but can we, I can just see like the wire kind of going through your shirt. Oh, run it like to the side, like down to the side of you. Just so that we don't see it so, and you can move it the whole thing to the other side if you want to get it, but you're comfortable, so it'll be good. Is that better? Yes. Okay. We're trying to have as many little distracting things. Oh, yeah. I mean, you've watched TV before. Someone's like, Oh, my gosh. What? What is that? Yeah. That's fine. The traditional joke is always for the videographer, like someone having a telephone pole coming out of their head. And it's like, you just have to be aware of like what's behind them. It's on them. So, it's little details. I don't even see. It's like, I can see that. Yeah, it looks good. Okay. Yeah. Thank you. Thank you. All right. So let's start with how long have you been here with Plattville? In Plattville for this will be the beginning of my 12th year. Okay. Yeah. Yeah. What changes have you seen over that timeline in terms of the number of kids coming in with speech delays or referrals and then the severity within there too. Yeah. I would say it has definitely increased. When I first started here, first grade was also in this building. So that was a little bit of a change when first grade allowed. I left and went over to Westview that changed the numbers a little bit, but now it's seeming to pick up to about the place it was when I started when there was in a whole nother grade here. And I would definitely the severity that I work with. So I've had a, I work here full time and then I have two therapists who come and help me out. One comes two and a half days a week and the other one comes two mornings a week. As there's just too many kids for me to fit in all there, all on that schedule. So I see more of the kids with more of those intense needs because I'm here every day. So I can help spread out and can coordinate with the classroom teachers and the special ed teachers and the aides and all that. I have more flexibility to do that. And then the, my colleagues who come shorter times see more of the kids who just have maybe some, a few sounds they need to clean up. So, so, but there has been a higher number of those kids for sure. So what was, what was it like working through COVID? Did you have to do some remote and then some like distance back in place? Yeah. So when the first, when we first shut down in March of 2020, we, that, we finished out that last quarter doing therapy over Zoom, which I was not trained to do telehealth. So that was a whole learning curve and doing a lot of research and figuring out how to share screens and do interactive games with kids over Zoom and that type of thing. Another challenge during that time when we were zooming is would kids show up to our scheduled time? If they scheduled up, would they be in a room quiet by themselves or did they have their siblings all doing their own Zoom meetings? So those were some of the difficult factors when we were virtual. And then when we came back, yes, I had to get a new table in my room to make sure it was six feet long. And then I had students at one end and me on the other. And when we first came back, I had a plastic barrier between us as well. So it was very difficult and I'd be like, okay, get behind the screen. I'm behind the screen. Okay, we're going to take our masks off for so you can watch me because that watching of how we make speech sounds is so an intricate part of remediation of those errors and that type of thing. So they'd be like, I'm not supposed to take it off sometimes. And it's like, oh, just for a minute, Mom said it's okay. So then they would take it off. We do a little bit of practice watching and me making sure they were doing the right things and then we put the masks back on and continue on from there. So it was definitely a new learning curve. And then there were times when I had to be quarantined and so I was home. And so they would set up a computer in the nurse's office that I was on Zoom and then they would just rotate kids through. So it was back to telehealth if anyone had to go through a quarantine or any of those types of things. So when you look at the kids that are coming in now that are three, four, five years old, they were born or were very young at the start of the pandemic. How much of just what everyone went through impacted some of those delays their experience? Yeah, so definitely the mask issue and not being able to get that visual feedback on how I'm supposed to move my mouth. What's that person doing with their mouth? What am I supposed to do? Then you take into account the social isolation and kids not really knowing how to play with each other and how to think about other people. I've noticed a difference in the initiation of kids and using language with that initiation when we first came back. And since then there are definitely kids who will just hand you stuff and expect that you know what they want to do with it and not say anything to you. So I've definitely seen an increase in those types of initiation, socialization, speech sounds. They're just not to speak negatively about them but they're a different kind of