We have expanded our team to make scheduling an appointment easier. We have added two well trained and seasoned school psychologists to help us in the more complex diagnosis and treatment planning for children, adolescents and young adults with Autism Spectrum Disorder.
We provide diagnostic testing for children one the age of six for autism spectrum disorder. Our testing procedures are aimed at meeting the requirements for the BC Ministry of Children and Family Services. We also understand that many people, after long waits to obtain an autism diagnosis are not able to get a psychoeducational assessment to assist the schools in developing appropriate and individualized education plans. We provide these psychoeducational assessments for all levels, from elementary school children to young adults entering college or university.
With the new additions to staff we are usually able to see someone for a psychoeducational assessment within 10 days to two weeks. The process involves an initial one hour session to discuss history and current issues, then there is usually two days of testing for a psychoeducational assessment. We then need a week to score the tests, gather information from others, such as school or family reports, and we write an assessment report. You are then invited back to the office to have the report explained, and to discuss how we can use the reported test results to develop better interventions and education plans.
Most school need a psychoeducational assessment in order to develop an IEP, an Individual Education Plan.
One unique aspect of our services is that everyone here has had experience in the school system, we have been school psychologist, teachers, school counsellors, behaviour management specialists and consultants for the Provincial Autism program.
For more information please look at our web page at www.relatedminds.com and then, if you are interested, either call us directly or email (there is an email form on the website).
Showing posts with label testing. Show all posts
Showing posts with label testing. Show all posts
Friday, February 2, 2018
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
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
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, 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
Monday, May 26, 2014
Testing and Treatment for Asperger's and Autism | Children, Adolescents and Adults
Testing, Assessment and Treatment for Autism and Aspeger's Disorder
Dr. Jim Roche provides testing and diagnostic services, as well as therapy, for children, adolescents and adults with autism spectrum disorder, Aspeger's Disorder and related cognitive deficits. For more information please visit my web page at: http://www.relatedminds.com/autism/
or http://psychologists.bc.ca/users/jimroche or www.relatedminds.com
Dr. Roche also sees adolescents and young adults for therapy and social cognitive therapy in his office, and accepts BC Ministry payments for these services. Services are also covered by your extended health care plan. He has over 20 years experience with children, adolescents and teens with autism spectrum disorder, non-Verbal Learning Disorders, Social Cognitive Disorders and Asperger's Disorder.
Please feel free to examine the web page or call doctor Roche with questions about assessments, testing and treatment for autism and Asperger's Disorder.
His offices are located in Burnaby and Vancouver and are close to Port Coquitlam, New Westminster, Port Moody and Maple Ridge.
Dr. Jim Roche provides testing and diagnostic services, as well as therapy, for children, adolescents and adults with autism spectrum disorder, Aspeger's Disorder and related cognitive deficits. For more information please visit my web page at: http://www.relatedminds.com/autism/
or http://psychologists.bc.ca/users/jimroche or www.relatedminds.com
Dr. Roche also sees adolescents and young adults for therapy and social cognitive therapy in his office, and accepts BC Ministry payments for these services. Services are also covered by your extended health care plan. He has over 20 years experience with children, adolescents and teens with autism spectrum disorder, non-Verbal Learning Disorders, Social Cognitive Disorders and Asperger's Disorder.
Please feel free to examine the web page or call doctor Roche with questions about assessments, testing and treatment for autism and Asperger's Disorder.
His offices are located in Burnaby and Vancouver and are close to Port Coquitlam, New Westminster, Port Moody and Maple Ridge.
Saturday, July 13, 2013
Child, Adolescent and Adult Testing for Autism / Aspeger's Disorder
This week two patients came to me and said they wanted an assessment for autism. Actually one said autism, this was an assessment for a teenager, and another wanted an assessment for Aspeger's Disorder. Both were sent by their family physicians, which is how I usually get my referrals.
Both wanted to know what it consisted of and how much it would cost. Those are very reasonable questions, but not so easy to answer. An assessment usually is completed to answer a specific question, and most of the time a diagnosis alone isn't worth spending time or money on. So I usually ask, "What do you need this diagnosis for?"
