Assessment and Treatment of Autism in BC

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

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

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

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

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

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

About Dr. Roche:

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

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

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

Transitioning to Adulthood with Autism Asperger's Disorder

Transitioning from adolescents to adulthood, for people with autism, is extremely difficult, and that planning needs to start very early. Every week at least one family comes to my office with a teen with autism or Asperger's (ASD) and wants advice on how to prepare their child for living on their own. Let's be frank, parents get older and realize they will not be around to take care of their son or daughter forever, and they want to know what to do. I am sometimes horrified that school districts have done little if any planning for this transition. Sometimes they wait until grade 11 or 12. By then it is difficult to make a transition plan, if not impossible. Some services are available for these students through provincial funding, but time after time even applying for these services has not been planned for. Applications require a recent -within the last two years - psychological assessment, and schools in this province have been taking one, two or even three or more years to provide an initial assessment, never mind a follow-up assessment of their students. Parents are then forced to fund these assessments themselves. For any child that comes in to my office I ask his or her parents, "What do you think Mike will be doing when he's 25?"  Sometimes their is a clear plan, one with a bright future, their child working, living independently and ...paying taxes! Sometimes parents break down and are overwhelmed by their stress about what to do. Aspeger's, high functioning autism, autism and related social cognitive disorders require one thing more than anything else: A plan.

Parent's of children with autism often bring in a 3 ring binder which has a picture of their child on it, and inside are stories, photos, all the testing and treatment information, work samples and so on. They use this to present their child to others in a positive way that makes them consider them as more than a disorder, coding and problem, but instead as a real person with interests, skills, and a story.

I sometimes suggest they start a second book with their child...one about the future. With drawings about where they might live some day, what they will do, who they will know and what life will be like. There's a Dr. Seuss book like thins called, " The Places we will go." So, start a "Future Book" or "Planning Book" with your child.

Today's blog started because of a great article in the New York Times about just this situation. It's about a young man transitioning out of high school in a great supportive transition/training program. (A program you should pay attention to: This is the minimal quality of support you should expect for YOUR child with autism or Asperger's Disorder - minimal! Maybe you should suggest his or her teachers read this.)

Here is how it starts, "People with autism, whose unusual behaviors are believed to stem from variations in early brain development, typically disappear from public view after they leave school. As few as one in 10 hold even part-time jobs. Some live in state-supported group homes; even those who attend college often end up unemployed and isolated, living with parents.

But Justin is among the first generation of autistic youths who have benefited throughout childhood from more effective therapies and hard-won educational opportunities. And Ms. Stanton-Paule’s program here is based on the somewhat radical premise that with intensive coaching in the workplace and community — and some stretching by others to include them — students like Justin can achieve a level of lifelong independence that has eluded their predecessors."  Here is the link:

http://www.nytimes.com/2011/09/18/us/autistic-and-seeking-a-place-in-an-adult-world.html

Great article, great video. A lot to think about. For those looking for some materials to look at right now bout adults with autism and Asperger's Disorder I suggest going to Michelle Garcia Winner's web page, "Socialthinking.com" You'll find a lot of great support material there, most of what I use in my practice, and a lot of what local school districts use, comes from Michelle's hands.

Two good books:

Socially Curious and Curiously Social: A Social Thinking Guidebook for Bright Teenagers and Young Adults by Michelle Garcia Winner
Social Thinking at Work: A Guidebook for Understanding and Navigating the Social Complexities of the Workplace. Also by Mitchell.

I hope you find the article helpful.

About Dr. Roche:

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

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

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

Helping Your Child Face Fears and Anxiety: Exposure Therapy.

One of the most basic therapeutic interventions we use in dealing with Anxiety (stress, fears and phobias) is Exposure Therapy. It's also one of the most complicated ones, and one that can go wrong easily. Children with Aspeger's Disorder, autism (ASD), ADHD and other related disorders relating to anxiety need, eventually, to "face their fears" and become exposed to what scares them. The complication with children who have Asperger's and autism is that some of the normal responses we would expect during exposure don't happen. These children have difficulty switching mental sets...transitioning from one mental or emotional state to another- and some of their anxiety is more related to neurological causes that need careful intervention. (A good resource for help with issues such as sensory issues would be your school's Ot or Occupational Therapist.)

Still, there are two good resources I can recommend on this topic, both are provided by the BC government.

1) AnxietyBC has an excellent handout, downloadable and free, that is part of their overall Anxiety Program for children. You'll find this at their website: AnxietyBC.  The name of this handout is "Helping Your Child Face Fears: Behavioural Exposure.  Thi set of materials helps you develop an understanding of fears and anxiety that your child suffers from, and helps you develop a clear program for address it. This includes building a "Fear Ladder," telling you how to appropriately reward brave behaviour, and how to do "exposure" and "Face Their Fears."  Over and over they give you an important piece of advice: Don't Rush, Practice, Set Goals.

2) AnxietyBC also has a couple of excellent videos that walk you through the process, actually demonstrating these techniques. I'd recommend watching the DVD "Separation Anxiety" and the DVD on Obsessive Compulsive Disorder." I'd watch both of these because the more exposure to use of these techniques you have, the greater your chances you will do them correctly. And the more information, knowledge and practice you have the less anxiety you will have yourself. And nothing is more important than doing this in a relaxed manner. There is a third excellent DVD for adults: Effectively Managing Panic Disorder: A Self Help Guide that might also help you understand the process.

All of these DVDs are available through AnxietyBC, and most can be found at the public library. Remember, you can go on-line and reserve a DVD (or book) and as soon as it is available the library will email you and you can pick it up at any branch. If your anxious about doing this, just drop in to your local library and ask for a demonstration or walk-through.

