Her husband is an engineer which means he's left-brained (for the most part) and she's likely right-brained. I reviewed the traits of each of those personalities and the steps she can take to ease the tensions. Zoe needs help him. She can get ideas as to "why" from this blog post.
I also recommended that she read as much as she can about how relationships are impacted by "different brains" and "why" opposites attract. She might want to look at this book.
We reviewed ways to help her daughter to understand the reasons for this attention and also the encouragement to conduct herself with self-respect and dignity. She's gotta be smart about this kind of thing.
Want to know more about the growth and development of teens? Here's some information for you. It's a blog post from my website. If you want more details, do an online search for the "Tanner Scales".
He heard me talk about NeuroStar which is a non-invasive treatment based on transcranial magnetic stimulation (TMS) which is being used on a widespread basis because of the success rate.
Tej has decided to go forward with the treatment and he asked, "What questions should I ask?"
I told him to talk with his current treating physician and the clinician administering the NeuroStar treatment to determine if he should stop taking his medication and if so, the steps he should take to manage his symptoms while waiting for results.
Also, he needs to talk about his handedness. Emotions come from different places in the left-handed brain than from the right-handed brain. Current brain research has overturned the idea that everyone's emotions come from the same areas of the brain and being left-handed has implications for transcranial magnetic stimulation.
If Tej is left-handed, the typical placement for the sensors will actually cause his symptoms to worsen because his positive emotions (happiness, pride, anger) are likely to be on the right side of his brain instead of the left side which is where they are in right-handed people.
Check out this article that briefly describes these issues. Sooo fascinating.
She asked, "In your opinion, what is the single most important 'make-or-break' factor in successfully raising teens?" My response: "Time. Spending time with your kids". For my in-depth discussion, listen to the podcast which can be accessed on the front page of DrClaudia.net.
In that Parenting Pointer, I talked about the number of 20-somethings I have diagnosed with high-functioning autism who were being treated for anxiety and depression. Several had begun using illegal drugs in an attempt to gain control over their anxiety and a few more who were considering suicide because they felt that there were no answers for them. All were exceptionally intelligent and their behavioral "quirks" had been explained away because of their smarts. They were explained away until the anxiety and depression exploded.
I must say that for every 20-something I evaluated with the history described above, the autism was very evident to me as these guys (all of them were young men) walked through the door.
One young man walked through the door on the balls of his feet. Another young man wore blue nylon shorts like basketball players wear and a red top and I was wearing dark rinse blue jeans and a red top. When I remarked, "Oh, I see you got the memo" and pointed to his outfit and my outfit, he looked at me and said, "I don't get it". I thought, "Of course you don't my friend, you're autistic".
After the assessment, diagnosis and treatment plans were implemented every single one of them has turned out to be very high functioning young adults. And, none of them balked at working with me. They were desperate.
Everyone who is struggling needs a map. The map comes in the form of a comprehensive assessment which begins with an assessment plan.
An assessment is expensive and time consuming. It's very difficult to help parents deal with their anxiety as the process continues, but the client's emotional state and his/her pace and tolerance for the process are paramount and cannot be compromised...EVER. It just isn't possible to get valid results by testing a young adult for 4 hours a day. It's not a forced march.
Attention and anxiety are HUGE issues with autism and must be respected or they will take you out. The results won't be valid and the client is thrown back into the blender.
There are two particularly important "rule outs" to make. A "rule out" is a diagnosis that you reject because the results don't fit the profile.
Think about this example. Is this pain I feel appendicitis? Constipation? Gas? Intestinal blockage? All of these and more must be considered before taking action. Do you sit on the toilet or rush to the emergency room?
The two (at least) rules outs are: Social Communication Disorder and Schizotypal Personality Disorder. Do an online search to learn more as I won't get in the weeds on this for the purposes of this post.
Why am I saying this, parents? DON'T PRESSURE THE EVALUATOR. DON'T DEMAND DRIBBLES OF RESULTS. All of the data has to be gathered and put together like a puzzle. Contain yourselves.
