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Dr. Jeremy: Hello, everyone. Welcome to the Testing Psychologist Podcast, the podcast where we talk all about the business and practice of psychological and neuropsychological assessment. I’m your host, Dr. Jeremy Sharp, licensed psychologist, group practice owner, and private practice coach.

This episode is brought to you by PAR. The BRIEF-2 ADHD form uses BRIEF-2 scores to predict the likelihood of ADHD. It’s available on PARiConnect-PAR’s online assessment platform. Learn more at parinc.com.

All right, welcome back y’all. As always, I’m so glad that you are here for another episode of the Testing Psychologist Podcast.

Today’s episode is pretty remarkable. I am talking with Dr. Liz Angoff, about specific tools that you can use to enhance your feedback process specifically with kids, not with their parents but with kids in particular.

And the cool thing about this is that Liz has developed a manual that is actually packaged as a kid-friendly book, a children’s book to walk through during the assessment process and help them get enrolled in their assessment and learn about themselves. So it is super cool. We spend a lot of our time talking about Liz’s experience with trying to do feedback, how that didn’t go so well, and then her journey to figure out better ways to do it. And like the title suggests you’re going to walk away, I think with some very specific tools on how to improve your feedback sessions with your kiddos. It was great.

So, let me tell you a little bit about Liz, and then we will jump into it. Dr. Liz Angoff is a Licensed Educational Psychologist with a Diplomate in School Neuropsychology. She’s been practicing for over 15 years as both a school psychologist in public schools and in private practice. She provides assessment and consultation services to families in the Bay Area, California.

So like I said, there’s a lot to take away here. I think you will enjoy this episode. And what’s unique about Liz is that she is really trying to launch this product and spread the word about this book. So you’ll see links in the show notes for how to access her book and get it through Kickstarter, which is where it is right now. So definitely check those out.

Before we jump to the conversation, I want to invite any beginner practice owners out there to consider the upcoming Beginner Practice Mastermind. If you are thinking of launching your practice in 2021 or would like some support for a practice that you’re currently trying to launch or just post-launch, this could be for you.

This is a group coaching experience with five or six other psychologists, myself as the facilitator. And we hold you accountable, help you set goals, and help walk you through that whole process of launching your practice. So this is only beginner practice owners all working through those initial stages of practice development. If that sounds interesting, you can check out thetestingpsychologists.com/beginner and schedule a pre-group call to see if it would be a good fit.

All right. Without any further delay, here’s my conversation with Dr. Liz Angoff.

Hey Liz, welcome to the podcast.

Dr. Liz: Hey Jeremy, thank you for having me.

Dr. Jeremy: Yes, I am happy to have you. Like I said before we started to record, I am totally thrilled to be talking through your thoughts on feedback sessions with kids because we haven’t really tackled this on the podcast before, but it is something that I think most of us are doing at least a couple of times a week, so probably pretty important. Thank you for being here. I’m excited.

Dr. Liz: Yeah.

Dr. Jeremy: Yeah. That’s what we’re doing. I mean, that’s a big part of our job. So, let’s just start as I usually start with guests. And I would love for you to talk through, of all things, why this? Why zone in on feedback with kids? Why is this important to you?

Dr. Liz: Yeah, so of all the things. I think for me, the reason to focus on it is just that it did not come naturally to me at all. And then when I actually started to poke around and talk to other people, it turned out that a lot of people weren’t much more natural at it than I was. So it seemed to be something that was pretty challenging. A lot of people would go so far as to say, “I don’t do feedback with anybody younger than 12.”

As I started my career as a school psychologist, and so I’m in school and there’s a principal who was like, “Oh, you just finished assessing Johnny. Can you talk to him about it as ADHD? I don’t think he really gets it.” And I was like, Oh, okay, that sounds like something that’s totally within my skill set. And I sat him down and said, this is what ADHD is and just watched him completely glaze over totally overwhelmed. He walked out in that zombie’s face. I was like, “Oh, that didn’t quite work the way that I imagined that it would.”

And then I transitioned to private practice then and had a lot more of your time to really have these conversations with kids. And it was just really inconsistent. Some kids were totally ready to absorb the information. They were excited about it. And other kids still glazed over overwhelmed. One kid ran crying to his car. This is definitely something that we need to figure out how to do.

And I think that the kicker for me is that in private practice, I started working with a lot of adults who had histories of learning disabilities and needed a re-up on their assessment for grad school or work or whatever it was. And I’d ask them, what were your challenges in school? And they would say things like, I don’t know, I was just dumb. I was really slow. I hated school. I was in a special class, but I’m not really sure why. And then we would do the assessment and start really unpacking how they process the world and do that demystification process in the context of the assessment. And it ended up completely rewriting the narrative of their childhood to the point of tears with some people.

And it happened over and over again with adults and I realized that this is not optional. It is not an option that we need to talk to kids about how they learn, how they process the world, why things are hard so that they have a way of understanding that’s positive and empowering, even if it’s just a little piece of it. Because we have that power to really help them define the way that they are relating to the school and to other people and how they think about those relationships.

