the you know what are their strengths in terms of their communication modalities so is it reading is it writing is it vision what are the other things that they have that are you know, factors to consider.
32:00.04
Lauren Schwabish
Sometimes someone might have a tremor.
32:02.39
Jon
Mm.
32:02.09
Lauren Schwabish
Right. So a tremor.
32:03.94
Lauren Schwabish
when you have a small keyboard and you just need that light touch that’s going to be a game changer right where we no longer can have that so that might be someone where i’m saying okay i’d like you to switch over and into um speech to text where maybe your spoken language is audible and clear and we can have you write something down where you know texting is challenging um or someone who has suddenly only their non-dominant hand is the only side that they can use right so we need something that’s a little bit more accessible and then partnering with other healthcare professionals so an occupational therapist is really looking at fine motor skill
32:09.57
Jon
Yeah.
32:29.59
Jon
Right.
32:38.31
Lauren Schwabish
or an adaptive technology professional that’s someone who’s really going to be you know very knowledgeable in the suitable technology. especially for someone who maybe is unable to generate speech or communicate at all.
32:50.95
Lauren Schwabish
So my clients are probably not as impaired as that, at least when I encounter them. And so we’re able to use more conventional everyday technology, especially stuff they’ve used before.
32:55.89
Jon
Mm hmm.
33:00.91
Jon
Mm hmm. Okay, so let’s… Turn two. ah My kind of people. The people who are the dataviz people, so…
33:09.33
Lauren Schwabish
move it
33:10.32
Jon
they’re building charts reports websites dashboards whatever they’re building and there is um obviously a lot of people thinking about accessibility when it comes to data visualization. I’ve had a bunch of those people on the show before.
33:23.82
Jon
Um, But what would you flag? as a thing that most ah most, maybe designers, creators wouldn’t really think of. Something that…
33:35.71
Jon
You would see in a website or a data portal, whatever it might be, just a website, I guess, working with a patient that maybe ah a designer creator wouldn’t.
33:45.98
Jon
think of right away.
33:47.77
Lauren Schwabish
This is where you and I overlap, right? We have so many shared, like how many lectures have you given where you’re talking about the needs of the audience?
33:49.99
Jon
Yeah. I mean.
33:54.39
Lauren Schwabish
like
33:55.07
Jon
I mean, we share a lot except for the you listening to this show. I mean, other than…
33:58.64
Lauren Schwabish
Same, same. Nope.
33:59.95
Jon
Nope.
34:00.58
Lauren Schwabish
We’ll never.
34:00.83
Jon
No, you’ve you’ve like blacklisted it on your on your phone. It’s like not allowed.
34:04.75
Lauren Schwabish
There’s so much other stuff to listen to.
34:06.74
Jon
I know, but…
34:07.33
Lauren Schwabish
um
34:08.25
Jon
Yeah, but come on.
34:09.05
Lauren Schwabish
Yeah. Now this audience is.
34:09.94
Jon
I need to get that like, I need to get that like 12th listener.
34:13.90
Lauren Schwabish
That’s all.
34:16.51
Jon
Okay.
34:16.61
Lauren Schwabish
Maybe I’ll draw them in. We’re going to develop a whole new PolicyViz podcast.
34:19.61
Jon
We’re gonna have a whole…
34:21.07
Lauren Schwabish
fan base.
34:21.59
Jon
Yeah. of us just like Talking.
34:24.75
Lauren Schwabish
Yeah.
34:25.29
Jon
It’s gonna, yeah.
34:26.15
Lauren Schwabish
That’d be fun. So this is but this is truly where we overlap. So I think the idea here is what is the priority message?
34:30.39
Jon
Yeah.
34:33.54
Lauren Schwabish
that you need to communicate
34:34.45
Jon
Mm hmm.
34:35.37
Lauren Schwabish
and really thinking about less is more. Right. So it’s that same concept of like, if I only had so many characters or I only had so much attention. What is the information that is going to be the most accessible to this particular audience?
34:50.91
Lauren Schwabish
So that has to like. That’s why person-centered care is so much of it is about like clinical interview. It’s like understanding what people need. um and then really trying to prioritize the interventions. So what are the key points that you’re looking for?
