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Autism and Parenting Performance with Avela Health's Dr. Cynthia Anderson on Expectations and Well-Being · Inchstones with Sarah | Autism Advocacy & Caregiver Stories

• 0:00
  Speaker A: Hey, everyone. Welcome back to the Inch Zones podcast. We are well into the sixth chapter of Inch Zones, and I can't believe how much we've grown. And one of the best things that has come my way as I lean into advocacy work is the incredible amount of companies that are out there actively building the scaffolding with which to support families of children with autism. And Today I have Dr. Cynthia Anderson of Avela Health and Avala is providing from start to finish, the support network, the clinical direction, the 247 questions in care, from diagnosis to education to therapy support. And as they grow, it's become apparent to me that this is something that I could not have wished for more when I began my journey as an autism parent. So, Dr. Cynthia, thank you so much.
• 0:57
  Speaker B: For being here today. Thank you. I'm really happy to be here. Sarah.
• 1:00
  Speaker A: Well, I always like to start with personal connections. My, my heart, my soul has always been towards individuals and going, tell me who you are. So what is your personal connection to the autism world?
• 1:12
  Speaker B: Gosh, I've been working with people with neuro, neurodivergent people, broadly speaking, for most of my career, and that's been across various settings. So I started out, gosh, way back in the day when I was still an undergrad working at Johns Hopkins University in an inpatient unit for folks who had often life threatening, complex behavior. And I really, I think there is where I really got a feel, maybe for the first time, at least a little bit of a feel for what it must be like to be parenting a child that you loved so much and who was harming themselves or harming other people, unable to be safe on their own. And it just opened a place inside of me that I don't know that. I mean, I was 22 years old. I don't think I knew that it existed before then. That experience really just awakened a passion in me for trying to not just deliver, but also understand what works for whom, how and when. And that experience, I went on to grad school and got a Master's and PhD in Clinical Psychology and really have split my career between research and practice. Research following questions, just like that, like, okay, so this looks really great in a randomized clinical trial or in a top tier journal, but what happens when we take this intervention and we ask teachers to do it? You know, a teacher who's responsible for 30 kids or 25 kids, or how, how does this intervention work for a parent who is trying to parent their child who has really complex healthcare needs and parent two other kids and be A partner in a marriage and maybe hold a job. How does that work? What does that look like? So those questions have just really. They've just really struck with. Stuck with me throughout my career and joining Aveila Health, really co founding Aveila Health, I felt like was an opportunity to bring my experiences in research and practice. And also I have several friends who are parents of neurodivergent children. Their experiences, as well as what research tells us to try to bring it all together into something that maybe can make real change for people.
• 3:28
  Speaker A: The word that rose up as you spoke in my body and mind was that generalization point where there's all that we know and continue to try to learn about children with neurodiversity and, you know, in my case, profound autism, you know, apraxia, dyspraxia, oral motor planning disorders. And it's paralyzing, to say the least. And I think that the generalization that is almost insistent, like as you said you had, you got to witness this as in your young twenties in studies, in your studies. And you were absorbing how, okay, we're researching something, but what does this actually look like when it's implemented in schools? And then what does it look like to parents in the home? And there's this. That term. I was always like, we need to generalize this behavior. Let's attempt to generalize this behavior. And it really can become a walloping theme, because to your point, we wear so many hats as parents that the generalization can almost take over and become the only hat that you feel like you can wear. Because if things aren't generalized, what's the use of us growing a skill set in a contained environment?
• 4:32
  Speaker B: Right.
• 4:32
  Speaker A: The parent who just received that diagnosis. Had I known about AVEA back then, how do you. How does joining and actively seeking support through Aveila allow the families to move from that fear into a greater confidence level?
• 4:48
  Speaker B: Gosh, that's such a great question and.
• 4:51
  Speaker A: A layered question, my heart, you know. Cause it's just like, it's. So I think about how little people discuss the role that I'm in, and then I think about why. And I think that it goes down to just deep shame and fear. And how do we then take the majority, if not the. The almost totality of that population and go, we're here to support you and, and, and build that confidence, like piece.
