Education, executive functioning and neuro-affirming practice – podcast transcript

Listen to this episode on Spotify here.

SPEAKER: Angela Palacios, Senior Educational Psychotherapist, Neurodiversity Affirming Practitioner, Executive Function Coach, ASD Assessor. 

In today’s episode, we’re joined by Angela Palacios, Senior Educational Psychotherapist, Neurodiversity affirming practitioner, Executive function coach and ASD assessor. Angela is going to tell me a bit more about three key areas of support we offer through the Wellbeing Hub: Educational Psychotherapy, Psychotherapy for Emotionally Based School Avoidance (EBSA) and Executive function coaching. So if you’ve ever wondered why extra tutoring isn’t working for your child, or why seemingly simple tasks lead to a complete breakdown, this episode is for you.

Charlotte 00:40 You’re obviously a professional, and you’re providing varying levels of support techniques – quite typically for people who are neurodiverse – but you’re also neurodiverse yourself. Do you want to share a little bit about how that came to be and your particular type of neurodiversity?  

Angela  Yes, you know, I always thought that there was something different about me, starting from school. I used to get very distracted. Sometimes I would forget – a lot of the time I would forget about my homework – not just that I had to do homework, but what was it? I didn’t write it down. I started panicking. Oh my gosh – I’m trying to get to talk to my friends so they could tell me what their homework was about, like all of those things. I heard many times, “Oh, she’s so smart, but, you know, she’s very lazy. If only she applied herself a bit more”. You know – that type of thing. And yeah, as I grew older, doing essays and putting things together, my thoughts together, writing things down, that was such a struggle – like it would take me forever for my body even to find the motivation to start to get the pain, to start writing, to turn my laptop on, that type of thing.   

Angela  02:00 So I always felt like I didn’t have the energy or the motivation to do any of those things, because there were things that required a lot of thinking, or because I wasn’t that interested in doing that admin side of things. So I always thought it seems like everyone can do things very easily, and they’re typing away, and they’re doing all these things one after the other. They get all the to do list done very quickly. And for me, it just takes forever. So I always thought – clearly there must be something here. Because it’s not just now, as a grown up. It’s been there forever. So yeah, I got diagnosed with ADHD at the age of 43. And that’s made a lot of sense to me and to my everyday life.

I understand things I don’t feel ashamed about – you know, making mistakes and not being able to meet deadlines and things like that. I know why, and I’m trying to put the strategies in place. So it does make a lot of sense to me now.   And now it helps me a lot to also understand my clients and the people that I work with, because I know that we have those shared experiences. I can tell them, you know, “try this. It’s worked for me.” Or, “this didn’t work for me, but maybe it will for you.” So just having those conversations around our brains and what can we do to make things a little easier. It’s never going to go away, it’s always going to be there, but we can certainly do things to help ourselves manage.   

Charlotte  03:43 I think it’s interesting what you said, just thinking about the clients that you work with, the young people, and you saying that you were described at school, as being basically able, but not motivated, and how that felt in your body. But with it sounds like, from what I know about executive function coaching (and I will ask you to explain a little bit more) that it’s something that is particularly helpful for children and young people who have neurodiversity. I myself am dyslexic. And how does, what does that look like? What is it? What does an executive function coaching session consist of? Obviously, it’ll be slightly different. But if you could give us an idea of that, that’d be really helpful.  

Angela  04:37 Well, I think it depends. It varies from individual to individual how old they are. we would focus differently if we’re working with a child or even a teenager. Or a grown up who does work in an office and things like that. But essentially, what we look at is the individual’s executive function profile.   So the executive functions are skills that we use every day for everything. From tying up our shoelaces to packing our bags with our laptops and all the things that we need for the day, to even remembering where we put our things, our keys, our mobile phones, all that kind of stuff. So very basic skills that we use on a daily basis.   

