Dr. Stein's Psychology Blog
My thoughts on mental health counseling, therapy, neuropsychology, collaborative divorce and more.
Here's my article on anger:
Obtaining psychological clearance before you begin a trial period of spinal cord stimulation is routine, but many people are unsure about why this is such an important step.
Spinal cord stimulation uses electrical current to minimize the feeling of pain reaching the brain. It involves insertion of small devices in the area around the spinal canal, which send the current when activated.
Following are a few common questions people ask about the required screening session with a neuropsychologist and how the results can be used to help meet your needs.
Q: Does a referral to a neuropsychologist mean my surgeon thinks I’m crazy or will go crazy after the stimulator placement?A: No, but not everyone responds well psychologically when a foreign device is implanted into their body. For some, the stimulator can cause an increase in worry and anxiety. Unfortunately, this stress can reduce the effectiveness of the simulator placement. In part, the pre-surgical clearance examination helps your physician prepare you for the procedure and make recommendations to help you adjust to this new part of your body.
Q: What happens during the pre-surgical psychological examination?A: Sometimes patients who have never met with a psychologist before get anxious about the initial visit. Knowing what to expect can help decrease worry.
Typically, the examination consists of a conversation between you and the psychologist about your medical history, including your chronic pain struggles. It also involves a social history, family history, information about previous alcohol or substance use, and what kind of psychological treatment you may have had in the past.
Q: What if I am depressed or anxious? Will that stop me from having the stimulator placement?A: No. In fact, chronic pain patients are much more likely to suffer from depression and anxiety than the general public. It is typical and expected that people living with chronic pain will have high levels of irritability, anxiety, and depression.Also, pain relief often helps decrease depression and anxiety. If you are struggling with depression and/or anxiety, the pre-surgical clearance evaluation will offer recommendations to help diminish these feelings.
Q: Can the psychologist make other recommendations besides the stimulator?A: Yes. The psychologist can be a valuable member of your pain management team. Many people find that alternative or complementary treatments, such as biofeedback and mindfulness approaches, can be helpful in helping manage chronic pain. Psychologists can guide people in these therapies as well as provide traditional psychological counseling.
Q: How long is the appointment and can the screening usually be done in a single appointment?A: Typically, an evaluation takes two hours and—depending on your insurance—can be done in one appointment. Following the evaluation, the results are shared with you and your physician.
Q: Are most people cleared to proceed with spinal cord stimulation?:A: While most people are cleared to have the trial placement of the stimulator, a small number of people are not. Those who are experiencing hallucinations, delusions, and cannot understand and follow post-operational directions should not have a stimulator. Instead, complementary and holistic interventions such as mindfulness, cognitive-behavioral therapy, or biofeedback may be a more effective option for pain management.
If you have any questions, feel free to call me in my Red Bank, NJ office at 732-747-8818.
(Initially published at: http://www.sports-health.com/blog/3-ways-stay-sane-when-injury-puts-running-hold)
If you're an elite runner, a weekend warrior, or somewhere in-between, it's generally not a question of if an injury will happen, but when. See Common Running Injuries
Half of runners will be hurt more than once in a given two-year period, according to Stephen Messier, the director of the J.B. Snow Biomechanics Laboratory at Wake Forest University in Winston-Salem, N.C. Women runners are somewhat more likely to be injured than men.
Running injuries can be caused by a traumatic event, but are most often happen over time due to repetitive movement. See Running InjuriesApplying repeated force over a extended period of time or suddenly boosting a training level causes conditions such as runner's knee, Achilles tendinitis, plantar fasciitis, shin splints, iliotibial band syndrome, patellar tendinitis (also spelled tendonitis), ankle sprain, pulled muscles, blisters, chafing, and side stitches.
