Wednesday, December 20, 2017

Skills for Children with Autism | Small Talk Can Loom Large: Teaching your child the flow of conversation.

RelatedMinds Educational Services  provides individual therapy for children with autism spectrum disorder, using the social learning curriculum from Michelle Garcia Winner. We see individual children, pairs, groups when possible, and provide consultation for parents and educators. We also help with school related issues, such as consulting on your child\'s IEP and behaviour plans. See our website for more information: www.relatedminds.com or http://www.relatedminds.com/autism/

Here is an excellent, and short, article on teaching your child about small talk. This can be a very difficult social skill to learn, and certainly during the holidays. A great read:  (Just click below)

https://autismawarenesscentre.com/small-talk-can-loom-large-teaching-child-flow-conversation/?utm_source=Autism+Awareness+Centre+Email+List&utm_campaign=3aae6e4a79-Monthly_Book_Blast_June6_17_2013&utm_medium=email&utm_term=0_3ea35006c7-3aae6e4a79-90235037&mc_cid=3aae6e4a79&mc_eid=03c49807ed

Sunday, December 17, 2017

University Accommodations for Learning Disabilities and ADHD in BC

Academic Accommodations for Students with Learning Disabilities in the Lower Mainland

We provide assessments / testing for students seeking academic accommodations due to specific learning disabilities, ADHD (attention deficit hyperactivity disorder), depression, anxiety, and other psychological or neuropsychological problems. These assessments are also appropriate for those in the workplace seeking workplace accommodations.

Comprehensive assessments for ADHD cost $800, and full Psychoeducational Assessments run between $1,800 (if you have a more recent assessment that needs updating) to $2,400.00.  Be aware these costs are not covered by BC MSP, but may be covered by your extended health care plan. Some schools will assist students in paying for this type of assessment. You need to contact the school directly. As far as insurance goes, you need to check with your own plan, as each plan is different and we have no way of knowing the extent of any individual’s coverage.

Assessments include testing, collecting a psychological and medical history, scoring of the tests, the determination of a diagnosis, if appropriate, and a final written report ranging from 5-15 pages, depending upon the type of report.  We spend about one hour with you to review the findings and make suggestions as to skill development, suggested accommodations, possible tutoring and study skill that would be helpful.

We are often involved with students after their testing providing tutoring and study skill training.

Each local college or university has different requirements for obtaining assistance, support  and accommodations. 

Academic Accommodations are put in place to mitigate the functional impact of a student's disability in the educational setting.  These supports are intended to promote access for students with disabilities without compromising the integrity of the learning environment. Accommodations are determined based upon medical documentation and in consultation with the student.
Please contact us at RelatedMinds Educational Services:  www.relatedminds.com
Our phone number and an email contact form can be found on the website.
Examples of Academic Accommodations
The following list is a sample of available academic accommodations. It is not all inclusive:
Assignments:

Alternate format/assignment
Classroom:
Interpreter
Notetaker
Preferential seating
Use of adaptive technology
TypeWell transcription
Exams:
Extra-time
Separate setting
Use of a computer
Use of adaptive technology
Reader
Scribe
Studying:
Alternate format for course materials/text books (e.g. mp3, e-text)
Here is a sample agreement letter to record lecturers:


More detailed information on the specific requirements for local colleges and universities can be found below:

Simon Fraser University (SFU)


University of British Columbia (UBC)



Douglas College


For ADHD:

Langara College


Vancouver Community College



University of the Fraser Valley




Friday, December 15, 2017

Independent Neuropsychological Exams / Independent Medical Exams (INE/IME)

Dr. James Roche of RelatedMinds Psychological Services provides Independent Neuropsychological Examination for the investigation of insurance claims, intervention planning and case management purposes. He provides a comprehensive neuropsychological assessment, as well as personality assessments, adaptive behaviour assessments and functional assessments. These exams should be arranged through your insurance provider or legal representative. Issues of suspected malingering, effort, substance abuse and diagnostic clarification are common reasons for these types of examinations.

Dr. Roche also provides assessments for workplace issues, including ADHD and autism assessments. He also provides individual therapy such as social skills training, anger management and executive functioning support.

For more information visit the RelatedMinds website at www.relatedminds.com
Te website provides contact information.

