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Dr. Lawrence Fung - Understanding and empowering people on autism spectrum
579 Plays9 months ago
Welcome to this weeks mental race podcast episode, where we'll dive deep into the rich world of neurodiversity and autism. Our guest is Dr. Lawrence Fung, a renowned psychiatrist and a pioneering figure in the field. Dr. Fung is an Assistant Professor of Psychiatry and Behavioral Sciences at Stanford University, where he directs the Stanford Neurodiversity Project. Dr. Fung's research and clinical work focuses on improving the quality of life for individuals with autism and other neurodiverse conditions, as well as creating more neurodiverse friendly workplaces and schools.
Adding a deeply personal dimension to his professional expertise, Dr. Fung is also a father to a son under the autism spectrum. This personal connection partly drives his passion and commitment to advocating for acceptance, support, and empowerment of the neurodiverse community.
Dr. Fung haș said: “We need to build identity based on strengths, not on diagnosis”
In addition to empowering individuals, Dr Fung explains how improving person-environment fit for neurodiverse individuals can also be good for business.
So join us as we explore Dr Fung´s groundbreaking work and gain insights into his journey both as a researcher and as a parent.
See more about Dr. Fung and his work here:
https://med.stanford.edu/profiles/lawrence-fung
https://med.stanford.edu/neurodiversity.html
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Transcript
Podcastin esittely
00:00:14
Speaker
This is the Mental Race Podcast. Together with my guests, I will be discussing what human energy and mental performance is all about. I am Heike Hovinen. Welcome to the show.
Autismi ja neurodiversiteetti
00:00:28
Speaker
Welcome to this week's Mental Race Podcast episode where we will dive deep into the rich world of autism and neurodiversity. Our guest is Dr. Lawrence Fung, a renowned psychiatrist and a pioneering figure in the field. Dr. Fang is an assistant professor of psychiatry and behavioral sciences at Stanford University, where he directs the Stanford Neurodiversity Project. Dr. Fang's research and clinical work focuses on improving the quality of life for individuals with autism and other neurodiverse conditions, as well as creating more neurodiverse-friendly workplaces and schools.
00:01:07
Speaker
Adding a deeply personal dimension to his professional expertise, Dr. Fang is also a father to a son under the autism spectrum. This personal connection partly drives his passion and commitment to advocating for acceptance, support, and empowerment of the neurodiverse community. Dr. Fang has said, we need to build identity based on strengths, not on diagnosis. In addition to empowering individuals, Dr. Fang explains how improving the person environment fit for neurodiverse individuals can also be good for business. So join us as we explore his groundbreaking work and gain insights into his journey, both as a researcher and as a parent. Let's go to today's episode.
00:01:57
Speaker
Dr. Lawrence Fung, really a privilege and pleasure to get you on the mental race podcast. Let's start from a personal question that what gives you energy, personally speaking? What gives me energy? Well, every day I feel I'm doing so something that's going to be helping people, that's going to be giving me energy. And a lot of it it also originate from ah my son who is on the autism spectrum because every, every day I interact with him. And I also have opportunities to be working with people like him who are on the autism spectrum or with other neurodiverse conditions or other differences. So it's never a dull moment.
00:02:47
Speaker
So it really seems to be a vocation so you have ah dedicated a lot of your time and energy on on it on the work and that's helping a lot of people but also really personally your son as well and that seems to be also then energizing you. What about something else like in personal life, like what gives you energy and gives balance also to to the vocation?
00:03:10
Speaker
that's a Good question. I feel like I spend almost all of my energy on things that are related to my my my profession. Definitely my family's support is very important over over the weekend. My wife is my boss. hey so She gives me tremendous energy because of all the support that she's giving over all the years and other than my son, my daughter also give me a lot of good things that I can be happy about. Yeah, whenever I spend time with my family, that's that's basically my balance. Yeah. I think it takes a man to say that my wife is my boss, at least on the weekends.
00:04:03
Speaker
I think that's nice. That's nice.
Stanford Neurodiversity Project
00:04:05
Speaker
Okay. Hey, let's go to the topic of of today and neurodiversity. Okay. Autism is is a big topic today, or ADHD a little bit as well. You are a director in the neurodiversity project or program in Stanford University. So perhaps we start from there. So could you tell a bit more about your work and what is that neurodiversity program all about? Yeah. So the Stanford neurodiversity project is a special initiative of the psychiatry department. It is basically a project is all about leveling the playing field for neurodiverse individuals through the understanding and a practice of the strength based model. And basically we are doing it in various different levels.
00:05:02
Speaker
Uh, ultimately we would like to change the culture that in our society. We have basically a lot of ableism. There's a lot of really deficit based thinking. And this is basically not helpful for neurodiverse individuals. And on the other hand, thinking about like the neurodiverse individuals contributing to the society so much thinking about like Isaac Newton, Albert Einstein, Alan Turing, the list goes on and on and on. Without these really amazing people with neurodiverse conditions, or at least if we look at the history books, they they're they're consistent with neurodiverse individuals. we we we we our We won't have the same life. We won't have the same society. We won't have the same gadgets that we are going to be playing with. So our society really need neurodiverse individuals. And if we are able to provide a environment that is going to be helpful for neurodiverse and individuals to to to be developed in their education and also in their career, then it's going to be a win-win situation.
