Latest / The Academic Coaching Podcast / Should Students Know Their Own Diagnoses? | Liz Angoff

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Should Students Know Their Own Diagnoses? | Liz Angoff · The Academic Coaching Podcast

• 0:00
  Dr. Liz: We sat down to talk about it and he just put his head down on the table and just completely collapsed into tears.
• 0:07
  Dr. Liz: It was so heartbreaking, and I couldn't figure out for the life of me what had gone wrong.
• 0:14
  Dr. Liz: I realized that he had been carrying this understanding of himself as stupid and lazy.
• 0:24
  Dr. Liz: And so the short story is that over time, I started really diving deep into how do we do this?
• 0:32
  Dr. Liz: 'Cause none of my colleagues were doing this work.
• 0:36
  Dr. Liz: There was nothing out there on how we talk to kids directly, and so I really wanted to figure out how we avoid scenarios like the one that I had encountered.
• 0:53
  Welcome back to the Academic Coaching Podcast brought to you by the Anti-Boring Learning Lab.
• 0:58
  I'm your host, Gretchen Wegner, and this is the show where we dig into the art and science of coaching students skillfully.
• 1:06
  We're talking study skills, executive function strategies, neurodiversity-affirming practices for coaches, so all students have the tools and the agency to not bore their own brains, and more importantly, that we educators have those tools too.
• 1:22
  Today, my guest is Dr.
• 1:24
  Liz Angoff, an educational psychologist whose work focuses on helping kids and families understand how their brains work.
• 1:32
  And Liz and I have a, kind of a spicy little personal connection that we'll share in a moment as well.
• 1:39
  We're also gonna talk about what it means to make students authentic collaborators in understanding their own brains.
• 1:47
  A tricky situation is going to come up that a lab member shared regarding a family's resistance to a diagnosis that Liz is gonna help us about.
• 1:55
  And stay to the end and hear two surprisingly simple things to look for when you're helping a family choose a good assessor if you think this kiddo needs a diagnosis.
• 2:05
  So we're gonna get into it shortly, but before, if you're finding these conversations useful, please, please, please, please hit like and subscribe.
• 2:14
  It helps more academic and executive function coaches find this podcast and helps us do even more good in the world, and that's a small thing you can do to help us.
• 2:24
  Gretchen Wegner (she/her): Hi, Liz.
• 2:25
  Gretchen Wegner (she/her): It's nice to see you today.
• 2:27
  Dr. Liz: Hey, Gretchen.
• 2:28
  Dr. Liz: It's nice to be here
• 2:30
  Gretchen Wegner (she/her): Now, it's very rare that, uh, partners and colleagues in this world of neurodiversity and supporting students are local to me in the Bay Area of California, but you are.
• 2:46
  Dr. Liz: I am.
• 2:47
  Dr. Liz: I am.
• 2:48
  Gretchen Wegner (she/her): everybody what we did just a week and a half ago together
• 2:52
  Dr. Liz: Oh, yeah.
• 2:53
  Dr. Liz: Well, we walked the beautiful reservoir in Lafayette, so it's where my, my office is, and, um, with the luscious greenery and all the, the amazingness of, of beautiful Lafayette
• 3:09
  Gretchen Wegner (she/her): Yeah, and sun.
• 3:10
  Gretchen Wegner (she/her): It was a sunny day.
• 3:11
  Gretchen Wegner (she/her): It was a beautiful day
• 3:13
  Dr. Liz: it's gorgeous out here
• 3:14
  Gretchen Wegner (she/her): Yes.
• 3:15
  Gretchen Wegner (she/her): Um, also because we're local, uh, you and I met in a very specific and unique way.
• 3:21
  Gretchen Wegner (she/her): Will you tell everybody that story?
• 3:23
  Dr. Liz: Yeah, so Gretchen and I actually met dancing, partner dancing.
• 3:29
  Dr. Liz: Um, and I think we met swing dancing, although we've done blues and fusion, and I don't even
• 3:36
  Gretchen Wegner (she/her): memory is
• 3:37
  Dr. Liz: remember
• 3:38
  Gretchen Wegner (she/her): dancing back when it was Friday Night Blues,
• 3:42
  Dr. Liz: Oh my goodness, that was ages ago.
• 3:45
  Dr. Liz: So a few decades ago, then we met at, at Friday Night Blues, and we struck up a friendship over partner dancing and soon realized that we had the education connection, which has just evolved over time
• 4:01
  Gretchen Wegner (she/her): Here's why I remember that it was blues,'cause blues is a slower dance, and Liz is a lead as well as a follow, at least when we're dancing together,'cause I'm
• 4:10
  Dr. Liz: Угу.
• 4:11
  Gretchen Wegner (she/her): And I remember it was blues'cause could talk while we were dancing, whereas when you're
• 4:16
  Dr. Liz: Well
• 4:16
  Gretchen Wegner (she/her): dancing, you can't talk while you're dancing.
• 4:19
  Gretchen Wegner (she/her): And that's how we discovered that you were actually working in schools at the time.
• 4:23
  Gretchen Wegner (she/her): And then over time as we danced together, we would keep, we would update each other about each other's work.
• 4:29
  Gretchen Wegner (she/her): And then it was like,"Oh, you are gonna, you know, you're in this program and moving to actually start doing assessments outside of the school context." And anyway, so I followed your career dancing.
• 4:43
  Dr. Liz: Through our dances.
• 4:44
  Gretchen Wegner (she/her): Yes
• 4:45
  Dr. Liz: The little, the little updates that we get.
• 4:47
  Dr. Liz: Well, that makes sense'cause Lindy Hop, you definitely can't catch your breath, never mind a conversation.
• 4:52
  Gretchen Wegner (she/her): Ja
• 4:53
  Dr. Liz: but yeah.
• 4:54
  Dr. Liz: So we, um, yeah,'cause I remember, um, you were...
• 4:58
  Dr. Liz: My first memory of, of your business, you were doing something called the Muse Cubes, which is just, like, reflects your, like, thread of creativity and improv and all the ways that you engage students in these really unique ways.
• 5:12
  Dr. Liz: Um, and yeah, I was working for the school district when we first met, um, and
• 5:17
  Gretchen Wegner (she/her): public schools
• 5:18
  Dr. Liz: in Oakland Public Schools, yeah, where I was for 13 years, um, in total, and that was really where I kind of came into my own in my, my professional life.
• 5:31
  Dr. Liz: And then in 2013, I transitioned to private practice, and then I've been able to explore really unique and deeper ways of working with kids and families, um, in getting into some of the stuff we'll talk about today.
• 5:48
  Gretchen Wegner (she/her): Yeah.
• 5:48
  Gretchen Wegner (she/her): And, uh, let's actually go ahead and name now before we dive into the scenario I wanna give you.
• 5:55
  Gretchen Wegner (she/her): Uh, you've also moved into publishing books, and will you just say a little bit about why that's so having...
• 6:03
  Gretchen Wegner (she/her): What the books are and why they're so important to your philosophy around assessing students?
• 6:08
  Dr. Liz: Yeah.
• 6:09
  Dr. Liz: So when I first went into private practice, I was confronted with a really interesting request that I never got when I worked for the school district, and that was: Will you explain this to our child?
• 6:25
  Dr. Liz: So I did an assessment.
• 6:27
  Dr. Liz: It was a dyslexia assessment with a family.
• 6:30
  Dr. Liz: They found it just so helpful to really understand their child's brain.
• 6:35
  Dr. Liz: It switched the way that they were thinking about homework and learning, and I realized I had never had the opportunity or the challenge of sitting down with a kid and explaining to them what was going on.
• 6:50
  Dr. Liz: And so I did a little Google search.
• 6:53
  Dr. Liz: I found a nice metaphor.
• 6:55
  Dr. Liz: I had some visuals for the kid, and we sat down to talk about it and he just put his head down on the table and just completely collapsed into tears.
• 7:05
  Dr. Liz: It was so heartbreaking, and I couldn't figure out for the life of me what had gone wrong.
• 7:12
  Dr. Liz: And so from that point, you know, he's fine.
• 7:16
  Dr. Liz: He, he recovered.
• 7:18
  Dr. Liz: He's got some amazing parents, and we kind of problem solved to figure out how to get him there.
