Megan W 

My experience growing up in the world of YMCA, overnight camping, Maaike developed a strong appreciation for the ways in which children build confidence, resilience and relationships outside of work. She remains connected to the camp community and enjoys reading family time and parenting her two kiddos. So Maaike, I'll let you take it away. Like I mentioned, we're so excited to have you here today, and as always, feel free to send some messages in the chat throughout the presentation, and we'll have a question period, a brief one at the end. So take it away, Maaike, thank you, awesome.

Maaike 

Thank you, Megan. Hello. It's so nice to see everybody here, and thank you for having me today. So as Megan mentioned, my name is Maaike. I'm a school and clinical psychologist. I've been registered with CPO for just over 10 years, and I've have experience with working in school and clinical settings with kids, adolescents and families like Megan mentioned in Since 2019 I have been the clinical director of a practice in Simcoe County, Riverwise Psychological Services. So we are a group practice that offers a range of supports to kids and teenagers and families. We do assessment, intervention, consultation, and we're running some groups more recently and personally, I have a special interest in working with parents, and I love helping parents and supporting them to further understand their children and their children's areas of strengths and needs, which kind of relates to the topic today. So early in my career, despite having what I think was pretty good training in the area of psychological assessment, I found myself feeling pretty anxious and unprepared for how to actually effectively and comfortably give feedback to the families that I was working with. So talking with other colleagues, and learning that nobody really knew exactly how we were supposed to be doing this kind of piqued my interest in the topic. With more experience and supervision and collaboration, I've come to actually love giving feedback for assessments, and I find it to be one of the most rewarding parts of the process. And most recently, I completed my doctorate at U of T, and my dissertation was focused on this topic, so trying to understand a little bit more about psychologists and their experience in training and giving feedback for psycho educational assessments. So I'm really excited to be here to talk to you about this today. I also am a mom. This is one of my that's my older son there, and so I come at this from a clinical perspective, but also a parent perspective too. So what I'm going to do today is just talk a little bit about why giving feedback for psycho educational assessments is important. I'll share with you a little bit about my research findings and implications in the area, and then I would like to introduce you to a model for giving feedback that comes from therapeutic assessment. So my talk today is going to focus on giving feedback to parents and caregivers. So I will use the term parents for simplicity, but please know I'm referring to parents or other caregivers who may be participating in a child's assessment as well. I'm not going to be focusing today on giving feedback to children or teenagers or other parties, although the information I'll share may be relevant to those those parties as well. Okay, so let's talk a little bit about assessments. So I think a lot of people here might be providing psycho educational assessments as part of their practice. So you guys know better than anyone that these kinds of assessments are really a cornerstone in School Psychology and in clinical psychology practice as well. Typically, we share assessment results in two main ways. So one of those ways being our formal reports, and the other one being feedback meetings. So typically, feedback meetings are including parents and caregivers. They may also include students, school staff, other professionals, and they might take place in a school, they might happen in an office, or they might happen virtually. So these meetings are important for so many reasons. Although it was not always seen this way, as our ethical codes have developed over time, we've really come to recognize that clients have a right to information about their assessments, and it's our ethical obligation to provide this info to them. In addition to being an ethical obligation, participating in feedback meetings actually offers a range of therapeutic benefits to our clients. So this can include benefits for parents who participate, and then in turn, their kids as well. So we have some research that tells us that when we participate, when we invite people to participate in feedback, it can increase openness, cooperation and engagement. It can lead to families having a better understanding of their child. It can even lead to things like improvements in parent child relationship, increased self esteem for kids. It can help decrease anxiety or helplessness that parents might feel. And when we do this within school based assessments, especially, it can also enhance collaboration between home and school, and it can increase the probability of the recommendations that we make actually being implemented for the kids, which is pretty important. Clinicians can also benefit from giving feedback in that it really encourages us to fully understand and interpret our assessment results and develop skills so that we can communicate those effectively with the people we're working with. So there's really not a lot of published literature regarding feedback meetings, especially not in the school psychology field in particular. So we have to kind of pull from other literature that touches on psych assessments more broadly and in more clinical settings as well. So the research we do have tells us that psychologists today value giving feedback. They're willing to provide it, and generally, people are doing so pretty regularly in their practices. Research also tells us that psychologists identify a lot of those positive outcomes that we talked about in the last slide around giving feedback. So they're noticing that it's beneficial for families and for kids, and they also identify challenges to be navigated. So it's not always easy to give feedback. There can be barriers. Sometimes it involves managing uncomfortable feelings or communicating difficult information. There really is not one set of best practices or agreed upon standards when it comes to how to give feedback, but there are some documented approaches out there and some guidelines for this practice in the literature that we can go to. Some