[SPEAKER_02]: As girls go into puberty, again, that is a time that we might start seeing more symptoms.
[SPEAKER_02]: The social interactions become a lot more abstract and a lot more subtle.
[SPEAKER_02]: And so, for girls with autism, that can be really difficult to navigate.
[SPEAKER_02]: So, overwhelming to them, they don't understand all of the nuance of it and the subtlety and the abstractness of the conversation.
[SPEAKER_00]: Hello and welcome to the women and ADHD podcast.
[SPEAKER_00]: I'm your host, Katie Weber.
[SPEAKER_00]: I was diagnosed with ADHD at the age of 45, and it completely turned my world upside down.
[SPEAKER_00]: I've been looking back at so much of my life.
[SPEAKER_00]: School, jobs, my relationships, all of it with this new lens, and it has been nothing short of overwhelming.
[SPEAKER_00]: I quickly discovered I was not the only woman to have this experience and now I interview other women who like me discovered in adulthood they have ADHD and are finally feeling like they understand who they are and how to best lean into their strengths both professionally and personally.
[SPEAKER_00]: Hello, hello, welcome to Episode 214.
[SPEAKER_00]: Now, today's episode is a little different.
[SPEAKER_00]: I'm actually handing the mic over to a member of the women and ADHD coaching team Lindsay Buchanan.
[SPEAKER_00]: You might remember Lindsay, I interviewed her for episode 201, where she shared her own adult diagnosis story.
[SPEAKER_00]: So Lindsay is not only an ADHD life coach and a member of the Women in ADHD coaching team.
[SPEAKER_00]: She also happens to be the sister of Dr. Brady Bradshaw, a dual board certified psychiatrist in adult and child psychiatry.
[SPEAKER_00]: So Lindsay approached me because she wanted
[SPEAKER_00]: ADHD and autism in girls and women, especially reviewing some of the science and the research and address some of the common myths and misconceptions around neurodivergence in girls and women.
[SPEAKER_00]: So in this episode, Lindsay sits down with Brady for a very personal and highly informative conversation about ADHD and autism in girls and women.
[SPEAKER_00]: They explore what these diagnoses actually
[SPEAKER_00]: What we know and don't know about what causes autism, the overlap between autism and ADHD, and how parents can begin to navigate next steps when they suspect something is different about their child.
[SPEAKER_00]: I am certain you are going to enjoy this conversation as much as I enjoy listening to it.
[SPEAKER_00]: I really glad Lindsay decided to do this.
[SPEAKER_00]: It's both a compassionate and practical conversation full of insight, not only for parents, but also for women exploring their own neurodivergence.
[SPEAKER_00]: and really for anyone who wants a better understanding of these often misunderstood diagnoses.
[SPEAKER_00]: So without further ado, I will step aside and present to you Lindsay Buchanan and her sister Dr. Brady Bradshaw.
[SPEAKER_01]: All right.
[SPEAKER_01]: So I'm so excited to be here today.
[SPEAKER_01]: It's my first time interviewing a person
[SPEAKER_01]: My name is Lindsay Buchanan, and I am an ADHD life coach, and today I am so excited that I get to interview Dr. Brady Brachaw.
[SPEAKER_01]: Dr. Brachaw MD is dual board certified by the American Board of Psychiatry and Neurology in adult psychiatry and child and adolescent psychiatry.
[SPEAKER_01]: She specializes in evidence-based treatment of mood.
[SPEAKER_01]: anxiety and mental health disorders.
[SPEAKER_01]: She's extensively trained in psychopharmacology and psychotherapy at the University of Miami.
[SPEAKER_01]: She offers a comprehensive personalized approach that is tailored to her patient's individual needs.
[SPEAKER_01]: She has her own medical practice that she owns, where she practices, called Bracha and Associates located in Orlando, Florida.
[SPEAKER_01]: and most importantly, she's also my sister.
[SPEAKER_01]: So this is a special interview because of that.
[SPEAKER_01]: So thank you for joining me.
[SPEAKER_02]: I'm happy to be here.
[SPEAKER_02]: Thanks for having me.
[SPEAKER_01]: Yes.
[SPEAKER_01]: with that will dive on in.
[SPEAKER_01]: So we wanted to have this podcast interview today.
[SPEAKER_01]: I actually approached you and asked you if we could do this podcast interview.
[SPEAKER_01]: I was just going to give a little background before we dive in, if that's okay.
[SPEAKER_01]: Because I really wanted to talk about with a medical doctor.
[SPEAKER_01]: ADHD in girls and women, and then also autism in girls in women, and maybe what the overlap is, what the overlap can look like, what the similarities are, what the differences are,
[SPEAKER_01]: And, you know, what prompted me to reach out and ask for this was it was one of those days where I was reading the newspaper headlines and I read a article just the headline about vaccines and autism.
[SPEAKER_01]: And it just got to me and I thought, okay, I feel like we need to be talking more to everybody and, you know, educating everybody more about what is autism and where does it come from, what causes it.
[SPEAKER_01]: kind of debunk maybe some myths if there are some out there that are floating around right now that you hear pretty regularly.
[SPEAKER_01]: And the reason why it's close to home for me is because personally I have my own ADHD diagnosis as everybody knows.
[SPEAKER_01]: I've told my story on this podcast before.
[SPEAKER_01]: I was diagnosed as an adult with ADHD.
[SPEAKER_01]: So I've learned all about ADHD because of that
[SPEAKER_01]: to become an ADHD coach as well.
[SPEAKER_01]: That was because of my deep dive into that topic.
[SPEAKER_01]: But then also, I also have a daughter who is diagnosed with level one autism.
[SPEAKER_01]: And as you know, I got that diagnosis with her probably about three years ago.
[SPEAKER_01]: And so that's been such a journey for me to learn about autism, about level one autism in particular in girls.
