Showing posts with label adult autism. Show all posts
Showing posts with label adult autism. Show all posts
Sunday, November 27, 2016
Diagnostic Autism Assessments for Children, Teens and Adults: Burnaby, Vancouver, Coquitlam
Dr. Jim Roche provides diagnostic assessments for Autism Spectrum Disorder for children over 6 to adults. Dr. Roche has been working in the filed of autsim and Asperger's for over 25 years. He has been a teacher, educational psychologist and consultant in the field in California, New York and British Columbia. For more information on assessments or treatment od autism spectrum disorder visit his website at www.relatedminds.com, https://therapists.psychologytoday.com/70682 or at http://www.psychologists.bc.ca/users/jimroche
Saturday, July 9, 2016
Autism Diagnosis and Treatment in Vancouver, Burnaby, Coquitlam: Child, Teen and Adult
I provide diagnostic services for individuals suspected of having autism spectrum disorder, ASD (formerly called Aspergers Disorder). This includes diagnostic services for children under 19 to obtain ministry funding and qualify for school-based support services.
Additionally I see many adults for suspected autism disorder, and have worked with adults with ASD or "Asperger's" for over 25 years. This includes working on issues of social cognition, social learning, employment, higher education and various legal issues.
I have served as the behaviour management specialist for several school districts, worked as a teacher of children with autism, as a school psychologist and as a clinical psychologist in the field. The focus of much of my work is on "social learning" and applying the techniques and methods of Michelle Garcia Winner to adults. I advise all parents, teens and adults dealing with issues in this area to look over Mitchell's wonderful site and her curriculum materials at www.socialthinking.com
For more information of autism related services that I provide please visit my website at www.relatedminds.com
Additionally I see many adults for suspected autism disorder, and have worked with adults with ASD or "Asperger's" for over 25 years. This includes working on issues of social cognition, social learning, employment, higher education and various legal issues.
I have served as the behaviour management specialist for several school districts, worked as a teacher of children with autism, as a school psychologist and as a clinical psychologist in the field. The focus of much of my work is on "social learning" and applying the techniques and methods of Michelle Garcia Winner to adults. I advise all parents, teens and adults dealing with issues in this area to look over Mitchell's wonderful site and her curriculum materials at www.socialthinking.com
For more information of autism related services that I provide please visit my website at www.relatedminds.com
Monday, March 7, 2016
Behaviour Interventionist Burnaby / Vancouver
I provide behaviour interventionist services in my Burnaby office for individuals with autism spectrum disorder (ASD and Asperger's disorder. I am a member of the ACT (Autism Community Training) RASP list and my services are covered under minsitry funding programs for children and teens.
Most of my services are focused on specific behavioural problems which parents and consultants are having a hard time dealing with. I provide parent training, consultation and some school based training and consltation. I have workd as the behaviour management specialist for several school districts and as a provincial autism consultant through the Provinical Outreach Program for Autism and Related Services (POPARD). I am deeply familiar with school based programs and have supervised and cnsulted with many professionals in local districts.
Two other things that I provide in my pracritce:
First, I provide autism diagnosist services. If you suspect your child has autism an appointment can usually be set up within 10 days to 2 weeks. I prioritize my cases with individuals with autism spectrum disorder because I am aware how few services there are here in BC. Please visit my website for more information on arranging an appointment for an autism diagnostic consultation. I require an initial 1 hour session to discuss current symptoms and history. The cost of this session is $175.00 and this is part of the overall costs if we decide to move forward with testing.
I also see children and teens in my office for individual therapy. This therapy usually is focused on issues of communications and follows the structure of interventions you will find in the work of Michelle Winner ( Social Thinking). Often these sessions include a period of play therapy, some didactic training and skills development, and then a period of feedback with parents so that they will understand the process and be able to impliment supportive skills trainng in the home.
In addition to diagnosising and providing therapy for autism spectrum disorder / Aspegers disorder, I also focus much of my practice on ADHD and executive dysfunction issues. These are often co-morbid with a diagnosis of ASD.
Finally, I not only provide autism spectrum disorder services to children and teens, but also to adults as well, and see patients from across the lifespan.