Wednesday, December 13, 2017

ADHD Assessment, Diagnosis and Treatment

We provide comprehensive assessments for ADHD (Attention/Deficit-Hyperactivity Disorder), sometimes called ADD in our offices in Burnaby. The procedure for an ADHD assessment includes:
1) An initial meeting to review your current symptoms and history. This meeting also allows us to determine if an assessment is appropriate at this time, or if your time and resources might be better spent on another plan;
2) We ask that you complete a series of self-report inventories which address symptoms, and that you complete a personality assessment and clinical interview. This is to rule out other possible causes for your symptoms, as well as look for possible co-morbid disorders, such as executive dysfunction, anxiety, depression or possible learning disabilities. Nearly 50% of individuals with ADHD have a second disorder, such as anxiety or dyslexia, which needs to be treated if the ADHD treatment is to be successful.
3. You then complete a computerized neuropsychological assessment. This looks at memory, motor functioning, simple and complex attention and processing speed. Sometimes we ask that you also complete several short paper and pencil neuropsychological tests as well.
4. Information is also sought from people who know you well, so that we can see how your symptoms are experienced by others, and if possible, information about your symptoms before the age of 12.

The tests are then scored and all the results are analyzed in order to make a diagnosis. From there a comprehensive report is written for you to take to your medical provider if you are considering medication. This report also includes information about interventions and life style changes that you may find helpful.

Some individuals stop here, others come back for coaching over a period of time.  We also provide parent training, individual therapy and help with school based interventions and IEP's.

Dr. Roche has been working in the field of ADHD for well over 30 years, as a teacher, school psychologist, director of behavioural services for school districts in California, New York and Canada.  He brings this wide experience to assessments and treatment planning for children, adolescents and adults.

Please review our information on our website at http://www.relatedminds.com/adhd/

We can be reached at relatedminds@gmail.com or 604.726-2652

Autism/Asperger's Assessment, Diagnosis and Treatment

Assessment and Diagnostic Services
Our services include assessment and diagnosis of children for autism spectrum disorder. We primarily provide these services to children over 6 years old and meet the the BCANN Standards which qualifies a child for with autism for services in the schools and funding through the provincial government. Our wait lists are usually very short, one to two weeks. Services are provided by a registered psychologist, and if further assessment is necessary for schools (such as a psychoeducational assessment) we provide those services by certified school psychologists under the supervision of a registered psychologist.  Some of these services may be billable to your extended health care plan, however the services of a registered psychologist are not currently covered in BC by provincial MSP.

Treatment and Interventions
Once your child is diagnosed and you are registered for services with the Ministry counselling, behavioural and family therapy services are covered by you autism funding. We provide supportive family counselling, behavioural counselling and parent education in our office in Burnaby.

We will work with you in developing an intervention plan, and assist you with school related issues, such as the development of an IEP (Individual Education Plan).

Three areas we are very focused on are behavioural interventions for anxiety and acting-out behaviour of younger children, social-cognitive therapy with older children and teens ( Dr. Roche was trained with Michelle Garcia Winner and uses her social-thinking curriculum)  and working with young adults. We are one of the few providers working with adults with ASD in the lower mainland.

Dr. Roche is a Registered Psychologist and Behaviour Interventionist (a member of the BC RASP, the list of approved providers of behaviour intervention services for British Columbia).

For more information visit our website at www.relatedminds.com
or email us at relatedminds@gmail.com
Our offices are located at the Production Way Sky Train Station, just below Simon Fraser University, easily accessible by transit from anywhere in the greater Vancouver area.




Friday, November 17, 2017

ADHD - Attention Deficit Hyperactivity Disorder: Assessment/Diagnosis/Treatment

Attention Deficit Hyperactivity Disorder (ADHD or ADD) in Vancouver/Burnaby, BC
Many people contact me about ADHD assessment. Let me clarify the process:
Patients may see me on their own, or at their physician's request, for a diagnosis of ADHD. Your physician can diagnose ADHD, but often want a more comprehensive exam. There are many reasons for this. As a clinician I only do comprehensive assessments of ADHD. These cost between $800-$1,200. This involves the following:

1. An initial meeting ($200.00) to discuss your current symptoms and history. Often patients come to see me who think they have ADHD and simply do not. I don't want to waste your time or money on assessments that will go nowhere. Also, sometimes patients have limited medical coverage, and what they have is far better spent with a few skill training sessions. I want to get through these issues first.

2. A comprehensive assessment. A comprehensive assessment means completing the the customary forms and self-reports  you may already have completed, as well as a personality assessment, screening for alternative causes for your symptoms, and a neuropsychological assessment to understand your cognitive strengths and weaknesses. ADHD presents very differently in different people. Some individuals have difficulty with prioritizing, others with organization, some have difficulty with simple focus and memory, others have difficulty with complex focus and memory, some have working memory problems, others have weaknesses in verbal recall, others with non-verbal recall, many have learning disabilities. Other's have difficulty to to slow processing speeds. We also do screenings for depression, anxiety and related issues. This takes anywhere from three to four hours of face-to-face time, depending upon the individual. Additional information is gathered from people who know you.

