While some schools provide small groups to work on skills training with students with Aspeger's Disorder, it seems to be the exception here in the lower mainland. Children, teens and young adults with autism spectrum disorder, especially those who are higher functioning and until recently we would have said they had "Aspergers Disorder," need supportive servies for a number of issues. These services can be provided in several different ways:
1. In small groups, such as what one might find in a school setting. This type of group, often called a "social thinking" group is often directed by a psychologist or school speech pathologist. The most frequent type of group that we see are those modelled after Michelle Garcia Winner's Social Thinking program, and address issues such as developing the ability to engage in small-talk, learning to "read others," by studying their entire body and learning to use methods to gather information that they can use to engage in the give and take of conversation, and sometimes direct learning and practice using another of Michelle's curriculums such as her "Social Behavior Mapping" program. You can see many of these materials at her website" www.socialthinking.com
2. When groups and school based programs are not available many children, teens and adults use one-to-one therapy to learn and practice these skills. Sessions might include some diadactic learning, some conversation time and then a period to reflect on the quality of the conversation and on issues relating to their experiences in other environments, such as school, home or the workplace. While I organize and sometimes direct small groups through schools, in my private practice much of my time is spent providing these types of services. I find that most individuals can make use of Mitchell's materials, and keeping the focus on skill development for reciprocal conversation skills is key. Many adults see me because of relationship issues, and problems in the workplace relating to asperger's and communications problems.
In addition to these language based services, I often spend a good deal of time directly teaching skills relating to anxiety, stress, and for many, depression. Manby of my patients have previously seen therapists or counsellors who have tried to address issues like anxiety, stress and depression who are not familiar with autism spectrum disorder and how it effects individuals across the lifespan.
3. The third way I often see patients about asperger's or autism spectrum disorder is through my services as a family therapist. This might mean working with a couple, or working with parents, providing parent education and behavioral skills training.
For those with children who have provincial funding I am a registered behavior specialist with ACT - Autism Community Training, and my services for children or teens can be billed directly to the Ministry. If you suspect your child or teen has autism spectrum disorder I also provide diagnostic / testing services that help you meet the qualifications for BC autism funding.
Adult services are often covered by their extended health plans, and in some cases cololege, universities and employers help with payments. Most individuals with autism spectrum disorder - Asperger's Disorder - also qualify for tax benifits, which can help defer the costs.
For more information on my services please feel free to contact me through my website at www.relatedminds.com, or call 778.998-7975
Dr. Jim Roche is a licensed and Registered Psychologist with over 30 years experience in the field of autism, education and neuropsychological assessment.
KEY WORDS: Autism, Asperger's Disorder, Burnaby, Vancouver, Coquitlam, New Westminster
Thursday, January 14, 2016
Monday, December 28, 2015
Books for Teens, Young Adults and Adults with Autism / Aspergers
As a provider of assessments for children, teens and adults with sautism spectrum disorder, or what was previously called "Asperger's Disorder," I am often asked for a good book to read on the subject. Specifically, today, I will suggest one book for teens and young adults. There are others for adults and married couples, but honestly, there isn't too much quality material available.
For teens and young adults I would recommend "Socially Curious and Curiously Social" by Mitchelle Garcia winner and Pamela Crooke. I also often suggest this to adult who can relate to many of the issues and experiences that this teen-young adult book speaks about.
After recieving a diagnosis of autism spectrum disorder (ASD) or Asperger's Disorder young people are often in need of a book, or at least a resourse of materials, on issues they relate to every day. This book, which is an anime-illustrated guidebook, is written to help explain how the social mind is expected to work in order to effectively relate to others at school, at work and in the community. This book redines what it means "to be social."
Michelle Winner is the leading practitioner in the field of ASD - Asperger's. She has a large clinic in San Jose California where she provides individual, group and family therapy to those with Aspergers/ASD, and provides training and curriculum material that most of the schools I work with, in many different states and provinces, in the schools. This includes materials such as here "Social Thinking" curriculum, "Social Behavior Mapping," and "Thinking About You Thinking About Me." These materaisl work well with other related systems such as "The Incredible five Point Scale."
Here web page, www.socialthinking.com is an excellent resourse for other related materials.
..............................................
Dr. Jim Roche provides assessments / testing for autism spectrum disorder and Asperger's in his offices in Burnaby and Vancouver, providing services for children with autism, Asperger's and NVLD in Vancouver, Burnaby, coquitlam, North Vancouver, West Vancouver and throughout the region. He is a licensed and registered psychologist, a certified teacher of special education and a licensed school psychologist. He has worked as a behaviour management specialist for schools in BC, California, Washingto, and New York. He has been providing assessment and testing for children, teens/adiolescents and adults with autism spectrum disorder and Asperger's Disorder for over twenty years. His assessments help many individuals qualify for provinical funding and related support programs. He is one of the few practitioners in BC who has worked in schools and workplaces directly with individuals with autism spectrum disorder and Asperger's Disorder and brings his experience as a teacher, psychologist and consultant to each case.
For more information on assessments and testing for autism spectrum disorder or Asperger's disorder please visit his webpage at www.relatedminds.com
https://therapists.psychologytoday.com/rms/70682
For teens and young adults I would recommend "Socially Curious and Curiously Social" by Mitchelle Garcia winner and Pamela Crooke. I also often suggest this to adult who can relate to many of the issues and experiences that this teen-young adult book speaks about.
After recieving a diagnosis of autism spectrum disorder (ASD) or Asperger's Disorder young people are often in need of a book, or at least a resourse of materials, on issues they relate to every day. This book, which is an anime-illustrated guidebook, is written to help explain how the social mind is expected to work in order to effectively relate to others at school, at work and in the community. This book redines what it means "to be social."
Michelle Winner is the leading practitioner in the field of ASD - Asperger's. She has a large clinic in San Jose California where she provides individual, group and family therapy to those with Aspergers/ASD, and provides training and curriculum material that most of the schools I work with, in many different states and provinces, in the schools. This includes materials such as here "Social Thinking" curriculum, "Social Behavior Mapping," and "Thinking About You Thinking About Me." These materaisl work well with other related systems such as "The Incredible five Point Scale."
Here web page, www.socialthinking.com is an excellent resourse for other related materials.
..............................................
Dr. Jim Roche provides assessments / testing for autism spectrum disorder and Asperger's in his offices in Burnaby and Vancouver, providing services for children with autism, Asperger's and NVLD in Vancouver, Burnaby, coquitlam, North Vancouver, West Vancouver and throughout the region. He is a licensed and registered psychologist, a certified teacher of special education and a licensed school psychologist. He has worked as a behaviour management specialist for schools in BC, California, Washingto, and New York. He has been providing assessment and testing for children, teens/adiolescents and adults with autism spectrum disorder and Asperger's Disorder for over twenty years. His assessments help many individuals qualify for provinical funding and related support programs. He is one of the few practitioners in BC who has worked in schools and workplaces directly with individuals with autism spectrum disorder and Asperger's Disorder and brings his experience as a teacher, psychologist and consultant to each case.
