The Human Centered Design Podcast with Gerry Scullion

"Empathy, Neurodivergence, and Holistic Support: A Conversation with Occupational Therapist Suzanne Hanway"

John Carter
January 29, 2024
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"Empathy, Neurodivergence, and Holistic Support: A Conversation with Occupational Therapist Suzanne Hanway"

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We speak with Suzanne Hanway, an occupational therapist from Dublin with 28 years of experience. Suzanne discusses her journey into occupational therapy, the focus on daily life aspects, and the impact on illness, disability, or neurodivergence. The conversation delves into neurodivergence, advocating for a unified term and emphasising acceptance. Suzanne highlights challenges faced by neurodivergent individuals in accessing services and the importance of strong connections between parents, schools, and therapists. The discussion covers the prevalence of neurodivergence, societal understanding shifts, and Suzanne's emphasis on a holistic, body-based approach, including movement breaks. The podcast concludes with Suzanne advocating for tighter policies, standards, and structured training to enhance collaboration in supporting neurodivergent individuals.

A really interesting one, particularly for those with an interest or any personal links to neurodiversity. Enjoy!

Episode Transcript

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[00:00:35] Gerry: Look, Suzanne Hanway, I'm delighted to have you on the podcast. I've been asking you to come on this podcast. I was saying to my wife today, nearly a year. Please Suzanne, come on, please.

I'm very busy, which is a good sign. Maybe we'll start off, maybe tell our listeners a little bit about yourself, where you're from and what you do.

[00:00:58] Suzanne: yeah, so I'm, Suzanne and I'm, I was very lucky to be in the profession that I'm in. I'm an occupational therapist and have been so, I said I was thinking about that. I was like, oh my god, 28 years!

[00:01:11] Gerry: years?

[00:01:12] Suzanne: 28 years! So I obviously don't look that old.

[00:01:14] Gerry: you only look here about 25.

[00:01:16] Suzanne: And I kind of started off, I didn't go into OT straight away, I went into science in UCD and I started off and loved the sciences, loved it, kind of, you know, the biology side of things and went into UCD and I was like, Oh my God, it's like cattle market.

There's 500 people in the lecture hall. I'm not really understanding this. I don't understand that. And went this, I'm not getting that connect, you know? and I think that connect has been a hallmark of my career and where I've gone. So anyhow, I switched, and applied for OT in Trinity. Well, first of all, I kind of went and visited a couple of places, spoke with an uncle of mine who has a very significant physical disability.

And his first OT was Anne Beckett. Who is a niece of Samuel Beckett,

[00:02:03] Gerry: Oh, really? Wow.

[00:02:04] Suzanne: the first OTs in Ireland, and she lost one of her legs in an accident, and she was my uncle's OT, and he's very kind of affected by his disability in some ways, but what he's achieved is absolutely amazing, and he always spoke so highly, and he said, Oh, I think you might like that.

Go and visit a couple of OT departments, and I hadn't heard of OT before then. Looked into the course and went, Oh, I like that, you know, and it was a heavy course, you know, compared to anyone who was doing their 10 hours a week of lectures, it was 35, 40 hour a week lectures placement, but loved it. Like the minute I did it, I was like, okay.

And it was tough, academically tough. and I think something which has happened now that it was the case, it's, the match of the person you're seeing people maybe go into OT, not always, it's quite high points. and, they might academically be really gifted, but I think the personality of the person is hugely important to our profession.

[00:03:05] Gerry: just back up there a little bit on the OT point because some people listening will be like, what is OT? How would you describe what occupational therapy is? Because I remember hearing about it when I was studying 20 years ago and I was like, occupational therapy, is that something that happens in the workplace where you're, how you're sitting or like some sort of rehabilitation?

[00:04:06] Gerry: So just about how you describe the Occupational Therapies, it's something that happens in the office. That's my original kind of premise on it. hmm. 

[00:04:22] Suzanne: where the, I suppose the, principle of ot, it looks at occupational performance areas, so it looks at a day, it looks at life and what you do within that day. It's your work. If you're obviously in a job, it's your, education.

If you're a child, it's your play, it's your leisure, it's your activities of daily living. So they're your occupational performance areas. And then an OT looks at how an illness, how a disability, how maybe a neurodivergence affects your performance in that area and looks at ways to either adapt, compensate or develop your skills.

And again, it very much depends what clinical area you work in. You know, I obviously work in the area of kind of younger children, in care. It'd be very different my work day compared to if I was in, you know, Beaumont or a hospital, you know, much more of a rehab area.

[00:05:11] Gerry: Now, a lot of the listeners to this podcast in particular are designers or changemakers. So they're probably classified as creatives and they're all throwing their eyes up to heaven. I can see them now. But, a lot of those people and a lot of my peers at the moment. It seems to be, over the last five, 10 years, a lot of people have been assessed for things.

