The Autism category compiles any blog related to Autism on the North Shore Pediatric Therapy website.  The blogs in this category are meant to help educate, inform and encourage parents of children with Autism. Readers will learn about Applied Behavior Analysis, Autism-friendly activities, school, appropriate toys, red flags, special needs lawyers, financial planning, multidisciplinary treatment options and more. If you are looking for any information related to Autism, this category will help you get started. If you need additional assistance, please give us a call at (877) 486-4140.

what to expect in a neuropsychological exam

Neuropsychological testing for kids at NSPT

what to expect in a neuropsychological exam

A child receives a referral for neuropsychological testing when there are concerns about one or more areas of development. Certainly, these areas of concern can include cognition, academics, attention, memory, language, socialization, emotional regulation, behavioral concerns, motor difficulties, visual-spatial, and adaptive functioning. Testing can identify your child’s learning style and cognitive strengths. Lastly, through testing, our neuropsychologists can recommend accommodations to implement at school and at home.

What is a neuropsychological evaluation?

A neuropsychological evaluation aids the psychologist in determining a diagnosis.
Such as:

How do I know if my child needs a pediatric neuropsychological evaluation?

An evaluation is usually recommended if your child has a medical condition such as Down syndrome, epilepsy, or a traumatic brain injury (TBI). So, the goal of the evaluation is to identify your child’s strengths and weaknesses. With this information, we can provide the right treatment recommendations, determine progress and response to intervention, and monitor functioning.

After your pediatrician has made a referral for a neuropsychological evaluation, you need to schedule an intake appointment. Typically, each intake appointment is one hour long.

Is my child eligible for testing at NSPT’s neuropsychological testing center?

Due to our growing team, we are able to test a larger population. Most noteworthy, we offer three types of testing services:

      1. Early Childhood Developmental Assessment
        This is a multidisciplinary approach where our team works with a speech therapist and occupation therapist to assess children ages 15 months to 3 years, 11 months with developmental concerns ranging from socialization, language, and motor development. Each of the 3 scheduled testing appointments are typically on separate days.
      2. Neuropsychological Evaluation
        NSPT’s standard neuropsychological evaluation for individuals ages 4 through college-age.
      3. Adult ADHD assessment
        This is a new service we are now offering to adults who are interested in an ADHD evaluation. Typically, this is a one-day, 4-hour evaluation.

What should I expect during the neuropsychological intake?

  • Your first appointment is centered around talking with the psychologist about your areas of concern. Therefore, you will be asked to do the following:
    • Provide information about your child’s history.
    • Including medical, developmental, academic, attention, behavior, motor, and social history.
    • Inform the psychologist of any current, or past, services your child receives, such as:
      • speech-language therapy
      • occupational therapy
      • physical therapy
      • individual therapy
      • academic tutoring

What to bring to the neuropsychological intake:

  • You and your child
  • Completed intake paperwork
  • Similarly, any prior psychological/neuropsychological evaluation (if applicable)
  • Your child’s most recent 504 Plan or IEP (if applicable)
  • Additionally, any recent private intervention evaluation (e.g., speech-language therapy, occupational therapy)
  • Certainly, don’t forget your child’s most recent report card or standardized exam scores
  • Finally, any relevant medical information (e.g., EEG report, CT/MRI scan report)

Lastly, after the intake, you will schedule the testing session for your child.  Most of the time, testing is completed in one day (5 hours of testing). Occasionally, the testing will be completed over two days.  The psychologist will create a neuropsychological battery based on the areas of concern. However, the battery is subject to adjustment on the day of testing.  Typically, this occurs if another area of concern arises during the testing session.

To sum up, a pediatric neuropsychological evaluation can also help to determine any appropriate therapies such as speech or Applied Behavior Analysis. For more FAQ, click here

 

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes Plaines and Mequon! If you have questions or concerns about your child, we would love to help! Give us a call at (866) 815-6592 and speak to one of our Family Child Advocates!

 

How to Teach Play Skills to a Child With Autism

Play skills are one of the most important areas that children, especially those with Autism, need to learn. These skills provide opportunities for the child to entertain themselves in meaningful ways, interact with others, and learn important cognitive skills. A successful way to teach play skills to children with autism is to initially teach the specific play skill in a very structured manner. Play Skills

  • Break the play skill into small, discrete steps and teach one step at a time. As the child demonstrates success in learning one step, add the next step. (After the child can add eyes to Mr. Potato Head, then add ears, then arms, etc.)
  • Use modeling to teach the skill (e.g. the adult builds a tower of Legos as the child watches, then the child builds his own tower).
  • Always provide reinforcement (behavior specific praise “Nice job putting the piece in the puzzle”, immediately following the child’s demonstration of the skill.). As the child exhibits improved accuracy of the skill, reinforce successive approximations.
  • The child should have plenty of opportunities to rehearse the skill in a structured setting. Practice, practice, practice!
  • In the structured setting, have the learning opportunities be short and sweet, so the task does not become aversive to the child.
  • Fade the adult prompting and presence out gradually, so the child can gain more independence. Systematically fade the reinforcement so that it is provided after longer durations.
  • Remember to keep the activity fun and exciting. You want your child to WANT to play with the toys and games.