Please visit my website at www.relatedminds.com or http://www.relatedminds.com/autism and contact me if you have any questions I can help you with.
Most of my services are focused on specific behavioural problems which parents and consultants are having a hard time dealing with. I provide parent training, consultation and some school based training and consltation. I have workd as the behaviour management specialist for several school districts and as a provincial autism consultant through the Provinical Outreach Program for Autism and Related Services (POPARD). I am deeply familiar with school based programs and have supervised and cnsulted with many professionals in local districts.
Two other things that I provide in my pracritce:
First, I provide autism diagnosist services. If you suspect your child has autism an appointment can usually be set up within 10 days to 2 weeks. I prioritize my cases with individuals with autism spectrum disorder because I am aware how few services there are here in BC. Please visit my website for more information on arranging an appointment for an autism diagnostic consultation. I require an initial 1 hour session to discuss current symptoms and history. The cost of this session is $175.00 and this is part of the overall costs if we decide to move forward with testing.
I also see children and teens in my office for individual therapy. This therapy usually is focused on issues of communications and follows the structure of interventions you will find in the work of Michelle Winner ( Social Thinking). Often these sessions include a period of play therapy, some didactic training and skills development, and then a period of feedback with parents so that they will understand the process and be able to impliment supportive skills trainng in the home.
In addition to diagnosising and providing therapy for autism spectrum disorder / Aspegers disorder, I also focus much of my practice on ADHD and executive dysfunction issues. These are often co-morbid with a diagnosis of ASD.
Finally, I not only provide autism spectrum disorder services to children and teens, but also to adults as well, and see patients from across the lifespan.
Please visit my website at www.relatedminds.com or http://www.relatedminds.com/autism and contact me if you have any questions I can help you with.
Tuesday, March 1, 2016
Adult Diagnosis of Autism Spectrum Disorder and Asperger's Disorder
The diagnosis of autism spectrum disorder (ASD), sometimes referred to as "Asperger's Disorder" can be very difficult for a family practitioner due to the amount of time and the instruments and tools used to complete a comprehensive examination.
While many people make a determination by filling out an on-line form, the diagnsis is actually far more complex. In British Columbia an "offical" diagnosis of autism spectrum disorder, especially high functioning autism which until recently was referred to as Asperger's Disorder - sometimes also diagnosed as "non-Verbal LEarning Disorder" requires several specific tests. For children under six a team is required, including a psychologist, physician and a speech pathologist. The reason a team is required is that autism can often look like other disorders, and other disorders can often look just like autism. Here the Ministry of Children and Families also requires specific tests be used. These include AT LEAST the ADOS- Autism Diagnossit Observation System, which is a procedural test that looks at current symptoms and behaviours, and the ADI-R, the Autism Diagnositic Interview Revised, which is a highly structured history. These are necessary for recognition of ASD by schools and the ministry.
When assessing/testing adult I use these same tests, as an autism diagnosis in BC can be used for obtaining tax credits, social services and most often accomodations at school, college, university and the workplace.
In addition to these specific tests and procedures I also administer a series of neuropsychological tests and personality assessments in order to rule out other possible causes of the symptoms. Additionally individuals with autism spectrum disorder/ adult Asperger's can also have co-morbid disorders, such as depression, anxiety, OCD and ADHD. This comprehensive look at your symptoms and hisotry helps guide treatment choices.
The cost of such an assessment is $1,200-1,600, depending upon the complexity. Regretfully, these costs are not covered by provincial MSP (medical Service Plan) but some costs may be covered by your extended health care plan.
My schedule allows me to see most individuals who are seeking an assessment for adult autism spectrum disorder within 3-4 weeks, as I try not to schedule out more than 4-6 weeks in advance, and prioritize adult autism spectrum disorder assessments as there are few professionals in the lower mainland with the ability or experience necessary to do these assessments.
For more information on adult autism spectrum disorder assessments please visit my web page and contact me by phone or by completing the form on the web page. I am a Registered Psychologist in British Columbia with over 25 years experience in the field of autism, including working as a special education teacher for students with autism spectrum disorder, as a school district behaviour management specialist and as a provincial autism consultant. I have also worked as a rehabilitation psychologist and neuropsychologist with adults returning to the workplace. This hands on experience with individuals across the spectrum of ages and development provides me with a unique set of skills and knowledge base.