A lot of my peers are now discovering that they maybe have ADHD or just generally neurodivergent. I'd love to get your take on a description of what neurodivergence is. And then we'll come up with the second question is, and what are the kinds of challenges that you see that neurodivergence, you know, people with neurodivergence have in their daily lives.

[00:05:59] Suzanne: I think for, first and foremost, there's a shift with the understanding of neurodivergence. 

[00:06:05] Gerry: And 

[00:06:06] Suzanne: Yeah. And acceptance, it's not a, you need to be fixed. It's like, this is who I am. And there is a big shift. There is even a shift in clinical practice about, in a couple of years time, are we, going to have all these different diagnostic categories anymore?

Are we just going to have the term neurodivergent? Are we going to have DCD? Which is obviously, some people might know it as dyspraxia, developmental coordination disorder. ASD, Autistic Spectrum Disorder, ADHD, all of those come under neurodivergence. I think we're seeing, it's always been there, but it's never been connected to the same way that it has now.

I think we'll all look back in our past and we go, Oh, maybe I'm a bit neurodivergent. I definitely am. We look at people in our class and they're maybe just labeled, oh, they were labeled different. You know, they maybe had mental health issues, but there definitely is a shift to, to label things more.

I think in a couple of years time, it won't be that because there is more, again, more of a shift as well in accepting the person. And I very much do that within, practice. It's not. Someone is coming to me to be fixed. It's about giving them insights into it. Well, that's why that's hard for you to get really overloaded by sensory information, you know, and here's some strategies that might help.

So it's learning. strategies to, manage that neurodivergence and to navigate, and it can make navigating things a little bit more challenge when you don't understand it, but I always think it's when you understand it more, you can navigate it and you can figure out some people need to do assessment to figure that out.

Other people just go, do you know what I know? I maybe have as in an adult, I know I maybe have a neurodivergence, but I figured out how to, navigate that. So I don't need. a label, but obviously some people do, go that route.

[00:07:57] Gerry: mentioned there that a lot of your work is with young children, what are the kind of challenges they face because even though the industry within OT has evolved and has accepted the fact that this isn't about being fixed, society is somewhat behind. So what are the challenges

[00:08:15] Suzanne: I think the challenges are access to services. It's like, even in private practice, it's quite hard to access services, HSE services, waiting lists are, you know, just. Bunkers, absolutely bunkers. So the, clinical services and the HSE. And there's some fantastic professions within those areas, but waiting lists really are, a challenge.

I think schools can be, a challenge. The more people that can tune into the person's individuality. and I absolutely appreciate teachers of a class of 30 odd kids and they can't always make it. But if they hold that neurodivergence in their head relating to all the kids, That can be really good. So I know for me, I get better outcomes in the work I do when I get that really good connection with the parent and I get a really good connection with the school and the parent get that connection with the child.

And really outcomes in intervention are stratospherically different. It's the ones where I'm saying that, Oh, we haven't got the school on board or maybe mum and dad aren't as tuned in to where, you know, their child is at. That really does affect. So as an OT, I very much try and coach and empower parents in schools to get that connection because it's really, powerful.

And any of the research that's coming out now says, you know, getting that connection first and foremost, really influences outcome

[00:09:41] Gerry: Yeah, now on that point, the, pressure on schools to support, an additional need, if you want from a child, if you had a class of say 30 and they were all assessed, how many of those children would you say on average would be a neurodivergent

[00:10:02] Suzanne: A third, I would think,

[00:10:04] Gerry: about a third of a class of 10? So. In my year, like when I was in school in the early eighties, all the way through until the mid nineties, there was definitely people that were in my class that would've been neurodivergent, that would've learning disabilities, and they were kind of classified as just being difficult or slow or any of these terms that are very kind of derogatory.

but we've noticed a shift that's happened in the last. Definitely 20 years, anyway, with my generation of parents, there seems to be an acknowledgement that we could probably better support people. What do you think is behind that? What has caused this kind of universal shift to kind of global understanding that we're all different and we're all unique?

[00:10:56] Suzanne: I think of you. I think models of practice have, have, have evolved. I think that the training that teachers and clinicians are getting, you know, is, sowing that seed, you know, and it's. It's the ability to reflect and go, what we were doing wasn't working well, you know, neurodivergence when it wasn't being supported, when it wasn't being understood, you were seeing the impact in the mental health services.

And there's so, you know, I look back to my own, you know, clinical placements within my training and some of my earlier work, and you saw people who had very significant mental health difficulties and you know, it's because their neurodivergence wasn't understood. You know, so the mental health services then were getting blocked up and they're going, Oh, there's something not quite clicking, you know, we need to go back.