Once the child masters the skill in the structured environment by independently completing the play tasks for extended periods of time, he or she can then begin to practice and develop the skill in more natural settings. Bring the toys and games into other rooms of the house, to school, and eventually have peers present, so the child can use the skills learned in a social setting.

NSPT offers services in BucktownEvanstonDeerfieldLincolnwoodGlenviewLake BluffDes PlainesHinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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What Are Executive Function Skills?

Many of us have heard executive functioning used in terms of our children at school and at home. But what does it mean? Executive Function Blog

Executive Function – a Definition

Executive functions are necessary for goal-directed behavior. When we use the phrase “executive functioning skills,” we are describing a set of cognitive skills that control and regulate other behaviors and abilities. Our thought processes influence attention, memory and motor skills. (minddisorders.com).

Executive functioning skills help us to learn and retrieve information, plan, organize, manage our time, and see potential outcomes and act accordingly. When these processes work without difficulty, our brains do these tasks automatically, often without our awareness.

High Executive Function

In children and adults, those with high executive function skills are able to:

  • Initiate and stop actions
  • Make changes in behavior
  • Plan for the future
  • Manage time wisely
  • Anticipate possible consequences
  • Use problem-solving strategies
  • Use senses to gather information

For instance, the ability to initiate and stop actions may include working on a project for school or studying for an allotted time. Monitoring ones changes in behavior includes being able to act appropriately in a given situation and alter that behavior as needed. Planning for the future and managing time may include not procrastinating due to understanding the consequences of doing so.

Low Executive Function

When one is deficient in executive function skills, it may be difficult to plan and carry out tasks. The person may seem unable to sustain attention and feel overwhelmed by situations others find easier to navigate.

People with deficits in this area may also have comorbid diagnoses (meaning they go together). These include, but are not limited to: Attention Deficit Hyper-Activity Disorder, Autism, depression and obsessive-compulsive disorder. Executive functioning deficits may run in families (learningdisabilities.about.com).

So, a child with executive functioning deficits may be able to pay attention to a lesson, until something new is introduced that requires a shift in their attention or that divides their focus. Children lacking in executive functioning skills also may have issues with verbal fluency.

Additionally, a child (or adult) with low executive function may have social problems. Executive functioning skills allow us to anticipate how others might feel if we do or say something. Those with low executive function may have difficulty interacting with others. Because they sometimes do not think things through before saying them, people with executive functioning deficits may blurt out inappropriate or hurtful comments, leading others to avoid them.

Working with your child, a therapist, and creating structure at home and accommodation plans at school are all ways to provide help for your child.

Increasing executive functioning skills will enable her to become a more organized, less stressed and less frustrated individual as she grows into a world of ever-increasing pressures.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Hand Flapping: When to Worry

Many people correlate hand flapping with only Autism, however this is not the case. All children could exhibit a hand flapping behavior when they are in a heightened emotional state including when anxious, excited, and/or upset.  Many believe that children with Autism will engage in hand flapping as a self-stimulatory activity, which can be accompanied by other stimming behaviors like rocking and/or spinning. Blog-Hand Flapping-Main-Landscape

Children with autism are often extremely sensitive to specific sensations and sounds that may not effect someone who is not on the spectrum. Environments in which there are multiple sounds, loud noises, and crowds can cause distress for some individuals with and even without autism. Hand flapping is seen as a way to escape the over stimulating sensory input present in the environment.

Other times when hand flapping can be observed in children (both verbal and non-verbal) is when they are trying to express or communicate to others around them. It is viewed as them trying to express that they are: happy, excited, anxious, or angry. In cases like these, families and professionals often feel that hand flapping should not be a concern, stopped, or corrected.

Hand flapping would be something to worry about when and if it impacts a child’s functional daily living ability, for example if it impacts their ability to navigate their environment safely.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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Here’s What You Can Expect from a Neuropsychological Evaluation

A child may be referred for a neuropsychological evaluation when there are concerns about one or more areas of development. This can include cognition, academics, attention, memory, language, socialization, emotional, behavioral, motor, visual-spatial, and adaptive functioning. Blog-Neuropsychological-Evaluation-Main-Landscape

A neuropsychological evaluation aids the psychologist in determining an appropriate diagnosis, such as Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Specific Learning Disorder, Language Disorder, and emotional and behavioral disorders. An evaluation can also be recommended if your child has been diagnosed with a medical condition such as Down syndrome, epilepsy, or a traumatic brain injury (TBI). The purpose of the evaluation would be to identify your child’s strengths and weaknesses in order to provide appropriate treatment recommendations, determine progress and response to intervention, and monitor functioning.