research has also looked at how psychologists get trained in how to give feedback to their clients, and what we know from this research is really that psychologists pretty consistently indicate that there's been a lack of formal training in this area. So people are not identifying that they're getting much in class, formal training and how to give feedback. Rather, they're gaining experience through practicums, internship opportunities, and learning this skill kind of on the job the way a lot of us have been doing as well. And there's generally a pretty clear consensus among those who have written on the topic that more training in class, more formal training at the graduate level, is recommended and needed. So we really don't have much information, particularly around school psychology and psycho educational assessment feedback, specifically, and then even less available about practicing in Canada. So that's just kind of a really brief overview of some of what we can learn from the literature in the area. So locally, we do have some association and professional guidelines that speak to the practice and expectations for us as psychologists in Ontario around giving feedback, essentially, practice guidelines from OPA and CPA and some of our standards from CPO tell us that we need to do it. So it's incumbent on us as psychologists to provide feedback to our clients, and we do have some guidance telling us that we need to do this in ways that are accessible and understandable, but that's kind of as far as things usually go in terms of of the professional guidelines that we have. So we don't really get a lot of information from our association, and definitely not from our college but the best ways of doing this, so I hope it's kind of evident from the last few slides that giving feedback is really important and it's an expected component in our assessments. Yet the formal training in the area seems to be lacking, and we don't have clear standards or process for the practice, and we know even less about giving feedback for school based or psycho educational assessments in particular, and in light of the fact that our assessments are such an important part of our practice, this is a really important gap. So this problem in practice is what fueled my research project in this area. So in order to explore this a little bit further, I conducted a qualitative study, purpose of which was to gain a more in depth understanding of how school psychologists in Ontario are building capacity and learning to give assessment feedback to parents and also their experiences and practices in doing so. So this study was a qualitative design. It was a case study approach, and my goal was really to get sort of a more in depth understanding of the perspective of the participants. I used. I analyzed the data for my project using brown and Clark's reflexive thematic analysis model, and I chose this model because it's focused on the idea that subjectivity is actually. A useful tool in research, which is something we don't always, always hear, but it was important for me to be able to leverage my own experience and subjectivity as a clinician to better understand the data that I collected. So I'm going to share with you guys a little bit more about the project. So I had the opportunity to work with six participants for the study. Recruited them through just sort of professional networking. It was exciting. When I went to recruit participants, I actually had tons of people who were interested, which told me that this topic was interesting, not just to me, but to other clinicians as well. So six people participated. They were all CPO registered clinicians with competency in school psych, two of them were more early career, two were mid career, and two were more seasoned clinicians. And the participants identified serving kind of a range of clientele, so low, middle and high SES populations in urban, suburban and rural settings, and most of the participants identified completing about 30 to 65 assessments each year, so assessment clinicians, so I was able to collect data in a few different ways. So participants completed a questionnaire which provided some basic info about their practices, training and experiences and giving feedback. Each participant also completed a 60 minute interview with me. This really allowed us to do the deeper dive into these pieces. And then they each completed a set of reflective practice worksheets as well, in which they were asked to reflect on their thoughts and experiences with regard to one specific feedback meeting, both before and after the meeting took place. So in my analysis, I coded all the data, created over 150 initial codes, eventually revised and reworked them over several rounds, and then in the end, I came out with three kind of key themes. So the first theme was that customization is really important. Second theme was career long, multifaceted learning. And the third theme was navigating a landscape of emotion. So I'm going to share a little bit with you guys about each of those themes. So the first theme that I created through the analysis was customization as important. So participants emphasize that rather than being rigid or strictly standardized, they deliver feedback in ways that are flexible and varied. So and focused on the needs of the recipients. So participants touched on the importance of understanding the needs of specific parents as a foundation for customizing the feedback process. So this included factors like building rapport and relationships with parents, having an understanding of family dynamics, awareness around parents, language or cognitive abilities, cultural considerations, factors related to the child's profile, and also parents current understanding of their child's needs. So in attending to these kinds of factors, the clinician spoke about making adjustments to the language they use, the content of the sessions, the pacing, the way information was presented, the length of the feedback meeting, who might be attending the modality, and also whether follow up would be offered. And participants touched on the idea that preparation to customize a feedback meeting was really important, but so was making adjustments in the moment when needed. So these were a few quotes that came from this theme. So one one of the participants said, depending on what the parents need, I might go into more detail or less detail. I might use more visuals to support I might make myself more available to help them navigate some of the next steps or recommendations. Sometimes we might need an interpreter there. Another