We need to look at what we were doing from the very beginning. So I think it's a

[00:11:45] Gerry: More of a holistic approach, more of a correlation, you can see, well, This generation are relatively unsupported and it's having a, an effect in the health services later on in

[00:11:57] Suzanne: Hugely so. I'm like, you would see, like, even in the prison system, you know, there would be definitely kind of people who would be maybe on the spectrum who it wasn't picked up, it wasn't picked up, and their social difficulties then were, misinterpreted as, oh God, and they ended, they were very, socially maybe vulnerable, and they ended up in situations.

So definitely research would show that there are people in the prison system who haven't been diagnosed. so I think there is a plus for, diagnosis in, in, in very many cases. So being able to kind of understand and say, okay, let's look behind the behavior. And I think that's a key thing that I look at in practice and get parents in schools.

Don't just look at the behavior. Why is it there? What is it? What is the intent of that behavior? And if we can figure out the intent, we can shift things rather than a behavioral or we're going to stop it. We're going to reduce it. In some cases that does work, a more cognitive, approach, but when there's a behavior there that has more of an emotional component, our limbic system, you know, and you think of the flip the lid, this is very basic.

So your limbic system is kind of your thumb and it's chucked away over your frontal, lobe, your executive function. Okay. Okay. So if your limbic system is on fire, we flip the lid and executive function and frontal control is gone. And that's the behavioral sign of things in, in, in very many cases, certainly the cases I would work with.

So if we go back and we do body based approaches, we go back and we say, let's support the limbic system. Let's get that regulation that connect and we keep the executive function and the limbic system. You know, tucked away, you know, it's like when the child has an absolute meltdown, language, you know, they're not going to process it.

They're not going to hear it. So we need to let that limbic system settle down and that frontal, the frontal part, you know, come back. That's it. It's accessible.

[00:13:48] Gerry: To regulate. Okay,

[00:13:50] Suzanne: you know, in some of the work I do with children in care, it's encouraging body based approaches rather than a cognitive approach.

[00:13:58] Gerry: which is like one of the questions that I had for you, like with occupational therapy, the help that you can provide to children. 

[00:14:04] Suzanne: Hmm. 

[00:14:05] Gerry: what are some of the activities that you do that maybe teachers or people who work with children can start to incorporate into their, practice, so to speak?

[00:14:15] Suzanne: Yeah, movement, like movement is absolutely so powerful. you look at maybe a model like Finland where children get movement every 15 minutes. So

[00:14:25] Gerry: they do this? Like, let's stop on this one a second. Because like, when you look at a classroom,

[00:14:30] Suzanne: but it could be just even at the desk, it could be, let's everyone stand up and, you know, shake your hands,

[00:14:35] Gerry: books on each other.

[00:14:36] Suzanne: Yeah, it has to be, and this is where I try and work with teachers and say, it doesn't have to be that you're going into the PE hall, it doesn't have to be that you leave the class.

You can have those really quick and easy, you know, shifts and movements then allow the brain to be accessible for, learning. So you think of it like filling your cup up, the cup will fill up and if the child's cup is full. Pouring stuff in, it just overflows. So movement sometimes can allow that cup to empty a little bit and for there to be capacity for connection and learning.

So, really simple, quick movement breaks, even before, like a handwriting activity, could be everyone shakes their hand out. You know, shake them up, shake them down, stretch them out. Really, simple things and teachers that buy into that and see it as a support for the curriculum definitely have better outcomes of engagement for all the kids, not just kids that are neurodivergent.

[00:15:29] Gerry: Yeah. It's crazy.

[00:15:31] Suzanne: this, even I have to say, for me, like I'm sitting with you now and I'm really focused on the screen. I know by the time I'm finished, I'll need movement.

[00:15:40] Gerry: Yeah.

[00:15:40] Suzanne: You know, I need some movement before I go on to something, else, because I've really had to focus, I've had to tune everything out to, you know, to engage.

So I think teachers can do that. bilateral movement, some movement that involves two sides of your, two sides of your body. There's a huge amount of research around how that it supports executive functioning, you know, impacts on processing speeds. It impacts the literacy and numeracy. So having movement that has that bilateral.

So it's using the two sides of your body and crossing, crossing over with

[00:16:12] Gerry: So what would that look like? If you're, to give us an example, I know you've got so many amazing methods, haven't seen you in action. what does that look like in terms of methods? Because we're talking about stuff here that you can apply for children, but it's obviously, it applies to adults as well.

Like I train an awful lot of adults and I do incorporate some sort of. Games and, activities and movement. Probably not enough though, based on what you're telling me here. Like, you know, like if we're doing a six hour workshop and we're splitting it into segments, there's probably enough opportunity there for all of us.

Change makers to, to weave some of this thinking into our practice.

