Full PreFrontal

Ep. 190: Dr. Willie F. McBride, Ph.D. - Preparing All Kids for Life

October 20, 2022 Sucheta Kamath Season 1 Episode 190
Full PreFrontal
Ep. 190: Dr. Willie F. McBride, Ph.D. - Preparing All Kids for Life
Show Notes Transcript

Students with underdeveloped Executive Function skills often present themselves as highly impulsive or distracted, reactive rather than reflective, forgetful of their goals, lacking persistence or as those who dislike effortful tasks. Such behaviors often are alarming as they sabotage personal success and social cooperation. However, a myriad of traumatic exposures in childhood in Black communities leads to stress-related cognitive, emotional, and physiological compromise that tends to disproportionately affect that community and requires special consideration.

On today’s episode, assistant professor and Adult Emphasis Neuropsychology Director at Spalding University School of Professional Psychology, Dr. Willie F. McBride discusses what considerations we must give and how best to work with and engage in intersectional thinking while serving the needs of Black children and adults. Helping children from diverse backgrounds to build their Executive Function skills requires neuropsychologists, clinicians, and educators to personalize tools for advocacy and a pause to activate our own discernment can go a long way.

About Dr. Willie F. McBride, Ph.D.
Dr. Will McBride is a neuropsychologist, assistant professor and co-director of the Complete Neuropsychology Services at Spalding University. He completed his neuropsychology fellowship at the University of Virginia Health System where he primarily focused on evaluating neurodegenerative processes in older adults. He has a burgeoning interest in cultural neuropsychology and examining health disparities within the African American community and is a co-founder of the Society for Black Neuropsychology. He completed his doctorate at the Virginia Consortium Program in Clinical Psychology. His hobbies include collecting vinyl records, playing video games, spending time with family, and watching movies/anime.

Website: www.soblackneuro.org

About Host, Sucheta Kamath
Sucheta Kamath, is an award-winning speech-language pathologist, a TEDx speaker, a celebrated community leader, and the founder and CEO of ExQ®. As an EdTech entrepreneur, Sucheta has designed ExQ's personalized digital learning curriculum/tool that empowers middle and high school students to develop self-awareness and strategic thinking skills through the mastery of Executive Function and social-emotional competence.

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Sucheta Kamath: Welcome back to Full PreFrontal exposing the mysteries of executive function. I'm your host Sucheta Kamath. And I believe having these conversations about important topic of executive function, how does self regulation work? How do we guide our thinking our behaviors and actions, by self enlightened way so that we can achieve our goals and allow other people to achieve their goals as well. And there's so many important things that go into understanding executive function, and creating communities where people have very strong executive function because executive function can also be the backbone of morality, critical decision making, and a taking a perspective of the other, I kind of want to share with you some of the symptoms or signs or behaviors of children, adults or adolescents with underdeveloped executive function, or what do they do when our executive function skills are not sharp or on par? You tend to be impulsive, easily distracted act without thinking. You easily forget goals, you know, dislike effortful tasks, or lack persistence. There's a low level of frustration tolerance and high interpersonal conflict. Often, those individuals tend to go for risky things. And I like to call the below the radar risky things which is not turning in homework is a risky thing, right? And not preparing for a test is also a risky thing. So one risky thing will maybe speeding when you know, at that band cop tends to be and poor problem solving, lack of self correction, and requiring constant attention or motivation from an adult if you're a child, but also if you're an adult, requiring a lot of nudging from your contemporaries peers, or your spouse's or bosses. So with that in mind, is our understanding of executive function clear and concrete as we think it is, or is there any role racial bias plays? Because are we seeing certain groups to not be capable of doing these things well, or are we faulting them for their dysregulation as if, as if it is a character flaw, and those are very important topics that I like to dive deep into, and that's why we have a very special guest today Dr. Willie McBride. He is a new assistant professor with Spalding University School of Professional Psychology where he is the adult emphasis neuro psychology director. He finished his two year fellowship with the neuro psychology department within the University of Virginia Health System. He also serves as the treasurer for the Society for black neuropsychology, which we're going to talk to him about. And he also previously completed a fellowship in interprofessional psychology at the Tennessee Valley Health Care System in Murfreesboro, Tennessee. He one of the reasons I'm really excited to talk to him about because His research interests include neuro psychological practice with minority communities, forensic neuro psychology and personality. He is originally from Louisville, Kentucky, and not to stereotype but he does enjoy vinyl records, video games, and loves to debate the merits of anime as a national pastime. Oh my god, I can't wait to hear more about that. So with all that said, it's going to be a very delightful conversation. Welcome to the podcast, Willie, how are you?

Dr. Willie F. McBride: I'm doing well. Thank you for having me. 