[SPEAKER_01]: And I feel like the more I learn about it, the more I just become passionate about wanting others to understand more about it too.
[SPEAKER_01]: So that's what prompted this.
[SPEAKER_01]: Is there anything you want to add to that?
[SPEAKER_02]: Yeah, I mean, I remember all of that happening in real time and I do think there's a lot of misinformation that can create anxiety and families and.
[SPEAKER_02]: maybe make them hesitate to seek out a diagnosis or to understand more.
[SPEAKER_02]: And so I think it's good to get out evidence-based information so that people can make an informed decision.
[SPEAKER_02]: It's based in the data and really help support their family, no matter what the diagnosis are.
[SPEAKER_02]: I also have ADHD and was diagnosed when my son was getting his diagnosis.
[SPEAKER_02]: which is ironic for Lindsey and I because we'd come from like a very ADHD family and it's sort of ridiculous that nobody realized it until we ever thought we had a textbook sort of like definition of ADHD in my son so so it's often that women and girls are overlooked and not diagnosed and because what symptoms are internal it can be easily missed.
[SPEAKER_01]: Yeah, so why don't we start there.
[SPEAKER_01]: That's a great.
[SPEAKER_01]: I think that's a good place to start.
[SPEAKER_01]: Like if somebody doesn't yet know about ADHD and girls maybe what are some of the things you could say you could look for if you suspect you wonder about your daughter or yourself.
[SPEAKER_01]: What are some of the symptoms of ADHD and girls and women that you see.
[SPEAKER_02]: Yeah, so they are the same as they are in boys.
[SPEAKER_02]: It's really how they manifest that looks different on the outside.
[SPEAKER_02]: We still use the same, the DSM is what we use in psychiatry to make a diagnosis.
[SPEAKER_02]: And so there's a DSM diagnosis of depression, of anxiety, and there's a DSM diagnosis for ADHD.
[SPEAKER_02]: We use the same criteria.
[SPEAKER_02]: it's that the way that it looks can be missed or misinterpreted.
[SPEAKER_02]: So it also can depend on the age.
[SPEAKER_02]: So when we're talking about child psychiatry it's very much part of like what age group are we talking about or we're talking about a girl that's before puberty after puberty and adult women.
[SPEAKER_02]: So a lot of times we see in girls and in women that they have sort of these watershed moments
[SPEAKER_02]: more apparent, and that's usually with big hormonal shifts.
[SPEAKER_02]: So their symptoms can become more apparent.
[SPEAKER_02]: They can present my office during puberty.
[SPEAKER_02]: Sometimes they'll also present postpartum or during perimenopause.
[SPEAKER_02]: So we are watching that timeline because of those hormonal shifts.
[SPEAKER_02]: They affect the way that the ADHD symptoms make the severity of them.
[SPEAKER_02]: And so internally, a girl with ADHD might report a busy brain.
[SPEAKER_02]: That's one way that I talk about it.
[SPEAKER_02]: We know that in all, I'm kind of backing up for a second.
[SPEAKER_02]: All diagnosed.
[SPEAKER_02]: females, biological females tend to present with more inside symptoms or internalized symptoms and biological males tend to present with more externalizing symptoms, so symptoms that you can see.
[SPEAKER_02]: And so that will prove for ADHD.
[SPEAKER_02]: So when we're talking about ADHD and females,
[SPEAKER_02]: It can be a busy brain, a hyperactivity of the mind.
[SPEAKER_02]: They can feel like their mind is driven by a motor.
[SPEAKER_02]: They can sometimes have disturbances in their sleep, so a heart and falling asleep or a heart and staying asleep.
[SPEAKER_02]: They can be forgetful or absent-minded.
[SPEAKER_02]: Sometimes it can seem their heads in the clouds.
[SPEAKER_02]: It's pretty unusual that an ADHD girl would get flagged for a behavior problem, which is what we can sometimes see with ADHD boys more commonly.
[SPEAKER_02]: So the ADHD girl, she's not disrupting the classroom, but she might be daydreaming looking out the window, twirling her hair.
[SPEAKER_02]: not closing in a behavioral disturbance, but certainly not paying attention or engaged in the lecture of the classroom experience.
[SPEAKER_02]: They can also sometimes get in trouble for talking too much.
[SPEAKER_02]: We hear that a lot with ADHD girls, so they can be just really talkative and not realizing it's time to be quiet or that impulse activity can look like, even though they know they're supposed to be doing their work, maybe they're talking to their neighbor,
[SPEAKER_02]: Another thing we'll sometimes hear is that girls with ADHD, the teachers will say that they aren't working to their full potential, and so whenever I hear that somebody's been described as lazy or forgetful or daydreamy, I'm always looking for ADHD.
[SPEAKER_01]: That's really good.
[SPEAKER_01]: Thank you for explaining that.
[SPEAKER_02]: If they lose things, that's another little key, losing your keys, losing the water bottle, they're back, back, back, back, back, back, back, back,
[SPEAKER_01]: Yeah, so it's it's it's an internal job more with girls it sounds like as far as how the symptoms show up and that makes sense for why a lot of us ladies who have ADHD did not get a diagnosis until we were adults because it's really a lot of times when they're seeking a diagnosis for a child that they'll read through.
[SPEAKER_01]: the criteria for the DSM and realize, oh my goodness, a lot of this sounds like me.
[SPEAKER_01]: Yeah, yeah, that's really good.
[SPEAKER_01]: Thank you for explaining that.
[SPEAKER_02]: high intelligence and anxiety are also protective factors for boys and girls with ADHD.
[SPEAKER_02]: And we know that anxiety is more common in females as well.
[SPEAKER_02]: And so a lot of times what we'll see is like perfectionistic behaviors or anxiety about getting in trouble or anxiety about discipline or teacher or more people pleasing stuff.
[SPEAKER_02]: And so that will often accommodate the ADHD
[SPEAKER_01]: That's fascinating.
