Autistic Children & The Whole Family Approach with Dr. Taylor Day

Dr. Taylor Day is a child psychologist who uses a neuro-affirming approach she calls The Whole Family Approach in working with families of autistic children.

Her own experience of having an autistic younger brother (and a mother who fiercely advocated for him) has shaped not just her career path but her approach within her clinic.

This is PART ONE of two. Listen to PART TWO: Diagnosing High Masking Autistic Children 

You can follow Dr. Tay on socials:
Instagram: @the.dr.tay
TikTok: @the.dr.tay

Learn more about her clinic and services: DrTaylorDay.com

Listen to her podcast: Evolve with Dr. Tay
Episode 16, her family's autism story

"No Bad Parts" by Richard Schwartz (affiliate link)

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I am sharing my lived experience. If you relate to any of the content in these episodes, do your own research and speak to a medical professional if needed.
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Transcript

Today's episode is with Dr. Taylor Day. 

She's a child psychologist using a neuro affirming approach where she works with families. To either diagnose their children as autistic or. Guiding them after a diagnosis, as far as what that means for the family, she has what she calls the whole family approach. She looks at early diagnosis as well as has a special interest in PDA. 

She also has her own podcast called evolve with Dr. Tay. We reference a few of her episodes in this. So if you want to learn more, definitely head to where every year podcast and listen to that.

Currently her license allows her to work with families in over 40 states in the U S. So head to Dr. Taylor day.com. If you want to learn more about how you might be able to work with her. 

She posts on both Instagram and Tik TOK  at  dr  dot tay dot day I'll add that in the show notes, but she's an entertaining as well as good resource to follow. She shares a bit of her own life and experience as well as professional tips and resources.

I recently put a poll out on socials asking whether you would prefer longer podcasts or breaking them into two shorter parts. So this is going to be the first. In that format, this is a longer podcast with her that I've broken into. What you'll get is part one today. And part two will come out shortly. 

So let's jump into  📍 it.

 

Thank you, Dr. Tay for taking the time. You do have your own podcast, which I'll link in the show notes, which is, can I just say such a wealth of information because you do solo and guest. And so sometimes it's just you as a psychologist who works with families that have autistic children.

Sharing your experience. And then sometimes it's like you've just had a sleep expert come on, which was  such a good listen. But if we could go way, way back and start how you got into how you got into psychology and how you specifically started to work with families that have autistic children.

Yeah, absolutely. So it definitely has a personal story to it. So my brother is 10 years younger than I am. So I was an only child for 10 years. I used to beg for a sibling and I was like, I don't want to be an only child. And finally, my brother was born and, it's interesting too, even how he, Came into this world.

Like it was a very like traumatic experience. Honestly, both my mom and brother almost didn't make it. In the U S he was in what's called the NICU, the neonatal intensive care unit. Cause the cord was wrapped around his neck. So it's interesting to even think ultimately he was diagnosed with autism, but even just like how things had to shift right away.

Of being an only child. And then all of a sudden it was like, okay. life really has changed. And so he was tracked by the early intervention system as a result of that and did have a language delay. But ultimately so my mom had him in multiple therapies, as a toddler. I believe he was in speech.

He was in O. T. He I don't think he was in PT because he was quite like active and, had good gross motor skills, but they were tracking him and he was, I think things just weren't clicking and my mom felt like there was more. And so at 23 months of age, ultimately she advocated for a diagnosis.

So my brother is 24 now. So this was over two decades ago. Like early diagnosis was like. Pretty much non existent. And she just was like the squeaky wheel that didn't give up. And I feel like that is one of the like principles I bring into my practice so much because I think it was so modeled for me.

And yeah, I'm 12 at this point. So I very quickly learned what autism was. And I think before we even had a word from it for it, from 10 to 12 we're providing a lot of accommodations and supports. And my brother would have.  two plus hour meltdowns. He would sit there and he'd like open and close doors repetitively.