Sucheta Kamath: So I don't know which direction to go first. So I'll start what I do with my psychology friends. I would love to know how your executive function skills were when you were a child in a middle school in high school, and how would you describe your own self awareness and strategic thinking when it came to managing your learning?

Dr. Willie F. McBride: Oh, wow, how much time do you have? You know, as you were reading off all of those issues that kids or adolescents or even in adulthood we have with executive functioning. I was thinking about, Oh, I had that one. I had that one I had that issue. So so it's very interesting to hear those things. But but for me personally I was Always a high achieving kid growing up, you know, I think there's a difference between like, you know, study hard, but then some things come naturally to you as well. And I did study hard, but then there were just things that things that just kind of came intuitive. And I tended to rely on do intuitive stuff, I always did good, like, at least to be, you know, in terms of grades and things like that. And I would get get my A's as well. But I always thought about that I could be pushing myself a little bit harder, and I could be doing a little bit more. And I'm like, why, why am I not like 4.0? You know, I wasn't a student who was a 4.0 student, and it was like, I was a procrastinator, even even with how great I did. And as a PhD doctor, I still had those moments of procrastination, where it was like, Hey, I'm doing really good. I don't know if I want to push myself as far as I can go. And it was like, sometimes, just like procrastination, I would wait to the last minute. And, you know, I struggled in those things in terms of, I think people have the misconception that high achieving people can't struggle with executive functioning issues. You know, we just happen to be high achieving as well. And I hope it doesn't come off as a little narcissistic. But it's like, that's, that's what I was, I was high achieving, I probably could have done exponentially better. But I was like, I'm just, I don't feel like it sometimes. You know, I'll wait to the last minute. I've read it before I know what I need to do. Those types of things used to come out.

Sucheta Kamath: You know what's so interesting, as you're saying that, and I know, we'll get to the meat of your expertise, but But I think when we talk about personal competence, high motivation, which kind of helps you sustain effort. But just because you're sustaining effort, you may not be strategic. So to me, that's the kind of piece that you're talking about, that you can have. When you develop your high level of executive function, you become very strategic. So you're impactful it with your effort. Sounds like you're smart, talented, you saw the rewards, and, and you continued to see the benefit of your hard work, but you were not consistent or strategic is what comes to mind.

Dr. Willie F. McBride: Yeah, I was I was not strategic as much as I could be, and that I knew exactly what I needed to do to get the good grades, but not necessarily to push myself beyond those limits of where I can really be going to like maximize that potential. Absolutely.

Sucheta Kamath: So let's dive into this question of neuro psychology. Explain to our audience what does the field of neuro psychology mean, and what do you as a neuropsychologist do, I have had lifelong relationships with neuropsychologist, which has been one of the My Favorite partnerships, because based on those findings, I'm able to construct a treatment plan. So and secondly, you know, what are you passionate about when it comes to neuro psychology? How did you discover that? Yeah, absolutely.

Dr. Willie F. McBride: So neuro psychology is a subspecialty of psychology in general, I mean, there's a number of different subspecialties that you could go into, it's like a rabbit hole. But neuro psychology, the broad focus is the study of brain and behavior, okay, brain behavior relationships. So we look at anatomical regions of the brain, we look at, you know, what correlations we can see. So if somebody has deficits in what we call the prefrontal lobes, the areas in the front part of the brain that speaks to executive functioning dysfunction. So what neuro psychologists are do, specifically clinical neuropsychologist, so we work in clinical populations, we work in hospitals, private practice, school settings, we work with people that have dysfunction of the brain. And so where I did, the bulk of my training is working with people with older age issues that are related to dysfunction of the brain. So Alzheimer's disease and Parkinson's disease, stroke, all of those things impact the brain, emotionally, our ability to process information. And so what I do is I help neurologist, I help primary care doctors figure out the severity of those issues. So for instance, you know, we can take an image of the brain, right, we can do a CT scan, we can do an MRI, we can do an x ray, we can get all of these images of the brain, and you can actually see where there might be dysfunction. You can see evidence of a stroke, you can see evidence of a brain tumor or you know, other things, but that can't tell you what that's going to look like in that person's day to day life. Right? Those are not a one to one correlation. So what neuro psychologists do is that we help figure out okay, how severe is this person's memory deficits going to be? How severe is their inability to inhibit what they say or plan, how severe are those things going to interfere with their life. And so that's the bulk of my work is doing evaluations and doing assessments of people who have those difficulties. I enjoy my job, I love just the mystery of the brain. When somebody comes into my room or into my evaluation clinic, and they have concerns for dementia, or is it dementia or depression, I love exploring about what is actually causing the issues that they're having. I think of it as a puzzle, I think of it as you know, I'm an investigator, I get to ask a lot of questions that they're not usually prepared for. And then I love being able to do the testing and the evaluation to see how those things line up. So I like the inquisitive aspect of it. And I just like a brain, it's just such a cool, Oregon, you know, there's so much that comes from it. And we're still learning more about how it works. So so that's kind of like, you know, I nerd out when I talk about, you know, things related to the brain. So I just I enjoy it all around.