clinician said, for some parents, I start with the diagnosis because they're anxious, anxiously waiting for it. But for other parents, I think they won't hear anything after a diagnosis, so I give them the details first and get to the diagnosis after. And then another clinician said, you come in with some key things that are going to guide the meeting, but you just have to be open to it being dynamic and flexible, and that's okay. The second theme that I'm going to talk about was identified as career long, multifaceted learning. So this related to sort of how people are building capacity and learning to give feedback in discussing and describing how they learn to do this. Clinicians clearly saw the process as happening in different ways throughout the length of their careers, and this was true for participants at all levels of experience. They talked about their experiences in graduate school, emphasizing that just like the literature tells us, they also. The experience that in class learning on the topic was minimal and generally lacking, and they described more learning happening in grad school through training opportunities like practicum placements or internships. Beyond experiences in grad school, participants talked about learning to give feedback as being a really self directed kind of process that's been happening for them outside of school. So they spoke about seeking out resources, learning through their own experiences, and giving feedback, talking with colleagues and learning from supervisors. One of the pieces that was interesting was that, in terms of learning from others, the participants touched on positive learning experiences, but they also talked about becoming aware of approaches they didn't want to use. So mentioning colleagues or supervisors who were using maybe like an overly formal approach or struggled to convey results clearly. And as they described giving feedback and learning how to do this over time, the participants touched on their their desire and willingness to learn more. So at all levels of experience, people sort of showed a drive to continue learning about how to give feedback, and offered some ideas about what that might look like as well. So these were a few quotes that came out from this theme. One participant said, "we learned about testing, we learned about analyzing data, and we learned about diagnosis and formulation, but I don't think anyone ever taught us how to do the feedback session. It wasn't part of a course, it wasn't even a chapter, it wasn't even an afternoon session." Another person shared, "I wish we would have got more content formally taught in courses, because then I wouldn't have been trying to glean all these things by myself. I feel like I would have, if I would have had a shell or guidance that would have been really useful." Someone else said, "I'm self taught in terms of how to prepare. It wasn't really taught to me or coached by anyone. It's just what I found helpful, and it's evolved over time," and one person shared, "I think this is an important area for more professional development. I think sometimes we forget this is the most important piece of the assessment. We need to be meeting every parent's needs, and it's pretty complex. So I think it would be helpful to have more PD in this area." And then the third theme I'll talk about was identified as navigating a landscape of emotion. And this theme encompasses the idea that feedback is a process that can be very emotional for parents, and also the idea that it's the clinician's role to acknowledge and support parents with their emotions. So parent emotion came up really frequently in the data and participants described parents expressing a range of emotions. So both what we might consider more positive emotions like relief or hope or gratitude, also more challenging or uncomfortable emotions like resistance, anxiety, anger, self blame, overwhelm, those kinds of things. And in talking about the importance of being able to recognize and support emotion during feedback, many of the participants talked about how their training in counseling and psychotherapy was really relevant. So that was kind of an interesting piece from this theme as well. So again, a few quotes from the theme. One person said, I usually have a sense of how from the intake, of how much anxiety there will be about the results, how much resistance when there's anger, I take it as a sign that they're afraid deep down, or it's hitting them close, because it's so much like their own difficulties or other children's difficulties in their home. Another clinician said sometimes parents are very relieved and talk about feeling validated. They've been needing confirmation of something they've known about their child for a very long time. And a third participant said a feedback meeting isn't the same relationship as therapy, but it's still a therapeutic relationship in a way, and you're really providing them with empathy and unconditional positive regard and all of those things that you would do along therapeutic lines as well. So it's similar. So a range of implications are kind of evident from from the results of this project. So kind of boiling them down, just to really summarize, giving feedback is a complex task, and it requires specialized skills, even though it's been kind of overlooked in terms of training and research, giving feedback is about so much more than delivering results. So accessibility and navigating emotion were two of the pieces that really came out as important from this project, and training in the area really is lacking and is definitely more desired by clinicians at all experience levels. So in the spirit of offering more training in this area, I thought it might be helpful today to introduce you to a bit of a framework. Set of guidelines for giving feedback that I think aligns really nicely with the results from this project and with my experiences as well. So this framework comes from the world of therapeutic assessment, which might be familiar to some of you. So if you're not familiar, therapeutic assessment is an approach that is seen as sort of a short term intervention in and of itself. So basically, what that means is the assessment itself not is not just considered kind of an assessment or information gathering, but it's actually a process that can facilitate change for our clients. So the therapeutic assessment model is collaborative, which really differs from the traditional kind of more hierarchical approach that a lot of us have been trained in and exposed to in practice and in being collaborative therapeutic