Fierce, Kind Mama of Multiples
This podcast is for anyone raising multiples (twins, triplets or more). I speak to inspiring parents of multiples who have healed from unexpected pregnancies and birthing experiences and who candidly share the highs and lows of raising multiples. I also speak to the professionals that work with multiple birth families. Together, we cover the practicalities of raising more than one baby at a time as well as enhancing the emotional wellbeing of caregivers and children alike.
Fierce, Kind Mama of Multiples
Beyond Misconceptions: A Deep Dive into Neurodiversity with Adelle Sushames
Important annoucement
Sadly, the majority of multiple-birth parents report overwhelming exhaustion at some point in their parenting journey.
To help you with this, I've created a FREE, on-demand workshop that is available until the 28th of February, 2024 called Unwind and Thrive: 5 Simple Ways to Avoid Burnout as a Parent of Multiples.
Ideal for both soon-to-be and current parents of multiples. To sign up, head over to https://www.fiercekindmama.com/burnout
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On today's episode, I am joined by Adelle Sushames, a clinical psychologist specializing in supporting neurodivergent individuals, including those with autism and ADHD. We delve into the crucial topic of neurodivergence, aiming to dispel misconceptions while offering practical guidance, particularly for parents of neurodivergent kids.
Adelle sheds light on what neurodivergence means and provides valuable advice for parents navigating the unique challenges of raising neurodivergent children. A poignant aspect is the emphasis on self-check-ins, recognizing that parents themselves may be neurodivergent, adding an extra layer to the familial dynamics.
Acknowledging the heightened demands on parents of multiples, the episode offers practical strategies and information to assist those in similar situations. The goal is to provide support not just for individuals with neurodivergence but also for their families.
A significant point of discussion is the shift towards a neuroaffirming approach, moving away from perceiving autism and ADHD as disorders. Adelle stresses the importance of adopting a more positive and understanding perspective, aligning with the evolving neurodiversity movement.
Throughout the interview, there's a genuine exploration of the richness, strengths, and untapped potential within neurodiverse individuals. The episode encourages listeners to rethink preconceived notions and embrace a more inclusive and affirming view of neurodivergence. As a listener, you'll gain practical insights and a deeper understanding of the diverse experiences of those living with autism and/or ADHD.
How to connect with Adelle Sushames:
Instagram: https://www.instagram.com/neurodivergent_ally/
Thanks for listening! If you are a soon-to-be or current parent of multiples, be sure to head over to my website http://www.fiercekindmama.com to get my FREE resources designed specifically for you!
Be sure to follow me on Instagram and Facebook too.
Credits:
Music from #Uppbeat (free for Creators!):
https://uppbeat.io/t/aylex/with-you
License code: YLMJTQCPKRANEOVB
00:00:06 Dr Cristina Cavezza
Welcome to the Fierce Kind Mama of Multiples podcast. This podcast is for anyone raising multiples, twins, triplets or more. I speak to inspiring parents of multiples who have healed from unexpected pregnancies and birthing experiences and who candidly share the highs and lows of raising multiples.
00:00:27 Dr Cristina Cavezza
I also speak to the professionals that work with multiple birth families.
00:00:31 Dr Cristina Cavezza
Together we cover the practicalities of raising more than one baby at a time, as well as enhancing the emotional well being of caregivers and children alike.
00:00:41 Dr Cristina Cavezza
Come join us as we laugh, cry and share our personal and professional wisdom on all things multiples. I'm your host Dr Cristina Cavezza, and I am a Fierce Kind Mama of Multiples.
00:00:59 Dr Cristina Cavezza
Did you know that most studies comparing mental health outcomes in parents of multiples versus parents of singletons have found that parents of multiples tend to suffer more depression, anxiety and stress?
00:01:14 Dr Cristina Cavezza
Unfortunately, parental burnout and exhaustion is super common among us parents of twins, triplets or more.
00:01:21 Dr Cristina Cavezza
That's why I'm so excited to announce my free workshop where I teach 5 simple strategies to avoid burnout as a parent of multiples. The best part is that this is a pre-recorded workshop that you can access anytime from anywhere.
00:01:37 Dr Cristina Cavezza
You can sign up for free at www.fiercekindmama.com/burnout. The link will also be in the show notes for you too, so I encourage you to check it out and if you know anyone else who is a soon-to-be or current parent of multiples, please forward these details on to them too.
00:01:56 Dr Cristina Cavezza
The pre-recorded workshop will be available until the 28th of February, so I invite you to sign up now. I can't wait for you to check it out. If you have any questions or feedback, reach out to me by email at hello@fiercekindmama.com
00:02:12 Dr Cristina Cavezza
Now today I'm joined by Adelle Sushames. She's a clinical psychologist who supports neurodivergent (autistic and/or ADHD) kids, teens and adults.
00:02:24 Dr Cristina Cavezza
I'm excited about this episode being released because there's so much discussion out there right now about neurodivergence and I
00:02:31 Dr Cristina Cavezza
think sadly too
00:02:33 Dr Cristina Cavezza
there's still a lot of misconceptions about people with neurodivergence.
00:02:39 Dr Cristina Cavezza
In this interview, Adelle helps us to understand what neurodivergence is and what to do if you're a parent of neurodivergent kids.
00:02:47 Dr Cristina Cavezza
But also she highlights the importance of checking in with yourself too. As many parents of neurodivergent kids may also be neurodivergent themselves, and it can be a challenge for families that are navigating how to manage all their kids needs as well as their own.
00:03:03 Dr Cristina Cavezza
One of the points that Adelle mentions is how hard this can be as a parent of multiples because the demands on our resources as parents are so high already.
00:03:13 Dr Cristina Cavezza
And so my hope is that you find some practical information and strategies here on how to manage if you're in this situation yourself, and if you know someone else who might be in this situation, then please share this episode with them. My hope is that people get a better understanding of themselves or their loved ones who may be living with autism and/or ADHD.
00:03:33 Dr Cristina Cavezza
I also want to point out that Adelle and I talked about the importance of moving away from viewing autism and/or ADHD as disorders and moving towards a more neuro affirming approach. Now, don't worry if you don't know what that means just yet, because Adelle explains this more in the interview. But when I was listening back to this interview, I noticed that sometimes
00:03:55 Dr Cristina Cavezza
I was stumbling across my words trying to find the best way to describe the experience of individuals with autism and/or ADHD.