Sucheta Kamath: Well, I think the and it truly comes through your your passion for this investigative attitude, you know, that great curiosity, problem solving. And I share that with you, I think I was wondering, you know, in education, and me, you know, for me coming from a speech language pathology perspective on impaired brain, also helping people regain their skills and strength has been my path. But when I look at education and children, we have psycho educational battery, or psychologists who assess the relationship between teaching and learning, versus neuro psychology, which is the brain behavior relationship. What are your thoughts about? You know, we need to know a lot more about the brain, because learning how to learn is really the key to unlock your own ability as a learner and thinker. But when we look at the testing, or evaluate somebody for struggles, we are always seeing did learning take place? So we are looking at, you know, what your level of math competencies, what your level of reading is? So what are your thoughts about, we're not doing that enough in schools? Or do you feel comfortable commenting on that?

Dr. Willie F. McBride: Well, you know, I don't do a lot of my work in schools. But you know, what I would say is that I absolutely agree with you. And that is thinking about the individual and learning styles, from not just just the individual, but culturally, you know, how people are reared in the home and how people learn, you know, where did they start learning how to learn, and that's typically done in the home. And so if you have cultural differences and how people learn, and then you give an example for our audience? Well, sure, like, you know, for just like, African American children, there are differences in how their learning styles are, in terms of more active learning. You know, it's not just sitting down and reading, but there's a lot of physical play, and just different things in that aspect. For instance, you know, from a cultural perspective of Western culture, or Western, like United States culture, the tests that we use, looking at what we call processing speed, and all a lot of our tests, look at how quickly can you do something in this certain amount of time? Can you complete this task quickly and efficiently? You know, our culture is designed and looks at getting things done quickly. You know, if you go to a restaurant, it's like, Okay, how many people can you get in to go into a restaurant, but if we go to other cultures, where speed and getting things done as quickly as possible is not a priority. You see that? Actually, most people even if you give them a test, where they say, Hey, finishes really quickly, they're going to prioritize accuracy, and taking their time over speed. And that's not a bad thing, right? That's not nice. That doesn't mean that someone has a deficit because they take more of their time. And so I think we need to rethink, you know, it's not a one size fit all for educational background or educational learning styles. We need to be more mindful of individual learning styles and how do we fit our teaching methods to that chill child or adolescent?

Sucheta Kamath: Wow, you know, I really appreciate you kind of making a reference to the cultural component, which is, again, I think, in our field is new. I feel you know, most of psychology also began as a deficit based How can we address deficits versus now looking at the larger development of how people gain skills and knowledge and you Am I myself coming from, you know, being born and raised in another country and then migrating to another has given me great insight into how cultures operate. And, for example, you know, work is non negotiable. So, there is no Can I do this later, this concept just doesn't exist at home. So, when when parents says, do it now, do it and you must do it, there's no one, it's not negotiable. And And second thing, for example, you know, doing work around the house comes before your schoolwork. So, you cannot say I have schoolwork, hence, I cannot help. That is non negotiable. I remember we, when I was growing up, we had a very intense, like state board exam, okay, like, it's like, I don't even know what you equivalent test would be here. But the most difficult test, a national test, if you want to get into college, and the night before my test, my my parents still required me to set the table, do the dishes, help out with with the mopping? And then they say, Okay, now you're free to go to study?

Dr. Willie F. McBride: Can I get a break just this one night? Just just this one's just this one's.

Sucheta Kamath: And what I found, though, I think that was such a profound Lee, that made such an impact on me. Because I think like you are always part of a community and your community depends on you and, and your goals are secondary to the to the community school goals was really important. And now I see just the opposite. In my private practice, for example, the parents are like dropping the projects off, or they're taking the homework that was left on the table, you know, I mean, and the kids are absolutely, their plates are on in their bedroom, because the parents have served dinner there, you know, those kinds of things? I'm not knocking anybody out. But I do think there can be a cultural tone that sets the expectation. So violating expectations, is a failure of executive function, or its failure to expect executive function proficiency.

