Core Evaluations
A list of our core evaluations are below. However, we still customize each evaluation to fit the individual. Check out our intake process.
Autism
A serious developmental disorder that impairs the ability to communicate and interact.
What is Autism?
Autism is a spectrum of closely-related disorders with a shared core of symptoms. Every individual on the autism spectrum has problems to some degree with social skills, communication, empathy, social relatedness, restricted activities, and flexible behavior. However, the level of disability and the combination of symptoms varies widely from individual to individual. For example, two children with an autism spectrum disorder may look very different in regard to their behavior and abilities. Further, just because a child has a few autism symptoms may not mean the child has an autism spectrum disorder.
In order for AIM to make a diagnosis of an autism spectrum disorder, it is necessary to demonstrate the following three key areas:
Communication
Relationships
Behavior
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The child exhibits deficits in social communication and social interaction as evidenced by: (1) persistent failure of the child to engage in normal back and forth conversation with others through reduced sharing of interests or emotions or, (2) complete withdrawal from interacting with others.
Nonverbal The student must also demonstrate deficits in nonverbal social communicative behaviors either by:
• Abnormalities in eye contact or body language.
• Deficits in the understanding and use of nonverbal communication such as facial expressions or gestures, or
• Total lack of any facial expression.
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In addition, the student must also demonstrate deficits in developing and maintaining relationships, appropriate to the child’s development level, as evidenced by difficulties adjusting behavior to suit different social contexts. This can be seen in a child’s difficulty in sharing imaginative play and making friends or an apparent lack of interest in people.
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Finally, the student has to demonstrate at least two symptoms of restricted, repetitive behaviors or interests:
• Repetitive motor movements or stereotyped use of objects or speech• Inflexible adherence to routines or ritualized patterns of verbal or nonverbal behavior
• Highly fixated interests that are abnormal in intensity or focus
• Hyper- or hypo-reactivity to sensory input or unusual interest in sensory aspects of the environment
These symptoms are manifest in the early developmental period but may not become evident until the social demands of school exceed the child’s capacity to relate to others.
AIM uses a variety of measures to assess for Autism spectrum disorder (ASD).:
The child is observed in school in both structured and unstructured settings.
The child’s speech and language abilities are assessed.
Measures of cognitive and achievement are administered.
Information on the child’s early history is obtained from the parent along with parent reports of current behavior.
Information is also obtained from teachers about the child’s behavior in school.
Data is also gathered from school and private records along with reports provided by other relevant informants.
Psychological screenings with the parent, teacher, and possibly the child are conducted using the Behavior Assessment System for Children-3 (BASC-3). Instruments specific to ASD include:
The Autism Spectrum Rating Scales (ASRS)
The Childhood Autism Rating Scales-2 (CARS-2)
The Autism Diagnostic Observation Schedule-2 (ADOS-2)
The Gilliam Asperger Disorder Scale (GADS)
The Gilliam Autism Rating Scale-3 (GARS-3)
The Autism Diagnostic Interview-2 (ADI-2)
No one measure is used to establish a diagnosis of ASD. Instead, the evaluators look for data consistent with ASD that occurs across (1) several instruments and several contexts and (2) information provided by parents, teachers, and private practitioners which supports an ASD diagnosis.
Dyslexia
A learning disorder characterized by difficulty reading.
What is Dyslexia?
Dyslexia is a type of reading disability that typically manifests in one or all of the following characteristics: difficulty reading words in isolation, difficulty accurately decoding unfamiliar words, difficulty with oral reading (slow, inaccurate, or labored) and difficulty with spelling.
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The exact cause is unknown but these reading difficulties are commonly associated with specific cognitive weaknesses. These include: phonemic awareness, phonological memory, and rapid automatic naming.
A student with dyslexia typically has evenly developed skills in most other cognitive and academic areas, so weaknesses related to reading are unexpected. Current research suggests that students with dyslexia attempt to process reading in Broca’s area alone, instead of synchronizing with Wernicke’s area and the occipital lobe.
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The consequences of dyslexia are far-reaching and include:
• Possible difficulties with reading comprehension
• Written expression
• Math calculations
Depending on the nature and severity of the cognitive weaknesses, listening comprehension can also be impacted. To accurately determine whether a student’s reading difficulties are related to dyslexia, a thorough evaluation is needed that looks at each piece of the academic and cognitive processes mentioned above.