With a child an autism diagnosis, and it doesn't matter if we are looking at "classical autism" or Asperger's Disorder, High Functioning Autism or whatever term you may be using (it is now all one diagnosis on a spectrum in the new Diagnostic and Statistical Manual, the DSM-5) if it's to help with education you often need both an assessment for autism using the ADOS (Autism Diagnostic Observation Schedule) and the ADI-R (Autism Diagnostic Interview-Revised) to qualify for school and provincial services here in British Columbia, as well as a full psychoeducational assessment. This is necessary to help determine what interventions to use in the school to help the student learn. This is a very comprehensive procedure and can cost between $2,600 and $3,400.00
I ask about this because the school may be able to complete the psychoeducational assessment component, which significantly reduces the cost. Or, maybe a psychoeducational assessment has already been completed!
Adults, on the other hand, often come to me for an assessment and diagnosis because they want to understand themselves and be able to explain behaviours. They just want to know why they might be doing the things they are doing. In this case I'm often reluctant to conduct a time consuming and expensive assessment. An assessment should not just tell you what you have, it should tell you what to do about it! Adult assessments often are used in employment as well, to get accommodations and consideration at the work place.
A diagnosis of adult autism or Asperger's Disorder (sometimes called Asperger's Syndrome) means not just seeing if you meet a list of criteria or symptoms, it means ruling out the many other possible disorders that look very much like Asperger or High Functioning Autism. This means completing not only the usual assessment for autism/Aspergers but also personality assessments, some neuropsychological tests and often speech and language assessments, as some specific speech and language deficits can look just like autism/Asperger's.
Just like a student, who would use the assessment/test results to develop an educational plan (an IEP or Individual Education Plan is developed by the school based upon the assessment results) an adult should also expect to be able to use their test results to make a life intervention plan, use the results to come up with a plan to improve issues at work, home, in relationships or recreation.
Assessments are used to make plans and look forward, not just to diagnose. I would agree with parents who object to getting a "label" but would urge them to get a good diagnosis and use it to make a plan.
For more information about the diagnostic services I provide you can visit my web page at www.relatedminds.com. You will find information about autism services for children, adolescents and adults and assessment services. You can also call me at 778.998-7975 or email me at relatedminds@gmail.com
I provide assessment services, diagnosis of autism/Aspergers for provincial funding, parent education, behaviour management programs and individual and couple therapy for adults with high functioning autism and Asperger's Disorder.
Thursday, June 23, 2011
Autism testing while asleep? Maybe....
First, a reminder that my blogsite is moving to Wordpress. You can find the new WordPress version at: www.relatedmindsbc.com/blog My professional site is now at www.relatedminds.com
Medical News: Brain Out of Sync in Tots With Autism - in Pediatrics, Autism from MedPage Today
This new and interesting study finds that toddlers with autism displayed weaker interhemispheric synchronization as shown by functional magnetic resonance imaging testing conducted during sleep compared with those with language delay or typical development. The investigators suggested that this might provide an early diagnostic tool which could then prompt earlier intervention. While none of these tools will be terribly useful as stand alone instruments, they will help us differentiate on disorder from another, saving time, getting appropriate treatment to the correct children and in the long run, saving money.
The study demonstrates that toddlers with autism have poorer synchronization between the hemispheres of the brain during sleep, potentially providing a biomarker that can aid in early diagnosis of the disorder, researchers found. Among children ages 1 to 3½, those with autism had significantly worse synchronization in two areas of the brain associated with language production and comprehension than other kids, according to Ilan Dinstein, PhD, of the Weizmann Institute of Science in Rehovot, Israel, and colleagues. How does this related to autism? Well the inferior frontal gyrus is positively associated with verbal ability and negatively associated with the severity of autism-related communication problems.
"These results suggest that poor neural synchronization is a notable neurophysiological characteristic that is evident at the earliest stages of autism development and is related to the severity of behavioral symptoms....The ability to measure this characteristic during sleep, when task compliance and subject cooperation are not required, suggests its utility as a possible diagnostic measure to aid growing efforts of identifying autism during infancy," they concluded, adding that early identification would lead to earlier intervention. Yes, this is a test we might be able to use with children who are uncooperative, sometimes seemingly untestable...while they sleep.
The researchers say that "the fact that poor synchronization was found in the language system of toddlers with autism, and not in toddlers with language delay (both groups exhibited similarly low expressive language scores), suggests that reduced synchronization may reflect the existence of a specific pathophysiological mechanism that is unique to autism."
This is where our limited autism funding should be going, rather than more testing of alternative medicines that have no logical hope of cure, or searching for causes that have been ruled out multiple times. We need to focus on where the science drives us, not politics.
