Posts

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!

 

Language Development in Children with Down Syndrome

Language development for children diagnosed with Down Syndrome can be challenging and confusing. Factors such as cognitive and motor delays, hearing loss and visual problems can interfere with language acquisition. It’s important that a child’s caregivers provide a variety of opportunities to increase language development.Down Syndrome Language Development

Using many normal everyday activities can enhance the child’s language and expose them to new concepts. The language you teach to your child will assist them in learning and generalizing new information.

The following are early intervention strategies that can be used to help children with Down Syndrome develop and increase their understanding of language:

Take advantage of language opportunities during daily routines:

  • Activities such as taking a bath, cooking, grocery shopping, changing a diaper, or driving in the car are a wonderful time for learning. Caregivers can consistently identify actions, label items, expand on their children’s utterances to facilitate vocabulary acquisition and overall language development. It takes a lot of repetition for children to learn and start to use words appropriately. Include a variety of words that include all the senses. “Does the water feel hot?” or “Can you smell the cookies?” When speaking, identify textures, colors, express feelings etc.

Read, read, read:

  • It can never be said enough how important reading is to children. When reading a book, it’s important to not only read the words on the page, but to talk about what is on the page, what the characters are doing or how they might be feeling. Make reading a book an interactive experience.

Incorporate play time with other kids:

  • Children can learn a lot just by interacting with other children as they are interested in and motivated by their peers. They imitate each other’s actions and will learn from them. Play time with other children will also help them develop social skills. Concepts such as sharing, taking turns, pretend play, creating, etc. can all be increased.

Play with them:

  • Children don’t know how to play with toys and games on their own, we need to show them. Get on the floor and play with blocks, balls, bubbles, sing a song, etc. During this time talk about what you and the child are doing (Ex: stack up the blocks, let’s blow more bubbles, it’s my turn) and expand on their utterances. Play time is critical for children to develop their ability to focus and attend to a task. When you are engaged together in a task, you are developing a special bond with your child and they are learning!

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!

Who Will Take Care of our Special Needs Children When We’re Gone? Who Will Provide for Them Financially?

This guest post is from Howard N. Suss, MBA.

These are questions my wife, Zahava, and I talk about. Our son Shimmy is a spunky, lively, 15-year-old young man with both Down Syndrome and Autism. Shimmy is usually the life of the partyblog-financial-main-landscape and can make everyone in a room laugh, but also exhibits extreme behavioral issues (Thank you North Shore Pediatric Therapy, for helping us improve in that area).

About two years ago, our family (my wife and 6 kids) attended a special needs family retreat and my older kids had an “ah ha” moment when they attended a siblings presentation (this is a presentation that was given by a social worker, who herself has a 30-year-old brother with Down Syndrome). This presenter opened their eyes to the probable eventuality that one day THEY were going to have to take care of Shimmy. That wasn’t something a 20-year-old was expecting to hear.

My kids, generally, are very good with Shimmy and they work really well with him as far as providing for his needs and well being, as well as his safety. Long term, I’m not really concerned about that. What I am concerned about, and what I have been counseling clients about for over 20 years, is the financial burden that I don’t want placed on the kids when they have to step in, one day.

I have been practicing long term financial and estate planning, in general, and special needs planning in particular, for over 20 years. My company, The Suss Financial Group, is located in Skokie, Il. and we have an attorney in the office (I am not an attorney, we often work together).

My client’s number one objective is to structure a plan to provide long term income for their special needs “child” without jeopardizing government benefits, such as SSI. We work on setting aside money, on a consistent basis so that there is money for the future. This is a must for everyone, but especially for families in our situation. Things can change, but as it appears now, our Shimmy will probably not be able to earn a living and that’s why planning is so important.

There isn’t one financial solution for every family. I would recommend that you sit down with both a special needs planning attorney and a financial planner to discuss your specifics, but here are some ideas that work for clients who have family members with special needs:

  • Systematic savings for the individual with special needs either in the bank or brokerage account
  • Stocks, bonds or mutual funds
  • Private investments
  • Life insurance

Usually life insurance is the way to go, because you can provide a large sum for not a lot of money. The thought is, that the real need for funds results when mom and/or dad pass away and in most cases that’s not until much later in life. We will discuss this in more detail in a future blog.

Please remember that you really don’t want to title any assets in your kid’s name as it will affect his/her government benefits.

