#111: Professional Collaboration with Parents | Interview with Ria & Kristen

professional collaboration

One of my goals is to give parents the tools they need to become true partners with the professionals in their child’s therapy. Ria, a parent, and Kristen, a BCBA, discuss how to achieve a good working parent and professional collaboration to help a child reach their fullest potential. When Ria’s son was diagnosed with autism, Ria had a background in nursing, so she could bring her medical background in to help her family adapt to her son’s needs. But parents don’t need a medical background to help their child. They only need a BCBA that’s willing to work with them to teach them what they can do to support their child’s progress.

Kristen Colyer is a BCBA and the Director of Children’s Services, and she’s worked with Ria’s son over the last year to help him learn enough words so that he can begin communicating with family members and teachers. The most important question that Kristen asks the parents of her patients is, “What’s the one thing I can help you change?”. She believes that no matter what her goals for a child might be, the family’s culture should inform part of the therapy so that the family can find a way to thrive.

An essential part of any therapy plan is a baseline assessment to help you see where your child really is at. Ria’s son could only say four words when she sat down and carefully counted everything he said. By keeping track of his words, she was able to know which words to work on and be able to see his improvements. Since she has taken my online courses she has the knowledge to continue to build his language at home based on his baseline assessments.

My newest book Turn Autism Around: An Action Guide for Parents of Young Children with Early Signs of Autism was specifically written to help parents like Ria so that they can see how they can help their child while they wait for a diagnosis or services, or so that they can work hand-in-hand with professionals to enhance the therapy services their child already receives.

TODAY’S GUESTS

Ria is a registered nurse and the mother of 3 children, the youngest of which has autism.

Kristen Colyer, MC, BCBA, LBA is the Director of Children’s Services for Mid-Atlantic Human Service Corporation. Currently she oversees the development and operations of a clinic-based center that provides intensive ABA interventions to early learners with a primary diagnosis of autism. In addition, she consults in a public school system in which she oversaw the development of an ABA/VB program that is run in the schools for children with autism from kindergarten through graduation from high school. She provides continuing consultation and professional development specific to Applied Behavior Analytic strategies and principles. Kristen obtained her Master’s Degree in Special Education and Human Service Management from Western Maryland College in 1993, her BCBA coursework from the University of North Texas in 2011, and is currently working toward her Ph.D. in Applied Behavior Analysis from The Chicago School of Professional Psychology in Washington D.C. Kristen has worked in the field of human services for over 30 years providing support for individuals with disabilities in many different capacities. She has worked with adults and children in school, residential, and vocational settings. Most recently her focus has been with children with autism from birth to 21.

YOU’LL LEARN

  • For parents who are waiting and waiting for a diagnosis, there are a few out-of-the-box ideas for finding providers who can help you.
  • How to find an ABA center that emphasizes positive child-centered therapy.
  • Including caregivers and extended family members like grandparents into the therapy plan can reinforce the language and behavior learned in therapy sessions and sustain the child’s progress.
Want to get started on the right path and start making a difference for your child or client with autism?
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Transcript for Podcast Episode: 111
Professional Collaboration with Parents | Interview with Ria & Kristen
Hosted by: Dr. Mary Barbera

Mary: You're listening to the Turn Autism Around podcast, I'm your host, Dr. Mary Barbera. And today we have two guests on the show. We are talking all about parent and professional collaboration. And we have two people, one parent and one professional on the show. They actually work together and they both independently took my courses. So it's a great example of how parents and professionals can work together and they have a lot of great wisdom to share. So we have Ria, who's the mom of three, including her youngest child, Alex, who is diagnosed with autism. He recently turned four. And then we have Kristen Colyer, who is a behavioral analyst, and she is pursuing her doctorate in ABA and she is the director of the Center for Behavioral Services. And she also consults with schools and she is providing behavioral services for Ria's son, Alex. So let's get to this great interview about parent and professional collaboration.

Mary: So thank you so much, guys, for joining me today. I have Ria and Kristen, thank you so much.

