Demystifying the Less Obvious Presentations of Autism

Demystifying the Less Than Obvious Presentations of Autism When: Friday, May 6  2022 @ 9:00 am - 12:00 pmBCASP Members: $55Non-Members: $80Dr. Donna Henderson has been a clinical psychologist for over 30 years. She earned her doctoral degree from the School of Professional Psychology at Wright State University and subsequently worked as a staff neuropsychologist and then director of acquired brain injury at the Gaylord Hospital in Connecticut. Dr. Henderson joined The Stixrud Group in 2011, specializing in neuropsychological evaluations for individuals with cognitive, academic, social, and/or emotional challenges, with a particular interest in autism. Dr. Henderson is a frequent lecturer on the less obvious presentations of autism, on autistic girls and women, and on parenting children with complex profiles. She also enjoys assisting other healthcare professionals through case consultation. Over the past 20 years the prevalence of autism has risen from 1 in 150 to 1 in 44. This is due in part to our more sophisticated understanding of verbal individuals with a less obvious presentation of autism. Still, boys and men continue to be diagnosed far more frequently than girls and women (approximately 4:1). It has always been assumed that the prevalence of autistic boys is naturally greater than girls, but recent research demonstrates that many autistic females are being misdiagnosed or missed entirely. In the past ten years, there has been a burst of research on autistic girls and women, particularly those with average to above average intellectual functioning, and it has become clear that they can present differently from their male counterparts in many ways. Moreover, research demonstrates that these girls and women are highly vulnerable to multiple co-occurring challenges, such as anxiety, depression, eating disorders, and victimization. While this less obvious presentation of autism seems to be most common in females, it can also apply to clients throughout the gender spectrum. Receiving a proper diagnosis can be life changing for this population, so it is essential that all clinicians are updated on the ways to recognize all presentations of autism.This workshop will provide that clarity:Describe characteristics of individuals with a less obvious presentation of autism.Identify ways that autistic females can present differently from autistic males.Identify components of an effective social cognition assessment. BCASP Virtual Workshop 2022 BCASP Members Registration Non-Members Registration

2022-04-07T11:09:44-04:00April 7th, 2022|Categories: Blog Post|Tags: |

COVID-19 Company Update

The Stixrud Group: COVID-19 Update We have been open for in-person, face-to-face evaluations since June, 2020! As of February 12, every employee of the Stixrud Group has received both doses of the Covid vaccine! Our testing model: The majority of our clinicians are using a hybrid model of in-person testing and tele-health interviews and feedback sessions for most clients. This allows us to decrease in-person interaction. Covid-19 precautions in the office: The Stixrud Group follows guidelines set forth by the Centers for Disease Control and Prevention (CDC). We begin each day by staggering the arrival of our in-person clients, to minimize exposure between families. We will ask you to call the front desk when you park, and you will be instructed to come up to the office or, possibly, to wait a few minutes. Parents of very young children, or clients who need extra help, are usually able to stay in our (spacious) waiting room, but we ask all other parents to find another place to wait so that we are not overcrowded. When you arrive, your clinician will take the client’s temperature, as well as his/her own, and screen for COVID-19 symptoms. Every office has been arranged so that the psychologist or psychology associate and the client are sitting at least 6 feet apart for the majority of the testing, there is a plexiglass barrier on every desk, and every room has at least one HEPA-certified air filtering machine. Finally, all employees, clients, and families are required to wear masks at all times, including in the waiting room.

2021-06-16T21:51:36-04:00February 25th, 2021|Categories: Blog Post, News|

Surface Dyslexia: Another Form of Context Blindness in Autism?

