PAP 096: What the Nervous System Tells Us About Understanding & Improving Behavior, with Mona Delahooke, PhD
Understanding & Improving Behavior Through the Nervous System
with Mona Delahooke, PhD
Mona Delahooke, PhDMona Delahooke, PhD, is a licensed clinical psychologist with more than 30 years of experience caring for children and their families. She is a senior faculty member of the Profectum Foundation, an organization dedicated to supporting families of neurodiverse children, adolescents and adults. She is a trainer for the Los Angeles County Department of Mental Health. Dr. Delahooke holds the highest level of endorsement in the field of infant and toddler mental health in California, as a Reflective Practice Mentor (RPM). Dr. Delahooke has dedicated her career to promoting compassionate, relationship-based neurodevelopmental interventions for children with developmental, behavioral, emotional, and learning differences. She is the author of Beyond Behaviors: Using Brain Science and Compassion to Understand and Solve Children’s Behavioral Challenges (PESI, 2019)
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Mona Delahooke, PhD (00:00): Let's just say a child starts to fidget or move around in their chair or make noise or tap their pencil on the desk really loud, because they are really trying to regulate their physiology. If you call a child out for that, what do you think that does? Does it feel safer or does it make them feel more anxious?
Intro (00:30): Welcome to the Parenting ADHD Podcast, where I share insights and strategies on raising kids with ADHD, straight from the trenches. I'm your host, Penny Williams. I'm a parenting coach, author, ADHD-aholic and Mindset Mama, honored to guide you on the journey of raising your atypical kid. Let's get started.
Penny Williams (00:59): Welcome back to the Parenting ADHD Podcast. I am crazy excited to be talking to Dr. Mona Delahooke today about behavior, polyvagal theory, autonomic nervous system. The fact that behavior is communication and the ways that we need to really look at behavior in order to actually be helpful and compassionate with our kids. Talking a lot about the content of her latest book beyond behavior. Thanks so much for sharing some of your time and wisdom. Will you start just by sharing who you are and what you do for those who don't know you?
Mona Delahooke, PhD (01:37): Oh, sure. Penny, thank you so much for having me on. I'm really excited to talk to you. I'm a clinical child psychologist, and I've been working in the field for all my third decade and I'm a mom and I recently became a grandmother. So I am deeply devoted to child development in parents and trying to help our world understand children better. I feel so fortunate that throughout my career, I've been able to dive deeper than the field of psychology. I was able to take several specializations early in my career that dove into the brain body connection. And from that training, I, I really found I think ways to look at children and their behaviors, especially, and also parents with a lens of compassion and really appreciation for behaviors rather than fearing them. So that's me in a nutshell, I'm so happy to talk to you.
Penny Williams (02:49): Oh, me as well. Thank you. I have been reading your book "Beyond Behaviors" and I have underlined, starred, dogeared, post-it flagged so much of it, everything that I think and feel and teach about behavior all in one place. And I love it. I'm very excited about it. I wanted to start our conversation really with a short passage from the book. If you don't mind, you said, "a child who seems to be misbehaving is in the process, adapting and surviving. Instead of viewing behaviors purely as difficulties we need to get rid of, it's helpful to see them as forming an instructional manual for how to support each child's nervous system." And I wrote "yes", in the margin and flagged. That really pulls it together very succinctly in a very short, brief synopsis. That behavior is not misbehavior. I hate when people say good behavior or bad behavior. Behavior is just a symptom, right?
Mona Delahooke, PhD (04:08): Yes. Behaviors should be neutral. I mean, our attitudes towards them shouldn't be evaluative in the way they are. They should be, in my opinion, they should be positively evaluative. As that sentence said that you just read behaviors are adaptations of our brain and body connection that are heroic. Really. We need to view them as heroic and, in my field, they're turned into labels or sometimes even disorders. And I think there's really one week when we update our paradigm, we're going to see that behaviors really tell a great story about each child and the story is going to be different for every single person.
Penny Williams (04:57): Yeah. And they offer an explanation, not necessarily an excuse because certainly not all behavior is wanted or appropriate, but they offer us an explanation and kind of a guide when we look at them that way.
