Behaviour Interventionist Vancouver

Dr. Roche provides behavioural intervention services in both his Vancouver office, located near City Hall in Vancouver (corner of Yukon and 8th Ave West) and his Burnaby office. He is an approved behaviour interventionist with ACTBC (Autism Community Training - BC) and has over 20 years of experience providing behavioural interventions and treatment planning for children, adolescents and adults with autism spectrum disorder and Aspeger's disorder, as well as other cognitive dysfunctions. Dr. Roche specializes in providing behavioural training to parents and schools and has worked with parents, teachers and other professionals throughout the province as a provincial autism outreach worker. As an approved behavioural interventionist he is able to accept provincial payments for his services. 

Dr. Roche also provides comprehensive diagnostic assessments for children, adolescents and adults who are suspected to have autism. This includes psychoeducational assessments for use in the schools to develop IEPs (Individual Education Plans) and behaviour management plans. 

Please use the contact form on the home page of the website to contact Dr. Roche and make an appointment for assessment, counselling or therapy in either his Vancouver or Burnaby office.

Please visit my web page at www.relatedminds.com for more information.

Why is there a decrease in autism/Aspeger's diagnosis rate with the new DSM-5?

A new study, published in the Journal of the American Academy of Child and Adolescent Psychiatry finds that the number of cases of "autism," would decrease now that the diagnostic requirements have been changed. Overall researchers found that 83 percent of the children who had received a diagnosis of autism under the criteria of the DSM IV would still fall under that category in the DSM-5. The remaining 14% would be diagnosed with social communications disorder or SCD. This study can be found here: http://www.jaacap.com/article/S0890-8567(14)00044-6/fulltext

This study helps us understand the recent findings at the US Center for Disease Control and prevention which found that lower rates would be around 10%.

What is social communications disorder (SCD) and how does it relate to autism and Asperger's Disorder? 

This new diagnosis is part of the revision of the DSM- Diagnostic and Statistical Manual. SCD can best be described as individuals who have social and communications difficulty without the repetitive behaviours and restrict interests that many typically associate with high functioning autism or Asperger's Syndrome (often called Asperger's Disorder). 

Of those children previously diagnosed with Asperger's Disorder 91% would still get the autism diagnosis - Asperger's Disorder and autism spectrum disorder have now been combined into one category.  6% of these individuals would be diagnosed with with social communications disorder and 3% with another disorder.

Why has this happened? Mostly to assist research, and to attempt to separate one distinct disorder from another. The problem is that most services provided by government agencies require a specific diagnosis, and this small group would now not make that diagnosis. Will they be denied funds and services? Hopefully not, but this is an issue for mental health agencies, governments and our government representatives to fix. Not those who write the DSM. 

There is clearly the same level of disability in many cases, and for the most part behavioural, social and educational treatments are the same. So action needs to be taken on changing the guidelines for funding, and not on artificially changing the guidelines for science, which we need to remain clear to further support research.

Does a child with a serious social communications disorder deserve less funding, fewer services and lower levels of support than a similar child with an ASD diagnosis? No. Do they both benefit from services to the same degree? I would think so, but truthfully there needs now to be further study if treatments should differ by diagnosis.

But the truth is children with ASD or SCD more often than not have other complex co-morbid conditions, and these children need out support. I suggest we all contact those in government who make financial decision and make sure those decisions are based on science, need and effectiveness.

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If you are interested in contacting me about my practice in the field of Aspeger's Disorder or Autism Spectrum Disorder I have offices in both Burnaby, BC and Vancouver, BC. more information can be found at my website: http://www.relatedminds.com or http://www.relatedminds.com/autism/

I provide diagnostic services for children, adolescents and adults with autism and Asperger's Disorder as well as behavioural and communications training. Treatment and support services for teens and young adults in the workplace is one of the focuses of my practice.

http://psychologists.bc.ca/users/jimroche

Adult Aspeger's Syndrome | Adult Aspeger's Disorder

For almost 20 years I have been specializing in work with individuals with Asperger's Syndrome or Aspegers Disorder here in British Columbia and in California. Much of my work has been with parts of the population not seen by other mental health providers, children and adolescents with extreme behavioural problems, and young adults and adults who are experiencing difficulties at home, work or socially because of Aspeger's symptoms.  

Asperger syndrome is one of the autism spectrum disorders, or was until the new DSM-5 put all of these disorders together on one single spectrum. It was classified as a developmental disorder that affects how the brain processes information. In this case, social information. Getting the point of interactions, understanding what's in other people's heads. It's funny, because normally we talk about "being in someone else's head" as a bad thing, but the truth is it is hard to communicate without having a real understand of what the others in your conversation are thinking. We sometimes call this "social thinking" or "perspective taking" or even "pragmatic language." Someone with Asperger's may have this problem to a slight degree, or to a great degree. It really is different from person to person, however the main concepts of treatment - teaching these skills - remains the same. All in all people with Asperger syndrome have a wide range of strengths, weaknesses, skills and difficulties. 

Common problems adults come to see me for include difficulty in forming friendships, communication difficulties (such as a tendency to take things literally), an inability to understand social rules and body language and often the associated anxiety one would expect to have if you aren't sure what others around you are thinking! 

Although Asperger syndrome cannot be cured, appropriate intervention and experience can help individuals to develop these communications skills. I avoid saying "social skills" because far too often children and teens with Aspergers are sent to "social skills" groups which are inappropriate, as they are aimed at simply teaching social skills (you can learn those from a book) instead of focusing on the communications or language deficit that is really going on. Learning compensatory strategies and help build up coping skills. And talking with someone who understands the problem and it's relationship to anxiety, depression and obsessive thoughts can be very helpful. 

Counselling or psychological therapy (including modified Cognitive Behaviour Therapy) can help people with Asperger syndrome understand and manage their behavioural responses and learn to live a calmer, less anxious and better understanding life.

Many adults with Asperger syndrome can successfully maintain relationships and parent children. However, like most relationships, there are challenges. Much of my time is spent working with couples and families, teaching them how to navigate this neurological disorder and create an environment and way of communicating that helps ease them all through the day.

An adult’s diagnosis of Asperger syndrome often follows their child’s diagnosis of autism spectrum disorder. This can be a very difficult time for both partners, as now the "neurotypical" spouse may feel very alone, and worried about what the future holds. We deal with these issues in couples counselling, and psychoeducation - learning the science based techniques to deal with the symptoms and the situations you find yourself in. 

Most of my patients with Aspeger's syndrome /Asperger's Disorder are fairly successful in life, especially at work. Some are HIGHLY successful, but the influence off the symptoms becomes stronger after the birth of a child, or a change in living arrangements.  Some person with Asperger syndrome may find their job opportunities limited by their disability. It may help to choose a vocation that takes into account their symptoms, and capitalises on their strengths rather than highlights their weaknesses.  At any rate, Asperger's Disorder is not something that goes away after childhood, it is a neurological disorder, language/communications based, which can be treated, but not cured.

Two excellent books I often recommend to my teens and adults with Asperger's are:  "The Journal of Best Practices: A Memoir of Marriage, Aspeger's Syndrome and One Man's Quest to be A Better Husband," by David Finch, and for teens and young adults, "Socially Curious and Curiously Social,: by Michelle Garcia Winner.

If you are interested in contacting me about my practice in the field of Aspeger's Disorder or Autism Spectrum Disorder I have offices in both Burnaby, BC and Vancouver, BC. More information can be found at my website: http://www.relatedminds.com or http://www.relatedminds.com/autism/

http://psychologists.bc.ca/users/jimroche