#101: ADHD and Autism | Interview with Holly Blanc Moses
For Holly, a diagnosis does not make a child different; it does not change their personality but it can be challenging for parents. What Holly found from working with hundreds and hundreds of kids for 23 years now is that a diagnosis helps people understand the child more and it opens more doors for services. There are a lot of kids who are diagnosed with ADHD, meet the criteria for autism but don’t have the autism diagnosis. These children have a very difficult time getting needed services.
From one Behavior Analyst to another, both Holly and I believe that kids with just ADHD and no autism diagnosis benefit from ABA interventions. This is why early diagnosis is very important because children can get the help they need.
Holly’s eldest son was already diagnosed when he was adopted but her second son was only one year old when he was adopted. Holly talks about the early signs that tipped her off that her second son might also have ADHD and how she proceeds with diagnosing kids who may have ADHD or autism or both. In this episode, Holly also shares how she’s able to cope with seeing things as a parent of kids with disabilities and interacting with clients both as a parent and as a professional Behavior Analyst.
Holly Blanc Moses is a psychologist, behavior analyst, published author, and consultant who has specialized in Autism for over 20 years. She has a passion for teaching parents and professionals simple and effective strategies to improve behavior and social skills. Holly is also a mother of a teen on the Spectrum.
- How Holly’s understanding of ADHD and autism changed as a Behavior Analyst and as a parent of a child on the spectrum.
- Why early diagnosis of autism is important for children who have ADHD.
- The early signs that told Holly her second son is neuro-diverse as well.
- Why IQ testing is cautioned before the age of 5
Attend a FREE Workshop!
— MaryBarbera.com/workshop (Sign up for a free workshop online for parents and professionals)
— #035: Autism Diagnosis, Waiting Lists & Early Language Development with Dr. James Coplan
— What is the ADOS Test?
— The Experiences of “Autism Mothers” who became Behavior Analysts: A Qualitative Study
— Holly’s Website
— Wired Differently Podcast
Transcript for Podcast Episode: 101
ADHD and Autism | Interview with Holly Blanc Moses
Hosted by: Dr. Mary Barbera
Mary: You're listening to the term autism around podcast, I'm your host, Dr. Mary Barbera, and today we have a guest talking all about ADHD and autism and how to tell if children have autism or ADHD or whether it's both.
Mary: So Holly is a behavior analyst. She's also a licensed counselor and she can diagnose autism in the state of North Carolina. Holly is also an author, consultant and specialized in autism for over 20 years. Holly is also the mother of two children, one on the spectrum and one with ADHD. So we talk about her parent and professional journey, as well as how to tell the difference between autism and ADHD. So let's get to that now.
Welcome to the term autism around podcast. For both parents and professionals in the autism world who want to turn things around, be less stressed and lead happier lives. And now your host, autism behavior analyst and bestselling author, Dr. Mary Barbara.
Mary: So, Holly, thank you so much for spending some time with us today.
Holly: You're welcome. I'm super excited to be here.
Mary: Yeah, I don't think we've ever met in person or even I feel like this is as in person as we're going to get during these covid time. So I've been following your work, and I know that you recently did an autism summit and I realized that we were already Facebook friends and kind of was looking into your background.
Mary: And I was like, I think you'd be a great guest. So so we like to start out with describe your fall into the autism world. And I know you have both a professional fall and a parental fall as well.
Holly: I do. Since I can remember, Mary, I have been interested in people. I've been interested in why they do what they do and what seems to work better. I I've also been doing little things since I was quite young when I was in first grade. And this sounds so mean and I apologize. I would never do this now, but it was Valentine's Day and I decided to reward the people, the kids in my class who were the nicest to me.
Holly: And so I went into the coin jar at our house and I took out a quarter and I put it inside their valentine if they were really nice.
Holly: Now, there were a few people that got nothing, they didn't even get a penny, which was not nice at all. I got in trouble for that, by the way.
Holly: But the people who I gave a quarter to, they became even. Even nicer to me.
