In this insightful episode of Heal Your Roots Podcast, host Kira Yakubov is joined by Dr. Karen Wilson - a Clinical Neuropsychologist, Director of West LA Neuropsychology, PC, the founder of ChildNEXUS.com.
They delve into the complexities of children's mental health, discussing common learning disabilities, processing disorders, and the intricacies of diagnosing ADHD, Autism, and Learning Disorders in children. Dr. Karen explains the importance of neuropsychological evaluations, early detection of language-based issues, and the differences in how boys and girls present learning disabilities and Autism symptoms.
Kira and Dr. Karen also explore the challenges parents and teachers face in identifying and addressing mental health issues in children, discussing the crucial role of gathering information from multiple sources and creating a neurocognitive profile for each child. They emphasize the importance of empowering the child and the whole family through understanding and intervention.
The conversation also covers the overlap between Autism and ADHD and recommendations for school interventions and modifications. Dr. Karen sheds light on the impact of the frontal lobe on fine motor skills, the transition to independent living, and the importance of self-advocacy and self-care during the emerging adulthood period - particularly when going off to college.
Finally, they discuss Dr. Karen's company, ChildNexus, and how it provides parents with reliable information and resources to navigate the world of children's mental health.
Check out the rest of the Heal Your Roots Podcast episodes at our website.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Karen Wilson (00:00):
I wish that we had found you five years ago when
(00:03):
their son was in second grade.
And the father who was sittingon the call said to me, I wish I
had found you 40 years ago,because he realized from my
discussion about what his sonwas experiencing that he also
struggled with the same thing,but didn't have a name for it
when he was a child.
Kira Yakubov (00:24):
Hi, I'm Kira Yakubov, Licensed Marriage and
Family Therapist and founder ofHeal Your Roots Wellness
practice. Every episode, we talkwith a professional from the
mental health field to learnmore about their approaches and
specialties, and also theirjourney of becoming a therapist.
In this podcast, we'll uncover adeeper look at the world of
therapy from new perspectives.
You'll meet the therapists ofHeal Your Roots Wellness
(00:47):
practice, and trusted colleaguesfrom the community tackling
mental well being. We're your goto Network for practical and
professional insight in mentalhealth. Subscribe for new
episode releases every otherWednesday.
Hi, I'd like to welcome ourguest today Dr. Karen Wilson.
(01:10):
She is a clinicalneuropsychologist, Director of
West LA neuro psychology and thefounder of childnexus.com. She
also specializes in theassessment of neurodevelopmental
disorders in children,adolescents, and I cannot wait
to pick your brain today. Karen,thank you so much for coming on
today.
Thank you so much for having me,Kira.
Absolutely.
(01:30):
So every episode, we start withreally diving into the
practitioner, share a little bitabout your background, and what
made you get into mental health.
And specifically in being achild psychologist,
Karen Wilson (01:41):
I think probably from the age of nine, I knew
that I wanted to be doingsomething in the medical field,
I thought I was going to be apediatrician. And then when I
got to undergrad, I realizedthat I probably didn't like the
sight of blood. And so I wasgonna have to find something
else to do. I actually had takenpsychology as my elective and
just fell in love with the studyof the behavior study of the
(02:07):
brain. And then when I found outabout neuro psychology, that
really piqued my interest, andthere was like no turning back
from that point forward. So Ikind of took all the courses on
brain and behavior, neuroendocrinology, neuro psychology,
neuro anatomy. And then when Iwas applying to graduate schools
looked into clinical psychologyprograms that focused on neuro
(02:28):
psychology as a sub discipline.
Kira Yakubov (02:30):
That's awesome. I always loved my neuro psychology
classes in Psych as well. It'sso fascinating to learn about
the brain and all the differentthings that it does. It's so
powerful.
Karen Wilson (02:41):
Yes, absolutely.
Kira Yakubov (02:42):
Can you share a little bit more about how you
became a psychologist and howspecifically working with
children. Like if that wasalways something that you were
interested in?
Karen Wilson (02:49):
it wasn't actually my initial focus when I entered
psychology, you know, when I wasin graduate school actually
chose to do an adult emphasis.
So a lot of my instructioninitially was in working with
adults. I actually wanted to dogeriatrics and study Alzheimer's
disease and memory impairmentsand did some work in that area
for a long period of time. Andthen it wasn't until I was on my
(03:10):
clinical internship. The yearbefore I graduated that I did a
rotation in child psychology,child neuropsychology, and I was
evaluating kids who werestruggling with learning
challenges with, you know,medical issues that were
impacting their cognitive andemotional functioning. And I
just thought this is such agreat opportunity to be able to
(03:32):
provide support early on, and Ijust didn't look back from that
point forward.
Kira Yakubov (03:39):
That's wonderful.
And I think it's so amazing thatin these programs, we have that
hands on learning to recognizethat and learn that because you
might have continued in, youknow, researching and helping
people with Alzheimer's and maynot have recognized that that
would be your passion is workingwith children.
Karen Wilson (03:54):
Absolutely, absolutely. I think that's one
of the benefits of being inthose types of programs where
you do get to rotate indifferent areas, the medical
psychology field, I did work inHIV and AIDS, I did some work in
transplants. So there's a numberof areas where I got to explore
and have these experiences, andthen really determine where I
(04:17):
wanted to spend my time andwhere I was thinking about a
career move.
Kira Yakubov (04:21):
Yeah, that's incredible. These are amazing
careers that help so many peopleI'm so honored to have you on
today and hear your insight andknowledge. And so Karen, can you
share a little bit about some ofthe most common learning
disabilities or processingdisorders that you work with
while you're helping evaluatechildren for families?
Karen Wilson (04:38):
Absolutely. So in my practice, we do evaluations,
neuropsychological evaluations,psycho educational evaluations,
and when parents bring theirkids to us is typically because
their kids are struggling insome way. And oftentimes they
don't know why their kids arestruggling. So oftentimes, the
parents will say, you know, thepediatrician said that we should
(04:59):
make an appointment with you, orthe school is concerned, or the
parents are seeing something athome, that is worrisome. They've
talked to other family members.
And they've recommended anevaluation. And so generally in
those instances, their child isstruggling at school or at home.
It can be behavioral struggles,it can be struggles that are
that are impacting theiracademic functioning. common
(05:20):
struggles are, you know,difficulty staying seated,
paying attention, accessing thecurriculum at school, it can be
some mental health challenges,maybe there's anxiety that's
really interfering with thechild's ability to do what they
need to do, perhaps, you know,they don't want to go outside,
and they don't want to interactwith peers, because they're so
(05:40):
nervous. And they're the worriesare excessive. And there are
significant fears. And withschool, it can be, you know,
comments from teachers that youknow, your child is very bright,
but we can't get him to focus,we can't get him to engage with
us. They're having difficultyfollowing instructions
directions, or they're behindacademically, you know, they
(06:04):
some, oftentimes, parents orteachers will say, you know,
when I asked the student, thequestion, they know the answer,
they're the first one with theirhands up, but then when they
have to write it down, or theyhave to read that they can't do
it, or they can't demonstratetheir knowledge. So there seems
to be a disconnect between whatthey seem like they're able to
do, and then their output, ortheir ability to do specific
(06:25):
tasks, whether that be reading,writing, or math. And so when
individuals are coming in, andkids are coming in to see us,
it's because parents want toknow, you know, why is my child
struggling? Why do they seem tobe having more difficulty than
the peers their age? Or why isit so hard for them to do what I
asked them to do at home? Isthere some processing issue that
(06:46):
is interfering? And that's ourjob is to figure that out for
the family, and then providethem with information about, you
know, whether or not this is aneurodevelopmental disorder,
what that means provide somepsychoeducation. And then, you
know, develop a plan, create aplan for that child, what are
some things that we can put inplace to provide support at home
(07:07):
at school? Are there clinicians,therapists, other allied
professionals that this childshould work with to really help
that child reach their fullpotential, and that's our job
and also to make recommendationsfor accommodations or
modifications at the school asappropriate?
Kira Yakubov (07:26):
Yeah, so it sounds like it's really important to
have everybody on board,parents, teachers, doctors, any
other supports, maybe relativesas well, friends, so that
everyone's kind of on the samepage. sounds like a very, like
holistic and systemic way ofapproaching this.
Karen Wilson (07:43):
Absolutely.
Because you want to make sureyou know, when you're making a
diagnosis, that's it's veryserious, right, we want to make
sure we're not diagnosingsomeone with something they
don't have. And so there's a lotof checks and validation of what
it is we're seeing, you know,oftentimes, even to in order to
make a diagnosis, you can't havesymptoms or the behaviors in
just one setting. For example,with ADHD, you can't just be
(08:06):
seeing hyperactivity andimpulsivity at school, and not
at home or anyone else anywhereelse, you know, and that's to
validate that this is apervasive issue that's
impacting, you know, manyaspects of an individual's
functioning, because if it'sonly happening in one area, then
we certainly want to look atthat area, maybe there's
something about the school thatis anxiety, provoking the
(08:27):
academic environment, the homeenvironment, the demands placed
on the child. And so we want tobe able to look at everything to
make sure that if we're making adiagnosis, if we're saying this
is what's causing the strugglethat it is accurate, and that
the plan fits, what it is thatwe're finding, the last thing we
(08:47):
want to do is to say somethingis ADHD, when in fact, it's
anxiety because anxiety and ADHDhave two completely different
treatments and approaches forintervention.
Kira Yakubov (09:00):
So it's very thoughtful and methodical
process of going through this.
And so do you see there's adifference among genders? How
that might show up in certain,like learning disabilities, or
how that presents in a socialway, depending on kind of the
expectations or like thestereotypes that we might think
about, especially for like ADHD,right? I know, it's kind of
(09:21):
thinking about, at least for me,it's like the stereotype is a
little boy not being able to sitin their seat when it's a lot
more than just that.
Karen Wilson (09:30):
Yeah, I think it can, it can definitely manifest
in both boys and girlsdifferently. There's some
research to suggest that theremight be some more inattention
in girls and more hyperactivityand impulsivity in boys, but it
also, when you have a boy who isrambunctious oftentimes, some of
those behaviors can beinterpreted as boy behaviors,
(09:51):
and not as ADHD. Right. Andgirls who are you know,
compliant in the classroom andsitting still and doing well,
They might say, Well, that can'tbe a ADHD because she's able to
sit there, she's not getting outof her seat. She's not
impulsive, she's notinterrupting. But that same girl
could be sitting there lookinglike she's paying attention, and
daydreaming about what she'sgoing to do after school and
(10:12):
missing a great deal of theinformation presented. So I
think that that can happen. Andthere's also some research to
indicate that girls, autisticgirls can camouflage a lot of
their, their their symptoms ofautism, better than boys, the
social demands are different forgirls than there are with boys
in terms of how they interact,how they socialize, the things
(10:35):
that they do when they spendtime together is very different.
