Welcome to the Great Minds blog.


Accommodations on High Stakes Testing
Submitted February 7, 2013 by Dr. Janet Reed

Children and adults with documented learning, attention, or psychiatric problems are eligible for accommodations on standardized college entrance, medical school, law school, and licensing examinations with appropriate diagnostic evaluation and documentation from a qualified evaluator and formal application for accommodations. Documentation often requires testing multiple domains of cognitive ability, academic achievement, emotional functioning; interpretation; establishment of the need for specific accommodations; and appropriate credentials for diagnosis and interpretation.  Neuropsychologists are uniquely qualified for selecting tests sensitive to attentional, learning, and neurologic or psychiatric difficulties.  Your local Student Disability Services office can direct you to the necessary requirements and documentation for evaluation to determine the need for accommodations for the specific test you are planning on taking.

There's an App for That!
Submitted May 24, 2012 by Dr. Janet Reed

With all of the new telephone, touch, pad, and hybrid reader devices becoming more affordable, parents are increasingly becoming interested in applications that can help to stimulate their child's development and provide aids for children with special health care needs. I have compiled a "list of lists" I have found. There are more applications being developed every day, with some not as good as others. These individuals and organizations with a variety of background and experience have compiled their own reviews. Try some out, and don't forget that you may be able to sample applications prior to purchasing through sites such as

Augmentive communication and applications for parents of special needs children are listed by the following organizations:

Autism Speaks

Top 10 AAC iPhone and iPad Apps Under $30

Jeremy Brown’s Android App List

Favorite iTunes Apps from the AACchicks!

The iTaalk Top 30:Educational Apps to get you started, and all for less than $50!

Autism Apps That Will Help You

 iPad Apps & Resources for Autism

Apps for Children with Special Needs

Apps for Special Education from Cognitech Cafe

Apps for Autism: An Essential Guide to Over 200 Effective Apps

Autism Internet Modules

Sample Program Evaluation Report
Submitted November 10, 2011 by Dr. Janet Reed
American Academy of Pediatrics Updates Guidelines on the Diagnosis and Treatment of ADHD
Submitted October 24, 2011 by Dr. Janet Reed

This past month, the journal Pediatrics published updated guidelines on the diagnosis and treatment of Attention Deficit Hyperactivity Disorder, with one of the major changes involving the need to evaluate for ADHD in preschool children and adolescents.  Office-based screening often involves ruling out medical problems and obtaining information from caregivers and parents regarding the patient’s functioning. However, in young children, there may not often be a day care provider or preschool teacher. In addition, the first line recommendation of behavioral parent training, while appropriate, may delay accurate diagnosis of other neurodevelopmental risk factors. One aspect of determining a diagnosis is to rule out other possible causes of the behaviors of concern. For young children, this could entail early language, motor, or learning delays. We know from available research that early intervention is critical to the remediation of developmental delays. Delaying a diagnosis for behavioral intervention may result in losing important time to address developmental delays that may impact later learning.

For school-age children, the guidelines emphasize the importance of ruling out other behavioral and learning issues in the identification and treatment of ADHD. There are a number of learning, emotional, and behavioral issues that frequently co-occur, or mimic ADHD which should be identified and addressed to maximize the benefit of medical interventions.

For adolescents, ruling out substance use problems is considered important under the guidelines.

With regard to treatment, the guidelines emphasize the importance of treating those with confirmed diagnoses of ADHD as individuals with Special Health Care Needs. As such, it is important to facilitate management of this chronic disorder across the lifespan, and coordination of behavior therapies and classroom accommodations.

The revised guidelines represent an advancement in the diagnosis and management of ADHD as well as related neurodevelopmental, learning, and emotional/behavioral disorders. The earlier the identification and proper diagnosis, the sooner that interventions can alleviate problematic symptoms and set a child on a smoother course.

A summary of the guidelines are available at:

When it Doesn't Add Up: Dyscalculia
Submitted August 14, 2011 by Dr. Janet Reed


What is Dyscalculia?
Broadly, dyscalculia refers to a specific learning disability in which math skills are poor.  Arithmetic is a complex skill, requiring the development of several skills such as numeracy, computation, memorization and retrieval of math facts, strategies for problems solving, sequencing, visual-spatial organization, and verbal problem-solving.

How Common is Dyscalculia?
A recent study published in the journal Science found that the rate learning problems for math was equivalent to the rate of learning problems in reading, at about 6% of the population. More than 60% of children with learning disabilities experience dyscalculia.

