What Type Of School Is Best For My Special Needs Child?

September 9th, 2014

So many from which to choose

There are many school options for parents; brick-and-mortar public schools, public cyber schools, private schools, specialized alternative placements, and homeschooling to name a few. Parents are often left wondering which is the best option for their child, especially parents of children with special needs.

The Public Option

Public school has many advantages given that, by law, the public school system must provide a “free and appropriate education”, and implement special education services if the child meets special education criteria. Public schools are largely compelled to educate no matter the condition (as opposed to expel your child), and ultimately meet your child’s needs or transition to a facility that can, and pay for it.

The Cyber Option

There are situations where parents believe the public school system is failing their child, and the alternative specialized placements are not seen as appealing. Parents may then decide to cyber-school, which can be an excellent option if it’s important for your child to have an individualized environment, a more flexible daily schedule, and be able to work at their own pace. However, parents need to recognize that the “individual attention” is likely going to be provided by them (the parent); and that you may find yourself in the challenging situation of being your child’s ‘teacher’; i.e. sitting with them and providing the prompting, praising, guiding, and cajoling to get your child through their school assignments. If you have the time and gumption, then this can work, but it can be quite an undertaking.

The Home Schooling Option

Whatever is indicated as challenging above under “The Cyber Option,” multiply that x2 for Home Schooling. Not only is the parent compelled to provide individualized attention, the parent also must investigate, obtain, and implement the proper curriculum. Sometimes this works just fine but, again, similar with cyber-schooling, a parent serving as both ‘Mom’ (or Dad) and ‘Teacher’ can be tough for both Mom and the child.

A Private School?

A Private School can be a wonderful option. Private schools typically offer smaller classrooms, sometimes are more flexible than public schools in modifying structure, and teachers are often very accommodating. Moreover, parents often appreciate the spiritual elements inherent in such a setting. However, private schools are not legally compelled to educate your child and can expel if proving to be too difficult, and they are not required to provide ‘special education’ services. Also, at times such schools have the attitude of ‘our way or the highway’, which may not work so well for special needs children.

What about specialized or typical preschools?

Children with developmental issues often thrive in specialized preschools such as through DART/IU programs. However, parents often appreciate their child being in a regular preschool setting so as to model after neuro-typical kiddo’s language and play skills, but have concern that their child may not do well with 15-20 other kids in that typical preschool class. Deciding between the two school options can be quite a dilemma, which is often resolved by doing both. In that regard, enrolling part-time in a specialized preschool, and part-time in a typical preschool but with individualized attention such as from Therapeutic Staff Support. In this way, the child gets the best of both worlds.

So which is best?

Of course, there is no singular answer to this question; it depends on your child, the situation, and the time-frame. In terms of time-frame, I often see parents of a child with an anxiety disorder, for example, ultimately choosing to home or cyber-school their child due to ongoing anxiety and school-refusal. These children often subsequently perform well in the home setting, but the problem is that their anxiety disorder is often not addressed given that the standard mode of treatment for anxiety is having the child confront their fear (go to school). Nevertheless, the cyber or home-schooling experience can be advantageous for a few semesters as the child receives therapy and bolsters their coping mechanisms. However, a return to a more traditional school setting, at some point, would be optimal. In the same sense, many children with special needs flourish in smaller private school settings and home/cyber-school situations and parents relish the opportunity to assist in meeting their child’s educational needs, and have no reservations about the time and energy if it’s seen as beneficial. In those situations, everyone wins. It’s important, however, that parents know ‘what they are getting themselves into’ prior to undertaking the endeavor to avoid any regrets. It’s also vital to thoroughly interview school officials to be sure exactly and precisely what is expected, and what will be provided to meet your child’s needs. It’s also helpful to observe classrooms when possible. These decisions are often complex and multi-faceted; I invite parents to contact me at jcarosso@cpcwecare.com to discuss their child and help them with such decision-making. God bless you in your efforts to meet your child’s needs.

Dr. John Carosso, Psy.D. Child Psychologist

Child Won’t Sleep In Her Own Bed? Here’s What To Do.

August 21st, 2014

How it all starts

It usually begins innocently enough; your child isn’t feeling well and wants to sleep in your bed. One night turns into two, then three… Or your infant child has colic and is difficult to soothe and you find yourself often falling asleep with your child, year after year. In either case, as well as countless other potential scenarios, the end result is the same; your child is consistently sleeping in your bed and won’t sleep alone in her own bed.