• 7:23
  Dr. Liz: But I realized that he had been carrying this understanding of himself as stupid and lazy and all these horrible negative words that were his, that were his narrative about why things were not going well in school.
• 7:45
  Dr. Liz: And sitting down for that conversation, he was terrified that I was about to confirm all of these things.
• 7:53
  Dr. Liz: And so the short story is that over time, I started really diving deep into how do we do this?
• 8:01
  Dr. Liz: 'Cause none of my colleagues were have- doing this work.
• 8:06
  Dr. Liz: There was nothing, um, out there on how we talk to kids directly, and so I really wanted to figure out how we avoid scenarios like the one that I had encountered.
• 8:18
  Dr. Liz: And I realized that I had to change my entire assessment process to really involve kids as the authentic collaborators that they should be in the process.
• 8:31
  Dr. Liz: They already have a narrative of what's going on.
• 8:33
  Dr. Liz: They already have an understanding of themselves.
• 8:36
  Dr. Liz: They just might not be able to articulate it.
• 8:39
  Dr. Liz: And so I started with some PowerPoint, you know, kind of slides and, uh, some different tools to, to help kids, um, articulate that, and they turned into these books called The Brain Building Books.
• 8:53
  Dr. Liz: Um, and these are tools that kinda help you walk kids through how to talk about their authentic experience, their lived experience of being in their brain during the tutoring or assessment process.
• 9:09
  Dr. Liz: And so by the time you get to the diagnosis, you're just repackaging or reframing what we've already discovered about their brain.
• 9:17
  Dr. Liz: So we're turning this conversation into a collaborative discovery process rather than a didactic,"I'm telling you about yourself" experience, and it's changed everything.
• 9:30
  Dr. Liz: It's such an empowering process for kids, and it's so fun to have them create...
• 9:37
  Dr. Liz: We create this metaphor together about the brain that's under construction, and they riff on the metaphor.
• 9:44
  Dr. Liz: They use it to explain their experiences.
• 9:47
  Dr. Liz: And then when we get to the point to say like, like,"And you're not alone.
• 9:52
  Dr. Liz: We call this dyslexia.
• 9:53
  Dr. Liz: We call this ADHD," there's this moment of,"Ah, no kidding," as opposed to, you know, tears and collapse, which has just been amazing for, you know, the assessment process.
• 10:06
  Gretchen Wegner (she/her): I just had this wave of shivers up my arm.
• 10:09
  Gretchen Wegner (she/her): I don't know if we can...
• 10:10
  Gretchen Wegner (she/her): No, I, I can't see it.
• 10:11
  Gretchen Wegner (she/her): But I think it's because s- s- there's a reason why we connected early on and have continued connecting over the years.
• 10:18
  Gretchen Wegner (she/her): Uh, in my early experience academic coaching, I found that students were landing in office, so to speak, on my Skype and then Zoom, uh, with these long profiles that either they didn't understand or nobody had told them about, and suddenly I had all this information'cause I had the paperwork.
• 10:38
  Gretchen Wegner (she/her): And no one had explained it to them, and I was always shocked.
• 10:42
  Gretchen Wegner (she/her): And so I was also in the position of, oh, I guess I got to explain this to them if the family gives me permission, but sometimes the family didn't want the student to know, and then I had to figure out how do I work with all this information I have without the student having a name for it.
• 10:57
  Gretchen Wegner (she/her): And so it was, was just so shocking to me that I remember we had some conversations a long time ago about how you did it differently, and you also felt it was important to make sure that the student left with not just an understanding, but it mean, it sounds like they're, they're, they're empowered by that understanding, uh,
• 11:15
  Dr. Liz: Yeah, for sure.
• 11:17
  Dr. Liz: And I think what you're talking about is that it's not just the kids who are bringing shame to the assessment or the coaching sessions, but, but their parents are bringing a lot of shame in, um, their understanding of what a diagnosis means.
• 11:33
  Dr. Liz: And this has changed dramatically since we were children in our understanding of neurodivergence and the importance of neurodiversity in all these different brains.
• 11:43
  Dr. Liz: And a diagnosis is simply a way of understanding what makes your brain unique.
• 11:48
  Dr. Liz: It's a way of understanding the strengths as well as the challenges that you bring to the, to the table.
• 11:57
  Dr. Liz: And I think that's a big shift from the list of deficits that we might see in the DSM, um, or our understanding of a diagnosis as a short code for what's broken in you, which is what a lot of parents have grown up with.
• 12:14
  Dr. Liz: And so they're afraid of sharing this information with kids.
• 12:17
  Dr. Liz: And then kids pick up on that.
• 12:19
  Dr. Liz: There's something about me that people are afraid of that should be a cause for, you know, for shame or fear or, you know, any of these negative emotions.
• 12:30
  Dr. Liz: And we, we get to shift that.
• 12:32
  Gretchen Wegner (she/her): don't they?
• 12:33
  Dr. Liz: Oh, they do
• 12:36
  Gretchen Wegner (she/her): I think the other reason I got shivers, I just wanna say quickly, is that we also have this common approach around what's like the, what's like the easiest metaphor or the I call it the least you need to know.
• 12:48
  Gretchen Wegner (she/her): But I, but also, like, is the one thing we can share student, with students that makes the difference fastest?
• 12:54
  Gretchen Wegner (she/her): And what I heard in what you shared is this construction metaphor that, by the way, people can go to Liz's website and, uh, will you say the website really quickly so that they-
• 13:04
  Dr. Liz: it's explainingbrains.com
• 13:07
  Gretchen Wegner (she/her): Yeah, so if you wanna hear the metaphor in more depth and see it in the books and that sort of thing, head there.
• 13:13
  Gretchen Wegner (she/her): But I was inspired by is that the one metaphor works for every student, no matter what their diagnosis ends up being, and that you start at the beginning.
• 13:24
  Gretchen Wegner (she/her): It's not just that you do all your testing and then you deliver it back to them, but you're starting from the beginning with an explanation about how brains are under construction, so that way the metaphor has been more fully internalized by the time you're delivering,"And this is what we know about your brain and who else you have stuff in common with."
• 13:44
  Dr. Liz: Yeah, exactly.
• 13:45
  Dr. Liz: So we, um, we start with some psychoeducation around the brain, that this is a brain, it has multiple parts, and each part has a different job to help you do the things that you wanna do, and it's really basic.
• 13:59
  Dr. Liz: Um, the front part of your brain is for helping you pay attention and make decisions.
• 14:05
  Dr. Liz: The back part of your brain helps you process visual information.
• 14:09
  Dr. Liz: We have parts that help us with what we hear and reading.
• 14:13
  Dr. Liz: We have parts that help us put things together and know where things are, like our bodies in space.
• 14:18
  Dr. Liz: Um, and then we have parts that help us with balance and coordination.
• 14:23
  Dr. Liz: Um, of course, there's emotional and memory parts.
• 14:26
  Dr. Liz: It's just very simple, but the fact that the brain is multiple pieces that all have to work together is a big concept for a lot of kids who just think,"My brain is either X or Y.
• 14:39
  Dr. Liz: My brain is either smart or dumb." But we're breaking it into there's lots of different things going on, and they all have to work together to help you do the things you like to do.
• 14:49
  Dr. Liz: And we always start with something that kids love, and, you know, so it might be, like, rock climbing.
• 14:55
  Dr. Liz: Love to go rock climbing, and then we can talk about how you need all the different parts of your brain to do that thing.
• 15:01
  Dr. Liz: So we're establishing really early on that your brain's not broken.
• 15:04
  Dr. Liz: It works great.
• 15:06
  Dr. Liz: It works fantastically, in fact, to do the things that you love to do.
• 15:10
  Dr. Liz: Um, and then we start to talk about your, um, how y- your neurons are making these connections all the time, and they're kind of like billions of tiny roads in your brain, and those roads are under construction.
• 15:24
  Dr. Liz: Some of them have already been built, so those are your highways, the things that come naturally to you or things that are, that you've built through your hard work over time.
• 15:34
  Dr. Liz: And we can remember some of the things that were not highways when you were little, no matter, even with six-year-olds you know?
• 15:41
  Dr. Liz: When you were little, like when you were three or when you were born, you didn't know how to walk yet.
• 15:46
  Dr. Liz: You didn't know how to talk yet.
• 15:47
  Dr. Liz: You had to build those roads.
