Dr. Shoshana Levin Fox is a Jerusalem-based child psychologist, play therapist and autism specialist who has worked with typical and special needs children for over 35 years.
While working at the Feuerstein Institute in Jerusalem between 1992 and 2017, Shoshana used Feuerstein outside-the-box perspective on autism combined with interactive play (DIR/Floortime) to assess and treat children thought to be autistic.
In her recently-published book, An Autism Casebook for Parents and Practitioners: The Child Behind the Symptoms, Dr. Levin Fox shares how her creative and effective approach helped so many children and their parents.
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Speaker 1 (00:03):
Welcome to the Parenting in the Digital Age podcast. Many parents are concerned that their child might be falling behind. Others are just looking for ways to help their children thrive, not just in the classroom, but socially and well into their future careers. Each episode we explore the challenges facing parents in the modern world, from behavior, education, and nutrition to device and gaming addiction. We interview a range of leaders in the area of childhood development to help you successfully navigate parenting in the digital age. Here is your host, Jamie Buttigieg.
Speaker 2 (00:39):
Hello parents. And welcome to another episode of The Parenting in the Digital Age Podcast, because there's no instruction book for being a great parent. We find experts from around the world to help us navigate all things parenting. Dr. Shoshana Levin Fox is a Jerusalem based child psychologist. Joining me today, she's a play therapist and autism specialist who has worked with typical and special needs children for over 35 years. While working at the Feuerstein Institute in Jerusalem between 92 and 2017, Shoshana used the Feuerstein outside the box perspective on autism, combined with interactive play to assess and treat children thought to be autistic. In her recently published book, an Autism case book for parents and practitioners, the Child Behind the Symptoms, Dr. Levin Fox shares how her creative and effective approach helps so many children and their parents. And I know this is, uh, we were just saying, uh, before the podcast, this is a important, and it's a somewhat controversial topic, so I'm looking forward to diving into all of that. But the theme today is really about assessing and treating young autistic children using an outside the box perspective. Dr. Shoshana Levin Fox, welcome to the show.
Speaker 3 (01:53):
Thank you so much, Jamie. Pleasure to be in Australia. Never been here before.
Speaker 2 (02:00):
Likewise. And, uh, you're coming all the way from Jerusalem, so it's,
Speaker 3 (02:03):
Yeah, right. It was, uh, yeah, and I got up. Wonderful to do it too. It was <laugh>. Happy to be here. Thank you.
Speaker 2 (02:11):
No, we appreciate, appreciate you doing it. It looks like we have a bit of a delay here, but we'll, uh, we'll forge through. So please, maybe, uh, you can start off by maybe sharing in your own words, uh, what you do and what you are passionate about.
Speaker 3 (02:25):
Absolutely. Okay. Well, as you mentioned, so my background is I'm a child psychologist and play therapist and so on and an autism specialist. And I had, uh, throughout my career, Jamie, I was always interested in autism, always. And then in, in 1992 when I, I was at the, I was the other side of the world for both of us at, uh, university of British Columbia in Western Canada. And I just finished my doctorate in counseling psychology. And I was fortunate to receive a shirk doctoral, uh, a post-doctoral fellowship. Shirk is social sciences and Humanities Research Council of Canada, um, fellowship that enabled me to contact Professor Feuerstein talk more about him later. And so in 1992, I worked at his institute until 2017, for 25 years, as you mentioned, assessing and treating autistic children. And it was there that, that, that career long interest from when I was in my twenties.
Speaker 3 (03:33):
There were always autistic children in my caseload. Wow. When I got to the institute, I was just, just immersed in it. And I was supposed to be doing research. And I'm not much of a researcher, to be honest. I'm much more interested in working with the children. That's, that's my passion. And I happen, I wanna say a bit about the Forest John Institute. It was, I'm gonna use, use the past tense cuz I'm no longer there, but it's still going strong. So it was, and is a really, really remarkable place. Unfortunately, the professor died in around 2013 to 14, 2014. But he was a really courageous, um, iconoclastic psychologist. All the sacred cows of psychology were out the window, like norms and symptom checklists and all that. They were out the window and we were work working with the child. So for 25 years, I was assessing and treating children, but not using conventional means as most psychologist, child psychiatrist as well do was basically u using, he had, he was a man of great vision and people would come from all over the world, uh, literally from all over the world, families and bringing their children with special needs of all sorts.
