FYI
Nowell Neuropsychological Services, Inc. - David D. Nowell, Ph.D.
FYI

Marry Well and Get a Crackerjack Assistant at Work

To Love and to Work
Sigmund Freud suggested that in order to be happy, adults need “lieben und arbeiten” – to love and to work! And that’s exactly where adults with ADD/ADHD may have their greatest challenges.   

Because ADHD may have its biggest impact in "love and work," I often recommend  that adults with the condition "marry well and get a crackerjack assistant at work."  And what follows is the content I will share tonight with a Boston area ADHD support group

Ongoing Changes in DSM Revision Process

As reported inNatureon Wednesday, then CBSand other outlets yesterday, some important decisions have been made towards shaping what will become our next standard diagnostic manual, the DSM-5.  

Specifically, "attenuated psychosis syndrome" and "mixed anxiety/depression disorder" have been excluded from that revision.  DSM panel members report that despite possible clinical utility of these categories, there appears to be a lack of empirical support.

Many of my colleagues and

Please stop saying "The prefrontal cortex is the CEO of the human brain"

Well they did it again.  They referred to the prefrontal cortex as the"CEO" of the brain.  Makes me crazy, it's a pet peeve of mine.  Someonedid it here, too.  Andhere.

The reason this irritates me is that the CEO metaphor completely misses the point and purpose of brain-based executive functioning.  The Chief Executive Officer's role in an organization is to say things like "Steve do you have that 2nd quarter report?"  and "Let's ship out 20% more tablets to the Asian market this fiscal year.

Q: How can we ask for what we want?

A journalist prepping a story for Woman's World magazine put out this query: 

Looking for expert tips on how readers can effectively ask for what they want while at the same time, feel good about themselves.

And here's my response to her query:

Each of us would do well - for ourselves and those around us - to determine what exactly it is that wewant. Not superficial wants but deep-down desires.  I suggest to workshop attendees that each of us is here on the planet to do and be and have and share .

Quick! Can you tell me in less than a minute how to do risk assessment?

Questions for Clinicians: 

  • Can you quickly identify who is at greater risk for self harm, and what life stressors increase that risk?  
  • Can you document your clinical decision making so that if (heaven forbid) you had to defend that decision weeks or months later, you would feel confident in that documentation?
  • .....and could you tell students and trainees in less than a minute how todorisk assessment?


If you're a mental health clinician and you'd like to be even more confident responding to  these types of questions, I'd recommend my upcoming workshop

What I learned from Dr Kevin Murphy at last night's inaugural meeting of the Central Mass CHADD Adult ADHD Support Group

A big thank-you toJenna Knight  for organizing last night's inaugural meeting of the Central Mass CHADDAdult ADHD Support Group!

I think the Worcester Library is going to be a great location for the group - it was easy to find, not too far from I-290, and has easy-peasey free parking. 

A highlight of last night's meeting for me was learning fromDr Kevin Murphysome practical approaches to workplace support for adults with ADHD. He suggests an approach which is client-specific and seeks a win-win with employers and employees.

Concussion in the News: Boston Bruins' Nathan Horton Removed from Play

Boston Bruins forward Nathan Horton was taken out of play for the remainder of the 2011 Stanley Cup series after sustaining head injury during game three. (Aaron Rome received afour-game suspensionfor that hit).
 
At least some reports described Horton asvisitingthe locker room after that hit, suggesting that a duration of loss of consciousness consistent with mild traumatic brain injury (TBI).

More recently, Horton sustainedanother blowto the head on January 22.  Since that event, e has been noted to report fogginess and headaches which are part of the post-concussive syndrome which may follow mild TBI.

What recommendations might follow a neuropsychological evaluation for attentional or learning problems?

Earlier this week I blogged about a practical alternative which I regularly offer to individuals and families who have questions about ADHD and related disorders, but aren't sure they're ready to spring for a full neuropsychological evaluation.  The next post here at this blog was a consideration ofhow to determine when such evaluationis in fact right for you or your family member.

So what happens after a neuropsychological evaluation?  After all the testing and scoring and writing up the results.

So when would it be recommended to have a complete neuropsychological assessment?

Yesterday I blogged about apractical alternativewhich I regularly offer to individuals and families who have questions about ADHD and related disorders, but aren't sure they're ready to spring for a full neuropsychological evaluation.  A neuropsychological evaluation requires a greater commitment of time than a briefer office consultation. Another concern here is the considerable expense of neuropsychological evaluation. 



So howdowe make this determination, To Test or Not to Test

The ADHD Q&A Consultation: A Brief Alternative to Full Neuropsychological Evaluation

The too-brief (and all-too-common) evaluation

I'm often dismayed to hear that children or adults receive an ADHD diagnosis after brief office visits or cursory review of checklists.

While there is no objective "test" for ADD/ADHD, arobustclinical evaluation includes:

  • an interview,
     
  • a thorough history,
     
  • behavior observations,
     
  • review of pertinent medical records, 
     
  • collateral report (interview with a roommate, spouse, parent, or teacher), and

  • (at least in my own evaluations) assessment of general cognitive functioning, academics, receptive and expressive language, memory, attention, vigilance, and executive functioning.