Attention Clinic
What is attention? Are there different types of attention? Why are some people able to work in chaos while others need silence to focus? What is an "attention deficit" : does it mean one has less attention than others? If so, how can one compensate for this? Is there anything else besides medication?
Not sure if you want / need a neuropsychological evaluation?
Schedule an initial in-person consultation, a 2 hours appointment during which Dr Gagnon will conduct a thorough interview and basic cognitive screening, as necessary. Based on this initial assessment, a neuropsychological assessment will be recommended or not (see above). You may also receive suggestions and recommendations or a brief educational session, depending on the initial findings and clinical impressions.
Adults
This is the usual process for the evaluations of adults
- Session 1 (2 hours) = Clinical interview. 2 hours. Arrive early to fill out the consent forms and be prepared to fill out questionnaires after our meeting – I am trying to get to know you as best and quick as I can.
- Session 2 and 3 (usually 2 hours each. ideally, 1 week apart) = Neuropsychological Evaluation. 4-6 hours. Tests of attention, memory, language, reasoning, etc. We are trying to understand how you process information.
- Preparing a report (5 hours). This includes scoring the tests and questionnaires, interpret them, conceptualize the case, etc. During this process, I will review all clinical and psychometric information to write the report. This takes 5 hours. I look at all the questionnaires, all the tests, all the symptoms you have reported and I try to find patterns, explanations and solutions. Then I prepare a report for you and your Physician. You will get a PDF copy of the report by email.
- Session 4 (1 hour) = Feedback session. 1 hour. I give you my impressions and hypothesis about the Diagnosis, or we talk about the diagnosis. Discussion about the diagnosis can also be discussed again during the intervention phase. It is often beneficial for the patient to take the time to integrate all this information. Its also helpful to think about solutions for the problem and start the intervention after the diagnosis. I offer cognitive remediation for adult with ADHD, to improve functioning. This could be used with or without medication. The medication has to be prescribed and controlled by your family doctor. He is the one who knows best about your physical health.
Do you wonder if your have ADHD...?
These symptoms look just like you? Just like your loved one? Teachers says your child might have ADHD?
Great news : here is an opening for growth so don’t be lazy: hasty conclusions are too easy. Many neuropsychological disorders will look like ADHD, in child and in adults. Many psychological disorders will look like ADHD, in child and in adults. Even challenges with relationships can make you wonder about ADHD. Understandably. Because there are a xillion reasons why one can exert a certain set of “symptoms”. Is it dyslexia, intellectual giftedness, memory impairment, depression, adjustment disorder, non verbal syndrome, asperger, visual agnosia, a visual spatial learning style, or ADD / ADHD…how will you know?
Some authors will say “ADHD does not exist”.
Others will blame the “over-diagnosis of ADHD in adults”
Both positions highlight that “ADHD” can actually be many other things! This diagnosis should be one of exclusion: a professional has to rule out all other possible causes for inattention, impulsivity or disorganization, before jumping to conclusions. For a valid diagnosis, all other probable causes should be assessed and ruled out. This means assessing attention, intellect, language, memory, mood and so forth. Without proceeding to careful evaluation, we might over-diagnose ADHD – like we currently do.
So now what do I do?
Ask a neuropsychologist. Take the time to do this process of discovering yourself / your child. Take the time to evaluate all the options and see what really makes you think you/your child have ADHD? In short, what’s bugging you? Is it interfering with your functioning? How? Be ready to ask yourself questions and keep an open mind for the answers.
Ask your Family Doctor for a reference.
You have 2 options: public or private.
Find one in the public system? Nowadays, there are very little neuropsychologist in the public system. Most will only work with complex cases and do not accept reference from the general population. Try your luck and ask your doctor. But also be ready for option 2.
Go private? Just like going to the dentists: it can get a bit expensive, but its worth it. Services are covered by most insurance package (under “psychologist”).
Here is how to find a neuropsychologist, the only professionals that can asses and diagnose neuropsychological disorders (bill 21) https://www.ordrepsy.qc.ca/web/ordre-des-psychologues-du-quebec/trouver-de-aide
One last thought: ADHD is hardly diagnosed in a 15-45 min consultation. Its an exclusion diagnosis. We have to look at other options or else we might miss the point and never really address the problem with the right interventions.
Children, adolescents and students
For the evaluations of children, adolescents and young students, the process is often more detailed.
- Clinical interview. 1 to 2 hours. Usually involves the parents and the child. Arrive early to fill out the consent forms. Be prepared to fill out questionnaires after our meeting - there will be questionnaires for the child, the parents and the teacher. You can return them by email or at the next visits.
- Neuropsychological Evaluation lasts between 4 to 7 hours. The length depends on the complexity - duration of the evaluation is hard to predict. Some work faster than others. Some need more support and encouragements to complete tasks. Some need more detailed evaluation than other. For students of all ages, a throughout evaluation is very important in order to identify precisely what is going on. Misdiagnosed or undiagnosed conditions may have long term effect on someone's ability to study and/or the person's mood.
- Because children and young adults are still studying, a full assessment is essential, along with tests of attention, memory, language, reasoning, etc. We are trying to understand how you process information. Also, academic achievement has to be evaluated. I will need a copy of the report cards and I also like to send questionnaires to the teacher. Its important to get an idea of the person's functioning in many different environments (home, school, work, hobbies, etc).
- Scoring the results. I look at all the questionnaires, all the tests, all the symptoms you have reported and I try to find patterns, explanations and solutions. Then I prepare a report with all the results and recommendations for home and for school. This process takes approx 4 hours but can take longer in complex cases or if report include more explanations of the findings, a teaching section and more strategies.
- Feedback session. 1 hour. We discuss the hypothesis concerning the diagnosis and I make some recommendations.
- Follow sessions of coaching are also available. NOTE : I recommend at least one follow up session, one month after the diagnosis. To see how its been integrated at home and in school. Its sometimes hard to make a real change at home and in school : most parents and students need help, even after the diagnosis and recommendation.
- if needed, some medication has to be prescribed and controlled by your family physician. He is the one who knows best about your physical health. Take an appointment and bring a copy of your report with you.