Dr. Willie F. McBride: I think, yeah, I agree with you. I think it's it's probably the latter, you know, in terms of like, just kind of thinking about our conceptualization of executive functioning, like, what are we really talking about? It's this, you know, even in the neuro cycle, I'm sure you know, this the in the neuro psychology world, there's debate about using the term executive functioning to describe this entirety of just multiple abilities and tasks in just like, what are we really talking about here? And I think, I don't think there's a consensus on executive functioning. So you're gonna hear a lot of different perspectives on it, if you talk to a number of different people, hence, this podcast Absolutely, is being needed. Because you have so many perspectives on it.

Sucheta Kamath: Yeah. So I think maybe, in your opinion, how do you see? How should we understand executive function? And, you know, you particularly are interested in minority communities? And how do you see the proficiency or lack of proficiency in executive function seen in that particular community? Which is we don't need to leave the country right here, you know, so, share that with us?

Dr. Willie F. McBride: Well, I think of executive functioning. I would say that, you know, from my own perspective, and just kind of my own study, there's there's levels to executive functioning, you have your, I would say basic building blocks, attention, working memory processing speed, though, I will guess lower order executive functioning abilities, but then you have higher order executive functioning ability. So you know, can you inhibit a thought or inhibit impulsive behaviors? Can you multitask with between two opposing things? You know, two people are talking in your ear, can you, you know, block out what's one person saying and focus on your attention there. And then thinking about planning, foresight, judgment, decision making those those involve a lot of different processes that not only rely on your frontal lobes, which is the area where we think of executive functioning being housed, you know, if, let's say judgment or decision making, okay, judgment, decision making, making a rational choice, based on on ideas or things that we learned, where does that information come from? Where's that information stored? Like the ideas of okay, I shouldn't cross the street. Right? We use those types of questions. I should look both ways before I cross the street. But where does that knowledge of crossing the street come from? Right, that's not housed in the frontal lobes that might be in the deeper parts of the brain and our memory storage banks where it's like, hey, somebody told us that we shouldn't cross the street eatin so now we're having to use our frontal lobes to go grab that information. So it's a multi system process, right? In the frontal lobes is probably what my supervisors used to call, and I'm going to quote her, it's like the CEO of the brain. Yes, that's the area that does all those things that relies on all of those other parts of the brain to organize and make those decisions. When it comes to, you know, the culture that I guess I would represent in terms of the African American culture, I've seen some troubling things just in terms of when let's take children who have what we would call executive functioning difficulties, they're impulsive, they can't sit still in their seats, they're inattentive, what we would call probably ADHD, attention deficit hyperactivity disorder. There has been research that has shown that when you look at matching, and I'm paraphrasing, teachers who are of a different race, and they have students in front of them who are African American, the more likely to recommend them for, you know, behavioral disruptive classes or special education, rather than, you know, gifted education or things like that. And so you see this, what, what is the reason for that? What is the thing that is causing that issue to happen, and I think it's expectations and understanding of what executive functioning looks like, and people who have are of a different background or cultural background. So I see that, you know, African American kids tend to be labeled more as disruptive, problematic, you know, behaviorally disorganized, and not effective learners. But I think that there are some other things that are going on that impact that that we need to address, which is, I think, a lot of bias.

Sucheta Kamath: And so, um, and, you know, even, can you maybe extend that how that this may show up in adult world, as you and I deal with clients, minority clients, and, again, I don't know about your profession. But you know, my profession, for example, is 95%, is predominantly white. And the field of speech language pathology is in service, providing service to people of all sorts of, you know, communities. And so understanding that it's really critical, but, uh, you may not have the greatest understanding about, I'll give my example. And this has nothing to, you know, I tell people, I became brown after coming to this country. But you know, when I was growing up in India, I was like, all shades of brown, you know, but I do remember, I was a young and I even was not married, but I had a patient who had a stroke. And she was during childbirth. And so her baby and the mother were wheeled into our art department, and she had a stroke. And there was the family who was from different culture than I was. In India, it's like many Europe, I like to say, you know, different regions of India is different practices. And they all were very, they also were from the rural part of Bombay. And so when they came they, and we talked about therapy, their first pushback was, she doesn't need to speak, we'll take care of her. So what it meant was like, we will never leave our own alone. But if you didn't understand that context, it might sound like she doesn't have any identity, or should it doesn't have any need. So we heard, you know, disability now is permanent. So we're going to walk away. So if you didn't take that time to understand what that cultural reference meant, you could misunderstand that interaction. And so anyway, so any thoughts about how this, you know, comes up in the adult interactions, serving the needs of various communities?