Holly: And so that was sort of like, wow, there is something to this, and I just kept going through elementary school and just really paying attention to why does so-and-so have so many friends? What are they doing? What's different about them? And what about this person? And then I got into middle school. Now I'm in my mid forties, closer to 50, honestly. But really, there was a lot of separation between neurotypical people and people. And I remember seeing people on the spectrum that would be across in the hallway and we had no classes together. And I didn't understand like what why whyare we not together? And so really, I started learning more about this population and I knew I wanted to be in mental health and learn about more behavior with children on the spectrum and adults that work with adults as well.
Mary: So then so you became a licensed counselor and did you become a behavioral analyst right away or was that later?
Holly: I did, because again, I am fascinated with with people's behavior.
Holly: I nerd out on that all the time. I watch people, the grocery store, and it's borderline creepy, like, why are they doing that? So it's interesting.
Holly: And I again, was was in mental health. My degree of a master's in clinical psychology as well, and so wanting to go down that road of understanding as much as I could about mental health and behavior in this population.
Mary: OK, and then you have a parental fall into the autism world as well.
Holly: Yes, this is as is almost even a more interesting journey. So I have and I have some health problems. I have severe Crohn's disease. I have an ileostomy. I've got a lot of things going on for those people who know what that is. It's kind of an interesting thing to me to have lost your large intestines and lots of other things I have to deal with. So I have a lot of these health problems and also other things that came along with it. I wasn't able to have children biologically, so we were looking down the road of how do we adopt? Because I definitely wanted to be a mom. My husband wanted to be a dad.
Holly: How do we make this happen? And we decided to adopt through foster care. And so our oldest son, we adopted him at age six and he is going to be 16 this month.
Holly: And he is on the spectrum. He is what you consider level two if you're nerdy into diagnostics. So he level two and has severe ADHD.
Holly: And then also we adopted our younger son, they're not biologically related, and he was one when we adopted him.
Mary: OK, and but he is not on the autism spectrum here, young.
Holly: He has severe ADHD and learning disabilities, but he is not on the spectrum. Yeah, yeah.
Mary: So did you know before you adopted your six year old that he was on the spectrum?
Holly: Well, I was already had already been in this field for quite some time, so it was pretty obvious to me. But he had also been through quite a bit of trauma. So we needed to make sure we took care of that when we went to the Child Protective Center. He was jumping from desk to dust of the social workers and screaming and throwing things and had a lot going on.
Holly: So, yes, this is my kid. So we brought him home that night and and he's been with us ever since.
Mary: Does your husband have any kind of mental health background?
Mary: But did that scare did that scare him like this might be a little much.
Holly: I mean, you were a little bit scary, but, you know.
Holly: I think it was because of what I already knew being in the field and also we're like, we love this kid, like as soon as we saw him, so we knew that he was just going to be our kid.
Mary: And you just he wasn't diagnosed with autism at that point, so you had to untangle the trauma and all that and then you had to seek a diagnosis for a six or eight year old.
Mary: That's not easy either. Not easy.
Holly: He had already been diagnosed with about everything so reactive attachment disorder, ADHD, oppositional defiant disorder, I mean, PTSD, you name it. It was in there, but not ASD.
Mary: When the developmental pediatrician diagnosed Lucas' two decades ago, his name is Dr. James Copeland, who was on the podcast a while back. You can search for him. But I was like freaked out by the diagnosis. Of course, I was in denial for a long time before the diagnosis.
Mary: And and I said, well. What like what's kind of is it necessary to pin this diagnosis on him, even though he was three and maybe it'll get better and that sort of thing? And he said, you know what? What he would see routinely is if you don't get a diagnosis of autism, you're going to or go shopping around to different doctors. You'll get a bunch of other diagnoses that may not be. May not be correct and won't really serve you well either, and I know we're going to talk a little bit about autism and ADHD, but, you know, Dr. Copeland really suggested that having autism.
Mary: There is a spectrum and you don't need all these other diagnosis, like oppositional defiance or obsessive compulsive or even ADHD, and you probably don't agree with that. I'm not sure.
