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Life on the Autism Spectrum | A Psychiatrist in Autism

In this episode, Keith and Will, joined by cultural correspondent Stacey and book reviewer Jennifer, interview Dr. Linda Lotspeich, a Clinical Professor and Staff Psychiatrist at Stanford University. Dr. Lotspeich speaks of her practice primarily with parents of children on the autism spectrum, as well as how she has seen the autism world change over the past 30 years. Subscribe to Aascends


Unknown Speaker 0:10

Welcome to San life on the autism spectrum. Today our program is a psychiatrist in autism with our guest, Dr. Linda lodge speech of Stanford University. I'm Keith Halperin, I'm Will burnick. And before we begin, which was your NASA t shirt,

Unknown Speaker 0:30

but funny, you should ask that because this this episode shirt is an is by NASA is my NASA shirt. It represents space and, and, and, and astrophysics. I got I got it from from I got it from Texas from my aunt and uncle. And next next year marks the 50th anniversary of the moon landing by Neil Armstrong. So, so this episode will commemorate that anniversary.

Unknown Speaker 1:00

Very appropriate for appropriate. Well, we all would you know, like to begin with Dr. Lot's speech

Unknown Speaker 1:08

as soon as possible. Linda, Linda, lots speech. Can you tell us about your background and how you came to work with families in our autism community?

Unknown Speaker 1:19

Yes, thank you. Well, um, I came to work with autism. When I was in college, and at that time, I was studying to be a teacher. in special education. However, my interest goes all the way back to elementary school when I was in the sixth grade, and they cleared out the first floor of the school to bring in a whole group of kids who couldn't hear they were deaf. And I got a chance to be a big sister with some sixth graders, as well as be a helper for the preschool class. And I became fascinated with how you learn to talk when you can't hear that was a real challenge, I thought. And so I learned a lot from the kids there. I myself was having problems reading and I was later diagnosed with dyslexia. So I think I was always interested in language reading, and talking. So when I went to college, I went to the University of Cincinnati in a program to become a teacher of people who are deaf. And then I met a child with autism. And that was even more challenging, because this was a six year old boy who couldn't speak. But it wasn't as easy as the understanding of the clause as coming from being deaf. But instead, it was the fact that they had autism. And we're talking around 1972. So back then, they really didn't understand the causes of autism, and they still have difficulties. So from there, I went off and taught for about five years. kids with autism, also kids with a variety of conditions. Deaf Blind, physically handicapped, I was very fortunate to learn from all those kids. And and in my fifth year of teaching, I really wanted to understand what was the cause of autism. So I decided very simplistically, I would go into medicine. With that question, what's the cause of autism? I've now sense that I understand better why we still don't understand what the cause of autism is. But I went ahead and went into medicine at the University of Cincinnati came out to Stanford for residency, and came on faculty. I've done research in the early days in the 1990s, in genetics and neuro imaging, trying to answer that question, but I found that really, my passion and love was working with the families. So I stopped doing the research and I've continued to work clinically ever since.

Unknown Speaker 4:08

Can you tell us about your current work as a psychiatrist with families in our autism community? Yes.

Unknown Speaker 4:14

So that work has transitioned over the years. But what I spend most of my time doing now is doing what I call parent counseling. I support parents and understanding their kids with autism, mostly a middle school, high school and a few young adults. I find that I'm a translator. I like to help parents understand the kids behaviors, particularly with the individuals who are mildly infected in the Asperger range. parents get very frustrated. In some of their behaviors, and I try to help them understand where those behaviors are coming from.

Unknown Speaker 5:08

Can you tell us about your affiliation with Stanford's University neuro neuro diversity of efforts?

Unknown Speaker 5:14

Yes. So a couple of years ago, Stanford started a neuro diversity program. It's chaired by my colleague, Dr. Lawrence Fung. And he in a very short time has really worked with various areas of Stanford to develop this program. It has a few branches to it, the first branch was to work with the the university it program, and they have agreed to hire some individuals with autism. I think they're either just started hiring are within weeks of doing that. And so that's been the major effort. We work with an organization called neuro pathways, I think you recently had a job club, with Ronda, correct. And so that's one branch. The other branch is starting to work with the the office at Stanford that supports students with various needs and wanting to make sure that their modifications appropriate for autistic students that come to Stanford, both graduate and undergraduate. And then the third branch that I'm aware of is Dr. Fung, who is both an adult and child psychiatrist. He's in the process of developing a clinic and our adult psychiatry clinic to care for adults, because most of the individuals we see with autism are in child psychiatry clinic. And and because our patients grow up, we frequently still care for adults, because we started with them as kids. But we don't take in new patients as adults,

Unknown Speaker 7:09

can you tell us about some of the issues that the parents deal with and how you advise them? Sure.

