Behavioural Interventionist and Visual Supports for Children with Aserger's Disorder

I visited another school a few weeks ago and asked the parent of the child I was observing if I could go over my observations in the blog, "YES! Share so that other people realize this!"

So, parents are always arguing for classroom aide, a paraprofessional, to work with their child. And they often want that assistant there ALL the time. But there is a problem with this, actually a few. See if you can tell what the problem will be from the old cartoon I often show parents to explain the issue.

Heres number 1: Your child should be getting his or her cues from a couple of places in the classroom environment. Often teacher aides become the only place they look. Where should the social cue come from? First, the classroom teacher. And second, other students. When I do my observations in a school I pay close attention to the number of cues a child picks up, and usually the number from the teacher, other students or the white board or classroom schedule is near zero. Almost all of the social cues, what to do when, are obtained from the teacher aide.

This is why as a behavioural consultant I push the use of visual prompts and cues over verbal prompts and cues. Verbal prompts end up being requested, they end up being waited for, and students end up reliant on verbal prompts.  "Use visual prompts - point, and stop talking so much," is my usual advice. Yes, I know we want students with ASD and Aspegers to talk more and give eye contact, but you need to be careful. The eye contact becomes a prompt for the teacher aide to tell the student what to do.  Look at the cartoon. Got it?

Here is an example: The bell rings for recess (environmental cue ...a big one!), the teacher says, "Let's get our desks cleaned up and line up..." (another Massive prompt here, but regretfully not from where the student is use to looking. He or she usually looks to his classroom aide for prompts!) At this point the other students all start to put their coats on for recess. (a GIANT social cue). But what is this a prompt to do? The student sees the other students getting their coats on and turns ......to his aide!!!!!! At that point she says, "Now lets get your coat on."

READ THE CARTOON. See what happened?

This is why its necessary to occasionally have your behavioural interventionist go to the school and observe what's going on. In most professions observation and feedback is a critical part of quality control, but who is doing that for the teacher aide? The teacher? I don't think most teachers have the behavioural expertise to take on that task.

So, that's that. All of this could have been avoided by using the classroom aide (the schools behavioural interventionist) use visual supports to guide the student, not to getting things done, but to learning how and where to find social prompts as to what is going on and what I should be doing. The aim of a support person is to teach skills that lead to independence, not get todays math done or your child's coat put on. Independence comes through learning to use environmental and social prompts to navigate the world.

Besides that, the cartoon is funny. Just so typical, right?

For information of behavioural interventions services, autism diagnosis and treatment that Dr. Roche provides please visit his website at www.relatedminds.com

Adult Autism | Aspeger's Disorder in Burnaby | Vancouver

Dr. Jim Roche provides diagnostic testing, assessments and treatment for adults with ASD|High Functioning Autism|Aspeger's Disorder.  He has been working with adults with Aspeger's and related cognitive disorders for over 20 years.

Dr. Roche has worked as a clinical psychologist in private practice, a psychologist for local school districts, a provincial consultant on autism and related disorders and in community based rehabilitation programs. For more information visit his website at www.relatedminds.com