• 15:49
  Dr. Liz: You know?
• 15:50
  Dr. Liz: You didn't know how to do a cartwheel yet.
• 15:52
  Dr. Liz: You had to build those roads.
• 15:54
  Dr. Liz: And so we can talk about all those things that they're building so that they get the sense of,"Oh, yeah, I remember when that was hard, and it's not hard anymore." Or,"I see my baby cousin learning how to ride their bike, and they're falling all over the place, but that's not hard for me anymore.
• 16:09
  Dr. Liz: But I can kind of remember when that was hard.
• 16:12
  Dr. Liz: So I know I'm still building things." And then we can talk about,"What's your next construction project?" What are you working on now?
• 16:20
  Dr. Liz: What's been trickier for your brain?
• 16:22
  Dr. Liz: And it becomes a lot easier'cause we've kind of taken down that wall of shame to say like,"Yeah, you're constantly under construction, and you've done it before.
• 16:30
  Dr. Liz: You're gonna do it again.
• 16:32
  Dr. Liz: What's next?" Um, and so it's just a different way of looking at those things.
• 16:37
  Dr. Liz: And then at the...
• 16:38
  Dr. Liz: Then once we've established that metaphor, we can take the information that we know, whether it's that we're collecting through the assessment and, like, getting, kind of collecting these little pieces of information through the assessment process, or if you're a coach and you already have that information, you can share some of those little tidbits to add on to what the child already knows about themselves to say,"You know what?
• 17:02
  Dr. Liz: The person that you worked with, they also saw how, like, focused you are when you're doing the things that you love.
• 17:09
  Dr. Liz: They also saw how much you love reading and how that's grown over time.
• 17:15
  Dr. Liz: They also saw that this next construction project seems like writing.
• 17:19
  Dr. Liz: Like, that seems like something that you're really working on.
• 17:23
  Dr. Liz: Um, and, and so we're gonna figure out some tools to do that together.
• 17:28
  Dr. Liz: And it turns out that you're not alone.
• 17:30
  Dr. Liz: When we put all this stuff together, we have a fun name for it.
• 17:34
  Dr. Liz: Uh, we can call it dysgraphia," you know, that when you have difficulty, you know, learning to write, when your next construction project is learning to write, there's a name for it, and there's lots of people out there.
• 17:45
  Dr. Liz: You know, the, the guy who, um, Daniel Radcliffe, who played Harry Potter in the movies, he has dysgraphia.
• 17:52
  Dr. Liz: He had to learn this skill the same that you do.
• 17:56
  Dr. Liz: Um, or we call this ADHD, and that, that Dav Pilkey, who wrote, um, the Dog Man books that you love, uh, has ADHD as well.
• 18:07
  Dr. Liz: And so, like, we can make these connections to, um, help them feel like, like, oh, they're not alone, and this is just another name for what their brain is, is working on and building.
• 18:19
  Gretchen Wegner (she/her): I'm hearing so much in what you're saying that are kind of like hot tips for practitioners.
• 18:24
  Gretchen Wegner (she/her): One of them is have easy access to a list of potential diagnoses and what famous people who are currently in the kiddos' zeitgeist, uh, might be connected with those, it seems.
• 18:37
  Gretchen Wegner (she/her): Or, or
• 18:38
  Dr. Liz: Mhm.
• 18:38
  Gretchen Wegner (she/her): do the quick internet or ChatGPT research alongside the student just then.
• 18:42
  Gretchen Wegner (she/her): But I think that's, that's exciting.
• 18:45
  Gretchen Wegner (she/her): And I, I love your name, like the way you said, like,"There's a fun name for it." Um, and also for those who are listening who are already Anti-Boring Learning Lab members who have worked through the Anti-Boring Toolkit 40-hour credentialing process, um, I think with a few simple tweaks, there's a really nice connection between the construction metaphor that Liz was just sharing with us and the explorer metaphor that we-- I teach you, I think it's in module four, that where we talk specifically about how are pathways in the brain made for learning so that the student can control their own learning process by studying and being present in class in brain-friendly ways.
• 19:29
  Gretchen Wegner (she/her): And I think, yeah, with a few tweaks, I could see that actually the construction metaphor that we might teach them as some psycho-education at the very beginning of our coaching process could then, uh, be layered or be the beginning layer of then the explorer metaphor when we're needing to talk specifically about learning and study skills.
• 19:49
  Gretchen Wegner (she/her): So I hope someone
• 19:50
  Dr. Liz: Угу.
• 19:51
  Gretchen Wegner (she/her): and come back-- comes back and tells me about it.
• 19:54
  Dr. Liz: Yeah.
• 19:54
  Dr. Liz: Yeah.
• 19:55
  Dr. Liz: I mean, the construction metaphor is a really...
• 19:58
  Dr. Liz: I found it to be really nice'cause we can take it in so many places.
• 20:01
  Dr. Liz: So you can think about, like, exploring new roads.
• 20:04
  Dr. Liz: You can think about, um, how, like, roads that are tricky to build, you might need a different way to get there.
• 20:12
  Dr. Liz: So you might need to take an airplane, or you might need to dig underground, and you might...
• 20:17
  Gretchen Wegner (she/her): once in a while you have to come in and like, it's actually happening outside.
• 20:20
  Gretchen Wegner (she/her): You guys can't hear it right now, but there are drills happening in the road, digging up something.
• 20:25
  Gretchen Wegner (she/her): And last year they dig up- dug up the same thing, and sometimes we have to go back and rework some of the same road foundations
• 20:33
  Dr. Liz: Yeah, exactly.
• 20:34
  Dr. Liz: It's just, it's so easy to riff on and so easy to, uh, build on
• 20:39
  Gretchen Wegner (she/her): Yeah.
• 20:39
  Gretchen Wegner (she/her): Aha
• 20:40
  Dr. Liz: it makes it really, really fun for, for kids.
• 20:44
  Dr. Liz: Um, and then, um, and easy to, easy to adapt.
• 20:48
  Dr. Liz: And so I think that's why-- that's where I landed when I was trying to figure out how do we make this-- kinda operationalize this so that it's easy as a practitioner, that I'm not trying to...
• 21:00
  Dr. Liz: Originally, I was trying to come up with a different metaphor for every child based on their interests and, um, and then create a little PowerPoint for them, and it was just too much time.
• 21:11
  Dr. Liz: And I found that this is a really easy one.
• 21:14
  Dr. Liz: Even for older kids, I just assessed a 15-year-old, and we didn't use the, the books with, um, with him.
• 21:22
  Dr. Liz: But I just printed out a piece of paper that has four quadrants on it, and one is his highways, one is the construction projects, one is the helpful words, which is where I put the diagnostic terms, and then tools and construction crew.
• 21:37
  Dr. Liz: And so your tools are your strategies.
• 21:39
  Dr. Liz: Your construction crew is the people who are helping you build your brain.
• 21:43
  Dr. Liz: And so even for a 15-year-old, even for a 55-year-old you're-- we're using the same metaphor to say you can kinda think of it in this way, and this might be helpful for you, you know, as you're, you're moving forward to think about these like next steps as things that, that you are building.
• 22:01
  Dr. Liz: Um, and it just makes it really accessible instead of, you know, all the, the neuropsych terms that we float around.
• 22:10
  Gretchen Wegner (she/her): I also am realizing that the mini lecture that I train people to, uh, teach to students, uh, from our Overcome Procrastination module fits so nicely into your fourth quadrant because we talk about how to get in gear.
• 22:25
  Gretchen Wegner (she/her): And so given your three other boxes, how do you get yourself into gear?
• 22:30
  Gretchen Wegner (she/her): And there are four gears, and
• 22:31
  Dr. Liz: Угу
• 22:31
  Gretchen Wegner (she/her): is the, what are the literal tools you need?
• 22:34
  Gretchen Wegner (she/her): What are the routines you need to use those tools?
• 22:38
  Gretchen Wegner (she/her): What's the team you're gonna work with to help you?
• 22:42
  Gretchen Wegner (she/her): And then how do you take care of yourself, uh, in the proc- the self-care?
• 22:46
  Dr. Liz: I love this.
• 22:46
  Dr. Liz: There's so much overlap in, in really, like, how we empower kids to be able to take that next step and, and really feel like they have agency in the process
• 22:58
  Gretchen Wegner (she/her): Yes.