Mona Delahooke, PhD (05:11): That's right. When we view them from far away from the lens of good or bad behaviors. Let me reiterate what you just said. If a behavior is going to be harmful to the child or to someone else, of course, we have to protect the child in the end, everybody around them. So it doesn't mean that we are just a laissez Faire about behaviors, but when we view them as good or bad in our kind of in our older paradigm, then we are aligning consequences to those behaviors and wanting to look at them as either compliant or noncompliant. And that's really kind of a more, what I call a medical model, an older disorder based model that looks at behaviors is something we can solve at the surface rather than seeing them through the lens of adaptation of our nervous system. And that is the good news because it really takes us away from the blame game and puts us into this compassionate stance of understanding that not all of our children's behaviors are intentional or willful. And that's kind of an eye-opener for some parents and for some professionals.
Penny Williams (06:38): Yes. I think looking at intention as important, and this is something that I talk to parents about all the time — while it might feel like your child is disrespecting you, is that their intention? Before you respond, it's so important to know if it's the actual intention your child has. And at that point, if it's intentional or willful, maybe a consequence is appropriate, but more often than not, it is not the intention.
Mona Delahooke, PhD (07:10): Well, when we look at behavior through the lens of our nervous system and how adaptive our nervous systems are, then absolutely, we can actually determine if they are purposeful or not. We have a way to do that. And that was that forms. The backbone of my book "Beyond Behaviors" is that I show professionals how to do this roadmap as to where the behavior is emanating from or coming from. I use the iceberg analogy. And so we take the focus from the tip of the iceberg, which is what we see, those behaviors, but below the waterline lies that huge chunk of ice. And that's where we find the reasons underlying behaviors. So when we don't look to the underlying causality and we assume that a child is doing something to get attention or to get out of something or to be willfully defiant, and we punish the child or reprimand the child for that, it's really giving the message that we don't want to give. And that is that we are believing that you're not choosing to do right by us and children as Ross Greene says, "children do well if they can and when they can." And I fully believe that they want to please us.
Penny Williams (08:39): Yeah. When we really look at our kids with that frame of reference that they want to do good, they're trying to do good. They're really working at it. Then it really helps us to stay calm, to be able to then look at behavior through this lens of kind of faulty neuroception as you talk about in the book, lagging skills as Ross Greene talks about. And then we're just, we're kind of armed to be the parent. We need to be in those moments and to really be helpful instead of just trying to control — so much instinct and especially our cultural definition of parenting is this authoritarian, controlling relationship. And I find that so harmful for every kid.
Mona Delahooke, PhD (09:35): Well, it's really in our culture. And it's pervasive, I think also through our education system and our mental health system and even our criminal justice system, to be very evaluative, and there's a new way to be evaluative. And I really began to embrace that thought when I started learning about the function of our different nervous systems, but especially through the lens of the polyvagal theory, which Dr. Stephen Porges developed. It's this evolutionary based, phylogenetically grounded neuroscientific model for how human beings behaviors are really adaptive to our survival. And once I did that, I could not carry out the behavioral interventions or sign off on them as I was often asked to do on IEP meetings and reports. I couldn't do it because I'm seeing that when you're focusing at shifting a child's behavior, without understanding what's going on below the water line of the iceberg, you can actually sometimes cause more stress to the child and impact their self confidence and their self image and their self esteem.
Penny Williams (11:03): Yeah. Let's talk about safety — feeling safe or feeling unsafe. I think that's a good starting point for the polyvagal theory conversation before we dive a little bit deeper into what it tells us. This idea that our kids kind of all the time either feel safe or not safe. And what do we really mean when we use the word safe? Because so many people assume you're in danger or you're not in danger, or if you're not in physical danger, then you should automatically feel safe. But for our kids with these neurological differences, that's not true. I describe it from my own son's experience as being on high alert when he was feeling really unsafe. And unfortunately, I didn't know about safe versus unsafe and polyvagal theory and all of these things back then, but his freshman year in high school, when he got there, he was just on the edge all the time.
Penny Williams (12:07): He was just on the precipice of freaking out and melting down every moment. And what I realized now is that he just felt so unsafe. I knew it was sensory overwhelm. I knew it was social challenges. I knew it was people expecting more out of him because he's super intelligent and not seeing the differences in learning ability and output ability. But now I realize in a nutshell, he just didn't feel safe and it was our responsibility to make sure that he did.