assessment approaches are focused on our clients. So they're focused on the questions and priorities that our clients have, and they include involving families and clients at all levels of the assessment. So this includes things like having clients involved in setting goals and asking questions about the assessment, in the data collection and interpretation and even in collaboration on reports. So this model, I like it because it's really flexible, so it's possible to offer kind of like a full blown therapeutic assessment, if you have the capacity to do that kind of thing. But it can also, there are also kind of more brief models of therapeutic assessment, and we can also just draw in elements of therapeutic assessment to the way that we're already practicing. So I like the flexibility in the approach. So like I mentioned, it's a collaborative approach. So traditionally, in a feedback session, a psychologist might be seen as like the holder of all the knowledge, the expert and the parents, parents are just sort of the recipients or like receivers of the knowledge, and that type of approach is focused more on data and delivery of data, whereas in this model, the clinician and the family are collaborators, and in a feedback meeting, the clinician's role is really to collaborate with the client to help facilitate new insights and new understandings, rather than just offering kind of more like results as like a truth that needs to be accepted at the end. So rather than being driven by data, this approach is more centered on the client. So I've listed here some of the kind of assumptions and principles that come along with giving feedback under this model. So basically, feedback can help parents and kids develop a new story about them, themselves or their child. One of the assumptions here is that humans are attached to their existing stories, and they can resist making modifications to that. So sometimes, you know, we and our clients have one way of thinking about things, and it can be difficult to shift to that. But the idea here is that the collaboration helps kind of circumvent that self verification process where people are just looking for information that confirms what they already know. So the collaboration is seen as the foundation for effecting change and developing new ways of seeing things, or developing that kind of new story. And this model also acknowledges the emotion piece, which I love. So it's just assumed that developing the new story is going to come with some emotional challenges, and that clients are best able to do this when they feel held in the supportive relationship with the clinician. So again, just that collaboration piece. So within this model, there are some kind of reflection questions that one of the these came from an article that I can share with you guys, but these are kind of food for thought while you're preparing for feedback. And I love these questions. So if I were this parent, not just a parent, but if I were this particular parent, what would be the best way to talk to me about the assessment findings? Who should we invite to the session? What order should I present the findings? How do I even decide what the major findings and recommendations are for this case, what kind of language should I use? What kind of tone should I take? How am I going to know if the parents are becoming overwhelmed? And then I love this last question, because if it's sort of an inward facing question, How am I feeling about the session? Am I feeling anxious about it? And if I am, what can I know and explore about that, and how can I take care of it? So I put a little asterisk beside this one here, because I want to talk a little bit as well about within this model some guidance on how we can decide what some of the major findings and recommendations might be, and how we can deliver those so basically, therapeutic assessment offers us this model of leveled information. So they encourage clinicians to think about any kind of information that will be shared with a client as falling within level one, two or three. So level one refers to findings that verify parents usual ways of thinking about their child or family. So these are findings that are going to be really easily accepted where you might hear a parent say, that sounds exactly like my child. So we always want to start here, because these kind of findings can lower parent anxiety and reassure them that their their existing understanding of their child is supported by what we've learned in the assessment as well. Level two findings are those that kind of modify or amplify parents usual ways of thinking about their child or family. So they're a little different than the way people are already thinking, but they're unlikely to be really threatening or cause a lot of defensiveness. So you might hear a parent here say, I never thought about my child quite this way, but I can see how what you're saying fits. So you might think of this as like a slight modification or a reframe of a way a parent might already be thinking about their child, and a lot of our results are going to fit here. And I think if you're a clinician who does assessment work, you can probably easily recognize this. We often hear parents saying, like, yeah, it wasn't totally new, but you kind of repackaged the information or shared it with me in a way that was a bit different. And then level three findings are findings that are very new and discrepant from parents usual ways of thinking about their child and family. So these are results that are more likely to be anxiety provoking, they're more likely to trigger defenses and they're likely to be rejected so but within this model, what we know is that these kinds of results can be accepted if we have a good foundation of parents feeling understood, taken care of and supported. So these sorts of results can be more cautiously presented, and we want to be keeping a close eye on responses to them and being sort of more cautious about how much level three information is provided. So I love this model. It totally changed for me how I think about assessment results. And it's important to know as well that what's level one or Level Two for one family might be completely different for another family. So it refers to that idea of really customizing and having a good understanding of the families you're working with in order to kind of assess this. And before coming into the assessment session, we can never really know for sure where we're going to land, like what is going to be a level one, two or three, but we can take clues right from our intake