Medical News: Brain Out of Sync in Tots With Autism - in Pediatrics, Autism from MedPage Today
This new and interesting study finds that toddlers with autism displayed weaker interhemispheric synchronization as shown by functional magnetic resonance imaging testing conducted during sleep compared with those with language delay or typical development. The investigators suggested that this might provide an early diagnostic tool which could then prompt earlier intervention. While none of these tools will be terribly useful as stand alone instruments, they will help us differentiate on disorder from another, saving time, getting appropriate treatment to the correct children and in the long run, saving money.
The study demonstrates that toddlers with autism have poorer synchronization between the hemispheres of the brain during sleep, potentially providing a biomarker that can aid in early diagnosis of the disorder, researchers found. Among children ages 1 to 3½, those with autism had significantly worse synchronization in two areas of the brain associated with language production and comprehension than other kids, according to Ilan Dinstein, PhD, of the Weizmann Institute of Science in Rehovot, Israel, and colleagues. How does this related to autism? Well the inferior frontal gyrus is positively associated with verbal ability and negatively associated with the severity of autism-related communication problems.
"These results suggest that poor neural synchronization is a notable neurophysiological characteristic that is evident at the earliest stages of autism development and is related to the severity of behavioral symptoms....The ability to measure this characteristic during sleep, when task compliance and subject cooperation are not required, suggests its utility as a possible diagnostic measure to aid growing efforts of identifying autism during infancy," they concluded, adding that early identification would lead to earlier intervention. Yes, this is a test we might be able to use with children who are uncooperative, sometimes seemingly untestable...while they sleep.
The researchers say that "the fact that poor synchronization was found in the language system of toddlers with autism, and not in toddlers with language delay (both groups exhibited similarly low expressive language scores), suggests that reduced synchronization may reflect the existence of a specific pathophysiological mechanism that is unique to autism."
This is where our limited autism funding should be going, rather than more testing of alternative medicines that have no logical hope of cure, or searching for causes that have been ruled out multiple times. We need to focus on where the science drives us, not politics.
Saturday, December 4, 2010
MRI Test Shows Diagnostic Promise for Autism - in Pediatrics, Autism from MedPage Today
Medical News: MRI Test Shows Diagnostic Promise for Autism - in Pediatrics, Autism from MedPage Today\
Does this new research mean we can get a quick, easy and absolute diagnosis of Autism from a simple MRI scan? No, regretfully not, although that's how the mainstream press presents it. MRI scans of the brain in this research protocol focused on two specific regions in the temporal lobe was able to diagnose high-functioning autism with 94% sensitivity in a preliminary evaluation. There are, however some serious limitations with this study included the small sample size, lack of a comparator group with developmental disorders other than autism, and use of highly selected features for evaluation. These limitations mean that we don't know if this type of scan can or ever will (although ever is a long time) tell us if a child has autism, a language disability or other disorder. So far, and for the near future, the scan can't tell these different disorders apart, and that's why we use more complex tests for autism such as the ADOS (Autism Diagnostic Observation Scale) and the ADI-R (Autism Diagnostic Interview0-Revised). These remain, and most likely will remain, the standard for assessment here in British Columbia.
Autism, like many other social and learning disorders present on a scale, and it is necessary for the treating clinician to understand the unique way the disorder presents itself. Two children with identical brain scans may, I would expect, present very differently in terms of behaviours and immediate intervention needs because the disorder interacts with their temperament, other co-morbid issues (such as sensory sensitivities), environmental factors such as parenting skills/temperament/siblings and developmental experiences. Add on to this factors relating to the larger social environments such as schools. An MRI, blood or urine test may be helpful, and may very well become necessary for diagnosis or government funding in some locations, but a good clinical interview, observation in multiple settings, history taking and appropriate "hands-on" diagnostic assessment are still the foundation for building a good treatment and intervention plan.
.....................................................................................
My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as many other learning disabilities. Please visit it at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.
Autism assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
Does this new research mean we can get a quick, easy and absolute diagnosis of Autism from a simple MRI scan? No, regretfully not, although that's how the mainstream press presents it. MRI scans of the brain in this research protocol focused on two specific regions in the temporal lobe was able to diagnose high-functioning autism with 94% sensitivity in a preliminary evaluation. There are, however some serious limitations with this study included the small sample size, lack of a comparator group with developmental disorders other than autism, and use of highly selected features for evaluation. These limitations mean that we don't know if this type of scan can or ever will (although ever is a long time) tell us if a child has autism, a language disability or other disorder. So far, and for the near future, the scan can't tell these different disorders apart, and that's why we use more complex tests for autism such as the ADOS (Autism Diagnostic Observation Scale) and the ADI-R (Autism Diagnostic Interview0-Revised). These remain, and most likely will remain, the standard for assessment here in British Columbia.