35:05.58
Lauren Schwabish
How can I eliminate unnecessary information? And it could be in like a slide, right? Or it could be in some sort of data visualization that they’re doing is really trying to take out what does not need to be there.
35:11.45
Jon
Mm hmm.
35:20.23
Lauren Schwabish
I also like the idea of layering information. So maybe if there does have to be multiple pieces of data. Sometimes it helps to present.
35:31.88
Lauren Schwabish
one piece at a time and maybe we have sort of like the background.
35:35.07
Jon
Mm hmm.
35:36.19
Lauren Schwabish
and then we add in a new piece of information and onto that we layer on another piece so that people
35:41.89
Jon
But a, but a. but a background that may that might be… Aww. simpler. like right like right like not something that comes on top of a complicated
35:48.98
Lauren Schwabish
Definitely.
35:53.10
Lauren Schwabish
No.
35:53.50
Jon
In this case, like a complicated graph with more text on top of it.
35:56.82
Lauren Schwabish
Right. it’s thinking about a very simple foundation and one of the things you talk about like
35:57.62
Jon
Yeah.
36:00.38
Jon
Mm-hmm.
36:01.87
Lauren Schwabish
pretentive attributes right so one of my favorite analogies which is another way to really help people understand these complex concepts right so like i had one already for you today for neuroplasticity so we’re gonna have to go into that but one of my favorite analogies is when talking about cognition is thinking about your cognitive skills like a tall multi-story building right like a high rise
36:03.60
Jon
Mm hmm. Yeah.
36:13.91
Jon
Let’s go back. Let’s do it.
36:21.98
Lauren Schwabish
that has multiple floors sitting on top of each other And the foundation of that building that is underneath the ground, you cannot see it, but it holds everything up, is a tension. So we really have to understand people’s attention needs.
36:31.73
Jon
Mm hmm.
36:34.93
Lauren Schwabish
And then we think about maybe the first floor or their sensory processing, right? what What is the sensory processing skill? Do people need to see something? Do they need to hear something? Do they need both?
36:45.96
Lauren Schwabish
Do they have any limitations on what that sensory processing is? And then… We look at memory. So a lot of people, when they think about thinking skills, they go straight for memory because memory is probably the domain that’s best understood.
36:56.53
Jon
Right.
36:59.32
Lauren Schwabish
But a lot of it is about attention. and processing. And then you get up to, you know I mean, there’s all sorts of floors on this building, but that the the highest penthouse floors are executive functions, which is regulating your cognition.
37:12.86
Lauren Schwabish
So we might think of that as the penthouse, or we might think of it like the…
37:13.09
Jon
Mm hmm.
37:17.27
Lauren Schwabish
maintenance staff of the building where they know the ins and outs they know how everything works so some people are good at regulating their attention and their focus. And some people are not. So really visually what we have to do is we have to guide people to the most salient information.
37:31.72
Lauren Schwabish
So whether that’s removing the wallpaper photo on the phone and enlarging or simplifying the apps.
37:35.73
Jon
Mm hmm.
37:38.94
Lauren Schwabish
or you’re building a presentation or some type of data viz. You really want to start with a very solid foundation of attention. What do they need to be looking for? and make it as clean and simple as possible.
37:52.79
Lauren Schwabish
And I do think it would be helpful for this audience, especially if they have zero clinical, you know, any family history with aphasia is to take a look at some of these guidelines because. aphasia-friendly communication is really good for all levels. So if you’re someone who’s presenting very sophisticated, complex information to an audience that doesn’t share that background,
38:14.26
Lauren Schwabish
Simple is better. And that’s really what aphasia-friendly communication is.
38:16.57
Jon
e
38:18.46
Lauren Schwabish
So when you have to think about, if I had to get rid of all of this text from my report, or if I had to get rid of all of these default settings in my Excel chart, what is left? What do I really want to highlight?
38:27.95
Jon
Mm-hmm.
38:29.20
Lauren Schwabish
And that’s where you need to begin.
38:30.99
Jon
Mm hmm. Let me… The… throw one at you because I think one of the challenges People face. when they’re creating their dashboard website, whatever.
