OUR SERVICES
Neurodevelopmental Evaluation Services
VCARDD and its trusted consultants provide multidisciplinary, comprehensive evaluations for children and adolescents who are suspected of having Autism or other neurodevelopmental disorders as defined by the DSM 5©. This service is designed to meet the needs of individuals who have not been previously diagnosed, or for those who wish to have a previously diagnosed neurodevelopmental disorder re-evaluated. We go beyond diagnosis to offer management and supportive services for patients, parents, other caregivers and social agencies.
Early diagnosis leads to early intervention, which in turn leads to better outcomes. The effective treatment of neurodevelopmental disabilities has and always will encompass incorporating the best modalities from many disciplines. No single discipline has “all the answers.” Each evaluation is tailored the individual patient’s needs- there is no set process in this office.
Comprehensive Behavioral Intervention for Tics (CBIT)
In addition to Evaluation Services, we provide treatment for Tourette Syndrome and Tic Disorders. For more information on this service, see this Web site: https://www.tourette.org/research-medical/cbit-overview/.
What is the evaluation process?
- The first appointment in the evaluation process begins with a review of concerns by a health care professional. During this visit, written histories are completed and all pertinent records reviewed. A physical and/or neurological examination is conducted, and appropriate tests and consultations are ordered. A follow up appointment is scheduled.
- At the second appointment, reports received to date are reviewed. More in depth testing may be ordered.
- At a third appointment, a diagnosis is made (or deferred) and a treatment plan is outlined in a comprehensive report. Distribution of the report is at the discretion of the recipient. A follow up appointment is made usually within one to three months.
- Ongoing management (or support) appointments occur a minimum of one to twelve months after the last evaluative appointment.
Evaluation Tests or Instruments
A variety of diagnostic tests or measures are used when assessing neurodevelopmental disorders. These tests depend on the age, developmental level, and communication skills of the patient. Neuroimaging, neurophysiologic and neurogenetic testing may include standard MRI, sleep deprived EEG and/or cytogenetic studies. Neuropsychological testing typically assesses intellectual skills, academic skills, speech and language skills, motor coordination skills, and Neurocognitive skills. In addition, rating scales completed by parents/guardians, teachers, and if appropriate, an adolescent or the patient him/herself may be employed.
Testing is for your family’s benefit and you will be provided with valuable resources at the session and in the accompanying report that you will receive at your next appointment with Dr. David. Children’s Neurological Services contracts with several professionals to deliver the testing. Their time is limited, and it may be a few weeks to a few months before testing can be scheduled. Therefore, it is VERY IMPORTANT that you attend the session when scheduled.
Vineland Developmental Screening
The Vineland Adaptive Behavior Scales measures adaptive behavior. At VCARDD, a parent or primary caregiver is interviewed by a professional who completes the assessment. Typically, the professional will see the child for a short period of time, and then the majority of time is spent with the parent/caregiver in the interview. It is helpful if the child either waits in the waiting room (with someone else if s/he will not wait quietly or is very young), or the child is taken home by another adult. This interview typically runs from an hour to an hour-and-a-half. In addition, the professional will offer resources for the family. After the assessment, an appointment is made with Dr. David to read the results and make further recommendations. There is typically a month in between the appointments. This assessment is covered by most insurance policies and it is necessary that the child’s insurance card is brought to the appointment.
Test of Pragmatic Language
The Test of Pragmatic Language – 2nd Edition (TOPL2) is a 30- to 60-minute assessment that is run directly with the child. The parent/caregiver may or may not be in the room, usually depending on the child’s age. This assessment is covered by most insurance polices and it is necessary that the child’s insurance card is brought to the appointment.
Autism Testing
Autism testing in this office typically consists of the Autism Diagnostic Observation Schedule (ADOS), a 40- to 60-minute assessment that is run directly with the child. The parent/caregiver may or may not be in the room, depending on the child’s level of speech. The rest of the appointment will include other assessments that are either self-completed or completed via interview. We do not accept insurance for this assessment. Payment in full will be collected on the date of the assessment.
Educational Evaluation
The Woodcock-Johnson® IV Tests of Achievement (WJ IV™ ACH) -A Comprehensive set of individually administered, norm referenced tests for measuring academic achievement. We do not accept insurance for this assessment. Payment in full will be collected on the date of the assessments.
Scheduling and Further Questions
If you suspect that you, your child or adolescent may have a Neurodevelopmental or Autism Spectrum Disorder and would like to schedule an initial insurance-covered appointment, please contact Children's Neurological Services (Affiliated with and a Subsidiary of Virginia Child Neurology P. C.) at (804) 673-9600. These evaluations are complex, and are individualized to each patient’s needs- there is no “cookie-cutter” workup. It will be difficult for our support staff to answer many of your questions. Make a written list for discussion at your first appointment. Again, we will tailor our evaluation and management process to your individual situation.