• 22:58
  Gretchen Wegner (she/her): Well, okay, and so speaking of which, let's dive into a question.
• 23:01
  Gretchen Wegner (she/her): I didn't start the podcast as a way to get guest experts to give my lab members advice, but that's what it seems to be becoming, is awesome.
• 23:10
  Gretchen Wegner (she/her): Um, so in, uh, a call this week actually in the lab, somebody asked the following question, and I wanted to run it by you and see what you'd have to say about it.
• 23:21
  Gretchen Wegner (she/her): So you game for that?
• 23:22
  Dr. Liz: Okay.
• 23:23
  Dr. Liz: I'm game
• 23:23
  Gretchen Wegner (she/her): Good.
• 23:24
  Gretchen Wegner (she/her): So here we've got a high school student with significant, uh, the way the coach put it, was executive function and autonomy challenges.
• 23:33
  Gretchen Wegner (she/her): And, uh, they want the adults to stop reminding, and it's, uh, it, he uses he/him pronouns, so, and stop reminding and managing him, but he still relies heavily on his dad for reminders and structure around basic responsibilities.
• 23:46
  Gretchen Wegner (she/her): So there's already a key tension between what the kiddo says he wants versus what his actions rely on.
• 23:54
  Gretchen Wegner (she/her): And lately, he's become verbally aggressive towards Dad when expectations are placed on him, and it's, um, it was actually really hard for the coach to talk about, like, how aggressive this kid is towards his dad.
• 24:09
  Gretchen Wegner (she/her): And the coach herself is trying to hold both, like understanding the kiddo has genuine EF challenges and also needs some accountability for some harmful behaviors that he's in.
• 24:21
  Gretchen Wegner (she/her): And the other piece is he's recently been evaluated, and autism is part of the new diagnostic picture, but his family does not want to tell him the diagnosis'cause he's already struggling with his regulation, worried um, he will struggle more.
• 24:38
  Gretchen Wegner (she/her): They're also, there are some other typical worries that you can probably talk about that families have, which is why they don't want the kid to know the diagnosis.
• 24:44
  Gretchen Wegner (she/her): So anyway, that's the sitch.
• 24:47
  Gretchen Wegner (she/her): What do you think, Dr.
• 24:48
  Gretchen Wegner (she/her): Liz?
• 24:50
  Dr. Liz: Wow.
• 24:51
  Dr. Liz: Well, that's really challenging, and I think as a coach, I could imagine you would feel really in a bind of, um, there's these challenges that are coming up that we have information about to help unlock it and We're not able to share that information.
• 25:17
  Dr. Liz: Like, we're not, we're not playing with a full deck of cards.
• 25:20
  Dr. Liz: Like, if we were able to integrate the autism information, then it might be easier to kind of, you know, talk about things in more of a structured way of thinking about and, like, how do we, you know, help, help this kid given how his brain works and to give-- because I'm sure that those aggressive moments are not fun for the kid either.
• 25:45
  Dr. Liz: That, that they're...
• 25:47
  Dr. Liz: It's not a fun place to be dysregulated.
• 25:49
  Dr. Liz: Um, so, so I just, just it's a, a really kind of rock and a hard place, um, place to, to be.
• 25:58
  Dr. Liz: Um, I do have a lot of...
• 26:01
  Dr. Liz: You know, that said, I, I do have a lot of empathy for families who are worried about sharing an autism diagnosis.
• 26:06
  Dr. Liz: You know, a lot of times kids are in a place where, um, they feel very vulnerable and, um, and, um, what's the word?
• 26:18
  Dr. Liz: Um, just very tender and fragile.
• 26:23
  Dr. Liz: Um, and so kind of adding something else, you, um, it makes sense that you would be worried about what happens when we add this other thing.
• 26:32
  Dr. Liz: Um, and families are carrying a lot of, um, kind of negative myths about autism, you know, that have been in our society for a long time.
• 26:45
  Dr. Liz: Um, and currently in our political climate, there's also a lot of, um, really difficult messages coming across about autism.
• 26:53
  Dr. Liz: And so it's just, it's just a scary time and a very confusing time for families.
• 26:59
  Dr. Liz: And so giving families, um, resources and time to process that diagnosis for themselves, I think is a key piece.
• 27:09
  Dr. Liz: Um, and some, their parents may need some active coaching around just understanding what autism actually means.
• 27:17
  Dr. Liz: Um, so there's, there's that piece.
• 27:19
  Dr. Liz: That said, um, I have found that for kids who, um, might struggle with, um, the executive functioning challenges, um, and some of that rigidity that comes with, like, I want things in a certain way, but I'm frustrated that they can't be that way.
• 27:40
  Dr. Liz: Um, wanting the autonomy, but not ready for it, and just, just in that frustrating space.
• 27:45
  Dr. Liz: Whether it's autism, ADHD, anxiety, no diagnosis, just adolescence bearing its head.
• 27:55
  Dr. Liz: Like, no matter what is going on, um, this really approaching things from a, a collaborative and, um standpoint becomes really important.
• 28:08
  Dr. Liz: And what that means is, um, this, um, psychologist Ross Greene talks about going upstream from the pro- from the behavior.
• 28:18
  Dr. Liz: And so the, we see the aggressive, the verbally aggressive behavior as more of a symptom
• 28:23
  Gretchen Wegner (she/her): Mm-hmm.
• 28:24
  Dr. Liz: of what's really underneath, and our job is to uncover what's going on underneath.
• 28:28
  Dr. Liz: And we can be diagnostically agnostic.
• 28:30
  Dr. Liz: We can put the diagnosis aside and just think about the underlying challenges or what Dr.
• 28:37
  Dr. Liz: Greene refers to as lacking skills, um, that are getting in the way so that we can support this kiddo, this young man.
• 28:47
  Dr. Liz: Um, and so what that looks like is during a time when things are not heated, during a time to say, you know, like,"You're not in trouble.
• 28:56
  Dr. Liz: I've just, I've noticed that, um, this specific situation," it might mean, be like, uh, it says he has trouble getting reminded about things, right?
• 29:08
  Dr. Liz: Like,"I notice when I, you know, remind you about your..." Like,"I notice that you're having difficulty when I remind you about your homework assignments.
• 29:16
  Dr. Liz: What's up?
• 29:17
  Dr. Liz: I really wanna understand'cause we're in this cycle, and I wanna get out of it,
• 29:22
  Gretchen Wegner (she/her): Uhum
• 29:24
  Dr. Liz: going on for you?" And we listen.
• 29:27
  Dr. Liz: We give kids the opportunity to talk first and really listen.
• 29:32
  Dr. Liz: Um, if he has difficulty articulating what it is, then we can give him choices.
• 29:38
  Dr. Liz: Like,"I wonder if it's X, Y, or Z.
• 29:41
  Dr. Liz: Can you tell me what it, what it is?" Or,"I have a theory.
• 29:44
  Dr. Liz: Can you-"
• 29:45
  Gretchen Wegner (she/her): the video, uh, Liz put up her
• 29:47
  Dr. Liz: Oh
• 29:48
  Gretchen Wegner (she/her): when she said X, Y, or Z.
• 29:49
  Gretchen Wegner (she/her): Can you tell me what it is?
• 29:50
  Gretchen Wegner (she/her): And I always like to point out when there's a visual cue, because I think it's not accidental that you're doing that, uh, to have the visual and
• 29:58
  Dr. Liz: One, two, or three
• 29:59
  Gretchen Wegner (she/her): same time
• 30:01
  Dr. Liz: We, um, you know, can also, um, pose a theory.
• 30:05
  Dr. Liz: Like,"I wonder if it feels like I am, I'm nagging instead of, of helping.
• 30:10
  Dr. Liz: How would you rate that, you know, from one to five stars?
• 30:14
  Gretchen Wegner (she/her): Oh,
• 30:15
  Dr. Liz: if you were to give me a, you know, like a, um, a Yelp rating, um, what, what would you, what would you give me for, for a rating?" So we, we're trying to get information from this young person first on what's going on and what their experience is, and offering a lot of, of empathy, of really showing that we're listening, so...
• 30:39
  Dr. Liz: And it's not a teaching moment, it's just a listening moment.