And so, you know, there's somebelief that some of the criteria
we even have for autism isreally based on a boy model,
because a lot of the researchthe early research is based on
on autistic boys.
Kira Yakubov (10:52):
That's really interesting to hear. So I mean,
I know about masking for peoplewho have ADHD, but I didn't know
necessarily about kind of themasking or camouflaging for
females who might be on thespectrum,
Karen Wilson (11:03):
right
Kira Yakubov (11:03):
Because that is kind of thinking about more
expected of females to care moreabout friendships, and to show
up in a particular way, and tobe more agreeable, versus if you
think about stereotypicallyyounger boys and that way
Karen Wilson (11:17):
Absolutely.
Kira Yakubov (11:18):
Would you be able to share the type of actual like
assessments that you do withchildren to evaluate to like,
differentiate or rule things outwhen it comes to this?
Karen Wilson (11:27):
Yes, absolutely.
So the process is prettycomprehensive. I mean, it starts
with, you know, sitting downwith parents and going through
the child's history. You know,when we're sitting down, I want
to know everything frompregnancy, birth and delivery to
you know, what's happening withyour child at this particular
moment, because some things thatmight happen early on might be
(11:49):
risk factors, you know,significant stress during
pregnancy. And early delivery ofa premature birth with a low
birth weight puts kids atgreater risk for
neurodevelopmental disorders. Sowe want to know that, we also
want to know if there's anyonein the family who has ADHD, who
has autism, who has anxiety,depression, dyslexia, because
(12:10):
those neurodevelopmental issues,mental health challenges are
heritable, you know, and so theyput, again, individuals, kids at
greater risk for havingstruggles in those areas, when
there's a family history.
And then we want to documentdevelopmental milestones.
Oftentimes, if kids, forexample, are having difficulty
(12:34):
with reading, you know, it maymanifest and become something we
recognize as dyslexia. For someindividuals, there's an early
indication of language basedissues. You know, there's a
higher number of kids diagnosedwith dyslexia, who had speech
and language problems when theywere younger. So we know that
that's a risk factor. That's whydoing that clinical interview
(12:55):
with parents is so important. Sowe find out, okay, there's an
early history of speech andlanguage issues, there's a
family history of dyslexia,there's a family history of
anxiety. So we know that some ofthe behaviors might be
associated with those disorders,and, and also knowing that that
child is at higher risk becauseof the family history and their
(13:16):
own developmental history. Sothat's all part of the process.
And then we want to know, whatparents are seeing at home,
because some parents will say,you know, the teacher is saying
X, Y, and Z. But we want to knowwell what are you seeing at
home, and parents will sometimessee things differently than the
teacher see, and that, and thatwould be expected because the
home environment, schoolenvironments are very different.
(13:37):
You know, you have 20, sometimeskids have 23 25 other
individuals in a classroomsetting. Very few families have
that many people at home, rightin one place. And so the
distractibility factor is muchhigher at school than it is at
home. But then at the same time,the school also provides more
structure in terms of what theday looks like. And a lot of
(14:00):
homes may not have that samelevel of structure.
So knowing how kids navigatethose two different environments
is often very important. Andgetting that information from
parents is really helpful inidentifying, you know, what are
the challenges for a child athome? Are they similar to what
the teachers are seeing atschool? sometimes in home
(14:21):
environments, kids are able tocompensate or at school, they're
able to compensate for areas ofstruggle, because of an inherent
structure built into the homeenvironment or the school
environment and then sometimesparents will say, for example,
with homework, the teacher willsay, well, the child is getting
the homework done, but what theydon't see is the amount of
effort that is needed to getthat work done. So the parents
(14:43):
might say, you know, the teachersays, These are 30 minute
assignments that my child issupposed to do on a weekly
basis, but it's taking my childthree hours. So that indicates
that it might be a processingissue. So the teacher gets the
homework, and it's complete.
It's accurate. It might beperfect, but They don't see the
effort or know the effort thatwas needed, and the support that
might have been needed from theparents in order to keep that
(15:05):
child on task to complete theassignment. And then also the
amount of time that it took andthe effort that it took to
actually get that assignmentdone. And so that information
from a parent is so important.
Because really, what we'relooking at are processes and
what's involved in completingtasks. So that's a little
Kira Yakubov (15:26):
Wow, that's so involved
Karen Wilson (15:26):
bit about that information, it's very involved
and that's only a parentinterview, because then what I
want to do is I also want tospeak to teachers, I want to
know, what are the teachersobserving in the classroom. And
oftentimes, I'm speaking to morethan one teacher, because
inherently in a lot of kids,there'll be one class where they
do really well. And then onewhere they're struggling,
particularly if kids arestruggling more with reading,
(15:49):
one with sciences or more withmath, then, you know, speak with
language arts teacher and a mathteacher, to see if their
observations are different inthe classroom.
Kira Yakubov (15:58):
Yeah.
Karen Wilson (15:59):
And that also speaks to the extent to which
these behaviors and theseconcerns are showing up in
different environments, and howthey show up.
And then so we're gatheringinformation from parents, we're
gathering information fromteachers, I'm speaking with
them, they're also completingrating forms. So what the rating
form tells me is whether or notthese parents and teachers are
(16:21):
reporting more problems, morebehaviors that are typically
seen in children of that child'sage. And then the child comes in
for testing. And that can beanywhere from, you know, six to
10 hours of testing over, youknow, two to four days,
depending on the age of thechild, depending on the
(16:41):
concerns. And I'm, you know,talking to the child about their
experience, at home at school,what's hard for them, what's
easier for them what they like,what they don't like, and then
they're doing, they're doingtests, and we're coming in, and
they're, we're looking at theirgeneral cognitive abilities,
their ability to problem solveand think through tasks. We're
looking at their academicskills, we're looking at reading
(17:04):
and writing and math, all thethings that they are asked to do
on a daily basis at school.
And then I'm going to look atthe processes that go into
completing tasks. So things likeattention, paying attention to
things you should versus thingsthat you see, right, those are
two different, they're bothattention, but they're processed
in different areas of the brain,the ability to be able to
(17:24):
remember information you seeversus information that you hear
your ability to processlanguage, how well does a child
understand what they hear whatis said to them? And are they
ability? Are they able toexpress their thoughts and ideas
in a way that comes out the waythat they intended? Is their
language sequences organized?
Are they having trouble findingthe right words for things? All
(17:44):
of that is important. Becauseagain, we're ruling out is this
a language based issue? Is thisan attention issue? Is this a
reading impairment? Is this amath disability? And so we want
to be very comprehensive in ourapproach.
And then we're looking at socialemotional functioning, the
parents and teachers arecompleting forms about whether
(18:05):
or not they're seeing signs ofanxiety or depression or poor
self concept. And then thechildren who come in are also
answering questions andcompleting their own
questionnaires, about theirfeelings about themselves, and
about their experiences.
And then we put all of thatinformation together to get a
nice picture, a neurocognitiveprofile of that child, their
(18:27):
strengths, their weaknesses,areas of concern, and, and then
we, from that information, wecan determine whether or not
there's a neurodevelopmentaldisorder, if and then what those
strengths are, because it's notenough to just identify where
the problems are. So, you know,if it turns out that the child
does have ADHD, it's importantto know that because there are
(18:49):
treatments that we can recommendand things that we can put in
place at home and at school tosupport that child. But we also
want to know, well, what are thestrengths in this child? What
are the child's strengths?
Because oftentimes, thosestrengths are things that that
child can use to compensate forareas of weakness. So it's just
as important to be able toidentify the strengths as it is
to identify areas of weakness.
Kira Yakubov (19:11):
Wow, that is an incredible process. I mean, that
is a lot of data to becollecting. And then, yeah, so
it sounds like this is over. Imean, maybe the course of a few
weeks before you just get all ofthis data before you kind of sit
and look through and analyze tosee what it is. And that's just
like, part of the first step isidentifying and then being able
(19:34):
to think about like, what do wedo next? How do we reform
everybody now to create like avery safe and supportive
environment for this child tothrive and not have low self
esteem and not kind of beatthemselves up in comparison to
their classmates or siblings?
Karen Wilson (19:51):
Right, absolutely.
And, you know, part of thatprocess, like I said, you know,
when people think aboutassessment, they think of just
the testing piece, butassessment is the parent
interview, it's theconversations with the child,
it's the testing, it'sconversations with teachers,
that's analysis of the ratingforms. And it's the feedback
meeting, it's having that followup meeting with the family to
say, this is what we found. Andthis is what we're recommending,
(20:14):
and having a conversation withthe child to say, you know,
these are things that you doreally well, these are areas
where you're so strong, but thisis harder for you. And this is
why we're gonna get you supportin this area, that's often a big
relief for kids, becauseoftentimes, they may not
understand why this is so hard.
(20:36):
You know, I think about thosekids in the classroom, if you
think about, you know, entering,i don't know when's the last
time you entered an elementaryschool, classroom, classroom or
school, but everybody's work ison the board. And while
everybody's on the bullet,everybody's work is put up on
the bulletin board for openhouses. And kids who struggle
with writing are often you know,embarrassed when their work is
(20:57):
up there, and they've got theirpeers have, you know, three
paragraphs of text put up on theboard, and they've got three
lines, right. And so, yeah,it can be some embarrassment
about their difficulties. They,you know, a lot of kids who have
struggled with reading will say,the most terrifying point of
part of their day is when theyhave to take turns reading out
that because they worry thatkids will snicker, and they will
(21:20):
laugh, they'll stumble overwords, and they get embarrassed.
And that can create anxiety, itcan create sadness, it can
create, contribute to a low selfconcept. And it can make kids
feel like they're not smart, andthat something is wrong with
them. So to explain that to achild, that your brain is just
wired differently. But here areareas where you are really
(21:40):
strong. And you know, we canprovide you support for reading
now that we know why this is sohard for you. It's often a big
relief for students.
Kira Yakubov (21:51):
Yeah, I can imagine. I mean, it sounds like
really playing up the strengths,because that's important. And
leaning into that, and usingthat to help in those other
areas. So they're not feelingdown and feel empowered, like
the child and the whole family.
And everybody involved feels alot more empowered. And it's not
walking away feeling kind ofsad, or disappointed, but
relieving. Like you're sayinglike, okay, knowledge is power.
(22:12):
So you can start doing differentthings with this information.
Karen Wilson (22:17):
And that's exactly it. And I sat down with parents,
you know, probably a month ago,now, and they had a child who
was, you know, in middle school,and was getting diagnosed with
dyslexia for the first time, andhad been brilliantly
compensating, by memorizing whatwords look like, for that long,
(22:38):
exceptionally bright kid, buthad dyslexia and didn't
understand that you justmemorize what words look like,
didn't know that you had tosound out words, actually said,
I thought everybody did that.
And the parents said to meduring that feedback session,
you know, I wish that we hadfound you, you know, five years
ago, right when their son was insecond grade. And the father,
(22:58):
who was sitting on the call saidto me, I wish I had found you 40
years ago, because he realizedfrom my discussion about what
his son was experiencing, thathe also struggled with the same
thing, but didn't have a namefor it when he was a child.