Dr. Jeremy: Sure. That’s so powerful. I love that we’re just coming right out of the gate with that. I wrote that quote down. This is not optional. I haven’t thought of it that way before. I’ve thought of it as optional, but when you flip it around and look through the adult lens, that totally makes sense. Like we’re giving all this feedback, many of us, I think probably just to parents or in some abbreviated version to kids and then 10, 15, 20 years down the road, what are they going to remember from that whole process? And often it’s not great. They walk away with these narratives of failure or something being wrong with them. It’s not empowering or helpful at all.

Dr. Liz: Right. I think most of us weren’t really trained on how to do it. I mean, there’s definitely a subset, but most of the people that I’ve talked to did not get training on how to do the feedback with kids, especially young kids. I think there’s a lot of ideas out there, but kind of hit the ground running, there was a kid looking at you, the training I haven’t heard a lot of.

I think there’s a lot of nuance to it because we’re working with young kids. And it’s hard enough to break this language down. To translate a neuropsychology report to parents is hard enough, to school teams is hard enough, and then to go to the kid that’s even harder. So there’s just a number of things that get in the way that weren’t something I gave a lot of thought to before I started to fail at it so often.

Dr. Jeremy: Well, yeah, that’s how it works a lot of the time. We get smacked in the face with blatant failure and turn that into learning. Oh my gosh. You’re so right. I wish we could do it somehow, like a show of hands right now just to see how many people actually got trained in how to do a feedback session with a kid versus parents during grad school or internship or wherever it might’ve been. I don’t think it’s that many. So, yeah, this is super important. I’m already getting really jazzed about our conversation here.

So as we’re diving into this, my brain starts cranking on well. If nobody’s really learning it, I’m just making that assumption based on anecdotal experience, but if nobody’s really learning it, why aren’t people learning it? And then I go to, well, is there any research or are there any guidelines for how to do it? Is there anything out there that you know of as far a… I don’t want to say a manual to do it, but any information that we could have been taught at some point?

Dr. Liz: I started to poke around and I have a background with collaborative proactive solutions, which is really about how to help kids talk about the things that are hardest for them. And that’s a huge influence and just shifting the way that I approach all my conversations with kids with things that are challenging. And so there are pieces in there. And then you had Karen Postal on your podcast with feedback that sticks and there are so many gems in there. And then of course the therapeutic assessment community, that’s where this is nailed. Like they have a process for working with kids. And it’s actually something I came into really late in my process, just really recently. And so I’m still learning a lot.

My understanding is that the therapeutic assessment process, it’s looking at an intervention for the family system which is something that’s extremely important, obviously. I think I was coming at things from a slightly different angle and more the psychoeducation angle and helping kids develop a vocabulary and building a shared vocabulary within the family or the school team for self-advocacy.

So obviously there’s a ton of overlap. And as I said, I’m still learning. I actually think that the approach that I’ve started to do over time, I have a lot of stuff from there I can integrate. I have not found the manual on child feedback sessions. I definitely have not found that. There’s a lot of stuff from Mel Levine on demystification.

I think I have a lot of trouble taking theory, and putting it into what do I do right now with this kid in front of me? And so like for me, I needed some more concrete tools to really guide that process. And there’s a lot of things that weren’t so intuitive to me that I discovered over time just working with a lot of kids and like keep trying this out and trying something different. And having something systematized was really helpful for me.

So I think that for me, there are pieces all over the place, but I needed a way for my brain to bring all that stuff together so that I had more of a routine to really help me through with each kid. A flexible routine so that with each kid I had an approach and then I had a starting point to go from there.

Dr. Jeremy: Yeah, I like that. I think we all do best with a framework, even if we’d like to adapt it and then be flexible. It’s nice to have that mental or that concrete framework to fall back on so that we know what we’re doing. We’re going to hit the high points, but we can also be flexible within that. So I think this is a great segue to the meat of our conversation, which is really like what have you learned over the years and how have you distilled this into a framework of sorts? So we can take any direction that you would like. But yeah, I’d love to actually dive in and learn about the framework you’ve developed here.

Dr. Liz: Sure. So definitely from trial and error, but there are four things that I’ve been keeping in mind. And so it’s the before, during, after, and beyond assessment for helping kids with feedback. The first thing, and this drove it home for me, there was that podcast that you did with Karen Postal forever ago that I think it was her that said “Feedback starts at intake.” Which is just a phrase that I love because of the idea of feedback as an ongoing process that no parent, no child, no anybody can process all of this stuff within one session. It doesn’t happen like that. So the idea that this is ongoing.

But the first critical piece that I realized was that for kids feedback actually starts before intake. It starts before their first session because it starts with how parents talk to their kids about assessment before they ever come in. And so I developed a handout that’s on my blog. It’s very available.

Dr. Sharp: I’ll put it in the show notes.

Dr. Liz: Yeah, a little handout that just has the language that I use for talking to kids about learning about, developmental differences, about just different ways of being in the world and uses that growth mindset language. And it’s set up as here’s how you can introduce what we’re going to do to your kids. And here’s how you can talk to them about it. And what to do if they say, no, I don’t want to go.

And it completely shifts how the kid walks into my office the first time because when kids have had these conversations with their parents and their parents are saying, Hey, we’re going to go discover something. We get to learn about how you learn. We’re going to discover your strengths and it’s going to be really cool. You get to learn about the brain. Oh, and also that thing that you’ve been complaining about how I’m always nagging you about homework, she’s going to help me with that too.