Dr. Willie F. McBride: What what I would say that I think it's a multi there's so many ways you could go with with that in the sense so like, let's start with still with those kids. So I referenced the the study, and I'm blanking on the author's but if if those kids those African American kids are placed in special education or education that is not whatever standard that impacts are developmental growth, educational growth as they matriculate through school. They still may graduate high school, but we're learning particularly for African Americans is that Um, quality of education. In the test that we use as neuropsychologist we have to use norms with normative data. So when I'm seeing someone in my clinic, I'm having to use, like, they get a certain set of scores. Let's say I give them a memory test, and they get, they remember five words. Okay, what does that score mean? Right? What does that five words mean? Is that a good score? Is that a bad score? Is that a great score? And we have to norm these tests, the when, when the people who create these tests, they did all of this psychometric research, and they normed them. And they got a group of people who they said, Hey, these are normal people. And these are people who are impaired. And if you get a score here, compared to normal people, that means you're in this range, average, low, average, above average, etc. But what we're learning is that for one, a lot of these tests don't have really great norms for culture for minority groups. Yes. Right. African Americans, absolutely, you know, Latino groups. Any culture outside of the majority culture, the norms aren't usually that great. And so, you know, we're thinking about the quality of education, and how that is a better indicator of people's functioning later on. Those kids who become adults who have had that lack of quality of education, that's going to impact their ability to, you know, have good jobs, that's going to impact particularly if they, you know, have later behavioral issues that could lead them into juvenile justice system or to and the criminal justice system. You know, I could imagine that if you look in the criminal justice system, a lot of those people who are incarcerated, have had a history of learning difficulties, and if had been held back and have had so many different things. So thinking about it from just the perspective of what it leads to that ultimate negative side is that not having great learning, being taught how to learn efficiently, can impact your ability to do so much in the rest of your life, even just having quality life?

Sucheta Kamath: Yeah, I completely agree with you. And so such a thoughtful way of considering that And that actually brings me to another perspective here. Would love to hear what you think, you know, we know from the work done by psychiatrist and author of the Body Keeps the Score Bessel Vander Kolk, that children and adults who have experienced traumatic experiences adapt to life and learning differ differently than those who haven't experienced such things. So should there be any special considerations given to children whose childhood experiences have social cultural bearing that may have induced trauma, including racial discrimination?

Dr. Willie F. McBride: Absolutely, yes. 100% Yes. We know, Aces adverse childhood experiences. That's not my area of expertise, necessarily. But the literature shows that those childhood traumatic events and that's not just when we think about what I think about typically is, you know, emotional, verbal, physical sexual abuse, but poverty, lack of, you know, food, homelessness, you know, there are a number of children out there that are experiencing inconsistent home, housing. So all of these things up low, I mean, air pollution, you know, all of these things that create health disparities, they absolutely impact the development. One of my you mentioned one of my fellowships, the interprofessional. Fellowship, and that was at a Veteran's Hospital. Right. So I'm working with veterans who have experienced trauma as a more than likely related to military combat. And we know what that does to the brain. It impacts executive functioning, it impacts memory, emotional regulation, what do people think is going to happen to children who are experiencing things things on a daily and yearly basis? You know, the, an example I'll use is that, you know, a young African American kid who's coming to school, he's coming to school because he needs to get food, right? That's where he's getting consistent meals every day. And he doesn't get food at home. And so he's thinking about his mind is not necessarily on learning necessarily, right? Can we fault him or her for that not being a priority when there's so much food insecurity in that person's life? So no, you know, we can't just think that we cannot overlook those aspects and those factors, and how they significantly impact the development of young brains, old brains, all brains.

Sucheta Kamath: You know, and I think as you know, more and more, I read about different ways the outcomes like life outcomes, or you know, Scholastic outcomes or the America's ranking in the world, it just breaks my heart that we have not paid great attention to impact of poverty and poverty in America. And the kind of support that we have determined is adequate for people in poverty, somehow there is a colloquial wisdom that goes into it thinking that people have inflicted poverty on themselves by making poor choices. And also people have lack of motivation, to not demonstrate a vigor to pull themselves out of poverty by pulling themselves with the bootstraps. And so there's incredible structural disadvantages that are not paid a proper attention to, do you have any thoughts about what are we not getting right, when it comes to the way we designed support for people, because support also has this summer fundamental belief of deservingness? You know, who deserves support and opportunity for change versus who doesn't? And secondly, I don't know about your field, but in my field, everything is driven by insurance, or private pay, right? So insurance, whether it's children, then the way we have structure receiving therapy, or executive function, intervention comes from schooling, or as a private practice practitioner, or it is something that as a tutor, right, so that all is now tied into affordability. So the very skill that needs to be improved with help, you need experts, but those experts are not accessible. So I'm wondering what you're sorry, for my little drawn out question. 

