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  • Collaborative ADHD Evaluations: A Neurodiversity-Affirming Approach

    Comprehensive ADHD Evaluations for Children and Adults

    Serving all of New York in-person or via telehealth!

    Is your child struggling at school, in peer relationships or with behavior at home due to dysregulated attention, hyperactivity or impulsivity? 

    Are you an adult who consistently struggles with forgetfulness, organization, completing tasks and has to work really hard to focus on the things you need to, but not really the things you love? 

    If you do, consider reading more below about Attention-Deficit/Hyperactivity Disorder.

    We are accepting new referrals for evaluations now with little to no wait to get started!

    A Therapist’s Guide to an ADHD Diagnosis

    Not sure where to start to get you or your child evaluated for ADHD?

    On a long waitlist and want to jump-start the process?

    Check out our FREE organizational guide to an ADHD Diagnosis!

    What is ADHD?

    Attention Deficit/Hyperactivity Disorder (ADHD) is an over-arching and consistent challenge with self-regulation that interferes with functioning. Our current guidelines for ADHD come from the DSM-5-tr, or Diagnostic and Statistical Manual of Mental Disorders, 5th Edition. (Official Adult ADHD guidelines for the US are hopefully coming this year!). 

    Unlike the name suggests, ADHD is more accurately explained as a dysregulation of attention; the brain has difficulty paying attention to what it is supposed to pay attention to, when it is supposed to pay attention to it, and for how long it is supposed to pay attention. Individuals with this type of attention challenge often have difficulty with attention (persistence) toward the future because what interests them in the present, takes center stage. This does not mean that people with these differences don’t care about the future or about important tasks or being cooperative, it’s just harder to engage with those things and be mindful of their activities.

    The DSM classifies ADHD in 3 different types of current presentations: Inattentive Presentation, Impulsive/Hyperactive Presentation, or Combined Type (Inattentive and Impulsive/Hyperactive). 

    Neurodiverse-Affirming Care

    Neurodiversity is a movement centered around the understanding that there is no such thing as a "normal brain". Instead, there are many types of different brains and one is not better than the other. Meaning, neurodivergent brains/nervous systems are not inherently pathological or disordered (i.e. "bad or broken"), and have many strengths to celebrate. "Neurodivergent" is an identity that people can choose for themselves. Unfortunately, our society right now runs on many beliefs, practices and attitudes that make it very difficult for neurodivergent individuals to thrive. 

    Part of the problem could be the very fact that, in order to receive proper support, one needs to be diagnosed as disordered by a professional. This is a barrier for many individuals. (summarized from Sonny Jane Wise, We're All Neurodiverse)

    Here at this practice, we offer Neurodiverse-Affirming care; we believe and know that all experiences are valid. We also know that living in this neurotypical world as a neurodivergent individual (ADHD, Autism, OCD, Dyslexia, Tourette's, Bipolar, etc.) can be very challenging and some individuals might benefit from the additional supports and most importantly, understanding, that come with a diagnosis. 

    Brain Based Differences

    With ADHD brains, scientists have learned that there is a deficiency in the neurotransmitter, norepinephrine. Norepinephrine comes from a molecule called dopa, which is converted into dopamine, and then into norepinephrine.

    Studies have shown that there are differences in certain areas of the brain in individuals with ADHD, namely: The prefrontal cortex, the limbic system, basil ganglia, and the reticular activating system. Not everyone will have differences with all 4 areas of the brain, but since they all work together, differences in just 1 area can result in challenges for the individual while trying to operate in this predominantly neurotypical society. 

    Symptoms of ADHD

    While individuals with ADHD can have distinctly different sets of strengths and support needs, there are some overarching similarities that must be present (according to the DSM) often enough to contribute to significant challenges with social, occupational or academic functioning. (Are you picking up on the "disordered" mindset here?)

    Inattentive Presentation: Difficulty with regulating attention, makes careless mistakes, forgetful in daily activities, does not seem to listen, difficulty following through on chores or responsibilities, difficulty with organization, easily distracted.

    Impulsive/Hyperactive Presentation: Fidgety or restless, feel like they are often "on the go", talks excessively, interrupts others or blurts out answers, difficulty waiting their turn and staying seated when staying seated is expected

    Combined Presentation: Currently meets criteria for both of the above types

    Myths and Misunderstandings

    Individuals with ADHD are NOT: 

    Dumb, lazy, need to try harder, bad/naughty, only boys, only hyperactive, able to always "outgrow" it, a result of "bad parenting", over-diagnosed, over-medicated, only a disorder of childhood, destined to have substance abuse disorders.

