The Brain Building Book is part of a larger framework for helping children truly understand their assessment results.  The components of this framework are as follows:

1. Feedback Starts Before Intake

2. Building a Shared Vocabulary

3. No Surprises!

4. Continued Conversation

Here is an overview of the Brain Building Feedback Framework, including links to the additional tools you may find helpful.

1. Feedback Starts Before Intake

There’s a concept in the assessment literature that “feedback starts at the intake interview.”  However, for children, the first interview is not the first conversation about testing.  

The first conversation about testing happens with their parents, before they ever set foot in my office.

The language parents use to describe the assessment and the reasons they give for “why” the child is being assessed will affect the entire assessment process – including the feedback session.  

To set parents and kids up for success, I started offering parents a handout with specific language to help them talk to their child about testing as a brain-building, collaborative discovery process. 

This language sets the frame for the work we will do together so that kids come in curious about understanding their brains.  Their curiosity will help us identify our assessment questions, which will, in turn, drive our feedback session.

2. Building a Shared Vocabulary

Helping kids understand their brains is easiest when they have a specific question.  Many of us start our assessments by asking, “What questions do you have? What would you like to learn about yourself?”  But all too often, kids don’t have much to say.

The fact is that many young children simply do not have the language to ask a question or even talk about their experiences.  In addition, there is a big emotional barrier to talking about stuff that’s hard!

This is where The Brain Building Book helps.  

The book helps you to build a shared vocabulary with the child about the brain, learning, and emotional regulation, and it helps kids to ask their own assessment questions.

Brain Words

The first pages (1-6) of The Brain Building Book introduce some basic, brain-based language.  I use these pages as part of our initial interview and an introduction to testing.  

We’re here to learn about your brain!

As we talk about the different parts of the brain and their respective roles, we start asking questions about the brain in general:

  • What parts of the brain do you need to play video games?
  • How does your brain figure out a new rock climbing problem?
  • Which parts do you use when you draw?

While these questions are not the “referral question” that brought them in, they create a fun place to start the feedback session later on.  When we meet, I can start by explaining what we found that helps us understand why, for example, they like rock climbing so much!

Highways and Construction Zones

The next pages (7-11) introduce a construction metaphor to help explain strengths and challenges.  I’ve found the construction metaphor helpful because it is accessible.  Most children have been in a car, have been stuck in traffic, and have watched something being built on a construction site!

While most kids are able to talk about their highways, or strengths, talking about construction zones, or challenges, is harder.  In the past, I often had kids tell me that they didn’t have any challenges – or that everything is fine now!

To get kids talking about what’s hard now, The Brain Building Book has two pages (8-9) designed to ask what used to be hard but isn’t anymore.  What roads have they already built?  

From here, it is much easier to talk about what they want to build next.  On pages 10-11, they are now ready to list the things that their brain is working extra hard to do.

Whatever the child identifies as their “next construction project” becomes the basis for their assessment question, which will, in turn, be the focus of our feedback session.  Here are a few examples of assessment questions based on this process:

  • Why is math easier than reading?
  • How can I get better at writing?
  • How can I get faster at homework?
  • Why am I getting in trouble all the time?

It should be noted that children often need help turning their thoughts into a question.  I might say, “I think I heard you say math is easy but reading is tiring.  Maybe a good question would be, ‘Why is math easier than reading?’” and then ask if they agree with that question or want to tweak it at all.

Once they have a question, we write it down in the book.  As other questions emerge, we write these down, too!

3. No Surprises!

This is probably the mistake I’ve made the most over the course of my career.  There should be no “big reveal” at the feedback session!

I can get very excited about my “brilliant discoveries” about a patient’s challenges; however, I’ve learned the hard way that if I haven’t brought my patient (or their parents) along for the journey, chances are that (a) I’ve missed something, or (b) my client will be too overwhelmed to process anything I am saying.

This is especially true for children, who will likely be nervous about what we are about to tell them, or may simply have difficulty processing information.  

The Brain Building Book helps with overwhelm in a few different ways.  

  • Building a shared language so that the child understands all the concepts introduced at the feedback session
  • Helping children articulate their assessment questions so the child has defined what we will be talking about at the feedback session
  • Writing down observations in real time – collaboratively – so that the child already knows much of what we will be talking about at the feedback session

By writing together in the book throughout our assessment sessions, we lay down the building blocks for talking about their results or diagnosis – without any surprises. 

Answering Assessment Questions

The first key to avoiding overwhelm or a shut-down at the feedback session is to make sure we are answering the child’s questions.  This is why developing the shared vocabulary is so important. It helps them ask questions so we have a starting point for the feedback session.  

There are two types of questions noted above.  The first questions come about during the introduction of brain words, and tend to be “curiosity questions.”  These may be things that are interesting to know about, but may not address a specific “problem.”  

That said, what we discover during testing can inform these questions.  For example, here are some “curiosity questions” kids have asked: 

  • Why am I better at rock climbing than my parents?
  • Why do I have lucid dreams?
  • Why is science my favorite class?

The second type of question is the “Why is this hard for me?” question.  As noted above, these come from the conversation about the child’s “next construction project.”  

Sometimes these questions are related to the parents’ or teachers’ referral question.  Sometimes they are not.  Regardless, this tells me where I should start at the feedback session.  Since this is the problem the child is presenting, we will get the most buy-in from them by helping them answer the question they ask.

