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What is a Pediatric Neuropsychologist?

Pediatric neuropsychologists are clinical psychologists who focus on completing comprehensive evaluations to ascertain the most appropriate diagnosis in order to lead to the most effective treatment outcome. All neuropsychologists have their Ph.D. or Psy.D. in Clinical Psychology and also have several years of training with brain based behaviors, neurodevelopmental conditions, as well as effective interventions and accommodations.

The typical questions that parents will bring forth in a neuropsychology clinic are related to the child’s academic performance, behavioral regulation, social interaction, and/or emotional functioning. It is the goal of the neuropsychologist to help identify what is causing the negative behavior and what would be an effective course of action.

Conditions and diagnoses that pediatric neuropsychologists often work with include the following:

Often, it is found that a child may have multiple conditions. One of the goals of the neuropsychologist is to help determine what the main condition(s) to address are and the most effective interventions.

The interventions that are determined by a pediatric neuropsychologist are often found in the following places:

Accommodations on the SAT and ACT

Many high school students with learning disabilities or Attention Deficit Hyperactivity Disorder require additional assistance and accommodations when they are required to complete lengthy examinations such as the SAT and the ACT.  These adolescents often are unable to complete the examination within the time frame allotted to them or exhibit difficulties with certain aspects of the examination because of their learning disability.

It is important for parents and academic staff to be aware that the testing boards are clamping down on allowing accommodation on these examinations.

There are several factors that need to be met in order for an adolescent to qualify for accommodations:

  • There has to be documented evidence of a learning disability or medical condition that impacts the individual’s performance.
  • There has to be school evidence that the symptoms from the condition have an impact on the adolescent’s academic performance.
  • There should be a ‘paper trail’ established in which the individual has a history of accommodations and interventions within the academic setting.

Once the necessary requirements for accommodations have been met, it is then important to help determine what specific accommodations the individual would necessitate for the examination.

Accommodations are created based upon the individual’s specific needs; however, a list of possible accommodations that many adolescents with ADHD and/or learning disabilities may benefit from include:

  • Extended time under a minimum of time and one half conditions
  • Small group testing
  • Ability to type responses as needed
  • Ability to write in the test booklet as opposed to having to transfer responses to a separate bubble sheet or scantron form

The most important thing for parents to understand is to not wait.  If you speculate that your child might need accommodations on formal testing, have an evaluation completed as soon as possible in order to help establish the needed diagnosis and paper trail.  Visit our Neuropsychology Diagnostic and Testing Center for more information on formal testing.

Social Skills Training for the Treatment of ADHD

Research has indicated that the number one treatment for Attention Deficit Hyperactivity Disorder (ADHD) is a combination of stimulant medication and social skills training.  The purpose of this blog is to give a primer for parents on skills training and what this constitutes for a child with a diagnosis of ADHD.  There are four major components associated with skills training for a child with ADHD:

1. Parent training

Parent training focuses on inattentive and impulsive behaviors that are evident within the home environment.  With this intervention, parents are taught specific behavioral strategies to help modify the child’s environment to best manage the behaviors in the home environment.  Time is spent discussing changing the environment to limit distractions as well as create specific and practical schedules of reinforcement to improve the frequency and duration of positive behaviors while extinguishing negative behaviors.

2. Social skills training

Social skills training is often conducted in a group format and focuses on improving the child’s socialization skills in a safe setting.  Here the child is forced to socially engage with same age peers.  In addition, the group leader is able to provide immediate and practical feedback regarding the success or failures of the child’s success in the social setting. Read more

How Does Occupational Therapy Help with ADHD?

It has been well documented that children with ADHD often struggle with maintaining focus in various areas of their day to day lives and consequently achieving their full potential. As Dr. Greg Stasi explains in his June blog, ADHD and Learning: Attention Deficit Hyperactivity Disorder’s Impact on Learning, children with ADHD often exhibit impulsivity or hyperactivity, difficulty with following directions, and poor executive functioning skills. The impact of these difficulties can be extensive on a child’s success in school, relationships, and overall self esteem.