• 5:15
  Speaker B: By piece, you know, that's. It's such a great question. And the first thing that came to mind is that I was listening to you and talking about fear is. I was thinking Gosh, I'm a parent of a 16 and a half year old and I'm afraid and unsure almost every single day of what I'm doing. And I, I, I, I do think that parenting is just to some extent trying to learn to live with and accept that feeling that we don't have all the answers and we might not be doing enough and we somehow, or at least maybe feel like you're never doing enough and somehow showing up anyway. You know, I think that, Gosh, I was just talking to a friend of mine about this this morning. She has a daughter who's having some struggles right now and she's just talking about how early on in preschool, so called experts noticed some things and just went down kind of a crazy road with her. And one of the things that we talk a lot about at Avala Health is that you're the expert of you and really trying to help parents understand that they're the expert of their families, they're the expert of themselves. And that doesn't mean that you have all the answers and it doesn't mean there's not a place for folks like me who have some training. But my training and my lived experience isn't the same as your lived experience. And what we like to do at Avela is really build a collaborative relationship where we can come to the table and all bring our own experiences, our own areas of expertise and put them together. I think that, I don't know, Sarah, I'd love to hear your thoughts on this, but I think I want parents first hear the word autism when somebody suggests it, or often more often. I think these days parents notice something and they start to read and they kind of things start to line up around autism. I think people are also often very fearful. And I think that that comes from a lot of the ways that autism is talked about and not talked about, both. Right. You know, when I first started working in this field, all that I was exposed to around autism was what we now consider profiled autism. And so this whole idea of the true heterogeneity of autism, I'm exposed to any of that. And so profound autism as we now talk about it is that has always been a place and dear to my heart. And I think some people are aware of that and then other people just hear really different kinds of things. And I think that what helps maybe the most is just information and not misinformation, but actual information, which really is just having to sift through so much that's out there and remembering that you're the expert of you. I don't know if I'm answering your.
• 7:45
  Speaker A: Question at all, but I think one of the greatest things that was revealed to me, you know, my son Mac was just an infant, like literally an infant like days old when Millie got diagnosed. And when I remember through those first few years and then Matt getting a diagnosis at around 20, 22 months and those, that chunk of my motherhood, what it revealed to me was exactly what you're saying. It revealed to me that I was the one seeing behaviors, I was the one noticing what were, um, the sensitivities. I was the one. And it wasn't from a place of I'm the mother. I know, like I'm the mother right now. It was from a place of. I, I'm, I'm being very conscious about, you know, writing things down. What, what was like, like really taking data. And, you know, I wish I could have done it probably to a better extent, but what I was able to do is go, every time X happens, I emerges. And why is that? And because I think I innately stayed curious, it then kept revealing to myself about why curiosity matters, why the mothers matter in this situation, why the caregivers matter, why. Thinking back on the, on the entirety of the child's life, I know in any intake for a doctor for Millie or Mac, I'm sure you can confirm this. It's like, when did you give birth? Like at what week did you give birth? How was their birth experience? You know, there's so many from the moment that they breathe that first breath. And I think that I know that their father couldn't probably remember that. You know, that's, it's not, it's not wrong. It's not being unkind. It's just that the mothers really know. And I think the more honest we can do to just be truthful, I think it does rid the shame and fear that surrounds the conversation about your child. I think it, it can just, it can be beautifully revealing if you can pace it with your own self reflection. And that is, I mean, again, it's so complex. It's so deeply complex. And that's why I love the scaffolding that Aveila can provide. Is it says, we're gonna give you some guardrails to this. Not to say we know, but to help lead you along this. Because it would have felt supportive, it would have anchored me, it would have lifted and said, yeah, what you're seeing, that's. I, I've seen that in practice consistently.
• 10:07
  Speaker B: That's right.
• 10:08
  Speaker A: And go Oh, I wasn't seeing anything. I didn't make that up. I wasn't too tired to notice that. I did notice that. And I, and I, I just, I wonder about the beautiful byproduct that people are unaware of when joining Aveila as a family and that holistic approach to it, that it's not fear based, it's actually support based care, just deep care.
