Stanford Schwab Learning Center | Dr Lawrence Fung | the Stanford Neurodiversity Project

4:05AM Aug 25, 2021

Speakers:

Lawrence Fung MD PhD | Stanford | Assistant Professor of psychiatry and behavioral sciences | child and adolescent

Keywords:

neuro diversity

neuro diverse

people

stanford

students

individuals

positive psychology

thinking

visual spatial

developing

psychiatry

strains

support

average

project

good

neuro

collaborate

practice

independent living skills

Thank you, Dr. ofiesh for the invitation is quite an honor to be here. And thank you Mr. Schwab, who is really the driving force of a lot of these activities here. So today I'm going to be talking about mainly the new work that I have been involved in. And in the past two years or so, focus on the strength based model of neuro diversity and how we are practicing this model in the Stanford neuro diversity project. I'll first give an introduction to neuro diversity, and then talk about the strains based model of neuro diversity, and then the neuro diversity project and then finally, open up some opportunities for everyone to consider. So what is neuro diversity? According to some experts before me, they define neuro diversity as a concept of really thinking about the behaviors and brain function of of all the people that have differences as part of the normal variation of the human race. So I think most of us have seen the bell shaped curve, the bell shaped curve has the green area where most people are in, that's considered average. And then the yellow part on the right hand side would be people that are one standard deviation above, and the people that are on the left hand side, but yellow, they are one standard deviation below the average, and people that are on the red, that means they are in the far extreme, they are really, really well above average, or well below average. So when we are thinking about IQ, that's how we define IQ. So IQ of 100 would be average, and someone that have IQ of 115 will be really high. And 130 is kind of like almost genius. And some people even have 145, like Einstein and people with intellectual disability would have like IQ of 70 or below. So, but IQ is only one aspect of how or one assessment that we use to determine how good a person is in terms of the cognitive function. There are many other functions that are really not included in the typical IQ test. So this person, Howard Gardner at Harvard University has put forth a theory of multiple intelligences. So basically, what it is, is that we have people that have musical abilities, they are referred that they really understand rhythm in their brain, they are very good at visual spatial function. Some there are some people that are very good at verbal, linguistic, and some people are very good at logic, logical mathematical. And some people are very good at bodily kinesthetic. And some people are very good at interpersonal and interpersonal abilities. So basically, we can think of like, for example, Einstein can have some kind of profile that I'm going to show you the arrows that I think he may be having. So in terms of the first one musico, he is actually quite musical he he played the violin, and visual spatial, he really can imagine a lot of things in his head without really any assistance. So he's really way ahead of everyone. And verbal, linguistic, he's kind of okay, when he was a child. When he was five years old, he started talking, so he's kind of behind for several years early, but as an adult, he definitely had no problem. So logical OR mathematical. Clearly, he's the all time genius. So we don't know exactly where he is, but we're all the way to the right. And intrapersonal not so good. Interpersonal, maybe even a little bit lower, bodily kinesthetic, probably average. So A genius

