 Good morning and welcome to Moments with Melinda. My name is Melinda Moulton and I'm your host. And today I have with me Dr. Melissa Hauser. Hi, Melissa, how are you? Oh, it's great to be here. I'm really glad that you agreed to join my show and to share yourself with all my viewers. So let me tell folks a little bit about you. Dr. Melissa Hauser is a family doctor and founder and executive director of a nonprofit Neurodiversity Affirming Community Health Organization. All Brains Belong. She is an expert in neuro-inclusive health care and employment, brain science of mental health and neurodivergent teams. You can visit Dr. Hauser's All Brains Belong website at allbrainsbelong.org. Is that about right? That's the best introduction I've ever heard. Better than I introduce myself. I don't know about that, but there's a lot about you. There's a lot out there. So we're going to jump right in because we only have a half an hour, Melissa. So share with my viewers a little bit about your childhood, where you grew up, and a little bit about your family and your education. Sure. So I am a recovering New Yorker. And I guess what I would say is that it's by luck, serendipity. You know, whatever word you'd want to describe it that led me to here. You know, I think I've maybe what I'll first say is that I did not learn that I was autistic until I was 37 years old. And so when you ask about my childhood, my childhood is, you know, it's a story of someone who, you know, I guess what I would say is that I always thought that I was different. I always felt different. I didn't know exactly why that was. And I think that my life's journey to date has been about like, you know, looking looking for, you know, a way of carving out meaning and purpose in a world that often seems to make no sense. So 37 years old. That's a long time to have autism and not know and not be diagnosed. So that must have been a challenge. Did you, so what brought you to medicine? And in particular, the care and support for neurodivergent children and families, of course, because you yourself have autism. But how did that tie in with your growing up? Did your was there someone who inspired you to go into into medicine? And also I'd like I would love to know how your family reacted when they learned that you that you had autism. Yeah, so I would say that I I never thought that I would be that I would pursue medicine. I did a variety of things before medical school. And I think what they all had in common was, you know, relationships, connection and, you know, trying to support people on their own life journey. I was, you know, I did clinical research. I did I was a cycling coach. I did like a whole bunch of things that seemingly don't relate to one another. But what they relate to is like, you know, you know, being having the privilege of being invited into people's lives and hearing their story and, you know, trying to do my part to to support them in achieving their their their personal goals. I would say that when I did ultimately decide to go to medical school after doing a whole bunch of other things, I I I had the again serendipity. I had a mentor in medical school, a rural family doctor who I I really. I just I wanted to grow up and be and the idea of, you know, just just someone who showed me the the power of doing things differently. The power of, you know, not being afraid to unlearn to learn and unlearn some of the, you know, the conventions that the health care system dictates. And I think that, you know, now now looking back, I think, you know, that's that's that's what I'm trying to do. And, you know, I left, I guess, first to answer your question about, you know, how did I come to be focusing on the support of neurodivergent kids and families up in multi-generational families? That that came through parenthood. So six and a half years ago, I became the parent, I became a parent for the first time, and it was, you know, I. And my child is also autistic. And, you know, that that is a that's a that's a common trend that that that that neurodivergent adults discover their own brains after like beginning the journey of discovering, you know, how to support their children and then they, you know, they they they that learning process leads to other things. So what I would say is that that that is what, you know, it became really clear to me in early parenthood that, you know, my child was not typically developing and that my medical education, even though I had like a whole bunch of training and child development that was like an area of expertise that I had, it just was profoundly inadequate. So that's what, you know, drove me to do lots of extra training and in particularly to center the experiences of autistic adults to, you know, I it became really early early on in parenthood, it became clear to me that the experts in autistic life are autistic people. I didn't know I was one. And so, you know, I read and I watched and I like anyway, that's that's that's the path I took. And so, you know, I, I'm I'm always looking for synergy. I have the kind of brain that compartmentalizing different domains of my life doesn't really feel good. And so that's, that's how my professional life, you know, fused with my personal life. Loaded. Well, fascinating. Um, now, Melissa, you have devoted much of your life to promoting true social inclusion of children with neuro developmental differences. So can you talk to my viewers about neurodiversity and talk about your all brains are awesome website and oh, yeah, all brains are awesome YouTube stations, station. Totally. I'm going to answer that question backwards. So, you know, early in COVID, you know, here I am, I'm a doctor taking care of patients in the hospital and in an outpatient clinic. Like it was just really, it was chaos. And so I was, and