    Individuals with ADHD CAN:

    Focus on some things (sometimes really well!), succeed, have many strengths, get support, be gifted in other areas, feel good about themselves, learn to handle emotions better, have fulfilling relationships, accomplish their dreams, be ok JUST as they are! 

    What's Included in ADHD Evaluations?

    In-Person or Live Telehealth Appointments available (NYS only)

    -Screening and Registration 

    -3-4 Evaluation Sessions (average) with ADHD specialist 

    -Collateral contact (school, primary care doctor, significant others etc., if appropriate and necessary)

    -Specific questionnaires geared toward your needs. This includes Standardized questionnaires for executive functioning.

    -Feedback Session: Whether diagnosed with ADHD or not, we aim to send you off with helpful information and recommendations for your next steps.

    Questionnaires & Screenings

    Questionnaires and screenings are individualized based on presenting concerns:

    For Children and Adolescents:

    • Behavior Assessment System for Children, Third Edition (BASC-3)
    • Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2)
    • Reynold’s Intellectual Screening Test, Second Edition (RIST-2)
    • Children’s Yale-Brown Obsessive-Compulsive Scale (CY-BOCS)
    • PTSD Scale and Child Dissociative Checklist (CDC), Version 3
    • Screen for Child Anxiety Related Disorders (SCARED) 

    For Adults:

    • The Adult Self-Report ADHD Scale (ASRS, V1.1)
    • The Generalized Anxiety Disorder Scale (GAD-7)
    • The Patient Health Questionnaire (PHQ-9)
    • The Mood Disorder Questionnaire (MDQ)
    • PTSD Scale and Dissociative Experiences Scale, II
    • Behavior Rating Inventory of Executive Function, Adult (BRIEF-A)
    • Reynold’s Intellectual Screening Test, Second Edition (RIST2)
    • DSM Symptom and Personality Screener
    • SCAARED Anxiety Screening for Adults
    • Autism Questionnaires
    • Weiss Functional Impairment Rating Scale
    • Wender-Utah Rating Scale
    Treatment for ADHD

    Whether you are being evaluated through our program or received an evaluation through a different program, we have many treatment options available:

    -Affirming individual therapy (helpful for those with additional mental health concerns or a history of shame or trauma associated with ADHD)

    -Parent Education

    -School accommodations recommendations (504 Plan)

    Medication Management, if appropriate

    Medication Management for ADHD

    We offer Medication and Non-Medication interventions for individuals with ADHD. 

    Check out our Certified ADHD Specialist- 

    Psychiatric Nurse Practitioner, Kelly Dorman, NPP!

    Payment Options

    -Payment is made at the time of service, as each step progresses; NO lump sums! Please inquire through email for fees and Good Faith Estimate.

    -We can stop or pause the evaluation process at different points, if appropriate. If there are significant concerns that require a referral to another provider or treatment modality, we will alert you as soon as possible. Pricing is then locked in for 3 months following the most recent appointment so you can return to the evaluation process at a later date.

    We are Out-Of-Network with all insurance companies. A payment outline will be provided to you prior to beginning the evaluation with information and insurance codes so you can check your benefits.

    We cannot guarantee reimbursement, however, we will work with you as best we can to help you get any reimbursement you can from insurance companies.

    FAQ's

    1) Why can’t my doctor or my child’s pediatrician diagnose ADHD? Answer: They might be able/willing to! Many doctors are an excellent place to start for concerns around ADHD and anxiety. Sometimes physicians or nurse practitioners might want a more detailed assessment or might have questions around possible co-occurring diagnoses, so they refer their patients to an outside mental health provider or psychologist. 

    2) We suspect Autism Spectrum Disorder and ADHD, would your practice still be able to provide an evaluation? Answer: If you have concerns regarding ASD, we can still provide you with an ADHD evaluation and also provide a thorough Autism screening. As diagnosing clinicians, we are qualified to diagnose ASD, however some presentations may be complicated by other factors that would be better suited for social cognition testing, learning disorder testing, etc. in order to be confident in the diagnosis. If that is the case, you’ll want to look for a licensed Psychologist to perform the appropriate testing. For children, sometimes the school district can also provide an Autism screening. We can help guide you on this path, if necessary.