So, we’re defining things in terms of the kids’ problems and putting it in their terms and putting it in discovery terms from the very beginning, which means I don’t have as much uphill work to do to get them there when they come in because they’re already like, “Okay, let’s do it.”

Dr. Jeremy: Sorry, just to jump in. I mean, I like to be very practical with all this. You said this is happening in a handout. So are you like giving this handout to parents at the end of the intake but before testing or what?

Dr. Liz: Either in my first call, when parents call to say hey, I want to figure out if I want to work with you. Often in that call, one of their questions is how do I tell my kid about this? They’re going to freak out. And so sometimes before they’ve even decided to do an assessment, I’ll send it to them just so they can see, but definitely at intake when it’s like, your child’s coming in the next week. Here are some tips on how to talk to them about it.

And so it won’t just be sent home. I’ll verbally walk them through how I would introduce it. And then we can talk about some things that they might be concerned about for their own child and how we might approach it directly. But it’s nice to have that concrete language there, that bulleted sentence frames for parents that they can use so that they know what to say.

Dr. Jeremy: Yeah, absolutely. I get that question I would say at least half the time. How do I talk to my kid about this? How do you suggest we bring this up? Because they’re always, Stephanie Nelson used that term secret question. The secret question is kids are going to… how do I make sure my kid doesn’t think there’s something wrong with them or how do I do this without making my kid feel bad? Something along those lines.

Dr. Liz: And parents are on different pages too. I get this a lot like,  how do I convince my spouse that this is a good idea as well. And so just have it reframing it for everybody. And then the secret question piece is a lot of times, the parent or parents who are calling, they also have that secret question of maybe there’s something wrong with my child. And so reframing it for them from the get-go is really powerful because it starts the shift for parents and thinking. And so when parents come in, if we’re doing all this work and helping their kids develop this language for thinking about assessment and learning challenges, then we’re going to be shifting the way they think about it as well.

Dr. Jeremy: Right. I love that parallel process. Yeah, I didn’t even think about that until the last few two minutes. But yeah, the underlying thing there is parents are pretty insecure as well and we got to help them too. Very cool.

Dr. Liz: So the second thing is building that shared vocabulary with the child during the session. And there’s a couple of reasons for this. The idea of kids asking their own assessment questions is super powerful. I’ve since learned and I think that comes from the therapeutic assessment work as well for me for the younger kids because for older kids, middle school and beyond, a lot of times they were able to answer that. They had their frustrations. They had the things that they wanted to figure out.

But for little kids, what I found is that a lot of kids either didn’t have the words to say or they weren’t aware. I mean, they just weren’t aware of any problems or it was really fascinating that with some kids, it happened enough to be a pattern that kids would get very defensive and say like, oh, I don’t have any problems. It used to be a problem. It’s not a problem anymore. I’m fine now. Everything’s fine.

And so there’s the giving them the safe space to be able to talk about challenges and the words to talk about it, both of those things have to happen. And so the first piece, I love talking about the brain. And even at a very simple level, kids like it too. And I have a brain model like a lot of us do. And I have a little brain diagram that I draw on too. We look at just the lobes of the brain and general jobs that they have, and then think about something that they really like to do and how their brain is all working together to make that happen.

The most recent kid, he loves to do legos. And so I was like, what part of your brain do you think you’re using when you’re building Legos? And he’s like, the part that tells me where things are. I was like, great. What else? Like, Oh, I have to see the Legos and I have to really make a plan. And there are so many instructions that I have to follow. And then I have to hear the click to make sure that they’re together. And so we look at it and I have to pick up little ones. And so we get to talk about how their brain is working in all these cool ways. And it gets them excited about the idea of discovering something about their brain through the tests that we do.

And it also gets them starting to ask questions. And I actually, with any kid, I don’t care what question they ask. I just want them to ask a question. So like, why am I so good at rock climbing is a question I had recently. I’m like, great, let’s do that because we’re going to get into the fact that this particular young person has incredibly visual spatial skills and is really struggling with the language. And so like how we get to make those parallels. So any question.

And then talking about how neurons are forming connections and we’re constantly building our brains. I like to use a construction metaphor. So neurons are connecting, making roads in your brain. There are highways and there are things that are under construction. We’re always building and always growing. And so let’s talk about your highways. What are some of the things you’d like to do? What comes easily to you? And then let’s talk about some construction that you’ve done over time. And this was key to shifting for younger kids. Like, what are some things that used to be hard that are now easier for you? What are you proud of building?

And so these construction projects, the finished construction projects, a lot of kids are excited to tell me. And even if they don’t have something to say, kids who have been tutoring, they’re like, Oh my God, I’ve done so much better in reading. Most frequently, I’m building my Minecraft skills. I’m really good at it now but I used to not be so good.

And so, I got to a new level in a video game. It’s all construction. Or we can just start with walking. Like you used to not be able to walk when you were a baby and every kid can connect to that. Like, Oh, okay. I guess I am building skills. And then we get to say, what do you want to build next? What’s next on your agenda? And now we can talk about the things that are hard. And it’s a way easier entry point because now they have some language for it. We’ve established that things are growing and changing. So whatever they say is something we’re going to work on, not something that we’re going to discover is broken.