For more information on assessments and testing for autism spectrum disorder or Asperger's disorder please visit his webpage at www.relatedminds.com
https://therapists.psychologytoday.com/rms/70682
Wednesday, October 7, 2015
Autism Diagnostic Services| Burnaby
Dr. Jim Roche provides diagnostic services for children, teens and adults with suspect autism spectrum disorder or Asperger's disorder. These services are used to help families obtain funding through the BC autism funding program, school-based services and accommodations in school, college, university or work for adults.
I am a registered and licensed psychologist with
I am a registered and licensed psychologist with
over twenty-five years of experience in this field. I also hold licenses and certificates in school psychology and as a teacher of special education, so I am familiar with what it's like to run a classroom.
For ore information on my services please visit the ACT-RASP web page at http://www.actcommunity.ca/profiles/224/
Or visit my web page at www.relatedminds.com
Other places you can find information about my services include:
http://psyris.com/drjimroche
https://therapists.psychologytoday.com/rms/name/Jim_Roche_JD,PhD,CAGS,RPsych,RMFT_Burnaby_British+Columbia_70682
http://www.psychologists.bc.ca/users/jimroche
For ore information on my services please visit the ACT-RASP web page at http://www.actcommunity.ca/profiles/224/
Or visit my web page at www.relatedminds.com
Other places you can find information about my services include:
http://psyris.com/drjimroche
https://therapists.psychologytoday.com/rms/name/Jim_Roche_JD,PhD,CAGS,RPsych,RMFT_Burnaby_British+Columbia_70682
http://www.psychologists.bc.ca/users/jimroche
Wednesday, May 6, 2015
Dr. Jim Roche
I am a Registered Psychologist and Marriage and Family Therapist who specializes in working with teens and young adults with autism spectrum disorder (ASD), and what has been called Asperger's Disorder. My work with teens and young adults addresses school issues, sometimes psychoeducational testing, school observations, emotional issues and behavioural issues.
I am a member of the ACT RASP and am a registered behaviour consultant with them, and therefore can see children below the age of six using provincial funding. I provide autism diagnostic services and help parents become familiar with the many treatment modalities that are available to them. As a registered psychologist my services are also covered by most extended health care plans.
A number of patients see me for weekly 1-2 therapy, often addressing issues of anxiety, stress, depression or behavioural issues. I also see parents for parent education and sometimes for family or couples related counselling relating to the stress of dealing with the many aspects of ASD.
With most clients my focus is on either behavioural training, aimed at parents, caregivers or schools, or on social communications issues. I often use materials from Michelle Winner and her Social Thinking program. This includes curriculum materials such as "Social Behaviour Mapping," and "The Incredible Five Point Scale." I also teach a number of visual support techniques.
The methods I use are those that are considered by most school districts as "research based" and in use in those districts. As a previous POPARD provincial consultant for autism I am familiar with the methods, materials and curriculum used in most schools in the Vancouver/BC area and try to work in a manner that works well with what you should expect from the schools.
I also provide school based observations and consultations in both public and private schools.
I am a registered and licensed psychologist with over twenty five years of experience in this field. I also hold licenses and certificates in school psychology and as a teacher of special education, so I am familiar with what it's like to run a classroom.
For ore information on my services please visit the ACT-RASP web page at http://www.actcommunity.ca/profiles/224/
Or visit my web page at www.relatedminds.com
Other places you can find information about my services include:
http://psyris.com/drjimroche
https://therapists.psychologytoday.com/rms/name/Jim_Roche_JD,PhD,CAGS,RPsych,RMFT_Burnaby_British+Columbia_70682
http://www.psychologists.bc.ca/users/jimroche
I am a Registered Psychologist and Marriage and Family Therapist who specializes in working with teens and young adults with autism spectrum disorder (ASD), and what has been called Asperger's Disorder. My work with teens and young adults addresses school issues, sometimes psychoeducational testing, school observations, emotional issues and behavioural issues.
I am a member of the ACT RASP and am a registered behaviour consultant with them, and therefore can see children below the age of six using provincial funding. I provide autism diagnostic services and help parents become familiar with the many treatment modalities that are available to them. As a registered psychologist my services are also covered by most extended health care plans.
A number of patients see me for weekly 1-2 therapy, often addressing issues of anxiety, stress, depression or behavioural issues. I also see parents for parent education and sometimes for family or couples related counselling relating to the stress of dealing with the many aspects of ASD.
With most clients my focus is on either behavioural training, aimed at parents, caregivers or schools, or on social communications issues. I often use materials from Michelle Winner and her Social Thinking program. This includes curriculum materials such as "Social Behaviour Mapping," and "The Incredible Five Point Scale." I also teach a number of visual support techniques.
The methods I use are those that are considered by most school districts as "research based" and in use in those districts. As a previous POPARD provincial consultant for autism I am familiar with the methods, materials and curriculum used in most schools in the Vancouver/BC area and try to work in a manner that works well with what you should expect from the schools.
I also provide school based observations and consultations in both public and private schools.
I am a registered and licensed psychologist with over twenty five years of experience in this field. I also hold licenses and certificates in school psychology and as a teacher of special education, so I am familiar with what it's like to run a classroom.
For ore information on my services please visit the ACT-RASP web page at http://www.actcommunity.ca/profiles/224/
Or visit my web page at www.relatedminds.com
Other places you can find information about my services include:
http://psyris.com/drjimroche
https://therapists.psychologytoday.com/rms/name/Jim_Roche_JD,PhD,CAGS,RPsych,RMFT_Burnaby_British+Columbia_70682
http://www.psychologists.bc.ca/users/jimroche
Saturday, November 15, 2014
Punishment in the Schools for Students with Asperger's or Autism Spectrum Disorder
Our Province is know for it’s poor treatment of special education students. For example, read this about students with ADHD in Canada: http://shar.es/1X3bOa or here: http://www.ldao.ca/educational-implications-of-recent-supreme-court-ruling/ These articles demonstrate some of the evidence of what parents of students with ADHD are up against when dealing with the public school system here in BC.
But more shocking than how students with ADHD can be is the treatment of children with autism spectrum disorder (ASD) or "Asperger’s Disorder" sometimes called high functioning autism. On my desk right now is a folder of writing assignments I have copied over the years given to students with autism/Asperger's as the result of behavioural issues they have had in the school. They may have hit another child, got in a fight, refused to cooperate or follow rule or yelled something inappropriate. These writing assignments range from a “Behavioural Worksheet” which calls for a student to fill in a blank worksheet that is a problem solving techniques (which I myself have used, with appropriate children) to a list of questions about what the student had done wrong and what he or she will do to make up for their behaviour to a sheet of sentences they needed to copy repeatedly, yes, “ I will not…..” just like Bart Simpson.