• 10:31
  Speaker B: Yeah, I think one of the things that we. There's two pieces that stuck out to what you said, and one piece is that I think information and connection matters. And certainly a part of Aviela Health is having access to clinicians who have deep expertise in neurodivergence and autism and understanding interventions from what I would say is a not holistic way. So really thinking about, okay, if I'm going to use a cognitive behavior therapy type approach, let's say I'm working with a teen who is really wanting friends but struggling. I'm not going to do it in a way that I would with a neurotypical youth. I'm going to really explore what is social interaction going to look like for you as an autistic person? And so that's part of it. But I think, Sarah, another part of Avela that I think is really special is something that one of our founders, Robin McIntosh, pushed from, from the very beginning, which is community. And we are able to get parents meeting with other parents, autistic kids meeting other autistic kids. So we have chats that people can have together. We have groups that are formed around intervention, but also have just a support function. We have a group for actually autistic adolescent which just started and the discussions in there about Minecraft and things are just amazing. But we have these groups for parents who are parenting profoundly autistic kids. How amazing is it to maybe connect with another parent who doesn't know your kid, but who knows what it's like to be in your shoes. So I think that that connection is a really important piece of something that we offer that is often hard to find for families. It's really hard to find.
• 12:08
  Speaker A: And I, um, you know, I was sharing with you and your, another employee of Avala before we recorded that. I'm really sensitive to keeping even these podcasts really condensed and short because I, I not in a way to limit the information, but I'm so acutely aware of the information overload that is provided to parents that are in mothers and caregivers in the situation I'm in. And I, I think the sensitivity to that allows for jumping into a support group and, and, and, and not hanging so much weight on well, how much time is this going of energy is this gonna expend? And just say it's amazing what I'll give back. Even in the, the smallest of doses. You don't realize it until you finally realize that another mom knows exactly what you mean. When Velcro is an issue. Right. That, that zippers are when your kid.
• 12:57
  Speaker B: Won'T sleep in their pajamas at night. Like, why is that a problem? Yeah. All that stuff. Yep.
• 13:03
  Speaker A: I love it about my son, but man, that kid likes to burrow and nest. I wake up, get him up in the morning. I mean it's a he. He is all. But I mean his head is almost under the covers now. He's old enough, he can move him. His head. I mean he's 8 years old, but man, that boy loves a good burrow and like that sensory input. And it's cute and sweet to share with my friends. It's only through the eyes and the heart of another autism parent, profound autism parent like myself that would go, oh yeah, oh yeah, you wanna see that, my child? You know, I'll, I'll find books piled next to my son. I think he loves the pressure of the books next to him.
• 13:35
  Speaker B: Yeah.
• 13:36
  Speaker A: And it's more than validation. It's saying, I live a world parallel to you. And it's arguably what I've always said one of the best things about the global village. There's so many downsides to the third space being online. This is not one.
• 13:52
  Speaker B: And I think for autistic people, it's so true as well. We have a bunch of teenagers who. There's nobody in the community who gets them, but they can be in our group and there's somebody like them. And I think that's so cool.
• 14:03
  Speaker A: So if a mom is listening and is wondering how Availla can start to finish, be that support for her, what do you want her to hear from you as a clinical director, what would be something that lands and goes. And she says, yeah, that is what I need. Or that is what we could, we could.
• 14:22
  Speaker B: Yeah, I think that maybe I could answer this a little bit differently and maybe answer your question at the same time by thinking about whenever a person is considering seeking out supports and care, what are the things that you might look for? And we can talk a little bit about Aveila within that, but I think I would rather just talk about this more generally and we can talk a little bit Aveila as part of it, But I think that, you know, you're the expert of you. And so when you're considering a care partner, I don't know that I would approach it, so I'm not in your shoes, so I'm going to say what I think I would do. But. But I think that you're trying to find a provider and a service that is the best fit for you, your child, and your family. And there's a lot that's wrapped up in there. Talk to me about how you define progress, because if the answer is focused mostly on reducing behavior or making a kid look more typical. Yeah, yeah. I think that progress for our autistic children ought to be about helping children and parents feel safe, feel connected, and feel successful. And that what success looks like is different for every child and every parent. And I can't define that for you. And so if a provider is defining success for you and your child and family, I would be concerned. I would have a lot of questions. You're working with an inter. You're working with a clinician or a specialist to develop skill, strategies, supports, and identify accommodations in the environment to help your family and your child thrive. So I think really focusing on how do you define progress? How do we agree on that? I think I'd want to know what does my involvement look like?