And it really changes the way. And so we’re building this vocabulary. I’m listening to the way that they talk about things, but because young kids don’t always have a way, I’m also building that vocabulary with them so we can jointly figure out a way to talk about their experiences both the positive and the tricky ones.

Dr. Jeremy: Right. I just love that you’re that early in the process planting the seed and getting them acquainted with the idea of, it’s okay to not be so good at something because I have these experiences where it got better and then it’s priming them for whatever you might talk about from the assessment that’s not super strong. Well, now they know that they’ve worked on other things and made them better. Now this. Yeah, that’s great.

So again, just very practically, when is this happening during the assessment? Is this clinical interview stuff or like throughout the testing day or what?

Dr. Liz: It’s worth mentioning the way I do testing is over a couple of days. So kids come in. But I start with a brain diagram and drawing on the brain diagram with them. That’s how I introduce testing. And so depending on the kid, we might play a little game and then get into it or he might just drop right into it. But their first experience of coming into the room is I’m pulling out markers and I have a colorful book that we’re doing together, which we’ll talk about in a little bit, but it’s colorful, it’s engaging, it’s exciting, and it does not look like a test. So it’s very exciting.

And then that sets us up for like, okay, let’s go see what we can discover. We’re going to be doing all things that make your brain work in different ways. And then that language of highways and construction zones, I’m using that throughout the testing. Like through a clinical interview, we find out that these are things that come easily to you. Do you think of those as your highways? Is that something that we could call your highways? Let’s write that down. Or it sounds like you’ve been working really hard, is that a construction zone that you have? Let’s write that down there.

And then through the testing as well, if they knock something out of the park, and not for every test but for things where it’s like, wow, that was really fast. I think we found another highway. Or when they really struggle with something, now we have the vote. Instead of being demoralized by it, it’s like, Ooh, that must be a construction zone. I wonder what we’ll figure out about that. Can you tell me more about how you did that or what was hard? And since we have that vocabulary, I’m writing things down all throughout and documenting it in our book where we’re going to go back to later so that we’re creating this thing together.

Dr. Jeremy: Yeah. This is real-time feedback in a way. I mean, you’re talking through it as it’s happening.

Dr. Liz: Exactly. Which leads to the next piece. And I think the biggest mistake I made during feedback sessions for a long time with parents also is, I’ve been thinking about it as surprises suck for all of us. And you never want to lay a surprise on somebody in a feedback session. There’s no big reveal of like, here’s what we got. And it doesn’t work with parents and it definitely doesn’t work with kids. And so by having a framework, and as I said, I need a framework and a structure. So having a structure to document all of this stuff in real-time with the kid means that when we get to the feedback session, we’re just completing something we already started and we’re just reviewing what we learned, which they already know, we wrote it down. The child watched me write it down.

And if they’ve asked questions, they know that when they come in, we’re going to answer those questions. And so whether it’s why the kid who’s become staring at right now, why are some parts of math hard and some parts of math easy? And so he knows that when he comes back in, that’s the question we’re going to be answering. Or if it’s, why am I so awesome at rock climbing? We can answer that too.

So one kid asked, why do I have lucid dreams? I was like, I’ll get on that. I’ll figure that out.  But a lot of times there is something about why is this hard and this easy, and those are our awesome questions. And then the kid knows that’s what we’re going to answer when we come back in. And we’re going to go right back to the same stuff we’ve already written down. And so now we don’t have surprises.

And also I have their language or our shared language to define any diagnosis. And this is what I’ve been writing about most recently in my blog. How do we define these diagnoses for kids? And it sounds something like, we discovered that you have these strengths-these highways, and these challenges-these construction zones, and it turns out that this pattern is actually pretty common and you’re not alone and we have a name for it. And this is when it’s appropriate. Some kids it’s appropriate, some kids not. But when it’s appropriate, we have a name for this. We have some terms we can use.

And so when we see this pattern of highways and construction zones, we call it ADHD. And it has to do with your whole profile. Not like you have trouble with attention, and that’s why we call you ADHD. That’s not how it works. We know what’s in the DSM. And then what we know about how different brains interact with the world are two totally different things. So really helping kids to understand their differences in terms of the whole picture and that this is everything together.

And even I had a 6-year-old this morning who we didn’t diagnose with anything. But he’s at risk for a number of things. And we talked about how his brain is built to run super fast. He gets jokes really fast. He answers questions really fast. And he comes up with ideas really fast, but we got to work on his breaks. So, there’s the pause button. We got to construct his pause button. And he does a lot of Minecraft. He’s like, Oh, I could build it and I can do this. And so we’re just giving kids a way. We’re redefining things in a way that’s going to help them move forward and get them really engaged in whatever intervention is happening so they know why that’s happening. I never want a kid leaving my office, going into some intervention or therapy because their parents said so and they have to. Even a 6-year-old, I want him going in saying like, I’m here to work on my pause button.

Dr. Jeremy: That’s great. I love the language. Just helping kids develop this vocabulary to describe their own experience is invaluable. They’re going to carry that. And it’s like you’re getting there first in a way before anybody else or anything else can give them a more negative vocabulary or a way to think about themselves. That was fantastic. I’m just thinking through all of these things and everything I’m not doing Liz. Construction zones.