[SPEAKER_01]: Mm-hmm.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: I feel like that's reminds me of my own self.
[SPEAKER_01]: So you said, add a cost.
[SPEAKER_01]: What do you mean by that?
[SPEAKER_02]: Well, it can look like a duck sitting on the water.
[SPEAKER_02]: They're furiously paddling underneath.
[SPEAKER_02]: And so sometimes, back about white knuckleling or it's a lot of work.
[SPEAKER_02]: And some of my ADHD growth sometimes, they're under tremendous amount of stress trying to hone their attention, trying to be organized, sort of overcompensating for their natural destructiveness or disorganization.
[SPEAKER_02]: and it can require a lot of energy and it can be very tiring.
[SPEAKER_02]: They can also have a bit of anxiety like feeling really anxious if they forget to turn something in, as their teacher met at that and all of that kind of stuff.
[SPEAKER_01]: Yeah, that's fascinating.
[SPEAKER_01]: So what do you feel like is the benefit of seeking a diagnosis for a girl?
[SPEAKER_01]: If a parent is like,
[SPEAKER_01]: I wonder about my team daughter or something like that.
[SPEAKER_01]: But they're like, thinking to themselves, but she's doing fine.
[SPEAKER_01]: She's getting good enough grades.
[SPEAKER_01]: Her anxiety is helping her get by, you know, maybe we don't need a diagnosis.
[SPEAKER_01]: What would you say would be like, what is the benefit of like investigating?
[SPEAKER_01]: If you might want to get a diagnosis,
[SPEAKER_02]: Well, I would just say that you will want to seek a professional that you know is knowledgeable about ADHD and women because sometimes these cases can sort of be brushed off if the child's not having obvious behavioral problems that we would tend to associate with ADHD.
[SPEAKER_02]: So you want to make sure that you're seeing a professional who relates to a familiar with ADHD and women or girls.
[SPEAKER_02]: And then I do believe that just understanding you have ADHD and what that means can be very therapeutic.
[SPEAKER_02]: So seeing the diagnosis doesn't necessarily mean you're going to start medication, I think that's another common misconception.
[SPEAKER_02]: medication might be recommended, depending on the case in the severity.
[SPEAKER_02]: But you can seek a diagnosis and still choose not to use a medicine.
[SPEAKER_02]: So understanding that you have ADHD and starting to talk with your, if it's a child and a parent, starting to talk with your child about what that means.
[SPEAKER_02]: Like, okay, we tend to forget things.
[SPEAKER_02]: So we need to write it down.
[SPEAKER_02]: What should we do about that?
[SPEAKER_02]: Where do you want to write it down?
[SPEAKER_02]: And
[SPEAKER_02]: Or if you're seeing a symptom at home being able to talk to your kid like, hey, I know that you said you're going to
[SPEAKER_02]: take your plate to the sink you didn't like how can we help you remember that you know so being able to talk about those things and starting to like raise their awareness of themselves is very helpful that is an executive function which is sometimes a deficit for people with ADHD to to be aware of their symptoms and how they affect other people.
[SPEAKER_02]: So understanding a diagnosis can
[SPEAKER_02]: I also tend to look at what the level of impairment is, and so if they're having any kind of like social troubles, obviously if they're having any academic problems, if they're having like, you know, anxiety symptoms that maybe they're not sleeping well, anytime you see things that are potentially impairing their growth or their development,
[SPEAKER_02]: that would be a time to seek out a diagnosis.
[SPEAKER_01]: Yeah, I think about just on the personal level myself, I sometimes think about what would it have been like if I had known that I had ADHD.
[SPEAKER_01]: And I think as girls, at least for myself, I can speak for myself, I think I was really good at masking.
[SPEAKER_01]: I don't know if our parents ever would have said she's struggling socially or she's struggling at school.
[SPEAKER_01]: But I think,
[SPEAKER_01]: I probably had anxiety symptoms.
[SPEAKER_01]: I think they could have cut in on those if we could turn back the clocks and they knew everything that we know now.
[SPEAKER_01]: I think they could have seen the anxiety symptoms because I remember calling, like not wanting to go to practice and like crying on my bed and not wanting to go and like them getting me to go, you know?
[SPEAKER_01]: Or like, I think I remember going to the clinic one time and having to like breathe into a paper bag because I was hyperventilating.
[SPEAKER_01]: I probably had anxiety flags, but I think it would have been really helpful for me to have understood that about myself going into college.
[SPEAKER_01]: I feel like when I went into college, that's when my behavior got very
[SPEAKER_01]: erratic and impulsive and just hard for even me to understand myself and classes got a lot harder school got harder you know I just changed my major because it was too hard I felt like and I wasn't used to having a hard time at school and like I didn't talk to anybody about it you know so I think if I had had an understanding going into college maybe I would have had some more coping
[SPEAKER_01]: skills or somebody I could have talked to, I could have had a coach or something or a therapist to say.
[SPEAKER_01]: school is really hard right now and I'm not used to it being hard.
[SPEAKER_01]: What should I do?
[SPEAKER_01]: You know?
[SPEAKER_02]: Yeah, I do feel like with smart kids girls and boys, but particularly girls we're talking about it's almost like the smart kids they reach like a ceiling where it's like okay now your smarts are being outstripped by the demand of the schoolwork.
[SPEAKER_02]: And so then if the HD is on board then
[SPEAKER_01]: it feels impossible.
[SPEAKER_02]: Yeah.
[SPEAKER_02]: So either kids will like, you know, choose something else, like you said, like do something that maybe is less rigorous or less sting or another thing that can happen is then they start to like reach for things that aren't healthy, but maybe are managing their ADHD symptoms, like
[SPEAKER_02]: vaping, cigarettes, caffeine, energy drinks, and all of that kind of stuff to try to manage their symptoms.
[SPEAKER_01]: I feel like I definitely did both in college combined.