00:04:03 Dr Cristina Cavezza
And I point this out because I think even the most seasoned professionals can get this wrong at times.
00:04:09 Dr Cristina Cavezza
The neurodiversity movement is changing the way we describe and think about autism and ADHD, and my sincere hope is that as you listen to this interview with Adelle, you think about the strengths, richness, and potential of neurodiverse people. I hope you enjoy this episode, and if you have any questions, feel free to reach out to me
00:04:30 Dr Cristina Cavezza
Or to connect with Adelle, her contact details are in the show
00:04:34 Dr Cristina Cavezza
notes for you.
00:04:36 Dr Cristina Cavezza
Adelle, it's so wonderful to have you here. Thank you for being here.
00:04:39 Adelle Sushames
Thank you. It's lovely to be here.
00:04:42 Dr Cristina Cavezza
Why don't we start by you telling us a bit about yourself and the work that you do?
00:04:46 Adelle Sushames
Sure. So I work in a solo private practise as a clinical psychologist. I've had my own practise for around six years now and before that I worked in autism, early intervention and disability related services.
00:05:01 Dr Cristina Cavezza
Yes, lovely. Tell us about your.
00:05:03 Dr Cristina Cavezza
Work in the autism space and how that kind of came about.
00:05:08 Adelle Sushames
OK, for sure. I recall back in my university days being quite interested in autism and learning about everything that I could back then. Interestingly, reflecting now I think the textbooks really just spoke about autism in children and never really mentioned what it might look like in.
00:05:27 Adelle Sushames
Teenagers or adults
00:05:29 Adelle Sushames
So that's an interesting reflection. When I think back now, but I was lucky enough to gain some positions in areas that allowed me to gain that professional experience and particularly the early intervention service that I was part of for around five years and.
00:05:46 Adelle Sushames
When I went from there to private practise originally, I hadn't intended to specialise or focus exclusively on autism, but it just so happened that, you know, word of mouth referrals started coming in thick and fast. And so eventually I just concluded that, well, for a start, I really enjoyed this work. But why...why look a gift horse
00:06:05 Adelle Sushames
in the mouth, so to speak. Let's just roll with it and see what happens.
00:06:09 Adelle Sushames
And I found that over time, my passion around this area really increased and of course, personally speaking too, I've come to the realisation and understanding that myself and my husband and both of my children, are neurodivergent as well. And so there's been this blending of the personal and professional in terms of knowledge and skills and.
00:06:31 Adelle Sushames
Passion, I guess.
00:06:33 Dr Cristina Cavezza
Thank you for sharing that, Adelle. It sounds like there's a lot of richness in your professional and personal experience, which I'm sure we'll get into. But my first question now is what do you love about this work?
00:06:46 Adelle Sushames
I really enjoy being able to spend time with people who may not.
00:06:50 Adelle Sushames
Have had a.
00:06:51 Adelle Sushames
Very affirming experience when they've spoken with health professionals.
00:06:55 Adelle Sushames
Around these topics, before you know autism and ADHD, which is quite closely related, are really quite.
00:07:02 Adelle Sushames
Pathologised by the medical model. And so that's often a a families or a parents first experiences in dealing with a child health nurse or their GP or a paediatrician where their knowledge and training may be primarily informed by the medical model and therefore words like disorder and deficits and.
00:07:22 Adelle Sushames
You know, difficulties are are fairly commonly used and there can.
00:07:26 Adelle Sushames
Be a real.
00:07:27 Adelle Sushames
Deficit focus rather than a more rounded view of the child or young person as a whole. So I guess in the work that I do, I really enjoy being able to use a much more affirming approach and to use language and concepts that are in alignment with that and to just have.
00:07:44 Adelle Sushames
People you know, especially kids, have their eyes kind of light up and that you can see that aha moment on their face when they realise that somebody understands what's happening for them but doesn't view it as a bad thing or a negative.
00:07:57 Dr Cristina Cavezza
Yeah. And I imagine there's some people listening to this might may not know or fully understand what we mean by neuro...neurodivergence. And I think that that might be because, partly because the way we've traditionally spoken about it has been, like you've said, through this lens of.
00:08:17 Dr Cristina Cavezza
There's a problem or disorder, that kind of thing. Could you help us better understand what neurodiversity is and what it isn't?
00:08:26 Adelle Sushames
Yeah, I sure can. So neurodiversity is a term that's used to describe all different brain types or neurotypes. So people that we would have, you know, traditionally considered to be neurotypical or average or, you know, part of the the the largest normative group within our society.
00:08:46 Adelle Sushames
They are included in neurodiversity, and so too are individuals who may be autistic, ADHD, or have other particular brain types that are more closely aligned with what people understand when we use terms like OCD or an anxiety disorder or a personality
00:09:02 Adelle Sushames
disorder. So there's quite a wide range of different ways that people can identify or present, but we consider that all of those, all of the human experience falls under the term neurodiversity. We're all neurodiverse together as a group.
00:09:21 Adelle Sushames
Neurodivergent, as the name kind of implies, is trying to capture all of those people that aren't in the neurotypical.
00:09:29 Adelle Sushames
Part of neurodiversity.
00:09:32 Adelle Sushames
So if you kind of imagine, you know, an umbrella, the umbrella diagram, you've got neurodiversity at the top and then falling down from that, you've got all of the subtypes.
00:09:42 Adelle Sushames
From neurotypical, right through to autistic, you know somebody who might have.
00:09:49 Adelle Sushames
A personality disorder or features of a personality disorder. Yeah. So neurodivergent just means diverging from the neuro norm.
00:09:58 Dr Cristina Cavezza
Yeah. All right. OK. And how can this show up in families? Like, what do we know about?
00:10:04 Dr Cristina Cavezza
Whether it's hereditary or you know some of that kind of background, could you help us understand that a bit more?
00:10:10 Adelle Sushames
Yeah, I can speak a little bit to that. So I think you know the research is really starting to catch up with what clinicians have suspected for a long time, which is that for many types of neurodivergence and my areas of interest are in
00:10:25 Adelle Sushames
Autism and ADHD, so I'll speak primarily
00:10:27 Adelle Sushames
To those, but that these types of brains tend to run in families. So, you know, there is a strong genetic component that we're beginning to understand more and more. And I think that that begins to make sense when we think of autism, for instance, as not only presenting as those really narrowly defined
00:10:47 Adelle Sushames
DSM criteria, the diagnostic manual that psychiatrists, psychologists and other mental health professionals use to assess and diagnose different different presentations, and to to formalise things.