We were hardly ever leaving the house, like life dramatically changed. And then autism just ended up being a word that described it. And so ultimately went through like very intensive early intervention specifically like ABA therapy, which now is definitely,  there's a lot of conversation around ABA.

And if it's the right approach but that was all that was available back then. But my mom also advocated for a very naturalistic approach where she was like, so they sat him down at a table and they like started trying to get him to match card, like flashcards. And my mom was like, give them the whole deck.

And they're like no, that's not how we do things. My mom's give him the whole deck. And. They gave him the whole deck and he like matched everything and they were like, oh, okay. And so my mom was like, we're not going to sit at a table. He was in therapy for ABA for 40 hours a week. And then plus additional therapists were coming in.

We probably had therapists in our house for 45 hours a week. And so it was very naturalistic. And so I think that  I don't even think I know it very much shaped, my career trajectory. I knew pretty quickly that I wanted to be in the autism field. I thought I wanted to go to med school. So all of college, I was planning to go to med school.

And  yeah and it's actually interesting. I wrote in high school, I was in what's called the IB program, the international baccalaureate program This is how much clarity I had. And I was like, I want to write it on early intervention for autism. And my advisor was like no. That's like way beyond your scope of what this extended essay is.

And I was like, no, this is what I'm doing. So my mom and I clearly have similar characteristics. But. Anyway, long story long, psychology came about because I started getting connected with research and I was like, I really like this, but I knew I wanted to be on the like clinical side of things. And so clinical psychology was this perfect blend of being trained in research methodology and also the clinical piece.

So I worked a few years after college, applied to PhD programs and the rest is history. 

Yeah. And so is that when you were in med school being exposed obviously to research, then you decided to make that pivot, make that shift? No, 

it was still in undergrad, but like I had all the qualifications. I think even leaving I, my senior I got involved in research a little bit before that, but it was my senior year where I finally was like, maybe I like this.

And I like, didn't feel excited to take the MCAT. So I was like, Okay let's explore other things. Let's go get a research job. So I never applied to med school, never took the MCATs, anything like that. Once I discovered psychology, I was like, I think this is the path for me.  

Yeah. And you do have, I'll link it.

You have a whole episode where you go through  the real details of  your brother's upbringing and birth and  everything. And,  Because I don't think it needs like a asterisk. But in that episode, I found it really interesting that you were using some things that maybe people would call quote unquote outdated terminology.

But you also said, I am telling our story as it happened in that episode. The, early 2000s, and this was the language that we used then. I thought it was interesting that you added that and you didn't try and censor yourself. It was just authentic of how you remember speaking about it in your house.

Exactly. But it also  

shows, like, how quickly our language evolves and changes and just that going from someone with autism to now, I think there's still a bit of the debate in the community, but for me, as someone who's autistic, I,  for saying I'm autistic, but the language has just, it's shifted so quickly.



Yeah. And I think my brother, this is, again, I go more into this. They ended up, this was such an old school mentality. And as a, psychologist who diagnosed this autism now, I like highly disagree with this, but they ended up removing my brother's diagnosis about after about two years of intensive intervention, because he had made a lot of progress and gains.

And so he didn't grow up with this identity of being autistic. He knew about his diagnosis. So that was always an open conversation. He experienced a lot of anxiety, all of that, but it's interesting because it is, it even saying my brother is autistic feels,  it feels incongruent because it's like not the language we use in our house yet.

I use that every single day, if I get a parent or a kid that prefers with autism, of course I pivot, but my default is to say autistic, but it's almost like this.  visceral feeling that when I say my brother is autistic it's Ooh, that doesn't feel right. Because it's just, it's not his identity.

And I also don't want to project that onto him. He's very fine with me talking about it. I think I even asked him at one point, like, how do you want me to explain it? He was like, I don't care. So I think it's just interesting, but it was, it was my family's story. And I do think  just to tie this in as well, that this is where my values as a clinician come into play so much is I want to honor.

Each individual's experience and that sometimes means working with kids, each family's experience in this. I also, because of, all my mom's advocacy work, I'm super big into empowering parents of what's your gut telling you, and following that intuition. And then, also, and some of that is empowering them as experts of their kid.

