Wednesday, August 16, 2017

My child has ADHD and has trouble at school. What can I do?

Dr. Jim Roche, Registered Psychologist
Practicing in the Fields of Educational, Clinical and Neuropsychology
Assessment and Treatment for ADHD, Learning Disabilities and Behavioural Issues

School is starting in one week! What to do if you child has ADHD

If your child doesn't have a diagnosis, get one! Your psychical can do this, or contact a psychologist. No one else should be diagnosing ADHD. On-line check lists are inappropriate and often wrong. Avoid them. But don't avoid a diagnosis. Remember, with younger students almost 50% have another co-morbid disorder, such as a learning disability. To understand these issues you need a psychoeducational assessment.

If your child has had academic difficulty for a year or two, despite SIGNIFICANT and REAL interventions by the teaching staff, ask for a psychoeducational assessment.  Do not allow the school to present a "learning plan" when they haven't done an assessment! Would you take medications without a medical diagnosis? 

A private psychologist can also provide a psychoeducational assessment. They cost from $1,800-$4,200. The cost varies widely. So does the experience of the psychologist. I would insist my psychologist has experience working in schools. Many do not. And remember, only a REGISTERED PSYCOLOGIST cn do this. I often see reports done by "reading consultant, reading expert, dyslexia specialist." These are people without a license! Would you see a "toothologist" instead of a dentist? See a psychologist, and make sure they have worked IN a school.

If your child has behaviour problems due to ADHD do not allow the school to write a "plan" and most certainly not a "safety plan" without a psycoeducational and/or functional behavioural assessment (FBA). For severe behaviour issues an FBA is necessary. If no one in the school is trained in doing an FBA, tell them to find someone. Always put your requests in writing.

Children with ADHD are often given plans that consist of a list of things the child/student is required to do. For instance, "Mark will finish his work on time." That's nice. Mark has ADHD. The plan should tell ou how the school will do two things: 1. Accommodate your child due to his or her disability, and 2. What new skills THEY are going to teach your child. It is not a list of requirements, punishments and guidelines, its an outline of how your child will learn the skills necessary to be successful in the academic environment. The regular way of teaching and learning don't work with children with ADHD, so we are going to do these specialized individual things to help him or her.

Finally, no plan should be about punishments and consequences. With ADHD, which is a neurological disorder, rewards, praise and support are what work. Not punishment or more rules. We know this from decades of research.

Parent education, by the way, has been found to be the most effective of interventions!

Finally, here are my most basic resources for students in the higher grades:



Study and School Related Resources
  • Foe older students in high school, college or graduate school: The Cornell Note Taking Method: Click here  This is the best way to take serious notes that help you in understanding materials, clarifying materials and studying for quizzes, tests and exams. I also teach another note taking method called the "Two Column Note" that is useful in more general study situations, but the Cornell System is overall the number one method of note taking.
  • The New York Times has an excellent article, actually a series of articles and videos, on "Doodle Note Taking." I strongly suggest looking at this. NEW YORK TIMES HOW TO TAKE NOTES
  • I often suggest we start with some very simple tasks or techniques, and these ideas seem to fly in the face of peoples expectation that they should make use of a large book or workbook that addresses multiple issues. Stick to one issue at a time. Learn a skill, think about how it works and apply that knowledge to your next problem.
  • Here are two great articles on studying. There is a LARGE and LONG book on this topic, several as a matter of fact. But this short version is just as helpful combined with some consultation or coaching.  1.  HOW TO LEARN     2. The longer HOW TO LEARN
For more information please visit my website at www.relatedminds.com

Wednesday, July 26, 2017

ADHD Testing and Treatment Vancouver Burnaby

Dr. Jim Roche is a Registered Psychologist who provides in-depth ADHD Assessments in the Vancouver/Burnaby area. He has over 35 years experience in the field of ADHD and has worked in private practice, at NYU Medical Centre, as a school district behaviour management specialist, school psychologist and certified teacher of special education. Contact him through his website at www.relatedminds.com or http://www.psychologists.bc.ca/users/jimroche


Two good places to find information about ADHD (Attention-Deficit/Hyperactivity Disorder are:
Here-To-Help at: http://www.heretohelp.bc.ca/sites/default/files/attention-deficit-hyperactivity-disorder-in-adults_0.pdf
And CADDRA at: https://adhdlearning.caddra.ca/adhdlearning/#!*menu=17*browseby=1*sortby=1

What is ADHD?
Attention-Deficit/Hyperactivity Disorder, or ADHD, is a biological based illness that affects the way you act and focus. ADHD is usually diagnosed in school-aged children, but it can continue to cause problems into adulthood. About two-thirds of people living with ADHD continue to experience symptoms as an adult. As we learn more about the course of ADHD, it’s becoming more common for teens and adults to be diagnosed with the illness. One reason we now diagnose ADHD more often in teens and adults is very simple: We didn’t use to diagnose it for anyone over 18!
So when you hear we now “over diagnose” ADHD, remember, we just started making adult diagnoses.