00:11:00 Adelle Sushames
But when we look at autism in particular, we can see that there's actually a really broad way in which the characteristics can be expressed and that these things tend to change quite significantly when we take into account different genders, different age ranges, things like that.
00:11:17 Dr Cristina Cavezza
Yeah. OK. And what do you know what? What is the prevalence of let's focus on autism and ADHD. That is your particular area. And I think that that's really where I would love to to focus on in this this.
00:11:33 Dr Cristina Cavezza
This interview, because I think you know my experience in talking with people who have multiples.
00:11:39 Dr Cristina Cavezza
That there is a lot of discussion around 1 twin being diagnosed and then wondering oh is the other does the other twin the other multiples? Do they also have it or now I'm wondering if I have it or my partner has it so there's it just seems to be
00:11:56 Dr Cristina Cavezza
in
00:11:57 Dr Cristina Cavezza
Just in my experience in speaking with people just generally, you know, and just in the community, a lot of discussion around whether they or their children have ADHD or autism or somehow some of those symptoms, if you like or I wouldn't say symptoms because it's not, you know that presentation, right? So do you know?
00:12:17 Dr Cristina Cavezza
What's the prevalence of autism
00:12:21 Dr Cristina Cavezza
and ADHD in multiple births do
00:12:24 Dr Cristina Cavezza
We have that information?
00:12:26 Adelle Sushames
You know what? I I don't know if we have that specifically or not. And I was thinking when you were talking just now, I wouldn't even be confident to give you a prevalence estimate and say, you know, this is how many autistic people there are in, you know, every 100 people say. And I think the reason for that is because what we're learning and understanding has been updating.
00:12:47 Adelle Sushames
Quite frequently recently, and it even varies depending on which country in the world.
00:12:53 Adelle Sushames
We're looking at so there have been stories in the media recently around, you know, autism diagnosis really skyrocketing in Australia and other parts of the world. And why is this and some people will say, oh, it's because everybody watches TikTok and so they think that they're autistic or it might be, you know, here in Australia, people are saying, well, it's because they want NDIS funding and things.
00:13:11 Adelle Sushames
Like that, but I think really the prevalence rates depend on a lot of factors.
00:13:15 Adelle Sushames
Including what the the research criteria or the research approach is that's being used to gather.
00:13:21 Adelle Sushames
The data so I don't know what the prevalence rates are, but I'm pretty comfortable not knowing that because I tend to prefer to look at the individual's lived experience and how that aligns with what I know about autism or ADHD, for instance. And so, as you said before, like, you know, do we talk about symptoms? I don't talk about symptoms. I would talk about characteristics and different ways of being and experiencing the world.
00:13:45 Adelle Sushames
And that's how I assess autism and ADHD.
00:13:48 Adelle Sushames
When I'm looking at that clinically.
00:13:51 Dr Cristina Cavezza
And and what is that in terms of how individuals see the world or experience the world? Like, can you give us some examples of what that looks like?
00:14:01 Adelle Sushames
Yeah, for sure so.
00:14:03 Adelle Sushames
If you look.
00:14:03 Adelle Sushames
At the DSM criteria which I try not to look at too often, but it will talk about, you know, having differences in the way that somebody interacts socially with others and so.
00:14:13 Adelle Sushames
That could be.
00:14:14 Adelle Sushames
You know, at the very I guess, traditional or stereotypical end of people's understanding of autism, things like not making eye contact or preferring to play on your own. If we're talking about a child or it might be not being able to make and maintain friendships. But then if we look at the more nuanced layers of that, we can understand that.
00:14:36 Adelle Sushames
Actually, you know, when autistic adults describe their experiences, they find making eye contact physically uncomfortable to the point of it being painful. And that casts a whole new light on what the lived experience actually is. For these kids that are coming through early and being diagnosed but are unable to actually verbalise perhaps or use.
00:14:54 Adelle Sushames
Or have you know an understanding of the concepts they would need to give us that explanation of what it's.
00:14:58 Adelle Sushames
Like for them, you know, and again at the more subtle end of how, you know, a difference in social interaction may present could be particularly in girls and women. And they have individuals whereby they spend quite a lot of time preparing.
00:15:14 Adelle Sushames
The social interaction they're scripting what they're going to say, they're trying to anticipate what the other person might ask or want of them, and then afterwards they're going back over that information and evaluating themselves and trying to figure out ways that they might.
00:15:27 Adelle Sushames
Do it more successfully next time if they're evaluating themselves against you know, the neurotypical standards that we're all taught are the correct way to be in a social setting.
00:15:38 Dr Cristina Cavezza
Yeah. And so is a lot of your work then helping these individuals with social interactions, helping them understand this about themselves and how they can be more accepting of that, that this is how they are. Is that kind of.
00:15:53 Dr Cristina Cavezza
Part of the work.
00:15:55 Adelle Sushames
Yeah, I think you know clinicians working in this space can approach it very differently depending on what their training is, what their own personal philosophical approach is and what they think is, you know, evidence based or the most ethical approach to take in these scenarios. So when I first started out particularly working in early intervention.
00:16:15 Adelle Sushames
We followed a.
00:16:15 Adelle Sushames
Very. You know, behaviourist based approach where you were trying to encourage people to learn new skills and, you know, providing positive.
00:16:23 Adelle Sushames
Reinforcement or rewards when they were able to achieve and demonstrate those, and maybe you know this wasn't how I worked specifically, but there are certain clinicians out there who have, you know, followed that approach quite rigidly in terms of also providing punishments or negative consequences if there was a display of a behaviour that was considered inappropriate or challenging, for instance, so.
00:16:43 Adelle Sushames
That's one way that clinicians may work with an autistic individual and that still happens today in many parts of the world, but my preference and my passion is for neurodiversity, affirming care. And So what that entails is really a lot of education and helping.
00:16:59 Adelle Sushames
Kids and their families, their teachers, anybody that's in that individual support network to understand what their brain type is and what their resulting needs may be so that they can be successful, whether that means forming a friendship.
00:17:15 Adelle Sushames
Or whether it means connecting with others online with no expectation.
00:17:19 Adelle Sushames
That you will ever.
00:17:20 Adelle Sushames
Meet up face to face. You know the goal can be different depending on the person and what their preferences are. It doesn't have.
00:17:25 Adelle Sushames
To be determined.
