349 Beautiful Complex Podcast
Tracking & Maintaining Progress, with Caroline Fitsimones

[00:00:00]
Penny Williams: Welcome back, everyone. I am so glad that you are here and you are listening. Today I have with me Caroline Fitsimones, who is an A DHD parenting coach and an occupational therapist, and we're gonna talk about tracking and maintaining progress. Which I think sounds overwhelming and difficult, and Carolina's gonna help us to really break that down.
Penny Williams: And we're gonna talk about why we need to do it, why we would want to do it, and then what it looks like step by step. How do we, how do we do this, and how do we then take that information to make improvements? So Caroline, will you start by letting everybody know who you are and what you do.
[00:01:00]
Caroline Fitsimones, OT: Yes. Thank you Penny for having me. Um, yes, I'm Caroline Fitsimones and I have been a pediatric occupational therapist for 21 years now. And I will say my biggest learning experience and application has been after having kids, one of them being neurodivergent. And this is where the rubber hit the road.
Caroline Fitsimones, OT: And, um, I really had to take inventory of what I thought I knew and what I really didn't know. And so it's been such a wonderful learning experience, um, filled with heart and humor. And, uh, just after having been through that lived experience myself, uh, I just have a whole new compassion, uh, and empathy for parents that I work with.
Caroline Fitsimones, OT: And so, yes, a lot of what I do now is much more, um, realistic. Uh, the expectations are more, um, realistic for families in general, and there's just so many hardships that we're navigating anyway, and so it's something that's much more doable for parents and more supportive in just my approach in general.
[00:02:00]
Penny Williams: And I hear parents so often say nothing is working. And I remember the days that I would tell everyone in my kid's orbit, nothing is working. And typically they would say, well, be specific. Tell me what it is specifically, tell me when it happens. And I learned that I had to take notes. I had to really hone in on specifics of what was working, what wasn't working, so that it would be helpful.
Penny Williams: Um, and I, you know, over time learned that our brains are wired to focus on the negative to keep us safe, and so that was why by the time I got to a monthly appointment, I felt like everything was crumbling. So I think intention here is super important. Why else do we wanna look at tracking and maintaining progress.
[00:03:00]
Caroline Fitsimones, OT: Uh, that's such a good example, and I'll back up a little bit. As far as in the clinical setting for OTs, we have to set goals and otherwise we're not working towards anything, um, measurable. And we're start, we're sort of, um, just kind of shooting in the dark. So setting goals, um, gives us a vision to work towards.
Caroline Fitsimones, OT: And then in between, you know, let's say I evaluate a child, set goals, and then 12 months later I reevaluate him. Now I have a baseline. And so setting goals is not to set us up for failure, but it is to give us something to track. And so when we're off base, we get to course correct and pivot, uh, instead of.
Caroline Fitsimones, OT: Pounding your head against the wall and saying, why isn't this working? But every hiccup, every quote, unquote failure is data, just like you were saying. You get to track it and pivot and notice, okay, we have found all the ways that don't work. Now we get to try different ways that do work, and oftentimes that means we need to think outta the box and do something very differently in a way we probably wouldn't have tried before.
[00:04:00]
Penny Williams: I think the whole game for parenting Neurodivergent kids is about pivoting. It's about analyzing, being aware, and then pivoting, um, because we have to do it differently for our kids, so many things, but also because things change from day to day, from age and stage to the next age and stage. And so I think it's so important to focus on the fact that we're not looking for that one thing.
Penny Williams: We're going to keep following the trajectory, right? We're going to keep assessing. Does that make sense?
Caroline Fitsimones, OT: Absolutely, and we are practicing in real life, in real time, exactly what we want to teach them, which is cognitive flexibility. If this doesn't work, let's shift. And there's nothing wrong with that.
Penny Williams: Yeah. That flexibility, it's a hard thing to come by sometimes, so I love that. That also really teaches that too. So you have a six step process for this. Are you ready to dive into that? Anything we need to know before?
[00:05:00]
Caroline Fitsimones, OT: Uh, that's it. And yes, I'm definitely ready to dive in.
Penny Williams: Well, let's talk about step one then.
