 Sharon Thomas Yarbrough. And our guest today is Dr. Elsa Lee. I am so excited about having Dr. Lee, Linda Della-Cruz, and I've been chatting about this situation for a couple of months now. And so let me tell you a little bit about Dr. Elsa Lee. She is Asset School's clinical director and oversees the Transforming Lives Center. The center opened in June 2022 at Asset School's K-8 campus. Dr. Lee provides assessments to struggling students in public, private, or charter schools and provides schooling for struggling students in public, private, and charter schools and those who are homeschooled. The Transforming Lives Center offers evaluations for students who may be struggling with a range of academic, psychological, and socio-emotional challenges. Dr. Lee, welcome to Sister Power. Thank you for having me, Sharon. You're welcome. We were chatting earlier, and I've heard some wonderful things about assets, school, and the Transforming Lives Center. So tell us about assets, school, and the Transforming Lives Center. No, absolutely. So Asset School is a K-12 grade school. So we start from kindergarten, and we go through 12th grade. And we're the only school in the state of Hawaii specializing in educating children with learning differences, with dyslexia, language-based learning differences. I should specify. And then we also work with those who are gifted. We have two campuses. We've got one K-8 campus that's located near the airport pretty close to town. And then this is where the Transforming Lives Center is located as well. And then our high school campus is in the Eliwa Heights area. And as you had mentioned, the Transforming Life Center had opened in June 2022. So we've been up and running for a little bit more than a year now. And what we do here is we offer psychological and psychoeducational comprehensive evaluations for our students. And this isn't just for students within the assets community, and this is really for all students and families across the island, not even just on the island of Oahu, but also we've got students who come in from other islands as well. And it's mainly for students or parents with kids who have questions or they think that their kids may be struggling with a wide range of academic problems, learning issues, psychological issues, or any social-emotional problems. Wow, approximately how many students overall? So up until today, a little bit less than a year now, we've received over, I'd say, about 200 to 300 inquiries. Not all of them amounted to actual evaluations because some of the kids actually did not need evaluations. And so we provided some consultations. The actual assessments that we completed up until this state, we've done about 70 of those. And we find that to be a very promising number. And we're really proud that we've served so many families in such a short period of time. Good. Well, you're leading the Free Summer Parents workshop series with two virtual sessions. How was the role of parenting changed over time? And what are some common challenges that parents frequently face? Great question, Sharon. So yeah, so I am primarily the one who's leading these Free Summer Parenting workshops. And we have planned for two of these. And they're conducted through Zoom. Our first one actually already happened back in July. And the next one is actually happening tomorrow, tomorrow at 6 o'clock. And I'm happy to provide more information as we go along. But to answer your question, I think the main reason why we want to host these parenting workshops is because we think that parents have a lot of questions that they need support. So over just the past year of my time at the Transforming Life Center, I've received just ongoing inquiries, requests, questions, on ideas, on how do we support our children? How can my family do more to help our kid who is struggling with socializing, with ADHD, with emotional issues, with behavioral problems, or even learning difficulties? That's what we specialize in after all. And I think that while we are indeed a school that specializes in learning differences and giftedness, we also know that there is a significant percentage of children who struggle with more than just one condition. So in clinical terms, we call it a comorbidity. So when you have one condition, there is a high chance for you to also have another condition that may work against the primary problem that you may be dealing with. So oftentimes, parents may not know how, let's say, to communicate with their children who have specific emotional needs or who have specific learning difficulties. And parents may have a lot of questions. How can we intervene? How can we support the kids' emotional health or their mental well-being? And so I think that these workshops are based on a lot of the questions that have come in, really. And I've compiled a series of inquiries and referral questions that I have received over the past year from parents on the island when I conducted these evaluations. So I thought it would just be a good idea to help increase the awareness of the parents in our community and maybe provide some practical tips and strategies for those who may want to learn more about parenting. All right, let's go over it again, because it's tomorrow. So what's the time and how can parents and other people get involved? Yeah, so our next workshop, which is happening tomorrow, so it's August 10th. And it's happening from 6 PM to 7 15 PM through Zoom. And so in this workshop, this is a workshop that's particularly specialized. It should say it specializes, but it focuses on ADHD. So we want to talk about how we can help parents understand the condition of ADHD. How can we help parents manage these symptoms in their children? What can they do to support them? How can they collaborate with their teachers, with the school? And my parents can hopefully