Understanding Comorbid Diagnoses in Autism (S7E26)

Introduction:

In this insightful episode, we welcome Dr. Suzanne Goh, a pediatric neurologist and behavior analyst, to discuss the complexities of comorbid diagnoses in children with autism. Dr. Goh shares her expertise on the role of pediatric neurology, the importance of a holistic approach, and how parents can better advocate for their children.

Guest: Dr. Suzanne Goh

Dr. Suzanne Goh is a renowned pediatric neurologist and behavior analyst based in San Diego, California. Specializing in autism, Dr. Goh leads a comprehensive practice that integrates medical, behavioral, and developmental care. As the founder of Cordica, a network of 24 centers providing autism care services nationwide, she is dedicated to improving the lives of neurodivergent children and their families. Dr. Goh is also an author, with her latest book, “Magnificent Minds,” offering a holistic approach to autism care.

Key Points and Takeaways:

  • Dr. Suzanne Goh’s Background: Pediatric neurologist and behavior analyst specializing in autism.
  • Shortage in the Field: There is a significant shortage of professionals specializing in pediatric neurology and autism care.
  • Role of Pediatric Neurologists: Diagnosis, genetic testing, metabolic testing, and epilepsy management.
  • Neurobehavioral Framework: Combining neurology and behavior analysis for a customized approach to autism care.
  • Common Comorbid Diagnoses:
  • Medical Conditions: Genetic, metabolic disorders, epilepsy, sleep disorders, gastrointestinal issues, immune disorders, and autonomic nervous system dysfunction.
  • Impact of Comorbid Conditions: These can significantly affect a child’s health, quality of life, learning, and well-being.
  • Advocating for Your Child: The importance of looking deeper than just the autism diagnosis and finding the right medical team.

Relevant Links:

Quotes and Highlights:

  • “The source of behavior is the brain. So it’s a natural connection. And how can we really understand behavior if we’re not thinking about the brain?”
  • “About 90% of autistic individuals have at least one co-occurring condition and 50% have four or more.”

About Rob Gorski and The Autism Dad podcast:

Rob Gorski is a single Dad to three amazing autistic boys and the Founder and CEO of The Autism Dad, LLC. Multiple award-winning blogger, podcaster, content creator, social media influencer, and respected public figure for the last 15 years.

Connect with Rob: theautismdad.com

If you found this episode helpful, please subscribe to our podcast, leave a review, and visit our website for more resources. Connect with us on social media to stay updated on future episodes.

Transcript

Dr. Suzanne Goh_mixdown

Rob Gorski: [00:00:00] Thank you so much for taking the time to be here today and for rescheduling. Cause I had some scheduling hiccups. I really appreciate you being willing to do that. Um, could you take a second, introduce yourself and tell us a little bit about who you are and what you do.

Dr. Suzanne Goh: Sure. Thank you, Rob. I’m so happy to be here with you.

My name is Suzanne Goh. I am a pediatric neurologist and a behavior analyst, and I’m a practicing physician in San Diego, California. And my area of passion and interests, um, And experience is autism. So, uh, really my practice is focused on that. And, um, I’ve had the privilege of working with a team and we, we now provide autism, uh, care services around the country in 24 centers called Cordica.

Rob Gorski: Really? That’s really cool. Um, I have, I have. I have quite a few questions and, and we’re going to sort of focus on, um, like comorbid diagnoses with autism today, because there’s a lot of confusion I think surrounding that with parents. Um, but I [00:01:00] wanted to ask you a couple of questions. So being a developmental neurologist, uh, you said developmental neurologist, right?

Pediatric neurologist. Pediatric neurologist. Okay. Do you, do you find that there’s like a shortage of people doing what you do? Yes. If that makes sense. Yes.

Dr. Suzanne Goh: There is a, there’s a real shortage and really there, there always has been things are getting better. There are, there are more professionals entering the field, both physicians and also therapists and mental health professionals, but really there still aren’t enough.

Um, in fact, there’s some research showing that there’s an 18 fold greater. Uh, demand and need for services, then there are professionals to provide those services.

Rob Gorski: So what role would a pediatric neurologist play in the diagnosis of, you know, a child that is presenting with, you know, symptoms of autism?

