Latest / Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy / 443 | Update + Should Parents Tell Their Child About an Autism Diagnosis?

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443 | Update + Should Parents Tell Their Child About an Autism Diagnosis? · Play Therapy Podcast: A Master-Class in Child-Centered Play Therapy

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  You're listening to the Play Therapy Podcast with Dr.
• 0:03
  Brenna Hicks,
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  your source for centered and focused play therapy coaching.
• 0:08
  Hi,
• 0:08
  I'm Dr.
• 0:09
  Brenna Hicks,
• 0:09
  The Kid Counselor.
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  This is the Play Therapy Podcast where you get
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  a master class in child-centered play therapy
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  and practical support and application for your
• 0:17
  work with children and their families.
• 0:20
  In today's episode,
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  I am answering a question from April in Hong Kong.
• 0:24
  And I also wanna give you an update on
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  my travels over this last week,
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  and I also wanna read an email that I received.
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  So this is gonna be kind of a
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  conglomeration episode.
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  Let's start with
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  me being gone.
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  I apologize for not getting a Tuesday episode out to y'all.
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  I was speaking in New York.
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  I had
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  a VIP event on Friday.
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  I had the I Am CCPT live event in Jersey on Saturday.
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  I had the podcast meet up in Jersey on Sunday,
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  and then I was asked to speak
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  at a clinic in
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  New York on Monday and Tuesday.
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  So,
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  thanks for being gracious that I'm only getting one podcast out to y'all this week.
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  What an incredible 5 days.
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  It was lovely.
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  Some of y'all are gonna think I'm literally crazy for saying this out loud,
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  but it was so lovely to see fall leaves
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  and
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  have cooler weather.
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  It actually felt like October up there.
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  And
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  The people
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  and the time and the community and all of it,
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  it was just absolutely an incredible experience.
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  So
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  a huge thank you to all of you New Jerseyans and New
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  Yorkers that hung out with me over the last 5 days.
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  What a special memory
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  that I was able to take home back to Florida.
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  So really grateful about that.
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  Something else I'm very grateful for when y'all send
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  me emails and you tell me what's going on
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  with your work and how CCPT is changing your practice
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  and your lives and
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  everything about you.
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  And this is one such email.
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  Taylor from Florida,
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  interestingly enough,
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  not too far away in Lakeland,
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  that's only about forty-five-ish minutes from me.
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  And
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  this is one of the most special emails that I've gotten in a really long time,
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  and I've actually referenced it several times since when I've been speaking.
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  I said it in Jersey and I said it in New York.
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  And I want the rest of y'all to hear this as well.
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  This is
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  a testimony to the model and what it does for kids.
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  So,
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  I'm gonna read
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  Taylor's email in its entirety,
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  and I want y'all to just kind of take this in.
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  For those of you that are maybe on the fence about CCPT.
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  For those of you that maybe feel like you are mostly
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  CCPT but you deviate sometimes or you are eclectic or integrative,
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  for those of you that
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  are 100% CCPT,
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  this is just a reminder of why we remain adherent.
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  What a special email.
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  So,
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  let me read this.
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  I currently work for an agency where I see foster children in their homes.
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  Although I've been listening to your podcast,
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  I just assumed I couldn't do CCPT in my
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  current role because I didn't have a set playroom.
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  I've been implementing a lot of CCPT techniques
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  and child-centered expressive arts in my sessions,
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  but didn't feel like I could fully adhere to the model being in people's homes.
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  Recently,
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  I dug further into the podcast and listened to several episodes where
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  you encourage mobile play therapists to still adhere to the model,
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  as CCPT is dependent on relationship,
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  not toys.
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  Well,
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  I went full send
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  and got a nice mobile toy room
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  that I hauled along with me this week
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  and I went into my sessions fully CCPT.
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  Y'all,
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  here it is,
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  and I was shocked.
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  The kids made more progress
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  in
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  capital letters yelling one session
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  than I have seen in the past 3 months working with them.
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  Since we already had a very strong relationship thanks to
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  what bits of CCPT I had already been implementing,
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  they fully embraced the change.
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  They did the hard work in the session that I feel they had been craving.
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  Each child showed very obvious themes
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  on par with their traumas,
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  and their play spoke louder than any words they have ever said before.
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  I am so thankful for this model and feel so blessed to be able to bring them this
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  relief.
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  It's like they can finally let out everything they've been holding in.
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  First to you,
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  Taylor,
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  thank you for sharing that and living that out and being
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  permissive enough for me to read that.
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  Y'all,
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  that's what it's all about.
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  I,
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  I stressed over and over and over again in Jersey and New York these last 5 days.
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  We get out of the way
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  We're not even in the car.
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  We're the guard rails.
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  We're those little metal things that run alongside the edge of the asphalt.