Ria: Great to be here.

Mary: Yeah. So I know we're going to get into your individual falls into the autism world, but I just wanted to start out by saying that Ria is a parent who has taken my courses and Kristen took my course with the first round back in 2015. She's also seen me present live and she's been on a business retreat with me, trying to help me take steps forward with my business. So they both independently took my courses. And actually I was able to connect Ria with Kristen in terms of finding a good ABA program for her son.

Mary: So while we usually have the privacy concerns about a professional talking about a client, both Ria and Kristen signed written permission and are here to really share how we can how we can have great parent professional collaboration and how we can spread the word about how effective ABA can be, and especially using the Verbal Behavior Approach and the Turn Autism Around approach. So with that being said, Ria, can you briefly describe your fall into the autism world?

Ria: So it wasn't graceful. I'd fallen into it very hard. This is when my youngest child, Alex, was diagnosed when he was thirty-three months. So autism was first mentioned to me through my daughter Elaina. She has speech delays, but was eventually garbled out. We did early intervention with her and she did well. So as my second child and I have infants and toddlers see her too, with some issues with speech delay, but she eventually was able to meet her milestones and did not need any services. But with Alex's first year of life is very challenging. At three months, he was diagnosed with ITP.

Ria: So our attention was focused on the ITP, this autoimmune disease that was consuming our lives. But then he was approaching two years old. He started showing signs first with the speech. DeLay wasn't progressing, very picky with eating and a lot of self-induced behaviors. Prior to that, we got some speech therapy from the infants and toddlers from the county. We were on that for four months, but with no progress. And then I called Kennedy Krieger for an appointment. But we also had to wait eight months. And then as I was mentioning my story to a friend, she mentioned Kristin to me. And we were able to get in in four weeks. And then we received the diagnosis that, yes, he's in the spectrum and we started the process from there.

Mary: Right. And you also found my course at some point around that time, shortly after 2, right?

Ria: Yes. So basically, it was like two and a half when I found your course is when we started with the infants and toddlers. He was a. He just turned to I found your cause around you, and you have at the same time I was working on getting him diagnosed. So it all happened at the same time because I must have Googled and searched. They know about the answers to my questions and anything that would help us, especially he had a lot of self-injurious behaviors. So I want to focus on that. That was my main concern at that point.

Mary: Wow. Yeah, so you had told me that he had like his some of his science were like lack of pointing and hand leading, which you take an adult's hand and bring them to something and put it on there. And those are especially the combination of the lack of pointing by two and then also hand leading our to two big signs so we can link those video blogs in the show notes. Yes. So you did find Kristen. So we're going to move to Kristen now and she is going to tell us about her fall into the autism world. We also did a whole podcast with Kristen Coiler who is a board-certified behavior analyst. So, Kristen, can you briefly we'll put her whole episode in the show notes, but can you briefly tell our listeners about your fall into the autism world?

Kristen: Sure. I started my career as I was the psych undergrad major and a master's in special education and human service. And I worked with mostly with adults with intellectual disabilities. And then I kind of stayed home with my children. And then when I decided I was going to go back into my career, I was hired by a school system as kind of in a behavior position. At the same time, I was working toward my Buckby, and at that point I started working with children with autism and kind of really doing more research and kind of finding my finding my this is where my niche was. My true love is working with children with autism. And I just that's kind of it kind of went from there and I kind of veered more of my education and expertise in understanding verbal behavior and how to work with children, understanding what autism is and kind of really understanding how to work with children with autism, using that the verbal behavior approach. So and then since then, I've been just working specifically in the field of autism as a behavioral analyst.