Speaker 3 (04:56):
So there I had an opportunity to just be immersed in using alternative methods of assessing the children, which I can talk about as we go on and in treating them, I didn't make up either. I give credit, obviously full credit to the wonderful professor, uh, who was really an inspired and courageous psychologist. And, uh, for his focus on Modifiability, he just believed in his heart and soul that, um, human beings, just because we're human beings as opposed to say monkeys or whatever, you know, um, are capable of change. And we would just go for the gusto with any child that came on our doorstep. What's, we had all this conventional referral material. Um, this child has this kind of problem. This child has this kind of syndrome, and you know what we do with that? Read it. Mm-hmm. <affirmative>, that's interesting. Put it aside and say, now let's find out what this child could do. Because we could see that the child was capable of doing so much more than conventional psychology gives certain syndromes and certain disorders credit for. So that applied to me in, in the, in my special area of interest, autism. And I must have worked with thousands of children over the 25 years I was there. Um, I think I just went off on a tangent, Jamie, so you, you feel free to refocus me. Uh,
Speaker 2 (06:52):
No, that's, that's okay, doctor. No, I appreciate, uh, I appreciate any tangent we go on today. This is gonna be, uh, I'm, I'm already looking forward to this and, uh, and, and so deeply engrossed in what you're saying. But let me ask a question. You talk about outside the box and, and doing things a little differently to the norm. So tell us what's so outside the box about the way you and your colleagues treat and assess, uh, young autistic children. In other words, like what do you do differently from other professionals, and more importantly, how does that help the young children you see?
Speaker 3 (07:23):
Okay. I think for the second part, I'll give you some examples, but first I'll, I'll give you the, the major headings of what was different. So most, um, psychologist look for a diagnosis. First off, they look for symptoms. What's wrong with this child? We were looking for strengths. And that absolutely applied to the autistic children. The professor called them eyelets of normalcy. So that's the first difference. Secondly, in conventional psychology, most psychologists take, okay, there's the symptoms. And what disorder does this fit in The book of diagnoses, which is known in short as the dsm. Okay, what's the diagnosis we would read the referral material we've got from parents we weren't seeking. They often had a diagnosis already. Put that diagnosis aside, put it aside because we thought that the diagnosis masks and obscures both underlying difficulties in autism of what appears to be autism.
Speaker 3 (08:35):
And it also masks an obscures individual children's strengths. And that's what we went for. Those eyelets of normalcy. Um, assessment, if I can keep going on this, there's so many things of different, I'll try to do it in compact. In compact form, condensed form. Um, assessment is usually, so assessment is usually quantitative in psychology scores, norms, where does this kid fit? That was out the window at the Feuerstein Institute. We did interactional. We interacted with the child to bring out the best of them in a learning situation. We helped them on the assessments and then paid attention to how much they had retained That to us was much more meaningful than what they actually knew. So with autism, and I'll talk about this, uh, later, um, I interacted with the children using play my background as a psychologist, as play therapist. I used what's called d i r floor time.
Speaker 3 (09:42):
Um, and I'll, you know, be happy to talk a little bit about that. I didn't make that up either. There's some wonderful practitioners who made that up, developed that roughly 30, uh, 30 odd years ago. Um, the assumptions in psychology regarding autism are usually, well, you were born that way and, um, you got it for life and you'll never be non-autistic. Now, I don't wanna, I have no intention of insulting some of the, um, older individuals who have recently gotten this autism diagnosis and found it helpful to them. That's one thing. I worked with young children that had their whole life before them and were capable of change. So our assumptions for any developmental difficulty were that was basically, let's do it forward. Let's not let this diagnosis create a a glass ceiling. Um, our expectations were generally optimistic and positive of the child as opposed to negative.
Speaker 3 (10:52):
Um, our work methods are, were different. Most interventions, or many interventions for autistic children are skill-based. I'm gonna teach the child to say good morning. Okay, we didn't, we weren't there. We wanted to build what's called reciprocity, an interaction with the child. And there, that's where d i r floor time, which is play-based, came in for me, often children up, pardon me. The, the advice that's given to parents is usually, well, you know, accept the child as he is. And we obviously want the parent to con to love the child for what, for what, for who he is, which is different, what and who. And we helped them adopt a vision of change cuz we were looking for that modifiability. It was very exciting work. And finally, in terms of recommendations in Israel, um, I can only speak about the experience in Israel. I did work in Canada for quite a number of years.