Unknown Speaker 7:20

One of the most common issues that come up is homework, and academic performance. So many autistic students, they may be very bright and can handle the academic requirements, but they don't have the organizational skills, executive functioning skills. And so that contributes to poor academics. Another one is motivation that I've talked to many adolescents with autism who doing well in school is not high on their priority. And I've learned a lot from those discussions, actually. So when I talk with parents around their concerns of homework not getting done, or grades going down, the first thing I tried to do is to help them understand all the things that may be contributing to it. The other thing is that I talk a lot about letting the kids just experience natural consequences, so that if they don't get the homework done, and they don't turn it in, their grades will go down, just to see whether that matters to them or not. Because now we're tapping into where the motivation is. What's very hard for a lot of parents to do. And a lot of autistic students, they do need support, they do need parents to be more involved. And so what I do is I really try to individualize and work with each family to kind of find that sweet spot. But frequently, I'm talking about dropping the expectations and monitoring. The other thing that has been my experience, there's no research behind it. But it seems to me, though, a lot of students who are they to attend regular education classes, what most kids in neurotypical kids in middle school accomplished, autistic kids will do in high school, and then off so that I've helped myself not be so nervous that we have to get everything set up fast, or by the time they turn 18 and allow a natural process.

Unknown Speaker 9:38

It sounds as if that much of what you deal with are the parents trying to figure out how to get the autistic child to modify their behavior. And I'm curious about how much of the work you do with the parents actually involves sort of the the emotional aspects of having an autistic child or children. Could you tell us about

Unknown Speaker 9:57

that? Yes, I do. And that Hard is, is occurring throughout all these discussions, and I'm very attentive to what the parents are saying, and where their level of frustration is. And I want to validate their frustrations because it can be very challenging at times, if not very, very stressful. Um, what I also offer is, I teach mindfulness meditation to parents, I'm, I'm in process, it's an eight week course, on teaching the apes course, I developed my own mindfulness practice, about 15 years ago, and after I had developed it further, I knew I wanted to bring it into my work. And so that's another way with some of the parents, many of the parents I work with now have taken my class. So we'll actually meditate for a few minutes at the beginning of each session. Very interesting. So you see, understood, we have a question.

Unknown Speaker 11:00

You know, thinking back to, you know, when you said you help out parents, like, understand their kid mourn, and also just let them just naturally? How would you say, you know, if they know something should get done, they don't do it, that type of thing? Or I have you experienced for those that have who kids who pretty much like, are always good about doing their homework, they're very organized, but the home is just so hard like to do. And for sure. Some experience of mine, I mean, my parents wanted to help me, they just didn't know how or so. But, I mean, obviously, it sounds like that. That's what you like, do these days, you help parents, you know, understand them and understand their like academics like are so do you see a lot of kids these days, like struts, like struggle with homework? Or is that a little better?

Unknown Speaker 12:02

Like, yeah, I see the whole rain. So you. So having been a special education teacher has really helped me as a psychiatrist. So when I'm talking to parents about homework, particularly in the beginning, I will start asking a lot of questions, want to get results of any previous testing? Because one of the things that I'm trying to decide, is it just executive functioning, you know, different motivation? Or is there a learning disability, and I already mentioned, I have dyslexia myself, and so I know what it's like to have a learning disability. And I remember when I was in school, so um, yes. And then there's a fourth thing, which is a little bit more a morphus. But I talked to parents a lot about it. And that is that I think, a lot of things that autistic individuals do. It takes more effort, it's just harder. And I talk about, you know, kids going off to school, and schools are one of the most social environments and in the last time, you've walked down the hall, the middle school, I was amazed. I mean, I walk down the hall at Stanford all the time. And I'm not bombarded by all these people. And so I think that by the time a kid has gone through school, they've put out so much effort, I talk about an effort bucket, the bucket is empties out faster. And so before they can even come home and even think about homework, they need to take a break. The other thing, and this is where I can get on a roll, and I won't keep going on. But homework is best done at school, or at a library. All right. I don't remember the author, but I had this little book in my office was written by an adolescent who said the problem with homework, it's it's done at home. And I think for a lot of kids, it's better to get the homework done elsewhere, and they may need some tutoring and help. Well, you had another question.

Unknown Speaker 14:14

What are some of the worst? What are some of the issues that frustrate parents?

Unknown Speaker 14:21

Okay, well, um, homework is one and we talked about that. Another issue is behaviors. A lot of autistic kids, when they get angry, they can get aggressive, and they can be scary, particularly when they get bigger. And so parents are worried that they may get hit or somebody else might get hit. Jennifer, I understand your question as well.