00:17:26 Adelle Sushames
By what I as the clinician think is best for them.
00:17:31 Dr Cristina Cavezza
Yeah, so it's very individualised and.
00:17:34 Dr Cristina Cavezza
I suppose comes at it from the angle of. What does this person in front of me need? What what's what are they asking for? What are they going to benefit from? And it's not about putting our expectations or priorities on them, or their family. I wonder if this sometimes.
00:17:52 Dr Cristina Cavezza
You know, parents are, I imagine, parents a lot of times are seeking these assessments.
00:17:59 Dr Cristina Cavezza
Are they coming with, you know? Are they coming with challenges or particular things they're worried about in their children, and that's why they're coming. Could could you speak a bit, you know, a bit about that?
00:18:09 Adelle Sushames
yeah, for sure. So for the younger children in particular, when a family approaches me for assessment, they're usually coming because either.
00:18:20 Adelle Sushames
Somebody else has said to them you.
00:18:22 Adelle Sushames
Know do you?
00:18:22 Adelle Sushames
Think that little Johnny may be on the autism spectrum? Maybe you should get him looked at.
00:18:28 Adelle Sushames
But more often than that, what I'm finding now is that parents are coming because they have observed that their child struggles in particular situations and may be prone to being quite emotionally reactive. You know, having meltdowns, not being able to cope with particular sensory input or doing things that you know.
00:18:47 Adelle Sushames
Aren't expected in a child of that age, whether it's to do with sensory experiences or how they play, or how they approach others socially. So all of those types of things, and I think parents are very savvy now because, you know, we have the Internet at our fingertips and we have so much.
00:19:05 Adelle Sushames
Information and while that.
00:19:06 Adelle Sushames
You know it's great because it means that parents can get knowledge and seek answers sooner. Sometimes it also contributes to quite a bit of anxiety around what the outcome and assessment may be, because there is still a lot of, I suppose you know, there's lots of information online and in different groups for parents, that is still quite pathologising and how it approaches.
00:19:27 Adelle Sushames
Autism and what you know, a child's prognosis may be, for instance, which isn't even a word that I use when you know, I'm having these conversations with families.
00:19:37 Dr Cristina Cavezza
Yeah. How can families like? I'm thinking about the case of multiple birth children. I'm thinking where, you know, one child.
00:19:46 Dr Cristina Cavezza
Might have received this, you know, confirmation that they're autistic or on the spectrum or they have ADHD.
00:19:55 Dr Cristina Cavezza
And then the family is now trying to parent and manage and balance the needs of their children. OK, where one or more, let's say one or more.
00:20:05 Dr Cristina Cavezza
Is neurodivergent...what...how...How can families do that? How can they manage and balance the needs of their children?
00:20:13 Adelle Sushames
Mm-hmm. Yeah, I think it's such a complex and layered question because you know, and you would obviously have far more expertise on this than me. But when I think of parenting multiples and the advice and I guess almost the folklore that's around what it's like to have twins or triplets or other, you know, versions of multiples
00:20:34 Adelle Sushames
Is that that this sense that that twins or triplets may almost be exact replicas of one another and that they will have this, you know really intense connection and that they will be really attuned to one another. And I think in some instances you can see that playing out. But I think also you know what's often the.
00:20:53 Adelle Sushames
Case is that.
00:20:54 Adelle Sushames
These are individuals with very individual needs, and even though they may have genetically that same predisposition towards an autistic neuro type, it doesn't mean that how that presents and.
00:21:09 Adelle Sushames
You know is observable in the world or is in a way that the child thinks or experiences sensory information is going to be the same as their sibling. I think it's more often than not that would be quite different and really needs to be looked at on an individual basis.
00:21:27 Dr Cristina Cavezza
Yeah. And would you recommend that a families they've been given, say, the confirmation that one child has is on the spectrum or has ADHD, do you, would you be recommending them to seek out?
00:21:42 Dr Cristina Cavezza
You know an assessment for their other multiples. So say they they have one twin that has been diagnosed or what is the?
00:21:53 Dr Cristina Cavezza
You know, because we we've spoken about how.
00:21:56 Dr Cristina Cavezza
It may be more prevalent in families. There's like a hereditary factor here, so if the parent is like.
00:22:01 Dr Cristina Cavezza
OK.
00:22:01 Dr Cristina Cavezza
Well, my son has, we've received this confirmation. Should I go and get his twin?
00:22:09 Dr Cristina Cavezza
You know his his other. The other children. Should I get them assessed as well? What would you say to a parent in that situation?
00:22:16 Adelle Sushames
I would say it depends on what we're observing and witnessing in the child's like right now. So I think there are definitely going to be families where one like where you know 1 twin has a formal diagnosis and the other is displaying
00:22:33 Adelle Sushames
Very similar characteristics. Or maybe the same characteristics, but not in as intense or frequent way. So they may, you know, appear to have less needs on the surface, although their needs are still readily apparent in those instances. Then I would say for sure, I think you should have your second child or the second twin assessed as well.
00:22:53 Adelle Sushames
Because the earlier that the family understands the child's neuro type and what their needs are, the better they are able to match those and to meet the needs and for the child to have start to develop their own understanding of how their mind and body work and what they need, and to have a positive sense of self attached to that rather than a negative.
00:23:14 Adelle Sushames
One moving.
00:23:15 Adelle Sushames
Forward, I think in cases where it is far more subtle, where you know a parent might say, well, you know.
00:23:24 Adelle Sushames
One has these definite characteristics and we've taken them along to a psychologist and they can see it too. And the teachers mentioned some of the things that they've noticed and we're going to get a diagnosis or an assessment to see if they're autistic. But our other child, you know, only seems to, you know, get really emotionally dysregulated when they get.
00:23:44 Adelle Sushames
Home for school from school and when when they're at school, their teachers have no concerns and say that they socialise beautifully and they cope with everything asked of them during the day.
00:23:53 Adelle Sushames
In those cases, I can certainly understand why parents may.
00:23:57 Adelle Sushames
Be hesitant to seek.
00:23:59 Adelle Sushames
A diagnosis for the second child, but I think it's definitely warranted to do that because there are those more subtle indicators there that the child is not, in fact, coping with the demands of the school day, for instance, and that by the time they've arrived home from school, they've really got nothing left.