Oh, I also have an outline of a public meeting where the student was suppose to take part in a “restitution process” which I was told is based upon a "First nations" way of dealing with conflict…and called for the student, an elementary student with autism spectrum disorder, to make a public apology while standing in front of his entire class, state what he did, why it was wrong and explain how he would change…oh, he also discussed his diagnosis and medications with the other students. His teacher thought they should know. That day I had great difficulty containing myself, especially when in response to my concerns about using punishment as a corrective intervention with students with diagnosed mental health issues i heard that, “every student should be treated the same, fairly.” Otherwise, “what would other students think?”
In none of these classrooms were their any of the well researched classroom management techniques taking place such as token reinforcement systems, visual support systems, use of a "time away" procedure instead of punitive time out (read here to know the difference: http://www.pent.ca.gov/beh/rst/timeaway.pdf Sometimes this is very frustrating. The constant questioning if a student is doing something, "because he wants to" or "because of his disorder." More time is honestly spent trying to answer that question than to figure out what deficits the student has and what skills they need to learn or supports need to be provided. Sometimes we spend a lot of energy in the wrong place.
Let me quote:
“Students with autism spectrum disorders (ASD) present unique challenges to educators trying to plan effective instructional programs…..6 core elements that have empirical support and should be included in any sound, comprehensive instructional program for students With ASD. These core elements are (a) individualized supports and services for students and families, (b) systematic instruction, (c) comprehensible/structured learning environments, (d) specialized curriculum content, (e) functional approach to problem behavior, and (f) family involvement.” (Effective Educational Practices for Students with Autism Spectrum Disorder, Rose Iovannone, SAGE Press.
Our BC Minstry of Education actually does have some guidelines, and those can be found here:
http://www.bced.gov.bc.ca/specialed/docs/autism.pdf If your a parent of a child with ASD I would get a copy of these guidelines.
In spite of these guidelines we find some odd things happening. In the past few years I have visited schools and found “TimeOut” or Isolation Rooms for students with autism. In some cases I can understand this, but these rooms had no rules, no manual of “policies and procedures” to be used, no real limits and seemed to have no purpose. Oddly, in those cases there were not even Functional Behaviour Assessments completed on the students, or Positive Behavioural Support Plans developed. (More on this below) All that existed were “Risk Assessments,” which, if you read the regulations about Risk Assessments you would come to realize they have NOTHING to do with student, and are only used to address danger to staff and other students. "Risk Assessments" which are constantly written up on 5 and 6 year old students here in BC are a Work Place Safety procedure, not an educational procedure. Remember this when they discuss the "Risk Assessment" they have developed on your 6 year old after he punched an aide. About these Time Out rooms, there were no plans, and they were shut immediately. Read these articles if you think this is unusual:
https://ca.news.yahoo.com/blogs/dailybrew/advocates-demand-b-c-schools-end-called-seclusion-213327613.html
http://www.edu.gov.on.ca/eng/general/elemsec/speced/asdfirst.pdf
If your looking for some positive guidelines on what a good program for a student with autism should consist of, try this webpage from the Ministry of Education in Ontario:
http://www.edu.gov.on.ca/eng/general/elemsec/speced/autismSpecDis.htm
And to make the point clear that schools in BC are often simply not prepared to deal with children with ASD/Aspergers/autism here is an interesting blog article about a child in a Langley school who was removed by Work Safe BC because staff were not properly trained! This article, and the outcomes, are shocking.
http://autisminnb.blogspot.ca/2011/04/child-with-autism-removed-from-bc.html
Finally, to understand how backwards and ill prepared BC schools are compared to ANY school in the US, I advise parents to visit this website and see the strengths of the US system, where children are guaranteed a “free and appropriate public education” (FAPE) and schools are legally held to the contracts they sign with parents (IEPs -individual education plans are CONTRACTS). In the US a parent doesn’t need to spend all their money on court costs and have cases go on for a decade, only to have the school district lose but then say the outcome of the case only applied to this one student.
http://www.wrightslaw.com
Here is what I have to say about punishment and students with autism spectrum disorder- especially Asperger’s Disorder:
I understand that there are some situations where a student should experience the same consequences as others. I get that. But a special education student with an IEP is NOT bound to the same school rules as every other student. They are provided appropriate accommodations and supports consistent with their IEP and their handicapping condition.
If a student with Asperger’s or high functioning autism is given punishment, it should be done so in a way that takes into account their mental health condition. A school needs to pay special attention to what might be negative outcomes from an especially sensitive student. For example: Does this punishment increase the student’s ANXIETY, which is a primary symptom of the disorder? Might it lead to school refusal, depression….the list goes on. This needs to be thought about honestly and seriously.
DON’T administer punishments that will only make maters worse. For instance, a teacher told the parent that after a fight the child’s trip to the zoo, in two weeks, should be taken away. It’s unlikely that a punishment one, two or town days later will have any effect.
And ask yourself, is what I am proposing going to be effective? Taking into account that autism spectrum disorder in a disorder of social communications, social understanding and is a neurological disorder?
And then the most important part: No what are YOU, the teacher, teacher, school, parent, going to do about this? Are you going to conduct a Functional Behavioural Assessment? This SHOULD be done before or at the same time a “Risk Assessment” is done. If a child needs a “Risk Assessment” written up on them, ask “Where is the FBA?” and then the plan that comes from it —- the Positive Behavioural Support Plan (PBSP)? If there is no FBA and PBSP then the student’s handicapping condition was ignored. No learning will occur. And you punished for punishment’s sake.
Here in BC the Ministry is clear on the need for an FBA - a Functional behavioural Assessment. Many people think the “Risk Assessment” is about the child. IT IS NOT. If a school district is writing a “Risk Assessment” on your child and has no plan to address the skills your child needs to be taught, they are confused and going down the wrong path. Contact the director of special education or superintendents office in writing and ask about the plan your child really needs.
Foor more information on ADHD, autism spectrum disorder and school related behaviours please feel free to contact my office via my website at www.relatedminds.com
Key Words: Autism, Autism Spectrum Disorder, Vancouver, Burnaby, ASD, Asperger's, Asperger's Disorder, Asperger's Syndrome, School, Punishment, Classroom
But more shocking than how students with ADHD can be is the treatment of children with autism spectrum disorder (ASD) or "Asperger’s Disorder" sometimes called high functioning autism. On my desk right now is a folder of writing assignments I have copied over the years given to students with autism/Asperger's as the result of behavioural issues they have had in the school. They may have hit another child, got in a fight, refused to cooperate or follow rule or yelled something inappropriate. These writing assignments range from a “Behavioural Worksheet” which calls for a student to fill in a blank worksheet that is a problem solving techniques (which I myself have used, with appropriate children) to a list of questions about what the student had done wrong and what he or she will do to make up for their behaviour to a sheet of sentences they needed to copy repeatedly, yes, “ I will not…..” just like Bart Simpson.