[00:16:51] Suzanne: Oh, hugely so. So like a quick and easy thing could be everyone stands up and there's a thing called a cross call where you get your right hand to touch your left knee. You get your left hand to touch your right knee, you know, so you're crossing over that midline, so you're

[00:17:03] Gerry: the hokey pokey, turn around.

[00:17:06] Suzanne: Yeah. You know,

[00:17:08] Gerry: it's all about. That kind of stuff.

[00:17:10] Suzanne: jumping jacks, even something simple like jumping jacks.

[00:17:13] Gerry: Yeah.

[00:17:14] Suzanne: you're using and you watch in a classroom, kids doing jumping jacks and you'll go, Oh, and you'll see the difficulty some kids have and some adults have with that bilateral. But there is great power in bilateral based movements, you know, and as opposed to, you know, there, there's a misconception sometimes that, you know, Oh, game of football, a game of football can, some can be someone's absolute nightmare.

You know, for a child who gets really overloaded by sensory information, for, you know, a child that struggles in maybe in those big, noisy groups, a child who doesn't have the coordination, the quick postural control, it's an absolute nightmare for them. And it sends them back to class really dysregulated.

So it's knowing what movements will regulate. As in kind of keep you in that nice kind of zone or what movements can dysregulation send you up that you go back into class and you're going, Oh, I can't focus on my maths and my, Irish,

[00:18:08] Gerry: Was probably most of us in school in the nineties.

[00:18:11] Suzanne: Yeah. So, so I think it's, teachers again, I'm a great believer in, you know, coaching and empowering people with the knowledge and when they have the knowledge, I've done work with teachers and they'll go, Oh, I feel so bad now.

I was stopping a child swinging on their chair. Now I know that they just weren't getting enough movement. Opportunities in the classroom, I'm going to go back and try and do that before a really demanding cognitive task.

[00:18:35] Gerry: One of the pieces that I, really came to respect was the OTs kind of, kind of collaborative nature of wanting to incorporate their learnings with the other disciplines, like teachers, the medical professions. But there seems to be a lack of, opportunity there, like a system to feed into it.

Like it's, very broken in those kinds of channels. So the evidence that you have based on scientific research for a parent to go back to the school or the medical profession, like a doctor and stuff, they're required to be the proxy between all three or four of them. What do you think the future looks like for Government services that are more holistic and being able to document and share so you all kind of access the same Repository of information.

[00:19:28] Suzanne: I think it's challenging. I think we still

[00:19:32] Gerry: data challenging as well. Probably.

[00:19:34] Suzanne: Yeah, I think we still have a long way to go. I think it's setting the structures and the standards in place and not just kind of keeping it too loose and allowing every school to operate. And obviously they do have standards, you know, and that's, you know, they're all doing amazingly, but it's to kind of say, okay, you need to pull these people in.

So having a standard, so it's not left. So loose. So I think there needs to be tighter policies and standards and there is that shift but things move so slowly within the public sector and obviously the private sector as well. I think it's getting in it from a training point of view. So in teacher training.

training of medics, training of all the professions that you need in that team, that everyone is on the same page and understands that profession. Because we don't always understand that the framework and we need to respect that profession and how we can connect and engage the, best. So I think it starts from the really early, the training and having that framework in place.

So if a teacher goes into a school, they know, okay, These are some of the things that I might need to, look out, for. And it is happening, but it needs to be certainly 

[00:20:45] Gerry: yeah, absolutely. One of the things that I've basically been working on for the last nine months, as you know, the Makers and Doers School, because I know you've been interested and you all have shared it out on your own social channels, and I really appreciated that, the importance of other avenues for children who aren't, say, Sporty, who aren't, kind of interested in doing the traditional sports like football or tennis or any of these things, they may find it very difficult due to the coordination or just interest.

What do you think, or do you think, the opportunity lies with the arts and crafts and design generally? What would that give? To children, like if it was included much earlier, because I know other countries in the world, like Finland, they introduce design at a much earlier age. What's the effect on their brain, the younger brain, by weaving this kind of thinking into it?

[00:21:42] Suzanne: Oh, I think it has massive positive impacts. You know, it's the construction part of our brain is being, is it being fired up and the ability to develop what we call our praxis skills through, play, design, creative activities and everyone needs to be able to, have strong praxis. You know, the term dyspraxia comes from difficulty with the skill of praxis and praxis is about ideation, getting an idea.

Sequencing and doing it. And when we, you know, play with Lego, when we make things, we have to get that ideation and then we have to sequence all the steps. And this is when I look people, you know, having free play on Lego and not just reading the instructions, you know, and building it. And, you know, I certainly have had some people and you go on, I glued it all together and you're like, Oh my God.

Like, you know, so the brain

[00:22:31] Gerry: send me mad.

[00:22:32] Suzanne: like there's so many parts of the brain that get stimulated by that, that, that creative, that ideational play. It's really, powerful. And I think it's really important. And there's definitely a shift in schools and in that kind of opportunities and learning as well.