walk away with some strategies and some ideas in working with their children. So this is via Zoom? This is via Zoom. And I should add that for those who are interested in attending, they can visit our school's website, which is assets-school.org. And they or they can go on to the social media, on Facebook, on Instagram, and Twitter, at Asset School. I think the easy thing to do is just to log on to our website and then they could find more information on there. OK, great. So the concept of ADHD seems to be gaining more acceptance and attention. What exactly is ADHD? How is it diagnosed? Yeah, so I should expand on the acronym ADHD. It stands for attention deficit hyperactivity disorder. In short, we call it ADHD. It's a term that is just gaining a lot of attention. Popularity is a weird word to say, but that's how I kind of see it. And a lot of people in our field, because people have been using this term a lot, kids have been using this term a lot. They go on to social media. They figure out these different symptoms. And they wonder, you know, come to us. They go to their parents and they go, like, do you think I have ADHD? And I say, do you even know what that stands for? And oftentimes they have no idea. So in full, it stands for attention deficit hyperactivity disorder. Now ADHD is a neurodevelopmental disorder. It is a biological condition. And that primarily affects children starting usually from young childhood around ages six to seven. That's usually when the symptoms begin to peak. But it could persist into adolescence and adult blood. And then people with ADHD often struggle with symptoms like paying attention, not being able to focus. They may have trouble managing their impulsivity. And they can seem very active all the time, kind of. They're always on the go. They're always in motion. But just to be very clear, there are different types of ADHD. And just for simplicity's sake, there are three main types. There's one type, which we call an attentive type. And then there's another type that's called hyperactive impulsivity type. And then there is also a combined type. Or now we call it presentation instead of type. Without going into too many technical details, children or even sometimes adults that we see, not at assets, but people in our field, in the mental health field, they work with these symptoms like inattention, difficulty sustaining their focus. They start something that they can't follow through. People may struggle with organizing things. They seem forgetful. They often lose track of what they are supposed to do. And these are some of the typical symptoms that we see in people who may have ADHD, the inattentive type. And then there is the other type, which is the hyperactive impulsive type. And for the people who struggle with this, they would complain or they would exhibit symptoms like being very hyperactive. Like I mentioned before, they're always on the go. They may be impulsive. They're fidgeting a lot. It's hard for them to stay seated, interrupting other people, kind of difficulty waiting for their turn. It's very easy to pick up. It's quite obvious. And then there's a combined type, which is people who may be struggling with both the inattention and also the hyperactivity or impulsivity. So that's how we generally define the condition. I know you also asked about how is it diagnosed. So to put it in simple terms, we always recommend parents to speak to a health professional. They could speak to their pediatrician. They can talk to a psychologist, mental health counselor, social workers, licensed mental health professionals should be able to provide some pointers for parents who may be concerned about their children or child having these symptoms. But generally speaking, these symptoms would have been shown around the age of six or seven. And in some cases, a little bit older, but most of the symptoms should be present before the age of 12. And we are looking at things like impairment and their functioning and their learning. They're having trouble with maybe maintaining friendships. So those are a couple of things that we usually look at and we kind of examine it before we decide, hey, is this ADHD or is this really something else? Or is it just the child being a child? You know, that was my question. I wonder how parents, kids are active. They're busy. They're busy bodies. I just wonder how parents can decipher for themselves before they ask for help for their children. Yeah, so a question that we get asked a lot is how can we tell if it's true ADHD or if my child is simply being active, right? It's a very valid question. It's also a question, it's a political question that we clinicians have to answer, right? We don't want to overdiagnose, but we also don't want to miss the diagnosis. So one of the main differences between what I would call a typical growing active child and one who may have ADHD is that for those who struggle with a disorder, it typically affects the child's ability to function. So we highlight the idea of functioning. We look at the concept of functioning. If the child is having a lot of substantial problems functioning, getting along well with people in school and social situations, no matter how hard they try, they just can't keep up, let's say with what the teacher is telling them or they need a lot of prompting. Johnny, get back to your seat or Jennifer, you got to just keep your eyes on me and listen to what I'm saying. And even with multiple prompting and reminder, and the child is still struggling and it's still not able to function, then we start having concerns and these are a red flag. So we want to look at functioning. Active children, right? Most children are active, let's be real, right? We can't expect a child to be sitting on a chair for 45 minutes straight without complaining or wanting to move and get