3. After the assessment is completed a written report is prepared and we meet a third time to review your assessment results and go over a plan of action.

4. Some individuals who are attending school/college/university need a different type of testing, they need a psychoeducational assessment. This is a separate procedure but includes  an assessment for ADHD. We will discuss the type of assessment you need during our initial meeting.

5. If you are involved in a legal matter, such as threats of losing your job, or action that has already been taken at work because of ADHD like symptoms, you also need a different type of assessment. This is a "forensic" assessment, and addresses specific issues that employers and courts need in the procedure. This type of testing, as with any testing that is related to a legal issue, MUST be arranged by your lawyer/solicitor. 

ABOUT DR. ROCHE
I have been providing services for children, adolescents and adults with Attention-Deficit/Hyperactivity Disorder (ADHD/ADD) for over thirty years. This includes comprehensive ADHD/ADD testing/diagnosis with the aim of obtaining appropriate school, work and testing accommodations and supportive service, as well as individual behavioural treatment, such as skill development, to deal with deficit areas such as planning, attention, organization, and procrastination.

I also provide teacher training and classroom consultations about ADHD. As a former classroom teacher, special education supervisor and behavioural consultant for several school districts in Canada and the United States. I bring a unique set of skills and perspective to this work.

Over thirty years ago I began seeing couples dealing with ADHD, sometimes one or more of their children had ADHD, sometimes one or both of the parents. For them I provided cognitive behaviour therapy to help deal with the psychological effects of ADHD and couples/relationship/family therapy to deal with the stress that ADHD can have on your relationships. I try to provide simple, understandable and focused treatment aimed at teaching specific skills you will find helpful in your day to day life and relationships. These ADHD services are provided in my offices in Burnaby and Vancouver.
 
Services include:
• ADHD testing and assessment (neuropsychological and psycho-educational assessments)
• ADHD Treatment Plans for home, work and school
• Couple and Relationship Counselling for ADHD related issues
• Training for problems with focus, concentration, reading, planning and procrastination and anger management (including Cogmed and other training programs for deficits in working memory)
• Assistance with obtaining appropriate accommodations and services through your school, college, university or workplace
• You may be asked to complete a number of forms before you come in for your appointment. They can be found by clicking here.
______________________________________________

Frequently Asked Questions (FAQs)
Well, I think I have ADHD. Where do we start?
All treatment for Attention Deficit Hyperactivity Disorder (ADHD/ADD) begins with a comprehensive assessment. ADHD is a very general diagnosis and it doesnt tell us much about the specific problems you as an individual are having with ADHD. If your medical doctor has told you he or she suspects ADHD, it might be ADHD Inattentive Type, where we see an individual unable to focus, concentrate, having difficulty planning or completing tasks, or it it might be ADHD Hyperactive Type, in which the main problems you face is an inability to sit still, the need to constantly move around or fiddle with things (and people with ADHD Inattentive Type might have no problem with this issue what-so-ever!), or it might be ADHD Combined Type, in which the symptoms of ADHD take in both the problems with attention/focus/planning and excessive movement and fidgeting. And within each of these specific types of ADHD there are individual differences in the severity of symptoms, and how we can tolerate them. Testing also helps us differentiate symptoms that look like ADHD from other things, such as depression, anxiety, mood disorders or related "executive dysfunctions." Many people are diagnosed with ADHD who in reality have something else.

Can I get services from my MD?  Isn’t a medical doctor necessary to diagnose ADHD?
No, a medical doctor is not necessary to diagnose ADHD. A trained psychologist can do an ADHD diagnosis. Many medical doctors would prefer you to see a qualified psychologist about ADHD because they do not have the expertise to do a full diagnosis, which often involves not just a simple checklist of ADHD or ADD symptoms, but also ruling out other possible reasons for the symptoms you or your child may be experiencing. This means completing some other possible testing and an extensive history taking your MD may not have time to complete. Of course, some MDs are able and willing to do a diagnosis of ADHD for you and will use these simple scales. In both my Burnaby and Vancouver offices I see many patients who are referred by their MD after they have already met the criteria for ADHD. This is because they may not feel they have the experience to do a complete diagnosis correctly – because in approximately 50% of cases ADHD or ADD is associated with co-morbid disorders such as learning disabilities, language deficits and behavioural problems you will need to see the psychologist about anyway. The MD, however, is often able to complete an initial diagnosis under your provincial MSP, which is free to you. Services from a psychologist must be paid by your extended health care provider, your employer or through self pay. This is a very legitimate concern.