[SPEAKER_02]: you know then you can like create systems for yourself to help support yourself either therapy or just understanding tricks and things that work for you or it's almost like you're stumbling blindly trying to figure out what's going to work for you and then when you're college aged kid there's a lot of developments still going on that you're also trying to know at the same time.
[SPEAKER_01]: Yeah and I think there's a lot of
[SPEAKER_01]: Because of all the masking up to that point, there can be a lot of shame to feel like, oh, I'm not doing it as good anymore, and I always did good.
[SPEAKER_01]: So you don't naturally just like go tell everybody that, you know, as a girl, I tried to hide that.
[SPEAKER_02]: Yeah, and there's a lot in college when we do see for ADHD kids when they transition from high school to college, if their home has been creating that like structure and support when they transition to college, they no longer have that structure and support in place, and a lot of the work is supposed to be independent where you're managing your time and you're studying and preparing for tests, and somebody with ADHD is not going to naturally be good at that.
[SPEAKER_01]: All right, I'm ready to pivot now to make sure we have time to also talk about autism in girls and I don't know I'll let you lead if you want to narrow it down to level one autism and maybe we can explain what that means and I think it would be really helpful to just explain how come some people are autistic what causes that what does it mean.
[SPEAKER_01]: and maybe then we can also talk about what does that look like in girls?
[SPEAKER_02]: Yeah, so this is a really interesting topic and I think maybe I'll start with just like some of the worries that are sort of like thrown around casually so we can have some questions.
[SPEAKER_02]: That would be good.
[SPEAKER_02]: Yeah, in general we talk about neurodivergence and so neurodivergence is this large umbrella and underneath neurodivergence there's autism spectrum disorder and ADHD.
[SPEAKER_02]: So both of those are underneath the neurodivergence umbrella.
[SPEAKER_02]: So sometimes when people are talking about neurodivergence, they're talking about both autism and ADHD.
[SPEAKER_02]: And we do know that the majority of people who have autism also have ADHD, the majority of ADHD do not have autism.
[SPEAKER_02]: So there's a lot more ADHD than autism.
[SPEAKER_02]: However, most of the people who have autism do have ADHD.
[SPEAKER_02]: can be tricky because if people are on social media, there might be somebody that says, oh, I have autism and here's all the things that I do.
[SPEAKER_02]: And some of a girl with ADHD might see that and be like, well, I do a lot of those things too.
[SPEAKER_02]: So I think it's important to make a distinction that a lot of people with autism also have ADHD.
[SPEAKER_02]: And so if they're talking about their autism, they might also be talking about their ADHD.
[SPEAKER_01]: That's fascinating.
[SPEAKER_02]: Yeah, something to think about if that's where you're getting information or your teen is getting information, which is really common.
[SPEAKER_01]: I feel like I'm hearing a lot more of that these days on different podcasts and things that I listen to about ADHD.
[SPEAKER_01]: I'll hear somebody say, and I might be on this spectrum too.
[SPEAKER_01]: I probably am, and it seems to be a little more casually talked about, which on one hand is good
[SPEAKER_01]: But I also feel like how can we be careful that we're not just throwing that around without understanding what it really means to also be on this spectrum.
[SPEAKER_01]: So maybe, can you define how it's different?
[SPEAKER_02]: Yeah, so autism spectrum disorder, there's a level one, two, and three, and it has to do with the amount basically the amount of verbal impairment
[SPEAKER_02]: So, a level one autism patient, we used to call it Aspergerers, they often have a normal IQ, they have good language functioning, they may have high IQ, it could be a whole range there.
[SPEAKER_02]: Level two, their verbal skills might be more limited, their functioning might be more limited in terms of like taking care of themselves and managing life, paying bills, stuff like that.
[SPEAKER_02]: So, we would see more of an impairment in the level two.
[SPEAKER_02]: and then level three is pretty, you know, significantly impaired, so maybe non-verbal or very little meaningful language.
[SPEAKER_02]: So I think for our conversation maybe we can focus on level one because level two and level three can be much easier to diagnose.
[SPEAKER_02]: You know, you see more of those external symptoms, whereas level one patient may have more internal symptoms.
[SPEAKER_02]: and the symptoms might be less obvious or less easy to recognize.
[SPEAKER_02]: So one of the big sort of like, just straightforward takeaways for autism is that you're looking for deficit and social communication that can be verbal and nonverbal.
[SPEAKER_02]: So that then also impacts relationships.
[SPEAKER_02]: So striped both to really understand the social and emotional reciprocity of relationships and sort of the natural back and forth of conversation and relationship.
[SPEAKER_02]: They have a harder time understanding that on a sort of organic natural level.
[SPEAKER_02]: And so what can happen is when they present, they can come across as,
[SPEAKER_02]: that can be more challenging.
[SPEAKER_02]: We talk about masking.
[SPEAKER_02]: So a lot of times really intelligent people with autism will know I'm supposed to look you in the eye.
[SPEAKER_02]: I'm supposed to give you a turn to talk.
[SPEAKER_02]: I'm supposed to wait and look like I'm listening to you.
[SPEAKER_02]: So they'll kind of know those social rules and be thinking about them while they're having the conversation to appear
[SPEAKER_02]: you know, that they don't have deficit or that struggle, but internally, they're thinking all of those things while they're having a conversation.
[SPEAKER_02]: Compared to someone who doesn't have autism, that's going to do those things naturally without thinking about it most of the time.
[SPEAKER_02]: So it really comes down to the social relating that is a challenge for people with autism.
[SPEAKER_02]: There's other distinguishing parts of the diagnosis that I want to make sure to mention, but do you want to something about the social part first?
[SPEAKER_01]: I guess I was just gonna say one more thing.
[SPEAKER_01]: Sorry, I was thinking, what about when you hear, like sometimes women with ADHD will say, oh, well, I tend to talk a lot in people say, I'm in erupting them and, you know, I don't know how to take turns, sometimes in the conversation.
