Individual Treatment

Our integrated treatment model implemented by our multidisciplinary treatment team is the ideal approach for treating children and adults with autism spectrum disorders.

Autism Spectrum Assessment 

Our psychologists administer a series of assessments that have been deemed the “gold standard” for diagnosing Autism Spectrum Disorder. Through these different assessments, psychologists make an accurate diagnosis while determining if a co-existing disorder is present. We frequently see depression or anxiety accompany an Autism Spectrum Disorder diagnosis, however, there are many other possible co-existing disorders. A comprehensive report of the findings will be written; included will be a diagnosis, if there is one, recommendations for treatment, and academic accommodations, if appropriate. This report includes the required assessments schools and colleges require for academic accommodations.

If a client already has a diagnosis of Autism Spectrum Disorder, they will complete the Initial Diagnostic Assessment. This assessment reviews previous testing, the client's developmental, medical, academic and psycho-social history. This assessment uses rating scales and a clinical interview to identify the clients current functioning, presenting concerns, any possible co-existing disorders, and then will determine the client's specific treatment needs. 

Individualized Treatment Plan

An individualized treatment plan is developed for each client based on the psychologist’s assessment and treatment recommendations to address the client's specific treatment needs.

To address the impacts of an autism spectrum disorder, specialized treatment services will be included in the treatment plan. These can include, cognitive behavioral therapy will be used to address self-esteem, manage their feelings of anxiety, anger, depression, and reduce their feelings of inadequacy arising from their difficulty communicating and interacting with others. Role play, life skills coaching, exposure therapy to triggering situations and social skills training will help the client develop and implement more effective social skills and become more confident in social situations.

Teaching parents research-based strategies in parent counseling, parent management training, parent child interaction therapy, behavioral treatment plans, and family therapy are effective in helping parents feel more effective and competent in the management and support of their child.

Therapists can also work with the child's teachers to help them implement more effective accommodations, and behavioral management plans in the classroom. Therapists can also provide teachers with more effective intervention strategies when the child becomes overwhelmed by anxiety or has explosive outbursts.

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Children and adolescents with ADHD experience multiple difficulties in the school environment including conduct problems, learning difficulties, mood instability and social skill deficits. The graduation failure rate of students with ADHD who are not treated is around 32%. A college student without ADHD is four times more likely to graduate from college than a college student with ADHD. However, it is clear that the high rates of school failure can be positively impacted by school-based interventions, which include the coordinated efforts of the ADHD patient, parents, teachers, school mental health providers and the patient’s mental health provider. There can be little sustained improvement in the ADHD student without consistent collaboration between the student, the parent, the school district and the health care providers. Behavioral change occurs only when there is adequate instruction of the desired behavior along with systematic cueing and reinforcement of the desired behavior through an agreed upon monitoring system.

Educational supports or accommodations are important variables for the successful treatment of students with ADHD. This is why the Individuals with Disabilities Education Act (IDEA) and section 504 of the Rehabilitation Act exist. Students with ADHD have educational rights under these laws that include reasonable accommodations and access to other services that assist them in their learning efforts. Making sure that our clients get necessary school accommodations is part of our treatment for ADHD. Sometimes our assessment leads us to recommended atypical accommodations that need detailed explanations to the school district before they are implemented which is why we conduct meetings with school personnel to make sure that our recommended accommodations are in place.

A cognitive assessment is usually accepted for school accommodations however at the college and university level there may be different assessment requirements and these can be found on the college / university website under disability office or academic accommodations.

What we can do:

• Conduct the necessary assessments and provide a report specifying diagnosis and general recommendations.
  
• If necessary, provide a letter of specific recommendations for client.
  
• Meet with school officials pertaining to accommodations.
  
• Follow up with school officials about implementation and concerns about accommodations.

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What is an Initial Diagnostic Assessment?

An Initial Diagnostic Assessment is a report that can evaluate a client’s emotional health and well-being. A clinician will provide a clinical interview to determine a mental health diagnosis and eligibility for treatment. 

What to expect:

On the day of this appointment, the time spent in our office for an Initial Diagnostic Assessment will be approximately 2- 2 ½ hrs. New client paperwork must be completed and brought to this appointment. The next 1-1 ½ hours will be spent with the clinician. He or she will meet with the parents/family members and actual client as appropriate. Previous history will be discussed as well as current symptoms. The first hour will be with one of our staff who will help administer rating scales. 