Sensory Processing Disorder and ASD

According to a policy statement from the section on Complementary and Integrative Medicine of the American Academy of Pediatrics Sensory Processing Disorder should not be used as a medical diagnosis. They express concern with it's overuse, and the application of sensory based therapies for which there is little if any evidence of effectiveness. Regretfully, even with a diagnosis of Autism Spectrum Disorder or Asleger's Syndrome many school district produce IEPs (Individual Education Plans) that rely heavily on these unproven treatment- while they avoid the use of validated behavioural treatments. Often the reason for this is that sensory based treatments are easier to implement with untrained staff, and there is simply a lack of trained professionals in the field of behavioural interventions (or classroom management). Click http://www.medpagetoday.com/Pediatrics/GeneralPediatrics/33018 for the full story The statement says, "Pediatricians should not use sensory processing disorder as a diagnosis, according to a policy statement from the American Academy of Pediatrics. Although there are standardized measures of a child's sensory processing abilities, there is not a widely accepted framework for diagnosing the disorder, members of the AAP's Section on Complementary and Integrative Medicine wrote in the June issue of Pediatrics." The reort notes, "that the committee developing the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) has called for further research before officially recognizing sensory processing disorder." In addition, the authors wrote, "it is unclear whether children who present with sensory-based problems have an actual 'disorder' of the sensory pathways of the brain or whether these deficits are characteristics associated with other developmental and behavioral disorders." The report suggests that instead of diagnosing sensory processing disorder, pediatricians should perform a thorough evaluation -- usually with appropriate referral to a developmental and behavioral pediatrician, child psychiatrist, or child psychologist. The report continues, "consideration should be given to other developmental and behavioral disorders that may be associated with difficulty tolerating or processing sensory information, including autism spectrum disorders, attention-deficit/hyperactivity disorder (ADHD), developmental coordination disorders, and childhood anxiety disorders." "Pediatricians should inform families that occupational therapy is a limited resource, particularly the number of sessions available through schools and through insurance coverage," the authors wrote. "The family, pediatrician, and other clinicians should work together to prioritize treatment on the basis of the effects the sensory problems have on a child's ability to perform daily functions of childhood." Here in Bc there has been tremendous growth in school based "sensory rooms." Often children with ADHD, Autism Spectrum Disorder or Asperger's Syndrome are removed from class and sent to the "sensory rooms" in an effort to calm them down, rather than the school completing an appropriate Functional Behavioral Assessment and developing a behavior based intervention plan that either teaches new skills or uses behavioural techniques (long known about and familiar to experts in the field) such as controlled exposure, relaxation and thought stopping interventions to teach the child appropriate ways to deal with unwanted sensory input. Little effort is made to help the child develop coping skills, self-southing skills or other alternative behavioural skills to deal with the sensory issues. Many parents feel that the over use of sensory rooms and removal from the teaching environment do little more than reinforce inappropriate and unwanted behaviours. A second look at the over use of the "sensory Processing Disorder" diagnosis seems like an appropriate place to start. While here in BC excessive removal from a classroom (Time Out / Time Away) due to behavioural issues seems acceptable. In the United States such removal would be considered a "change in educational placement" and would require approval by both the school special education team and parents. An excellent source of information on how behaviours that interfere with learning should be addressed in the classroom through well know and scientifically supported educational and behavioural techniques can be found at this web page: http://www.pent.ca.gov The PENT website offers free materials which any school district could use to address problematic behaviours which interfere with learning. An appropriate Functional Behavioural Assessment (FBA) is the place to start when addressing these kinds of issues. I have used the PENT training materials to implement training programs in completing and writing Functional Behavioural Assessments for almost 10 years and it is really unmatched ....and FREE. All of these training materials are....FREE. Rather than providing easy interventions that are not supported by science. I would hope that every school instead provides science based assessment and intervention programs that directly assess the behaviours of concern and use interventions techniques we know work. The problem comes down to this: If your child has a serious behavioural problem at school, you should expect that the school would implement strong, science based interventions that are designed to directly address the problem AND teach new adaptive behaviours. Changing the child's environment, and removing them from the classroom, is not a plan. Sensory room or not. If your having such problems with your child in school I would suggest contacting an expert in the field, a psychologist or professional educator, to visit the school, observe the situation and complete an FBA (Functional Behavioural Assessment)

Adults with Aspergers and ASD in the workplace

I am often asked to see young adults with Asperger's to help them find "the right career." What is the right career for someone with Aspergers? Well that's really hard to say because the truth is individuals with Asperger's come in all shapes, sizes, colours, temperaments, with different dreams, wishes, hopes, abilities, skills, interests, talents and...deficits. Some people do find with working a full day...but have difficulty when they come home continuing a long period of social interaction, while some others can deal with 20 hours of work a week, or can only deal with work that involves few social interactions. But keep in mind, the vast majority of adults I see with Aspergers hold full time jobs, in exciting careers, doing complicated and demanding tasks. Some that I can't imagine myself doing. What work would suit them best? Ask them! And try different experiences out. If your working with a therapist there are ways to get a better idea about what might be more to your liking. This includes interest inventories, psychoeducational assessments and things like Michelle Winner's Social Thinking- Social communication Profile. (www.socialthinking.com) 

Adults with AS can be very capable workers in the work force who are highly productive but struggle to relate socially. An example of this is the worker who is asked to sign a get well card for someone they don't know, and refuses. Or someone who just can't participate in the "small talk" that goes on and is necessary to be part of a team. These are often skills that need to be explained (psychoeducation), modelled and practiced in the workplace with feedback and....more practice. This can be difficult and anything but rewarding at first. These individuals need support throughout the process.