Oh, I also have an outline of a public meeting where the student was suppose to take part in a “restitution process” which I was told is based upon a "First nations" way of dealing with conflict…and called for the student, an elementary student with autism spectrum disorder, to make a public apology while standing in front of his entire class, state what he did, why it was wrong and explain how he would change…oh, he also discussed his diagnosis and medications with the other students. His teacher thought they should know. That day I had great difficulty containing myself, especially when in response to my concerns about using punishment as a corrective intervention with students with diagnosed mental health issues i heard that, “every student should be treated the same, fairly.” Otherwise, “what would other students think?”
In none of these classrooms were their any of the well researched classroom management techniques taking place such as token reinforcement systems, visual support systems, use of a "time away" procedure instead of punitive time out (read here to know the difference: http://www.pent.ca.gov/beh/rst/timeaway.pdf Sometimes this is very frustrating. The constant questioning if a student is doing something, "because he wants to" or "because of his disorder." More time is honestly spent trying to answer that question than to figure out what deficits the student has and what skills they need to learn or supports need to be provided. Sometimes we spend a lot of energy in the wrong place.
Let me quote:
“Students with autism spectrum disorders (ASD) present unique challenges to educators trying to plan effective instructional programs…..6 core elements that have empirical support and should be included in any sound, comprehensive instructional program for students With ASD. These core elements are (a) individualized supports and services for students and families, (b) systematic instruction, (c) comprehensible/structured learning environments, (d) specialized curriculum content, (e) functional approach to problem behavior, and (f) family involvement.” (Effective Educational Practices for Students with Autism Spectrum Disorder, Rose Iovannone, SAGE Press.
Our BC Minstry of Education actually does have some guidelines, and those can be found here:
http://www.bced.gov.bc.ca/specialed/docs/autism.pdf If your a parent of a child with ASD I would get a copy of these guidelines.
In spite of these guidelines we find some odd things happening. In the past few years I have visited schools and found “TimeOut” or Isolation Rooms for students with autism. In some cases I can understand this, but these rooms had no rules, no manual of “policies and procedures” to be used, no real limits and seemed to have no purpose. Oddly, in those cases there were not even Functional Behaviour Assessments completed on the students, or Positive Behavioural Support Plans developed. (More on this below) All that existed were “Risk Assessments,” which, if you read the regulations about Risk Assessments you would come to realize they have NOTHING to do with student, and are only used to address danger to staff and other students. "Risk Assessments" which are constantly written up on 5 and 6 year old students here in BC are a Work Place Safety procedure, not an educational procedure. Remember this when they discuss the "Risk Assessment" they have developed on your 6 year old after he punched an aide. About these Time Out rooms, there were no plans, and they were shut immediately. Read these articles if you think this is unusual:
https://ca.news.yahoo.com/blogs/dailybrew/advocates-demand-b-c-schools-end-called-seclusion-213327613.html
http://www.edu.gov.on.ca/eng/general/elemsec/speced/asdfirst.pdf
If your looking for some positive guidelines on what a good program for a student with autism should consist of, try this webpage from the Ministry of Education in Ontario:
http://www.edu.gov.on.ca/eng/general/elemsec/speced/autismSpecDis.htm
And to make the point clear that schools in BC are often simply not prepared to deal with children with ASD/Aspergers/autism here is an interesting blog article about a child in a Langley school who was removed by Work Safe BC because staff were not properly trained! This article, and the outcomes, are shocking.
http://autisminnb.blogspot.ca/2011/04/child-with-autism-removed-from-bc.html
Finally, to understand how backwards and ill prepared BC schools are compared to ANY school in the US, I advise parents to visit this website and see the strengths of the US system, where children are guaranteed a “free and appropriate public education” (FAPE) and schools are legally held to the contracts they sign with parents (IEPs -individual education plans are CONTRACTS). In the US a parent doesn’t need to spend all their money on court costs and have cases go on for a decade, only to have the school district lose but then say the outcome of the case only applied to this one student.
http://www.wrightslaw.com
Here is what I have to say about punishment and students with autism spectrum disorder- especially Asperger’s Disorder:
I understand that there are some situations where a student should experience the same consequences as others. I get that. But a special education student with an IEP is NOT bound to the same school rules as every other student. They are provided appropriate accommodations and supports consistent with their IEP and their handicapping condition.
If a student with Asperger’s or high functioning autism is given punishment, it should be done so in a way that takes into account their mental health condition. A school needs to pay special attention to what might be negative outcomes from an especially sensitive student. For example: Does this punishment increase the student’s ANXIETY, which is a primary symptom of the disorder? Might it lead to school refusal, depression….the list goes on. This needs to be thought about honestly and seriously.
DON’T administer punishments that will only make maters worse. For instance, a teacher told the parent that after a fight the child’s trip to the zoo, in two weeks, should be taken away. It’s unlikely that a punishment one, two or town days later will have any effect.
And ask yourself, is what I am proposing going to be effective? Taking into account that autism spectrum disorder in a disorder of social communications, social understanding and is a neurological disorder?
And then the most important part: No what are YOU, the teacher, teacher, school, parent, going to do about this? Are you going to conduct a Functional Behavioural Assessment? This SHOULD be done before or at the same time a “Risk Assessment” is done. If a child needs a “Risk Assessment” written up on them, ask “Where is the FBA?” and then the plan that comes from it —- the Positive Behavioural Support Plan (PBSP)? If there is no FBA and PBSP then the student’s handicapping condition was ignored. No learning will occur. And you punished for punishment’s sake.
Here in BC the Ministry is clear on the need for an FBA - a Functional behavioural Assessment. Many people think the “Risk Assessment” is about the child. IT IS NOT. If a school district is writing a “Risk Assessment” on your child and has no plan to address the skills your child needs to be taught, they are confused and going down the wrong path. Contact the director of special education or superintendents office in writing and ask about the plan your child really needs.
Foor more information on ADHD, autism spectrum disorder and school related behaviours please feel free to contact my office via my website at www.relatedminds.com
http://www.psychologists.bc.ca/users/jimroche
Key Words: Autism, Autism Spectrum Disorder, Vancouver, Burnaby, ASD, Asperger's, Asperger's Disorder, Asperger's Syndrome, School, Punishment, Classroom
Saturday, November 8, 2014
Is the Best Treatment for Teens with Asperger's or Autism Social Skills?