Dr. Suzanne Goh: Yes. So pediatric [00:02:00] neurologists vary a lot in terms of their. Specialization. So pediatric neurologists like me, who specialize in, uh, what we call cognitive and behavioral neurology, uh, do, uh, provide a whole host of services that can be very helpful for autism. Some of us do diagnostic evaluations and can provide those diagnoses.

Most can if they, uh, if they specialize in behavioral neurology. Um, but often, you know, child psychiatrists or psychologists. also have an important role to play in diagnosis. The part that pediatric neurologists can really, you know, my own practice is quite broad because of my interest in autism. So most pediatric neurologists don’t do the whole range of support and care for co occurring.

Um, Uh, or comorbid conditions. We can talk more about those. Um, but all of them will do things like genetic testing. Um, they’ll do some level of metabolic testing, uh, and then where they really have expertise is an [00:03:00] epilepsy diagnosis and management. And we know that’s really important in autism, because about 20 percent of autistic children have epilepsy, and then a much higher number somewhere around 40 to 50 percent will have unusual findings on an EG.

on an electroencephalogram that actually are important to know about and might inform treatment decisions.

Rob Gorski: That is two of my three kids, actually. Uh, I have one who, my oldest was diagnosed with epilepsy like much later in life. He’s 24 now, but he was diagnosed about 15 years ago. So he was 10 or 11. Um, And then my youngest or my, my middle child, he’s 18.

Now he, he tested, they didn’t diagnose him with epilepsy, but they said like all the pieces are in place. Like, um, we just haven’t had any, any seizure activity or any, you know, irregular electrical activity. But they said like the, like the, I forget how they describe it as like a four way stop or something where there was just, um, [00:04:00] Like it was just like, like the, the roadway is there, but he’s not having issues, I guess, if that makes sense.

Dr. Suzanne Goh: don’t think I

Rob Gorski: described that right.

Dr. Suzanne Goh: They, they likely saw something on an EEG that, that showed the parts of his brain may be prone to having seizures, but he wasn’t having seizures yet. Or at that time or, or, um, so yeah, so we can, an EEG is a great test because it measures the brain’s electrical activity and can show us signs of maybe Um, you know, what parts of the brain are firing in unusual ways, how that might be affecting the way a child thinks and learns and behaves, um, and then guide us to it towards steps that we could take to help.

Rob Gorski: Do you, so I’ve, I’ve never met someone in your profession and we’ve worked with pediatric neurology and developmental neurologists and pediatric psychiatrists, all that, all that stuff. Um, I’ve never met somebody who specializes in both. The neurological side and is also a BCBA. And that is really interesting to me.

That was one of the things that really stuck out. Um, [00:05:00] when we, we got connected because there seems like there would be so much positive overlap and, and helping you to understand how one impacts the other. And I was just wondering if you could kind of talk a little bit about how that sort of helps you to.

You know, better, uh, impact the lives of, of kids that are, you know, dealing with something like autism.

Dr. Suzanne Goh: I really appreciate the question. It makes such a big difference. And I hope that more and more of our physicians will get, um, education and training, you know, in, in behavior and vice versa. Um, because you’re right.

I mean, the source of behavior is the brain. So it’s a natural connection. And how can we really understand behavior if we’re not thinking about the brain? Um, so, you know, I, I was a pediatric neurologist first and then went back to school and got my BCBA, um, just in the math, the last five years. And, um, it’s allowed me to develop and then to use in my practice and in cortical clinics, an [00:06:00] approach that we call a neurobehavioral framework.

And so it’s, Taking everything that is really effective and positive about ABA and the behavioral approach and then taking it one level, what I consider sort of one level deeper, you know, then once we’ve identified behavior and we’ve analyzed the environment and taken data and we understand based on that information, why behaviors are happening, then we can say, okay, what do we know about a child’s unique neurodevelopment?

What we know, what do we know about the way their brain processes information. Sensory motor, cognitive language, um, social, emotional, and then that allows us to tailor the different antecedents consequences, you know, the different aspects of the environment specifically to then shape that child’s behavior and learning.

So I think it’s such a powerful combination.

Rob Gorski: So it’s more of like a, like a, like a customized approach rather than trying to apply a [00:07:00] general rule or a general approach to what are usually very, very unique kids.

Dr. Suzanne Goh: That’s exactly right.

Rob Gorski: So do you see more, do you see more success with kids when that kind of approach is taken?

I mean, it would make sense that you would. Yes. Is that sort of what translates to in real life? That’s right. Very cool. Um, how did you, how did you get started doing this? Did you do. Like what, like what sparked your interest in working with kids?