Upon completion, clients will schedule a Treatment Planning Session with the Client Care Coordinator as well as the clinician who completed the Initial assessment to go over the findings as well as review treatment recommendations. This appointment is included in the cost of the Assessment.

How are the results of the Initial Assessment used?

A report of the assessment findings and recommendations is compiled and the client will meet with the client care coordinate to review the report and discuss a customized treatment plan. The treatment plan could include any of the following services: 

• Executive Skills Coaching to teach the strategies to compensate for executive function deficits.
  
• Individual Therapy and/or Cognitive Behavioral Therapy to teach effective coping skills to manage anxiety, depression and anger.
  
• Marital/Couples Therapy if the ADHD symptoms have negatively undermined relationships.
  
• Medication evaluation to determine whether medication could be used to treat presenting symptoms. 

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What is a Cognitive Assessment?

A cognitive assessment is used to diagnose ADHD in children, adolescents and college students. The assessment includes:

A Health and History Questionnaire is completed prior to the assessment. It gathers information about difficulties the client's is having, and the client's developmental, medical, academic and psycho-social history. 

Standardized Rating Scales 

Standardized rating scales are used to screen the client's attention, executive functioning, psycho-social functioning and to determine whether the client is experiencing symptoms of depression, anxiety or poor self esteem. Rating scales are completed by the client if they are old enough and by the client's parents or caregiver and their teacher or in order to get corroborating information about client's symptoms.

Clinical Interview   

The psychologist reviews previous the client's academic records and reports, the information in the Health and History Questionnaire and the results of the rating scales. Using this information they conduct a mental status examination to more closely evaluate the client's mental status and identify the client's strengths and weaknesses 

Standardized Testing

The provider then administers a battery of cognitive tests to assess the client' s following cognitive skills in order to obtain a baseline of strengths client's cognitive strengths and weaknesses:

• intellectual functioning (including verbal and nonverbal reasoning skills)
• working memory
• processing speed
• verbal learning and memory
• visual learning and memory
• receptive language
• expressive language
  

Assessment Report

Based on the information gathered and client's behavioral responses during the clinical interview and testing and the client's performance on the cognitive tests the psychologist makes a diagnosis and develops a report containing the assessment results, conclusions, diagnosis and recommendations for treatment and accommodations to be implemented at school and home to support the client.

Feedback and Treatment Planning

The clinician will review the report with the client and their parents then develop an integrated treatment plan which addresses all the client's specific treatment needs and focuses on the client's strengths and weaknesses.

Who should complete an ADHD Cognitive Assessment?

Clients presenting with following symptoms would benefit from a ADHD Cognitive Assessment:

• inattention/distractibility   
  
• hyperactivity/ impulsivity  
  
• executive skill deficits such as poor organization, planning and time-management skills 
  
• emotional dysregulation such as severe anger outbursts, oppositional defiant behavior

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What is an Adult ADHD Assessment?

The Adult ADHD Assessment includes:

• A Health and History Questionnaire is completed before the assessment to gather information about the difficulties the client is having and developmental, medical, academic and psycho-social history.
• The standardized rating scales are completed to screen the client's attention, executive skills and psycho-social functioning. 
• Initial Diagnostic Interview - a clinical interview is conducted by a psychologist to obtain a thorough history of the psychosocial and cognitive development, prior diagnoses and interventions, academic performance and current functioning.   
  
• Neurocognitive Battery of Standardized Tests is administered - cognitive functions assessed include: 
  
• Composite Memory 
• Verbal Memoryo Visual Memory 
• Psychomotor Speed 
• Reaction Time 
• Complex Attention 
• Cognitive Flexibility 
• Processing Speed
• Executive Function
• Simple Attention 
• Motor Speed   
• Assessment feedback about the assessment findings based on the assessment report and an individualized treatment plan addressing the client's specific treatment needs will be developed based on the recommendations in the report.

Who needs this assessment? 

Client presenting with the following symptoms would benefit from completing the Adult ADHD assessment:

• Inattention/distractibility
  
• Hyperactivity /impulsivity
  
• Executive skill difficulties such as difficulty initiating tasks, poor organizational, planning and time management skills, emotional overreaction

The above symptoms can be the result of several different mental health and medical disorders which include anxiety, depression, insomnia, hyperthyroidism, situational stress, other mood disorders or ADHD. To complicate things further, ADHD often has co-existing disorders previously mentioned.

 Successful treatment depends on an accurate diagnosis. The clinical interview and battery of tests administered allows the clinician to identify the primary disorder and eliminate or identify any co-existing disorders.