out. The difference is that active children who are developing appropriately to age generally don't struggle as much with their functioning. They may need a little bit of a nudge here and there like, hey Jennifer, get back on your task and Jennifer goes, okay, sure. And then they finish or she finishes what she starts, right? So we look very closely at functioning and so that's why we need a lot of feedback from parents and definitely from teachers as well. So without the feedback and input from parents and teachers or other family members who may be involved with the caregiving, it's quite hard to diagnose it. So what we try not to do is simply look at the child for a couple of minutes, observe a couple of symptoms and say, here you go, this is your diagnosis. We always want to talk to the school teachers, any staff, any family members, relatives, people who know the child well. And that plays a very big role and that's a pretty simple answer to a otherwise complicated question. I'm sure, wow. How can parents keep their children? How can parents help, I should say, their children who are struggling with ADHD? So I'd say education is everything. Education, not as an education, you receive from school, but education as in gaining awareness, just be open your eyes, listen to things like attend a workshop like what we're offering. Get education about ADHD, understand its symptoms, understand how these symptoms affect their child. Know the challenges that their child may be facing. And in that way, the parent would be able to support the child with more empathy, with more understanding. And so I'd always think that that's the first thing that any parent can do. Many other ways that parents can help their children, communicating is another way. We know that children with ADHD often can't do very well with long-winded instructions or questions. And as parents, and I'm a parent myself, it's quite easy and it's very tempting for us to just say a mouthful, right? And we say, pick up your backpack, grab your lunch, put on your shoes, you wear your glasses. And a child with ADHD is unlikely to be able to hold on to all those instructions and commands. So when parents talk to their children who have this disorder or this condition, they wanna make sure that the commands or these instructions that they give their child, they're short, they're brief, and they're to the point. So they want to be as succinct as they can. Try not to give multi-step commands. So avoid multitasking if they can. One thing at a time, right? One command at a time. And so building routine, setting structure, giving them a schedule, just a sense of predictability, helping them get through the day by giving them prompts, reminders, breaking tasks into smaller steps, kind of almost like serving as the child's frontal lobe. So the frontal lobe is a part of our brain. I mean, the frontal area that is in charge of planning, organizing, and a lot of times we see that parents do have to serve that role because that part of the child's brain is not developing as quickly as they should, which explains in part why the child may be having these symptoms. And so many practical things that parents can do to help their child. And that's, these are just some quick examples of what they can do to help support their kids. And we're gonna go over all these things in more detail in the workshop. Wow, this is amazing. Because it seems like I need this kind of information just for myself, really. We all do. Yeah, we all do. So tell us a little bit about the importance of mental health in children. What are some high points that parents should be aware of when raising children? Well, excellent question, Sharon. So, you know, there's been an increasing awareness in children's mental health overall, I'd say among parents, which is wonderful, right? As a mental health clinician, we always love parents asking us questions about their mental health. They wonder about things like depression, anxiety, learning, not even just ADHD, as we've been spending a lot of time talking about. But, you know, because the importance of the children's mental health, it just can't be overstated. You know, just like we think a lot about physical health, right? You wanna eat well. You wanna have a healthy balance diet. You wanna exercise. You wanna teach the kids all these things. And we know that, you know, just as physical health is important and crucial for our overall well-being, mental health plays a significant role in the child's emotional, cognitive, social, emotional development, right? So, you know, we know that this is also based on research studies that early experiences and their mental health and in childhood, they do lay the groundwork for how people navigate their emotions, interpersonal relationships and challenges throughout their lives. And so, you know, positive mental health is closely related and associated with various aspects of functioning, their cognition, their academics, how well they learn, how well they sleep, you know? And sadly, we do know that children and adolescents with mental health problems, they do display a lower overall life satisfaction and a poor, worse, I should say, worse health related quality of life when they enter adulthood. So short answer to, again, a complicated question is that we wanna start early. We wanna pay attention to this early on when we have the power to do so as parents, when we're in the place and in the position to provide that kind of support for them. And this isn't just lip service, right? We want to be able to support them by asking them questions, by communicating, by giving them the help that they need if the child is actually displaying symptoms, go get help, get them to talk to someone, get them an evaluation, right? Or if it doesn't involve anything that serious, parents can be that pillar for