Dr. Suzanne Goh: Yeah, well, there were, you know, when I look back, um, there were a few experiences I had actually as a child that I think planted the seeds for what I do today and for Cordica.

Um, one is that my father was a pediatrician and so I grew up in Toledo, Ohio, and I just remember at that time, you know, the practice of medicine was different, he would have patients come to our home on nights, on weekends. And so it just felt like. I just remember having such positive experiences seeing my dad take care of children.

Um, and then another big part of it was, uh, when I was a high school student, [00:08:00] I volunteered as a camp counselor at a local summer camp for neurodivergent children. And that’s, that was my first exposure to children, um, autistic children, uh, the children with epilepsy, ADHD, spina bifida, um, a whole range of neurological differences.

And what was. One of the really incredible things at that camp was they paired a neurotypical camp counselor volunteer with a neurodivergent camp counselor volunteer, and my co counselor happened to be a young man with cerebral palsy. And for me, that friendship was so powerful, seeing his intellect, his humor, um, recognizing, um, what now I think of as really the beauty of neurodivergence.

And so that, that stayed with me. And so as I went through medical school, Um, and then later of course, chose a residency and, and pursued that. Um, yeah, it was just that those early experiences were really powerful for me.

Rob Gorski: I think it’s so cool when, when people have one of those kind of profound experiences early on in life, and it sort of [00:09:00] shapes the direction that they go in.

And even if it was like, Never thought about doing something like that necessarily until you have this experience and it, and it kind of guides you or it’s lights a fire sort of, or even sort of fine tunes, the direction that you were, you know, we’re looking to go in, that’s very, very cool. Cause you guys have like a passion for what you do and it’s not like, um, Yeah.

I mean, there’s, there’s, well, there’s a whole shortage of people doing what you do. So, I mean, you went through all the extra schooling and everything else. And I really appreciate that because like, I’m, I’m actually in Ohio too. I’m in Northeast Ohio. Um, and there’s like a three year wait list here for kids to be diagnosed.

And we need as many people like you, as we can possibly get to help. Uh, cut those lists down because there’s like these, you know, the vital early years where we need intervention, uh, kids are on hold, you know, because insurance won’t cover things until you have an official diagnosis. I was just talking to a mom the other day who he’ll ask to wait like three years [00:10:00] to get a diagnosis.

Um, do you guys, do you guys do anything online? We do.

Dr. Suzanne Goh: And so we, what we’ve built out is what we call a hybrid program, meaning that we do, we provide services. online through, you know, telehealth, so virtually, um, we provide, um, in center services in home, in the community and in school. And the reason for providing this kind of hybrid care model is that different children and families have different needs.

And so we really want to meet the child and the family where they’re at and deliver the service in the way that is best for them. Really customized for, you know, what will will best serve that child. Um, and the, the part that we have really been, um, developing very actively, certainly during COVID, um, and since is, is their telehealth offering, um, in part, because we now know, and there’s a lot of research to support it, that telehealth delivery of a [00:11:00] whole set of different healthcare services for neurodevelopment is extremely effective.

Even things like occupational therapy, speech language therapy, um, certainly parent education, you know, parent coaching part of ABA. Um, direct services for ABA are harder to do by telehealth, but if you have, um, a motivated family, so much can be accomplished through, um, uh, caregiver coaching. So, we have, um, a lot of, all of our services now are available through telehealth.

And it allows us to reach families, you know, in states and locations where Cordica doesn’t have a center. But one of the things we’re very excited about and we’ll be launching next year is a whole, is um, a full set of comprehensive care services for autism that can be done virtually, including diagnosis and all the different therapy services.

Rob Gorski: Oh, wow. That’s really, that’s really, really cool. I’ve seen that starting to pop up. I’ve not experienced what, what that’s like, you know, virtually, but, but I think there [00:12:00] is such a need for that, especially because there’s a lot of people who live in, you know, the outskirts and, and they don’t have those resources available to them and they have to go online or travel for hours to get, you know, somewhere.

So that’s, that’s really, really cool. I’m excited to see how that,

Dr. Suzanne Goh: Yeah. And you know, the, the wait times, the lack of access to care is it for, for neurodevelopment for autism and neurodevelopment more broadly it’s, there are the longest wait times of any medical specialty. And for me, that’s. You know, I just think that’s, um, it, it deserves so much more attention and effort because it, I think of it as a form of institutionalized discrimination.

