521840?1348844371
Rebecca Resnik, PsyD  
Female
Bethesda, MD

Specialties: ADHD, dyslexia, developmental delays

Interests: Developmental Disabilities
MindWell Clinical Psychology
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301-581-1120
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Blogging for Mental Health Day, May 18th

May 18, 2011 - 3 comments
Tags:

Health

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Mental Health

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treatment



<img src="http://www.yourmindyourbody.org/wp-content/uploads/2011/05/APA_BlogDayBADGE_2011.jpg"

Its mental health awareness month everyone! Check out the American Psychological Associations 'Blogging for Mental Health" event at http://www.yourmindyourbody.org/mental-health-month-blog-day-may-18/
Bloggers from all over the world are posting about psychology, psychotherapy and the experience of coping with mental health problems. The goal is to help get the word out that we need to seek treatment for our mental health problems the same as we do for our physical ones--without shame or stigma!

Did you know that mental health problems are among the most expensive problems the world faces? Depression alone costs more in terms of diminished worker productivity than most diseases like heart problems or diabetes. Mental health related problems like substance abuse, juvenile behavior problems, and non-adherence to medical treatment plans (like not changing your diet if you have diabetes!) not only cause a lot suffering, they have a significant economic impact.

The good news is that the fields of psychology and psychiatry have developed effective treatments for these and other mental health problems. These problems are treatable, but so many people out there are afraid to get psychological or psychiatric care. So take a moment today to think about if someone you love needs a little encouragement to go get some help.

Best Wishes
Dr. Rebecca Resnik

Psychological Testing for Accommodations: What Parents and Student Need to Know to get Ready for the SAT and other Standardized Tests

May 04, 2011 - 0 comments
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accommodation

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psychological testing

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testing

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psychological

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standardized tests

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disabilities

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Adult ADHD

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ADHD

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Childhood ADHD

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IEP

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504 plan

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parents



Accommodations for Standardized Tests--What You Need to Know about Psychological Testing to Document a Disability

There is such confusion and stress about applying for accommodations during “high stakes” tests such as the SAT, ACT, GRE, LSAT, and MCAT. For some students, accommodations such as extended time or frequent breaks during testing gives them a better chance of showing their true potential. As a clinical psychologist, I frequently receive calls from parents or young adults asking what they need to do to arrange for accommodations when they take standardized tests. Unfortunately, most parents, students and even some psychologists are not familiar with the process. Common mistakes can jeopardize the student's chances of being granted accommodations. It is critical to do your research well in advance. This blog was written to help you plan ahead to document a disability and request accommodations.

The right to reasonable accommodations is granted to people who have disabilities that impair their ability to perform major life task (such as learning, reading, speaking, working). The law that guides who gets accommodations under what circumstances is the Americans with Disabilities Act (ADA), Section 504. This section of the law protects individuals with disabilities from discrimination. Students with disabilities may receive special education services during the K-12 years as delineated in a “504 Plan.” A student with a documented disability has the right to reasonable accommodations. The key word here is 'reasonable.' The word 'reasonable' does not mean that the testing situation has to be perfect, only that testing companies take reasonable steps to 'level the playing field' so that students with disabilities can compete with their peers. Accommodations may include special privileges to help minimize the impact of a person's disability. For example, a person with diabetes may take breaks to check blood sugar or eat. A person who can not write well with a pencil may dictate responses or use an alternative interface. A person with dyslexia may take his test untimed or with 50% extra time.

There have been recent changes to ADA that will make it easier to document a disability. The changes also broaden how many people may qualify for accommodations. Under the revised ADA, people may have accommodations even when their disability is managed with a “mitigating measure”. A “mitigating measure” refers to medication or other helpful device that the person uses to cope with his disability.  For example, a student with diabetes can still have accommodations, even though insulin regulates her blood sugar. It can also mean that a student with ADHD is still entitled to accommodations when taking their stimulant medication. The new changes in the law also protect people with disabilities that are do not impact their lives all the time. For example, a person with epilepsy could be entitled to accommodations even if he is not actually have a seizure during the testing.