00:24:16 Adelle Sushames
In their tanks, socially, emotionally, or in a sensory way. And that means that everything else is hard at home, and my preference is that there can be more of a balance between the two environments where a child can cope while at school and also has something left when they get home to be able to enjoy their downtime and their family time. And sometimes what is needed is a diagnosis.
00:24:38 Adelle Sushames
So that the child can access supports at school, even though they may not appear on.
00:24:41 Adelle Sushames
The outside to need them.
00:24:43 Adelle Sushames
So that then they still have. I'm going to use the word spoons and I'll explain what I mean by that in the moment. So I still.
00:24:49 Adelle Sushames
Have spoons left when they get home and they're not, you know, running on empty, so to speak. So when I say, use the term spoons that comes from spoon theory, which was coined, I think it may have been.
00:25:05 Adelle Sushames
In the 90s, but don't quote me on that. A lady by the name of Christine and I'm never pronounced her name correctly either. It was Miserandino
00:25:15 Adelle Sushames
I cannot recall because my brain doesn't do names so well, but she was using this idea of spoon theory to help her friend understand what it's like to live.
00:25:24 Adelle Sushames
With a chronic health.
00:25:25 Adelle Sushames
Condition like lupus, and she said. Imagine you've got 12 spoons to start the day, and the spoons represent your resources. Social, emotional, psychological, physical energy and such. Every time you do something, it costs you a spoon.
00:25:38 Adelle Sushames
What happens when you run out? You've got no energy left, so therefore something you could do yesterday. You may not be able to do today, for instance.
00:25:45 Adelle Sushames
And so it was.
00:25:46 Adelle Sushames
A really useful analogy to explain what it was like for her, and as you can imagine, the neurodivergent community when they learned about this, loved it. Because it's also a really great analogy for what's happening for neurodivergent
00:25:59 Adelle Sushames
Individuals and so I'm often talking with parents about the fact that kids can be using up their spoons at school.
00:26:05 Adelle Sushames
Without it being obvious to their teacher or the casual observer that that's what's happening, especially for girls, because a lot of the spoons and the situations that take them up are internal.
00:26:18 Adelle Sushames
Their thoughts, their emotions, sensory experiences that girls are very, very adept at hiding and masking in front of others, but nonetheless, when they get home and their spoons are depleted, they don't. They don't have anything left. And so I'd like to see a situation in families of multiples where each of their children.
00:26:38 Adelle Sushames
Has their needs recognised and supported, though it's not you know a case of the squeaky wheel getting the grease when actually the grease is needed by both.
00:26:48 Dr Cristina Cavezza
Yeah. And I'm so glad you brought up spoon theory because I think that it is such a wonderful way to describe it.
00:26:57 Dr Cristina Cavezza
But also I think you know when I when I was listening to you speak the thing that I was thinking about is even as a parent of multiples, you know I've spoken to many.
00:27:06 Dr Cristina Cavezza
Parents and one thing that you will often hear is.
00:27:11 Dr Cristina Cavezza
Especially by the end of the day, you feel like yourself..you have nothing left. You know you. You may have spent all day caring, but let's take the case of when the multiples are young, right? And still at home and.
00:27:25 Dr Cristina Cavezza
You know, home from school, I mean, so preschool age. And you've literally spent your day just.
00:27:32 Dr Cristina Cavezza
Taking care of everybody else's needs, right? Looking after making sure everybody's fed, making sure everybody's changed, making making sure the naps are, you know, people are having naps and trying to just navigate all of that and you may have other children too, right? Like I've spoken to many multiple with parents who who have other kids under 5 and they've got multiples. So it's a huge load.
00:27:53 Dr Cristina Cavezza
And so when I heard you speak, I thought, you know, there are plenty.
00:27:56 Dr Cristina Cavezza
Of times when I can think of.
00:27:58 Dr Cristina Cavezza
Feeling like I have nothing left and then I'm I'm expected and and it is our responsibility that we have as parents right to then still be attuned and patient and you know, look after my kids who might themselves now have.
00:28:18 Dr Cristina Cavezza
Limited spoons left, you know, limited resources so.
00:28:23 Dr Cristina Cavezza
I guess this is kind of my roundabout way and I don't know if there is an easy answer to this. I suspect there isn't, but I wonder what what we can do as parents, especially multiple birth parents with young children at home.
00:28:38 Dr Cristina Cavezza
How can we manage and balance all of that?
00:28:40 Dr Cristina Cavezza
You know what are some what? What are some advice you'd give to those families, those parents?
00:28:44 Adelle Sushames
Yeah. Yeah. So I kind of feel like we're looking at, you know, how in psychology we will use those feelings or emotions, thermometers with younger kids, and we kind of have, you know, the bottom part of the thermometer
00:29:00 Adelle Sushames
The meaning, you know, you're feeling calm, you're feeling good, and then the next level, you're getting a bit worried or a bit frustrated, and then you're angry and you can kind of imagine the mercury moving up, and it's a visual representation of how emotions can go from manageable to unmanageable. You know, for kids to understand. And I think about a similar kind of thermometer or a similar kind of.
00:29:22 Adelle Sushames
Yardstick that we're using to measure this experience that parents have whereby starting at the bottom, parenting is really hard.
00:29:29 Adelle Sushames
Right.
00:29:30 Adelle Sushames
And then parenting multiples is harder. I'm sure many of your listeners would agree to that parenting neurodivergent kids.
00:29:40 Adelle Sushames
You know, probably on a par with multiples or maybe you know different depending on your experience, parenting neurodivergent kids who are also multiples and then you're adding in others like, you know, the the mercuries left the end of the the thermometer and has
00:29:54 Adelle Sushames
Shot skywind because it is just so challenging to be able to manage all of those multiple layered needs on top of your own needs as a person, because you know, I don't think it's a huge secret to know that if you have neurodivergent children.
00:30:14 Adelle Sushames
You might be neurodivergent yourself, so you're not only managing their sensory needs. You're not only managing their, you know, maybe lagging skills in particular areas of daily living such as toileting or needing a lot of support with eating, and so so on. But you've also got your own stuff.
00:30:32 Adelle Sushames
On top of that, so you might really not cope well with that feeling of being touched out that mums describe you might really not cope with the child having a meltdown because they're screaming at a high pitch that just feels like.
00:30:45 Adelle Sushames
Red hot pokers in your eardrums, you know? So there's just so much going on when we're looking at this type of situation. And so I think the spoons analogy is really great here, because what I'll often do with kids in particular is, you know, put down some cards that I've designed that show all the things that use up our spoons and give them 12 teaspoons and say, show what
00:31:07 Adelle Sushames
Uses up all of your energy and.