38:42.85
Jon
is they’re thinking, okay, there’s some percentage of people that have accessibility needs, but… ah I’m guessing this is what… some people think It’s a proportion of people, but it’s not enough of my audience to warrant going through all the extra steps or I want to have the bells and whistles. And so, yes, some people are going to be.
39:04.32
Jon
left behind. um And as… you said i totally agree like if we make things accessible it’s accessible for everybody So but let’s place this in a very specific.
39:15.18
Jon
instance or location. So are there… tools, websites. even data in a hospital setting or in a therapy setting that you wish were better.
39:27.47
Jon
or that you wish. Um, that your patients could use that would that are more accessible? Like are there… when you’re working with a patient and you know, obviously, it depends because it’s person centered care, but like, you’re working with a patient.
39:42.02
Jon
you know, are there are there things that you wish were available to them that were more accessible that maybe don’t yet exist or not. useful for the sorts of people that you work with, because I can imagine sort of round this out. I can imagine someone saying, yeah, yeah, yeah. I’ll add my alt text, but. you know, I’m not gonna worry about. someone who’s had a stroke.
40:02.46
Jon
But if a hospital came to that person said we need you to improve this thing For our patients now you’re thinking specifically for that for that population. And so i’m I’m curious if there are things that you’ve come across that you wish were better or easier or existed, that maybe don’t exist yet or just you can’t use because the accessibility features are just garbage
40:25.36
Lauren Schwabish
Yeah, so maybe we can think about it in… um One of the tools that you and I were working on together, which is one of those. um
40:33.08
Jon
Yeah.
40:33.47
Lauren Schwabish
aphasia impact questionnaires right so again aphasia is this acquired language disorder
40:35.54
Jon
Yeah. Yeah.
40:39.11
Lauren Schwabish
And. um It’s important that… someone who has aphasia is assessed, right? So we can understand what their communication needs are. And, you know, you had mentioned the buckets. In addition to physical and cognitive communication, there’s also emotional.
40:53.14
Jon
Mm.
40:52.98
Lauren Schwabish
right So obviously when someone loses their language abilities, there’s a tremendous emotional component to it, plus fatigue. right so This tool I love.
41:00.92
Jon
Yeah.
41:03.42
Lauren Schwabish
It’s essentially a Um… questionnaire with several scenarios. It uses a Likert scale. um which goes confusingly sometimes from four to zero, right?
41:15.74
Lauren Schwabish
You were like, what is going on?
41:15.98
Jon
Yeah.
41:17.47
Lauren Schwabish
But it also has illustrations.
41:18.28
Jon
Yeah. Right.
41:19.88
Lauren Schwabish
And it has very simple text. And so I really like this tool. But the problem is, and this actually happens in neuropsychological tests too, where someone’s getting tested by a neuropsychologist. It’s like a…
41:31.18
Lauren Schwabish
four hour. tests, there’s tons of data that comes out of this, right? And what happens is the patient ends up receiving This. 15 page report.
41:42.95
Lauren Schwabish
of jargon information and numbers.
41:45.05
Jon
Mm-hmm
41:45.92
Lauren Schwabish
and they Don’t understand what it means.
41:49.47
Jon
Yeah.
41:49.55
Lauren Schwabish
Same thing with the aphasia impact questionnaire. It might be really good in engaging. the information from the client. but then The output is this, it’s like, you know, just a single sheet report.
42:01.52
Lauren Schwabish
And so you and I thought, well, why don’t we make this more accessible? What would that look like? Right? So then we’re bringing in some type of face sheet that takes all of those responses and creates.
42:05.89
Jon
yeah
42:12.44
Lauren Schwabish
very clear simple explanations of trends of um maybe priorities that someone has had. I have a friend who’s a psychologist and I sort of was like imploring her to be able to create a similar thing.
42:26.96
Lauren Schwabish
What is the visual that’s going to tell the story of what lies within this report?
42:28.81
Jon
Mm-hmm
42:32.48
Lauren Schwabish
So I think that test results are a great example. there’s um I don’t remember the name of it, but there’s a… Radiology. website that I think um a healthcare organization right and it just interprets test results in plain language.
42:41.68
Jon
Oh yeah.
