Child ADHD

  • Attention deficit-hyperactivity disorder (ADHD) is a neurobehavioral disorder that has a negative effect on one’s ability to stay on task and/or inhibit certain behaviors (response inhibition). Other symptoms include difficulties in listening to instructions, organizing school work, fidgeting, talking excessively, leaving projects, chores, and homework assignments unfinished, and paying adequate attention to details.
  • A neuropsychological evaluation can provide important information and determine the underlying cause of your child’s difficulties and provide important recommendations for intervention and treatment across school, home, and community settings.
  • In some cases, behaviors that look like ADHD are caused by other factors. PsychBreak provides emotional and behavioral evaluation in conjunction with neuropsychological evaluation to uncover the causes and collaborate with families to create comprehensive treatment plans.

Adult ADHD

  • Attention deficit-hyperactivity that typically starts in early childhood but may not be diagnosed until adulthood. Adult ADHD can result in unstable relationships, poor word or school performance, and low self-esteem
  • Symptoms of Adult ADHD include:
    – Difficulty focusing or concentrating
    – Restlessness
    – Impulsivity
    – Difficulty completing tasks
    – Poor organization
    – Mood swings
    – Hot temper
    – Difficulty coping with stress
    – Unstable relationships
  • A neuropsychological evaluation can help determine the underlying causes for symptoms associated with Adult ADHD and whether diagnosis and treatment are warranted. It is important to note that changes in mood resulting from anxiety and depression can also have an adverse effect on attention and focus, and this too can be explored by way of neuropsychological assessment.

Educational and Career Accommodations

PsychBreak provides neuropsychological testing for students who are not achieving at the expected level or who may be having difficulty functioning within the academic setting for emotional or behavioral reasons. Although these types of evaluations are often offered within the public school setting, more often than not they are not as comprehensive as a neuropsychological evaluation and may not be available to students attending private schools. A neuropsychological evaluation provides specific information relative to your child’s optimal learning style, method of information processing, and academic function that can help identify any underlying disorders in learning as well as carve out and tailor a specific plan for treatment and accommodation within the school setting.

For adults, a neuropsychological evaluation can accurately assess and diagnose difficulties in learning and academic performance. Results can also provide information important for accommodations that might be necessary in college or graduate school settings.

  • Developmental Reading Disorder (Dyslexia)
    Dyslexia is a developmental disability in reading that results from the brain’s difficulty recognizing and processing certain symbols that are necessary to interpret language. A child’s early reading skills are based on word recognition, which involves the ability to isolate the sounds in words and associate them with specific letters or groups of letters. As such, children with dyslexia can also have difficulty understanding sentences.
    In general symptoms include:
    – Difficulty determining the meaning (idea) of a simple sentence
    – Difficulty learning to recognize written words
    – Difficulty rhyming
    Dyslexia can also occur in conjunction with difficulty learning in other areas such as writing and math as they too are largely dependent on the interpretation of symbols.
    A neuropsychological evaluation is useful in accurately diagnosing dyslexia by administering tests specific to reading, reading comprehension, and additional tests associated with other academic and thinking skills. In this way, a neuropsychologist is able to rule out other possibilities for reading difficulty such as emotional struggles, intellectual disability, certain medical or neurological conditions, and other cultural or educational factors that can affect a child’s learning. In addition, a neuropsychologist can recommend academic accommodations and interventions in school and at home that will assist your child in learning to read.
  • Mathematics Disorders (Dyscalculia)
    A mathematics disorder is often present when a child’s math ability is far below what would otherwise be expected for their age, intelligence, and education.
    Symptoms include:
    – Difficulty reading, writing, or copying numbers
    – Problems counting or adding numbers and making what appear to be simple mistakes
    – Difficulty knowing the difference between addition and subtraction
    – Difficulty understanding math symbols and word problems
    – Errors in lining up numbers in the correct columns to perform math operations
    – Difficulty arranging numbers from smallest to largest or vice versa
    – Inability to interpret graphs
    A neuropsychological evaluation can accurately diagnose and/or rule out other potential causes for your child’s math difficulty as well as provide recommendations for early intervention in school and home settings.
  • Writing Disorders (Dysgraphia)
    Dysgraphia is learning disorder that is characterized by poor spelling, reduced legibility in handwriting, and difficulty communicating one’s thoughts on paper.
    Symptoms include:
    – Awkward body position and/or pencil grip when writing
    – Poor handwriting
    – Avoidance of writing or drawing
    – Fatigue from writing
    – Talking to self while writing
    – Leaving sentence unfinished or omitting words
    – Difficulty organizing thoughts on to paper
    – Difficulty with syntax structure and grammar
    – Disparity between written ideas and level of understanding communicated through speech

A neuropsychological evaluation can accurately diagnose and/or rule out other potential causes for your child’s writing difficulty as well as provide recommendations for early intervention in school and home settings.