There is a good book available for those trying to learn about counseling adults with AS, Cognitive Behavioural Therapy for Adult Asperger Syndrome by Valerie Gaus. This is really a book for the therapist rather than the client, but its a minimal requirement for anyone you might find yourself working with.

So what are some of the types of issues I've dealt with in the past few weeks with my own clients with AS? Heres a short list:

1. Dealing with anxiety through Cognitive Behavioural Therapy

2. Dealing with depression through Cognitive Behavioural Therapy

3. Learning to listen to others and hold a conversation that's two way - using reflective thinking and understanding the perspective of others

4. Using Michelle Winner's "Social Behaviour Mapping" program

5. Dealing with a spouse and child after a full day at work

6. Understanding appropriate limits in email (a pretty common problem for everyone at work!)

7. Dealing with panic attacks

8. Dealing with OCD behaviours

9. Anger management and assertiveness training

10. Staying awake and off the internet

11. Goal setting, time management and planning large projects

12. Workplace romanace, and sexual appropriateness

13. Going to Vegas with workmates

14. Going out after work and engaging in small talk

15. Asking for a raise

When I look over this list I realize it isn't that much different than anyone else's list of problems and concerns. So don't be discourages, get to work, find a coach or therapist and get ready to jump in!

For more information on my practice and services I provide, including full diagnostic services for autism spectrum disorder (ASD) for children, adolescents and adults, as well as individual, couple and family therapy, please see my website at http://www.relatedminds.com or at http://www.relatedminds.com/autism/

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Psychological services (including assessment, testing and therapy) provided in my offices include (covered by most extended health care insurance):
ADHD (click here: http://www.relatedminds.com/adhd-attention-deficit-hyperactivity-disorder/)

Anxiety and Stress (click here: http://www.relatedminds.com/anxiety-stress/ )

Autism and Asperger’s Disorder (Click here: http://www.relatedminds.com/autism/)

Individual Counselling (click here: http://www.relatedminds.com/individual-therapy/)

Child Counselling / Therapy (click here: http://www.relatedminds.com/child-therapy/)

Testing and Assessments and Learning Disabilities (Click here: http://www.relatedminds.com/testing/)
Couples Counselling / Therapy (click here: http://www.relatedminds.com/couples-therapy/)
Depression
The Angry Child (click here: http://www.relatedminds.com/dealing-with-angry-aggressive-and-explosive-children/)
Anger Management (Click here: http://www.relatedminds.com/anger-management/)
Pain Management and PTSD (Click here: http://www.relatedminds.com/pain/ )
Forensic Services (Independent Medical Examinations or IME)
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About Dr. Roche
I am a Registered Psychologist and a Registered Marriage and Family Therapist (RMFT) in British Columbia. In addition to my doctorate in clinical Psychology (The Union of Experimenting Universities), I hold a master’s degree in family therapy from Goddard college, a certificate of advanced graduate studies (CAGS) in school and educational psychology from Norwich University, and have completed two years of post doctoral studies in neuro-psychology at The Fielding Institute in Santa Barbara, California. I am also a certified school psychologist, certified teacher of special education (New York and California), and a Clinical Member of the American Association of Marriage and Family Therapists (AAMFT). Finally, I hold a doctoral degree in law (JD) with an emphasis in medical malpractice and education law. Beyond my academic credentials, I have completed two years of supervised clinical experience in both hospital and community based clinics and two years of post doctoral training in neuropsychology. I have served as director of behaviour programming for several school districts, as a consultant on autism for the province, and have held numerous academic positions including Clinical Instructor in Psychiatry at New York University and Bellevue Hospital in New York as well as being a faculty member at NYU, Brooklyn College, SUNY New Paltz, and Norwich University.