Caroline Fitsimones, OT: Okay, so this is where we are vision casting, and this is where we get to dream as big as we want to. There's no right or wrong. Uh, and it could be more broad level. So when we're vision casting, uh, think about, uh, a puzzle we're putting together. We're usually starting off with the corner pieces, the edges, and then we're just sort of setting it out and it gives us a foundation for where we wanna go.
Caroline Fitsimones, OT: So vision casting might be, um, for our family, for example, having more peace and joy and trust and freedom as a whole, and having that felt sense of safety on a daily basis. And this can be hard for some families who only know chaos in survival mode. I've been there. And so anything outside of their current day-to-day life may seem unreachable.
[00:06:00]
Caroline Fitsimones, OT: But so what we're doing here is just we're writing it out without having any, uh, sense of is this achievable or not. We're just writing down our goals and what success would look like for us. I'm sorry, our vision, uh, what success would look like for us, for our family, for our kids. Um, it could be, for example, for our kids to be creative problem solvers.
Caroline Fitsimones, OT: So these are just in general what we desire for our family as a whole, what we desire for ourselves as parents, and what we desire for our children.
Penny Williams: So it's more general than goals. Okay.
Caroline Fitsimones, OT: Yes, and the next steps we will get to more specific goals, but starting off with a vision gives us a sense of direction, sort of like a compass of where we wanna go.
Penny Williams: A feeling almost like how, how do we wanna feel?
Caroline Fitsimones, OT: Exactly.
Caroline Fitsimones, OT: The more we sit in that, the more it gives us clarity. So that's the other part of sort of vision casting. We're reverse engineering, uh, and seeing what we want and working backwards on that.
[00:07:00]
Caroline Fitsimones, OT: And step two would be, this is where we are working on the next system, which is ourselves as the family dynamic.
Caroline Fitsimones, OT: So we're building a culture. So step two is build a family culture. And again, if you think about the hierarchy, we, the family is, we are our child's environment. So when we, again, looking at the lens from a lens of an OT, we look, uh, we work very holistically. We're looking at the individual as a whole.
Caroline Fitsimones, OT: And what impacts them is their environment, which is us, the parents, uh, or you. And so when we work on our family also as the environment, that sort of starts to fill in the puzzle again from the outside in. So building a family culture may look like building gratitude. And this sounds so simple and I know a lot of, um.
Caroline Fitsimones, OT: This encouragement is heard, uh, in, in every field, but it just makes such a difference. When we are modeling gratitude, we're modeling resilience. We're modeling how we choose to, uh, meet the challenge ahead of us.
[00:08:00]
Caroline Fitsimones, OT: We're modeling coping skills. Uh, we're also choosing connections with our kids. So something that I have learned, let's say for myself is we all have our fight or flight flee tendencies.
Caroline Fitsimones, OT: For me, when I get highly stressed out, I emotionally leave the room. I check out. So I'm there with my kids, but I'm not there emotionally. But when I get to practice gratitude, I'm bringing myself to the present, the here and now. And when my kids see that, they say that this is capable for my mom. So it must be capable for me too.
Caroline Fitsimones, OT: And so of course that's seeds planted over time, um, that takes root. But yes, gratitude is such a huge one for building a family culture. Uh, we're in this together and we can choose to find joy even in the hardship.
[00:09:00]
Penny Williams: Mm. Yeah. And when we create a rhythm around that, I think it really helps our nervous systems to feel more steady and safe and secure. And it also provides, I think, a sense of predictability that a lot of our kids struggle with. You know, when things are unpredictable, it really, um, dysregulates them or makes things harder for them.
Penny Williams: And so, um, we talk a lot about family culture and family, um, traditions or, or, um, you know, things that we do. And even as simple as like Taco Tuesday or pizza on Fridays, like something that's just part of that rhythm and flow that our kids can look forward to. Works for that too, right?
Caroline Fitsimones, OT: Exactly. Exactly, and I was gonna touch on that. And so yes, these are part of our systems. So it's, it is not just relational, which it is a big part of, but it's also environmental. What is our environmental family culture? And just like you said, the rhythm, like, and here's another, here's a few. I'm gonna give some goals for each step, like some examples.