Kristen: Right. So right now, you're the director of the center where Ria's son comes and found my course and your services pretty much at the same time and got a diagnosis, even though Kennedy Krieger said an eight month wait, which is very, very common. She was able to then go to a psychologist to get an evaluation. And a lot of people don't know. But like developmental pediatricians can diagnose neurologists, child psychiatrists and psychologists. And so for a lot of center based where you need ABA and you need a diagnosis, a lot of times you can go to a psychologist. But that psychologist really needs to be trained on diagnosing autism because it's really important that a psychologist not eyeball kids and and not have any valid tools to actually walk you through so that you get the right diagnosis or you don't have somebody just eyeball a child and say, no, it's not autism. And I've had that experience with multiple kids I've known over the years. It's now it's probably not your good. And then they don't give him a diagnosis and you can't get treatment or it's probably going to turn out to be ADHD. But if you go to a variety of practitioners to get a diagnosis, sometimes you get a bunch and sometimes they're not right. Do you have experience with that, Kristen?

Kristen: We're really lucky. At the center, we have a clinical psychologist who consults for us once a week and he comes in and that's actually where we was, how I was able to get the diagnosis so quickly that she was able to we had him on staff. He's not on our staff. He's a consultant for us. And to that, we were able to get her to him. And he did a very thorough I feel he does a very thorough diagnostic assessment using many, many tools. He has a very great understanding of the children with autism. So kind of gives a very good evaluation. But yeah, I mean, I work we have forty children at the center and we get diagnostic assessment, comprehensive assessments that can be like a paragraph where, you know, children come in and I'm like, how did they really get in?

Kristen: How did they really get this diagnosis? So the different levels of people in the different types of time that people are actually putting in to making these diagnoses are you wonder? You know, and I've heard many parents, especially now with the situation with covid and telehealth, where parents will say, oh, they made my child stay in the room in our house for three days. I had to do it to take two or three days in a row where we had to have the exact same things in the room. And, you know, my child wouldn't attend to the screen and stuff. But then they're getting these diagnoses that are either. Yeah, they do. I spent two hours on the phone yesterday talking to a mother that was telling me all the indicators, speech, hand leading, not pointing itself and his behavior, and that they did a telehealth diagnosis and they got a diagnosis of sensor not autism. So, you know, I see both ends of it, and I feel like parents are really getting the short end of the stick. Are they really getting the proper diagnosis, though?

Mary: Yeah, yeah. Wow. I don't know that we've ever mentioned in any podcast, but you know, I think maybe another avenue to get a diagnosis, especially when you're facing an eight or 12 or two year wait, which is not out of the normal, even in the United States, is to search for an ABA clinic or center, preferably with verbal behavior and VB-MAPP expertise. That is kind of how I recommend searching is, you know, if you live in in Tampa, Florida, I would put in ABA verbal behavior, VB mapp, Tampa, Florida, and see what comes up.

Mary: And so some of those centers could also have connections or consultants of psychologists who believe in ABA because otherwise you wouldn't be consulting with them or referring to them. Right. And a lot of times, even if you're if they're out of network in terms of insurance, if you can show that the wait list for Kennedy, Krieger or Hershey or Children's Hospital of Philadelphia or 12 months wait and you can get in a lot of times you can get an out of network diagnosis or evaluation. So those are probably good tips for a lot of people to hear. OK, reia so it took you several months of searching, worrying until you found first my course and, and Kristen's work and the actual diagnosis. And so how were you feeling back then.

Ria: It was very confusing, like during my search, but when I found your book and I found your cause and I started looking into it, it kind of empowered me to do more important, because now I know what works and I know what will help him. So at first he was very confusing. When you're looking at something, there's a lot of conflicting information online. So your mind is kind of absorbing everything as a new parent who is dealing with something like autism. And it's not easy to absorb everything. This is now like in your face, got to find some solution, especially like my son who had some is dangerous behavior. I couldn't wait. I feel like I have no time to wait for like I have to find it. So when I was looking and I stumbled into, of course, and I keep saying this empowered me and gave me a lot of knowledge, a lot of skills, and it kind of lowered down my worry. Not so much. What he can do about memory gave me hope that, yeah, there is a solution for this, which I did.

Mary: Yeah. So part of my course is I start out with getting baseline assessment information, so writing down words you hear within an hour or any words you hear for half an hour the whole day. So you did that baseline work, of course, because you are a nurse and really you know that baseline information. You know, if you're going to try to treat a fever, you kind of need to know what's the temperature. And so it makes sense. So when your son started out, he had, what, just a few words?