00:31:09 Adelle Sushames
You know, they'll show me and then I'll say, what else do you have to do today? And they'll look at the other 10 or 20 cards that are still there showing all of the things that they have to do and they just.
00:31:18 Adelle Sushames
You get this.
00:31:18 Adelle Sushames
Realisation dawning where you can't do all of that. It's not possible to do.
00:31:22 Adelle Sushames
All of those.
00:31:22 Adelle Sushames
Things in the day if you've got no spoons left, and I think the same applies here, it is not possible to do all of those things successfully.
00:31:31 Adelle Sushames
Because you're limited, you've only got limited means for coping, and so I think my main message would be that mums need support, all mums need support and the village.
00:31:43 Adelle Sushames
When you, you know, have multiples, you need extra when you have neuro divergent multiples, you need extra when you have neurodivergent multiples and you may be neurodivergent yourself, you need. You really need to throw everything support wise that you can.
00:31:58 Adelle Sushames
At that situation, because if you don't, it becomes overwhelming.
00:32:01 Adelle Sushames
Very, very quickly.
00:32:03 Dr Cristina Cavezza
Yeah, such an important point. And you know, we speak a lot about, I guess in the.
00:32:09 Dr Cristina Cavezza
You know, we think about parenting spaces around having supports having that village and it's.
00:32:14 Dr Cristina Cavezza
It's just something that I think.
00:32:16 Dr Cristina Cavezza
We need more of right. We need. We need to focus on that. We really need to prepare ourselves to.
00:32:23 Dr Cristina Cavezza
I suppose seek out and not be afraid to seek out for additional support when we need it.
00:32:29 Adelle Sushames
Mm-hmm. Absolutely. And I think, you know, parents are often inundated with ohh, you're having twins or or multiples. You need to get all the equipment. You better get one of those.
00:32:39 Adelle Sushames
Breastfeeding pillows that allows you.
00:32:40 Adelle Sushames
To feed both babies at once. But what happens if you have one baby who loves snuggle time and loves skin to skin and loves being fed and
00:32:49 Adelle Sushames
Will stay at the breast for hours
00:32:49 Adelle Sushames
and the other baby doesn't really like to be touched very much and would prefer to be just lying in a bassinet for a lot of the day and and doesn't want to be close to other, you know, close to their sibling.
00:33:01 Adelle Sushames
Perhaps that image that we get in our mind of, you know, the two breastfeeding twins and they're clasping one another's hands, you know.
00:33:07 Adelle Sushames
That's not always the experience.
00:33:09 Adelle Sushames
For neurodivergent families. So yeah, it's not about what do you, you know, what are the things and their supplies and equipment that you need, maybe we should be thinking more about how are you going to prepare yourselves for, you know, managing your own sensory needs, how you're going to prepare yourself for managing the needs of the child if they're competing with their twin.
00:33:28 Adelle Sushames
Or their sibling in some way.
00:33:30 Dr Cristina Cavezza
Yeah, I love that you brought up that example of the holding hands while breastfeeding, you know, because I think that often we can romanticise what it's like to have multiple babies and what that experience will be like. And I think as.
00:33:45 Dr Cristina Cavezza
In pregnancy, you know, I speak to many women that speak about the image that they had of what was going to happen once their babies were born and what that was going to look like.
00:33:53 Dr Cristina Cavezza
I think the other important point to make there is that it doesn't. It doesn't always turn out the way that we anticipate it, obviously, but the other point is responding, being responsive and attuned to your individual babies and what they need. That's so important. And I think I imagine anyway.
00:34:12 Dr Cristina Cavezza
In when we talk about Neurodivergence, that becomes even more, more important. You know really or or or it's more at ..it needs to be at the forefront of our minds like how how are our children.
00:34:25 Dr Cristina Cavezza
Unique. You know? What do they need individually, right?
00:34:30 Adelle Sushames
Yeah, for sure. And I think if you're asking those questions, you're gonna be in a much better place to be able to meet the needs even.
00:34:36 Adelle Sushames
If you're.
00:34:37 Adelle Sushames
Not able to do it you know independently.
00:34:40 Adelle Sushames
You may be able to reach out to.
00:34:42 Adelle Sushames
Family members or other support systems to be able to get those needs met and find that actually, when that's happening, life does become more manageable and easier.
00:34:52 Dr Cristina Cavezza
Yeah, and I think.
00:34:53 Dr Cristina Cavezza
What we've been touching on here too is part of it is understanding. So we we need to know, right? We need to have that information that our child, yes, meets this.
00:35:04 Dr Cristina Cavezza
Neuro type or has the these characteristics that are consistent with, say, autism or ADHD. So how would the parent go about getting that confirmation either for themselves that they may have
00:35:15 Dr Cristina Cavezza
You know, some of these characteristics themselves or their child or their children might have.
00:35:20 Adelle Sushames
Yeah. Yeah. So there are a bunch of, you know, information sources online from checklists through to quizzes that you can do. There's, you know, some of them are good. Some of them are not so good. But for parents with young children, there is an app, a free app, that.
00:35:34 Adelle Sushames
You can download called ASD.
00:35:36 Adelle Sushames
Detect as in the acronym ASD and then detect attached to that and that can help them to get a bit of a sense of whether or not getting another opinion is the next step. Many states will have a free or low cost government funded assessment service so it will be worth contacting.
00:35:58 Adelle Sushames
Either your you know your child health, nurse or GP to find out if that's true for wherever you are located. Sometimes states will also have like an autism like a not for profit organisation that's just around information and support and directing people to services so that can be a good place.
00:36:17 Adelle Sushames
To look and seek more information as well.
00:36:20 Dr Cristina Cavezza
OK. And then once the family gets that confirmation, right, what happens next in terms of
00:36:28 Dr Cristina Cavezza
Interventions or treatments or supports? What does that typically look like, or what can that look like?
00:36:34 Adelle Sushames
Yeah, I think that depends on what the child's needs are at the outset and what the families goals might be. So traditionally we've definitely been encouraged to.
00:36:48 Adelle Sushames
Ensure families are aware that early.
00:36:51 Adelle Sushames
intervention is really important and you know you'll have families attending psychology and OT and speech and physio appointments on, you know weekly or fortnightly basis. It is a lot to juggle because I think it's, you know based in this really neuro normative idea that you have this young child who has these.