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At times, what initially seems like dyslexia to parents and teachers may actually be another type of disability, an instructional issue, a medical issue, or even an environmental issue.
ADHD
A chronic condition including attention difficulty, hyperactivity, and impulsiveness.
What is ADHD?
We often hear people talking about “attention deficit” or “ADD” or “hyper” when the issue of attention or focus comes up. ADHD is the official label we use for such issues. The acronym stands for Attention-Deficit/Hyperactivity Disorder and this disorder comes in a couple of variations. An individual might have ADHD that is characterized by inattention only, by hyperactivity and impulsivity only, or a combination of all of the above. All of these “flavors” of ADHD come in mild, moderate or severe form.
Different Categories
The different ways ADHD presents are probably best understood by thinking about two different categories. In the first category we have a set of behaviors that happen because the child or adult doesn’t respond to what’s happening around them. Perhaps they do respond but it’s a response that is milder or less frequent than the demands on them would require. In the second category we have issues that arise because of a behavior they do or a response they demonstrate to a stimulus. Basically, one set of behaviors arise from not doing something and another set of behaviors that arise from doing something.
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The first category – not doing something – is often referred to as “inattention.” This looks somewhat different from person to person and from setting to setting but there are some common characteristics that tie it all together. Individuals with inattention often “tune out” when “tuning in” is a requirement for the task or setting. They daydream in class or on the job. They are easily distracted. They don’t follow all the steps in directions or forget what they were just told. Individuals with inattention make careless mistakes in work and miss important details. They struggle to stay focused on lectures, or reading, or even conversations. They are described as forgetful and disorganized. These folks turn in late work or lose it altogether. They lose their keys, socks, backpack, phone, calendar, glasses, etc. They also lose track of time, often being late for appointments
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The second category – people who do things that trip themselves up – are often referred to as being “hyperactive” or “impulsive” or both. These two concepts really are difficulty to differentiate. These are the fidgeters, the wigglers, the blurters, the tappers, the squirmers, the interrupters, the wanderers, and the talkers. They are often described as constantly “on the go” or “driven by a motor.” Their behavior distracts them and others and is often a cause of interpersonal conflict because they can be seen as bothersome or annoying.
Characteristics
A lot of the symptoms above can come along with other disorders or issues making it important to talk to a professional to help sort out the differences. A diagnosis of ADHD requires that a certain number of characteristics be present before the age of 12, that the symptoms clearly impair the person in their pursuit of a job or education and that they can’t primarily be contributed to another disorder. The symptoms also have to occur in multiple settings, like home and work or school. A person with ADHD would not exhibit symptoms in only one setting, which would more likely be an environmental issue.
Note:
ADHD is a very misunderstood disorder. It’s complicated and frankly, often messy. In the past it’s probably been overused as a way to categorize or understand a set of problematic behaviors that don’t cleanly fit into any other category. It’s gotten a bad rap and some people still think it’s being used as an excuse or a crutch.
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It’s important that we don’t make ADHD synonymous with BAD. Individuals with ADHD have much less control over the symptoms they demonstrate than we think they do. Telling a person suffering from ADHD Inattentive Type to “focus” is about as helpful as telling someone to “get taller.” If ADHD has been well diagnosed, that is if we haven’t incorrectly identified some other problem as ADHD, we can assume that most of the symptoms they are demonstrating are biologically driven. The kids who have been identified as having ADHD Impulsive and Hyperactive are like cars that only have a gas pedal and no brake.
About half of people who have a diagnosis of ADHD have a co-occurring condition. The best way to determine if the issues at hand really are ADHD or something else that can masquerade as ADHD is through an evaluation. Many, many disorders have symptoms that overlap with ADHD but the cause, treatment and prognosis of the other conditions can vary greatly. In addition to the external characteristics of ADHD, there are common cognitive profiles found in students with ADHD that can only be identified through psychological testing.
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When we look at all of the negative or difficult things that come with ADHD, we lose sight of the positives that come with it as well. Children and adults with ADHD are often charismatic, charming, engaging and affectionate people. They can be quite creative, inventive, imaginative and talented with their hands. With proper treatment and in the right setting, they can use these gifts to excel and succeed in the school or work setting.
