Mind Pump: Raw Fitness Truth - 882: Melissa Mello on Autism- It's Causes & Treatments
Episode Date: October 18, 2018In this episode, Sal, Adam & Justin speak with Melissa Mello of the UC Davis Mind Institute on Autism. Mind Pump Recommends: White Boy Ricky. (3:21) Introducing Melissa Mello: Who is she and what doe...s she do? (4:50) What got her into this field of research? (6:00) Has autism exploded or have people become more aware? (6:31) How do we categorize autism? (8:41) What do we know about the autistic brain? (11:50) Breaking the myths of autism. What causes it? (13:50) Is there a link between poor nutrition/lack of exercise and autism? (17:36) Have there been any evolutionary advantages to having autism? (19:45) How does one treat autism? (21:42) What are the different forms of autism? Spectrums? (23:05) What symptoms can parents look for? (25:11) Are there any tools/objective tests to see if kids are on the spectrum? (27:14) The lessons she has learned working with children with autism. (28:23) Has she had a particular breakthrough recently? (29:36) Are there common mistakes parents make that have autistic children? (32:03) Are we doing a good or bad job treating children with autism? (36:23) What are the biggest roadblocks when it comes to furthering research and treatments? (38:00) What is the hallmark of autism? (39:21) Is there a gut/brain connection when it comes to autism? (42:39) What frustrates her the most and does she have to battle the parents? (44:26) What are the big rocks to address if your child gets diagnosed with autism? (46:15) When the child wants to talk, but can’t. What does that mean? (47:51) How does she deal with failure? (49:04) Does she get emotional connected to the children she treats? (50:48) Her thoughts on labeling things without knowing. (54:40) Knowing what we know now, does she speculate on who may have had autism? (57:10) What potential future research excites her in the field? (1:01:30) Have there been paradigm shattering moments in her career? (1:03:15) Does she find herself closed off from other people after a long day? (1:05:05) Recommendations for websites with quality autism research/information. (1:07:14) Are there symptoms she sees in adult patients? (1:10:27) Favorite books? (1:11:30) Featured Guest/People Mentioned: Melissa Mello, M.Ed. BCBA - Project Manager Autism Phenome Project (APP) Research Team UC Davis Health Tony Lowe (@tonyloweyoyoyo) Instagram Links/Products Mentioned: White Boy (2017) Data and Statistics | Autism Spectrum Disorder (ASD) Social Cognition, the Male Brain and the Autism Spectrum Environmental Chemical Exposures and Autism Spectrum Disorders: A Review of the Epidemiological Evidence Challenging Autism With Exercise: An Opportunity Worth Stretching For Applied Behavior Analysis (ABA) | Autism Speaks Joint Attention and Vocabulary Development How inflammation and gut bacteria influence autism New findings on probiotics and autism: What you need to know Picture Exchange Communication System (PECS)® Temple Grandin: Inside ASD | Autism Research Institute Joe Rogan Experience #1169 - Elon Musk - YouTube Large study on parent age & autism finds increased risk with teen moms The NPDB Autism Speaks: Home Let me hear your voice - Book by Catherine Maurice The Reason I Jump: The Inner Voice of a Thirteen-Year-Old Boy with Autism - Book by Naoki Higashida Journal of Applied Behavior Analysis
Transcript
Discussion (0)
If you want to pump your body and expand your mind, there's only one place to go.
Mite, op, mite, op with your hosts.
Salda Stefano, Adam Schaefer, and Justin Andrews.
So, one of our forum members, Tony Lo, is the one that introduced me to...
Shout out to Tony?
Shout out to T-dog.
Yeah, he's a... That's our guys.
And I can't get T-dog. I'm trying to give it to T dog. Yeah, he's a, that's our guys. Yeah, I can't, can't T dog everybody.
I'm trying to give it to somebody else.
He did T dog.
Maybe he's T bone.
No, no, he did T dog.
Dau.
DAWG.
Oh, okay, that's, our T dog is a T dog D.O.G.
You're right, you're right.
Anyway, he's the one that introduced me to the guest
you're going to hear us interview Melissa Mello,
who she's a scientist at the UC Davis Mind Institute
and works, she's been working with children for 12 years, I think, and specializes in working with
kids with autism.
Right.
And so we thought the fascinating topic in itself, right?
Fascinating.
We thought it would be an interesting topic because it's so controversial nowadays, right?
It seems like autism.
Well, not just controversial, it's also growing.
I mean, it's a we're seeing more and more of it today.
Exactly.
And so I think it's become more common.
I think when we were kids, I just, I didn't even know any autistic kids where now I have
very close people to me that have an autistic kid.
And so I think most people probably listening either have been touched by someone personally
in their life that potentially may have it or a friend or a family member that has a
kid that has it.
So I think it's a really good topic and discussion
and I thought that it was a great recommendation from Tony.
So shout out to him for sending her away.
So we asked our lot of questions
and she did a very good job of answering them
and explaining kind of what autism is,
what we know that may contribute to causing it,
what we know that doesn't cause autism,
what to look out for if you have a child.
Right, some of the do's and don'ts.
Do's and don'ts, like how you work towards
like the success rate that they've had
with working with kids, really, really fascinating.
It's a growing area of research because like Adam said,
we're much more aware now of autism
and it does seem to be growing, accelerating
and she talks about that in this episode as well.
Again, Melissa Mello at the UC Davis Mind Institute.
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And without any further ado,
here we are interviewing Melissa Mello
on the subject of autism.
How was your drive over here, Mel?
It was rough.
Yeah.
Yep.
Travel.
How'd you sleep last night?
Last night was some great, but got on the road about 615.
Just got here.
I slept like crap last night.
I watched a documentary on white boy Ricky.
Are you familiar with that story?
There's a movie right now with Matthew McCoy.
White boy Ricky.
Yeah.
White boy Rick, I watched the movie.
Excellent movie.
Yeah, you got to watch the documentary.
Is it a gangster? Like what? Yeah, white boy Rick, I watched the movie. Excellent movie. Yeah, you gotta watch the documentary.
Is it a gangster?
Like, what?
Yeah, he's a, no, he is.
He's like known as one of the most profound 15 year old drug
dealers.
And it's kind of a crazy story.
The crazy part about it is he's been,
he's now I think 29 years he's been served.
Spoiler alert.
This is the real end of the movie.
That's not the end of the movie.
That's the end of the movie.
That's the end of the movie.
You should watch the documentary first.
I would definitely tell someone to watch the documentary
for, but I was so mad because I thought,
this is crazy that somebody could serve this long.
He got busted for, the short story is that he got busted
for cocaine, but the cops were using him at 15,
16, and 17 years old as an informant.
So they're having him run around and do all
stuff and because there was a murder that happened, they ended up trying to cover it all up and
they wanted to keep him locked away forever. So he's still.
You got busted for being an informant. Yeah, basically pretty messed up.
Pretty. Stuff like that when I watch it's the worst to watch before you go.
Then I can't see. Then your mind just starts spinning. Oh yeah.
So now you're tired. Not okay though. I've had my-
Look handsome.
You still look good.
I had my coffee.
But so you were recommended to us by a good friend of ours and a listener, a long time
listener on the podcast, but so our listeners know, give us a little bit of a rundown on
what exactly that you do.
Yeah, sure.
So I work for the UCD of this Institute, which is a neurological research center.
So we do a lot of research on a variety of neurological disorders, primarily autism,
fragile X syndrome, and Down syndrome among some of the others. So it's part of UC Davis,
and it was actually started by families who were really interested in making sure that there was more
research being done on these neurological
disorders in the hopes of ultimately finding cures or at least absolute best outcomes for
their children with these issues.
Now, how is that funded?
Is that funded by the university?
Is it actually part of the university?
So initially it was funded by these families.
So everything was started based off of their passion, which is a pretty incredible.