Dr. Liz: Yeah, definitely in my construction zone. I can’t say that I have this down like Pat. This is constant learning because every kid that comes into our office is a little different. And I think that’s what was really challenging about finding feedback tools and ways to talk because there’s a ton of stuff out there. I mean, there are metaphors for days but every kid seems to need something just slightly different. And on my part, I was spending hours and hours trying to find something for every kid. And what’s the metaphor that works for them? And it’s not quite there. And it’s not at their level or it’s not words that they’re going to understand or this video is too long?

And so I need some way to do this. It was going to be flexible enough so that I could adapt feedback sessions to the kid in front of me without spending hours and hours trying to design something especially for them.  It is especially for them, but to do the hours and hours to do that?

Dr. Jeremy: Well, sure. Yeah, aAnd that’s the thing that I love. I’m excited to talk through the… you mentioned this book that you use to go through this whole process. Before we dive into that, I think we still got the one component, right? Like the onward piece. And actually, I’m going to interrupt myself before I even do that. Tell me, what do your feedback sessions very literally look like? I mean, are kids and parents there at the same time? Are you separating them? How long are they? What’s the structure?

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All right, let’s get back to the podcast.

Dr. Liz:  If we could turn on the camera, I could show you the fallout on the podcast. And that’s probably going to fall out of the session I had this morning with the games all over. Talking specifically about elementary school-aged kids, I have the parents come in or at least one parent. And in COVID times, this looks like a highly ventilated room and everybody in masks. But we do meet outside. It’s the rainy season here but outside whenever we can. So that’s what it looked like.

But we start with a game just to get everybody in the room. So we played family Jenga and just did a check-in. And then we talk about what the child remembers from what we did. And then we go over what we already talked about just reminding them about, you told me some of the things you really like to do or these things, remember we drew all over this brain. Do you remember how we talked about how your brain does Minecraft? And then for kids, I am giving them maybe 1 or 2 highways that we discovered in our process and 1 or 2 construction zones. And they have to be things that are aligned with things that are important to them. I’m not introducing anything new.

And there’s a sentence frame in the workbook that I use. You should know that lots of people’s brains have highways and construction zones that are very similar to yours. In fact so many that there are special words to describe what’s going on. And then we introduce our special words.

And for the child this morning who is 6 years old and does not have a formal diagnosis, and I don’t know that we would be ready to share any with him even if there was, his special word was perseverance for his highways because he has worked so hard. And he’s so proud of himself for the work that he does. And he’s really excited about catching his errors, so we use the word. So one of his special words was perseverance. And then for construction zones, it was building his pause button. So that his highways are like he can process things so quickly and he goes so fast, but he’s building his pause button. And he has perseverance. And so that’s how we described it.

But for another child, I might actually write in like we learned that your brain is built in a way that comes up with ideas so quickly and so easily. And your hand is having a hard time keeping up. And we call that dysgraphia. So dysgraphia means that your hand is having a hard time keeping up with the thoughts in your head. And, of course, dysgraphia can cover a lot of ground. So just that as an example. It could mean different things for different kids. There’s a couple of ways that dysgraphia shows up, but for that kid that might be the way that it shows up. So we’re defining it in terms of their strengths and challenges. We’re just giving it a new name. And then I usually come up with one celebrity that has the same challenge.

Dr. Jeremy: Always a good strategy.

Dr. Liz: So Daniel Radcliffe who played Harry Potter had trouble with writing in school. So I like that one for little kids for a writing challenge. So we’re physically writing down that definition for parents to be able to go back to that definition so that they know. And then we’re writing down their construction crew and who are the people who are going to be helping them including if there’s going to be somebody new on their team. And then we’re writing down a couple of tools that they’re going to use. So things that will be helpful for them.

Dr. Jeremy: Yeah, this is great. So are you talking primarily to the kid throughout this time or what?

Dr. Liz:  Yeah, I’m talking to the kid. It takes about 20 minutes. It’s really quick. And then usually they go play and I talk to the parents to just review. Two minutes of just saying, here’s how you’re going to use this book going forward. Here’s how you’re going to use this language going forward to continue the conversation and to set the context. And this is the first bit of an ongoing conversation, but here’s the language that will help you moving forward.

And that’s the ongoing piece. Is setting parents up to continue the conversation. So we’re coming full circle from the beginning that priming parents with a language to talk and teachers as well, but priming their parents to talk about it before kids come in and then helping them to use that same language to define the results of the assessment so that they can keep talking to their child in that positive growth mindset empowering way.

Dr. Jeremy: Yes. So important.

Dr. Liz: Yeah. In PS, often a lot of parents there’s a lot of like light bulbs that go off in the feedback session with a kid because like, Oh, that’s what you meant. So it’s a nice way to present things in a very visual way for parents as well.

Dr. Jeremy: Yeah, that’s amazing. So then how long is the entire feedback session then?

Dr. Liz: Less than an hour. I mean, this is the kids. I do it separately then the parents. So the parents come in first for their feedback session. I do a session with the parents to review the report. And then on a separate date, sorry that wasn’t clear, on a separate date, the kid comes in for a short session with their parents to finish the book so that their parents can hear how we’re talking about it. And then they take the book home with them.