Mary: But I do think now two decades into this. There are medications and there are strategies for the ADHD that comes along with autism in some situations that it might benefit from having both. But what are your thoughts on on all of these diagnosis of your child or whether it's a client, but especially the higher functioning kids? They tend to come in with quite a list of previous diagnoses.
Holly: They do, and that's an excellent question. I think of it like this. What does that child need, a diagnosis does not make this child different. It does not change them. It doesn't change their personality. It can be hard, though. It can be hard for parents. I'm one of them. It can be really tough.
Holly: But the thing is this, what I find and I've seen hundreds and hundreds of children, I've been working with children with ASD for twenty three years now, people understand them more. They're able to it opens the doors to more services. Definitely. You know, it's unfortunate that if you have a child that's diagnosed with ADHD but also meets criteria for ASD, but they don't have the diagnosis, it seems like they don't get what they need as much. And it's unfortunate, but that's true. I hope that changes at some point, but it's just not that way now. And so it is a label. But if the child meets criteria for ASD, again, there's still the awesome kid they've always been, but I find that professionals, teachers, other people can understand them more and that is incredibly important.
Mary: Yeah, and definitely with services.
Mary: Because of the work of many autism parents and advocates, some of whom are lawyers, like Laura was on a previous podcast and she went around the country for Autism Speaks, for legal reform, for coverage, for ABA services for children with autism.
Mary: So that's one of the big differences I see, is kids with just ADHD who don't meet the criteria for autism or don't have the autism diagnosis, have a very difficult time getting any kind of ABA services, which is critical as big as another one behavior analyst to another.
Holly: For sure it is. And it's unfortunate. And hopefully, again, that will change behavior analysis can be so effective for so many people. Any time we praise as a parent or say great job to a colleague. I mean, this is not just for children on the spectrum. So I think that is important. Early diagnosis, the most important, certainly. But I do find that children do get more of the help they need once they have the diagnosis.
Mary: Yeah, and just to tie in, another thing of ABBA is a science, it's the science of changing socially significant behavior. And and it seems like a lot of the neuro diverse crowd or the ADHD parents or professionals even really have a problem with ABBA and and don't appreciate the power of ABBA saying, like, we don't do ABBA, we don't do reinforcement. It's like as a behavior analyst, it seems so like, how do you respond to things like that?
Holly: Like, well, I think that it's it's a question of just understanding. What I say in the set might sound circular, but I guess it is in some ways is we are where we are when we're there.
Holly: I thought mistakenly when I was a new behavior analyst, I knew everything, I knew everything right.
Holly: And I think that's what where we all are kind of when we're younger.
Holly: And I thought, oh, I knew this. I knew everything until I became the parent. That was a whole nother level of understanding. I think, again, we know what we know when we know it, and if you are using any kind of sticker chart or point system, any I mean, there's tons of whole behavior classroom management approaches that use that.
Holly: That's the science. So.
Holly: I you can call it, I guess, whatever you want, do whatever makes you feel comfortable, but that is, you know, trying to increase behavior that maybe that child was struggling with and and they will be able to get more reinforcement this way.
Holly: But I think there are some semantics then. And they just get a little bit confusing.
Mary: Yeah, yeah, like some people, some parenting experts are like, we don't use threats or punishment. I'm like, yes, good, good. I don't either. And we and we don't use any rewards or reinforcement. I'm like, whoa, whoa, whoa.
Mary: Whether you think you use it or not, everything is about. I mean, even our listeners listening to this, they're listening because something we're saying is somewhat interesting or reinforcing to them. Otherwise, you wouldn't be listening. If you're walking right now, you wouldn't be walking unless there is some benefit to you. It is is providing some kind of reinforcement.
Holly: Absolutely. And then as far as even decreasing behavior yesterday, my husband does not like things in the same.
Holly: And I left a mug in there and he was pretty upset. And I because of his reaction and my feeling to that reaction, I'm going to pay better attention to put the mug in the dishwasher.
