School-Based Interventions for the Treatment of ADHD in Children and Adolescents

School-Based Interventions for the Treatment of ADHD in Children and Adolescents

School-Based Interventions for the Treatment of ADHD in Children and Adolescents | Psychologists | Toms River, NJ | Manahawkin, NJ | Freehold, NJ - Ocean County NJ

School-Based Interventions for the Treatment of ADHD in Children and Adolescents

Children and adolescents with Attention-Deficit/Hyperactivity Disorder (ADHD) often exhibit cognitive and behavioral symptoms that adversely impact their academic performance. Children with ADHD may experience difficulty with staying on task, fidgeting, poor impulse control, or emotion dysregulation that serve as barriers to their ability to learn. Given this, school-based interventions are imperative for promoting the academic performance of individuals with ADHD. 

School-based interventions for ADHD may include behavioral strategies, modifications to the learning environment, or special education services. Behavioral interventions for ADHD within the academic environment may include having the teacher utilize positive reinforcement throughout the school day. For example, the teacher may implement a reward system for the child, which serves to increase the occurrence of desired behaviors and reduce disruptive behaviors. 

In addition, modifications to the learning environment may be provided under a 504 Plan. Environmental modifications in a 504 Plan may include extended time on testing, receiving a copy of the class notes from the teacher, or cuing from the teacher to assist with staying on task.  

Finally, special education services for ADHD may be provided under an Individualized Education Program (IEP). Specific accommodations and modifications listed in an IEP may include participating in a smaller classroom setting for particular subjects, receiving extra breaks throughout the day, or having an aide present in order to reduce the occurrence of disruptive behaviors. 

If you have concerns that you or your child might have ADHD, please contact Pathways Neuropsychology Associates at (732) 930-2242 to inquire about a neuropsychological evaluation. 

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Source: Pathways Neuropsychology
School-Based Interventions for the Treatment of ADHD in Children and Adolescents

Can You Outgrow ADHD?

Can You Outgrow ADHD?

adhd evaluation & testing

Is It Possible to Outgrow A.D.H.D.?

Doctors typically advise a combination of behavioral interventions, counseling and medication to address a child’s symptoms. A child who can manage the symptoms of A.D.H.D., allowing for a more successful experience in school, may reach a point when A.D.H.D. is far less of a problem. So facilitating success in school and ultimately in life may be the path to “outgrowing” the diagnosis.

Excerpt From NY Times  – Read Full Story Here

The Pathways team of professionals has helped thousands of people with ADHD. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

ADHD EVALUATIONS

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Source: Pathways Neuropsychology
Can You Outgrow ADHD?

Neuropsychological Evaluations for Monitoring Cognitive Functioning in Dementia

Neuropsychological Evaluations for Monitoring Cognitive Functioning in Dementia

Dementia Symtoms & treatmentsNeuropsychological Evaluations for Monitoring Cognitive Functioning in Dementia

Alzheimer’s disease is the most common cause of dementia in the United States. Alzheimer’s disease is an insidious illness, which progressively impacts cognitive functioning. Over the course of the disease process, an individual’s ability to participate in daily activities, including driving, managing medications, and managing finances, may also decline. 

When patients present with subjective cognitive decline, a neuropsychological evaluation assists with determining whether the cognitive changes are secondary to Alzheimer’s disease or a reversible condition such as depression. In individuals with Alzheimer’s disease, neuropsychological evaluations identify areas of cognitive strength and weakness in order to provide the patient with strategies for maintaining his or her cognitive functioning for as long as possible. Neuropsychological evaluations also elucidate the individual’s ability to complete daily tasks, including managing their own finances, medications, and conducting household tasks. Finally, given that Alzheimer’s disease is associated with psychological symptoms such as irritability or depression, neuropsychological evaluations may also examine whether the individual has experienced any mood changes as a result of their illness.    