And currently a lot of our grants and things that we get for our research is funded through
things like the National Institute of Mental Health, autism speaks, and other health-related
grant options. Now, how long have you been doing this, and what got you into why were you
interested in this field of research? Yeah, I got a job ages ago at a school for kids with autism.
I was doing my undergrad in psychology
and was like, I had to get a job in the field.
It seemed like something that would meet the needs
I had to meet for school and ended up falling completely in love.
There's just something really incredible about
someone who's unable to communicate,
gaining that skill and seeing their life change.
And I just got addicted and thought
I'll never do anything else.
Now I wanted you on the show,
because it was Tony that contacted us,
and shout out to Tony Lo.
He contacted me and said,
you know, it kind of told me about you.
And I wanted you on the show,
because first off, it's a fascinating topic.
But second, it's a topic,
especially autism is a topic, especially autism,
is a topic that is embroiled in so much controversy.
It's such a controversial topic.
And so you're an expert in that,
and I wanted to talk about all the,
maybe the things that people believe
that maybe true or not true, statistics that seem,
like here's a good question,
that lots of people point things out like
Autism is exploded over the last
10 to 20 years and they've ever heard other people saying well, we just you know
We can identify it easier now. So that seems to be one of the reasons why has it exploded?
Do are we seeing this dramatic increase in autism?
Because there's more people with autism or is it just because we're
Identifying it now differently or classifying it differently?
Yeah, we would say in the past couple years there's been a huge focus on autism awareness and we're way more aware of autism than in the past.
Previously it was known as childhood schizophrenia and was really seen as even a different set of symptoms.
So we've become much more aware of what is autism, as well as the range of what
classifies as autism. So people with, you know, not a great set of skills, we would say, is more
low functioning to people who are really quite high functioning, with a lot of language who would
still qualify under the label of autism. So I think really it comes down to better identification,
as well as better awareness. So more people are falling under that umbrella than previously would have.
So when we control for all of that, like if we go back 30 years and take all the kids and people that were under different categories,
you can say that that accounts for what seems like a rise or growth of autism.
Yep, exactly.
Previously, a lot of people would have been left out of that umbrella that now are getting
captured and falling into that.
Even adults who have lived most of their life without a label are now getting a label.
And to some extent, I would say feeling some relief knowing that they're not just, you
know, some weird person.
They have this, you know, label.
So what do the numbers look like?
How many kids are we seeing with it in comparison to maybe 20, 30, 50 years ago?
Yeah, certainly looking just at that, it's going to absolutely look like an increase.
We can, I think the current number is something around 162.
So that's pretty significant.
I think even just a couple of years ago, we were saying one in 150.
So yeah, pretty significant changes in numbers.
And autism is affecting people
worldwide. So you'll see similar numbers across the world. So it's not just something that's
more prevalent, you know, like in the United States. Anywhere that they're looking at what is this
category of symptoms? We're seeing kind of similar rates. What are those symptoms then? How do we
categorize autism? Yeah. So to be kind of diagnosed with autism,
there's a number of, we really look at it behaviorally,
so you have to meet a certain number of criteria
that you can look for, right?
It's not something that you can test
and see in your blood, you have to watch the person
and see how they're behaving
and then classify those behaviors.
So we're really looking for some sort of delay in language,
and this is all in early childhood.
So even as an adult, you have to be able to say,
yeah, when I was under five, I was delayed in some way
with my language.
And that can be even pragmatically.
So you have language, but socially, it's not where it should be.
Or the inability to speak at all.
Some sort of difference in social skills,
that's a big one you hear about like the lack of eye contact
or relating to other people.
So affected in the area of social skills,
as well as what we call like stereotype
to repetitive behavior.
And those are the types of things
where you hear about like children
who line up their toys or engage in hand flapping
or some sort of like
repetitive behavior.
Is that self-suiting behavior?
Would that be okay?
Yeah, I think it's gonna be, you know,
it's hard to talk in generalities.
It's gonna be different for everyone,
but for I think a lot of people with autism,
it's either calming some sort of anxious feeling
or arousing, you know, the self.
Now any one of these,
because I mean, I know people who, I know kids who line up toys,
I know people who may have taken longer to speak,
is it more of a combination of all these things?
And is it more difficult to identify
than just list of symptoms?
Like in other words, would it require professional
to observe and then be able to say,
because I wanna make sure people aren't
freaked out listening to the podcast.
Yeah, because the kid lines toys up.
Yeah, or maybe didn't start talking
until a little over a year, a year and a half or whatever.
Yep, absolutely.
So one of the challenges is that this, you know,
is something that happens in early childhood,
but there's such a range of what we might see
from kids in early childhood, you know,
it's not unusual on its own to toe walk
or to hand flapper to jump when you get excited. So it is about all of these things coming together
and it is absolutely about working with a professional who can say, you know, actually this one I'm not so concerned about, maybe these things keep an eye on, but I would definitely not just listen to this and get, you know, overly concerned.
You've got to work with a doctor or psychiatrist, someone who knows exactly what to be looking for and what's within and not within the range of
typical child development. What do we know about the autistic brain? Like what's
going on that's causing these sets of symptoms? Is it a sensory is it a
problem with sensory perception? Is it a deficiency in neurotransmitters? What
do we know so far about the autistic brain?
A lot is still being learned, but deficiency in neurotransmitters is a big piece of what
it looks like we're finding out.
So, signals not quite making it all the way to where they're supposed to be going.
We're also finding differences in things like the amygdala, which is where people usually
process emotions.
For some people with autism, they're processing what a neurotypical person would process
to another person, they're processing the objects.
So kind of a built-in difference in what captures your interests.
So we may see objects as not that exciting, someone with autism might be quite drawn to
them in the same way we would to another person.
That's interesting because I've heard, and I'm sure this is, I don't know if this is
correct or not, but I've heard, or at least I've read that the autistic brain or mind is
an extreme version of the male mind or male brain.
Now, I know statistically autism affects men or boys
at a much higher rate than girls.
And you just say something about being fascinated by objects
and no one historically psychological,
psychology papers have said that boys and men
tend to be more interested in things and girls
and women tend to be more interested in people.
Is that true?
Is it an extreme form of the male brain?
Is that accurate?
And how much, how many more boys and men does it affect versus girls?
It's an interesting theory. I don't think we can say with certainty that it is like an
exaggeration of the male brain. We do find it in women. However, it is about three times
more common in men. So we do see that it's occurring much more in men, but as to why we can't say with any definition
at this point.
Okay.
What causes it?
Is there a link between, I have friends and family members
on Facebook that post, that, you know,
things like vaccines cause autism almost weekly.
And some of the stuff that they post is,
I'm not gonna lie, it's quite compelling.
One of the arguments that I consistently hear
is that the amount of vaccines that we get as children
stimulates an immune response,
which causes inflammation in the body and brain,
which then changes how the brain operates.
And so I've heard these arguments before,
what do we know as far as research is concerned?
Have we made any connections at all with vaccines?
So one myth that I would love to dispel is that vaccines cause autism.
There was one report written by a doctor that has been completely debunked and that doctor
has actually had his license removed and is no longer allowed to practice medicine.
And there have been plenty of subsequent reports showing that vaccines do not cause autism.
If it is a fear, there are things that parents can do
like space out the timing of getting their vaccines.
There's some flexibility and options that parents have,
but I would really recommend families
don't not vaccinate for the worry of autism.
There is no link between vaccines and autism.
I think something interesting that often happens is timing,
where along the same time that children
are getting their vaccines is also when we typically see
autism symptoms start to emerge.
So families then erroneously link the two
and say that one caused the other without maybe noticing
or thinking about some of the behaviors that they maybe were happening
prior to receiving that vaccine.
Are there any epigenetics sort of components where they've found certain things might express it further?
Like that they've introduced, or is that anything proven yet?
I wouldn't say anything proven yet. What it looks like we're gonna find one day are likely many different types of autism
and we're kind of on the path of identifying those.