In fact, the late runner-philosopher Dr. George Sheehan called running injuries “diseases of excellence.” While heart disease, type 2 diabetes, and hypertension are often seen as maladies of the sedentary, athletic individuals are not immune to health issues such as shin splints, stress fractures, and pulled groins. See Stress Fracture Causes
But let’s face it, most runners—myself included—aren't comforted by that badge of honor and don’t tolerate injuries well. Instead, we bemoan the fact that we can’t participate in something that keeps us physically and mentally healthy.
When injured, we fret over the loss of fitness, the possibility of weight gain, and the anxiety that we won't return to our previous level of physical intensity. Runners who are injured can become depressed. Their friends and family can find them difficult to deal with.See All About Ankle Sprains and Strains
Here are three coping skills runners can use to manage being sidelined:
1. HAVE A SECOND PHYSICAL ACTIVITY: Christy Victor, an ultra-marathoner, advises having an auxiliary physical activity already in place before an injury occurs.
“When I broke my ankle last fall, I threw all my energy into the strength training that had just been a secondary activity," explains the busy veterinarian, wife, and mother. "It helped in so many ways. It gave me a physical outlet, helped keep me from falling into the self-pity trap, and I worked really hard to correct some chronic imbalances that needed to be remedied.” See Exercises to Lessen Back Pain While Running
Having a physical outlet independent of running can ease concerns about losing fitness and helps you continue to enjoy many of the mental benefits seen from running. A secondary physical activity also helps individuals keep structure and routine in their lives, two things that help prevent or reduce depression. Additionally, a secondary physical activity helps maintain fitness, something that eases the emotional burden of being injured.
2. STAY CONNECTED: Team athletes can remain involved in athletics even when injured, but running tends to be a solitary activity. Social media, though, can help runners who do not belong to their local clubs or teams boost feelings of connectedness and reassurance. Facebook, message boards, and running apps allow runners to forge friendships, share milestones, and most importantly, offer encouragement and support when injured. Social media also helps runners remain accountable for getting back to running when healed from their injury. See Treating Acute Sports and Exercise Injuries in the First 24 to 72 Hours
Greg Medwid, a master-class runner who has a personal best of 79 minutes in the half marathon, knows what it's like.“When you are injured, you suddenly feel like an outsider. You watch your friends speed off, chatting and laughing while you wallow in a collection of pity and resentment. However, staying in touch can make all the difference. We need to at least be able to talk about running, and running friends provide that opportunity. Friends can give you that chance to keep up to date, to think about goals when you do come back. Good friends will even lie about how bad their runs were so you don’t feel too jealous.”
3. CHALLENGE CATASTROPHIC THINKING: It’s no secret that runners pride themselves on their passion and spend a lot of time thinking about the sport. When injured, it's easy for thoughts to turn dark and catastrophic.Psychologist Albert Ellis, the pioneer of Rational Emotive Behavioral Therapy, would suggest that when injured, a runner employ his “ABC method.” For Ellis, the Activating Event (A) would be the external fact of being injured, something that for the time being cannot be changed. This event in itself is not the cause of suffering. Rather, the Belief (B), that follows is what leads to a negative emotion or, in other words, a Consequence (C). Ellis argued that, over time, as you alter your aberrant beliefs (B), your negative emotions diminish.For example, a recent patient of mine effectively managed depression with running and was excitedly preparing for her first marathon. She was fit mentally and physically. As the marathon approached, though, a severe case of plantar fasciitis compelled her to withdraw from the race.See Plantar Fasciitis Risk Factors
The injury (A) triggered a series of catastrophic thoughts (B) that at first she was hardly aware of, including ideas that she would never finish a marathon. She also believed that the running she did was diminished by her injury. Even worse, she thought her depression would return at a level more severe than before. Lastly, this patient was very concerned about being embarrassed and humiliated because she spoke often to her family and friends about participating in her first marathon. At her core, she believed that she was a “loser” for getting injured.