[00:10:00]
Caroline Fitsimones, OT: So for the family culture goal, one of mine was I'm going to track the calendar every day with my child. And so this is where every morning, we're already sitting down to eat breakfast. The calendar's right there on the fridge along with our to-do list. It takes two minutes to go over it with them while we eat.
Caroline Fitsimones, OT: And so what this does, just like you said, was it builds a rhythm of predictability and it's teaching them the long-term skill of, uh, executive function skill of, um, planning and, uh, future thinking and, uh, even planning their own calendar one day. So we're modeling those in real time and we're setting up a system of predictability and felt sense of safety when you know what's coming next.
Penny Williams: It's so good.
Caroline Fitsimones, OT: And a relational daily, uh, a relational goal might look like having a daily connection time of five minutes with each of my kids, and this means one-on-one face-to-face time. I'm not correcting, commanding, expecting anything, but we're just there together.
Penny Williams: Mm-hmm. No teaching, no judgment, right, during that time.
Caroline Fitsimones, OT: Yes.
Penny Williams: What's next?
[00:11:00]
Caroline Fitsimones, OT: All right. Let's see. Step three would be us as focusing on us as the parents. We're strengthening ourselves as the parent. So that's the next hierarchy there. And this is where we're looking at accountability. How are we tracking our goals? Um, are we using, sometimes it could be a checking off on the calendar.
Caroline Fitsimones, OT: Each day that I spend, I make sure I'm spending time with my kids. Those five minutes of daily connection time. Once I have that check mark, now I have a chain that I can visualize and see. I don't wanna break that chain. I've been doing so well for so many days. So it could be simple as that, or it could be accountability in the sense of who are you hanging around with, who are you talking to?
Caroline Fitsimones, OT: That is your support system. Um, I heard a quote one time that, um, someone says, I wouldn't take criticism from someone I wouldn't take advice from. So who do you admire as far as being a parent in themselves? Are they, do they have the same values as you do? Do they have, um, the same method, methodology that you do and that you want to refine your, those skills with?
[00:12:00]
Caroline Fitsimones, OT: So in that sense of accountability, yes, they could be a friend, a spouse, an online community, um, any of those things where you can seek support.
Caroline Fitsimones, OT: I just wanna ask real quick, like why is it so important for us to also think about ourselves? Because we're taught that to be a good parent, we sacrifice ourselves. So why is strengthening ourselves part of this process?
Caroline Fitsimones, OT: Oh, it's, I could give a hundred reasons, but I will say we are humans just like our children, and at some point, willpower will fail us because our energy reserves will become depleted. Um, challenges arise, uh, there is a sense of stress and we all experience stress. That's a normal thing. But when it's outside of our window of tolerance, we can manage, we can deal with the stress, uh, in a very unhealthy way, which not only further depletes us, but then it bleeds over to our kids where we're not able to show up the way they need.
[00:13:00]
Caroline Fitsimones, OT: If we're dysregulated, they will be dysregulated. The more regulated we are, the more we will be able to, um, lend our kids our calmer nervous systems. I don't say calm because we're not always a hundred percent calm, but we will be able to slowly bring them into regulation as we are regulated ourselves.
Penny Williams: Yeah, I often use the word steadiness instead of calm, because sometimes we can be regulated and not at all calm. And so yeah, more like steady, stable.
Caroline Fitsimones, OT: Absolutely. And it's great when you can even model how you're regulating yourself and you're using declarative language or reflective language, and even I call it living out loud. You're stating your internal sensations out loud for your kids to see because now you're building their language, but also you're normalizing, uh, regulation and dysregulation and feelings.
Caroline Fitsimones, OT: We all experience, um, those, uh, regulation, dysregulation, and, uh, that can be so powerful in itself. And my, my kids, I, I, sometimes I hear them talking and I just think to myself, wow, that's so much emotional maturity for a child your age, just because they've been exposed to that language.
[00:14:00]
Caroline Fitsimones, OT: Um, just the other day, my youngest, he was six, he goes, mom, you seem really overwhelmed right now.
Caroline Fitsimones, OT: And I was just curious. I was like, what made you think that? And I must have emotionally left the room 'cause I wasn't even aware. But he goes, well, you're talking fast. And your voice is getting a little bit louder and you're moving around the kitchen really fast. And I said, you know what? You are totally right.