It does look like strongly,
there is a genetic component,
but what is a big challenge in autism is it's not like
other neurodevelopmental disorders
where you can say this is the gene.
We've identified multiple different genes
that are appearing differently in different people.
So it seems like there's an absolute genetic component.
There's also a lot of twin studies
that show twins are both likely to have it
or if you have one child with autism,
your chances of having a second with autism are higher.
And then it also looks like there's
like an environmental insult that some people are
more susceptible to.
So maybe kind of already a genetic predisposition that meets an environmental insult.
What does environmental insult look like?
What is that?
So again, it's difficult to say anything with strong certainty because there's all just
kind of preliminary studies.
But there is some research.
I just kind of want to highlight correlating, so not causation, but correlation between
some chemical sprays and rates of autism.
So families who live closer to sprays have higher instances of autism, and as you move
further and further away, you start to see those rates decrease.
And that's been shown in multiple different locations throughout the US. Really? What kind of sprays are these? You're seeing where they live.
So, is it, are pesticides and herbicides?
Pesticides, yeah. Really?
Symphetic or organic?
Symphetic.
Okay. That's fascinating. But you're saying it's not caught.
We don't know if it's causing anything yet.
I think it's too soon to say there are, there is plenty of research.
You can look it up and read the reports
but I think you know it's always as we practice science right so we like to have a lot of evidence
to say that something is a cause it's an interesting link for sure. So what are we finding out about
nutrition then? Nutrition is tough so I was thinking you guys like probably get a lot of questions
about like the gut brain connection and children with autism who seem to have more trouble going on in their gut.
What we're thinking is that's going to likely be one day, one of those types of autism
that I was talking about.
So there are children with autism who do seem to have some sort of gut issue going on.
There's also children with autism who don't.
So you need to think about your child and
if that really is happening and if it's not.
If you're thinking about nutrition, I mean, there's still humans, right?
So good health and food that's good for you is still going to support people with autism
as it would anyone, you know.
So you're saying that there could be cases where, because I've seen like some really good
documentaries where you'll have like a kid that's on a really poor diet
where he's eating cheese puffs and just garbage food
all the time and they swit, they radically switch his diet
and like his outbursts and things like that diminished greatly.
So you're saying that that may help some kids,
but then other kids that may not do anything for them.
I think if someone's got a terrible diet
that's gonna help people with autism,
the way it would help anyone. That's a good point. that may not do anything for them. I think if someone's got a terrible diet, that's gonna help people with autism
the way it would help anyone.
That's a good point.
Yeah, I mean, being healthy is gonna make it easier
for you to handle anything, right?
Like if you're healthy and you have, you know,
a neurological disorder, it's probably better
than if you weren't healthy
and you had a neurological disorder.
Well, then along those lines, what about exercise?
Because I think of like, you know, part of like,
when we get an injury, we get this neurological almost disconnect
to like parts of our body,
and then you can train that to work on that connection.
Are there things that you can do for autism
to help train these connections?
So they're better for them.
So there is actually research to support.
I mean, it's not groundbreaking, right?
That exercise does help people with autism,
and I mean, it's not gonna be what changes
everything for your child, but it can help.
I mean, just like anyone when you're having a stress day
or feeling anxious and you go for a walk
or take a hike that can improve your mood,
those same pieces of the brain are working
as they should for people with autism.
So they're gonna bring some anxiety relief
for people with autism as well.
So there is a lot of support to, you know,
go out and get some exercise and add that to your routine.
Are there any, have there been any proposed evolutionary advantages to autism,
like why it even exists in the first place?
And I go, I think back to pop culture, like Rainman, or I know of a few CEOs,
I'm not going to mention any names, but have been widely speculated
to have high functioning autism, but they're also extremely brilliant at what they do.
Have we, is there anybody been saying, like, oh, there may be an evolutionary advantage
in some cases, or maybe the autistic mind is better at these types of things versus these
other things?
I think there are certainly strengths in autism, and I try to, when I work with families,
encourage them to find those things that their children are particularly good at and see
if they can encourage that in a way that is going to lead to, you know, a meaningful and
fulfilling life in their future.
People with autism can have an incredible ability to focus and attend to just one task at a
time, which, you know, looking at our world and how
much we're getting texts and emails and phone calls and checking Facebook, we are, you
know, spread across so many different things and it can be really hard to focus. So I think
that's a strength to be able to tune everything out and focus very intensely on this one skill,
which can absolutely lead to, you know to brilliant CEO work or art or architecture
or music, whatever it may be.
So I think there's evolutionarily, I'm not so sure that people have done much work to really
support this as an advantage, but I certainly believe that there could be strengths and
advantages to autism, as well as us all kind of starting to accept neurodiversity
because, you know, one in 62 is pretty high. I think that's only going to get higher. It's
here. It's happening and we should embrace brain differences because we all, you know, really
have them. It's only in these more extreme cases that we start talking about it.
But-
What do the treatments look like when you're working with people with autism?
Does it start with behavioral therapy?
Is it okay?
Yeah, behavioral therapy.
So science called applied behavior analysis, ABA is really a common practice for working
with and treating people with autism.
So through ABA, we work on improving communication skills, social skills,
decreasing maladaptive behavior, working on self-help skills,
like toilet training, clothing, you know, anything that a person with autism is struggling with.
There are medications, but that is really, my work is very focused on the behavioral therapy.
And even medication still have a lot of research
that needs to be done.
There's, you know, it's so case-by-case
it's really hard to say that this is the drug
that supports someone with autism.
It really, you have to work with your doctor
and your child's symptoms and figure out
what's gonna be the best route.
What are the typical drugs that they would recommend?
Are they ADD drugs?
Is it a dopamine deficiency that they try to boost with? So I know Zooloft is common. Again, I'm not, you know,
not the best person to talk to about medications, but there's there can be a lot of challenging behavior
in autism and anxiety. So things that help kind of reduce that challenging behavior. Okay, so it's more
like palliative care to try and maintain symptoms or whatever. I want to know a little bit more about the spectrum, like as far as like how to kind of determine where,
you know, you may lie as far as like, you know, autism goes and like if you have definitions for
kind of each way along that spectrum. I only know about Asperger's, that's the one I know about, yeah.
Yeah, and Asperger's is actually currently no longer a diagnosis. So in the most recent DSM, everything that kind of used to be ranges of autism have now
been, they're captured under just the umbrella term autism.
So aspergers currently is no longer a diagnosis that's now called autism.
And it's classified by three categories.
So one being needing substantial support, one being needing support, and one being needing much less support, but still seeing that kind of range of symptoms.
So we can see someone who's presenting very severely with a lot of maladaptive behavior, maybe engaging in tantrums or aggression or self injury, having pretty affected social skills,
and a lot of repetitive behavior to someone who,
you know, you mentioned Rainman before,
which previously was Asperger's
that would now currently be called Autism,
who has language is able to function in society,
and you might just notice like some awkward social things,
but sometimes balanced with these strengths and math or whatever it may be.
So when you do this research,
you're taking people in volunteers
who are under this umbrella and then you're observing them
and working with them, that's how it works.
And how is that working with,
is it mostly children, by the way,
or is it adults as well?
Our work, so our lab is really focused
on early intervention,
but there are lots of services available
for throughout the range of the age range as well.
So less, so I would say for adults and much more
on the early intervention side,
there's a lot of evidence that supports the sooner
you start working with children.
The brain in those first five years
is still very valuable.
So if we can start intervention early, we have the ability to really
change the outcome for that person. So I was gonna ask that if there was an
advantage to find figured now on that point are there things that you guys, some
basic things that you tell parents to kind of look for like you know here's
you know the ABCD if these all check off that you're noticing these things maybe
you should bring them to a professional.
What would that look like?
Yeah, so again, I don't want to cause too much worry for anyone, but even in, so we've
been able to diagnose children with autism as young as 18 months.
So it's really looking for thinking about what you might see in typical development and
then looking at your child and seeing what differences might appear.