• 16:06
  Speaker A: Yes, very much.
• 16:07
  Speaker B: I, you know, I used to do a lot of school consultation, and I had this middle school principal that I worked with who said these words to me that have stuck in my head. And he said, you know, Cynthia, we design programs for our kids as if parents don't exist, and then we work like crazy to get them involved. And I thought, at first, I thought, well, that's weird. And then he said, you know, of course kids do better when parents are involved, but what about the few kids who can't? So I think the first question for a parent is what does involvement look like? For me, every parent, in my opinion, as a parent, should be and has to be and is involved in their child's care because they're parenting. So what I think it's maybe important to think about is what is this going to look like for me? What are ways that I can parent more effectively? How am I part of the process? What does it look like in whatever intervention you're telling me that I should do with you? How are you assuming that I'm going to participate? What's it going to look like? Does that work for me? I think those questions are really important, too.
• 17:05
  Speaker A: Very much so. You know, as someone who felt like it was this, like, rucksack on my back, right. That constantly, you know, rocks kept being added. Five pound rocks kept being added. And at some there, there's this fluidity of knowing that I as a parent within my, my own experience and I was very thankful for what I had. But being able to say we need to, we're going to need to press pause here for a little bit and catch up. You know, some things are happening at the home. I'd like to really target that and having, having the strength and also the receptivity of a team to be able to discuss that back and forth. Not necessarily like you said, to create like a solution, but that it's never a plan. It's constant planning, planning and I think having slack in your desires and like thoughts around what progress looks like to you and for your family. My kids and I, they're actually wonderful at flying.
• 18:00
  Speaker B: Right.
• 18:00
  Speaker A: I've sort of gotten that down to our own little science. I know a lot of people probably look at me like I am a crazy Sherman or like Sherpa when I'm through the airport. It's actually, it's totally fine. It's completely fine. It's totally normal for us. I don't venture out to like a large amusement park all that often or even go to a sensory experience or even really go to like sensory based performances. It really doesn't work that well. Given the constraints of what my family's needs and desires are and allowing that to go even within the community of support, it's still going to look different based on what share and I think that we put so much conditioned expectations even within the autism community of like, well, they're going to the sensory event. Like I guess I should try that again. Or why don't. I think it has to come from such a place of. It's not selfish to say that doesn't work for my family. This does. And, and to feel a lot of ownership. Deep. I feel such deep peace when I travel with my kids. I'm so proud of how far we've come. It means a lot to my family. I know that that doesn't mean a lot to others and that's okay.
• 19:10
  Speaker B: That's absolutely right.
• 19:12
  Speaker A: Like that, that example just always rises for me because it just works for us. It doesn't mean it's going to work for everyone. And I, you know, I think that from a clinical standpoint, knowing that when a team is set up having those very realistic conversations, not having such demands as you say, put on a end goal, that might not be what can Happen for your child and family. And the recalibration of those and reorienting to reality, I know is so emotional for parents. You know, it is a deeply emotional experience. But the more we can like remove those conditioned expectations, I think the freer we all become in what our children.
• 19:55
  Speaker B: Can do and what they, and I think related to that too is also what your child wants to do and what you want to do. So important. You know, not every kid, autistic or not, wants to go to the pumpkin patch. And that's okay. Friendship looks different for different people.
• 20:11
  Speaker A: Money. Why do we get so deeply upset? I say we as like a reactionary culture of autism parents. Why would we get so reaction, like reactive upset that a heavily fluorescent lit grocery store with strangers and wheels and carts and voices and you know, textures and everything. Why are we so confused as to why that is disruptive to our child? Right. You know, I always think like what, what makes us so sure that they have to do that?