Caroline Fitsimones, OT: I think I need to slow down and take a deep breath right now. And so I did that in front of him. And again, it is not gonna change the world overnight, but you're planting seeds of growth and change for them and modeling, again, what regulation looks like. And that it is normal that we all need to take those measures sometimes.
[00:15:00]
Penny Williams: I think living out loud is one of the most powerful parenting tools that we have, um, especially with neurodivergent kids. It's skill building as well. Like so often, the skills that we take for granted that are intuitive for us, we're just sort of vocalizing it and being transparent about what we're going through.
Penny Williams: It humanizes us and they can pick up a lot of skills that way too. So I love that. That's part of this part.
Caroline Fitsimones, OT: Yes, yes. They need so much more explicit teaching than we, than we think. Sometimes we, we sort of assume that kids will just pick up on things and, and they, they do to an extent. Uh, skills are caught more than they're taught sometimes. But also we do need to be explicit and intentional with, uh, what we're modeling and teaching too.
Penny Williams: So are we on number four? I think.
[00:16:00]
Caroline Fitsimones, OT: Number four has to do with, uh, installing systems, um, oh, I'm sorry. This follows up with, um, with what I just spoke of the environment. So these are where the routines and the visuals come in, in place. Um, so we have our, um, like I said, we are talking about our family culture and ourselves as the parents and then the systems, um, the explicit, um, supports that we have in place.
Caroline Fitsimones, OT: So visuals we talk about so much and we take it for granted. 'Cause I'm sure any one of us parents with kids in the school systems have, who are dealing with accommodations, have heard, you know, using visuals strategies, but really sometimes we don't make it as explicit enough or consistent enough.
Caroline Fitsimones, OT: And so, and, and this is where it gets really powerful when we do put those measures in place and we're consistent about it. We get to notice how much support it, it helps our kids when, let's say those supports are removed.
[00:17:00]
Caroline Fitsimones, OT: So for example, the other day I was working with, um, two of my kids back to back and I had forgotten to use my visual schedule. I used to go real fancy and have all these pictures that you would sort through and put on the Velcro board, and then I was like, I don't have time for this. I'm, I'm also A DHD.
Caroline Fitsimones, OT: I don't have time and the patience to look for these pictures to replace ones that are torn up. So I really just simplified it, got a whiteboard and just drew four little check mark boxes, and then four pictures of what we're gonna do. Or I wrote them out with words if they were older kids. And there were two sessions back to back that I didn't do this.
Caroline Fitsimones, OT: And my kids five minutes into the session said, can I make a visual schedule for us? And these were five and six year olds. So they knew. They knew how much structure and support it gave them just to have it nearby to, to refer to visually.
Caroline Fitsimones, OT: Um, and it wasn't something that would've completely derailed us, but they definitely noticed how, how much it helped them. So again, when we are using something in a very, uh, intentional way, we're modeling to our kids in real time for them how to use it one day.
[00:18:00]
Caroline Fitsimones, OT: So one day they'll be using lists, uh, they'll be using, um, their notepads on their phone or writing it out, planners or organizers.
Caroline Fitsimones, OT: Um, these are all the baby steps to get there.
Penny Williams: Mm. I love that you brought up baby steps.
Caroline Fitsimones, OT: Mm-hmm.
Penny Williams: That's how progress and growth really happen, through baby steps. Yeah.
Caroline Fitsimones, OT: Yes.
Penny Williams: What's next?
Caroline Fitsimones, OT: So, yes, so step five, um, these are where we get to now look at our kids' skills. So, um, I don't, I hate to use the word behavior, but you know, in the most neutral way now we're specifically, specifically targeting their behaviors and their skills, their skillset. So I'll give some examples of goals, but just to kind of give some quick tips, like you just said, baby steps.
[00:19:00]
Caroline Fitsimones, OT: Not even baby steps, but micro steps. What are the steps? What do I want to happen and what are the preceding steps to even get there? So a goal like getting out of the door, um, in 30 minutes in the morning might be way too broad.
Caroline Fitsimones, OT: Um, for us, we had to even start with, my son will put his shoes on. Um, my son will bring his own backpack into the car. So like we're having to really break down those steps and if those were hard for him, then we would break them down even more.