Speaker 3 (12:01):
And they're the situation at the time, I don't know what it is now, it's different. But here in Israel it's really, it's fascinating. Um, legally parents can request, uh, educational integration, but there's a catch 22, there's no budget to do it properly. So they have an, like, you can integrate your child, your inte your autistic child in a regular classroom, good child, let's say needs an integration aid. Mm, not good. We have no budget for it. Oh, parents says, okay, uh, thank, thankfully both of us are working we'll. We'll, um, you know, we'll pay for that. Oh no, we can't do that cuz of insurance. We can't have people. So we at the institute, however, were, uh, for in most cases, not in all cases, were against special classrooms that are just homogeneously special needs children. We were very much warriors for educational integration. And so we were like the salmon swimming upstream all the time in our meetings with the municipal, uh, the, the educational placement committee of the municipality, for example, actually all over Israel, we're fighting for integration in a system that's not built for integration.
Speaker 3 (13:29):
And sometimes we succeeded. We became experts at finding the principals who were open to it, the teachers who were loved having one special needs child in their class every year. And we developed a network. And of course, and the feedback from the parents with talking about the young children, 3, 4, 5, 6, those were the easier ones to place in integration. So there's just so much that's different. And I'll just say regarding the play part of it and how it helped, um, a play is just so powerful. Uh, it's a powerful developmental language for children. It's a powerful developmental tool. So I, rather than ticking off the symptoms, I could see the symptoms, I could see the child's problems, but I'd say to the parents, okay, I got it in the first 15 minutes. I'd say, okay, I see where your child is struggling, you know, I've got it.
Speaker 3 (14:40):
I said, that's not the end of the work. That's just the beginning. Now let's find out what your child can do. Now let's find out your child's strengths. And the way that I did that was to take d i r floor time. And I know you'll want to hear more about it in a successive question. Um, and used it to assess the children's down on the floor with the little ones. Playing with them at the table with some of the older ones. Keeping that same playful, um, atmosphere going, oops, where'd you go, <laugh>? Should I keep going then?
Speaker 2 (15:23):
Yeah, just, just keep going. Um, sometimes it may drop out. We can, we, we, we can I this out?
Speaker 3 (15:31):
Okay, no problem. Sorry about that. So using play, interacting. Now, you, you also asked, you want me to, the other part of your question was, how did this help the children ama amazingly
Speaker 2 (15:45):
Earlier. Amazing. Yeah, yeah. What, what are some of the changes you saw?
Speaker 3 (15:48):
Okay, I'll talk about how little changes. This is why I wrote the book actually, Jamie, an autism case book. Cuz I wanna, I should mostly share cases stories. So some of the changes that I would see, for example, I think, let me talk about, maybe I'll talk about one subtle one. No, actually I'll talk about a child that I, we saw changes in, I would say the majority of children we, we worked with in this way. Um, I'll, um, write, okay, here's, here's a, a nice example. I, in the book, I call them Ernie Hope. I'm not, this is not a spoiler for people who, who wanna read it. But, uh, it was probably one of the most, uh, dramatic, uh, experiences in my career at the Feuerstein Institute. I do remember that it was something like two in the afternoon and I had already seen three or four children, cuz our appointments were long, uh, up to two hours with, with each child.
Speaker 3 (16:54):
And, uh, I was tired and I was reading the referral information for a little guy, I'll call him Ernie, who had just turned seven a few days ago. And he had been seen by a very prominent autism specialist here in Israel. And, um, she had used the DSM four. Now there's the fifth version, which I'm afraid is much more problematic. And she had listed all her the symptoms and why this child was profoundly, he was, he was autistic, he was clearly autistic. And, um, also, uh, also suffering from mental retardation. So I thought, oh, I'm tired. I sure hope I'm up for this. This takes energy. I open the door and in walks this most fetching, adorable blonde boy with sparkling blue eyes full of anticipation as he walks through the door. And I'm thinking, what, this is great. Now he's almost seven. He had maybe a vocabulary of 20 words.
Speaker 3 (18:18):
He was in a kindergarten for, um, autistic children. He had been in such a, and he was brought by his guardians who said, we think he's intelligent. We see his responses. And he had a very difficult background at home. And that's why he was with these guardians. Well, he walks in and I have toys all over the room. I put them out. I sort of had to look at him out in the waiting area. I thought, I put out a few things that I thought might appear appeal to him. And he looked at them and he didn't really play, but I just gave him his time and watched him, wanted to talk about how, how he changed. And at, and at a certain point I took out a picture book, like a picture dictionary and has lots of pictures, very simple. And he came over to the table where I was.
Speaker 3 (19:06):
And he pointed at one of the pictures and he said, tree. I said, yeah, that's a tree ball up. I said, yeah, you, you got it. That's a ball. And I'm realizing this child has so much in him. I took out some puzzles, I pity, I didn't think to bring one, um, downstairs and show you three dimensional puzzles that were unique to the in institute. They were like box puzzles. And they took some, took one out, put them on, brought him over to the table cuz he was calmed down by then and put it on the table. And, uh, took an apart and just sort of motioned him. I said, well, you know, this is a puzzle and all goes together. And he looked at me like, I don't have a clue, but I could just feel the energy in his child. He was interesting.
