In my practice I provide comprehensive assessment services for ADHD and related neuro-cognitive disorders. I hold a doctorate in Clinical Psychology from The Union of Experimenting Colleges and Universities (UNION) as well as a post-graduate certificate in educational psychology (Certificate of Advanced Graduate Studies- CAGS) from Norwich University and have completed two years of post-doctoral studies neuropsychology at The Fielding Institute. Finally, I hold a second doctorate (education and family law) from The Law School of the City University of New York (CUNY Law). I completed two years of APA clinical psychology internship at Middletown Psychiatric Center, NYU Medical Center-Bellvue Hospital and Kirby forensic Center in New York. I have served as the department chair for several agencies, held the position of Clinical Instructor in Psychiatry at NYU Medical Center and hold an advanced certificate in Cognitive Behaviour Therapy from the Albert Ellis Institute in New York. I have worked as a forensic psychologist for the State of New York, as a Provincial Consultant for Autism in British Columbia and as the behaviour management specialist for several school districts in the Bay area. I have worked in the field of ADHD, autism spectrum disorder (ASD) and neuropsychological rehabilitation for over 30 years.
For information on services for individuals who suspect they have ADHD and would like testing, visit this website's ADHD page: http://www.relatedminds.com/adhd/
Often I suggest readings, web pages and other resources for individuals or their families with ADHD, autism, Asperger's Disorder and related neuro-cognitive disorders. Here is a list of several of those resources you may find useful. If any of these pages/links become outdated, please email me at firstname.lastname@example.org
Is ADHD a "real" illness? Often I am asked this question, in spite of many decades of clear supportive research, people still fall victim to some non-sense on the web that questions the validity of the ADHD diagnosis. Here is a link to the consensus report showing support by the vast-overwhelming- body of scientific researchers: Click here: Consensus Report on ADHD
What's the best website for science-based information on ADHD?
The best websites I can suggest are 1) Dr. Russell Barkley's site (click here: http://www.russellbarkley.org) and 2) the CHADD website (click here: http://www.chadd.org). Dr. Barkley is THE leading researcher and is the man to go to for up to date information on ADHD research and treatment. CHADD is a great support network, and a good way to avoid less than useful theories and fads that are all over the internet. There is also a local chapter of CHADD: Click here: http://www.vcn.bc.ca/chaddvan/home.htm
There are also two very good government websites to help you understand ADHD, it's diagnosis and treatment, that are scientifically based - evidence based. One for Canada, and one for the United States. Here are the links:
NIMH web page: This page has everything you need to know about treatment, diagnosis, ongoing research, medications and so on. http://www.nimh.nih.gov/health/topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml This link addresses ADHD in children and teens: http://www.nimh.nih.gov/health/publications/attention-deficit-hyperactivity-disorder-teens-fact-sheet/index.shtml
Canada also has a very useful site: http://www.caddra.ca The CADDRA website has a lot of good reading and resources for you. Very helpful, and often, regretfully, not something your family doctor is familiar with.
What does a good diagnosis of ADHD consist of - and why does your ADHD assessment cost $800?
Let's start by looking at the "practice guidelines for Canada on the CADDRA site: http://www.caddra.ca/practice-guidelines/expanded-toolkit. Theese are the forms and procedures your doctor should use to make a real diagnosis of ADHD. Because ADHD symptoms can be caused by several other issues, and ADHD can mask other co-morbid conditions, an assessment of any quality takes time. We have to rule other possible causes out, and make sure you don't have other problems as well (nearly 50% of children diagnosed with ADHD have another disorder such as anxiety, depression or a specific learning disability. While in truth a diagnosis of ADHD can be made in a few minutes by collecting a history and current symptoms, and some professionals say no testing is really needed (Dr. Barkley says this, but if you look at the history and number of symptoms checklists Dr. Russell advises you to use you will see following his "no-test" procedure will take even longer than using tests!) Finally, writing a treatment plan means knowing more than the fact you have ADHD. We need to understand your strength and weaknesses in order to develop a plan that fits you. These things take time.
I hear all sorts of things about sugar, diet, herbs, homeopathic treatments and scary things about medication. How do I know what's true and what isn't?
That's a hard one. Start by reading articles on a popular science based website called "Science Based Medicine." The web site can be found here: http://www.sciencebasedmedicine.org Learning the ins and outs of science research is a big task, and honestly, many people with graduate degrees don't do too well at this either. But Science Based Medicine is a good and fun place to start. A lot of people come in and ask about homeopathic treatment. Homeopathy is not what most of them think. Heres a good place to start: http://www.sciencebasedmedicine.org/reference/homeopathy/ Another place to learn about homeopathy or to find out about any treatment you have some doubts about is a site with the direct name: Quackwatch. You can find that site here: http://www.quackwatch.com Finally, you can type into google or any search engine a question about some treatment and type the word "skeptic" after it, this will usually lead you to an article on some science based web page that includes information from someone who has "done their homework" on the topic.
I bring these issues up because many parents and adults come to my office after having spent a great deal of time and money on treatment, interventions or life style changes for which there is no scientific evidence, and sometimes evidence that they don't work or harm, but for which you can find many web pages full of science "sounding" information that is nothing more than someone with a strange, often paranoid belief system who tells you about 1/2 the story. Before you engage in anything, look it up on these web sites and simply ask your doctor. And remember, if your doctor says, "It won't hurt..." she usually means it won't help, but I don't want to hurt your feelings or get into a long discussion. Go to Quackwatch, Science-Based Medicine or type the work skeptic.
Do you have recommendations for an ADHD coach?