So you should be hearing babbling, you should be seeing eye contact.
There should still be those like reciprocal exchanges where the child is looking at a
toy that they're interested in and then gazing at the parent.
And we call that joint attention.
So really sharing interest in objects.
Those are things that tend to be real deficits in people with autism, even at a very young
age.
So really looking for those back and forth things,
gestural communication,
so nonverbal communication, pointing to things, waving,
those are some of the first things
that tend to be impacted for children with autism.
Response to name is a really common deficit
that we hear about.
So, you know, why call is name, my child never looks,
is never giving eye contact.
Again, the way they're playing with and interacting
with toys can tend to be different
from what you would see in typical development.
So, more of a focus on the parts of objects
rather than the whole.
So, if you have a car, children may be hyper focused
on spinning the wheels of the car
rather than, you know, rolling it down a track.
Oh, interesting.
Yeah, I had a friend who has an autistic son.
And when I talk to my friends, the parents,
they say, we could just tell that something wasn't right.
And it wasn't obvious.
It wasn't super obvious.
Like if there was a big problem,
they could just tell that there was, there was something off.
And so then they took their, you know, the kid to professionals and got diagnosed
with autism. Are there any objective measures that we have?
Because a lot of this is behavior.
And I'm pretty sure in the more difficult or for lack of better term,
extreme cases, probably obvious, but I can also
imagine on the other end of the scale, they may be things that some parents might be like,
well, I mean, yeah, they're a little different, but I don't think they're autistic or whatever.
Is there anything objective like imaging, brain imaging or testing something where we
could say, okay, here we know now that you're kid?
Is there anything like that?
Not currently, but there are lots of research like that being in the works currently. I actually
work on a MRI study where we imaged kids. Really? Many years ago to see what the brain looks like in
people with autism and people without autism, and we're currently bringing everyone back to scan them
now that it's been 15 years later to see if those differences remain.
And the hopes that we can have something so we can scan young children and say this
brain looks like one that is in line with developing autism, but currently we're still not quite
there yet.
Are you allowed to talk about some of the differences that you have observed or you have to wait until
the research?
Yeah, that's what I thought jumped again.
What's a like working with with autistic
children? Are you doing this all day long? Yeah, all day long. It's such a gift. There's
so much that I've learned from people with autism, so much joy and excitement that's
been brought into my life and so much tenderness learning about families who are, you know,
I'm meeting families right after the diagnosis.
So I was never intended to be a part of their life,
but it's a really special thing to get to work with families
through this difficult transition and help them to see,
their child is still, their child,
really nothing major has changed.
You just now have a different label to look at them through,
but all of the
brilliant things about them are still there.
Like I said before, there's just really no gift in my mind greater than allowing someone
the ability to start to speak or to communicate and to be able to share their likes and dislikes
and get their needs met without having to have a tantrum
or do something much more challenging,
like aggression or hurting themselves,
but to see their lives open up,
I really consider it such a gift to be able to do that with people.
Can you tell us like maybe a recent,
maybe time you had a breakthrough with a kid?
What's that life break?
Because I'm picturing like a kid who doesn't want to talk
and then all of a sudden, you know, they start talking.
That's got to be a very powerful emotional moment.
You tell us in any stories like that?
Yeah, I mean, yeah.
So working in early intervention,
that's like the privilege that I get to have all the time.
So we recently wrapped up an early intervention treatment
study.
We're working with children most about two years of age. So when we meet
them, I can think of one particular child who at the age of two was using no language
and at two, you have lots of different things that you want. But if you can't communicate
for them, you're going to use challenging behavior to get those needs met. So falling to the
floor, having tantrums, he started aggressing towards his mother and biting himself,
all just to get, really it was food items that he wanted.
So it's a pretty long journey.
You know, I don't want to give any false hope
and it doesn't always happen for everyone.
But we found that he was just really excited about cookies
and was willing to do almost anything to get a cookie and...
Brybury.
Yes, sure, Brybury.
But we were able to kind of shape his language, so at first he would make any sound and we
would accept it and he would get that cookie.
And then over time, trying to get the c sound and he started to be able to consistently
make that sound.
And only for making that sound, do you get this cookie?
And over time, he was able to get closer and closer, you know, cuck, cuck.
And then eventually he said, cookie, mom was in tears.
She brought out, you know, we got a whole package of cookies.
However, over when you want.
And it was this really powerful moment, I think, for the child too.
First of all, I want to be clear that it's not that people with autism don't want to talk. We talked about that connection in the brain. It's just
that it's very hard to send that signal to use that language, and it's just this slow process of
building up that signal. But when you can see it all finally come together and the difference it made
in this family's life, this child slowly gained more and more language and completely stopped using all of those maladaptive behaviors because
he was able now to either nonverbaly, so we taught him to point to things or verbally
just ask for what he wanted.
In his world just opened up and he didn't have to rely on those challenging behaviors to
get his needs met.
Do you ever find yourself undoing some of the work
that parents are doing home?
Are there common mistakes that parents make
that have autistic kids?
I think there's kind of some common misconceptions
about people with autism.
We hear a lot of parents, or, you know,
I never want to throw parents under the bus,
because I really believe they're just doing the best they can
with the information that they have.
But we hear a lot of people say that people with autism are just lazy, throw parents under the bus because I really believe they're just doing the best they can with the information that they have. Of course.
But we hear a lot of people say that people with autism are just lazy and that's something
that I really also want to dispel people.
I don't think anyone would choose to have your life be so challenging.
It's actually much easier to just talk than to spend your day on the floor in 15 minute
tantrums desperately upset because you can't get what you want.
That's not easier than just saying cookie. So I do not think that people with autism are lazy.
I think they have a really big challenge to face in things that we take for granted that seem so
simple. So a lot of people, I mean, we'll say, you know, oh, my child's just lazy. He won't,
you know, do whatever. So working with that a lot. And then sometimes
there's ways that families or other people who know someone with autism would be accidentally
encouraging some of the challenging behaviors. So I know that when he sees the cookies and
doesn't get him, he's going to fall to the floor. So the second he screams, I'll just give
him the cookie, which is, you know, if you think about, if you know much about reinforcement
or kind of entering the applied behavior analysis world, that's really just
reinforcing the behavior of tantrumming. So we do a lot of work to think about, you know,
what's something more appropriate that we can give them the cookie for so that we're
no longer reinforcing those challenging behaviors.
Is there a distinct difference between the kids that have parents that put a lot of the work in and carry on what you're probably doing with them in the office or whatever and between the ones that don't just there's not access to services or, you
know, just less availability to get support can parents alone doing treatment for their
children lead to improved outcomes and it absolutely can, as well as for children who
are getting services every minute of a child with autism's day that's filled with social
interaction or being engaged is going to lead to improved outcomes.
So we're there just for a short period of time, but when we leave, the rest of this child's
days and their parents' hands, so the more that their time is filled with interactive
activities that their parents can do or that they're carrying over the work that we're
going to do in the home, the better the outcomes for that child are going to be.
Are there, oh sorry, there's they'll say how often do they see you
to get these treatments?
Are these kids visiting you once a week, twice a week, more?
There's a big range.
So it kind of depends on like for us, it's our research.
So what does our research look like?
For people in the community, it kind of varies
on how much services are available, where you are,
and what are the skills deficits that kind of triggers how much services you available where you are and what are the skills deficits
that kind of triggers how much services you're gonna get.
Our last treatment project,
we were actually serving children for 25 hours per week.
So that's five hours of intervention a day,
Monday through Friday,
and that was us going to the child's home
for the most part.
I'm assuming that's more effective than less, right?
I'm assuming that if you're with someone
for five hours a day working on these skills in their home, it's gonna be more effective than less, right? I'm assuming if you're with someone for five hours a day, working on these skills in their home, it's going to be more effective than if they just visit,
you know, for, you know, an hour, you know, twice a week or something. Is that true?