Looking at several websites I find that the most often suggested treatment (counselling or therapy) for teens with Asperger's Disorder or teens with "high functioning autism" is usually social skills training. While the websites often seem to be produced by people who should be familiar with treatment for teens with Asperger's or autism spectrum disorder, they demonstrate a misunderstanding of the disorder right from the start. From the "My Aspergers Child" webpage here are the goals for social skills training for helping kids and teens with Aspergers:
1. read body language of others
2. play and have fun
3.learn to cope with mistakes
4. learn strategies for developing peer relationships
5.learn peer group problem solving
6. become aware of their emotions
And it then follows with this statement, " Aspergers kids are pliable to treatment because they tend to be compliant." All of this seems to run counter to what I experience day to day with kids and teens with Asperger's or high functioning autism. As a trainer and consultant with many school districts ( I am also a member of the BC RASP and an approved Behavioural Specialist with the ministry) I hear kids with Asperger's are difficult for those teaching social skills because of their lack of cognitive flexibility and ritualistic behaviour. So I spend much of my time trying to distinguish for these educational partners the difference between a "social skills" group and a "social learning" group. Thinking teens with Asperger's need, most of all, social skills training is to be going down the wrong neurological pathway.
Where can one turn for ideas and techniques to use with teens with Asperger's and high functioning autism? Turn to the web page social thinking.com This website is about the work of a speech pathologist Michelle Garcia Winner who has a clinic in San Jose, California. She has trained most professionals working with teens with Asperger's here in the Northwest and BC, including myself. And notice she is a speech pathologist. That's because Asperger's or high functioning autism is not a disorder of social skills - many of these kids and teens can tell you all you ever want to know about social skills, instead it is a disorder of communications and executive functioning. Yes, developmentally BECAUSE of Asperger's or autism your teen may have missed out on experiencing and learning developmentally appropriate social skills, and those need to be reviewed. But at the heart of the matter are the child's social-cognitive-speech deficits. And that's where treatment should start.
When you visit Michelle's web page you will see many many social cognitive directed books, training manuals for teachers and posters, stories, all you need. These are the materials I use with children with Aspergers, teens with Asperger's and yes, my work with adults with Asperger's disorder.
Here is an outline of what treatment for a child, teen or adult with Asperger's Disorder should look like, a brief synopsis of Michelle's model from her web page found here: https://www.socialthinking.com/what-is-social-thinking/the-ilaugh-model
H= Humor and Human Relatedness (Gutstein, 2001; Greenspan, & Wieder, 2003; Prizant, Wetherby, Rubin, Laurent & Rydell, 2006)
Most individuals with autism spectrum disorders, Asperger’s and similar challenges have good senses of humor, but they feel anxious since they miss many of the subtle cues that help them understand how to participate successfully with others. It is important for educators and parents to work compassionately and with humor to help minimize the anxiety these children are experiencing. At the same time, many of our clients use humor inappropriately; direct lessons about this topic are needed and relevant.
Human relatedness - the ability to bond emotionally with others - is at the heart of human social relationships and the fuller development of empathy and emotional regulation. Teaching students how to relate and respond to other people’s emotions as well as their own, while also helping them feel the enjoyment that arises through mutual sharing, is critical to the development of all other aspects of social development. " (selection taken from the above webpage)
Books related to the above discussion include:
1. read body language of others
2. play and have fun
3.learn to cope with mistakes
4. learn strategies for developing peer relationships
5.learn peer group problem solving
6. become aware of their emotions
And it then follows with this statement, " Aspergers kids are pliable to treatment because they tend to be compliant." All of this seems to run counter to what I experience day to day with kids and teens with Asperger's or high functioning autism. As a trainer and consultant with many school districts ( I am also a member of the BC RASP and an approved Behavioural Specialist with the ministry) I hear kids with Asperger's are difficult for those teaching social skills because of their lack of cognitive flexibility and ritualistic behaviour. So I spend much of my time trying to distinguish for these educational partners the difference between a "social skills" group and a "social learning" group. Thinking teens with Asperger's need, most of all, social skills training is to be going down the wrong neurological pathway.
Where can one turn for ideas and techniques to use with teens with Asperger's and high functioning autism? Turn to the web page social thinking.com This website is about the work of a speech pathologist Michelle Garcia Winner who has a clinic in San Jose, California. She has trained most professionals working with teens with Asperger's here in the Northwest and BC, including myself. And notice she is a speech pathologist. That's because Asperger's or high functioning autism is not a disorder of social skills - many of these kids and teens can tell you all you ever want to know about social skills, instead it is a disorder of communications and executive functioning. Yes, developmentally BECAUSE of Asperger's or autism your teen may have missed out on experiencing and learning developmentally appropriate social skills, and those need to be reviewed. But at the heart of the matter are the child's social-cognitive-speech deficits. And that's where treatment should start.
When you visit Michelle's web page you will see many many social cognitive directed books, training manuals for teachers and posters, stories, all you need. These are the materials I use with children with Aspergers, teens with Asperger's and yes, my work with adults with Asperger's disorder.
Here is an outline of what treatment for a child, teen or adult with Asperger's Disorder should look like, a brief synopsis of Michelle's model from her web page found here: https://www.socialthinking.com/what-is-social-thinking/the-ilaugh-model
" I = Initiation of Communication (Kranz & McClannahan, 1993)
Initiation of communication is the ability to use one’s language skills to establish social relations and to seek assistance or information from others. Many students with autism spectrum disorders have significant problems initiating communication in stressful situations or when information is not easily understood. Language retrieval is difficult in anything other than calm, secure situations. Even within the higher functioning population with autism spectrum disorders, the student’s ability to talk about a favorite topic of interest can exist in sharp contrast to how that student communicates when needing help or when attempting to gain social entry into peer groups. Yet, these two skills – asking for help and understanding how to join a group for functional or personal interaction - are paramount for any student’s future success.
L= Listening With Eyes and Brain (Mundy & Crowson, 1997; Kunce and Mesibov, 1998; Jones & Carr, 2004)
Many persons with autism spectrum disorders and other social cognitive deficits have difficulty with auditory comprehension. From a social perspective, listening requires more than just taking in auditory information. It also requires the person to integrate information seen with that which is heard, to understand the full meaning of the message being conveyed, or to make an educated guess about what is being said when one cannot clearly understand it. For example, classroom teachers expect students to “listen with their eyes” when they point to information that is part of the instruction. They also indicate to whom they are speaking in a class, not by calling the student’s name but instead by looking at the student or moving closer. Students repeatedly relate to their peers through nonverbal cues, ranging from rolled eyes to signal boredom, to raised eyebrows to indicate questioning, to gazing at a particular item to direct a peer’s attention. Clearly to “listen with one’s eyes” requires students to have mastered the concept of joint attention – a skill that seems to effortlessly develop by the time a child is 12 months to 15 months old in neurotypical children, but may be missing from the social repertoire of the student with autism spectrum disorders, ADHD and similar challenges. Instruction in this essential and fundamental function of social interaction begins with teaching students that eyes share social information. Not all students understand this concept, nor do they grasp that listening requires full attention to both verbal and nonverbal cues. It can then expand to teaching students to relate to each other’s thoughts through play and other activities of social relatedness, followed by extending the student’s realm to attending to and processing increasingly complex cues that help students “listen with their whole bodies.”
