Video: Anxiety Strategies for the Twice-Exceptional Child

Monday, Sept 20, 2021, 7-8:30pm

Our recent parent survey results show that anxiety is a HUGE concern for parents of 2e learners. Neuropsychologist Dr. Vivien Keil joins us to talk about why 2e kids experience anxiety as well as strategies and solutions to help both at home and in school.

Students who are twice-exceptional (2e) have tremendous intellectual gifts alongside a wide range of possible learning challenges — attention differences, slow processing speed, social immaturity, and/or weak executive function skills, just to name a few of the possibilities. This asynchronous development can make it extremely challenging to meet their unique needs and contribute to significant anxiety. Learn more about the profiles of 2e students, why they experience anxiety, and how parents and educators can help support these exceptional youth.

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https://www.chconline.org/people/vivien-keil/

Dr. Keil is a Pediatric Neuropsychologist and Consultant at CHC in Palo Alto. She specializes in the developmental evaluation of young children and neuropsychological evaluation of children and adolescents. Her goal as a clinician is to understand the whole child as she strives to balance the clinical perspective with a strengths-based approach. She is passionate about working collaboratively with parents to help them understand their child’s strengths and weaknesses so that they feel empowered to advocate for their child’s unique learning and mental health needs. Dr. Keil earned her Bachelor’s of Science degree in Cognitive Neuroscience from Brown University, graduating Magna Cum Laude. She earned her PhD in Clinical Psychology from the University of California, San Diego.

Recording

Read the transcript here

Welcome and Introduction 0:00 - Welcome everyone, we're so excited to have you here. I'm Yael Valek, one of the co-founders of REEL along with Calli Turk who's unable to attend tonight, and we have a new member of our team Abby Kerrigan who will introduce herself momentarily. For those of you who are not familiar with REEL, our mission is to ensure that twice exceptional students thrive in school by raising parent and educator awareness and understanding through resources, tools, events such as this one and services.

Brief Overview of 2e 0:38 - Dr. Kyle's going to cover this in a lot more detail but just briefly, twice exceptional kids have both distinguishing strengths and complex challenges at the same time. You can see some of the examples here and just to let you know that REEL has many resources on our website reel2e.org including fact sheets that you can share with your teacher, checklists to check to see if your child might be twice exceptional and all kinds of other amazing resources that might help you through your 2e journey.

Upcoming Events 1:16 - We have a few more speakers slated for the fall. We're launching our 2e parent support group with Parents Helping Parents on October 7th. On October 28th we are having a private school parent panel where several parents will share their experiences and we'll also have an educational consultant. In early November the Stanford Neurodiversity Project is having their second summit which is three days of amazing speakers about neurodiversity including three sessions that are co-created by REEL for the K-12 audience. One of the biggest struggles that we hear from people is that 2e students struggle with writing, so the renowned Dr. Susan Baum will be speaking in November to help us with some tips on writing. You can RSVP to all the events on our website.

REAL Resources 2:06 - REEL also hosts a Google group where you can ask questions and get answers from other parents on our website and we're also on Facebook and Twitter. You can follow us for interesting posts related to 2e and we also offer a workshop menu that you can share with your school, your teacher, your district. We will come and do any of these sessions currently at no cost for your district in order to help them learn more about 2e students.

Speaker Introduction - Dr. Vivian Kyle 2:42 - Dr. Kyle is a pediatric neuropsychologist and consultant at CHC in Palo Alto. She specializes in the developmental evaluation of young children and neuropsychological evaluation of children and adolescents. Her goal as a clinician is to understand the whole child as she strives to balance the clinical perspective with a strength-based approach. She is passionate about working collaboratively with parents to help them understand their children's strengths and weaknesses so they can feel empowered to advocate for their child's unique learning and mental health needs.

3:27 - Dr. Kyle has nearly 20 years of experience working with children and families. She completed her pre-doctoral clinical internship at Children's Hospital of Orange County and her post-doctoral fellowship at the UCLA Semel Institute for Neuroscience and Human Behavior. Following licensure she worked at the Neurobehavioral Clinical and Counseling Center in Orange County with a focus on conducting comprehensive psychoeducational and neuropsychological evaluations on children and adolescents with both mental health and medical diagnoses. In addition she was a supervising psychologist at the Department of Outpatient Psychiatry at Rady Children's Hospital San Diego where she focused on providing evaluations and psychotherapy to diverse and underserved populations. Dr. Kyle earned her bachelor's of science degree in cognitive neuroscience from Brown University graduating magna cum laude. She earned her PhD in clinical psychology at the University of California San Diego.

Introduction of Abby Kerrigan 4:20 - Just before I let her get started after all those amazing accomplishments I just wanted to briefly introduce Abby who's the newest member of the REEL team. I don't want to take too much time from Dr. Kyle but I'll just say hi, I'm really excited to be joining Yael and Cali working at REEL. I'm a graduate student with Cali at the Bridges Graduate School of Cognitive Diversity and I also work part-time in administration at a school. I have three kids, two of whom are twice exceptional, and also have a background in computer science and design so really excited to be working with the team and I'm excited to get to know you all.

Dr. Kyle Begins - Collaboration Note 5:07 - Thank you Yael and Abby and I will say I do hope that you also feel free to chime in along the way. There might be questions in the chat box or just things that you can answer from your lived parent experience and I do feel like that's often what can be most valuable for families so please feel free to share your experiences and suggestions as well. I should tell the audience too that Dr. Kyle will present for about 45 minutes and then we're leaving a lot of time for Q&A afterwards so please feel free to add your questions and we will ask them at the end.

Children's Health Council Overview 5:48 - I will do my best to stay on task in terms of time and in doing so I will kind of speed through some of these introductory slides because I'm sure they'll be made available to you after the presentation to the REAL community and those who registered. Just a little bit about CHC - we're a community-based non-profit, we've been around for almost 70 years, so we're quite rooted in the Bay Area community. These are our specialty areas: ADHD, LD, anxiety, depression and then autism or you might hear the acronym ASD for autism spectrum disorders.

6:27 - We have several divisions at CHC and if you're looking for for example an evaluation or psychotherapy or anything of that nature that would be our clinical services division. Another really exciting development that is evident on our website but not yet on my slide deck is that we have the Schwab Learning Center at CHC now. Some of you may have been familiar with the Schwab Learning Center - it used to be at Stanford but it is now actually at Children's Health Council. The Schwab Learning Center works with high schoolers and college age students who have a primary concern around either ADHD or learning difference. So something to keep in mind and certainly check out the information that's available on our website.

Today's Agenda 7:20 - To kind of tailor things and provide an outline for our talk today, these are all of the things that will be covered. It is a lot in part because thank you to all who registered - we got a ton of questions from all of the registrants. One of the things that I noticed too is that we have a pretty equal distribution in terms of questions about school-age children versus the middle schoolers versus the high schoolers. So we have the full age range here and so I tried to make this talk more general so that hopefully everybody regardless of the age of your child or teen can kind of come away with maybe a couple of new strategies to consider.

8:02 - I will go into sort of the definitions of giftedness, 2e and developmental asynchrony but very briefly because I think that it is sort of foundational with the REAL community that these are things that have been discussed already but I will keep it in the slide deck for those who want to refer to it later. I will also be discussing a little bit about - it's actually Susan Baum who will be doing a REEL talk - the strengths based approach to 2e out of her book "To Be Gifted and Learning Disabled". Then we're going to go ahead and jump into perfectionism, anxiety, how to understand and talk about big emotions and what some strategies are that might be helpful for the home and school environment and also a bit of an overview of the evidence-based treatment, actual therapeutic approaches that are out there for anxiety.