Caroline Fitsimones, OT: I would hold your shoes, you can, and making as fun and playful as you can. We're gonna piggyback ride to the car and I'll hand you your shoes and you can put it in there.
Caroline Fitsimones, OT: So just looking at what you can break down into micro, how you can build in fun and playfulness into a routine that is not so fun and playful.
Caroline Fitsimones, OT: Um, and I know that our capacities are different and we don't always, uh, feel playful all the time, but we can always choose a more connected and regulated way if we just pause and take a deep breath and then proceed.
Penny Williams: I think, um, some parents listening have teens or young adults and would be asking what does, like, breaking that down or taking micro steps look like.
[00:20:00]
Caroline Fitsimones, OT: Sure. So, uh, one of my parents, uh, in the parenting program, and I love, love when parents gave me the examples that work for them. Um, so this was not so much as a breaking it down micro step, and I'll give you one soon, but she noticed that whenever their family dog would sleep in her son's bed, he would fall asleep, uh, faster, stay asleep longer and wake up quicker.
Caroline Fitsimones, OT: And it was so funny 'cause she was just like, I hate washing his sheets. There's dog fur everywhere. And then we really had to talk about, you know, what are the risk and benefits or the cost and benefits here for him to go to sleep and stay asleep and get enough sleep, which was such a struggle for him.
Caroline Fitsimones, OT: And wake up on time because of, you know, having this dog, their family dog with him and helping him co-regulate, helping him feel comfortable and safe. Um, all of those were huge wins.
Caroline Fitsimones, OT: Um, the trade off was yes, there's dog fur in your bed, in his bed, um, but not just looking at the baby stuff, but looking at the supports and having to really think outside of the box too.
[00:21:00]
Caroline Fitsimones, OT: Um, and so something else that she did for him was they would plan collaboratively what meals that would help him that morning to be motivated. Um, but also to, um, shorten or just simplify their morning, um, routine. So during the weekend, he would pick out his meals, they would meal prep together. It would be, it might be a sausage, a egg cheese sandwich or something.
Caroline Fitsimones, OT: And then all he would have to do is heat it up and go in the morning. So there's collaborative work on even what does it look like for us to maybe get out of the, um, house a little bit quicker or, um, reduce the routines, make the steps to make it easier.
Caroline Fitsimones, OT: So there, it's not a one and done conversation, but it's like, what one thing can we try, um, this week, do you think?
Caroline Fitsimones, OT: And just trial and erroring it sometimes. Um, but yes, for them also.
Caroline Fitsimones, OT: Um, and also for us, I have, um, early, um, school, elementary kids, and we sleep in our clothing, clean clothes at night before. And so that cuts out one step in the morning. There's no shame in my game and there's none in her either. Whatever simplifies the process.
[00:22:00]
Caroline Fitsimones, OT: So the micro step is just consolidating your steps. Do everything in one room versus three different rooms. Um, eating meals that you can always also ready, uh, be ready to go. And then as they master each step, then you can, um, provide, you can, uh, make it more complex meals, for example, if you wanted. So, um, yes, just simplifying wherever you can.
Penny Williams: Yeah, and it's great that you mentioned doing a cost benefit analysis of sorts as well, because sometimes I do think that we're, you know, it does take more time, more energy from us as the parent sometimes.
Penny Williams: Um, sometimes that's just frontloading it and later on we get that time back. Um, but yeah, like sometimes there's trade offs and the trade offs are better.
Penny Williams: They're still not ideal, right? Like your kid just magically doing the things that you need, but.
Penny Williams: And I think too, like using that cost benefit on things that maybe we're pushing on where the cost is great for our kid. It's not always about the cost benefit for us. Right.
Caroline Fitsimones, OT: Right?
Penny Williams: I'm really glad you brought that up.
Caroline Fitsimones, OT: Yep. And, and there's, and again, there's cognitive, cognitive flexibility at play there. And, you know, not tying down to one way, but being open and managing our own emotions around that. Like, I would rather not have to do extra laundry because of dog fur, but it moves the needle and it helps them feel empowered and—
Penny Williams: Mm-hmm. Yeah. Yeah. I love that example. It's a good one.
Caroline Fitsimones, OT: Yep.