A = Abstract and Inferential Language/Communication (Minshew, Goldstein, Muenz & Payton, 1992)
Most of the language we use is not intended for literal interpretation. Our communication is peppered with idioms, metaphors, sarcasm and inferences. Societies around the world bestow awards to writers, and even comedians, who are most creative with language. Each generation of teens creates its own slang; kids who follow along are in; those who don’t, are often out. Advertising and other forms of mass media follow these cues. The abstract and inferential component of communication is huge and constantly in flux. It is a mistake to assume that our students with social thinking deficits understand our society’s non-literal use of language. In fact, most of them don’t! Literal interpretation of language is a hallmark characteristic of individuals with ASD. Yet, as educators and parents, we either miss this impairment entirely – thinking our smart kids must understand our nuanced communication - or we address it in the briefest of ways, with instruction dedicated only to explaining idioms, irony and metaphors as part of English class.
Accurate comprehension of a communicative message depends first on the basic recognition that two codes of language exist: literal and figurative. It also involves recognizing and interpreting both the verbal words and the nonverbal cues that accompany them. It requires an individual to place the communication within the context of the social and cultural environment within which it occurs. Furthermore, the listener must take into consideration any prior knowledge or history involved and the possible motives of the person initiating the message. Finally, emotional maturity and social development factor into how well a person interprets what is being said.
Active interpretation of the motives and intentions of others emerges in the first year of life and expands in complexity thereafter. Children learn that mom’s tone of voice speaks volumes and that attention to only her words can miss much of her message. As children grow developmentally, they understand that message interpretation depends heavily on one’s ability to “make a smart guess” based on past experiences, what they know (or don’t know) about the current person and situation and the communication clues available. Language users assume their communicative partners are trying to figure out their messages. By third grade, neurotypical students understand that we are to infer meaning rather than expect it to be coded literally.
Abstract and inferential language comprehension appears to be directly tied to a person’s ability to quickly and flexibly discern the different thoughts, perceptions and motives of other people – in essence to “read the mind” of another from a social perspective.
For example, a 17 year-old teenager with high-functioning autism was visiting this author at her house. When the author tried to strike up a conversation with the teenager by saying to him, “I hear you are in the school choir”, the teen responded with, “No, I am in your house.” This is not sarcasm, but literal language interpretation.
Students who fail to expeditiously interpret the abstract/inferential meaning of language also struggle with academic tasks such as reading comprehension, especially that which requires interpreting a character’s thoughts and actions based on the context of the story and what one understands about the character’s history and motives. Without the benefit of real-world experience, these students are unable to imagine how characters might think, feel and act within the story.
U = Understanding Perspective (Baron-Cohen & Jolliffe, 1997; Baron-Cohen, 2000)
To understand the differing perspectives of others requires that one’s Theory of Mind (perspective taking) work quickly and efficiently. Most neurotypical students acquire a solid foundation in ToM between the ages of 4 to 6 years old. Perspective taking is not one thing, it represents many things happening all at once meaning it is a synergistic and dynamic process. A definition of perspective taking can include the ability to consider your own and others:
Initiation of communication is the ability to use one’s language skills to establish social relations and to seek assistance or information from others. Many students with autism spectrum disorders have significant problems initiating communication in stressful situations or when information is not easily understood. Language retrieval is difficult in anything other than calm, secure situations. Even within the higher functioning population with autism spectrum disorders, the student’s ability to talk about a favorite topic of interest can exist in sharp contrast to how that student communicates when needing help or when attempting to gain social entry into peer groups. Yet, these two skills – asking for help and understanding how to join a group for functional or personal interaction - are paramount for any student’s future success.
L= Listening With Eyes and Brain (Mundy & Crowson, 1997; Kunce and Mesibov, 1998; Jones & Carr, 2004)
Many persons with autism spectrum disorders and other social cognitive deficits have difficulty with auditory comprehension. From a social perspective, listening requires more than just taking in auditory information. It also requires the person to integrate information seen with that which is heard, to understand the full meaning of the message being conveyed, or to make an educated guess about what is being said when one cannot clearly understand it. For example, classroom teachers expect students to “listen with their eyes” when they point to information that is part of the instruction. They also indicate to whom they are speaking in a class, not by calling the student’s name but instead by looking at the student or moving closer. Students repeatedly relate to their peers through nonverbal cues, ranging from rolled eyes to signal boredom, to raised eyebrows to indicate questioning, to gazing at a particular item to direct a peer’s attention. Clearly to “listen with one’s eyes” requires students to have mastered the concept of joint attention – a skill that seems to effortlessly develop by the time a child is 12 months to 15 months old in neurotypical children, but may be missing from the social repertoire of the student with autism spectrum disorders, ADHD and similar challenges. Instruction in this essential and fundamental function of social interaction begins with teaching students that eyes share social information. Not all students understand this concept, nor do they grasp that listening requires full attention to both verbal and nonverbal cues. It can then expand to teaching students to relate to each other’s thoughts through play and other activities of social relatedness, followed by extending the student’s realm to attending to and processing increasingly complex cues that help students “listen with their whole bodies.”
A = Abstract and Inferential Language/Communication (Minshew, Goldstein, Muenz & Payton, 1992)
Most of the language we use is not intended for literal interpretation. Our communication is peppered with idioms, metaphors, sarcasm and inferences. Societies around the world bestow awards to writers, and even comedians, who are most creative with language. Each generation of teens creates its own slang; kids who follow along are in; those who don’t, are often out. Advertising and other forms of mass media follow these cues. The abstract and inferential component of communication is huge and constantly in flux. It is a mistake to assume that our students with social thinking deficits understand our society’s non-literal use of language. In fact, most of them don’t! Literal interpretation of language is a hallmark characteristic of individuals with ASD. Yet, as educators and parents, we either miss this impairment entirely – thinking our smart kids must understand our nuanced communication - or we address it in the briefest of ways, with instruction dedicated only to explaining idioms, irony and metaphors as part of English class.
Accurate comprehension of a communicative message depends first on the basic recognition that two codes of language exist: literal and figurative. It also involves recognizing and interpreting both the verbal words and the nonverbal cues that accompany them. It requires an individual to place the communication within the context of the social and cultural environment within which it occurs. Furthermore, the listener must take into consideration any prior knowledge or history involved and the possible motives of the person initiating the message. Finally, emotional maturity and social development factor into how well a person interprets what is being said.
Active interpretation of the motives and intentions of others emerges in the first year of life and expands in complexity thereafter. Children learn that mom’s tone of voice speaks volumes and that attention to only her words can miss much of her message. As children grow developmentally, they understand that message interpretation depends heavily on one’s ability to “make a smart guess” based on past experiences, what they know (or don’t know) about the current person and situation and the communication clues available. Language users assume their communicative partners are trying to figure out their messages. By third grade, neurotypical students understand that we are to infer meaning rather than expect it to be coded literally.
Abstract and inferential language comprehension appears to be directly tied to a person’s ability to quickly and flexibly discern the different thoughts, perceptions and motives of other people – in essence to “read the mind” of another from a social perspective.