Finally, the law has been changed to recognize people's difficulties across a broader range of 'life activities.' These activities may include learning, self-care, writing, or working. The student's performance can now to be compared to what would be expected for a person as compared to their peers, not only the general population. This means that the student's need for accommodations can be compared to the other people in their same situation, such as other students applying to graduate school. All of these changes mean that more people with disabilities could be eligible for accommodations. Companies who produce and administer standardized tests must comply with the provisions of ADA.

Though the changes in the ADA law are good news for people with disabilities, it is very important to understand the process to avoid being denied. There is a natural tension between students and the publishers of standardized tests. Parents and students want to get the best scores possible.  Testing companies want to make sure the scores they produce continue to be useful predictors of how a student will perform in the higher education setting. Testing companies naturally want to maintain standard procedures as much as possible. Standard procedures ensure fairness as well as the validity of the scores they produce. As a result, they carefully study all applications for accommodations. Its not that testing companies are 'bad guys' who want to deny students at all costs; they provide a service and must protect their ability to do so as well as they can.

So how do parents and students go about getting accommodations? The first thing to do is to PLAN AHEAD. Make sure that the student has a DOCUMENTED record of receiving, using, and benefiting from accommodations in the educational setting well before the test. Any accommodations that the student will request from the testing service should already be a documented aspect of that student's educational program (e.g. 504 plan or IEP). Many parents make the mistake of letting their high school students 'get by' with informal accommodations granted by helpful teachers. For example, Ms. Smith may let Jay turn in his work late, and finish tests during lunch because she knows he will do well if given more time. Some students beg their parents to let them avoid a 504 plan or IEP so they will not have to feel different from their peers. Of course, many parents give in and do things like spend hours helping with homework or hiring tutors to help the student along. This will hurt the student when she then applies for accommodations from a testing company, because there is no documentation of what the student had to do differently from her peers in order to succeed.  Without a formal 504 plan, IEP, Disability Support Services record from a college, or private school education plan, there is no documented history of a need for accommodations. If the student has been successful without accommodations for all of his educational, why should the testing company believe that he suddenly needs them a month or two prior to a 'high stakes' test?

Parents and students also make the mistake of calling to schedule a psychological evaluation a few weeks before the test date. Waiting until the last minute can be a disaster. Companies like the Educational Testing Service review thousands of applications for disability accommodations. They specify on their websites how much time they need in advance to review each student's case. Do not miss their deadlines. Also consider that during peak times of year, particularly January through April, a psychologist may be booked out for months. After the testing, some psychologists and doctors may take at least four weeks or more to produce your report. Families must make their testing appointment months in advance of the application deadline to ensure having results on time.

Parents and students also make the mistake of selecting the wrong person to do the testing. Some clinicians who do psychological testing are not familiar with the law or with the guidelines of the testing companies. As an active member of my state psychological association, I often see listserv questions come up between psychologists who are confused about how to test to document disabilities for high stakes testing. Additionally, not all professionals who conduct evaluations know much about the provisions of ADA and IDEA (the laws that protect students with disabilities). They may have excellent clinical skills, but no training in how to advocate for a student's rights in a letter or report. Last but not least, before you schedule your testing, make sure that the psychologist or educational diagnostician has the credentials the testing company requires.This information is on the testing services websites.

Aside from credentials, it is critical to ask if the evaluator has the experience, the very latest versions of all tests, and up-to-date training to make sure the testing is done properly. The last thing anyone wants is to pay for an expensive psychological evaluation only to learn that the evaluator was not well prepared to document a disability for 'high stakes testing.' Before calling the psychologist, parents and students must visit the websites of each testing company to learn exactly what to ask for in an evaluation. For example, each test publisher has specific requirements about what tests they accept as documentation and whether they require the student to take his medication as usual ( some testing companies require testing be done with the student taking his medication as he does on school day, even though doing so may make it harder for the psychologist to understand the nature of the student's impairments).