Speech/Language and Communication Disorders

  • Speech and Language Disorders may be present if your child has difficulty understanding speech (receptive speech problem) or accurately communicating with spoken language (expressive speech problem).
  • As part of a neuropsychological evaluation, tests specific to speech and language are administered to determine the nature and severity of your child’s language difficulty. Additionally, other contributions to your child’s speech difficulty are explored, such as shyness, anxiety, or other emotional/behavioral concern.
  • A PsychBreak neuropsychological evaluation provides specific recommendations for treatment, such as a referral to a speech and language pathologist or to a talk or play therapist, and accommodations and interventions can also be designed for the school setting.

Autism/Asperger’s Spectrum Diagnosis

Autism Spectrum Disorder (Pervasive Developmental Disorders)

  • Autism Spectrum Disorders are a group of developmental brain disorders, such as Autism or Asperger’s disorder, that refer to the “spectrum” of symptoms, skills, and levels of impairment that might be present. They are typically characterized by difficulty in the following areas:
    Socialization
    Communication
    Repetitive or stereotyped behaviors
  • At PsychBreak, a neuropsychological evaluation can accurately diagnose an autism spectrum disorder and differentiate it from other concerns such as an underlying speech/language disorder or emotional/behavioral disorder. Results of the evaluation provide important information to guide appropriate treatment and intervention geared toward improving socialization, communication, and behavior.

Autism
Autism is characterized by difficulty in socialization, communication, and repetitive/stereotyped behaviors with symptoms affecting:

Socialization

  • Poor eye contact
  • Failure to respond to others in the environment, even if looking at them
  • Difficulty engaging in everyday social interactions
  • Does not readily seek to share their enjoyment of toys or activities by pointing or showing things to others
  • May display unusual responses to others who show anger, distress, or affection

Communication

  • Slow to respond to child’s name or other means of acquiring attention
  • Slow to develop gestures such as pointing or showing things to others
  • May boo or babble in first year of life but then stop doing so
  • Delayed language development
  • Communication via pictures or own sign language
  • Speaking in single words and/or repeating certain phrases; inability to combine words into meaningful sentences.
    ( Repeating words or phrases that they hear (“echolalia”)
  • Use of words that seem, odd, out of place, or having special meaning to the child

Repetitive or Stereotyped behaviors
Repetitive motions or unusual behaviors that may be very noticeable or more discreet including:

  • Flapping hands or arms
  • Walking in specific patterns
  • Repeatedly touching eyes or face; gesturing
  • Chirping

Asperger’s Disorder
Asperger’s is characterized by difficulty in socialization, and repetitive/stereotyped behaviors with symptoms affecting:

Socialization

  • Poor eye contact
  • Failure to respond to others in the environment, even if looking at them
  • Difficulty engaging in everyday social interactions
  • Does not readily seek to share their enjoyment of toys or activities by pointing or showing things to others
  • May display unusual responses to others who show anger, distress, or affection

Repetitive or Stereotyped behaviors

  • Repetitive motions or unusual behaviors that may be very noticeable or more discreet including:
  • Flapping hands or arms
  • Walking in specific patterns
  • Repeatedly touching eyes or face; gesturing
  • Chirping

Epilepsy Pre/Post-operative Assessment

Epilepsy
Neuropsychological evaluations can assist neurologists and neurosurgeons by way of providing neurocognitive data that can help localize the source of seizure activity within the brain and assess cognitive function both pre- and post-operatively if surgical resection is being considered. If you or a loved one is affected by epilepsy, consult with your neurologist or a staff member at PsychBreak to determine if a neuropsychological evaluation would be of benefit.