then I found myself like homeschooling of then three year old and like figuring out how to do that, and it became really clear to me that my child learned really well on video. I had to unlearn a lot of like these assumptions about screens and young children that, you know, my medical education had like fed me. Anyway, turns out from a visual processing standpoint and an attentional standpoint, you know, this, this was, this was a really powerful tool. Um, so, uh, turns out, uh, she also learned best with me on a screen. So I started making YouTube videos to connect with her. Um, in the context of her interest, her monotropic focus up at time was Elsa from Frozen. So we had a lot of frozen videos about like all kinds of socio-emotional learning concepts. Anyway, so I figured, you know, if I'm making these videos for my child every day and like I made videos every day, like in the middle of the night, you know, while on call. Anyway, I figured let's put on YouTube and try to promote, um, you know, really, um, the, the, the basics that I think all children need to understand neurodiversity, which is what neurodiversity means to me is that it's that we all have different brains. We all have different brains that learn, think, communicate, behave, play differently. And there's no right type of brain. And so, you know, uh, then, so, so I wanted my three year old, um, to know that. Um, and so, um, and, and even, you know, um, I, uh, not all my patients are neurodivergent. And so even, you know, typically developing kids, I don't want them thinking that their brain is the default brain. There is no default brain. We all have different brains. So that's what the, that's what the all brains are awesome, um, uh, YouTube station. You know, I don't, I don't, I don't have time to, um, add, add, I don't, I don't make a whole lot of, um, of new videos. Certainly all brains belong our non-profit organization that I'll tell you about. We, we, we produce content that there are a lot of content that's up, that, that continues to be added to that same YouTube station. Um, but some of the older, the older videos are, are, are kind of fun. Right. Well, my folks should certainly go onto YouTube and pull up all brains are awesome and also go to the website, all brains are awesome. Um, now, now let's talk about your work as a physician and some of the medical care that you specifically provide folks with neuro diversity. Now I understand autism because my grandson who's 18 is a non-speaking artist. He has very unique and special strengths and his healthcare is also unique and special. Talk just a little bit about your practice. Yeah. Yeah. I mean, first I would say that just, you know, when I, uh, was working in traditional primary care, I saw that there were so many of my patients who were not having their needs met both in healthcare and outside of healthcare, you know, kids being bullied in school and struggling to have their access needs met. Adults struggling to, you know, access in inclusive employment. Um, you know, people of all ages struggling with social isolation and that like people of all ages were, you know, often getting ignored by the healthcare system. And so, you know, and I think that that really to me relates to how all the defaults in society, like, you know, this is the way you get healthcare. You must pick up the phone to make an appointment. You must fill out the 20 page packet to become a new patient, you know, at school, you must sit in the chair and like, you know, all the things, right? So, um, it also made no sense to me that since I was spending all my time in the exam room, helping people problem solve life outside the exam room, it made no sense to me to like, like that life fragments the silos of all of these different domains that people are trying to access because they're all part of health from my point of view. Like it's fairly arbitrary to make like, you know, healthcare really separate from these other domains of what I think are health, you know, meaningful life. Um, so, um, uh, the, the, the other tangent that I'll introduce is that in the context of like a very, very, very stressful time in my life, um, like many late identified or late diagnosed neurodivergent adults, I got my autism diagnosis in the context of something called autistic burnout, which is, um, uh, a state characterized by physical and mental exhaustion, um, uh, where there is loss of skills and really an intolerance of stimuli and really just, uh, you can almost think about it as like the brain, the brain's shutting down from, you know, chronic toxic stress, um, from navigating things in a world that's not designed for your brain. And this is common, common, you know, unfortunately, um, the, the, the, a lot of people don't come to medical attention or, you know, don't, don't come upon learning about how their brains work, um, until they are so profoundly dysregulated that they start appearing more stereotypical because the DSM criteria for autism are autistic stress behaviors. So anyway, in that context, it was like, okay, well, um, I, I, I really need to, um, I need to make some changes. And at that time, I learned that the average life expectancy for an autistic person was 36 to 54 years. I was 37 and I had a four year old. And like the healthcare system doesn't know that doctors caring for autistic people, they don't know that. Um, and anyway, it just became like, no, no. So, um, I, you know, I had to really break free of the restrictive ways of practicing and, um, you know, and try to, try to develop something new, which is, um, a village. It's a community village of learning and healing where rather than separate medical care from all these other domains, all brains belong to everything. Um, because to me, to do anything for the neurodivergent community, you