Not on Today's Agenda 8:57 - These are the things that are not on today's agenda. We just don't possibly have time to cover all of this and so if your primary purpose in being here were any of these items I will not take offense if you decide you would like to log off. We won't be getting into specific diagnostic criteria or really tailoring interventions to your specific child because we just don't have the time to do it and that requires a considerable amount of thought to figure out kind of what the exact nuance is in your child's profile. Also not discussing advocacy even though this is hugely important in the 2e space, advocating particularly in the school setting. I am sure there will be more presentations just on the topic of advocacy.

Definition of Gifted 9:53 - Let's jump in and just talk definitions essentially. What does it mean to be gifted? The word gifted is used fairly commonly in the lay public too. In terms of the clinical science behind it, typically what it means is that you have exceptional cognitive potential and usually that is measured by standardized and well-established IQ tests. Particularly you'll see the Wechsler scales used quite a bit so you'll hear about the WPPSI for preschoolers, the WISC for school age kiddos and then the WAIS for your 16 plus crew.

10:26 - Historically the cutoff has been set at 130, so essentially - and some of you may know about the Nueva 130, that's done on purpose - that is two standard deviations above the mean which is average is 100. So a 130 is two standard deviations above that, so you're basically in terms of your problem solving and your intellectual capacity you're functioning at about the 98th percentile relative to your same age peers.

10:58 - Something to keep in mind though is that there is of course lots of discussion around whether it be the theory of multiple intelligence or anything in that vein. Of course there are other immense talents out there whether it be science, engineering, music, creativity - there are lots of ways that your children can be gifted. But typically in terms of testing when you're talking about evaluations and things like that you're talking about cognitive capacity.

The Bell Curve 11:29 - The reason why I throw this bell curve up here is because I think if you look to the far right and you see that 130 marker for example, it is a really nice depiction of how different your child is functioning relative to the masses. Most people hang out in kind of the middle of the bell curve, but if you're functioning at that 98th percentile you are quite different than most of your peers and I think that's where a lot of that social isolation comes in and feeling like you're really really different and you don't fit in.

Definition of 2e 12:09 - So that's gifted. If you step into the 2e world essentially what that means is you have this exceptional talent or cognitive ability and you also have significant challenge areas or a disability, whether it be dyslexia or ADHD or autism spectrum disorders. You may also have identified weaknesses that aren't necessarily a diagnosis which would be things like slow processing speed, weak working memory, poor executive functioning skills. Those aren't clean diagnoses like an attention deficit hyperactivity disorder but they're still very much impairing.

12:56 - I think what's hard about the 2e umbrella is that there is so much heterogeneity. So your 2e child probably looks very different than Abby's 2e child or Yael's 2e child, right? And so the challenge there is that sometimes it can be hard to find your community because your child is just different in a number of ways and they don't fit into buckets.

13:27 - I think the other challenging piece of being a part of the 2e community is that it is one of the clinical areas where you have to be collaborating just as closely with the educators as the clinicians. They sit in these two worlds, both of which have a hard time making complete sense of them and so it creates a ton of stress on the family and particularly the caregivers. Because you're struggling to find the right environment and the right teachers and everything like that.

2e Profile Example - Belin-Blank Center 14:03 - This is a graphic of a 2e profile and this is from the Belin-Blank Center. If you have not yet gotten connected with their website, the Belin-Blank Center at the University of Iowa, they have a really strong research presence around 2e. I highly recommend that you visit their website and you take a look at some of their online resources. This is from one of their parent packets, you'll see the website below.

14:33 - What this shows us graphically is that you have on the far right this exceptionally bright kid who reasons at a very high level in the high 90s. But if you take a look at that processing speed, their processing speed is 56th percentile - right smack dab in the middle of the bell curve. That's a big problem from a functional output standpoint and a frustration and anxiety standpoint because here you have this kiddo whose ideas and thoughts are coming at a very deep level but he struggles with just the output of work. So whether that be getting his thoughts on paper or completing assignments in a timely manner, you would think that he might be finishing up things faster than his peers given how bright he is but that is not the profile that he has. It takes him a long time just to get assignments out.

Developmental Asynchrony 15:34 - So that profile that I just showed you is a depiction of what's called developmental asynchrony which is essentially uneven development where you have these highs and these peaks and lovely strengths but you also have strikingly significantly lower valleys or weaknesses. That unevenness in development is called developmental asynchrony.

15:57 - You'll see here there are additional examples both coming very much from clinical cases that I've seen. So you've got this eight-year-old who is a phenomenal reader and reading comprehension is exceptionally high but impulse control, emotional regulation, social skills is more like a preschooler. Or on the flip side you've got a teenager who has these exceptional cognitive abilities but their processing speed is relatively slow and much slower than their actual cognitive ability.

Why Does This Matter 16:39 - Why does this matter? It matters a great deal because there are large, there are lots of peaks and valleys typically in the 2e profile much more so than your neurotypical profile. Because their peaks and valleys are so great, very often these kids feel - these are their words - dumb, deficient. I think of an eight-year-old girl who was significantly dyslexic but a 140 and she came into my office and said "I know you're going to tell me I'm stupid." That really was her experience of what it was like to cognitively be quite capable but unable to read even at a great level despite all of her - the engine that was inside of her, her LD was so impairing that she felt like she was stupid.

17:36 - So I bring up all of these examples because I think they get at why do our 2e kids feel anxious - it's because there's a ton of inconsistency in their strengths and weaknesses. It doesn't make sense to the average educator, quite frankly it doesn't make sense to the average parent. You might be ahead of the curve and have a lot more knowledge on this topic but I think to the average person you don't expect these striking peaks and valleys. And so we have a hard time making sense of them, they have a hard time making sense of themselves. You can see how that would be a breeding ground for anxiety.

Flipping Our Systems - Susan Baum's Approach 18:23 - So what does Susan Baum say? Her and I am in full agreement with her that one of the things that we have to do is try and flip our systems on their heads a bit. In terms of I think certainly my field, the clinical field, is very deficit based. That is literally our training, that is why I went to graduate school so that I would be able to find those weaknesses and then be able to put together some treatment recommendations. That's a problem. It's very hard to identify and grow strengths when you have more of a deficit based model.

19:00 - So I really love what Susan Baum and our colleagues have put forth which are: here are some of what 2e students need. They need a psychologically safe environment - you all know that's easier said than done, we'll talk about some strategies that can perhaps help us get there.

What 2e Students Need 19:13 - First and foremost it has to be strength-based, talent focused first. You have to grab the strengths before you go after the challenges. And I think that that order is critical.

19:33 - So for example, your child has dyslexia. The interventions for dyslexia are very very intensive - for those of you who have been in that camp you have to do either Orton-Gillingham, Lindamood-Bell, Wilson reading method. These are typically daily, oftentimes multi-hour interventions to remediate that dyslexia. So I get it why parents and clinicians might say you've got to focus on that, he doesn't have time for his soccer team. Don't do that. If that is his love and passion you don't want to take away their talents, their time for their talents in order to just keep on hammering away at the weaknesses.