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What is an IQ Test? 

A person's intelligence quotient or IQ, is the total score of several standardized tests designed to assess human intelligence. An IQ test serves as a psychological measure of an individual's intelligence level. Valid IQ tests measure intelligence in two areas: verbal and performance. These two areas are further divided into several subscales designed to measure different components of an individual's overall intelligence. An IQ test gives an individual a standardized score that can be compared to the population as a whole. 

Standardized tests are defined as those tests in which the conditions and content were equal for everyone taking the test, regardless of when, where, or by whom the test was given or graded. The purpose of this standardization is to make sure that the scores reliably indicate the abilities or skills being measured, and does not measure other things, such as different instructions about what to do if the test taker does not know the answer to a question. 

IQ tests measure both crystallized and fluid intelligence. Crystallized intelligence refers to the skills and knowledge one has acquired through life, while fluid intelligence refers to a person's problem-solving and reasoning abilities.Who Needs an IQ Test? 

1. When a person is being assessed for ADHD, a Learning Disability or Autism Spectrum an IQ test is often administered to determine whether the person's attention issues, difficulty remembering information. learning to read write or do math, or communicating or interacting with others is not being primarily undermined by their intellectual abilities. 
2. When a student complains of being bored in class because he learns more quickly than his peers and is more advanced than the lessons being taught an IQ test will determine whether that students intellectual abilities are above average and that they therefore need more intellectual stimulation in a Gifted Talented class for example. 
3. When a motivated student is having difficulty keeping up with the academic demands of the class an IQ test may be administered to determine whether they need a learning environment more tailored to their intellectual abilities. 
4. IQ tests are sometimes completed for job placement. 
5. Many private schools have an admission requirement for IQ testing to ensure the students has the intellectual abilities to cope with challenges of their academic curriculum. 6. When there is a possibility that a person has sustained traumatic brain trauma IQ testing is usually part of the assessment battery to identify any intellectual functions that may have been affected by the trauma.
   

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What is a Neuropsychological Evaluation at The Woodlands Behavioral Health & Wellness Center?

A Neuropsychological Evaluation is a comprehensive, individualized assessment of cognitive, behavioral and psychological functioning. A neuropsychological evaluation evaluates how alterations in typical development, brain disorders, or brain injuries affect functioning. Results reveal the individual's strengths and weaknesses across a variety of abilities and cognitive functions, including:

• intellectual functioning (including verbal and nonverbal reasoning skills)
• working memory
• processing speed
• verbal learning and memory
• visual learning and memory
• receptive language
• expressive language
• sustained attention
• executive functioning (including impulse control, verbal fluency, sequencing, switching/cognitive flexibility, planning ahead, organization, and novel problem solving)
• visual perception
• visual-motor integration
• fine motor coordination
• bilateral fine motor dexterity
• academic achievement in reading, writing, and mathematics
• emotional/psychological functioning
• behavioral regulation
• adaptive functioning
• social skills

How does a Neuropsychological Evaluation differ from a Core Evaluation or testing completed at school?

A Neuropsychological Evaluation is completed by a neuropsychologist who underwent extensive training in brain development and brain-behavior relationships. This specialized training allows the neuropsychologist to administer and interpret a customized, comprehensive set of standardized assessments to determine the presence of and reason for any functional difficulties. The neuropsycholgist is then able to provide comprehensive recommendations on how to maximize strengths and compensate for any potential areas of weakness with the goal of improving the individual's functioning at home, at school or work, and in relationships.

What is the evaluation like?

A Neuropsychological Evaluation first begins with a comprehensive diagnostic interview in which detailed information regarding the individual's developmental, medical, educational, and psychological history will be gathered from the patient and relevant family members (i.e., parents, spouse). Following this interview, the patient will complete a comprehensive battery of standardized assessments with the neuropsychologist. No invasive or imaging procedures are completed as part of this evaluation. All assessments are completed verbally, via pencil and paper, or via computer. Testing may be completed over 1-2 days depending on the patient's age and stamina. Once all testing has been completed, a feedback appointment will be scheduled 2 weeks out to allow the neuropsychologist time to score, interpret the results, and write a comprehensive evaluation report. At the feedback session, the results, diagnosis, and recommendations will be discussed at length and participants will have the opportunity to ask questions. A copy of the report will be provided.

Who needs a Neuropsychological Evaluation?