Autism, like many other social and learning disorders present on a scale, and it is necessary for the treating clinician to understand the unique way the disorder presents itself. Two children with identical brain scans may, I would expect, present very differently in terms of behaviours and immediate intervention needs because the disorder interacts with their temperament, other co-morbid issues (such as sensory sensitivities), environmental factors such as parenting skills/temperament/siblings and developmental experiences. Add on to this factors relating to the larger social environments such as schools. An MRI, blood or urine test may be helpful, and may very well become necessary for diagnosis or government funding in some locations, but a good clinical interview, observation in multiple settings, history taking and appropriate "hands-on" diagnostic assessment are still the foundation for building a good treatment and intervention plan.
.....................................................................................
My web page lists a number of resources you can make use of yourself in dealing with Autism Spectrum Disorder and Asperger's, as well as many other learning disabilities. Please visit it at www.socialcognitivetherapy.com, or one of my other sites at: Psychology Today, AAMFT, PSYRIS or my professional site or www.adhdhelp.ca.
Autism assessment and treatment services are offered for individuals, couples, families, children, adolescents and adults in the Burnaby, Vancouver, Coquitlam, Port Moody, New Westminster and Maple Ridge areas of the lower mainland. This includes neuro-developmental assessments, psycho-education assessments, autism assessments as well as behavioural and cognitive behaviour therapy. I also provide diagnostic assessments for autism and Asperger's Disorder in my Burnaby office.
Dr. Jim Roche
Registered Psychologist, British Columbia 01610
778.998-7975
www.relatedminds.com
Wednesday, July 7, 2010
(1/2) Do Vaccines Cause Autism? Correlation vs. Causation
This is an excellent little video about the use, and misuse, of data. In spite of all the information out there that clearly shows vaccines have no relationship to autism some individuals and groups continue to confuse correlation and causation. Watch this for a simple explanation.
For information about my diagnostic services (ASD / autism diagnostic services are available within 10 days to 2 weeks) and my science based treatment programs please read the information provided on my website at www.relatedminds.com or go to my Psychology Today website to find out more about me.
For information about my diagnostic services (ASD / autism diagnostic services are available within 10 days to 2 weeks) and my science based treatment programs please read the information provided on my website at www.relatedminds.com or go to my Psychology Today website to find out more about me.
Friday, February 5, 2010
About Assessment for Autism, Asperger's, Learning Disorders and ADHD
A lot of people call my office and have been told by a day care provider or teacher that they are sure their child has autism, Asperger's Disorder or ADHD. And often this is based on some list of symptoms that they read on the internet. Parents often then scramble and start looking themselves. Even adults do this, I get a fair number of adults who have wondered about possibly having autism after someone mentioned it to them and they began a web search.
Autism, ADHD, Asperger's disorder are not an easy diagnosis to make. And one of the important things that takes place when assessing a child, adolescent of adult for autism spectrum disorder (ASD) is what we call a "differential diagnosis." The symptoms you may be concerned about may or may not be ASD. They could be another problem such as a language disorder, auditory processing disorder, a learning disability, some form of speech disorder, mental retardation, ADHD (both often confused with ASD), a movement disorder, OCD. The list goes on.
Additionally the disorder may be more than one thing. ASD is often found to be c-omorbid with another disorder such as ADHD. ADHD itself is not an easy disorder to diagnose. The Centre for ADHD/ADD Advocacy, Canada (CADDAC) has set standards for a full differential diagnosis of ADHD and it includes an extensive amount of data collection and takes a considerable amount of time. Another source of information on diagnosis ADHD is from Dr. Russell Barkley. His procedures are very similar to CADDAC and are the procedures I follow in my practice. As I mention below for autism diagnoses, you usually have one chance at an assessment and it should include all of the tests below except the ADOS and ADI-R. You need to know if there is a co-morbit learning disorder, and you need to understand exactly how ADHD is expressing itself in your child. While a neuropsychological examination is not necessary for a diagnosis, it is necessary if you want to know what to do about it. A very simple computer based test a medical doctor could offer you for a child 8 years old or over is the CNS-Vital Signs assessment which tells us about memory, ability to switch sets, executive functioning, processing speed and other critical bits of data we need to develop a treatment plan. Many of my patients are referred by medical doctors because they do not have the time or specific skills to make a firm diagnosis.