20:18 - Think about what if your boss did that to you and if they said to you "Vivian you're really bad at this so Monday through Friday I want you to do this every single day." How likely would it be that you would like to stay in that job? Fairly unlikely. Whereas if you allowed your child to do their favorite favorite things still while then supplementing all of those remedial supports, they still will feel that you're honoring their talents and not focusing on basically all of their deficits.

21:03 - Relationships are key - I don't need to tell you this. I think this tolerance for asynchronous behaviors is a big one, so meaning these kids need to be seen for who they are. I think sometimes especially with the unseen weaknesses in processing speed, working memory and executive functioning, because they're so bright but they can't seemingly do something basic like getting a worksheet done in a reasonable amount of time - unfortunately they're not tolerating the asynchronous behaviors. They probably think the kid is lazy or unmotivated and not really seeing that no, this is actually one of their valleys despite the fact that they have these really high peaks. So you really have to accept and see those valleys for what they are and be careful about the expectations that you're setting for that particular child.

22:12 - Time is oftentimes incredibly important because a lot of kids with that 2e profile have slower processing speeds. And for them it might just be a quote "average" processing speed but it's still for them a significant barrier.

Strengths-Based Approach 22:25 - We've talked about this already so I won't belabor it more but I think the most important thing to keep in mind again is that always the way around and the way to improve their weaknesses is typically through their strengths. So grabbing them there - if there is a math issue on board and you know you have a kid who loves baseball, the good thing is that there are a ton, there's a ton of math in baseball. So the more you can apply school lessons and things like that to their world that matters to them, whether that be sports and statistics or baseball statistics or anything like that, that is the path of less resistance if you're going after a math LD for example.

Perfectionism and Anxiety 23:18 - Okay let's just jump into perfectionism and anxiety because I know everybody wants to chat about that. Perfectionism defined - what that is is a personality trait where someone, and this is applicable to grown-ups too, possesses an overwhelming desire to succeed at very high levels.

23:36 - There are two camps of perfectionism: adaptive and maladaptive. Adaptive is great - that is what helps you be successful, that is what helps you strive to always improve. If you can have an adaptive perfectionism it's kind of like that lifelong learning concept where you're always striving to get better.

24:00 - A maladaptive version of perfectionism is you know one who basically can't cope with any level of failure. So mistakes are not acceptable under any circumstance. So they want to be an engineer and they come home with a B on a math test and so hence therefore they now have assumed "I will never be able to be an engineer." That is a very maladaptive approach to perfectionism.

Bay Area Culture and Perfectionism 24:38 - Something to keep in mind is that it is very much baked into the Bay Area culture. So you can't escape perfectionism in terms of - and anxiety in terms of it being kind of woven into the fabric of our very high intensity, high achievement oriented, high success, high education culture that is the Bay Area.

25:03 - And I mentioned this because I have had the opportunity to work with lots of parents and certainly am a parent myself. You might have your values within the walls of your home in terms of praising efforts and not getting hung up on the 100 and everything like that - that is fantastic and I encourage you to keep holding on to those family values. That does not mean that this bullet does not apply to your family because they're hearing and seeing different things in their school environments. You can only protect your social world so much - they very much are products of the Bay Area.

25:43 - So having honest conversations, especially if you've got a teenager in the house. If you say to your teenager "you know all I want for you is to do what you love and for you to be happy," quite frankly that teenager might say back to you "that's great mom, you just don't get it." And so unfortunately that's an example for teenagers in particular of their parents not getting it because that is not the primary message "just be happy" - that is not the message that they're getting from their peers at Paly or Gunn High School or Menlo School or insert whatever other high achievement orientated school here. So acknowledging that influence in your child's life I think is important so that they feel heard.

Anxiety Defined 26:30 - Anxiety - so perfectionism and anxiety exists, consider it like a continuum. You can see how perfectionism can then turn into anxiety. In its best forms anxiety is fantastic, it helps keep us safe. You want your kid to be scared about crossing the streets without looking - that's anxiety, it's fear that keeps us safe in certain situations.

27:02 - The problem is is that anxiety disorders happen when our anxious response, whether it be heart racing or panic or whatever it is or just a more of a diffuse uncomfortable stressed feeling, the problem is when that response applies to situations that are not dangerous. So for example, assuming your kiddo has not been in an actually dangerous bullying situation at school, kids shouldn't feel scared to go to school. So their anxiety is interfering with their everyday task which is going to school.

27:37 - Now I'm not, we're not talking about COVID fear - I think that that's just a part of our fabric right now that complicates things a little bit. But hopefully you see the point which is just that if it's applying to everyday life circumstances that should not be fear provoking or dangerous or scary, that's when we as clinicians will say oh that's more of an anxiety disorder as opposed to just maybe a thread of anxiety. And that's because it's impairing their ability to engage in their everyday life.

Anxiety Short-Circuits Everything 28:09 - Something that's important to keep in mind with anxiety - it short-circuits everything. Probably many of us have encountered this as a grown-up - if your anxiety is too high you don't think clearly, you're in more of a panic fight-flight state and that is not when you do your best learning or your best planning or organizing or problem solving. So it's true for our kids just as it is for us.

28:39 - Something else to keep in mind is that anxiety disorders are incredibly common. So if you're in this camp you're in a large camp because about 30% of children and teens will meet criteria for a full-blown anxiety disorder at some point in their childhood or adolescence. So you are not alone, your child's not alone at all. There is a huge community here that knows exactly what you're going through.

Causes of Anxiety 29:17 - In terms of figuring out the causes we know that it's a combination of both genetics and environmental factors. Understanding where it's coming from with your child is helpful and I always tell parents you really do know your child best more so than the teachers, more so than the clinicians, more so than the grandparents or other family members who have an opinion. And you might not know the answer and that is okay. If you don't know where it's coming from I think the thing to focus on really is: has there been a change in my child or a decline in their everyday functioning or impairment in their ability to just do things that they previously enjoyed? Those are all red flags to get connected with a behavioral specialist like a therapist or a psychologist or someone who can help figure out what supports are needed.

Anxiety in 2e Kids 30:17 - For 2e kids the source of the anxiety can be a number of things. Sometimes it really is the asynchrony and them feeling deficient and incapable in certain ways. Sometimes it has to do with really really unrealistic expectations whether that be from the child, caregivers, teachers. Adults are really good at setting expectations and unfortunately sometimes we set them too high. We don't fully understand where they should be. So thinking about what is the realistic expectation here.

30:59 - If you, when I think about some of the 2e kiddos with really really high verbal IQs, if your kid falls into that camp those are the ones that usually clinicians and teachers, we love them because they are all about verbal communication. What we do unfortunately naturally as human beings is when we assess somebody's communication skills, if they're really really high in that area we tend to set the bar there for everything else. So being mindful of the fact that if you've got a high high verbal IQ kiddo and they've got other significant weaknesses that are far lower than that verbal intelligence or verbal problem solving, it's very likely that they're going to get hit with sort of a mismatch of expectations at some point.

Understanding Anxiety - The Whole Brain Child 31:56 - Before we start getting into specific strategies for anxiety, I'm going to back up a little bit and talk about anxiety more just as one of our big emotions. Because a lot of what the interventions focus on are just talking about emotions very simply and anxiety is one of those.

