Attention Clinic

Blog article by G.Gagnon

YOU WONDER IF YOU HAVE ADHD..? These symptoms look just like you? Just like your loved one? Teachers says your child might have ADHD?

Great news : here is an opening for growth so don’t be lazy: hasty conclusions are too easy. Many neuropsychological disorders will look like ADHD, in child and in adults. Many psychological disorders will look like ADHD, in child and in adults. Even challenges with relationships can make you wonder about ADHD. Understandably. Because there are a xillion reasons why one can exert a certain set of “symptoms”. Is it dyslexia, intellectual giftedness, memory impairment, depression, adjustment disorder, non verbal syndrome, asperger, visual agnosia, a visual spatial learning style, or ADD / ADHD…how will you know?

Some authors will say “ADHD does not exist”.

Others will blame the “over-diagnosis of ADHD in adults

Both positions highlight that “ADHD” can actually be many other things! This diagnosis should be one of exclusion: a professional has to rule out all other possible causes for inattention, impulsivity or disorganization, before jumping to conclusions. For a valid diagnosis, all other probable causes should be assessed and ruled out. This means assessing attention, intellect, language, memory, mood and so forth. Without proceeding to careful evaluation, we might over-diagnose ADHD – like we currently do.

So now what do I do?

Ask a neuropsychologist. Take the time to do this process of discovering yourself / your child. Take the time to evaluate all the options and see what really makes you think you/your child have ADHD? In short, what’s bugging you? Is it interfering with your functioning? How? Be ready to ask yourself questions and keep an open mind for the answers.

Ask your Family Doctor for a reference.

You have 2 options: public or private.

Find one in the public system? Nowadays, there are very little neuropsychologist in the public system. Most will only work with complex cases and do not accept reference from the general population. Try your luck and ask your doctor. But also be ready for option 2.
Go private? Just like going to the dentists: it can get a bit expensive, but its worth it. Services are covered by most insurance package (under “psychologist”).

Here is how to find a neuropsychologist, the only professionals that can asses and diagnose neuropsychological disorders (bill 21) https://www.ordrepsy.qc.ca/web/ordre-des-psychologues-du-quebec/trouver-de-aide

One last thought: ADHD is hardly diagnosed in a 15-45 min consultation. Its an exclusion diagnosis. We have to look at other options or else we might miss the point and never really address the problem with the right interventions.

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SERVICES WE OFFER IN NEUROPSYCHOLOGY – THE ATTENTION CLINIC

Children, adolescents and young students  

  • Clinical interview. 1 to 2 hours. Arrive early to fill out the consent forms and be prepared to fill out questionnaires after our meeting – I am trying to get to know you as best and quick as I can.
  • Neuropsychological Evaluation. 4-7 hours. The length depends on the complexity – duration of the evaluation is hard to predict. Some work faster than others. Some need more detailed evaluation than other. For students of all ages, a throughout evaluation is very important in order to identify precisely what is going on. Misdiagnosed or undiagnosed conditions may have long term effect on someone’s ability to study and/or their mood.
  • Because children and young adults are still studying, a full intellectual assessment is essential, along with tests of attention, memory, language, reasoning, etc. We are trying to understand how you process information. Also, academic achievement has to be evaluated. I will also need a copy of the report cards and I like to send questionnaires to the teacher. Its important to get an idea of the person’s functioning in many areas (home, school, work, hobbies, etc).
  • Scoring the results. I look at all the questionnaires, all the tests, all the symptoms you have reported and I try to find patterns, explanations and solutions. Then I prepare a report with all the results and recommendations for home and for school. this takes approx 4 hours but can take longer in complex cases.
  • Feedback session. 1 hour. I give you the diagnosis and some recommendations.  NOTE : I recommend at least one follow up session, one month after the diagnosis. To see how its been integrated at home and in school.  Its sometimes hard to make a real change at home and in school : most parents and students need help, even after the diagnosis and recommendation.
  • if needed, some medication has to be prescribed and controlled by your GP. He is the one who knows best about your physical health. Take an appointment and bring a copy of your report with you.

Generally cost around $1760 or more – depends on time needed

 

Adult   

  • Clinical interview. 2 hours. Arrive early to fill out the consent forms and be prepared to fill out questionnaires after our meeting – I am trying to get to know you as best and quick as I can.
  • Mini Neuropsychological Evaluation. 2 to 3 hours. Tests of attention, memory, language, reasoning, etc.  We are trying to understand how you process information.
  • Scoring the results. I look at all the questionnaires, all the tests, all the symptoms you have reported and I try to find patterns, explanations and solutions. Then I prepare either a verbal report, a 2 pages summary for you, a letter for your Physician or a full report – depending on your needs. 1 hour to 4 hours.
  • Feedback session. 1 hour. I give you my impressions and hypothesis about the Diagnosis, or we talk about the diagnosis.
  • NOTE : Discussion about the diagnosis can take longer than 1 hour. It is often beneficial for the patient to take the time to integrate all this information. Its also helpful to think about solutions for the problem and start the intervention after the diagnosis. I offer cognitive remediation for adult with ADHD, to improve functioning. This could be used with or without medication. The medication has to be prescribed and controlled by your GP. He is the one who knows best about your physical health.

Generally cost around $960 or more – depends on time needed

 

Not sure if you want / need a neuropsychological evaluation?

Initial in-person consultation. A complete neuropsychological assessment is a very thorough process and might not always be warranted. An initial in-person consultation is suggested. This initial consultations is a 2 hours appointment (320$) during which Dr Gagnon will conduct a thorough interview and basic cognitive screening, as necessary. Based on this initial assessment, a neuropsychological assessment will be recommended or not (see above). You may also receive suggestions and recommendations or a brief educational session, depending on the initial findings and clinical impressions.

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