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In my private practice, I have the privilege of working with fantastic children, teenagers and their families. They all display many strengths including their imagination, passion, determination, creativity and positive high energy. Many of them often begin their counseling journeys with similar goals such as:
I find that in our society, children are often engaged in various treatments & interventions, take medication, have conflictual family relationships, feel socially isolated or rejected from peers and more… yet are not given the information and tools about how “their mind works” and that “having a different kind of mind” from others, is just fine, and in fact a positive thing. Children are aware of their strengths and weaknesses in relation to their siblings and peers instinctively, but without a clear structure of how to think about it, they are left to dangerously imagine their own reasons for these differences such as “I am mental, I am crazy, I am weird, I am not understood, I feel alone.” For the purposes of this discussion, I would like to focus on ASD, Autism Spectrum Disorder and ADD, Attention Deficit Disorder. However, parents are encouraged to use the principles below and apply them to various diagnosis discussions with your own child or teenager. You will want to adapt accordingly for your child’s specific diagnosis (including medical and/or mental health related), language and comprehension ability, age & developmental level, and always to your own genuine family style & culture. Some of the reasons I often hear from parents about why they have chosen not to disclose a diagnosis to their child may include: “They are too young to know.” “They won’t understand or care.” “They may get better or grow out of it.” “They might use it as a crutch for every trouble they experience.” “We are scared of their reaction and how they will feel about themselves.” “We don’t want others to treat them differently.” Most practitioners and educators would agree that even if these concerns are valid, it is still more helpful to the child to share some information with them to instill some self-awareness and understanding that can combat possible negative self-concepts such as shame, anxiety, inferiority, troublemaker, not accepted for who they are, and feeling misunderstood. Talking about their diagnosis gives your child a valuable chance to ask questions. It may also be relieving to them when they learn to normalize and accept the special ways they experience life. It also helps your child see why treatment is helpful, so they are more likely to buy-into & take an active part in their own treatment and advocating for their own goals. Temple Grandin is famously quoted to say, “I am different, not less.” It is vital for all children to know and accept who they are in a safe and measured way, including their strengths and weaknesses, rather than let their inner fantasies and other people’s misconceptions, guide and determine their self-image for a lifetime. And we know that incorrect or generalized negative labels can be both be a self-fulfilling prophecy, and hard to overcome. In addition, the reader may reflect on the following: Greater Self-Knowledge & Self-Awareness leads to --> Increased Self-Advocacy and Self-Actualization which can lead to --> Improved Equity for your child or teen across the many areas of life. Milestones Autism Resources (2017) described self-advocacy as an individual’s ability to effectively communicate, convey, negotiate or assert his or her own interests, desires, needs and rights. We all want this for our children as parents step back, and they grow into teenagers and then young adults. However, the first important step in this process, is Self-Knowledge. Your child must understand their own strengths, tastes, identity, feelings and needs as early as possible to make their own choices in life. Choices may include how to spend their free time, speaking to how they are responding to specific medication type and dosage, what qualities and common interests they are looking for in a friend or future romantic partner, what passions do they want to pursue post high-school, and more. Without Self-Knowledge & Self-Advocacy, Equity is more out of reach: There is also an important concept of Equality vs. Equity that affects us all, neurotypical and neurodivergent. Equality is treating everyone the same. Equality aims to promote fairness, but it can only work if everyone starts from the same place and needs the same help. Equity is giving everyone what they need to be successful. For example, Equity is very important to keep in mind for teachers as they differentiate their teaching in the classroom to meet the individual needs of all their learners. Fair is not equal, but fair is equity: receiving what an individual needs to be successful. But imagine if your child ‘refuses to ask for help from others’, or ‘does not know what kind of tools help them learn best vs. what distracts them’ or they have ‘not practiced how to calmly and maturely self-advocate their individual needs in an appropriate way.’ What typically happens thereafter is decisions get made for them instead of with them. Steps for Families to Consider: When your family is ready to share this information with your child, here are some recommendations below to help begin this journey, towards a continuous process of understanding. (adapted from on online article from: Intermountain Healthcare Primary Children’s Hospital, 2018).