If that, you know, if the quality of care is poor and the access is poor and we know, and it’s fragmented, you know, that is just, um, that’s really something that has to change in our healthcare system.

Rob Gorski: I completely agree with you. Completely agree with you. I hear from parents. [00:13:00] Everywhere, uh, about just the frustration with trying to navigate the system and kids not getting the care that they need, or, uh, you know, maybe even doctors not having the training that they need to, to, to really kind of dig in and help with some of these, uh, challenges.

So I, I completely agree with you. I’m, I’m very much looking forward to seeing you guys launch that, uh, because I think that’ll be a great resource for, for a lot of people. Um, One thing we wanted to touch on today was the comorbid diagnoses. And, you know, some of the ones that I’m familiar with that I hear a lot about or I dealt with, with my kids, uh, you know, we have epilepsy, a lot of sensory related stuff, and ADHD is a big one.

And I guess I was wondering if you could kind of talk a little bit about what some of the common comorbid diagnoses are and then how, you know, how, you know, You know, one can impact the other because sometimes like symptoms overlap and it’s really hard to kind of tease out like what’s anxiety versus what’s ADHD or what’s just autism and what’s, you know, whatever.

[00:14:00] So can we just talk a little bit about, you know, what your experience is with, with dealing with comorbid?

Dr. Suzanne Goh: Yes. Why it’s so important to understand these comorbid or co occurring features or diagnoses is because they can actually affect a person’s. Health, quality of life, learning wellbeing, even more than the, the features of autism itself.

So we know that these are extremely common. About 90, well, an estimated 90% of autistic individuals have at least one co-occurring condition and. 50 percent have four or more. So these are incredibly common. The way I like to think about them is in different categories. So the first category being medical.

So the most common medical co occurring conditions are, um, genetic and metabolic conditions. Those are present in about 20 to 30%. Epilepsy around 20%, um, sleep disturbance or sleep disorders close to 80%. Um, and then gastrointestinal symptoms and disorders. Close to [00:15:00] 90%. Um, and then the, the last big category would be, um, sort of, uh, in immune, you know, immune disorders or dysfunction.

And then, um, also a category called autonomic nervous system dysfunction. Um, that’s, are you familiar with the autonomic nervous system?

Rob Gorski: Yes. My, my oldest, when he was about. I don’t know, he was about 11. I think, uh, he was getting his 72 hour EEG and on the way home from that evaluation, he crashed in the car and his heart rate, uh, went haywire.

His blood pressure went haywire, his body temperature, and he went essentially unresponsive. Turn around, take him back to the hospital. And then after months of testing, he Uh, he was diagnosed at the Cleveland clinic with, they never named it, but it was an autonomic dysfunction, sort of like pots, but like an extreme version of pots where his brain would just stop [00:16:00] controlling autonomic functions like, uh, his heart rate and his blood pressure and, uh, even body temperature, he’d get these weird rashes that would start in one place and you could just watch it move all over his body.

And he would be hospitalized for upwards of a week at times. And there was. It was all supportive care because there was no way for them, they didn’t know how to stop it at the time. So that’s, um, is that, is that something that you see like those just mysterious kids that present in these weird ways that just, you don’t know what to do with.

Dr. Suzanne Goh: There’s well, we now know that they are connected. There’s still a lot of research that needs to be done to figure out exactly what those mechanisms are. And, and it’s probably, you know, complex and interactions of lots of genetic variables and. Certain environmental variables and, and that waxing and waning kind of presentation.

Yes. I mean, there’s so much we’re still trying to figure out, but at least now we understand it is all connected and that these things are much [00:17:00] more common in, in neurodivergent children and adults.

Rob Gorski: Yeah. So that, you just totally kind of blew my mind when you, when you said that, because you’re the first person that I have talked to that has sort of connected those dots.

Uh, in some way, and that was really kind of validating. One of the things that I think parents struggle with is, is being taken seriously when, when it comes to some of these things, because, you know, I hear from a lot of parents and even my own experience with my kids when they were younger is, you know, you take these symptoms that you’re seeing at home and you take them to your care provider and they tend to want to just sort of sometimes anyways, lump everything under the autism diagnosis and just say, well, they’re autistic.