Holly: So, again, I think it's just the understanding of how behavior works and and what we do. And maybe we don't understand quite what we do when we're talking about reinforcement and decreasing and increasing behavior. But really, we all do it and all humans do.
Mary: Right, right, so let's talk a little bit about your younger son, who was only a year when you adopted him and went on to get a diagnosis of ADHD, so. Well, I just told you before we hit record that I have a new book coming out at the end of March in time for Autism Awareness Month, it's called Autism Around.
Mary: And it is for parents, very young children with signs of autism, which signs of autism in my book and in my mind can be signs of ADHD, too, can be signs of learning challenges or we don't know what it's going to be. And maybe young children, maybe a young child does have a diagnosis of one or more of these things.
Mary: But it's really, in my experience and background, very, very difficult to tell what it is when a child is one or two, 18 months, those sorts of ages.
Mary: So when you adopted your son, when he was one and so what were some of the earliest signs you saw that that showed you that maybe he was going to have some diagnosis underway?
Holly: Sure. The adoption journey is for any of you listening that have been through that, it's just it's it's incredible. And I just realized this is I think so many of you are going to appreciate this.
Holly: I've got my mommy needs sleep mug for my third cup of coffee right now. So that just tells you a little bit. And I think a lot of us can relate. Right. So my youngest, again, we got him at three months. And when you adopt through foster care, it's a very different experience. My oldest son came to live with us when he came into custody at four and we adopted him at six. It took two year court to make that happen. And then for our youngest son, we were able to adopt him at one. What we noticed was there were some a little bit of a speech delay just by a few months, nothing very significant, a little bit of motor differences, fine motor differences that we noticed. Also some emotional regulation differences that are hopefully when they.
Holly: Update the diagnostic manual, ADHD will be more clear in the diagnostic criteria about the emotional differences that come with ADHD.
Holly: So we so I knew something was different.
Holly: For him and then I obviously I do this for a living, so I knew that he was going to have learning differences and ADHD prior to the diagnosis, but we did get a diagnosis, got him diagnosed early because I think early diagnosis is extremely important and can open the door to services. So for him, he had occupational therapy for my fine motor skills. He had a lot of.
Holly: Writing differences that that can be pretty frustrating for him, so we put some accommodations in for him. And again, how we interact and what our expectations are and having to go with the flow with both boys, so it's it'sit's been a journey.
Mary: Yeah. Now, are your boys on medications and did you struggle with that?
Holly: Oh, goodness, I did. I did. And it's it's hard to be a parent, period. It is.
Holly: But when you're a parent differently wired children, that's a whole other level.
Holly: I did my undergraduate honors thesis on parenting stress in parents of differently and literally it's off the chart of the parents drug literately.
Holly: So that kind of tells you how that is anyway. But when you are also a professional, because I know you have a lot of audience that is professional as well, there is this expectation that we have of ourselves that I should be able to do all the things perfectly.
Holly: I should be able to have the best behaved kids that have ever entered Wal-Mart or whatever that looks like.
Holly: So I think we need to just kind of give ourselves grace.
Holly: It is it's not easy. And we have to understand our kids what they need. But we also have to understand that, you know, we can do the best we can, just like they can do the best they can. But yes, having havinghaving two kids that are differently wired is it can be really tough and it's tough on them.
Mary: Yeah, yeah, I did do a paper which we can link in the show notes, it is called The Experiences of Autism Moms who become Behavior Analysts. And that's a qualitative study I did when I was pursuing my PhD.
Mary: So even though you were a Buckby before you became an autism mom, I think you'll appreciate some of that. And some of that is once you become a mom to your children on the spectrum, you really do see things. You can see things from both, both as a professional and as a parent.
Mary: But, you know, when I would go into schools working through the verbal behavior project for the first seven years of my career, a teacher would say like.
Mary: They come and their shoes, they they just keep taking off their shoes. I told mom she needs to get new shoes or, you know, it's like. It's almost like a little blame on the parent or and it's like I would always defend the parent because, like, Lucas used to take off his shoes, like, obsessively, and it was like, I would just keep trying different shoes.