I hope this information has been helpful, inspiring and empowering to parents and caregivers, schools and community members. Self-Knowledge of why we all do what we do, only deepens our understanding of our choices in life. And sharing it through self-advocacy helps us share how we can be our best; while in turn, learning and developing greater empathy about the many differences and similarities in us all Monica Fyfe is the Founder & Executive Director of OUR VILLAGE, a 501 (c)(3) non-profit agency that provides evidence-based Play and Social skills groups to children, teens and young adults. She is also a mother of two and grew up in the South Bay! Monica is a Licensed Marriage and Family Therapist, #47541, Board Certified Behavior Analyst, and Registered Play Therapist-Supervisor. Monica is an Adjunct Professor at Pepperdine University in the Graduate School of Education and Psychology and an Instructor in the UCSD Play Therapy Certificate Program. Monica works in Redondo Beach, CA at her private practice business called Play 2 Learn. Please visit these websites for more information at: www.p2lfamilytherapy.com and www.ourvillageslc.org References & Resources for Families: The Milestones Autism Website lists several self-advocacy skills by age that children and teens with ASD should strive to accomplish: http://milestones.org/individuals-with-asd/self-advocacy/ © 2018 Intermountain Healthcare, Primary Children’s Hospital, “Let’s Talk About ADHD: Talking with Your Child.” https://intermountainhealthcare.org/ext/Dcmnt%3Fncid%3D521377860 The Wimpy Kid: Do it Yourself Book “What’s in Your Brain?” https://diary-of-a-wimpy-kid.fandom.com/wiki/The_Wimpy_Kid_Do-It-Yourself_Book Demystifying Autism: The Friend 2 Friend Simulation Game Program by Heather McCracken, Friend 2 Friend Social Learning Society © 2009. https://www.friend2friendsociety.org/autism-demystification/ American Academy of Child and Adolescent Psychiatry (AACAP) (search for ADHD resource center)https://www.aacap.org/aacap/families_and_youth/resource_centers/adhd_resource_center/Home.aspx Centers for Disease Control (CDC) Autism page at: www.cdc.gov/ncbddd/autism Understanding Autism Spectrum Disorder: A Workbook for Children and Teens, 2nd Edition, by Robert Jason Grant Ed.D. AutPlay © Publishing, (2018). https://www.autplaytherapy.com/store/ Driven to Distraction (Revised): Recognizing and Coping with Attention Deficit Disorder by Edward M. Hallowell M.D. & John J. Ratey M.D. Anchor House, A Division of Random House, Inc. New York (2011). The ASD Workbook, Understanding your Autism Spectrum Disorder, by Penny Kershaw © 2011. Different... Not Less: Inspiring Stories of Achievement and Successful Employment from Adults with Autism, Asperger's, and ADHD (Revised & Updated) by Dr. Temple Grandin, New Horizons, Inc. USA (2020). All Cats Have Asperger Syndrome by Kathy Hoopmann, Jessica Kingsley Publishers, London (2006). All Dogs Have ADHD by Kathy Hoopmann, Jessica Kingsley Publishers, London (2008). Smart but Scattered: The Revolutionary "Executive Skills" Approach to Helping Kids Reach Their Potential by Peg Dawson and Richard Guare, The Guildford Press, New York (2009). Taking Charge of ADHD, Third Edition: The Complete, Authoritative Guide for Parents by Russell A. Barkley. The Guilford Press, New York (2020). (THIS ARTICLE BLOG WAS SHARED WITH SOUTH BAY FAMILIES CONNECTED AND FEATURED ON THEIR SPECIAL NEEDS RESOURCE PAGE FOR THE COMMUNITY) https://dana-brawer-ehhy.squarespace.com/blog/discussing-the-diagnosis This article by Monica Fyfe, was featured in "Inclusive L.A. Parent Newsletter in L.A. Parent Magazine"- https://www.laparent.com/social-skills-tips
Play Skills Groups and Social Skills Groups are really an art to create. There needs to be careful planning & matching of peers, inclusion of peer mentors, and a fun and creative atmosphere. There also should be adherence to using research-based techniques and interventions. One helpful and efficient technique that parents can also employ at home is called a Teaching Interaction. Teaching Interactions (or TI’s) were developed in 1974 by Minikin & colleagues, as a Teaching Family Model. Since then, thanks greatly to the work at Autism Partnership in Seal Beach, TI’s are commonly used for breaking down and teaching a social skill to children in play groups, ABA treatment and counseling settings. This technique is so powerful, simple and easy to implement, that all parents can easily implement it into their toolbelt of skills and become their child’s own personal “social coach.” Once you have the steps down, your child will like how systematic it is, how predictable it is, and how it can be a lot of fun! There are 6 steps that need to be taught in order for a Teaching Interaction: 1). Label & Identify the Skill to learn Dr. Dan Siegel often advises, “you have to name it to tame it.” So, for our children to understand exactly what we are talking about and know what we are looking for in them, we need to operationalize the skill and give it an age-appropriate, short NAME. This way we are clearly on the same page about what is expected, without adding confusion or judgment. For example, instead of saying to your