When she was able to identify her dysfunctional thoughts and look at them more closely, she was able to make small, positive changes in her beliefs. Her mood did not improve overnight, and she later observed that she was still not happy about being injured. After all, who would be? But when she put her negative thinking to the test, she was able to view her injury as part of the marathon challenge.In time, she felt less helpless. Overall, she changed the mind-movie in her head of not achieving her goal and the sadness went away.
No runner likes the idea of getting injured while exercising. But having a variety of coping skills including a backup physical activity, staying connected with social media, and thinking clearly about the issue will be of benefit until you can literally and figuratively get back on your feet.
Do you dread the Back-to-School season just as much as your child? Are you too familiar with homework conflict, negative phone calls from teachers, and school refusal from your kid? Often, when these situations occur, parents don’t realize that their child is not just being stubborn, lazy, or negative. Instead, the child may be battling an undiagnosed learning issue. And, if one is discovered through a psychoeducational evaluation, a series of interventions and accommodations for the child are often available, providing some relief for not only the student, but also the whole family indirectly.
Last week I wrote a blog called Five Reasons Why A School District’s Evaluation of Your Child May Be Insufficient . In the following piece I will explain why one may need a psychoeducational evaluation in the first place. There are a wide range of common cognitive, learning, and psychological issues that impact learning:
What Types of Learning Issues Are There?
What can be done in school if my child is diagnosed with a learning and/or attention issue?
If an expert diagnoses a student with a learning disability, then he or she is entitled by federal law to receive extra assistance, typically through a 504 plan or IEP.
What is a 504 plan?
A 504 is a nickname for Section 504 of the Federal Rehabilitation Act of 1973. This civil rights law prevents discrimination against people with disabilities. Any child with a disability, including one that impacts learning or attention issues, is eligible for a 504 if the disability interferes with the child’s ability to learn in a general education setting. Section 504 has a broad definition of a disability, which is why many children in general education classrooms qualify for a 504.
What is an IEP?
An Individualized Education Program (IEP) is mandated by the Individuals with Disabilities Education Act (IDEA). The IDEA is a federal special education law for children with disabilities. To get an IEP, there are two requirements. First, a child must have one or more of the 13 specific disabilities listed in IDEA. Leaning and attention issues may qualify. Next, the disability must impact the child’s educational performance and/or ability to learn and benefit from the general education curriculum.
How Can My Child Get a 504 or IEP?
To get a 504, parents are not allowed to ask for an independent educational evaluation, but they can always pay for an outside evaluation themselves.
To get an IEP, parents can request the school district pay for an independent educational evaluation by an outside expert. But, the school district does not have to agree. Parents can always pay for an outside evaluation on their own.
What is actually in a 504 or IEP?
A 504 plan generally includes specific accommodations (changes to the learning environment), supports, or services for the student as well as who will provide each service and be responsible for ensuring the plan happens. A 504 plan can include instruction tailored to your child’s needs within a general education classroom.
For instance, within a 504 plan, a child with anxiety can leave the room to practice breathing exercises, a boy with an attention deficit disorder can pace while learning vocabulary words, and a girl with a central auditory processing disorder can receive information orally and in writing.
An IEP sets learning goals for a student and lists the services a school with provide such as special education, related, supplementary, and extended school year services. It must include how the child is currently performing in school, goals for the school year, and an explanation of how progress will be tracked. It also details when the services will begin, how often they will happen, and how long they will last. An IEP may offer accommodations (changes to the learning environment) and/or modifications (changes to what they child is expected to learn or know.) An IEP will explain how a child will participate in standardized tests and how the child will be included in general education and school activities. Other ways that educators can meet some learners’ needs via an IEP are by providing extra time on tests, providing class notes from a peer or teacher, seating the student in the first row, and modifying tests.
Who creates the specialized plan?
A 504 gets completed by a group of people who are familiar with the student and who understand the evaluation data and special services options. This can include: the student’s parent, teacher, principal, and/or psychologist.