As noted above, some examples of questions from kids might be: 

  • Why is math easier than reading?
  • How can I get better at writing?
  • How can I get faster at homework?
  • Why am I getting in trouble all the time?

I try to answer these questions by referring to what we have written on the Highways and Construction pages, including adding any [slightly] new information if we haven’t already discussed it.  

When the question the child is asking is very disconnected from the parents’ or teachers’ question, it is a clue that the child may not be ready to hear parts of the information.  

One example that comes to mind is a child whose ultimate diagnosis was Anxiety, but asked “Why is Spanish so hard?”  He was interested in the Spanish question, but shut down as soon as the conversation turned to anxiety.  That piece was a surprise.  

For this child, we were able to help him understand that classes with a lot of language can be overwhelming, but he needed more than one session to understand the anxiety piece.  My job in this case was to make sure his parents and teachers had the tools to keep the conversation going.  

Defining the Diagnosis Using Our Shared Vocabulary

Whether we use formal diagnostic terms or not, I believe it is incredibly important to give kids a way to describe what’s going on.  This is key to their own self-concept and helping them advocate for themselves.

When I share a diagnosis with a child, it’s simply another way of explaining their experience.  The following sentence frame has helped me to this end:

Sometimes it doesn’t make sense to share a specific diagnostic term with a child, either due to age, parent wishes, or if the diagnosis is not clear.  In these cases, I use the same sentence frame, but substitute other non-diagnostic terms.  It may sound like this:

It turns out – you’re not alone!  This pattern happens a lot.  Like lots of people, your brain is working to get better at:

  • Sounds and symbols
  • Executive functioning
  • Processing speed
  • Sensory processing/sensitivity
  • Organization
  • Initiation
  • Working memory
  • Big feelings

Tools and Interventions

Another place kids can get overwhelmed is when we start listing all of our recommendations.  I find it helpful to add things to this page during our assessment session, any time they bring up something that’s been helpful to them, including technology, strategies, or an adult who works with them in a specific way.  

When we turn to this page during the feedback session, they see a list of familiar ideas.

For this part of the discussion, I start by asking the child if there are any strategies or tools they’ve found helpful.  The more it comes from them, the better the buy-in.

Then I add one or two more, ideally related to what they have already said.  For example, one child said, “Mr. Smith gives me a Post-it with my homework so I can just stick it in my planner instead of writing it.” I replied, “Great!  Having things written down for you seems to help.  We might try having teachers write down other things for you, too, or print out math problems so you don’t have to copy as much. What do you think?”

Finally, I encourage parents and teachers to continue to add to this page over time.  This leads us to the final component of this framework.

4. Continued Conversation

No matter how magical our one feedback session is, it is not enough.  Our brains just don’t work that way!  Children (and adults) need repetition and processing time to truly internalize and act on what we’ve shared.

For this reason, The Brain Building Book is designed to give adults:

  • A reference for the specific language we used to talk to the child
  • A mechanism for revisiting and adding to the conversation over time

Child-Friendly Language at the Parent Feedback Session

The report we write after an assessment has many audiences: parents, teachers, special education professionals, physicians, therapists, as well as the next evaluator.  It is very challenging to make sure the report both includes everything these audiences need, and is still consumable to parents.

This is not to say that parents are not capable of understanding the report.  It’s about making sure we highlight the information that is most directly related to the specific actions they can take to help their child.  

As I explored ways to help children understand their testing results through the construction metaphor, I started hearing from parents that this language was benefiting them as well.  

So, I started preparing for the parents’ feedback session in the same way I was preparing for the child’s feedback session, by writing down the child’s highways, construction zones, special words, construction crew, and tools.  

I use this worksheet to organize my thoughts, and then share it with the parents as a summary sheet of the formal report.

PS – I’ve started sharing this handout at school meetings as well.  The feedback is overwhelmingly positive, especially from teachers who want to know how to talk to the child about their strengths and needs.  

Concrete Take-Homes

The second piece to helping adults continue the conversation is simple.

Give the child something to take home!

In this example, I’m talking about The Brain Building Book itself; however, any physical take-home will be equally helpful – even the handout referenced above, especially if the child is older.

Here are some ways The Brain Building Book specifically is helpful as a take-home from the assessment:

  • The book itself is full of the specific language and visuals you used with the child, including the very personalized pieces you added throughout the assessment.  This makes it easy for parents to repeat and emphasize the same messages over time.
  • The book is designed to be written in, which means additional information can be added over time.  As children discover new information about their brain, or new strategies that are helpful, they are encouraged to write them in their book.  This gives adults a great excuse to revisit the metaphor and messages to help children process the information over time.
  • Finally, the children I’ve worked with are really proud of their book, and are often excited to share it with their teachers, counselors, family members, and anyone else in their lives.  This means that they are getting a lot of practice explaining their brain, and many opportunities to advocate for what will be most helpful to them.  

Whether you use The Brain Building Book itself or just the concepts and language, these concrete reference tools are critical for setting adults and children up for success in continuing the conversation, and ensuring their understanding of their brain continues to evolve over time.

I hope this framework has been helpful.  For step-by-step guidance in using The Brain Building Book as part of this feedback framework, click below:

How to Use The Brain Building Book

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