The time given us

I hope that you are well and that your loved ones are healthy, too.

I am meeting with patients and families via tele-health during this public healthcare situation and plan to keep doing so moving forward. I am using Doxy.me (secure portal) for most folks and recently upgraded bandwidth at home to accommodate working remotely. I’m also open to choosing a platform and format for how we conduct our sessions during this time period.

We will get through this together.

Meeting with patients and their families has been a balm and a blessing during this time, and I will do what I can with you to bring order and calm to whatever place you are at right now. This will involve creativity and flexibility to meet with each other digitally until further notice, and I believe that we can do this effectively and efficiently if we keep working at it together.

Beyond the work changes, my family is going through many of the same challenges others are going through now: children and parents home all day, everyday; working and schooling at the same time, often in the same space; adjusting to a new normal; and, coping with the loss of social activities, celebrations, and milestones we were working towards and looking forward to.

I am in this with all of you.

I am recommending a few things during this time to help us all get through:

I made my own AUggie named “Little B” to keep me company in my home office in the attic.

1. Be kind to yourself

2. Practice gratitude

3. Find rhythm in routines (see image of our dining room/school work space)

4. Get outside often

5. Read something fun (see quote below)

6. Connect with others in your community

For me, an example of #6 is continuing to support AutismUp in my role as Board Member. This means participating in virtual Board Meetings, reading the daily content in @Home with AutismUp they are sending to members and anyone who signs up for the emails, and even participating and sharing in efforts to keep everyone connected.

I see people rising to the challenge of the healthcare situation, and I am amazed at how well everyone is adjusting to this new version of everyday. I encourage you to do less, well and to be patient with the things you cannot hurry and gentle with things that do not move.

“All we have to decide is what to do with the time that is given us.”
J.R.R. Tolkien, The Fellowship of the Ring

Three Years In

Today marks the anniversary of when the practice first opened on July 11, 2016.

In this time I have had the privileged to serve so many amazing people, get to know wonderful families, and help people through life’s challenges big and small. As I reflect on all of the things that have happened over the last three year my most overwhelming feeling is gratitude…

Gratitude to have a job that I love going to each and every single day.

Gratitude to have a career that offers flexibility to be a present parent and partner.

Gratitude to have a business that supports and works with our community.

Gratitude to be in a community that creates services to meet community needs.

Gratitude for YOU for supporting my dream to help people in our community.

In the last three years, so many things have changed. I’ve practiced in three different locations before landing in my forever home in January 2019. I started out as one person in 2016 and today we are in the process of hiring talented therapists to join me in serving our community.

In 2016, I planned on focusing primarily on weekly therapy. Between then and now, I have had opportunities to use my skills for educational evaluations and advocacy; helping patients obtain OPWDD services; testifying in federal court as an expert witness; and working with different school districts to provide social skills for students with developmental differences.

In the last three years, a lot has also remained the same. I’m still committed to serving every patient and family to the best of my ability. I’ve kept the quirky even as I have moved and upgraded my office location. Patients and their families have gifted me sentimental tokens - Lego mini-figures and socks. These mementos have traveled with me and bring a smile when an unsuspecting character is spotted in an otherwise professional looking office.

Gandalf in a doorway

Batman on the TV

Yoda over a window

Swamp Creature on the TV

Link is the Man in the Arena

Flash guards my license

The traditional gift for a 3rd Anniversary is leather, so My Better Half recently upgraded the chair I sit in to a new leather one. Feels like I have celebrating covered even while sitting.

New office, new chair, but I still wear goofy socks everyday. Today is fox socks.

Thank you for believing in and supporting my dream. That is the greatest gift of them all.

Day 1 and Day 905

New year, new office!

This morning I welcomed my first patients into the new office at 610 Pittsford Victor Road.

This reminded me of when I first started blogging in anticipation of starting private practice.

In the spring and summer of 2016, I put a countdown in a blog post titled “Final Countdown.”

Feeling nostalgic and wondering if time stood still on this post, I took a look. That countdown clock has continued ticking ever since and here we are in a new forever home 905 days later.

Getting the space ready for today has been an all-hands-on-deck labor-of-love for the Harrison family. This included holiday visits from different sides of the family to pitch in with everything from childcare to switching out door knobs, major trash removal to interior decorating counsel.

We rung in the New Year at the new office working on important finishing touches such as…

Organizing toys in the waiting room.

Testing out Mario Kart in my new therapy space.

Thank you to everyone who has helped to make this dream come true. The trust and support of so many people has helped grow this practice into a place where more people can find help. Something that I know I can do no justice to is highlighting the role My Better Half has played in all of this. I intend to devote a full post to describing how my wife and best friend has built my dreams and given me the opportunity to live out my life’s calling. Can you guess when this post will appear? Until then, you’ll just have to remember that she even thought of the Keurig!

Coffee (and tea and hot cocoa) for everyone!

One of the greatest features of this new office is more space to expand!

For those of you that have reached out since I first announced my move, thank you. Thank you for your interest. Thank you for your patience. Now with this additional space, I will work with other providers to meet the needs of families, both the ones I currently see and those waiting patiently for services. You will be the first to know!

Day 1 in the new forever home.

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.

I'm a guest blogger... again!

Some folks may have noticed that I've been a bit quiet on the blogging front lately.  

There are three main reasons for this: 

1. Private Practice is really taking off! Thank you to everyone who has made the time to make an appointment with me, those who have made referrals, and those who have recommended me to your family, friends and colleagues. I cannot do this without you!
    
2. I'm preparing for a few speaking engagements this fall.  Stay tuned to this blog for exact dates and times. I am honored and excited to partner with local not-for-profits and organizations that serve families in our Rochester community.
    
3. I was asked to write another blog for The Scientific Parent. This time my topic is Developmental Milestones and Delays: When to Seek Help

Like in my previous blog entry for The Scientific Parent, What is Autism & When Should Parents Seek a Diagnosis?, this time I wanted to provide some concrete information and additional perspective for parents and caregivers. In this recent post, I focused on giving caregivers guidance about whether their children are meeting their developmental milestones on time. This is a worry most parents confront at some point in time, as they watch their child's behaviors around same-ages peers at the play ground, in child care settings, or within the family. Writing this article gave me a great opportunity to address some of the concerns that impact perceptions, such as comparing the child's progress to peers, siblings, family, even the parent's own childhood development timelines. I was also able to tackle the concept of a milestone being continuous, componential, and variable in onset. Read on to learn what I mean. 

“So what does it mean to meet a developmental milestone? We tend to view the meeting of a milestone as a binary event: Either they’ve done it or they haven’t. Milestones are rarely all-or-none in the final analysis. Remember the time you spent repeating “dada” or “mama” over and over to your baby as they studied your lips and tongue to try and mimic the sound. There were likely many attempts that came out as “ada” and “da” before they were able to finally say “dada” or “mama.” ”