How does occupational therapy help a child with ADHD?

Occupational therapists often work with children to help them develop self-regulation and executive functioning skills. By teaching children strategies to address these challenging areas, we empower them to become more independent and self assured by targeting two important areas: Read more

What is a 504 Plan?

I have received several telephone calls over the past few weeks from anxious parents about their child’s school wanting to create a 504 Plan in the academic setting.  Many times parents are not informed about what this means or about possible benefits that might be exhibited from such a plan.

What is a 504 Plan?

Section 504 is part of the Rehabilitation act of 1973 which was designed to protect the rights of individuals with disabilities in any facility that receives federal financial assistance.  What this means for a school age child is that the school is unable to deny academic services to a child because of a specific disability.  These plans were originally established for children with medical concerns such as being confined to a wheelchair or having a medical condition such as a seizure disorder.  Today, it is quite likely that the main reason 504 Plans are offered to children are from diagnoses of Attention Deficit Hyperactivity Disorder.

 How do 504 Plans and IEPs Differ?

There are a few major differences between a 504 Plan and an Individual Education Plan (IEP).  A child with an IEP has significant academic concerns in which he or she requires intervention from either a learning resource teacher, or specific therapist such as a speech and language therapist.  The 504 Plan should be thought of as accommodations within the classroom setting to help address the specific concerns that a child may exhibit.  These accommodations are designed such that the child’s academic demands are the same as his or her peers but there is assistance given such that the child can reach his or her academic potential. Read more

Q and A: Gender Differences in ADHD

Recently we highlighted a study that suggested that diagnosis rates of ADHD differed in children of different races.  Today’s blog points out the differences in symptoms and diagnosis rates between genders. ADHD

Now, more than ever, researchers are uncovering tangible evidence to explain the differences in Attention Deficit Hyperactivity Disorder (ADHD) symptoms among boys and girls.  With accumulating data, we are better equipped to understand the neurobiology of these developing boys and girls, refine assessment, and focus on treatment.

Q & A | Gender Differences in ADHD:

Q: Are boys, in fact, more likely to have ADHD? 

A: The ratio of ADHD in boys to girls is relatively equal, with reliable reports ranging between 2:1 (CDC, 2011) and 1:1 (Froehlich, 2007).  To no surprise, however, boys continue to be disproportionately diagnosed at higher rates than girls (Bruchmuller, Margraf, & Schneider, 2011), likely due to their tendency to display more disruptive behaviors. Read more

Racial Differences in the Diagnosis of ADHD

A recent study published in the June issue of the Journal of Neurosurgery: Pediatrics indicated that Caucasian children are more likely to receive a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD)ADHD in comparison to minority children.  This study followed more than 17,000 children across the nation from kindergarten through eighth grade and asked their parents whether not their children were ever diagnosed with ADHD.

Findings-Racial Differences in the Diagnosis of ADHD:

The researchers found that Hispanic and Asian children were about half as likely to receive a diagnosis of ADHD as Caucasian children.  African American children were about two thirds less likely to be diagnosed with the condition.

Implications of this Study:

It is important to realize that the study cannot indicate whether or not ADHD is over diagnosed in Caucasian children or under diagnosed in minority children.  However, the numbers are pretty glaring and most definitely indicate a discrepancy in not only diagnosing the condition, but also in the interventions received. Read more

ADHD and Executive Functioning Resource Guide

Are you looking for more information on ADHD or Executive Functioning?  Read on for top picks from our ADHD ResourcesNeuropsychologist.