Ria: I was looking back at this when you invited me, like I was looking at this and it was four words that I can remember, four or five. And to myself, he doesn't even call me mom. And I was so upset about that. So and then I used it again, I think this year causing two weeks and lifetime. And it wasn't even as consistent because I did it three times a week, 20 minutes each time, because I work full time as a nurse. So I just do it in school. But at the end of four weeks, he was saying I was listing my getting longer and it was about one hundred like words, word, approximations in sounds. And, you know, he can say no, he can say Gucky used to say Ki and I would say I would write it down on the sound. So I, I know the steps in my head and I was excited to watch videos I want to go over and again if it doesn't work and go back. So it's no it was not like hard for me. I got the steps.

Mary: Well once you start to see that kind of progress then that's super motivating. Right. And I just want to highlight that, because a lot of people think like, I don't have time and really three, 20-minute sessions per week, that's one hour per week. You had already had early intervention in there for four months, for more than one hour per week, not making any progress. And you did one hour per week for four weeks and you went from four words to one hundred and twenty words. And it wasn't just that burst of growth. Right. Your son now just turned four and he's continuing to make progress. Right. So that was just like the beginning of the progress.

Ria: Right now I want to mention, because it was a little bit exciting for me when I started it. And the speech therapist is not making progress. And we were doing table time at ten. Not to mention, when he was diagnosed our insurance didn't cover for it. So we have to wait for that, too. So when I was doing your course in the speech therapist, I said, I am doing a long time with my son and if you want to watch us do it and she agreed, she said, OK, let me see. And she couldn't believe that he was sitting for thirty minutes. And prior to that, before I make him sit down. So I said, this is what we do. I mean I have a reinforcement. I have. So yeah, I was excited to show. And what we do and what works and when she came back after I think two weeks of not seeing him, he actually said, yeah, yeah.

Mary: And it was great that you were able then to also find Kristen and her center. So what kind of hours did he go initially or does he go now to the center? Well, let's say before Covid, because you started all this right before covid.

Ria: So we started on so he was diagnosed October twenty nineteen. We did start three months later because the insurance coverage. We started January 2020, covid kind of stopped everything like March 16th, I'll never forget that day.

Mary: I don't think any of us will forget that day when the world shut down.

Ria: He was on ABA for about, correct me Kristen if I'm wrong, about ten weeks total. When covid came, he was in ABA January, February.

Kristen: He comes to the center five days a week for four-hour sessions. OK, that's what we were doing. So he was getting 20 hours of intensive ABA, you know, which incorporated table time that we were doing some social skill a little bit. Not really much in the beginning because he didn't have that skill set yet. But yeah that twenty hours a week.

Mary: Yeah. So when you got him, you know, what kind of skills did he have and what were your main goals in the beginning?

Kristen: So when he first came to us, he was a very low level one learner on the VBMAPP so that you know, that little pyramid you always talk about when you when you say he was like a poster child for it. So he had that nice little pyramid. So our biggest concern was to get some real functional mands out of him, getting him to make those requests without the pull, getting him to tact and label his environment.

Kristen: And our big concern for him at the time, like Ria talked about, was decreasing those problem behaviors. He had the self-injurious behaviors, which included headbanging. So he went ahead and heart services. That was definitely something we needed to focus very quickly on.

Mary: And how often did that occur, Kristen? Like a couple of times a day or three times a day?

Kristen: Definitely. It was his go to when he couldn't get his needs met. He didn't have the language or if something happened that he didn't like. So that was one of the things that he did not like was Mom not being present. So that was definitely something seeing that we're a center-based environment we had to overcome, which he did amazing. I literally lost sleep.