Kira Yakubov (23:14):
Sure. I think that's a really interesting part
too. Because as you're gettingthis family history to see if
it's hereditary, anybody else inthe family has it. And if
they've never even had theopportunity to explore this, or
know what this is even called,or what this might be like, it's
kind of like a shock foreverybody involved. They're also
getting this new diagnosis, andthis new information decades
(23:37):
later in their life,
Karen Wilson (23:38):
right, absolutely.
Kira Yakubov (23:39):
while helping their child move through it too.
Karen Wilson (23:42):
yea
Kira Yakubov (23:42):
wow.
Karen Wilson (23:43):
Yeah, I can't tell you how many parents have said,
you know, do you do you assessadults? Because when we're going
through their child history andexplaining why they feel this
way, why they're behaving thisway, why they're, you know,
learning in this manner, and whythis is so hard, they realize
that, you know, they had thesame struggles, but it just was
never identified.
Kira Yakubov (24:03):
Wow. So you do such powerful work. I'm so
inspired, because this is like
Karen Wilson (24:06):
thank you
Kira Yakubov (24:07):
you see all of it, and bring it together and help
so many people through thisprocess. And so I know we
touched a little bit on you kindof see kids who have ADHD,
Dyslexia, maybe on the spectrum.
Are there some processingdisorders that maybe people
haven't heard of, but are verycommon for you while you're
evaluating children?
Karen Wilson (24:28):
Yeah, I think that there are definitely language
language based disorders, whichis a processing disorder.
So language disorders can be in,in a couple have and people who
have language disorders canstruggle in a couple of areas.
One is just your ability tounderstand information that you
take in, you know, oftentimesthey have an understanding what
words mean, you know, they mayhave a more limited vocabulary,
(24:50):
they may have trouble kind oforganizing their words when
they're speaking. Choosing theright word to say when they need
to They may seem more shy ormore quiet in situations because
they spend so much time tryingto figure out how to say
something, that by the time theyget it, the conversation has
moved on. And so you know, thatcan create some anxiety as well.
(25:12):
So there's definitely languageprocessing disorders that we
see.
And you know, ADHD is anattention, processing disorder,
it's a difficult. It's someonewho has difficulty with
processing information, itsstruggles with the the ability
to, you know, persist withtasks, the ability to stay
focused over an extended periodof time, the ability to inhibit
(25:35):
distractors in your environment,and also to manage even complex
tasks, because we know theexecutive functioning system,
that process and those processesthat are part of that executive
functioning system are oftenimpacted in individuals with
ADHD also for autisticindividuals, and you see some
difficulties in mood disordersand anxiety as well. So there's
(25:58):
a lot of overlap too in termsof, of processes that are
impacted when there's aneurodevelopmental disorder or
even mental health challenge.
Kira Yakubov (26:06):
Yeah, and I imagine they're like, you're
seeing a lot of overlap thatthere's going to be comorbidity,
right, like someone may haveADHD inattentive, and also be on
the spectrum and may experienceanxiety too
Karen Wilson (26:17):
Absolutely
Kira Yakubov (26:17):
Is that something you find common? like being able
to identify that there areseveral things happening? And
how to like, separate that andtreat them separately? Or I'm
assuming there might be someoverlap in the treatment as
well?
Karen Wilson (26:29):
Yeah, there definitely can be some overlap
in the treatment. And then wealso the timeline in terms of
when these behaviors when thesechallenges started, kind of help
us figure out what came first.
You know, sometimes, like Isaid, kids can experience
anxiety because of theirstruggles, right. And then there
are other kids who have alwaysbeen described as anxious kids,
they had separation anxiety,when they're in preschool,
(26:51):
parents will say, you know, Ihad to sit in that preschool
classroom for the first monthand a half that my child
started. And so we know thatthat's a long standing issue.
And so again, that's why thatfamily history, and that
timeline of difficulties reallytells us, you know, kind of what
came first, what came second,and also helps us determine, you
(27:11):
know, a course of treatment. Weknow that
with neurodevelopmentaldisorders like dyslexia and
ADHD, there's in 40 to 50% ofkids, they have something else.
So 40 50% of kids with dyslexiaalso have ADHD. And the reverse
is true 40 50 percent of kidswith ADHD also have a learning
disorder. And so we know thatthere's a lot of comorbidity.
(27:32):
And we know that kids whostruggle with learning are at
greater risk for mental healthchallenges, like anxiety, for
self concept, and depressedmood. And so and that's one of
the reasons why we do thesecomprehensive assessments,
because we want to be able toidentify if there is more than
one thing going on, so that weaddress everything. You know, if
(27:52):
a child has dyslexia, and weonly look for dyslexia, and we
miss the ADHD, then, you know,when we're recommending
intervention, you know, how areyou going to recommend, and
we're going to recommend, youknow, an hour a day of reading
intervention, or two hours, youknow, a day of reading
intervention for a kid who hasundiagnosed inattentive type of
ADHD, it's gonna be really hardfor that child to pay attention
(28:16):
to the intervention. So beingable to identify that both are
present helps you determine thecourse of treatment that is most
effective for that child andtheir specific neurocognitive
profile.
Kira Yakubov (28:27):
Wow. I mean, that's incredible information. I
had no idea the numbers were sohigh for both of those to be
existing at the same time,you're saying it's even higher
of the overlap as well
Karen Wilson (28:38):
the overlap between autism and ADHD. They
actually, you know, up untilmore recently, you couldn't
diagnose ADHD in autistic kids,because it was so common to be
to find inattentive, andattention, hyperactivity,
impulsivity. Now you candiagnose both, but I think the
(29:00):
research shows that 70 to 80% ofautistic kids meet criteria for
ADHD.
Kira Yakubov (29:05):
Do you find that parents are like wildly
surprised by that, too? I mean,I'm a therapist and I and I'm
surprised by that level of, ofthose numbers and research.
Karen Wilson (29:14):
Yeah, well, they, they see it, they're not
surprised because they see it,they see that impulsivity they
see the executive functioningdifficulty and they see the
inattention, anxiety is veryhigh as well. And so knowing
that these things coexist andour common, it's helpful for
parents, so then they canunderstand what it is that
they're seeing, and then they'remore highly motivated to engage
(29:37):
in the treatment, that would beappropriate.
Kira Yakubov (29:39):
Sure, that makes sense. And so Karen, would you
be able to share a little bitabout some of the interventions
or like common things thatwhether it's you or your team,
or like other teachers andclinicians can help families
kind of do to manage some ofthis or to like play on the
strengths to bring up some ofthose weaknesses?
Karen Wilson (29:57):
Yeah, I mean, we see kids with so many different
presentations of different areasof struggle, you know that
they're going to have differentinterventions. But I can think
of, you know, kids withdyslexia, for example, that I
mentioned, we know what theresearch shows, is effective for
kids with dyslexia, you know, amultimodal phonics based program
is going to have the biggestimpact, particularly one that is
(30:21):
intensive in nature. And that'stypically done by an educational
therapist, or someone who hasspecific training and, you know,
this, these multi sensoryevidence based approaches to
dyslexia. So we know that thatis what we would recommend for
kids who have that type oflearning disorder.
We know that for kids with ADHD,for example, that you know,
(30:45):
about, you know, seventy todepending on the research study,
but 70 to even 90% of kids withADHD respond to medication,
there were various types ofmedication, I defer to pediatric
psychiatrists in terms of whenit's appropriate, and who it
helps a lot of parents with withthe young kiddos don't want to
start with medication, which isunderstandable. And so there,
(31:09):
you know, accommodations we canput in place, there'll be
there's behavioral support, werecommend working with a
cognitive behavioral therapist,who can coach parents on what
they can do to support theirkiddos at home, you can write a
plan for teachers in terms ofwhere that child should be
seated in the classroom. Youknow, how can we minimize
distractions around that child'sdesk and environment, helping
(31:31):
the teacher to know that this isan attention issue and impulsive
issue and not a childdeliberately trying to be
disobedient, or you know,disrespectful. So providing some
psychoeducation, to parents andteachers, and then also
recommendation if a child is isconstantly off task?
How can that teacher redirectthat child without causing the
(31:55):
child to be embarrassed in frontof his peers, you know, and so
all of that is part of therecommendation.
So when I think about ADHD, Ithink about, you know,
medication management, you know,cognitive behavioral training
for parents, the child havingsupport at home and at school
systems in place that supportthe child. And a lot of times,
(32:17):
if kids are taking longer tocomplete tasks, then extended
time, but also guidance in termsof how to use that extended
time. Because sometimes if kidshave attention issues and
executive functioningchallenges, they can be given
extended time, but no not knowhow to utilize that, that time
well. And so they might needsome executive functioning
(32:37):
coaching in terms of how toutilize that time. And then
also, again, accommodations atschool breaking down, you know,
large tasks into smaller chunks,getting, you know, stretching
breaks and opportunities to, todecompress. So all of those
things are all important interms of, of recommendations,
(33:01):
interventions, accommodationsand modifications at school,
that might be helpful.
A lot of kids with ADHD, alsohave some fine motor issues,
because that front part of thebrain that's responsible for
attention and sustaining focusand inhibiting distractors, and,
you know, executive functioningis also very close to the fine
(33:25):
motor areas in the brain in thatfront area of the brain. And so
many kids with ADHD also havefine motor or graphomotor
issues. So they're, you know,parents will say that their
handwriting is really poor, it'sillegible. And so oftentimes,
they will benefit fromoccupational therapy that will
address those fine motor, finemotor issues. And so that might
be a recommendation ifappropriate for a child who has
(33:47):
both the motor issues and ADHD.
Kira Yakubov (33:51):
Interesting.
That's so interesting. So Imean, full disclosure, I have
ADHD inattentive type, and I'msuper clumsy. And I've seen like
through social media, a lot ofpeople say like, oh, I'm clumsy
too. And this makes a lot ofsense. I just thought, I don't
know, like, I get easilydistracted by my surroundings.
But it sounds like it's a lotmore than just that as the fine
motor skills that or is it?
(34:13):
Could you explain that a littlebit more what that means, like,
why that might be impactingthat?
Karen Wilson (34:17):
Yeah, I mean, in the frontal lobe, there's, you
know, neuro chemicals arereleased norepinephrine,
dopamine, and they serve thefrontal lobe, they allow the
brain to, to focus, directattention, shift focus from one
thing to another, again, toinhibit distractors. But that
front part of the brain is alsoresponsible for fine motor
coordination. There's a motorstrip there. And so if that same
(34:39):
area of the brain is also notgetting enough dopamine, that
it's not only going to impactattention and focus and
impulsivity, it's going toimpact the ability to, you know,
to form letters well, right,that fine motor dexterity is
also going to be impacted.
Kira Yakubov (34:57):
Yeah. Interesting.
That's so fascinating.