Top Resources for Information on ADHD and Executive Functioning:

  • Taking Charge of ADHD:  The Complete Authoritative Guide for Parents.  Barkley, Russell (2013): This book provides parents with evidence based interventions regarding ADHD.  It is well written and easily readable, while providing parents and practitioners with the latest research supported information regarding ADHD and various interventions.
  • Executive Skills in Children and Adolescents:  A Practical Guide to Assessment and InterventionDawson, Peg and Guare, Richard (2010): This book is aimed at practitioners that work with children with Executive Functioning concerns.  It may be a little research heavy for some parents; however, it is a wonderful resource for therapists and educators.   It includes basic research on Executive Functioning as well modifications and interventions that can help children and adolescents with a variety of Executive Functioning issues including disorganization, inflexibility, initiation of tasks, and monitoring work. Read more

ADHD and Learning: Attention Deficit Hyperactivity Disorder’s Impact on Learning

Many children with a diagnosis of Attention Deficit Hyperactivity Disorder exhibit significant concerns with regard to their academic

ADHD and learning diability

achievement.  Research has demonstrated that a lot of children with the diagnosis also have a co-existing diagnosis of a learning disability.  However, even children without a separate learning disability diagnosis are also at risk for struggling with their academic achievement.

The hallmark feature of ADHD is inattention.  If a child has significant inattention and distractibility, he or she is unable to listen to the teacher and follow directions.  These children often present with impulsivity or hyperactivity, which can result in concerns with behavioral functioning in the classroom environment.

Another area of concern for children with ADHD is poor executive functioning which could have an impact on a child’s academic performance.  Executive functioning is the child’s ability to organize work, transition between tasks, develop effective problem solving strategies, and monitor one’s work.  Read more

The Impact of Nutrition on ADHD

For families dealing with ADHD, nutrition concerns or questions may arise. Although there is not clear evidence for diet modifications that can treat the cause of ADHD, there are nutritional guidelines that can affect symptoms and accompanying behaviors.

The Following are Some Nutritional Considerations for Children with ADHD:Nutrition and ADHD

  • Meal Patterning: There is a reason why there are traditionally 3 meals a day. During the day, our body’s physiology requires periods of being fed followed by periods of activity (physical and/or mental). In order to best fuel physical and mental tasks, we need to ensure regular, balanced meals for our kids. This means no skipping breakfast or dinner. Snacks should also be scheduled and finite. Grazing all day can decrease appetite for more nutritious foods at mealtimes and can lead to overeating less nutritious snack foods. Proper meal patterning also helps keep energy stable throughout the day.    
  • Protein, Fiber, and Healthy Fats: These three nutrition components are key to balancing blood sugar. Our brain and red blood cells use glucose as primary fuel, so it is important to keep that fuel running steady without peaks and valleys that affect energy and mood. Protein, fiber, and fat all slow gastric emptying compared to a meal of simple carbs, which means sugar is digested and absorbed into the blood stream at a slower rate. Also, protein food sources are building blocks for neurotransmitters involved in all brain signaling. And finally, healthy fats like omega-3s are used for developing brain and other nervous system tissues.
  • Reduce Refined Sugar (and anything else that you notice exacerbates problem behaviors): Refined sugar tends to provide quick, drastic bursts of energy when consumed alone and/or in large quantities. Often following the energy burst is a crash, since the sugar is quickly used up from the bloodstream and so is the energy. For kids, a little sugar can go a long way since their systems are smaller. Consider things like cereals, sweet beverages, and of course candy and desserts. Try to avoid keeping sugary foods and drinks in the house.
  • Side Effects from Medication: Some ADHD medications have a side effect of decreasing appetite. I have worked with kids on these medications who report they “forget to eat” because their appetite is so impacted. This can lead to weight loss, or in some cases, weight gain because the kids end up overeating junk food later in the day. To remedy this, act as a meal and snack advocate for your kid. Make sure you put the food in front of them and encourage them to eat, since they may not seek it out themselves. It may be easier for them to drink something nutritious like a smoothie, or eat a nutrient-dense bar such as a Clif Bar or Larabar when they don’t have much of an appetite.
  • Compulsive Decisions: Depending on how your child responds to ADHD treatment, he or she may still struggle with compulsive behaviors. When presented with junk food, they might go overboard, or they might seek out unhealthy food. Try to educate your kids as much as possible about the importance of nutrition in settings where they are not faced with snap decisions. That way, they will hopefully remember to make good decisions. Be a role model for them by stocking the house with healthy options and eating the way you hope for them to eat.

For more nutrition guidance related to ADHD, click here to make an appointment with one of our registered dietitians or call 877-486-4140.