kid than what kids pre-pandemic were like. Yes, the majority of them. They just had a completely different experience. Yeah, they didn't have that sharing of toys and daycare. They were home playing with their own toys, that type of thing. For like our kindergartners were probably like two when that started so they might have been in daycare and then pulled out and had a little bit of break in that development where they would be learning. I was wondering how to share and take turns and so I would say all the classroom teachers have shared different stories about how they see that impacting even their free play time. And how much of that then rolls into behavior issues where speech is so connected to if you can get your needs fulfilled and if you can then how do you react? Right, right. Yeah, for sure. We and I in this building have implemented some grade level wide strategies so I do want me to show some of the things I do in the or not. Okay, so yeah, so I go into the kindergarten classrooms and work on those social skills once a month with those kids and just teach them like, you know, you have thoughts but when you do something someone else thinks about you. That impacts how they treat you and all of those types of things are definitely being more needed grade level wide rather than just if you have an identified need. Is this something that you think kids will come out of it or will the kids that were born or were very young during COVID always have a different learning curve? I'm hopeful that we're implementing some things at least in our school that will help negate some of those things and help encourage that another thing the school has done is we have board game days now once a month and so every classroom rotates board games and so for half an hour once a month everybody sits down and takes turns and learns how to move pieces on the board and be a good winner and be a good loser. And so those are some things like that that those social skills we're trying to address here. You shared with me some of the numbers for referrals and you've seen a pretty dramatic increase. I mean, what lessons should we be taking away from that just the sheer number of kids? Yeah, what should you take away from that? I mean, when someone in the public is going, oh, I hear that there's, you know, some more kids need speech. How bad is it? Yeah, it's pretty overwhelming for sure. I would say to parents that have young children or maybe who have some of these like just get on the floor and play with them, right? And as you're playing, name the things you're playing with or talk about the different places they're going to do some concepts, do some role playing, you know, just I think getting back to just sitting on the floor with our kids and playing with them is almost the lost art during this time. There's lots and there's just a lawsuit filed over a meta yesterday regarding mental health for teens. How significant is the screens issue with kids? Oh, so this is my personal opinion. It's not anything that's like has a lot of like hard evidence behind it, but I see definitely kids on screens being an issue, but also for these young kids parents being on screens. So they're not like, and you know, you see it in Walmart, like you walking in a kids trying to get their parents attention and they're scrolling on their phone while they're shopping or FaceTiming someone and the kids just aren't getting that back and forth human interaction that we need. They need whether they're on a screen or the parents on a screen, it's impacting them, no matter which way it goes. So in terms of how you and your staff are handling this influx, how is everyone holding up? Because obviously your case load is skyrocketing. It is. We just had a meeting last week, there's four speech therapists here, and we kind of did a check in. How are you right now? And we all said, we're okay right now. The thing that's making me a little overwhelmed is like the number they keep coming, right? Those referrals keep coming. As those kids are evaluated, and if they qualify getting them added onto my schedule, that's when it's going to start to be. Okay, now I feel like I'm drowning. Now what are we going to do? But I'm not to that point yet. But when you hear five this week. Yeah, yeah, that's and that's pretty typical of this first quarter, like two, two to three almost. It seems like every week or every other week. So yeah, I just at this point, I just read it and I'm like, another one, you know, which is, we'll do it, right? We're a couple months into the school year. Can, will that slow down? I don't, not, not significantly, I would say, usually we do 4K screenings in February in this district, and we usually get eight to ten referrals from that. And so then those take until the end of the school year. So there's always that jump. Hopefully by the time we finish this first wave, we'll be finished with them and get them in place before the second wave kind of hits. I mean, yeah, because the reality is that the next cohort of kids coming in also. Exactly. Experience the pandemic. Right, because they'll be like starting January of 2020, right? So they would have been