Everything about the brain isjust so wild. And so if we can
shift gears a little bit, I knowwe've been talking about more so
with children, what does thislook like for young adults or
adolescents who are about to gooff to college, especially if
they're moving away, like,sometimes it might be a little
bit different if they still stayin their, their home that they
(35:19):
grew up in, and they're, youknow, just commuting to college
and classes, but, or for youngadults who are like going to
move or there's this hugetransition and all their
patterns and behaviors andhabits.
Karen Wilson (35:32):
Right, I mean, again, it depends on that young
person's individualneurocognitive profile in terms
of what those challenges mightbe. But for many, again,
particularly those students whohave had a lot of support at
school, and maybe even a lot ofsupport at home, by, you know,
an educational therapist andexecutive functioning coach, you
(35:54):
know, accommodations,modifications at school, for
many of them, the loss of thatstructure can can really create
problems for them, when theymake that transition. It's why
it's so important for thepreparation for that transition
to begin way before 12th grade,right? Way before 12th grade, I
want to develop thoseindependent skills, independent
(36:16):
living skills, those selfadvocacy skills are really
important. And that's a thingfor parents to keep in mind.
With disorders like ADHD, youknow, oftentimes, there's a
developmental delay in thedevelopment of specific areas of
the brain, particularly thefrontal lobe.
And we know the frontal lobe isthe last part of the brain to
mature and develop. And so allof those functions controlled by
(36:39):
the frontal lobe, the ability toorganize, plan, prioritize,
manage your time, you know, youknow, sustain your focus over an
extended period of time,particularly, when something's
not interesting to you, all ofthose things get better as you
get older, you know, yourability to problem solve,
decision make, exercise goodjudgment, all of those things
(37:00):
get better as you get older. Butkeep in mind that there's a
delay in the development ofthose areas of the brain and
individuals with ADHD. Andagain, that's a general term for
some individuals that might, youknow, they might be more
developed than others with ADHD.
But they're trying to be as muchas a three year delay in the
development of the frontal lobe.
And so if you think about an 18year old, going off to college,
(37:25):
but if your frontal lobe isreally, you know, a 15 year old,
then they're going to have moredifficutly than their same age
peers, in terms of managingthose things.
And the thing that happens whenyou go off to college is that
not only do you lose a lot ofthe structure that you had in in
high school, now the executivefunctioning demands of life has
(37:46):
have increased considerably. Nowyou're managing your finances,
now you're cleaning a home, nowyou're figuring out how to get
your meals made, because youknow, Mama's not there anymore.
You know, you're doing your ownlaundry, right, you're making
sure you have clean clothes towear, you're washing dishes,
you're doing all these differentthings that you may not have
done, in addition to, you know,staying on top of your
(38:09):
Courseload, making sure you'restudying for your test. And to
think about all the distractionsin college, you know, the
parties and the organizations.
And now you've got a roommate,and, you know, a residence hall,
and you may have had a parent,I've had parents say, you know,
I still get my teenager up inthe morning to go to school, you
know, and now you no longer havethat physical person telling
(38:30):
you, you know, hey, it's time togo, gotta get going. And so it
can be a very difficult time forstudents who are not prepared
for that transition.
Kira Yakubov (38:43):
Absolutely. I mean, those are so many things
to juggle. And for anybody atonce, it's adulting. Right? One
on one, right? It's tough.
Having to figure out what islike how to prioritize all of
this, what is the sequence to dothese things? Like timing them
out, managing, and then alsocreating friends, friendships,
right? Like, there's all thesedifferent things that are
(39:05):
happening. Yeah. And thenmanaging if you have a roommate,
and what that looks like, ifyou're messy, or they're clean,
there's
Karen Wilson (39:12):
right
Kira Yakubov (39:12):
a million different things that are going
on for somebody during thatstage in their life. Wow.
Absolutely.
Karen Wilson (39:19):
Absolutely. And then, and that's why the self
advocacy skills are soimportant, because they're,
they're high school. For manykids who've had the
accommodations. The teachersknow, the teachers know that
they need extended time, youknow, they have an IEP and then
they go off to college. And ifyou're not in a, in a, you know,
a hall with, you know, 400 otherpsych students, the professor
(39:41):
doesn't know that you needaccomodation.
Kira Yakubov (39:43):
Yeah.
Karen Wilson (39:43):
You have to find your seat in the front of the
classroom. You have to registerwith students with disabilities
office, and you have to, youknow, let notify the professor
that you need extended time, youhave to get the paperwork filled
out yourself and So there's alot of self advocacy that needs
to take place at college thatmaybe at this at a level that
(40:06):
wasn't needed when a student wasin high school.
So what I often say to parentsis that, you know, this period
of between 18 and 25, we callthis emerging adulthood, it's a
time when brain development iscontinuing to occur. I mean, the
frontal lobes are not fullymatured until our mid 20s. And
so many students, particularlythose who are neurodiverse, who
(40:29):
have these learning challenges,continue to need parental and
societal support during thistime.
Kira Yakubov (40:36):
Yea, that's so important. I'm glad you
mentioned that, because wethink, or at least, you know, 18
years old, you're an adult, youcan leave, do all these things,
make your decisions, but you'renot even close to having your
brain fully developed yet to beresponsible. And have the skills
and the support to maintain justliving and existing a life that
(40:56):
is fulfilling and happy and ableto juggle all of these things
Karen Wilson (41:00):
Absolutely.
Absolutely. And then, you know,if you think about students
going off to college, there'salso again, and they're
impulsive, there's so manytalked about all the things you
could be doing the parties, butthey're also it's a very
vulnerable period for, you know,again, those early those young
adults, right. And thoseemerging adults, it's a
vulnerable period for theirmental health, there's higher
(41:24):
rates of loneliness, depressionand anxiety during that time. If
kids never had those mentalhealth struggles, and they're
going to manifest, oftentimes,they manifest right in that
early adulthood period. And thenwe also know that, you know,
there's, they're at greater riskfor substance use, you know,
they're being exposed to thingsthat they may not have been
(41:45):
exposed to, when they wereyounger. And now, and if they've
got impulse control issues, andthen not a fully developed
frontal lobe, where That's wheretheir decision making their
judgment is, they're gonna makethe mistakes, do things that you
know, are not in their bestinterest.
Kira Yakubov (42:02):
And I think this is so important for people to
know, like young adults andparents is that this stage of
life, right, while you'refiguring all these things out,
everything is so new and you'remaking these mistakes, is to
kind of accept where you are,and not have a lot of shame
around that. And know that like,part of it is out of your
control. And the other part isknowing this information. So you
(42:23):
can do the things within yourcontrol, and kind of rolling,
rolling with the punches whileyou figure this all out while
your brain is still developing,which is really wild to think
about,
Karen Wilson (42:33):
right. And then making sure that you have things
in place to support you, if youknow that you're at risk for
anxiety and depression, oryou've had that in high school,
making sure that you'reconnecting with a mental health
professional at your university,knowing that you know, where the
health center is where you canget access to mental health
services, knowing that if you ifyou know that you have executive
(42:54):
functioning challenges, youknow, connecting with executive
functioning coach, andeducational therapists who can
work with you, particularlyduring that transition, that
first year of university, whenyou're trying to figure out the
lay of the land and managethings that you've never had to
manage before. And then makingsure that you're engaging in all
those self care practices thatare so important for
(43:16):
functioning, you know, makingsure you're getting adequate
sleep, you know, we know thatthe brain needs sleep, right? We
need sleep, spend so much of ourlives in a state of sleep. And
because it's important, we needit for optimal cognitive
functioning, we need it formental health.
And then we know that when we'renot getting adequate sleep,
(43:37):
we're going to be moreforgetful, because that's the
period of time when we'reconsolidating our memories. So
if a student is at school duringthe day, and when they go to
sleep at night, all of thosethings that they've been exposed
to get consolidated, they gofrom short term to long term
memory when they're sleeping. Soif you're getting inadequate
sleep, you're going to be ifyou're getting inadequate sleep,
we're going to have moreforgetfulness, it's gonna be
(43:58):
harder to pay attention in theclassroom. So all of those
things will be harder, and thenyou're going to be dysregulated
you're going to be emotionallydysregulated because you're not
getting enough sleep. So Ialways say adequate sleep,
making sure you're gettingenough exercise. mindfulness
practices have been reallyhelpful with, you know, helping
to address anxiety, stress,lower stress levels, and also
(44:21):
increased focus.
Kira Yakubov (44:22):
So it sounds like being super proactive about
getting all those supports andtaking care of yourself, like
physically and mentally to setyourself up for success while
you're growing and learning allthese different things.
Karen Wilson (44:34):
Yes, absolutely.
Kira Yakubov (44:35):
Awesome. And so Karen, I know we're coming close
to an end. Can you share alittle bit about your company,
Child, childnexus.com Thatdirectory because I'd love to
hear a little bit more and I'msure the listeners would love to
know about that as well.
Karen Wilson (44:48):
Absolutely. So I started Child Nexus because I
was getting so many parentssaying you know, I'm not getting
adequate support. I don't knowwhere to go to get information
about what my childhood Dealingwith and how to provide support.
And so I wanted to create aplatform where they could get
reliable information that theycan trust. So parents support
(45:09):
services, they can accessinformation about attention
difficulties, behavioralproblems, they can get
information about, you know whatinterventions work, they can get
information about how to requesta special education assessment
through the school, they can getinformation about how a school
assessment differs from aneuropsychological assessment.
(45:29):
And then they can connect withproviders, occupational
therapists, speech and languagepathologist, child
psychologists, educationaltherapists, executive
functioning coaches, parentcoaches, who can help them get
their children the support thatthey need in order to thrive.
Kira Yakubov (45:43):
Wow, that's incredible. So you've created a
nice hub.
Karen Wilson (45:47):
Yeah, it's a nice hub
Kira Yakubov (45:47):
For all the support and all the different
ways. Yeah. So everyone can getthe help they need and the
information.
Karen Wilson (45:53):
Yes, yeah. So we provide information we have
blogs, on different topics, theycan search by topic area based
on their the problems ordifficulties that their child is
struggling with, or they canalso listen to our podcasts. We
have a diverse thinkingdifferent learning podcast,
where we invite experts to comein and talk about different
things, you know, autism, ADHD,ADHD and girls, autism and
(46:16):
girls, language disorder,anxiety, mental health and young
people. So we cover all of thethings related to struggles that
kids who think and learndifferently face and how to
optimize their cognitive andmental health functioning.
Kira Yakubov (46:31):
That's beautiful.
I love that. And so for thelisteners, can you share how if
they want to get in touch withyou or work with you or find
your website, anything like thatthey can reach out to you?