Mona Delahooke, PhD (12:42): Yes. Yes. So let's define what we mean, what we describe as neuroception, what Dr. Porges coined, this term neuroception because there was not a word that described this subjective subconscious perception of threat or safety. So neuroception is truly a guiding principle. And what we mean by neuroception is that the body has this system that is going on outside of our awareness, like a computer program constantly in the background, making sure that we are safe, that we're physiologically safe from our inside monitoring of our internal organs to our environment. And we can think of it like a personal TSA agent, always checking and checking to make sure things are safe, in and outside of our bodies. And so it's not objectively it's subjective. So what each individual experiences in their own body is their own neuroception. So an example would be, one source of neuroception are sensory triggers. So we all have different thresholds for how we take in information. Some individuals will have different thresholds for auditory information, for example, information that's coming in through our hearing.
Mona Delahooke, PhD (14:15): Some children can hear sounds like a mile away, like I'm thinking of some of the kids in my office. There might be a siren that I cannot hear, but the child says there's a siren. And then maybe three or four seconds later, I hear it. So that's called extra sensory perception, or maybe overreactivity. Through our senses, our neuroception gets triggered into a state of safety or threat. And when it gets triggered into threat, then our body tells our sympathetic nervous system, which is our fight flight system, that it needs to move or do something to feel better. And it's just this really wonderful guiding principle that is not known yet very well in any of our sectors. And I've tried to explain it. I think about IEP teams again, because I go to a lot of IEPs where the school will say something like with all good intentions, of course, they'll say, well, this child is already in a safe environment.
Mona Delahooke, PhD (15:28): There's a good teacher. It's a safe classroom. We have nothing, no bad stuff going on. And yes, that's true, but that's a different definition of safety. That's not neuroception. Neuroception is how each child —brain and body through all of their nerves, their central nervous system, their peripheral and their autonomic nervous system — interprets the world around them. And this is the mind blowing kind of paradigm shift that I'm talking about in the book, not a traditional sense of safety. Each of us is going to have their our own reactions. And there isn't such a thing as a child acting out of the blue, right? Sometimes they'll say, "well, if the child just smacks someone out of the blue or they started running out of the classroom out of the blue," but it's not out of the blue, it's just invisible. The trigger is invisible. Does that make sense?
Penny Williams (16:23): Yes. Yes! And I I've shared this many times because I feel like it's such a good explanation — I have anxiety myself. I've had some pretty severe social anxiety all my life. I still struggle with it at times. I avoid things because of social anxiety. And I can tell from the experience, I can share with people that anxiety is one of those things that is very reactive physiologically. As soon as I perceive threat, whether my brain created it or my worry brain has gone off the cliff for no reason or not, I still have these physical reactions. My stomach hurts. I get tingly all over. I might get an instant headache sometimes or muscle tension. And it's completely outside of my control in those moments when it's first triggered, I am not controlling it.
Penny Williams (17:29): I am not consciously interpreting the environment and then saying, "okay, I'm not safe." And then my body reacts. It is absolutely my physiological being that is reacting in that instant, that then tells me, "okay, I'm apparently anxious right now. Let me figure out why," and then I can cope with it and help myself and feel better and get through it. But so many people that I've met in my life, who don't have anxiety, don't understand that there's absolutely zero conscious choice in those reactions. Right? And I think that's such a good example that people can understand that I have my own personal experience with. So I really feel like I can communicate it more effectively by using that example. But, we look at kids and their behavior and say, they're choosing it. And the beauty of incorporating polyvagal theory in thinking about our kids and their behavior is that it shows us scientifically that there's physiological responses that are fueling, at least in part, these behaviors.
Mona Delahooke, PhD (18:46): Absolutely. Absolutely. You just described it so, so beautifully, like that experience in your own body, your body luckily gives you signals that, okay, my physiology has shifted. And sometimes we don't realize it, but if you tune in and if you help a child tune in to exactly, that is my heart rate increasing, are my palms getting sweaty, is my tummy hurting. Then we know that the partially survival based part of our brain through our neuroception is recognizing that it has to mobilize, meaning move, and movement in any way, shape or form. So movement could be fidgeting or movement can be our heart rate going up. Now let's talk about for some of us, how sometimes we can get triggered into that need to mobilize, and we actually are fine.