• 30:42
  Dr. Liz: Like,"I hear it feels like I'm nagging you.
• 30:44
  Dr. Liz: I hear that you want more autonomy.
• 30:48
  Dr. Liz: It sounds like you wanna give it a try yourself.
• 30:51
  Dr. Liz: It sounds like..." You know, like, whatever it is that they're bringing up.
• 30:54
  Dr. Liz: And sometimes we're kind of shocked, you know, like, what comes up, um, and it can be new information.
• 31:01
  Dr. Liz: We're kind of waiting for that aha moment of,"Oh, I didn't know that part." Um, so that's where things start.
• 31:08
  Dr. Liz: And then we get to say, like,"The thing is," and we get to put our expectation on the table.
• 31:14
  Dr. Liz: "The thing is that homework, you know, needs to be done by nine o'clock so that you can get to bed,'cause I'm really concerned about your sleep.
• 31:22
  Dr. Liz: So I wonder if there's a way that we can address all of the things that you just brought up, which are really, really important, and make sure that you get your homework done by a reasonable time so you can get to bed, because sleep is really important to me.
• 31:38
  Dr. Liz: Do you have any ideas?" And then we brainstorm together, and no idea is a bad idea.
• 31:45
  Dr. Liz: Some ideas are not possible, but we can consider all ideas, and we're, we're looking for something that's a win-win.
• 31:53
  Dr. Liz: So when, when child says, you know, like,"Don't bother me at all, I wanna do it all on my own," like,"I would love that, and I've also noticed that sometimes you ask me for help, and I'm getting confused about when to help and when not to help.
• 32:08
  Dr. Liz: So I wonder if we can kind of iterate on that a little bit.
• 32:12
  Dr. Liz: And, and, you know, like, I wonder if, if we could add something to your idea of leave you alone, um, so that I know when you do want help to step in in a way that's, that's more helpful to you.
• 32:26
  Dr. Liz: Like, can we have a code word, or is there a way that you might ask me that can work?" And so we start to put our heads together, um, and, and come up with some solutions, and giving him that autonomy, and then everything's an experiment.
• 32:42
  Dr. Liz: And so we talked about this on our walk, that everything ends with an experiment.
• 32:46
  Gretchen Wegner (she/her): yes
• 32:47
  Dr. Liz: that we always say, like,"Okay, let's give it a try.
• 32:51
  Dr. Liz: We'll try it for two weeks, and if it works, great.
• 32:56
  Dr. Liz: If not, we'll just come back to the drawing board and iterate on that." We'll massage it a little bit so that no one's getting in trouble and there's no like, like,"Well, it didn't work.
• 33:06
  Dr. Liz: Now we're gonna do it my way," kind of, kind of thing
• 33:10
  Gretchen Wegner (she/her): I love the star, the star suggestion because what's great about Yelp or Lyft driving or, you know, whatever, is that any party can give it stars.
• 33:22
  Gretchen Wegner (she/her): So the parent can give it stars too.
• 33:24
  Gretchen Wegner (she/her): Like,
• 33:25
  Dr. Liz: Oh yeah.
• 33:26
  Dr. Liz: Yeah
• 33:26
  Gretchen Wegner (she/her): "That felt to me like a two-star.
• 33:29
  Gretchen Wegner (she/her): What did it feel like to you?" Uh, but so the students can...
• 33:32
  Gretchen Wegner (she/her): And, and it's like, oh, if we're, if we're, if we've got radically different star ratings for whatever the situation was, then we need to keep on collaborating a- and experimenting until we find the solution where our star ratings are closer to each other.
• 33:46
  Dr. Liz: Yeah.
• 33:46
  Dr. Liz: Yeah.
• 33:47
  Dr. Liz: And I, I think that for a kid who's struggling with executive functioning but just pining for autonomy, um, this is a really important strategy because it gives the kid autonomy, and there's a huge difference between,"I'm gonna be here to help you," and a kid saying,"I will ask you when I need help." Um, for a kid to be able to have that autonomy to say, to be able to say like,"Well, sometimes I need you, so could you be in the next room?" And if that's gonna work for you as a parent, then that's great.
• 34:24
  Dr. Liz: I, I have a, an example from my own son from recently, like who is eight years old, and he was refusing to take a shower.
• 34:32
  Dr. Liz: He was just delaying shower, and he would never get in the shower till late, and then he'd be late to bed, and he'd like miss out on stories and, you know, the kind of positive consequences of being able to get stuff done on time.
• 34:46
  Dr. Liz: Um, and so we had one of these conversations about shower, um, and it turned out that he was...
• 34:52
  Dr. Liz: um, he really doesn't like being alone.
• 34:56
  Dr. Liz: Um, and he's scared when he's in the shower'cause he can't hear anything.
• 35:00
  Gretchen Wegner (she/her): because it looks like defiance, right?
• 35:03
  Gretchen Wegner (she/her): It looks like
• 35:03
  Dr. Liz: r-
• 35:04
  Gretchen Wegner (she/her): when they're saying no, but that's brilliant self-awareness
• 35:07
  Dr. Liz: Right.
• 35:08
  Dr. Liz: And so it looked like distraction, it looked like defiance.
• 35:11
  Dr. Liz: You know, we'd just nag him, and just like, it was so ugh.
• 35:17
  Dr. Liz: And then he said, like, he delays shower because he doesn't wanna be in there alone.
• 35:22
  Dr. Liz: And so, um, I said, you know...
• 35:25
  Dr. Liz: Uh, he said,"If you could just be in there and talk to me." I was like,"I, I don't...
• 35:29
  Dr. Liz: I'm too tired to, like, stand next to the shower and talk to you, and you don't need me to do that.
• 35:35
  Dr. Liz: But I wonder what happens if I'm in the next room, so you know that you could just, like, shout out and I'd be able to hear you.
• 35:42
  Dr. Liz: You know someone's near you, and then I can do work or read a book or whatever." And that would work for me,'cause I'm...
• 35:49
  Dr. Liz: It wor- it's a win-win situation.
• 35:51
  Dr. Liz: I get some downtime and actually get to read a book, and he gets somebody who's close by.
• 35:57
  Dr. Liz: Um, and so now he'll...
• 35:59
  Dr. Liz: Like, it's so much easier to get him to go take a shower, and, um, because he knows that somebody will, will be there.
• 36:08
  Dr. Liz: And, you know, it, it ends up being a win for me.
• 36:11
  Dr. Liz: I don't get to do the laundry or the dishes, but I do get to read a book, and it's just,
• 36:15
  Gretchen Wegner (she/her): Which
• 36:15
  Dr. Liz: it's so nice.
• 36:16
  Dr. Liz: Right?
• 36:19
  Gretchen Wegner (she/her): like me.
• 36:20
  Gretchen Wegner (she/her): And so to be like,"Oh, is it reading time?
• 36:21
  Gretchen Wegner (she/her): Oh, yay.
• 36:22
  Gretchen Wegner (she/her): Okay, I got
• 36:23
  Dr. Liz: Yay
• 36:24
  Gretchen Wegner (she/her): or 15 or five or whatever."
• 36:26
  Dr. Liz: Right.
• 36:27
  Dr. Liz: And it was great'cause it was something that he asked for and we worked on together to find a collaborative solution, and, um, and we ran that experiment, and so far it's working.
• 36:37
  Dr. Liz: So, you know, um, and that'll evolve over time, um, you know, like as, as needs change.
• 36:44
  Dr. Liz: But I think it's, it's a really great approach, and it doesn't matter the diagnosis.
• 36:48
  Dr. Liz: I think there's a whole other question about how important it is for, you know, especially an older adolescent to know
• 36:57
  Gretchen Wegner (she/her): उहम।
• 36:58
  Dr. Liz: um, he is autistic and that that can make it harder for, you know, for his brain in some ways.
• 37:06
  Dr. Liz: It also gives him a lot of strengths in that he might work, you know, best when he has that autonomy or when things are in a certain routine.
• 37:16
  Dr. Liz: He might work best with a certain environment when there's less, you know, sensory input.
• 37:22
  Dr. Liz: There may be things that are more helpful for him because his brain works in a different way, and that it's not a negative.