I, of course, provide.  Support of, like, how do they start talking about  neurodiversity and how do they integrate this into their conversation and give their child a voice in all of this?  But as kids are, when kids are younger, they need their parents to advocate. And sometimes what that means is yeah, it's not going to be 100 percent what I think is the the quote unquote ideal.

I do have families that still do ABA. Do I talk about what the autistic community says about it?  Absolutely. And I'm going to talk with parents about how they can advocate for better practices, but I also am not living inside of their home. So I don't. As a clinician, thank me coming in and being like, you should never do this in terms of absolutes. 

I think just living this experience and realizing, the impact on the family and empowering parents is such an important piece of what I do.  

And you do have what you call the whole family approach, which I think it's just how everyone should be practicing, because as you say it is not just the autistic child that is affected, it is the whole family.

And you obviously experienced this  in your family growing up, but you see it every day. So can you talk a bit more about that approach and what sessions with you would look like, or what kind of working with you as a family looks like? Sure.  

Yeah, I think one of the things with in terms of what it looks like working with me, this is always constantly evolving right now as we're recording this, I primarily, once kids are diagnosed do a group therapy model where it is a lot of parent coaching.

So I'm not necessarily working. A ton with the autistic child themselves, but I'm talking about how do the parents help? How do they advocate for the child? How do they again, talk about the child's neuro divergence, all of that. But then we talk about the parent's capacity. We talk about how siblings are navigating this.

Like a lot of times when you go to therapy, it's okay, let's talk about the child and the child only and like centering on that. And we need to center on that. And yeah. I'm going to actually point this out because I've gotten some pushback of it's not about the family. It's about the autistic child themselves.

And I never want that message to get lost in the whole family approach because supporting the family unit around the autistic child directly impacts the autistic child. And so I and so I think that's so important. And so we do still center on the autistic child, but we're having broader conversations is how I would describe it.

So to like concrete examples of this. For example, visual schedules, they can be an amazing tool. First off, we're even considering, are they the right tool for your autistic child? I think that's an important piece in all of this. But say we determine the answer is yes. What is the parent's capacity to be able to execute this?

Because sometimes too, it's parents are like, yeah, I'm going to do this. And then they come to the next session. They're like, I've done nothing. And it's so easy to be like, oh my God, like I did this. Like I should have done it like beating. I see parents beat themselves up all the time and have this cascading effect of guilt and shame.

And I'm like, hold on, let's take a pause. So a child only focused approach would be like, Okay. Yeah. We need to do that. A whole family approach says, can we take a pause? What got in the way? No shame. I want you to just to help me understand what, this was actually a session I had. This was a while ago, but the mom's yeah, I just, I thought about laminating and how I was going to print things and what I needed to print and how I was going to make it.

And it was all these like executive function. That needed to happen and all these organizational skills and this mom actually has ADHD and she's I just got stuck in paralysis. And I was like. Oh, okay. Great. Now we know that your neurodivergence, it doesn't necessarily align with this tool in this strategy.

Let's shape it in a way. So I was like, you know what you can do. I want you to go take pictures of things just quickly around your house, put them in an album on your phone. And then that way you can talk about a nighttime routine. For example, the mom's Oh, I can do that. I don't have to worry about printing and laminating and searching and all of that, I was like, no, just put them, take pictures, put them in album, and guess what?

It got done. And that's the thing is, that's one example of looking at what is the parental capacity in all of this. And still getting what the child needs. But the other example that really comes to mind is the cascading effect, and we could still use this visual schedule, but there's so many things.

This cascading effect of guilt that is coming into play, of feeling, parents feeling like they have to have all the answers and all the solutions, they have to constantly be on. And so I find this, for example, when I'm talking about like the PDA profile, and we're shifting to toward more of a, low demand, high autonomy, high agency approach.