Is a neuropsychological assessment necessary for an ADHD diagnosis?
 No. The neuro-cognitive (neuropsychological) assessment that I provide for those with ADHD includes, but is not limited to, issues such as verbal memory, visual memory, processing speed, executive function (decision-making, picking out what is important or salient, impulsivity and emotional control), psychomotor speed, reaction time, complex attention, cognitive flexibility and long-term attention and focus. Through this testing we learn about how ADHD affects your flexibility of thinking, concept formation, problem solving, planning, creativity, impulse control, emotional stability, inhibition and procrastination (an inability to switch from one task to another). This information is very helpful in determining where to focus our interventions. Not only telling us about the weaknesses you may have due to ADHD, but also pointing out your cognitive strengths and affinities. This helps us develop strategies based upon your strengths.

How do you know I have ADHD and not something else? I understand a lot of people get diagnosed with ADHD who don't really have ADHD
In addition to these neuropsychological tests and extensive history taking we also look at factors that might direct us towards other or co-morbid diagnoses such as depression, anxiety, bi-polar disorder, learning disabilities and so on. ADHD is known for being found in combination (co-morbid) with several of these other disorders in children, adolescents and adults. Sometimes these disorders mask the nature of the ADHD. Sometimes we can mistake another disorder for ADHD. So along with the comprehensive neuropsychological assessment we also look at personality issues that help in ruling out other possible causes for the issues that you are concerned about. This is a particularly helpful for medical doctors who often send their patients to me for help as they are often not equipped or experienced in this level of diagnosis. This information helps your medical doctor in making better choices in terms of medication if you and your doctor make a choice to explore medication for your ADHD.

Finally, we complete a comprehensive behavioural and medical history that also helps us understand your problems, how ADHD may effect your day to day life at work, home or school, and how we might intervene to help you deal with your ADHD symptoms.
Some parts of this examination are repeatable, so that at a later time we can see if ADHD treatment interventions have really had an effect on your symptoms. I provide a set of procedures and documents that you, your child’s school or parents can use to measure the effects of any ADHD intervention (behavioural or medical). The truth is sometimes we feel better because we think we are better, or sometimes we fail to notice complex cognitive improvements after taking medication because they are hard to measure. These tests and data collection procedures are specifically designed to help determine if real changes have taken place in your ADHD symptoms.

What would a treatment plan for an adult with ADHD look like?
Once a diagnosis of ADHD is made and we have enough information to understand how ADHD impacts you we develop an intervention plan. We meet an average of eight times, using a combination of psycho-educational (teaching) and weekly consultation to get you off on a program you can continue on your own. Here is a general outline of the meetings and intervention schedule I often use. Over 8 consecutive meetings we will likely discuss immediate uses you are having, and spend part of the time discussing these following topics (This is a sample program, individual programs are developed for each patient based upon their test results, needs and resources):
• Assessment, Review and Overview
Session 1 Review of assessment results; Overview of the ADHD program; Discussion of involvement of family and work mates
• Organization and Planning for Individuals with ADHD
Session 2 The basics of organization and planning skills; Organizing multiple tasks
Session 3 Problem-solving and managing overwhelming tasks; Organizing papers
• Reducing Distractibility due to ADHD
Session 4 Gauging your attention span and distractibility; Modifying your environment
• Adaptive Thinking Part 1
Session 5 Introducing the Cognitive Model of ADHD (Cognitive Behaviour Therapy)
• Adaptive Thinking Part 2
Session 6 Review of Adaptive Thinking and previous sessions
Session 7 Dealing with Procrastination
Session 8 Preventing ADHD Relapse and setting future goals
Following this eight week outline together we cover all major areas of concern that commonly are found with ADHD. As I mentioned above, we also fine tune the program to address your specific deficits and strengths that we identified during the assessment process, making success much more likely. Individuals are then able to use appropriate self-help tools with confidence and the knowledge and experience they need to make the most of them.
After this initial program ADHD clients sometimes see me on a monthly basis, or quarterly, for “check ups†and to address problems with relapse.

For those who with the help of their primary medical provider decide to take medication to deal with this disorder I provide ongoing neuro-cognitive assessments that help monitor the effects of the medication. Research has found that for those diagnosed with Attention Deficit Hyperactivity Disorder (ADHD or ADD) a combination of medication, psychoeducation and behavioural training is the most effective path.