[SPEAKER_01]: Sometimes you hear a little overlap there.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: How would you differentiate that?
[SPEAKER_02]: Yeah.
[SPEAKER_02]: So that, I think, one of the other main criteria for autism that would be a difference is either an insistence on sameness is what we call it or repetitive behaviors.
[SPEAKER_02]: So the insistence on sameness can look like really intense rigidity.
[SPEAKER_02]: So it has to be this way, this way, and then that way, like it has to go that way.
[SPEAKER_02]: And if it doesn't go that way,
[SPEAKER_02]: There's a huge flood of anxiety and then you might get some behaviors or emotional dysregulation.
[SPEAKER_02]: So that insistence on sadness and virginity is one, I think he distinguished you feature for autism, especially, you know, autism and girls that we're talking about, or repetitive movements, which can be hand-flaping or stemming behaviors.
[SPEAKER_02]: Those are also required to meet the diagnosis of autism, either insistence on sadness or repetitive behaviors.
[SPEAKER_01]: Interesting.
[SPEAKER_01]: Okay, thank you.
[SPEAKER_01]: And the repetitive behaviors is another word for that stemming stemming.
[SPEAKER_01]: Yeah, okay, to make sure I'm using the correct language and that's different from fidgeting, which people with ADHD do.
[SPEAKER_01]: exactly.
[SPEAKER_01]: So hence you see why there is a little confusion around the two and how they have some pieces that can be overlapping a bit.
[SPEAKER_01]: So that rigidity piece, I feel like that's what really helped me realize with my own daughter that I was seeing something different from what I had
[SPEAKER_01]: from the time that she was too, I can remember.
[SPEAKER_01]: her insisting that I be the one who buckled her seat belt in the car seat, for example.
[SPEAKER_01]: And she would scream and cry if my husband would try to buckle her seat belt.
[SPEAKER_01]: And I remember thinking as a parent, because I autism, I didn't know anything about it at the time.
[SPEAKER_01]: So it was not at all on my radar, like zero as you know.
[SPEAKER_01]: But I remember thinking, oh my goodness, she is very difficult sometimes to parent
[SPEAKER_01]: She is very demanding.
[SPEAKER_01]: I didn't know why.
[SPEAKER_01]: I remember thinking maybe it was my husband.
[SPEAKER_01]: Like, I was literally thinking maybe he's not bonding with her for some reason and being like, I remember feeling angry at him because I was like, well, she's acting like this for a reason.
[SPEAKER_01]: Like, she doesn't want him to do this stuff for a reason and blaming him because in my brain, I just didn't have that other criteria to understand this.
[SPEAKER_01]: So I think the rigidity was really significant a piece that I could look at and understand, yeah, there's something different about the way her brain is wired.
[SPEAKER_01]: That once I learned about autism, it was so helpful because then I could be like, okay, her brain is wired this way.
[SPEAKER_01]: This is hard
[SPEAKER_01]: How to be a little bit flexible, but she's going to have to learn that it's not going to come naturally to her to be flexible.
[SPEAKER_01]: So even still like as she's gotten older, it can look a little different.
[SPEAKER_01]: It might be she's still sometimes only wants me to do the bedtime routine for example.
[SPEAKER_01]: So and she's seven now.
[SPEAKER_01]: And I'll say, well, Daddy has to take a turn.
[SPEAKER_01]: Mommy can't do all the jobs or else I get too tired and Daddy's your parent too.
[SPEAKER_01]: And so it's different for sure that type of rigidity and parenting that is really a unique challenge.
[SPEAKER_02]: mm-hmm.
[SPEAKER_02]: I think it's the intensity of it that I would use as a washing factor because people with ADHD, I mean they can have things that they can kind of get excited about and see like really in like an interest that they can get like very obsessed with you know and like really excited about and they can also have a really high drive.
[SPEAKER_02]: So it's like we're gonna do this
[SPEAKER_02]: If they're excited about it, but the intensity that you feel with the rigidity of autism, it can feel, I think, as a parent arbitrary.
[SPEAKER_02]: Why do you have that shirt?
[SPEAKER_02]: That doesn't make sense.
[SPEAKER_02]: Why that shirt?
[SPEAKER_02]: You can wear this shirt.
[SPEAKER_02]: It's also purple.
[SPEAKER_02]: That would be good.
[SPEAKER_02]: And as a parent, I think it can feel extremely frustrating because it doesn't make sense when you can see it through the lens of autism that like, no, if they don't wear that shirt, then they are in fight or fight mode.
[SPEAKER_02]: They are like very anxious and afraid.
[SPEAKER_02]: That gives you a lot more empathy for what they're experiencing.
[SPEAKER_02]: And I think that understanding can be more helpful and supporting them starting to learn.
[SPEAKER_02]: Okay, can I be flexible here or not and, you know, kind of using that language of flexibility?
[SPEAKER_02]: The parent model that and start to teach them that.
[SPEAKER_02]: It's not natural.
[SPEAKER_02]: They can learn it, though.
[SPEAKER_02]: I think the intensity of that insistence on saying this is a distinguishing feature.
[SPEAKER_02]: You can also see however, how it would impair them.
[SPEAKER_02]: So, yes.
[SPEAKER_02]: So 80, 80, deco, they can be very flexible if they, you know, because they want to play with somebody, let's say, if they want to play football and their friend wants to play basketball, they were like, okay, yeah, let's play basketball because they just want to play with somebody, you know, so they can kind of flex for the sake of the story relationship.
[SPEAKER_02]: Whereas they can't with autism, if they, you know, they might be like, no, we can only do this activity because this is what I plan for us to do and if the friends like, well, you know, I think I'll do this thing.
[SPEAKER_02]: They're like, no, we're only doing this.
[SPEAKER_02]: That's it.
[SPEAKER_02]: This is what we plan to do and they might then have a big explosion if the friend keeps pushing.