Web page: www.relatedminds.com
http://www.relatedminds.com/autism/
http://www.relatedminds.com/adult-autism-and-aspergers-disorder/
While many people make a determination by filling out an on-line form, the diagnsis is actually far more complex. In British Columbia an "offical" diagnosis of autism spectrum disorder, especially high functioning autism which until recently was referred to as Asperger's Disorder - sometimes also diagnosed as "non-Verbal LEarning Disorder" requires several specific tests. For children under six a team is required, including a psychologist, physician and a speech pathologist. The reason a team is required is that autism can often look like other disorders, and other disorders can often look just like autism. Here the Ministry of Children and Families also requires specific tests be used. These include AT LEAST the ADOS- Autism Diagnossit Observation System, which is a procedural test that looks at current symptoms and behaviours, and the ADI-R, the Autism Diagnositic Interview Revised, which is a highly structured history. These are necessary for recognition of ASD by schools and the ministry.
When assessing/testing adult I use these same tests, as an autism diagnosis in BC can be used for obtaining tax credits, social services and most often accomodations at school, college, university and the workplace.
In addition to these specific tests and procedures I also administer a series of neuropsychological tests and personality assessments in order to rule out other possible causes of the symptoms. Additionally individuals with autism spectrum disorder/ adult Asperger's can also have co-morbid disorders, such as depression, anxiety, OCD and ADHD. This comprehensive look at your symptoms and hisotry helps guide treatment choices.
The cost of such an assessment is $1,200-1,600, depending upon the complexity. Regretfully, these costs are not covered by provincial MSP (medical Service Plan) but some costs may be covered by your extended health care plan.
My schedule allows me to see most individuals who are seeking an assessment for adult autism spectrum disorder within 3-4 weeks, as I try not to schedule out more than 4-6 weeks in advance, and prioritize adult autism spectrum disorder assessments as there are few professionals in the lower mainland with the ability or experience necessary to do these assessments.
For more information on adult autism spectrum disorder assessments please visit my web page and contact me by phone or by completing the form on the web page. I am a Registered Psychologist in British Columbia with over 25 years experience in the field of autism, including working as a special education teacher for students with autism spectrum disorder, as a school district behaviour management specialist and as a provincial autism consultant. I have also worked as a rehabilitation psychologist and neuropsychologist with adults returning to the workplace. This hands on experience with individuals across the spectrum of ages and development provides me with a unique set of skills and knowledge base.
Web page: www.relatedminds.com
http://www.relatedminds.com/autism/
http://www.relatedminds.com/adult-autism-and-aspergers-disorder/
Thursday, January 14, 2016
Therapy for Teens and Young Adults with Asperger's / Autism in Vancouver and Burnaby
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
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
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
Wednesday, June 25, 2014
Testing for Adult Autism / Asperger's Disorder
I've been asked by a number of people if there is time during the summer for any further adult assessments for autism spectrum disorder or Asperger's Disorder: yes. I have several days set aside for patients who are seeking an assessment for adult Aspergers or adult autism, as I know there are not many clinicians prepared to complete this work.
What does testing for adult Aspeger's or adult autism spectrum disorder consist of? Primarily we look at symptoms and behaviours you had as a young child. This is done with a structured clinical interview, the ADI-R. In addition to that we engage in a structured interview process called the ADOS which requires you to participate in a number of activities and answer some questions about your current life and thoughts. Usually individuals take a structured personality assessment to rule out possible disorders that may look just like adult autism or Aspegers, and when appropriate we use some neuropsychological tests to help flesh out the diagnosis. It is just about necessary to have someone who knows you well, especially your behavioural and social history, to complete some forms about these issues.
We usually start with an initial one hour session and discuss your current signs, symptoms and problems so that we can make a good choice about the appropriateness of proceeding with an assessment.
For more information on testing for Aspeger's Disorder or autism spectrum disorder in adults, teens/adolescents or children, please visit my website and then contact me directly.