can have some really big challenges in some areas, but not all areas. And if someone is able to, like Einstein be able to really think about what can be focused on and really go with it, and then you can really change the world. So, well, Jay Leno is another neurodiverse person he, I think he openly told people about his dyslexia. And I would say musical maybe average, visual spatial average verbal linguistics probably way above average, and logical mathematical average, interpersonal, I think is up there intrapersonal interpersonal, I was up there and bodily kinesthetic, probably average. But basically, the idea here is that there can be, we can consider neuro diversity as a competitive advantage if you are able to find where the strains a person has. So, so that there are diverse conditions that we are thinking about our autism, dyslexia, and ADHD most of the time, but there are also other neuro diverse conditions that we also think about. So for. For the sake of time, we're going to be focusing more on these three conditions and more so for dyslexia. But you can see also that in the autism population, there's about 1.7%, which is not rare anymore. That means it's like one in 59, like one every couple of classrooms, you can find it someone with autism, dyslexia is very high 13 14%. I think, earlier on. Early speakers, were saying 15%, ADHD, five to 7%. So considering that a lot of these people with disabilities, they generally cannot really get the job, or their employment is much lower than others who do not have disabilities. It will be really wonderful if we can turn their abilities into something that is very useful for them. So that's why we consider the strength based model of neurodiversity and is very different from the disability model. So the disability model really has all the medical background of defining what the deficits might be. And because we can find the deficits, we will have the target to try to normalize the that particular function. But sometimes we miss out the boat by not thinking about all the other things that are really going to be helping the each person like the entrepreneurial spirit, creativity, visual, spatial thinking, hyper focus, attention to details, deep interest in particular topics. So the first few, the top three especially are more for dyslexia. And for the next three more for autism and maybe this one too, for autism, and determination. We see a lot of individuals that are neuro diverse, that have quite determined more so than others. So when we are thinking about the practice, so I'm a psychiatrist. So I think about what I'm taught, or what I was taught when I was in training, and how I think it's going to be practice with positive psychiatry. So assessment, traditional psychiatry will focus on the pathology, the passive psychiatry would be more about the positive attributes and strains. research focus more so for risk factors pathology for traditional practice, but if we practice positive psychiatry, it will be more like thinking about neuro plasticity protective factors. In terms of treatment, traditionally, we would think about how to relieve the symptom, but passive psychiatry would say maybe we can increase the well being and growth

and treatments. I do a lot of pharmacology in my practice and short term psycho therapies but positive psycho psychiatry really is about psycho educational and trying to enhance The positive attributes, and we are thinking like positive psychiatry is going to be more helpful for preventative kind of treatment, which is largely ignored, ignored in traditional psychiatry. So talking about dyslexia, we know the common challenges of dyslexia are reading, writing, spelling difficulties, time, awareness, rote memory. But there are constraints. like Dr. tenpenny was talking about the creativity and the visual spatial function. They are generally very good problem solvers and synthesizers, and they are very good, observant and very good socially. Sometimes, I like to use this acronym mine strains. Dr. oafish intro introduced this acronym to me. So M stands for material reasoning, I interconnected reasoning, and is narrative reasoning and d is dynamic reasoning. In the case of autism, the common challenges of press preserved duration can be actually a strange depending on the context. So it can be considered as a persistence. And seeing big picture is usually a big problem for individuals on the spectrum, but because of that, they really get into the details more so than anybody else. And sometimes, if the problem requires the detail, you have the right person. So field interests of individuals on the spectrum translate into very deep funds of knowledge and perspective taking problems sometimes. The the other flip side of it is that these people, when they are your friend, they are really concrete and honest, and they, they, they are very loyal people. So the next thing is ADHD. common challenges are the definition of ADHD. And common strains are the multitasking, creativity, entrepreneurial spirit, and they are quite resilient. So to practice the strength based model of neuro diversity, we consider two components. The first is the positive psychology part. And the other part is about the development opportunities to help with development. And we also want to focus on stressing that these neuro conditioned neuro diverse conditions are conditions rather than disorder. And we want to not forget about the challenges, but we call them challenges instead of deficits. And we want to apply this strength based model broadly. So Part one is positive psychology. These two people, Martin's Seligman from University of Pennsylvania, I may have aged checks in May Harvey, who was in university of chicago, as Department Chair of psychology department for many years later on went to Claremont, they basically first talk about positive psych psychology just about 20 years ago, and this paper has been cited more than 16,000 times. So what they think is that the core of positive psychology would be well being the contentment and satisfaction and, and flow and happiness as well as hope and optimism. Because of the, the, such a good vibe from positive psychology, there are many people who have published and practice positive psychology. And there are 50, free published definitions of positive psychology. So it's difficult to really keep up exactly what the definition may be. But there are basically free themes that are most popular according to these free 50 free published definitions. And the first is virtues, character strains, positive personality traits and related attributes, and abilities and talents. The second is phenomena in the indicative of happiness, positive emotional well being subjective sense of fulfillment and satisfaction with the quality of life. And the third is more developmental is a developmental process of becoming strong growth, fulfillment of capacities, actualization of potential and development of the highest authentic self. So when I was thinking about how we are really shaped Our programs at Stanford with positive psychology in mind, I thought I have to pick something, some kind of definition is really, really hard to pick. So basically, what I'm thinking is always everything about these free themes. So anything that's there's really good coming out from positive psychology. So how do we conceptualize the use of positive psychology in individuals with neuro diverse conditions. So the first thing that I would think about is to basically designed the environment that can raise awareness for personal strengths, increased trust, in personal ability, so to build the self confidence of the person and help them learn to engage in relationships, and also increase this self satisfaction through success. And on the other hand, for any psychologists in the room, use cognitive behavioral therapy, and a lot of the time what your goal is really to change the we call them automatic thoughts that come to the brain, get the negative ones to become positive, that's basically the goal. So basically, what that's what we are trying to do for all those comorbid issues like anxiety and depression and executive function, or executive dysfunction. So building strings, you utilize inches positive behavior supports and Universal Design for Learning are the tools that we use. The other part of neuro diversity, our strength based model of neuro diversity is the seven vectors of development posed by chickering. Also, coming also developed by a Stanford education Professor chickering. Actually, sorry, Harvard,