ADHD can come in a variety of forms. You can have ADHD with only inattention, ADHD with only hyperactivity, ADHD with both inattention and hyperactivity, and sometimes we diagnose ADHD when things don’t quite meet the diagnostic criteria, but there is simply no other explanation.

My comprehensive diagnostic procedure addresses many of the problems we have had with diagnosing ADHD in adults. For instance, ADHD may look like another mental illness, or another mental illness may look very much like ADHD. Therefore we complete a comprehensive “differential diagnosis,” we rule out other possible causes.  To do this you are given the usual ADHD self-reports, we collect information from people who knew you when you were young, if possible information from someone close to you who knows you now, and we complete a series of diagnostic neuropsychological assessment tools. 


The neuropsychological assessment helps us understand the exact nature of your ADHD, as well as helping us understand the pattern of your cognitive strengths and weaknesses. Do you have weak verbal memory but strong visual memory? Are you better at complex tasks than you are at simple tasks? Is there a time limit to how long you can stay on-task? All these, as well as other questions, are addressed in the comprehensive ADHD assessment. Every month I see dozens of individuals with ADHD symptoms in my Burnaby offices. They come from Burnaby, Coquitlam, Vancouver, Richmond and sometimes from as far North as Ft. Nelson. 

When the assessment is completed I provide you with a comprehensive report, including direct skills sets that should help you addressing your attention and behavioural issues.

What about medication for ADHD?
As a psychologist in British Columbia I do not prescribe medications. However, if you are interested in medication your report contains a short summary statement to take to your physician. You and your physician can make decisions about medication with this knowledge.

Some people do not choose to use medications, and there are some alternatives you can try. These are not diet or supplement interventions, for which there is very little scientific support. Instead we work together on making general lifestyle changes and learning skills to help you address the negative symptoms ADHD has brought.

Even with medications individuals with ADHD need to develop skills. There is a pill to help you focus, to calm down some of the excessive movement, and to control your reactions to environmental stimuli. Still, there are no pills to teach you study skills, organization skills and emotional control. These come from on-going ADHD coaching or behavioural counselling.

I also provide school related consultations for students of all ages. This might include help with developing an IEP (individual education plan) for an elementary school student, or develop study skills for older students. Learning to move away from procrastination, and learning to self-monitor your actions is a key component to dealing successfully with ADHD.

What about school based accommodations?
Most college students can obtain accommodations through their ADHD diagnosis. I usually provide a list of common school based accommodations along with the written report. Some schools, however, require a more complete assessment called a psychoeducational assessment. These schools often want evidence of how ADHD is effecting your school work, not just that you have ADHD. Try to find out from your school, college or university what exactly they need before we begin. I can complete a psychoeducational assessment, however it is faster and cheaper if we know one is required before we start.

An assessment for ADHD costs approximately $1,000. A psychoeducational assessment can range from $1,800-$2,400. Planning ahead can save time and money.

Visit my web page at www.relatedminds.com for more information.
You will also find information about me at:




Friday, June 23, 2017

Learning Disabilities: The Basics of Visual Note-taking

In my practice I often see patients with a variety of learning disabilities. Sometimes as part of a pstychoeducational assessment, and sometimes after a psychoeducational assessment as part of the follow-up meetings where we provide consultation and coaching on learning skills. One of my favourite areas is written expression. So many young people have problems with visual expression. More specifically, with handwriting. Handwriting problems can mean a student will not be able to produce work that is commiserate with their abilities. This can be frustrating and debilitating.



Besides the usual accommodations that we suggest, such as the use of tablets, keyboards and voice dictation programs, I always suggest that an individual not avoid writing. Writing when taking notes is a critical part of getting the information into your head and fully understanding it. For those individuals we have specific writing techniques which differ from age to age, and generally we suggest visual note-taking, sometimes called doodle-note taking. Not only does it help with memory and retention, it also helps with sustained attention and distractibility.



Take a look at the entire New York Times webpage on this topic, which can be found here:

https://learning.blogs.nytimes.com/2015/09/24/skills-and-strategies-doodling-sketching-and-mind-mapping-as-learning-tools/?_r=0



For more information on psychoeducational assessments, as well as diagnostic assessments for ADHD and autism spectrum disorder, please visit my webpage at: www.relatedminds.com

The best way to reach me about a psychoeducational assessment is by email. You will find my email on the webpage.