What’s the big deal?

Interestingly, some parents don’t seem to mind, and there is even a movement by some groups to suggest that this is a healthy arrangement. If you’re in that group, I guess you can stop reading. Otherwise, if you’re a parent who actually wants to be alone with their spouse, is tired of constantly being kicked in the stomach during sleep by their forever-moving child, or is somehow aware that a healthy child is able to sleep comfortably alone in her own bed, then definitely keep reading.

Is it best for my child to sleep alone?

Yes, it is. The process of falling asleep is rather complex and particular skills are involved. For example, a child needs to be able to clear their mind, turn off their thoughts, calm themselves, and allow themself to comfortably drift away into la-la land. This is no easy task, especially for kids who find themselves, at bedtime, away from everyone and alone in a dark room. The process of self-soothing is a learned skill, and is also subsequently used during the day to calm when in a stressful situation. It’s a skill that definitely comes-in handy. In fact, countless times I’ve seen kiddo’s appear more mature, relaxed, and confident after they learn how to fall asleep alone at night. Not to mention parents appearing a lot happier.

What to do?

If you find yourself consistently sleeping next to a very small person who, nightly, finds their way into your room, you’ve probably tried the common strategy of taking the child back to their bed only to find the child back in your bed when you awaken in the morning. Or maybe you’ve attempted to reason with your child, or use sticker charts, and other rewards. If you remain consistent, these are all commendable approaches, and it can also be quite effective to use these commonly applied approaches:

1. Talk to the child during the day, pleasantly explaining the expectations and rewards for sleeping on their own.
2. Keep a consistent bedtime routine.
3. Answer any fears the child may have.
4. Comfort your child at bedtime while sitting beside the bed as they begin to relax and fall asleep.

However, it’s vital you do not fall asleep with the child, or have the child fall asleep while you’re beside the bed (the goal is for the child to fall asleep alone). Yes, your child may fuss, cry, and call-out for you, but it’s vital you allow your child to learn that ‘everything is okay’ and he or she can fall asleep on their own. The first few nights may be tough, but hang in there.

What if?

Okay, I hear your big question: what if my child simply will not remain in her bed, tantrums, and won’t stay in her room? What then? Okay, here’s the hard part; you have two choices. 1.) keep-up with the slow but progressive approach of walking your child back to their bed, getting them comfortable, and then leaving. You may make that trip many times, but consistency is the key. Do not verbally engage, and remain with your child for as little time as possible (the less attention, the better). Of course, that approach is quite taxing, especially after you’ve worn a path in the carpet between her room and yours.

What else can I do?

Well, this next tip can be tough for many parents, but it’s also quite effective and faster as a remedy to this problem. Here’s what you do: you tell your child the expectations for bedtime and offer all the aforementioned reassurances. Explain that you’ll be leaving their door open, and yours, so that she can feel comfortable at bedtime. You’ll explain, however, that if she won’t remain in her room, that you’ll close her door. If she still won’t remain in her room, you’ll explain that you’ll be securing the door from the outside or in some way confining in their room (by using a gate, or ¾-door…). Of course, you won’t confine your child until you’re sure that the room is safe, and that she won’t tantrum in a manner that will cause her harm. You may even drill a peep-hole in the door so you can always see what’s going on in there. However, ultimately, if necessary, you’ll close and secure the door or use some type of gate that keeps your child in the room. Of course, she’ll tantrum, cajole, complain, threaten, and may even kick the door. However, you’ll stand firm and you will not provide any verbal feedback (you want her to think you’ve fallen asleep and can’t even hear her). What will happen next? Your child may tantrum for an hour or so the first night, but you’ll see the tantrums reduce appreciably the next night. In fact, most kids don’t tantrum after the first night; they’re not stupid and don’t want to be confined in their room. However, I want to emphasize again that safety is the key; it’s vital to ensure the room is safe and that your child will not become self-injurious when tantrumming. I usually advise starting with the first approach (walking the child back to their room…) before moving to confining your child, and I imagine your kiddo will appreciate that latitude. Also, if your child is prone to violent tantrums and extreme emotional reactions, it’s best to contact me to discuss, at jcarosso@cpcwcare.com or call me at one of the offices, before moving forward with the approach of securing your child in their room. However, in the vast majority of cases, with typical kids, it works out just fine.