Dr. Jeremy: Okay, very cool. And then speak just a little bit to that ongoing component. Is there more to that in terms of follow-up that you do or, is it all housed within this workbook that you’re using? What’s the after and beyond?

Dr. Liz: Part of my assessment process is meeting with the school team and following up with other professionals who are working with the child. And so whatever language we come up with in the child’s feedback session, I’m communicating that to either the school team when we meet or the other professionals that I talked to so that the language is consistent.

And then just the way that I run assessments, I always do a check-in three months after our last session. And so that’s a moment in time too. But I think because it’s such a moment in time, the assessment process is just like a snapshot, we come in, we do our thing and we’re gone, and realizing that one of the things that makes feedback with kids so hard is that it’s just a moment in time and that’s not how it works. That’s not how kids work.

The way that they’re processing differences that are going to come up at different points in their developmental trajectory is going to require a new framing. And also like to expect the child to understand it in one session, that’s ridiculous. That’s not going to happen. We’re trying to jumpstart things. And so,  one of the key reasons for having something concrete that families can take home is so that they have my language and my voice and the collective words that we came up with to continue the conversation because otherwise, parents are overwhelmed in this process as well. And it’s really hard to remember all the details and how he did that.

So that concrete nature, something they can go back and revisit with the child is interesting to look at. I think it is really helpful in continuing that conversation. And that’s the feedback I’ve gotten from families. They’re like, yeah, we look at all the pages we did and all the drawings you did. And in the early days, this was like a clip art printout. And so then I would write on, which is like another way to do it. And I have kids who still have them posted on their walls and stuff. I have the drawing of our brain on my wall. And so that those physical pieces and the visual piece are just so critical for making sure that that conversation keeps going.

Dr. Jeremy: Right. I think that’s a nice transition to actually talk about the book because it has been quite an evolution from what I understand. So talk through how this even came to be? We haven’t really shone a spotlight on this very much so far in this conversation, but you sent me one of these books and it’s a legitimate book. This is not just a thrown-together binder kind of thing. This is a real book that you’re writing in and creating with these kids. So tell me, how did this even develop from the clip art to where you’re at?

Dr. Liz: I went into private practice. I was having trouble explaining brains to kids. And so I went back to school and did this additional neuropsychology training. After that training, I actually got more confidence skills, knowledge to be able to actually start drawing out the brain for parents during feedback sessions. And so I would bring out my markers. Parents would come in ready for the 30-page report and I’d bring out one page and markers. And the experience was like, you could just see everybody relaxed, like, “Oh, well, if she has crayons and markers, this can’t be too dire.”

And then parents started asking me to do that with their children. That evolved into just a PowerPoint presentation that I would personalize for each kid. And that was really helping with the feedback sessions when I had that personalized thing. But what really changed things is when I printed the thing out. And we had a physical book that we could look through together. I thought it was going to be way more interesting to kids on the screen and flipping through things and animations and all this stuff, and it was not as fascinating. It just was not.

But when I printed it out and they could point to things and draw on things and we could do that, then that was way more effective. And then this concept of surprises sucks, I was just realizing that if we did it all, it was too much for just the feedback session. So I started introducing pieces of it at the beginning of the session, and just for me because it was so much time to make a personalized PowerPoint presentation for every kid, I had a template, but I was trying to find images that were personal to the kid. And it was just so much.

So, I ended up with something that was more generic and a lot more white space so that we could draw our own stuff in. And that was a game-changer because then we started it at the first session in introducing little pieces along the way. And then that made it so that the feedback sessions were not so overwhelming. And that little clip art printout once that got stable enough that it was the metaphor, the construction metaphor was working with all of the kids that were coming in, it was pretty versatile.

Dr. Jeremy: Can I ask a question about that?

Dr. Liz: Oh yeah. Sure.

Dr. Jeremy: Sorry to interrupt you. But that occurred to me earlier and I’m glad that it came back up. With the construction metaphor, I was curious, do you find that the majority of kids resonate with that? It seems very traditionally masculine to me. That’s the question. Do most kids get on board with that or have you seen some results?

Dr. Liz: It’s so funny that you asked that. Somebody else asked me that. And it’s funny because that’s the metaphor that resonated with me the most. It was just about my personality. And that’s something that I could talk about and relate to. But it has never been something that any of my kiddos have shied away from. And there’s always a relationship because most kids are either Legos or Minecraft or Roadblocks, like the video games are very much doing these things. And even for kids who aren’t into that, it’s very easy to understand.

And we’re talking a lot about neurons making connections and higher brains working together. And so depending on the sophistication of the kid, I might put my emphasis in different places. For the 6-year-old that was in this morning, we talked a lot about Minecraft and building things and all of that. And for another kid, we might use a different aspect of the metaphor. But I have not seen a difference in the girls and boys that have come in. Maybe it’s how I talk about it because I’m really into it. It’s not a new metaphor. I want to be really clear. I did not make this up. It was the most versatile and the one that was easiest for me to talk about.

Dr. Jeremy: That makes sense.

Dr. Liz: And it has proven true over 2 years with dozens of kinds. And so that’s been really useful.

Dr. Jeremy: Nice. Yeah,  I just had to ask that. It got to me a couple of times. So thanks for talking through that. So then you really made it come alive with these strong metaphors?