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  And we try to get in the car and drive it,
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  or we try to steer it,
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  or we try to step on the brakes,
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  or we try to get them to put it in drive instead of reverse,
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  or we,
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  we're trying to control.
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  Where the child is going,
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  the child's the driver.
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  We're not even in the car.
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  Were the guard rails running alongside.
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  Just making sure that eventually
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  in whatever way,
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  in whatever time,
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  in whatever path they choose.
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  They end up where they're trying to go.
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  And
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  Taylor just very clearly articulated.
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  I was doing all these other things and when I finally went all in CCPT.
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  They got the relief
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  And they were able to do the things that they've been needing to do.
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  Because the relationship and the environment
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  were conducive for it.
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  So what an exciting testimony of the model.
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  Thank you,
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  Taylor.
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  So now let's move into our question.
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  So this is from April in Hong Kong.
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  Hello to all of you on the other side of the world in Asia.
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  This is about
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  actually a parent question.
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  So,
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  we're kind of addressing this from how do we
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  communicate to parents to communicate with their children.
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  The parent wants to know how they should
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  talk to their child about having a diagnosis.
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  So I think this is a really helpful question.
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  Thank you,
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  April.
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  So let's dive into parts of this and then we'll process.
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  The parent asked how they should talk to
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  their child about having an autism diagnosis.
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  The child is beginning to notice that
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  they are receiving additional support at school
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  and is becoming more aware that they
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  may experience things differently than their peers.
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  The parent is wondering whether they should directly tell the child
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  and how to do this without the child interpreting
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  being different
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  as something negative.
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  This also made me think more broadly about how
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  we as play therapists respond when parents ask similar questions
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  about diagnoses such as ADHD.
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  Would you generally encourage parents to first
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  help the child understand their own experiences,
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  strengths and needs before introducing the diagnostic term?
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  And when the child is ready,
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  how would you recommend introducing words such as autism or ADHD
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  in a developmentally appropriate way without allowing
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  the diagnosis to become the child's identity?
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  I'd really appreciate hearing how you approach these conversations with parents,
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  particularly from a child-centered play therapy perspective.
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  All right,
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  really helpful question.
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  So
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  I've covered similar concepts
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  in the parenting podcast before.
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  I don't think we've ever talked about it on the therapist podcast,
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  so I'm excited to dive in.
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  One of the most important things we need to realize as adults,
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  therapists or parents,
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  is that children need age-appropriate truth.
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  So when there's a scenario that a child needs
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  to be made aware of,
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  it's not necessarily a diagnosis.
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  There can be
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  this can be lots of things.
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  Parents are going to separate,
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  parents are going to get divorced,
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  someone in the family died.
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  There's going to be a new sibling.
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  Something happened,
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  there are things that come up
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  and parents typically do not know how to handle that.
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  And one of the very common responses among parents is
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  No,
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  they can't know that.
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  I'm not gonna tell them that.
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  We have to keep that a secret.
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  That will upset them.
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  That will be too much for them.
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  They won't be able to understand that.
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  So we're just gonna not tell them at all.
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  Well,
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  if we go back to what we know about children,
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  And what they need
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  We center in on relationship.
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  And by omitting information,
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  That is relevant to the child.
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  Look,
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  let me be real clear for a sec.
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  We should never tell a child.
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  Something that they don't need to know.
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  If a parent can't stand their spouse
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  and they just want to vent about how annoying the child's dad is,
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  that's not something that a child should hear.
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  So we absolutely safeguard
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  and we govern what the child is told.
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  If it does not apply to them,
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  if they don't need to know it,
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  then they don't need to know it.
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  We absolutely aren't gonna put them in the middle
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  or triangulate them
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  or share adult information with them or put them in a position where
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  they're being forced to listen to an adult that just wants someone to listen.
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  That's not what I mean,
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  but
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  a diagnosis,
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  a death,
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  a birth,
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  a move,
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  a divorce,
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  a separation,
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  a change of schools,
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  whatever the scenario is,
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  if it impacts the child,
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  they need to know.
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  And when we don't tell them,
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  when we omit that information,
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  It becomes a relationship fracture.
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  Because a relationship is built on trust
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  and on honesty.
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  And down the road,
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  the child will find out
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  that they were not told.
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  There's no skating past this
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  because a child eventually does find out
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  and then a child eventually finds out that the parent knew.
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  And it becomes very apparent
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  you lied to me.
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  You hid this from me.
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  You kept me from knowing the truth.
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  And that creates bitterness and resentment
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  and relationship rupture.
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  So we have to help a parent understand
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  it is very,
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  very important
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  that they tell their children
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  important things,
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  including diagnosis.
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  But we do it in an age-appropriate way.
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  And we coach parents on how to respond because
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  typically,
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  children are going to
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  have questions or comments or want more information or need time to think about it.
