If you have concerns about your child’s development, or suspect that something is not “right,” you might consider completing an evaluation. All children have some difficulties to some degree, but difficulties that significantly impact a child’s daily living might be a sign that something more is going on. Some of these signs might include failing grades, getting in trouble in school, difficulties making and maintaining friendships, trouble understanding others or expressing one’s self, and difficulties in other community settings. If you have concerns about your child’s development, one of our providers can assist you in determining if an evaluation might be appropriate.
Not using language, or having very limited language, at age two does raise some cause for concern. We do recommend speech and language testing to identify a child’s current levels of language functioning, which allows the speech and language pathologist to develop individualized goals for the child based on the child’s strengths and areas of need. If there are other concerns in addition to language development, testing for autism spectrum disorder might also be recommended. Our psychologists are happy to provide phone consultation with you to best make this decision. Some additional concerns that may lead us to recommend further testing for autism include: difficulties engaging with other children or preferring to play alone, limited use of gestures (waving hi and bye, nodding and shaking head, pointing, etc.), limited play skills, repetitive behaviors (such as banging or lining up items), unusual motor mannerisms, or sensory concerns (under or over-reaction to sounds, smells, touch, etc.). Often times, we conduct joint speech/language and psychological evaluations for our young patients, which allows us to gain a more comprehensive understanding of the child’s functioning and allows for consultation across disciplines to ensure appropriate diagnoses and treatment.
Children are gifted when their ability is significantly above the norm for their age. At Gentry PBS, we assess for giftedness with the Stanford Binet, 5th Edition (SB-5), which is a measure of intellectual functioning. The SB-5 is a one-on-one, direct assessment administered with the child that yields standard scores regarding the child’s verbal, nonverbal, and quantitative reasoning skills. This information can be used to help with educational planning or decision making.
Prior to the testing appointment, please make sure your child gets an adequate night’s sleep, and make sure your child eats a good breakfast on the day of testing. Make sure to bring your child’s glasses, hearing aid, or any other prescribed device they use. If your child is prescribed psychotropic medication, check with the psychologist and the prescribing physician beforehand to coordinate dosage and administration time, or plan to administer medication as normally prescribed. If your child has had school testing, an individual education plan (IEP), or has related medical records or other previous evaluations, please send copies or bring these records to the intake session. The appointment length varies depending on the type of testing being completed, as well as the child’s age and behavior. Parents are not typically in the room during testing (aside from some assessments for our toddler-age patients)
Applied Behavior Analysis (ABA) therapy is the scientifically based treatment method used to create meaningful behavior change. The purpose of ABA is to increase behaviors that are helpful (i.e., communication) and decrease behaviors that are harmful or affect learning (i.e., tantrum). ABA treatment programs vary in their intensity and duration and are designed specifically around the child’s and family's needs. ABA is a research-based treatment method used for children with autism, however it is also a successful approach to addressing all behavior concerns in children. For more information about ABA and what we offer at Gentry PBS, please click here.
ABA therapy can be paid through private insurance if your child has a diagnosis of an autism spectrum disorder. Some parents also choose to pay privately or use funds from ESA. Please call the office for more information or if you have any specific questions.
We work with individuals up to 17 years of age. Please call the main office line if you are interested in a referral for an adult therapist. Note: in some cases, we may evaluate older individuals up to age 21, when an intellectual disability or autism spectrum disorder has already been established.
You have a couple of different options if you child is falling behind in school. If your child attends public or charter school, you can look into requesting a psychoeducational evaluation from the school district, which can evaluate for a learning disability within the school setting. Alternatively, you can also obtain a private evaluation (such as those at Gentry PBS). For these types of concerns, we typically recommend a comprehensive psychoeducational evaluation, which assesses for learning concerns, as well as potential behavioral difficulties that may or may not also be contributing to the problem. Children with learning disorders possess adequate intellectual functioning; however, there is a “disconnect” in one or more areas of reading, writing, and/or math that prevents them from learning as we would expect. An evaluation for a learning disorder involves cognitive/intellectual assessment, as well as assessment of academic achievement, including reading, writing, and math skills. We may also recommend further testing for phonological processing, executive functioning skills, and/or speech and language.
We will also collect information, via parent and teacher rating scales, to determine if any other difficulties, such as attention problems, hyperactivity, anxiety, or depression seem to be occurring at home or at school. A clinical interview with parents helps us gather information to develop the best range of assessments for each individual child. Learning disorders are categorized into three areas: reading, writing, and math. In particular, a common disorder of reading is termed dyslexia, which refers to difficulties with word reading and decoding, phonological processing, reading fluency, and spelling skills.
At Gentry PBS, we offer a variety of options for children who need social communication support. A comprehensive speech and language evaluation are typically recommended prior to treatment. In some instances, we can base our treatment plan from a recent evaluation that was completed by the school or another private practice. During the evaluation, our speech-language pathology team will determine your child’s strengths and weaknesses in receptive and expressive language as well as core social competencies, such as the ability to inference, take another person’s perspective, or read body language. From there, we can make personalized recommendations to help your child develop and practice essential social skills.