Mary: And it's hard as hard as a parent or the child would be having problem behaviors or or anything at school. I'd be like, what do these this child do all weekend long?
Mary: Like what? I would just like to see what how they're engaging themselves or how much supervision they must need for them to even be safe. And so I think as both a parent and professional. We have the advantage of being able to see both sides, and I can also see sides where a parent is having unrealistic expectations and being very demanding, like we all need a positive every negative. So when I'm interacting with my son or my clients, but also when I'm interacting in the past, when Lucas went to school with his school district staff, they need a positive to every negative to and I'm like, where is that data? I don't like the fact that he came on with marker all over his hand. He seems to have a mark on his arm. Like if you're delivering that kind of negativity to the school, it's going to be hard to have a team approach where you're just moving forward in a positive way.
Holly: Wow. You you just touched on so many important that I just was thinking, wow, I want to I want to talk about that.
Holly: You know, one of the first things before I go into talking to parents and teachers and and how that all interact, because it's absolutely true. Everything you said. My first experience with parent shaming. Which I it was new to me, and I know the parents listening are going to say, yes, they know one of the first time that it happened because it's dramatic. When our son came to live with us, he had these shoes that had holes in them and they didn't fit him. And I was new to parenting. I this was my first baby. That's one way to get into parenting, let me tell you. So he really had to be fitted.
Holly: I took him to the mall, which is is his first experience at the mall by myself, probably not the best idea. And so he was hiding under one of the benches.
Holly: We're waiting for his feet to be measured and another child thought that looked fun apparently, and also hid under another bench and the mother yelled at her child and said, you better not go under there. Some people just don't know how to parent.
Holly: And I. I was shocked.
Holly: I wanted to say I wanted to say I just for 11 years, our story, you know, getting this kid's been through more than you'll be thrown a lifetime, you know, and just off.
Holly: And I probably would have been arrested if I didn't have some kind of internal speech to be able to work through my checklist and say that would be, golly, you know, so I stayed quiet because that would have distressed him, my son.
Holly: So I'm like, keep it together.
Holly: And so being on that side of parenting when first starting as a professional, that was something it was quite a different experience. There was a time where he had been in grocery stores before, but he was taught to steal. And so that was very difficult at first, obviously. So as a behavior expert, you're going to set him up for success. We're only going to go in. We're going to get one thing. I've got a picture that one thing I know exactly where it is. And if he walks next to me, if he was a runner, he walks next to me, he's going to be able to check out. And so we had planned this Pratham roleplayed. You bet it. We did it.
Holly: And we went in, was all going well and he took off. And so, OK, come back, we're going to practice this, we're going to do some cuts, we're going to get this done.
Holly: And then we were leaving, but he didn't earn it, but he was going to be able to earn it.
Holly: We were going to come right back in and do it again. So he got the opportunity to I was going to set him up for success. He decided he wanted this finger candy ring. I have, like, traumatic experience every time I see one.
Holly: To this day, he was screaming, freaking out, rolling around on the floor. People came out from the aisles to watch. I mean, people stop shopping to watch this tantrum. It was so amazing.
Holly: And so I was impressed even and I've seen thousands of drums, so he's like circling all over the place, I had strangers come up to me and offered to buy it for him. Strangers, multiple strangers, and I said, I've got this, thank you.
Holly: He grabbed it, jumped in the air. This is amazing. Origi, the video jumped in the air and actually swung it across the scanner and it beat.
Holly: And the person checking this out was horrified because they see all this going down and he's like, I got it. And I said, Well. Now.
Holly: And so she had to undo it and then we laughed and then of course we did again, he did great. But on that parent side, it is a whole different ballgame. It really is.
Holly: So I can see why you'd just be like, give it to him. Right. Because it was embarrassing. I mean, people were coming up to strangers.