I'm a really, strong advocate. For the need for really holistic options for sports in school. It shouldn't just be AA, it shouldn't just be rugby, it shouldn't just be soccer. Because you want someone to find a physical outlet that they get their joy from. And if we really have it that narrow, children then, I suppose they get it, they get a sense, I'm not good at sports.

You just haven't found your sport. You know, it brings me back to my own school days. God, all our PE teacher did was basketball and rounders, which I was absolutely rubbish at. Rubbish at. And you just had to do that and there wasn't, there was no other options. And certainly as a younger adult, it took me longer to navigate and find the sports that I got my joy from, but that was because I'm just that kind of a person.

The system wasn't doing it. And I do think schools need to make sure they offer enough afterschool, they offer enough Children can find their physical outlet that they get their, joy from, because we see a huge correlation with children, maybe who have DCD, who never find that sport, they get obese, mental health problems develop later on in life.

So it's actually really important to do all that sampling and find the activity that gives you joy.

[00:24:03] Gerry: So it's not really about, an alternative then is what I'm hearing. if you like sports, great. You've got lots of opportunities. If you don't like sports, don't give up on it. Find a Sport that the child does like, but there is an alternate. Neely needs to be complimentary for all Children.

[00:24:21] Suzanne: I think you need to do both. You need to do the creative medium and you need to do the sports medium. I think they shouldn't be, they shouldn't be neglected.

[00:24:29] Gerry: That's really interesting because a lot of people, a lot of the parents that I spoke to when I was kind of like prototyping makers and doers, they were like, Oh, this is great. It gives them an alternative to not having to go and do the football on the Sundays or the Saturdays, whatever days.

And I was like, yeah, but it still didn't really sit right with me. And it's really refreshing for you for me to hear that you're saying that it should be complimentary. It's not just an exclusionary exercise.

[00:24:53] Suzanne: And maybe that occupies more of their leisure time. The creative, that's okay. And the same way someone, maybe the sports, you know, occupies more of their time, but it's to get the mix of the, two of them is important and can be hard for some children to find that,

[00:25:10] Gerry: sure. Yeah, absolutely. Especially in a crowded space like, you know, when you go out on a Saturday morning in your car to drop your kid to a sporting event, you just see how many sporting events have just popped up in the last 10 years. It was the same in Australia, same here. I think the world is kind of like realizing that there's a lot of benefits for this extracurricular activities after school.

[00:25:36] Suzanne: Yes and no. I think it's, you want after school activities, but you want that, yeah, you want that unstructured time.

[00:25:44] Gerry: I was about to say, what does that come with a risk? I know from speaking to you before, a little light bulb went off in my head. I wouldn't claim to have a big light bulb going off in my head because, you know, my brain isn't as big as you think it is. But you saying to me before that too much and too many of these classes.

in terms of structured play, has its disadvantages. Can you tell me a little bit more about that? 

[00:26:14] Suzanne: you think of what we talk about ideation, being able to figure out how to occupy your time.

[00:26:19] Gerry: Yeah?

[00:26:21] Suzanne: if we schedule our children, and it's not always the case. Some kids can have everything scheduled for them and they're fine. They can figure out, they can occupy, but an awful lot. They're like, okay, what am I doing today?

Where am I going? What activity am I going to? But the skill from a mental health point of view. And a learning point of view, this, the ability to reflect and have time on your own as a child, as an adult, and figure out what you're going to do and how you're going to occupy your time is such an important skill.

And definitely as a parent, I can absolutely relate how you need, you know, your children occupied because you're working and you, know, they can't just be. You know, your child, you want to reduce your child minding fees as well. So as you can see that from a parent's side, and I remember post, posting an, in a parent's WhatsApp or, social media forum link to my own, something like, like that in my own children's good.

Oh, I got eaten. And I went, okay, well, like you're obviously not a working parent. Well, no, I am a working parent, you know, and maybe that free time is a little bit at the weekend when you're not, when you're not at work, but you really are empowering your child with a powerful skill.

[00:27:24] Gerry: Yeah, so 

[00:27:26] Suzanne: okay, I've got an afternoon.

Oh, I'm going to, I'm going to do some painting. I'm going to, I'm just going to read a book. You know, and being able to, quieten ourself down as well, because you're like a rollercoaster and you're up there all the time when you're doing all the activities and the brain needs to be able to go, okay, I can slow myself down.

[00:27:44] Gerry: Yeah.

[00:27:44] Suzanne: You know, that ability 

[00:27:46] Gerry: when you say it.

[00:27:47] Suzanne: to come down is, really important as opposed to, oh, I have to be going all the time. I can't slow down. I can slow down.