After your pediatrician has made a referral for a neuropsychological evaluation, you will need to schedule an intake appointment, which is typically an hour long.

What to Expect During the Neuropsychological Intake:

  • Inform the psychologist about your areas of concern
  • Provide information about your child’s history
    • Including medical, developmental, academic, attention, behavior, motor, and social history
  • Inform the psychologist of any current, or past, services your child receives (e.g., speech language therapy, occupational therapy, physical therapy, individual therapy, academic tutoring)

What to Bring to the Neuropsychological Intake:

  • Completed intake paperwork
  • Any prior psychological/neuropsychological evaluation (if applicable)
  • Your child’s most recent 504 Plan or IEP (if applicable)
  • Any recent private intervention evaluation (e.g., speech language therapy, occupational therapy)
  • Your child’s most recent report card or standardized exam scores
  • Any relevant medical information (e.g., EEG report, CT/MRI scan report)

After the intake, you will schedule the testing session for your child.  Most of the time, testing is completed in one day (5 hours of testing), but occasionally the testing will need to be completed over two days.  The psychologist will create a neuropsychological battery based on the areas of concern; however, the battery could be adjusted on the day of testing.  Typically, this occurs if another area of concern arises during the testing session.

What to Bring on the Day of the Neuropsychological Test:

  • Plenty of snacks and lunch
  • Completed paperwork and rating forms
  • Any prior evaluations that were not brought to the intake

After testing is complete, you will return for a one hour feedback session approximately two weeks later, with the clinician to review the testing data, any diagnoses determined based on your child’s profile, recommendations for home and school, and any intervention services to foster your child’s development.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

Meet-With-A-Neuropsychologist

5 Things to Keep in Mind When Potty Training a Child with Autism

Potty training is a big milestone for any child. It definitely is an important milestone for parents as well! No more diapers!! However, there are some things to keep in mind prior to considering potty training as well as during potty training. Blog-Potty-Training-Main-Landscape

  1. When should you consider potty training?
    • On average you would consider potty training when the child is around 2.5 years of age and above, can hold urine for 60-90 minutes, recognize the sensation of a full bladder, and show some form of awareness that they need to go to the bathroom.
    • Do at a time when you can spend large amounts of time at home! Some parents find it best to do in the summer (less clothing!).
  2. What schedule should you use when potty training?
    • You want to take your child to the bathroom every 90 minutes, if your child urinates then you wait for the next 90 minute interval, if not you reduce the time by 30 minutes.
    • Consistency is extremely important to ensure success.
  3. While on the toilet what should we do?
    • Praise your child for sitting appropriately on the toilet.
    • You can do activities with them as long as they are not too engaging or involved.
    • If they do urinate you want to CELEBRATE!
    • You need to wait up to 15 minutes if there is still no urination, then you let them get off and bring them back after 60 minutes (this keeps decreasing by 30 minutes each time there is not urination).
  4. What should you do when there is an accident?
    • It happens! Make sure you have your child help you clean it up, this is not meant to be punishing but more a natural consequence of having an accident. Keep a neutral tone and assist your child if needed to clean up the mess.
    • If your child is having too many accidents you may need to shorten the intervals of going to the toilet, or it may be that your child is not ready to be potty trained yet. Always rule out any medical reasons as well!
  5. Things to remember!
    • When starting potty training you want to make sure you child can sit on the toilet for up to 15 minutes with minimal challenging behaviors.
    • The goal is INDEPENDECE, you want to work towards your child walking to the bathroom on their own and removing and putting on their underwear and pants independently as well as washing their hands.
    • Make sure you child is in underwear throughout potty training! NO DIAPERS/PULL UPS!
    • Diapers and pull-ups are okay during nap time and bed time.
    • Number one thing to remember is PATIENCE, try to be consistently upbeat and encouraging to your child and deal with accidents as calmly as possible!

It is important to ensure that potty training is as positive an experience as possible for your child! Maintain your positive energy and constantly praise appropriate behavior seen throughout the potty training process! This will encourage your child to become more independent as well as want to go to the bathroom more often on their own!

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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IEP Legal Rights

This guest blog was written by Sandra Strassman-Alperstein.

As a special education attorney, I am often asked by parents of children with autism about their children’s legal rights at school. Fundamentally, children with autism are entitled to the same Blog-IEP Rights-Main-Landscapeeducational rights as other children with disabilities, namely FAPE (free appropriate public education).  What constitutes “appropriate” education is at the crux of many special education disputes regarding students with autism as well as other students with disabilities.