• 37:27
  Dr. Liz: Um, but I have learned over time as I've gotten really into how important it is to talk to kids, that first we need to work with parents and make sure that they are able to shift their lens to a more affirming understanding of the diagnosis before we, um, start sharing that with kids
• 37:46
  Gretchen Wegner (she/her): I'm, I'm already thinking the next, uh, concern a parent might have in this situation is, but in the real world, they're not always gonna...
• 37:55
  Gretchen Wegner (she/her): Like, I'm thinking about my nephew right now who's trans and likely AuDHD and always wanted the lights off in the kitchen, uh,'cause the bright lights.
• 38:03
  Gretchen Wegner (she/her): And so there was always a fight because mom is perimenopausal, I- and also aging, and eyesight needs more light, and he wants less light, and they would, there would be these fights about it.
• 38:15
  Gretchen Wegner (she/her): And, um, the parents would say like,"In the real world, you can't just always have what you want and what you need, so..." dot, dot, dot.
• 38:24
  Gretchen Wegner (she/her): And so there would be arguments in the family around these things because of this in the real world argument, and I'm curious what you would say about that.
• 38:33
  Dr. Liz: In the real world, we have much more agency than we think over a lot of things.
• 38:39
  Dr. Liz: Um, in the real world, as adults, we get to choose, you know, our, our career, our environment.
• 38:46
  Dr. Liz: Uh, we get to choose, um, our relationships.
• 38:51
  Dr. Liz: We get to choose what our home looks like.
• 38:54
  Dr. Liz: We have a lot more, more choice in, in agency.
• 38:58
  Dr. Liz: Um, and the world is changing and understanding accommodation much more.
• 39:03
  Dr. Liz: And so, um, you know, you can't always get what you...
• 39:07
  Dr. Liz: get exactly what you need, but we have more flexibility and agency than we think.
• 39:13
  Dr. Liz: And the way I explain it to parents, um, is that in the real world, we live in community, which means that we're all making adaptations to make sure that we can all live together.
• 39:25
  Dr. Liz: And so while your child will, will have to make certain adaptations to live in the world, my hope is also that the world can accommodate him as well, um, and we can find that win-win, um, situation.
• 39:40
  Dr. Liz: And so, like in the real world, yeah, you're gonna have somebody who needs light and somebody who doesn't need light, and I wonder if there are solutions like, um, certain times of, of day when, when mom needs the light to see certain things, um, but other times it can be low light.
• 39:57
  Dr. Liz: I wonder about wearing sunglasses in the house, if that's an, something that,
• 40:02
  Gretchen Wegner (she/her): I
• 40:02
  Dr. Liz: you know, the child could do, um, to help when mom really needs that light.
• 40:07
  Dr. Liz: Like, we all live in community, and so it might be...
• 40:10
  Dr. Liz: it might seem like, like,"Why are you wearing your sunglasses?" Like, what a strange thing to do.
• 40:16
  Dr. Liz: Or we can say,"What a great solution,"
• 40:19
  Gretchen Wegner (she/her): Mhm.
• 40:20
  Dr. Liz: you know, so that we can live in community, so that we can all get what we need from this environment
• 40:26
  Gretchen Wegner (she/her): Yeah.
• 40:26
  Gretchen Wegner (she/her): I, I love that answer, and I also got curious as we were saying you can't always get what you want, and you know the song.
• 40:33
  Gretchen Wegner (she/her): So I was looking up the lyrics.
• 40:34
  Gretchen Wegner (she/her): I was like,"What are the lyrics?" And it's, uh, it's like,"You can't always get what you want, but if you try sometime, you'll find you get what you need." And I feel like, like if you try sometime, that's like in some ways the most important part of that lyric.
• 40:51
  Gretchen Wegner (she/her): Uh, and what does it mean to try?
• 40:52
  Gretchen Wegner (she/her): And what does it mean to try together
• 40:55
  Dr. Liz: Yes, that piece
• 40:57
  Gretchen Wegner (she/her): Rather than one person having to dri- try harder than the other to get their
• 41:02
  Dr. Liz: Yeah.
• 41:03
  Dr. Liz: Yeah, and what I hope for your child is that they're able to find the, that community and that, you know, the social community, the workplace community, the family community where they're able to meet in the middle with the people that they're, they're with, where they feel supported and that they don't have to, um...
• 41:23
  Dr. Liz: It's not all on them to tolerate bright lights all the time, that we're working together to find a solution so that, that we're getting what we need, even if it's not 100% of what we want, but what we need.
• 41:36
  Dr. Liz: And when you have a, a disability, when you have a difference in your brain, a neurodivergence, what you need, and being able to feel good about saying like,"No, this is a need.
• 41:50
  Dr. Liz: This really is something that we, I need.
• 41:52
  Dr. Liz: And so we have a problem to solve, and we can solve that together."
• 41:56
  Gretchen Wegner (she/her): And speaking of that, there's one more little story I wanna tell, uh, related to my family, and my sister-in-law may actually be listening, and so I'm realizing I need to probably get consent, even if she's not listening, to tell these stories.
• 42:10
  Gretchen Wegner (she/her): I'm gonna kinda tell it anyway.
• 42:13
  Gretchen Wegner (she/her): I'll talk to my brother and sister-in-law about this.
• 42:17
  Gretchen Wegner (she/her): But there was one time when, uh, my sister-in-law was in a very big argument with the, with my nephew, and it was really hard, and I know it was hard because she took a voice memo of it and sent it to me so that I could hear the exchange, and she sent it to me'cause I think she was looking for empathy, like,"This is how hard it is." And it, it was hard.
• 42:40
  Gretchen Wegner (she/her): It was a very difficult, moment for both of them, and I have such empathy around that.
• 42:46
  Gretchen Wegner (she/her): And, and one thing I noticed by listening to the voice memo, and I, I actually didn't say anything to her about this at the time, is that actually my nephew was naming pretty coherently what he needed, but he was doing it in a tone, and even with some words around it, that did feel abusive.
• 43:10
  Gretchen Wegner (she/her): And, um, it was fascinating, like if we had a transcript, if we took all the emotion out of it, both sides were doing good actually at saying what both sides needed.
• 43:22
  Gretchen Wegner (she/her): But the emotional calmness of my sister-in-law was very triggering to my nephew, and my nephew's was very triggering to my sister-in-law, and it was a hard moment.
• 43:34
  Gretchen Wegner (she/her): And that got me curious as we've been talking about sometimes I think we need to be careful when we make, say phrases like verbally abusive.
• 43:43
  Gretchen Wegner (she/her): Like, what exactly does that mean?
• 43:45
  Gretchen Wegner (she/her): I realized in hindsight, I don't know, like is the kiddo actually advocating with words that might provide instruction about what he needs, but doing it in a way that's very hard to hear?
• 43:59
  Gretchen Wegner (she/her): Or like what's actually happening there?
• 44:01
  Gretchen Wegner (she/her): And I realize I wish I'd asked for more specifics when we were talking about this in the lab.
• 44:07
  Dr. Liz: Yeah, I think, um, that's those words like, like aggressive, um, um, violent behavior, you know, like, like all of these, these really negative words that, that we use that describe different experiences.
• 44:24
  Dr. Liz: Um, it is really interesting.
• 44:26
  Dr. Liz: I love what you said about, like, if we just took a transcript of it
• 44:29
  Gretchen Wegner (she/her): हम्म
• 44:30
  Dr. Liz: the, you know, raised voices and emotional, like what would we get out of that?
• 44:35
  Dr. Liz: Is just an interesting thought exercise, um, for parents who have kids who can become really dysregulated.
• 44:43
  Dr. Liz: Um, but it also points to how important the preventative work is, the proactive work,
• 44:49
  Gretchen Wegner (she/her): हूँ।
• 44:50
  Dr. Liz: really having these conversations when it's not the heat of the moment.
• 44:54
  Dr. Liz: And so I like to say like the, my metaphor is have it over ice cream.
• 44:58
  Dr. Liz: Like do it at a time when it's very obvious you're not in trouble.
• 45:03
  Dr. Liz: You can't be in trouble while you're eating ice cream.
• 45:05
  Gretchen Wegner (she/her): Yeah
• 45:06
  Dr. Liz: like if it's going for a walk, if it's like adolescence, when you're driving in the car,'cause there's no direct eye contact, it's just a lot less
• 45:15
  Gretchen Wegner (she/her): Mm-hmm.