An IEP must be created by a team that includes a child’s parent, at least one of the child’s teachers, at least one special education teacher, a psychologist who can interpret results of a psychoeducational evaluation, and a district representative who has authority over special education services. Typically, the entire IEP team must be present for IEP meetings.
If you think that your child may have a learning issue that requires closer attention, please call me at my Red Bank office at 732-747-8818 for a free 15-minute consultation. We can discuss whether or not an independent psychoeducational evaluation is in your student’s best interest.
As parents, we tend to trust in our child’s school system, with the notion that its priority is our children’s educations. However, these days, thanks to state and federal policies, most school districts are in a cash crunch. Sometimes it seems like they may care more about saving money than discovering how to meet students’ individual educational needs better. That means in-school evaluations may be shortchanging your child’s learning potential.
Over the course of my years in practice as a Neuropsychologist in Monmouth County, New Jersey, I have completed many educational evaluations. As part of that process, I’ve reviewed hundreds of evaluations for children of all ages that were completed by specialists employed full-time by school districts. Unfortunately, some of these have not been as valuable as they should have or could have been. Simply put, in-school evaluations may fall short in several important areas and provide only partial information. Why is this limitation a significant problem? That is because time is of the essence in terms of a child with special learning needs. Specifically, the longer a child with special learning needs waits for proper academic or behavioral interventions or accommodations, the further he or she will fall behind. Below are some of the restrictions of an in-school evaluation compared to a private psychoeducational evaluation.
1. So Many Students, So Little School Time: In-school specialists have large caseloads of students and a narrow amount of time and resources to spend on each of them. This can severely limit the breadth and depth of their evaluations. While an in-school evaluator may be afforded two hours of time to complete testing, enough for a basic intelligence test and perhaps an academic battery, an independent neuropsychologist is free from those restraints. A thorough evaluation can take 10 hours of face-to-face interaction with a student and his or her parents/guardians. Discovering what specific problems a student is having in school, why he or she is having those difficulties, and what can be done to help simply cannot be accomplished in a two-hour evaluation. Learning problems are complex and intricate. Most often, a student has more than one learning struggle and maybe even a co-occurring psychological issue with external stressors at home or in his or her social life. When I complete an evaluation, I gain a comprehensive understanding of a student’s personal strengths and weaknesses. I use this data to provide very specific recommendations and accommodations that are tailored to meet the individual needs of the child rather than the school’s financial needs.
Also, there is a long process that teachers and parents are required to go through before schools agree to evaluate students. Sometimes just getting the wheels turning can take up to nine months while the student flounders. Once the process begins, schools have a legal time frame they are required to stick to, but sometimes they purposely take the entire time allotted in order to stall the process or save money. Using an independent evaluator tends to be not only more effective, but also more efficient.
2. Educational Evaluations Require A Lot Of Detective Work: An educational evaluation is a mystery to be unraveled. In order to come to the right conclusion, every clue must be followed until the student’s problem(s) can be correctly identified and solved. But in-school evaluations typically are “once size fits all.” That means that all students get the same tests and the same evaluation. This is discouraging; an effective educational evaluation should be specifically tailored to each and every student.
For instance, I have seen many in-school evaluations note a student’s difficulty with attention and focus. But, they simply stop there, and draw conclusions. Identifying whether or not a child can pay attention in class is only the first step. Attention is a very broad skill; there are many different types of attentional abilities including visual, verbal, simple, complex, sustained, selected, alternating and more. An evaluator must identify the specific type of attentional difficulty in order to determine the correct type of intervention to implement. A second example of the limitations of a school evaluation is when the report identifies the student struggles in reading. Reading is a broad ability made up of many other skills including visual perception, phonetics, short-term memory, lexical abilities, and comprehension. Simply identifying a reading problem, like many in-school evaluations do, is like a plumber coming to your house and telling you there is leak, but not bothering to find out where it can be found. There is no real help in that. In contrast, an independent neuropsychologist can provide the full range of necessary insight.
