Visible Voices Vote

My Better Half shared this article with me on November 6, 2018 (Election Day), and I want to pass it along to others while trying to touch on some of the issues and resources in this article.

I really appreciate the idea and process of supporting all persons with making informed choices and to do so in a way that respects their autonomy as humans and their rights as citizens.

The idea of a social story and anticipatory guidance feels so smart and kind for most adults who are voting for the first time. I think many young adults could benefit from this resource and, as such, I consider it a gift from this mother to have created it for her son and share it.

As I read and re-read the resources in this article, I delved deeper into the Bazelon Center site.

It’s eye-opening and mind-blowing how variable and fraught with ambiguity the law seems to be on the matter of whether individuals with disabilities and mental health concerns can vote. It reminds me, in many ways, of the bar we set before people wishing to become a US citizen.

More specifically, my work often involves talking with families about the topic of guardianship for their children as they transition from adolescence to adulthood. This article gave me cause for pause and added to my understanding about how guardianship determinations could impact a person’s ability to vote later in life or in another state if they so choose to move.

In closing, I would like to encourage folks to share this Know Your Rights resource on voting.

Third Time's the Charm

What counts as luck depends on what you're looking for…

My Better Half gave birth to our third child in May of 2017, so he's coming up on a year and a half on this earth as we roll through fall. He's about as close to perfectly adorable as one baby could ever be. He's generally happy and adored by his siblings; he loves social gatherings and being held by lots of friends. He goes by a lot of different nicknames based on his behaviors.

But he loves to wake up more often than our previous children and has less variety in his diet. He has not hit his speech and motor milestones at the same time and rate as our first two kids. So in many ways, our third child has held the mirror up to my face when it comes to my work. 

I work with a lot of people who work hard at improving their sleep or that of their loved ones.

I work with a lot of people who work hard at increasing the types of foods their loved ones eat.

I dispense a lot of advice and guidance around eating and sleep routines in my work, and the process of parenting our third child has been quite humbling and eye-opening. Put simply:

Sometimes the evidence does not work so well.

I have read (and re-read) the literature on sleep hygiene, and we consulted with our providers to put in place a well-organized evidence-based approach to increasing the variety in his diet.

And still every day feels the same.

This is all not to say to heck with science/medicine and to go rouge on reality because of it. But this is me acknowledging as a human who happens to be a psychologist that sometimes the ideas and the plans that derive from the scientific method don't apply equally well to all.

That is a sobering thought to hold. 

Our third child has given me a different type of appreciation for those who face these issues and deepened my empathy (and my resolve) for how stressful, challenging, and rewarding these things can be.

When I became a parent, I did not know that love could come in so many forms. The way I feel and I respond to each of our children is so different and implicit it defies the words I have here.

Our youngest is his own unique person - challenges, successes, personality, and all. The big kids often call him “Boss Baby” because he has a huge head on a small frame. And, because he wants what he wants when he wants it and he lets us all know it. So as luck would have it, his smile and his laughter are so infectious that our joy clearly continues to outweigh our work.

Autism Evaluation Process

April is National Autism Awareness Month, so I wanted to post about topics that relate to the autism aspects of my professional training and practice. One piece that is often not discussed is what actually goes into an autism diagnostic evaluation - for patient and practitioner alike.

I take the process of conducting an autism diagnostic evaluation very seriously. I try to give as much of myself as I can intellectually and emotionally in order to provide patients and families with guidance. My goal is to offer an evaluation that is compassionate, informative, and useful.

These are the measures I routinely use as part of an autism diagnostic evaluation:

• Autism Diagnostic Observation Schedule - Second Edition (ADOS-2) - clinician-administered
• Social Communication Questionnaire (SCQ) - caregiver report
• Social Responsiveness Scale - Second Edition (SRS-2) - caregiver & self-report
• Detailed Developmental History - caregiver report
• Chart Review - pediatric medical records and educational services & assessment history

As outlined above, the diagnostic evaluation is not just me and the patient taking a prescribed set of tests. It is often what I learn in the life narrative that gives me the confidence to proceed with a clear diagnosis and treatment plan. In order to get this information and an accurate health history, I need to talk to caregivers and review pediatric records. This is true for my adult patients seeking a diagnosis as well. While it may seem like a long time ago, childhood behaviors as reported by caregivers give me a fuller picture of the patient's life. 

Beyond the ADOS, I provide anxiety, ADHD, and mood screening Instruments when applicable. An evaluation is so much more than a "Yes" or "No" stamp for a single diagnosis, as it represents a person and a plan to improve their lives based on the challenges they have had and face today.

The inspiration for my wanting to be Ever Better at conducting autism diagnostic evaluations comes from the families I've met along the way. Those who've talked with me about what went well and what they wished could've been different on the day they learned the diagnosis.

I've also found new inspiration and room for growth in working with adults who are seeking a diagnosis later in life. The feelings and dynamics of obtaining a first diagnosis as an adult are something I am learning to navigate with my clients, and I am honored to learn with them.

I am starting to get into a rhythm with scheduling diagnostic evaluations, and I hope to keep receiving referrals for individuals across the lifespan who wonder if they're on the spectrum. In private practice, I am afforded more flexibility in scheduling and administering tests. What this has meant is that patients can get an appointment more quickly and often during "outside of typical office hours" so they can get the answers and help they are seeking more smoothly. 

This April, I'm providing autism diagnostic evaluations on Saturday mornings. So far, I have enjoyed serving new patients in a timely manner - it is very fulfilling for me to get a call from a new referral and be able to serve them within a week or two of their inquiry. Providing answers and helping families better understand their loved ones is one of the most satisfying parts of my work, and I am grateful for the opportunity to serve patients and families in this way.