42:45.28
Jon
Yeah, yeah. yeah
42:46.14
Lauren Schwabish
That’s a great example of accessibility, right? Because a medical report, first of all, it gets into the portal very quickly. So people, as long as they can access their portals, they might be able to see information that could be very important.
42:53.93
Jon
Right.
43:00.72
Lauren Schwabish
It could have bad news. or good news, and they see it before their healthcare care provider has a chance. to explain it to them. So some of it is, let’s make sure that there’s maybe accessibility features like this website, we should find it because it was pretty good, that would explain what this test was.
43:19.20
Lauren Schwabish
and what it found, but also are there videos embedded or is there
43:24.84
Jon
Mm hmm.
43:25.74
Lauren Schwabish
illustration that’s embedded so that I think health information. is of the great equalizer here which is to say it’s tremendously complex it’s pretty um emotionally laden, right?
43:33.07
Jon
Yeah. Yeah.
43:38.85
Lauren Schwabish
um It can mean. big things for people, it comes at a literally a financial cost, right? Because of benefits and things like that.
43:46.07
Jon
Mm hmm.
43:47.50
Lauren Schwabish
So there’s a lot tied up in that information. um And I facilitate a group. um of parents with aphasia these are people who are younger stroke survivors they’ve had a stroke Sometimes in their 30s or their 40s, they’re raising children. And when we ask them, what would make things simpler?
44:07.86
Lauren Schwabish
or what is more challenging. It’s portals related to healthcare, care to their kid’s pediatrician. It’s portals related to schools and educational information.
44:16.93
Jon
Mm-hmm.
44:18.83
Lauren Schwabish
And these are typically accessed through technology, and they’re difficult for people who have communication impairments.
44:24.24
Jon
Yeah.
44:26.31
Lauren Schwabish
so I hope this is answering your question. I mean, I think what I’d really like to see is some sort of accessibility features that, again, are not just alt text because alt text is ultimately a reading activity.
44:29.05
Jon
Yeah, yeah
44:37.69
Jon
Right.
44:38.02
Lauren Schwabish
Me.
44:39.04
Jon
Right.
44:38.83
Lauren Schwabish
So. That assumes that people can just handle more written information in already an overwhelming information environment. So sometimes if we can make it accessible by removing information.
44:52.23
Lauren Schwabish
And I understand someone who might you know say, well, I’m not going to make my economic data available to the stroke survivor, right? Unless that’s relevant.
44:59.87
Jon
Yeah.
44:59.89
Lauren Schwabish
That’s not what we’re asking here. What we’re asking is offering some flexibility and some choice. And maybe there’s a simple version, like one of the resources I want to put into the show notes.
45:10.71
Jon
In the show notes, which exist.
45:10.90
Lauren Schwabish
it is um Ha ha! BYU has a really wonderful resource of research articles about people with aphasia that is aphasia friendly.
45:21.48
Lauren Schwabish
And if you click on these icons, you see the research. sort of abstract you see the findings and you have photos and for that stakeholder community it is
45:28.21
Jon
Mm hmm.
45:34.64
Lauren Schwabish
essential. Like this is research for this individual.
45:35.97
Jon
Yeah.
45:37.30
Lauren Schwabish
It should be accessible. But if you can look at some of these resources and say, how can I have like. you know one One of my favorite strategies for folks more with concussion versus stroke, but folks who struggle with variable levels of cognitive energy, we call it the low-medium-high.
45:55.18
Lauren Schwabish
So depending on your energy level, you may want to have a very simple version, a medium version and a high version, right? Which is to say, what’s the entry point for me to do this meaningful activity? So if you have a someone who’s a data designer.
46:09.80
Lauren Schwabish
You might say, first of all, who is your audience? Does your audience have a mix of level of experience or knowledge about this topic? Can you create… a low, a medium, and a high version.
46:21.80
Lauren Schwabish
Something for each user where the message is the same. And of course, if someone needs more information, they could just skip over to the next level.
46:28.95
Jon
Yeah.
46:28.38
Lauren Schwabish
But how can really, you know, and, and you know, if someone is, let’s say, has a high level of knowledge, but they don’t have a lot of time. Right. Or they don’t have maybe um the bandwidth and they need to kind of go back and and and look at the low.
46:36.34
Jon
Mm hmm.