Mona Delahooke, PhD (20:02): We're safe. So that is what Dr. Porges calls faulty neuroception. Now faulty neuroception isn't a bad thing. Again, it's a neutral concept. Which means that a trigger that one person may find innocuous, such as being in a classroom, is actually very, very stressful for the child. And so they are picking up on signs of threat, even though the environment is safe. And I think this is a very important piece that helps us to go naturally to compassion rather than working on behavioral compliance for that child. Because again, if it's adaptive... let's just say, a child starts to fidget or move around in their chair or make noise, or tap their pencil on the desk really loud, because they are really trying to regulate their physiology. If you call a child out for that, what do you think that does to the child's physiology? Does it make them feel safer or does it make them feel more anxious?
Penny Williams (21:18): Yes. Yes. And we're sending the wrong message too. You had outlined one of your patients' stories in the book, and I can't remember the name of which child at this point, but you talked about the child on the autism spectrum who had an aid. And when he kind of brushed up against her arm, she would move farther away from him. Instead of seeing that he was saying, "I need your help, I need to attune to you," he was then punished. And the whole time I was reading that little story, I just kept thinking about how heartbreaking that is, what that felt like to him is that that person didn't want to have anything to do with him. Right? I mean, it feels like she was pushing him away and saying, "I don't like who you are, this has to change." And kids get the message, so often kids with ADHD and autism, get that message that we want to change them. My son has said to me several times over the years, "stop trying to change me, mom." Big eyeopener. It shows that that's how it feels to him when we're trying to change behavior.
Mona Delahooke, PhD (22:45): Right. Right. We need to think about the message, again, a message to a child who needs our direction in our teaching and our discipline is one thing. It's important. Of course, we need to raise up our children. But when I was thinking about this person, yes, the message to the child was I don't care about you. Let me tell you, that aid in that classroom loved this child. And she was required through his behavioral plan to ignore his behaviors. And so it was actually going against her instincts. And I believe that many of our school assistants and aides are trained in a way that overrides our instincts to connect and protect children because in his IEP, they have this whole series of rules that they are supposed to do to stop his disruptive behaviors. What they didn't realize was that this is a child with minimal speaking abilities.
Mona Delahooke, PhD (23:56): And I don't use the word non-verbal because I think it's disrespectful. He's very, he's very verbal, but he's non-speaking, was mainly non-speaking. And so his only way to get help from adults was through his motor system, which wasn't accurate. So yes, when he was looking at the aid and not paying attention to the clock, to the teacher, that was determined as a behavior that was trying to seek help on a very minimal level. He was looking for help. Children and toddlers and babies when they need help, they look for their caregivers. So he did that. She told him to pay attention, and then that wasn't what he needed. He actually needed something else and he needed that engagement system. And when he tapped her and started to get dismissed that's when he moved from what I call the green pathway to the red one, where his nervous system was in neuroception of threat.
Mona Delahooke, PhD (25:00): He started to what looked like hitting her, but it wasn't, it was just that he was activated and mobilized and that's all his body could do at that point to get help was to hit. So it was a very pointed, I will never forget that day in the classroom that I was visiting. It was the day that I really decided that I was constructed and years ago, because without blaming or shaming educators, I really say this on every podcast that I do. I have utmost respect for educators, and I believe they have good intentions, but our system is so outdated. It has not updated to neuroscience. It has not integrated what we know about the autonomic nervous system drive for safety. And that's why I'm out here talking to a lot of people and writing examples on my website, through my blog — parents need data to present to their IEP teams or teachers. You can use a search engine on my website. We need to talk about it because we need to stop some of the inflicted stress that we are inadvertently placing on our students.
Penny Williams (26:21): Yeah. I wrote down, as you were talking, "while we do the wrong things, our intentions are good for parents, for educators, always intending to do the right thing for our kids." And we can only do what we know. Right?
Mona Delahooke, PhD (26:35): Don't beat yourself up. Yes. We are told by our pediatricians and by parenting books and by leaders, right? Like teachers and psychologists, and many of my colleagues that I respect, but haven't really integrated this new knowledge yet, because it's pretty, it's very new. So please don't beat yourself up, have compassion. What your child's needs from you, which I'm sure you have given to your child, is love. And that overcomes everything. So please don't take what I'm saying as you've made a mistake, it's just a way to go forward. It's a new way to view behaviors that we can share with our child's team across disciplines.