Dr. Liz: Yeah. So, when we all went into lockdown, I hired an illustrator.

Dr. Jeremy: When we’re bored. Yeah.

Dr. Liz: It had actually been something that I was thinking about for a long time because the clip art was a little lame. And so the clip art definitely did not resonate. That was a little harder to find the right images than the other. I was fortunate enough to work with an illustrator and a close colleague who is a scientist and a phenomenal artist. And so he helped me to bring my image of the metaphor to life. And then we had a digital artist make the images and the book. I’m super proud of the book. It looks really cool. It’s super engaging. Kids are responding really well to it. And it’s really colorful. It’s different than your traditional workbook.

Dr. Jeremy: I know. It looks great. It yeah. Like I said, I was fortunate enough to get to peek at it as we were prepping for this. And yeah, it was super impressive. When you said, Hey, I’ll send you a copy of this book that I put together, honestly, my expectations were low. Nothing to do with you, but we can create any number, everybody’s creating something. So, it was a pleasant surprise. It really is pretty awesome.

Dr. Liz: Thank you.

Dr. Jeremy: The important piece here is you’re trying to maybe get this thing in the hands of more clinicians who could use it, is that right?

Dr. Liz: Right. So this has been a super helpful tool to me and a couple of colleagues who are really excited to use it. And then it grew from there. And so I’ve talked to enough practitioners at this point to know that child feedback sessions are a problem for a lot of us. There’s a lot of us who want to get better at it. We see the need. There’s both a lot of stuff out there and not enough stuff out there to really help get this targeted about what we do in the office on the ground.

And so the hope is that this workbook, it’s called The Brain Building book in line with the metaphor, and the goal is to bring all these pieces together. So to have a structure for building that shared vocabulary with the kid, for having something you can do along the way, and then to have a final product at the feedback session that makes the feedback session more predictable. It makes kids excited about what they’ve learned and it gives parents the language to continue that conversation with them without taking up a ton of my time in preparation. Something that’s a little easier to put together and still be exciting and impressive.

And so this has definitely solved this problem for me in my practice. It’s been super fun to use. And now the question is this going to solve the problem for more people? And I think there are two pieces to it. So there’s a Kickstarter campaign that is designed to see if enough people are interested to really make this thing possible.

Printing them one by one for my own practice is totally worth it but expensive. And so, to make it affordable to people to be able to use, we would have to do a bulk print, which means that I need to know that there are 200 people interested enough to be able to do that bulk print and make it really affordable. And so the Kickstarter campaign that’s going on right now is a way to do that. So people can pre-order the book. And then if we meet our goal, they’ll get printed and shipped. And if we don’t meet our goal, then everybody gets their money back and we try a different way to solve the problem. Try something else. So there’s that piece of  just, is this the thing? Knowing that it’s definitely a problem that people are interested in solving, is this a thing that’s going to solve it?

And then the second piece is that getting a bunch of people using this means that I can get a lot of feedback on how it’s working and anything that needs to be tweaked or what else could be useful. I’ve had people asking like, can we do a different version that’s specific for rehab, or can we do one version that’s for dyslexia and one version that’s for autism and one version that’s for ADHD or different aspects of it. And so getting all of that feedback, I think would help evolve this tool into something that really could solve this problem. And that’s super exciting for me that it could up all of our game. Because as I said, I’m very passionate about solving this problem because I really think that it changes a kid’s trajectory in a major way to be able to have a way to talk about their experiences. And so, it’s important to me to get something out there that could really help.

Dr. Jeremy: Yeah. Absolutely. Well, it’s just cool. I wish people could see your face because you’re just beaming and so energetic. I can tell that this means so much to you. And that goes such a long way. When we started talking about this, it immediately resonated. Yeah, this is something that I think a lot of us could use. It just seems so helpful in this process. And so the business consultant part of me is kicking in. And I’m like, you should do training, Liz. Like somebody gets the book and you train them how to use it. It’s this whole process and everything.

Dr. Liz: It will come with a manual. So, if the Kickstarter is successful and we do end up producing this thing, it will come with a manual. And I will do a training on how to use the book that everybody will have access to. And the hope is to also bring together just everything that I’ve been learning about child feedback in general to get some of those concepts out because they’ve been just game-changing for me. I mean, just  completely mind-opening and things that just weren’t intuitive to me. So, it’s neat to talk about those things in general also.

Dr. Jeremy: Well, yeah, definitely. And those connections with the community I’m sure are like a snowball rolling downhill. It’s going to help. Just keep feeding itself. It’s really cool. Of course, we’ll have the links to the Kickstarter campaign and everything that we have mentioned here in the show notes. Just to say a little bit more about it. This seems very appropriate for elementary-aged kids. How do you apply this thing to older kids if you do, or do you not, what’s the age range here?

Dr. Liz: So this particular book that’s on Kickstarter right now. It is definitely kind of the K5 or elementary school. Here, elementary school is K5. So that’s the age range I have in mind. I actually have developed one for middle school that is called Brain Building 101. We’re going to try this one first. If this brain-building book is successful, that one will be coming out soon. The middle-school version will be coming out soon.