Holly: When you're when you're walking through that journey and again, being both a professional and a parent, I think you really do have a special lens that you can look through. As a parent, I am absolutely more in tune as I should be with the parent part of all this. Often times there is blame and again, people do what they do when they do it, they know what they know when they know it. So if you have a teacher, they're frustrated, they're exhausted, they're overworked.
Holly: You may hear the word refuse. Your child is refusing. Or your child ran out of class or you didn't get all that homework done.
Holly: And so you feel defensive because you want to defend your child, but you also feel blamed at the same time it can set up some really difficult interactions between the school and in home.
Holly: So I feel like when you go and just ask some simple, nonjudgmental, being very mindful of yourself, whether you're a teacher or a psychologist or a parent, whoever, and say, what is this child telling us they need?
Holly: When you come back to that, it always gets better. What is this parent, me? What is this teacher need?
Holly: When you come from that perspective, it's a lot harder to to have these big feelings and big judgments, they could come up because we all have judgments. We're all human. It happens. But it's lovely how you can really step back and ask that simple question and start doing some good work.
Mary: Yeah, the whole ring and the know, while you were describing that incident, I thought a lot of parents on on anywhere in any Facebook group, even in my closed Facebook groups and my Q&A calls with my members know.
Mary: Once it gets to that point where they want to know what to do the next time he throws a fit at the store, you know, even as behavior analysts, that is a dance.
Mary: And it is when we have when we have a big outburst like that is it's not a very Win-Win situation. In the end, it turned out OK because you knew what you were doing and you practiced it and you came back in and you did it again. But very few parents would be able to navigate that and do it in any way correctly so that as to not cause harm or cause whatever. And and I feel like know my message is, is really I'm sure you're going to agree with this is like we want to teach parents how to prevent and how to how to go in the store for one thing. And but once you get into a full blown meltdown, like that's something that it's it's not just getting a tip from the show or whatever, like meltdowns are if these meltdowns are daily or very, if you have a large child and the meltdowns can cause serious injury, you really need some help and some help from a behavioral analyst or somebody that knows what they're doing.
Mary: Because even I could picture myself and I'm running through scenarios in my mind of different incidences that happen with my own child or my clients when I was involved. And it's like, wow, this behavior stuff is really hard.
Holly: It is so hard and I do not recommend that. I do not recommend doing what I did. If you had done all that legwork and had an expert help you, I would not.
Holly: Because like you said, Marion, it's important that a child is in that school. It's just about keeping them safe, getting them comfortable. It is just about that first, always. And so I'm glad it brought that up, because that's what that is not easy. And that was a lot of work leading up to even walking in that store. Yeah, yeah.
Mary: And it might even involve buying candy and getting out of there or getting your child into a safe position and trying again next year with a more proactive like you said, it might even be that situation where it's that dense. Now, in that situation, I knew what exactly.
Holly: I knew it. I knew exactly what I needed to do. But it could have been the case where I had him hold it. We went back and got another item and then came in, then came back. I mean, this is there are lots of nuances. There are lots of things that can happen. So that is not it's not a time to to have a big, massive event in public that could possibly be unsafe. The only reason why I did that is I knew exactly what to do and I had a lot of free work going into it.
Mary: Right. Right. And you knew you were going to turn around and it was going to be successful, what, the next time.
Mary: And a lot of parents without behavioral background will be like they would get out. They'd be in a full blown sweat, like I'm not going back there ever again. Know.
Mary: And so it and.
Mary: You know, my big thing is, is safety and just keeping preventing preventing them always and that's yeah, I knew that you would totally agree with me, but this is where and even if we had five behavior analysts looking at the video. After the fact, we probably have five different opinions, and it's like my one exactly, you know, in some ways is kind of like a jump rope, like you kind of have to jump in and sometimes you miss that window and now you're if you jump in, you're going to end up reinforcing the wrong thing and is quite it's quite complicated.
Holly: And it happens. I mean, there is no perfect parent, including me. There isn't. And I do this for a living. Yeah, I know it's hard. It is because we're all human. And I think we just need to be gentle with ourselves, like we're learning kids and, you know, what they need and how they need it and how much work on the front end that they need. Obviously he was also little and that that's a big point.