Kristen: Like, how are we going to, like, get this? You know, this particular case was one that I was like, I don't know. I called several called in several friends, like, you know, my peers like I don't know. And he amazed us all. So and the other behavior that he engaged in was a lot of tantrum type behavior crying. And, you know, that was just his kind of go to for anything. But the minute we started getting language out of him and getting him to understand that I can ask for this, you can use these words and they get me what I want. And, you know, that motivate all of that stopped. We we stopped seeing headbanging behavior within the first two weeks of him being at the center. The tantrums took a little bit longer. It's definitely his go to. And it is interesting with you know, and I talk about this a lot like, OK, we know he's going to cry and we're going to let him know that that's not you know, here's what we're going to teach him what he can do. We're going to teach those replacement behaviors. And as soon as he figures it out, it's amazing to watch him kind of silly me. I know that I could just use my words and we can figure it out. So we started as a level one learner, quickly became a level, fell right into level two. He is currently completed all of level one, level two, and is now emerging into a level three learner. So he is just.

Mary: We're talking about the VB-MAPP and I'm assuming that the barrier is part of the VB-MAPP has started out high and is now going down. And that's what we want to see. And we want to not only do the VB-MAPP, but we want to program from the VB-MAPP. Like I have seen other kids. I've looked at a couple reports and a couple kids in programs that are ABA programs that do the VB-MAPP.

Mary: And then they make goals like the child will have eye contact for three minutes or they'll still engage in, in turn taking of conversation, or they'll sit at a table for two minutes. And it's like that is not what programing from the VB map and using the verbal behavior approach and the autism approach looks like. We want pairing and manding to be at the center, we want the parent to remain the captain of the ship and be very involved. We want your children to be happy and we want them running to the table or at least walking eagerly and not trying to escape from what we're trying to teach them. And we want major problem behaviors down near zero. And then we want crying and whining and other minor problem behaviors also way down.

Mary: And, you know, like you did have like separation anxiety when mom dropped him at the center because he's almost three. He's been home with mom. She now is the giver of all good things. And now he's coming to a center, which is scary for him. And if you do get crying or head banging or whatever, you need to keep track of the duration of the incidences and get them down. And you were able to do that very quickly?

Kristen: Definitely. So we eased mom out of it slower than we would typically. Mom came into the center and actually dad stayed the first day. Mom didn't want to stay, so dad stayed the first day, which is great. But I can remember the data in my head. I have it I have it graphed up. But 13 minutes the first day, eight minutes the second, five the third, three the fourth. And then that was it. So I thought we were going to have three to four hours with very quickly because we use the right approach. We didn't rip mom and dad away. We cared.

Kristen: We provided all, we had all of the things that we knew that he liked and we were just we were giving them and so. Well, you know what? This really isn't so bad. This is going to be fun. We played. We had the favorite toys, his favorite characters that we were there. And he quickly he said, well, you know what? This is going to be a lot of fun. And we were very, very successful with him. But on the other end of that would not have gone as well if Ria and her husband just weren't as involved and as cooperative and as involved with it and understanding of it as they were. So it just was a really awesome collaborative approach for Alex that made him amazingly successful. So we got to, yeah, one of the best parents I've ever, ever worked with because she is a go getter. And the other thing is he definitely gets it and utilizes all the technology. It always makes me feel so happy when I hear her use our language. She says the words of pairing.

Mary: And we have had situations where parents take my course and then they get to the front of the line for ABA and they're all excited. And then they're told things like, well, expect a lot of crying. We're going to keep him in his bedroom, keep him at the table, he's going to cry. That's just part of ABA. And guess what? That's not a part of ABA. And, you know, the child has made really amazing gains, like Ria reported with her son. And they don't even want to see the videos or sit with the mom to do the shoe box program to see how to kind of transfer the power, if you will, or transfer the pairing and the demanding to from mom to the therapist and be there with the therapist. I think that's a big mistake.