The three ticket strategy

On a different but related note, if you have a child who gets in bed but then pesters for everything under the sun including a drink, a hug, to go to the bathroom or to get something to eat, or any number of other things to keep you around and to keep from going to sleep, here’s a strategy you may find helpful. Of course, you can simply ignore these requests, or you can give your child 2 or 3 “tickets” that can be traded for something they want. However, after getting the drink, for example, they give-up a ticket. After 2 or 3 times, they have no tickets left and no more requests are indulged. I’ve found, and research results support this observation, that many kids will ultimately use none of the tickets and simply go to sleep. They find that having the tickets is comforting and knowing they can use them, if necessary, is enough for them.

That’s about it

Okay, that sums it up. You have two choices to get your child to sleep alone, both of which can be effective: the more traditional but longer approach, or the quicker albeit more stressful strategy (in that regard, it can be stressful to consider securing your child in their room). It’s advised to start with the first, and then think carefully before trying the second. Remember, safety is the key. Please feel free to contact me at jcarosso@cpcwecare.com with any thoughts or questions about this common problem, and these strategies.

John Carosso, Child Psychologist

Getting Back to School: Autism and Beyond

August 8th, 2014

Yes, it’s that time

Yes, it’s tough to even think about the Fall, but nevertheless it’s time to prepare for the ‘back to the school’ routine.

Summer vs School Routine

Need I mention the difference between summer and school-year routine? If you start about 2-3 weeks out, it’s much easier to ship your kids into shape. Otherwise, it’s a culture-shock for your child, and not too pleasant for you either.

What to do (tips for parents of children with autism, and typical kiddos):

1. Begin slowly adjusting routines for earlier bedtime.

2. Incorporate lengthier study and quiet-reading sessions throughout the day and week. This could include anything even remotely academic.

3. Visit the school playground more frequently to promote your child becoming more comfortable with being at school, and on the school grounds.

4. Arrange play-dates with school friends/acquaintances not seen for most of the summer, especially those kids who will be in your child’s class or grade.

5. If you can arrange a visit to the classroom, and meet the teacher, so much the better.

6. It can be helpful to color-code school supplies (notebooks, file-folders…). Integrate material-color with picture schedule.

7. Purchase school clothes early, wash them a few times, cut-off tags, and make sure your child is comfortable with them well in advance.

8. Pick-out a “cool” outfit for the first day and get a fresh haircut (first impressions are important).

9. Use picture schedules and social stories to prepare for the first day.

10. Prepare school with emergency contacts and any dietary issues.

11. Prepare the teacher, aide, Guidance Counselor, ‘specials’ teachers, cafeteria workers, and anybody else who will listen for what to expect, and how to effectively intervene if necessary.

12. Don’t forget to say a prayer with your kids before they venture off to school; they find that comforting and reassuring.

13. Autism-Speaks also has some nice back-to-school bulletins (I especially like the ‘about me’ activity): CLICK HERE to go site

If you have any other tips, please comment; it will be appreciated. Comment at jcarosso@cpcwecare.com.

God bless and enjoy the rest of the summer!

Dr. John Carosso, Child Psychologist

DSM-V and the Autism Diagnosis: Is The Change Hurting Children?

July 18th, 2014

Fuss

There has been lots of fuss about the DSM-V and the autism diagnosis; will it result in less children meeting diagnostic criteria and therefore less children getting the services they need? Is this concern legitimate? I’ve written about this in prior posts, but here I’ll provide further elaboration.

What’s the problem, and what is the diagnostic criteria?

Is the DSM-V Autism Spectrum Disorder (ASD) diagnosis the issue at hand, or is it another DSM-V diagnosis that might be a “problem”?

First let’s take a brief look at the ASD, the criteria includes:

1. “Deficits in social communication and social interaction” manifesting in, for example, poor back-and-forth communication, deficient eye contact, and absence in an interest in peers or inability to sustain the relationship/interaction.

2. “Restricted, repetitive patterns of behavior, interests, or activities, and/or hyper or hypo-sensitivities.