know, I knew we had to do everything. So we have medical care. We have social connection programs. We have employment programs. Um, and we do educational trainings, um, neurodiversity related education trainings because it's about shifting the broader community conversation on neurodiversity and inclusion that's going to make the, you know, the most impact in making the world a better place for people with all types of brains. Wow. Um, so I'm going to save these two questions for later. Um, and I'm going to move right into the discussion about your nonprofit, all brains belong. Uh, you taught, you touched a little bit on it, um, about why you established the organization and you stated that it is important for kids to grow up knowing that there's not one right way to be in this world. And as we both know, being neurodiverse can be very lonely. Um, talk to us a little bit more about all brains belong and, and the website and tell us what the website is as well. I think I meant, yeah, allbrainsbelong.org. That's right. It's allbrainsbelong.org. So folks can go visit your site. Talk a little bit about how my viewers can get engaged in your organization, whether it's, um, uh, you know, whether they personally are affected with neurodiversity or they know someone who is, um, talk to us a little bit about that. Absolutely. So, you know, as, as I said, we have these four types of programs. So, um, so, so the whole concept of the whole organization, the whole model is based on connection. Connection is the path to health. And so we have, we have medical care. But then we have these other programs that are open to everyone, even when even folks who are getting their health care elsewhere, even people located outside of Vermont. So anyway, um, the best way to get involved is to come to our program. So for example, um, every Tuesday we have a program called Brain Club for adults, um, Brain Club every Tuesday at 6 p.m. Eastern, it's on Zoom. And it's a, it's, it's an educational program about everyday brain life topics, you know, related to executive functioning, regulation, relationships, employment. This month we're doing a spot on neurodivergent health, um, topics. Anyway, so that's a great way to meet other people. And it's a great way to, you know, just to, to, to collectively learn and often unlearn some of the assumptions that, that we grow up with about, um, what, uh, how brains work. So, so Brain Club for kids, we have a free program about all our community social connection programs are free, by the way. So we have another, another free program called Kid Connections for kids four to 17. And we certainly a little bit older is also OK. Where we, we connect people based on shared interests. It's a customized friend matching program. You know, I think social isolation is common, um, and, uh, it's, it's, it's, it's not about connecting people with a shared diagnosis. Um, uh, autistic and or ADHD brains tend to be monotropic. That means fewer things captivate our interest at a time and do so more intensely than other brains. So if, um, if my six-year-old has a monotropic focus on dragons, uh, can you hear for screaming in the background, by the way? No. OK, because we have the suppression on. All right. OK. Just just checking. That's what I'd love to hear. That's happening. Yeah, I'm talking to that. Yeah. She may be like being a dragon right now, for all I know. Anyway, so, um, yeah. Right. So anyway, she loves dragons, but like, you know, just, if you have a monotropic focus on dragons and there's no one in your class who wants to think, play, talk about dragons, then it's going to be really hard for you to have, you know, satisfying social interactions because dragons are what you think about at all times. It's the attentional tunnel that's what monotropism is about. So kid connections acknowledges that and we make customized matches based on shared interests and, you know, communication profiles. It's fascinating because it is a lonely world. Um, now, thank you for sharing allbrainsbelong.org and I really encourage my viewers to go on that website and learn more about Dr. Houser's, Houser's work. Um, so now a few months, a few months ago, you testified in favor of a bill that would limit restraints and seclusion in schools, which is a form of control by adults in working with neurodiverse children. We've experienced it ourselves with my grandson. Physical force is never acceptable. So why has this been happening in Vermont and how will this bill change that? No, I think that let's just just just thank you for bringing that up. I am so grateful that you're bringing this to public awareness, right? Because I think the majority of Vermonters don't know that this is happening. So what we know lives in the balance reported that, um, at least five hundred and eighty seven sweet little loves are restrained and are secluded in schools each year in Vermont. These practices are disproportionately used against children of color and children with disabilities. So what what what what what what happens is. Kids, there's because we don't often have the awareness of the like brain science. When kids are dysregulated and we meet them and they're in the state of fight or flight, we meet them with scary traumatic practices that induce further dysregulation and more trauma. And yet, you know, we talk about trauma in foreign schools, trauma from health care, trauma for everything. But yet this happens. So, you know, as as a as a physician caring for mostly neurodivergent kids, I hear these traumatic stories all the time. And that's how all brains belong came to be involved in this of telling the story, the providing education about that that these practices have no place in trauma informed schools. As the bill passed. No, so it it there's legislative recess right now. And