Speaker 3 (20:06):
And I started to, um, I thought, okay, I'll demonstrate one. So I said, this goes here and this goes here, this goes here. And then there's the frame, and you build it like this. And then I took it apart again. Gave it over to him. 1, 2, 3 chick chicha, what you say in Hebrew, 1, 2, 3, no problem. He puts it together. And then, oh, Jamie, this was so excited. He's rocking back and forth, which is a typically autistic symptom, flapping his hands and he's speaking more, more. He wanted more. I had 20 puzzles like that. He did all of them. And at the end, at the end of this play-based assessment, I realized mental retardation, no way. This child is so hungry for learning autistic symptoms. Yes, he's got some autistic symptoms, but there's this thirst for learning. And he was in contact with me. He was talking to me more, which he could have said, well, these are, he didn't, wasn't saying, oh, these are really interesting, I want more.
Speaker 3 (21:17):
But that's what he essentially was saying. So using play, can I give you another example? Another, another example of Yes, please. Okay. Um, I'm, I'm thinking of, um, a little boy. He's also in the book, I think I call him Sasha. He, he was one of the youngest ones I saw. And at 18 months, he hadn't been formally diagnosed simply because the parents, it was very much on their minds. Autism. They got him, fortunately to a specialist in Tel Aviv, who's terrific with d i r floor time. And he was already starting to change when I saw him, but they were still very worried about autism. And he came into the room, Jamie, and he sat on the carpet, and that's where he stayed. He sat on the carpet looking completely lost, completely lost. You would expect most 18 month old babies to be moving around and exploring the space. And he was lost. He did not have any language, anything like that. The play with him started according to d i r principles, much more subtly.
Speaker 3 (22:29):
He wasn't interested in objects. I thought, well, I forgot to drop down developmentally and keep that play sensory based. So after he had acclimated, and he might have sat there for a long, long time, it was clear to me, and some of your listeners will think, huh, how can she say such a thing? It was clear to me, this was not autism. It was clear to me. He was developmentally stuck perhaps a few months ago before he started with d i r. He had, his presentation was more autistic looking, but by the time he got to me, he just looked stuck and lost and very sad. And, um, I got down on the floor and I, I asked his parents, if I can take off his shoes, I don't remember if I took off his socks. Sometimes they would ask permission whenever I was gonna touch a child, I would obviously ask parental permission.
Speaker 3 (23:29):
And I positioned myself along, along his line of vision, sat down there and just gently started. I think maybe, I don't remember if it was gently tickling or rubbing the souls of his feet. Now this is gonna sound like nothing, but it's not nothing. He looked at me with interest, and that was about the extent of it. In that first meeting, I said to his parents, based on that little play, baby play time interaction, I said, you're doing the right thing. I didn't talk anything about autism. It was already enough on their minds. I I actually wasn't worried about autism with him. I was worried about where he was stuck. That's for sure. I said, you're doing the right thing. Keep going to this d i r specialist. See if you could see her three times a week rather than once or twice a week.
Speaker 3 (24:30):
Whatever you are, you're, you're going in the right direction. You're committed to keeping him integrated. Topo in, in his daycare or whatever with regular children. Don't go off to special education. I wanna tell you where he was three year, three years later, they brought him in. No, they brought him. There were other times that I would, they would, they kept canceling appointments, but they, I knew they were in good, good hands, but I was, I wasn't worried. He's roughly three years old. I get a call from the parents, we'd like to bring Sasha in. I said, terrific. I'd love to see him. We'd like you to see where he's at.
Speaker 3 (25:07):
What a change, a precocious, talkative, um, present. Emotionally full three-year-old. Can I take credit for that? No, Sasha should take credit for it. His parents should take credit for their faith in him. And the person who was doing, doing the d i r two, three years, uh, for, you know, two or three times a week for the last couple, couple of years. But it was so exciting. Again, play-based assessments. So Sasha comes in full of beans and he's, he's ready to play and we're playing for a while. And then I take out a book, um, which, uh, is, was translated into Hebrew, but, uh, it's first it was born in, in English, uh, Goodnight Gorilla, which is, oh no, yeah, goodnight Gorilla. It's a terrific book. I don't know if you're familiar with it, if you have children, it's a young children. It's a super, super book. Simple text, almost no text. Lots of great pictures about a gorilla who's, who steals the, the zuki and lets the animals out and ends up in bed. Oh, this will be a spoiler, sorry, folks ends up in bed with the zookeeper and his wife <laugh>. You know, it's really, it's really, really cute. He loved it. I read it to him. And then this little guy, he was so great. He was so precocious and he was an irregular convert. He says, uh, he says to me, I, I wanna read it now.