There are also specifiers for severity of the social and verbal deficit, and the extent of restricted interests. Finally, there are specifiers for “with or without intellectual impairment”, “with or without language impairment”, and “associated with a known medical or genetic condition or environmental factor”.

So, you can see that this criteria, with the specifiers, cover everything from what formerly was called ‘Autistic Disorder’ at the more severe end; ‘Asperger’s Disorder’ at the ‘high end’ and ‘Pervasive Developmental Disorder NOS’ for those in-between.

Is There Another Diagnosis?

Yes, there is another ‘competing’ diagnosis, and this is where there may be a potential “problem”. In that regard, the DSM-V has a new diagnosis referred to as “Social (Pragmatic) Communication Disorder (SCD), which entails “persistent difficulties in the social use of verbal and nonverbal communication manifesting in”, for example, difficulty “greeting others and sharing information”, using “overly formal language”, and “following rules for conversation” such as in turn-taking and rephrasing, and “difficulty understanding what is not explicitly stated.”

This diagnosis would cover those kiddos who may have autism-like verbal and social deficits and kiddo’s who ‘don’t quite get it’ socially, but who do not have any restricted or repetitive patterns of behavior or interests.

Which DSM-IV diagnosis will be most affected by the SCD diagnosis?

At least a portion of the kiddo’s who would have been diagnosed with Pervasive Developmental Disorder Not Otherwise Specified (PDDNOS) will now be diagnosed with Social Communication Disorder (SCD). Research published in January 2014 in the American Academy of Child and Adolescent Psychiatry found that about 8% of kids diagnosed within the autism spectrum under DSM-IV have subsequently been changed to SCD, which is a far-cry from the 20% predicted earlier by the Center for Disease Control (CDC). Most of the children whose diagnosis was changed had been diagnosed with PDDNOS, and were changed to SCD, which is understandable given that PDDNOS has such vague criteria. Those who had been diagnosed with Autistic Disorder or Asperger’s Disorder under DSM-IV were largely unaffected.

Nonverbal Learning Disability

Another “diagnosis” that may be impacted is “nonverbal learning disability” which essentially is the same as SCD. However, given that there has never been a formal DSM-IV “nonverbal learning disability” diagnosis, now these NVLD kiddo’s too have a better diagnostic fit with SCD.

Consequence of the DSM-V?

It’s likely this change in diagnosis to SCD, for the very few children who will be affected, will generally be positive. In that regard, having seen these kiddo’s first-hand, they clearly struggle with verbal and social skills, but are not “autistic”. Up to now, the diagnostic options have been few besides PDDNOS. These children can still obtain services consisting of individual and group speech/language, and outpatient social skill training, while avoiding the autism diagnosis that does not quite fit anyway.

Hope that helps to clarify the effect of DSM-V regarding the “Autism Spectrum Disorder” vs. PDDNOS, Autistic Disorder, Asperger’s, and Social Communication Disorder.

Feel free to follow-up with me, with any questions at jcarosso@cpcwcare.com.

Would You Rescue Your Spouse Before Your Kids?

June 20th, 2014

Here’s a story for you

A Dad and his son were fishing in a boat. The son looked toward his Dad and inquired, “Dad, if Mom and I fell out of the boat and were drowning, who would you save first?” His Dad, without hesitating, responded “son, I’d have your Mother in the boat, and dried off, before I’d even think about coming after you.” The son, astonished, looked with eyes wide and was about to exclaim his disapproval but stopped, appeared contemplative, then grinned and said, “yea, that’s the way it should be.”

The kid’s pretty wise

The son came to understand that the strength of the home, the foundation of the family, is Mom and Dad, together in harmony, close in their relationship, working for the family, strong in their bond, and on the same page with the kids. It’s true, there is no stronger glue to hold the family together than when Mom and Dad are secure in their relationship, which helps the kids to also be secure with themselves. Secure kids are far more likely to be calmer, more compliant, and easier in disposition. Of course, we don’t want to interpret the story literally, any number of factors may contribute to the Dad rescuing his son first (his wife is a better swimmer…) but, of course, that’s not the point of the story.

Single parent?

If you’re a single parent, for whatever reason, then you’re undoubtedly doing the best you can, and God bless you in your efforts. The sentiment of this post in no way diminishes your diligence and love for your children, or suggests that your child is not healthy and happy. The basis of this story is simply to express the importance of parents remaining strongly committed, and clearly there are advantages of having two loving, committed, and harmonious parents working together with the kids. In a single-parent situation, of course, when possible, it’s optimal that both parents, despite separated, remain highly involved with the children, civil with one another, and work toward having consistent expectations between the homes.