So when we look at the individual’s profiles, we look at what executive functions are most challenged for this person. For someone it could be working memory or time management. And then we think about – when do we see the challenges around these executive functions? And we think of goals – what do we see improving?  Someone might say, “Well, I want to be able to leave my home with enough time to get to work and have maybe five or ten minutes to settle, prepare my things, perhaps get a cup of coffee, rather than just walking in all stressed because I’m very late, I have a meeting” – that type of thing.

So we sort of break that down into steps.   “Okay, so in order to leave your place on time, what do you nee d to do? Do you need to get up a bit earlier? Or do you need to structure your time? Get up at the same time, but maybe don’t spend so much time in the shower or on your phone before you get to leave.” We look at the individual’s routine and structure, and we think – okay what needs changing? And with that in mind, what strategies can you practice and put in place so that you can then leave your house a little earlier and get to work on time? – you know, that sort of thing.  

Charlotte  06:40 So it sounds like it’s quite applicable. Executive function coaching is applicable for anyone who needs help with those kind of daily tasks. I’m particularly interested in the neurodiverse aspects, because what you’re describing – in order to leave the house on time and to make sure that you have enough space when you get to the office, for example – for I imagine quite a few people it’s, “I just have to get up and make sure I leave on time.”   

For myself, also as a neurodiverse person, I have to think about it in blocks.  I have to go all the way back to, “Right, I need this. I need 30 minutes to get dressed and sort myself out. I need to pre-plan my outfit, because otherwise, I know that slows me down. If I’m like, “Oh, I haven’t got these jeans, they’re in the wash”, then that throws me.   I need to pack my breakfast beforehand, because I know that again, that’s going to slow me down. And breaking it up into increments and steps, like, you know, “I’m a 32 year old woman, I have to think about these things, because that’s just the way that my brain works.”  But I think for younger people, things like that in the classroom and understanding – that it’s okay, that I just need that bit more time. Or it’s okay – it’s not strange that I need to think about these things when other people are saying “What do you mean? I just get up and go and it’s fine”, or “It’s not stressful to me to be rushing.” 

Angela  08:20 Yes that’s the thing. For all the neurotypical people, as we hear it, this sounds like, “well, what’s the issue? You just get ready and leave. What’s the problem? Why are you stressing?” But it is very stressful.   And it sounds like your brain in some areas like this, in getting ready, you’re very organized! I can’t do any of those things, even if I remind myself that I have to do all those things. And that’s my ADHD. I just can’t do it. So I always stress. What do I wear? And I just grab the first thing I see. There’s no planning. It’s just rushing, even if I say to myself, “Okay, I’ve got an hour.” So like you said, “Let me just structure my hour, right? So in the next 15 minutes…” – No, it just simply doesn’t work. So it takes a lot of effort to be able to do all of these things, that for somebody else is just a very normal, easy thing to do – to just get ready with no stress and leave the house.  

Charlotte  09:20 And I guess it’s that effort that is so draining, right? That you’re having to do that extra thinking. I’m aware that we’ve kind of strayed into one of our favourite topics talked about – which is neurodiversity and how it manifests. But also that is a really good example of executive function coaching and how you would get a client to think about the systems they need to put in place to support themselves.   What is Emotionally Based School Avoidance? Because I’m not sure… 

Angela  09:55 Well that happens when a child doesn’t want to go to school. And it’s usually because of some anxiety associated with school. It could be because they don’t like one of their teachers, or it could be because something’s happened.   You know, maybe not necessarily bullying, but there are aspects of school that are difficult for the child, and that brings up some anxiety. And the child might be a bit frightened to go there to see some people, or to just be in a lesson with a particular teacher.   

So what they do? They sort of refuse to go to school. And often they complain about tummy aches, or they say, I can’t really go because x or y, and say some excuses. But it’s not because they don’t want to. They probably want to go to school, but they just simply can’t, because the anxiety is so much that it stops themselves from putting themselves in that situation.   And a lot of people look at it as if they’re just being difficult, they’re lazy, they don’t really want to go to school. They’re trying to be a position number. But it’s not really. In most cases that’s not really the reason. They just simply can’t. You know, it’s like when I was talking about my body not being able to move and to start things. Well, it’s the same.