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  So,
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  children process things differently.
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  They're not cognitive,
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  they're not rational,
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  they're not verbal.
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  So we're going to
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  require a child to be all three of those things when we tell them something like this.
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  They're going to need to feel and experience their way through it.
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  That may take a while.
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  They may circle back.
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  They may ask questions,
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  they may get emotional,
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  they may want to know something.
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  We need to prepare parents
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  for
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  how that might be a longer term thing than just a one and done conversation.
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  However
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  Kids know
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  When something is off.
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  And this is true about diagnosis.
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  This is true about all the circumstances that we've been talking about too.
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  Kids know when parents aren't getting along.
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  Kids know when
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  people are like whispering and not filling them in on something,
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  and as soon as they walk in the room,
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  everyone shuts up.
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  Kids know when
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  They're not quite like their peers.
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  Kids know that they're struggling with things
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  that other kids aren't struggling with.
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  Kids are very smart,
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  y'all.
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  Kids are very
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  intuitive.
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  Kids are very intuitive.
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  Kids are very perceptive.
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  Kids are very aware,
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  and they do not get credit for those things.
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  So kids know,
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  and when it comes to a diagnosis,
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  Especially in autism diagnosis.
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  A spectrum diagnosis is important for children to be made aware of because
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  it gives them the why.
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  If they don't have the why.
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  In other words,
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  Age appropriate truth
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  is
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  Your brain is a little different
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  than
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  other people's brains.
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  You were born that way.
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  So you think differently
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  and you feel differently and you understand things differently
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  and you understand things differently.
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  That's age-appropriate truth.
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  And when a child is made aware of that,
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  now their struggles and their difficulties and the things that make them feel off.
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  Can be explained
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  and if they don't have that,
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  it turns inward and they start to blame themselves.
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  I'm stupid.
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  I can't ever do anything.
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  I always screw up.
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  I'm just an idiot.
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  I always get things wrong.
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  I never understand what's going on.
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  Everyone else laughs at a joke but me.
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  And then
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  they blame themselves and they put themselves and they put themselves at fault.
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  What does that do to a child's self-concept and worth and self-esteem?
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  It tanks it
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  So it's really important
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  for a child to have the why.
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  It doesn't change anything.
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  Their neurodivergence is never going to go away.
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  But they at least understand,
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  oh,
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  OK,
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  well,
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  there's nothing wrong with me,
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  my brain's just different.
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  So that's a very powerful
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  component to the way that we share things,
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  and we don't need to
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  elaborate.
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  Let's go back to our rule of thumb.
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  If you can't say it in 10 words or less,
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  don't say it.
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  Parents want to over talk and overexplain and over preach and overteach.
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  Coach parents through a script.
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  Before you were born,
• 13:29
  your brain grew a little bit differently.
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  So your brain is different than other people's.
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  That makes you especially
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  talented and skilled at some things.
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  And it makes other things a little bit hard.
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  That's it.
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  There needs to be no further discussion unless the child has a question.
• 13:52
  Well,
• 13:52
  is it ever going to get better?
• 13:55
  Well,
• 13:55
  your brain is wired the way your brain is wired,
• 13:58
  but there are things that you can do to make things easier.
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  So,
• 14:03
  we are very sensitive to whatever the child wants to know,
• 14:06
  but we don't need to overexplain.
• 14:09
  Parents need to really rein that in.
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  That is hard.
• 14:12
  So we have to kind of give them scripts and,
• 14:14
  and encouragement.
• 14:16
  And
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  your follow-up question,
• 14:18
  April,
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  would you encourage parents to first help
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  the child understand their own experiences,
• 14:22
  strengths and needs before introducing the term?
• 14:25
  I don't think that there's an order for that,
• 14:27
  and I don't think that that's a prerequisite.
• 14:30
  children need to understand what they're struggling with.
• 14:33
  And out of that conversation,
• 14:35
  there will inevitably be a conversation about
• 14:38
  their needs and their struggles and their strengths and their experiences,
• 14:42
  because
• 14:43
  when a child says,
• 14:45
  well,
• 14:45
  I have autism,
• 14:46
  so it's really hard for me to
• 14:48
  understand what a kid's saying when they're being funny.
• 14:51
  I've had kids say stuff like that to me before.
• 14:55
  There's their why and it becomes normal
• 14:58
  for them.
• 14:59
  It's still neurodivergent,
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  but it becomes normal for them.
• 15:04
  And once they have that language,
• 15:05
  they're able to explain that to people.
• 15:10
  And
• 15:11
  that is a natural byproduct of knowing the diagnosis.
• 15:15
  Now,
• 15:15
  let me go on a quick side note here because
• 15:19
  you included ADHD in this dialogue here.