Given the progressive nature of Alzheimer’s disease, it is crucial to objectively monitor the cognitive, psychological, and functional abilities of the individual. In individuals with Alzheimer’s disease, it is typically recommended that neuropsychological evaluations are repeated every 12 to 18 months in order to better understand the course and prognosis of the illness. If you or your family member are experiencing memory difficulties, please contact Pathways Neuropsychology Associates at (732) 930-2242 to inquire about a neuropsychological evaluation.

The Pathways team of professionals has helped thousands of people with Dementia. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

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Source: Pathways Neuropsychology
Neuropsychological Evaluations for Monitoring Cognitive Functioning in Dementia

Overview of Neuropsychological Evaluations for Diagnosing ADHD in Pediatric Patients

Overview of Neuropsychological Evaluations for Diagnosing ADHD in Pediatric Patients

Neuropsychological Evaluations for Diagnosing ADHD in Pediatric Patients | Psychologists | Toms River, NJ | Manahawkin, NJ | Freehold, NJ - Ocean County NJ

Overview of Neuropsychological Evaluations for Diagnosing ADHD in Pediatric Patients

Attention-Deficit/Hyperactivity Disorder (ADHD) is one of the most commonly diagnosed neurodevelopmental disorders in children and adolescents. ADHD has a behavioral and cognitive presentation that may be similar to other conditions, including learning disorders, depression, anxiety, or impulse control disorders. Given the overlapping symptoms among these disorders, it is important to employ diagnostic procedures that can parse out whether the child meets criteria for ADHD, or whether the difficulties are better accounted for by another neurodevelopmental or psychological condition.   

Neuropsychological evaluations are a comprehensive procedure commonly used for diagnosing ADHD in children, adolescents, and adults. Within the pediatric population, neuropsychological evaluations begin with an initial consultation, in which the clinician has an in-depth interview with the parents and the child in order to determine whether a neuropsychological evaluation would be appropriate.  

Once the determination has been made to proceed with a neuropsychological evaluation, the testing is typically completed during two in-person sessions. During the testing sessions, the child will be asked to complete various tasks that tap into a wide array of cognitive functions (e.g., intellectual functioning, attention, learning, memory, speed of information processing, and visuospatial skills), psychological factors (e.g., depression, anxiety, and behavioral difficulties) and adaptive functioning. Examples of neuropsychological tasks include having the child solve visual puzzles, learn and recall new information, fill out paper-and-pencil measures (when age-appropriate), or complete academic exercises. In addition, collateral information will be obtained from parents and teachers in order to develop a richer understanding of the child’s behavior within the home and school settings. 

Once the testing has been completed, the child’s performance is scored and compared to a normative sample of age-matched peers. A profile of cognitive strengths and weaknesses is developed, which helps to determine whether the child meets criteria for a diagnosis of ADHD, a psychological condition such as depression or anxiety, and/or another neurodevelopmental disorder. 

Finally, a feedback session is held, in which the neuropsychological findings are reviewed in detail with the parents and child. During this session, the parents are provided with an overview of the child’s cognitive strengths and weaknesses, diagnoses, and recommendations that are tailored to meet the specific needs of the child. Examples of recommendations for a child diagnosed with ADHD may include academic accommodations, behavioral strategies to be used within the home, participation in executive functioning coaching, psychotherapy to address behavioral and/or cognitive difficulties, or a referral to a psychiatrist to discuss pharmacological interventions. All diagnoses and recommendations are provided in a written report, which can be shared with the school at the discretion of the parents.

If you have concerns that you or your child might have ADHD, please contact Pathways Neuropsychology Associates at (732) 930-2242 to inquire about a neuropsychological evaluation. 