My website can be found at www.relatedminds.com
Dr. Jim Roche
What does testing for adult Aspeger's or adult autism spectrum disorder consist of? Primarily we look at symptoms and behaviours you had as a young child. This is done with a structured clinical interview, the ADI-R. In addition to that we engage in a structured interview process called the ADOS which requires you to participate in a number of activities and answer some questions about your current life and thoughts. Usually individuals take a structured personality assessment to rule out possible disorders that may look just like adult autism or Aspegers, and when appropriate we use some neuropsychological tests to help flesh out the diagnosis. It is just about necessary to have someone who knows you well, especially your behavioural and social history, to complete some forms about these issues.
We usually start with an initial one hour session and discuss your current signs, symptoms and problems so that we can make a good choice about the appropriateness of proceeding with an assessment.
For more information on testing for Aspeger's Disorder or autism spectrum disorder in adults, teens/adolescents or children, please visit my website and then contact me directly.
My website can be found at www.relatedminds.com
Dr. Jim Roche
Thursday, June 5, 2014
Adult Autism and Asperger's Syndrome Reading
In my practice I provide services for children, teens and adults with autism spectrum disorder and Aspergers Syndrome. Often adults come by with marital problems or oner relationship issues and we work on social learning skills and CBT (Cognitive Behaviour Therapy) that is helpful to them in their relationships. Often, however, I am asked for book recommendations. I don't think there are currently any "GREAT" books out there to recommend because most adults have very specific issues and problems and often want direct, specific and to the point advice. Most books, on the other hand, are more targeted to a general reading audience. This only makes sense as its hard to write and sell a book about a small and particular topic. Because of this face to face therapy is often the best way for adults to approach issues.
now most issues adults with Aspergers or high functioning autism do have are not that different than the general population so it's more than appropriate to look at workbooks and self help books that anyone their age would look at - and get some advice and "translation" of the materials from someone who knows about Aspergers Syndrome in adults.
In spite of all this, I'll make a few recommendations of books you might want to own, have around for reference, or maybe just borrow from the public library to skim through:
Aspeger's From the Inside Out: A Supportive and Practical Guide for Anyone with Asperger's Syndrome by Michael Carley and Peter Gerhardt
Emotional Mastery for Adults with Aspegers: practical techniques to work with anger, anxiety and depression by Leslie Burby and Mark Blakey
(For clinicians) Cognitive-Behavioural Therapy for Adults Asperger Syndrom by Valerie Gauss, MD
Aspeger's on the Job: Must-have Advice for People with Asperger's or High Functioning Autism and their Employers by Simone and Temple Grandin
Parenting a Teen or Young Adult with Aspeger Syndrom (Autism Spectrum Disorder0 by Brenda Boyd
Asperger Syndrom and Long Term Relationship by Ashley Stanford
These are some of the books patients have spoken positively about and that I have reviewed. Again, I think the best idea is to see a professional who is familiar with Asperger's Syndrome and high functioning autism across the age span and develop and individualized intervention plan. It's always important to start with psychoeducation - learning more about what is going on - and the best place to start from my point of view is with works and writings by Michelle Winner at www.socialthinking.com While most of her materials are aimed at teens, the insights are valuable to everyone of all ages. When you find someone to work with, you should also make sure that that professional is VERY familiar with her work and has used and applied it in a number of settings.
I hope these suggestions are helpful. for more information about my practice in the field of autism spectrum disorder and adult Aspeger's Syndrome please visit my web page at www.relatedminds.com or call me for an appointment. I provide individual counselling for children, teens and adults with Aspeger's Syndrome and ASD, couples/marriage counselling or therapy and do home and workplace observations and work with schools and workplaces. I also provide assessments and testing for adults with autism/Asperger's and work on numerous legal cases relating to workplace issues and adults with Aspegers.
now most issues adults with Aspergers or high functioning autism do have are not that different than the general population so it's more than appropriate to look at workbooks and self help books that anyone their age would look at - and get some advice and "translation" of the materials from someone who knows about Aspergers Syndrome in adults.