Speaker 3 (26:44):
I said, sure, sure, go right ahead. Sasha, obviously he couldn't read yet. I'm sure he's doing brilliantly in school right now. He read, um, he told me the entire story. So you can get what's called Jamie. You can get what's called an autistic form presentation where symptoms appear to be autism, but they are not the real thing. And if I'm thankful for one thing in my life, I'm thankful that I arrived at the Feuerstein Institute. I'm thankful for many things as it happens. But we won't go into all those right now that I arrived at the Feuerstein Institute, which was a place where I could work unfettered and I could use my specialty play, which I'm modified, using the d i r floor time, um, to just go for the gold inside every child. And we just saw so many children change in, in that way. Some of them profoundly, some of them moderately depended on a lot of things. But this distinction between autistic form, which is a word that should be, it's out there in the field, but not enough. You can have an autistic appearing symptom and not have the real thing. I've probably gone on for too long. But,
Speaker 2 (28:08):
Uh, <laugh> that's interesting. You, you, you, you No, no, no. That that was a wonderful, that's okay. I, I know we've got a bit of a delay where, uh, we're working through that. Um, that was a good segue into where I want to go next and, uh, okay, sure. Um, you know, in your book, an Autism case book, the Child Behind the Symptoms, you claim that many children are being misdiagnosed as autistic. Um, and I would believe that, like, as a layperson, I'm gonna, uh, totally agree with that in, in what I say. I think there are too many practitioners and parents and, uh, other people in, uh, school communities looking to label something for whatever reason. But on what grounds do you make this claim? So, firstly, uh, and if, if, if many children have been, uh, uh, if that many children are being misdiagnosed, how can these children be helped?
Speaker 3 (29:03):
Right? Um, wow. Is this ever a, a topic close to my heart? Um, so the reason I think I came to the conclusion that, uh, many, many children are being dis misdiagnosed has to do with what's every 15 or so years. The, the field of psychology reinvents the, the, the manual of diagnoses. Okay? So the DSM four was not good for autism. That's my bailiwick. So I'll just speak about autism. There are a few other problematic categories as well. The DSM five, I hope that would correct some of the faults of the DSM four. It went overboard in stretching the criteria for autism in the DSM five. What is unique is that they talk about a range of symptoms. So a child can have a communication problem, it can be very minimal, it can be moderate, it can be extreme. It literally talks about, for several criteria, a range of symptoms.
Speaker 3 (30:12):
Well, Jamie, when you have a range of symptoms, you no longer have clinical specificity. You no longer have a clear vision. So that means a child like Ernie, who definitely, he had some strong autistic features, but he also had some strengths. And a child like Sasha, who's, yes, he was in trouble at 18 months, he was, nobody was denying it and said, this kid is fine. He had problems, but they apples and oranges. But they can come out with the same score. And then you have what's called an autistic spectrum diagnoses. So, in other words, we, we've got, we now have, I don't use it, I never use the DSM for autism. It was just in my, in my estimation and a disaster, uh, it is a disaster. The DSM five, four autism, you have these elastic criteria. So guess what? You've got a one size fits all diagnosis.
Speaker 3 (31:14):
So guess what? Lots of kids with all kinds of autistic form symptoms, but with other problems, are going to fall into this, uh, into this category. Um, if there, if I have a minute, I would like to just quickly cite a number of the kind of problems that I saw that we're being commonly misdiagnosed as autism. They did have symptoms that appeared, again, autistic form. It has the form, but not the substance in here in, in Israel. You know, where, where the Jewish tradition, you know, we're big on chicken soup. I like to, I like to draw, uh, uh, <laugh>. Yeah, a parallel with sort of like, there's a difference between grandma's chicken soup with the nice muzza balls in there. And it just, you know, you wanna jump in and something, the little dried stuff you get in a package and, and it looks like it.
Speaker 3 (32:20):
So autistic form and autistic. But the conditions I found that were commonly misdiagnosed as autistic, heartbreaking for me in many respects to see these. And I did everything I could to help the parents understand what was really going on moderate to profound hearing impairments that hadn't been factored in enough in the child's language problems. What's, here's a technical term, which I learned through my work at the institute, oral dyspraxia, which means the muscles for creating speech are not higher hardwired to the brain. Just like if, if you said to Misoshauna, could you please wiggle your ears? Well, I really wanna wiggle my ears, but you know, I don't have that gene. So my, so when it happens around the mouth, a child will not speak. They will have social communication problems, but it, that's not working. So I had quite a few of those, um, children with a whole range of emotional problems that were impacting on their communication children that just had kind of what I called garden variety developmental problems that you couldn't classify.