Mary: Even if it's a home program, is expecting the RBA or whoever shows up to, first of all, know what they're doing, know that it's the same approach is what you're doing, because spoiler alert, it's not going to be and thinking that, OK, they're here, let's leave it to them. Let's leave it to the professionals. Even knowing I remember when Lucas went to the first and only ABA center school when he was in kindergarten, I remember feeling like a big sense of relief, like, oh God, finally I can just transfer my worry and it's just like I don't have to worry about anymore. But I did. I still had to worry because I was pursuing my ABA certification. I wasn't a BCBA but I knew a heck of a lot. And then I found out that, yes, they were an ABA school, but they didn't really like the VB Assessment or using verbal behavior.

Mary: And so, like, that doesn't sit well with me. And I wouldn't sit well with Ria, like if Ria if you dropped your child off and they said things like, well expect them to cry or you know, we're not interested in knowing about the shoe box program or anything like how, how would you feel if you dropped him off at a center that wasn't really aware of the VB map and verbal behavior. And some of my approaches?

Ria: I would say I'm lucky on that part. Right, because I never experienced that. Oh, yeah, that's what we do here, but what I can say is when I was looking for a place to start ABA with Alex, it's the promptness of answering my questions, because at this point I know what to ask. I know what I'm looking for because I have a little background, which, of course, in your book. So when I ask them what approach do you use? And they would ask me, what do you mean? When approached you use what kind of ABA? And so they would mention other things other than the answer to my questions, which is hard and it's hard to reach them. I look at two other places that I have very good reviews about them, but every time I ask a question, it wasn't answer correctly or at least give me a glimpse of what you do and what's your program. And they would tell me you have to leave them here for eight hours a day. And it's not all ABA and I mean, it's not all ABA. So and then they would not call me back.

Ria: So it's I did not have like so many when I suggested your program, it's more like asking them what is this about their ABA that they would do for money? But I did not get straight answers. So that was my experience. But again, steering the last part, it already where he's going or I plan to put in. So that would devastate me. I think I would say that if I get that a lot when we were doing speech therapy with the county, but they have an idea what verbal behavior was. And another thing was a great they know the terms I'm using. I know what they're about to do. So, yeah, the county here also used that approach. So I would be devastated if something that works for my son and no one would even recognize it. So I feel for those parents who are meeting these challenges.

Mary: Yeah, yeah. And in general, I would just say, you know, just as I probably mentioned before, is, is if you're somewhere around the world just searching verbal behavior, VB MAPP your city, state, country, try to find like-minded people with my new book that's coming out the end of March, Turn Autism Around. It's actually available for preorder now at turnautismaround.com. It really is a step-by-step guide to teach only not only parents, but also professionals what to do, what to look for, to make sure your goals are appropriate based on your individual assessment, even if that's just the one page assessment on the one page plan that are part of my course and a part of my book so that we're going forward in a positive setting. Like, I mean, one thing when looking at even daycares or child care centers, not even talking about autism necessarily, is I would go in, I would look for positive people, positive, nice people who are not like threatening kids, like I'm going to take away that jump rope. You're not sharing nice. You know, if you don't get in line, you're going to lose something. And all those kind of threats of punishment, those are all red flags that we're not working in a very positive collaborative approach. And that's really where I would start.

Mary: So what kind of ongoing communication do you think do you guys have? Do you and Ria and Kristen have together what ongoing communication? What would you recommend in terms of parent and professional collaboration? Maybe? Kristen, you can answer that.

Kristen: So we have a standing biweekly meeting. So where we meet every other week for at least an hour, where we go over progress, we talk about treatment goals that we're working on, where you know, where he is, where we're where we're moving toward, toward. It's the opportunity for Ria and Justin to ask questions, concerns that might be going on in the home. I talk about here's what we're doing here. Here's how you can transfer that over into his other environments, because while twenty hours is great, it needs to be an all environment. So we talk about how to make that transition into those other environments. So that's definitely standing every other week meeting that we do. And I think that is essential for this to be successful. The other thing that's really great about. It is we see each other every day at drop off and pick up, you know, so like if she has if I were to have a quick question, we can answer questions. She can email me, which she is great at. Email me a question. I'll respond. So that's it. You know, not daily, but, you know, was way more in the beginning. It's not as much now, but it's having that open communication with the parents. It won't work if you don't do that, if you say, the only time I'm going to answer your questions is every other Monday at eight o'clock. You're not going to be successful. You have to be able to have that open line of communication.