In spite of all this, I'll make a few recommendations of books you might want to own, have around for reference, or maybe just borrow from the public library to skim through:
Aspeger's From the Inside Out: A Supportive and Practical Guide for Anyone with Asperger's Syndrome by Michael Carley and Peter Gerhardt
Emotional Mastery for Adults with Aspegers: practical techniques to work with anger, anxiety and depression by Leslie Burby and Mark Blakey
(For clinicians) Cognitive-Behavioural Therapy for Adults Asperger Syndrom by Valerie Gauss, MD
Aspeger's on the Job: Must-have Advice for People with Asperger's or High Functioning Autism and their Employers by Simone and Temple Grandin
Parenting a Teen or Young Adult with Aspeger Syndrom (Autism Spectrum Disorder0 by Brenda Boyd
Asperger Syndrom and Long Term Relationship by Ashley Stanford
These are some of the books patients have spoken positively about and that I have reviewed. Again, I think the best idea is to see a professional who is familiar with Asperger's Syndrome and high functioning autism across the age span and develop and individualized intervention plan. It's always important to start with psychoeducation - learning more about what is going on - and the best place to start from my point of view is with works and writings by Michelle Winner at www.socialthinking.com While most of her materials are aimed at teens, the insights are valuable to everyone of all ages. When you find someone to work with, you should also make sure that that professional is VERY familiar with her work and has used and applied it in a number of settings.
I hope these suggestions are helpful. for more information about my practice in the field of autism spectrum disorder and adult Aspeger's Syndrome please visit my web page at www.relatedminds.com or call me for an appointment. I provide individual counselling for children, teens and adults with Aspeger's Syndrome and ASD, couples/marriage counselling or therapy and do home and workplace observations and work with schools and workplaces. I also provide assessments and testing for adults with autism/Asperger's and work on numerous legal cases relating to workplace issues and adults with Aspegers.
Thursday, January 2, 2014
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!
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.
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
Thursday, November 14, 2013
Adult Autism Assessment and Diagnosis
Today I was asked if using the GARS-2 (Gilliam Autism Rating Scale-Second Edition) was enough for an adult diagnosis of autism or Asperger's Disorder. I have a new copy of the GARS, and have used it many times in the past, especially when working in California. With children we would do a dual interview, two professionals asking questions, and we would score separately to make sure there was evaluator agreement. The GARS is used for individuals from age 3-22, and most of us would use a version of it for older individuals. But in British Columbia the GARS simply isn't good enough.
Usually a diagnosis of either autism spectrum disorder, or Asperger's Disorder, sometimes called Asperger's Syndrome , in adults can be complex. It requires not just using a checklist/interview like the GARS, but also ruling out the many other possible disorder that could be causing the symptoms of concern. I usually do this with a structured personality assessment and structured mental health history/health history.
In BC, with children and adolescents (teens) who are suspected of having autism spectrum disorder or Asperger's (yes, I know they are now considered to be on one single spectrum, however many individuals still find it useful to distinguish between these two disorders) we use the ADOS (Autism Diagnostic Observation Scale) and the ADI-R (Autism Diagnostic Inventory). These are considered the gold standard here in BC, and are a required part of any autism assessment that will be accepted by either a school district or the Ministry for funding. So, I try to follow these guidelines as much as possible.
Often people need a diagnosis for "legal reasons." For instance, they may require a diagnosis to obtain services, or to make a tax credit claim, or sometimes they are having social problems at work and a diagnosis is part of keeping their job and getting appropriate accommodations. As you might suspect, when this is the case we need a very comprehensive assessment. One that rules out other possible causes for their symptoms, and one that shows both their strengths and weaknesses so we can make specific accommodation recommendations. That's why a simple check off list of symptoms doesn't make for a good diagnosis!
A diagnosis of Asperger's Disorder or autism in an adult takes several hours of face to face time, the collection of historical information (much of the diagnosis is based upon behaviours and concerns at an early age) and some period of time to observe the individual doing tasks that we consider important markers for the disorder.
For more information you are welcome to contact me in my office at 778.998-7975. There is a short waiting period for adult and child assessments, but usually you can be seen within a week to ten days. For more information visit my website at www.relatedminds.com
I have offices in both Burnaby and Vancouver, British Columbia.