NSPT offers services in Bucktown, Evanston, Highland Park, Lincolnwood, Glenview, Lake Bluff, Des Plaines, Hinsdale and Milwaukee. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates!

New Call-to-Action
Howard N. Suss is a Registered Representative of Park Avenue Securities LLC (PAS). OSJ: 2550 Compass Road Suite H, Glenview, IL 60026. 847-564-0123 Securities products offered through PAS, member FINRA, SPIC. Financial Representative of The Guardian Life Insurance Company of America® (Guardian), New York, NY. PAS is an indirect, wholly-owned subsidiary of Guardian. The Suss Financial Group is not an affiliate or subsidiary of PAS or Guardian. 2016-28772 Exp. 9/16

howard-sussHoward N. Suss, MBD, has been practicing long term financial and estate planning , in general, and special needs planning in particular, for over 20 years. His company, The Suss Financial Group, is located in Skokie, Il. Howard resides in Chicago with his wife Zahava and 6 kids (one married and 2 in college) as well as 3 younger kids at home, including Shimmy, who has both Down Syndrome and Autism.

 

Howard can be reached at:

The Suss Financial Group
8170 McCormick Blvd., Suite 102
Skokie, IL. 60076
(847) 674 9470 ext. 1, office
(847) 674 9473 fax
www.sussfinancial.com

Reasons to Seek a Neuropsychological Evaluation for Your Child

Neuropsychology is a field of psychology that focuses on the relationship between learning, behavior, and brain functioning. A child may be referred for a Blog-Neuropsychological-Evaluation-Main-Landscapeneuropsychological evaluation when there are concerns about one or more areas of their development. This can include a child’s cognitive, academic, memory, language, social, self-regulatory, emotional, behavioral, motor, visual-spatial, and adaptive functioning.

This type of evaluation can help rule out diagnoses such as Attention Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Specific Learning Disorder, Language Disorder, as well as various emotional and behavioral disorders. A neuropsychological evaluation can also be helpful if your child has been diagnosed with a medical condition such as Down Syndrome or other genetic disorders, Traumatic Brain Injury, or Epilepsy. The purpose of the evaluation is to identify a child’s patterns of strengths and challenges in order to provide parents, schools, and other providers with strategies to help them succeed across contexts. It can also be used to track a child’s progress and response to targeted interventions.

In order to assess whether a neuropsychological evaluation may be helpful for a child, a family may identify concerns in the following areas:

  • Cognitive
    • Difficulties with verbal and nonverbal reasoning and problem solving
    • Requiring a significant amount of repetition and/or additional time when learning
    • Delays in adaptive functioning
  • Academic
    • Grades below peers
    • Concerns with reading (phonetic development, fluency, comprehension), mathematics (calculation, word problems), or writing (spelling, content, organization)
    • Needing additional time to complete schoolwork, homework, or tests
    • Frustration with academic work
  • Language
    • Expressive (output of language) or receptive (understanding of language) difficulties
    • Challenges initiating or maintaining a conversation
    • Difficulties with sarcasm or non-literal language (e.g, “It’s raining cats and dogs”)
    • Repetitive or odd language usage (e.g., repeating lengthy scripts heard from television or news programs)
    • Pronoun reversals or odd use of language
  • Self-Regulation
    • Difficulty paying attention or sitting still
    • Needing frequent prompts or reminders to complete tasks
    • Difficulty with multiple-step commands
    • Losing or misplacing items
    • Forgetting to turn in completed assignments
  • Social
    • Poor peer relations
    • Inappropriate response when approached by peers
    • Difficulty with imaginative, functional, or reciprocal play
    • Limited interest in peers or preference for solitary play
  • Repetitive Behaviors
    • Repetitive vocalizations
    • Repetitive motor mannerisms (e.g., hand flapping, finger flicking, body rocking)
    • Lining up toys, spinning wheels of cars, sorting objects for prolonged periods of time
  • Behavioral Dysregulation
    • Physical or verbal aggression
    • Defiance or non-compliance
    • Difficulties with transitions or changes in routine
    • Self-injury (e.g., head banging)
  • Emotional
    • Poor frustration tolerance
    • Irritability or easily upset
    • Eating or sleeping difficulties
    • Somatic complaints
    • Negative self-statements
    • Lack of interest in things he/she used to enjoy
  • Visual-Spatial, Visual-Motor, and Motor
    • Poor handwriting
    • Trouble with fine motor tasks (e.g., unwrapping small items, buttoning or zipping clothing, tying shoe laces)
    • Difficulty transferring information from the classroom board to a notepad, or transferring information from a test booklet to a scantron/bubble sheet
    • Difficulty with overwhelming visual displays (e.g., computer screen with several icons; homework with several problems on one sheet; a book with several colors and pictures)