• 45:16
  Dr. Liz: Um, driving in the car, going for a walk, eating ice cream, playing ball, like playing catch, all these times when it's just like, like low, um, emotion, um, and, and calm and to ask, you know, like,"I just, I'm really curious,
• 45:35
  Gretchen Wegner (she/her): Mm-hmm.
• 45:36
  Dr. Liz: what's up?
• 45:37
  Gretchen Wegner (she/her): Yeah
• 45:37
  Dr. Liz: What was going on there?
• 45:38
  Dr. Liz: What was your experience?" Like,"It was just, it was hard for me to hear, and I'm ready to listen now." Um, and then to, to be able to hear it in those proactive moments, because in a state of emotion, we, our frontal lobes shut off.
• 45:53
  Dr. Liz: We're not in a place to hear or to think in order to problem solve.
• 45:58
  Dr. Liz: W-we aren't as parents and our kids aren't.
• 46:02
  Dr. Liz: Um, and so it's just really about calming everybody down and keeping everybody safe in those moments, and then finding that proactive time when we can really problem solve.
• 46:12
  Gretchen Wegner (she/her): Yeah.
• 46:13
  Gretchen Wegner (she/her): Such good advice.
• 46:14
  Gretchen Wegner (she/her): And I just looked at my list of things I wanted to talk about, and there are two more topics.
• 46:20
  Gretchen Wegner (she/her): Are you cool?
• 46:21
  Gretchen Wegner (she/her): We- we're gonna go a little longer maybe than most,
• 46:24
  Dr. Liz: Yeah, sure.
• 46:25
  Gretchen Wegner (she/her): But, um,
• 46:26
  Dr. Liz: for it
• 46:27
  Gretchen Wegner (she/her): yeah, so next I would love for you to share just a little bit about your upcoming workshop,'cause I think it's so related to what we're ta- the topic we're talking about right now, and I really wanna encourage even coaches educators to go to it.
• 46:42
  Gretchen Wegner (she/her): I know it's geared for people who are assessors, but I, I think it's such an important topic for all of us.
• 46:47
  Gretchen Wegner (she/her): So will you tell us about it?
• 46:48
  Dr. Liz: Yeah.
• 46:49
  Dr. Liz: We're talking about tricky feedback sessions, and so this is when you are sharing, um, assessment results or a diagnosis with...
• 46:58
  Dr. Liz: This is focused on parents.
• 46:59
  Dr. Liz: And so with your anecdote earlier that these are the parents from that, that family, it sounds like they had difficulty receiving the autism diagnosis and processing the autism diagnosis.
• 47:11
  Dr. Liz: And so this workshop is really about how we help families to n- not just hear the information that we have to share, but really understand it.
• 47:23
  Dr. Liz: So our imperative, you know, kind of legally is after we do an assessment, is to explain the results.
• 47:32
  Dr. Liz: We're supposed to prepare a written report and, and share that with the family, and but if you look at our, um, like, um, oh, the words are escaping me.
• 47:45
  Dr. Liz: It's not our moral gui- or ethical guidelines.
• 47:47
  Dr. Liz: Thank you.
• 47:49
  Dr. Liz: Our ethical guidelines, um, and the multicultural guidelines that we have as psychologists, it's really about making sure families understand the results, and that we are culturally competent, that we are, um, you know, able to see beyond just the surface level of, did I share this with the family or not, to what can I do to really help the family understand the, the results of this, this assessment?
• 48:19
  Dr. Liz: And that's an entirely different journey than, did I tell them all the test scores that we got?
• 48:27
  Gretchen Wegner (she/her): Right
• 48:28
  Dr. Liz: Um, now part of what makes that really challenging is that, um, sometimes families come in, they were curious, you know,"Does my kid have ADHD?" We get to say,"Yes, they have ADHD." They go home, they get it, it's all done.
• 48:45
  Dr. Liz: It's really easy and straightforward.
• 48:47
  Dr. Liz: But sometimes kids are really complex.
• 48:51
  Dr. Liz: They have multiple, um, pieces to their diagnostic profile, or they don't fit into a box very easily.
• 48:58
  Dr. Liz: Sometimes what we see as assessors is very different, or even as coaches, what we see with the child is very different than how the parent is perceiving them.
• 49:09
  Dr. Liz: So we have, uh, conflicts, and we have differences of opinions there.
• 49:14
  Dr. Liz: So how do you share something with families that they may be resistant to hearing, or they may not be ready to hear, or they may just genuinely see something completely different?
• 49:26
  Dr. Liz: How do we help them?
• 49:28
  Dr. Liz: Um, sometimes parents differ.
• 49:31
  Dr. Liz: If there is a two-parent household or if there are multiple caregivers involved, they might have very different perspectives on the child and really have very different responses to, um, the assessment or treatment.
• 49:46
  Dr. Liz: Um, or sometimes the diagnosis just catches families by surprise.
• 49:51
  Dr. Liz: So especially when I talk to assessors, especially autism and intellectual disability are two, um, diagnoses that can really catch parents off guard.
• 50:02
  Dr. Liz: And so we're gonna talk about how you share that information with families, um, when there's complexity, when there's conflict, and when it's just information that's really, for a particular family, very surprising or hard to hear
• 50:18
  Gretchen Wegner (she/her): Mm-hmm.
• 50:19
  Gretchen Wegner (she/her): what I loved when we were walking around the lake and you were sharing with me about this is you said one of the ways you put this together is kind of looked throughout your career and like,"What are all the mistakes that I've made or the really tricky situations didn't know how to handle?
• 50:31
  Gretchen Wegner (she/her): And now, like, what would I say, what even advice would I give to myself about those?" Am I remembering that correctly?
• 50:37
  Dr. Liz: Yeah.
• 50:38
  Dr. Liz: Well, you know, one of the things I mentioned is that the universe has, has not been stingy on the amount of difficult feedbacks that I've had recently where all of these things have come up, the complexity, the surprises, the, um, the conflict, you know, like the differing opinions.
• 50:55
  Dr. Liz: You get one, one survey back, and all the ratings are, um, you know, like very, very high.
• 51:01
  Dr. Liz: Uh, and then, um, another rating scale comes back from, you know, the same-- the, the other parent living in the same household, and all the ratings are very, very low.
• 51:11
  Dr. Liz: Um, and so, you know, all of these things have come up even recently.
• 51:16
  Dr. Liz: Um, but yeah, there's been, you know, a handful of, of times in my own career where something has gone way awry, just really surprising that I think I have a foolproof case to present and all the data's there, it's really clear-cut, and I sit down with the family, and they just push back in all kinds of ways.
• 51:39
  Dr. Liz: Sometimes kindly, sometimes emotions get the better of, of families, and it can come across, you know, as just they're-- they have a really, really hard time.
• 51:49
  Dr. Liz: Um, and I-- This putting together the workshop has been an opportunity to go back and figure out, like, how would I do things differently and what, what went wrong there?
• 52:01
  Dr. Liz: What was-- What wasn't I taking into account if my goal is for the family to understand?
• 52:08
  Dr. Liz: Not to explain, but to have the family understand, and how, how can I make that happen?
• 52:14
  Dr. Liz: Um, and I love being in the thick of this'cause these difficult feedbacks that have been coming my way so far, they're going really well because, because of that lens shift.
• 52:26
  Gretchen Wegner (she/her): Yeah
• 52:27
  Dr. Liz: it's not about presenting my case.
• 52:29
  Gretchen Wegner (she/her): Aha
• 52:30
  Dr. Liz: It's about helping the family to understand.
• 52:32
  Gretchen Wegner (she/her): Wow.
• 52:33
  Gretchen Wegner (she/her): And again, that's what we as coaches often have to do if we are inherit a cl- a client who had an assessor who just gives the diagnoses and doesn't help understand, then it's on our, our shoulders to help them understand.
• 52:50
  Gretchen Wegner (she/her): That's why I think your workshops would be so useful for people.
• 52:53
  Gretchen Wegner (she/her): So if somebody is curious, give the date,'cause if you're listening to this after the date, it may be too late unless you are gonna be selling recordings
• 53:01
  Dr. Liz: I'm gonna be recording it.
• 53:02
  Dr. Liz: Um, so, and you can earn continuing education credit if that's interesting to you for live or for the recorded.
• 53:09
  Dr. Liz: It's gonna be October 23rd, 2026.
