Autism Center of Excellence's Evaluation Services

CNNH’s treatment approach is to bring together a compassionate multidisciplinary team of experts in neurological, neuropsychological and neurobehavioral care all under one roof. Using the most advanced tools and technology, our experts can provide the most extensive, innovative, and evidenced-based evaluations and treatments which leads to an improved quality of life for children with autism.

CNNH Team of Specialists: Neurologists, Neuropsychologists, behavior specialists, Speech and Language Therapists, Occupational Therapists, Nurse Practitioners, and more…

Comprehensive Neurological Evaluations

The clinical neurological evaluation is an important and essential component of the assessment of individuals with neurological, neurobehavioral or neurodevelopmental symptoms or signs.

Clinical neurological evaluations performed by our expert and board certified staff will assist you in determining:

• if there is an underlying neurological or medical mechanism for you/your child’s symptoms;
• if there are any clinical neurological findings on examination;
• whether additional neurodiagnostic testing (such as MRIs, EEGs, cognitive testing, etc) is necessary;
• to determine if there are medication or non-medication treatment options that may be useful;
• and to demystify the neurological condition in question.

These assessments are comprehensive, and involve a review of our completed medical/neurological history data form; review of other available records; complete physical and neurological examination; discussion concerning our diagnostic impressions and additional recommendations; and a comprehensive written report.

These findings will assist us in determining if there are medication or non-medication treatment options that may be useful and to demystify the neurological condition in question.

Comprehensive Neuropsychology Evaluations

Our neuropsychological services are under the supervision of licensed neuropsychologists, providing an array of evaluation and therapeutic services.

Neuropsychological testing is an assortment of standardized tests that can only be administered by properly trained and certified or supervised personnel, and must be interpreted by a licensed Neuropsychologist. Neuropsychological testing provides a window into how the brain functions, including providing quantitative information about cognitive (intellectual) abilities, memory and motor skills, as well as diagnostic input.

Neuropsychological testing provides a “profile” of a person’s cognitive potential and deficits, which allows for a better understanding of the underlying neurological mechanism for an individual’s concerns, and can greatly assist in creating a pragmatic treatment plan; formulating an educational plan and curriculum; or for monitoring the benefit (or not) of other treatment interventions.

 

Autism Testing Tools

	Autism Diagnostic Observation Schedule (ADOS-G)
	The ADOS is is the "gold standard" tool for assessing and diagnosing autism and pervasive developmental disorder (PDD) across ages, developmental levels, and language skills. It is a standardized series of tasks designed to allow observations of a child’s social and communication skills. Information is obtained regarding a child’s social reciprocity (e.g., participation in reciprocal conversation, shared enjoyment in interaction), social responsiveness, and effectiveness of social overtures, as well as for imagination/creativity, restricted/repetitive interests, nonverbal aspects of communication (e.g., facial expression, gesture, voice intonation), and stereotyped or atypical behavior (e.g., sensory-seeking behavior and stereotyped motor mannerisms such as spinning). The ADOS is used with other information regarding developmental history to determine the absence and/or presence of an Autism Spectrum Disorder.
	Autism Diagnostic Interview - R (ADI-R)
	The Autism Diagnostic Interview-R (ADI) is a semi-structured interview for caregivers of children and adults that provides a thorough assessment of individuals suspected of having autism spectrum disorders. The ADI-R focuses on behavior in three main areas: quality of social interaction (e.g., emotional sharing, offering and seeking comfort, social smiling and responding to other children); communication and language (e.g., stereotyped utterances, pronoun reversal, social usage of language); and repetitive, restricted and stereotyped interests and behavior (e.g., unusual preoccupations, hand and finger mannerisms, unusual sensory interests). A trained interviewer questions a parent or caretaker who is familiar with the developmental history and current behavior of the individual being evaluated. The interview can be used to assess both children and adults, with a mental age above 2 years, 0 months. The measure also includes other items relevant for treatment planning, such as self-injury and over-activity.

The combination of ADI-R and ADOS-G identifies Autism or Pervasive Developmental Disorders, as described in the DSM-IV-TR, most appropriately. Both instruments seem to be of great value in the diagnostic process

Dense Array Electroencephalography (DA-EEG)

At CNNH, we are proud to announce the availability of the latest in non-invasive EEG technology: Dense Array EEG using the Geodesic® EEG System 250 from Electrical Geodesics, Inc. (EGI) Dense Array EEG is an improvement on standard approaches to EEG, as it uses a much larger number of “electrodes” (small saline soaked sponges that are able to record the electrical activity of the brain) so that there is better accuracy and localization of the source of any abnormal electrical activity. EGI has devised an ingenuous way to apply the large number of electrodes (128 in our system) by devising a “net” that can apply the electrodes in minutes. The application is painless, reduces patient anxiety about the test and, therefore, increases compliance. Additionally, the net application does not require the need for sedation, and since there is no abrasion of the scalp as is used with standard EEG, there is a reduced risk of infection. Our EEG technicians have specialized training and experience in the use of dense array apparatus, and strive to create a good experience for patients without the need for sedation. Just as Magnetic Resonance Imagining (MRI) and Computed Tomography (CT) allow a structural image of the brain, Dense Array EEG is a way to electrically “image” the brain, as the electrical information that is gathered is run through a powerful computer that allows the location of the electrical activity to be determined with great accuracy. Recent software advances in this technology now provides for the electrical source to be mapped right on to a MRI. Dense Array EEG has been used for many years for research applications investigating aspects of brain function and mind control, and has been featured on the cover of National Geographic and Newsweek. Dense Array EEG is a useful clinical tool in our office for the detection of electrical abnormalities associated with seizure activity (i.e. Epilepsy,) but also for “subclinical” electrical activity that might be interfering with attention or learning.