Usually a diagnosis of either autism spectrum disorder, or Asperger's Disorder, sometimes called Asperger's Syndrome , in adults can be complex. It requires not just using a checklist/interview like the GARS, but also ruling out the many other possible disorder that could be causing the symptoms of concern. I usually do this with a structured personality assessment and structured mental health history/health history.
In BC, with children and adolescents (teens) who are suspected of having autism spectrum disorder or Asperger's (yes, I know they are now considered to be on one single spectrum, however many individuals still find it useful to distinguish between these two disorders) we use the ADOS (Autism Diagnostic Observation Scale) and the ADI-R (Autism Diagnostic Inventory). These are considered the gold standard here in BC, and are a required part of any autism assessment that will be accepted by either a school district or the Ministry for funding. So, I try to follow these guidelines as much as possible.
Often people need a diagnosis for "legal reasons." For instance, they may require a diagnosis to obtain services, or to make a tax credit claim, or sometimes they are having social problems at work and a diagnosis is part of keeping their job and getting appropriate accommodations. As you might suspect, when this is the case we need a very comprehensive assessment. One that rules out other possible causes for their symptoms, and one that shows both their strengths and weaknesses so we can make specific accommodation recommendations. That's why a simple check off list of symptoms doesn't make for a good diagnosis!
A diagnosis of Asperger's Disorder or autism in an adult takes several hours of face to face time, the collection of historical information (much of the diagnosis is based upon behaviours and concerns at an early age) and some period of time to observe the individual doing tasks that we consider important markers for the disorder.
For more information you are welcome to contact me in my office at 778.998-7975. There is a short waiting period for adult and child assessments, but usually you can be seen within a week to ten days. For more information visit my website at www.relatedminds.com
I have offices in both Burnaby and Vancouver, British Columbia.
What does research say about treatments for adolescents and young adults with Autism Spectrum Disorder and Aspergers?
A 2012 publication"Interventions for Adolescents and Young Adults with Autism spectrum Disorders" was published by the Agency for Healthcare Research and Quality. It is an excellent report, 374 pages of data, and would be useful to any parent of a young adult, and should be part of the collection of literature in any school district, private practice or mental health program that works with young adolescents (teens) or young adults with Asperger's Disorder/Syndrome.
The full report can be found here: http://www.ncbi.nlm.nih.gov/books/NBK107275/
For instance, many school districts provide "Music Therapy" for student's with Autism Spectrum Disorder or Aspergers. Often this is provided by a "Registered Music Therapist" here in British Columbia. How does this government report look at music therapy for students with autism?
For instance, many school districts provide "Music Therapy" for student's with Autism Spectrum Disorder or Aspergers. Often this is provided by a "Registered Music Therapist" here in British Columbia. How does this government report look at music therapy for students with autism?
" 2 poor-quality case studies. Some gains in social skills reported using unvalidated and largely subjective measures. No comparison groups or measures of treatment fidelity; participants not clearly characterized; assessors not masked; differences in concomitant interventions not reported.”
If music therapy is being offered to your child, but no behavioural program, small group social learning group (using materials such as ABA for some or "social learning" programs such as Michelle Winners for others), you need to know that the evidence for using music therapy with autism is weak.
While the report is long it can be downloaded in PDF format and read on your computer or iPad screen. At least those professionals designing, approving and supervising the programs out children use should be familiar with this compendium of research and it's implications as to where to put our effort, money and hearts when dealing with our children, students and clients.
The study comes to this rather bleak conclusion:
"Few studies have been conducted to assess treatment approaches for adolescents and young adults with ASD, and as such there is very little evidence available for specific treatment approaches in this population; this is especially the case for evidence-based approaches to support the transition of youth with autism to adulthood. Of the small number of studies available, most were of poor quality, which may reflect the relative recency of the field. Five studies, primarily of medical interventions, had fair quality. Behavioral, educational, and adaptive/life skills studies were typically small and short term and suggested some potential improvements in social skills and functional behavior. Small studies suggested that vocational programs may increase employment success for some individuals. Few data are available to support the use of medical or allied health interventions in the adolescent and young adult population. The medical studies that have been conducted focused on the use of medications to address specific challenging behaviors, including irritability and aggression, for which effectiveness in this age group is largely unknown and inferred from studies including mostly younger children."