Typically, that's true. It really depends on the quality of the services. So, um, you know, it's,
it's not necessarily 25 hours of not great treatment. It's going to lead to improved outcomes,
but absolutely about the quality. So 20 hours or so of really high quality treatment is kind of what we're looking at.
But honestly, there's also research supporting that amount more.
So then it's still semi-common for children to get up to 40 hours per week of intervention.
And it's actually looking like that may not be quite as necessary of targeted intervention,
but rather working with families to teach them
what we're doing so families can take over.
It seems like it's still important for children
to have typical time to go to the park,
time to interact with friends and family
and not have your entire day just be in a room
with an interventionist receiving one-on-one treatment.
Or actually have to practice those social skills.
Are we generally doing a good or bad job,
you know, treating children with autism?
I think of the public school system,
and the average person doesn't have the,
and I'm assuming when you're doing research,
it probably doesn't cost the parents anything, right?
They can enroll their kids.
But for people who don't have those kind,
the access to those kind of services,
and the average family trying to make ends meet,
is there, are we doing a good
job of working with these kids?
What does it look like?
There's certainly room for a lot of improvement.
There is a big challenge with the number of kids that are identified and diagnosed with
autism, all needing to get into services.
The companies and the agencies that are providing that support are having to grow at monumental
rates that aren't always sustainable
or leading to best practices when it comes to training for staff,
or support for staff.
It's really more about keeping up with numbers game,
much more so than that kind of focus on quality
that I was talking about before.
So there's a lot of room for improvement.
Do you get any pushback from people?
Like if you tell a parent, we think your child has autism,
they're like, you're just trying to label my kid,
and my kid's fine, I can imagine that happen.
You get any of that kind of pushback?
Yeah, sure.
I think it's really scary to imagine
what changes this might have for you or your child's future.
And of course, parents know best
and are the experts on their child.
So they see things that we're not seeing.
They're brought in for this one couple hour assessment, but you have a two year history
of this child.
So it's quite natural, I think, to feel like we're not getting the full context of their
child's behavior.
What are the biggest roadblocks right now?
You talked about how vaccines, there's no connection.
And I know how big that world is in terms of,
you know, this is what's causing autism and you're doing the research and you're saying no,
is that getting in the way of your guys' progress?
To some extent, yes, we are pretty fortunate where we are. I think a lot of people in the Sacramento area tend to follow us in our research,
so I think we're a people in the Sacramento area tend to follow us in our research.
So I think we're a bit lucky in that way. But I think at a grander scale, depending on you know, different communities and socioeconomic statuses, there's a wide range of what people
believe is going to help cure autism. And I think even once you're past the barrier,
there's a number of treatments that people pursue.
The behavioral treatment that I'm talking about is long
and it takes a lot of effort on both the family
and the child's part.
And it can certainly lead to improvement,
but is by no means a quick fix.
And I think a lot of families are really looking for that.
Of course, they wanna see their child do better
and have the best possible future that they can.
And we see a lot of treatments that I think can actually slow down a child's progress,
or be a hindrance to their overall health, let alone their progress.
And so working with families on changing some of those beliefs can be a challenge.
Yeah, I've read stories of parents who'd say things like, my child completely changed after they got this vaccine
or they completely changed after this one situation
and that's when they got autism.
Does autism present itself that way
where everything looks fine and then all of a sudden
there's like this big change in your child's behavior?
Is that something that is a hallmark of it in some cases?
Again, I think that that is a hallmark
of one of the types of autism.
So there is actually a type of autism that we're kind of informally calling the regressive
type, where it does look like your child is starting to talk.
You have older footage of them and it looks like all their skills are intact.
And then at some point, like he was saying mama, no, he's not.
He was much more socially engaged and now he's not.
But there are cases of that, like, regardless of timing of vaccines.
So again, that's not a link to when they're vaccinated.
So it's like someone's fine and then boom, they become autistic.
That feels to me like something happened.
It feels that way.
It feels very natural to think that because very few
neurological disorders happen in that way except for, you know, maybe like dementia or Alzheimer's, which tends to be gradual as well. I can't think of too many others that happen with a child where
it's like, oh my kid was normal and then all of a sudden something happened. It kind of points to
than all of a sudden something happened. It feels kind of points to something outside environmental,
so I can kind of see where they would come from.
Yeah, absolutely.
And it's so scary in such an intense time.
Of course, families want answers and want something to say,
this caused it, and having that cause can be something
that leads people hopefully to treatment.
But again, especially with this type of autism,
we are still totally unclear about what exactly that causes. There is a lot of money being put
into autism research right now, which is great. So hopefully we will have an answer. But yeah,
again, just no link to that. You don't think nutrition plays a bigger role? Like maybe, yeah,
like like, I just, I just think that, I just think that it has to be something along the lines.
I mean, when you look at the last 100 years,
the things that have changed the most,
like it was the way we consume food,
you think about the pesticides that are being sprayed
on a lot of our foods, I mean, to me,
that's what it sounds like,
but do you think that?
I mean,
yeah, so I'm always gonna be looking at science
and what science says,
but more just anecdotally, yeah, of course, I mean, I think anyone who has a healthy body and whose body is in good condition,
thinking about like the prenatal body, a mother who's pregnant, who is in very good health,
and free of pesticides or any environmental insults as much as we can control for that,
is going to be in just generally a better position
to have a healthy baby.
I think that's true for everyone.
And then same for the body of that people person with autism.
Is there a connection between autism and other disorders like ADD and ADHD?
There are lots of instances of dual diagnosis, so anxiety is a really common one. ADHD actually is common
although attention deficits are sort of the presentation of autism as well. So it can
be tough until a child is older to really tease out, you know, what's autism and what's
an even more severe attention struggle.
I read a recent study, I think I might even have talked about on the show where, and it
was a small study, but they gave children with autism probiotics
and in a significant number of the kids
in the study showed improvements.
Are you familiar with this research?
What is it saying?
What do we see so far?
So again, I think thinking about that type of autism,
it does seem like there is a type
where there is some sort of gut brain connection.
You absolutely families are gonna need to look at, is this true for their child?
If you're not seeing any reason to work on the gut, then don't work on the gut.
But if there is, then all of the same things that we would use for anyone who's having
gut problems, like probiotics, we know we're going to help with that, could help that child
who's having those gut challenges.
Again, why some children present with that? could help that child who's having those gut challenges.
Again, why some children present with that?
We're not sure.
Maybe that's one of the more,
kind of like the environmental link.
We can't say definitively yet,
but that might be the case where you look at diet
or you look at doing all of those things
where we know are going to improve gut health.
But again, thinking about, is this right for your family?
Is this right for the child?
And I would say taking data on are the things
that you're trying actually leading to improvement?
Are you seeing a change in your child or not?
I think it's one of the biggest frustrations
has to be that there's so much we don't know.
We don't know what's really causing it.
There's so many different versions like you're saying,
and you speak just like a scientist,
which I appreciate where scientists aren't gonna make
speculations without saying this is a speculation.
But we have an article here that says,
oh, probiotics may help, we have another article over here
that says, there's a correlation between pesticides
and it's like, it makes it, it's got to be very
fr, like what's the most frustrating thing for you in this whole thing?
I think well for me, I think the most frustrating thing is really not listening to science and
how I absolutely can understand and relate to the frustration of how long things take and
how much you want answers for your child and for there just to be, you know, one direction
and I wish that were the case. But I think it's more frustrating to see actions being taken that can actually
cause harm to the child or to the child's health and having to feel like I'm working against
all of these things that some even have research to support to say, you know, this is harmful
or can cause damage to the child. Things like collation, which, you know, there's
collation. It's a process of removing metals from the blood,
which has not led to an improvement in symptoms for anyone
without a them and it can actually be quite harmful because
you're removing things that you need in your system as well.
Yeah. How are they doing that? Are they giving them like,
key leading, you know, dialysis.
Yeah, like really?
Yeah, it's happening through like IV needles
and yeah, things like that.
