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What Comes After the ADHD Diagnosis?

Many times parents leave a doctor’s office with more questions than when they came in. This is true for medical doctors as well as for clinical psychologists. After a parent is informed that his or her child has Attention Deficit Hyperactivity Disorder (ADHD) the next phase is to start to develop a treatment plan to help the child reach his or her potential. Treatment of ADHD should be thought of as a possible three tier system: medication, therapy, and school based accommodations. Blog-ADHD-Diagnosis-Main-Landscape

Medication for ADHD

Research indicates that stimulant medication is one of the primary treatments of choice for ADHD. Many parents are very cautious and scared about putting their child on medication. One of my first pieces of advice for parents is to stay away from doing their own on-line literature search. Anyone who has access to a computer and the internet is capable of creating their own website. A website that I refer parents to all the time is www.chadd.org which is the national resource on ADHD. The literature this website provides is empirically supported and often times created by some of the biggest names in ADHD research. The other piece of advice I give to parents is to schedule a meeting with the child’s pediatrician and have a discussion regarding medication; from how the medication works to what possible side effects to look out for.

Therapy for ADHD

Children and families often get referred for therapy when the child is diagnosed with ADHD. I am a proponent of therapy that is done correctly. There first needs to be a focus on what the targets of the therapy are as well as what specific goals will be worked on in the sessions. The therapy goals need to be specific and measureable. There needs to be some metric implemented to assess for change in the child’s behavior. Finally, parents must be active participants in the therapy. There needs to be homework assignments to work on during the week as well as specific strategies that parents can implement in the moment to help modify behavior.

School Accommodations for ADHD

The final domain that needs to be considered after a child was diagnosed with ADHD is accommodations in the classroom setting to help alleviate symptoms of inattention and impulse control which have a negative impact on the child’s academic performance. Many times after I diagnosis a child with ADHD, I discuss with the parents about creating a 504 Plan in the academic setting. A 504 Plan consists of a variety of classroom and testing based accommodations to help address academic symptoms of ADHD. The plan is always individually tailored based upon the specific concerns that a child exhibits.

The diagnosis of Attention Deficit Hyperactivity Disorder is only the first step of helping the child. Parents frequently will have to seek out outside resources such as pharmacological intervention, therapy, and school based accommodations in order for their child to reach his or her potential.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, and Hinsdale! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

IEP Meetings From a Mom’s Perspective

I have worked for North Shore Pediatric Therapy for more than two years in the marketing department. I thought I was familiar with the many challenges families go through with their children, Blog-IEP-Meetings-Main-Landscapehowever, the idea of going through “the IEP process” never crossed my mind, until I had to.

When my son started kindergarten, we had some concerns about certain behaviors, but honestly really thought they were only phases. A few weeks into the school year as they began practicing drills, he had a severe panic attack requiring help from the school social worker. At that time, his teacher recommended he begin seeing the social worker more frequently and that led to our process of seeking a full evaluation to really understand him.

He was evaluated by Dr. Greg Stasi at NSPT and given a diagnosis of Anxiety Disorder and Sensory Processing Disorder. It was then that we were faced with the dreadful IEP meetings. I had heard so many stories of hardship parents faced when fighting for their child’s needs. As a result, I went into the process expecting a fight, and boy would they get one if necessary because in my mind, nothing was going to come between my child getting the help he needed.

Because of my job, I am fortunate enough to have access to excellent professionals and resources, who understand the IEP process, and who helped me prepare for the initial IEP meeting. I was ready for that day. And you know what happened? I didn’t have to fight. I was so fortunate to have a wonderful team wanting and willing to give my son everything he needed to succeed. Everything I was prepared to fight for was already part of their plan, too.

I know this isn’t typical, and so many families struggle to get their child’s needs met.