child, “we need to practice how you overreact or run away every time your peer annoys you, and you are making it much worse by totally ignoring it or blowing your top in front of everyone!” Say this instead, “we are going to practice BRAVE TALK.” 2.) Provide a Rationale about the skill Here you always want to include your child’s rationale for “buy-in” and motivation. You can ask “Why is this skill important?” or “What do you think that means?” Write out all the rationale reasons your child gives you on large piece of paper or a white board. Then summarize them and add your own rationale to the bottom. We want to encourage the child to find their own motivation to work on a challenging social skill; not merely accept an adult’s reason in a Top-Down power structure, such as “It’s important because I say so” or “I know the right way to do this because I am older than you.” These types of reasons will surely shut down a child from learning and embracing an important new skill. And we want their minds open and ready to learn something new, as well as keep their buy-in throughout the process. 3). Adult models the skill through Description and Demonstration including “what to do” and “what not to do” In this important step, Role-Play (act out) or create Drawings with Talk Bubbles to show your child visually what the skill should look like, appropriately. In addition, the adult should be the only one to provide a non-example or “what NOT to do.” Even though it might be fun for your child, it is not advised to have your child practice “what NOT to do” because we don’t want this non-example to inadvertently become part of their social skill repertoire. The parent can act this out with another adult or mentor child/teen, what we call in our social skills groups “an advanced player.” It is important to keep this step playful, fun and embedded with humor! It is also fun to use props such as Movie Clipboards or Megaphones, Video-Modeling, Puppets and more! We like to say the phrase “Ready, Set, Action” before we do the Role-Play and then “Cut!” when we are done. 4). Child Practices the skill through their own Role-Play or what is called a “Behavior Rehearsal” Here the child can practice the role-play steps with another child (like in our groups), a friend or sibling, puppet, or with the parent! It is nice to teach your child a fun way to discriminate what they are seeing and doing as appropriate vs. inappropriate. They should rate each role-play or drawing throughout the TI process. In our groups, we like to use a non-verbal gesture of Thumbs Up and Thumbs Down. It is always interesting when your child rates something as Thumb sideways as this gives you both a great moment to explore their thinking process together. For verbal responses, we like to use the following rating phrases, “cool” vs. “not cool” or “new” vs. “old” or “helpful” vs. “not helpful.” Stay away from labels that add criticism and judgment on the person instead of the skill such as “good/bad” or “right/wrong.” 5). Have children practice on their own and provide them with Feedback Continue to have the child or children practice until everyone gets a turn and provide positive feedback with some minor corrections. We don’t want to shut down our child, but we do need to give them gentle feedback and corrections in safe setting, before they generalize that skill to the natural setting with peers. For example, “I like the comeback you gave to your brother when we practiced that was short and not offensive, way to go! Remember don’t forget to walk away as fast as possible so you don’t keep the argument going.” 6). External Consequences may be given, Optional In this last step, you can get creative and survey your child for what kind of reinforcement they might like paired with this fun Teaching Interaction! Always start with Specific Verbal Praise such as “I love the way you tried something new” or “Wow I can really see you got this Brave talk down!” If you need some additional motivation, you can pair with small tangibles, special time with you or friends, or marbles/pom pom’s in jar working towards an activity that is “socially fun” with others! In the end, remember Social Skills need to be taught! Especially for our children that don’t do as well naturally learning and imitating by observing others. If we don’t teach them, these skills are at risk of skipping a generation, which can lead to many problems of poor interaction, inclusion and empathy in our community as our children get older. Try this simple, effective, fun and research-based intervention of Teaching Interactions (TI’s) out with your family! And we hope over time you can add your own natural family style and culture, and make it your own! To find out more about the many Social Skills Groups and Play Skills Groups for Children, Teens and Young Adults offered by Monica Fyfe and the many wonderful clinicians at OUR VILLAGE, a non-profit agency, please visit www.ourvillageslc.org for more information! "Social Skills Tips for Parents" by Monica Fyfe, was featured in "Inclusive L.A. Parent Newsletter in L.A. Parent Magazine"- https://www.laparent.com/social-skills-tips |
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