32:20 - For little kids in particular, so your school age crew I'm talking to you here - although if you have a 2e profile where social emotional is quite, is much lower, if you've got a middle schooler but their social emotional profile is much more like a school-aged child this might work just as well for them. This is from the book "The Whole Brain Child" - that is Dan Siegel and Tina Payne Bryson. It's a fantastic book in terms of giving parents a language for talking about emotions. I think this is especially crucial if you have a highly intense emotional child - you need a language, a common language to talk about their experience.

32:55 - So the visual here is very much just using your palm as a brain, this is your model of the brain. And when they're anxious or having a meltdown or just having a behavioral outburst, which is oftentimes anxiety, they call it "flipping your lid." So there's this nice visual here and it doesn't require words. If you have a kiddo who really struggles with that verbal output, after you teach them this model this can be their symbol for "I've lost it," "I've flipped my lid," "I am not in a place" - when any of us are in this space we are not able to problem solve. This is true for grown-ups too, feel free to use this on your significant other because the same thing applies.

34:00 - Because when basically your frontal lobe has gone offline because you're in an entirely sort of anxiety driven state, you're just functioning out of this sort of fight-flight response which is the lower part of your brain as opposed to the prefrontal cortex which of course helps us plan, organize, problem solve, all of these lovely things that we would love to see for everyone really. So this is one useful way to start talking about emotions with your young person.

Upstairs vs Downstairs Brain 34:29 - Another helpful visual is talking about an upstairs brain and a downstairs brain. It is very much similar, it's just a different way to think about it. So the downstairs brain is this part right here, it's the one that is essentially your fight-flight response and where anxiety lives versus your upstairs brain which is like your prefrontal cortex - lots of good problem solving regulation happens there. So establishing language around when they're in different emotional states becomes a very helpful tool in problem solving.

Personal Example 35:09 - Funny personal story on this upstairs downstairs brain - I was working on this slide deck last week and my son, my six-year-old was home because they had teacher conferences at school so he's hanging out next to me and he's like "mommy what's that?" So I'm explaining to him the upstairs downstairs brain and he says to me "so when I had my meltdown earlier that was my downstairs brain" and I was like "yup that is exactly right." And it's funny because I didn't mean for this to be a teaching tool for him but it was such a funny reminder about how these simple visuals can be really useful even for very young kids.

35:54 - Visuals are great, they are interested in how their brain works. So if you can start laying the groundwork for upstairs brain and downstairs brain it just gives you a way to chat about these things when your child has dysregulation challenges. And then that same evening he came upstairs to get his teeth brushed and he said "mommy I'm in my upstairs brain" because sometimes he doesn't go along with my plans for brushing his teeth and so he was very proud of himself for being in his upstairs brain. So think about how you might be able to integrate some of this language into your kids' life - not when they're having meltdowns. Don't do any of this teaching when they're in their downstairs brain. All of this has to set the stage later when everybody's in a good space.

The Importance of Language 36:47 - So what you'll notice is there's a theme of language in the last couple of slides and the next few slides. Language is everything in setting a foundation around managing anxiety and promoting regulation.

Growth Mindset 37:02 - So you hear a lot about growth mindset. This is one of the many questions that were submitted so I'm going to try and give you some verbiage that you might find helpful. So how do we promote growth mindset? How do I help my kid think more like that? We want them to be more flexible thinkers.

37:24 - First and foremost, talk about strengths and weaknesses openly with all family members. If you have multiple children in your home and you have maybe only one that has a 2e profile and one that has a neurotypical child, you want to talk about strengths and weaknesses for both of those kids because we all have them. Similarly you want to talk about strengths and weaknesses for the caregivers in the home too because we've all got them.

37:52 - The reason why you're doing that is you're taking away the shame and the stigma of what it means to have weaknesses. Kids, even in their oppositional moments, they still respect and look up to parents. They have a tendency to think that we're perfect, we don't make mistakes. And so the more we can talk about our own weaknesses and our own mistakes the better framework you are providing for your child to get comfortable with that own idea for themselves.

The Power of Yet 38:19 - I also really love the idea of the power of "yet." So your child will make all sorts of statements about all of the things that they can't do. Forcing them to add "yet" to the end of the sentence is one way to sort of foster more of a growth mindset as opposed to a fixed mindset.

Process Praise vs Product Praise 38:45 - You will also hear about process praise versus product praise. So as much as possible you're trying to praise the journey and the process as opposed to the results. So if you have a phenomenal artist it's very - I do this all the time because I'm tired and I don't really want to think about what a process praise would look like and I'll just say "great job" to one of my kids. Oh I love it. If you can go the extra step to say "I love how much time you spent choosing the colors for that drawing" or "I love the details that you put into that tree," something like that. So you're you're praising kind of the effort that was put into the product. That's another trick to foster more of a growth mindset.

Modeling That Challenges Are Exciting 39:38 - As much as possible, modeling that challenges are exciting. So taking on an assignment with your kiddo and saying "oh this looks cool, what do you think we're going to learn today?" or "what are some new strategies that we could learn with this assignment?" or "do you think we'll be able to practice some of those strategies that you learned last week on this particular assignment?" Try and make it as genuine as possible.

40:01 - I know I have had my challenges with Common Core math and I really do try very hard to try and be enthusiastic about the 5,000 ways you can solve just a basic math problem. And that is, I have to learn to embrace that as well because I am a primary model for my child. So if I get fed up with Common Core, which I do sometimes - Common Core math I should say - I will talk about like "okay I'm having a hard time with this strategy because I've never learned this strategy before and I'm not exactly understanding why this strategy applies to this specific math problem." So that verbal problem solving, by doing that in front of your child you are showing them that it can be hard for you and you can still push through it.

Mistakes as Opportunities 41:07 - Similarly with mistakes - there are opportunities. These are opportunities to learn as opposed to things to be ashamed of. So for if you have a child who makes a ton of careless errors on math problems for example, you could say something like "oh wow it looks like that pink highlighter is really helping you pay attention to those signs." So you're highlighting that you've, that your child has learned something through the process despite it being difficult.

41:38 - And this is all good because your brain needs to grow and the only way that it's going to grow is by getting stronger in those things that are hard for you. And you can easily do a PE sports analogy here - you know how when I start exercising and then I'll complain that I'm so sore and I don't feel good, it's because I hadn't used those muscles. So this uncomfortable me being sore feeling or you being sore feeling, that means that you're growing muscles.

Other Language Strategies 42:19 - Other language strategies - you will hear about and may have already heard "name it to tame it," super catchy. Name it to tame it basically talks about how you need to apply language to whatever the emotion is. Emotions get out of control very quickly and I can't tell you how many times I'm working either I'm talking to one of my own kids or I'm working with another kid, if you ask them how they're feeling when they're having more of an anxious state or meltdown, they don't, they're not able to say "I'm frustrated because..." or things like that.

42:53 - And so the more you can just help them like "I can see that you're scared when you work on this assignment because I you know that there's gonna have to be a presentation at the end of this book report and I know that's not something that you typically enjoy doing." So helping them talk through - they don't have to provide the input if they can't but if you can label it for them you're helping them acquire a language for their discomfort.

Connect and Redirect 43:17 - Similarly, connect and redirect. So all this says is basically you don't want to, when somebody's in a highly elevated state that's not when you go into problem solving mode. That doesn't work well. If any of you have ever been in that state yourself and then your significant other tries to say "well why don't you do this, why don't you do this" and they start throwing solutions at you and it aggravates you.