Here are some tips, from a mom’s perspective on how to approach IEP meetings to get what you, and your child, need:

  1. Be prepared. Those same resources I have access to because of my job…guess what? YOU have access to those same things! NSPT has so many blogs and infographics to help you begin your journey. Having a full neuropsych evaluation is a real plus as it lends a direction for goal development and is appreciated by the district staff.
  2. Be understanding. Understand that those on the other side of the table really do want to help. Often they are restricted by legal mandates. So you may find that there are questions you ask where they can’t fully answer.
  3. Ask questions. Don’t be afraid to ask any and all questions you have in order to understand each element being addressed. It goes fast. And they use a lot of terms you don’t recognize. Stop them and ask.
  4. Bring help. Don’t be afraid to bring outside support, such as a school advocate, to help speak on your behalf. They know the rules and can help you “fight.”
  5. Don’t sign the plan if you are not happy. You will be asked to sign the plan at the end. If you are not comfortable, don’t do it, unless it’s on the condition that you are requesting another meeting to go over the details again to re-write the goals.
  6. Hold Accountability. As the school year continues, don’t be afraid to check in on the team, the therapists, and the teacher to ensure all accommodations are being met.

Be the voice. Remember, you are your child’s voice. Don’t be afraid to speak up.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

Academic Accommodations for Children with ADHD

Children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) may face many obstacles in the classroom. Structure and consistency are the two main keys to success for children withBlog-ADHD-Accommodations-Main-Landscape ADHD, but each case presents with its own challenges and accommodations should address the unique needs of the individual student.

The following are examples of what a child with ADHD may present in the classroom and associated accommodations:

For a student presenting with difficulties sustaining attention and following directions:

  • Instructions should be kept brief and specific and presented one step at a time.
  • Maintain eye contact with child while presenting instructions and have the child “teach” the instructions back to the teacher.
  • Reduce task length (i.e., focus on quality of work rather than quantity) or break complex tasks into smaller pieces.
  • Seat the child near the teacher and away from distractions such as doors, windows, or other students who may be disruptive.
  • Provide a “quiet zone” for the student to complete tests or in-class assignments.
  • Use verbal cues or signals as behavioral prompts when the child falls off task.
  • Set time limits or “challenges” for completing tasks.
  • Provide visual prompts for classroom routines.

For a child presenting with excessive activity and/or impulse control:

  • Allow the child to stand near his or her desk or kneel in his or her chair during seated work as long as no disruption is caused.
  • Use instructional approaches that encourage active responding such as talking, moving, or working at the board.
  • Provide breaks for directed movement such as passing out materials.
  • Reward short periods of waiting or on task behavior and gradually increase the period a child is successful.
  • Encourage non-disruptive activities such as reading or doodling during times of day that have proven problematic.
  • Clearly state rules and expectations, and clearly state positive and negative consequences for behaviors. Review these rules often and post visual reminders.

All children will benefit from positive feedback, reinforcement for small improvements, frequent opportunities for active participation, and assignments related to the child’s interests. Additionally, established routines and schedules, along with both verbal and visual reminders, will help any child to be successful in the classroom environment. Most importantly, remember not to assume that a failure to follow instructions is due to a lack of effort or an intentional failure to pay attention, nor is overactivity or impulsive behavior intended as an act of defiance.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

Reasons to Seek a Neuropsychological Evaluation for Your Child

Neuropsychology is a field of psychology that focuses on the relationship between learning, behavior, and brain functioning. A child may be referred for a Blog-Neuropsychological-Evaluation-Main-Landscapeneuropsychological evaluation when there are concerns about one or more areas of their development. This can include a child’s cognitive, academic, memory, language, social, self-regulatory, emotional, behavioral, motor, visual-spatial, and adaptive functioning.

This type of evaluation can help rule out diagnoses such as Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Specific Learning Disorder, Language Disorder, as well as various emotional and behavioral disorders. A neuropsychological evaluation can also be helpful if your child has been diagnosed with a medical condition such as Down Syndrome or other genetic disorders, Traumatic Brain Injury, or Epilepsy. The purpose of the evaluation is to identify a child’s patterns of strengths and challenges in order to provide parents, schools, and other providers with strategies to help them succeed across contexts. It can also be used to track a child’s progress and response to targeted interventions.