Penny Williams (27:20): Yeah. Yeah. Let's talk about the parts of the polyvagal system now, because I want to make sure that we talk about this because I think it's so valuable toward the understanding and toward acknowledgement that a lot of our child's automatic physiological reactions are outside of their control in those moments. And I like how you categorize them in the book into three different colors, almost like three different zones. And green is the ventral vagal in the polyvagal system. And I wrote down calm and connected and safe — I'm sure this is why you called it green. We think about green as being good, like all go forward. Good zone, green is. Do you want to talk a little bit about that ventral vagal system and the physiology behind that?
Mona Delahooke, PhD (28:17): Sure, sure. Yeah. My colleague, Dr. Connie Lillis developed these colors in her neurorelational framework, which is an updated framework for understanding behaviors. And she coded these three pathways of the autonomic nervous system with colors, which I thought was just so user friendly, but these are not the colors that teachers use in classrooms for behavior charts. Just so I can make that clear. Like sometimes you have a green, Oh no, move your color yellow. If you're getting a little bit bad and then I move it to red, if you're really goofing off, this is not that. It's just what she used for these three colors. And so there's two main pathways of the autonomic nervous system. I'm sorry, two main branches, the sympathetic branch and the parasympathetic branch. And in the parasympathetic branch, we have two different pathways. One is the ventral vagel pathway, which is what I call the green pathway.
Mona Delahooke, PhD (29:21): And the other is the dorsal vagal pathway. And that is the blue pathway. So the green pathway is known as the social engagement system. And it is in contrast to the other branch of the autonomic nervous system, which is known as the sympathetic nervous system, which is the red pathway. So when we think of the green pathway, this is where our physiology is most comfortable and safe. What were those three words that you just used? I like them.
Penny Williams (29:57): Calm, connected, and safe. Those were the notes I made as I was reading.
Mona Delahooke, PhD (30:02): Calm, connected and safe. So the child appears to be calm. You can see features that the child's body, their posture, they're not clenching or gripping. They have the face has relaxed, their body's relaxed, and they are able to connect. This is why it's called the social engagement system, because we're able to connect with others in this calm state.
Mona Delahooke, PhD (30:29): Of course, we're teachers and parents, we love our kids to be in this state when they're calm, connected, but it's important to understand that as humans, we are not always in this state because our world is, as we know, especially now filled with challenges on a daily moment by moment basis. And so luckily our TSA agent, our neuroception is able to tell us when something needs our attention and we need to move. And when we start to get a reading that something's off, we get moved from, again, it's not our choice. Our nervous system moves from this ventral vagel, calm, to the sympathetic nervous system. That's the first thing that is triggered is movement. And so I think it's kind of interesting for your audience of parents who have children who have a lot of movement needs diagnosed with ADHD, which also includes a lot of need for movement in the physical body.
Mona Delahooke, PhD (31:40): Now, I'm not saying that ADHD is completely related to the sympathetic nervous system. I'm not an expert on ADHD, so I'm just using it as an example that for human beings in general, when we feel uncomfortable or when our neuroception picks up that something isn't quite right, or we're stressed in our bodies, we tend to move. We want to move. And oftentimes in schools, I know I'm talking a lot about schools here, but it's kind of hard to allow each child to have their needs met in the classroom. So it's hard for teachers, but some children's bodies need to move. If it's truly a physiological need, no amount of talking or reinforcing the child with a sticker is gonna meet that need for movement.
Penny Williams (32:37): Yeah. And I connected a lot to that when my son was younger, he was extremely hyperactive. He had, it seemed, like zero proprioceptive input in his normal world. And so he was always crashing and banging and thrashing himself against walls and on the floor. And so much of what you talk about in the book really resonated with that. There are physiological explanations for that behavior. Occupational therapy for us was such an aha. When I learned about proprioceptive input, that was the first piece of real understanding I had for my kid. And it's so important to really understand those sensory systems. I don't think we give that enough gravity, enough weight in what is fueling behavior or what is even making us feel safe or unsafe again.