Yeah, pretty intense hyperbaric chambers.
And to me, these are all things that are taking away time
that a child could be spending in the appropriate treatments.
You're about to argue a parent's over this kind of stuff?
Absolutely.
Really? What's that like? It's challenging.
I mean, I never, I really want to feel like I'm aligned with parents and in partnership
with parents.
And ultimately, one day, I'm not going to be in their life, and they're still going to
have their child.
So yeah, I mean, it's hard when I feel like I see this need that I can meet, and I feel
like I have ways that I can help if only I could try to get
you know someone a bit more on board but I also want to be understanding that it's not my
child and and you know they're desperate to get some help. So if let's talk about that for
saying if you had an autistic kid and you've just found out what are the big rocks? What are you
what are you attacking first? What are you going to address first?
Yep, so I'm going to absolutely focus on teaching my child to speak. I think again that ability
to have language and share your wants and needs with others is just life-changing. So
there's a variety of ways that that can be done. If they're unable to really use language,
there's a system called picture exchange communication where you use
visuals like little pictures and you can exchange those cards to get the item that you're asking for.
So if there's not an ability to use words, I would be looking into other systems or other ways.
In this age of technology, there's lots of iPad apps that can be used in a similar way.
Looking at like gestural communication,
so teaching, pointing and teaching,
waving all of those nonverbal skills
that have a lot to do with how we communicate
that people with autism often miss.
Looking at how they're interacting with objects
and teaching appropriate play
and appropriate age, age appropriate social skills.
So being at parks, being at play groups, being out in the community, and working with, you know, my child to engage with children the way other children are.
I think it's, you know, sometimes not the right direction to be keeping your child at home and kind of just, you know, but having them be out in the world and experiencing life the way everyone else is, we have to really think about flexibility and working on that
from a young age.
It sounds like a large part of your therapy involves with,
is involved with teaching them how to be able to express themselves and to
communicate. And you made a comment earlier where some people think, well,
the kid doesn't want to talk. And you're saying, no, they can't.
What do you mean by that?
What do you mean by that?
So that signal, that neurotransmitter
that we were talking about earlier
that would take a signal from the language part of the brain
and actually send it to your vocal cords and your throat
and how you're going to communicate is really affected.
And that can be true both for receptive and expressive communication.
So some people with autism are processing our language much slower.
So it's going to take a much longer time for them to understand and then respond to what
was said and then same for vocal output.
So oftentimes by the time they've even made that connection and might be able to start putting
that word together,
we're 10 steps ahead of them and moved on
and we've already repeated our instruction
and asked them to say it again,
when this person with autism might need much more time
to process what's being asked of them
and to make that move through their brain
into vocal output.
Yeah, I can definitely tell that you're very passionate
about what you do.
It's gotta be extremely difficult
and frustrating when you're working with a kid
and nothing you're doing is working.
How do you deal with that?
How do you deal with that when you've worked with,
have you had situations like that
where you're working with a kid for a year
and you just can't seem to get through to them?
And what's that like for you?
Yeah, it's super-fishing, especially knowing
like where someone could end up
and you so desperately want them to get there.
I wouldn't say I've worked with anyone who I haven't been able to get
some sort of progress from, but there's absolutely varying degrees
of how ready the brain is for different things.
For some children, it's been the case more so that we're still working with them.
We're never going to stop trying to move things forward.
But we've seen someone who was really struggling at age two, who by age three, suddenly the
brain just seems much more ready, developmentally, to start taking in some of the things that
we are trying to teach.
And it really makes sense autism is a developmental delay.
So really meaning there's a delay in the brain's development.
So a two-year-old chronicologically.
Chronologically?
Thank you.
You're welcome.
Two years old might be developmentally six months old.
So as they've aged in years, developmentally,
they've kind of not caught up, but have aged as well.
So now by the age of three, they're just more ready for some of the skills
that we're trying to teach.
But we also take like a very systematic approach
and we'll look at every single aspect of the child's life
that we can try to change to start to see some amount
of improvement and it's a very slow and diligent process.
But through that process, we're usually able to get
somewhere even if it's not as far as we'd hoped to be. I know it's very systematic and I know science and diligent process, but through that process, we're usually able to get somewhere,
even if it's not as far as we'd hoped to do.
I know it's very systematic, and I know science
is very hypothesis, test, and you get your results
and whatnot, but you've got to get emotionally connected
to some of these kids by working with so many of them.
I mean, what's that like working with these kids,
especially when you gotta say buy to them?
Oh, yeah.
The last project we did did we were only treating kids for one year and in some ways that was
beautiful because their the first year is where we tend to see the most improvements so it was
incredible to get to see that but of course I mean we we just spent 25 hours a week for a year
with these children and to have to then transition them, especially be,
I have goals that maybe aren't met yet and to have to leave that kid.
We're working with the family's along, you know, side as the whole way, which is some
of what helps.
I can sort of trust that I feel like I've taught this family what they need to move forward
and that certainly helps in the process.
But yeah, we get incredibly emotionally attached. And I feel sometimes like a cheerleader, you know, just really rooting for these kids
and to have to say, you know, like, well, your year's up. Good luck is one of the hardest
things.
You stay in contact with them, maybe through social media.
Absolutely. Yeah. Yeah. Families, oh, yeah. Families will send us, you know, every couple
months. Here he is. That is kindergarten picture. And he was able to transition into a,
you know, typically developing kindergarten this year.
And yeah, we get lots of updates and pictures and reports, and it's great.
So my mom is a teacher for one of the public school districts here, and she works with
autistic children.
And there was a child that she worked with when he was really young, and he had a lot
of trouble, and she was assigned to just him.
So he had so much, she was assigned to just him. So he had so much she was just working with him and she would sit through his classes with him for a long
time. Well, the kid now is graduate. This was back, I mean, this was years ago. So this
is an elementary school and she even went to him to junior high for a little bit and he
would continue writing letters to her afterwards about how well he's doing. Graduated college
maybe about three years ago and he's doing really well.
I mean, I know it's only one kid, but I mean, I remember she would tell me the stories
of what it was like working with him and early on, it was very difficult.
Like he would hit her or he'd throw things or whatever, but his progress was to that now
he's graduated, he's married, he's happy and he continues writing my mom and she gets
very teary, I just talking about the kids.
So that's always an aspect that I, you know,
that I always wonder about, you know,
is that emotional connection?
Because you work with a kid for that long,
they become like, you know, like they're like family.
And you follow along with them.
And what are they saying to you years later?
And how long have you been doing this?
Are you talking to kids who you worked with five years ago now
who are sending you letters and stuff now or whatever?
Yeah, I've been in the field 15 years.
So I still have, yeah, you're a baby.
You look so young.
Did you graduate in your 12?
Yes.
Yeah, she's, so 15 years, you're getting kids now who have done that and have gone through
that process.
What do they say to you about their experience?
Yeah.
So a couple of things I want to highlight from what you said and from my experience is that
people with autism are going to college, are getting married. So you can have this diagnosis and
still live a very full and engaging life. I've gotten a lot of reports. I think you can read
different things from people with autism. Like Temple Grandin is a really famous person with autism
who's done a lot of work with livestock animals
and she'll say, you know, like the therapy,
even though it was something I didn't always want,
was one of the most helpful things for me
or when people kind of pushed me out of my comfort zone.
It's again, relatable to everyone, right?
Like it's hard to go there on your own
to do those uncomfortable things.
So having someone guide you along the way
is sometimes kind of a necessary discomfort.
And children that I've worked with have reported
kind of like the same thing.
Like I hated you when I was seven,
but I'm so grateful now because I can look back and see
the ways I would have never forced myself to grow.
What do you say to people who, you know, will say,
God, we gotta to label everything.
And we're just giving people excuses
by saying that they have something.
Why don't we just tell them to do what they need to do
and don't tell them, don't label?
What do you say to parents like that?
And is there any truth to what they're saying?