- Sarah Wayland Author: Donna Henderson, Psy. D Poor awareness of the sounds of language or a lack of understanding of the spelling-sound correspondence is the cause of the most common type of dyslexia. People with this type of dyslexia will make spelling errors that do not make phonetic sense (such as spelling “desk” as deks or “with” as weth). In contrast, I have noticed that some of the children I work with have an unusual pattern of spelling errors. These kids seem to understand which letters go with which sounds, but they actually over-rely on the letter-sound correlation. For example, they might spell the word “garbage” as garbij or the word “wiggle” as wigul. To understand these different types of errors, it’s important to first understand how children learn to read as well as what typical dyslexia looks like. It all starts with the phoneme. A phoneme is the smallest unit of sound, and there are 44 phonemes in the English language. In the word “cat”, for instance, there are three phonemes (/k/ – /æ/– /t/). Both speaking and reading rely on being able to identify, distinguish, blend, and manipulate these phonemes. Good readers know that specific written letters are associated with particular sounds (the phonemes) and that the sounds (and thus the letters) must be in the proper order. Beginning readers and writers must use the phonological form of the word to determine how say or spell it. However, the English writing system does not necessarily observe a one-to-one correspondence between letters and sounds.  For example, if we see the letter “k” we associate it with the /k/ sound, but if we see the letter in a certain context (knife), we know that the sequence of letters will alter the sound of that particular “k”.  Likewise, the letter “c” can be pronounced as /s/ or /k/ (as in “concise”), depending on the word’s origin and the letters that surround it. Knowing the rules that govern a letter’s pronunciation can make decoding words much easier. There are many of these irregular words, such as “laugh” and “neighbor.” These words cannot be sounded out; to read or spell them, the reader must either be able to recognize the word automatically from memory (a sight word) or know how to apply the unique reading and spelling rules. The spelling rules of English can be difficult to learn, as there can be many ways to spell the same sound. The phonological awareness skills (to sound out regular words) coupled with a knowledge of the spelling rules of English (to cope with irregular words) are both necessary for fluent reading and writing. Good spellers must know the spelling rules of English in addition to having good phonological awareness. In the most common type of dyslexia, phonological dyslexia, people do not have adequate phonological skills, so they have difficulty sounding out or spelling even regular words. Other students, however, may have adequate phonological skills but fail to fluently use [...]

2019-03-13T21:42:49-04:00March 13th, 2019|Categories: Blog Post|Tags: , , |

Helping Children Feel Empowered – Dr. Susan Hammond

SEE FULL CV VM: 2005 RECENT PUBLICATIONS A month ago I attended a weekend reunion of the summer camp I went to for six years, celebrating the 70th anniversary of the camp. The women there ranged in age from around 80 down to 19. As we spoke of our years at camp, I was struck by a common theme: the development of self-confidence and empowerment that comes from overcoming real challenges and contributing to a vital community. Through summer camp, these women had learned as children and adolescents that they could be successful in ways they never imagined – whether through camping in a rainstorm, swimming the circumference of a Vermont lake, or building a cabin from scratch. They took that confidence with them through their lives at school, at work, in their families, and in their communities. When I evaluate children with learning, behavioral, or emotional challenges (and when I parent my own children), I wonder how they will gain a sense of empowerment and success that can carry them through hard times. I often find that children who learn differently come to the worst possible conclusions about themselves: that they are not capable, that their peers are smarter or better than they are, or that they will never succeed in life. It is critical for these kids that they be given opportunities to feel competent, so that they can gain self-confidence. While a summer roughing it at camp is wonderful, not every child can have that experience. But there are many ways parents can give their children opportunities to feel competent and valuable. In the family, kids can help with younger siblings, with household chores, or with pets. In school, they can assist the teacher with classroom tasks or work with younger children. The key to empowerment is to find tasks which are truly useful, not just make-work, and give children the opportunity to succeed at them. It is also important to prioritize activities in which children excel. Parents easily can become overwhelmed by their children’s needs – for therapies, tutoring, and even down-time. But kids also need to spend time pursuing their interests, passions, or just having fun. Success on the soccer field, in scouts, or in music can give them the crucial confidence that keeps them going when things are hard. I still remember my first overnight hike at camp. It rained, and rained, and rained. But when we got back to camp we were singing!

2017-12-03T22:22:36-05:00April 1st, 2015|Categories: Blog Post|Tags: |

The Importance of Independent Schools in an Age of Inclusion

For the past 20 years, Dr. Stixrud has been extensively involved in the training and supervision of psychologists and learning specialists. View Profile Throughout my career as a clinical neuropsychologist, I have been a big fan of the independent schools that serve students with special needs.  I recall that when the field of special education was developing, experienced educators intuitively knew that students who do not learn easily or are not developing at a typical rate need highly specialized instruction that is provided in small, structured, supportive classroom settings with a low student-teacher ratio.   Along with the development of special education programs in public schools following the passing of the first special education law in 1975, numerous independent schools were founded in the Greater Washington area and around the country to meet the needs of students who required a highly specialized learning environment.  In my work over the last 30 years, I have met dozens, if not hundreds, of children and teenagers who have been “saved” by these independent schools.  These are students who hated school and, in many cases, hated themselves before they entered these special independent schools, where they felt understood and supported – and did not feel stupid.  We have all met successful adults who struggled as children and attribute their success in life to adults who “got them”, believed in them, and supported them.   Over the last three decades I have met many, many people who have told me that they are thriving in life as adults because teachers, administrators, and/or support staff in these independent schools saw potential in them and nurtured it. Over the last 10 years, the landscape in public special education has changed dramatically, as changes in special education law have led to a stronger emphasis on education in the “least restrictive environment”, and as reduced resources for public education have forced schools to close their small, specialized programs.  Although I believe that many students can be included successfully in regular education classrooms – and that school districts make a very sincere effort to support their students, it is my experience that many students cannot be successfully included and need the kind of specialized learning environment provided by these independent schools.  I’d like to briefly share with you some of the reasons why I think this is the case. Safety First.   One of the most important principals of education, based in research on the effects of stress on learning, is that kids need to feel safe in school in order to learn.  Many of the children and teenagers I have seen over the years have been highly stressed in regular education environments and have simply felt safer in their own skin in a small independent school.   This is commonly because the classrooms and hallways in typical schools are too noisy and distracting or because being in a regular classroom leads to a painful awareness that other kids learn easier, get their work done more quickly, seem smarter, etc.  In my [...]