Karen Wilson (46:40):
Absolutely, they can go to childnexus.com That is
the hub where they can get allthe information. That's where
our blogs are. That's where thelink to our podcasts are. If
they want to join a parentlearning group, you know,
they've just been their childhas just been diagnosed with
ADHD or anxiety or dyslexia. Andthey want to learn more than
(47:00):
they can join one of thosegroups right on the website. And
if they want, they don't knowwhat they need, they can book a
consultation, a 45 minuteconsultation and get some
answers to their questions. Andif they want to reach out to me
directly, they can email me atDrKIWilson@childnexus.com.
Kira Yakubov (47:19):
Wonderful. This has been super insightful. All
the knowledge and expertise youbring on. I'm really honored to
have you on today. Karen, thankyou so much for giving us your
time and sharing your story withus.
Karen Wilson (47:30):
Thank you so much for having me. It's been such a
pleasure,
Kira Yakubov (47:33):
of course
I wish that we had found you five years ago when
(00:03):
their son was in second grade.
And the father who was sittingon the call said to me, I wish I
had found you 40 years ago,because he realized from my
discussion about what his sonwas experiencing that he also
struggled with the same thing,but didn't have a name for it
when he was a child.
Kira Yakubov (00:24):
Hi, I'm Kira Yakubov, Licensed Marriage and
Family Therapist and founder ofHeal Your Roots Wellness
practice. Every episode, we talkwith a professional from the
mental health field to learnmore about their approaches and
specialties, and also theirjourney of becoming a therapist.
In this podcast, we'll uncover adeeper look at the world of
therapy from new perspectives.
You'll meet the therapists ofHeal Your Roots Wellness
(00:47):
practice, and trusted colleaguesfrom the community tackling
mental well being. We're your goto Network for practical and
professional insight in mentalhealth. Subscribe for new
episode releases every otherWednesday.
Hi, I'd like to welcome ourguest today Dr. Karen Wilson.
(01:10):
She is a clinicalneuropsychologist, Director of
West LA neuro psychology and thefounder of childnexus.com. She
also specializes in theassessment of neurodevelopmental
disorders in children,adolescents, and I cannot wait
to pick your brain today. Karen,thank you so much for coming on
today.
Thank you so much for having me,Kira.
Absolutely.
(01:30):
So every episode, we start withreally diving into the
practitioner, share a little bitabout your background, and what
made you get into mental health.
And specifically in being achild psychologist,
Karen Wilson (01:41):
I think probably from the age of nine, I knew
that I wanted to be doingsomething in the medical field,
I thought I was going to be apediatrician. And then when I
got to undergrad, I realizedthat I probably didn't like the
sight of blood. And so I wasgonna have to find something
else to do. I actually had takenpsychology as my elective and
just fell in love with the studyof the behavior study of the
(02:07):
brain. And then when I found outabout neuro psychology, that
really piqued my interest, andthere was like no turning back
from that point forward. So Ikind of took all the courses on
brain and behavior, neuroendocrinology, neuro psychology,
neuro anatomy. And then when Iwas applying to graduate schools
looked into clinical psychologyprograms that focused on neuro
(02:28):
psychology as a sub discipline.
Kira Yakubov (02:30):
That's awesome. I always loved my neuro psychology
classes in Psych as well. It'sso fascinating to learn about
the brain and all the differentthings that it does. It's so
powerful.
Karen Wilson (02:41):
Yes, absolutely.
Kira Yakubov (02:42):
Can you share a little bit more about how you
became a psychologist and howspecifically working with
children. Like if that wasalways something that you were
interested in?
Karen Wilson (02:49):
it wasn't actually my initial focus when I entered
psychology, you know, when I wasin graduate school actually
chose to do an adult emphasis.
So a lot of my instructioninitially was in working with
adults. I actually wanted to dogeriatrics and study Alzheimer's
disease and memory impairmentsand did some work in that area
for a long period of time. Andthen it wasn't until I was on my
(03:10):
clinical internship. The yearbefore I graduated that I did a
rotation in child psychology,child neuropsychology, and I was
evaluating kids who werestruggling with learning
challenges with, you know,medical issues that were
impacting their cognitive andemotional functioning. And I
just thought this is such agreat opportunity to be able to
(03:32):
provide support early on, and Ijust didn't look back from that
point forward.
Kira Yakubov (03:39):
That's wonderful.
And I think it's so amazing thatin these programs, we have that
hands on learning to recognizethat and learn that because you
might have continued in, youknow, researching and helping
people with Alzheimer's and maynot have recognized that that
would be your passion is workingwith children.
Karen Wilson (03:54):
Absolutely, absolutely. I think that's one
of the benefits of being inthose types of programs where
you do get to rotate indifferent areas, the medical
psychology field, I did work inHIV and AIDS, I did some work in
transplants. So there's a numberof areas where I got to explore
and have these experiences, andthen really determine where I
(04:17):
wanted to spend my time andwhere I was thinking about a
career move.
Kira Yakubov (04:21):
Yeah, that's incredible. These are amazing
careers that help so many peopleI'm so honored to have you on
today and hear your insight andknowledge. And so Karen, can you
share a little bit about some ofthe most common learning
disabilities or processingdisorders that you work with
while you're helping evaluatechildren for families?
Karen Wilson (04:38):
Absolutely. So in my practice, we do evaluations,
neuropsychological evaluations,psycho educational evaluations,
and when parents bring theirkids to us is typically because
their kids are struggling insome way. And oftentimes they
don't know why their kids arestruggling. So oftentimes, the
parents will say, you know, thepediatrician said that we should
(04:59):
make an appointment with you, orthe school is concerned, or the
parents are seeing something athome, that is worrisome. They've
talked to other family members.
And they've recommended anevaluation. And so generally in
those instances, their child isstruggling at school or at home.
It can be behavioral struggles,it can be struggles that are
that are impacting theiracademic functioning. common
(05:20):
struggles are, you know,difficulty staying seated,
paying attention, accessing thecurriculum at school, it can be
some mental health challenges,maybe there's anxiety that's
really interfering with thechild's ability to do what they
need to do, perhaps, you know,they don't want to go outside,
and they don't want to interactwith peers, because they're so
(05:40):
nervous. And they're the worriesare excessive. And there are
significant fears. And withschool, it can be, you know,
comments from teachers that youknow, your child is very bright,
but we can't get him to focus,we can't get him to engage with
us. They're having difficultyfollowing instructions
directions, or they're behindacademically, you know, they
(06:04):
some, oftentimes, parents orteachers will say, you know,
when I asked the student, thequestion, they know the answer,
they're the first one with theirhands up, but then when they
have to write it down, or theyhave to read that they can't do
it, or they can't demonstratetheir knowledge. So there seems
to be a disconnect between whatthey seem like they're able to
do, and then their output, ortheir ability to do specific
(06:25):
tasks, whether that be reading,writing, or math. And so when
individuals are coming in, andkids are coming in to see us,
it's because parents want toknow, you know, why is my child
struggling? Why do they seem tobe having more difficulty than
the peers their age? Or why isit so hard for them to do what I
asked them to do at home? Isthere some processing issue that
(06:46):
is interfering? And that's ourjob is to figure that out for
the family, and then providethem with information about, you
know, whether or not this is aneurodevelopmental disorder,
what that means provide somepsychoeducation. And then, you
know, develop a plan, create aplan for that child, what are
some things that we can put inplace to provide support at home
(07:07):
at school? Are there clinicians,therapists, other allied
professionals that this childshould work with to really help
that child reach their fullpotential, and that's our job
and also to make recommendationsfor accommodations or
modifications at the school asappropriate?
Kira Yakubov (07:26):
Yeah, so it sounds like it's really important to
have everybody on board,parents, teachers, doctors, any
other supports, maybe relativesas well, friends, so that
everyone's kind of on the samepage. sounds like a very, like
holistic and systemic way ofapproaching this.
Karen Wilson (07:43):
Absolutely.
Because you want to make sureyou know, when you're making a
diagnosis, that's it's veryserious, right, we want to make
sure we're not diagnosingsomeone with something they
don't have. And so there's a lotof checks and validation of what
it is we're seeing, you know,oftentimes, even to in order to
make a diagnosis, you can't havesymptoms or the behaviors in
just one setting. For example,with ADHD, you can't just be
(08:06):
seeing hyperactivity andimpulsivity at school, and not
at home or anyone else anywhereelse, you know, and that's to
validate that this is apervasive issue that's
impacting, you know, manyaspects of an individual's
functioning, because if it'sonly happening in one area, then
we certainly want to look atthat area, maybe there's
something about the school thatis anxiety, provoking the
(08:27):
academic environment, the homeenvironment, the demands placed
on the child. And so we want tobe able to look at everything to
make sure that if we're making adiagnosis, if we're saying this
is what's causing the strugglethat it is accurate, and that
the plan fits, what it is thatwe're finding, the last thing we
(08:47):
want to do is to say somethingis ADHD, when in fact, it's
anxiety because anxiety and ADHDhave two completely different
treatments and approaches forintervention.
Kira Yakubov (09:00):
So it's very thoughtful and methodical
process of going through this.
And so do you see there's adifference among genders? How
that might show up in certain,like learning disabilities, or
how that presents in a socialway, depending on kind of the
expectations or like thestereotypes that we might think
about, especially for like ADHD,right? I know, it's kind of
(09:21):
thinking about, at least for me,it's like the stereotype is a
little boy not being able to sitin their seat when it's a lot
more than just that.
Karen Wilson (09:30):
Yeah, I think it can, it can definitely manifest
in both boys and girlsdifferently. There's some
research to suggest that theremight be some more inattention
in girls and more hyperactivityand impulsivity in boys, but it
also, when you have a boy who isrambunctious oftentimes, some of
those behaviors can beinterpreted as boy behaviors,
(09:51):
and not as ADHD. Right. Andgirls who are you know,
compliant in the classroom andsitting still and doing well,
They might say, Well, that can'tbe a ADHD because she's able to
sit there, she's not getting outof her seat. She's not
impulsive, she's notinterrupting. But that same girl
could be sitting there lookinglike she's paying attention, and
daydreaming about what she'sgoing to do after school and
(10:12):
missing a great deal of theinformation presented. So I
think that that can happen. Andthere's also some research to
indicate that girls, autisticgirls can camouflage a lot of
their, their their symptoms ofautism, better than boys, the
social demands are different forgirls than there are with boys
in terms of how they interact,how they socialize, the things
(10:35):
that they do when they spendtime together is very different.
And so, you know, there's somebelief that some of the criteria
we even have for autism isreally based on a boy model,
because a lot of the researchthe early research is based on
on autistic boys.
Kira Yakubov (10:52):
That's really interesting to hear. So I mean,
I know about masking for peoplewho have ADHD, but I didn't know
necessarily about kind of themasking or camouflaging for
females who might be on thespectrum,
Karen Wilson (11:03):
right
Kira Yakubov (11:03):
Because that is kind of thinking about more
expected of females to care moreabout friendships, and to show
up in a particular way, and tobe more agreeable, versus if you
think about stereotypicallyyounger boys and that way
Karen Wilson (11:17):
Absolutely.