• 53:14
  Dr. Liz: Um, and you can go to explainingbrains.com/webinars, and you'll find it there along with a bunch of other content for neuro-affirming practice, including one webinar that's specifically about explaining, uh, diagnosis to kids, if that's helpful to you.
• 53:31
  Dr. Liz: Um, and you'll also see on explainingbrains.com, there's a blog where I post all this content as well, if you'd rather read, read through.
• 53:42
  Dr. Liz: Um, and a ton of, uh, free resources for educators, um, psychologists, coaches, anybody working with kids.
• 53:51
  Dr. Liz: Uh,'cause I do think that you guys end up with a lot of this helping families understand work.
• 53:58
  Dr. Liz: Um,'cause as assessors, we're just-- we're not trained on
• 54:02
  Gretchen Wegner (she/her): Угу.
• 54:03
  Dr. Liz: how to really deliver feedback in a really effective way, and I'm hoping it's something that's changing in the field.
• 54:12
  Dr. Liz: Um, I'm definitely trying to do my best to help shift that lens, you know, to, to something different.
• 54:19
  Dr. Liz: But so often, especially if you're assessed as part of a, a larger institution, um, insurance companies just don't give, um, assessors the time to really
• 54:31
  Gretchen Wegner (she/her): Do
• 54:32
  Dr. Liz: do the thorough job that we can do in private practice.
• 54:35
  Gretchen Wegner (she/her): Well, and then speaking of that, I just recently had a college, uh, girlfriend reach out to me because her nephew, it's time for him to be assessed.
• 54:45
  Gretchen Wegner (she/her): I d- I don't know the details about him.
• 54:47
  Gretchen Wegner (she/her): But, uh, she was like,"Oh my God, it's so expensive.
• 54:50
  Gretchen Wegner (she/her): This one person," she sent the link to who they're thinking about working with,"is$4,000, and, ugh, like I just, it's so much money.
• 54:56
  Gretchen Wegner (she/her): I wanted to make sure that this is legit in some way." And I looked it over and I said,"It sounds super normal and super legit." And then I said,"The one thing that I know to think about when you're choosing an assessor, it is how thorough is their understanding of the importance of, of feedback afterwards." And so just know that you might be choosing,'cause of your location, you might have to work with somebody who's not trained in that.
• 55:21
  Gretchen Wegner (she/her): But that is an important part of the process.
• 55:23
  Gretchen Wegner (she/her): Um, so I guess my question to you is sorts of things should families or coaches, those of us who are starting to partner more with neuropsychologists and other assessors, what, what would you recommend we look for to know that, okay, this is gonna be like the really, the best possible experience?
• 55:42
  Dr. Liz: Yeah.
• 55:43
  Dr. Liz: I mean, I think there's a lot of common questions like, you know, what does the process look like?
• 55:47
  Dr. Liz: Um, and, you know, how do you support our family?
• 55:52
  Dr. Liz: Like, these are our goals, how would you help us meet those goals?
• 55:55
  Dr. Liz: Um, and you can get all those questions, but there's two things that I think are most important when you're talking to an assessor.
• 56:02
  Dr. Liz: The one is, do you feel like the call was helpful?
• 56:09
  Dr. Liz: Like, when you are talking to somebody for an intro call to...
• 56:14
  Dr. Liz: You know, first of all, they should get on the phone with you and have a little 15, 20 minute, I do 30-minute intro calls and just to chat to get a sense of the person.
• 56:24
  Dr. Liz: And during that call, you sh- pay attention to how you feel.
• 56:31
  Dr. Liz: Do you feel like this person is warm and caring?
• 56:34
  Dr. Liz: Do you feel held by that person?
• 56:36
  Dr. Liz: Do you feel like they were helpful on the call?
• 56:38
  Dr. Liz: Was it helpful even just to talk to them to organize your thoughts around your child?
• 56:44
  Dr. Liz: Um, what was, what's your feeling?
• 56:46
  Dr. Liz: Because you, your, how you feel talking to that person is gonna be really similar to your child's experience working with them or just your experience working with them, even on that intro call.
• 56:58
  Dr. Liz: So listening less to their list of credentials and more to the feeling of how does it feel to work, work with this person.
• 57:06
  Dr. Liz: A second thing is I was actually asked the question, um, what happens after?
• 57:12
  Dr. Liz: What happens after the assessment is done?
• 57:15
  Dr. Liz: Um, and the, the response that you're listening for is,"We create a plan, and we make sure that that plan is gonna work." Or,"I'm, um, bring your child back in, and we have a session with them." Or,"I'm available for follow-up for the next three months to make sure that everything is working out as planned." Um, or,"I contact you with a follow-up." You know, just like, what's gonna happen after?
• 57:46
  Dr. Liz: Because when I started my private practice, I talked to lots and lots of families who had been assessed before to ask them what was the hardest part about assessment, and they all said figuring out what to do next.
• 57:59
  Gretchen Wegner (she/her): Yeah
• 57:59
  Dr. Liz: We had the assessment, we got the diagnosis, but we just felt lost.
• 58:05
  Dr. Liz: And it's overwhelming.
• 58:06
  Dr. Liz: It's information through a fire hose.
• 58:08
  Dr. Liz: Like, it's just, you know, drinking through a fire hose.
• 58:11
  Dr. Liz: That's a metaphor.
• 58:12
  Dr. Liz: Um, and, um, it's, it's a lot.
• 58:16
  Dr. Liz: And so is there a system?
• 58:18
  Dr. Liz: What I realized is that I needed a system in place to account for the fact that it's overwhelming, to account for the fact that families are not able to ask all their questions in one feedback session, to account for the fact that we gotta talk to the kid about it.
• 58:31
  Dr. Liz: We need closure with the child.
• 58:34
  Dr. Liz: Even if we don't share the diagnosis, they need to know about their brain.
• 58:39
  Dr. Liz: They need something that they can walk away with, um, so that it helps them shape that narrative that we talked about.
• 58:46
  Dr. Liz: So what happens after is the most important question, I think
• 58:52
  Gretchen Wegner (she/her): That's beautiful.
• 58:53
  Gretchen Wegner (she/her): Great advice.
• 58:54
  Gretchen Wegner (she/her): So thank you very much.
• 58:55
  Gretchen Wegner (she/her): I actually realized I'm gonna send this recording to, to my friend to say I haven't chosen anyone yet, and if it helps.
• 59:03
  Gretchen Wegner (she/her): Uh, so the last so important question to you is when are you dancing next?
• 59:09
  Dr. Liz: Nah.
• 59:09
  Gretchen Wegner (she/her): To join you.
• 59:11
  Dr. Liz: Uh, I'm super into West Coast Swing right now and learning how to lead West Coast Swing.
• 59:17
  Dr. Liz: So, um, I'm taking some classes in Oakland, um, that are super, super fun if you wanna come,
• 59:24
  Gretchen Wegner (she/her): Are you going
• 59:25
  Dr. Liz: come join.
• 59:26
  Gretchen Wegner (she/her): it's Tuesday, right?
• 59:28
  Dr. Liz: It's on Tuesdays.
• 59:29
  Dr. Liz: Yeah.
• 59:29
  Dr. Liz: Not next week.
• 59:30
  Dr. Liz: I'm gonna be in Disneyland.
• 59:32
  Gretchen Wegner (she/her): Ooh, okay.
• 59:33
  Gretchen Wegner (she/her): Well, then I'll
• 59:34
  Dr. Liz: but the week after.
• 59:35
  Gretchen Wegner (she/her): on my calendar.
• 59:37
  Dr. Liz: Yeah.
• 59:38
  Gretchen Wegner (she/her): Okay
• 59:38
  Dr. Liz: Yeah, and I will, I will see you there.
• 59:40
  Dr. Liz: It's a super fun time
• 59:42
  Gretchen Wegner (she/her): Great.
• 59:42
  Gretchen Wegner (she/her): And in the meantime, while Liz and I are dancing together, you all, go to explainingbrains.com or go to antiboringlearninglab.com and find out about all of the fabulous follow-up you can do with either one of us.
• 59:54
  Gretchen Wegner (she/her): So thank you, Liz
• 59:56
  Dr. Liz: Thank you, Gretchen.
• 59:58
  Dr. Liz: It's been fun