that

I wish that the Stanford but but this book, actually student mental health, actually, that this book is, is coming from from from us. So my department chair, Dr. Laura, Laura Roberts, co author, was editor of this book. And I was privileged to be writing one of the chapters that talk about how we can practice the chickering vectors of development. So in terms of the first thing that we are trying to do is to develop competence. And for every single vector, what we are trying to do is to think about what we can help teach students based on that developmental task. And the second thing is what can the school officials do in order to help the students and the third thing is what can mental health providers do in order to do in order to help with developing that particular aspect. So I'm not going to read it all to you. But the concept is develop developing competence, managing emotions, moving through auto autonomy towards interdependence, not only independence, developing mature interpersonal relationships, establishing identity, developing purpose, and developing integrity. Those are the seven things that we always think about when we develop these programs that I'm going to describe to you in the Stanford neuro diversity project. And the object There are six objectives. The first thing is the most important thing. So we want to help students that are neuro diverse, but before they come to Stanford, we want them we want environment to be ready for them. So basically, we want to establish a culture that treasures, the strengths of neuro diverse individuals. And we want to empower these individuals to develop their personal identity, so that they can have really good long term success in dealing with life. And we want to, if we were doing it right, then we're going to attract the students to come here to Stanford instead of MIT or Harvard. We are already taking them anyways, but we want more of them. And we want to train others to really care about this particular topic on neuro diversity. And we want to disseminate this model. Eventually, locally, and then Slowly and and basically at the end we can maximize the potential of neuro diversity not only for the neuro diverse individuals but for all of us. So we have a very small team. Dr. Laura Robbins is our executive sponsor. I'm director of the project. Mary Herbert is sitting right there. She she's the program manager, Laurie spurious. ageng lecturer. She used to be at Yale and I was able to pull her to our direction. So we are thinking about four different major things when we are practicing d'amato. So the first thing is education, educating the neurodiverse individuals as well as the public and also internally in various departments at Stanford, and we work with service organizations and companies on helping with identifying jobs that may be suitable for individuals that are nearly diverse. And we also have, because I'm a psychiatrist, I provide mental health support. And we collaborate with our legal scholars in the law school for advocacy issues, as well as on paper. I'm 85%. researcher. So I'm supposed to be doing research all the time. But NIH does not know that I free and free 100% of my time, all the time. So neuro diversity project has three main initiatives. The first is awareness and education. The second is work and wellness. And the third is independent, independent living skills and