Speaker 3 (33:29):
So I didn't, I wouldn't classify, I don't believe that every developmental problem has to have a name tag. It has to be worked with, uh, typical children with developmental delays. Absolutely. Normal children. Absolutely normal children. I could look at them. I interacted with them. I said, they've got all the pieces are there. Okay? They need another year in nursery school, another year in kindergarten, and they're gonna be, I, I say the appearance. Okay? So when they're 26, they'll act like we're 25. You know, there's, your child has got it. Um, there are other things that were rather more serious that were sometimes, um, brain abnormalities, genetic symptoms, re's disorder. Obviously I didn't diagnose those, but it would say in the referral material, the child has such and such a brain abnormality, such and such a genetic disorder and autism. And I would say to the parents, I mean, sometimes that can be true, but often it was no, it hasn't been factored in enough. What appears to be autistic is really secondary. Let's help your child with some of the other aspects of his development. And we should see some of these autistic form, uh, symptoms diminishing. I hope I answered the right question. <laugh>. So I say that it's,
Speaker 2 (35:00):
No, you must say it legally.
Speaker 3 (35:01):
I, I hope I, so when you've got a one size, an elastic, when you've got elastic criteria that are just everybody welcome, and it's one size fits all diagnosis, you, you're going to, you're going to get a huge number of diagnoses. And that is what's happening today. And I am very sad about
Speaker 2 (35:23):
That. Yeah. And, and I feel, uh, you know, yeah, it is, it's heartbreaking. Um, and, and I feel, and, and I will, maybe this is controversial, this is just my opinion, listeners, but I, I think, um, particularly we see it in Australia, uh, many, many kids are, are, are very, they're, they're very quick to give a label. And I think it's because if they're given a label, there is so much support out there, or government support, particularly in Australia, uh, it's a little different to, uh, to where you are in the world. And, uh, but without that label, they can't access it. And so, you know, that, that may be true. That may, there may be some truth to that. And, and maybe I'm, I'm missing the mark to, to some extent, but, uh, you know, it is what it, and I'm glad, you know, I, I love this thing about, you know, okay. We, we don't have to necessarily label it. We have to work with it. You know, we have to do what's right. You know, look for the kid's strengths and, and, and see where that path takes us. So let's, let's talk about maybe a practical aspect from a parental perspective. Now it's quite a, can I,
Speaker 3 (36:22):
Speaker 2 (36:22):
Of course, of course. Can
Speaker 3 (36:23):
I just, can I just respond to what you just said? That's absolutely true. That it's absolutely true. You just said that, uh, you need the label to get the services. So many of the children that I saw most, in fact, had been diagnosed elsewhere. They knew that we worked differently at the Feuerstein Institute. So they wanted our perspective. And it was almost always different in terms of how to bring out the potential of, of the child. But the thing is, if a child came into my office and after seeing the child for a number of times, two hour sessions, play interactive director, it usually didn't take me that long. But usually I would say to the parents, look, here's where I think the diagnosis does not apply. Your child is not genuinely autistic. And I'd take out the DSM criteria of the DSM four or DSM five, whatever was happening, and show it, show it to them.
Speaker 3 (37:14):
And I'd say, and they'd say, wow, that doesn't really help, does it? And I say, no, it doesn't, does it? I would say, look, don't worry. They're already getting money from the national insurance to help them. I say, your child does however need speech therapy. He does, however, need occupational therapy. He does, however, need help in his kindergarten, use that money. I said, don't worry, I'm not gonna get on the phone to National Insurance and say, uh, little Jimmy here is, um, he's really not autistic. I, you know, I I I I, I don't think you should send, I said, no, you need the money. So my caution to parents about that is, if you have to get that label to get the services, don't you, do not have to let it define your child. And yes, it is controversial because many young adults and older adults who are getting that diagnosis, who are out there in the world, have found the diagnosis helpful to them in some way, in, in a, helps 'em understand more about themselves. That, for me, is a separate bailwick. I keep my attention focused on the young children and trying to extract the maximum potential from them. So yeah, that's, that's, you're absolutely right on that one.
Speaker 2 (38:34):
So here's a, an unscripted question. So if I have a, let's say I'm a parent with a seven or 10 year old child that has been given the diagnosis or the, let's call it the label, right? Um, it, do you recommend telling the child that? Or do you recommend the child not know that label? Um, and the reason I ask that, cuz you know, there, there's a, a case that's sort of close to my home and close to my heart in relation to that. And, and I see this particular child, uh, use it as an excuse to not participate or to not engage, or to not evolve, you know, uh, in other words, there's something wrong with me. I'm out. Right? And, um, uh, is there some sense to that or am I just totally wrong in saying that?