Bottom line?

Simple; do whatever you can to maintain the sanctity, security, commitment, closeness, and bond in your marriage. Place your spouse first in your life (well, technically, second to God, but He too understands the importance of two becoming “one”… see Genesis 2:24). Live like it’s you two against the world, and you’ll always be ready for that overboard plunge. God bless.

Are Your Kids “Lazy”, Or Are They Being Lazy?

June 5th, 2014

Subtle difference?

Well, it’s really not so subtle. It’s the difference between labeling your child, or simply describing an annoying and transient behavior.

What’s the big deal?

When we call our kids “lazy”, “rude”, “liars”, “thieves”, or whatever, we are defining their character, and suggesting that this is their enduring quality. Okay, so now you’re saying, well, they are!! That may be true, but I’ll bet you can think of lots of times when your child is motivated, nice, told the truth, and did not steal. Even if the particular behavior is somewhat enduring, your child is still young; their personality is molding and shaping, and you’re in a strategic position to help shape it in the right direction.

What “labels” tend to do

Okay, here’s a scenario for you; you’re young, impressionable, don’t have a solid grasp or sense of yourself as a person, and have a tendency to believe what you’re told especially when told by the most important person in your life. In this scenario, you’re consistently told that you’re “lazy” or a “liar” or whatever. One can imagine that you may come to personally identify and internalize these traits, and expect to consistently behave in that way. Note that kids, and people, often live up (or down) to expectations.

A better option

Here’s a better option for you; label the behavior, rather than the child. Quite simply, for example, say “you’re lying” rather than “you’re a liar”; or you’re being lazy, or you’re being rude”. This option is definitely better than directly labeling the child, but it’s still not the best option.

An even better option?

Yes, there is an even better option. Instead of labeling the child or the behavior, simply redirect the behavior, describe very specifically what you want to see, and use the situation as a teachable moment. Think about it, calling your child “rude” does not teach; it simply degrades and disparages. Instead, if you’re child calls you a name, rather than call him “rude”, describe the behavior as unacceptable, explain how he could have better-expressed his frustration, maybe even have him repeat the more appropriate words, and then implement a fair consequence. Same holds for “lazy”. Rather; tell your child exactly what you need to see him doing, set a firm limit for him to get started, and then implement a consequence if necessary.

You get what you praise

If your child has a particular problem with not being especially motivated, or telling mistruths, or taking items, then pay very close attention to her behavior and praise big-time when your child demonstrates the pro-social alternative. Remember, if you consistently praise a behavior, it is much more likely to be repeated. Sticker charts also do wonders.

Happy and Harmonious

You want your home to be a happy, pleasant, and cordial environment, right? Of course. You’ll go a long way to making that happen after dropping labels, describing behaviors you instead want to see, relying on firm consequences without yelling and emotion, and using lots of praise. Not to be redundant, but think about it, how do you feel when you’re called lazy, rude, or a liar? Would you do better calling your husband “lazy” or simply telling him exactly what you need and that he’ll suffer a consequence (he knows what you mean) if he does not immediately help you?

Hope this was helpful. By the way, if you have any helpful personal experiences, or other good alternatives to labeling, please share at jcarosso@cpcwecare.com. Thanks.

Don’t Miss These Helpful Parenting Resources!!

May 22nd, 2014

At cpcwecare.com you can find a bunch of helpful parenting resources.

Here are a few:

Check out our TV programs from “CPC Presents” covering any number of topics including:

o Facts and fallacies about autism
o Teenage cutting
o Understanding fears and phobias
o Facts and fallacies about ADHD
o Trichotillomania
o Selective mutism
o Managing behavior problems
o Bipolar Disorder in Children
o Video game addiction
o Back to school anxiety
o ADHD and Learning Disabilities
o Child custody issues
o Childhood sleep disorders
o And more

· We have a link to the AppleTreeInstitute.com site that offers on-line step-by-step guidance on how to effectively manage children with autism and/or behavioral challenges. We also have a link to our dyslexiatreaters.com website.