[00:27:54] Gerry: That was, in one of the pre chats we had for this, you were talking about that whole kind of giving space and permission for them to do what they want. And our, my children are quite young, like they're four and a half and nearly seven. And. I was Oh, we haven't really done that. Like on Saturday afternoons, it's usually like, OK, let's do something else after a busy Saturday morning.

Whereas now we're starting to weave in some of your advice in terms of OK, like for the next, you know, two hours you get to do what you want. and it could be just letting them play in the garden. It could be letting them do Lego, whatever it is like, you know, but the Children are finding it difficult.

Well, my Children are finding it difficult to let go without. Parental supervision. And I know I'm not alone in this. So what advice would you give to parents who are trying to incorporate some of the things that we've spoken about today in this episode, and they're struggling with their child's neediness and clinginess, saying, come on mommy, you need to play over here, come on daddy, push me on the swing.

How do you get around that? How do you, introduce this without having them kick off and, you know, getting a thump in the head?

[00:29:04] Suzanne: I think sometimes it's the adult needs to engage with the child. If they haven't got the ability to play on their own yet, it's sometimes the adult getting that connect. With the child, and getting the child then in that zone where they're nice and regulated and they haven't got attachments and regulation.

There, there's a concept in, a framework called sensory attachment, intervention by an OT called Aideen Brannock, who's absolutely amazing. And she developed this model, around sensory attachment for, children who've had adverse, you know, childhood experiences. And one of the things she's really strong at is the activity that you have shared joy and pleasure.

So it's the adult and the child finding something that they can connect and they both can have that shared joy and pleasure with. And with that comes connection, comes regulation. And then when the child is connected and regulated, then they're able to go off a little bit on their own. So it's also grading and going, okay, well maybe they're not able for the two hours.

Maybe it's just a half an hour. Maybe it's only 10 minutes. So 

[00:30:06] Gerry: build it

[00:30:06] Suzanne: it's building it up. So it's, setting the targets, right. And as, as a clinician, you know, you have to reflect on that as a parent, I think you have to, because you can set the bar so high. We're setting ourselves as parents up for failure.

You're setting yourself as a, professional. Oh God, now that was, you know, it's like someone saying to me, you're going to have a six pack by the end of the week. Like, that's not achievable, know? 

[00:30:29] Gerry: done any exercise. How did you know?

[00:30:31] Suzanne: Yeah. Do you know, so we have to set the bar at the right, you know, it's the just right challenge, you know, and there's so many little phrases that I've kept as a therapist from, you know, maybe a clinician influenced or a course I really did, things like shared joy and pleasure, connect, that connect before you regulate, the shared joy and pleasure, the connect, and then the, what was the other one?

What was the other one I was saying?

[00:30:58] Gerry: Share joy and pleasure.

[00:30:59] Suzanne: Reregulate. The Just Write Challenge.

[00:31:02] Gerry: The just right

[00:31:03] Suzanne: The Just Write Challenge. Because you can set, like, I could have a session for a child set up with all my goals. And all my ideas and all my challenges and the child could come into the room and I go, you know what?

They've had a difficult transition. they're not really in the zone of sitting down and doing this activity. I'm going to have to change tack. So I'm going to have to get my challenge just right as to where they are at and I have to connect with where they're at. Then when I connect with where they're at, they're going to be more regulated.

Then we can challenge them.

[00:31:32] Gerry: Okay. In terms of accessing services, it was one of the first things that you called out in terms of the difficulties for parents at the moment, trying to find the right channel, the right support channel. In some cases, it can take years for a parent to find a, resource and then Be the right resource

[00:31:53] Suzanne: Yeah.

[00:31:54] Gerry: because they're waiting so long before they can actually experience it.

For people at the moment who may have a sense that their child is neurodiverse, what advice do you give them in terms of being able to support them in the interim?

[00:32:12] Suzanne: I think it's not jumping the gun to do formal diagnostic assessments straight away. I've had quite a lot of parents who come to me at the end of a journey and they have done so many assessments and they still none the wiser about how to work with their, child. I think it's finding a person who can support you to go, Okay, where are we at?

How can we map where we need to go to? What do we need to do first? What do we need to do next? The HSE run lovely drop in clinics that can be quite useful. You know, once a month they do drop in clinics and I would encourage a lot of parents to, do that. In my own practice I do that quite a lot at the start.

And I've turned away people and said, you know what, in your journey I don't think OT is where we need to, start. If I do assessments, I will always try and map out, this is really a priority. This is what we need to look at now, next, mapping that out. But I think as a parent, it's really finding someone who you can connect with on a relational level, because when you get that relational connection, then I think it's much easier to map things out, you know, and I've seen so many reports from parents and they paid so many, so much money for, and they're not buying into it. But they felt because this person had all these letters after the name, you know, or they so many years of experience that, Oh, this person must be right, not always, you know, there are some cases that it can be very hard to figure out that diagnosis and it needs a very skilled team of, clinicians as well but I think it's not writing off the HSE. There's some, you know, some nice things going on within the different areas, dropping clinics. You know, for OT, for psychology and they're, chats and they can be good starting places. So to link with someone within either the HSE, you know, if your GP is really good, if you have a private therapist, say, listen, I just want to brainstorm and I don't know where to go.