Finally, there are research data to indicate that quite a few students who request testing for accommodations exaggerate or even fake problems. So aside from giving a sermon about why this is wrong (if you can read this, you already know), its a mistake to try it. If a student tries to exaggerate a disability, he may end up skewing the results to look like he is of low intelligence or severely impaired. Not a great idea if the student plans to use the report to advocate for herself in college or graduate school. The student may also happen to be tested by a psychologist who uses tools designed to detect malingering or detect unusual response patterns. Remember, psychologists are behavior specialists, and will be very skeptical if a very smart, successful student comes in and earns unexpectedly low scores (most would probably refer that student for a serious neurological work-up). I certainly don't claim that we can't be fooled, but if a student corrupts the data of a psychological evaluation, then that very expensive document becomes pretty worthless.

To learn more about ADA and IDEA, please check these websites:
The National Dissemination Center for Children with Disabilities  www.nichy.org  
The Council for Exceptional Children   www.cec.sped.org
and of course, check the website of the publisher of any standardized test you plan to take

I am greatful to JoAnn Simon Esq and Robert Mapou PhD, as well as Jim Hardcastle Esq for their excellent training in understanding the changes to ADA

Good luck on your tests!
Dr. Rebecca Resnik
Licensed Clinical Psychologist


New Screening Measure Detects Signs of Autism at 12 month Well Child Visit

May 02, 2011 - 10 comments
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Autism

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psychological testing

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child development

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developmental delays

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well baby visit

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well child visit

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speech delay

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Behavior Problems

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early identification

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autism spectrum



New Screening Measure for Doctors Detects Signs of Autism at 12 Month Well Baby Visit--Good News!

There is some wonderful news for all of us parents of young children! The Journal of Pediatrics has published a new tool for screening one-year-olds for early signs of developmental delays--including symptoms and behaviors consistent with Autism. Autism is a developmental delay that impacts children's language, social functioning, play, learning, and behaviors. Since Autism varies so much in severity, clinicians refer to it as a 'spectrum disorder' (you may hear the term Autism and Autistic Spectrum Disorder used interchangeably in news stories). This is excellent news for parents and children, because early identification is crucial.

The new screening questionnaire called the Communication and Symbolic Behavior Scales Developmental Profile for Infants and Toddlers (abbreviated CSBS DP IT) is specifically designed to be used by pediatricians during the 12 month well baby visit. So why is this such a big deal? Most children who have Autism and other developmental delays do not get referred for a proper diagnosis until around 5 and a half years of age. This means that most families lose two or three years that would be the very best time to get their child early intervention services. Research has shown that early intervention services (including speech language therapy, special education, applied behavior analysis and psychotherapy) are the gold standard of care in treating children with Autism. Not only is this the time when the child's brain is the most adaptable, but professionals can intervene early to prevent undesirable behaviors from taking root. Young children with Autism desperately need to learn skills that unfold naturally for most children, and there is no time to be lost in getting them the help they need.

Lets consider a fairly typical course for a child with Autism. I'll ask you to imagine the case of a child named Aiden Doe (not his real name). Aiden was an incredibly easy baby. He was beautiful and healthy. He did not cry much, but liked to be left in his crib to stare at his mobile. Since he was their first baby, his parents did not notice that he babbled and smiled less than most babies. During his doctor's visits, he was growing and gaining weight. The physician did not note anything amiss. Aiden did begin speaking at 18 months, so that was a relief. What his mom did not realize for a while was that he was not speaking like most children, but repeating things other people or TV characters said. Over time, Aiden became more and more different from his peers. He developed sensory hypersensitivities to noise and textures, and started having temper tantrums. His mother took him to the doctor, but during his visit he played happily with the otoscope and sang songs, so the physician did not get to see anything unusual. The next couple of visits he had ear infections and strep throat, so he just clung to his mother like all children do when they are sick. So again,the pediatrician could not see anything of concern.