interviews, from interactions we've had with the family throughout the assessment process, from the data families have been providing to us. So we we can take those clues about how they're already seeing their child, and then we can kind of watch carefully during the assessment to see if where we've landed and where we thought the information would fall in these levels was right, or need some tweaking. So based on this, this is it's really small. You guys probably can't see it super well, but I can send this out after if people are interested. But this is a little feedback preparation tool that I created based on some of this information. So these are kind of reflection questions that I will use preparing for a feedback meeting so that I can make sure I'm sort of just trying to attend to all of these pieces that are important but may not always be top of mind when preparing. And then this is just the last piece that I'm going to chat a little bit about. So this is a map or sort of some guidelines from therapeutic assessment about how you might actually structure the meeting. So they recommend starting with a check in with family members. How are you since last time we saw you? What's been happening with your child, any updates that sort of thing. So just kind of doing a broad check in, learning about any updates that might be important, they also recommend reviewing the plan for the session, which I love. This is a really easy thing we can take from this model, but knowing that people are anxious and not necessarily sure about what to expect coming into the meeting, it's great to be able to just review a plan. So first we're going to talk about this, then I'm going to share this, then we'll talk about some recommendations and next steps, that kind of thing. So just sort of laying out a map. I also really love during the check in to just sort of bring emotion to the table and ask people how they're feeling coming into the meeting. Since I've been doing that, I have been so interested in the types of responses I get, I usually have a guess about how people might be feeling coming in but and sometimes it's right and sometimes it's not right, but it really can guide the tone and the direction for the rest of the meeting, to know how people are feeling. And if you've got more than one parent or caregiver in the room, are they feeling the same way? Are they feeling differently? That can be such helpful information for us in terms of making the collaboration stronger. We also want to share appreciations for the client. So I think a lot of us intuitively do this, right? This is like, oh my gosh, I loved working with your kid. He was so funny. This happened, you know, just sharing some of what we've seen and some of the beautiful qualities in the kids that we're working with. I know myself as a parent, this always lands so well for me when I'm meeting with anyone who has worked with my child, or my kids, just to hear them and hear that they're seeing some of the the awesome strengths and qualities that I see in my own kids, it can really build that connection and trust, which we know can set the stage for talking about some more challenging information that might be coming. We want to review assessment results and recommendations, and throughout the feedback meeting, we can be eliciting reactions and questions and just paying close attention to how the information is being received or responded to. And we also want to check with comprehension, how does this fit with you, seeing how people are understanding, you know, any new information that's been provided, that kind of thing. And within this model, they also talk about the importance of just describing any future contacts that might happen. So what clients can expect? Right? You can expect to receive the report from me in the next few days. Many of us will offer opportunities for questions that might come up later. So just sort of setting an expectation for what any future discussions or contacts might look like is really helpful. And this is another tool that I have that I use in my practice. So somebody recommended this, a mentor of mine, when I first started giving feedback and felt really uncertain about how to approach it, someone recommended to me, you put all the information about the assessment on one piece of paper, front and back. And I started doing that a long time ago, and I have continued doing it, I find that this really challenges me to sort of have the most important information in mind and to also have a really good solid understanding of the information I'm going to share, such that I can glean it from that one piece of paper and not have to rely on looking in a report or flipping through, you know, multiple pieces of paper, or that kind of thing. So this is not something that will necessarily work for everybody, but I thought I would share it here, because I think it fits with some of what we've talked about today, and it's been a good resource in my own practice. So just some kind of closing messages, considerations for giving feedback. There's sort of a summary of some of what we've talked about today. There are huge benefits for kids, families and clinicians when we give effective feedback and customization and attunement to the needs of the families and their emotions are really key as a foundation here. So I hope that my talk today has kind of encouraged you to consider some of these collaborative approaches. I think a lot of us are doing some of this stuff because we it feels right and we know it's right and it works. But I hope that some of the information and the model that I shared with you today gives you a little bit of a structure for thinking about it a bit differently, too, and in light of the fact that people are wanting more sort of professional development in this area, I encourage you guys to talk with your colleagues and do consultation on this. I am hoping to talk with more people about this in future too. So if it's interesting to you, please reach out. And I also wanted to acknowledge there's so much we didn't have time to talk about today. So there's lots of blocks and barriers that we have to navigate. This is a difficult process, and it can be complicated. We didn't get to talk about a lot of those today, and we also didn't talk specifically around sharing with kids and teens and other parties, which is also super important when we're thinking about giving feedback. So that's kind of the conclusion of the formal part of my presentation. And if people have questions or comments, happy to chat about them, I'm going to stop sharing so I can see.

