Introduction to Neurodiversity
Cheryl Bohn: Welcome to the Mothers of Boys Survival Guide podcast, where we dive into the real challenges moms face every day. I’m Cheryl Bond, and joining me is my co-host, Suzy Shaw, author of Mothers of Boys Survival Guide.
Suzy Shaw: Hi, Cheryl. Hey, Suz. And I want to let everyone know I call the Mothers of Boys the MOB, so welcome to the MOB.
Cheryl Bohn: I love that.
Suzy Shaw: Today’s podcast is Raising Remarkable Boys: Recommendations for Navigating Neurodiversity, Autism, ADHD, and more with our guest, Dr. Paul Hokemeyer. Welcome, Paul.
Paul Hokemeyer: Hey, thank you. It’s good to see you again.
Dr. Paul is a licensed marriage and family therapist and author of Fragile Power: Why Having Everything is Never Enough, and a companion book, Fragile Power 2.0, Wealth, Narcissism, and Mental Health. He is a clinical fellow at the American Association of Marriage and Family Therapists and a graduate of the Global Leaders in Healthcare at Harvard Medical School.
Suzy Shaw: So Dr. Paul has agreed to record two podcasts on this critical neurodiversity topic. Today’s podcast will focus on understanding what neurodiversity is and digging into the latest brain science, recognizing the signs, and steps that moms can take to support their sons of all ages.
What is Neurodiversity?
Cheryl Bohn: Dr. Paul, neurodiversity seems to be a more recent term. Can you explain to us the meaning of neurodiversity?
Dr. Paul Hokemeyer: Yeah, sure. It is very much a recent term. It came out in 1998 through some research that a woman was doing that explores how brain differences are not necessarily a sign of an illness, but that the human brain operates on many different levels.
It’s an umbrella term that refers to a number of disorders, the most common of which are ADHD, autism, and dyslexia but it also includes things like dysgraphia, where our kids have a hard time writing. And so, again, the point of the term is to point out that these disorders are not necessarily signs of weaknesses, but they’re just differences in the way that the human brain operates.
Identifying Signs of Neurodivergence in Childhood Development
Suzy Shaw: And at what age in a child’s development should you begin to see signs of neurodiversity? And before you get into that, I will say I had a son who had a hard time holding a pencil. And we went through all sorts of occupational therapy kinds of things. And he was more on the ADHD sort of scale. And he never ended up holding the pencil correctly, and is having a fine career in IT and cybersecurity. So, when should you begin to do something when you see something? And what signs should you be looking for?
Dr. Paul Hokemeyer: You know, the sooner you notice something different, the better. You know, typically, these things reveal themselves early in the kid’s life. So if the kid has a hard time maintaining eye contact, the kid has a hard time engaging with other people, if they seem to be off in a different world, if their mind is somewhere else, if they’re fidgety, then you could, you know, start to think about perhaps that they are neurodivergent and take them to a professional and see what they think.
And then the sooner you can intervene on them, the sooner you can start putting strategies and routines in place to support them on their journey of becoming like a famous IT professional, like your son, right?
Steps Parents Can Take to Support Learning Difficulties
Cheryl Bohn: What are some of the steps that a parent can take to support their child?
Dr. Paul Hokemeyer: You know, it’s really important. Routines are really important. You know, we know this in parenting, right? Like having a set time when your kid wakes up, having a set time when your kid goes to bed. So routines are important.
Consistency is important. If your kid is overstimulated, which, you know, a lot of kids are like, be aware of that and make sure that you try to create environments that are calming and soothing for them.
I had one parent whose kid would really go off on some tirades and she found it very, what was very effective was taking him and putting him in a bathtub. So, I mean, not with water, an empty bathtub. So basically, he was in this clothes-contained environment. Changing the environment provides an environment for your kids to calm down and to be able to soothe their, whatever their neurodiversity is, their hyperactivity, really, if that’s the case.
Diagnosing Learning Disabilities and Neurodivergence
Suzy Shaw: And why is it a diagnosis relevant? Is a diagnosis relevant? And how do you talk to your child about it and when, you know, at what age?
Dr. Paul Hokemeyer: You know, I’m a clinician, so I operate in the realm of diagnoses. There’s some controversy around diagnoses and if they’re pathologizing and, you know, if, if they’re, if they’re appropriate, if they’re not appropriate.