[00:23:00]
Caroline Fitsimones, OT: And then lastly, step six, reflect, assess, debrief. So there's no point in setting goals if we are not going to go back and assess how we're doing with those goals. So this is where we get to close the loop and set up ourselves for opening the loop again. This is where reinforcement happens.
Caroline Fitsimones, OT: Reflecting, assessing and debriefing, um, on a broader scale might look like, is this goal still meaningful for us right now? So is the morning AM routine the biggest, um, fish to fry right now, or should I pivot?
Caroline Fitsimones, OT: And also just giving ourselves grace to know when we pivot, it doesn't mean we're failing, it just means we're adjusting.
Caroline Fitsimones, OT: We're making room for what's more important in the moment, our values. And then we may al we can always circle back. But, um, yes, just that, that consistent reflection.
Caroline Fitsimones, OT: Um, even at the end of the day, did things go the way I wanted to? Did I show up as the parent that I wanted to show up? What could I have done differently?
Caroline Fitsimones, OT: Are there any repairs that need to be made? And when there are, did I make the repair in a timely manner?
Caroline Fitsimones, OT: And sometimes we do need to make a really brief repair and then circle back the next day when we're all more regulated. But just that kind of reflection is what is the difference between, um, being intentional and just flying by the seat of our pants.
[00:25:00]
Caroline Fitsimones, OT: Um, so we feel much more empowered when we can reflect and then assess. Hmm. What can I do differently? And let that bring us the next day of starting over and resetting with, uh, with a much more empowered state of mind.
Penny Williams: It's modeling again, we're modeling that reflection and intentionality for our kids.
Caroline Fitsimones, OT: Absolutely. And the cool thing is those, those six steps, the more you do it, it, it feels so hard. And, and give yourselves grace. Just knowing that human, human nature is that we persist for so long and then it gets very, very hard.
Caroline Fitsimones, OT: That's when we tend to, uh, the discomfort feels very, very great and it's very tempting to slow down or even give up in those moments, but set the intention of a.
Caroline Fitsimones, OT: In two or three weeks, when I set a goal, I'm probably gonna hit that slump. Uh, there's a phrase for it. Uh, a valley of despair is what it's called.
Caroline Fitsimones, OT: And set yourself up for success, uh, with, um, with backups. And you know this if then statement, if I don't do this, then I can still do, do this. If I don't make the repair right away, then I'm gonna circle back after.
[00:26:00]
Caroline Fitsimones, OT: So and so after I just regulate myself with a cup of tea. Or if this morning didn't go as planned, then, uh, whatever happens next. So just having the backup plan so that you, you can give yourselves grace knowing that you're human, but also life happens.
Caroline Fitsimones, OT: And so there's things that are out of control, um, that we are out of our control, but still making, setting the intention to choose what we do have control over, which is our mindset, how we show up.
Caroline Fitsimones, OT: Um, and how we choose to also experience and perceive our child. We know that at any moment, we're all doing the best we can with the skills we have, including our child and ourselves.
[00:27:00]
Penny Williams: This is such an important lesson, I think, for us as adults, as we do get on autopilot, we do get overwhelmed. We are sometimes in survival mode and intentionality, I think, is the way that we can break the cycle and start to move forward towards growth. You're giving us this great process to go through.
Penny Williams: Um, to really make sure that we are on a track for growth, that we're on a path to where we want to go or our kids want to go, and it's so very valuable. It's a good reminder for that. Will you tell everybody where they can find you online so that they can learn more from you and potentially work with you?
Caroline Fitsimones, OT: Sure. Um, caroline Fitsimones coaching.com. Uh, the name is spelled a little bit differently. It's, uh, C-A-R-O-L-I-N-E, last name F-I-T-S-I-M-O-N-E-S coaching.com. So yes, I look forward to just hearing from anyone with questions, and also thank you again for having me.
[00:28:00]
Penny Williams: Always, it's such a pleasure. I learn so much from you, um, every time that we talk and I'll link up your website in the show notes at parenting adhd and autism.com to for everyone, um, to make it super easy for you to find Caroline online and connect in that way. Thanks so much for the work that you're doing and for being here, and I thank everybody listening for showing up for your kids as well.
Caroline Fitsimones, OT: I appreciate it.
Penny Williams: I will see everyone next time. Take good care.