2017-12-03T22:26:58-05:00November 13th, 2013|Categories: Blog Post|Tags: |

Myths of Autism – Dr. William Stixrud

For the past 20 years, Dr. Stixrud has been extensively involved in the training and supervision of psychologists and learning specialists. View Profile Individuals with high-functioning autism or Asperger’s…. Social/Emotional Myths Don’t want to make friends.   Some individuals with autism spectrum disorder (ASD) really want to have friends but do not know how. Can’t make friends.   Many individuals with ASD do have friends; often their friendship forms around a shared interest. Don’t engage well with anyone, including adults.   Kids with ASD are often better at interacting with adults than peers, and may be affectionate with their parents, siblings, or others close to the family. Don’t feel emotions or experience anxiety and/or depression.   The emotions are there, even though insight into their own emotions and the emotions of others may be limited.  Individuals with autism who are aware of their social difficulties may feel rejected, incompetent, and lonely, leading to anxiety and/or depression. Are weird and/or not likeable.    We know and very much like many people with autism! Diagnosis Myths Have obvious behaviors and traits which everyone can identify.  If an individual with ASD does not have the more noticeable motor mannerisms or unusual language, his or her social impairments may go unnoticed. Will be harmed or limited by a diagnosis of autism.  Diagnosis can provide access to targeted services and treatments, and provides the teachers, family, and the individuals themselves a non-judgmental framework for understanding behaviors. Can’t have autism if they have already been diagnosed with other disorders, such as ADHD, sensory integration disorder, auditory processing issues, or mood disorders. ASD often comes along with related neurodevelopmental issues, and sometimes these other issues  are identified first. Other Myths Don’t have language difficulties.  Even with a seemingly good command of language, many individuals with ASD have trouble understanding non-literal aspects of language (e.g. metaphors, idioms, inferences) or may have difficulty taking  the listener’s perspective when speaking (e.g. too much detail, or insufficient background information). Always demonstrate “stimming” behaviors.  Self-stimulatory behavior is seen in some but not all individuals with ASD; and for those who do “stim”, there is a wide range of “stimming” behaviors, some more subtle than others. Can’t lead productive lives, go to college, nor have a family.   Individuals with ASD often need additional support in managing life transitions and developing functional independence.  Their families are their biggest supporters in learning how to navigate big life decisions. Have autism due to their parents’ poor parenting skills.  Research indicates that there is a strong genetic basis to ASD.  We also know that no particular parenting style causes ASD. By Patricia Eyster, M.Ed, Donna Henderson, Psy.D., Rebecca Penna, Ph.D., NCSP

2017-12-03T22:38:42-05:00October 28th, 2013|Categories: Blog Post|Tags: |

Where should my child go to school? – Starr Stixrud

Where should my child go to school? This is a common questions parents ask who’ve recently had their child evaluated at our practice.  In fact, help with school placement is often one of the reasons that children are brought in for evaluations in the first place.  Let me say first that the psychologists and the neuropsychologists at The Stixrud Group and the educational consultants from Stixrud Educational Consulting do not have a preference for private school or public school. We believe that both systems have their place and making the right choice is a very individualized decision, because of the myriad of factors that impact ultimately what the best option might be for an individual student.  Last week I discussed that a critical component in school selection is locating a school where your child’s teacher can be a non-anxious presence in the classroom.  This week I want to discuss what I think it means to be a non-anxious presence and why I think this is such a critical concept. The notion of a non-anxious presence was identified by Edwin H.  Friedman, PhD in his book A Failure of Nerve: Leadership in the Age of the Quick Fix.  A working definition of non-anxious presence is someone who can be honest and expansive without causing undue fear.  This kind of emotional approach can be expressed from a micro-perspective, (e.g. individual relationships) as well as from a macro-perspective, (e.g. how the teacher thinks about the class and the school).  You may be reading this and wondering “how can I as a parent possibly have any impact or input on my child’s classroom teacher with respect to her emotional approach?” (i.e. the non-anxious presence feature) .  I contend that, as a parent, you actually have a fair amount of influence over this.  To affect the anxiety level your child experiences in the classroom, and one of the most valuable things you can do for your child’s experience in class, is to become a non-anxious presence in your child’s teachers life. One of the techniques that I employ in this type of circumstance is to actively try to place myself in the other teacher’s shoes and to actually try to imagine their perspective, so that I can have a deeper appreciation of their reality.  Almost always with this kind of role play, I am able to develop an insight and a viewpoint that is more empathetic.  When I am more empathetic, I am less reactive and then I am less reactive I am less fearful. Back to the teacher and my child. As a parent, I saw my relationship with my child’s teacher as shifting from that of a silent partner to an active team player, depending on the need of the situation.  I believe that if the teacher saw me as a supportive partner, he/she was less fearful of me and thus was able to see my child in a different light.    It was clearly the teacher’s classroom…he/she was in charge but I was her willing and active accomplice.  My perception [...]

