Child & Adolescent Services
We are proud to employ the most rigorous and scientifically-sound assessment methods in all of our evaluations. We utilize a multi-method, multi-informant, multi-time series approach for all of our assessments.
- The multi-method component means that we gather information through several different methods including but not limited to clinical observations, clinical interviews, collection of standardized rating forms, administration of standardized psychological tests, and review of records. The use of multiple types of assessment methods allows us to arrive at the most valid diagnoses by not relying on only one type of assessment.
- The multi-informant process means that we gather information from all important sources in a patient’s life, such as parents/caregivers, teachers, physicians and other professionals. By gathering information from multiple sources, we can ensure that we get the most accurate picture of a patient’s functioning.
- Lastly, we utilize a multi-time series approach. This means that we do not simply collect information at one appointment. We all have good and bad days and would certainly not want an entire diagnostic impression to be based upon one day. Thus, we include several appointments in the evaluation process so that we get a more valid overall picture of how a patient typically functions in his/her everyday life.
Understanding any neurodevelopmental or mental health disorder is often a confusing and difficult task. The good news is that although difficult, accurate diagnosis can be achieved and can lay the foundation for improving your or your child’s life!The goal of any diagnostic process should be to facilitate the development of appropriate and effective treatments to improve a person’s life.
Our diagnostic assessment process is well-aligned with major professionals’ groups. We are proud that our diagnostic evaluation process is based upon the most scientifically-sound practices. We take very seriously the privilege and responsibility of helping you, and we hope that you will find your process with us to be valuable and informative.
We take a broad and thorough approach to neurodevelopmental disorders. That is, we understand that children with neurodevelopmental disorders often have many additional symptoms and impairments that result in multiple diagnoses. Thus, our diagnostic assessments are individually tailored to answer two primary questions: "What is it?" and "What isn’t it?" as it relates to diagnosis. This is the basis of good differential diagnosis. From this broad approach, we routinely conduct the assessments to diagnose the following concerns:
- Intellectual Disabilities
- Dyslexia and other learning disorders
- Emotional, behavioral, and social problems associated with medical conditions
- Anxiety Disorders
- Depressive Disorders
- Mood disorders
- Cognitive impairments related to stroke, dementia, traumatic brain injury, etc.
- Tourette's Disorder
Neuropsychological assessments are very useful when a patient has a complicated history and presentation. For example, a neuropsychological assessment is often indicated when a person is suspected of having a brain injury (e.g. head injury, concussion) or brain disease (e.g. tumor, infection, dementia). Many times, we conduct neuropsychological assessments when there is a history of significant prenatal or delivery complications (e.g. significant premature birth; very low birth weight; lack of oxygen; exposures to cigarettes, prescription medications, or alcohol during pregnancy) that could have resulted in brain damage or injury. The goal of a neuropsychological evaluation is to identify any deficits in major areas of brain functioning including attention, memory, language, motor, and executive abilities, as well as aid in differential diagnosis and treatment planning. In short, the more we know about a patient’s brain functioning, the better we are able to arrive at diagnostic conclusions and develop effective treatment plans. Neuropsychological assessments are also useful in documenting any problems that may require supports and accommodations in work and school settings.
Once all testing is completed, the patient will schedule a review with the clinician to discuss the findings (e.g., individual’s strengths and weaknesses), recommendations and make plans for treatment, if necessary.
We offer a variety of group-based, cognitive-behavioral treatment programs to help children make optimal gains in basic skills such as attention, impulse regulation, social reciprocity, and other socially appropriate skills (e.g., eye contact, tone of voice). At the start of all of our group-based therapies, children meet in a group to discuss social skills (e.g. validation, communication, cooperation, participation) and the rules for the group. Some of our groups also incorporate significant physical components that facilitate motor coordination and basic athletic skills. In all of our groups, children participate in hands-on group activities, which challenge them to work together, take turns, self-regulate, and encourage them to continue to participate even if they become frustrated. Children are highly motivated, and most make significant self-regulatory and social improvements. For children who may have limited opportunities to engage in natural play activities with peers, our social groups are an excellent avenue to help increase their self-esteem and self-efficacy, and are appropriate for many children with ADHD, autism, social difficulties, and anxiety disorders.