They can’t possibly get themselves to get ready because where they’re heading to is very, scary for whatever the reason.   For somebody else, it might not even be an issue at all, but for them, it feels really intense, so they can’t – and then they come up with these excuses which for them are very true, but for other people might sound like they’re just being difficult. They don’t really want to go away.  

Charlotte 11:39 So with educational psychotherapy, specifically for Emotionally Based School Avoidance, what would a session look like? Psychotherapy is talking therapy, right? So is that you sitting down with the child or young person, one-to-one, and unpicking? Or is the parent involved? What does that look like?  

Angela  12:09 So it’s different from psychotherapy in that you add that learning element or that school element, right? It might not necessarily be an issue around maths or divisions or whatever, it might be that there is some anxiety linked to school. So what do you do? You try to unpick that by first talking to the child and trying to understand what it is about school that they find so tricky. And if you realise that really the issue is linked to some learning difficulty. Maybe say maths – they don’t understand numbers, and they just simply don’t want to go to school because they know that they’re going to be exposed to all these things that everyone seems to be able to do, but they themselves can manage.   

And so you start from thinking – okay, maths is the issue. Let’s go deeper into that. What bits about maths is that you don’t understand? Is it just the numbers? Is it when you put numbers together? Is it when you’re trying to solve some problems and things? And that’s when you introduce some of the maths elements and the learning. So you’re not helping them learn how to do their timetables, or anything like that. But you bring in the element, the skill itself, the learning, to then see what comes up for them. Whether they’re anxious, whether they refuse to do it?  

And then that’s where you start reflecting and exploring with them. “Okay, clearly there is an issue when we bring this into the space. I notice that this is what’s going on for you.”  And then they might eventually feel ready to say, “Yes, I don’t like maths because this, this, this and that.”  And that’s it – then you’re trying to explore with that, and you support them with that, but you don’t teach them. It’s not tutoring, right? So the academic performance is not what matters here. What matters is the feelings associated with that particular aspect of learning.  

Charlotte  14:10 And the sort of intersectionality between the two that they kind of inform each other. So you can’t just say, “Oh, you’re anxious about school because you don’t like this lesson.” It sounds like a much deeper exploration of that – which is really interesting.  

Angela  14:28 It could be that maybe, say with maths again, the child felt shamed when they couldn’t solve the problem, or when they couldn’t calculate a sum, and they felt rejected, and they felt ashamed. And so there is this avoidance to go there again, because it brings back feelings that are very unpleasant. And so they have this response to maths where they avoid it all together, yeah, and that’s you work with in the session.  

Charlotte  15:01 So the educational psychotherapy – I guess I’m going back to thinking about if I was a parent listening to this – would be appropriate for a child or young person who’s struggling with school? Who’s not necessarily saying or refusing to go, but who is clearly going and coming out anxious before, stressed before, Sunday evening is a nightmare…Then the school avoidance is quite a serious accumulation of all of that anxiety and stress around education.  That child is saying, “Actually, I’m not going now.”

So educational psychotherapy would be very appropriate for a child who’s obviously struggling in school (jump in and correct me if I’m if I’ve grasped this wrong), who doesn’t need tutoring, but needs some kind of therapeutic support and therapy. Because whatever’s going on with their education is what is causing the issue for them. It’s having an effect. And I guess at that age, when you’re in primary school and secondary school, your whole life is school and learning. It’s a huge part. You forget, being an adult – but school is your whole social life. It’s everything.   

Angela  16:28 Also, it could be that a child is very bright, but again, for some reason that links to their emotions, they’re not able to function or make progress in a particular area of their learning. Say English – because spelling is tricky for them, or the writing. They’re not confident, and that would affect how they feel about school altogether. It’s not just English, it’s everything else – because they might come in at eight or nine o’clock and they have a few different lessons. And then it’s English after five hours of being at school. But for those first five hours, the child will be completely anxious. It’s not that they will be functioning before English. They will be distressed the whole day during and after English, if that’s what they’re struggling with.   