Kristen: Of course, that doesn't mean the parents can text you at ten o'clock on a Saturday night, but you have to have those professional boundaries. But having that email communication option is also great. And I also have she has my text. So she what she will ask me questions and I'm fine with that. And I'll answer it when I can. So it's really important to have that piece and it really will not work if you don't have communication between the families. You know, I pretty sure this I got this from you, Mary. You know, the first question I ask in a session with a parent when I first meet them is what's the one thing? And I ask it every time. What's the one thing you want me? If I could only do one thing, what's the one thing I could help you change? I always ask that question and I always focus on that when I'm doing my treatments and writing my programing, because that's important. You know, it's just such an important step. Yes, I ever all my treatment goals are based off of Dr. Soderbergh's VB MAPP. And I also use Dr. McGreavy as essential eight and his essential for living. But I also part of my treatment is what does the family need? What do we need to focus on so that the family is also being successful? Because I consider Alex my my client, but I also consider his parents, my clients, so that we have to make that all work together so that I would say that's right.

Mary: And you might have different family culture needs, whether they have two other siblings, whether they both work full time, whether there's five siblings in the home, whether there's a new baby that just came. I mean, all of those things, whether they are religious or whether they're, you know, it matters.

Kristen: So, for example, the area we were actually was having some problems with one of his sisters sharing and being able to understand that. So sister came along to the parent meeting and she and I talked about some things and we discussed why maybe Alex grabs it and how she can respond to that to make it so he doesn't grab the toys and other ways that you can get him to not do those types of things more successfully and have a helping her understand why some of those behaviors might happen. So involving not just the parents, the siblings, grandma, grandparents have come to parent meetings. And, you know, like you were saying, whoever is really highly involved in the child's life, it's really important to make them part of the treatment package. And again, I've talked to parents about pronoun teaching. Are we teaching pronouns or not teaching pronouns? And making sure that that's important and part of their what they want for their child or religious. All of those things that you mentioned are so important for successful programing.

Mary: Yeah. So Ria, what advice would you have for parents who are seeing early signs of autism, who have a brand new diagnosis and they're not in Maryland where they can go to Kristen's Center? Like what? What advice would you have for them?

Ria: My advice, I'm still very new to this like are. But with what I encountered through the past year, is never stop. I always say never stop to look for answers. There are things that would work, wouldn't work, but shouldn't stop to look for answers. And when you find it, focus on it and advocate for it. Tell them this will work. You know your child more than anybody else that would see them or meet him. You tell them I'm very passionate about what I know. I'm very focused kind of person when it comes to things. I know if I know it and I know it works, I talk about it over and over again until somebody here is not. Whether that would be a positive turn out or not, I know it would because I'm doing it for my son.

Ria: So my advice is do your own research, read, read a lot until you can't read anymore. And I always say you will find the answers and you have to be very patient about it. But also this. They learned when I was reading your book, treat it like an emergency, like any other diagnosis. Maybe I have a little bit of background because I'm a nurse. I act on it all the time. I'm so used to I want a solution. And I want an answer. I have no time to wait because I've always been taking care of people's lives, but. I treated it like an emergency, I didn't wait for anything. What I learned the most from your book is when you see the symptoms, act on it, whether it would turn out not to be autism or autism. It will help whatever you do to solve some of the issues and answer some of the questions.

Mary: Yeah. And even you said, you know, even if it turns out not to be autism, your two daughters both had speech delays and some signs of autism. And so it it never hurts to get an evaluation, to get some therapy, to read about speech delays versus autism. Just don't stick your head in the sand like I did way back more than two decades ago. Like, really, I like what you said, like, don't stop. And actually, the first chapter of my new book is called Early Signs of Autism are an Emergency. So why are we all waiting? And I think this episode and yours, your journey certainly really points out the fact that the early signs are in emergency and parents have a lot that they can do and you can become empowered and you can learn what to do, whether it turns out to be ADHD or learning disabilities, speech, delay or nothing. It's just ways to engage your child to help them reach their full potential. So we are getting to the end. And I always like to wrap up. I think this has been really helpful in terms of seeing a good example of parent and professional collaboration and knowing that Ria is going to continue to kind of be in the captain's seat for her son. And, you know, at some point he'll be getting older and entering school.

