Learning Assessments: Building a Roadmap to Your Brain

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Hello, welcome to Thought Club. I'm your host, Elisabeth Gray, here on the show where we try to rethink education and how we might all be better thinkers, and better help the next generation to think. I'm here today with a wonderful, very special guest, Dr. Paul Yellin. Dr. Yellin is the founder of the Yellin Center for Mind, Brain, and Education, and he's also the clinical associate professor of pediatrics at NYU Grossman School of Medicine. Thank you for being here, Dr. Yellin.

What a pleasure it is being here. I've had the pleasure of collaborating with you so many times over the years, and it's just a thrill that you thought to invite me. So thank you.

I'm so glad to be able to have a conversation with you today. We're usually too busy to have conversations.

Exactly. We're usually too busy. So this is a real gift. For people who don't know you, Dr. Yellin, what are you up to?

People come to us because we do what are called neuropsychological evaluations as a piece of the work, but I think there are ways to do it, and I'd say our mission is really trying to help parents understand their children, help children feel empowered and positive about the direction their lives are going to go. So we do neuropsych evaluations. We also meet with families who are having concerns about their children's behavior, concerns about whether they might have attention problems. And we do some research, and some teaching of other professionals around our approach.

But your background originally is in pediatrics, right?

They say that you learn from your children. I was a newborn intensive care specialist, actually, and I did that for almost 20 years. There's a chunk of my life where I was a hospital administrator. I was the chief medical officer at a hospital that NYU took over when I was on the faculty full-time there. Well, I discovered that I like working with kids way more than I like being a hospital administrator, and I'm probably better at it. But I think the issue for us was that one of our own children had a lot of challenges, and what was striking to me was how little, as a pediatrician, I knew about it, and also how the world didn't make sense. My wife called it the department store phenomenon, where whoever saw your kid last put a label on them.

In medicine there's something we call differential diagnosis, which means that when you see a doctor you're expecting them to think of all the possible reasons in some systematic way, to understand your symptoms. Whereas what I would see is people would put a label on my child and then automatically know what they needed to do. Like, what do you do for a reading problem? And of course any answer is the wrong answer. It's kind of like saying, what do you do for a cough? It depends. So I became fascinated about understanding the work. I had the opportunity to join an organization doing research into how brains learn, and looking at kids from the perspective of understanding their strengths, and also getting to the bottom of their challenges. I opened my own place in 2007.

I'm curious, are there any shifting trends in evaluations, in terms of what you're seeing with diagnosis over the last 20, 25 years?

On one hand, we're seeing a lot of anxiety. Anxiety seems very often to be part of what we see, so we're seeing fewer kids who have straightforward learning problems. I think we're picking up things earlier as well. And there's been a trend around autism. When a medical condition is first discovered, people see the most severe forms, and as we learn more we start to see the milder forms. There's been a tremendous amount of knowledge gained around how brains understand social interactions. For example, I think we routinely miss autism in girls. It looks very different than it does in boys.

What does it look like in girls?

Girls are often able to mask. I remember working with someone recently, and the way she described it was that she felt like her friends were better at being a person than she was. I remember years ago I totally missed it, but a woman was explaining to me. She was in an Ivy League college writing a history paper, and she provided what she wanted to say but didn't provide any background, and the professor really dinged her. She said, well, he's a full tenured professor in history, he doesn't need me to tell him the background. She described that she did fine in social situations, but for her it wasn't natural. She had to be thinking about it. She saw that other people knew the dance. So to the outside world she looked like she was doing fine, but she'd come home at the end of the day absolutely exhausted, because it took all of her energy to keep it together. Had I known then what I know now, I think I could have helped her understand herself in a better way. All of us have parts of our brain on manual and parts on automatic. For some kids it's reading, for some it's math, for some people it's how to read social situations. The fact that she could outwardly function didn't let us see what it was costing her.

I'm curious about this. If you're a parent at home now and your kid's doing just fine at school, is there any value to having an evaluation? Or is that something reserved for times of educational crisis? Could it really serve more as a road map for understanding how your child learns best?

I'll answer that sideways and say I think there's value in understanding every child. Every human being has strengths and challenges, and there's real benefit in looking at that early on. More than 20 years ago, when I was no longer working in the ICU, I got a call from the dean of student affairs at the medical school. He said, we want you to figure out why we have medical students on the verge of flunking out. And what we discovered is that, like the rest of us, medical students don't have perfect brains. But when your strengths are really strong, you can get really far in life without knowing you have challenges. And then suddenly you bump up against them. They'd come into my office in tears. I'd say, the question on your mind is that you're going to go through this process and find out you don't belong here. And I can tell you that the fact that you're here means you belong here, but your strengths have been so strong that you've gotten far without needing strategies for your challenges, and now we need to figure out what they are.

There was a psychologist named Carol Dweck, who wrote a book called Mindset. She did this really cool project. She spoke to people going into high school. She didn't even do an assessment. She just counseled them that everybody has strengths and everybody has challenges. And just that conversation empowered a lot of them to take risky classes. People shouldn't feel that an assessment is going to damage their child. We've had people come to us with their first child who's struggling, and then say, I'm going to bring my other kid who isn't struggling, because this was so empowering.

At the same time, I'll play devil's advocate on skipping the evaluation, because one of the things we see is that the kids whose strengths have academically held them up for a long time, kids who'd be diagnosed as twice exceptional, gifted and neurodivergent, develop a lot of brittleness around change and resiliency. There's so much ego attachment to the strengths that there's an inability to pivot and address the weaknesses. I feel for parents who say, I had a straight-A student, and now I've got a kid in law school or medical school who's flunking out and having real challenges with mental health.