Kira Yakubov (11:18):
Would you be able to share the type of actual like
assessments that you do withchildren to evaluate to like,
differentiate or rule things outwhen it comes to this?
Karen Wilson (11:27):
Yes, absolutely.
So the process is prettycomprehensive. I mean, it starts
with, you know, sitting downwith parents and going through
the child's history. You know,when we're sitting down, I want
to know everything frompregnancy, birth and delivery to
you know, what's happening withyour child at this particular
moment, because some things thatmight happen early on might be
(11:49):
risk factors, you know,significant stress during
pregnancy. And early delivery ofa premature birth with a low
birth weight puts kids atgreater risk for
neurodevelopmental disorders. Sowe want to know that, we also
want to know if there's anyonein the family who has ADHD, who
has autism, who has anxiety,depression, dyslexia, because
(12:10):
those neurodevelopmental issues,mental health challenges are
heritable, you know, and so theyput, again, individuals, kids at
greater risk for havingstruggles in those areas, when
there's a family history.
And then we want to documentdevelopmental milestones.
Oftentimes, if kids, forexample, are having difficulty
(12:34):
with reading, you know, it maymanifest and become something we
recognize as dyslexia. For someindividuals, there's an early
indication of language basedissues. You know, there's a
higher number of kids diagnosedwith dyslexia, who had speech
and language problems when theywere younger. So we know that
that's a risk factor. That's whydoing that clinical interview
(12:55):
with parents is so important. Sowe find out, okay, there's an
early history of speech andlanguage issues, there's a
family history of dyslexia,there's a family history of
anxiety. So we know that some ofthe behaviors might be
associated with those disorders,and, and also knowing that that
child is at higher risk becauseof the family history and their
(13:16):
own developmental history. Sothat's all part of the process.
And then we want to know, whatparents are seeing at home,
because some parents will say,you know, the teacher is saying
X, Y, and Z. But we want to knowwell what are you seeing at
home, and parents will sometimessee things differently than the
teacher see, and that, and thatwould be expected because the
home environment, schoolenvironments are very different.
(13:37):
You know, you have 20, sometimeskids have 23 25 other
individuals in a classroomsetting. Very few families have
that many people at home, rightin one place. And so the
distractibility factor is muchhigher at school than it is at
home. But then at the same time,the school also provides more
structure in terms of what theday looks like. And a lot of
(14:00):
homes may not have that samelevel of structure.
So knowing how kids navigatethose two different environments
is often very important. Andgetting that information from
parents is really helpful inidentifying, you know, what are
the challenges for a child athome? Are they similar to what
the teachers are seeing atschool? sometimes in home
(14:21):
environments, kids are able tocompensate or at school, they're
able to compensate for areas ofstruggle, because of an inherent
structure built into the homeenvironment or the school
environment and then sometimesparents will say, for example,
with homework, the teacher willsay, well, the child is getting
the homework done, but what theydon't see is the amount of
effort that is needed to getthat work done. So the parents
(14:43):
might say, you know, the teachersays, These are 30 minute
assignments that my child issupposed to do on a weekly
basis, but it's taking my childthree hours. So that indicates
that it might be a processingissue. So the teacher gets the
homework, and it's complete.
It's accurate. It might beperfect, but They don't see the
effort or know the effort thatwas needed, and the support that
might have been needed from theparents in order to keep that
(15:05):
child on task to complete theassignment. And then also the
amount of time that it took andthe effort that it took to
actually get that assignmentdone. And so that information
from a parent is so important.
Because really, what we'relooking at are processes and
what's involved in completingtasks. So that's a little
Kira Yakubov (15:26):
Wow, that's so involved
Karen Wilson (15:26):
bit about that information, it's very involved
and that's only a parentinterview, because then what I
want to do is I also want tospeak to teachers, I want to
know, what are the teachersobserving in the classroom. And
oftentimes, I'm speaking to morethan one teacher, because
inherently in a lot of kids,there'll be one class where they
do really well. And then onewhere they're struggling,
particularly if kids arestruggling more with reading,
(15:49):
one with sciences or more withmath, then, you know, speak with
language arts teacher and a mathteacher, to see if their
observations are different inthe classroom.
Kira Yakubov (15:58):
Yeah.
Karen Wilson (15:59):
And that also speaks to the extent to which
these behaviors and theseconcerns are showing up in
different environments, and howthey show up.
And then so we're gatheringinformation from parents, we're
gathering information fromteachers, I'm speaking with
them, they're also completingrating forms. So what the rating
form tells me is whether or notthese parents and teachers are
(16:21):
reporting more problems, morebehaviors that are typically
seen in children of that child'sage. And then the child comes in
for testing. And that can beanywhere from, you know, six to
10 hours of testing over, youknow, two to four days,
depending on the age of thechild, depending on the
(16:41):
concerns. And I'm, you know,talking to the child about their
experience, at home at school,what's hard for them, what's
easier for them what they like,what they don't like, and then
they're doing, they're doingtests, and we're coming in, and
they're, we're looking at theirgeneral cognitive abilities,
their ability to problem solveand think through tasks. We're
looking at their academicskills, we're looking at reading
(17:04):
and writing and math, all thethings that they are asked to do
on a daily basis at school.
And then I'm going to look atthe processes that go into
completing tasks. So things likeattention, paying attention to
things you should versus thingsthat you see, right, those are
two different, they're bothattention, but they're processed
in different areas of the brain,the ability to be able to
(17:24):
remember information you seeversus information that you hear
your ability to processlanguage, how well does a child
understand what they hear whatis said to them? And are they
ability? Are they able toexpress their thoughts and ideas
in a way that comes out the waythat they intended? Is their
language sequences organized?
Are they having trouble findingthe right words for things? All
(17:44):
of that is important. Becauseagain, we're ruling out is this
a language based issue? Is thisan attention issue? Is this a
reading impairment? Is this amath disability? And so we want
to be very comprehensive in ourapproach.
And then we're looking at socialemotional functioning, the
parents and teachers arecompleting forms about whether
(18:05):
or not they're seeing signs ofanxiety or depression or poor
self concept. And then thechildren who come in are also
answering questions andcompleting their own
questionnaires, about theirfeelings about themselves, and
about their experiences.
And then we put all of thatinformation together to get a
nice picture, a neurocognitiveprofile of that child, their
(18:27):
strengths, their weaknesses,areas of concern, and, and then
we, from that information, wecan determine whether or not
there's a neurodevelopmentaldisorder, if and then what those
strengths are, because it's notenough to just identify where
the problems are. So, you know,if it turns out that the child
does have ADHD, it's importantto know that because there are
(18:49):
treatments that we can recommendand things that we can put in
place at home and at school tosupport that child. But we also
want to know, well, what are thestrengths in this child? What
are the child's strengths?
Because oftentimes, thosestrengths are things that that
child can use to compensate forareas of weakness. So it's just
as important to be able toidentify the strengths as it is
to identify areas of weakness.
Kira Yakubov (19:11):
Wow, that is an incredible process. I mean, that
is a lot of data to becollecting. And then, yeah, so
it sounds like this is over. Imean, maybe the course of a few
weeks before you just get all ofthis data before you kind of sit
and look through and analyze tosee what it is. And that's just
like, part of the first step isidentifying and then being able
(19:34):
to think about like, what do wedo next? How do we reform
everybody now to create like avery safe and supportive
environment for this child tothrive and not have low self
esteem and not kind of beatthemselves up in comparison to
their classmates or siblings?
Karen Wilson (19:51):
Right, absolutely.
And, you know, part of thatprocess, like I said, you know,
when people think aboutassessment, they think of just
the testing piece, butassessment is the parent
interview, it's theconversations with the child,
it's the testing, it'sconversations with teachers,
that's analysis of the ratingforms. And it's the feedback
meeting, it's having that followup meeting with the family to
say, this is what we found. Andthis is what we're recommending,
(20:14):
and having a conversation withthe child to say, you know,
these are things that you doreally well, these are areas
where you're so strong, but thisis harder for you. And this is
why we're gonna get you supportin this area, that's often a big
relief for kids, becauseoftentimes, they may not
understand why this is so hard.
(20:36):
You know, I think about thosekids in the classroom, if you
think about, you know, entering,i don't know when's the last
time you entered an elementaryschool, classroom, classroom or
school, but everybody's work ison the board. And while
everybody's on the bullet,everybody's work is put up on
the bulletin board for openhouses. And kids who struggle
with writing are often you know,embarrassed when their work is
(20:57):
up there, and they've got theirpeers have, you know, three
paragraphs of text put up on theboard, and they've got three
lines, right. And so, yeah,it can be some embarrassment
about their difficulties. They,you know, a lot of kids who have
struggled with reading will say,the most terrifying point of
part of their day is when theyhave to take turns reading out
that because they worry thatkids will snicker, and they will
(21:20):
laugh, they'll stumble overwords, and they get embarrassed.
And that can create anxiety, itcan create sadness, it can
create, contribute to a low selfconcept. And it can make kids
feel like they're not smart, andthat something is wrong with
them. So to explain that to achild, that your brain is just
wired differently. But here areareas where you are really
(21:40):
strong. And you know, we canprovide you support for reading
now that we know why this is sohard for you. It's often a big
relief for students.
Kira Yakubov (21:51):
Yeah, I can imagine. I mean, it sounds like
really playing up the strengths,because that's important. And
leaning into that, and usingthat to help in those other
areas. So they're not feelingdown and feel empowered, like
the child and the whole family.
And everybody involved feels alot more empowered. And it's not
walking away feeling kind ofsad, or disappointed, but
relieving. Like you're sayinglike, okay, knowledge is power.
(22:12):
So you can start doing differentthings with this information.
Karen Wilson (22:17):
And that's exactly it. And I sat down with parents,
you know, probably a month ago,now, and they had a child who
was, you know, in middle school,and was getting diagnosed with
dyslexia for the first time, andhad been brilliantly
compensating, by memorizing whatwords look like, for that long,
(22:38):
exceptionally bright kid, buthad dyslexia and didn't
understand that you justmemorize what words look like,
didn't know that you had tosound out words, actually said,
I thought everybody did that.
And the parents said to meduring that feedback session,
you know, I wish that we hadfound you, you know, five years
ago, right when their son was insecond grade. And the father,
(22:58):
who was sitting on the call saidto me, I wish I had found you 40
years ago, because he realizedfrom my discussion about what
his son was experiencing, thathe also struggled with the same
thing, but didn't have a namefor it when he was a child.
Kira Yakubov (23:14):
Sure. I think that's a really interesting part
too. Because as you're gettingthis family history to see if
it's hereditary, anybody else inthe family has it. And if
they've never even had theopportunity to explore this, or
know what this is even called,or what this might be like, it's
kind of like a shock foreverybody involved. They're also
getting this new diagnosis, andthis new information decades
(23:37):
later in their life,
Karen Wilson (23:38):
right, absolutely.
Kira Yakubov (23:39):
while helping their child move through it too.