My offices in Burnaby and Vancouver serve Burnaby, Vancouver, Coquitlam, Port Moody, Port Coquitlam, New Westminster and Maple Ridge. Clients often come to my Vancouver office from North Vancouver, West Vancouver and even as far as the Sunshine Coast. For more information on the location of my Burnaby and Vancouver offices, please see my “Office Location” page, which contains a Google map.

Key Words

ADHD | Anxiety and Stress | Autism and Asperger’s Disorder | Individual Counselling | Child Therapy | Testing and Assessments and Learning Disabilities | Couples Counselling | Depression | The Angry Child | Anger Management | Pain Management and PTSD | Forensic Services | Attention Deficit Hyperactivity Disorder | Vancouver | Burnaby | Coquitlam | New Westminster | Maple Ridge | Port Moody | Child Psychologist | Psychologist | Learning Disability | Assessment | Testing | Psychoeducational Assessment | Neuropsychological Assessment
http://www.relatedminds.com

http://Therapists.PsychologyToday.com/rms/70682

http://www.therapistlocator.net/member?183420

http://www.bcpsychologist.org/users/jimroche

http://www.actcommunity.net/jim-roche.html

New Definition of Autism May Exclude Many

Usually, once a week, I teach a graduate class in diagnostics at a local college. Students are surprised to hear that the definitions of different mental health conditions such as ADHD or autism spectrum disorder can change. Any every few years, when the new edition of the DSM (Diagnostic and Statistical Manual of Mental Disorders) there are often changes. Most of these are brought about by new science, new understanding, experiments and research that helps re-define and make more specific how we make a diagnosis. This time around, as we prepare for the 5th edition, some people are concerned about the effects of many of the changes, especially those for Attention Deficit Hyperactivity Disorder (ADHD or ADD as it was once known) and autism spectrum disorder (ASD).

The proposed changes in the DSM for autism would, according to many, sharply reduce the skyrocketing rate at which this disorder has been diagnosed. And honestly, some days almost all of the calls to my office are from individuals who talked with a friend, read a newspaper article or saw something on the web that made them think they might possibly have autism. After talking with their family doctor, who usually has no idea how to make such diagnosis, they call me. Many want, more than anything, to get a diagnosis so they know what is wrong. But this is exactly where the new DSM is struggling. As a recent article in the New york Times puts it, "where to draw the line between the unusual and abnormal..." The new proposed guidelines are most likely going to exclude many people from the diagnosis who are "higher functioning" and move them from that the "category" of abnormal- or "diagnosable" to "unusual." Many people who are currently diagnosed as having Aspeger's disorder will most likely be left out.

currently at least a million children and adults have a diagnosis of Asperger syndrome (or disorder) or "pervasive developmental disorder-not otherwise specified- PDD-NOS - and endure many of the same social struggles and deficits that people with autism have, but they do not meet the criteria for ASD - autism spectrum disorder. The proposed changes to the DSM would put all three of these categories -PDD (Pervasive Developmental Disorder), Asperger's Syndrome, and Autism Spectrum Disorder (ASD) together, eliminating PDD-NOS and Asperger's from the manual entirely. Under the current criteria for a diagnosis a person can qualify for the diagnosis by exhibiting 6 or more of the 12 required observed or reported behaviours; under the new proposed definition a person would be required to exhibit 3 3 deficits in social interaction and communication and at least 2 repetitive behaviours, a much narrower definition for diagnosis. The problem is, especially in places like BC where a strict diagnostic procedure is enforced, kids may no longer qualify for a diagnosis of ASD (autism spectrum disorder) even though they have fairly significant behavioural and social deficits.  Some services are always driven strictly by a persons diagnosis.