3. It’s a Challenging Puzzle to Piece Together: Completing an effective comprehensive educational evaluation requires a deep breadth and depth of knowledge and abilities across many areas. Some in-school evaluators lack this expertise and are not able to comment in-depth about a student’s cognitive abilities, academic skills, neuropsychological functioning, and social skills. Having this expertise and knowledge base is essential in taking large amounts of information gained in an evaluation, understanding the interaction of cognitive skills and academic functioning, and distilling this information into a cohesive and understandable report that will benefit the student. Too often I have seen a school’s computer printouts of intelligence tests or academic batteries used as ineffective, “cookie-cutter” reports that do not clearly explain a child’s strengths and weaknesses to a parent.
4. Privacy Concerns: Although your child has a confidential school record, the results of an in-school evaluation can be seen by anyone who has a right to look at those records. You might not feel comfortable with that. However, the school staff only sees a private evaluation if you decide to release it to the school. Also, even though an in-school evaluation would take place in the somewhat familiar setting of the student’s school, he or she would likely be pulled out of his or her regular schedule for the testing process. This sometimes makes students feel stressed out or embarrassed. Your child may prefer the privacy of a Neuropsychologist’s office outside of school.
5. Freedom Of Expression: School evaluators are part of a school’s team. You can’t select them. Plus, their suggestions may be influenced by school concerns, such as resources. As someone who does not work for a school district and who is independent, I am free to make any and all recommendations that I see fit to benefit the academic, social, psychological, and cognitive functioning of a student. Additionally, since my evaluations are conducted in a methodical and scientific manner, those recommendations are easily supported and defended.
In conclusion, although it is always important to keep an eye on one’s budget, psychoeducational evaluations may not be the place to cut economic corners. A child who is struggling in school does not deserve to be shortchanged; the student needs his or her parents and teachers to get as much understanding into the situation as possible to maximize learning prospects. If you think your child might need a psychoeducational examination, call me for a free, 15-minute, consultation where we can discuss it. In certain circumstances, the relief that appropriate learning accommodations and interventions can give are priceless, and only a comprehensive evaluation can provide the information you need. 732-747-8818
Finding out your child has been diagnosed with dyslexia is not easy news for any parent to hear. One of the first things you should do is take a deep breath and watch this YouTube video: https://www.youtube.com/watch?v=fzHaLYsTgJc. In it, you will see that your child’s potential is still endless.
In my many years of counseling and conducting neuropsychological examinations in Red Bank, New Jersey, I have helped many parents move through and beyond their child’s diagnosis of dyslexia. Once parents digest the news and get assistance with a learning plan for their child, parents they often still have a wide variety of fears and concerns. The feedback I give is influenced by both clinical research and my own personal experience as being diagnosed at age 7 with dyslexia. Below are some of the most frequently questions I am asked along with the advice I offer:
Will My Child Be OK? I always answer this with a resounding “YES.” By the time I gather enough data to diagnose dyslexia, I have already conducted a full neuropsychological examination that also includes a thorough evaluation of a child’s many cognitive, academic, and psychological strengths. While a lot of time and effort is focused on the dyslexia itself, what is equally, if not more important, are the child’s assets. Utilizing the child’s strengths helps to set them up for success, and while there is no “cure” for dyslexia, a strengths-based approach is a time-tested compensatory strategy in the school setting.
Do I Tell My Child They Have Dyslexia? Again, I always answer this question with a resounding “YES.” While I recognize this is a difficult conversation for parents to have with their children, it is an important one to have, multiple times, throughout their academic career. Children are often relieved to know that there is a name for the struggles that they are experiencing in school. After all, the child most likely already recognizes a problem exists because of feedback he or she has received from other teachers, parents, or by their own observation of others’ performance in the classroom. What is most important to help your child understand is that he or she will learn to read and that he or she is not “dumb”, “stupid,” “lazy, or any other pejorative adjective.