It's like society's telling us that's not the right way to do things. And so then what happens is parents will try to drop the demand of yeah, it's fine if you don't sit down with at dinner with us. But then they feel so much guilt and there's this secret expectation that's underlying it of but I really wish you would still sit down with at dinner with us.

I'm going to give you a choice, but they're really still is the right choice. And that creates so much undue stress for the autistic child. And so these are two examples of where these things are ultimately benefiting the autistic child, but we're looking more holistically at the family unit and how it's functioning.



Yeah, and that's one thing. I've actually had that exact conversation recently with a friend. And that was what I questioned of like, how much is that your stuff? Because I think in parenting, definitely for myself, I didn't realize there would be so much re parenting of myself while I'm parenting my child.

So my daughter's three and. In a lot of ways I am parenting very differently than how I was raised,  and the aspect of now knowing I'm neurodivergent and the fact that I'm autistic ADHD, my partner's ADHD, so our daughter is Pretty much guaranteed to be ADHD, plus it's very obvious comparing her to peers.

So there's that lens that we see everything through, but also just in, in regards to being a more respectful, gentle parent, whatever term you want to put on it, that is very different than how I was raised. And the default mode, I call it. in me is like really strong with some things.  I learned very early on that my motto  is does it really matter?

Does it really matter if she sits at the table? It doesn't matter. At the end of the day, if she eats, Who cares? But for me, I didn't realize how hard that internal struggle of working through my shit, for lack of a better word,  would be while I'm also very mindfully and purposely, obviously my partner also has a say, we're  parenting her in this certain way.

And I didn't know how much  that struggle would create so much conflict for me. And then sometimes leads to me being dysregulated when it seems like I shouldn't be dysregulated. But it's but you don't understand what's like going on inside of me right now. I'm stopping myself from doing these things that are my quote unquote default mode because I know I want to do it a different way. 

I literally, this is probably one of the biggest focuses right now in our group therapy, because I think this is so underestimated and some of it, and I'm very candid about this. And in that episode about my family story, I talk about it more. And then there's a later episode. I have my mom on the podcast too,  of I'm going through therapy right now.

And some of it is like related to growing up as a sibling. And I always say. And for so long, it was so hard for me to ask for help and want to go to therapy because I was afraid I was going to be indirectly telling my parents that they did something wrong. And I, what I realized is they were doing the best to their ability and it wasn't always enough.

And I blame the system for that, right? They weren't supported in this autism journey. Then why in turn would they know how to support me in navigating this completely uncharted territory? But I go to a psychologist who I absolutely love and we're doing a therapeutic approach called internal family systems.

And so there's an amazing book. I recommend literally like my group members laugh at me because they're like, here she goes again. But it's been life changing viewing things in this way. It's called No Bad Parts by Richard Schwartz. And he's the one that developed internal family systems. And it's about this parts work and like basically learning to reparent the these parts of us that are inside of us that often drive.

The bus, so to speak, and we'll take over and they're taking over because they learned that role and it's so helpful. It was so helpful for them when we were kids,  but now we have way more tools and strategies. And so I think read. Re working through this is so incredibly important. And I think sometimes I see this where the thing your child is doing actually ends up triggering other things inside of you.

And it's this cascading  effect. And so I think it's working through that. I think it's also like it takes a lot of intentionality to parent differently than you were parented. And so also working through that, but then what happens is these parts get activated and they think it's wrong, more likely than not.

And so it's learning how to talk to them, learning how to nurture them. And I find that is a key piece of parents being more regulated in  is less about the immediate. What do you do in the moment? But more like, how are you working through?  Through your own shit, we all have it and it doesn't mean you're flawed.

And I think for so long,  I was, I'm the helper by nature. Like it's in my DNA. It was pre my brother. And obviously I'm in the helping field and that's an area that it serves me, but it doesn't serve me in every area of life, like constantly feeling like I need to have the answers and be the helper.

And learning to let some of that go is so important. And you think about it from a parenting perspective, like that energy is like, of course, it's hard to be regulated in that moment. You have your own things that you need to work through that actually aren't about your kid and it's going to help you show up so much more clear minded.