Mary: And, you know, and no matter what, she's going to still remain a big part of his program. There's not such a thing as just dropping your child off for 20 hours or 30 hours at a clinic. And, you know, there's stuff that goes on sleeping, eating, potty training, all that stuff, community visits to the doctors, dentists. And that's why the parent really needs to work with professionals in their lives to help the child reach their fullest potential. So I always like to end my podcast with the same question. Part of my podcast schools are for parents and professionals to be less stressed and lead happier lives. You're a nurse and covid outbreak and three kids and an interruption in school and ABA services. And so what are your stress reduction self-care tips?

Ria: I should be asking that. I shouldn't be giving the advice because I'm not good at it, but I'm still learning what self-care is. It's very common word, but I can't seem to get myself into it since covered a lot of changes like any other families have, the stress from home and at work was too much to handle at some point. But when we got over that hump right now for self-care, I would say I watch my movies when I and I start exercising, eating healthier. I think anything positive where minutes to an hour of your time each day, weekly and also main that I'm self-care is finding the right people. Find your people. And what I mean by that is surround yourself with the people that will give you wisdom, that will give you knowledge. I think that's a big self-care that we tend to forget.

Ria: I have this friend who took care of this kid and she always give me wisdom for some reason. Everything she says kind of uplifting. And I, I like to surround myself with God because if everything else is crashing around you, you want people to lift you up. Being part of your community is actually your online community. It's really nice. It's almost like and I always put this in perspective that we're all in the same boat and trying to save each other from sinking. If somebody with both a problem, everybody will pitch in. And it's amazing, I think even online or in person, whatever, help us. You can get yourself. I'm still a work in progress or just help you working on now.

Mary: I like that. Surround yourself with positive, uplifting people. I think that's great. And really finding your people and participating in support groups, whether they're online, which is most times these days or in person. Yeah, that's great. OK, Kristen. Self-care tips from you for both parents and professionals.

Kristen: For me, I'm a big exerciser. So going to the gym every morning at four, five o'clock in the morning is my. Believe it or not, my way to relieve my stress. But so and it's important for me, really, that environment. It kind of goes along with what I said. Well, yeah, I love the exercise and I do some power lifting and those types of things. So that's strength thing is it's important for me, but I'm also surrounding myself with people that I really care about.

Kristen: You know, they're kind of my people. So that's really, really nice. And I really agree with Ria for families that I work with, finding each other and becoming support systems for each other is really, really important that I do a lot of talking to parents and they talk about I just want somebody to understand, like what I'm going through. So finding that support of other families who also have children with autism is very helpful. But I, I don't have a child with autism. But from what I've heard from other families that I've talked to is when they are able to find people who are kind of going through the same thing, they are very, very helpful and helps to relieve a lot of their anxiety and stress. So that would be what I would look really recommend, is finding those support system and advocacy groups and stuff like that can help support each other. So that would be my.

Mary: Yeah, I love that. And just for the record, getting up at 4:00 or 5:00 in the morning to exercise would not be a stress reliever for me. But I know that is a huge part of your life. And surrounding yourself with people that also feel like getting up at 5:00 in the morning is a great thing. And they're positive and they're happy about it.

Kristen: It's a big shout out to my five a.m. crew.

Mary: All right. Well, thank you so much, Ria and Kristen, for joining us today on the topic of parent and professional collaboration. I think you guys are a great example how parents, professionals can and should work together and hopefully in the future will we'll be seeing more examples like you guys. So thanks so much for joining us today and tune in next week for another episode of the Turn Autism Around podcast.

Kristen: Thank, Mary.