Tuesday, June 6, 2017

Speech and Language deficits in children with autism may not cause tantrums.

A recent study from Penn State College of Medicine suggests that speech and language impairment may not be the cause of frequent tantrums in children with autism. This is important because many parents are told that as their child matures and developed speech and language skills their behaviour will improve. This study suggests that is not necessarily so.

Researches found that only a very tiny percentage of temper tantrums are caused by an inability to communicate, or an inability to be understood by others.

While the study doesn’t answer the question “what” causes the tantrums, it may be more productive to spend time focused on mood dysregulation and low frustration tolerance - both of which can be addressed through an appropriate form of applied behaviour analysis (an FBA), and some simple behavioural techniques. 

The problem is to be relying on a total language based program, which really won’t address the core issues, or teach the necessary skill stet to the child.

This is similar to the American Academy of Paediatrics warning about over-reliance on a sensory based program, to the detriment of more basic behavioural therapy and skills learning.

Here is the article at Autism Awareness:
https://autismawarenesscentre.com/tantrums-in-autism-frustration-at-poor-communication-or-behaviour-issue/?mc_cid=9f468d94f5&mc_eid=03c49807ed

Here is a short version at Science Daily:


I continue to see patients for a variety of problems, including ADHD, autism spectrum disorder, depression and anxiety in my Burnaby office. This includes children, adolescents and adults. The majority of my practice right now are young adults and adults with autism. Please contact me for any information.  You will find a contact page on my website at www.relatedminds.com



Thursday, May 11, 2017

ADHD Assessments. Burnaby/Vancouver/New Westminster

Assessing for ADHD is often done by family doctors. Such an assessment often consists of little more that completing a checklist of symptoms. Here in Canada we also have a specific set of forms that medical doctors are asked to use from our Canadian ADHD Association, CADDRA.

Many doctors refer patients to me for an ADHD assessment because a more comprehensive look at your symptoms is necessary. My ADHD assessments include more than a simple checklist of symptoms because for the most part the list of symptoms your doctor gives you doesn't rule out other possible causes for your concerns/problems, and also doesn't tell us much about the nature of your individual case of ADHD.

During a comprehensive assessment we also need to look for other "comorbid" disorders, disorders often found in people with ADHD. These include things like depression, anxiety and OCD symptoms, as well as problems like learning disabilities, problems with executive dysfunction and working memory. A checklist isn't going to be able to tell you about these issues, and certainly can't be used  to develop an intervention plan. For this reason, we complete a more comprehensive assessment every time we do an ADHD assessment.

Assessments for ADHD start with an initial appointment to review your history and current signs and symptoms, and together decide what kind of assessment, if any, we are going to engage in. If we move forward we schedule a two hour session for testing, and then a final session to review the results. The total cost of the assessment is $800. The cost of the initial meeting, $200, becomes part of the overall $800 cost.

Some patients the move on to medication, others do not. Many patients see me for follow up sessions during which we address specific skills that are found helpful by many individuals with ADHD.

For more information, and to arrange an appointment, please visit my webpage at www.relatedminds.com

Friday, March 31, 2017

Therapy for Adolescents/Teens with ASD/Asperger's

Counselling and "Social Thinking" therapy for teens and young adults in Burnaby. Dr. Jim Roche provides counselling services based upon the theories of Michelle Garcia Winner - Social Thinking - in his offices in Burnaby. The office is located at the Production Way Skytrain Station. Social Thinking is a form of social cognition training and cognitive behaviour therapy (CBT) for young adults to help them understand the perspective of others. Most teens and young adults with autism spectrum disorder, or what was formerly called "Asperger's Disorder" need help in developing social cognitive skills to make social interactions easier. Therapy differs from individual to individual but usually focuses on issues such as social perspective taking, dealing with difficult people, handling stress and anxiety, controlling an over controlling brain - learning to be socially and cognitively flexible, and emotional regulation.

Young people often also have academic issues they need help with, and these issues are dealt with as well.

Dr. Roche is a member of the BC RASP (approved providers of autism services) and is a Registered Psychologist. Contact him by email to set up an appointment of arrange for a short phone consultation. His website is found at www.relatedminds.com

Parent training and education about autism spectrum disorder and Asperger's Disorder is also available, and often parents are seen in order to learn skills necessary to help their children succeed in the social world. Testing and treatment for ADHD and learning disabilities is also available. Dr. Roche has over 30 years experience in the field as a teacher, school psychologist, behaviour management specialist for school districts and as a provincial consultant on autism spectrum disorder.

Besides Dr. Roche's website, parents often find the website of Michelle Garcia Winner very helpful. That can be found at: www.socialthinking.com