43:51 - So you really need to sort of stop and validate the emotion like "I can see how hard this is for you" or "I can see that your school day was completely overwhelming." When you're in a better space let's sit down and problem solve and come up with things that might be able to make your school day go more smoothly. But we don't need to, don't force it then because they're just not in a receptive state.

Left Brain Right Brain Integration 44:15 - So ultimately the goal is - this is a left brain right brain. I am very much a left-brained person, I'm sure there's others of you on this call and then you have some folks who are very very right-brained. Ultimately regulation is integration, so you need to have both pieces to be sort of a well-regulated person. And you can have either in excess.

44:44 - What you really don't want with anxiety is for them to just stay in their anxiety with no language around it because that is a very heavy, it's a right hemisphere activation with little to no activation in the left hemisphere. So to give you an example, severe trauma, PTSD - and this includes for kids with PTSD and also adults who have severe PTSD like as a result of war for example - they have, if you scan their brains, their right hemisphere which is their emotional center is extremely over activated. Their left hemisphere is virtually, it's not active.

45:28 - So if you expose them to certain stimuli you see a lot of anxious responses in their right hemisphere and you don't see their left hemisphere lighting up on imaging studies. So what are the interventions for severe severe trauma which is basically the worst type of anxiety? The interventions are all around language targets. It is about trauma narratives and adding language to the experience. So that eventually they learn that there is a story here that they survived and that story includes yes what happened to them but it also includes them overcoming - it's their survival story. That is the narrative.

46:14 - And once that intervention is successful you then see much more typical brain imaging studies where you have both right and left hemisphere lighting up. That's your goal with anxiety - you want to make sure you can pull in this left logical language brain to their highly anxious experience.

Strategies - Home and School 46:43 - So strategies. Here are some home and school strategies to consider. Something to keep in mind is that you're the expert on your child and your household. And really just because it worked for somebody else doesn't mean it's going to work for you. So there's a piece of this that really is trial and error and there's nothing fancy I or any other clinician can say to you about "oh no I know for sure that this will work for your child." So there is a trial and error piece of this that you'll have to go through with your family.

Framework - Anxiety is Contagious 47:07 - I think framework though in terms of a foundation - know that anxiety is contagious. It is one of the very rare and unique areas of mental health in that you really can catch it from the environments that you're in. If any of you have had a highly anxious boss just remember what that was like - not enjoyable at all. And there is a, it becomes part of your problem because you have to deal with that level of anxiety as well.

47:51 - So taking stock of where you were at and kind of where your family system is at with anxiety. Because a lot of what we do as parents absolutely fuels our own kids' anxiety. I know I do this sometimes too and I have to catch myself as well. Probably a lot of us did it even more within the context of this pandemic because there are lots of legitimate fears to be concerned about. But think about how you might be contributing to the anxiety within your family system.

You Are a Therapeutic Tool 48:17 - And then embrace the fact that within that system you really are one of the most powerful therapeutic tools. So keeping in mind what's my tone of voice, am I problem solving out loud about my own anxiety? I have had many a moment in this pandemic, this working from home state where I have snapped at one of my kids in a way that honestly it was because I told them not to enter my meeting and it was like the third interruption of the day and I snapped at them. That was not helpful or productive.

49:00 - But then going back to them after the fact and saying "you know what I'm sorry I was really stressed out during that meeting, that's why my tone of voice isn't very kind and I just was really impatient with you. I have my moments too. I have my coping skills that help me get through the day" and really identifying what those are. "These are the things that make me feel better when I'm super anxious" - eating chocolate, going outside. These are all great examples of things that help me.

49:30 - For you it's possible if you've got a super verbal kiddo they might be able to say "oh yeah these are the things that help me" - reading my favorite novels, playing my video games or going outside in the backyard and looking for bugs. There are all sorts of options but you really want to have those conversations about what are the coping strategies and make it clear to them that you need coping strategies too because you have your moments as well.

Consistency, Predictability, and Flexibility 50:04 - Consistency and predictability is also quite important with flexibility - which I know that sounds like where is the balance? The balance is when it's possible to give options, give them. Because if you have a highly intense highly emotional profile there tends to also be a high need for control.

50:27 - So if it really doesn't matter what order they get their homework done in, give them options, let them choose, tell them it's like an experiment - "let's see what it's like when you do your math homework first before you do your other things." And you can treat it more as like an experiment. Or if they don't have to do three extracurriculars give them a choice and say "you know what we still want you to get practice socializing with your peers, so pick two. It's fine for us to get rid of one of them."

Calming Space 51:03 - And then as much as possible having a calming space at home that is user friendly for your particularly intense child. A lot of sensory - you might have a child who has lots of sensory driven behaviors and they might want specific things for that calming space whether it be a weighted blanket or tons of fidgets or a place to play music or things like that. So keep all of those, those are all potential strategies to deal with an anxious child.

Positive Behavioral Supports 51:28 - And then keeping in mind that generally speaking when behavioral supports can be done in a positive way the better. So if your child loves to delve into novels and kind of get lost in books, letting them earn more book time for your desired behavior and being calm and everything like that as opposed to when they're having a meltdown taking away their love. Similar to the strengths based approach, try and use their strengths to encourage more desired behaviors.

51:53 - You'll see a lot of commonalities between home-based supports and school-based supports. There is a ton of overlap so I won't go through each one.

Testing Accommodations 52:20 - But thinking about testing accommodations is a big question always. Sometimes extra breaks and testing in separate rooms can be helpful for the kids with the anxious profile in particular. It gives them time to sort of just calm themselves during the test. And the testing in the separate room particularly those who have a touch of that social anxiety can be quite helpful. But again every profile is different so do not think that any of these testing accommodations are a silver bullet for all kids with anxiety because what is great for one profile really can be problematic for another.

53:05 - Extra time for example - you see that a lot with kids who have either ADHD or processing speed weaknesses. For some kids with ADHD giving them extra time is awful because they now have time and a half or double time to daydream, which does not help their performance at all. But if you have a child who has a significant processing speed weakness you can see why a time and a half might be more helpful than that other profile that I just mentioned.

School Support Plan 53:46 - In terms of what you want your school support plan to be, your ideal support plan really highlights both the strengths and the needs for accommodation, again in that order. It really does matter. These are, language has power. And so you want their support plan to acknowledge their strengths also.

54:12 - As your kid gets older they're going to be reading those support plans and should be reading those support plans and should be participating in some of those school-based meetings. So you really want it written in a way that honors their strengths while also working to support their areas of weakness.

54:29 - And you'll see that there really is a need to consider advanced classes, enrichment activities, acceleration. There are a ton of ways that you can do talent development in your child's particular gift areas. I am admittedly not an expert on that - there are dozens, Yael you might know the exact number of sort of enrichment options for the gifted profile. And if you have questions about all of those options feel free to connect with either REEL or the Gifted Support Center in San Mateo. And Smit, the director there, knows a ton about all of the enrichment options for the gifted profile.

Remediation Options 55:08 - And then remediation could look like things like occupational therapy, speech and language for pragmatic language issues for example, counseling via the school counselor. And then you also want to include self-advocacy goals as you, as kids get older as part of their school support plan.