“He's just a boy,” or “He'll grow out of it” said Aiden's relatives. Aiden's parents tried him in the best preschool they could afford. Preschool was a nightmare for Aiden. He became so stressed he withdrew to the train corner and screamed when anyone touched him. He was soon expelled for hitting other children who tried to touch 'his' trains. Mrs. Doe quit her job to stay home with Aiden. Mr. and Mrs. Doe were facing increasing behavior problems at home. Aiden began banging his head on the wall when they tried to stop him from playing with his trains or watching his favorite video. He would spend hours pacing and talking to himself. When he was upset, he rubbed the skin on his lips until it was raw. They could no longer go out to eat or to visit friends without fearing Aiden's meltdowns. “How on earth is he going to be ready for Kindergarten next year?” they began to ask. “Are we just bad parents?” they worried.

Now lets imagine that Dr. Jones gave Mrs. Doe the CSBS to complete before Aiden's 12 month visit. It would have taken Mrs. Doe about 5 minutes to complete the 24 item questionnaire. The CSBS could have picked up on early signs such as less eye contact, delayed communication skills (both language use and gestures), and unusual motor and social behaviors. All of us parents know that a well baby visit lasts about 15 minutes. This is barely enough time for the physician to conduct a physical exam, never mind learn much about the child's development (and lets face it, doctor's visits are hardly the time when your child presents his best self). Unless your child is demonstrating obvious differences during those precious 15 minutes, even a terrific physician can miss important signs of developmental delays.

In this scenario, Dr. Jones would have had data to indicate that there was something unusual about Aiden's development. Dr. Jones could then have referred the Does to a psychologist, speech language pathologist, developmental pediatrician or the public school system's Infants and Toddler's Program. Any of these professionals could have given Aiden a thorough evaluation to determine if he had a significant developmental delay. Each of those professionals would have been able to create an individualized treatment plan just for Aiden. The Does' could have accessed the services they needed to help their son. Aiden could have spent the next four years learning the skills he would need to cope with the world. His parents could have learned how to manage his behavior and soothe him.  When it was time for Kindergarten, the family would have had a team of professionals in the public school system (or private, as appropriate) who were designated to meet Aiden's needs so that he could make progress. Best of all, the Does could have escaped the misery of not knowing how to help their little one.

Since 2007, the American Academy of Pediatrics has recommended that physicians screen for Autism and other developmental delays at 18 and 24 months. With this new tool, physicians can gather information that may identify up to 75% of children with developmental delays at 12 months. It is not the standard of care anymore for a pediatrician to simply 'eye-ball' a child and ask a few questions--particularly when there are such high quality, easy to use screening tools. I encourage all of the parents who read this to ask your pediatrician to use objective screening devices. Children with disabilities need to be identified as early as possible! The CSBS can be downloaded for free from this website:
http://www.brookespublishing.com/store/books/wetherby-csbsdp/checklist.htm. If your doctor does not already use it, you can bring it in yourself.

Your Child’s IQ Score: How to Prepare for Your Child’s Intelligence Test

Sep 22, 2009 - 8 comments
Tags:

IQ

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intelligence

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testing



Your Child’s IQ Score: How to Prepare for Your Child’s Intelligence Test

There are many reasons parents seek an evaluation of their child’s intellectual functioning, which we commonly call ‘IQ’ testing. Aside from an evaluation to diagnose learning problems, parents seek IQ testing for school admission or entry into a ‘gifted and talented’ program. No matter what the reason, having an IQ test done can be anxiety provoking for both parent and child. It is easy to lose perspective on what the IQ test actually does, and what the scores actually mean.