00:06:30
Speaker
So because of that, basically other than by thinking about changing the culture, we also have specific objectives that are going to be helpful for helping neurodiverse individuals to build their identity based on their streams. And also have the, the objectives of training people that are going to be helpful to sustain the environment. so that the neurodiversity friendly environment can be something that will last for a long time.
00:07:07
Speaker
a Okay, that's really nice. And I heard you say before that it's you your kind of mission is to build identity based on strength, not on diagnosis. And you said the same, that you have an objective to two yeah do exactly that. So a strength based model, how they understand and perceive themselves. And this is super important for me as a coach, not only for buts different people, neurodiverse people, but for people in general, that you actually appreciate, see your talents, if you will, like what is the innate thing in you that is to the joy and benefit of yourself, but then also of others. so And what you're saying there, that kind of Elbowism, a deficit-based talk or discourse or even culture is a bit kind of hampering that opportunity for for different people to
00:07:59
Speaker
get an understanding of like that talent aspect of themselves. And and then as a consequence, actually, yeah, contribute fully to the society and and live a flourishing life. Yeah. And absolutely. um Yeah. So we be ah big um because of that, we are very strategic in in implementing our projects. And over the years, we have projects that are focusing on employment. an education and a clinical setting. And we create curricula that's helpful for ah helping the employers to understand how to create neurodiversity friendly environments. We have curriculum that's helping neurodiverse individuals to understand the hidden curriculum of the world that is largely built by neurotypical people.
00:08:55
Speaker
and And collectively we want them to be the employer and the employee to be collectively build building a more neurodiversity friendly workplace. and And this will be much more meaningful for everyone because it's not something that one person has to carry the load and the other is just basically passively participating or the the the role sharing of wanting to to make a better workplace together is what we are hoping for and in education setting as well. yeah we We have a different curriculum over the years and I teach neurodiversity as a course at Stanford. so
00:09:53
Speaker
ah students are benefiting from it. I also teach the this high school students through a summer camp and through the summer camp they learn about neurodiversity and they also learn about how to create projects that are going to be related to neurodiversity itself. So so basically the experiential format can benefit not only neurodiverse students, but also neurotypical students. Okay. Yeah. Yeah. So kind of what you said earlier, the win, you can create a win-win situation actually. It doesn't have to be zero sum game. Hey, let's let's go a bit deeper on neurodiversity that first of all, like what is neurodiversity if you would define that yourself?
Neurodiversiteetin määritelmä
00:10:45
Speaker
Yeah. So neurodiversity is really about acknowledging differences and
00:10:51
Speaker
our brain function and behavior as part of normal variation of the human population. And it is it so that's one sentence definition. But thinking about like diversity as a general concept, but not very much different from the gender diversity or racial ethnic diversity movements over the years. Neuro is just another way of embracing diversity. Okay. So people come in different colors, so so it applies to many things, so brain structure and and and ethnicity and a lot of different things. so But when we when we go to these specific neurodiversity conditions or diagnosis, so what goes under neurodiversity, then we could speak about autism, especially today.
00:11:49
Speaker
Yeah, so so autism is definitely the the first that we talk about because two decades ago when Julie Singer coined the term neurodiversity, that's the time that autism basically is the only conversation. And now we are in the last 10 years, we appreciate that really more accurately and and understand that ADHD or dyslexia or other motor disorders, even other like neurologic conditions like epilepsy or other psychiatric conditions. They should also be subsumed under neurodiverse conditions because of the definition that that I just stated. Hmm. Okay.
00:12:41
Speaker
I see. And how about the autism spectrum? How many people, what's the prevalence of, of all this? Yeah. The prevalence in the United States is 2.85%. In the other countries, generally most reports are with between one to 2%. Cause it's been closer to 1% in a lot of places and probably in the last 10 years or so. Is the prevalence higher in universities for autism spectrum? oh that's a good question There are a number of studies that have tried to get at the the prevalence
00:13:25
Speaker
of autism in the um in university setting. and Basically, 1 in 50 to 1 in 150 is kind of the the range. so Basically, it's between 0.7% to 2% depending on the the study. is It is not really higher than 2.85%. The problem also is how accurate we can determine the the the prevalence in university because of not disclosing. There are a lot of people that do not want to disclose. Yeah. Yeah. Okay. So you don't, you don't get all the actual individuals in those percentages necessarily. So how about then ADHD? What's the prevalence for that? Yeah. ADHD is about five to 7%.
00:14:23
Speaker
worldwide and and dyslexia is much higher is about 15%. Okay. Okay. So that's, that's already a lot of people actually already autism spectrum, a lot of people, but then even more with ADHD and and dyslexia. Okay. How about the like Could you tell me more about the autism spectrum? that What is different in these people, in the neurobiological structure of them? Let's start from that one on and then go to the behavioral side of things as well.