55:27 - So this is just a snapshot of some of the strategies. I think that there is a lot of, and I'm sure REEL will have talks on this front - it's tricky because oftentimes you're working with schools or districts that don't necessarily have the education and the familiarity and the expertise in 2e. So I totally agree that this is much easier said than done and that's why I really love some of REAL's offerings in terms of providing that psycho education to schools and school districts. So know that you don't, if you are in one of those schools that has no awareness of this you don't have to go it alone. See if you can get REAL or another advocate in there to help support.

Evidence-Based Treatments 56:18 - So I've talked a lot about kind of language strategies and this kind of leads nicely into okay what about actual treatments, therapeutic approaches to anxiety? And I think it is important because there are a lot of options out there that are not evidence-based. You will not be hearing about those options from me. I'm just going to really focus on what we know about anxiety disorders and what works.

Exposure-Based Therapies 56:37 - The first area are exposure based therapies. You may have heard terms like systematic desensitization, exposure and response prevention or ERP which is particularly useful for OCD profiles. So if you have a child who has that kind of OCD profile you really want ERP - that is by far gold standard treatment for obsessive-compulsive disorder.

57:09 - And the goal of exposure is really to expose - I know this sounds cruel - but it's to expose your child or teen to whatever the fears or stressors are and they're going to be exposed to that in a very safe controlled environment with the goal that they can kind of sit with their anxiety and not engage in the avoidant behaviors which is typically what most of us like to do in response to our anxiety. You want to get the heck out of whatever's making you anxious - you can't do that in exposure-based therapies.

57:48 - The good news is before starting in terms of the exposure they also work on coping strategies - what are things that you can do to help calm yourself in the moment when you feel yourself kind of panicking or feeling anxious? And essentially what they learn over time is that oh they can not only sit with that anxiety, they will actually experience it decreasing over time even as the clinician works with them on dealing with higher anxiety, more anxiety provoking situations.

58:27 - So if your kid's got a bathroom phobia or germ phobia, the earlier stages are going to involve you just talking about what makes you anxious or talking about imagining yourself going into a public restroom that seems dirty in the time of COVID, all the way up to potentially actually going into a public restroom which can be quite paralyzing for folks. So that is kind of an example of the exposure-based therapies.

CBT - Cognitive Behavioral Therapy 58:59 - Cognitive behavioral therapy or CBT - you'll hear about the CBT triad a lot. Thoughts, emotions, behaviors forms this lovely triangle with thoughts typically sitting at the top of this triangle. The assumption and very research-backed truth is that what we think affects how we feel and act. So the goal of CBT is really to come at it, to go after that thought level of the CBT triangle because if we can change people's thoughts then there will be resulting improvements in emotional and behavioral dysregulation.

59:39 - So you spend time on essentially figuring out what those - you hear about cognitive distortions or automatic thoughts a lot in the CBT space. The idea being that a lot of us who have whether it be anxiety or depression, this is also very evidence-based for depression, there are automatic thoughts that pop into mind that are counterproductive and fuel the anxiety and depression.

Common Cognitive Distortions 1:00:06 - So some of the well-known ones are all-or-nothing thinking also known as black and white thinking. An example of that would be "if I don't get into UC Berkeley I will never be an award-winning author." It's all or nothing, it's every, all of your eggs are in the Berkeley basket and nothing else is acceptable.

1:00:32 - Or catastrophizing - you've got you know a lot of kids love their schedules and are perhaps too rigid with their schedules. And you know maybe a kid's mom is like 20 minutes late because of awful traffic and in that anxious kid's head he's thinking "oh my gosh mom probably got into a really awful accident and maybe she's in the hospital or something." That's a good example of just a completely catastrophic thought - there's no basis for it.

1:01:01 - Over generalization would be "because I got a B on a math test I'll never be a successful engineer." That's the over generalization. Or personalization would be "the teacher didn't call on me because she doesn't think I'm smart." So feeling like parents or teachers are targeting them unfairly would be an example of personalization.

Goal of CBT 1:01:36 - So the goal of CBT is to basically tackle the cognitive distortions and replace them with healthier thoughts. "Yes I want to be a best-selling author, I don't have to go to Berkeley in order to get there. There are lots of different avenues to be a successful author. Here are some of the other options that would work out quite well." So you make more adaptive thoughts, you insert more adaptive thoughts.

Challenge with 2e Profiles 1:02:01 - Now the challenge here and I'm curious if others have tried this with their kids in their 2e profile - I've tried this a little bit within the context of evaluations that I do particularly for teenagers and I'll try and, because their cognitive distortions are usually not hard to pick up during the evaluation process. And so I'll test them a little bit and try and get them to see things or think things a little bit differently.

1:02:33 - Sometimes your 2e profile is really fantastic at staying very very intellectual. So you could talk about thoughts all day and in fact actually some of that thought process sometimes can fuel an existential depression sort of profile - "what's the point, we're all gonna, the earth is going to hell anyways, you know the climate change and the political..." So "why would I just change my thoughts because I'm just fooling myself."

1:03:08 - And so you can get stuck on that intellectual reasoning cognitive level and I think with some 2e profiles the challenge is actually getting at some of the emotional dysregulation and the emotional insight. And CBT doesn't always help in that regard. So just keep that in mind when you're thinking about treatment options for your particular child.

DBT - Dialectical Behavioral Therapy 1:03:29 - Because of that lack of focus on the emotional experience there is something really lovely about DBT or dialectical behavioral therapy. I think there's also just a, there's a complexity to the concepts in DBT that I think can really appeal to the 2e profile.

1:03:50 - If you do a Google search on DBT do not be alarmed at the fact that you'll see a lot of DBT for kids and teens who are suicidal or engaging in self-injurious behaviors. That is true, that is where this treatment approach started with some of the most acute profiles of emotional behavioral dysregulation and kids and teens who either had suicidal attempts or engaged in self-injurious behavior. So all of that is true but your child does not have to have that profile in order to potentially benefit from the concepts of DBT.

The Dialectic 1:04:28 - The core concept is the dialectic and what that says is basically what is a dialectic - two opposing truths can be true. So you have to find the balance. And the beauty of this is that it honors both perspectives, the two different perspectives which honestly oftentimes I think in the parenting equation it's the perspective of the child and the perspective of the parent. Both of their experiences are valid and DBT allows for that and in fact states that to be true.

1:04:59 - Similarly there is a balance here in addition to balancing perspectives - there is both the honoring and the experience, the emotional experience, and accepting and validating their anxiety, their frustration, their overwhelm AND also we need to change, we need to move forward, we need to find better ways as well. So both are true - that you validate AND you work to change.

Invalidating Comments 1:05:27 - So the tricky thing about invalidating comments is I don't think any of us as parents try to invalidate our children. It's not why we got in this game but we do it all the time, so it's okay, all of us have done it. Think about the times your child has been having a meltdown and you're like "it's okay, it's no big deal, you don't need to worry about this, I'm not worried, your teacher's not worried, this isn't the end of the world." So all of those are actually invalidating statements even though your intentions are incredibly pure.

1:06:08 - It's something to keep in mind - you're not agreeing or approving their emotional state, you're just saying "I hear you, I see you." And the reason why we do that is because that helps the other person regulate their own emotions. If you just say "you're overreacting" - you've probably said that to a significant other and or you've heard that from your significant other - that's not helpful, that does not help you calm down. Our kids are no different, they want to be seen and heard as well.