What about ADHD Treatment for Children and Adolescents?
I work extensively with children and adolescents. One thing I am able to provide, that others may not, are interventions for the school and home that are acceptable to the school staff. My experience as a classroom teacher for nearly 10 years, and as a school-based educational psychologist, gives me insight into how common treatments for ADHD are best adapted to the school and classroom environment. I also provide schools with training workshops and teacher consultation on ADHD.

Do you recommend any specific books about ADHD? Especially about Adult ADHD? There are so many out there I don’t know where to start?
For adults we often use the Cognitive-Behavioural Treatment Program for Adults with ADHD developed by Safren and Sprich, which has been found useful with adults. I also ask clients to watch Russell Barkley’s A New Understanding of ADHD (a DVD available in the office) as well as his new book Managing Your Adult ADHD and read either Kelly and Ramundo’s You Mean I’m Not Lazy, Stupid or Crazy?, Hallowell’s Driven to Distraction or Thomas E. Brown’s Attention Deficit Disorder: The Unfocused Mind in Children and Adults. All of these books can be obtained in my office or through Amazon.ca. For those who find reading difficult or find finding time to read difficult (and these are all 300+ page books) there are CDs and DVDs available. I have similar books on ADHD for parents that specifically address parenting and school-related issues.

For teachers dealing with ADHD in the classroom, the Ministry of Education provides some guidelines and intervention strategies which are an excellent place to start. This information may be helpful for parents as well, as often it is unclear what level of intervention we should expect for a student with ADHD in the classroom. Here is the website url: http://www.bced.gov.bc.ca/specialed/adhd/

What about faster methods for dealing with ADHD like neuro-feedback, hypnosis or diet changes? Don’t they work?
The short answer is no, they dont. There is some, but little evidence supporting any of these treatment methods by themselves for ADHD. You may hear that there is research showing neuro-feedback works for ADHD, autism, Aspergers and many other problems. The truth is that after over twenty years of research there is minimal evidence that neuro-feedback or neurotherapy has any significant effect on behaviour, school success, attention or impulsivity. Recently there has been some evidence that a combination of neurofeedback and medication is more effective than medication alone, but the best known interventions include medication, psychoeducation and behavioural/environmental interventions in the school and home. (Dr. Russell Barkley, a leading researcher in the field addresses this issue on his web page.)  Diets, except for those with a specific allergy, have been shown to have no effect on ADHD. Chiropractic and homeopathic interventions have not been shown to have any effect. “Sound Therapy” and hypnosis, likewise, has been show to have no effect. Two websites I often suggest individuals look at for information about these alternative therapies are www.sciencebasedmedicine.com and www.quackwatch.com.

I would be more than happy to share the research on these alternative methods with you upon request. My best advice is to ask your medical doctor what he or she knows about these often ineffective yet expensive interventions. He or she is your best source of information. you should seek out proven treatments that directly address your issues, treatments that have been shown consistently to work, and for which their is a good and long body of supportive evidence. Almost always psychological treatments should begin with psychoeducation, behavioural training, practice, practice and feedback on your practice.
How much does ADHD treatment cost?

Initial, Assessment and Continuing Sessions (usually 50 mins) are billed at a rate of $200.00. This is the current rate recommended by the British Columbia Psychological Association (BCPA). For those seeing me long term (more than 4 sessions) there is a reduction in the hourly rate. A full ADHD assessment for a diagnosis, which takes several hours - three sessions- costs $800.00-$1,200. The testing and assessment usually take three to four sessions, including a feedback session where we discuss the specific nature of ADHD and how it affects you and treatment interventions that would be appropriate.


More comprehensive diagnostic testing is sometimes necessary for obtaining adaptations and modifications in school, the workplace or for high stakes testing.Some colleges will require a full psychoeducational assessment before granting accommodations. Please check with your school or college prior to coming in and obtain and forms they may need completed.

For more information please refer to my webpage at www.relatedminds.com

Thursday, November 9, 2017

Behavioural Interventionists and Counselling for adolescents and young adults with autism spectrum disorder (ASD)

RelatedMinds Psychological and Educational Services provides one-to-one counselling and coaching for children, adolescents and young adults with autism spectrum disorder (ASD or "Asperger's Disorder."  Dr. jim Roche has over 25 years experience in the field working with programs in New York, California and Canada. He has served as a teacher, counsellor and psychologist for several major institutions and school districts. Services qualify for payment through the BC Ministry of Children and Family Services if your child has a diagnosis of ASD. Dr. Roche also provides testing and diagnostic services for ASD.

Our staff also includes school psychologists, registered clinical counsellors and behaviour interventionists. Dr. Roche is a member of the BC RASP.  Visit our website at www.relatedminds.com