Regretfully most of the ADHD coaches" I've met are individuals with no training and no license who have very little understanding of the complexity of ADHD, it's neurological causes and how medications work and how ADHD interacts with other co-morbid disorders. I often suggest, once we get going on a treatment plan for your ADHD that you simply bring in a friend, a co-worker, your spouse or whoever and they spend some time with the two of us learning about the disorder and how they can become your coach by providing simple check-ups of about 5-10 minutes a few times a week. It's cheaper, often more effective, and they are then working under the supervision of a professional in the field. Sorry, that's just how I see it. Most books on ADHD talk about coaches and how to use them, and usually you and someone you can trust and rely upon can use the instructions in one of these books to work out a procedure for you to get the help and support you need.
ADHD is a life long disorder, and treatments need to change as you change, grow and mature. Life situations change, jobs and responsibilities, relationships all change, and these changes can have an effect on your symptoms that on one day were under control and the next, not so much. Find a good mental health professional to work with.
How do I know someone is an expert in this field?
Someone licensed (if your in the US) or Registered (if your in Canada). That means someone who didn't just join some association or take a weekend workshop or two about ADHD or "coaching." . A "REGISTERED" professional in Canada is someone who has a license to practice granted by a regulatory board. Here we have only a few REGISTERED professions (although some individuals call themselves registered - not everyone is. The REGISTERED professions here in BC are Registered Psychologist, Psychiatrist, your Medical Doctor, nurses and Registered Social Workers.)
My perspective is that someone practicing ANY specialty should have a number of classes in that area, many hours of study- not just a weekend course, SEVERAL, plus supervised experience. That means for a period of time they had a senior specialist in the field to work with. When you contact someone about ADHD services ask, "What specialized training do you have in ADHD? And did you get supervised experience? What school or association was that through?" If your embarrassed to ask this in person or over the phone send them an email. If your looking for someone to deal with your child's school problems, what experience do they have in the schools? Of if you need couples, marital or family counselling, what background do they have in couples, marriage or family therapy? Family therapy, offered by many "counsellors," is actually a specialized field of study with a separate graduate degree track, certification and licensing/registration. While we don't have a regulatory body in BC for "Registered Marriage and Family Therapists(RMFT)" we do have a professional association that requires members to have been credentialed by the American Association for Marriage and Family Therapy, taken 2 years of full time supervised experience and in most states, an exam. Look for a psychologist who is also a member of the British Columbia Association for Marriage and Family Therapy (BCAMFT).
What about schools and ADHD? What should I expect for services in the BC public school system?
I have little positive to say about the schools in BC and the services they provide children or teens with ADHD. Some students in BC with significant learning problems wait for 2-3 years before a psychoeducational assessment is provided, and even with one they wait months before an Individual Education Plan is written. I have worked in schools all over North America, in Europe and Asia and I have never seen a situation like this. If your child has learning problems or possible ADHD they need interventions as early as possible. And those interventions need to be strong enough to make your child's educational experience successful. Am I just a complainer? Read this from the Canadian Association of medical doctors who specialize in ADHD (CAADRA): http://www.cbc.ca/news/technology/3-provinces-get-failing-grades-on-adhd-report-1.926530 Yes, BC received a failing grade for how it deals with ADHD in the classroom.
Here is a copy of the BC regulations about ADHD. If you have a child in the BC school system, I advise you to read these pages: http://www.bced.gov.bc.ca/specialed/adhd/
Other provinces have really excellent handbooks for teachers, video training etc. I often share those materials when I consult with schools. Dr. Barkley has a great training video for teachers with students who have ADHD. The number one intervention that we have used, that has been shown to improve behaviour and maintain student progress is an old one: positive behavioural supports. Completing a good functional behaviour assessment (FBA) and then writing a good positive behavioural support plan (PBSP). I use to teach these skills in districts during treater professional days, but the topic of "special needs students" has become a difficult one here in BC and interest seems to focus not on getting a good IEP written, or a good FBA and PBSP, instead most meetings focus on how many hours and minutes of teacher aide time will be available. So, for a complex educational issue the emphasis is often on increasing the time the child spends with the least trained person on staff. An odd and difficult situation. My advise is to go back, read the handouts on ADHD in the classroom from the ministry, print them out and use those as your basic level of expectation.
In the USA many parents rely on this site and the materials available from it: http://www.wrightslaw.com/speak/schedule.htm Regretfully here in Canada we have different laws, but take a look at what the expectations are just across the border! One thing I can tell you is: Send every concern in writing, emails provide a record of your interactions with the schools and their responses. And never attend any IEP or "support team" meeting alone. Bring a mental health professional with you if you can afford it, or at least bring a friend. Your child's educational plan is to be developed with your input and agreement. If you disagree there are formal ways to contact the ministry of education. Every school should have a flyer about that available for parents. I see them in some schools, and in others they don;t know what I'm talking about. Your child should have an IEP as soon as school opens, and it should be based upon a comprehensive assessment. It's as simple as that. Oh, and take a look at the American Academy of Pediatric's statement on the use of medications with children. Medication can be an important part of your child's learning success - but the AAP says behavioural therapy, classroom management techniques and parent education come first. Click here for the information: http://www.cdc.gov/ncbddd/adhd/guidelines.html
- Health Canada Consumer Medication Side Effect Reporting
- Attention Deficit Information
Created by Dr. Annick Vincent this is an excellent resource on ADHD(in French)
http://www.attentiondeficit-info.com/The English section of the site is at http://www.attentiondeficit-info.com/adhd/
Answers to questions about ADD (ADHD)
- Attention Deficit Disorder Association
- ADDitude Magazine
A website and magazine on living with ADHD and learning disorders
- Nine Types of Curriculum Adaptations
General Articles on ADHD
I hope this brief outline of resources is helpful. There are many, many more, but this provides enough to get you going. Again, if you have concerns yourself about ADHD with children, adolescents or adults, feel free to contact me.
Study and School Related Resources
- 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.