Our School Program is designed to help children and adolescents with attention, memory, executive functioning, communication or social interaction difficulties cope with the difficult academic and social challenges that confront them at different stages in their school life. The pre-K child is faced with the new challenge of controlling impulses, staying in one place, following instructions, focusing on and completing tasks, participating in group activities, and socializing and communicating with peers.

On entering kindergarten the child faces the challenges of learning to read, write, spell, and elementary math. A child with attention and memory difficulties is seriously handicapped in these early endeavors and it has nothing to do with intellectual ability. Research by Gathercole,S.E., Brown, L.,and Pickering, S.J. found that working memory assessment at school entry was a more reliable longitudinal predicter predictor of academic  achievement than intelligence and recommended that the working memory of pre-school children be screened and if necessary remediated before entering the formal educational system.

The school-going child is challenged by the demands of the more structured classroom environment and the attention, memory, comprehension and reasoning demands of the more formal learning experience. Getting homework completed is often a nightmare for both child and parent with the added frustration that they often forget to hand it in!

As the adolescent advances into junior high and high school, academic demands such as planning and executing projects, essay writing, studying, and writing exams challenge their executive skills functioning. In addition to academic demands the school-going child and adolescent has to cope with changing social demands and an increasing need for independence from their caretakers.

REFERRALS

Parents are often referred to the ADD Wellness Group by pediatricians, family practitioners, school teachers and counselors, or parents just take the initiative when they realize that their child is academically performing way below their potential.

PROCESS

Testing
Attention and memory problems can be result from neurological causes such as ADHD, emotional causes  such as anxiety or depression , medical causes such as sleep apnea, or environmental  causes such as the death of a loved one or divorce, or combinations of all of these factors. An accurate assessment is essential to avoid medical treatment that is not necessary.  The ADD Wellness Group provides a cognitive assessment that evaluates the child’s attention skills, working memory, executive functioning skills, emotional functioning, and social skills.  A full neuropsychological  assessment is recommended if the child has a severe learning disability such as severe difficulty in learning to read,  or has suffered traumatic brain injury as a result of an accident or disease such as meningitis.

A Wellness Assessment is also conducted at this stage to evaluate the child’s diet, sleep and exercise habits. All three of these aspects are directly involved in brain functioning and can contribute to attention, memory and executive functioning deficits.

The results of the assessment are provided to the parents in the form of an assessment report, which includes the results of the testing, diagnoses and recommendations based on the test findings, for the parents and school. If the child is eligible for and would benefit from academic accommodations these are also included and the parents are advised to discuss the finding with the school. Our neuropsychologists are available to have discussions with the child’s teacher or advocate for the child at the AARD meeting if necessary.

Treatment
At the time of the feedback treatment planning is also completed and an initial treatment plan is formulated to focus on those areas where the child needs help. Coaching is usually recommended if the child just has executive skill deficits such as organization, planning or time management. Counseling, a combination of therapy and skills training is recommended if the child has executive skills deficits, emotional problems and has been diagnosed with ADHD. Coaching and counseling focuses of real life situations the child is dealing with such as planning and completing a school project.

Parent counseling is usually recommended which will allow the parents to learn strategies to support and manage the child more effectively so that life becomes easier for themselves and their child. Family therapy is also available if the family system has been negatively affected by the child’s problems. A more direct hand- on parent coaching called Parent Child Interaction Therapy (PCIT) is recommended if the child is presenting with an oppositional defiant disorder. Parents are, “kept in the loop”, every step of the way in the treatment process.

Cogmed Working Memory Training is recommended if working memory deficits are identified. Healthy diet, sleep and exercise patterns are essential for optimal brain functioning especially if the alternative treatment track is selected instead of medication. Nutritional counseling and counseling can be recommended to develop healthy sleep and exercise patterns. Nutritional counseling is particularly beneficial if the child has been diagnosed with ADHD and their diet has to be adjusted to facilitate rather than handicap their cognitive functioning.

Behavioral treatment plans will be recommended to target and reshape unwanted behavior to more beneficial and productive behaviors using positive reinforcement. Cognitive therapy is used to help the child or adolescent identify the negative thought patterns that are leading to unwanted emotions such as depression, anxiety, poor self-esteem, or anger and behaviors such as self- isolation, avoidance, and aggression.

The social challenge children and adolescents face at school learning how to act appropriately with others and ultimately making and keeping friends. Social skills are learnt from observing role models. The observational skills of children with attention and memory deficits handicap their ability to learn in this manner and often need social skills training in groups to develop these skills.

Gathercole, S.E., Brown, L., Pickering, S.J., (2003) Working Memory Assessment at School Entry as Longitudinal Predictors of National Curriculum Attainment Levels. Educational and Child Psychology, 20, 109-122.