[SPEAKER_02]: struggle can attest to the fact that it feels like survival for them too because it's so intense.
[SPEAKER_01]: Yeah, it can lead to a huge meltdown is what it can lead to.
[SPEAKER_01]: And when you're parenting, that's really hard to deal with.
[SPEAKER_01]: You just what I felt like at the time before I had the diagnosis was like, I didn't have the tools.
[SPEAKER_01]: to know how to handle the escalating, the meltdown, all that stuff, I would just not know how to help basically, and that's really hard when you're a parent.
[SPEAKER_01]: When you want to be a good parent, you want to be empathetic and all that stuff.
[SPEAKER_01]: And you feel like no matter what you do, it just escalates, and it doesn't help.
[SPEAKER_01]: is very discouraging, so I'm super thankful that we got the diagnosis so that I could start to learn how to help her.
[SPEAKER_02]: Yeah, going back to the topic of autism and females, as girls go into puberty.
[SPEAKER_02]: Again, that is a time that we might start seeing more symptoms for some girls.
[SPEAKER_02]: and a lot more subtle.
[SPEAKER_02]: And so, for girls with autism, that can be really difficult to navigate.
[SPEAKER_02]: They don't totally understand why are we talking about so-and-so, since so-and-so about this, and that, and, but she likes him, and, like, they're like, it's just,
[SPEAKER_02]: It's overwhelming to them, they don't understand all of the nuance of it in the subtlety and the abstractness of the conversation, social relating.
[SPEAKER_02]: And so that's another place where sometimes girls will start to get diagnosed because they can really start to struggle socially, like they just don't get it.
[SPEAKER_01]: What's the benefit of like seeking a diagnosis if you're questioning maybe or if you're not sure as a parent?
[SPEAKER_01]: what would be the benefit of pursuing testing and maybe a diagnosis for your daughter?
[SPEAKER_02]: I think this would be a similar conversation that we just had with the ADHD that understanding the diagnosis is in itself can be therapeutic, understanding something about yourself is always very helpful and how you relate to the world.
[SPEAKER_02]: I will also tell parents sometimes that
[SPEAKER_02]: both ADHD and autistic people.
[SPEAKER_02]: They are picking up on feedback from the people around them and they're in school all day with peers.
[SPEAKER_02]: And if we don't say anything, if we don't talk to them about a diagnosis or what they're experiencing, they're going to make their own meaning of that.
[SPEAKER_02]: So if they're giving them feedback that they're not quite fitting in or they're not doing good in school or they are absent minded and did see for the each ones or maybe they're not socially picking up on all of the cues and they're missing things they'll start to make their own meaning of that well there must be something wrong with me.
[SPEAKER_02]: And I think that can be really scary for a kid and they don't have the knowledge that an adult parent might have to be able to understand why that is, why do I feel like I'm different from everybody else that I'm not fitting in.
[SPEAKER_02]: And so having a diagnosis can help them understand that so that they don't take it to something else.
[SPEAKER_02]: I mean, you're kind of just leaving it up to a kid to figure it out.
[SPEAKER_01]: Make their own meanings.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: What about, you know, when you hear headlines and things about vaccines and autism or red food dye and autism or diet and autism, how maybe if you change people's diet, they won't have symptoms, things like that.
[SPEAKER_01]: What's your medical perspective on that?
[SPEAKER_02]: So the science is really clear.
[SPEAKER_02]: The data is really clear that vaccines do not cause autism.
[SPEAKER_02]: That has been proven over and over again, the individuals who were saying that have all been deboned, that's very clear that vaccines do not cause autism.
[SPEAKER_02]: I think that there is a desire in our culture to understand what is causing this.
[SPEAKER_02]: And I think that's a really hard question to answer for most of psychiatry, but also for autism or ADHD.
[SPEAKER_02]: And so when we really want to find a cause for something, it's often that will blame and try to find something to blame.
[SPEAKER_02]: So I understand the desire to do that, but it's we know very clearly that the science shows that scenes do not cause autism.
[SPEAKER_02]: Okay.
[SPEAKER_02]: In terms of diet, a lot of children with autism do have
[SPEAKER_02]: either dietary restrictions because of sensory issues or sensitivity is to different foods.
[SPEAKER_02]: Sometimes that is legitimate and sometimes it's not.
[SPEAKER_02]: So, you know, just eliminating gluten and dairy and thinking that that will fix the autism, it's not, it doesn't work that way.
[SPEAKER_01]: it's not a cause and effect.
[SPEAKER_01]: It might just make them feel better in their tummy.
[SPEAKER_02]: Yeah, and so yeah, seeing a GI doctor would be appropriate to see if that is something that makes sense for your child.
[SPEAKER_02]: I think it can be really already as parents of a child with autism.
[SPEAKER_02]: It's already a very hard job.
[SPEAKER_02]: And so to then impose dietary restrictions on a kid who's already
[SPEAKER_02]: is soul crushing.
[SPEAKER_02]: So yeah, I think how to agree with that.
[SPEAKER_02]: And last, a GI doctor is telling you like, yeah, you definitely have a sensitivity to this food or this ingredient, then it's probably not worth the effort of it all.
[SPEAKER_02]: Interesting.
[SPEAKER_01]: Yeah.
[SPEAKER_01]: And I think
[SPEAKER_01]: what there's nuance there, what you're explaining to is also, it's not that their diet is causing their autism.
[SPEAKER_01]: Right, right, like if you change your diet, it's not gonna go away.
[SPEAKER_01]: That's not how this all connects.
[SPEAKER_01]: It's just another aspect of this person and they may, you know, you see what you need to do but it's not gonna be like, oh, if you don't feed them gluten,
[SPEAKER_02]: Exactly, I mean people with autism do have a lot of dietary sensitivities and that kind of goes back to like sensory sensitivities which we tend to see in autism.