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Source: Pathways Neuropsychology
Overview of Neuropsychological Evaluations for Diagnosing ADHD in Pediatric Patients

Behavioral Management for Defiant Children: Part 3

Behavioral Management for Defiant Children: Part 3

parenting and child psychology | Parent Training | Psychologists | Toms River, NJ | Manahawkin, NJ | Freehold, NJ - Ocean County NJ

Behavioral Management for Defiant Children: Part 3

As we close this series on behavioral management for your “defiant child”, we will cover a program model that utilizes Alan Kazdin’s ABCs of parenting: Antecedent, Behavior and Consequence. The following method is a tried and true way to change and shape your child’s behavior, which will ultimately change and shape your relationships for the better. The strategy is both simple and powerful when used correctly and it works for all ages. What is this magic tool? We’re talking about a point chart. A point chart is a visual tracking tool that displays desired behaviors your child has accomplished and an associated reward system. Research has proven the effectiveness of a point chart, demonstrating that such a visual system both keeps your child engaged and incentivised and reminds you, the parent, to consistently implement the program. The steps below explain what this point chart system looks like when put in place and how you can begin effective parenting today: 

  • Define the “positive opposite”

Before you can begin, take a moment to think about the problems you are facing at home and what behaviors are making up those challenges. As we discussed in the last post, once you’ve identified the behavior you don’t want, it is important to phrase it in terms of a behavior you do want, or as Alan Kazdin calls it, the “positive opposite”. For example, if bedtime is a battle every night with your toddler throwing tantrums, perhaps your positive opposite is going to bed peacefully and quietly. With your desired behaviors in mind, we can then create the point chart. 

  • Create the point chart 

The point chart is a simple, visual system that displays the desired behavior, the days of the week, and markings of whether or not the desired behavior was accomplished each day. There is no correlation between creativity and effectiveness, so your chart can be as elaborate or simple in design as you’d like. If your child performs the desired behavior, they get a check mark or sticker in the box for that day. If they don’t, mark a dash, but do not leave it blank. Location and consistency are key to the chart success. Place it in a spot that both you and your child will see often, such as the fridge. This will help keep everyone honest about progress and promote consistency. Lastly, it is better to have fewer days that are successful, than more, less successful days. If you think you need to start out with 3-5 days a week on the point chart, that’s fine. You can always build from there. 

  • Establish a reward system  

Next, decide what the “currency” is for the point chart. There are a couple important factors for establishing the reward system:

  • Do not take away existing privileges or items in order to give them back later. Make sure the reward is something new the child receives. This will prevent resentment towards the chart and program. 
  • Start rewards right away by having small rewards for a few points to begin with. Depending on the age of your child, this can be small, cheap toys from a grab bag that they get to choose from or simple privileges. 
  • Reward consistently and immediately. Timing matters! 
  • Add in special rewards for higher points. Since these high value items take longer to achieve, it is helpful to have a second chart for them. The main chart should maintain the frequent and immediate praise and rewards that makes the program effective. 
  • Explain the point chart

Describe and present the chart to your child. Keep your tone warm and excited as you explain how it works and identify the desired behavior for them. Get them involved by letting them choose how they’d like to mark the chart and pick some rewards. 

  • Practice

Do a practice round with your child. Role playing is a great way to show what your expectations are and establish what verbal and non verbal prompts are associated with the desired behavior. Praise your child throughout the “practice round” and add points to the chart when completed. Immediately give your child a small reward for successful practice. This is the first opportunity to provide positive reinforcement that makes this program so effective. 

  • Get started! 

You are now equipped with the tools to see the change in behavior you are looking for. With effective and consistent implementation of this method, you can say goodbye to tantrums, attitude and opposition and start improving the relationship between you and your challenging children. For any questions or guidance on integrating the Kazdin Method into your home life, Dr. Gordon and his staff at Pathways Neuropsychology Associates have a wide breadth of experience and knowledge to share on parenting, child development and behavioral psychology. Call today to set up an appointment! 