46:41.43
Lauren Schwabish
You know, the low version allows you to transfer that information very quickly, very clearly. And then they can maybe go to the higher version when they’re available. But attention. is at a premium. So the simple version might be the one that people can grab onto.
46:56.23
Jon
Mm hmm.
46:56.28
Lauren Schwabish
And then they can adjust and dig deeper as necessary. But I think it’s that flexibility. And I think thinking about different modalities.
47:01.85
Jon
Yeah.
47:03.57
Lauren Schwabish
So what can they hear? What can they see? What can they listen to? What what can they experience?
47:07.85
Jon
Mm hmm.
47:08.78
Lauren Schwabish
is probably… a what I would love to see in the world.
47:12.27
Jon
And I would… i would I guess I would just add what you already mentioned. um It’s not only just about the patients, but also about the. the the caregivers, the medical team, the family.
47:23.84
Jon
i mean the the the um AIQC. project that we’ve been working on is the questionnaire we’ve built like an excel version and an html version but that’s not just for the patient, it’s also for the therapist to be able to like record the data more easily.
47:39.40
Jon
Um, and share it with like so they you know You could work on it with your patient, but also share it to the patient’s neurologist more easily and more quickly.
47:47.35
Lauren Schwabish
Mm hmm.
47:47.53
Jon
So. lots of different places.
47:48.45
Lauren Schwabish
Again, the doctor or the whoever the healthcare care professionals or even the insurance company, right, who needs to be able to see and, you know, maybe look for a justification as to why services should still be covered.
47:52.95
Jon
Yeah.
47:59.15
Lauren Schwabish
that needs to be friendly to the lay audience, right? Because they might be the key decider as to whether this person continues to can get or reimbursed for therapy.
48:02.13
Jon
Right.
48:08.70
Lauren Schwabish
And the way that we do that is not to hit them with. everything we know, we have to hit them with what is the most salient information in a way they can understand.
48:13.51
Jon
Yeah.
48:18.39
Jon
Love it. um Okay. On that note. Amen. Where can people find you if they… Maybe they want to join the parents with aphasia group.
48:30.48
Jon
I think it’s on Wednesday nights. if they have a loved one who may need. care or therapy. in the DMV area. ah if they want to talk to you more. if they want to learn more about aphasia or stroke or Speech.
48:45.84
Jon
therapy, where can where should folks find you?
48:49.51
Lauren Schwabish
People can um engage with me in several different channels. Thank you.
48:55.85
Jon
You’re such a… You’re such a social media butterfly.
48:59.10
Lauren Schwabish
ae You know what? You got you got to rock it if you have it.
49:02.15
Jon
Yeah.
49:01.99
Lauren Schwabish
So I am um on Instagram, primarily a social media channel. that’s That’s my choice. I do a lot of health education. I do a lot of sharing of clinical success cases.
49:14.19
Lauren Schwabish
I do a lot of teaching. um and reaching out to audiences. And so at NeuroSpeechServices on Instagram is a great place to see kind of what’s going on. You can go to my website.
49:25.66
Lauren Schwabish
NeuroSpeechServices .com um I have done other podcast interviews with other people besides my husband.
49:35.09
Jon
podcast that maybe you listen to.
49:35.11
Lauren Schwabish
Thank you, Cody.
49:36.58
Jon
I don’t know.
49:37.01
Lauren Schwabish
Yep. wherever you get your podcasts and you just look up lauren schwabish some different things will come up um i uh yes so the national aphasia association if people are interested in just learning more about aphasia that is a wonderful um non-profit organization their whole focus is on improving awareness and advocacy and research for people with aphasia so national aphasia association definitely check them out
49:37.89
Jon
Yeah.
49:42.49
Jon
ah
50:00.66
Lauren Schwabish
um aphasia access is another great space where they’re really trying to coordinate um aphasia-friendly research. So that is another nonprofit I am proud to be a member of. They are very interested in stakeholder inclusion. So they have a conference that meets every other year and people with aphasia are invited. And that is the community that is really looking at creating accessible research for people with aphasia. So that’s aphasia access is another great space to be.
50:29.85
Lauren Schwabish
um Yeah. Or they could just, you know, email you.
50:31.40
Jon
Okay.