So it really does have an impact on themselves and how they experience the school as a whole, not just that particular aspect of it. And then, of course, that will have an impact on how they are with their friends, because they will be anxious, maybe they will be a bit moody. Friends will wonder, “what’s going on here?” So it does impact all of the aspects of school – not just that particular one, where they’re finding it challenging.  

Charlotte 17:48 And where just having a tutor, if your child is struggling in maths, may not actually be enough or the solution that offers them the most level of support. Because it’s about the emotional aspect and mental bit that’s really interesting. I hadn’t quite made the connection or really understood about the educational aspect of educational psychotherapy.   Do you think that with the clients that you see, who you do educational psychotherapy with – is there a common thread of neurodiversity, or educational additional needs, or specific needs that run through that?   So it’s a bit more common for children who have additional needs?

I would say, being dyslexic, like that is an additional need, and I didn’t have a formal diagnosis of dyslexia until I think in secondary school. And then I didn’t have any support in exams or anything until sixth form. And it was really tricky for me with learning. I can really relate to some of the aspects that you’re talking about. Would you say there’s a common thread of neurodiversity through those supports, or the children you see and you think there are themes in there?  

Angela  19:24 Yes, there is. Also because there is often these communication difficulties and social difficulties that are also linked to school and being around friends.  I would also say that I have clients where it works really well for children that unfortunately don’t have the support they need in their families. So they don’t have support around homework. They feel very lost, or they feel pressured to perform when they’re being helped to do their homework.

So there is a lot of anxiety associated with learning, right? Because they feel the pressure of it – they feel like they’re not good enough, from comments made by the parents or carers.   So when you have a child that doesn’t really get the support emotionally that they need, and makes you know they have a carer or an adult that helps them just with the homework or the learning, but not also with their emotions that come with that, with trying to get that done… When they don’t have that, the response is much more reactive, isn’t it, because they feel completely unsafe.   “I’m given this piece of work that is already making me feel awful and unable, and you know, it makes me feel dumb, really. And then the person sitting next to me – they don’t see that that’s how I’m feeling, and they’re pressuring me. They’re telling me that I’m very lazy. They’re telling me that I’m not listening to others.”   

So a lot of these children then have challenges and difficulties with getting started and performing and doing things because they avoid it all together. It just doesn’t feel good. That’s it.   “So why would I put myself in a position where I have to feel all of these things? Yeah, and no one helps me feel better about it or helps me in a way that really takes into account how I’m feeling.”   So all of those children that don’t get that help at home, that emotional help as well, they benefit a lot from educational psychotherapy, because it’s having that container of feelings as well.  

Charlotte  21:36 And you may come from a high performing family – everyone does very well academically. Your child might be doing pretty well academically, but clearly very stressed and anxious, and because they’re doing well at school, it’s hard to make the link or understand why they feel so stressed and anxious.  And having that kind of thinking about the feelings that are involved in that and they might be doing really, really well and scoring very highly – but the stress that goes with that sense of having to achieve… because, for whatever reason they feel they must, or they’re good, and they feel encouraged. “Oh, you’re great, so we’re expecting….”, “oh, you’ve got another A or will get another.”  All of these things that you might say as a parent, that you don’t even think about…” oh yeah, great. Oh, she or he always gets A stars, or we’re expecting…” – all of that language that I guess you wouldn’t think about the internalising of that.  

Angela  22:51 And that’s the thing! You might have a child who’s achieving and getting very good grades. But in order to get there – because there is a massive expectation – the levels of anxiety that they have to manage to get to that goal of achieving are huge. And that’s again, clearly having an impact on maybe their friendships or how they see themselves. Because, “if I don’t put in the huge effort, maybe I’m not good enough for mum and dad.” So there is a lot of pressure there.   And the fact that a child is managing doesn’t mean that they’re really managing and everything is going smoothly. No, things don’t go as smoothly as we think because we assume that, “okay, there is a good grade – they’re very bright, very smart, they’re very organised.” And, yeah, that could be true, but that doesn’t mean that the child is not very anxious whilst doing homework or learning. Yes there are a lot of emotions at play.  