Should a child demonstrate difficulties in some of the areas listed above, he/she may benefit from further consultation or a subsequent neuropsychological evaluation. Through this process, areas of difficulty can be identified, and targeted interventions will be suggested to enhance a child’s development.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview, Lake Bluff and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

childhood apraxia

Childhood Apraxia: The Facts

Childhood Apraxia of Speech (CAS)

Childhood apraxia of speech (CAS) is a neurologically-based motor speech disorder. Children with CASChildhood Apraxia: The Facts have difficulty producing speech sounds in the absence of muscle weakness or paralysis. Though a child with CAS knows what he/she wants to say, impairments in planning and/or coordinating lip, tongue, and jaw movement results in speech sound errors and differences in prosody (patterns of stress and intonation).

CAS is uncommon, occurring in 1-2 children per 1,000. It affects more boys than girls and occurs more frequently in children with galactosemia, fragile X syndrome, and Down Syndrome.

Acquired Apraxia of Speech versus CAS

There are two main types of apraxia of speech: acquired and developmental. Acquired apraxia of speech (AoS) is caused by damage to the parts of the brain involved in speech production and involves loss or impairment of existing speech skills. Causes of AoS include stroke, head injury, tumor, or illnesses affecting the brain. This disorder may occur with muscle weakness affecting speech production or language difficulties caused by brain damage. In contrast, CAS is present from birth and occurs in the absence of any muscle weakness or paralysis.

Cause of CAS

The cause of CAS is yet unknown. While some researchers believe that CAS is a disorder related to overall language development, others believe it is neurologically based and that it disrupts the brain’s ability to send signals to move muscles involved in speech production. Recent research also suggests a genetic component to this disorder, as children with CAS often have family members with a history of communication disorders or learning disabilities.

Diagnosing CAS

There is no universally agreed-upon list of diagnostic features that differentiates CAS from other childhood speech sound disorders such as phonological disorders or dysarthria. However, three characteristics of CAS are generally accepted by researchers and speech-language professionals:

  1. Inconsistent speech sound errors on consonants and vowels across repeated productions of syllables or words. While a child with an phonological or articulation disorder may make the same error each time he/she says a particular word, a child with CAS will not demonstrate a consistent pattern in his/her errors, even when repeating the same word.
  1. Longer and disrupted coarticulatory transitions between sounds and syllables. Children with CAS have difficulty combining sounds to form a word and may produce long pauses between sounds.
  1. Differences in prosody. Children with CAS produce speech that sounds choppy or monotonous, with stress on the wrong syllables.

Other Possible Signs/Characteristics of CAS

Young Children:

  • No cooing or babbling as an infant
  • Late development of first words
  • Production of limited set of consonant and vowel sounds

Older Children:

  • Numerous substitutions, deletions, and distortions of sounds
  • Understands language significantly more than can speak
  • Difficulty imitating speech, but imitated speech is more clear than spontaneous speech
  • Groping behavior when attempting to produce sounds
  • Saying longer words or phrases are more difficult to produce than shorter ones
  • Difficult for listeners to understand speech
  • Speech sounds choppy or monotonous or the wrong syllables are stressed
  • Distorted or inconsistent vowels

Possible Concomitant Conditions:

  • Language delay
  • Word finding or word order difficulties
  • Fine motor coordination difficulties
  • Oral hypersensitivity
  • Difficulty learning to read, spell, and write

Treatment of CAS:

Children with CAS receive frequent and intensive one-on-one therapy, tailored to their specific speech and language needs. Treatment focuses on improving speech imitation skills, speech-based motor sequences, length and complexity of producible syllable patterns, teaching rules of speech sound patterns, and, in severe cases, using augmentative communication systems (e.g., picture exchange communication system).

If you believe that your child shows signs of CAS or another speech sound disorder, do not hesitate to consult with a speech-language pathologist.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Sources:

 

The Importance of Person First Language

The language we use and the labels that we place on individuals are powerful. In today’s society we rely heavily on medical diagnoses to define a person’s values, their strengths and weakness, their education, the services that people are eligible to receive and ultimately their future. Too often an individual’s diagnosis is used to define them as an individual – the retard, the autistic boy, the stutterer. Person First Language is a way to put the person before the disability, “describing what a person has, not who a person is (Snow, 2009).