Dr. Willie F. McBride: No, um, you know, I, I think that there needs to be an overhaul of multiple systems that play a role, health system, um, in terms of what you described in terms of insurance, and the coverage, that the resources that are available to people who don't have those resources and have to be on, you know, maybe government assistance or government funded insurance, though, you know, helping to fix to fix poverty is a really labor intensive thing. And it's really hard. And so I don't know, if our system is designed to really put the amount of resources that are needed to help make changes. You know, there's a multi multi system, family therapy is a type of therapy that where it focuses on family, but it focuses on let's say, a child who's having trouble in school or at home, but it uses the resources of the community around that child. So it could be the parents, but also the grandparents, aunts, uncles, you know, football coach or counselor at school, you know, so it's like, you're, you're involving multiple people in the care of this of this one individual. And that takes a lot of time and resources. And, you know, I don't think that the system is designed that way at this moment, but I think it should change. I don't, I wish I could come up with a solution that would fix everything. But I think in terms of just kind of putting more money and resources to helping these communities, we would see a lot of changes there. We know what's the root of a lot of these things. It's it is these adverse childhood experiences. The research shows that the psychology research shows that, you know, in terms of what that does for the development and mental health issues. And so I think that if we don't start changing those systems systems from a policy, state and federal level, we're going to be trying to push back on a system that is just going to continue.

Sucheta Kamath: Yeah, this just reminds me of a study by her and his colleagues, who found that children living in households just above the Federal Poverty Level had grave matter volume three to four percentage points below the norm. And then children living below the federal poverty line, their gray matter volume was eight to 10% below the norm. Then eventually what happens is this leads to these kids performing four to seven points worse on standardized tests off the start, like and the single reason is poverty. So the brain has not had an opportunity to grow and nothing to do with core capacity or intelligence for sure.

Dr. Willie F. McBride: And so and that leads into there are a number of studies that look at something we call cognitive reserve, meaning the the faculties that help kind of stave off cognitive decline as we get older. And so if you're already starting out with that handicap, or that disadvantage, what does that mean for the trajectory of your brain long term, right? And what does that mean, if you do get a stroke, or if you do get some injury to the brain, that means that if you had that cognitive reserve that might protect you more, but because you're already starting out with such a handicap, that doesn't bode well for those individuals.

Sucheta Kamath: So another interesting thing you you have done, which is so important and vital is you and your colleagues co founded the Society for black neuropsychology, which is an organization of neuro psychologists, trainees, and students interested in promoting the discipline and practice of neuro psychology as it pertains to black population. So tell us more about your reasons to engage in this work?

Dr. Willie F. McBride: Well, it was all birthed out of an idea from a friend of ours, who is actually ironically no longer in neuro psychology. But we were all at a neuro psychology conference, I believe in Washington, DC, this was maybe five or six years ago. And so we were just looking around, and it was one of the few times where I'd seen that many black trainees, black students, black neuropsychologist, all in one place. And so we kind of came up and like, Hey, why isn't there an organization devoted towards the advancing Neuropsychology as it relates to black communities. And so we started putting our heads together and started creating the organization and grading the all of the stuff you need for an organization, the articles of incorporation and the bylaws. And so we planned it for such a long time. And like, this is what we want the organization to do. And so we actually launched, I think, at the height of the COVID pandemic, around the time that Briana and Taylor was murdered George Floyd and ahmaud arbery. And so it was this fortuitous time where society for black neuropsychology, SPN came to life. And so our goal is to ideally just be a place a home for students, trainees, and neuro psychologists who all identify as Black, who, you know, and not just African American, but if you are Caribbean descent, if you are from Africa, if you are from the Netherlands, and you identify as a black individual, we know that there is a need for Neuro psychology, services, research providers, for black communities, African Americans specifically, you know, have higher rates of Alzheimer's disease. They have some of the highest rates of health disparities as well. So all of those things impact the brain later on. You know, I make the joke that, you know, you can you can get a heart transplant, if you're lucky enough, you know, in terms of just being the right candidate, the right timing, that's something that modern medicine can do, right? We're not at a place where we can replace your brain. Right? Now, Elon Musk has not figured out a way to transfer consciousness to a computer, he's working on it. But we're not there yet. So until that time, we only have the faculties that we have. And so I want to talk to people about taking better care of the brain, because, you know, without that, everything else, you know, we we can't do a lot of other things. Yeah.

Sucheta Kamath: So what what do you particularly see this investment in increasing the representation of black neuropsychologist? What kind of impact would it have on the population that we are serving?