[SPEAKER_02]: So like tags I'm sure it's our smells or threshold either higher or lower.
[SPEAKER_02]: Textures of food, flavors of food, they tend to prefer
[SPEAKER_02]: more ultra processed food.
[SPEAKER_02]: But we can also see that in ADHD.
[SPEAKER_02]: So that's one of those symptoms that has overlapping areas.
[SPEAKER_01]: So if a parent gets an autism diagnosis for
[SPEAKER_01]: For example, for their child, what do you feel like is a good first step if they just feel overwhelmed with because there's so many things you could do.
[SPEAKER_01]: It's a bit overwhelming just speaking from experience as far as like you hear other parents talking about OT, you know occupational therapy physical therapy speech.
[SPEAKER_01]: ABA therapy, the list goes on and on and if you're a parent and you're working and you're now and you're trying to raise your children and you're trying to help them.
[SPEAKER_01]: What do you usually feel like is just a good first step to be like, start with this and then go from there.
[SPEAKER_02]: Yeah.
[SPEAKER_02]: It's a little bit of a tricky question because it depends on the family and the child.
[SPEAKER_02]: your daughter Lindsay.
[SPEAKER_02]: So the child is like functioning pretty well in school and you know has good language and is physically medically doing well.
[SPEAKER_02]: then all of those things were assuming are good, then I would start where I start with actually most childhood diagnoses parent education and parent support working with the parents is so much more high yield compared to working with a child individually one on one in this context.
[SPEAKER_02]: So helping the parent understand autism more,
[SPEAKER_02]: understand how it might look in their child and behavioral interventions.
[SPEAKER_02]: They can do it home to help their child because a lot of these high functioning ASD kids, they're symptoms, they're masking all day at school and so school okay, it's not me the problem when they get home.
[SPEAKER_02]: they're unmasked, they're interacting with the adults that love them and care about them and love them unconditionally, and so the symptoms are like on fire.
[SPEAKER_02]: So working with parents and giving them support, having a parent join a support rule for other families with children, with autism, can be helpful if they can find that, and really just like working with the parents and parent coaching, I think is the highest yield.
[SPEAKER_02]: If the child has some kind of speech deficits, then yes, obviously you should do speech therapy.
[SPEAKER_02]: If the child has significant, either fine motor or gross motor impairments, then OT is recommended or physical therapy.
[SPEAKER_02]: ABA is sort of the textbook answer for an intervention for autism.
[SPEAKER_02]: But as we're learning more about level one autism, we're also learning about something called PDA, which is demand of avoidance, demand of windings that's also often associated with level one autism.
[SPEAKER_02]: We're finding that maybe ABA isn't exactly the answer for everyone, and that other therapies might be more helpful for some higher functioning ASD.
[SPEAKER_02]: or level one autism kiddos.
[SPEAKER_02]: So we talk with a professional that knows your child that you trust, just what their recommendations are, whether ABAs appropriate for them or not.
[SPEAKER_02]: There are times when it's appropriate for your kid.
[SPEAKER_01]: Mm-hmm, yeah, it sounds like it's very unique for each situation, which makes total sense.
[SPEAKER_01]: Every person is totally unique.
[SPEAKER_01]: So what you want to start with will be different.
[SPEAKER_01]: It is helpful as a parent to feel like you could start with one thing and not with the list of everything, which they can feel that way, like it should just be everything all at once.
[SPEAKER_01]: And then that feels so overwhelming.
[SPEAKER_01]: So it's nice to realize there's not a hurry.
[SPEAKER_01]: You could just start with one thing.
[SPEAKER_02]: And remembering that a lot of families that I see the parents have either ADHD or autism or both.
[SPEAKER_02]: And so I do sometimes think my role is to help them triage, okay, let's start with this.
[SPEAKER_02]: Because as a parent, who may also have their own executive functioning struggles.
[SPEAKER_02]: It can be hard to know where to start.
[SPEAKER_01]: Exactly.
[SPEAKER_01]: That's so true.
[SPEAKER_01]: Amen.
[SPEAKER_01]: I can relate to that.
[SPEAKER_01]: So on that note, I was going to ask you if there's like any book that you recommend.
[SPEAKER_01]: This is kind of a set up because I don't know what your answer is going to be, so I'm curious to see what your answer is going to be, but any book that you recommend if they're curious and want to learn more about ADHD and or autism in girls.
[SPEAKER_02]: or level one autism, anything by Donna Henderson is perfect and really helpful.
[SPEAKER_02]: Even sometimes I tell patients just to look in your podcast, library and search for her name and you'll find great interviews.
[SPEAKER_01]: Okay, Donna Henderson, you said?
[SPEAKER_02]: Yeah.
[SPEAKER_02]: So she's got really great up-to-date information about autism and girls.
[SPEAKER_02]: For ADHD, I like anything by Ned Halwell
[SPEAKER_02]: ADHD 2.0 is net how well's most recent book about ADHD.
[SPEAKER_02]: There's obviously women in ADHD podcast, like there's lots of podcasts that are very helpful to understanding ADHD in women specifically.
[SPEAKER_02]: Okay.
[SPEAKER_01]: Thank you.
[SPEAKER_01]: That book saved my life.
[SPEAKER_01]: I feel like the autism one in particular, just because I didn't know anything about it.
[SPEAKER_01]: And it was so helpful to get a much huge or understanding of what it is and what the symptoms look like.
[SPEAKER_01]: It gave me so much more compassion and empathy and understanding for my daughter.
[SPEAKER_01]: So that book was a life saver.
[SPEAKER_01]: I would say for me, and I still
[SPEAKER_01]: I kind of want to keep going back to it and reminding myself again and again, it just helps to normalize things too and to be like, oh, this is a symptom, this isn't.
[SPEAKER_01]: Just whatever, you know, whether it's the food piece or just different things that are hard to understand as a parent sometimes when you just look around at what everybody else is doing.