So I think the label, personally,
I'm not someone who sees labels as so important,
but in this field, in this world,
in this context, that label is what is going to lead to services.
And so if you want to see improvements for your child, unfortunately, you can't access
things like this behavioral treatment without the diagnosis.
So it's kind of like the catalyst for getting support and hopefully ultimately seeing the
outcomes that you would desire.
So it's just kind of necessary in the way to get support.
I guess that makes sense because until you label something,
especially if there's a field of research behind it,
when we figure out what it is, then we know what treatments
to apply to it.
If we don't know what it is, I mean,
we're kind of poking around in the dark,
you know, especially if we have years of research showing, research, excuse me, showing
that specific forms of treatment seem to help this particular set of symptoms.
But I also sympathize with the labeling everything as, you know, where, you know, and I read,
you know, I read a lot of books by famous, you know, psychoanalyst Carl Jung being one of them.
He talks about how sometimes labeling things or whatever gives us an external locus of
control where we don't we have no say over our future.
It's everything else is affecting us.
Like, oh, I can't do anything because I have this or I can't.
So do you ever have to combat that where someone says, oh, well, I'm just autistic.
I can't or my kids autistic. They can't try those things. You ever have to combat that where someone says, oh, well, I'm just autistic, I can't, or my kids autistic, they can't try those things.
You ever have to deal with that?
So far for me, that's actually never come up.
The people with autism that I've met
have actually been quite relieved
when they've received that diagnosis.
I kind of hinted at this earlier where it's like,
now I'm not just some really strange person,
but I'm actually this set of things.
And a lot of people had in this community
at least have tended to find comfort in that, like, you know, I'm not just, it's not so
hard for me to be at parties for no good reason. Like I, I have this thing. And I don't, I've
not experienced people using that as a way to just like throw your hands up and not have
to do anything, but a way to kind of say, like, I'm not just super weird. I have autism, and that's this set of challenges that I work through.
Yeah.
Knowing what we know now, can you go back in time and speculate on people you think may
have had autism?
Oh, for example, like Einstein, didn't he not speak until he was three or something
like that and had displaced some of those symptoms?
Are there any, is there anybody in history that you guys maybe sit around and go, oh, this person?
Yeah, all the time.
But I think we, I'm saying actually is one that there's been a lot of, yeah,
yep, thought about someone who's had autism.
And, you know, of course, it's hard to say who knows, but he's got that strong
ability to, you know, hyper focus on something and it's just an example of what brilliance
that gift can lead to. That's what I was thinking too. I was watching the, and I'm not saying
this person has autism before I pissed everybody off, huge fan of this person by the way. I was
watching Elon Musk get interviewed by Joe Rogan and you know, you know, we used to say about,
we used to use the word eccentric, that person's very eccentric. He for sure fits the category
of eccentric and obviously you could focus very hard on
certain things.
When I think about some of the things that you're talking about and the capabilities,
I think of the potential benefits to be able to hyper focus, especially if you're going
to be like some of these people who invent products or solve the world's problems where it requires a level of focus
that the average person just wouldn't be able to do it
or whatever.
Have you worked with anybody who's,
you know, now the news for 15 years
who's gone on to do some pretty big things?
Some exceptional, yeah.
Yeah, I've worked with one student who,
student now, I mean, there's just a person now.
They were a student of mine when I was a teacher
who is just an incredible artist and can
look at a landscape one time and then draw it perfectly just from memory, never having
to look at it again.
And they've gone into the field of architecture and are now a very, very successful architect
because of that ability to kind of like vision buildings and how they
should be and then just draw them out immaculately.
When you're working with these kids, are you looking at them in just envisioning the potential?
Is that the mindset you're going in?
Yeah, so one of the first things I usually say to families is that I'm here not because
I think there is anything wrong with having autism or that autism is a problem, but it can be a barrier
to living, you know, the fullest extent of your life. And that is what I want to help
your child to achieve. And so I'm looking at, you know, what are all those roadblocks
that exist now? And how can we, you know, take those down so that we can help your child
reach their fullest potential?
You had talked a little bit about some physical things about like signs of autism.
You mentioned toe walking, flapping the hands.
Is there anything else?
Is poor motor control a typical characteristic or a potential sign?
It can be.
So again, it's, you know, it's, um, I was a toe walker when I was a kid.
So I just want to put that out there.
You're saying this on my holy cow.
Yeah.
So really, and Adam always tells me I'm weird. So right before he talks put that out there. You're saying this on my holy cow. So really mad, I'm always tells me I'm weird.
So right before he talks about Einstein.
Yeah.
Yeah.
It's like I said weird.
So weird.
So weird.
So weird, I must be a genius like that.
Elon Musk.
I made a little speculation.
You know me.
Yeah.
I see through his bullshit.
Don't worry, I'll put it out for you.
Thanks Adam.
I actually want to take you back to,
I've been trying to get in a word in,
but Sal has just been going firing questions
at you without a breath there.
I want to take you back to the big rocks.
I find it really interesting
that you didn't say anything about nutrition.
Why?
I think partially because that is not so much my specialty.
We, my work that I do is much more concerned about
the behavior that the child is presenting
and less concerned about why it got there.
I'm also not a medical doctor,
so it feels a bit outside of my scope of practice
to be guiding people in that way.
So my concern is really focused on
what are the behavioral challenges
and while I have the belief that nutrition, good nutrition benefits everyone, I also believe
that I can work on improving the symptoms of autism without needing to touch that at all.
Great.
Well, I mean, I have to agree with that definitely.
One of the things that pet peeves that we have is when people recommend, give people nutrition
advice we shouldn't, just like I'm sure you would probably get irritated if people were giving behavioral advice and who weren't
experts in that particular field.
Moving looking forward with the research that you guys are doing, is there anything exciting
or kind of breakthrough right now that you're looking forward and you seem like potential
in in terms of future research?
I definitely think all the work, there's a lot of work that's being done with genetics,
which, you know, me as much as anyone is looking forward
to finding more specific causes and being able to diagnose,
you know, very early so that we can get children
right into treatment.
Things like the MRI study that I was talking about earlier
are really exciting to be able to hopefully pinpoint
exactly what differences exist in the brain so that we can even start
really targeted treatment and really thinking about this
particular area of the brain and how can we lead to changes
in that.
Some of the research that our lab is doing is kind of
really looking at what defines that quality treatment that I
was talking about and working to then disseminate that into
the community.
It's so what if we can do it with the 30 children that we serve?
What about the other thousands who aren't getting that type of treatment?
So being able to disseminate what we're finding into the community to help expand our help
so that more children can reach these services.
Is the age of the parents when they have the child, because I think I read another study
that connected older parents to a higher instance of autism?
Is that something that's been confirmed?
That, yep, that's correct.
So, over 40, I think, is a much higher risk for not just autism, but Down syndrome and
other developmental disorders as well.
Oh, wow.
Okay.
So, and there's more people having kids at older ages, especially what we're at here in
Silicon Valley, where people now, the average age of a parent, it's going to be over 30 now,
I think, is the last time I looked at it.
Now, Mal, you've been doing this for quite some time now, and something that we talk about
on our show, in our time that we've been in fitness, is there's been many moments where
we've had our paradigm shattered, where we strongly believe in a direction and there was like,
oh shit, new study comes out, we're, oops, take a left here. Has there been situations like that
during your career? Yeah, absolutely. I mean, I think most of it has just been kind of like my own
personal growth. To some extent, like when I think back to my first years as a classroom teacher,
some of the things I did, I'm like first years as a classroom teacher, some of the
things I did, I'm like, oh my God.
But we're some of the things you were missing.
I wanted the reason why I want to point that out because just like in our space, there
might be people still doing those things, thinking it's the right thing.
Yeah, I think, you know, what I was mentioning before is like the lack of training and support
that there is for people that are in this field.