born into staying home and not having, you know, don't get too close to them and stay away from people and stuff. And I mean, I understand we didn't know what COVID was and we needed to take precautions. But there's definitely a long-term impact on our kids. And I mean, even, even if people didn't mask in the household, if you were doing anything outside of the household, most people were masking. Right. Sometimes even in public or outdoor spaces. Right, exactly. And if, like, going back to the screens, if you're home and your parents working from home, like they need to be on the computer, like focused on their job. So they don't, they're not doing that plan, the floor interacting with other kids type of thing. Have you heard from other speech pathologists around the state? I mean, I'm assuming you've got friends in other districts. This is not a localized thing. No, not at all. No. And I'm just glad that I have people who support me here. Because in some other districts, you don't have the support of your administration or have, like, there's some of those more rural districts only have one speech therapist. And getting someone else to come to a rural area is not the easiest thing in the world to do. And what I mean, their sheer number should be lower, but if it's just one person, they're getting everyone at those schools. Exactly. From three years old to 21 years old. Whereas we're able to split them up in this district, which is a help. But, yeah. Because that we've also seen an increase, like, looking at those numbers, we didn't have a lot of, like, middle school and high school referrals for speech and language. And those early years that we shared with you. But now we're getting, like, middle school, high school referrals. And I think, right, there's an impact on those older kids with COVID, too. They had to be away from their friends and then getting back in with their friends and has been hard. So they may have actually lost some speech sounds in that process? Well, more of the language skills, like the social pragmatic skills in interacting in that confidence to join a group again. Are you nervous if something else, you know, the illness or is it just, yeah. So give me a couple seconds on that, because I'm sure a lot of people will hear speech language and they will think it's a list. Oh, yeah. And just the very basic stuff that we see portrayed in a movie or show how broad can the services be? Very broad. I mean, we, you know, there's the different areas. There's the speech sound production. There's grammar issues. So if kids are using pronouns or verb tenses, you know, not knowing how to reverse sentences for asking questions versus statements. There is describing words and knowing all the different way to describe words. There's interacting with people knowing that, that perspective taking, right? Like, so this is how I feel and everyone should feel like me. Well, everyone doesn't feel like you and you can't just go telling people they're wrong all the time, right? You have to take another people's perspective. So that perspective taking that thinking I mentioned earlier, that thinking about you thinking about me, right? Like that you, what you do has an impact on other people. And then that's going to impact how they treat you. So if you're upset about how they're treating you, did anything happen before that, right? And just kind of deconstructing those social issues and seeing where the breakdown is and then how to build those skills back up so they're able to interact better. That would surprise a lot of people, but that falls under speech. Yeah, yeah, yeah. Those social interaction pieces are speech and language. Yeah, middle school and high school therapists. Here is amazing with social groups that she robs. She does like lunch groups and helps kids work through problems that way and how, what language you should use in different situations and all of that stuff. She's a much more expert on that than I am, but she does a great job of running those groups and getting those kids what they need at those higher age levels. Okay. Anything else you want to add along those lines, what we talked about? I don't think so. I feel like I got everything. Can I get you to say and spell your name and give your title just so I have that correct? My name is Megan Bolkin, so it's M-E-G-A-N-B-O-H-L-K-E-N and I am a speech language pathologist. Okay. And did you lose short straw or rock paper scissors to have to do this? We talked about our director back sent out an email and so I just responded and said, yeah, I'd be willing to. And so nobody else responded, so I guess that's like- I was just sure if you've been volunteered. Nope, he did. He did offer it. Okay. Yeah. And I think the team was like, yeah, you guys, like Stacey and I down, working in this youngest are seeing the biggest and flux. This is definitely the place that we're looking at in the story. Yeah. All right. So, yes, what we would love to do is- I just saw Elliot. Oh, okay. So- Oh. Can't you open the door? Hey, dude. Hello. Hi. It's warm in here, Elliot. Are you going to be our helper today? I'm just going to cut. You don't have to know all the answers.