· Of course, the CPB Blog is available (you’re reading it now) offering lots of tips and guidance on everything from autism, to learning issues, behavioral problems, mood, anxiety, and more. Please pass it on to a friend so they can sign-up as well.

· Our “Autism Spectrum” section answers the most common questions about the autism spectrum

· Under ‘Parent Resources’ we have our CPC Answers Series with over a dozen packets providing information about ADHD, Toilet Training, Mood Disorders, autism, dyslexia, Reactive Attachment Disorder, Encopresis, and more. Under that same section, we also offer a categorized index of helpful websites and resources on everything from autism to ADHD, and diet to sensory integration.

· Don’t forget our fun ‘Just for Kids’ section offering fun and educational games and activities.

· Of course, the site can also be used to locate our offices, make an apt, and download our intake packet.

We trust you’ll find the website to be easy to navigate and helpful. Let us know of anything you’d like added to the site. Have a great day!!

Five (5) Things You Really Need To Know About Special Education

April 29th, 2014

1. The School District Does not have to evaluate your child just because you submit a signed request to evaluate.

When you submit a written and signed request for an evaluation, the school district has 15 days to meet as a team, discuss your child’s educational needs, and provide a written response with indication of a game-plan to meet your child’s needs. That “game-plan” does not necessarily need to include a referral to the school psychologist for an educational evaluation. It may, rather, include any number of other options including modifications to how the classwork is assigned. However, you can appeal their feedback and request due process in that regard.

2. To determine eligibility for special education services, most Districts still use the 15 point discrepancy rule

If your child is evaluated by the school psychologist, various tests are administered (IQ, Academic…). The scores are listed as “Standard Scores” with an average of 100 (average runs from 90 to 109). There generally needs to be a 15 point “discrepancy” or difference between the IQ score and the academic scores (reading, math…) for a child to be deemed eligible for special education (Specific Learning Disability). For example, if the child obtains an IQ of 100, then it’s expected the reading and math scores will also be about 100 (it’s expected that the child will achieve at the same level as their IQ). However, if the reading or math scores are 85, that’s a 15 point difference and would qualify the child for special education (under the classification of a Specific Learning Disability). Less than a 15 point difference would preclude qualification. Other factors are also considered including PSSA scores, grades, work effort, prior opportunity for being appropriately educated, and English language proficiency. However, the 15 point rule is often primary.

3. The 15 point discrepancy model is why many kids, who may need special education, don’t qualify

It can be quite challenging to obtain a 15 point discrepancy, especially in the lower grades, and even more-so if a child has a lower IQ, say in the low average range. For example, if a child has an IQ Standard Score of 82 (low in the low average range), then the reading and math standard scores would have to be as low as 67, which is quite deficient and unlikely except in the most severe of situations. So, kids who have a lower IQ, and who are often in most need for special education, are often excluded. Keep in mind that, in this scenario, a child with a Standard Score of 70 in Reading is clearly struggling, but does not qualify because there is less than a 15 point discrepancy. This is a situation that most school districts acknowledge as a problem and try to provide alternative options such as Title I and similar programs.

4. The benefit of using grade-equivalents in addition to standard scores

A child may have a Standard Score of 87 in reading comprehension, which is at the upper end of the “low average” range and, on the surface, does not appear significantly deficient and often would not lead to a child meeting criteria for special education (under the classification of a specific learning disability). However, despite the low average score, the grade-equivalent (the grade-level on which the child is working) for that child may be two grades behind, truly revealing the degree to which the child is struggling. Most often, grade-equivalents are not listed in the report, and their importance tends to be down-played for various reasons I won’t bore you with today. However, I’ve found that grade-equivalents are important and need to be reviewed, discussed, and taken seriously during team meetings.

5. A classification of “specific learning disability” or “learning disability”, used by the school district, is essentially synonymous with “dyslexia”

The terminology used by school districts (Specific Learning Disability, Other Health Impairment…) comes straight from the Pennsylvania Department of Education in Harrisburg. This Department tells the Districts what terms they must use to receive funding. Consequently, school districts use the term “specific learning disability (SLD)”. It’s important to know that well over 90% of all kids who fall under the classification of SLD, have dyslexia (or dysgraphia, or dyscalculia…). In that regard, the reason they have a specific learning disability is because they have dyslexia. I’ve written at length about dyslexia, so feel free to read my prior posts about that disorder on the cpcwecare.com blog.