I think diagnoses are critically important because it gives us a place to start based on science, right? So there’s a lot of great science around what neurodiversity is, what ADHD is, what autism is. And so if we have a diagnosis of that’s what it is, we can begin testing with the solutions.
And look, not all solutions, you know, there isn’t a one size fits all here that what may work for your kid may not work for my kid, but the fact is we have to start trying and looking and seeing what works.
One of the challenges of issues with behavioral health, of these issues is that people are always wanting like a silver bullet, right? It’s like, I have a headache, I take an aspirin, it goes away. So we would love for the fact that if we have a child who is struggling with ADHD, which means the family is struggling with ADHD, right? Because these things occur in the context of a family, that they wish that there was like one thing that we could do. And typically, it’s a number of things that we could do.
So there are medical interventions, there are family interventions, there are dietary interventions and environmental interventions. So having a diagnosis enables us to begin to focus on the solution, right? As opposed to sort of wandering around and in this, in this problem, we can begin to try to see what works.
Who Diagnoses Learning and Attention Deficit Issues?
Suzy Shaw: And, who are the types of people that make the diagnosis? Is it the pediatrician? Where? Is it the school system?
Dr. Paul Hokemeyer: So that’s a super great, that’s a great question. I mean, typically a diagnosis of this would be made, I would prefer it to be made by a pediatrician. I would prefer it to be made by a licensed clinical psychologist.
If it is an ADHD and you’re looking for some sort of medical intervention, right, they’re going to have to write the script to whatever medication is going to be prescribed. So I would like for it to do that. Most primary care physicians, most pediatricians are very well-versed in these issues and have the capacity to do it. Certainly, you could go to a child psychiatrist to do it. But not all families have the financial means to be able to do that. We know, like psychiatrists now can be like a thousand dollars an hour. And so there are other levels, licensed level clinicians who can make these diagnoses. And, I would start with your, with your PHP, with your primary care physician, actually, and see what she recommends and, and what she thinks and where, where you should go.
Talking With Your Child About Neurodivergence
Cheryl Bohn: And so, how do you talk to your child once they’ve been diagnosed to help them understand what their diagnosis is and what that means for them and how you’re going to support them as a parent?
Dr. Paul Hokemeyer: I think in the context of diversity, I mean, we live in a highly diverse world, right? You know, we live with different genders, different races, different religions.
And, and, you know, it’s important that our kids know that early on. It’s also important to know that diversity adds value of life and that diversity is something that makes us and enables us to grow and be better people. And so putting it in that particular context and then say, hey, you know, and brains are diverse, just like people are diverse and some brains really have, are really good at focusing. Other brains are not, other brains are not good at focusing. And so it doesn’t mean that one’s better than the other. It just means that sort of, the path of learning is going to be different.
Suzy Shaw: One of the things I always said to my kids is that everybody has something that they’re, that they’re not good at. And some of us know what it is and it’s the, it’s whatever the thing is. You might be born with something, or you might have an accident. But once you understand what it is and then you can decide how to make it better and do the best you can with, within it. And it’s better than not knowing what it is.
Dr. Paul Hokemeyer: Yeah, absolutely. And I think it’s really important to like, to, you know, like identifying the problem is, is the, just the early step, right? You don’t, you don’t stay in the problem, you know, like you, you identify the problem and then the journey becomes, how do you, how do you not just, how do you address the problem, but in a way that enables you to thrive, right? We’re just not looking for basic functioning, but we’re really looking for ways that we can thrive in the world.
And I mean, I know in my personal life and in my professional practice that our perceived weaknesses become our greatest strengths, you know, great therapists are people who like really know psychic pain really well and are able to sort of recognize it and feel compassion for it in other people. So, having a brain of an autistic person where perhaps your interpersonal skills aren’t great, but your ability to analyze data and work with numbers and work with facts and systems, you know, that’s, listen, I wish I had that. I wish, you know, like back when we had checkbooks, I never really balanced. I don’t have to because my AI or whatever the heck does it for me. But, at the same time, you know, there are certain skills that I wish I had much better organizational skills than I have.
So, it’s all framing it and, and what, and what you do with it. That’s the thing, right? It’s like, what do we do with it? And we know that there are really great clinical interventions, family interventions, parenting interventions, uh, which you guys focus on, right? The parenting interventions can really provide value here.