1:06:41 - So it allows for that kind of assistance with the regulation like "I feel seen and heard." And it teaches them - you don't want to teach them to not trust their emotions. If you constantly say "it's not a big deal, why can't you just calm down, you're overreacting," what you're teaching them is not to trust their bodily response. That's not great. We don't, we want them to know and trust their emotional experience and we want to make it clear that they have to work towards some change.

Walking the Middle Path 1:07:14 - The other concept you'll hear which we've talked a little bit about with the dialectic is just the idea of walking the middle path which I think is a nice way of describing basically how you've got to balance the two perspectives - both basically the teen's desires and also the parents' concerns, interests, desires as well. So it allows for a lot of compromise talk which is especially helpful for your adolescent crew.

The Wise Mind 1:07:50 - The goal of DBT is the wise mind. And so what you'll see here is that the reasonable mind is what you know, what you know in your calm state to be true. Your emotional mind is what you feel when you are not in your calm state - it's your wave of emotions. The goal is always the wise mind which is basically "yes I know this and I feel this so this is what I'm going to do."

1:08:21 - So you're able to take both perspectives and problem solve accordingly. So you learn to trust both inputs to then become a reasonable problem solver who also has some emotional insight.

Integration is the Goal 1:08:39 - So to wrap it up, what's interesting here and I didn't happen on this on purpose but what you'll notice - the core goal of DBT is the wise mind and that has been shown to be true and effective for the most acute child and adolescent clinical profiles. The goal of just talking about emotions is exactly that - it is integration of emotional state with problem solving. And so you can see how that ultimately that's the goal whether you're talking to your school age kiddo or you have a teenager who is in an intensive DBT program. The goal is actually the same.

Helpful Resources 1:09:38 - So now I know I went over, my apologies. We'll definitely open it up to questions and you'll see lots of helpful resources here. If you need help with language around talking about anxiety, these Dawn Huebner books - these are like $10 Amazon books, they're workbooks and it talks, these are you can do them with your child and it'll give you some pointers around everyday language you can use and activities you can do to tackle some of these challenges in your everyday life. And I think that covers it for now so I'm gonna stop my share so that I can see some of the faces.

Q&A Begins 1:10:20 - Thank you so much Dr. Kyle, that was super helpful. Abby and I are going to tag team some questions out of the chat. Yeah okay great. Thanks so much. Okay what I'm gonna do is start way back in the beginning and just ask a few questions that came up in the chat.

Question: NVLD and Anxiety 1:10:39 - Okay so the first one was I think way back in the beginning when you're talking a bit about some of the differences that come along in the 2e diagnosis. And this person Scott asked what can you say about NVLD, nonverbal learning disabilities in general and how it relates to anxiety? And then sort of a follow-on question asking if a child who may have been diagnosed with NVLD younger should as they grow older get a neuropsycho-private neuropsych or should just continue to rely on IEP assessments?

1:11:10 - Very good question. So NVLD is absolutely a diagnosis, non-verbal learning disorder. What that means is visual processing is - and this is for the other folks I'm sure this parent knows this - but visual processing is a significant area of weakness. And so what you tend to find are kids who have math difficulties, kids who have significant challenges kind of navigating social scenes because a lot of what happens socially is visual. Think about facial expressions and things like that - that's all nonverbal learning that happens. And so for your child with NVLD that tends to be pretty challenging with them. And then oftentimes a unique sensory profile is very typical as well with that NVLD profile. So yes that is very much a 2e type profile.

1:11:59 - I would say around evaluations it depends if your needs are being met. So an NVLD profile is I would say one of the trickier 2e profiles because NVLD doesn't even have an official diagnosis in our diagnostic manual. And so unfortunately what that means is lots of people don't even really know what it is. It's not like ADHD which the vast majority of the public, especially with the prevalence rates and educators, they know what ADHD is. NVLD is much trickier to communicate to educators.

1:12:40 - And so if you happen to be in a school district that did a pretty comprehensive eval and a lot of Bay Area school districts have licensed psychologists and/or neuropsychologists who are actually functioning as the school psychologist, so if you have a really comprehensive one and you feel like your child's needs are being met then I say stick with it. If you're not sure or you don't trust that or you do have concerns that are bigger than just the school district's support plan, yes I would recommend a neuropsychological evaluation and really not a psycho-ed eval, an actual neuropsychological evaluation because NVLD is pretty unique and it more falls within the domain of the neuropsych background in training.

Question: Stealth Anxious 2e Kid 1:13:36 - Thanks for that helpful answer. We have Shirley asking: have you ever come across a case of a stealth anxious 2e kid - very bright, highly people pleasing and thus well behaved, academically doing well, appears to be just fine at school even to some clinicians, but then come home and the parent sees the fears, the tears? And any advice because the professionals have a hard time believing the parent - how do you get help for that child?

1:14:02 - Yeah it does happen absolutely. You can have some kids who are fantastic at masking and essentially putting on a really really good front because their desire to please is so so high. People pleasing at its extreme is anxiety. But I think when you have that sort of profile you really can sometimes keep it together at school and basically use up every last ounce of your cognitive resource bank and then you're done when the kid comes home. And they just come apart and you've got a crying screaming child when the teachers are like "oh he's such a joy in class."

1:14:46 - I mean my recommendation there would be to find people who hear you and get it and continue to communicate with the school to make it clear that it's great that he is performing in the way that he is in school but I can tell you that is not what we see at home and here is what we see at home. And this is a problem that this is the result when he comes home every day because he's so exhausted from keeping it together. So don't sweep it under the rug and keep going and tell the educators until you feel like they get it and they hear you.

Question: Overwhelming Schedule 1:15:39 - Here's another one, I think this one's really interesting. Amanda asked about - my child tries to keep it together with all their demands on them but towards the end of the week he's really over it. I try to tell him that there's just two more days of school but it's really hard to get out of the door in the morning. Any suggestions? And I think a few people including myself suggested try to find something that they do every day, give them time to do something that they love every day so they're able to show their strength. But I think that the extra interesting wrinkle here which may apply to a lot of people is that she in this case is doing ABA 3:30 to 7 so basically their whole day is taken up between school and therapy. And I think just generalizing, how do you, what do you recommend to people who are so booked with really critical services both maybe with their remediation as well as their schooling to fit in some of these important elements to keep our kids happier?

1:16:42 - Yeah depending on the age and ability of the child I think I would try and problem-solve a bit with them and figure out what are the non-negotiables in the week. And that might be ABA because maybe they have an ASD profile for example. Maybe it's three times a week - that was my question.

1:17:08 - Sorry to interrupt, that was my question and he's actually not meeting the required hours even though it's 3:30 to 7 because of COVID, closed on weekends. It's basically we're just at minimal hours so even 3:30 to 7 is a few hours of therapy according to them. And I tried to make it as easy as possible - not a lot of DTT, a lot of NET - but still it's an overwhelming day for him because those are two things that I simply can't afford to lose or afford to kind of change. Does he have five days? Yes, so ABA is five days a week, school is five days a week. And I think really he was kind of pushed into it because he used to go to school at 11 o'clock.

1:17:55 - So let me first tell you that he's six years old. So he went to school for half a day and then COVID hit so he was home 24/7 and then he went back to school for a full day. So he was no longer going from eight to 11 and that way ABA worked for us but now it's 8 to 3 and 3:30 to 7. Yeah I couldn't handle that myself. Exactly, that's what I said to Abby, I was having anxiety just writing it. No totally.