00:14:58
Speaker
Yeah, the the the most replicated finding in the field of autism in terms of structure of the brain is the size of the brain. Initially, it's really the head size. There's a significant like significantly larger head size in autistic individuals, especially when they are in their earlier years. So that translates to brain size. But over time, the the difference between the non-autistic group and the autistic group actually decrease as they become adults. So the when when we are comparing adults, the difference is much less. okay So that's one finding that we
00:15:53
Speaker
we can count on over and over again. The other things that we are seeing is that, the so when we are trying to understand the brain, we we can and try try to understand ah like the cortical structure, for example. So the surface of the brain is called the cortex. And then what's underneath is the the subcortical structure. And those are kind of the more like evolution. and When you think about evolution, the deep part of the brain, the subcortical structure is more primitive. So like there are some things that are related to like fight or flight, like the amygdala is deep in the brain.
00:16:41
Speaker
So, so over time, what we are seeing is that there are differences in particular, like sizes in, in, in different like areas of the brain. And one area that oftentimes that we talk about is superior temporal gyrus, which is a an area that is like not it is kind of like closer to the areas that are responsible for a speech. And there is also other studies that are implicating that
00:17:24
Speaker
the The areas of the brain that may be involved in people on the autism spectrum is the is the cerebellum. It's also ah related to the brain. And then there's also areas that are related to senses like the thalamus, for example. a And also the so the thalamus is a deep structure that's responsible for filtering senses. So all the different senses sensory information has to go through the, the families before they go back to the cortical structures. So the cortical structure, because of the sensory differences in people on the spectrum, the the sensory motor cortex is also often implicated.
00:18:15
Speaker
But there are other areas that we have over the years in seeing differences in between their function, like using functional and MRI. And, and those are some areas that are related to repetitive behaviors. So, so though some of those are also like more of a subcortical structure. But like anterior and cingulate cortex is also one that is talked about quite a bit. All of these different findings, however, a lot of the time we are, we are sometimes seeing convergence of the data, but sometimes we don't see convergence and the complexity of the neuroimaging studies, like different settings that can give us different findings.
00:19:14
Speaker
And because of the differences in the study design, even if you include like all males or you mix male ah males and females or different ages, all all of those matter. So part of the inconsistency sometimes is because of who you are including in the study. So, so basically in a nutshell, if if we are to kind of point at specific areas of the brain that are definitely always going to be shown to be relevant in autism, sometimes you don't really see that. You you can you can see some studies really consistent with consistent findings, but sometimes not. So there there are a lot of nuances to that because of the study design.
00:20:11
Speaker
So there's so many different versions of people on the autism spectrum. So you cannot look at specific brain regions that all of the autism spectrum people would have different compared to, quote unquote, normal people. Yeah. So the in terms of like brain structure is one thing, but the other thing that's what we
Aivojen rakenne ja käyttäytyminen
00:20:35
Speaker
are often thinking about is the the The biology, the neurobiology of it, not necessarily everything is about the structure. Some of it is really at the molecular level, at the circuit level. So a lot of the studies really going for the main theories of autism. So some of the theories that we often talk about is the excitation versus inhibition damage.
00:21:08
Speaker
This is a theory that started by Dr. John Rubinstein at University of California, San Francisco. And basically what that model in a very simplistic sense is that in our brain, there are processes that are kind of like the, the accelerator of the car. There are some processes that are like the brick, the brick of the car. And if you don't have a balance, you cannot really get to where you are. So what we understand is that there is more inhibitory processes, like there's more. So, so be basically, sorry, there's more of the excitatory processes compared to the inhibitory processes. So basically there's less of the break, but more of the accelerator.
00:22:08
Speaker
but That's very interesting. and And is that the reason why then a person on autism spectrum gets overwhelmed quite easily if you see an autism spectrum child, for instance, temper tantrums come quite soon and easily and and you yourself have experience of a child with who who is on autism spectrum. So so where where do these behavioral manifestations come from? Is this one one reason? or So when when when you hear the word the word excitation, the word inhibition, you may think like behavior is the same, but the the the correlation is not really just because of the excitation in the molecular level and then the behavior level, there is also the some level of excitation. but But what we believe is that there whenever there
00:23:02
Speaker
There is some kind of brain difference. We believe that there is going to be a a consequence to the the brain circuits. And if the brain circuits are associated with behavior, then there will be some kind of causal relationship. um But behavior is a very complex construct. So a lot of the time, it's not just like one circuit that you and ah you're talking about. Let's say language. When you're actually trying to understand language, language is not just about us talking. Language, yeah we have to think about that there is
00:23:52
Speaker
the words that ah your your eyes are seeing, and then it gets to the back of the brain, to the occipital cortex. And then you you need to to actually put the the words into the phonics. And then the brain has to make sense out of the phonics. And then after that, you you have to have brain areas that can actually put the different words together in a kind of a way that is a very seamless but because of the learning and then after that you you have to think about like you have other parts of the brain that will be important for you to actually produce the understanding of these words and then you have to respond to it
00:24:46
Speaker
you when you respond to it, it's also meaning that you have to start putting the words together. And putting the words together is different from like having the, it's a part of the brain that is different from the part of the brain that is actually helping to articulate the words. And there is also a an interactive component to it when you are responding to people because of other sensory modalities that you youre you are appreciating in the environment. So basically ah what that says is is that even for like the behaviors that we are very much taken for granted, we are speaking right now, we are not like thinking.