A Neuropsychological Evaluation is recommended when an individual has a history of abnormal development, brain disorder, brain injury, or other medical conditions that can impact brain functioning. Specific referral diagnoses may include:

• prematurity
• prenatal exposure to substances
• developmental delays
• genetic disorders
• hydrocephalus
• cerebral palsy
• neurofibromatosis
• tiberius sclerosis
• multiple sclerosis
• epilepsy
• meningitis
• traumatic brain injury
• hypoxia
• stroke
• heart disease
• lead exposure
• carbon monoxide exposure
• near drowning accidents
• exposure to generalized anesthesia prior to 2 years of age

Additionally, a neuropsychological evaluation may be recommended prior to and/or following certain medical treatments so that the individual can be closely monitored for alterations in functioning commonly associated with certain medical treatments (i.e., chemotherapy, radiation, brain surgery).

Finally, a neuropsychological evaluation may be recommended if an individual has been previously evaluated by a psychologist or educational diagnostician and the recommendations following that evaluation have not been helpful or if family members believe their concerns were not fully addressed.

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When does someone need a psychological/personality assessment?

When a client is having problems at work or school, or in personal relationships or just coping with everyday demands, a psychological assessment can help identify whether he or she may be having issues with emotional regulation or interpersonal skills, experiencing anxiety or depression or personality traits such as rigidity or introversion that be contributing to the problem. 

The underlying cause of a person's problems isn't always clear. For example, if a student is not getting along with other students do they have poor social skills, are they depressed or have social anxiety or do they have anger management problem? A psychological assessment will allow the psychologist to understand the nature of the problem, and develop an effective individualized treatment plan which addresses the clients specific treatment needs.

A psychological/personality assessment includes:

Rating scales are efficient tools for screening the client's cognitive, academic/vocational, social and psychological functioning and identify primary or secondary issues and areas that need more in-depth assessment. 

The Clinical Interview

The clinician conducts a formal clinical interview with the client before the start of the psychological /personality testing. This interview can last anywhere from 30 to 60 minutes, and includes questions about the individual’s personal and childhood history, recent life experiences, work and school history, and family background.

Our clinician will use the results of the rating scales to question the client more closely about areas identified in the rating scale reports. They will also check on the clients relationships, sleep, diet, exercise routines and other areas which are often impact or are impacted by the client's psychological issues. Valuable information is gained through interviewing. When it’s for a child, interviews are conducted not only the child, but the parents, teachers and other individuals familiar with the child. Interviews are more open and less structured than formal testing and give those being interviewed an opportunity to convey information in their own words.

Standardized Testing

We use the Minnesota Multiphasic Personality Inventories (MMPI) for adults and adolescents (MMPI) or the Millon Clinical Multiaxial Inventories for adults, pre-teens and adolescents. These are empirically –based standardized psychological/personality tests which are administered on and scored by a computer and are designed to accurately identify psychological problems and personality traits. In children or in the case of children and adolescents emerging personality traits. The psychological profiles obtained from these psychological, personality tests provide relevant information to aid in supporting or confirming hypothetical diagnoses made by the psychologist, identifying problems, the root causes of those problems , identifying deeper pervasive clinical issues and treatment planning. 

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What is a Vocational Assessment?

Vocational assessment identifies an individual’s interests, abilities and aptitudes and skills and matches them to a variety of career paths. Vocational assessments use standardized tests and interviews. Vocational assessment is part of the vocational guidance process and usually results in recommendations for careers and the academic and training requirements to qualify for those careers.

What happens in a Vocational Assessment? 

You will be given instructions to go to a website address and a code which will allow you to open and complete the Strong Interest Inventory Test online from your home computer. We will also schedule an appointment for you to meet with a counselor, after you have completed the test. The counselor will review the test results with you and assist you in exploring the career paths for those careers identified.

What is the Strong Interest Inventory? 

The Strong Interest Inventory is an assessment that helps people match their interests, aptitudes and personality with potential educational, career activities, using an individual’s preferences in a variety of areas to aid them in discovering what they’d most enjoy doing with their work. Each career option and college major category has a set of interest themes associated with them. Based on your answers you will score higher or lower on scales. Your scores on these scales will form patterns between your likes and dislikes, and what they mean when looked at altogether. The report developed by this assessment will give you insight into where your interests lie and which jobs and school majors match these interests.

Who needs to take this test?

• High school students who are confused about their career path and consequently the selection of their major at college.
  
• College students who find that they are not interested in the subjects they are studying and are questioning their career choice.
  
• Adults who want to change their career and want to determine what other careers they may be better suited to. 

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