Karen Wilson (23:42):
yea
Kira Yakubov (23:42):
wow.
Karen Wilson (23:43):
Yeah, I can't tell you how many parents have said,
you know, do you do you assessadults? Because when we're going
through their child history andexplaining why they feel this
way, why they're behaving thisway, why they're, you know,
learning in this manner, and whythis is so hard, they realize
that, you know, they had thesame struggles, but it just was
never identified.
Kira Yakubov (24:03):
Wow. So you do such powerful work. I'm so
inspired, because this is like
Karen Wilson (24:06):
thank you
Kira Yakubov (24:07):
you see all of it, and bring it together and help
so many people through thisprocess. And so I know we
touched a little bit on you kindof see kids who have ADHD,
Dyslexia, maybe on the spectrum.
Are there some processingdisorders that maybe people
haven't heard of, but are verycommon for you while you're
evaluating children?
Karen Wilson (24:28):
Yeah, I think that there are definitely language
language based disorders, whichis a processing disorder.
So language disorders can be in,in a couple have and people who
have language disorders canstruggle in a couple of areas.
One is just your ability tounderstand information that you
take in, you know, oftentimesthey have an understanding what
words mean, you know, they mayhave a more limited vocabulary,
(24:50):
they may have trouble kind oforganizing their words when
they're speaking. Choosing theright word to say when they need
to They may seem more shy ormore quiet in situations because
they spend so much time tryingto figure out how to say
something, that by the time theyget it, the conversation has
moved on. And so you know, thatcan create some anxiety as well.
(25:12):
So there's definitely languageprocessing disorders that we
see.
And you know, ADHD is anattention, processing disorder,
it's a difficult. It's someonewho has difficulty with
processing information, itsstruggles with the the ability
to, you know, persist withtasks, the ability to stay
focused over an extended periodof time, the ability to inhibit
(25:35):
distractors in your environment,and also to manage even complex
tasks, because we know theexecutive functioning system,
that process and those processesthat are part of that executive
functioning system are oftenimpacted in individuals with
ADHD also for autisticindividuals, and you see some
difficulties in mood disordersand anxiety as well. So there's
(25:58):
a lot of overlap too in termsof, of processes that are
impacted when there's aneurodevelopmental disorder or
even mental health challenge.
Kira Yakubov (26:06):
Yeah, and I imagine they're like, you're
seeing a lot of overlap thatthere's going to be comorbidity,
right, like someone may haveADHD inattentive, and also be on
the spectrum and may experienceanxiety too
Karen Wilson (26:17):
Absolutely
Kira Yakubov (26:17):
Is that something you find common? like being able
to identify that there areseveral things happening? And
how to like, separate that andtreat them separately? Or I'm
assuming there might be someoverlap in the treatment as
well?
Karen Wilson (26:29):
Yeah, there definitely can be some overlap
in the treatment. And then wealso the timeline in terms of
when these behaviors when thesechallenges started, kind of help
us figure out what came first.
You know, sometimes, like Isaid, kids can experience
anxiety because of theirstruggles, right. And then there
are other kids who have alwaysbeen described as anxious kids,
they had separation anxiety,when they're in preschool,
(26:51):
parents will say, you know, Ihad to sit in that preschool
classroom for the first monthand a half that my child
started. And so we know thatthat's a long standing issue.
And so again, that's why thatfamily history, and that
timeline of difficulties reallytells us, you know, kind of what
came first, what came second,and also helps us determine, you
(27:11):
know, a course of treatment. Weknow that
with neurodevelopmentaldisorders like dyslexia and
ADHD, there's in 40 to 50% ofkids, they have something else.
So 40 50% of kids with dyslexiaalso have ADHD. And the reverse
is true 40 50 percent of kidswith ADHD also have a learning
disorder. And so we know thatthere's a lot of comorbidity.
(27:32):
And we know that kids whostruggle with learning are at
greater risk for mental healthchallenges, like anxiety, for
self concept, and depressedmood. And so and that's one of
the reasons why we do thesecomprehensive assessments,
because we want to be able toidentify if there is more than
one thing going on, so that weaddress everything. You know, if
(27:52):
a child has dyslexia, and weonly look for dyslexia, and we
miss the ADHD, then, you know,when we're recommending
intervention, you know, how areyou going to recommend, and
we're going to recommend, youknow, an hour a day of reading
intervention, or two hours, youknow, a day of reading
intervention for a kid who hasundiagnosed inattentive type of
ADHD, it's gonna be really hardfor that child to pay attention
(28:16):
to the intervention. So beingable to identify that both are
present helps you determine thecourse of treatment that is most
effective for that child andtheir specific neurocognitive
profile.
Kira Yakubov (28:27):
Wow. I mean, that's incredible information. I
had no idea the numbers were sohigh for both of those to be
existing at the same time,you're saying it's even higher
of the overlap as well
Karen Wilson (28:38):
the overlap between autism and ADHD. They
actually, you know, up untilmore recently, you couldn't
diagnose ADHD in autistic kids,because it was so common to be
to find inattentive, andattention, hyperactivity,
impulsivity. Now you candiagnose both, but I think the
(29:00):
research shows that 70 to 80% ofautistic kids meet criteria for
ADHD.
Kira Yakubov (29:05):
Do you find that parents are like wildly
surprised by that, too? I mean,I'm a therapist and I and I'm
surprised by that level of, ofthose numbers and research.
Karen Wilson (29:14):
Yeah, well, they, they see it, they're not
surprised because they see it,they see that impulsivity they
see the executive functioningdifficulty and they see the
inattention, anxiety is veryhigh as well. And so knowing
that these things coexist andour common, it's helpful for
parents, so then they canunderstand what it is that
they're seeing, and then they'remore highly motivated to engage
(29:37):
in the treatment, that would beappropriate.
Kira Yakubov (29:39):
Sure, that makes sense. And so Karen, would you
be able to share a little bitabout some of the interventions
or like common things thatwhether it's you or your team,
or like other teachers andclinicians can help families
kind of do to manage some ofthis or to like play on the
strengths to bring up some ofthose weaknesses?
Karen Wilson (29:57):
Yeah, I mean, we see kids with so many different
presentations of different areasof struggle, you know that
they're going to have differentinterventions. But I can think
of, you know, kids withdyslexia, for example, that I
mentioned, we know what theresearch shows, is effective for
kids with dyslexia, you know, amultimodal phonics based program
is going to have the biggestimpact, particularly one that is
(30:21):
intensive in nature. And that'stypically done by an educational
therapist, or someone who hasspecific training and, you know,
this, these multi sensoryevidence based approaches to
dyslexia. So we know that thatis what we would recommend for
kids who have that type oflearning disorder.
We know that for kids with ADHD,for example, that you know,
(30:45):
about, you know, seventy todepending on the research study,
but 70 to even 90% of kids withADHD respond to medication,
there were various types ofmedication, I defer to pediatric
psychiatrists in terms of whenit's appropriate, and who it
helps a lot of parents with withthe young kiddos don't want to
start with medication, which isunderstandable. And so there,
(31:09):
you know, accommodations we canput in place, there'll be
there's behavioral support, werecommend working with a
cognitive behavioral therapist,who can coach parents on what
they can do to support theirkiddos at home, you can write a
plan for teachers in terms ofwhere that child should be
seated in the classroom. Youknow, how can we minimize
distractions around that child'sdesk and environment, helping
(31:31):
the teacher to know that this isan attention issue and impulsive
issue and not a childdeliberately trying to be
disobedient, or you know,disrespectful. So providing some
psychoeducation, to parents andteachers, and then also
recommendation if a child is isconstantly off task?
How can that teacher redirectthat child without causing the
(31:55):
child to be embarrassed in frontof his peers, you know, and so
all of that is part of therecommendation.
So when I think about ADHD, Ithink about, you know,
medication management, you know,cognitive behavioral training
for parents, the child havingsupport at home and at school
systems in place that supportthe child. And a lot of times,
(32:17):
if kids are taking longer tocomplete tasks, then extended
time, but also guidance in termsof how to use that extended
time. Because sometimes if kidshave attention issues and
executive functioningchallenges, they can be given
extended time, but no not knowhow to utilize that, that time
well. And so they might needsome executive functioning
(32:37):
coaching in terms of how toutilize that time. And then
also, again, accommodations atschool breaking down, you know,
large tasks into smaller chunks,getting, you know, stretching
breaks and opportunities to, todecompress. So all of those
things are all important interms of, of recommendations,
(33:01):
interventions, accommodationsand modifications at school,
that might be helpful.
A lot of kids with ADHD, alsohave some fine motor issues,
because that front part of thebrain that's responsible for
attention and sustaining focusand inhibiting distractors, and,
you know, executive functioningis also very close to the fine
(33:25):
motor areas in the brain in thatfront area of the brain. And so
many kids with ADHD also havefine motor or graphomotor
issues. So they're, you know,parents will say that their
handwriting is really poor, it'sillegible. And so oftentimes,
they will benefit fromoccupational therapy that will
address those fine motor, finemotor issues. And so that might
be a recommendation ifappropriate for a child who has
(33:47):
both the motor issues and ADHD.
Kira Yakubov (33:51):
Interesting.
That's so interesting. So Imean, full disclosure, I have
ADHD inattentive type, and I'msuper clumsy. And I've seen like
through social media, a lot ofpeople say like, oh, I'm clumsy
too. And this makes a lot ofsense. I just thought, I don't
know, like, I get easilydistracted by my surroundings.
But it sounds like it's a lotmore than just that as the fine
motor skills that or is it?
(34:13):
Could you explain that a littlebit more what that means, like,
why that might be impactingthat?
Karen Wilson (34:17):
Yeah, I mean, in the frontal lobe, there's, you
know, neuro chemicals arereleased norepinephrine,
dopamine, and they serve thefrontal lobe, they allow the
brain to, to focus, directattention, shift focus from one
thing to another, again, toinhibit distractors. But that
front part of the brain is alsoresponsible for fine motor
coordination. There's a motorstrip there. And so if that same
(34:39):
area of the brain is also notgetting enough dopamine, that
it's not only going to impactattention and focus and
impulsivity, it's going toimpact the ability to, you know,
to form letters well, right,that fine motor dexterity is
also going to be impacted.
Kira Yakubov (34:57):
Yeah. Interesting.
That's so fascinating.
Everything about the brain isjust so wild. And so if we can
shift gears a little bit, I knowwe've been talking about more so
with children, what does thislook like for young adults or
adolescents who are about to gooff to college, especially if
they're moving away, like,sometimes it might be a little
bit different if they still stayin their, their home that they
(35:19):
grew up in, and they're, youknow, just commuting to college
and classes, but, or for youngadults who are like going to
move or there's this hugetransition and all their
patterns and behaviors andhabits.