While there are other programs and materials that I suggest and use in my practice with children and adolescents with Anxiety and Stress issues, especially children with Asperger's Disorder, autism (ASD) and related problems, these are great materials to start with.  If your going to help your child with Anxiety, you need to become an Anxiety expert. This is possible with these types of supports.

About Dr. Roche:

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

Other information about Dr. Roche can be found at:  <a href="http://relatedmnds.com">www.relatedminds.com</a> or <a href="http://www.relatedminds.com/adhd">www.relatedminds.com/adhd</a>. Other information on my practice can be found at: <a href="http://Therapists.Psychologytoday.com/70682">http://Therapists.Psychologytoday.com/70682</a>, http://www.bcpsychologist.org/users/jimroche or <a href="http://psyris.com/drjimroche">http://psyris.com/drjimroche</a>.

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

Poorer movement skills at seven months in children at risk of autism, study finds

Dr. Jim Roche

www.relatedminds.com

Poorer movement skills at seven months in children at risk of autism, study finds

Poorer movement skills detected as early as 7 months old are observed in children at a higher risk of developing Autistic Spectrum Disorder (ASD) than children in the general population. These are the findings of a study being presented on 7th September 2011 at the British Psychological Society's Developmental Section Conference

in Newcastle.

Autism and Relaxation for Stress and Anxiety

For more information on the services I provide for individuals with autism spectrum disorder (ASD) and Aspergers please visit my web page at http://www.relatedminds.com


Click here: http://www.autismoutreach.ca/elearning/environmental-issues/relaxation-strategies
This is an excellent video by Jacquie Bezo, an Educational and Behavioural Consultant with POPARD. in the video she discusses some of the challenges individuals with ASD may face in the area of stress & coping. She provides both concrete and abstract methods of relaxation to deal with stress and anxiety with children with Autism Spectrum Disorder (ASD) or Aspergers. For parents with children with autism (ASD) or Aspergers in the school system will find this a valuable video as it presents several skills that should be part of any child's IEP (Individual Education Plan). It a nice, simple and show learning lesson.


Dr. Jim Roche
Registered Psychologist

Raising awareness of adult autism | BPS

Raising awareness of adult autism | BPS

Autism Spectrum Disorder (ASD) and Asperger's Disorder are lifelong conditions that in the UK alone affects over 500,000 people. In the UK there are a number of current government sponsored initiatives to raise awareness of adult autism and Asperger's. Often ASD is overlooked when adults are seen in mental health facilities, and many medical practitioners are unaware and untrained to administer tests and measures that effectively diagnose these conditions. While most professionals know something about autism, they do not necessarily understand how autism affects people, and these effects are what really matter in day to day living.

The British Psychological Society has developed a series of e-learning modules to raise awareness of adult autism. These are delivered through their BPS Learning Centre, the modules appeal to a range of learners, including members of the public. The modules concentrate on raising awareness, delivering knowledge and understanding from introductory to specialist levels. These are excellent training programs to start with, especially when it comes to adult autism, as there are so few good recourses out there. The link to the British Psychological Society site is above.

The three e-learning modules are:

• Building awareness of adult autism
• Supporting adults with autism (coming soon)
• Working with adults with autism (suitable for Practitioner Psychologists and other professionals) (coming soon)

If you are in need of assessment, diagnosis and treatment for autism and its effects on adults in the home, in relationships or in the work place, please feel free to contact me.

Dr. Jim Roche, Registered Psychologist
RelatedMinds Educational Services
www.relatedminds.com

Study finds new ADHD genes, links susceptibility with autism and other neuropsychiatric conditions

Study finds new ADHD genes, links susceptibility with autism and other neuropsychiatric conditions

New research led by The Hospital for Sick Children (SickKids) and the University of Toronto has identified more genes in attention deficit hyperactivity disorder (ADHD) and shows that there is an overlap between some of these genes and those found in other neuropsychiatric conditions such as autism spectrum disorder (ASD). The scientists used microarrays (gene-chip technology) to study the DNA of 248 unrelated patients with ADHD. They specifically searched for copy number variants (CNVs), which are insertions or deletions affecting the genes. In three of 173 children for whom the DNA of both parents was available, they found spontaneous CNVs, which occur when the parents are not affected and mutations are new to the child. Rare CNVs that were inherited from affected parents were found in 19 of 248 patients.

Within the group of inherited CNVs, the researchers found some of the genes that had previously been identified in other neuropsychiatric conditions including ASD. To explore this overlap, they tested a different group for CNVs. They found that nine of the 349 children in the study, all of whom had previously been diagnosed with ASD, carried CNVs that are related to ADHD and other disorders. The findings suggest that some CNVs, which play a causal role in ADHD, demonstrate common susceptibility genes in ADHD, ASD and other neuropsychiatric disorders.

"For the first time, we've tested these genetic alterations in ADHD and have a pretty good handle on a couple of decent ADHD candidate genes," says Scherer, who is also Professor in the Department of Molecular Genetics at the University of Toronto and GlaxoSmithKline Chair in Genome Sciences at SickKids. "This is critical, as it gives us confidence in interpreting our results."

ADHD is a common neuropsychiatric disorder that affects four per cent of school-age children worldwide. It is associated with inattention, hyperactivity and impulsiveness that often results in learning difficulties, social problems and underachievement. ASDs are diagnosed in roughly one in 100 children in North America and cause deficits in communication, social understanding and behaviour.

For more information on this study visit the above webpage. For information on services for children, adolescents and adults with autism spectrum disorder (ASD) please visit my website at http://www.relatedminds.com