Horovitz presents Research on Working Memory in ADHD and ASD

Max Horovitz, Ph.D., presented a guided poster tour of his research regarding working memory in children who have been diagnosed with attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD) or both ADHD and ASD as part of the 6th World Congress on ADHD hosted by the World Federation ADHA, April 20-23, 2017, in Vancouver, Canada.

 Working memory is the thinking skill that focuses on memory-in-action, which is the ability to remember and use relevant information while in the middle of an activity. For example, a child is using working memory as the child recalls the steps of a recipe while cooking a favorite meal.

Children who have trouble with their working memory skills will often have difficulty remembering instructions, recalling rules or completing tasks 

Children who have trouble with their working memory skills will often have difficulty remembering their teachers’ instructions, recalling the rules to a game, or completing other tasks that involve actively calling up important information. There are two types of working memory: auditory memory and visual-spatial memory. Auditory memory records what you’re hearing while visual-spatial memory captures what you’re seeing. Weak working memory skills can affect learning in many different subject areas including reading and math.

 For Keystone, Dr. Max serves as a clinical child psychologist, director of Keystone’s Attention Deficit Hyperactivity Disorder (ADHD) Clinic. Keystone’s Anxiety & Obsessive Compulsive Disorder (OCD) Clinic is a specialty clinic designed to provide evaluation, intervention and medication management for children and adolescents who experience anxiety. The Anxiety & OCD Clinic offers comprehensive assessments to accurately diagnose anxiety disorders. Common diagnoses include separation anxiety, phobias, social anxiety, generalized anxiety disorder, OCD, and selective mutism.

Dr. Max has experience working with individuals diagnosed with intellectual and developmental disabilities, particularly autism spectrum disorder (ASD), and children with attention-deficit/hyperactivity disorder in various capacities across development. He additionally has experience working with children with a wider range of emotional and behavioral needs, including oppositional and defiant behaviors, anxiety, depression, toileting issues, and sleep difficulties.  He currently provides a range of services including developmental, psychoeducational, and diagnostic assessments; individual therapy; parent training and school consultation. Dr. Max also has extensive research experience in the areas of ASD and intellectual disability. Dr. Max received a bachelor’s degree in psychology from the University of Florida. He subsequently obtained master’s and doctoral degrees in clinical psychology from Louisiana State University. Dr. Max completed an APA-accredited, predoctoral internship at the Devereux Foundation in Pennsylvania, where he provided clinical services at a residential center for adults with intellectual and developmental disabilities. Following his internship, he completed a postdoctoral fellowship at Keystone Behavioral Pediatrics and then joined the staff at Keystone as a licensed clinical child psychologist. Dr. Max is a qualified supervisor in the state of Florida for mental health counseling interns.

Neuropsychological Clinic Assesses Brain Injuries

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Keystone’s Neuropsychological Assessment Clinic is co-directed by Regilda (Rea) Anne A. Romero, Ph.D., licensed psychologist, and Rebecca J. Penna, Ph.D., NCSP, neuropsychologist and clinical psychologist.

Keystone Behavioral Pediatrics’ Neuropsychological Assessment Clinic can provide a comprehensive evaluation of brain functions and processes that is particularly useful for children who have experienced a brain injury. The assessment includes a profile of a child’s processing strengths and needs so that treatment, rehabilitation and educational plans can be developed. Clinic Co-Directors Regilda (Rea) Anne A. Romero, Ph.D., licensed psychologist, and Rebecca J. Penna, Ph.D., NCSP, neuropsychologist and clinical psychologist, can help with making “return to play” decisions.

Kids’ Concussions Cause for Concern

ABC News reported in September on an alarming new statistic: Kids only report one out of every 10 concussions. The danger in not reporting concussions is the possibility of post-concussion syndrome, a complex disorder that, according to Mayo Clinic’s website, can last for weeks and sometimes months after the injury that caused the concussion.

What makes the disorder even harder to diagnose is that a child who has suffered a blow to the head doesn’t necessarily lose consciousness. In fact, the injury may not even have seemed that severe.

The ABC News story reported on 15-year-old Willie Baun who was hit on the field during a game. His father, Whitey Baun, said, “It was absolutely a normal hit, nothing that made me go, ‘Oh! That was a real hit!”

But, in fact, they learned later that it was his second concussion in just six weeks. And, it resulted in Willie losing his memory. It took eight months and help from doctors for Willie’s memory to return.

According to Mayo Clinic, post-concussion symptoms include headaches, dizziness, fatigue, irritability, anxiety, insomnia, loss of concentration and memory and noise and light sensitivity. Parents should seek help if their child experiences a head injury severe enough to cause confusion or amnesia, even if their child hasn’t lost consciousness.

Coaches play an important role in preventing post-concussion syndrome as well. They should not allow a player who has suffered a head injury to return to the game. ABC News refers to the HeadMinder test as one way to test cognitive ability. After a hit, the player is asked a series of questions by the coach or parents. The score is tested against a baseline number to see whether there’s been an injury and whether the play is ready to go back on the field.

However, none of the diagnostic studies are completely objective and should never be used as the sole means of assessment or in deciding when to return an athlete to play.

The November/December 2011 issue of Practical Neurology reports that “the best way to assess an athlete or any individual who has sustained a concussion is still a comprehensive neurological history and detailed neurological examination performed by a properly trained physician.”

Keystone’s Neuropsychological Assessment Clinic also diagnoses other medical conditions that impact the central nervous system and complex clinical conditions that impact the way a child thinks and learns, for example, epilepsy/seizure disorders; neurodevelopmental disorders such as ADHD, learning disabilities, autism spectrum disorder and/or language delays; and various medical issues and illnesses that can impact the integrity of the brain, such as cancer and cancer treatment late-effects, viruses and infections, congenital or genetic disorders and stroke or Sickle-cell “silent strokes.”

Keystone child psychologists are eager to share information on neurological assessment with urgent care centers, school counselors, coaches, community and faith groups, pediatricians and other health care providers, as appropriate. To arrange an in-service training or presentation, contact Karen Rieley, director of marketing and communications for Keystone, 904.333.1151. If you are a parent who is concerned that your child may have suffered a brain injury or other medical condition that is having an impact on your child’s ability to think clearly and learn, contact Keystone, 904.619.6071, to set up an appointment with the Neuropsychological Assessment Clinic.