I worry about the kids for whom certain things come so easily that the things that don't come easily get pushed aside. I wish I could step into their lives early on and say, don't cut off these things that could bring you joy. I'll tell you a story. I was working with a woman who was a grad student in statistics at an Ivy League college, and she never knew her times tables. She's doing math way beyond my knowledge, and she turns to me and says, "You know, I'm stupid." And I said, "How is that possible?" She said, "Well, I can't remember my times tables, and every third grader can." I said, "Well, what about this math you're doing?" And she looked at me and said, "Well, that's easy." People devalue the things they're really good at, because it comes easily. So a lot of what comes out of our assessment is convincing people of their strengths. I don't know that everybody needs a neuropsych, but I do think everybody needs to understand that it's normal to not have a perfect brain.

I look at kids all the time, and I'll say, I want to tell you a secret: for a lot of us, being a grown-up is a lot easier than being a kid. Because in school they make you think you're supposed to be good at everything. But here's the secret. To be a successful grown-up, you just have to be good at something. And you're already good at a lot of stuff. So my job is to make sure we don't destroy your self-esteem along the way by making you feel badly about all the stuff you can do.

And maybe reimagining addressing the weaknesses as more about developing resilience and strength. This may come from Dweck as well, the study of dyslexics and the way they out-earn people who aren't dyslexic. Early on they discovered that there are some things you just have to be willing to work through, even if you're never going to be the best at them. It's one of the things we're always telling parents: you've got to learn to applaud process, not outcome.

It's funny, I was working with a guy who's a brilliant musician. He was like, why do I need executive function? So I said, when's the last time you saw the Rolling Stones perform and Keith Richards didn't show up? You have to have some executive function. It's really about giving yourself permission to do the things you're not great at. In your area of strength, you should get an A. But in those other areas, allow yourself to not get an A, and to enjoy them, and to grow in those areas.

Dr. Yellin, if you were talking to a parent right now who's got a child who's struggling, what would your counsel be?

First, I'd say take a deep breath. When I see parents whose kids are struggling, they inevitably feel guilty. They say, "I should have come sooner." And I say, no. Give yourself permission to be imperfect. What happens often is, as soon as you see difficulty, you want to fix it. I think you need to start in a phase of data gathering. Try to figure out what's happening, collect information, and the hardest thing is to collect information without coming to conclusions. Just describe what you see. When I take a history, a teacher will say, "He doesn't want to write." And I say, no, you don't know what he wants to do. Tell me what you see. Observe without narrative advising.

I had a child come into my office. He was calling out in class, and they sent him to me because they figured he needed medicine for ADHD. I said, "I've got a question for you. Has anybody ever asked you why you call out in class?" And he goes, "No, they don't care. They just want me to stop." So I said, "I'll tell you a secret. Between you and me, I don't care if you stop. That's up to you. I want to know why you do it." And he goes, "Easy. I'm afraid I'll forget it if I don't say it." So often we attribute a child's behavior to what it means to us, when we need to understand their behavior in terms of what it means to them. My job is to figure out the rules of the universe within which that child's behavior makes sense, because that's the universe that child is living in.

Number one is collect information. Number two is, now I have information, I need to make a decision. Talk to your child's teacher, talk to your child's pediatrician. I just spoke to someone and asked, what does your pediatrician think? And they said, well, we haven't told her. You're also entitled to an assessment at no cost from your school. Is it going to be as comprehensive as ours? No. But it might be sufficient. Maybe a start. And go by your gut. You know your child better than anybody.

I love talking to parents, because apples don't fall too far from trees. I had a mom say, with getting our child evaluated, I realized I don't even know how I work. The parents are now going on journeys to get their own evaluations, so they understand what they're bringing to the table, the tango between their own unique brains and the brain of the child they're parenting. It's not uncommon for a kid to get diagnosed with ADHD or anxiety, and a parent says, oh, I think I have that. If we all take responsibility for understanding our own brains, what does that open up in terms of compassion for others and for ourselves?

I was working with a child years ago who was a very nonlinear thinker, very out of the box. I said to the mom, I'm not a religious person, but sometimes I think the creator has a strange sense of humor, because he'll give nonlinear children to very linear parents. And she burst into tears. I've been trained to feel that when somebody bursts into tears, I did something wrong. But she turned to him and apologized. She said, "I've been angry at him, because that's exactly what it is. I'm a very linear thinker, and he's nonlinear." There's a book called The Teaching Brain, and it goes through the notion that education is a dance between the teacher's brain and the child's brain. Understanding how you learn and how you think is really powerful.

I just want to say you do the most amazing executive function work. It's always an honor to collaborate with you, so I'm really grateful for you inviting me here.

As we launch Thought Club, it's free materials, free curriculum, free support for parents and kids, in an effort to get the word out about things that are really achievable without spending any money. I think our work is impactful because we don't start from a place of knowing how they should do it. We start from being curious about how their brain might want to do it. We'll say to kids, listen, we've been there with our own brains. We're here to help you figure out your hacks, but we could get it wrong the first three times. We could knock on three doors that don't open and then figure out how to crack open that window over there. We're not inside your brain. You're inside your brain. There's no one right way to do anything. It's about figuring out your system, that you can be with without resistance. So I love the work we get to do. I feel very privileged to do it, being part of people's lives and helping them understand themselves.

It's a good life. Dr. Yellin, thanks so much for being here with us.

Thank you for inviting me. This is wonderful.

Such a pleasure. And thank you all for joining us. I'm Elisabeth Gray for Thought Club. Please join us, like us, follow us, all those things you can do on social media, and join us in this mission to figure out how we can improve education and improve our thinking, both for ourselves and for the generation ahead.