Research shows that the new definition seems to have more of an effect on the "cognitively able" rather than the "classically autistic" child. Currently several studies are looking at how the new definition would effect diagnostic decisions. But if a diagnosis is suppose to guide treatment interventions, the real purpose of a diagnosis, then some changes really do need to be made. We will have to wait to see what the outcome is. No matter what happens, we do know the end result will be that some children (and adults) who currently qualify for a diagnosis will no longer qualify. Effort will need to be made to expand the criteria for getting help that even the "cognitively able" and "unusual" child needs to be successful.

Assessment and Treatment of Autism in BC

I am often asked for basic information on the assessment and treatment of autism in BC.  Here in BC autism assessments need to be completed by a professional with specialized training in two specific assessment tools. First, there is the ADOS ( the Autism Diagnostic Observation  System) and second the ADI-R (Autism Diagnostic Inventory-Revised). These two tools are necessary for any child to be assessed here in BC and obtain provincial funding and appropriate school "coding" and supports for a student with autism (ASD0. This also applies for students with what some call "High Functioning Autism" or HFA and Asperger's.  Although these names will soon be left behind as we move to a new diagnostic book and category.

If your child is under six years old they need to be assessed by a full team, including a physician, speech pathologist and a psychologist or other professional specially trained to use these specialized autism tools. If your child is older than that a psychologist alone (again, with the appropriate skills) can complete the testing, but always needs an assessment from your paediatrician or family doctor. This is in order to full out other possible causes for the symptoms you are concerned about. While it isn't necessary at this age to include a speech pathologist, it's a good idea if the psychologist isn't familiar with speech and language problems.

Several hospitals and other provincial facilities provide these assessments for free. Why do people go to a private practitioner? Some simply want their own doctor rather than one paid by the government. Some are getting a second opinion. And finally, there is a significant waiting list for the services the province provides.

Often it is appropriate, and really necessary, to also complete a "psychoeducational" assessment. Students with Autism and Asperger's often have co-morbid disorders that need treatment, including school related problems such as learning disabilities, ADHD, anxiety or depression. In most cases, unless such an examination has already taken place, the psychoeducational examination is necessary.

How much should this cost? The cost varies from one autism assessment to another. One child may take a long time completing the tasks that are part of the exam, and another may need several additional tests to get to a learning disability. So it should vary. Costs run, on average, from $1,600-$2,600.00 depending upon how much work is to be done.

My final recommendation is that you always find a professional who has experience with schools, knows how schools work, how teachers react to suggestions and plans. If the professional does't have experience with the classroom they will have a hard time making realistic suggestions for accommodations and supports. They should also have hands on experience in dealing with children with behavioural problems. Don't be afraid to ask. You can find a psychologist with expertise in autism through the British Columbia Psychological Association.

About Dr. Roche:

Dr. Jim Roche is a Registered Psychologist and a Registered Marriage and Family Therapist with offices in Vancouver and Burnaby, BC. He has been in practice for over 25 years and has served as a Provincial Consultant on Asperger's/Autism/ASD as well as Director of Behaviour Programming for several school districts here in Canada, in New York and California. In addition to being a Registered Psychologist he is a Certified/Licensed Teacher of Special Education and School Psychologist.

Other information about Dr. Roche can be found at:  www.relatedminds.com , www.relatedminds.com/adhd, http://Therapists.Psychologytoday.com/70682, www.bcpsychologist.org/users/jimroche, http://psyris.com/drjimroche.

Specific Information about his services for children with autism and Asperger's Disorder can be found at: http://www.relatedminds.com/autism/

Increase in Autism Rates Noted in Korean Research

New York times Article:
click here: http://www.nytimes.com/2011/05/09/health/research/09autism.html

The New York Times has an article about an ambitious six-year effort by Korean researchers to gauge the rate of childhood autism in a middle-class city which has yielded a figure that stunned experts and is likely to influence the way the disorder’s prevalence is measured around the world. What's the number? The study shows that 2.6 percent of all children in the Ilsan district of the city of Goyan (aged 7 to 12). This is more than twice the rate usually reported in the developed world. note that even that rate, about 1 percent, has been climbing rapidly in recent years — from 0.6 percent in the United States in 2007, for example.