What does this mean for you?

In summary, there are lots of accommodation options besides directly referring to the school psychologist for an evaluation. In fact, you may find the process faster and smoother to receive feedback from the team regarding simple and efficient things they can do, now, in the classroom to help your child, and things you can do at home rather than waiting 60 days for the school psychologist to complete and present evaluation results. This is especially true given that a 15 point discrepancy is often needed for eligibility to receive special education services, and the chances are not great your child will have that discrepancy; especially in the lower grades. A 504 Plan may be more than sufficient and is much faster to develop. A 504 Plan is used for children who have a diagnosis for which various modifications can be used to ensure they have the same opportunity for an appropriate education as everyone else. It’s often used, for example, with kids who are diagnosed with ADHD. Ultimately, however, it’s vital to obtain information about what you can do at home to help your child learn. Again, see my prior posts about dyslexia (learning disabilities) for specific tips and suggestions.

Also, feel free to email me at jcarosso@cpcwecare.com

Autism / New On-Line Parent Training Program: Requesting your Suggestions

April 18th, 2014

We are delighted to announce:

Apple Tree Institute

AppleTreeInstitute.com is an Online Training program offering videos and webinars to help parents of children with autism and/or with behavioral problems.

Our goal is to make the site as helpful, user-friendlyand cost-effective as possible.

We would be indebted if you would view the Web site at AppleTreeInstitute.com, and share your thoughts with us about other topics that you’d like covered, and any suggestions to improve the Web site?

Please forward your thoughts to Dr. Robert Lowenstein, M.D. at r4lowe@gmail.com and Dr. John Carosso at jcarosso@cpcwecare.com.

Thank you again – your feedback is vital and appreciated.

How is ADHD Diagnosed? (and is it over-diagnosed?)

March 27th, 2014

Pathologizing?

There is wide-spread belief that children are over-diagnosed and over-prescribed, which implies that some kids are ‘just being kids’ and we’re pathologizing them, i.e. giving them a diagnosis, counseling, and medication when we should, rather, be sensitive and accommodating to the wide-spectrum in children’s activity-level and ability to attend. Is this an accurate perspective?

Just the facts Mam’

First, lets look at the stats: Rates of children, ages 4-17, diagnosed with ADHD are at about 7.8% (according to a recent National Health and Nutrition Examination Survey), which is not especially high, and stimulant prescription rates range between 4.3% and 4.4%, which you can see is substantially lower than 7.8%. Also, in that same survey, it was found that only 48% of the ADHD sample had received any mental health care over the prior 12 months, which would suggest children are, actually, being under-treated.

How is the diagnosis made?

To make the point further, if a clinician uses a strict clinical protocol, false-positives (inaccurate diagnosis) should be kept to a minimum. I provide a thorough explanation of the evaluation process in my video on the ‘evaluation process’

But here is a quick overview of specifically what is needed for an ADHD diagnosis: Click Here to Watch YouTube Video

-The child must have a long-history of demonstrating the core ADHD symptoms of inattention, impulsitivity, and hyperactivity. ADHD does not suddenly ‘spring-up’ one day after years of attentiveness. It’s usually something teachers and parents see from as early as the pre-school years.

-The signs are seen in multiple locations (school, home, community…).

-The problem is really getting in the way of the child’s functioning.

-Someone else in the family also has a similar problem with inattention, impulsivity… (ADHD tends to run in the family).

The problem cannot be explained better by some other malady. For example, if the child is distressed, depressed, anxious, or has learning issues, that may explain the symptoms better than ‘ADHD’. In that regard, if a child is experiencing some sort of stress or serious problem, it’s likely he or she will be preoccupied and subsequently have trouble concentrating.

So you can see…

If this protocol is followed, it’s far more likely that there will be an accurate diagnosis, and an effective treatment plan can then be established. I’ve written at length about proper strategies to address ADHD (please see my prior blog posts) that include a consistent and predictable routine, visual reminders, an organized environment, extra attention and assistance, counseling to improve insight and coping strategies and, in some cases, a medication consultation.

Questions?

If you have questions about this process or your child’s diagnosis, email me at jcarosso@cpcwecare.com or call the office. I’d be happy to answer your concerns.