Unknown Speaker 14:49

Yes, I myself didn't experience any academic problems until high school. But we have a segue into this But the whole time I was in school, I was getting the message that whatever autistic behaviors I was showing at the time, were purely socially constructed. Not only that, but it was a horrible tragedy that the school wasn't able to socially construct everyone else to be like me, because in a lot of ways, autistic kids do make ideal students. They're highly intelligent. They study in class instead of socializing every teacher's dream, right? But why is it so hard for the schools in particular, and society in general, to accept that this is not socially constructed, you're not going to be able to socially construct every kid in your class, to have Asperger's. So can you please give up trying and start paying some attention to the kids who already have Asperger's?

Unknown Speaker 15:59

Yes, we do hear about that. And so one, I just want to acknowledge the frustration, and this is part of the translation that I tried to do so not only Well, I work with parents, I will on occasion, talk to people at school, and to help them understand what autism is. And to not miss interpret, words that are said or behaviors that are expressed by autistic individuals

Unknown Speaker 16:35

were 18 years, almost 19 years into the 21st century. Why did the school still need you to do that? Why don't they get it already?

Unknown Speaker 16:44

Well, I don't absolutely know for sure. But here are a few ideas that I have. And it's helpful because I worked in the schools. And so the difference of when I worked in the schools to what I do now, is that what I do now I get to specialize, I get to know a lot about autism. And really, as the title says, Be in autism, where when I was a teacher, I had to know a lot about everything. So schools have to set up accommodations and work and understand all students with all differences. And I think that's a real challenge, not only in the schools, but other of our institutions. And so that's why, you know, there is more movement towards more diversity. But we still need a lot of work to be done.

Unknown Speaker 17:38

What kind of work is it more funding more training for teachers,

Unknown Speaker 17:42

but both but I think funding is a big piece, because the schools have a limited budget, and they are required by law to provide services. And they don't have the full range of funds that they probably need to be able to do that and levels of expertise.

Unknown Speaker 18:01

So during our last program, I discussed a specialized program at a specialized High School for autistic students called Orion Academy. It's absolutely wonderful that we have this program. The problem is, there's only one of it. And the overwhelming majority of teenagers on the autism spectrum don't have the opportunity to take advantage of this program. So my questions are, number one, why not? And number two, what are we going to do for these kids? Are they just added What do bad so sad?

Unknown Speaker 18:39

Yes. So I'm familiar with Orion Academy. I've never visited it. Excuse me. But you're right. They are a program that is solely designed to support autistic students. I do want to say that I have noticed over the last 10 to 12 years, some of the public schools really devoting more attention to autistic students throughout school, but when I'm speaking to right now is a middle school and high school. So these are kids that would be going to regular classrooms. But as you described because of the differences in the social behaviors, they may get dis ignored or misinterpreted and problems arise. So what they schools do is they have a special class called academic communication classes. Some students find them helpful, some students don't they refuse to attend. The other thing the schools have been doing that I think has been very helpful is that they have counselors that the students can meet with and really get to know and the counselor gets to know the student to really understand that particular students concerns and be able to problem solve right there in school, which is so great for the parents because when the students come home and complain to the parents Then the parents can guide the student to go back and speak with the counselor.

Unknown Speaker 20:03

What are some of the chief concerns and worries that the parents have about the kids going forward into the future?

Unknown Speaker 20:13

Well, the common worry that parents are concerned about is they will be independent, that because of some of their social differences, they might, you know, be able to get a job, but might get fired because of some behaviors, or they won't get the work done, or some that, you know, parents would like a lot of their kids to go to college and are worried that they won't be able to get through. And so because of that, they really feel that before the kids are 18, it's their duty to make sure the kids learn certain things. And that's where they start to push the kids. And so we talk a lot about this when I meet with the parents, because on one hand, we do want to ensure independence. Well, I understand you have another question.

Unknown Speaker 21:07

I do. Tell us about your research interests.

Unknown Speaker 21:10

So in the last 10 years, I've moved away from research, I used to be interested, as I mentioned before in genetics and neurobiology, and so my, but I still have interests that I explore. One is developing mindfulness for parents, and also talking to people about developing mindfulness for kids and adults. But a new interest of mine, which is one of the reasons why I'm really enjoying being here today, is that I really would like to have opportunities to interact and be with autistic adults, my whole career has been with children. I have a few patients that have grown up and I interact with them, but I interact with them as patients, and I want to be able to explore autism outside of the clinic. Could you mention more about like mindfulness and how it works? Sure. So mindfulness is a way of being fully present in the moment. And kind of sounds silly, because right now, we're always fully present in the moment. But actually, we're not we're frequently caught up in our thoughts. The one time you can think about it is if you're ever driving, or even as a passenger in the car, you will find that you've gone from point A to B, and you don't even remember the roads because you were daydreaming. So. So mindfulness is to help us train our mind to let go of those thoughts and be in the moment. Now, why is that helpful? Well, it turns out that we're happier. And we're frequently less stressed. It's a little bit more complicated to go into the details of why being mindful, decreases stress in our lives, but it definitely does. Jennifer.