Speaker 3 (39:20):
Um, I don't think you're totally wrong at all, Jamie. Um, I'm not an advocate of that. I, if I felt in the same way that I don't believe if a child has a learning challenge, I don't believe in telling them you have a learning disability. We didn't believe in learning disabilities. We believed in learning challenges, and we helped children with that at the institute. Um, there's a lot in what, there's a lot that I fi I find a number of issues in what you're saying in terms of that child. But, um, I, no, I would never use any diagnosis as a source of identity. And that is highly controversial. That is highly controversial because, particularly because there's a very vocal strata of society that have have of older adults that have found a label, the diagnosis very helpful. And I would never take that away from them if that's, if that's helpful to a person. Okay. But I would never, I don't think I would use any, um, I'm, I'm thinking Down syndrome. I would use never any use di any diagnosis, particularly once, you know, how, how easy it is to shoot holes through this diagnosis. It does not tell you anything. I'm sorry to say that. It may tell you the child has some certain problems. Yeah. Okay. Let's find out what those problems are.
Speaker 3 (40:54):
So, uh, I hope I haven't started a, uh, a family feud here, but <laugh>, I, uh, I, uh, no, no, no, no. I, I, I wouldn't go this
Speaker 2 (41:05):
Particular, this part,
Speaker 3 (41:08):
No. Even with the Down Syndrome children, go ahead. At the institute, even with the Down Syndrome children at the institute, and before we started, I helped to sort of jumpstart the, the focus on autism at the institute. The Feuerstein Institute was world famous for its work with Down syndrome, um, and so on, so many of those young people, okay, down syndrome, genetic syndrome, you know, chromosome 21 and all this, um, many of them know, the older ones knew I have downs. And, but you should have just in their, in the drama productions, they put on and on stage, literally, they were, you know, say hello. That does not define me. I'm a person. And I'm literally talking about stuff on stage that some of our, some of our young, uh, down syndrome adults put on. So it's interesting what's happened in the field of autism, and somehow people have taken this on as identity, but with a child, I would, I would never do that. Um, and one, one important point, most people, professionals, and laypeople consider autism a trait. We consider trait. In other words, it's part of you, we considered it a state different. So if you consider something, a state, you're not gonna say to someone, um, you have influenza syndrome.
Speaker 3 (42:40):
Okay? So two weeks from now, you won't have influenza syndrome. Um, so if you consider it a state, which we did, and not a trait, and that also would probably, what's the word? Rank a lot of people, but others warm to it. Yeah. So, yeah. Yeah,
Speaker 2 (43:04):
Yeah. It's an interesting situation because this, this situation I'm referring to is actually a, a split family. And, uh, on one side, uh, there's, there's an absolute necessity to put a label on it. The other side's like, Hey, this is a normal kid. You know, like, just, and, and would really, they're gonna get so much benefit out here in today's podcast. You know, like, let's work with the strengths. Okay, let's, let's not, you know, necessarily let this define. And, but unfortunately, this label, this kid's taking the label and he's owning it. And, and that's a challenge, uh, uh, for this particular family. Anyway, I'll, uh, that's problem. I'll come back to the, come back on track here for Yeah, it is, it is. Um, so what, from a practical standpoint now, what would you recommend to parents who are listening to today's podcast who have an autism diagnosed child? What can parents do to help their child?
Speaker 3 (43:54):
Okay. Very, very important question. Um, I think the first thing is to find professionals who believe in your child. There are too many naysayers out there in the professional field. Your child has autism, therefore they will never Mm. And they will never. Mm. And they will never, and I say to parents, handpick, handpick the people that are helping your child, if they don't see the potential in your child, keep shopping, keep looking. That's one advice, obviously, I spent a lot of time helping. One of the things I would say to parent is teaching them how to see those strengths and how to expand and develop those strengths. And, and those strengths can start from just a little thing, like tickling a child's foot and getting that eye contact that's within the model of d i r Floro. Time floor time means you start where the child is, could be on the floor.
Speaker 3 (44:54):
It's developmental, individual based and relationship based. And I think those practitioners work extremely well with Autism Diagnosed children. I get, I don't, I don't, I don't have any interest here. I don't get a percentage for plugging d i r for plugging d i r floor time. But it, I know because I belong to a, a Facebook group, d i r floor Time Australia, for some reason, I, I was looking for d i r groups to join. It is developed in, it is, it is learned and practiced. And if parents happen to be, can't access d i r floor time practitioners. I, I find they're usually mental health practitioners already.