Holly: Now he is one hundred and eighty pounds and that's a different story. So that's that's always something to think about.
Mary: Yes, he was he was small and he was pretty verbal and he had lots of variables.
Mary: So I'm glad we we talked about all those variables in my article on the autism mom becoming behavior analyst.
Mary: I know one of the big positives that the six women reported was they knew how to treat problem behavior and they knew how to prevent problem behavior, which really turned things around, know they knew that they could change behavior and that they had the skills. And so parent training on reduction of problem behavior skills is is really what they recommended in the end, which is really the whole point of the podcast. And I think, OK, let's move.
Mary: I'm sorry.
Holly: That's important. I wouldn't have already been a professional in the field. That is the first thing I would do was to get their training. Absolutely.
Mary: Yeah, so you do actually diagnose kids with autism and rule out autism in some kids and diagnose kids with ADHD and rule out ADHD or autism in other kids. So that's really fascinating. And we talked to right before we hit record about you don't do IQ testing and achievement testing, which is recommended for kids five and older.
Holly: You have a really young kid. Not to say I know how to do it, but I don't care to do it, if that makes sense.
Holly: I think we all have our preferences in our work environment. And it's I do know how to do those tests, but I do rather if I'm testing someone who's older, I rather than have IQ and achievement testing prior to because there might be a learning difference and that we can't ignore. And we definitely need to know that now with the younger kids, like you were saying when there was an IQ testing, probably, does it make so much sense for them?
Mary: Now, in fact, I would really caution against IQ testing before the age of five, especially when you are not not verbal or minimally verbal, because what happened to me was right before, a month before Lucas was diagnosed with moderate severe autism, the first of three agencies said, well, we can send you to a psychologist.
Mary: And he gave the diagnosis of at the time, this is two decades ago, and which is kind of like mild autism. But he he was I was crying. He was like, well, I could give him a diagnosis of, like, childhood schizophrenia. I'm like looking at this guy, like, what are you talking like? He was so outdated with his knowledge. But when I got the paperwork, Lucas's three, like, I had any regrets. So I had visions of him being like a genius and no problems. Then all of a sudden now he has autism. When I got the paperwork from the psychologist who is pretty outdated, he actually gave Lucas an IQ test and an IQ score and so on the paperwork it said D.a.'s, which was to me very devastating, but also mild mental retardation, which he had disclosed that he was even doing an IQ test. So Anthony Lucas was like Lucas was like sitting on my lap, really couldn't really talk. And and then when I asked him, I said, well, I have an appointment with Children's Hospital to see a developmental pediatrician in a month. Should I go there? And he's like, why? They're going to tell you the same thing I just told you. Like, why would you go there? Yeah, like, really bad. Really bad. But when I got to chop with Dr. Koechlin, I asked him about this IQ and he said through a children's hospital, he said we would not do an IQ test or consider an IQ score valid until at least the age of five for a child with severe language impairments, especially. Right.
Mary: So that's that is kind of my gut. And now you're a professional. You do this for a living. Like, do you agree with that?
Holly: Absolutely agree. I mean, you can do it before that. But I feel like once you're looking at around 5:00, it's going to be more reliable and valid. We want a good test. Right. Or that child is is in testing for no reason. And it's not going to be accurate. And you don't want to based recommendations on something that's not accurate. So, yes, I agree.
Holly: Yeah, I do think that we can diagnose autism earlier than five, so you don't have to wait to to get that evaluation.
Mary: Yeah, so is there something specific that you look for, say, a two year old that comes in to rule out autism versus ADHD?
Holly: ADHD is really interesting, especially in young young kids, because they're so active. They're not they're not sitting in a seat or academics. It can be really, really hard. Now, usually you're not going to be diagnosing ADHD at that young age. However, AEST, that can look different when you're looking at severe speech differences, playing different things. How are they using toys? How are they using language? What are they pointing is they're drawing attention. I mean, there's just so many things to look at. Are they engaging in any self stimulatory behavior?