Identifying Supportive Tolls and Framing Solutions
Suzy Shaw: You know, one of the tools that I taught my son who was, who was more neurodiverse, was to rely on a Google calendar and set alarms and remind yourself that this homework is done or this needs to be done because his disorganization was very, very overwhelming, but he loved technology. And so, you know, how to use technology and the tools that are available in positive ways. Do you have any other suggestions about that?
Dr. Paul Hokemeyer: No, I think it’s, I think it’s important. I think it’s important to frame, right? In therapy, we talk about the value of the frame. And I think that that’s important in this context. You need to create a frame for your children that holds them with boundaries and discipline but also gives them enough room to kind of bang around a little bit, right? And learn. And, it’s through those, the banging around, that the real learning happens because you can experience it, you experience it. And, when you experience, right, your brain registers, and it’s like, well, that, that didn’t feel good, or that didn’t end well. So maybe we shouldn’t do that again. So, I think creating a frame, creating structure, and then giving your kid some room within that structure so that they can maneuver and feel a sense of agency and feel empowered.
One of the things that I always advise parents of is that we don’t want to create a narrative of pathology for our kids. In layman’s terms, we don’t want our kids to think that they’re broken because they’re not, they’re not broken at all. Right. So, and that’s really important early days for kids, because, um, if kids begin to feel like they’re broken early on, like damaged goods, it doesn’t grow up well. So recognizing that they’re not broken, they’re just different. They’re just diverse and diversity can be a really terrific thing.
Cheryl Bohn: And it’s really important for this conversation to be happening in schools, right? With the teachers and all the children so that they’re, they have empathy towards each other if somebody’s more unorganized than them or not socially interacting the same as the other kids. Just to have an understanding that everybody’s brains are wired differently and it’s not good or bad. It’s just different.
Dr. Paul Hokemeyer: Right. It’s just different. And there’s, and there’s real value and that we can really learn from each other. And, you know, and this is part of like create community. And as our kids get older, right, as they become teenagers and adolescents and where their social relationships are so important and they’re learning how to negotiate social relationships, sort of showing them that they can learn from their peers and their peers can learn from them. Right? And so it isn’t one or the other or the one’s better than the other. It’s just differences. And it’s in those differences that, that, you know, they can become responsible, compassionate, empathetic, productive adults. You know, that’s also me. My parents are always like, “Dr. Paul, how do I not screw up my kids? Like, how do I make sure that they’re productive, you know, people in the world?” And, you know, it’s, it’s accountability, it’s discipline, it’s experimentation. It’s all of those things. And those are the interventions that we need to make sure we’re applying with newer, diverse kids as well, maybe even more so.
The Impact of Medication and Therapeutic Approaches
Suzy Shaw: Mm-hmm. And what effect do medications and there seem to be more all the time. How does, how does that work with the brain to, to make, help the child learn better in school, or sit in school, or be more organized?
Dr. Paul Hokemeyer: It’s a bit counterintuitive for me. Like when I first heard that these medications were stimulants, I was like, what? But they stimulate the brain so the brain is able to focus. The impact, the neuroanatomy and the release of chemicals, that enable the brain to focus. And it causes the child to calm down. Right? And these kids need to be calmed down. It’s, there’s a lot of chemistry involved. There’s a lot of biophysics and chemistry involved that exists in solid. That’s kind of all we need. So I’m like, I’m not going to go into the details here. But they work and they’re highly effective.
Conclusion and Mantra for Parents
Suzy Shaw: So Paul, we asked all our guests to share a little mantra about their topic, something really short that a mom can say in their mind as they’re dealing with, with, um, hyperactive and neurodiverse children. So what would you, what would your mantra be for moms?
Dr. Paul Hokemeyer: Wow. How about: Keep Calm and Carry On!
Cheryl Bohn: Love that. That’s great advice for every aspect of our life. And if we stumble, we will get up and keep going.
Dr. Paul Hokemeyer: You know what? That’s exactly right.
Cheryl Bohn: Well, Dr. Paul, thank you so much for taking the time to be our guest here today, to gain a better understanding of neurodiversity. Your knowledge and expertise are greatly appreciated and valued. The work you do in the field of mental health, both here and around the world is, it’s extraordinary. And we really appreciate your time today. Thank you so much.
Dr. Paul Hokemeyer: Thank you.