    3) We are concerned that our child has a learning disability, can you help us with that? Answer: While we can screen for some intellectual and learning disabilities, your child’s pediatrician and school are the best places to start a discussion regarding possible learning disabilities. If, during the course of our evaluation, we suspect there might be the presence of a learning disability, we will communicate that to you ASAP and guide you in the right direction, however we are not able to diagnose specific learning disabilities.

    4) I am an adult and think I might have ADHD, is it too late to seek a diagnosis? Answer: No! It is never too late to seek the proper medical care. If you are over the age of 65, we may recommend a memory or neurological consultation first, to rule out any normal age-related brain changes or non-age related brain changes. Check out Upstate Geriatric Care for a memory evaluation.

    5) I am scared that if we receive an ADHD diagnosis, someone will force me or my child to take medication. Answer: A diagnosis is a set of criteria that explains what is happening in your or your child’s life at that time, and can guide treatment. Treatment for ADHD includes education, awareness, accommodation and modification of the environment and sometimes medication. ADHD medications have been researched for a long time, are safe and highly effective, but some people opt to not take them or some people cannot tolerate the side effects.

    No one should force ADHD medication upon you or your child, but please, get educated first-there are a lot of myths out there about ADHD medications. Just like anything else in life- there can sometimes be risks to taking medication, but there can also be risks to not taking medication. Among them: accidents, lower academic success, financial mistakes, poor socialization, low-self esteem, anxiety, etc. Learn more here.

    Learn about all your treatment options so you can make an informed choice in your care or your child’s care.

    6) I am scared to have the label of ADHD for me or my child. Won’t people have negative judgements or will my child think there is something wrong with them? Answer: People have judgments and we cannot control what others think. Our job is to help you or your child to understand current strengths and needs and learn how to be a good advocate for what needs are present. Often times if we do not give the proper “label”, like ADHD, individuals can end up “labeling” themselves as “bad, lazy, stupid, annoying, weird”, or worse. Sometimes the proper terminology actually frees the individual to be themselves without shame and find a supportive community! Once the evaluation is complete, you have your report with any diagnosis listed and YOU can show it to whomever you want, or don’t want. 

    Our hope is that individuals come away from this process with more understanding, patience, compassion and acceptance for themselves and their loved ones. 

     

    ADHD Evaluations & Treatment

    Welcome to our ADHD Evaluation Program, we are so glad you’ve found us! Our program is comprehensive and collaborative. What this means is, we work with you to help you to rule out other concerns you might have for yourself or your child and determine together what the best interventions may be. ADHD can be a complicated clinical diagnosis for some; it cannot always be quickly diagnosed (or ruled out!) with 1 questionnaire or screening form.

    Other challenges that can mimic ADHD symptoms: Learning disabilities, head trauma, PTSD, anxiety, and some medical factors like anemia, Lyme Disease, high blood pressure, Fibromyalgia, and many others.

    To complicate matters, ADHD is often accompanied by issues such as anxiety, learning disabilities like dyslexia or dysgraphia, sensory issues, autism, etc. Sometimes these issues are diagnosed early on but the ADHD component is missed, which can be a barrier to achieving personal goals, increased understanding and compassion.

    You Deserve A Careful and Compassionate Evaluation!

    We want to partner with you in making important decisions about your care, not dictate to you what you need. We offer a balanced and honest approach to evaluations and feedback; if we believe you might benefit from receiving services or testing elsewhere at any point during the evaluation process, we will discuss this together. 

    Some individuals may require: 

    Specific testing with a psychologist (privately or through school); others might need a neuropsychological evaluation, medical testing or pediatric developmental evaluation. 

    Contrary to some beliefs, these diagnostic avenues are not always necessary for an ADHD diagnosis, but can prove useful in some situations. Please see our Guide to Diagnosis for more information on this topic!

    If that is the case, we will assist you with these referrals as best we can. Ours is a collaborative process until the end! 

    What is an ADHD Certified Clinical Services Provider?

    30+ Hours of training from leading experts in the field!

    Topic Areas Include:

    • Non-Medication Interventions
    • Evidence Based Medications and Treatment
    • Executive Functioning 
    • ADHD in Adults
    • ADHD and Learning
    • ADHD and Anxiety, Depression, OCD, Trauma, etc.

    ADHD