You know, you’re going to have behaviors like this, or some of these things are going to happen when in reality there’s, there’s actually Issue or there’s a health concern. Is there, you know, how do you recommend parents. [00:18:00] Advocate for the kids, you know, if they feel like they’re not being taken seriously.

Dr. Suzanne Goh: Well, it’s, I would say what you just described is probably the biggest problem currently in, in the field of, you know, healthcare for autism is that there’s a mistake that a lot of professionals make, which is to attribute some symptom or some You know, something that comes up, they’ll say it’s because of autism.

Now that doesn’t make any sense because the diagnosis of autism is just a descriptive one. It’s just a collection of observations of characteristics. A diagnosis of autism doesn’t speak at all to root causes. Or underlying biology and so, um, one example that I often give is if a child has self injurious behavior, you would never ever want to say, oh, that’s because of autism.

You need to look deeper. Is there a sensory processing difference? Is there a medical source of pain? Is there, you know, an autonomic nervous system response state of chronic stress that’s [00:19:00] contributing. Um, so you always have to look deeper. And if you’re, if as a parent, if you’re working with a, uh, professional who is attributing things to autism itself, rather than looking deeper, you probably want to find someone else to partner with.

And it can take time to find that team.

Rob Gorski: Or yeah, to find a good fit, I think too, because sometimes it’s hard to find, um, it’s hard to find a good fit. Yes. Uh, if you have, if you have a child that’s diagnosed with autism, is there, I mean, is there a recommended, um, Like primary care practitioner, if that makes sense.

Like you have like your, if you’re a pediatrician to handle like all the everyday stuff, right. The nutrition and whatever. Uh, but do you, do you recommend, you know, for kids who are neurodivergent that they have a developmental or a pediatric neurologist to kind of handle the overarching sort of like autism related type things,

Dr. Suzanne Goh: you know, it will look the [00:20:00] team that will best.

You know, support your child depends so much on kind of your local resources and the local expertise and interest and specialty of the different, you know, professionals in your area. So, for some, um, and I know, you know, I’m here in San Diego. There are a lot of pediatricians in the community who are fantastic and actually have quite a high level of knowledge about autism, are extremely open minded, um, understand a lot even about nutrition and supplementation and how different lifestyle factors and exercise and different things influence development.

So sometimes a general pediatrician can, you with that. Can cover all those bases in addition to doing things like, you know, uh, if your child gets sick or has a fever or, you know, well, child checks, those kinds of things. Um, but in, in other places that’s harder to find. And so you may then, uh, want to look for specialists and, um, sometimes that specialist is a pediatric neurologist.

Sometimes it’s a child psychiatrist, [00:21:00] sometimes the psychologist, it just depends. I wish, you know, parents will often ask me, is there a particular. type of professional or a label, you know, or a degree that will tell me that this person’s going to be right for my child. And unfortunately right now there isn’t.

So it really is about exploring, getting to know the resources, talking to other parents, and then trying it, trying it out and seeing if that person, uh, aligns with the way that, that you think about your child and the type of care that you want your child to have.

Rob Gorski: And I, I think it’s, I think that’s very well put.

And, and, you know, we’ve been very lucky. Well, I’ve been very lucky with my kids and our pediatricians have been very, they are very knowledgeable and they’re, they’re like huge team players. So, so we’ve had this like huge support team with Cleveland Clinic and Akron Children’s and, you know, a dozen different doctors in various different specialties.

And they all, you know, work together and share records and keep on touch with everything. And, and that’s been very, very helpful, especially with that complex. Um, so I, you know, I always just tell [00:22:00] parents, like if you, similar to what you said, like if, you know, you have questions, you know, speak up. If you don’t feel you’re being taken seriously, speak up.

If you’re still not taken seriously, get a second opinion or find a different doctor. You know, I mean, not everybody’s going to be the best fit for what you’re doing and you are. Your child’s best advocate, you know, and don’t be afraid to speak up. You know, I think sometimes parents are a little bit intimidated and don’t feel like they can do that.

Um, I wanted to also touch on your book, uh, uh, Magnificent Minds, because I think it just, it just came out like a week ago.

Dr. Suzanne Goh: Yes. Yeah. One week ago.

Rob Gorski: Awesome. Can you talk a little bit about. Magnificent minds.

Dr. Suzanne Goh: Sure. So a magnificent minds, uh, the, the full title of the book is magnificent minds, the new whole child approach.