Charlotte  23:51 Now we have to remember the whole school system and the education system is based on grades. It’s based on performing and learning – and in a very specific way that doesn’t actually work for everybody, but that specific way of performing.   And then you’re graded, and then you’re put into (I remember this so clearly) …into classes depending on how well you’re performing. So you’re put into a class with a different set, and all your friends are in the other set, and they all continue those peer relationships, because they’re in all the same lessons together. And you who might not be performing as well. And again, I keep using the term performing, because it is about a performance, isn’t it in school? And you’re then in a different group, and you’re in a different set, and the impact that this would have on a child and young person. And even if the narrative is not coming from your home, in school of – this is really important – and the shame when it comes to not doing as well.  

Angela  25:04 absolutely as well, what you internalise there is that you’re not good enough to be over there with your friends or the other group – of individuals who seem to be very bright and able to manage and to perform, right? So that alone is…well, you’re categorising people into levels of intelligence, if you like. That’s how someone would internalise it, isn’t it? “Well I’m not as smart as… clearly”, and impacts self esteem. “I’m not good enough, or as good as you.” Just comparing yourself to other people, you know?  

Charlotte  25:46 I did a podcast on EHCPs (Education, Health and Care plans) with Paul Stanley, and he was talking about how girls especially, internalise things. High masking autistic women, or girls at that point, in school / children seem like they’re doing well – good enough, right? “Performing good enough.” And I remember having this conversation, actually, in reception, with one of our parents about the EHCPs. And the school had said, “Oh, they’re going to come out with two GCSEs. That’s great for them.”   And she was like, “No, but my son can do better than that. And that might be your expectation, but you’re seeing it as they’re doing good enough. I know that my child needs more support in order to reach their full potential, not just to do good enough.”  

And I guess it comes back to those like narratives and, “well, you know, they’re doing okay. They’re middle, they’re in the middle set, and that’s fine, and that’s good enough.”  But I guess it’s a balance of, you know, good enough is good enough – you know, if it’s not worth the stress and the anxiety. But also parents knowing their children best and knowing that actually at home, when we talk about things and we have discussions, they’re clearly really able, and then you put them in the school context, and they can’t cope. And unpicking what that is, what that means, what’s going on.   

Angela  27:23 That’s why it’s so important, when we think about education and psychotherapy, to talk to parents and to hear all those things. You know, they’re very able, actually, but clearly, when they’re in school, something happens there for the child that then they can’t perform – or at the expected level, or in a way that reflects how well they can do at home.   So then you need to think about, “okay, because clearly there is something about school… we need to unpick that, and understand what it is, in order to help this kid.” Because it’s interesting, isn’t it, that someone manages in in one area or in one environment, like home, but they seem to struggle quite a bit in another environment, being in school. And why is that?  

Charlotte  28:13 Just as a final note, because we’ve discussed this term recently in a staff training, and I’d never heard of neuro affirming before…and I really liked it when you explained it and the kind of work I think we’re talking about…We’ve just spoken about language and internalizing – how what is said to you as an adult, as a child, as a young person… Could you just explain what neuro affirming is and what a neuro affirming approach is?  

Angela  28:51 Yes, so neuro affirming is really considering the individual as they are, with their challenges and their strengths, but without thinking of them as something or someone that needs to be fixed, right? So the person is who they are, and they function the way they do. And it’s good. It’s as good as anybody else.   There is a tendency (in society) to look at the person as well. They clearly don’t function as expected by society. Therefore, they need to change. They need to put all the effort themselves to change and to manage.   But when we think of neuro affirming practice or thinking, we think quite the opposite.   There’s nothing wrong with the person, they’re fine as they are.