Source: The Kazdin Method for Parenting the Defiant Child by Alan E. Kazdin, PhD

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Source: Pathways Neuropsychology
Behavioral Management for Defiant Children: Part 3

Behavioral Management for Defiant Children: Part 2

Behavioral Management for Defiant Children: Part 2

 parenting and child psychology | Parent Training |

Behavioral Management for Defiant Children: Part 2

In the first part of this series, we discussed seven different myths about parenting. With these common parenting misconceptions cleared up and out of the way, we can begin to build a more effective and stable parenting foundation with Alan Kazdin’s ABCs of parenting: Antecedent, Behavior, and Consequence. Understanding and consistently implementing this method will lead to improved behavior from your children, decreased stress for you, and overall better relationships in your family. Let’s break it down:

Antecedent: The Before

Alan Kazdin describes the first part of his parenting strategy, the antecedent, as “everything that comes before a behavior”. This includes the way you describe and request a behavior, how this behavior is modeled, and the context, both verbal prompts and instructions and nonverbal cues, that precedes the behavior. 

One of the key ideas of the antecedent is changing the way you think of behaviors. Specifically, moving away from labeling behaviors in terms of what you don’t want, to phrasing behaviors in terms of what you do want. As you will begin to notice, there is a common theme among effective parenting: positive is stronger than negative. Requesting a behavior through the “positive opposite”, as Kazdin calls it, versus a negative approach (i.e. “Please put your dirty clothes in the hamper”, a positive phrase, instead of “Don’t throw your dirty clothes on the floor”, a negative phrase), is a stronger, more durable method for establishing desired behaviors. This is because it is much easier and effective to reward positive behaviors than to punish negative ones.

Behavior: The During 

Once you’ve set up the requests, contexts, and expectations for a desired behavior, the next step is to help your child successfully and consistently perform the behavior. There are two important components to Behavior: shaping and practice. Shaping is when a behavior is broken down into smaller, more doable steps, building upon one another until the ultimate desired behavior is achieved. The crucial piece to shaping is to reward the small steps that are in the right direction throughout the process, even if they are less than perfect. Finding any bit of success and acknowledging it provides the encouragement and stepping stones to eventually achieve the final, complex task. 

Just with any new skill, practice makes progress. In order to see consistency, your child will need ample opportunities to practice the desired behavior. Furthermore, as you may recall from the parenting myths, just because your child may be capable of performing a behavior or you’ve witnessed them perform it once or twice, it is by no means a solidified habit. Not only do children need practice, but they also must learn to associate the desired behavior with a reward. Therefore, these learning moments must be paired with positive reinforcement, which brings us to the final step: Consequence. 

Consequence: The After

The final, and perhaps most crucial, part to behavior management is the Consequence, any form of positive reinforcement that follows a behavior. After witnessing any form of a desired behavior, whether it is a small step in the right direction or the complete complex task, your most effective and most promising tool is to provide your child with a reward. Rewards can be anything positive, ranging from attention, words of affirmation, or gifts. The reward itself does not matter as much as it does to deliver it as consistently and immediately as possible following a behavior. The idea is to establish and solidify the association of the behavior with the reward.

There you have it; parenting as easy as A, B, C! Following these research-based, proven steps, you can be sure to see improvement in the behavior of your “defiant” child. In the final blog of this series, we will cover what this method looks like in action. Until then, bring any questions you have to Dr. Gordon and his staff at Pathways Neuropsychology Associates. With their expert knowledge on parenting and child psychology, they can help you learn more about how you can start implementing ideas of positive reinforcement into your daily routines and master behavior management. 

 

Source: The Kazdin Method for Parenting the Defiant Child by Alan E. Kazdin, PhD

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Source: Pathways Neuropsychology
Behavioral Management for Defiant Children: Part 2

Behavioral Management for Defiant Children: A Series

Behavioral Management for Defiant Children: A Series

Parent Management Training -Understanding Strong-Willed Children

Behavioral Management for Defiant Children: A Series

Relentless tantrums, opposition and attitude at every request, always on the brink of the next crisis at home or in public… sound familiar? If you are among the many parents who are at their wits end parenting your “defiant child”, this next blog series is for you. Taking the wisdom from Alan Kazdin, a leading child and behavior psychologist, and his parenting guide, The Kazdin Method for Parenting the Defiant Child, we will explore his tried and true, research-based parenting technique for approaching difficult children. The goal of his method is to hone in on your parenting craft and improve your child’s behavior, which ultimately and most importantly leads to improved relationships. This series covers myths of parenting, the ABC’s of positive reinforcement, and a program that puts it all together. 