2017-12-03T22:43:45-05:00October 10th, 2013|Categories: Blog Post|Tags: |

Activity Rocket – Starr Stixrud

Getting to Know You My name is Starr Stixrud and for the past 23 years I have been the administrative director for The Stixrud Group (TSG).  We are a group of psychologists and neuro psychologists who evaluate children, adolescents, and adults with a wide range of learning differences and or social difficulties. In addition, I recently partnered with Martha Ein, M.Ed, to form the Stixrud Educational Consulting (SEC), where we work with families to find the optimal educational and social avenues for their children.  (For more about SEC and our backgrounds, please feel free to check us out here.) My dual role at TSG is unique in that I spend equal amounts of time running and managing a business as I do working closely with psychologists, parents, schools and referral sources. If I had to identify my favorite role, however, it is listening to parent tells me about their child and their family; in our office we call this the clinical care manager (CCM).  I have heard many, many stories about kids and their families. Each story is unique and yet there are some common themes that are nonetheless present. Without a doubt the primary underlying theme is that the parent expresses a deep love for their child and at the same time a fear that things are not going as expected.  We live in complicated times and yet I would say that this is an ongoing universal themes about children, families and development that transcend time.  My hope is that in sharing my perspective and experience I will answer some of your questions and relieve some of your fears.  In the coming weeks I will talk about many of my experiences as a teacher and as a clinical care manager from which I believe we can gleam some timeless and universal truths about children and families. As parents and educators the greatest and most important gift we can offer our children is to be a non-anxious presence in their lives. I know as a teacher and as a parent, when I feel calm and at ease, my students and my children are more likely to feel the same. If this feeling does not transfer to them, at least my response and actions are not magnifying the situation.  I will come back to this theme over and over.  Today I bring it up as something to think about when asking:  what is this best school for my child?  The answer: when the teachers are smiling, waving and happy to see my child get off the bus or out of the car.  It is only with this joy and ease can a teacher be a non anxious presence in their student’s lives. More on this next week.

2017-12-03T22:42:25-05:00September 18th, 2013|Categories: Blog Post|Tags: |

Being a Non-Anxious Presence for Your Child – Dr. William Stixrud

For the past 20 years, Dr. Stixrud has been extensively involved in the training and supervision of psychologists and learning specialists. View Profile Harvard University recently reported the worst cheating scandal in its history. Since then, I’ve been thinking a lot about what I presume to be the high level of fear (e.g., of not being successful) experienced by the students involved. I’ve been reflecting on Edwin Friedman’s view, which he described in the late 1990′s (in his book Failure of Nerve), that we live in a chronically anxious and emotionally reactive society. Mr. Friedman emphasized the need for people who can function in families, businesses, and organizations as what he called “a non-anxious presence” – or individuals who can lead with courage. I suspect that this is even more true today than it was then. In my view, it is important for us as parents to work in the direction of being a non-anxious presence for our children. Although kids don’t need perfect parents (just good enough parents), we can optimally support our children’s development when we are not highly anxious, fearful, reactive, or overly controlling. Consider, for example, that when we are not highly stressed or anxious we can much more effectively comfort an infant or sooth a toddler, respond to children in a flexible and mature manner, help teenagers figure out who they want to become, and enjoy our kids (which may be the best gift we can give them). So, about the best advice I can give parents is to build routines into your daily life that are “de-stressing”, whether it’s regular exercise, a daily meditation practice, yoga classes, or martial arts training. Also, make enjoying your kids — as they are — a top priority, and remember that most kids turn out to be perfectly fine adults even if they are not top students or don’t seem to excel at anything in particular as children. Find out more about Dr. Stixrud

2017-12-03T22:14:35-05:00September 2nd, 2012|Categories: Blog Post|Tags: |