00:25:38
Speaker
about like how we are going to be like using the words like I'm speaking right now, but I'm not thinking about how my muscles in in my oral cavity is actually operating. So a lot of the behaviors are very complex. And, and, and basically the excitation inhibition, a lot of the time we are thinking about the specific circuits that are in a much more basic level. And some places excitation would may be meaning basically making something do less. Sometimes excitation may may make something do more. it based It is really based on how what is the function of the circuit. So that's why this is it' going to be like very difficult to general generalize excitation excitatory processes that are potentially more in an autistic individual that can
00:26:39
Speaker
actually cause them to be more easily excited.
00:26:45
Speaker
a Okay. Yeah. So it's very complex and I'm a big fan of Robert Sapolsky and he's, I think he, one of his main messages this is exactly that that behavior is so complex. There's no one circuit. There's no one hormone. There's no one neurotransmitter. That's going to explain yeah things, behavior. So there's always going to be so many different things that explains human behavior. Absolutely. Yeah. Yeah. You're completely correct. Yeah. Yeah. But anyway, how about then, like, what's, can you still put a finger on what is, as you mentioned, the brain is bigger. That's quite consistent. Brain is bigger in autism spectrum people, but is there like specific
00:27:26
Speaker
brain reaches that somehow, let's say, work more efficiently compared to those who are not on the spectrum. You mentioned people like Isaac Newton and Albert Einstein and people like this. And and so what might be specific to their brains? Like have you been able to find out something that like this part of the brain is actually seems to be more functional, working more better?
00:27:52
Speaker
How can you say that? Well, that that's a very good question. So what what we can say is that we we can we cannot we cannot really tell exactly why Isaac Newton or Albert Einstein's brain is is working better. But what we can say is that in studies that are focusing on how people on the autism spectrum are doing math, for example. So mathematical computations, the the areas of the brain that are important for doing mathematical computation is also very complex.
00:28:35
Speaker
kind of ah ah Basically, it's kind of like to a certain extent, that you think about the language production, the different parts of the mathematical computation actually require different parts of the brain. and And one thing that can be, can be concluded in the children on the autism spectrum with the same IQ level as the neurotypical children. There are several studies that Dr. Vinod Manon at Stanford have done before. And basically what he had found was that the the approaches that
00:29:19
Speaker
children on the autism spectrum do maths, sometimes can be different than the neurotypical children. And because of that, there's ah there's a high likelihood that there may be different parts of the brain that are associated with the mathematical computations. and And indeed, the one part of the brain that is called the fusiform gyrus, that's basically supposed to be used for facial recognition. But in children on the autism spectrum, interestingly, when they do math, their fusiform gyrus actually would light up. And this this is different from neurotypical children.
00:30:13
Speaker
So neurotypical children when pheasiform gyrus light up usually is when they are looking at people's faces.
00:30:21
Speaker
So, so this kind of finding basically is telling us that but the way that they're diverse individuals use the brain for different functions. So they can use the same area of the brain for fun for functions that are typically not used in neurotypical people. That's very interesting. that's very interesting this um like As a coach, I'm trying to help people to
00:30:55
Speaker
ah really get more and more clear on their talents and how they could use those so that those are to the benefit and joy of others and also themselves. And what I notice, and this also comes from humanistic psychologists like Carl Rogers and Mihaly Csikszentmihalyi, who was the father of the flow theory. And what I have noticed and what these these humanistic psychologists also say is that when you actually can put your strengths and talents at use. ah you You can now self actualize yourself. So you can find a deep connection with, with the doing that you do. It might be called flow for, for, for one word this is six sense of me how this idea, but I'm also like thinking that like.