Across the world, people have broad interpretations of what it means to be intelligent. Many people interpret having a higher IQ with all sorts of positive outcomes, such as high achievement in school, prestigious careers, or upward mobility in society. Psychologists use IQ tests as tools to measure an abstract concept known as ‘G’, which may be broadly defined as the ability to solve problems. IQ tests typically assess abilities including: abstract reasoning, language functioning, processing speed, visual-spatial reasoning and a person’s knowledge base. How well a child does on various types of tasks shows a pattern of strengths and weaknesses that can be extremely useful in helping him succeed. It is important to note that an IQ test does not measure qualities such as talent, determination, or creativity. These latter qualities tend to be every bit as important in determining a person’s quality of life as his intelligence. Keep in mind that getting a number score from an IQ test does not change who he is or what he can do well.

There has been a recent surge in companies who sell IQ test ‘preparation’ to anxious parents. People sell materials taken from IQ tests, or sell ‘tutoring’ that they promise will raise children’s scores. These individuals exploit parent’s natural desire to do what is best for their children. What many parents do not know is that individuals are providing and illegal and unethical services. They are teaching children to cheat. IQ tests are kept highly confidential because they are critical tools in making diagnoses. Psychologists and Neuropsychologists need them to make important diagnoses such as learning disabilities, traumatic brain injury, or to measure the impact of degenerative illnesses. That is why all IQ tests are copyrighted, making it illegal to expose the content.  Licensed psychologists are bound by an ethical code, as well as copyright laws, to protect the content of the tests. A psychologist who offers to ‘help’ your child score higher or share test materials should be reported to the state licensing board. Anyone who would act unethically or illegally is not someone you want interacting with your child. Unfortunately, there are unlicensed people who have access to IQ tests, so it is important to check credentials. Aside from the fact that these people are acting illegally, the services they provide are not likely to raise scores as their advertisements claim.

It may seem strange that IQ preparation would not be a good thing, since we encourage our children to study for tests all the time. IQ tests are different. They are designed to present people with unfamiliar types of problems to see how well they adapt. Consequently, even if a child has been exposed to the test materials or taught to practice similar types of problems, there is usually not a significant increase in the child’s scores. Even if a test preparations program did raise the scores a bit, the resulting IQ test data would be contaminated and useless. Some parents may feel it is worth a bit of cheating to get a child into a special school or program. They may believe that this will give their child the best opportunity. However, there are negative consequences of inflating a child’s scores. Placing a child in an academic program that is not a good match for him is not kindness. It makes no more sense than putting him in a super competitive soccer team if he did not have the ability to make the team on his own. If there is not a good match between the child and the program, the child is likely to be overwhelmed, and to feel bad about himself because he can to keep up with his friends.

So how should you help your child get ready for an IQ test? You should start during infancy by talking to him and playing with him. As he grows, consider each day a chance to learn something new. The sorts of activities that will truly prepare a child for IQ testing include: puzzles, reading, building blocks, solving riddles, going to museums, and enrichment classes (anything from art and computer classes to music lessons). Most products that promise to improve your child’s IQ are only entertainment. This includes baby videos that promise to make your little one smarter, ‘learning’ toys, television programs, and computer software. Research has shown that these are no substitute for the kinds of real-life activities that will foster your child’s problem solving abilities.

Finally, when you are ready to schedule the testing, prepare your child by lowering his stress level. Find a licensed psychologist who has a good reputation for ethical practice. Find someone who specializes in children, who can help your child feel comfortable during testing. Have the child tested on a weekday morning, when he is at his most alert. Do not be tempted to make an appointment in the afternoon, evening, or on the weekend. These are times when your child has less energy. Avoid offering your child a reward or prize for earning a certain score. If a child is worrying about not getting a prize or disappointing you, he can not concentrate on the test. A good night sleep and a healthy breakfast have a big impact on test performance. Finally, relax. If you are worried about the test, you will only make your child nervous. Praise his effort (IQ tests are tiring!) and take him out to lunch afterward for a job well done.