Here in British Columbia a full diagnostic autism assessment is usually completed by a provincial agency. This might take place at Children's Hospital or through a provincial health authority provider. You start this process with a referral from your medical provider. The Ministry for Children and Families has information about the assessment process on their web site. Those services should be free to anyone here in British Columbia. However, there is a long waiting list for these services. Private practitioners, including medical doctors and psychologists, who have had specialized training in the two instruments I'll talk about below, can also provide this service, however either you or your extended health care (if your lucky enough to have it) has to cover this cost. It's usually about $1,800 -$2,100. And for children under 6 an assessment needs to be completed by a team of professionals, hard to arrange through a private practitioner and even more expensive.
What does the assessment consist of? First, for most children and adolescents there is an initial interview history taking. Then, usually, a psycho-educational assessment is completed. This includes an intelligence (cognitive) test and an academic performance test. Usually these scores are compared to look for discrepancies that would lead us to finding a specific learning disability. If your child get X score on this part of the intelligence test, we would expect he or she would score Y on this part of the academic test. This testing also helps rule out mental retardation or other cognitive impairments. If you are going the private practitioner route, you might be lucky enough to have the school complete the psycho-educational assessment, cutting back your costs.
Next your child is usually examined for behavioural and personality issues. This might take place through interviews, pencil and paper tests or self reports like the Beck Youth Scales and reports from parents and teachers. The examiner wants to rule out personality disorders, psychosis, depression, anxiety and similar issues that can often be mistaken for ASD.
There might now be some specialized test that the examiner would use to look at an issue he or she is concerned with. And some examiners will do more complete neuropsychological tests to give us information on problems that might relate to executive function, memory and learning, impulse control, motor and visual-motor issues. This is especially important for children with co-morbid ADHD or for whom we find ADHD is the primary concern. This information helps us come up with focused treatment interventions.
Finally, for children we are still concerned about ASD with the provincial government here in British Columbia requires two specific tests: The Autism Diagnostic Observation System (ADOS) and the Autism Diagnostic Interview (ADI-R). There are several other very good and reliable tests that focus on autism, however the ministry will only accept a report containing these two specific tests.
The ADOS is a series of activities and questions the examiner goes through with the child, giving him or her an opportunity to see how the child responds to new stimuli. The ADI-R is a lengthy report completed during an interview with the parents or other caregivers about the child's developmental history focused on symptoms found in ASD.
Some practitioners complete shorter reports using just the ADOS and ADI-R. This might be quicker but leaves us with doubts about other possible reasons for the behaviours of concern (not a real "differential" diagnosis) and provides little information we would be able to use to provide targeted interventions / treatment. And honestly, it's very difficult to obtain a second assessment to obtain this kind of essential information as there is a long waiting list of children and adolescents for initial evaluations.
To find a practitioner who can help you with an assessment I would start with my medical doctor, who may have a doctor of clinical psychology he or she knows and referrals to, or contact the British Columbia Psychological Association for a referral. You must, however, see a licensed or registered psychologist for these types of diagnostic services. Registered Clinical Counsellors (RCC) are not qualified to provide these services and often parents pay for assessments that are then not accepted by school districts or the ministry. School psychologists can only perform these tasks as part of their employment in the school district and are not qualified to do these types of assessments independently. (However, an RCC or school psychologist may ALSO be a licensed or registered psychologist, so ask,) Finally, before paying someone to complete any assessment, ask the agency you plan to use the assessment with (ministry or school) if this provider is qualified to provide such information to them.
Autism, ADHD, Asperger's disorder are not an easy diagnosis to make. And one of the important things that takes place when assessing a child, adolescent of adult for autism spectrum disorder (ASD) is what we call a "differential diagnosis." The symptoms you may be concerned about may or may not be ASD. They could be another problem such as a language disorder, auditory processing disorder, a learning disability, some form of speech disorder, mental retardation, ADHD (both often confused with ASD), a movement disorder, OCD. The list goes on.