Speaker 3 (45:50):
Excuse me. Um, that, that is very helpful. Two other points, um, which is they're not necessarily, uh, common assumption is parents of children who've been diagnosed as autistic. Talk to your child, talk to your child. Um, most parents think that talking to your child means asking them, what's this right pen? What's this water? What's this cell phone? No, that's not talking to your child. Be the voiceover in the documentary of your child's life. Just talk about what's going down. Even if your child is not responding, you're in the car, you've got your child strapped in the back, and he's, or she is really silent, and you think they're out there in autistic land, there's a person in there. So you could say things like, as if your other children were in the car, you'd be saying, oh, that stupid driver, he just cut me off.
Speaker 3 (47:01):
I can't believe it. Oh, I better call daddy and let him know I'm gonna be 20 minutes late. Oh, I forgot to stop. I forgot to stop at the grocery store. Talk to the person in there with whatever's happening. Talk to the person. And that is so critical. And guess what, Jamie, that makes differences. Children start to attend more, the eye contact improves. Now you need counseling. You need coaching to know what to do with the changes, which obviously I can't do. And my last pitch would be, dads, you are important. You are important. Any way that you, your wife or the practitioner can help you engage your child through play, do it. Uh, you're just so important. And, uh, fear not <laugh>. You know, I, I put that, that's my last tip in the book, in the appendix of appendix to parents, um, is Dads you are important. You know, often does get busy when they have this child with some kind of diagnosis or special needs. They get busy at the office. And it's really, I find a lot of times, either from sadness or commonly, I don't know what to do with my kid. I don't know how to talk to him. I don't know how to play. That can be learned, dads that can be learned. You can learn that stuff and it feels so great when you can connect with this child that you thought you couldn't connect with.
Speaker 2 (48:41):
Yeah. That's, uh, some, uh, solid advice there. And, and, um, Dr. Shoshana, I've gotta say, we, we've gotta wrap this up shortly, but, uh, I know, uh, thank you so much for an insightful, um, common sense, uh, refreshing evidence backed, uh, you know, maybe somewhat controversial, uh, insight into this topic. Uh, I know many parents will get some benefit out of, I know it'll actually create some thought, you know, if, if it encourages some conversation with, with, we've done a wonderful service today. Sure. How can, um, parents get their hands on your book?
Speaker 3 (49:18):
Easy, real easy. Okay, here's the, here's the baby. Okay, here's my, it's the baby An autism casebook for, for parents and practitioners. The child behind the symptoms, uh, love this little guy on the cover. You know, he's obviously, he wasn't a child I worked with. Uh, that's thanks to Getty Images, easy, Amazon, Barnes and Noble Book Depository all over, all over any of any, any of those places. And, um, once in a while, you could check the, also on the Rutledge site. It's published by Routledge, R O U t ledge. And, uh, once in a while they have 10%, 20%, 30%. It just takes them a lot, 30% off. It just takes them a lot, um, a lot longer to get it to people than Amazon. Amazon you go to sleep in half the next day, but, uh, rather no. Takes some time.
Speaker 2 (50:21):
<laugh>. Wonderful. And, uh, well, let's, let's finish off with something a bit lighthearted question. We ask all of our guests on all of our, our podcast, and that is, uh, if, if we did have a time machine and could go back to our 10 year old self, what's one piece of advice that you would give to your 10 year old self?
Speaker 3 (50:38):
Um, three short thoughts. Hang in there. Things will get better. And trust yourself and trust your feelings.
Speaker 2 (50:54):
Fantastic. Simple and, uh, and concise and, and wise, wise words. Indeed. Dr. Shohan, thank you for your, uh, uh, contribution today. Your generosity, your time. I know we had tried to ski. We've been trying to schedule this for months, but I'm so glad that we, we got to see you finally. And, uh, oh,
Speaker 3 (51:12):
Speaker 2 (51:13):
This is a message that needs to be heard, so indeed. All right. Take care. And, uh, I, I, I hope we cross paths again some other time.
Speaker 3 (51:23):
Yeah. Lovely. Okay. Thank you.
Speaker 1 (51:29):
If you enjoyed the show, please connect with Jamie on LinkedIn or Instagram. You'll find links in the podcast description. Parenting in the Digital Age is sponsored by Skill Samurai Coding and STEM Academy for Kids. Skill Samurai offers afterschool coding classes and holiday programs to help kids thrive academically and socially while preparing them for the careers of the future. Visit skillsamurai.com.au.