so that it was still being discussed and reviewed by the House of Representatives Education Committee. So I encourage any viewers who care about this to contact their legislators and tell your story because I think that's the you know, it's it's it's really remarkable how how common this is and how people don't and how people don't know about it. They don't know. They don't know. Like when I even I even remember, you know, the the the day that I testified before house education, I mentioned to my babysitter that I was doing this and she's like, that happens in school. Like that happens to kids. Yes. Yes, it does. It does. And we've experienced it personally. So now, Melissa, I do not support the use of the word disability, which is so often used to describe neuro and physically diverse people. I feel that any dis before a word diminishes and dis dismisses the gifts and extraordinary talents of these remarkable human beings. How do you feel about how common that word is when it's, you know, when when humans are labeled with a dis ability is if they can't, they don't have the ability. I want to change that. I just want to throw that out there. Yeah, yeah, I I I think that, first off, every individual I respect any terminology that an individual uses to describe themselves. And so there is a, you know, a culture of people with disabilities who who disability belonging to a disability culture is part of one's identity. And for those people, you know, I absolutely respect that. I think it's important to acknowledge, you know, when I think about disability, I think about the social model of disability as opposed to the medical model. And so what that means, you know, the medical model is like this person has, you know, deficits, they're broken, you know, like, no, the social model of disability refers to it's not the issue with the individual. It's about the environment awarding the individual. So it's about and the amount of disability that somebody experiences is relative to the barriers in the environment. So, you know, if I am a wheelchair user and I approach a building that has a ramp, I am going to have less disability than if I approach a building that does not have a ramp. And so when it comes to invisible disability, it's the same thing. There's the equivalence of the lack of ramp, like all over the place. And so, you know, I think that access, you know, we, it all brains belong. We do a lot of trainings, educational trainings for organizations of a wide range of types, all about, you know, accessibility. How do we remove barriers to access to full and meaningful participation? I think that's where the action is. And, you know, so often society expects our neurodiverse population to fit into some kind of mold that is their mold and doesn't accept them for who they are and honor who they are. And I hope that can change because in a lot of the education that these folks are going, these students are going through, a lot of it is about creating a human being who fits into the model of who we are, whether it's your table manners or whatever. And I, again, I get it, but I honor the differences of that. So, okay, let's talk about for a second about your inclusive healthcare partnership project. This is exciting. Where community advisors bring lived experience as leaders in self-advocacy and disability rights. And this website for my viewers is ihppvt.org. Talk a little bit about that, Melissa, would you? Yeah, so this is a project being carried out by the Vermont Developmental Disabilities Council, the DD Council. So, Auburn's Belong consults to this project. But it's the idea that, you know, often health information is not provided in an accessible way. So, you know, people with, particularly people with intellectual disability, but, you know, not even, you know, there's just plain language. So the idea of communicating in clear, easily understandable language benefits everybody. Having, you know, you know, clarity of information benefits everybody. So what the DD Council is doing through the inclusive health partnership project is co-creating health information materials using universal design. So what universal design is, is it's using multiple flexible different ways to do everything. And so with this project, there is text, there is video, there is artwork, and all of this was co-created with people, with developmental disabilities of a wide variety of types. And so the idea of finding out what are the topics that people want to know about and what are the ways that we can communicate effectively. And related to this also doing training for healthcare providers. So the type of training that my organization does is around kind of the nuances of neuro-inclusive health delivery. So, you know, covering topics of sensory processing and, you know, neuro-inclusive communication strategies, use of declarative language, supporting folks who are non-speaking communicators, you know, supporting executive functioning. Like this is like, this is the, IHPP is doing even a higher level training that a lot of healthcare providers don't have. There is not a lot of medical education around how to provide, you know, like even the standard of care for people with a wide variety of types of disabilities. So, I mean, talk a little bit about that for a second about some of the medical issues. I understand that during COVID you held a clinic because that was a very difficult thing to take my grandson in to get a shot. He refuses to, and they ended up figuring it out that if they just kept him in the car, somebody could jump in the car and give him the shot. I mean, it was, he refuses and he's a big boy and it's like you're not gonna stick that needle in me, but you had that clinic. And yeah, I'm sure Rowan would have felt more comfortable to be in that environment. So