Do I Tell My Child They Will Be Getting Special Services? Yet again, I always answer this question with a resounding “YES.” Much of the time, this is the part of the conversation that children dislike the most. While they may feel better by being able to put a name to their reading struggles, most balk at the idea of change -- actually getting help, tutoring, or special services –even though it’s designed to assist them become stronger readers. While children can keep the diagnosis of dyslexia to themselves, others may notice that they are indeed different learners. Kids generally don’t like the idea of being perceived as different. It is important for them to be able to express their concerns. They need to hear that you understand their anxieties, dislikes, and frustrations with any modifications to the school routine. Talk to them about how these changes will not just help them become better readers, but will also increase their enjoyment of school. With gentle reassurance your child will not just adjust, but thrive. Also, you should highlight your child’s special talents, skills, and personality traits.
In summary, rest assured that a brain with dyslexia is healthy. It just works differently. Is school going to be as easy as it is for some other children? Probably not. It is going to take some hard work. But, it can generate a lot of creativity and resilience in your child. If you had asked my mother when I was in middle school if I would go on to earn a PhD, she likely would have answered no. But look at me now.
If you think your child may benefit from an evaluation to determine whether or not he or she has dyslexia, let’s chat for a free 15 minutes. Or if you need some help adjusting to a new diagnosis, I’m here in my office for that as well. 732-747-8818
While it’s common knowledge that kids who have dyslexia find reading to be a more challenging task than others, most people don’t realize that there are actually different types of dyslexia, all of which can make mastering reading difficult. In my experience as a child neuropsychologist in Red Bank, New Jersey, I have gained expertise in distinguishing the different types of dyslexia. I tailor specific remediation or compensation strategies based on the specific needs of the child and his or her type of dyslexia in order to help solve the problem.
Generally speaking, there are three different broad categories of dyslexia. (Also, it is possible for a child to have more than one type of dyslexia.):
Phonological Dyslexia: Phonological dyslexia is one of the most common forms of dyslexia and is aquired developmentally through heredity and genetics. Approximately 75% of all dyslexia cases fall into this category. It is characterized by problems with subtle deficits in auditory abilities, because believe it or not, learning to read is a skill heavily influenced by oral language abilities. In laymen’s terms, phonological dyslexia is an issue with breaking words down into syllables and into even smaller units of speech referred to as phonemes. For instance, if you verbally present a word to a child who has trouble sounding out words, he or she can hear the word without difficulty and even repeat it back to you accurately. However, the child will not be able to tell you how to divide that word apart into the different sounds that make up this whole word.
A child with phonological dyslexia finds it frustrating to match the phonemes (sounds) with their written symbols (graphemes). When testing for phonological dyslexia, psychologists provide children with made up words to determine if the child can sound it out correctly. For example, the psychologist would show the word “bab,” a made up word, to the child. A child with phonological dyslexia would typically struggle to read the word “bab” aloud correctly.
Surface Dyslexia: Surface dyslexia is a type of dyslexia is also development and passed down through genes. Unlike phonological dyslexia, a child with surface dyslexia can sound out words well, even nonsense words. However, he or she can’t read or spell words spelled irregularly. It’s hard for the child to recognize irregular words, even after seeing them more than once. They need to scruntinize some words, sound them out, and decode them upone every encounter. Some examples of challenging sight words for a child suffering from surface dyslexia are “island” and “yacht.” Surface dyslexia impacts rate of speech and reading comprehension. Surface dyslexia also negatively impacts spelling skills.