Another example of overused interventions are sensory interventions. Some schools are full of these programs, with specialized rooms that children are taken to when they are having behavioural or emotional difficulty. Many times this is the primary intervention on an IEP for a child, in spite of the lack of supportive research for using these techniques. Here is what the American Paediatric Association says:
"Sensory-based therapies using brushes, swings, balls and other equipment are increasingly used by occupational therapists to treat children with developmental and behavioral disorders. However, it’s unclear whether children with sensory-based problems have an actual disorder related to the sensory pathways of the brain, or whether these problems are due to an underlying developmental disorder. In a new policy statement, “Sensory Integration Therapies for Children With Developmental and Behavioral Disorders,” published in the June 2012 Pediatrics (published online May 28), the American Academy of Pediatrics (AAP) recommends that pediatricians not use sensory processing disorder as an independent diagnosis. When sensory problems are present, health care providers should consider other developmental disorders, including autism spectrum disorders, attention deficit/hyperactivity disorder, developmental coordination disorder and anxiety disorder. Occupational therapy with the use of sensory-based therapies may be acceptable as one component of a comprehensive treatment plan. The AAP recommends pediatricians communicate with families about the limited data on the use of sensory-based therapies, and help families design simple ways to monitor the effects of treatment and discuss whether the therapy is working to achieve their goals for their child. Occupational therapy is a limited resource and families should work with pediatricians to prioritize treatments based on problems that affect a child’s ability to perform daily functions. - See more at: http://www.aap.org/en-us/about-the-aap/aap-press-room/pages/AAP-Recommends-Careful-Approach-to-Using-Sensory-Based-Therapies.aspx#sthash.ORoTzKDN.dpuf
So what is a parent (or spouse) to do?
First of all, do not rely on the overly optimistic reviews from practitioners. Many school and mental health facilities use the least trained ( meaning cheapest) staff available to work with these students and clients. Start by making sure you have a licensed or registered professional involved. High Functioning Autism and Asperger's Disorder are neurologically based. In many ways they are first and foremost language disorder and disorder of executive function - inability to move from one subject to another, accept changes, "read" other people, demonstrate mental flexibility and control their emotions. These are issues familiar to both behavioural psychologists and speech and language pathologists. (Remember, there is a reason the leader in this field, Michelle Garcia Winner, is a speech and language pathologist!) Start with experts in the behaviours you are most concerned with. Not with a "program."
Next, develop a clear outline of what you want to deal with, what are the problematic symptoms, deficits and concerns.
Then develop a program to address those.
What this study clearly shows is that too much effort is spent on ancillary treatments, that happen to be available, or for which their is a "workbook" that a para-professional can follow. Treatments address deficits and concerns, and whether it be in an IEP meeting (individual educational Plan) or a one to one meeting with your therapist, an appropriate assessment is the best way to find a path to appropriate treatment!
For older teens and young adults these group sessions are not available, and often inappropriate, as higher functioning teens and young adults are more likely than not to be suffering from co-morbid disorders such as anxiety, stress, depression and low self esteem. These, like many of the specific symptoms, can be addressed individually use adaptations of familiar, well researched and evidence based treatments.
While the problem of poor research for treatment of autism and Aspeger's is real, there are still many treatments which we know work, and work well, for most people, and if properly modified by a mental health professional who is familiar with autism spectrum disorder in children, adolescents and adults, the odds start to change.
For more information on diagnostic assessments for autism spectrum disorder (I am an approved provider with Autism Community Training -ACT, and a member of the RASP provider's list) which I provide as a private practitioner, contact my at 778.998-7975. My website is www,relatedminds.com and I have offices in both Burnaby and Vancouver. Most testing is done in Burnaby, as that is where most of the testing materials are.
My waiting list for autism assessment for children over 6 through adults is fairly short, about 10 days to start the process.
I also provide therapy for adolescents/teens and adults with Asperger's Disorder and Autism Spectrum Disorder.
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