00:37:11 Adelle Sushames
Lagging skills and they must be ready by the time they get to school age. And so we're going hammer and tongs to try and meet that goal without really recognising that. That might not be developmentally appropriate or possible for your particular child, or young person.
00:37:26 Adelle Sushames
So I think you know looking at it from the perspective that I and many others work, which is more neurodiversity affirming, it's recognising well what, you know, what are the skills that are lagging that are causing distress to the child and their family? Those are the things that we would like to target 1st, but it may not be that traditional approach of teaching the child to name all of the emotions and to recognise the pictured.
00:37:49 Adelle Sushames
Emotions and to follow particular steps or use an emotions toolbox when they find themselves getting upset because that's not recognising.
00:37:57 Adelle Sushames
The very many barriers that are in place for this child or young person.
00:38:00 Adelle Sushames
It's expecting them to fix.
00:38:03 Adelle Sushames
Their own problem or over, you know, outsmart their neuro type and it's just not possible to do that. So you know I would suggest in those instances you're actually working with the parents and the other adults around the child to help them recognise the signs.
00:38:17 Adelle Sushames
That the child may be becoming dysregulated to.
00:38:19 Adelle Sushames
Try to prevent or minimise
00:38:20 Adelle Sushames
some of those triggers and know what to do to provide that Co regulatory support when it does happen because you can't control for every eventuality, you're going to have children who become overwhelmed at times or may have a meltdown. And how do you deal with that as a parent? Because there's still so much fear of judgement and shame, and that really internalised.
00:38:42 Adelle Sushames
ableism that many of us carry around that our child needs to present certain way, particularly in public, and so it.
00:38:48 Adelle Sushames
Can be very very.
00:38:49 Adelle Sushames
Stressful for parents to try and navigate those situations.
00:38:52 Adelle Sushames
If if you know the wheels fall off and the child does have a meltdown, So what do they do in those situations? I think those are more helpful skills and strategies to have rather than a a really blanket early intervention approach because that might not actually be what serves the child and the family best in.
00:39:09 Adelle Sushames
The long run.
00:39:10 Dr Cristina Cavezza
Yeah, I'm so glad you brought up that example of having all the different types of intervention professionals involved, because I know that can be so overwhelming for families, particularly multiple birth families who are already under a lot of financial strain under time pressure, and then having to.
00:39:30 Dr Cristina Cavezza
Go to weekly, fortnightly appointments for every single thing you can imagine. Professional it. It's really daunting for a lot of families, and I know a lot of families report feeling that it's hard to keep up with that. You were also speaking about, you know, you said a few times the neurodiversity affirming
00:39:51 Dr Cristina Cavezza
Approach and I'd love for us to.
00:39:53 Dr Cristina Cavezza
Spend a bit of time.
00:39:55 Dr Cristina Cavezza
Talking about what that means practically like, how can parents, for example
00:40:01 Dr Cristina Cavezza
But even just.
00:40:03 Dr Cristina Cavezza
Just the general public. How can we be more neurodiversity affirming?
00:40:08 Adelle Sushames
Yeah, for sure. So at its core, the neurodiversity affirming paradigm puts forward that different neurotypes are just part of our natural human variation. You know, we're not all meant to come.
00:40:21 Adelle Sushames
Out exactly the.
00:40:22 Adelle Sushames
Same and therefore, if you have a different brain and a different body and different needs as a result.
00:40:27 Adelle Sushames
Of those things.
00:40:27 Adelle Sushames
That's OK. We're not trying to change.
00:40:30 Adelle Sushames
You, you know, we recognise.
00:40:32 Adelle Sushames
That all minds are valid types of minds to have what we should be doing is actually supporting the person so that their, you know, experience of the world can be more positive and they can have access to the same opportunities that everybody else has. So how do we actually how do we actually do that? What does that translate?
00:40:53 Adelle Sushames
Into, you know, from a therapeutic standpoint, it's more about, you know supporting the individual, listening to them and sharing information and resources with them than it is that approach where you might be trying to teach them, particular neurotypical social skills, like forcing yourself to make eye contact and.
00:41:08 Adelle Sushames
You know, doing lots of polite small talk that feels really quite agonising to a lot of neurodivergent individuals. So that's how a therapist might approach it. A parent might approach it in the sense of really looking at what their priorities and values are as a family and trying to align those with.
00:41:26 Adelle Sushames
Autistic culture, I'm gonna say so. Autistic culture is this idea that there is actually a way of living that really aligns best with autistic and ADHD and so forth types of brains
00:41:37 Adelle Sushames
And leaning into that way of doing life leads to many rewards because it instantly.
00:41:45 Adelle Sushames
destresses the individual and and the family unit, because they're not trying to jump through hoops that have been set impossibly high for them to jump through. So you know, in a practical sense, for a young child being affirming means that if they have a special interest in whatever it might be, bluey.
00:42:04 Adelle Sushames
Then you nurture their special interest in bluey. You don't say. OK, you know, we've had bluey on for three hours today. That's enough now. No more bluey. Bluey is finished, you might say. Ohh. You know, it's time for Bluey on the TV to be done. But now we're going to draw a bluey picture. Now we're going to make bluey cupcakes. Now we're going to, you know.
00:42:24 Adelle Sushames
Find some clothes to wear in all of the bluey colours, like it's using what the person's natural passions and interests are to help them to flourish rather than to say, well, you need to just you know, you need to rein that in a bit because other people get uncomfortable when you do that.
00:42:40 Adelle Sushames
So I guess that's how you might you.
00:42:41 Adelle Sushames
Know in a.
00:42:42 Adelle Sushames
For a young.
00:42:42 Adelle Sushames
Child apply that approach.
00:42:44 Adelle Sushames
For an older child or teenager, it might be things like recognising that the way that they choose to socialise is just as valid as how a neurotypical teenager might. You know, a neurotypical teenager.
00:42:59 Adelle Sushames
Might be wanting to hang out with their friends after school most days of the week. Go to maccas, go for walks, ride their bikes together, go to parties and.
00:43:08 Adelle Sushames
The movies and such.
00:43:08 Adelle Sushames
For a neurodivergent child or teenager at the same age.
00:43:12 Adelle Sushames
They may prefer.
00:43:13 Adelle Sushames
Just one on one interactions every now and then.