In order to assess whether a neuropsychological evaluation may be helpful for a child, a family may identify concerns in the following areas:

  • Cognitive
    • Difficulties with verbal and nonverbal reasoning and problem solving
    • Requiring a significant amount of repetition and/or additional time when learning
    • Delays in adaptive functioning
  • Academic
    • Grades below peers
    • Concerns with reading (phonetic development, fluency, comprehension), mathematics (calculation, word problems), or writing (spelling, content, organization)
    • Needing additional time to complete schoolwork, homework, or tests
    • Frustration with academic work
  • Language
    • Expressive (output of language) or receptive (understanding of language) difficulties
    • Challenges initiating or maintaining a conversation
    • Difficulties with sarcasm or non-literal language (e.g, “It’s raining cats and dogs”)
    • Repetitive or odd language usage (e.g., repeating lengthy scripts heard from television or news programs)
    • Pronoun reversals or odd use of language
  • Self-Regulation
    • Difficulty paying attention or sitting still
    • Needing frequent prompts or reminders to complete tasks
    • Difficulty with multiple-step commands
    • Losing or misplacing items
    • Forgetting to turn in completed assignments
  • Social
    • Poor peer relations
    • Inappropriate response when approached by peers
    • Difficulty with imaginative, functional, or reciprocal play
    • Limited interest in peers or preference for solitary play
  • Repetitive Behaviors
    • Repetitive vocalizations
    • Repetitive motor mannerisms (e.g., hand flapping, finger flicking, body rocking)
    • Lining up toys, spinning wheels of cars, sorting objects for prolonged periods of time
  • Behavioral Dysregulation
    • Physical or verbal aggression
    • Defiance or non-compliance
    • Difficulties with transitions or changes in routine
    • Self-injury (e.g., head banging)
  • Emotional
    • Poor frustration tolerance
    • Irritability or easily upset
    • Eating or sleeping difficulties
    • Somatic complaints
    • Negative self-statements
    • Lack of interest in things he/she used to enjoy
  • Visual-Spatial, Visual-Motor, and Motor
    • Poor handwriting
    • Trouble with fine motor tasks (e.g., unwrapping small items, buttoning or zipping clothing, tying shoe laces)
    • Difficulty transferring information from the classroom board to a notepad, or transferring information from a test booklet to a scantron/bubble sheet
    • Difficulty with overwhelming visual displays (e.g., computer screen with several icons; homework with several problems on one sheet; a book with several colors and pictures)

Should a child demonstrate difficulties in some of the areas listed above, he/she may benefit from further consultation or a subsequent neuropsychological evaluation. Through this process, areas of difficulty can be identified, and targeted interventions will be suggested to enhance a child’s development.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Specific Learning Disorders in Children

Learning disorders are some of the most common neurodevelopmental LearningDisorders-Main-Landscapeconditions that children face. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which is the guidebook on classification of diagnoses published by the American Psychiatric Association indicated that the prevalence of specific learning disorders across academic domains of reading, mathematics, and written expression is between 5%-15% in school aged children.

There is significant discussion both in the literature, and among clinicians and researchers, regarding how to appropriately classify and subsequently diagnose a specific learning disorder. Traditionally, it was assumed that a specific learning disorder existed when there was a significant discrepancy between a child’s cognitive ability and achievement in reading, mathematics, or written expression. However, within the US, changes have occurred over the past decade regarding the criteria used for determining a specific learning disorder which is now based on a multi-tier process involving early identification and intervention and the child’s response to the intervention.

Where children might exhibit learning disorders:

According to the DSM-5, there are three specifications of learning disorders that children might exhibit: Specific Learning Disorder With Impairment in Reading, Specific Learning Disorder With Impairment in Written Expression, and Specific Learning Disorder with Impairment in Mathematics. It is quite common for children to exhibit multiple learning disorders.

Potential related deficits:

There are definite concerns with a child’s social, emotional, and behavioral regulation if they have a documented learning disorder. Prior studies have indicated that up to 75% of children with a diagnosed learning disorder demonstrate significant social skill deficits expressed by peer rejection and social isolation.

What can be done:

It is our strong recommendation that in order to most effectively address a child’s specific learning disorder, it is important that the child undergo a comprehensive evaluation in order to effectively classify and make sense of the patterns of difficulty that the child presents with as well as to rule out additional existing factors of concern, and to best determine what specific interventions are warranted. Recommended interventions are specifically based on the area of weakness a child exhibits both across the testing as well as within the child’s academic environment.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

neuropsychological testing at north shore pediatric therapy

Diagnosing Your Child on the Autism Spectrum: Fact or Fiction?

Many times parents fear an autism diagnosis because they do not want a stigma for their child. However, it is important to understand that an appropriate diagnosis is the first piece of the puzzle. For those brave souls who don’t stop until they have the correct answer, the payoff is worth the effort and pain. A good diagnosis and evaluation should serve as a means of identifying appropriate and practical recommendations as well as a basis for progress monitoring from the intervention. At North Shore Pediatric Therapy’s Neuropsychological Center in Illinois, we utilize clinical testing to help identify the most appropriate diagnosis.