And I would do that a lot in practice and it's really shifted how I provide services to, to, to families.

[00:34:15] Gerry: One of the things that I wanted to kind of start wrapping up the conversation on is the proliferation of Instagram. A lot of parents, myself included, use it. And there's a lot of mum's advice out there that maybe have parents or have children who are neurodivergent. And they're offering advice. How do you see that playing out?

[00:34:39] Suzanne: I'm mixed about social media, definitely mixed about, and there's some wonderful Instagram accounts. And then there's some one, there's some that I think they're quite fake, they're quite false. It's about how it looks. I know myself, I try, I share a little bit of my social media, not a huge amount. I think the pressure, to kind of have it look amazing.

You know, have your makeup, have your hair, have your content looking really snazzy and then getting too generalized in recommendations. And I see a lot of content on social media, and that's what I say. There's some wonderful stuff. Really, And it's too generalized. You can't, you can't generalize some things, but some of it really isn't going to fit for your child.

So I think it's not to use that as your Bible. I think it's dip in, dip out.

[00:35:29] Gerry: yeah. My friend Rachel Deacus is a trauma informed design specialist in, the White House at the moment. She calls it practicing without a license. 

[00:35:39] Suzanne: yeah. 

[00:35:40] Gerry: and there's that. Yeah, so, there is a risk when it comes with that. One of the pieces I just want to go back to, you mentioned there were an ideation and the praxis, part of the brain really struggles.

In the prelude to this, you were saying some people just can't do it. They just can't do ideation. And for all the people out there who run workshops, myself included, for, clients, I've seen this firsthand. I watch people in, you know, leadership and executive positions being tasked with some stuff that in the design world, we'd be like, this is pretty, this should be easy enough.

And we whisper it and we just watch them stand there and like, you know, like phone and not be able to actually attempt it. What's happening there? Was that a case of like way back, they were unsupported in their development and they weren't able to play or

[00:36:39] Suzanne: It could be this, the lid is flipped,

[00:36:42] Gerry: Right. Okay. Is it possible if that lid is flipped to help them? What can we do to help them?

[00:36:49] Suzanne: you know, it could be at the start of maybe an activity, or like a workshop, have movement!

[00:36:53] Gerry: Right.

[00:36:54] Suzanne: Not that movement is the answer. It sounds like movement is the answer for everything. But it's, you know, 

[00:36:58] Gerry: Michael Jackson on

[00:37:00] Suzanne: it might be doing that. Like getting that movement. So if someone is coming

[00:37:04] Gerry: bilateral movements.

[00:37:05] Suzanne: bilateral movement, yeah, exactly, But you think you might go into a workshop and you might be stressed, you might be socially anxious. You know, some people go into those social situations. Lots of people they don't know.

So your limbic system gets activated. You know, your limbic system gets more activated, and if your limbic system gets activated, as I said, flip, flip the lid. So, and then you're like, okay, come up with an idea. But your limbic system, you know, it could be even something simple like a really, cold drink as well.

Like the, nerve that

[00:37:35] Gerry: me. This

[00:37:36] Suzanne: the vagus nerve that connects the gut and the brain. A cold drink, splashing some cold water, settles that down. Breathing, you know, so either doing, and there's a big shift to mindfulness and, What's the guy? He was, he's a comedian. He's doing some lovely stuff.

Oh my gosh. Dermal Healing. And he's, left the radio show and he's doing stuff

[00:37:56] Gerry: Oh, yeah.

[00:37:57] Suzanne: world. Some really, interesting stuff. But I think doing mindfulness, doing movement, before then the, more challenging cognitive tasks. So everyone is in that zone. Everyone is in a more regulated zone because everyone will respond different to coming into that environment and the stresses and the unfamiliar as well.

[00:38:15] Gerry: Yeah. Suzanne, you could talk about this stuff, and I know you can talk about it for days. Okay. How do

[00:38:25] Suzanne: my husband says, are you not still talking about the same thing?

[00:38:28] Gerry: Yeah. Is it a case that you could ask a question, leave the room and come back in and you're still talking about it?

[00:38:35] Suzanne: Quite possibly, quite, like it's my passion, you know, I

[00:38:38] Gerry: know. Yeah. You can

[00:38:39] Suzanne: love the work I do. I love problem solving. I love being, you know, there's, an OT, Kim Bartell, who uses the term a behavioral detective. You love trying to figure out, you don't always figure out, but I certainly enjoy the challenge.