Autistien ongelmanratkaisukyky
00:31:41
Speaker
Okay, like neurotypical people, these fusiform gyrus lights up when you see faces. So you kind of, let's say connect with other person, but I don't know if there's some similarities to then then that you kind of connect with the with the mathematical problem. so So using the same brain, but you are kind of, same brain area, but you are finding so somehow an innate connection with with with really something. I don't know if that makes sense at all, but just a thought. yeah I see what you're getting at, something that is that the person can be more connected to. Yeah, like something that is something that is really innately meaningful. Because seeing other people's faces is innately meaningful for for usually like neurotypical people. Yeah, and for they were diverse individuals, a lot of the time, especially for people on the autism spectrum,
00:32:41
Speaker
When they look at people's faces, they may not look at the look at ah people's eyes, or they may not be looking at the face at all. And sometimes they look at when they are looking at the faces, they look at other parts of the face that typically neurotypical individuals do not pay as much attention to. Like the lips, they sometimes would ah go for it or the nose instead of the eyes. So so the their tendency of like not going for the emotionally kind of more more like important cues like most people can use their eyes to to demonstrate their their interests or no not interest no no interest or
00:33:37
Speaker
or angry that like there is a a test called reading to the eyes test basically is trying to understand how people are understanding from just looking at the eyes and whether or not you can decode just from reading in the eyes so basically neurotypical individuals can can get a lot of the information from looking at the eyes. But for their diverse individuals, autistic individuals, usually they don't take that information because they the avoid going for the eyes. But there are a lot of the time to go for things that are meaningful to them. And um and sometimes that
00:34:32
Speaker
ah that That's helpful to them depending on what um what they are ah they're supposed to be doing. like If we are not thinking about social interactions, if we are thinking about the um like solving problems, a lot of the time autistic individuals will go for the details instead of like the overall ah big picture.
00:35:03
Speaker
And because of that, they can find the needle from the haystack. So is there so there's no right or wrong. It's just the difference in the tendency of neurodiverse individuals in looking at things that they are drawn to kind of more intrinsically.
00:35:26
Speaker
All right. Are autism spectrum people absorbing more information from the surrounding world compared to neurotypical people? There's an idea from a guy called Tor Noratranters. I believe he's a Danish guy and he mentioned that human beings on average can processed consciously, 16 bits per second information, 16 bits per second. And whereas, you know, information that is bombarded to the sensory system is 11 million bits per second. So it's like a super, super tiny, tiny fragment of information that at least neurotypical person can
00:36:11
Speaker
consciously be aware and process at a given time. So I was wondering that, is there a difference? Would you would you know, or can we know that is there is there a difference in how much information on spectrum people have? so Sorry, so like can can they process process more information compared to the neurotypical people? but So from my clinical observation and my experience personally, what I can say is that the the the likelihood for that for autistic individuals to be like processing a lot more information is probably not very high, but it is about how the information is handled. So let's say for people that
00:37:04
Speaker
Like for for example, when when you're in an environment, there there's noise, there is there's the visual information, and sometimes there's smell, there is sometimes there the temperature may be different. All of those sensory information, neurotypical people, a lot of the time they can kind of like filter out a lot of stuff. and focus on what's most salient to them. But for autistic individuals, they don't really filter down to what's most important to them. A lot of the time they collect a lot of those different senses. And and a lot of the time also that they are hypersensitive or hypersensitive to particular senses.
00:38:03
Speaker
So basically, it's kind of like you have various sets of sound system with different amplifiers that their amplifiers are not quite the same. And they don't really control which one you can they can dial down easily. so um So because of that, they um they sometimes can get ah very overwhelmed if they are hypersensitive to smell, for example, or noise, which which is the most common. and And I won't say that they are like collecting more information is just like the amplifier, how how that they ah sense the the sensory information is being acknowledged and then amplified is different.
00:39:01
Speaker
Okay, so it can be both hyper and hypo-sensitive as well. So being extra sensitive to certain sensory experiences and and then less than average sensitive to some experiences if you're hypo-sensitive. And I was thinking also about that detail orientation that that if if there's a lot of details around you that can be very, very overwhelming and I had a client who, who is on, on a spectrum. He's diagnosed with Asperger and I'm not working with him anymore, but I used to work on, and he told me a story when he was in a PE class in high school and they would play like a floor bandy. It's like, it's kind of like hockey, but not, not on ice. So, so you have, ah have a stick and you have a ball and you have nets and, and so what, what happened to him in those games was that.
00:39:53
Speaker
he completely froze. So it was completely overwhelming. He could not come see what's happening around him and he just froze. And and the PE teacher didn't really appreciate that and didn't understand also his his difference and how how he is different compared to others um and and they didn't really, let's say, say nicely, didn't really encourage him ah in in those situations. And and that experience then left a big mark on him and he thought that like you know exercise is not for me and there are the other people who do the exercise and you know it's just yeah it's too too complex and um we actually did with him we did exercise and he turned out to be quite
00:40:38
Speaker
quite good in developing his body strength-wise actually. and And it was a epiphany for him that, wow, I can do this actually. I can be good at this one. um and And he kind of explained how, yeah, like it's, he he he wants to kind of calculate things and understand things. And if he cannot calculate and understand, then it can be easily overwhelming and he can freeze like he did in the PE class. and um but But like, is this story familiar for you? Have you encountered similar experiences in your clinical profession or your research?