housing. So this overall effort was actually started from this special interest group for neuro diversity. Just about a year and a half ago, initially, we had about 20 staff and faculty members at Stanford wanting to develop something that can help with hiring individuals on the spectrum. And very quickly, it evolves. And it now be, so in April last year, so just about a year ago, this, our project that was used, used to be a grassroots effort. Now, it is a a formal special initiative in the Department of Psychiatry. And our 20, people now became over 100 people calling in to our monthly meeting. to basically listen to usually a speaker, every month, we have someone that talk about a topic of neuro diversity, that helpful for developing employment opportunities, or better experience in college. So this is a list of the topics, or the titles and presenters in each of those monthly meetings. And I'm not going to read them out loud, but a lot of topics that are really valuable for us to learn from so that we can build program that's as best as possible. So the next thing is awareness program. So basically, that means out, I talked to as many groups about neuro diversity as possible. And this is only as a small list. That included here I talk both internally at Stanford as well as outside Stanford. And a few weeks later, I'll be going to Moscow, Russia to talk about neuro diversity. So the idea is to really spread the word about neuro diversity across campus as well as outside campus and we'd like to engage with corporations because they can help identify positions that can be available for neuro diverse individuals. And we are also teaching our students about neuro diversity. So we started a course called knock topics in neuro diversity, introduction and efficacy. We talk about dyslexia, ADHD and autism in various different aspects. So behaviorally, socially and biologically, and how students at Stanford can think about the efficacy opportunities. So we have in this quarter Actually, we have our Stanford students mentoring others, high school students and Burlingame High School and That's a really good experience. So next quarter, we are going to be teaching this topics in neuro diversity design thinking approaches. So this is the design thinking approach, I'm not going to go over it. But basically, this is a iterative process that is very popular in the Silicon Valley that can generate a lot of design ideas. And a lot of this kind of iteration can very effectively get to a very good design, and sometimes generate ideas to form companies. So the next thing is about the seminar series in our neuro diversity at work ongoing support program. So we are doing this program for the managers and the rest of the team to help them with working with individuals that are neuro diverse in the transition time after onboarding. And the biggest thing that we are trying to do launch sometime, hopefully in the summer fall timeframe is this Stanford neuro diversity project neuro diverse students support program. So we would like to provide support in terms of transition for Stanford, incoming freshmen, we'd like to provide independent living skills support social life support, help them with accommodations, learning support, career

development, the mental health support, and we we are going to have a course that we will be covering all different aspects. And what we are planning on doing is to provide a curriculum to train peer mentors to help the students directly. And we have staff from Stanford neuro diversity project that will be monitoring will, we were forming a affinity group to help with social life and we collaborate with the Office of accessible education for accommodations, we collaborate with Nicole and the rest of the SLC for learning support, we collaborate with the Career Center at Stanford for career development, and I collaborate with Braden Health Center for Mental Health. So basically, we want to have a lot of support from all different angles. And at the end, it's going to be a big team helping with the student is kind of like the IEP of in the, in the high school and, and I mean, K through 12, but we're not going to call it an IEP, obviously. But we think that this can provide some students an opportunity to succeed. So the next thing is about the neuro diversity at work program, we have a, a, we have launched this program, recently by helping with facilitating the hiring of an individual and an individual on the spectrum to work at Stanford in the School of Medicine. And I'm not going to go over the process in detail, but basically, we are helping both and the neuro diverse individual as well as the team to find the best match. And we do not use the typical interview process because the typical interview process really doesn't work so well for neurodiverse individuals and we would like to, to change that. So that's why we are making a completely different model. So basically, does every single employee have a team of support people so in addition to the team manager in the work life support circle, there's the team buddy, there's the neuro diversity at work mentor, as well as a job coach and there's an A case coordinator as and job coach and the case coordinator with it will also work with the family and person and, and the counselor if necessary. So I also direct his adult neuro development clinic. So basically, this is a clinic for neuro diverse individuals. So, with the last couple of minutes, I'm just going to post this question, how can how can we work together to maximize the potential of neuro diversity? So if you are interested in neuro diversity, did you You can potentially join the special interest group, just send us an email. Let us know you're interested in neuro diversity, let us know if neuro diverse individuals that you know are looking for employment. If you know any organizations that want to learn about neuro diversity, or if they have jobs that's even better than us know, tell us how you want to be involved. And by working together, we can make a difference to the neuro diverse community and beyond. This is our website. And these are summary we talked about how neuro diverse individuals can offer much to organizations and how there are specific challenges that can be overcome. And we talk about the Stanford neuro diversity model and what our project is about. And this is how so we cannot really do this without our anonymous donor who gave us some initial funding for a few years. And Mr. And Mrs. Goldman, and then our Department of Psychiatry, as well as a lot of the committee members that have been really active in pushing this project forward. Thank you for your attention.