Attentional Dyslexia: Although the name suggests that there may be a focus problem, attentional dyslexia is NOT connected with Attentional Deficit Disorder (ADD). Attentional dyslexia is a rare type of dyslexia, typically caused by damage to the left parietal lobe of the brain from labor, illness, or accident. It is a reading problem in which letters migrate between neighboring words. The child can accurately pronounce and sight read words. However, in this form of dyslexia, letters actually seem to move to other words. For example “lap dog” could be read as “dag log.” It’s a challenge for the reader to keep the relative position of the word intact. As they child becomes older and is presented with longer and more complex words, reading comprehension decreases. Also the disorder is negatively impacted by strong emotions such as anxiety, anger, and excitement. Behavioral therapy with a psychologist may help manage emotions and improve reading ability.
Once a reading problem is identified, it is possible to learn strategies to improve reading skills and minimize frustration. If you or someone you know is struggling with reading in any way, consider scheduling an appointment with me for a psychoeducational evaluation. Feel free to call me at my office for a 15 minute free consultation to determine if this is right for you.
Recently a second grade female visited my office, along with her mother, in my Red Bank office for an initial consultation. Her mother reported that the girl was unable to read, write, and spell at grade level, and the teacher reported the daughter was “lazy,” “careless,” and “immature.” The student’s grades were high enough that the school district was not offering any additional help. However, her mom suspected that the average and below- average grades her little girl was earning did not reflect the student’s true abilities. And what was even more concerning to the mom was how the girl described how she often felt “dumb” and frustrated in school. Outside of the classroom, the elementary school girl appeared bright, highly intelligent, and articulate. Her mother asked me to assess whether or not her daughter was suffering from a learning problem.
The parent was familiar with dyslexia, but believed many of the myths that she had heard about in passing that are listed below.
Myth 1: Dyslexia is a visual or visual perceptual problem.
FACTS: Dyslexia is a problem with language processing at the phoneme level, sounds in a specified language that distinguish one word from another, not a problem with visual processing. While dyslexia impacts reading, it is not a visual problem. Dyslexia occurs in children with normal vision and intelligence.
Myth 2: Writing letters and words backwards is a symptom of dyslexia.
FACTS: Assessing written letters or words is not very useful in determining the presence of dyslexia, especially in older children and adults. In fact, a child can be severely dyslexic and have no history of letter or word reversal. It’s common for all beginners to write letters or words backwards as they are learning to write. This happens because young children are still in the process of mastering letter forms and spelling (orthographic representations.) Therefore, backwards letters or words do not necessarily signify a reading disability in children.
Myth 3: Dyslexia can only be diagnosed after a child begins school.
FACTS: Because a large part of a child’s ability to read is based on spoken language, parents and teachers may spot clues to dyslexia before formal education begins. Very young children who struggle with dyslexia often don’t recognize simple rhyming patterns such as “fit, sit, and bit”. Also, very young children who have dyslexia also find it difficult to learn the letters of the alphabet and appear to be unable to recognize the letters in their name. Dyslexia can be accurately diagnosed at about five years of age.
Myth 4: Dyslexia is more common in boys than girls.
FACTS: A well-known study by the Journal of American Medical Association (JAMA) demonstrated there are no differences for dyslexia between genders. Previously, it was supposed that boys were more likely to have dyslexia compared to girls. However, the gender myth of dyslexia continues and, unfortunately, the possibility of dyslexia in females is usually considered later in their academic career than it should be.
Myth 5: There is nothing one can do to lessen the burden of dyslexia on reading, writing, and spelling skills.
FACTS: Because dyslexia ranges from mild to severe, it may not be recognized unless a school or parent pursues an in-depth psychological evaluation of the child. Without a diagnosis and understanding of the condition, learning to read typically takes more time and effort than it does for dyslexia-free children. Dyslexic children benefit from learning strategies that will help them compensate for the condition. Usually, they gain these strategies with tutoring or an individualized education plan.
After we reviewed the myths and facts, the parent in my story gave me the green light to go ahead with a series of tests and interviews. I diagnosed her daughter as having dyslexia. Once the girl’s dyslexia was identified and other learning disabilities were ruled out, I made suggestions for classroom accommodations and interventions. With that information, her school specialists were able to devise an individualized and detailed learning plan. Over time, the student's reading abilities improved and so did her motivation and enjoyment of learning.