Let’s take Michael, a boy with autism severe  on the spectrum. Michael is 10 years old. He is not yet toilet trained. Michael demonstrates unsafe behaviors at school, such as self-injury, violence toward peers and staff, and elopement (running). Michael is rapidly becoming a danger to himself and others at school.

At Michael’s IEP meeting, the district recommends Michael’s current self-contained life skills classroom with a student/teacher ratio of 6:1. While many of the goals appear to be appropriate, Michael has made no progress this year. But we know Michael can learn in a 1:1 setting because he has made good progress with a private tutor at home. Also, the proposed IEP contains no goal for toileting skills, which are critical life skills, and no behavior intervention plan (BIP) to keep Michael and others safe when he displays unsafe behaviors.

What types of questions should Michael’s parents be asking at the IEP meeting? I’d suggest questions designed to elicit how the team proposes to educate Michael safely and appropriately, and how the proposed IEP is designed to accomplish this.

Let’s start with Michael’s present levels of performance in the IEP. Are they based on current data, and are they accurate reflections of Michael’s current abilities? How about his goals: do they address all areas of deficit? (For instance, the proposed IEP does not address Michael’s lack of toileting skills and unsafe behaviors – goals will need to be added to cover these areas.) Are the proposed goals reasonable given Michael’s present levels of performance? Are they SMART goals? (SMART goals, according to Pete Wright, are goals which are specific, measurable, use action words, are realistic and relevant, and are time-limited. (See http://www.wrightslaw.com/info/iep.goals.plan.htm#sthash.HUUaBQ3V.dpuf.) What about the proposed services – are they sufficient to allow Michael to achieve his IEP goals?

Now let’s examine Michael’s proposed placement (the 6:1 life skills classroom). Is this classroom appropriate for Michael, or does he need a smaller class setting with more adult supervision and structure? Michael clearly needs a BIP – can an appropriate plan be implemented in the proposed placement, or should the team be recommending a therapeutic day setting or even a residential placement for Michael?

Now take the case of Michelle, a 10 year old girl with what used to be called Asperger’s Syndrome (AS), a form of high-functioning autism (AS was eliminated as a separate diagnosis in the DSM-V that was recently released; however, it remains a useful descriptive term). Michelle can read and write, her grades are good, and she does not display unsafe behaviors in school. However, Michelle demonstrates social skills deficits that impact her in school: she sits alone at lunch, does not seek out friends or engage in reciprocal conversations, and often misreads social cues, causing conflicts with both peers and staff. Other students are starting to tease her and call her “weird.” This causes Michelle to withdraw socially, and sometimes to shut down and refuse to do her work in class. Michelle is beginning to develop a negative self-image, as she has been observed to say “I am dumb” or “I am weird” at least several times a day in school.

Because Michelle – like Michael – has autism, the team proposes the same self-contained life skills 6:1 classroom. However, it should be clear that while both children have autism, their needs are nothing alike.

Both Michael and Michelle have the right to be educated in the LRE (least restrictive environment). However, what that will look like is very different for each of these children. For Michael, it is very possible (even likely) that the self-contained public school classroom will not be restrictive enough; for Michelle, it is likely to be too restrictive. (The LRE is the setting in which the student has maximum access to typical peers, but in which the child can be appropriately educated. Thus, what constitutes the LRE will vary from child to child.)

So in Michelle’s case, the parents should be asking similar questions regarding present levels (are they accurate?), goals (do they cover all areas of deficit – such as social/emotional needs – and are they SMART goals?), services (are they sufficient to enable Michelle to meet her goals?), and placement (is the self-contained classroom the LRE for Michelle when she is able to progress in the general education setting?).

What these examples demonstrate is that different children have different needs, regardless of an autism diagnosis/label. The fact is, as the saying goes, if you’ve met one kid with autism, you’ve met one kid with autism.

For each child, parents should critically examine the key elements of the proposed IEP, namely:

  1. Present levels of performance (are they based on data and do they accurately reflect the child’s current performance?);
  2. Goals (are they SMART goals that address all areas of deficit?);
  3. Services (are they sufficient and tailored to meet the child’s unique needs to enable the child to progress toward the goals?)
  4. Placement (is it the LRE?)

Parents are their children’s best advocates. They are the experts on their child and have much to contribute to the IEP team. Hopefully this information will help parents fulfill their critical roles in their children’s education.

Sandra Strassman-Alperstein holds a B.A. in English from the University of Florida and a J.D. from the University of Chicago Law School (cum laude 1990). More importantly, Sandy is the mom of four wonderful kids, three of whom have received special education services in the public school setting via IEPs and 504s. Sandy has been practicing special education law & advocacy for the past 15 years and is an active volunteer on the national, state, and local levels. Sandy’s website is http://www.spedlaw4kids.com.

NSPT offers services in Bucktown, Evanston, Deerfield, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Mequon! If you have any questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140!

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