Mona Delahooke, PhD (33:27): Occupational therapy is, Oh my goodness. I've learned so much from the occupational therapists I worked with on the teams. Yes, you're absolutely right. Because this is how we all take in information, not just children, all of us humans. We only have one way to know our world. And that is through our sensory systems. What we see, what we smell, what we hear, how we move, what we taste and what we feel in our bodies. So it's critical. It's absolutely critical to have a very to have a workup for your child, especially if they have been identified and identified as having additional needs or special needs to have. There's a compassionate understanding of what their sensory processes need and what things are calming to the child and what things are disregulating to the child. It's really important because you can't begin to talk about behaviors until you understand the child's sensory processing.
Penny Williams (34:35): Yeah. So green is our safety zone. When we're in the green zone, we're feeling safe.
Mona Delahooke, PhD (34:41): We're connected. This is when we can ask our child to do things, to concentrate. And here's what we learned. This is a good time to ask children to problem solve and to learn. It's really the zone of connection, but it's also the zone of communication.
Penny Williams (35:02): And then the red and the blue zone, the blue, which we haven't really talked about yet, the dorsal vagal, both of those are unsafe, feeling unsafe in different ways. So the red was needing to kind of activate and mobilize, so fight or flight. And then blue, I think is more of what we think about when we think about a child who freezes, who just kind of gets paralyzed.
Mona Delahooke, PhD (35:25): Yeah. That is a kind of phylogenetically, it's the ancient pathway. It's that freeze kind of pathway, which our children should not be in that state for very long. Let me just put it that way, because it signals a sense of overwhelm in a child's body, such that they're losing hope, their autonomic nervous system is sensing so much threat that they begin to conserve energy and shut down. So this was something to really make sure that a child is not having the behavioral features of the blue zone for more than several hours. Two days at a time, you'd really want to look at what's going on and get a support, get help from a pediatrician or a mental health professional. If you see your child disconnecting, losing hope, not wanting to talk and not wanting to move. Fortunately, it's pretty rare, but we really want to watch out for our kids who have those behavioral features because they compassionately need support.
Penny Williams (36:45): Yeah. Shutting down is definitely not a good thing. I wrote down feeling extreme danger. If you're in the blue zone, the dorsal vagal, you're feeling extreme danger and you're really shutting down. And just and it's our body's way, I guess, of kind of conserving energy and trying to prepare for this extremely dangerous thing that's coming at us that may or may not be real, but it's such a good way to look at where our kids are. This is how we meet them where they are, this is how we understand them so that we can respond appropriately. We can respond calmly and compassionately. We can show empathy and validate how they're feeling because that's what's most important. And I had one more passage that I wanted to read to everyone that kind of sums this up, especially from the parent perspective or even the teacher perspective, you said, "what's important is the child's own perception of safety, not what adults think ought to constitute relational or environmental safety." So it's not our ideas of whether the behavior is appropriate or valid. It's what our child is going through. It's where they are in skill or in their autonomic nervous system. Right?
Mona Delahooke, PhD (38:08): Exactly. Yes, yes. It's not what we think it should be. It really is working from the child's level and taking their point of view. It is really a way of not judging what, again, based on our own sensory preferences or our own ideas, but really on what our child's body is us. And it's very freeing.
Penny Williams (38:36): Very freeing, very freeing for sure. And I think too, we can think about that on the flip side. We, we tend to be protective, sometimes over protective as parents, that's us using our own fears and what makes us feel safer and safe and trying to maybe keep our kids safe through that, instead of really letting them define what feels good to them in different activities. Maybe you go skydiving, that's an extreme example, of course, but that's what comes to mind. Like I would never let my child skydive. Right? And I do tend to be a little bit over protective, because anxiety, but I think it really goes both ways and looking for that. I know that we are out of time and you have to run on to other commitments. I want to thank you so very much for everyone who is listening right now, you can get a link to Mona's book, "Beyond Behaviors," her website, Facebook, Instagram, and Twitter. All of that information and links will be in the show notes and you can get those at parentingadhdandautism.com/096. And with that, we'll end this episode and I'll see everyone next time.
Penny Williams (39:57): Thanks for joining me on the Parenting ADHD Podcast. If you enjoyed this episode, please subscribe and share, and don't forget to check out my online courses, parent coaching and mama retreats at parentingadhdandautism.com.
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