As for Colleen, I've recommended the following steps:
A. Contact the local chapter of Autism Speaks and ask for a referral for an assessment for a young adult.
B. If you strike out there, go online to your county's psychological association and look at their referral list. Find 2-3 clinicians who conduct assessments. In order to give certain tests, they must be Licensed Psychologists. Contact them. If they can answer your questions about their ability to perform such an assessment, go see them first and pick out one that you think your son can work with. Go for an interview to see how the clinician handles it.
C. You absolutely need to go through this process to avoid a false start. Incidentally, some tests can be given only once a year, so if you have a false start and one of these "once a year" tests has been given, you could compromise the results.
D. However long it takes and no matter what kind of hoops you have to go through, this process must be done in a way that makes the clinician confident that the data is valid and tells the truth about your young person's functioning. Their lives really do depend on it.
Here is the assessment plan I use (and modify at times, depending on the client) to evaluate potential autism in a young adult.
You are NOT to take this list and tell an examiner to "give these tests". Clinicians are not allowed to dictate to one another how to do their job. Why? Because your child is not sitting in front of me, they are sitting in front of them. If you don't trust them, move on to someone else before the assessment begins. And yes, this will frustrate you and make you angry.
Understand that there's a great, great deal of information to be gathered by spending time interacting with your young man or young woman and by watching their attention span, cognition, learning skills, their strategies and approaches to tasks and their coping skills the tests results are interpreted.
There is NO substitute for spending the time with them. It takes a good long while for even the young adult with autism to get accustomed to the setting and the examiner. Rapport and trust are critical.
By the time some of you read this (in coming years), "versions/editions" of some of the tests are likely to have changed, so keep this in mind if you read this post in the next decade! Also, I will not explain each test. You're likely to find the basic information online that is available to non-clinicians in order to educate yourselves. Certainly, ask the evaluating clinician, once they offer their assessment plan, to briefly outline the purpose of each procedure or test.
- Wechsler Adult Intelligence Scale-4th Edition (WAIS-4)
- Leiter International Performance Scale-3rd Edition
- Woodcock-Johnson Tests of Achievement-4th Edition
Written Language subtests:
Spelling of Sounds
- Nelson-Denny Reading Tests-Form G/Reading Comprehension
Extended Time Administration
- Wechsler Memory Scales-4th Edition
- Rey Complex Figure and Recognition Trial
- Conners 3 Rating Scales/Long Form (DSM 5) to be completed by client, parents, teachers, if possible, and other reliable persons
- Woodcock-Johnson Tests of Achievement-4th Edition
Sentence Reading Fluency
Word Reading Fluency
Math Facts Fluency
Sentence Writing Fluency
- Behavior Rating Inventory of Executive Functioning-2nd Edition to be completed by client, parents and other reliable persons
- Behavior Assessment System for Children-3rd Edition-Adolescent version completed by client and parents
- Millon Clinical Inventory (Adolescent edition, possibly)
- Social Responsiveness Scale-2nd Edition completed by parents or teachers or other reliable informants
- Autism Diagnostic Observation Schedule-2nd Edition: Adolescent/Adult Module
- Vineland Adaptive Behavior Scale-3rd Edition/Interview Edition to be conducted in office with parents
- Rorschach Inkblots
- Clinical Interviews
- Extensive developmental history (I offer mine in the Resources section of DrClaudia.net)
- Review of records
- Intake Interview
I also recommended that Colleen have her son evaluated, comprehensively, for language processing issues, especially those related to social language and social pragmatics which are the "behaviors" of oral language such as staying on topic, appreciating the emotional state of the listener, eye contact, gesturing, and asking questions to engage the listener.
He may also benefit from an occupational therapy evaluation if he has sensory issues such as dealing with bright lights, scratchy fabrics, noisy settings, etc.
The optimal outcome in those with autism is to have appropriate interventions early and consistently. My young adult clients never had the opportunity to benefit from that kind of interventional programming and it was difficult to find competent and committed practitioners even in my area who could effect meaningful change with these young men. But, we found them!
Take your time in finding supportive therapists. Those who conducted the assessments should have a referral list to help you in your quest. Again, sit with the therapists to determine if they're a good fit for you. You've come this far, don't drop the ball now.
As you move through the process, Colleen, you are welcome to reach out and ask questions or give us updates over the DrClaudia.net "Ask Me" button.
For those of you with younger children, I've outlined the assessment plan for them. See this blog post.
Good luck and let us know how it goes.
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