For example, a 17 year-old teenager with high-functioning autism was visiting this author at her house. When the author tried to strike up a conversation with the teenager by saying to him, “I hear you are in the school choir”, the teen responded with, “No, I am in your house.” This is not sarcasm, but literal language interpretation.
Students who fail to expeditiously interpret the abstract/inferential meaning of language also struggle with academic tasks such as reading comprehension, especially that which requires interpreting a character’s thoughts and actions based on the context of the story and what one understands about the character’s history and motives. Without the benefit of real-world experience, these students are unable to imagine how characters might think, feel and act within the story.
U = Understanding Perspective (Baron-Cohen & Jolliffe, 1997; Baron-Cohen, 2000)
To understand the differing perspectives of others requires that one’s Theory of Mind (perspective taking) work quickly and efficiently. Most neurotypical students acquire a solid foundation in ToM between the ages of 4 to 6 years old. Perspective taking is not one thing, it represents many things happening all at once meaning it is a synergistic and dynamic process. A definition of perspective taking can include the ability to consider your own and others:
- Thoughts
- Emotions
- Physically coded intentions
- Language based intentions
- Prior knowledge and experiences
- Belief systems
- Personality
- While considering all of this with regards to the specific situation being considered.
Perspective taking is required any time you are in the presence of other people, even when you are not talking to them. Responding to another person’s perspective while communicating with them requires you do all of the above in relative light-speed, processing and responding your own as well as other’s thoughts within milliseconds to two seconds. The process can be overwhelming to those with social learning challenges, even if they are very bright.
The ability to take perspective is key to participation in any type of group (social or academic) as well as interpreting information that requires understanding of other people’s minds, such as reading comprehension, history, social studies, etc. Weakness in perspective taking is a significant aspect of ASD and other social cognitive deficits. However, like all other concepts explored in the ILAUGH model, one’s ability to take perspective is not a black or white matter. There is a vast range of perspective taking skills across the autism spectrum (Winner, 2004)
G=Gestalt Processing/Getting the Big Picture (Shah & Frith, 1993; Fullerton, Stratton, Coyne & Gray, 1996)
The ability to take perspective is key to participation in any type of group (social or academic) as well as interpreting information that requires understanding of other people’s minds, such as reading comprehension, history, social studies, etc. Weakness in perspective taking is a significant aspect of ASD and other social cognitive deficits. However, like all other concepts explored in the ILAUGH model, one’s ability to take perspective is not a black or white matter. There is a vast range of perspective taking skills across the autism spectrum (Winner, 2004)
G=Gestalt Processing/Getting the Big Picture (Shah & Frith, 1993; Fullerton, Stratton, Coyne & Gray, 1996)
Information is conveyed through concepts, not just facts. When involved in conversation, the participants intuitively determine the underlying concept being discussed. When reading a book of literature, the purpose is to follow the overall meaning (concept) rather than just collect a series of facts. Conceptual processing is a key component to understanding social and academic information. Difficulty developing organizational strategies cannot be isolated from conceptual processing. Students with conceptual processing challenges often have difficulties with written expression, organizational skills, time management and being overly tangential in their social relations. (All of these concepts require us to stay focused on a central theme or main idea and to keep our writing, discussions or planning focused to this central point. Many of our folks struggle with this, over-focusing on details and not focusing in the concept (an intuitive skills for neurotypicals).
H= Humor and Human Relatedness (Gutstein, 2001; Greenspan, & Wieder, 2003; Prizant, Wetherby, Rubin, Laurent & Rydell, 2006)
Most individuals with autism spectrum disorders, Asperger’s and similar challenges have good senses of humor, but they feel anxious since they miss many of the subtle cues that help them understand how to participate successfully with others. It is important for educators and parents to work compassionately and with humor to help minimize the anxiety these children are experiencing. At the same time, many of our clients use humor inappropriately; direct lessons about this topic are needed and relevant.
Human relatedness - the ability to bond emotionally with others - is at the heart of human social relationships and the fuller development of empathy and emotional regulation. Teaching students how to relate and respond to other people’s emotions as well as their own, while also helping them feel the enjoyment that arises through mutual sharing, is critical to the development of all other aspects of social development. " (selection taken from the above webpage)
Books related to the above discussion include:
- Inside Out: What Makes a Person with Social Cognitive Deficits Tick?
- Thinking About YOU Thinking About ME, 2nd Edition
If you have a child, teen or you are an adult with Asperger's disorder of High Functioning Autism (HFA) I urge you to click on the link above and visit her web page. This is basic and essential knowledge that should be at the forefront of any treatment program. I cannot recommend her books enough!
Are there other issues that teens with Asperger's need to deal with?
Yes, just like any teen, teens with Asperger's disorder can suffer from anxiety, stress, depression...learning disabilities or ADHD. They can have a mood disorder or a speech disorder. When finding a clinician to work with your child make sure they are capable of dealing with these issues- and have experience dealing with them from the point of view of someone with Asperger's or autism spectrum disorder. The treatment for an individual with Aspeger's needs to come from knowledge about the neurological implications of the disorder.
One final note: Most of the teens and young adults I see in my private practice are doing well in many areas of life. Parents often feel overwhelmed and hopeless when they get their child's diagnosis. Most of the adults I see having problems with depression, anxiety or relationship issues have good paying jobs, have attended college or university, many..if not most..of my clients with Asperger's have graduate degrees and significant careers. Like the rest of us, sometimes they need a little support in life. But our expectations should be high.
Please feel free to contact me about autism spectrum disorder or Asperger's disorder. I provide testing and diagnosis for the Ministry of Family Services, help with educational planning, provide couples, marriage and family counselling and see individuals for supportive therapy and coaching. My website is at: www.relatedminds.com or http://www.relatedminds.com/autism/
KEYWORDS: Aspergers, Asperger's Disorder, autism spectrum disorder, teen, adult, therapy, counselling, Vancouver, Burnaby, Seattle, behaviour interventionist, psychologist
KEYWORDS: Aspergers, Asperger's Disorder, autism spectrum disorder, teen, adult, therapy, counselling, Vancouver, Burnaby, Seattle, behaviour interventionist, psychologist
Monday, October 20, 2014
Adult Autism Testing and Assessment
In my offices in Vancouver and Burnaby I complete assessments / testing for Aspergers and Autism Spectrum Disorder. While until recently these were two different diagnoses they are now, in the DSM-5, combined and what we all would have agreed was "Asperger's Disorder" or "Asperger's Syndrome" last year this year is referred to as Autism Spectrum Disorder - a disorder on the autism spectrum.
My practice has focused on teens, young adults and adults with Aspeger's for the past 20 years, since I worked in Souther California and received training in treating Asperger's from Michelle winner through my local school district where I served as the behaviour management specialist.
Why get a diagnosis?