“This is a very impressive study,” said Lisa Croen, director of the autism research program at Kaiser-Permanente Northern California, who was not connected with the new report. “They did a careful job and in a part of the world where autism has not been well documented in the past.” So, the study, while comprehensive, doesn't necessarily show an increased rate, but a rate higher than we expected. We have simple looked more closely and found more cases.

The study was published in The American Journal of Psychiatry. It was produced by researchers from the Yale Child Study Center, George Washington University and other leading institutions. Together they sought to screen every child aged 7 to 12 in Ilsan, a community of 488,590, which is about the size of Staten Island.

This new number is in contrast to the Centers for Disease Control and Prevention in the United States and most other research groups measure autism prevalence by examining and verifying records of existing cases kept by health care and special education agencies. That approach may leave out many children whose parents and schools have never sought a diagnosis.

In recent years scientists have come to see autism as a spectrum of disorders that can include profound social disconnection and mental retardation, but also milder forms, like Asperger’s syndrome, that are pervasive and potentially disabling but that often go undiagnosed.

“From the get-go we had the feeling that we would find a higher prevalence than other studies because we were looking at an understudied population: children in regular schools,” said the lead researcher, Dr. Young-Shin Kim, a child psychiatrist and epidemiologist at the Yale Child Study Center. So, in effect, this study focused on finding children who may have a form of autism that is much less likely to cause school problems, and therefore be less detectable.

The New York Times reports that, "Dr. Marshalyn Yeargin-Allsopp, chief of developmental disabilities at the National Center on Birth Defects and Developmental Disabilities of the C.D.C., acknowledged that her agency’s records-based approach probably missed some autistic children — especially among the poor, among racial minorities and “potentially among girls” — and said the agency was interested in taking part in a population-based approach like the Korean study. “We believe this will be a way to get as complete an estimate of A.S.D. prevalence as possible,” she said in an e-mail, using the abbreviation for autism spectrum disorder."

The Times article itself goes into good detail about the study and is an easier read than the actual article itself. IT's nice to see decent science reporting that doesn't sensationalize a problem or a statistical change. Click above and read the entire article, there is also a link on the Times available to bring you to the original published research as well.

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For information about services for autism spectrum disorder, including Asperger's Disorder, that I provide in my office, please feel free to check my web page or contact me directly.
Dr.jim Roche
www.relatedminds.com
www.adhdhelp.ca

Dr. Roche is a Registered Psychologist and Registered Marriage and Family Therapist with offices in burnaby and Vancouver, BC. His practice focuses on children, adolescents and adults with autism spectrum disorder, Asperger's Disorder, Attention Deficit Hyperactivity Disorder (ADHD/ADD) and similar behavioural issues. He can be reached at 778.998-7975

ADHD and Autism

Kids with ADHD deserve action

Here is an excellent letter to the editor from the local Burnaby paper (click above).

Every year kids come to school with a variety of learning disabilities and mental health disorders, these include Autism, ADHD/ADD, depression, anxiety and related disorders. And recently studies have shown that BC is one of the places in Canada that is very unlikely to be prepared to help children with one of the most common of these disorders, ADHD, or ADD as many people mistakenly call it.

As the writer of this letter states, "Our Ministry of Education, as well as school communities, needs to know that ADHD is not a behaviour issue, that it can't be "cured" by changing diet, that it's not a result of poor parenting and that the kids who suffer from it aren't bad kids. And they need to know that I am not unnecessarily "drugging" my child. They need to know it's a genuine medical condition, that many kids with ADHD are very bright, that it affects up to 12 per cent of school children, that it's stressful for parents and hard to deal with for kids."