Additionally the disorder may be more than one thing. ASD is often found to be c-omorbid with another disorder such as ADHD. ADHD itself is not an easy disorder to diagnose. The Centre for ADHD/ADD Advocacy, Canada (CADDAC) has set standards for a full differential diagnosis of ADHD and it includes an extensive amount of data collection and takes a considerable amount of time. Another source of information on diagnosis ADHD is from Dr. Russell Barkley. His procedures are very similar to CADDAC and are the procedures I follow in my practice. As I mention below for autism diagnoses, you usually have one chance at an assessment and it should include all of the tests below except the ADOS and ADI-R. You need to know if there is a co-morbit learning disorder, and you need to understand exactly how ADHD is expressing itself in your child. While a neuropsychological examination is not necessary for a diagnosis, it is necessary if you want to know what to do about it. A very simple computer based test a medical doctor could offer you for a child 8 years old or over is the CNS-Vital Signs assessment which tells us about memory, ability to switch sets, executive functioning, processing speed and other critical bits of data we need to develop a treatment plan. Many of my patients are referred by medical doctors because they do not have the time or specific skills to make a firm diagnosis.
Here in British Columbia a full diagnostic autism assessment is usually completed by a provincial agency. This might take place at Children's Hospital or through a provincial health authority provider. You start this process with a referral from your medical provider. The Ministry for Children and Families has information about the assessment process on their web site. Those services should be free to anyone here in British Columbia. However, there is a long waiting list for these services. Private practitioners, including medical doctors and psychologists, who have had specialized training in the two instruments I'll talk about below, can also provide this service, however either you or your extended health care (if your lucky enough to have it) has to cover this cost. It's usually about $1,800 -$2,100. And for children under 6 an assessment needs to be completed by a team of professionals, hard to arrange through a private practitioner and even more expensive.
What does the assessment consist of? First, for most children and adolescents there is an initial interview history taking. Then, usually, a psycho-educational assessment is completed. This includes an intelligence (cognitive) test and an academic performance test. Usually these scores are compared to look for discrepancies that would lead us to finding a specific learning disability. If your child get X score on this part of the intelligence test, we would expect he or she would score Y on this part of the academic test. This testing also helps rule out mental retardation or other cognitive impairments. If you are going the private practitioner route, you might be lucky enough to have the school complete the psycho-educational assessment, cutting back your costs.
Next your child is usually examined for behavioural and personality issues. This might take place through interviews, pencil and paper tests or self reports like the Beck Youth Scales and reports from parents and teachers. The examiner wants to rule out personality disorders, psychosis, depression, anxiety and similar issues that can often be mistaken for ASD.
There might now be some specialized test that the examiner would use to look at an issue he or she is concerned with. And some examiners will do more complete neuropsychological tests to give us information on problems that might relate to executive function, memory and learning, impulse control, motor and visual-motor issues. This is especially important for children with co-morbid ADHD or for whom we find ADHD is the primary concern. This information helps us come up with focused treatment interventions.
Finally, for children we are still concerned about ASD with the provincial government here in British Columbia requires two specific tests: The Autism Diagnostic Observation System (ADOS) and the Autism Diagnostic Interview (ADI-R). There are several other very good and reliable tests that focus on autism, however the ministry will only accept a report containing these two specific tests.
The ADOS is a series of activities and questions the examiner goes through with the child, giving him or her an opportunity to see how the child responds to new stimuli. The ADI-R is a lengthy report completed during an interview with the parents or other caregivers about the child's developmental history focused on symptoms found in ASD.
Some practitioners complete shorter reports using just the ADOS and ADI-R. This might be quicker but leaves us with doubts about other possible reasons for the behaviours of concern (not a real "differential" diagnosis) and provides little information we would be able to use to provide targeted interventions / treatment. And honestly, it's very difficult to obtain a second assessment to obtain this kind of essential information as there is a long waiting list of children and adolescents for initial evaluations.
To find a practitioner who can help you with an assessment I would start with my medical doctor, who may have a doctor of clinical psychology he or she knows and referrals to, or contact the British Columbia Psychological Association for a referral. You must, however, see a licensed or registered psychologist for these types of diagnostic services. Registered Clinical Counsellors (RCC) are not qualified to provide these services and often parents pay for assessments that are then not accepted by school districts or the ministry. School psychologists can only perform these tasks as part of their employment in the school district and are not qualified to do these types of assessments independently. (However, an RCC or school psychologist may ALSO be a licensed or registered psychologist, so ask,) Finally, before paying someone to complete any assessment, ask the agency you plan to use the assessment with (ministry or school) if this provider is qualified to provide such information to them.
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