Holly: So those are types of things that we can see sometimes pretty early on. I mean, I diagnose children before the age of two.
Mary: Yeah, and you do also use the ADOS test, which I think I did a video blog on, and you interview the parents of the child at daycare or preschool, you interview them or have them fill out checklists.
Mary: So you really do diagnose. So. But the treatments, in my opinion, are pretty much the same if you are young, like in terms of parent training on teaching imitation, teaching that caregiver back and forth, diad teaching, babbling, pairing up, learning so that it's fun, reducing problem behaviors around, not just talking and things like that, but also going to doctors and dentists and sleeping and eating and potty training and all the problem behaviors, which is all what my new book is all on. But I think, you know, if I had a two year old that it was well, I'm not sure if it's ADHD. It's going to be a learning difference. It's going to be just a speechley. It's going to be autism. And a lot of times those people are standing in line waiting. So my whole thing is treat it. Some psychologist told me once, treat it like it's the most severe autism in the world and you won't like then think I should have done more. Like it seems like people that have higher language, kids tend to.
Mary: Not diving so much. Well, maybe they'll just.
Holly: And I can see why a lot and a lot of pediatricians are really skilled in understanding and doing screenings for autism, but some aren't because pediatricians are supposed to know a lot about a ton of things.
Holly: And sometimes I'll hear from parents that come to see me is we didn't know. And there's that guilt there. And it's hard when a pediatrician said they'll catch up, come back in a year, and then we've missed that. We get another window of helping so we can be hard.
Holly: And there's sometimes there's a lot of parent guilt there, and that's understandable.
Holly: So doing this here and being.
Mary: Yeah, yeah, but like you said the earlier, you can identify what the problem is that they meet the criteria for autism and if you are not waiting in line, you get the diagnosis, get the treatment, learn more. You don't have to learn everything overnight. We're both parents and behavioral analysts with decades of experience and just take baby steps in the right direction and you will learn as much as possible so that your child can reach their fullest potential, whatever that is.
Mary: Yeah, so we are wrapping up, we need to wrap up because we're getting close to the top of the hour. So part of my podcast goals are for parents and professionals to be less stressed and lead happier lives. So do you. I know we talked a little bit about this, but do you have any stress management tips or self care that you have used over the years that you would advise for our listeners?
Holly: Well, first, you want to get yourself like a mug or something to carry around.
Holly: I feel like we need to be more gentle with ourselves. And I said this earlier. I cannot stress that enough. You are going to have your own meltdown. It's not if you will, you will. It's when. And that's OK and loving on yourself, knowing that you're doing the best you can in that moment and not beating yourself up about what you should have done or what you could have done. That doesn't serve you. It does not serve you. So I always say do the best that you can in each moment. And when you don't be gentle with yourself and that's again, it's OK, you are going to be OK and you are not alone. And these are one of those podcasts that can help you feel not so alone as well. Support, get support around you, join groups. There's so many beautiful things out there to get support. Don't be alone. Don't isolate yourself. Love on yourself. Forgive yourself.
Holly: And take a breath.
Mary: I think that's great advice and people can learn more about you and Holly Blank. Moses Dotcom, you have a podcast which I just found out about called Wired Lead Wired Differently. And you also saw some courses online. So, Holly Blank Moses, it's been a true pleasure to get to know you better. I'm sure we're going to be in touch in the future, and I really wish you the best.
Holly: Thank you so much, Mary. I appreciate it. Take care everybody.
If you're a parent or an autism professional and enjoy listening to this podcast, you have to come check out my online course and community where we take all of this material and we apply it. You'll learn life changing strategies to get your child or clients to reach their fullest potential. Join me for a free online workshop at Mary Barbara dot com forward slash workshop where you can learn how to avoid common mistakes. You can see videos of me working with kids with and without autism. And you can learn more about joining my online course and community at a very special discount. Once again, go to Mary Barbara dot com forward slash workshop for all the details. I hope to see you there.
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