For some children, it will be beneficial to start with 1:1 speech and language therapy to establish core vocabulary and introduce the concepts. Additionally, we offer dyads, or pairs of two children who are at a similar age and language level, to work together on social communication goals under the supervision of a speech-language pathologist. For children who are ready for a small group setting, we offer social groups of 4-5 children. These weekly groups are led by a combination of speech-language pathologists, speech-language pathology assistants, and behavior technicians from our ABA teams. We integrate behavioral principles along with social communication strategies to help our children develop appropriate social skills. Within the social groups, we target group goals as well as individualized progress. All of our individual therapy, dyads and group therapy utilize play and a naturalistic setting to help children generalize these skills. We consistently provide parents with feedback and information, so that the terms and techniques can be carried over into the home and school environments.
Executive functions are a set of skills that help individuals achieve a particular goal and facilitate learning. They include many important cognitive processes, such as: planning and prioritizing, organization, task initiation, working memory, self-monitoring, flexibility, impulse control, and time management. Many children present with difficulties in one or more of these areas and can ultimately struggle with behavior, academic skills (e.g., following directions, writing, long-term projects), and social interaction.
The primary goal of speech and language therapy is to optimize each individual's ability to communicate. The executive functions have significant influence on various aspects of a child's language performance. Many challenges with behavior and self-regulation can be addressed through language-based interventions, such as establishing routines. Tailored to each individual's needs, our therapists incorporate executive function concepts into 1:1 speech and language therapy. For example, children can be taught to appropriately utilize timers, visual schedules, planners and reminders. They learn to identify distractions, use flexible thinking, and implement visualization strategies. Our therapists help shape each child's behavior, so that he or she can successfully make a plan, break down the steps, and demonstrate creative problem solving.
There are many similarities between how children and adults experience anxiety and depression, but there are also some differences. Anxiety refers to excessive worry or fear, but it can manifest in many ways. While some children will overtly express to parents things that they are worried about (such as school, or bad things happening), other times anxiety can be more difficult to identify. Children may also have specific types of anxiety in some situations, but not in others. If your child has difficulty separating from one or more parents, does not want to go to school or other places, seems afraid to participate in social situations (such as raising his hand in class, talking in a group, or giving a presentation), or has specific fears (such as fear of the dark to the point that he cannot sleep alone at night), he may be experiencing anxiety. In children, depression commonly presents as frequent periods of irritability (as opposed to prolonged periods of sadness). Depressed children also often experience difficulties with eating or sleeping, appear tired, and seem to have low self-esteem. Sometimes, anxiety or depression occurs secondary to another challenge. For instance, a child with a learning disorder or ADHD may begin to feel anxious or sad about his or her performance in school. It is important that anxiety and depression are identified and properly treated when they begin to impact a child's quality of life.
If your child is having difficulties with behavior in school, further evaluation may be warranted. ADHD is one of the most commonly identified disorders of childhood. Children with ADHD tend to have difficulties sustaining attention and controlling behavior impulses. He may appear overly active, or simply have difficulties with staying seated and raising his hand. Children with ADHD may also forget or lose things, fidget, have difficulties regulating their emotions, talk frequently and interrupt others, make careless mistakes, or have difficulties interacting with peers. A social-emotional/behavioral evaluation can help to determine if there is an underlying diagnosis for your child’s behavior, and provide you with recommendations to address these challenges and help your child be successful at home, at school, and with friends. An evaluation can also help identify strategies for the child’s teacher to use to set the child up for success. Evaluations for ADHD and other behavioral disorders (e.g., oppositional defiance, etc.) include a clinical interview with parents, rating scales for parents and teachers to assess functioning across settings, and direct testing of attention and executive functioning skills. We might also recommend a school observation, or additional testing to rule out learning concerns.
If an evaluation has already been completed, you might also wish to request a Functional Behavior Assessment from the school, which is used to develop a behavior support plan in the school setting.
Our psychologists are contracted with Blue Cross Blue Shield and Cigna. However, some plans have limited networks of providers, so please check with your specific plan to see if our providers are in network. If you have one of these providers, you can also call your insurance company ask about your benefits for psychological testing and therapy (common CPT codes are 90791, 96101, 90837), and if you have a deductible that applies or copay(s). Unfortunately, insurance will not cover the cost of school observations or participation in IEP/school meetings. Additionally, our speech pathology team is contracted with BCBS. If you are out of network, we can provide you with a superbill that you can submit to your insurance company for out-of-network reimbursement. Please contact your insurance company for your out-of-network benefits.
In order to obtain an IEE, you simply need to write a short letter to your school administration and/or Special Education Director stating that you disagree with the school district’s evaluation and are requesting an IEE. You can find sample IEE request letters on the internet if you search for "sample IEE letters." If you are requesting more than one type of IEE (e.g., psychoeducational and speech), you will need to delineate that you are requesting an IEE for both in your letter. Once the district approves your request, which should take no more than 5 days, you simply need to inform them which professional agency you will be using as your IEE provider. Next, just complete our Intake And Consent Forms, which are available on our website, and send them to us. Note: The district is required to provide you with a list of professional IEE providers, however, you do not have to select a provider from that list; you may choose any qualified professional.
Please provide ample notice if changes need to be made to your scheduled appointment. If an appointment is cancelled less than 24 hours in advance, you may be charged a $50 fee.