The Autism Testing Process at NSPT-Diagnosing Your Child:

Neuropsychological testing is an empirically supported way of assessing a child’s cognitive, academic, and social-neuropsychological testing at north shore pediatric therapyemotional functioning. The evaluation occurs over three days with an intake session, the actual testing day, and the feedback session.

  • Intake: The intake session is when the parents and child attend a formal meeting to discuss concerns. It is important that child attends the session as the neuropsychologist would want to attain some basic information regarding the child’s verbal functioning, social skills, and attentional regulation. Parents understandably do not want to speak in front of their child about concerns they have. We understand that and will ensure our best that the child is in a separate room when parents are talking about specific concerns.
  • Testing: The testing session consists of ascertaining information from a variety of resources including parents, teachers, outside practitioners (any therapist working with the child or family), behavioral observations, as well as the child’s performance on a variety of assessment measures. Testing is intensive and lasts upwards of four to five hours. The focus is to provide quantified information regarding the child’s functioning across a variety of domains and also to look for consistent patterns across performance.
  • Feedback: The feedback session is the most important aspect of the evaluation. This is the meeting in which the parents are provided information regarding the diagnosis that is given as well as what the next steps are to ensure that the child is able to progress to his or her potential. Read here for more on what to expect after neuropsychological testing.
  • Follow-up: The next step is for the neurologist to re-evaluate the child in six month’s to one years time (depending on the intervention that was prescribed) in order to monitor progress the interventions and to help progress monitor if additional supports or services are needed.

Be a Smart Detective When Seeking an Autism Diagnosis for Your Child:

For those parents with the courage to dive into discovering the diagnosis behind your child’s challenges, I say kudos to you! Those parents are the real child-advocates. Kick start your child’s success with a deep dive into your child’s diagnosis by seeking a neuropsychologist. I, Dr. Greg Stasi along with my colleague Dr. Amy Wolok provide in depth Autism Spectrum testing at our Neuropsychology Center in Chicago, IL. Our Center works alongside the many other therapists at North Shore Pediatric Therapy’s Glenview, Highland Park, Bucktown, Evanston and Lincolnwood Clinics to provide a comprehensive team all working together to help your child reach his or her potential. The neuropsychological evaluation is designed to help identify what specific strengths and weaknesses a child is exhibiting which leads to the best diagnosis and most importantly the most efficacious intervention.

what percentage of our brain do we use

What Percentage Of Our Brains Do We Really Use?

You may have recently seen (or more likely heard) the debonair voice of Morgan Freeman in a movie trailer for Lucy starring Scarlett Johansson. In the trailer, you hear him state the statistic that we, as humans, only use 10 % of our brain’s capacity. This seems a shocking statistic that makes you wonder… is this for real?

Well.

No matter how convincing that buttery voice may be, you can’t believe everything he says! The origins of this popularwhat percentage of our brain do we use myth is unknown, but it is thought to be traced back to the Einstein era. “Though an alluring idea, the “10 percent myth” is so wrong it is almost laughable”, says neurologist Barry Gordon at Johns Hopkins School of Medicine in Baltimore.

That is neither here nor there… What IS important is knowing how powerful our brain is and that we actually use most of our brain all the time! Our brain actually uses up 20% of our body’s energy, and in kids, it uses up 50% of their energy! John Henley from the Mayo Clinic in Minnesota states that “Evidence would show over a day you use 100 percent of the brain.”

Without even thinking about it, at this very moment you are doing the following with your brain:

  • Blinking (thanks your motor cortex)
  • Breathing (thanks to your brainstem)
  • Reading this blog (using your occipital lobe AKA eye sight AND your frontal lobe for thinking and reasoning)
  • Moving the mouse around (using your cerebellum).

That’s just to name a few… Even the most mundane tasks (like sleeping) can stir up quite a lightning storm in the ol’ noggin’. So when you hear Mr. Freeman state that overly used myth about only using 10% of your brain (in his elegant way), don’t let that voice forget you know the truth! That’s not to say we can’t get swept up in the alluring cinematic idea of being a super-human, right?!

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