So I personally have a slightly different book that uses a little more sophisticated language. But the process is exactly the same. The metaphor is the same. It just talks a little more about emotional regulation and that’s a big deal in adolescents in a positive way although both books address it. So it just uses a little more sophisticated vocabulary and pictures are designed for the older group.

So this book is for the younger kids, but conceptually how the framework has developed,  I’ve found it applies to all kids of all ages. So just thinking about how parents are talking to them about the process, introducing brain language at the beginning has been really helpful for me because for the older kids, it just takes on a different level of sophistication. And the conversation, especially with my teenagers, is often asking me questions I don’t know the answer to, which is very exciting. It’s like, “Okay, I forget. I need to go look that up. Check back with me in the next session.”

But that concept of introducing some language to help talk about things has actually been really helpful for all ages, and having the conversation ongoing. I think when I was first trained to do an assessment, it was more like you give the tests and standardization says, can’t talk to him, you know.

The first rule about testing is, do not talk about testing.  But I think making the process a lot more transparent, what was that like for you? And there’s actually a lot of theory about opening up the testing process and really examining, like, what was that like for you? Let’s go back and revisit some things. And putting that into the metaphor of highways and construction zones even for teenagers it’s just a really helpful way to be able to talk about things. And then the tools that we use might be a little bit different.

Dr. Jeremy: Right. That makes sense. I have taken so much away from this conversation. My wheels are spinning. I love that kids are co-creating this whole thing. They’re active participants and it’s not just you sharing the information with them or with their parents telling them what’s going on. They’re taking an active role in the whole process and have this physical representation to take away and look at. There’s going to be some pride there for kids I would imagine. So there are just so many layers to this that I love.

So closing, I suppose, thank you so much for coming on and talking through your process and this approach with putting this workbook together. If people do want to reach out and get a hold of you or ask questions or anything like that, what’s the best way to find you?

Dr. Liz: For more stuff about the book, brainbuildingbook.com is the place to go. And then for me, I’m at dr.lizangoff.com Please reach out, email me, let me know it’s on your mind. I’m definitely in a space where I’m collecting experiences and the challenges that practitioners are facing around this because if these tools are going to solve a problem, it needs to be based on what people are experiencing in their real lives with their real kids.

Dr. Jeremy: Exactly. Right. I cringe to think about my work as a child psychologist before I actually had kids, thinking back like what in the world was I telling parents? It’s so ridiculous.

Dr. Liz: I have a two-year-old. So I’m at the beginning of the humble pie eating process.

Dr. Jeremy: Yeah, we get two layers of that. And there’s the layer of actually being humbled by your child and your parenting skills, but then there’s a second layer of thinking back to all the things you told parents when you didn’t have kids of your own.

Dr. Liz: I think the biggest thing for me, when I had my son, I remember picking my pediatrician and the people that were on our team, those people who could tell me what to say and do.  I just needed somebody to say, “Here are your guidelines.” And I’m really good at saying no, I’m not going to do that, but I need the framework.

And so I think knowing that’s something that I need as a parent to have some language and have some approaches that give that piece of parents, not just theory of, “Well you need to talk about their strengths and really be supportive.” I think it has been really helpful for parents to have something concrete. And those words “here’s something that you can use, here’s a tool” have been really helpful. And I know it’s helpful for me. So maybe that’s part of how this thing evolved to something I would want.

Dr. Jeremy: Yes. I think that’s a nice note to close on. So thank you again. All the links that we talked about will be in the show notes. And of course, best of luck with this whole process.

Dr. Liz: Thank you. This has been amazing. It’s been really fun talking to you.

Dr. Jeremy: All right, y’all. I really appreciate you checking out this episode with Dr. Liz. I hope that you found it helpful. This is definitely one of those where I took away quite a few things and we’ll be putting it into practice pretty quickly. And like I said on the podcast this is no joke. Liz sent me an advanced copy of her book and it was really cool. It was pretty impressive, to be honest. So definitely check out the links in the show notes to get the book or back the Kickstarter. And there are plenty of other links to help you in your practice as well based on things that we talked about.

Like I said, at the beginning of the episode, if you are interested in the Beginner Practice Mastermind, if you need a group to help you stay accountable and reach those goals of launching your practice in 2021, we would love to help. Spots are filling up for this group. It starts March 11th, I believe is going to be the date. And it could be a great fit if you are looking for an accountability group and some group coaching. You can get more information at thetestingpsychologists.com/beginner and schedule a pre-group call.

Okay, y’all, it’s always good to be with you. Thanks for listening. Let’s see. What’s coming up next? I think we’re going to be in the middle of a Practice of the Practice Takeover of my business episodes. So, check it out. This upcoming Thursday, I think Joe Sanok is going to be on the podcast talking about getting your practice to the next level. So I hope everyone’s doing well. And I will catch you next time.

The information contained in this podcast and on The Testing Psychologist’s website is intended for informational and educational purposes only. Nothing in this podcast or on the website is intended to be a substitute for professional, psychological, psychiatric, or medical advice, diagnosis, or treatment. Please note that no doctor-patient relationship is formed here, and similarly, no supervisory or consultative relationship is formed between the host or guests of this podcast and listeners of this podcast. If you need the qualified advice of any mental health practitioner or medical provider, please seek one in your area. Similarly, if you need supervision on clinical matters, please find a supervisor with expertise that fits your needs.

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