00:43:17 Adelle Sushames
And that's not a failure. That's not, you know, not socialising correctly. It's not, you know, limiting their opportunities for being able to, to work or to, you know, have a successful relationship in the future. It just means that those things may look different for them, and that's OK. So being supportive of the ways that they're their neuro type expresses and what that means for them.
00:43:38 Dr Cristina Cavezza
Amazing. Thank you so much. You've you've given us so much advice already, but I wonder if we could just end the discussion today with if there's any specific things you haven't already mentioned, what advice would you give to those multiple birth families that might maybe are navigating an assessment or they're dealing with neurodivergence in their household?
00:44:00 Adelle Sushames
Yeah, I think you know, if you're navigating an assessment, it can be really daunting because parents feel this pressure to be able to provide every single bit of information, really the clinician just needs enough information to be confident that the criteria are met. So.
00:44:18 Adelle Sushames
You know if.
00:44:18 Adelle Sushames
You complete an assessment and then get home and realise you forgot.
00:44:21 Adelle Sushames
You know, five other details. You don't have to email them through. I mean you can if you want to, but the clinician is probably not gonna be too bothered by that. And it's probably not going to be the difference between the diagnosis and not. And no diagnosis. I think, you know for many.
00:44:36 Adelle Sushames
families, understanding that you can choose an affirming clinician if that's better with, you know, are in alignment with your values because there's nothing you know much more unpleasant. Following an assessment with a professional than getting a report that uses really confronting deficit based language.
00:44:56 Adelle Sushames
You know when the alternative is that you may have an experience both with the clinician yourself as a parent, but also through the eyes of the child that has to go through that assessment and then to receive a report that you will read. And at some point in their life, that child is going to grow up and read as well. Most likely, you know, how do you want that report to be worded?
00:45:14 Adelle Sushames
How would you want it to read? You know, what would you want to read in the report if?
00:45:18 Adelle Sushames
It was about you and just kind.
00:45:20 Adelle Sushames
Of taking that on.
00:45:20 Adelle Sushames
Board and actually being.
00:45:24 Adelle Sushames
You know more, more mindful, in who you might choose.
00:45:28 Adelle Sushames
To do the assessment, if you know if there are choices in in your area geographically.
00:45:33 Adelle Sushames
Yeah. Then I'd probably encourage parents to just have a think about that and to take a little.
00:45:38 Adelle Sushames
Bit more power of.
00:45:39 Adelle Sushames
Their power back in in making those early decisions even.
00:45:43 Dr Cristina Cavezza
Where can people find neurodiversity, affirming psychologist or professional like yourself, is there a place
00:45:50 Dr Cristina Cavezza
A central place where people can do that, or.
00:45:53 Adelle Sushames
Yeah, I think generally not. It's not so simple as just, you know, finding a list on the Internet of everybody.
00:46:00 Adelle Sushames
In your area.
00:46:00 Adelle Sushames
Who, who, who practises in that way, but I am aware that there are certainly intentions within the Australian neurodiversity, neurodiversity, affirming clinicians.
00:46:10 Adelle Sushames
Groups online where we all kind of share stories and commiserations with one another, but also celebrate the the things that we're trying to work hard towards getting changed and this movement getting out there. But there are certainly, you know clinicians within that group who are trying to put together those types of resources. But I think even just looking at.
00:46:29 Adelle Sushames
Individual websites and social media accounts of clinicians that might be available to you because neurodivergence, like anything, is being commodified and used as a marketing tool. So if you have somebody who's saying, you know, we're an affirming practise, but.
00:46:48 Adelle Sushames
The beginning of their advertisement uses the acronym ASD, with the D for Disorder. Then that's a pretty good clue that there may be still need to develop their practise in that area and to really understand the nuances of what that.
00:47:00 Adelle Sushames
Means because using ASD is not considered affirming. You know using identity first language and being able to say you know I'm an autistic person. My child is autistic, not they have autism or they're on the spectrum. Those kinds of terms are just little subtle clues that are there. If you are looking.
00:47:20 Adelle Sushames
That's probably a good way to to get a sense of how the person may work, but also asking them what kind of tools they use in their assessment and trying to be led by your gut feeling in response to the answers that you get.
00:47:34 Dr Cristina Cavezza
Yeah. Wonderful. That's a wonderful piece of advice. Thank you so much.
00:47:36 Dr Cristina Cavezza
Where can
00:47:38 Dr Cristina Cavezza
People find out more about you and your services?
00:47:40 Adelle Sushames
Oh, sure. So my clinic, which I probably only spend a couple of days a week in now is called nurture clinical psychology. I'm based in Alberton in Tasmania and I do conduct assessments there for for all ages and do a little bit of support for my longer term clients
00:47:56 Adelle Sushames
As well, but my main focus in the at the moment is actually a resource and coaching business that I'm developing and that's called Neurodivergent ally, A double LY. And so within that side of the work that I do, I try to design and develop resources that can be used by families as well as schools as well as therapists.
00:48:17 Adelle Sushames
And autistic individuals themselves, who are, you know, teenagers through to adulthood and also providing information coaching etcetera for for individuals.
00:48:28 Adelle Sushames
That can be of benefit across different different settings and contexts.
00:48:32 Adelle Sushames
So that's, that's the work that.
00:48:33 Adelle Sushames
I'm really passionate about and trying to be able to spend more of my time in so you can find me on social media under Neurodivergent ally on Instagram and Facebook.
00:48:43 Dr Cristina Cavezza
Wonderful. Thank you so much. We'll definitely put those details in the podcast show notes for people to go check you out. Thank you so much, Adelle, for spending time with us and and sharing all of that information. It's been wonderful having you here today.
00:48:57 Adelle Sushames
Sure. It was my pleasure.
00:48:59 Dr Cristina Cavezza
Thanks for listening to today's episode. If you'd like what you've heard, then please follow and leave a review so that other expectant and current parents of multiples like yourself can find this podcast and the valuable information it contains. I'd be so very grateful if you left a review and share this with anyone you think could benefit from listening.
00:49:18 Dr Cristina Cavezza
If you have a particular topic you'd like me to cover on this podcast, feel free to reach out to me via my website www.fiercekindmama.com.
00:49:27 Dr Cristina Cavezza
New episodes are released every second Wednesday, so we'll see you back here real soon. Any advice and information on this podcast is general only and has been prepared without taking into account your particular circumstances and needs. For tailored, individualised advice, please consult with a qualified professional.