Karen Wilson (35:32):
Right, I mean, again, it depends on that young
person's individualneurocognitive profile in terms
of what those challenges mightbe. But for many, again,
particularly those students whohave had a lot of support at
school, and maybe even a lot ofsupport at home, by, you know,
an educational therapist andexecutive functioning coach, you
(35:54):
know, accommodations,modifications at school, for
many of them, the loss of thatstructure can can really create
problems for them, when theymake that transition. It's why
it's so important for thepreparation for that transition
to begin way before 12th grade,right? Way before 12th grade, I
want to develop thoseindependent skills, independent
(36:16):
living skills, those selfadvocacy skills are really
important. And that's a thingfor parents to keep in mind.
With disorders like ADHD, youknow, oftentimes, there's a
developmental delay in thedevelopment of specific areas of
the brain, particularly thefrontal lobe.
And we know the frontal lobe isthe last part of the brain to
mature and develop. And so allof those functions controlled by
(36:39):
the frontal lobe, the ability toorganize, plan, prioritize,
manage your time, you know, youknow, sustain your focus over an
extended period of time,particularly, when something's
not interesting to you, all ofthose things get better as you
get older, you know, yourability to problem solve,
decision make, exercise goodjudgment, all of those things
(37:00):
get better as you get older. Butkeep in mind that there's a
delay in the development ofthose areas of the brain and
individuals with ADHD. Andagain, that's a general term for
some individuals that might, youknow, they might be more
developed than others with ADHD.
But they're trying to be as muchas a three year delay in the
development of the frontal lobe.
And so if you think about an 18year old, going off to college,
(37:25):
but if your frontal lobe isreally, you know, a 15 year old,
then they're going to have moredifficutly than their same age
peers, in terms of managingthose things.
And the thing that happens whenyou go off to college is that
not only do you lose a lot ofthe structure that you had in in
high school, now the executivefunctioning demands of life has
(37:46):
have increased considerably. Nowyou're managing your finances,
now you're cleaning a home, nowyou're figuring out how to get
your meals made, because youknow, Mama's not there anymore.
You know, you're doing your ownlaundry, right, you're making
sure you have clean clothes towear, you're washing dishes,
you're doing all these differentthings that you may not have
done, in addition to, you know,staying on top of your
(38:09):
Courseload, making sure you'restudying for your test. And to
think about all the distractionsin college, you know, the
parties and the organizations.
And now you've got a roommate,and, you know, a residence hall,
and you may have had a parent,I've had parents say, you know,
I still get my teenager up inthe morning to go to school, you
know, and now you no longer havethat physical person telling
(38:30):
you, you know, hey, it's time togo, gotta get going. And so it
can be a very difficult time forstudents who are not prepared
for that transition.
Kira Yakubov (38:43):
Absolutely. I mean, those are so many things
to juggle. And for anybody atonce, it's adulting. Right? One
on one, right? It's tough.
Having to figure out what islike how to prioritize all of
this, what is the sequence to dothese things? Like timing them
out, managing, and then alsocreating friends, friendships,
right? Like, there's all thesedifferent things that are
(39:05):
happening. Yeah. And thenmanaging if you have a roommate,
and what that looks like, ifyou're messy, or they're clean,
there's
Karen Wilson (39:12):
right
Kira Yakubov (39:12):
a million different things that are going
on for somebody during thatstage in their life. Wow.
Absolutely.
Karen Wilson (39:19):
Absolutely. And then, and that's why the self
advocacy skills are soimportant, because they're,
they're high school. For manykids who've had the
accommodations. The teachersknow, the teachers know that
they need extended time, youknow, they have an IEP and then
they go off to college. And ifyou're not in a, in a, you know,
a hall with, you know, 400 otherpsych students, the professor
(39:41):
doesn't know that you needaccomodation.
Kira Yakubov (39:43):
Yeah.
Karen Wilson (39:43):
You have to find your seat in the front of the
classroom. You have to registerwith students with disabilities
office, and you have to, youknow, let notify the professor
that you need extended time, youhave to get the paperwork filled
out yourself and So there's alot of self advocacy that needs
to take place at college thatmaybe at this at a level that
(40:06):
wasn't needed when a student wasin high school.
So what I often say to parentsis that, you know, this period
of between 18 and 25, we callthis emerging adulthood, it's a
time when brain development iscontinuing to occur. I mean, the
frontal lobes are not fullymatured until our mid 20s. And
so many students, particularlythose who are neurodiverse, who
(40:29):
have these learning challenges,continue to need parental and
societal support during thistime.
Kira Yakubov (40:36):
Yea, that's so important. I'm glad you
mentioned that, because wethink, or at least, you know, 18
years old, you're an adult, youcan leave, do all these things,
make your decisions, but you'renot even close to having your
brain fully developed yet to beresponsible. And have the skills
and the support to maintain justliving and existing a life that
(40:56):
is fulfilling and happy and ableto juggle all of these things
Karen Wilson (41:00):
Absolutely.
Absolutely. And then, you know,if you think about students
going off to college, there'salso again, and they're
impulsive, there's so manytalked about all the things you
could be doing the parties, butthey're also it's a very
vulnerable period for, you know,again, those early those young
adults, right. And thoseemerging adults, it's a
vulnerable period for theirmental health, there's higher
(41:24):
rates of loneliness, depressionand anxiety during that time. If
kids never had those mentalhealth struggles, and they're
going to manifest, oftentimes,they manifest right in that
early adulthood period. And thenwe also know that, you know,
there's, they're at greater riskfor substance use, you know,
they're being exposed to thingsthat they may not have been
(41:45):
exposed to, when they wereyounger. And now, and if they've
got impulse control issues, andthen not a fully developed
frontal lobe, where That's wheretheir decision making their
judgment is, they're gonna makethe mistakes, do things that you
know, are not in their bestinterest.
Kira Yakubov (42:02):
And I think this is so important for people to
know, like young adults andparents is that this stage of
life, right, while you'refiguring all these things out,
everything is so new and you'remaking these mistakes, is to
kind of accept where you are,and not have a lot of shame
around that. And know that like,part of it is out of your
control. And the other part isknowing this information. So you
(42:23):
can do the things within yourcontrol, and kind of rolling,
rolling with the punches whileyou figure this all out while
your brain is still developing,which is really wild to think
about,
Karen Wilson (42:33):
right. And then making sure that you have things
in place to support you, if youknow that you're at risk for
anxiety and depression, oryou've had that in high school,
making sure that you'reconnecting with a mental health
professional at your university,knowing that you know, where the
health center is where you canget access to mental health
services, knowing that if you ifyou know that you have executive
(42:54):
functioning challenges, youknow, connecting with executive
functioning coach, andeducational therapists who can
work with you, particularlyduring that transition, that
first year of university, whenyou're trying to figure out the
lay of the land and managethings that you've never had to
manage before. And then makingsure that you're engaging in all
those self care practices thatare so important for
(43:16):
functioning, you know, makingsure you're getting adequate
sleep, you know, we know thatthe brain needs sleep, right? We
need sleep, spend so much of ourlives in a state of sleep. And
because it's important, we needit for optimal cognitive
functioning, we need it formental health.
And then we know that when we'renot getting adequate sleep,
(43:37):
we're going to be moreforgetful, because that's the
period of time when we'reconsolidating our memories. So
if a student is at school duringthe day, and when they go to
sleep at night, all of thosethings that they've been exposed
to get consolidated, they gofrom short term to long term
memory when they're sleeping. Soif you're getting inadequate
sleep, you're going to be ifyou're getting inadequate sleep,
we're going to have moreforgetfulness, it's gonna be
(43:58):
harder to pay attention in theclassroom. So all of those
things will be harder, and thenyou're going to be dysregulated
you're going to be emotionallydysregulated because you're not
getting enough sleep. So Ialways say adequate sleep,
making sure you're gettingenough exercise. mindfulness
practices have been reallyhelpful with, you know, helping
to address anxiety, stress,lower stress levels, and also
(44:21):
increased focus.
Kira Yakubov (44:22):
So it sounds like being super proactive about
getting all those supports andtaking care of yourself, like
physically and mentally to setyourself up for success while
you're growing and learning allthese different things.
Karen Wilson (44:34):
Yes, absolutely.
Kira Yakubov (44:35):
Awesome. And so Karen, I know we're coming close
to an end. Can you share alittle bit about your company,
Child, childnexus.com Thatdirectory because I'd love to
hear a little bit more and I'msure the listeners would love to
know about that as well.
Karen Wilson (44:48):
Absolutely. So I started Child Nexus because I
was getting so many parentssaying you know, I'm not getting
adequate support. I don't knowwhere to go to get information
about what my childhood Dealingwith and how to provide support.
And so I wanted to create aplatform where they could get
reliable information that theycan trust. So parents support
(45:09):
services, they can accessinformation about attention
difficulties, behavioralproblems, they can get
information about, you know whatinterventions work, they can get
information about how to requesta special education assessment
through the school, they can getinformation about how a school
assessment differs from aneuropsychological assessment.
(45:29):
And then they can connect withproviders, occupational
therapists, speech and languagepathologist, child
psychologists, educationaltherapists, executive
functioning coaches, parentcoaches, who can help them get
their children the support thatthey need in order to thrive.
Kira Yakubov (45:43):
Wow, that's incredible. So you've created a
nice hub.
Karen Wilson (45:47):
Yeah, it's a nice hub
Kira Yakubov (45:47):
For all the support and all the different
ways. Yeah. So everyone can getthe help they need and the
information.
Karen Wilson (45:53):
Yes, yeah. So we provide information we have
blogs, on different topics, theycan search by topic area based
on their the problems ordifficulties that their child is
struggling with, or they canalso listen to our podcasts. We
have a diverse thinkingdifferent learning podcast,
where we invite experts to comein and talk about different
things, you know, autism, ADHD,ADHD and girls, autism and
(46:16):
girls, language disorder,anxiety, mental health and young
people. So we cover all of thethings related to struggles that
kids who think and learndifferently face and how to
optimize their cognitive andmental health functioning.
Kira Yakubov (46:31):
That's beautiful.
I love that. And so for thelisteners, can you share how if
they want to get in touch withyou or work with you or find
your website, anything like thatthey can reach out to you?
Karen Wilson (46:40):
Absolutely, they can go to childnexus.com That is
the hub where they can get allthe information. That's where
our blogs are. That's where thelink to our podcasts are. If
they want to join a parentlearning group, you know,
they've just been their childhas just been diagnosed with
ADHD or anxiety or dyslexia. Andthey want to learn more than
(47:00):
they can join one of thosegroups right on the website. And
if they want, they don't knowwhat they need, they can book a
consultation, a 45 minuteconsultation and get some
answers to their questions. Andif they want to reach out to me
directly, they can email me atDrKIWilson@childnexus.com.
Kira Yakubov (47:19):
Wonderful. This has been super insightful. All
the knowledge and expertise youbring on. I'm really honored to
have you on today. Karen, thankyou so much for giving us your
time and sharing your story withus.
Karen Wilson (47:30):
Thank you so much for having me. It's been such a
pleasure,
Kira Yakubov (47:33):
of course
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