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ADHD is a condition that can impair a child’s performance in school. If the impairment is significant, the student might qualify for additional support in the school setting. In the state of Texas, ADHD is considered a “health” issue and as such might be the basis for a 504 accommodation plan or special education eligibility based on an “Other Health Impairment.” The degree to which the ADHD impacts learning and education determines the options for support or services in school.
Intellectual Disability
Below average intelligence and set of life skills present. Features of Intellectual Disability:
Significantly sub-average general intellectual functioning, accompanied by…
Significant limitations in adaptive functioning in at least two of the following skill areas: communication, self-care, home living, social/interpersonal skills, use of community resources, self-direction, functional academic skills, work leisure, health, and safety
Onset during the developmental period.
No specific personality and behavioral features are uniquely associated with Intellectual Disability. Some individuals with Intellectual Disability are passive, placid, and dependent, whereas others can be aggressive and impulsive.
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No specific personality and behavioral features are uniquely associated with Intellectual Disability. Some individuals with Intellectual Disability are passive, placid, and dependent, whereas others can be aggressive and impulsive. Behavioral symptoms sometimes seen in Intellectual Disability include dependency, low frustration tolerance, and poor impulse control. The course of Intellectual Disability is variable: with good environmental influences, functioning may improve; with poor environmental influences it may deteriorate.
People with Intellectual Disability are particularly vulnerable to exploitation by others, such as being physically or sexually abused or being denied rights and opportunities.
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Individuals with mild Intellectual Disability often are not distinguishable from children without Intellectual Disability until a later age. There are difficulties in learning academic skills (reading, writing, math) with support needed to complete conceptual (cognitive and academic) tasks. During the adult years, these individuals usually achieve social and vocational skills adequate for minimum self-support, but may need supervision, guidance, and assistance, especially when under unusual social or economic stress. There is a somewhat concrete approach to problems and solutions when compared to age mates.
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Based on new research in the field of intelligence, it should be noted that intelligence or cognition is a complex system and not all parts are equally important to overall system functioning. The degree to which an impaired cognitive ability lowers the functioning of the whole system depends on the affected ability’s centrality (relative importance to overall system functioning). In some cases, a student will have deficits in only some areas of cognitive functioning, but those areas lower the functioning of the whole system, despite having some cognitive skills above this range.
In other words, a student with an Intellectual Disability does not always have sub-average intellectual functioning in all areas of cognitive functioning.
Speech Therapy Evaluations
In our private clinic, AIM can cover all your speech and language evaluation needs.
Receptive and Expressive Language
Pragmatic Language
Articulation
Fluency and Voice
Learning Disability
Learning disabilities are generally defined as deficits in specific areas of reading, writing, and math that are caused by cognitive deficits related to those areas.
How to determine if someone has a learning disability?
To determine whether a student has a learning disability, a thorough evaluation of the student’s personal academic and cognitive strengths and weaknesses must be completed.
What else needs to be considered?
In addition to this evaluation, information about the child’s development and health history, performance in school, and strategies used to remediate academic difficulties are all included.
In the school world, learning disabilities are defined in one of the following areas:
Basic Reading
Reading Comprehension
Reading Fluency
Math Calculation
Math Problem Solving
Written Expression
Oral Expression
Listening Comprehension
At AIM, all of our evaluators have worked, and in some cases continue to work, in the school setting where we have helped students, families, and schools understand what it means to have a learning disability. Sometimes that means explaining what a learning disability is not, which includes such difficulties as:
Physical or medical conditions
Autism
Developmental delays
Intellectual disabilities
Low intelligence
Emotional or behavioral disorders
Environmental challenges
Cultural or language differences
Motor difficulties
Hearing or vision impairments
One of our specialties is determining the difference between a true learning disability and one of the other potential causes of academic difficulties, as mentioned above. Because of our experience and expertise in this area, schools typically accept our evaluations in lieu of requesting a school evaluation, which saves time for parents, students, and schools as well.
In addition to evaluations geared toward schools, we also provide evaluations that follow the Diagnostic and Statistical Manual’s broader definition of learning disorders.