00:41:18
Speaker
and Clinically, it is not uncommon that we are seeing people that are kind of somewhat similar in in terms of like not like responding in the in the typical way because of the overwhelming information and they basically would would say so something that's maybe completely off or they would be not seeing anything at all um because of what's happening around them. So so this this is kind of a similar in that they don't know how to handle that particular
00:42:02
Speaker
a social situation and then basically because of that they sometimes they would not want to handle that and so that sometimes they there would not say anything and and sometimes it's a bad experience but if there's no exchange so so that basically hurt them in their social interactions Hmm. Yeah. I see. I see. And that was interesting. What is it before that neurotypical people, they can filter more information. So but but I don't know if that's one reason why it's less overwhelming in everyday life for the neurotypical person wise than for neurodiverse person. It's more overwhelming because yeah, the filtering system is not operating the same way.
00:42:52
Speaker
yeah Yeah. Yeah. Okay. All right. So how about when you have, because you have a spectrum and you might have these more difficult versions of autism, is it already kind of a different condition if you look at the mechanisms that produce very severe symptoms and lots, like really big difficulties in the person's life? So can you, can you find like market differences in, in, in the mechanisms behind these difficult cases of autism?
00:43:24
Speaker
compared to the less difficult ones. So so so it's kind kind of hard to say what like what is difficult and what is not difficult sometimes. And so when someone is has substantial needs, then typically you're you think that this is more complex cases. And when someone is speaking and going to school or going to college or even have a good career you think they may be not very complex case but sometimes it's not true they they just on the surface think you you you see a lot of results from them that look like neurotypical people and that's why you think there's no it's very simple sometimes it's not so I think what what we can say is that the heterogeneity
00:44:20
Speaker
of how people on the autism spectrum present is just so different. Everyone's unique. So to to think that like the neurobiology is also going to be unique, I think that's probably going to be somewhat true in some ways. It's in in a way when we are thinking about the different like reasons Like whether whether or not they if we are believing that genetics is a important part to define the neurobiology or biology of autism. What we can say right now is there are about like over, I think it's going to be closer to like 2000 genes, at least 1500 genes that are associated with autism.
00:45:14
Speaker
There are 200 or so that are strongly associated with autism. A few years ago, it's only like 100 that are strongly associated. So if you are thinking about that, even if there is one gene, if it's so clean that this one gene is about is one reason, one kind of neurobiology, there are 200. And that is not that simple. We know that there is a lot of crosstalk between different processes. So, so the biology is like very, very, very variable. And that's basically only the gen genetics side. The genetics side is right now from the new list studies with support that may be responsible for only 50%.
00:46:07
Speaker
of the the the reason for having autism. The other 50% is environmental. um So there are so many different things that potentially that can be contributing on the environmental sense and like the complications in gynecologic procedure, the different exposure to substances before birth. And there there are are many environmental things that we don't quite understand. So basically to kind of bow down to the biology, whether or not that's going to be more complicated or less complicated is is very much not a question that can be answered.
00:46:57
Speaker
I think what we can say is that the there are some conditions, let's say, the syndromic autism, like fragile X syndrome, tuberous sclerosis, neurofibromatosis type 1, bilemidermit syndrome, those syndromes are more well-defined.
00:47:22
Speaker
because of their genetics, but even for them, it is very much like there is some significant level of variability, even for very much like very circumscribed, very well-defined genetic syndrome of autism. And let's say Frederick's syndrome, not everyone has autism. It's 50, 60% of the people with Frederick's syndrome. has has autism. It's much more than 2.85%. But why is that? that's and So there there are a lot of nuances to the understanding of even the the most well-defined syndromic forms of autism.
00:48:14
Speaker
So you said 50% in genes contribute to autism and then 50% environment. And you mentioned that, that when you are in fetus, basically, is is that the most significant part of the environment or what are other environmental things? You also mentioned gynaecological procedures. And what did you mean by that one? What what are the most significant environmental premature birth? For example, it could be one or when there are complications during pregnancy. or complex Complications during labor, delivery, those those are some environmental contributors that report it. It is very difficult to to say exactly like what are the parameters, but basically if you are to bow down to like, is it is it possible?
00:49:05
Speaker
It is possible because there are studies that would support that gynecologic complications can be potential contributor. Okay. Okay. is Is C-section one of those or, or no? I don't think so. C-section is not, I mean, if it's like emergency C-section because someone has the labor complication, then that would be counted as labor complication instead of C-section. Okay. I see. I see. I see. Okay. That's very interesting. So again, it's very, very, very complex and it's you cannot just put your finger on one or two or even three things. There's always going to be a lot of different nuances to this. And also it's difficult to define what is difficult actually. So what you see from the surface might be different for for what it actually is in the end underneath. Yeah.
00:50:02
Speaker
Yeah. Okay. um Hey, how about having a few words about, you mentioned earlier, like you are working on building neurodiverse friendly workplaces, schools.