Dementia and Mild Cognitive Impairment

Dementia (including Alzheimer’s Dementia)
Dementia

  • Dementia is a loss of brain functioning that occurs with certain diseases and is typically non-reversible. It can affect all areas of cognition including learning, memory, attention, thinking, language, judgment, and behavior.
  • Symptoms include
    Difficulty with tasks of daily living such as finances, card games, or learning new information/routines
    Getting lost or disoriented when taking familiar routes
    Difficulty recalling the names of familiar people or objects
    Changes in mood, loss of interest in things previously enjoyed
    Misplacing items
    Changes in personality or social function; inappropriate behavior
  • A neuropsychological evaluation can differentiate between various types of dementia, provide education to the patient and his/her family, as well as recommend treatment options. Some common types of dementia include:
    Alzheimer’s Dementia
    Dementia with Lewy Bodies
    Frontotemporal Dementia
    Vascular Dementia
  • Results of a neuropsychological evaluation can be used to determine an appropriate course of treatment and intervention for you or a loved one, such as:
    Medication for memory loss
    Psychiatric Medication
    Individual or Family Psychotherapy
    Safety regarding driving privileges
    In home assistance or health care
    Consideration of alternate housing accommodations
    Calendars, message boards, assistive devices for reminders

Mild Cognitive Impairment

  • Mild cognitive impairment (MCI) is more severe than forgetfulness due to normal aging, but less severe than dementia. People with MCI experience mild difficulty with thinking and memory but it does not necessarily interfere with daily living. Not all individual who have mild cognitive impairment go on to develop dementia.
  • Symptoms of MCI include:
    Difficulty multi-tasking
    Difficulty solving problems or making decisions
    Forgetting recent events or conversations
    Taking longer than is typical to perform certain functions or activities

HIV related dementia and cognitive decline

Complex Medical Conditions

Complex Medical Conditions
Changes in cognition and academic performance resulting from neurological damage or disease can be accurately assessed by way of neuropsychological evaluation. Individuals are commonly referred for cognitive difficulty associated with:

  • Traumatic Brain Injury (TBI)
    – A TBI results from a hit, jolt, or penetrating injury to the brain that disrupts an individual’s normal brain functioning. TBI’s can be mild, moderate, or severe depending on the level of impairment, duration of lost consciousness, and degree of altered mental status.
  • Concussion
    The term “concussion” is often used interchangeably with” mild traumatic brain injury” or “MTBI” to describe an injury resulting from sports-related activity. Concussions usually involve a brief loss of consciousness or altered mental state that is accommodated by some of the following symptoms within a 24-hour period:
    – Headache
    – Dizziness
    – Vomiting
    – Nausea
    – Drowsiness
    – Blurred Vision

Stroke
A stroke, or cerebrovascular accident (CVA), results when blood flow to a specific part of the brain is disrupted long enough to result in an infarction, which is an area of dead or damaged tissue. Depending on the location of the stroke, certain brain functions can be impaired or compromised. A neuropsychological evaluation can help determine the severity and location of cognitive dysfunction after stroke, and also provide important information to rehabilitation teams regarding treatment effectiveness, progress, and return to activities of daily living.

Tumor
The presence of a Central Nervous System (CNS) tumor can impair cognitive functioning depending on the location, size, and grade of the tumor. A neuropsychological evaluation can provide pre- and post-operative data relative to cognitive functions that might be sensitive to surgery. Additionally, a neuropsychological evaluation can identify cognitive functions that need to be the focus of rehabilitation as well as help determine if an individual is ready to return to work or school.

Huntington’s Disease
Huntington’s disease is a genetic disorder that is passed on in families by individuals who carry the gene for Huntington’s disease. Symptoms typically emerge in person’s 30’s or 40’s and can include:

  • Cognitive impairment or dementia
  • Abnormal movements
  • Abnormal reflexes
  • Speech hesitation or enunciation difficulty
    Although there is no known cure to Huntington’s disease, a neuropsychological evaluation can help clarify diagnosis, monitor disease progression, and educate the patient and family regarding expectations, complications, and appropriate monitoring of risk factors such as depressed mood and suicidal ideation.

Parkinson’s Disease
Parkinson’s disease is a disorder of the brain characterized by shaking (tremors) and difficulty with movement and coordination. Symptoms typically emerge after age 50 and can include:

  • Movement problems
    – Difficulty initiating movement (e.g. starting to walk)
    – Difficulty continuing to move
    – Slowed movement
    – Difficulty with fine motor movement (writing, eating)
  • Shaking and tremors
  • Difficulty swallowing or drooling
  • Balance difficulty and difficulty walking
  • Blank facial expression
  • Slow or monotone speech
  • Muscle stiffness
    An individual with Parkinson’s disease may be referred for a neuropsychological evaluation by a medical professional to help clarify diagnosis and monitor disease progression as a means of treating symptoms more effectively.
  • Results of a neuropsychological evaluation can also provide important options for treatment and intervention including referrals for:
    Cognitive Rehabilitation
    Executive Function Skills Coaching
    Individual or Family Psychotherapy
    Medication
    Specialized medical intervention