• 20:43
  Speaker B: That's right.
• 20:43
  Speaker A: You know, I, I or that you.
• 20:45
  Speaker B: Have to take your kid to that. Why?
• 20:47
  Speaker A: Exactly like why? I mean I, my go to grocery store is down the street and Mac really likes going on the front of the cart, but it's quick and I don't take them for the 40 minute full on seltzer water on the bottom of the cart trips. We're over apples, maybe some snacks and we're out. And it's definitely a point of bonding. It's a point of inclusion. It's a point of getting out and just literally getting fresh air and walking down the street. And it's really minimal. And that's okay. But what sort of that condition response can we go into situations even of support not expecting something that, that, that doesn't exist.
• 21:26
  Speaker B: Works for other families, might not work for us. And that's okay.
• 21:29
  Speaker A: And that's okay. And I think that we've somehow become a culture of expected conditions from some fantastical realm that we don't even realize what our unconscious bias biases are toward. That's really true and normal, you know, peeling back those layers, I do believe ends up being so revealing to the system of a family too. And I think that if the more we can as parents and other parents, maybe earlier on in this journey can suspend those expectations. It does really reveal a lot of beautiful things about yourself as a human. I mean as a biological parent, you know, it does reveal to you about your own ways and things?
• 22:11
  Speaker B: Yeah, absolutely. For sure.
• 22:13
  Speaker A: How you learn, how you speak, how you interact, what you choose to Interact with is there, as you shared about, like the support groups for the caregiver? What do you think the impact of, you know, growth and regulation is on the child when the parent is also.
• 22:28
  Speaker B: Regulated and through, gosh, I mean, what's gotta be huge, I think we can think about from our own experiences, what is it like to be around somebody who's dysregulated? I've been in situations with supervisors who have been, I would say, not regulated. And it is very dysregulating. It's very hard this morning at a.
• 22:48
  Speaker A: Public relations thing talking exactly about bosses, regulations, or dysregulations like it is. It is a systemic category of thought and discussion. It's not just autism and families.
• 22:59
  Speaker B: It's a huge thing.
• 23:00
  Speaker A: It's a huge thing.
• 23:02
  Speaker B: One of the things that we talk a lot about at Avela Health is this idea that comes from a psychologist named Ross Green. And he says the kids do well when they can. I think people do well when they can. And if someone is not doing well, there's a mismatch between what's being asked of them and the context, the environment. And if we as parents can also recognize that we do well when we can, and if we're not doing well, there's a mismatch often between what we're asking of ourselves or what we perceive others are asking of us and the skills and capacities that we can access at that moment. So as a parent, I think a lot about this. And then also in working with parents about, it's okay to take a step back. It's okay to do what we call plan C. It's okay to say, you know what? I'm going to drop that expectation. I'm not going to expect that my kid's room is perfectly clean. I am not going to expect that I go in as soon as she gets up in the morning. And I'm just thinking about a family I know who's got a daughter. She's profoundly autistic, and she destroys her room every single night. And there's, like, nothing in it, and it's still destroyed. And her. It was actually. Her father had put this pressure on himself that when his daughter got up in the morning, before she went back upstairs to brush her teeth and get dressed with him, her room had to be clean again. And he was exhausted. And we talked a lot about that. And when he eventually dropped that expectation and he just let it go and he said. We said, you know, maybe that's a problem for future Ben. But current Ben isn't going to worry about it. And being able to do that allowed him to be so much more regulated because then he wasn't all tense and interacting with his partner and his, his child and he was able to be calmer and it just made the whole rest of the day go better. So I think that emotional regulation, I actually don't like that term because I personally, I think it's really hard to control your emotions. I think we can control our response to our emotions.