Let’s begin with some myths of parenting. Much of the instincts parents have are positive, such as the natural inclination to shower children in hugs and kisses. However, when it comes to behavior management, there are some underlying assumptions that parents don’t always get quite right. Here are seven common misconceptions: 

  • Punishment is an effective method to change behavior 

While punishment has its place in parenting, it is not actually an effective method for changing behavior. Contrarily, punishment is a temporary fix that works in unproductive ways and, in reality, has negative consequences. The unwanted behavior may stop in that moment, but your child now knows what not to do in front of you instead of understanding the desired behavior. They may now avoid you, become more aggressive, or become resistant to the punishment. When the bad behavior inevitably comes up again, possibly with increased aggression, you will naturally increase the severity of punishment and thus the cycle continues and the behavior remains.  

  • Quantity of reminders equates to quality of behavior 

Parents often assume that if they remind their child to perform a task enough times, the child will eventually listen. As perhaps you’ve experienced, more often this just leads you to be exasperated and frustrated when their room is still a mess after your fiftieth reminder to clean it! Your reminders are actually working against you. In fact, studies have proven that more reminders leads to a lower likelihood of the desired behavior: nagging decreases the power of your requests while increasing your own stress levels. 

  • Rationalizing with your child changes behavior

Okay, so punishments and reminders aren’t working. Surely explaining to your child why a behavior is not okay will be the solution. Unfortunately, rationalizing with your child is also a dead end for changing behavior. While explaining is a great tool for increasing understanding, understanding in itself does not lead to action (this applies to adults as well- we understand that dessert is not great for our health, but does that always stop us from eating sweets?). There are no tangible positive or negative consequences to reinforce behaviors in just an explanation. Therefore, on its own, it is ineffective for behavior change. 

  • Too much praise will make children spoiled

Praise delivered in the right way can be extremely effective in shaping behavior. The quantity of praise is not as much a factor as is its quality. The key to effective praise is to practice noting specific, positive behaviors instead of giving out general, empty compliments. 

  • Behavior will be consistent if demonstrated once or twice 

Just because your child demonstrated capability of performing your desired behavior does not mean you can count on seeing it consistently. Just with creating or changing any new habit, behaviors have to be solidified through consistent repetition and reward, also known as positive reinforcement. 

  • All children within a family need the same approach 

What works with one of your children may not work for others. Some of your children may need different strategies that your other children did not need and that is perfectly okay. It is important to relax your expectations across your children and loosen up your timeline for development benchmarks by appreciating their inevitable differences. 

  • Children are purposely being manipulative 

While it may seem that children are acting difficult for the sake of being difficult and manipulative, it is more likely that they are acting out unwanted behaviors that have been unintentionally reinforced. For example, maybe your child is whining and crying to get something. You’re at your limit and in order to get the whining to stop, you give them your attention or maybe even concede to their wants. You feel relief when the negative behavior stops, but you’ve also unknowingly rewarded whining and crying.

Now that we’ve debunked some of the misconceptions of parenting, we can start to reimagine effective parenting. In the next part of this series, we will do just that by explaining the ABCs of positive reinforcement. In the meantime, if you have any questions or concerns about your parenting approach, Dr. Gordon and his staff at Pathways Neuropsychology Associates have a wide breadth of experience and knowledge to share on parenting, child development and behavioral psychology. Call today to set up an appointment!