50:32.64
Lauren Schwabish
And, you know.
50:33.52
Jon
Bye. They could do that, but then I would just forward it.
50:35.03
Lauren Schwabish
That’s it.
50:36.38
Jon
Okay, so lots of places that I will include.
50:36.40
Lauren Schwabish
fool
50:39.04
Jon
In the show notes.
50:39.84
Lauren Schwabish
Mm hmm.
50:40.24
Jon
Because those exist on the show.
50:41.33
Lauren Schwabish
Mm hmm.
50:42.43
Jon
Laurence Wabish, thank you so much for coming on the show.
50:45.31
Lauren Schwabish
You are so welcome.
50:45.51
Jon
So good to see you.
50:46.78
Lauren Schwabish
We did not talk about the neuroplasticity analogy.
50:47.04
Jon
Love you.
50:49.25
Lauren Schwabish
Do we think we need to?
50:50.35
Jon
Do you want to talk about that?
50:50.36
Lauren Schwabish
I feel like we mentioned it.
50:52.13
Jon
You mentioned it. Do you want to talk about it before we sign off?
50:55.87
Lauren Schwabish
I think we should
50:56.05
Jon
people are like if People are listening to this and they’re like, is this how they talk to each other? And yes, this is how we talk to each other.
51:00.77
Lauren Schwabish
This is how we talk to each other.
51:01.94
Jon
This is it.
51:02.09
Lauren Schwabish
Yes
51:02.88
Jon
Just like.
51:02.85
Lauren Schwabish
um
51:03.76
Jon
End the conversation, but never end it.
51:03.85
Lauren Schwabish
I just don’t, I hate to mention something to tease something and not follow through. But another way that we really work on health education and interesting information is through analogies.
51:09.56
Jon
Yeah.
51:12.57
Lauren Schwabish
And there’s a good body of research that talks about meaningful analogies to transfer health information. So I have to share one last analogy, which is to explain neuroplasticity that people are actually, if they’re listening to this podcast for data viz.
51:26.23
Lauren Schwabish
Now they’re going to walk away with neuroplasticity. This is like case in point. why neuroplasticity works. So neuroplasticity is your brain’s ability to rewire itself based on your experience. It’s the whole principle of rehabilitation.
51:38.84
Lauren Schwabish
And it’s a big, long word and people don’t always understand it. So we usually like to think about it as. Um, like a super highway, right? Where your brain is sending signals, right? Like the beltway with no traffic, the beltway on a holiday, right? It is just zoom and zoom and zoom and the cars are signals and they’re going really smoothly and quickly. And then a stroke or a brain injury is like.
52:02.89
Lauren Schwabish
We’re going down to one lane or the exit is, you know, we’re we’re completely blocked. And so the brain has to come up with a detour. And so it’s going on the side roads and the speed of the signal slows down. And sometimes the efficiency, like maybe those signals don’t get sent, which is why someone has difficulty with.
52:19.46
Lauren Schwabish
functionality, talking, walking. eating, dressing, anything like that. Once someone has personally meaningful repetition experiences that are salient to their day-to-day where they can understand why they’re doing what they’re doing, it’s moderately challenging. There’s several different principles of neuroplasticity. That detour gets faster. So the signals can get to where they need to get to. And the brain is literally creating a route around the area of damage.
52:47.38
Lauren Schwabish
And again, when I communicate that to people, what am I using? I’m using an illustration. I’m using something that’s personally meaningful. I’m bringing it into an experience that is.
52:58.41
Lauren Schwabish
understood by many, especially in the Washington DC area. to explain what is a really tremendously complex concept. So hopefully everyone’s neuroplasticity is… up up up during this podcast.
53:10.50
Jon
Love it. Love the addendum at the end of the podcast.
53:14.91
Lauren Schwabish
You got to give the people what they came for.
53:16.86
Jon
That… Well, yeah. Okay. Yeah. I mean, I generally don’t know how to do that, but yeah. Okay. Thank you, honey.
53:23.17
Lauren Schwabish
so Thank you, honey.
53:24.66
Jon
All right
53:24.62
Lauren Schwabish
Love you.
53:25.74
Jon
love you bye
53:26.82
Lauren Schwabish
Bye.