Megan W 

Thanks so much Maaike, that was amazing. I'm wondering if you could talk a little bit, since we have a bit of time about some of those barriers that you might face in feedbacks, yeah, maybe if we could, yeah,

Maaike 

for sure. So I think for

Megan W 

that, I feel like that's helpful. Yeah,

Maaike 

absolutely love to talk about that. So I don't have anything formally prepared, but I'll just talk sort of about barriers and challenges that I've experienced, I know the setting can really some systems and settings that we're working within can sometimes create barriers. So for if there are clinicians here working in schools, you might have found yourself looking at those slides and being like, oh my gosh, how do I do this within the time constraints that I might have in a school setting? Or. Are policies and procedures that schools have in place that don't necessarily easily fit with some of these more collaborative approaches. So I think sometimes the systems we're working in can create the biggest barriers, and there's always the time barrier, right? When I learned about therapeutic assessment, I love the model. I think it's amazing. But the full model is like, I can't, still can't really wrap my head around, if you do a true therapeutic assessment, in its full expression, how you would ever be able to have the time to do that and still potentially make a salary or a little bit of money at the end of the day to pay your bills, because it's so time intensive, so but I also think that we can work around some of these barriers, and this is where chatting with our colleagues and finding little ways to kind of use bits and pieces of some of this can be important.

