Our doctors routinely assess for Autistic Spectrum Disorders, Learning Disabilities, and Attention Deficit Hyperactivity Disorder. We work with clients ages toddler through adult. We also assess for giftedness and work with students who are twice exceptional. The following is a brief summary of these evaluations.
Children and adults on the autistic spectrum have significant difficulties in their social and communication skills. Their language may be slow to develop, and their speech may include peculiar patterns or a formal, monotone voice pattern. Social problems may include difficulty understanding other people’s feelings, a lack of pretend play, and an impaired ability to develop friendships. Often, eye contact with others is avoided. Additionally, these individuals frequently demonstrate insistence on sameness and routine, have difficulty with change or transitions, and may have strong interests in a particular area. Our evaluations for Autism/Asperger’s Disorder thoroughly evaluate this array of characteristics, as well as cognitive skills, adaptive functioning (everyday independence), sensory processing (reactions to sound, touch, taste, movement), and academic performance (as relevant). Many of our clinicians have been trained in the ADOS-2 (Autism Diagnostic Observation Schedule - Second Edition) for assessing characteristics of autism spectrum disorder.
Learning disabilities are determined to exist when children have difficulty learning even though they have the cognitive capability and have been in an appropriate educational environment. Dyslexia is the term used when individuals have difficulty learning to read. Dysgraphia is the term used when individuals have difficulty with writing. Dyscalculia is the term used when individuals have difficulty with mathematics.
Dyslexia is the most common learning disability. Most people with dyslexia have trouble recognizing the basic sounds of speech (phonemes). They often have trouble connecting the speech sound (the /b/ sound) with the letter symbol for that sound (“b”). Difficulties with phonological processing make it hard for people with dyslexia to sound out words. Because of the time it often takes to sound out a word, the meaning of the word is often lost which can result in poor reading comprehension. Trouble with spelling is often found as well, given the difficulties in putting phonemes together to form words. Some children also have difficulty with orthographic processing. Successful readers use visual memory, or orthographic processing, to retain the way words look in print so they can read fluently. They need to sound out words less frequently because they recognize them from previous exposure. Rapid automated naming (RAN) can also be a concern. This is the ability to rapidly retrieve and orally express information stored in long-term memory. Fluent reading depends on a complex set of cognitive processes that must work together in perfect concert.
Early detection of dyslexia is key to remediation. Warning signs, beginning in preschool and kindergarten, include pronunciation problems, difficulty rhyming words, problems learning the connection between letters and sounds, letter reversals, inversions, transpositions, difficulty sounding out words, and resistance to reading activities.
Because of the importance of early detection, we have begun offering dyslexia screening evaluations in addition to our full psychoeducational evaluations for learning disabilities. Our dyslexia screener provides very basic information to determine if intervention is necessary to promote reading success. The dyslexia screener includes a cognitive evaluation, pre-reading and reading accomplishments, as well as phonological and orthographic processing. A concise written statement of the results is provided. A diagnosis may be made as appropriate, and the screener provides essential information for the determination of the need for intervention. It is suitable for children and adults who have no attentional, emotional, or other learning issues. Dysgraphia and dyscalculia screenings are also available.
Attention Deficit/Hyperactivity Disorder (ADHD)
Children and adults with attentional difficulties vary greatly and do not all have the same difficulties. Persons who are predominantly inattentive often ignore details, make careless mistakes, have trouble sustaining attention, problems following instructions or finishing tasks, or appear forgetful or disorganized. Children who are predominantly hyperactive-impulsive are often fidgety, have trouble staying seated, are often in constant motion, tend to talk excessively, and often blurt out answers and interrupt others. Some children demonstrate difficulties in both of these areas. Overall, it is important to note that individuals with ADHD can pay attention. However, they have problems with what they pay attention to, how long they pay attention, and under what circumstances they stay attentive. Their difficulties pervasively affect their life, both at home and at school. People with ADHD generally have difficulties with working memory (the ability to keep information in mind that needs to be used to make decisions and guide behavior) and executive functioning, which includes the abilities to plan, organize, multi-task, prioritize, persist, and self-monitor when completing tasks.
In order to provide a thorough evaluation of all relevant factors in an individual’s situation, we offer a comprehensive ADHD assessment. This assessment evaluates a child's or adult's history of difficulty, current cognitive functioning, academic performance, current behavior, executive functioning, virtual reality attention testing, and screening for social/emotional issues.
CPEA uses the latest technology to assess attention in both children and adults: Nesplora's virtual reality test of continuous performance. Continuous performance tests have been used to evaluate attention and distractibility under high and low demand situations. These are typically computerized tests that has a person respond to certain stimuli when it is presented and ignore other stimuli. For example, click the mouse every time you hear or see the number one and do nothing when you hear or see the number two. The problem with these older CPTs is that they may not reflect the real world demands of attention most effectively.
For children and teens ages 6-16, Virtual Reality testing uses a classroom setting:
For teens and adults ages 16+, Virtual Reality testing uses an aquarium setting:
Our Virtual Reality Assessments measure selective and sustained attention, auditory and visual attention, motor activity, impulsiveness, quality of focus, and reaction time.
This can also be used to measure ADHD medication response (~30-minute test)
Some individuals do not have any learning difficulties and pick up on information easily if they are provided circumstances that facilitate their learning (one-on-one teaching). These clients have often had other possible causes of their inattentiveness or hyperactivity ruled out, either by school personnel or counselors. For these individuals, we offer an ADHD screening evaluation that specifically focuses on the difficulties with attention. An abbreviated write-up is provided to clients and diagnoses are documented as appropriate.