I was certainly, you know, at the receiving end of a lot of that. So being thrown into a classroom of 11 to 13
year olds was severe autism while I was still in my credentialing program for, you know,
moderate to severe disabilities was like, wow, here I am way outside of my ability level in comfort
zone and knowledge level, having to figure out what I can do for
the kids in my room without anyone to come observe, anyone to talk to, anyone to run things
by.
So just simple things like that, like knowing that clinicians should work together.
There should always be another set of eyes available to look at kids because sometimes,
you know, when you're so in it, it's really hard to have that bigger perspective and look at yourself and what you're doing and how that's contributing.
So kind of sometimes it's really simple things like how to seek support and how to make sure that someone else is available. This work is really challenging and it will definitely take a lot out of you if you're not finding, you know, ways to get support in the work that you're doing. Have you noticed that affect your own personal life
in relationships?
I know a lot of people that are friends of mine
that give so much in their life,
they have a lot of challenges with their own personal.
Are you married or a relationship?
I'm on the market.
All right.
You guys missed a little dance.
That's a little bit of a side shuffle.
Yeah, that's good.
No, but yeah, I think like I said, I've learned so, man. Yeah, that's good.
Yeah, I think like I said, I've learned so much.
There's so parallel process and the work that you're doing
and what you can bring into your own life.
The lessons I've learned about patients, about...
Right, I feel like you could be the most easy woman to communicate.
I mean, if you can communicate with kids that can't fucking speak.
I mean, there's got to be a fucking man out there.
I mean, there's got to be like, out there. I mean, there's gotta be like,
I know we're not the best communicators, but.
That's right, Adam.
Yeah.
One with thing, great.
I bet you, I would think though,
you were, you'd be tired after that all day long.
I know sometimes I feel that way.
A lot of times people think that on this super extroverted
outgoing loud talk all the time,
but I feel like I do that all day long
that sometimes when I get home in the opposite.
So do you find that about yourself too?
Yeah, for sure.
Sometimes when I get home the last thing I wanna do
is talk to another person.
Or, you know, because it's early intervention,
we do a lot of work with the families
and sometimes a big portion of my day is parents asking me,
you know, do you think my child's going to college?
Do you think my child will get married
and takes a lot of, you know, of your energy
to kind of process those types of things
with families for, you know, your whole day.
Are the parents harder to work with than the kids?
Yeah, yeah, oftentimes it's a lot of, I mean, you know, if you think about a two-year-old with autism,
where you only have a two-year history of needing to work on changing behaviors,
but, you know, someone who's been around for 37 years and working on, you know,
you guys work in exercise nutrition,
getting people to change their behavior
is a really big challenge.
And oftentimes what we're asking parents to do
is in one way or another,
sometimes small, sometimes extreme,
is to not only change their behavior,
but to change their behavior
in order to change their child's behavior.
And we all know that getting adults
to change their behavior is a big challenge.
Even when you have this goal that you want so bad, it's still sometimes so hard to follow
through with the recommendations.
Right.
Do a lot of parents to come in with their own diagnosis and what they've read on Google
and how often are you having to educate right away as they come in?
Yeah, almost 100% of the time.
I mean, if you Google Autism Treatments,
you're going to get an instant 5,000 things pop up.
And probably two of them are evidence space
and things that I would actually recommend looking into.
What are those recommendations if you could provide that for our listeners?
Yeah, so again, we talk about things that have an evidence-based support, evidence-based practices.
And there is a website called the NPDC or Autism Speaks where you can go to find
what is this list of evidence-based practices. But basically, many of these 5,000 things that are
considered autism treatments, many of them have been looked into, researched,
and then put on this list to say, like, these have support and would be useful to look at for
your child and these ones have either emerging support, absolutely no support, or these are
even harmful.
And I've just kind of categorized that.
But most of them are going to fall under that umbrella of behavioral treatments and apply
behavior analysis.
Again, that behavioral piece is really what we see leading to the lasting change for kids.
If I'm not mistaken, I think there's a pharmaceutical company that's looking into cannabis dial treatments
for people with autism.
CBD, is there any science showing that CBD can help with the symptoms of autism?
So again, that would be like emerging, but it is actually looking.
There is research being done,
and I think there's already previous research
on CBD supporting some anxieties,
some of the symptoms of anxiety.
So a lot of people with autism also suffer from anxiety,
so there can be some support for that,
and looking into if there's some support for relief
from some of the other more behavioral challenges
that people with autism. Yeah, you more behavioral challenges that people thought to do.
Yeah, you said early on that people would get categorized as schizophrenic and now they're getting categorized as autistic.
I know that CBD has been shown to decrease the symptoms or improve people's schizophrenics.
And so since some of those symptoms tend to cross over,
I guess you would have to test it, right?
But it makes sense that it may actually have some benefits.
Early on, when you guys were,
when you first started, it worked in this field,
were there mistakes that you guys made
that now you look back and go,
oh yeah, that's not, that wasn't effective,
that might have actually been wrong?
Or has it been good the whole time?
I, so, because we're really like following science, I think it's more about refinement, you know,
like I talked about being extremely systematic and really following data.
I would say some early on mistakes were more like following your gut or your intuition,
which sometimes maybe is appropriate, but really using data collection and relying on data to
say, like, oh, actually, you know, this thing that we started is helping or it isn't helping
and it's something else.
So doing that much more so than relying on, like, oh, I think it's just this.
So like, I think when the window's open, he has a much harder day.
But like, let's actually take data and see what's happening and rely on that to make our
decisions. What are the symptoms with adults?
If an adult thinks that they may have autism,
we talked about kids, what about adults?
Like what are things that a person,
an adult person would look for in themselves
to think that to maybe get them to go see someone
like you to help them out?
Yeah, a lot of adults that are finding out they have autism
are attending to, that's coming up for them, I think more in the social realm. Yeah, a lot of adults that are finding out Bay of Autism are tending to
That's coming up for them. I think more in the social realm. So
Just finding that you're having like that social anxiety or don't like that experience of talking to or being with people as much as others
Do having finding eye contact something that can be really
uncomfortable or challenging for you
not really finding common language as understandable. You know, we use a lot of like idioms or phrases
and getting confused about language like that
and why people would talk in that way,
being quite literal is a common experience
for adults with autism and getting lost
in, you know, general conversation.
I think those are a lot of the things
that lead people to say,
like, you know, what's going on?
Why is this so easy for everyone?
And it seems to be such a challenge for me.
Interesting.
Any favorite books?
Ooh, yes.
Let me think if I can, oh my gosh.
Yep, there is a favorite book.
Let me hear your voice.
Yeah, super good.
I thought you wanted me to do something right there.
I'm looking for you right now.
I'm looking for you.
I'm looking for you right now.
You haven't heard the show.
Let me hear your voice.
Yeah, I think Catherine Maurice is the author.
It's written by a mother of a child with autism,
and it is kind of like her journey.
I think there's another one written by a child with autism. I think it's
called why I jump or the reason I jump. That one's really interesting all, you know, from the perspective
of the child with autism. Yeah, I was gonna say those are specific to autism. What about behavioral
science? I mean, I love to read behavioral science anyways. Is there specific books that you like
in that role? Oh, that's a really, I mean, God, there's probably so many. I mean, I find myself
reading a ton of articles.
So I'm really into like the journal
of applied behavior analysis.
I sound so nerdy.
That is where I spend a lot of my time.
It's all good.
Excellent.
Well, this has been great.
This has been very great.
I have very informative.
Yeah, again, it's such a, it's funny that it's a controversial
topic.
I don't know why it's so controversial.
I think like anything, you just look at the science
and do the research and we don't have all the answers,
but I'm glad people like you are putting a lot of work
and trying to figure it out, you know,
trying to figure out what's going on and try to help people.
So I appreciate you coming on the show
and talking all some of that stuff.
Thanks for coming down.
Thanks so much for having me.
This was a really awesome experience.
Thanks, guys. Excellent, thank you. Thanks so much for having me. This was really awesome experience.
Thanks, guys.
Excellent. Thank you.
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