Työpaikkojen ja opetussuunnitelmien kehittäminen
00:50:15
Speaker
So how do you actually do that? Yeah. So basically what we have been doing is to develop curricula, to train the employers on how to understand how to support neurodiverse individuals. And the one thing that I talked about before is the hidden curriculum. The hidden curriculum basically is is kind of like everyone knows about, but nobody talks about it. the All of the social rules that are intuitive to people after you're in the environment for a little bit. But for neurodiverse individuals, they don't really, ah so neurotypical people
00:51:01
Speaker
They don't have to be taught. They just experience the environment in that they get the social rules. But there are diverse people, ah especially autistic individuals. If you don't tell them, they may not know. So basically, some of the understanding of the hidden curriculum, we dissect the hidden curriculum and and explain to the employers and trying to get them to appreciate what are some things in their environment that can be considered to be hidden curriculum. And then they can help the neurodiverse individuals to to know what those social rules are. And also trying to get them to understand the differences in executive functioning
00:51:50
Speaker
the social interactions, helping them to understand like performance evaluation, how to do a more strength-based performance the evaluation. So those are kind of some of the the ah the topics that we talk about and there's more for the employers. And on the other hand, for the autistic individuals, we also have a curriculum that but would teach teach them more of the like what what is communication ah in the workplace and what are some things that they should know about but sometimes people on the spectrum especially if they do not have a lot of experience in the workplace before they they get into trouble for doing some things that they just don't know about like maybe they
00:52:46
Speaker
they write emails and or they receive an email from their boss and then and then and i mean to an email that's sent to the entire department and then they They accidentally reply to the boss and everyone with some like trivial question or it's something like that. Or there there can be some other situations that are like difficult in communication. So we teach them well all that and teach them about the, like how to, how to deal with like exactly function challenges because it is very common. And we also teach them about like an emotion regulation.
00:53:29
Speaker
strategies. And we teach them about how to advocate for themselves. So ah basically, on one hand, we are trying to get the neuro diverse individuals understand how to operate in the neurotypical world. But on the other hand, We are trying to get the employer to understand how to change the environment so that it will be more neurodiversity friendly so that they can actually kind of work together. Yeah. So both parties understand each other and where they're coming from. Yeah. So but basically taking a two-prong approach.
00:54:22
Speaker
We are person-centered, but we are also ecosystem-driven.
00:54:28
Speaker
Yeah, I see. So the broader community also wins, and not not only the individual, but you you're looking at both angles there. OK. And some of the things you said that about that hidden correct column, that perhaps like you need to make it unhidden. that that So it's more explicit communication about the rules and practices and what do you do at workplace. You make it very explicit, because for neurodiverse people, that what is sort of second nature and and very like automatic understanding for neurodiverse person, it's not. it's it's It's new information, so you need to be very explicit about different things, which I think is a good rule for general communication that don't assume don't ask you man and and that's yeah the more you assume, the more you might
00:55:16
Speaker
go to wrong ways when you communicate with other people. And then you spoke about strength-based performance evaluation, so so so that you really look at those and not deficit-based. I like that a lot, so we ah anyways have a negativity by us human beings, so it's good to look at the positive and look at what you can impact to yourself, and that's going to be more empowering for sure. in general as well. And you teach those neurodiverse people also emotional regulation and general rules how to operate in ah in ah in a working environment. Is there something specific in the environment itself, like physical environment, how you want to build that one so that it's it's neurodiverse friendly? it's It's very common that people on the spectrum have like auditory hypersensitivity.
00:56:02
Speaker
And it's also very common that people are sharing workspace space. So even cubicles physically, they have their own space, but people can hear each other. And more, what can be also would be difficult is if they are close to like a copier or something and that that noise is just not helpful. But so basically. A lot of the time, like know knowing that they can use noise canceling headphones, that they can be assigned to a place that is not closest to the copier and the and all the like social actions are taking place is helpful so so that they they won't be distracted and they won't be overwhelmed by the stimuli.
00:56:55
Speaker
Hmm. Great. Right. Hey, final couple of questions about when should you think about taking your child to medical professional to study for autism spectrum?
Autismikirjon diagnoosin arviointi
00:57:09
Speaker
So I would say if you, if you are, if you have a, an infant, like just a one or two years old, someone is. like that young definitely you want to wait a little bit, but when they grow older and they are like three or four years old and they are still not like speaking or their interactions are not quite the same as other children, it's I think it's reasonable to bring them for evaluation. And basically speech is really important. A lot of us really can
00:57:48
Speaker
do what we can do because we speak. And when someone is behind on speech, that the person is also going to be very behind with their social interactions. So so having interventions that will be helpful for speech early on is important. And a lot of the time that has the need a diagnosis to be more effective.
00:58:18
Speaker
Yeah, I see. So I mean, that that's kind of general for the little kids, but for older kids, that is not is never too late. Even when people are um young adults or full adult, if there there is a question about the diagnosis of autism, I think it's reasonable for understanding um yourself or understanding your child. And the the later the the more difficult because diagnostic procedure should include information that's from early on in life. So when someone is much older and they don't have their parents any anymore to recall
00:59:15
Speaker
the early developmental history, it will be more difficult to be sure about their diagnosis. yeah So it's never too late, but it's better. The earlier, the better, basically. The earlier, the better. yeah So how about like, how do you diagnose all this and then what are the key, just a couple of things that, that, how do you diagnose that? The diagnostic criteria in the United States is going by DSM-5. And basically we need three of the social you ah communicative criteria, which is the difference in their social, emotional re reciprocity.