According to the scientific literature, social learning is most likely to occur when persons are exposed to others who model appropriate social behaviors, and when the persons who are modeling appropriate social behaviors are of a similar age and background as the trainee. Modeling should be made as realistic as possible, using real-life cues. Also, researchers have reported success with structured social skills groups which include modeling, role-plays, video recordings, and constructive feedback within the group setting as effective methods for teaching skills such as making conversation, reading and interpreting body language, understanding the perspectives of others, and making friends. Some of our groups are developed for children and adolescents who are ready for more dynamic social skills training than is possible in individual sessions, but more intensive and slower-paced than our other group social programs. Some groups are purposefully small in number to afford children and adolescents the opportunity to benefit from more naturalistic, interactive social skills training in a small group setting. Groups are often structured in module format with each module developed to target skills most needed by the group. Module topics include:
- Understanding thoughts/emotion/beliefs of others
- Communication skills (verbal & non-verbal)
- Making friends & interacting with peers
- Adaptive functioning skills (Social, self-care, communication, self-care, communication, self-direction, etc.)
- Social problem-solving and reasoning
Instructional methods are geared to developmental level and include hands-on activities and games that offer modeling, guided practice, independent practice, teaching to mastery, and positive feedback. Children and adolescents are grouped according to developmental level and age. Each session includes the completion of an activity and feedback/discussion. Parent letters are provided regularly to encourage practice of the skills at home, which increases maintenance and generalization of the skills learned in session. As weeks progress, previous topics are reinforced through labeled praise. Pre/Post assessments are completed, as well as parent evaluations to determine effectiveness.
We offer a variety of individually-based therapies that help patients make meaningful gains in their lives. With our emphasis on science, we base our recommendations for therapy (individual or group) upon what is likely to result in the most improvement. When individual therapy is recommended, we most often use Cognitive Behavioral Therapy given the wealth of scientific evidence that supports it as a very effective treatment for a variety of problems. Not all persons are good candidates for individual therapy due to several factors including the nature of the problem (e.g. child with ADHD), age of patient, and severity of symptoms. Conversely, patients who are not good candidates for individual therapy may likely benefit from group therapy.
Our Parent Education and Skill Building sessions are a powerful mechanism that can be employed to fuel growth in children with developmental, intellectual and mental health disorders. Parents, other caregivers, and extended family are critical to a child’s success. That’s why we work so closely with them to share the wealth of knowledge that we have about child development and cognitive-behavioral techniques. Caregivers receive education on the nature and course of their child’s disorder and impairment, and are taught cognitive-behavioral principles and specific techniques for facilitating growth in self-regulatory, social, academic, and adaptive functioning. An added benefit of learning these skills is that parents report significant reductions in their own stress and simultaneous improvements in their effectiveness as parents. Siblings and other caregivers can also be taught the same techniques which strategically empowers all members of a child’s life. Basic, intermediate and advanced skill trainings are available. In addition, techniques such as bug-in-the-ear technology enable the ability for parents to receive in vivo feedback—an especially important component for parents who may have limited cognitive abilities or those who prefer a more hands-on approach.
Problem-Solving and Communication Training
Many parents and teens express frustration in dealing with one another. Parents often feel that their teens are unreasonable and argumentative. Teens often feel that parents do not understand them. Because teens are striving to gain their independence and parents are attempting to appropriately monitor and discipline, it seems somewhat reasonable to expect that some conflict will arise between parents and teens. When this conflict continues or becomes a major problem in a parent-teen relationship, it often helps to seek professional support. We work with parents and teens to improve their problem-solving skills and communication abilities, helping them to achieve more realistic expectations and build a better relationship. Parents and teens are taught the specific skills that lead to more effective communication such as using “I” statements and taking the other’s perspective. Clinicians also help facilitate problem-solving discussions with relevant family members.