Megan W 

Yeah, I think the settings one is really an interesting one, especially like in schools. And considering that, since so many families that's the route that they take is through the school system, I think somebody else is just wondering if you could speak to how you use this approach throughout the assessment process.

Maaike 

Yeah, I think it's such a key piece, right? Sometimes we think about a feedback as one meeting, right? One kind of final culmination of all of our assessment results. And it's not really that, or it doesn't have to be that. So we can start doing feedback from the very, very beginning of our assessment. So when we're collecting information from families and getting to know them, we're already starting to kind of lay the foundation for the information that we'll share at the end. And like I talked about in some of the slides, it's that foundation that helps us to make those customizations and tailor the feedback so that it can be, you know, most effectively received by the family, and we can only do that through the relationship. The other piece I I use in my practice all the time is I'm not necessarily waiting till the very end to share information with families, right? So we're in touch with families throughout the process. We might see parents when they're bringing their children to appointments, depending on our setting, and we can share little bits of information throughout. And doing that can be really helpful, because it can reduce the sense of overwhelm that people have when all the information has to be delivered in sort of like a one hour period. At the end of the assessment, we can be sharing pieces of information, doing that check in, eliciting responses as we go as well. So it really is kind of an ongoing process.

Megan W 

And I think that's something that's, like, so important to debunk and like, allow yourselves to do too, which, because I think, yeah, there's with it, even just being the feedback, this is the end of the process. Like, there's like, this pressure on that end date. How would you manage? And I know you kind of addressed this a little bit, but like specifically, if, say, you have a family, parents that you're providing feedback to, and you know that they're really apprehensive or almost scared of what the results will be, or that's a worry that they had, and that's ultimately whether it's a diagnosis or you're sharing something that's just really hard and that they were hoping would not be the result. How do you navigate that with family?

Maaike 

Yeah, I think it's such a great question, and something that does come up for all of us. So one of the things I really try to do is, like I said earlier, just sort of bring emotion to the surface and make some space for it. So I think as sort of assessment professionals, we we haven't always been taught to do that, right? We've a lot of us come from this more like data driven approach, where it's like you've got to make sure you share all the scores and the results and all of that kind of thing. But it can be really therapeutic too, right? So where we can make space from the very beginning of the assessment to say, How are you feeling about this, like, what are some of the fears you have, what are some of the worries that you might have about your child? This can create such a like, a richer and more deep kind of relationship with families, and it really can set the stage for us being able to share some of that scary, like level three type of information in a way that's more supportive and likely to be well received, right? And just to make space and normalize that emotion is something we can do that's not too complicated, but it can go a long way. Yeah, yeah,

Megan W 

I think, yeah. Really utilizing that like, maybe that fear, that worry that they might have, and and giving that emotion this space, when providing that feedback,

Maaike 

and also thinking about some of the other information we're sharing too, right, all of that level one and level two information that's going to be more comfortable for people to hear, which is that idea that a lot of us use, right? Like, it's the same kid you walked in with. He's amazing. He's got all of these strengths, resources, qualities that are wonderful, that we can tap into to support him over time. So it's not that we're just delivering the the level three stuff, but that we're kind of couching it in some of that, that other information as well.

Megan W 

I'll open it up. If anybody wants to ask a question openly to you, feel free to use the raise hand function. I feel like I could talk to you about this and just keep on going. But I want to give everyone else the space to to ask a question or speak speak to Maaike. Maybe that's not quite working, but yes, I think the the child feedbacks and like catering things to like, a developmentally appropriate level is helpful to understand too. I don't. I would love to hear a little bit of your thoughts on that? Yeah, that's