Dr. Willie F. McBride: Well, there are a number of things and there are a number of researchers that have been doing this work a lot longer than than then I have and are experts in the field. Jennifer Manley, Deseret Byrd, Monica Rivera, mint, those are some neuropsychologist who have been doing work on just cultural neuro psychology, looking at education, looking at diversity issues. And so neuro psychology as it relates to the black community, it can lead to better outcomes for those individuals. So I like to give talks in the community that I'm so so I'm originally from Louisville, Kentucky, and I'm back in Louisville, Kentucky. And so my heart, my passion, and my goal is to get in front of as many black communities as I can to tell them like hey, once you get to a certain age, you need to start looking at, you know, going to see a neurologist and going to have neuropsychological evaluations. This is why it's important to take better care of your brain. We know that African Americans tend to be diagnosed with Alzheimer's disease and dementia at a later point, right. So their progression of neurodegeneration is a lot farther along when they get their first diagnosis or even when they get in front of a neurologist. And so that means that maybe those resources or tools that we could use to help them or not there, because they're farther along in the disease progression, right. And so, you know, the outcomes are worse, if we have more black neuropsychologist, you know, we know that often, oftentimes, African Americans are misdiagnosed with dementia at a higher rate. So it's both things, they're not given the diagnosis when they need it. And then they're also misdiagnosed, because we know that the test don't necessarily always tap into the deficits that are impacting black community. So just in terms of having providers that know more about you and have your are impacting your community, we need that. And we know that that will be very important.

Sucheta Kamath: So as we think about, you know, working with diverse population, and really trying to serve the needs of all by improving our understanding and creating appropriate cultural context, this concept that was proposed by McCormick Han and their colleagues, which is a perspective taking you no idea. And so it's called intersectional thinking for advocating for social change. And I know you're very interested in that. So I was wondering if you can talk about how to apply that framework, which is, you know, for perspective, for ideas to shift our perspective to engage in in thinking that people now are not this, you know, one identity that is a multiple factors that have a role to play. So tell us about that. Yeah, yeah.

Dr. Willie F. McBride: So I can say this. And I say this jokingly, but also, with some serious as was that we, as humans, were somewhat lazy, in some aspects, and that, we like to categorize things in a way that makes it easy for our brain to just like, Okay, this is what I'm looking at, I see it, I know what it is. And so that we don't have to do as much thinking about things. And I think when we think about, particularly with race, right, and I speak to how for norms that are used to, to help us, you know, categorize and say, okay, these individuals are black. So we need norms that are geared towards black individuals, these individuals are Latin or Latinx, we need norms there, we need norms for individuals of Asian descent, but that doesn't really capture the broad spectrum of diversity within those groups. Right, there's so much heterogeneity differences between groups, but then there's so much in within group differences. And so when I think about the intersectionality, is thinking about multiple identities that intersect that impact, you know, just development in general, not just brain development, but thinking about, you know, race class, you know, and gender, those are intersecting identities. And so all of those things need to be taken into consideration when you have an individual in front of you, and you're trying to figure out, you know, educational plans, how to help from a social, you know, social work perspective, how to treat those individuals, medicine wise, and how to help them in their cognitive development. And so I think, you know, it's a framework that invites us to think more comprehensively about the work we're doing and considering all factors. For me, specifically, that could lead to diagnosis. Right? So if someone is in front of me, who was a Latin or Latinx culture who I need to know, okay, were you born in the United States? Or were you born from a another country or from another region or place in the world? When did you start learning English? You know, are you bilingual? What's your level of acculturation? You know, those are the factors in those intersecting identities that have to be taken into consideration because we know that those things impact cognitive development and cognitive abilities. So it's, it's really just asking us to take a more comprehensive view of individuals and then expanding it from a viewpoint that we just aren't accustomed to.

Sucheta Kamath: You know, what you're saying just reminded me of a story of a coach. She's an Iranian descent and the coach was not even her primary role. But she decided to help a young woman she encountered who was a first generation college gore. And who was not very keen on going to college because she found the process intimidating. But this Iranian young, this lady shared her perspective that when she came to us when she was, I think in her early teens, and what she found that that on college essay, the question was something like she said, I had witnessed, you know, bombing, I had witnessed, families being dragged out of homes, I had witnessed having to live in a shelter and hide for 20 straight days, and not a single question on my college essay, a probed into my psychology, my personal experience, or my diversity. And what she ended up writing was literally her. I think I forget, like a going to a local restaurant and ordering food or something like that, because the prompt was such. So yeah, you're right, you know, we're missing out on people's rich experiences that shaped their worldview. And this need to mainstream everybody, maybe, as you said, may help the brain to automatize its process and save fuel or glucose on the brain. But if we may be actually short circuiting some of the ways to grow our heart. Yeah, I really appreciate that thought process.