Unknown Speaker 23:07

So one other question I'd like to ask Linda, is a topic we haven't addressed yet. And that is bullying. many, if not most, children on the autism spectrum, have great difficulty developing age appropriate social skills. I certainly did. And that makes them easy marks, sitting ducks for bullying. So what are your thoughts on that?

Unknown Speaker 23:32

Yes, it happens a lot. I hear about it in the clinic frequently. And I'm happy to see that at least over the decades that I've been working in this field, that schools have started to have a no tolerance on bullying policies. That doesn't mean it doesn't still happen. There are also programs like Cornerstone to address bullying, and training kids on what to do when they're bullied, which the number one thing to do is to remove themselves and go find an adult. Thank you. Any final thoughts? Um, I would just like to say how much I've really enjoyed this morning and speaking with everyone, and I wish it would go on longer. Well, thank you. Thank you.

Unknown Speaker 24:20

It's been a great pleasure for us as well, and we hope to have you back sometime. We haven't totally scared you. Oh, no, you haven't scared me. Thank you so much. Thank you. And now we hear from Jennifer Brooks, our book correspondent.

Unknown Speaker 24:34

Thank you, Keith. Before I begin to tell you about today's book, I'd like to tell you about a research study published a few months ago. It's 2018. Cambridge University Press online article is pushing back hard on the notion that people with autism are not interested in socializing. The article being versus appearing socially. And interested, challenging assumptions about social motivation in autism questions the widespread assumption that the primary reason for autistic people's unusual behaviors is that they are not socially motivated. Rather, the author suggests their social signals are misunderstood, and insight the author's belief could open the door to more effective interventions. We hope this research will lead to more respectful treatment of people with autism, as well as development of more effective methods of supporting them, said namira ahktar, a professor of psychology at UC Santa Cruz, which is my alma mater, who co authored the paper with lead author, Vikram jaws wall and associate professor of psychology at the University of Virginia. focusing on what autistic people have to say about their own experiences, the author's explore for behaviors that are common among people with autism, and offer alternative explanations for each behavior. For more information, you can go to the Cambridge University Press website, you can download the article but not for free, they do make you pay for it. And now, let me tell you about today's book, it is called the other Einstein. This is a novel about Einstein's first wife mileva. Woot, meets Marieke. sure a lot of our viewers would be surprised to learn that Einstein was married not just once, but twice. His first wife was a fellow student in Albert Einstein's class at the University of Zurich. She was a brilliant physicist in her own right, but as evidenced by the title of the book, she has been overshadowed by her more famous husband, we know very little about her, which is why this is a novel instead of a biography because many of the details of this woman's life had to be imagined by the author instead of researched. However, it is a good story about a woman who likely was on the autism spectrum and almost certainly would be diagnosed as being on the autism spectrum. If she was in school today. She was a brilliant physics student, but she never will we first meet her as a college student. No, we'll hear from Stacy Kennedy, Our cultural correspondent.

Unknown Speaker 27:39

Okay, so today, I wanted to bring up that I've mentioned, probably monthly or every every two months or so that there's this weekly dance for all inclusive exercise class and El Camino at the El Camino YMCA, in Mountain View, and that's still going on Saturdays from one to two. where people can dance side by side. Oh, when it's I wanted to mention it's hosted by autism fun Bay Area. I'm sure you can find out more if you go to their website or you can email them at info dot autism fun Bay So yeah, this is a community for all with developmental differences as well as neurotypical families are welcomed to, but this is an experience that is fun and necessary to explore. November 8, Saturday, November 8 is an Autism Speaks walk and Golden Gate Park from 9am to 1pm. You can check out their Facebook page and let alone their website. But yeah, Autism Speaks just check them out. They're gonna have a walk. And later on that day, anybody who, you know, after the Autism Speaks, walk or whatever else you're doing, come to our ascend holiday party that starts around noon or 1pm or so at the arc of San Francisco. That's where it's usually located. So yes, whatever you're doing that day afterwards. Come to the holiday, ascend holiday party. Thank you. Thank you.

Unknown Speaker 29:26

Well, folks, that's the show for this week. Until next time, I'm Keith Halperin, I'm well burnick Stacy Kennedy, Linda lots speech, Jennifer Brooks, and we are San life on the autism spectrum. Until next time, happy holidays. Happy Holidays.

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