• 24:52
  Speaker A: Yes. Not leading with the emotional, not leading with the emotion. Allowing it to infer and help you understand where your thoughts can, can be organized around thinking. I think space in the curiosity of why. Maybe another, maybe another analogy for like emotional reactivity or disturbance or dysregulation is like these bottleneck feelings where it's like we wake up in the morning, la di da, okay, the room is, is insanely destroyed or there's feces on the wall or something and it just gets tighter and tighter and all of a sudden you're here. That's just like. And you've become so narrow in your ability to have slack for your child who already is showing you that any environment is very difficult for them. So if we continue to not have the slack, I do believe it comes to this really tight bottleneck and it's almost forcing the cruise missile to go off. Right? It's forcing that dysregulation. And it does begin with the parents. And I know I, I, I do a lot of like one on one peer counseling and so many mothers will share with me. Sarah, I get it. This is like also you though, like you like for better or for worse. They're like, I mean, you have it all together. I'm like, no, no, very much not. This is a very consciously trained skill that I have done and continue to do. It's a practice, right? It's did not happen overnight. And the, I just kept, I keep staying curious to what everything can mean because that cur. Because I think resilience builds in curiosity. I think there's no bad question. There's never a chance that even pressing pause can allow for other things to rise up. And we can't see that as like a negative or because if we're in constant comparison, we're going to miss out on the marathon that this is.
• 26:52
  Speaker B: That's right. I think the question to be able to pause long enough to ask the question of what is this anger about? What is this fear about? What is this frustration about? I am angry that there are feces all over the wall. Okay. But why is it judgment? Is it that if I clean it up I'm going to be late for work? Is it that I have to leave my child in the room for a moment and he might eat it? What is the fear and what is the anger? And then if you can pause to answer that you might be, you might be better off to address it.
• 27:18
  Speaker A: Yeah. And I think the more that we can sit in the curiosity and reflection from a place of, of learning and knowing that you know, I'm sure I, I, I know that like 12 year old Sarah would think that 42 year old Sarah was like old and wise and all these things. Right. Like we have all these thoughts about like what it means to be like a middle aged parent and what it means to have children that are 12, 10 and 8 and what let's pull that all down and just listen to who we are and are becoming as well as our children. And it does become just a practice over time and you learning and I think that when I've talked directly with Robin and with you and learn more about what Aveila can augment in the lives of families of children with autism. It's this holistic approach that has always and again I've been on this journey. Millie is ten and a half so a solid nine years now. Where from what's going on till present day. Right. That it is always looking at the humanity behind your child and ridding yourself of expectations never is the wrong choice. And so the support that comes along with that. See it as a gift. See it as a gift to yourself because there are very few parents that are a hand in life that are, that is such a curveball. We're lucky to be alive right now. We're lucky that the world is starting to acknowledge that greater support systems are needed in the scaffolding to build around and love that shows just innate love for the human, the humanity behind all of this and for yourself as well. I think it's, I think programs like and, and corporations and companies and healthcare systems that seek to put the power back into the families to create a more peace and loving and thoughtful journey holistically will I do believe always have the more, more positive general outcome or generalized experience. Um, and it's one step at a time. It's in stones.
• 29:16
  Speaker B: Yeah. It's inch zones. You know you've talked a couple of times about the pause and pausing and I was reflecting listening to you about the importance of pausing and thinking. You know when a parent, particularly a parent of a young child. When the child gets a diagnosis of autism, parents are often told, often by the person doing the diagnosis and certainly by the broader community, you've got to hurry. You've got to hurry and get an intervention. No time can be wasted. I think that's a terrible message. I think it's a terrible message for a few reasons. First is your child is the same person they were yesterday and the day before that, and the same person they're going to be tomorrow, and your family is, too. And this is a time for me, I think, to really center on what's important for you. What are the outcomes that you want for your child and your family? Who is your child? Is there really a need for intervention? If so, what's the goal and why? You know, there's emerging research that is suggesting that there is. No, this isn't to say that early intervention is important, but there is not evidence that if you intervene when a child is one or two or three, their outcomes are gonna be any different than if it's five or six. That's not to say that that research won't come, but currently, it's just not there.