In conclusion, a psychologist can be of assistance with dyslexia, or ruling it out as factor in one’s life. The earlier the problem is diagnosed in the academic career, the easier it is to lessen the issue. If you think you child may have dyslexia or another type of learning disability, feel free to call my office for a 15-minute free consultation to discuss how I may be able to meet your child’s needs. 732-747-8818.
Have you been referred to a psychologist by a school or medical professional because it’s suspected that your child may have Attention Deficit Hyperactivity Disorder? Over my 13 years of mental health private practice, I’ve noticed how confused and overwhelmed parents and guardians can get when faced with this task. When they initially contact my Red Bank, New Jersey office they are unsure about what an evaluation will entail and what kinds of useful information it will uncover. Below are 5 valuable and frequently asked questions parents ask in their first phone call or initial visit to me.
1) What exactly happens during an evaluation For ADHD?
A child neuropsychological examination should be comprehensive and extend over the course of several visits. That means the examiner over a period of time will want to meet with at least one parent or guardian, the child, review medical and school records, interview a teacher, and conduct a wide variety of intellectual, academic, cognitive, psychological, and social assessments. All testing data, should be scored and statistically compared to other children or adolescents your child’s age.
2) What are the tests like?
My office embraces the digital world and kids engage with the tests using an iPad. This tool speeds up the comprehensive process and provides accurate results. The tests themselves present a wide variety of tasks ranging from visual and verbal attention to reading comprehension. For most, testing begins at an easy level and becomes more challenging as the child progresses.
3) Why is about six hours of testing necessary?
Attention Deficit Hyperactivity Disorder is challenging to correctly assess and cannot be accomplished through simple observation. Also, children and adolescents with ADHD are very likely to have a second or even third diagnosis that includes additional types of learning disabilities, anxiety, and/or depression that all can impact school and social functioning. In order to boost the child’s academic and social functioning, other diagnoses must be identified or ruled out.
4) Who will do the actual testing?
It is crucial for a psychologist to do the testing, without the use of testing technicians. In addition to the data gathered through interviews and the iPad, the psychologist needs the opportunity to observe and gain insightful information about the student. I personally and directly handle all aspects of the assessment procedures. This allows me to get first hand observations of how the child problem-solves challenging test items and handles frustration. At the end of six hours or more of direct testing and observation, I get to know the child’s personality very well and am able to comment on other important aspects that may impact academic functioning such as anxiety, impulsivity, or inattentiveness.
5) What happens once testing is completed?
After the assessment procedures are finalized and the data has been analyzed, I write a detailed report, typically 12-16 pages long, regarding the child’s medical, social, and academic history. The report will also describe the child’s intellectual, academic, and psychological functioning in terms of strengths and weaknesses. I provide an accurate diagnosis or diagnoses, and most importantly, recommendations for treatment and academic interventions. The report is easy for parents and guardians, teachers, and other healthcare professionals to read and understand. The report can also be used as a baseline measure to the effectiveness of both academic and treatment interventions and/or for a school Individual Educational Plan.
If you think your child or teen would benefit from a psychological evaluation for ADHD, or a learning disability, please call me at my Red Bank, NJ office at 732-747-8818 for a free 15-minute consultation where we can decide together if making an appointment is the right move.
Click here: http://www.scientificamerican.com/article/harsh-critical-parenting-may-lead-to-anxiety-disorder-symptoms/
From the Scientific American article: "New research suggests that parents who stoke their children with harsh scolding may also be saddling them with anxieties that last a lifetime. In a survey published last November, researchers collected childhood memories from more than 4,000 adults of all ages and correlated them with the participants' self-reported mental health. The findings suggest that children with authoritarian parents will have a harder time adapting to adversity later in life."
I'm a clinical psychologist and neuropsychologist with a private practice in Red Bank, NJ.