1:18:32 - And so then the discussion becomes okay how can we - and it really is a discussion, it's a problem-solving session maybe with you and the ABA provider or you and if there's another caregiver in the home. Depending on your son's abilities he may not be able to engage in that level of discussion but that's too much for a six-year-old. Where is their give, whether that be saying "you know what we're gonna do ABA four days a week and Friday is gonna be next" or going to the school district and talking about is there a way to do a reduced day or is there a way for the ABA provider to provide some push in support during the school day. But oh my gosh no, 8am to 7:30pm for a six-year-old.

1:19:22 - Yes thank you, I totally agree and thank you for those things that I can talk about with the school because I was really to a point where I just wanted to homeschool him because it was seeming like I could be involved and I could do that but I really didn't want him to lose that social aspect. So I feel like I'm taking up too much time but thank you so much for that. Thank you Amanda, good luck with that. Thank you.

Question: Grand Ideas and Anxiety 1:20:09 - So Dr. Kyle we have an actually really interesting point that someone brought up about the reverse of anxiety where 2e students will sometimes get very grand ideas that are amazing but they're not able to execute them and so that causes anxiety. Any tips on that? Oh boy, like their grand ideas about starting a company when they're 12 and things like that and you not wanting to totally deflate them but needing to be realistic?

1:20:31 - Yeah, my own child has like he'll picture something in his head and try to make it but he can't make it because he's too young to actually physically make it and then he's having anxiety because of his inability to make this incredible machine that was in his head. Oh good question. So I'm curious what you have done with your little man, so I would love your input too.

1:21:01 - I think what I would probably, I think sometimes the anxiety comes from wanting to do something and then also feeling like if you can't do it now you're gonna lose it, you're gonna not be able to do whatever your idea was. And so my thought process is can you get him or her an ideas book where they can keep track of all of their ideas? It's also really cool because I suspect your 2e kiddo has lots of fantastic ideas. So can you put together an ideas book and so they know that they're not going to lose them if they don't get it done before dinner today. We'll have time to come back to it.

1:21:47 - And then that ideas book can also become a way for you to sort of think through and or sketch out what are the materials that you're going to need in order to make this really cool machine that you want to make. So you're engaging them in their idea instead of shutting them down and you're also engaging in that problem solving like let's think about the steps here. So that you're helping them see oh this is actually probably a lot more complicated than what they originally thought up in their head.

1:22:20 - Yeah I love that answer and you're right, sometimes his ideas I think they're not doable but then he surprises me and does them so I don't want to discourage. And we do, I try to come up with what's an alternative method also to get at what you're trying to do - is there some other simpler step along the way? Or sometimes I have signed him up to do something with an expert that does know how to do that thing. Like he wants to sew stuffed animals, I have no clue how to do that but I know someone who does. It's true, you could learn in your free time though. We could learn together.

Question: Self-Advocacy Goals and Catastrophic Thinking 1:23:05 - Abby did you want to ask someone? Let's see we have, actually there was, okay there was one question about could you talk a little bit about self-advocacy goals I guess around anxiety? And then a separate question and I also wasn't sure how philosophical they were getting with it but it was what is the root cause of catastrophic thinking? That feels very deep to me so that's an interesting one as well.

1:23:30 - Yeah let me tackle self-advocacy first. In your, if you look kind of developmentally I think advocacy in the elementary school years is often parent advocacy. Your child is not in a position when they're in the first, second, third to be talking about "oh these are my strengths, weaknesses" and so "these are the academic supports that I need" and things like that. So a lot of that is parent advocacy at the elementary level.

1:23:54 - By middle school it should be more joint advocacy. So you really do want that middle school age range, you want your kid to be a part of the conversation and even potentially sitting in school meetings dependent upon what your specific school situation is. Always by high school you really want the advocacy to be primarily teenage driven. So they're in the front seat, you're in the back seat sort of situation.

1:24:17 - So if you know that's your end goal - before they graduate high school they should be able to independently self-advocate - you want to not only talk about their strengths and weaknesses at a young age, you also want to talk about what works for them. You might have a verbal problem solver who's able to think through things more when they are able to talk out loud and problem solve and things like that. Or you might have a kiddo with an NVLD profile where giving them a bunch of visual organizers and diagrams is a nightmare, it's exactly counterproductive to their profile.

1:24:47 - So you want them to essentially know what their weak spots are so that they can ask for what they need. And so if you're by late elementary school, if you know you've got a processing speed weakness, your kiddo's got a processing speed weakness, in early elementary school you might talk to the teacher about can we do less of this drill and kill homework because these timed and these constant math worksheets are torture. So can we do only the odd numbers or only the even numbers.

1:25:24 - By late elementary school the kids should be able to talk about that themselves with their teacher and really have a conversation with their teacher about "oh these are some of the things that have been helpful" or "you know organizers are really helpful for me" or "if you can remind me, just tap me on the shoulder and remind me to write down my homework, that would be really really helpful." So thinking about basically higher levels of independence as they get older and making those actual school goals as opposed to of course just the usual school goals around academics and such things.

1:26:16 - What was the next - sorry working memory issue - what was the second question? It was what is the root cause of catastrophic thinking? Oh boy, depends on the person. Some folks are very much wired temperamentally differently and parents will be able to say "my kid has done this since he could talk, this is always how it's been." It can also be much more of a learned style particularly if they've encountered lots of stressors in their life or lots of setbacks or potentially trauma. You can see how a more catastrophic style of thinking might be born out of some of your lived experiences.

Question: How to Figure Out Strengths 1:27:05 - And I think this will be, we have time for one last question. Somebody asked how do you know your child's strengths, how can you figure them out? The things that light your kid up - that's probably my easiest. So you don't have to, you don't have to pay $6,000 for an evaluation I promise you, though you really, you can if you need to. But evaluations can be very expensive as a way to identify strengths.

1:27:32 - I think what lights them up, what do they spend the most time doing - that is their, those are those are their strengths. And then in addition to that of course figuring out what their personality strengths are whether it be their humor or things like that. And if you really are in the trenches and I get that, that is part of parenting and I think that is a, part of parenting - it's just it comes with the territory, nobody likes being in the trenches but it's okay if you're in that space.

1:27:59 - Where it's okay to say "you know what I can't even see my kid's strengths right now" and that's not a good place to be - you're not going to be there forever. But if you really do need help identifying your kids' strengths, talk to other people who love and respect them - an aunt or a teacher who really appreciated them. What are the things that other people have identified - their energy or their humor or whatever it is. See if you can find some hints from the other people in your life until you feel better able to identify them yourself.

Abby's Example 1:28:49 - Thank you so much, that is super helpful. And I've noticed too just with strengths with my kid, he loves to ham it up, he loves to talk a lot and I realize that translates into presentation skills. So we asked our teacher can he not write a script - he has a great memory, has great presentation skills - can he just go up and present? And that removed the challenge and let him show his strength. Love it, such a good example.

Closing 1:29:13 - Yeah well thank you so much for this evening. I'm sure there are a lot more questions but it is 8:30, I want to be respectful of our speaker's time. So thank you so much Dr. Kyle and please you can contact Dr. Kyle or the CHC for more support and you can go to reel2e.org to find out about future events and get support in our Google group. So thank you everyone so much for attending tonight. Of course, thanks for joining me on a Monday night, I appreciate it very much. Thank you so much for being here, bye. Thank you. And I can stay on for a few more minutes if people want to chat, I will end the recording.