And I wrote this book because. You know, I’ve been practicing now close to 25 years and have always wanted a book that [00:23:00] I could recommend to parents that I felt would give them all of the essential information. I think of it as like liquid gold, you know, something that could be manageable for parents, really easy to understand that they could get through, um, in the course of their busy schedule and that would be relevant, whether, you know, their child was newly diagnosed, or if they’ve been on the journey, you know, for many years.

And, um, I’d never, I was never able to find that book. And so I, that, that was a big part of what inspired me to write Magnificent Minds. Um, and, What what the book offers is, um, what I call the whole child path. So it really is intended as a road map, you know, something that will equip and empower caregivers.

And I also think, you know, I wanted something that would be energizing and uplifting to to help. Um, really set them on the right course, um, as they’re, they’re wanting to bring the best care for their children. So it covers [00:24:00] everything from, you know, medical therapies, testing, um, pharmacological interventions, device based therapies, and then also reviews mental health strategies and all the different developmental and behavioral approaches for autism.

And yeah, it’s, it’s my attempt to try to bring everything together.

Rob Gorski: And it, and there, it’s like, Practical. So, so it’s not like, um, outrageously complex or, you know, cause I think a lot of times parents get like, you know, homework to do with their kids or whatever, and, and it’s just not, it’s not realistic and, you know, being able to, to focus on that, that whole child and kind of attack things from multiple different angles is good for any kid, right?

Cause good nutrition is good for any kid. Good mental health is good for any kid, but you can, you can apply these things to your everyday life, which I think is really important because a lot of times parents Get lost. And they get overwhelmed and they don’t know what to do. And, you know, it’s like people, when they talk about self care, it’s, it’s frustrating because a lot of times people are [00:25:00] promoting, like, you have to go get a massage.

You gotta go on vacation and self care can literally be anything that is positive for you. That’s not self destructive, that is sustainable and puts back into you. Right. And, and having that sort of, um, the approach that you take with this makes it Attainable and accessible to people. So I just thought that was really, I wanted to point that out.

Cause I thought that was really cool. Uh, I do have my copy. I couldn’t find it though. I put it somewhere today thinking I’m going to sit it down. So I know where it is. And then I I’ll find it as soon as we’re done. Um, but very, very good. Very, very good. And we’ll have all the links in the show notes.

Cause, uh, it’s on Amazon, right? So I’ll have all those links. What is, what is the best way for parents to connect with you?

Dr. Suzanne Goh: Well, um, my, uh, they can find a lot of information on Cortico’s website. It’s cortica care c o r t i c a c a r e. com. Um, and they can contact cortica that way and send, I’ll get messages and, [00:26:00] you know, our staff will forward me any messages.

I also have a website, um, drsuzannego. com. Um, they can message me that way. And, uh, Instagram, uh,

Rob Gorski: Yeah, I’ll have all those links, uh, in the show notes and in the blog post, uh, for this, I’ll tag you guys in the promotional social media stuff. So people can connect with you. I, as a parent, I really appreciate how accessible, uh, you are and, and being open to hearing, uh, from parents because.

There are so many people out there who are so desperate and just, they feel like they’re drowning and you, you don’t know, maybe, maybe you do, but like, sometimes it’s that one person who, you know, is accessible to you, who is willing to just listen or connect with you or point you in a direction that makes all the difference in the world and sort of restores that hope.

And you get that strength to kind of get back up and move forward a little bit more. And I just thank you for doing everything that you’re doing. I really appreciate it.

Dr. Suzanne Goh: Thank you. It’s, um, sometimes people ask [00:27:00] me how, you know, what was the origin of the whole child approach and really it was because of listening to the questions parents brought to me and where I didn’t have the answers I would do my reading, I would do my research.

And so I was really guided by the parents that I worked with and have learned. I mean, I’ve learned more from the parents and the children in my practice than I have from anyone. So, um, it’s, it’s wonderful to hear that it’s, um, the book is resonating. And

Rob Gorski: yeah.

Dr. Suzanne Goh: Oh

Rob Gorski: yeah. Well, thank, thank you for everything.

And, uh, I’ll have all that information so people can connect with you and check out your book and, uh, find some help if they, if they need help.

Dr. Suzanne Goh: Thank you so much.

Rob Gorski: So, uh, thank you again for your time. I really appreciate it. And, uh, we’ll talk to you soon.

Dr. Suzanne Goh: Thank you.

Mentioned in this episode:

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