And I'm not afraid to ask someone else if I don't know I'm not this therapist that goes, I know everything. I know a lot, but I use the parents as a resource. I learned from the parents I work with. You've given me, you know, resources and tips and I really learned from the children that I work with. And I think to be that humble in your practice is really, I don't want to present this facade, you know, on Instagram that I'm this, you know, groomed, perfect person.

You know, I'm flawed. I have my. Character traits that, you know, my personality traits, maybe the, Oh, that's not, the best, but,

[00:39:31] Gerry: Well, we all think you're brilliant.

[00:39:32] Suzanne: Oh, thank you very much. But I

[00:39:34] Gerry: all think you're brilliant.

[00:39:35] Suzanne: having that thirst for learning and it's constantly evolving, you know, I've been an OT for a long time, but I don't, I still feel my learning is developing, you know, and that's why I loved when you were doing, you know, your workshops.

I said, Oh, that's really exciting. That's really different. I think that was great.

[00:39:52] Gerry: Where do you go to stay up to date? Like what, where are your, kind of knowledge pools that you, look at and

[00:39:59] Suzanne: peer group, I'm really lucky that I have a network of peers within my area and we'll share ideas. I think interdisciplinary resources as well. I work, you know, quite closely with speech and language therapists, psychologists, parents. So I keep up to date multiple ways, you know, social media to some degree, but I, can, you know, and you can go down the route and you buy a book that you've seen on social media and I've done it.

[00:40:26] Gerry: Yeah.

[00:40:26] Suzanne: And someone asked me recently about something that I bought through social media and she said, Did you read it? And I said, Oh, I got to chapter two.

[00:40:33] Gerry: Right.

[00:40:34] Suzanne: You know, so it was marketed, it was, really sold and it was, Oh my God, this is going to be amazing. Then I got it and I went, the contents of it, rubbish,

[00:40:41] Gerry: yeah. Bit wishy-washy.

[00:40:42] Suzanne: so, and obviously kind of journals, courses, it can get quite difficult when you've been an OT for as long as I have, because courses that are fresh courses that are new, you know, there's a certain kind of cycle of courses and sweeter courses that go around.

So it can be harder. You know, I went to England for a year to train in neurodevelopmental therapy because of that. so yeah, it's just been open and I think then the knowledge will find you and having those connections with people that inspire you as well.

[00:41:11] Gerry: Do you want to give a shout out to any books that you think that you're like that is a good book and that is a recommendation

[00:41:16] Suzanne: Yeah,

[00:41:17] Gerry: any parents or any people

[00:41:18] Suzanne: love the well balanced child. by Sally Goddard Bly, I, which is about all our early life experiences and, you know, our primary reflexes and how that can affect learning. There's another book by an Irish OT, Enis Lawler, Max and Me, a story about sensory processing, which I love and the kids that come into me love.

It's cartoons and it's about a little boy called Max the Modulator and what it's like to be in his world, but it's very affirmative. Love, love those two books.

[00:41:47] Gerry: Okay. Nice. I'll find them. I'll put a link to them in the show notes. Suzanne, if people want to reach out to you and follow you and learn more about what you do, what's the best way for people to get in

[00:41:58] Suzanne: Yeah, I'm on Instagram. I, think I didn't change my handle. I used to do a group called Master Movers. so I think it's Master Movers OT. 

[00:42:09] Gerry: it and I'll put it into the show

[00:42:12] Suzanne: and then my email, Suzanne That's always, a good, starting

[00:42:17] Gerry: Suzanne, I wrap every episode up by thanking the guests for their vulnerability, giving me their time and energy and being put on the spot and being able to speak with somebody like me. you know, I really, appreciate it because I know you are so busy. Like if people realize Suzanne Hanway, like the demand for Suzanne Hanway is.

It's through the stratosphere. So to give me an hour of your time, I really, appreciate it. So keep doing the great work that you're doing. And in the future, you're always welcome back to the podcast.

[00:42:49] Suzanne: enjoyed it and it's really interesting just to kind of finish up, I was getting ready to come and I was putting on this kind of more formal shirt. And I looked at myself and I said, Oh, that's not giving me joy. And my favorite color is orange. And I,

[00:43:02] Gerry: It

[00:43:02] Suzanne: is not remotely a work, like if you want to present a facade.

And I went, you know what? It's given me joy and I'm going to be in the zone. I'm going to be comfortable as opposed to this white stuffy shirt that might've looked very professional. And I went, you know, I want to have joy. I want to show the real me and I want to be in the zone and 

[00:43:22] Gerry: That's great. You did that because everyone who listens podcast, they're all about, you know, kind of presenting their best self. So, you know, you're living the mantra. Suzanne, thanks so much.

[00:43:34] Suzanne: Listen, thanks a million. Bye.

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