Maaike 

another area that I'm interested in as well. So we didn't really talk formally about that today, but I love the idea around sharing assessment results with kids and teenagers. I don't know if you guys have seen some of Liz Angoff's work, the brain building books and that kind of thing, but she's got some sort of frameworks for sharing with kids. I like to draw from some of that stuff. And, you know, there are lots of time barriers associated with it, but the kids are who we're doing the assessments for, and for them to be able to understand some of the results at a level that's obviously developmentally appropriate, can be really, really meaningful. So, yeah, I think it's another area that we're all kind of growing in. You know, we get no training really, in giving feedback, even to the adults, and I think we get even less about how to share this information with kids. So, but I it's exciting to me that more people are talking about it now, you know, 10 years ago, nobody was talking about giving feedback to kids, and now we at least are starting to see some resources in that area

Megan W 

recently, you know, like, even the kids themselves, like, as, like, parents are becoming more open with, like, what this process means. They're asking questions. Like, okay, so when will I get to know that? Like, it's, it's really becoming a bigger conversation, I think, and it's yeah, like you said, just beautiful to see. Yeah, absolutely. All right, if we don't have any other questions, I'll give everyone so I'm not monopolizing the whole Q & A here, but I'll give everyone a couple more minutes If I want to jump in or ask anything you um, what about tools that you can use in providing feedback, any tools that you like, actual tools that you can use,

Maaike 

yeah, so I'll share with you guys. I think Marie's trying to talk, except it's coming through very much like a mouse on my end. I don't know about you guys,

Megan W 

oh my gosh. It sounds like you inhaled like helium or something. It's

Maaike 

like a chipmunk situation. Yeah, yeah. So some of the tools that I shared with you guys today, I can send out and happy to share those with you guys. And I know there's, there's getting to be more stuff out there. I've been to a couple of other talks about, like, neurodiversity, affirming assessments and tools that we can use to share with parents and those kinds of things. So I'll share some of those tools with you guys as well.

Megan W 

That would be awesome. We also, we have a book that we use. It's called Wired for Awesomeness when we provide feedback to a child and we sort of go through like, you know, these are the different areas of your brain and what we found, and so that's been helpful. I think Sarah is going to share the link here if anybody wants to see it, but that's what we use when we provide feedback to children as well.

Marie 

Yeah, so just to say that it was modeled after Liz Angoff, but it really sort of focuses more on the neuro affirming approach. You know, obviously our clinic specializes in that, but we really, we love it, and included in all of our kids feed. So all the cost of the assessment, all of the kids come for feedbacks to us. So meet with parents. We do that, we do that feedback, and then the child comes for half an hour where we then give them their book, go through their sort of, their brain with them I guess you could say. Some parents ought choose not to do that. But yeah, so we just, we did a little rejig of Liz's book here in our in the chat. And yeah, we'd love to know what you think of it. Yeah, lot of love went into the book. This is awesome. Like, I feel like I am on such a delay.

Megan W 

Also, your your mic is working now, this is great. We can hear you, Marie, you're good. Now she's gone. Sorry, I was talking I didn't have my mic. Oh, I

Maaike 

thought it was me. Okay, gotcha.

Megan W 

That's the book over there that, yeah, like Marie said, I think, like, just so much love went into it.

Maaike 

I love that it's and I totally I appreciate that you guys are doing that as part of your assessments. I think more and more of us are doing it now, and it just needs to be, like you said, a piece of the process that that we do for everybody, because it's important,

Megan W 

and it's for them too. Like it's, yeah, it's, I think, you know, gives them a little bit of agency and autonomy, which is just beautiful. Yeah.

Marie 

We're actually just, am I all squeaky still? Oh my gosh. This is great. I've been talking even times. I've tried to interject in this talk. I have so many questions. It's so good. It's about to be Chantal. We're about to make it digital, so that we can, so that we can, yeah, so the book can access more people.

Megan W 

Thank you so much everybody for logging in today. Thank you, Micah, that was, and I think inspires a lot of further conversations about this, it was just wonderful to have your insights, and we appreciate you and all the work that you do in prioritizing really, really careful and beneficial feedback. So thank you.

Maaike 

Oh, thanks so much for having me. It was great. I appreciate it.

Megan W 

Bye, everybody. We will see you all next week for our 14th clinical exchange. Sarah will send out the info for everybody, but until then, have a wonderful rest of your week. You.