Dr. Willie F. McBride: Absolutely. And I think you brought up a great example, in terms of admissions process and things like that, and thinking about, you know, we use certain tests to help us with admissions process. And there's research showing that like, hey, those tests might not be as great as we think they are. And what are the other metrics that we're going to use to help us, you know, who's a quality candidate for, you know, getting into a university or this fellowship, or these things, and it's like, those are the things that stand out, I would love to hear about her experiences that that is wild, traumatic, it's an amazing experience. And there's an I'm sure, there's amazing story behind the fact that this person who has experienced these traumas is applying for college, and then the position she is, I want to talk to her. Yes, I want to teach her.

Sucheta Kamath: Yes, but it's nowhere, it's mentioned that that's what what you makes you the most desirable candidate, right? Like, I remember, when I applied for grad school coming from India, I literally read the previous years, students essay, and I mimicked it, because I wanted to be so cautious that I wanted to let them hear what they wanted to hear. But I was misinformed about what my story might be very valuable. You know, like having grown up, like my experience with people with disabilities, and, and my experience of having, how community supports of people with disability would have been such a great essay to write about. But I was never encouraged, or there was no admission process that said, that's what we want to know about you, you know, to your point about this framework that McCormick talks about, you know, participants are multi dimensional participants, social group membership is dying, or dynamic, you know, power is a feature of participants, intersectional positions. And last one, which is participants intersectional positions, create outcomes of systemic advantages and disadvantages, which are what a great way to think about it. So, as we close our interview, I'm always curious, my amazing guests what what is what has shaped their thinking about things? And so do you have any recommendations for our audiences about books that have influenced you? And shaped your thought process?

Dr. Willie F. McBride: Yeah, you know, I was, I was thinking about some and one that I read later in life in terms of probably started reading it, four or five years ago, or three or four years ago was a book called Cry Like a Man by Jason Wilson. He, he's a black author, and he talks about his story of upbringing and issues related to emotional expression as black men. Believe it or not, that's an issue in terms of the idea that, you know, showing emotion and being and that emotional intelligence being able to describe how you feel for the longest time. I, you know, I was not the most in depth in my emotional understanding. Yet, I'm a psychologist, which was interesting and another aspect but just like in relationships and being able to tell people and say, what is it exactly, I'm feeling like I don't have the words to say how I'm feeling. And in the book, he talks about how that led him down certain paths and how that impacted his relationships. And I think it's a great book took a particularly for, for me, but also for black men in terms of just understanding more about emotions and openness with discussing those emotions and talking about them. Not that Yeah, yeah. And then one that I've read, growing up was the autobiography of Malcolm X, by Alex Haley. Yes, you know, a phenomenal book that just looks at his growth. If you want to talk about trajectory, his trajectory was was fundamentally changed in so many ways. And I'll reference just one aspect of he was the son of a preacher growing up, and his father was very much of a, I guess, you would say, a black nationalist perspective, but teaching independence and to black men probably in the 1930s night, or in a time where him speaking on his father's speaking on the things that he was speaking on, was problematic. And so Malcolm X father, or Malcolm Liddell, at the time, his father was supposedly committed suicide by falling on a railroad track. And so what the story is that he was killed. And this happened when Malcolm was, you know, a teenager or a young boy. And so it's so talked about his him and his brother or him and his siblings being taken away from his mother, her ended up because of all of those things, having mental health issues, having to go into a psychiatric institution, they wouldn't give them the insurance money from his his life insurance plan, because they said that he killed himself. And all this in the setting of a time where black people were considered second class citizens. And so he went into a life of crime, ended up in jail. And then the rest is history in terms of his trajectory. And you think about how great you know, we talk about Malcolm X in terms of his thinking, and his just the wisdom that he had, regardless of, of your views on his beliefs and things like that, he still became something great. Just think if he didn't have those life experiences, where his father was taken from the family and those things that dramatically impacted his trajectory, how great he could have been outside of what he was already great, right. And it just speaks to, for me, just like, there are so many great people out here who just need opportunity, need some things to go right in their life. And we need to be able to help support people so that they can fulfill their potential because there's so many people out here with so much potential. And there's so many things in the way that we could really just, if we could just fix on a on a, you know, humanity level, we could see so much change in the world.

Sucheta Kamath: I 100%. Agree. And thank you for sharing these amazing recommendations I have, I am going to get both these books for myself. And once again, such a joy and pleasure to talk to you. And folks, that's all the time we have today. Thank you again, really for being my guest and sharing your wisdom and your perspective. And particularly giving us a view of hope. I really think though, the work that you're doing is, to me a deepen is going to have a deep and wide impact. And I thank you for that. And for you, listeners. Definitely keep listening. Thank you for joining us week after week. If you love what you're listening to share this episode with your friends and colleagues and give us a thumbs up or a rating. That's how people find us we are being listened to in 110 countries because of you. And because of that sharing that you do. It gives us the opportunity to bring on these amazing guests. So thank you, and until then, see you here again next time on Full PreFrontal.