The Importance of Person First Language:

In reflecting on the importance of person-first language, think for a minute how you would feel to be defined by yourPerson First Language perceived “negative” characteristics. For instance, being referred to as the heavy boy, the acne student, or the bald lady. To be known only by what society perceives as negative characteristics or “problems” would completely disregard all of the positive characteristics that make you as an individual who you are (Snow, 2009). Individuals with disabilities are more than their diagnosis. They are people first. The boy next door who has autism is more than an autistic boy, he is a brother, a son and a friend who happens to have autism. The girl who stutters in class is more than a stutterer – she is a daughter, a sister, and a best friend who has a fluency disorder.

Contrary to society’s definition, having a disability is not a problem. When defining a person by their disability, there is a negative implication that that person is broken. Especially within the health care field, it is imperative that we as professionals, co-workers and human beings begin to focus on other’s strengths. By focusing on the strengths of individuals who have disabilities, we are setting up our clients and friends for success. Using person-first language is a great first step to this change of thinking.

Use the table below to help guide your language in following person-first language recommendations:

Rather than… Please Say…
Autistic Child who has autism spectrum disorder
Stutterer Boy/Girl who has a fluency disorder
Retard A child with a cognitive defect
Slow child A child who has a learning disability
Non-verbal child She communicates with her device
Down’s kid Child who has Down’s Syndrome

This table is by no means a definite list. However, it can help build a framework for the importance of person-first language and how to implement it into your own language. When you are unsure of how person-first language applies to a situation, remember the emphasis is on the person as a whole – putting the person before his or her disability.

NSPT offers services in BucktownEvanstonHighland ParkLincolnwoodGlenview and Des Plaines. If you have questions or concerns about your child, we would love to help! Give us a call at (877) 486-4140 and speak to one of our Family Child Advocates today!

Snow, Kathie (2009). People First Language. Disability is Natural. Retrieved from www.disabilityisnatural.com

 

The Basics About Down Syndrome

 

 

 

Down syndrome is thought to be the most common genetic causes of cognitive impairment.  This condition has been found to occur in approximately 1 in 800 live births.  Down syndrome results from an extra copy of chromosome 21.

Children with Down syndrome often exhibit issues with their learning and processing of information.  Specific concerns that are often seen in individuals with a diagnosis of Down syndrome include:girl with down syndrome

  • Moderate cognitive impairment
  • Weakness with grammatical aspects of language
  • Impairments with verbal short term memory
  • Weakness with daily living skills

Children with the syndrome do show areas of relative strength and it is important to utilize these areas to help develop additional skills and compensate for areas of concern.  Domains that are often seen as a relative strengths include:

  • Spatial reasoning tasks
  • Visual memory
  • Social skills

There have been numerous studies which indicate a multi-tiered treatment approach can be beneficial to help children with a diagnosis of Down syndrome, including:

  • Speech and language therapy with possibly teaching sign language
  • Use of a visually based intervention teaching reading and vocabulary skills
  • Emphasis on the development of phonological awareness to improve reading
  • Use of rehearsal and repetition to enhance memory skills.
  • Occupational therapy for sensory integration and motor development
  • Parent training to emphasize the use of structure and planning

 

Hunter, S & Donders, J., eds. (2007)  Pediatric Neuropsychological Intervention








 

 

What is Down Syndrome?

Down Syndrome is thought to be the most common genetic etiology of mental retardation. This condition has been found to occur in down syndromeapproximately 1 in 800 live births. The genetics of the condition are such that the individual has an extra copy of chromosome 21.

Physical Features Associated with Down Syndrome:

  • Decreased muscle tone seen at birth
  • Excess skin at the nape of the neck
  • Flattened nose
  • Small ears
  • Small mouth
  • White short hands with short fingers

Cognitive Features Associated with Down Syndrome:

  • Moderate mental retardation
  • Weakness with grammatical aspects of language
  • Relative strength with spatial reasoning tasks
  • Verbal short term memory is more impaired than visual memory
  • Weakness with daily living skills (self-care skills)
  • Relative strength with social skills

Interventions for Children with Down Syndrome:

  • Speech and language therapy with possible addition of sign language
  • Visually-based interventions for teaching, reading and vocabulary
  • Occupational therapy for sensory integration and motor development