their child, be supportive, be empathic, be willing to spend time with them. And these are all things, relationship, we know is a very critical factor in predicting mental health as well in children. I was listening to you explain all the critical details. I wonder how the child with ADHD, how does he interact with his siblings? Is there any kind of guidance that the parents or conversations they're having with their siblings? Excellent question too. So this actually brings up a quick point. It's about the hereditary nature of ADHD. So there is a high chance that if one child has ADHD, the other sibling does have an increased risk of having the condition as well. Now, of course, it doesn't mean that just because let's say my brother has ADHD, then I'm definitely gonna have the same condition, right? It's not a 100% prediction model that we're looking at here, but there is an increased risk. So interestingly, thinking back to a lot of the children that came through our door, they do run in the families. And when the older brother came in for an assessment, we asked the parents and the parents go, you know what? The little brother is just kind of similar and they fight over the same things. They talk about the same issue, but because they butt head so much due to maybe both of them being very hyperactive or both of them being very impulsive, the older brother just somehow has an advantage of taking the younger brother's toy because he's stronger and bigger, but it doesn't mean that the little brother does not struggle with the same condition, right? So that's just the high, that that's highlighting the hereditary nature and the genetic component of ADHD, but to answer your question, you know, I think it all comes down to communication and the parents wanting to first understand what their child might be going through, right? ADHD is not something that happens to someone by choice. The child does not choose to have the condition. This is something that is biologically related. So parents knowing what these symptoms are, being very proactive in reducing some of the triggers, reducing some of those, you know, environmental, we like to call them environmental triggers and risk factors that can make it harder for the child to regulate, let's say their behaviors and emotions, that is already a big gift to the child, you know, and helping the younger sibling or the other sibling, it doesn't have to be younger to understand what the other sibling who has the condition may be going through, right? Again, open communication, working together as a family. And these are some of the high points, things that I would always tell parents, you just gotta talk it out, let everyone know, there's no hush-hush. But that is the second workshop in a series of two workshops. The first session happened already. Tell us about that. Yes, so the first workshop already took place in July. It was very well attended. I was very grateful for all the parents who came. The first workshop was actually about communication. And we wanted to find ways to help parents understand how to communicate and talk to their children and help their children be their best selves. And so the idea is through effective communication, by talking, by listening, by using specific ways in expressing their ideas, but also to help the child understand that the parents are actually receiving the message is a great way to start any conversation. And so that's kind of the gist of what we talked about. And for those who are interested in reviewing that workshop, it is also available on our, I think it's on the YouTube channel of our school and they can access at any time. Oh, good. Well, you know, in closing, I want to go back to your workshop because I want people to take advantage of this. If people are interested in attending the next workshop, I just want to review that, what should they do? Yeah, so if people are interested in attending, they can visit our school website, assets-school.org, and they can sign up on our website or they can go to social media, on our Facebook, our Instagram account, Twitter, assets-school. And I'd say the easiest thing to do is just to scan the QR code and submit your registration and then you'll get, I think, a confirmation email giving you all the details on how to log on and where to go and what to click on Zoom. And it's free. Yes, that's the best part. It is free. So, very quickly, can you talk about your success rates? Wow, that's... Well, that would take another show. We need to do that part, too, right? I love that question because I didn't even think about success rate. Let's put it this way. We want to think about how the parents, how well the parents feel equipped. When they come back and tell us, oh, that strategy that you talked about was so helpful, you know, my child is exhibiting fewer of those symptoms and they're listening a little bit better in school or, you know, that doctor referral that you made for me was really helpful because our pediatrician is doing everything they can to, you know, work on medication management. So there's so many different examples, but I'd say the more involved the parents are, the more involved the school is and the teachers are, the better they communicate amongst themselves, the higher the success rate is. That's where I'll leave it at. Yeah, love that. Thank you, Dr. Elson Lee, for your knowledge and your wisdom. You know, asset school and the Transforming Life Center is truly an asset to our community. So on behalf of Think Tech Hawaii and Sister Power, thank you for joining us. I'm Sharon Thomas Yarbrough. Aloha. Thank you so much for watching Think Tech Hawaii. If you like what we do, please click the like and subscribe button on YouTube. You can also follow us on Facebook, Instagram, and LinkedIn. Check out our website, ThinkTechHawaii.com. Mahalo.