First, I don't always suggest getting a full diagnosis. The problem is the cost. This is not a simple process like going to the doctor to get a diagnosis of a cold or flu. There are many complicating factors and possible causes for Asperger's Disorder/Autism Disorder like symptoms in an adult. These can include a personality disorder, depression, anxiety, OCD or other neurological issue.
This means a couple of days of testing using state of the art methods. I follow the same criteria which the province of British Columbia has set forth for diagnosing children: The ADOS (Autism Diagnostic Observation System) and the ADI-R (Autism Diagnostic Inventory-Revised) as the heart of the Asperger's/Autism diagnosis, along with scales and tests that address depression, anxiety, OCD and personality issues. While in some situations someone might use just one test or checklist, this is insufficient for two reasons: First, legally the diagnosis is used to obtain many benefits and legal accommodations, and 2) A good number of individuals with Asperger's/Autism have comorbid conditions such as depression, anxiety or ADHD. ADHD (Attention Deficit Hyperactivity Disorder) is a common comorbid condition, and not properly treating these disorders, sometimes FIRST, can make treating Asperger's or autism difficult or impossible.
Should you get a formal diagnosis? If you can, yes. Go to your GP and ask for a referral to a psychologist or psychiatrist who is familiar with Asperger's / Autism and move forward.
What would symptoms look like?
Most individuals with Asperger's/Autism have difficulty with social communication, difficulty with social interactions, difficulty with social imagination and some repetitive, hyper focused behaviours or thinking processes.
You may want a diagnosis as an adult who potentially has Asperger's or autism spectrum disorder in order to understand yourself, to help you understand your behaviours and difficulties, and to help you understand how treatment - much of it psychoeducation and coaching - can help you.
How much does an assessment cost?
It varies from individual to individual, but usually around $1,200.00 for a full assessment. Some individuals also need a psychoeducational assessment to get appropriate accommodations at college or on the job. That can be an additional few hundred dollars.
How long does the assessment take?
We usually meet for an initial session to go over current symptoms and problems you are having, get to know each other, and gather a medical and behavioural history. Sometimes people make a choice to move right into some type of treatment to address immediate issues, such as problems at work or with a friend or spouse. The assessment usually calls for two more sessions of face to face time, about 2 hours each, and the collection of data from people who have known you for some time. We especially want to talk to someone who knew you at an early age, as the diagnosis release heavily upon behaviour patterns you had at an early age. Usually this entire process is done in 2 weeks.
How long does it take to make an appointment?
I usually see patients for Asperger's and autism assessments within a week to 10 days. I leave a good deal of my time open for adult Asperger's and autism assessment and treatment because I know there are very few practitioners around with the tools, skills and background in the field to help everyone in need.
What's the next step?
The next step would be looking over my web page at www.relatedminds.com and then contacting me by phone or email. Phone is preferred, and it's best not to send extensive personal information over the internet.
Is this covered by insurance?
For my patients in Washington State, usually it is, however you need to contact your provider first. Payments are made at the time of the sessions and you will be reimbursed by your insurance company. But check your coverage! For patients in British Columbia MSP - the government sponsored health care plan - does not cover psychological services. Your extended health care plan may, however each plan is different. Some cover the entire cost, some a minimal amount. Check first.
Some local colleges and universities in BC also pay for services for students. Check with your student health plan provider.
You can find out more about me and my practice at the following webpages:
My practice has focused on teens, young adults and adults with Aspeger's for the past 20 years, since I worked in Souther California and received training in treating Asperger's from Michelle winner through my local school district where I served as the behaviour management specialist.
Why get a diagnosis?
First, I don't always suggest getting a full diagnosis. The problem is the cost. This is not a simple process like going to the doctor to get a diagnosis of a cold or flu. There are many complicating factors and possible causes for Asperger's Disorder/Autism Disorder like symptoms in an adult. These can include a personality disorder, depression, anxiety, OCD or other neurological issue.
This means a couple of days of testing using state of the art methods. I follow the same criteria which the province of British Columbia has set forth for diagnosing children: The ADOS (Autism Diagnostic Observation System) and the ADI-R (Autism Diagnostic Inventory-Revised) as the heart of the Asperger's/Autism diagnosis, along with scales and tests that address depression, anxiety, OCD and personality issues. While in some situations someone might use just one test or checklist, this is insufficient for two reasons: First, legally the diagnosis is used to obtain many benefits and legal accommodations, and 2) A good number of individuals with Asperger's/Autism have comorbid conditions such as depression, anxiety or ADHD. ADHD (Attention Deficit Hyperactivity Disorder) is a common comorbid condition, and not properly treating these disorders, sometimes FIRST, can make treating Asperger's or autism difficult or impossible.
Should you get a formal diagnosis? If you can, yes. Go to your GP and ask for a referral to a psychologist or psychiatrist who is familiar with Asperger's / Autism and move forward.
What would symptoms look like?
Most individuals with Asperger's/Autism have difficulty with social communication, difficulty with social interactions, difficulty with social imagination and some repetitive, hyper focused behaviours or thinking processes.
You may want a diagnosis as an adult who potentially has Asperger's or autism spectrum disorder in order to understand yourself, to help you understand your behaviours and difficulties, and to help you understand how treatment - much of it psychoeducation and coaching - can help you.
How much does an assessment cost?
It varies from individual to individual, but usually around $1,200.00 for a full assessment. Some individuals also need a psychoeducational assessment to get appropriate accommodations at college or on the job. That can be an additional few hundred dollars.
How long does the assessment take?
We usually meet for an initial session to go over current symptoms and problems you are having, get to know each other, and gather a medical and behavioural history. Sometimes people make a choice to move right into some type of treatment to address immediate issues, such as problems at work or with a friend or spouse. The assessment usually calls for two more sessions of face to face time, about 2 hours each, and the collection of data from people who have known you for some time. We especially want to talk to someone who knew you at an early age, as the diagnosis release heavily upon behaviour patterns you had at an early age. Usually this entire process is done in 2 weeks.
How long does it take to make an appointment?
I usually see patients for Asperger's and autism assessments within a week to 10 days. I leave a good deal of my time open for adult Asperger's and autism assessment and treatment because I know there are very few practitioners around with the tools, skills and background in the field to help everyone in need.
What's the next step?
The next step would be looking over my web page at www.relatedminds.com and then contacting me by phone or email. Phone is preferred, and it's best not to send extensive personal information over the internet.
Is this covered by insurance?
For my patients in Washington State, usually it is, however you need to contact your provider first. Payments are made at the time of the sessions and you will be reimbursed by your insurance company. But check your coverage! For patients in British Columbia MSP - the government sponsored health care plan - does not cover psychological services. Your extended health care plan may, however each plan is different. Some cover the entire cost, some a minimal amount. Check first.
Some local colleges and universities in BC also pay for services for students. Check with your student health plan provider.
You can find out more about me and my practice at the following webpages:
http://www.psychologists.bc.ca/users/jimroche
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