01:00:00
Speaker
the difference in their nonverbal communication. And we also need to have evidence for significant challenges in developing ah relationships. And in addition to these three, we need two out of the four social non-social criteria. So the first will be repetitive behaviors like hand flapping, rocking the body, that kind of stuff. And then this the second is cognitive differences in terms of inflexibility. And then the third is the special interests. And the fourth is the sensory differences. So you need two out of the four, ah plus the free social criteria that I just talked about. And in all of this, ah we need to have evidence from early on in life.
01:00:57
Speaker
Yeah. and Okay. All right. Cool. So you started this discussion how it's important to, let's say, allow neurodiverse but people to you know use their strengths and to the toian benefit of themselves and everybody else. And so we have that resource also at use and you mentioned how like one thing is that the speech is not developing and I can see how that can be a big stigma that is my child now disabled and less intelligent and and so on and so forth. However, you have your own experience as well how your kid is on on spectrum or your son and and I guess he he also didn't speak before he was four or something and and then then he went on also to
01:01:47
Speaker
Yeah, pursue good things in life. So okay could you, a little bit shed light light on on on your son's story, if if you if you but would would will. I think that could be could be nice in
Henkilökohtainen kokemus autismista
01:01:58
Speaker
then. Yeah. So so by my son was diagnosed with autism when he was four years old and that there was 16 years ago. And at that time he didn't speak. and And when someone is not speaking, and at that time I i wasn't an expert in autism, we we really can't say whether or not he's going to go to college or not. We didn't know if academics is for him. We don't know if he's going to have other challenges.
01:02:31
Speaker
And his doctors at that time would tell us about like lowering our expectation, but my wife and I just refuse to lower our expectation. We try to give all the opportunities that we think will be helpful for our son. And and he he he learns how to play the piano and he he actually like took all the different piano exams over the years and and and he's actually quite quite good in piano. And and and as he's growing up, he actually needed a one-on-one aid for several years, from entering school to sixth grade.
01:03:21
Speaker
And before he was in middle school, in middle school in the United States, it's from sixth to eighth grade. is ah His doctor was telling us that he's probably going to need a one-on-one aid for a long time. but My son proved everyone wrong. key One thing that's different from elementary school is that in middle school, you have to go to different classrooms. In elementary school, you stay in one classroom and the teachers come to you. In middle school, you have to know where to go. and And people, the teachers initially, the teacher's aide and the doctors were ah' saying that he
01:04:10
Speaker
He's going to have trouble with going to different places. And basically in six months after starting middle school, he he told us that, oh, I can do it. I can go to the the different classrooms. And basically from there on, he he actually did not even need a oneon one-on-one aid. And over time, he has also challenges with ADHD. He actually also needs to take medications for ADHD. and And when he is growing up, he becomes more and more like knowing what he has to be responsible for. And basically, at one point, he was just telling us, I'm just going to do it without
01:04:59
Speaker
medications and indeed he is proven to us that he can do it.
01:05:08
Speaker
And ah now he is in college, hes he has he still has a lot to to learn about with independent living skills with social skills and so forth. But he is thriving in college. He's now finishing his second year in university. He's studying mechanical engineering. So for the parents that are listening to the your podcast, I really urge them to
01:05:40
Speaker
make sure that please, please give all the opportunities to your children and never give up, even when the professionals are telling you it's going to be a tough road. It is a interesting, maybe sometimes torturous path, but if you believe in your children, they will show you that they can do it. Give them to all you or you can provide and give them a lot of love. And things will go in the right way for you.
01:06:23
Speaker
I think that's a fantastic way to end. So life and behavior is very complex and it's good to see the unique strengths in people and encourage that and provide a lot of love and then you will be good. So I think that's a really, really nice message from you. Thanks a lot. Where could people know more about your work? Is there some website or some resources that people could study further? Yeah, if you can Google Stanford Neurodiversity Project, you'll find our website and a lot of our work in neurodiversity is right there. And how our lab also has, so our website for the Stanford Neurodiversity Project is is mainly for the neurodiversity work, for the neuroscience related work.
01:07:18
Speaker
you You can ah find me under the Stanford website, and then you can find the the studies that we're doing. Fantastic. All right. Thanks a lot for your really valuable insights. Thank you, Haiki. Thanks for listening to the Mentor Race Podcast. If you like what you hear, please subscribe to the channel and leave a review. This helps us to get great guests and develop the show production. Also follow our social media channels, mentorrace.fi and heck you have been a coach on Instagram and check out our website, mentorrace.fi where you can see more about the podcast and our coaching products for leaders and high performing teams.
01:08:04
Speaker
Together we can actually achieve higher performance humanely. See you next time.