International Neurodiversity Week - Dr Esther Kiehl shares her diagnosis
This week is international Neurodiversity Celebration Week (18 to 24 March), which challenges stereotypes and misconceptions about neurological differences and celebrates difference.
Dr Esther Kiehl is a Consultant Clinical Psychologist who was diagnosed with dyslexia and attention-deficit disorder in her 30s.
She also has dyscalculia, which is a difficulty processing numbers and symbols, and dyspraxia, which affects co-ordination, balance and movement.
Esther explains how these neurological conditions affect her and shares her tips and tricks for neurodivergent and neurotypical people to work together as smoothly as possible.
I am dyslexic but didn’t find out until I was in my early 30s, just before I was due to submit my PhD. I had no idea you could be dyslexic and able to spell.
When I was at school I was thought of as lazy or failing because they knew I wasn’t stupid. But I felt stupid and the learning environment was such that I was often under-stimulated but at the same time I was presented with things I just couldn’t process. I had no idea I had specific learning difficulties, I just knew I wasn’t doing well at school.
If you get diagnosed as an adult, you are not alone. Quite a few of us have had these experiences during our schooling and have learned to cope. One of my ways of coping was to turn into the class clown (and I’m still prone to interrupting proceedings with an occasional quip!)!
University worked better for me and I was a freelance journalist for my last couple of years at school and during university. I think that’s what led me to psychology because making sense of people and their stories was the thing I enjoyed most about being a journalist. However, getting down to writing, particularly putting information in the right order, was difficult.
After my undergraduate degree, I was offered a teaching and research role at the University of Essex which included funding for a doctorate. I enjoyed the chance to get on with finding out about some things I was really curious about, but academic writing remained hard work. I didn’t want to stay an academic - I wanted to be a practitioner psychologist, but I thought there was no way I was going to get in.
So I resigned myself to using psychology in a practical way and applied to join a prestigious postgraduate training programme in HR Consultancy at a large bank.
I completed this, but felt I wasn’t really able to be a psychologist in my job.
I applied for the training to become a clinical psychologist, another three-year doctorate, and was delighted to get in. Finishing this may well be the hardest thing I’ve done.
Did it change the way I felt? It didn’t. I tried to collect degrees, acquire adequate levels of accomplishment and new skills, worked silly hours and did things like running marathons.
But it still hasn’t quite silenced my inner fear of not being good enough, working hard enough, being accepted enough. And I’ve learned to live with that. I now try to embrace these feelings as a natural counterbalance to feeling too certain, too sure of myself.
I would say there are upsides and downsides to my brain being the way it is.
Discrimination and the fear of being judged have stopped me doing things in the past but I think that happens to all of us. However we differ regarding how often, how disruptive and how intensely those experiences hit us.
For me, I have struggled with being labelled because of my diagnosis on the one hand, but having a diagnosis has been really helpful on the other.
Somebody assessing me properly and telling me I am not stupid, but dyslexic, dyscalculic, dyspraxic and have ADHD, was possibly the most liberating experience of my adult life.
If I look at these things as a psychologist, and at the factors that might contribute to those difficulties, I can see it is more complex than just a diagnostic label.
Having specific learning difficulties like these affects people in different ways. For example, I find it hard to stay focused, especially if I’ve been interrupted, and I find it more difficult than most other people to remember names and faces, times and dates, and to know how long something is likely to take, even if I’ve done it before.
I need to take more time and need help with structuring information in ways that are useful for other people. I am a decent proof-reader of other people’s work, but helpless at reading my own, unless I leave sufficient time to forget what I have written. Otherwise, my mind reads the words that should be there, not the words that are there.
Filling in forms and completing things like the ‘Captcha’ tasks to confirm that you are a human on line can take me many attempts.
Absorbing information from text, particularly non-fiction, requires a lot of extra time, peak concentration and energy and all tricks I can muster for information to go in.
I love reading fiction, partly because one can miss a lot more without losing the overall sense of a chapter in a novel, compared to a textbook or clinical article.
I experience musical tinnitus. At any time of day or night, there’s a song playing in my head and it can be quite persistent. I might have the same song playing for days. It gets really annoying and very distracting on top of ordinary tinnitus (a fairly constant, high-pitched tone that gets louder at times) so I use as many strategies as I can to deal with it.
But although my brain throws me curveballs and I get easily distracted, I think it also offers me bottomless enthusiasm, new perspectives, new ideas and creative solutions. And it makes it easier for me to step into other people’s shoes, which is what I do for a living.
Every neurodiverse person is different but I have listed below some simple things that help me, especially in the workplace, and might help others:
- Doodling, fidgeting, physically moving around, changing sitting and standing positions and switching between tasks helps me concentrate.
Sitting still for too long makes me unbearably fidgety and much less able to listen, particularly in a meeting or teaching setting, so I explain to the chair or trainer beforehand – I don’t want to look like I’m impatient or bored! - Don’t be afraid to ask for help
- Ask your employer to apply to Access to Work, a publicly funded employment support grant scheme that aims to support disabled people start or stay in work. You can apply for practical support such as specialist equipment and assistive software.
- Use technology such as a noise-cancelling headset, TextHelp’s Read&Write software, Dragon Naturally Speaking, Spark-Space mind map tools, or a handwriting recognition tablet can help, and a specialist assessment as above would help you figure out which of these or others might make a difference to you.
Here are some tips for neurotypical people to help communication with someone who has specific learning difficulties:
Things that someone who is dyslexic or has ADHD may have difficulty with
- Processing information – I am more likely to misread or misunderstand words
- I struggle with putting information in the right order for someone else to make sense of, so I don’t mind people asking me to clarify what I am trying to say
- I can’t write fast enough to keep up with my thoughts and lose track.
On email
- Use meaningful subject lines helps me prioritise emails – for example, say what the email is about, rather than just saying ‘Urgent’ or something vague
- Say what you need or want in the first paragraph
- When forwarding emails, remove excessive numbers of headers and recipients from the body of the email – this helps direct my attention to the information you need me to see
- Include your email signature on every email – your name, your job role, your contact information. A profile photo of yourself also helps people learn your name.
Writing
- Write out acronyms the first time they are used to help the reader understand what you are referring to
- Use appropriate headers, grammar and punctuation to make it easier for someone with reading difficulties to understand. Long paragraphs can make it harder to read and remember the information.
Most importantly, have a conversation and ask what works for them.
Useful links to find out more about dyslexia, dyspraxia, ADHD, and dyscalculia, including advice and training
The Neurodiversity Celebration Week website also has some useful fact sheets and information for parents and carers, children, educators and employers.
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