Source: The Kazdin Method for Parenting the Defiant Child by Alan E. Kazdin, PhD

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Source: Pathways Neuropsychology
Behavioral Management for Defiant Children: A Series

Gender Differences in ADHD

Gender Differences in ADHD

Gender Differences in ADHD | Psychologists | Toms River, NJ | Manahawkin, NJ | Freehold, NJ - Ocean County NJGender Differences in ADHD

A new study in the Journal of Attention Disorders sheds light on gender disparities in ADHD. The most striking difference is demonstrated in the physical manifestation of the disorder, where girls with ADHD are less hyperactive and show fewer motor responsive issues than their male counterparts. This was supported by observations from teachers who took part in the study, who reported more impulsive and inattentive behavior among boys. Girls also exhibit greater inhibition and cognitive flexibility (although this may be correlated to their faster brain development). Symptoms did overlap in their working memory and attention, where no significant differences were found among gender. 

These important findings help clinical psychologists better understand why girls get diagnosed less often than boys and bring to question whether current ADHD diagnostic practices are suitable for both genders. As girls may not outwardly display their attention deficit, they may go undetected in current ADHD screening processes and therefore miss out on helpful treatment. This study is a hopeful step in the right direction. With more research conducted on gender specific ADHD differences, psychologists are better equipped with more accurate information and tools to best address ADHD. 

If you are concerned your child may have ADHD, Dr. Gordon and his staff are highly trained in thorough, comprehensive ADHD evaluations. With expert and compassionate care, they will address your questions and concerns while providing proven, research based treatment. Call today to schedule an appointment!

Source: Attitudemag.com

The Pathways team of professionals has helped thousands of people with ADHD. We are Dedicated to effective and compassionate care for individuals with neurological challenges.

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Source: Pathways Neuropsychology
Gender Differences in ADHD

Racial Bias in ADHD Evaluations and Diagnosis

Racial Bias in ADHD Evaluations and Diagnosis

Racial Bias in ADHD Evaluations and Diagnosis | Psychologists | Toms River, NJ | Manahawkin, NJ | Freehold, NJ - Ocean County NJ

Racial Bias in ADHD Evaluations and Diagnosis

As our society continues the conversation on racial disparities, it is important to acknowledge and address its place in the psychology profession. Taking a look at ADHD evaluations and diagnosis, specifically, it becomes evident that there is great variance in treatment rates among racial and social groups. Black and BIPOC (Black, Indeginous, or Person of Color) children are diagnosed and treated for ADHD less often than white children. While there is currently not enough research to explain causation completely, there are several factors that unequivocally affect the diagnosis process, research, and social context. Understanding the factors that contribute to these disparities can help clinical care professionals administer more accurate and effective treatment. 

Methods and practices for ADHD diagnosis and treatment begins with research, and as it stands, research on ADHD that includes racial variation is scarce and limited. The vast majority of research is based on white male children of European-Caucasion descent. Lack of data on black and BIPOC children and ADHD results in limited understanding of the best ways to serve their communities. From the research that does exist, there are some trends psychologists are beginning to understand between ADHD and race. Prolonged exposure to prejudice, discrimination, and stereotyping can lead to trauma and stress, which are both linked to the onset ADHD-like symptoms. This can make differentiating between the behavioral and emotional contributions to ADHD like symptoms from actual ADHD symptoms challenging. Furthermore, parenting techniques for handling the challenging behaviors of children with ADHD vary across different cultures. What is commonly practiced and accepted by some cultures, may not be seen as appropriate by others. Understanding different parenting practices among cultures is an important focus of current research.

As the psychology community takes steps moving forward, it is important to acknowledge and be aware that even well meaning clinical care professionals may impart implicit bias in their diagnosis and treatment or may not fully understand some of the biases from past research. Here at Pathways NA we are committed to understanding and addressing these biases and advocating for equality.  

Source: Attitudemag.com

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Source: Pathways Neuropsychology
Racial Bias in ADHD Evaluations and Diagnosis