[SPEAKER_01]: Yeah, okay, and then let's see I was trying to think if there was any more questions I had is there any questions that you have for me before we wrap up.
[SPEAKER_02]: Um, well, I can make a comment on what you were just saying about understanding your daughter more and like feeling like that was really full of the book, when analogy that I've heard about ADHD, but I think it also applies for autism is that it's like two different operating systems and
[SPEAKER_02]: having autism or having ADHD is like being a Mac and a Windows world.
[SPEAKER_02]: I think that's a really challenging, because you can still be very functional, very successful, have a very full life as an autistic individual or with ADHD or both.
[SPEAKER_02]: but it just takes some translating when you're navigating in the Windows world that you have to be able to convert and I think is this autism for a non-autistic individual is sort of like giving you a lens to translate oh like okay this is why we're struggling with this this is why this video is happening so it helps you to understand more and understanding always brings more empathy
[SPEAKER_02]: or versus feeling trapped in the bed and overwhelmed and both cases the child and the parent.
[SPEAKER_01]: Yeah, that's really good.
[SPEAKER_01]: Thank you.
[SPEAKER_01]: I'm so glad to give that analogy.
[SPEAKER_01]: I love that metaphor because it's so hopeful too.
[SPEAKER_01]: This isn't bad news.
[SPEAKER_01]: This is a matter of understanding and translating and giving support where support is needed.
[SPEAKER_01]: and you can still very much thrive and have a full good good life with both or either of these diagnoses.
[SPEAKER_01]: And the more we can understand and support the more positive the whole thing can feel.
[SPEAKER_01]: So I love that.
[SPEAKER_01]: Thank you.
[SPEAKER_01]: I also wanted to give one shout out to one thing that has helped me a lot while we're here before we close.
[SPEAKER_01]: You were saying like support for the parents is so important and that was one thing that took me a little while to kind of navigate with the level one autism diagnosis.
[SPEAKER_01]: And just with how full our lives were when we received that kind of finding some support for myself in that type of parenting and what I found recently that has been a game changer I would say for me is this support group called mothers together and the reason why it's working so well for me is it's on Marco Polo.
[SPEAKER_01]: And the woman who started it, she's really cool, she has an autistic child, and she just was like struggling to find support where she lived.
[SPEAKER_01]: This is an international global organization now.
[SPEAKER_01]: So she started this, and basically it's a support group for parents of neurodivergent children.
[SPEAKER_01]: anything under that umbrella.
[SPEAKER_01]: And because it's through Marco Polo, it's kind of hard to explain it all so you'll just have to look it up if you're interested.
[SPEAKER_01]: But basically it works for moms who are on like a very demanding schedule to be able to still have friends and support who get what you're going through.
[SPEAKER_01]: and who are in a similar situation.
[SPEAKER_01]: So when you start, they have certain times of year that they start new people.
[SPEAKER_01]: They start you in what's called a pod squad, and they put you together with other people who have similar diagnoses as you, as what's in your family, or like a similar background for some reason, you fill out a questionnaire, and then they put you with people who are in a similar situation.
[SPEAKER_01]: And then you can decide to share as much as you want or not, to stay or go.
[SPEAKER_01]: I have found it to be very supportive for me.
[SPEAKER_01]: It has been working really nicely to have some friends who get it, who are also parenting level one autism children all over the world.
[SPEAKER_01]: And I'm able to like stay in touch with them on a daily basis and kind of chat and be like, how are you doing this?
[SPEAKER_01]: What's your experience with this?
[SPEAKER_01]: And that's been a game changer for me.
[SPEAKER_02]: I think that's so awesome.
[SPEAKER_02]: It can be hard to find.
[SPEAKER_01]: It's hard to go to anything, too.
[SPEAKER_01]: When you're already a busy parent, to be like, now you're going to go to this weekly support group.
[SPEAKER_01]: It's like, I don't know.
[SPEAKER_01]: I don't know how I'm gonna do that.
[SPEAKER_01]: So awesome.
[SPEAKER_01]: Thank you so much.
[SPEAKER_01]: This was amazing.
[SPEAKER_01]: I loved it.
[SPEAKER_01]: I feel like we could do this every week.
[SPEAKER_01]: I'll ask you all my questions.
[SPEAKER_01]: Your fabulous, thank you.
[SPEAKER_01]: You explain everything so clearly, so.
[SPEAKER_01]: All right, I think we're gonna call it a wrap.
[SPEAKER_01]: That will do it for today.
[SPEAKER_01]: Thank you.
[SPEAKER_01]: Thanks for having me.
[SPEAKER_00]: There you have it!
[SPEAKER_00]: Thank you for listening and I really hope you enjoyed this episode of the Women and ADHD podcast.
[SPEAKER_00]: If you'd like to find out more about me and my coaching programs, head over to Women and ADHD.com.
[SPEAKER_00]: If you're a woman who was diagnosed with ADHD and you'd like to apply to be a guest on this podcast, visit Women and ADHD.com-podcast guest and you can find that link in the episode's showdowns.
[SPEAKER_00]: Also you know we ADHD are brave feedback.
[SPEAKER_00]: And I would really appreciate hearing from you, the listener.
[SPEAKER_00]: Please take a moment to leave me a review on Apple Podcasts or audible.
[SPEAKER_00]: And if that feels like too much and I totally get it, please just take a few seconds right now to give me a five-star rating.
[SPEAKER_00]: Or share this episode on your own social media to help reach more women who maybe have yet to discover and lean into this gift of neurodivergency.
[SPEAKER_00]: And they may be struggling and they don't even know why.
[SPEAKER_00]: I'll see you next time when I interview another amazing woman who discovered she's not lazy or crazy or broken, but she has ADHD and she's now on the path to understanding her neurodivergent mind and finally using this gift to her advantage.
[SPEAKER_00]: Take care until then!