• 30:30
  Speaker A: Well, I mean, I can give. I mean, again, I'm just one family, but my son Mac had a diagnosis and received services a full year ahead of Millie's. If you really. I mean, if I look at the. At what their charts and observations say, I actually don't think he's. He's probably less typically or has. Has developed not nearly as fast as Millie has. And she's a.
• 30:55
  Speaker B: And.
• 30:55
  Speaker A: And everybody's on. And it's in. And there is no. I actually. I'm glad. I don't even think about that ever. I mean, I rarely. But I know I did. I know that back five or six years ago when he was 15 months and I was, oh, he's going to get this. This diagnosis.
• 31:11
  Speaker B: And we're.
• 31:11
  Speaker A: I'm ahead of it. I was so locked and loaded and. And I had such a chokehold on that timeline, thinking, yeah, like, I'm ahead of it now. You weren't. Mac was gonna.
• 31:21
  Speaker B: Which also just puts all the blame back on the parents. Right. If you don't intervene early, it's your fault.
• 31:26
  Speaker A: Right.
• 31:27
  Speaker B: Like, let's blame the mom a little more. And I think that's just so. Well, now, that's not to say that if your child is struggling a lot, your family is in crisis, things are super difficult, that early. Getting intervention earlier isn't a good idea because it may make life easier, but that should be the goal should be creating routines that make life calmer and that you and your child more connected with each other. Yeah, that'll be where we're going now.
• 31:51
  Speaker A: At the end of the day, if. If there's ever something that I feel so. That has risen and grown for me, it's like I just want my children to have regulated nervous systems, whatever that looks like for them, you know, Millie. For Millie. If you were to, as a clinical director, watch her, that might be. She's watching Argentinian football, she's doing Spanish bingo, and she's stickering all at the same time. And gosh, man, is she the. She is so joyful. She is so joyful.
• 32:20
  Speaker B: Amazing.
• 32:20
  Speaker A: All three of those things have to be going at the same time. Likely a Capri sun lemonade if she's really having a good day. Right?
• 32:28
  Speaker B: That's amazing. Yeah.
• 32:29
  Speaker A: Anyone else would go in there and go, whoa, whoa, whoa. Like you're hearing go in the background. And like, no, like. Like Bibliotheca. And like, she's matching it with the picture. And then she has her. Her stickers, and she's tactile with the stickers. Guess what, though? That is. That literally regulates her nervous system. It makes sense. And I think to myself, I never in a million years, five or six years ago, would have thought to accept that version of Millie. And I'm so glad I did. I'm so glad. I am. I'm so glad I'm letting it evolve. And that's. You're right, to the point. That was who Millie is. There's no. That's who she is. And you know what that turns into? One day, my. My thoughts and dreams for her look different than when I was pregnant with her, and they look different for myself. And I think that there's a. I think that there's such beauty in the holistic child approach, because I really do believe that when the family is included, it is a gift to the whole family. It is such a gift to the whole family. And I know it's so hard to see that through the truth of grief and acceptance and anger and questions and deep, deep questioning about life and what. What you thought it should mean. But, man, if you can sit in that and pull the film back on it, it. I do believe that. That it. It can create such a. A deeply human and validating experience to every child just becoming the best version of who they are.
• 33:53
  Speaker B: Full stop. Totally agree.
• 33:56
  Speaker A: Well, thank you so much for your time and for what. Avela is growing, and I know that I will be putting all of this information in the episode notes. I know that you guys are in more and more health networks nationwide. You are in Horizon, Blue Cross, Blue Shield here in New Jersey, which is the most local population that I serve. And so to know that this is available again, the it's always like, you remember, the least restricted environment for children to learn. This is like such a least it's becoming least restrictive to access. And that is, I mean, for moms and caregivers alike, man, if something is easier and least and less restrictive for me to help and regulate my family, it's a win.
• 34:38
  Speaker B: So that's our goal, to be there when and where people need us. Yes.
• 34:42
  Speaker A: Yes. Well, Dr. Cynthia Anderson, thank you so much for all that you do at avela. And we will catch you all next time here on the inchdomes podcast.