Maybe as a society, we need to change some things around so that the person can function a bit better. So it might be that in classrooms, for instance, there are so many things, so many posters, so many colours and displays everywhere, and a child can feel very overwhelmed by all of that. But instead of telling the child, “well, you have to manage,” we need to think about things that might help you manage being in the classroom without feeling so distressed or overwhelmed.   “How about we reduce this place and the bright colours so that the person then isn’t as impacted by everything around them.”  So that’s the thinking around it. It’s not changing the person. It’s all of us making an effort so that the person can manage and can function optimally. And so neuro affirming practice, then, is thinking about expectations and is linked to the person and not changing them.

But in the school setting, for example, or even in therapy, if we’re thinking of goals for that individual to achieve we often say, “well Charlotte in the next six months – she needs to be able to approach all the children and initiate play or conversation with them at least 60% of the time”, and maybe Charlotte or Mary, is autistic, and we know that for an autistic child or individual, that’s a very hard thing to do most of the time.  So then maybe the goal could be phrased differently, so maybe teachers can support Mary’s peers to understand her body language and to approach her when she seems or she looks like she’s able to manage that interaction, or teachers need to support Mary into expressing when she feels ready to do so as often as she needs to. There’s no need to put a number to it.   

So it’s just thinking about what the person can manage, rather than what we think they should manage. And it’s always through that neurotypical perspective, isn’t it? This is accepted. “This is the minimum that someone should be able to do.” – Well, not everybody exactly. “You need to fit into that, and you need to work very hard to be able to achieve that.” – Oh, but that’s not realistic for me because of my neurodivergence. So what do I do then? Do I have to force myself to be in a position that makes me feel really uncomfortable or overwhelmed, and then I go home and I have to be indoors for three days because it was too much for me to manage and I need to recover?   It just doesn’t need to be that way.

So it’s for everyone to work together so that that person can fit more, if you like, into the neurotypical world, and that alone is sad. I don’t like thinking about it that way.  The expectation is that the person needs to fit in. But again, I think the positive is that it’s everyone’s effort to make that possible, and not just that particular individual.  

Charlotte 33:03 Going back to the executive function coaching, and that revolves around support systems and putting things in place so that you can be on time, for example, you can start a task, or, you know, the things that you’re struggling with…I guess a part of that process of the coaching is – do you think about the positives that come with a child’s strength?   So I imagine you’re looking at the struggles, but you’re also looking at the strength.

Again, just my own experience of being a dyslexic person, proofreading is not my thing, but I can read something and take the information incredibly quickly, and I look at things and problems as a whole. And in it, I look at things in a completely different way to other people, and that’s only something I’ve learned recently. Prior to that, when I was younger, it was just, “Charlotte can’t spell and she inverts her numbers,” and it was all the “can’t do’s”, rather than, “these are the attributes that are positive, that you have to offer with your neurodiversity.”  

Angela  34:22 Yes, absolutely. So in in coaching, we will think, “Okay, what’s worked? What have you done before that’s worked? How can you use your strengths to help yourself manage these other aspects – whether it’s your creativity or your playfulness, even. If you can make a task be playful for yourself, and that’s something that’s going to help you manage and follow those steps, then do it.” It’s whatever works for the individual, but of course, taking into account their strengths and what they’re good at, to then think about, “okay, let’s use that to your advantage, and that might then help you improve other areas.”  

It’s just about trying and being consistent with executive function coaching, because we know that these skills, these executive functions, can improve over time – but only if we are consistent and we make new habits.  So when we consistently try a strategy for a while that will become a habit. And that’s when we see that improvement in that particular executive function challenge. And when something becomes a habit, you don’t even think about doing it, because it comes naturally.   So that’s why consistency is key. And for young or younger kids, we really need the parents to be the consistent reminder and help them so that they can do things and they can put things in practice. So it’s finding what works for us, because what works for you might not work for me – and we’re very different individuals.