• 15:23
  ADHD
• 15:25
  Is the most overdiagnosed
• 15:27
  pediatric diagnosis.
• 15:30
  When it is unwarranted in children.
• 15:33
  Everybody and their brother has ADHD right now,
• 15:36
  and none of them actually do.
• 15:40
  True ADHD is a chemical imbalance.
• 15:44
  And just because kids meet diagnostic criteria for ADHD,
• 15:48
  so would you and I on a particular day.
• 15:51
  Based on the criteria
• 15:54
  ADHD symptoms and behaviors can be explained away
• 15:58
  by
• 15:59
  understanding the whole child.
• 16:01
  Have we addressed the social,
• 16:03
  emotional,
• 16:04
  behavioral,
• 16:05
  relational,
• 16:06
  familial,
• 16:07
  academic,
• 16:08
  psychological,
• 16:09
  mental?
• 16:10
  I mean,
• 16:10
  I can keep going.
• 16:11
  Have we addressed all of that?
• 16:14
  And we still meet diagnostic criteria for ADHD?
• 16:17
  No way.
• 16:19
  Interestingly,
• 16:20
  it is the most overdiagnosed
• 16:22
  when it is unwarranted.
• 16:24
  But it is the most underdiagnosed when it is warranted.
• 16:29
  So the kids that actually need the diagnosis are not getting diagnosed,
• 16:33
  and the kids that don't need it are.
• 16:35
  So this is the conundrum in which we
• 16:37
  find ourselves with pediatric mental health right now.
• 16:40
  So,
• 16:42
  Are there children that are legitimately needing to be diagnosed with ADHD?
• 16:46
  Yes.
• 16:47
  You want to know numbers from my own personal anecdotal experience?
• 16:52
  I have no idea how many families with whom I've worked,
• 16:54
  thousands.
• 16:56
  In 21 years
• 16:59
  Two children
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  after a full round of CCPT.
• 17:05
  were appropriately diagnosed and medicated for ADHD.
• 17:10
  2
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  Out of thousands in 21 years.
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  So we need to be very thoughtful and very careful about
• 17:19
  just running with an ADHD diagnosis.
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  It's a catch-all.
• 17:23
  It's the default
• 17:24
  kid is struggling ADHD.
• 17:27
  Kid is struggling,
• 17:28
  diagnose,
• 17:28
  medicate.
• 17:30
  Kid is struggling,
• 17:30
  meets diagnostic criteria,
• 17:32
  check.
• 17:35
  If we go through a full round of CCPT,
• 17:38
  I would be shocked.
• 17:41
  If they still met diagnostic criteria for ADHD.
• 17:45
  So if a child truly has ADHD or another diagnosis,
• 17:50
  yes,
• 17:50
  they should be told.
• 17:53
  But just because they've been diagnosed doesn't mean that it's accurate.
• 17:58
  And you mentioned
• 18:00
  how it doesn't become the label or their identity.
• 18:03
  That's the danger of diagnosing
• 18:06
  because it does become the child's label and identity.
• 18:09
  It can become a crutch very easily.
• 18:12
  So we want to help parents
• 18:14
  ensure that it's an accurate and valid diagnosis.
• 18:19
  Before we would have these kinds of conversations,
• 18:20
  because just because a child's been diagnosed does
• 18:22
  not mean that that's actually what's going on.
• 18:26
  Kids that get diagnosed with anxiety disorders at 3,
• 18:29
  kids that get diagnosed with depressive disorders at 4,
• 18:33
  they're not even pediatric diagnoses.
• 18:36
  But we're throwing them out like candy
• 18:38
  to minors.
• 18:40
  I think we need to reconsider that and say let's do CCPT.
• 18:45
  And see where we are at the end of the
• 18:47
  course of treatment.
• 18:49
  Do we still
• 18:50
  meet the same criteria that we did before?
• 18:52
  We probably don't even need to talk to the child about
• 18:54
  it because that wasn't what it was in the first place.
• 18:57
  But a legitimate diagnosis,
• 18:59
  spectrum,
• 19:00
  learning disability,
• 19:02
  something like that,
• 19:02
  yes,
• 19:03
  absolutely,
• 19:03
  the child should receive age-appropriate truth.
• 19:06
  April,
• 19:07
  thank you so much.
• 19:07
  I hope that that was helpful.
• 19:09
  And if y'all wanna reach out,
• 19:10
  please do.
• 19:11
  I've missed y'all.
• 19:12
  I'm glad to hang out again.
• 19:14
  I love you.
• 19:14
  We'll talk again soon.
• 19:15
  Bye.
• 19:17
  Thank you for listening to the Play Therapy Podcast with Dr.
• 19:19
  Brenna Hicks.
• 19:21
  For more episodes and resources,
• 19:23
  please go to www.playtherapypodcast.com.