talk a little bit about self-regulation. I'm gonna go back to that. And the social demands that students with neurodiversity deal with. And I'm assuming that hopefully the schools are getting better, especially when this bill gets passed. But how are the schools helping them to navigate this public system that they are required to participate in? Do you feel like things are getting better in the schools that they're understanding and providing what's needed rather than, hey, you have to raise your hand and then you have to go over and get the key to go to the bathroom and then you have to open the door, go to the bathroom, come back, put the key back up and sit down. I mean, that just doesn't work, right? Yeah, it doesn't work. So I think it's important to distinguish between individuals and systems, right? So whether we're talking about education or healthcare, I think that individuals are wanting what's best. It's there's a lot of dysfunction in systems that really interfere, that like, toward the individuals from doing what they want to do, whether there be, anyway, in healthcare, for example, the idea that a healthcare system would require a primary care doctor to see a patient every 10 to 15 minutes. Well, there are a lot, there are lots of people with all different types of brains for whom that is not enough time. And that really thwarts one's ability to communicate effectively with healthcare providers. And then you throw in the environmental conditions, the fluorescent lights, the ticking of the clock. I mean, it's just a nightmare. And so it is in school. And so I think that there is a growing community of neurodiversity affirming educators, who both who have connected with our organization and folks who are out in the world that I know are out there, we made it conferences, et cetera, who are, they're changing, they're changing the system from within the system. And I think that neurodivergent kids really do need allies. And I think, when we think about stigma, I think part of perpetuating stigma is these narratives. When we think about the way that healthcare providers are trained to speak about autism, for example, the way that educators are trained to understand autism, that I think going far, far upstream and shifting how these neurological differences are trained about, I think that's also a huge part of the problem so that the pipeline, the pipeline of future educators and healthcare providers and all the people are learning about all the different ways in which brains differ. Do you think medical schools are teaching this in their schools, in their education programs? Well, I can tell you what my medical education experience was like. I got a one-hour lecture and it focused on the triad of impairments. And then in my clinical training, I saw stereotypes that matched what I got in that one-hour lecture. And then I did a lot of training in neurodevelopment, like a lot of extra training in my residency and beyond. And I think it's the, if doctors are in general trained in stereotypes and then they go out and they see the stereotypes that match their training, it's really reinforcing. There's a study from 2015, Zerbo et al, that showed that amongst primary care clinicians, less than 10% would suspect that their patients were autistic if they volunteered information, showed interest in people and could understand the whole picture. I can say that understanding the whole picture is one of the many strengths of the autistic brain. Absolutely. Yeah, so, and that, it's that stereotype that I think is really problematic. It is, I went to a conference about six years ago that was put on by a very large group here in Vermont and they had a physician up doing a presentation and he kept reverting back to Napoleon dynamite or whatever that guy was in that movie as the example, as a stereotypical person with autism and it was, I spoke, I got up and spoke afterwards and said that I was utterly offended that there was this, that it was just, it was, anyway. So I'm so glad that you are working in this area to educate those that need to be educated, especially in the medical field. You do have a practice, you are a physician, you have a private practice, you're not taking any new patients, so I can understand, are you? You are taking new patients, yeah, yeah, yeah. I've read that you are, so you are, so. Yeah, no, so we provide, so we have a primary care track and we have a non-primary care track. So, and with the non-primary care track, we are providing medical care to neurodivergent kids and adults and plus there's a variety of medical conditions that are more common for neurodivergent people related to hypermobility spectrum, euler-stanlos, POTS, dysautonomia, mast cell dysfunction, long COVID and like that whole picture. So, and folks also come for gender-affirming medical care. So yeah, so people can keep their primary care. Dr. Melissa, how has it been for business? All right, thank you for that. I am really moved by you and by the work that you've done and when you and I had our first conversation, it was a gift. To know that you're out there and that you're in Vermont and you're close by and that you're standing up with incredible vision, incredibly hard work and dedication and commitment for so many whose voices cannot be heard, the marginalized in our state. And for that, Dr. Melissa Hauser, I wanna thank you for all that you do and thanks for your time on my show. I'm so glad my viewers got to meet you and I'm sure they're gonna hear more of you and I'm gonna get you back on my show again later on to follow up with some of the questions I wasn't able to get to. And to my viewers, thank you so much for being with us today. This was a really important interview with Dr. Melissa Hauser and I wanna wish you all a beautiful day and take care.