So obviously I get, sorry, I'm like rambling because I could talk.  for so long. And it's like things that I say. So I love that you brought up this piece of it because it's so important. 

And I think when we do look at, say for, with that example, the whole family, it's also intergenerational. So for people my age, I'm a, Quote unquote, elder millennial, if they still have a relationship with their parents and then they're choosing to parent differently, like I've had some very sticky conversations with my parents, specifically my mom, because we just have much more of an open flow of communication about those things.

But  it, it can be really challenging to  know where to hold a boundary and where to. Be like, okay they just do things a little bit differently. And then also give them credit when they're obviously trying, but they have done these things and been this way for  years. And like their whole life, since I was a kid, one of the things that comes up  all the time, sorry, if mom's listening, but she knows this is like a thing,  the good girl,  the praise or just any type of.

Acknowledge it being good girl and I am  so against that because I, for me, feel like I had,  I'm dealing with like good girl syndrome, like that people pleasing. And so with my daughter, I'm like, there's so many other ways you could say something. And so it leads then sometimes to my mom quote unquote, slipping as she'll say and saying it. 

But like I said, giving that credit when like they're obviously trying but it's reprogramming 60 years of  habit and doing things and I think it's hard for me at 37 and then I'm like for them in their 60s.  

The default is so much more ingrained and yeah, and so with, my approach and with group therapy, if grandparents want to come join, I am more than happy to have them, and it is interesting, I think, especially in this space of this concept of like low demand parenting, high autonomy, high agency parenting, when like the theorized PDA profile is coming into play. 

Grandparents have a really hard time with that, right? Or even on this idea of compliance versus autonomy and advocacy, I find grandparents historically have a hard time with that because, how our generation was raised by our parents was very compliance based and praising compliance over self advocacy and I know I could go on a whole soapbox of this, but I'll say briefly, I think about it this way  is  with autistic kids.

We know that it's not that they don't learn or they can't learn, it's that sometimes it's just got to be taught in a different way, or sometimes it's got to be repeated trials to get to that end outcome. And so if all this time we're teaching them compliance, then all of a sudden at 18,  we expect them to shift to be able to advocate for themselves.

We've never taught those advocacy skills. And so it becomes really hard to. To be able to advocate. And so why aren't we teaching those advocacy skills from a really young age so that they're getting a lot of that practice. By the time you're removing the training wheels, basically at 18, they're actually ready to launch on a bike.

Versus like they might not even, there's a lot of, kids. that are raised with such a compliance focus approach that they get to 18 and they don't even know what the bike is, like that this bike of advocacy that they can go and launch on. And so I think about it that way. And I, one of the things that I hear is We need them to respect us.

We need, them to understand rules. And what I like to remind people, that's a very systemic way of thinking that it's either compliance or it's either advocate, either compliance or advocacy. There's a middle ground. We can teach our kids how to advocate for themselves and still understand.

Understand where the boundaries are around that and what the rules are and rules for safety. We're just being more mindful in allowing them more mindful of what we're quote unquote teaching compliance over, and then also giving them more permission to advocate for themselves in other ways. I have, sorry, one quick example of this.

Hand over hand is a great one. So hand over hand historically is a teaching strategy where you take your child's hand and. Physically do the thing that you want them to do so like pointing or pressing something. And there, there's some conversations around that's not teaching bodily autonomy. And that's one of those things though, that  it's such an easy thing to be like, Oh I can drop that.

I can give them more agency and showing me how they want to do that and being more patient. And I can model without expectation and know and trust. That skill will eventually come, which is what presuming competence also is but then dropping that specific compliance. But we're still saying they have to learn in the process.

We're not saying they have to do nothing. But like We don't need that as a method of teaching. There's so many other ways to effectively  📍 teach.  





That wraps up part one with Dr. Tay. Part two is going to be out shortly. So be sure to subscribe and keep an eye out for that. I've linked everything referenced in the show notes. So if you want to learn more head there. And as always, thank you so much for listening.