Well, I couldn't have said it better myself, and I am often frustrated by the way ADHD/ADD is treated or should I say not treated in the schools. This is especially important to parents of children with ASD or Asperger's Disorder. Treatment is often non-existant for ADHD. There is an assumption that behaviours are the result of choice, that the problems and failures are purposeful. While the provincial government had taken steps to address the need to provide treatment in the schools and community for autism and Asperger's Disorder, there is really very little available in the schools for children with ADHD/ADD. While there is a large percentage of children with ADHD/ADD you very seldom find a school district providing ADHD specific training for it's staff or parents. While I have spoken in dozens and dozens of schools throughout BC on autism and Asperger's Disorder, and provided training, consultation and observations focused on children with autism, it is nearly impossible to get a school to ask for a workshop, training session or a consultation on ADHD. And often our children with autism and Asperger's have ADHD as a co-morbid disorder. It is seldom addressed in Individual Education Plans (IEPs) and when a school does deal with the symptoms / behaviours that result from ADHD they apply "warnings" and punishments as the "treatment." This is something that sooner or later has to be addressed by our schools. This week alone three of the children seen in my practice were being punished for their ADHD symptoms. A school would never punish a student for their behaviours-symptoms of anxiety, or punish a student for behaviours-symptoms of Tourette's syndrome (although I have to admit, I have spent more than one full semester dealing with just this issue in a major school district in California). More than ny other disorder I have heard negative comments from teacher's and staff when addressing the simplest behaviours relating to ADHD/ADD. Sometimes it's like they have either never heard of the disorder, or if they agreed it existed out entire society would fall.

For parents I have suggested reading "So I'm Not Lazy, Crazy or Stupid," Mel Levine's "The Myth of Laziness" or Dr. Barkley's many works on ADHD. (All of these can be found on my web page.

Often different disorders have separate"camps" of supporters. There are "autism awareness" days, walks, Depression awareness days...all sorts of support groups and programs. Oddly, there is no ADHD walk or ADHD day in any school's or towns I've been to. That's too bad. ADHD more than any other disorder needs to be brought out of the closet and addressed, and those who deny that it is a real disorder, or that it's really a choice a ten year old is making to fail all his subjects and lose all his friends needs to be confronted and dealt with.

I can offer this one piece of advice to parent. Get a copy of the diagnosis for both Autism/Aspergers AND ADHD. Make a copy. LEarn it. Mark the important terms in yellow, underline them. Make a copy for everyone on your child's IEP team. And then make sure everyone know that punishment for symptoms went out about 100 years ago. We don't punish individuals who have a diagnosed disorders like autism, Aspergers, Tourette's syndrome or ADHD for exhibiting their symptoms. Ever. If they try, ask for the research that shows such a "technique" is a good idea. What supports that as an intervention? Instead redirect everyone back to answering how we as a team, parents and school, are going to provide positive behavioural support through the IEP process to teach your child how to do better and succeed. That's what an IEP is all about!

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The Autism blog is not offered as medical advice or as a means of diagnosing or treating Autism or Asperger's Disoder. The diagnosis of autism is complex and involves not just looking for symptoms of autism, which is all that those “web tests” do, but also involves ruling out other disorders that might look just like autism. Often individuals who think they or their child has autism or Asperger's Disoder have other disorders, and may have co-morbid disorders such as depression, anxiety or OCD. A simple check off sheet of “symptoms” doesn’t differentiate these. So avoid these on-line "tests" which are nothing more than a collection of symptoms. You need to see a licensed or registered professional for a real diagnosis. Medical doctors can diagnose autism, but the diagnosis is complex and often they will make a referral to a Registered Psychologist for a full understanding of a patient’s symptoms. You can obtain a referral for a psychologist with expertise in autism from the British Columbia Psychological Association (BCPA). The professional you select needs specific training and needs to use specific tools in British Columbia, including the ADI-R and ADOS, and also needs to complete a psycho-educational assessment. The government of BC provides these services for free, there is a waiting list, and some parents prefer private practitioners.

In my practice I offer autism assessment and treatment services for individuals, couples, families, children and adolescents in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education, cognitive rehabilitation for problems with memory and concentration and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.

My web page lists a number of resources you can make use of yourself in dealing with Attention Deficit Hyperactivity Disorder (ADHD). Please visit it at www.adhdhelp.ca or one of my other sites at either Psychology Today, AAMFT, PSYRIS or my professional site. Please feel free to call if you have questions about ADHD or other cognitive issues.

My autism web page can be found by clicking here. (www.socialcognitivetherapy.com)


Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com