What is Considered a Disability?
Traditionally, arithmetic and learning disabilities have been defined by an individual’s performance on standardized math achievement tests as compared to their performance on standardized tests of intellectual ability. Those with normal intellectual ability who performed poorly on tests of arithmetic are considered learning disabled. With the implementation of the new Individuals with Disabilities Education Act (IDEA; 2004), the ability-achievement discrepancy requirement is no longer required for qualifying a person for focused educational intervention.

Who is At Risk for Dyscalculia?
Students with certain neurological and medical disorders are more likely to experience poor arithmetic performance and development of skills. Those with Williams Syndrome, a genetic disorder affecting visual-spatial skills are characteristically poor at arithmetic. Girls with Fragile X and Turner Syndrome are more likely to experience math learning disabilities.  It is suspected that disorders of arithmetic are associated with problems in visual-spatial working memory, and that those who are also poor readers have problems in verbal working memory; suggesting that there is a central component of working memory deficits in these children.  Dyscalculia can also occur in those with ADHD, reading disabilities (dyslexia) and developmental coordination or writing disorders (dysgraphia).

How Do Children Learn Math?
Math skills develop early and sequentially. Number sense emerges in children as early as 1 year of age when children can differentiate between groups of two and three. Most 3 – 4 year olds can understand which has “more” and “less”.  While much of this occurs naturally, it is also influenced by early teaching.

How is Dyscalculia Identified?
Learning difficulties in mathematics can be identified by working with the student’s teacher, who evaluates skills based on the curriculum and associated evaluation procedures. Educational and psychological evaluation can identify the severity and nature of arithmetic deficits and formally diagnose an arithmetic learning disability.  Neuropsychological evaluation can also identify underlying cognitive processing weaknesses and deficits.

How is Dyscalculia Treated?
Programs and interventions are targeted at treating the specific deficits encountered by the individual. Individualized interventions may be aimed at developing number counting skills, memorizing math facts, learning strategies for facts and story problems. Research evidence also indicates that training targeted at improving working memory in children is beneficial in improving arithmetic performance. Accommodations for those with spatial, organizational and sequencing difficulties may include allowing the use of graph paper as a visual organizer, permission to use a calculator, additional time for test taking, and alternate test format.

Back to School
Submitted August 14, 2011 by Dr. Janet Reed

The mornings and evenings are darker, the days are cooler, and we are putting that late summer fertilizer on the lawn. Chances are, you have heard at least one kid say, “I’m bored”, and that you know exactly how many days are left before the school doors open.  Once you have done the clothing and school supply shopping, there a few other things you can do to make the return to school easier on your kids (and you).  

Schedules. Summer is a time of relaxed limits, with fewer hard and fast rules about bedtime and mealtime, but when parents are juggling work and changes in work and transportation schedules, there is often a clash between the need to stick to a schedule and the habits developed over the summer months. If you have not already done so, purchase a calendar or communication board that is posted for all to see.  Until the schedule becomes a habit through practice, a visual display of individual family member schedules, pick up times and locations, and extracurricular activities will help to reduce the stress associated with the chaos of change. Older children can be taught to add important information into their agenda, mobile phone, or other electronic aids.

Time Management. With the need to add school, homework, and extracurricular activities into a famly schedule, there are natural limits placed on leisure activities.  Screen time should be limited to one hour per day during the school year, and strictly enforced. Reminders about rules during the school year will be important for children to understand changing expectations. Designating and setting up a specific location at home, and designated times for studying and completing homework will help establish habits and expectations. If you have several students, it may be helpful to designate a time, or quiet hour, when all family members are engaged in quiet activities and all electronic devices are turned off.

Sleep and nutrition. Sleep and nutrition are also important to consider when developing child and family schedules. Allow enough time for your children to eat a healthy breakfast in the morning. The importance of sleep and breakfast can not be underestimated in preparing children to be ready, alert, and more focused when they arrive at school, especially as growth during the elementary school years is rapid.  Lifelong nutritional habits are established early and based on habits learned early in life. Set your child up for healthy lifestyles.

Students of all ages will need adequate sleep in order to remain alert, focused, and attentive throughout the school day. Difficulty arousing or problems with daytime sleepiness could indicate that your child is not obtaining adequate sleep. Children and teens of all ages will need time to adjust to early bedtimes required for the school year. Start at least one week before school begins and require your child to go to bed one hour earlier each night until he or she is going to bed at the normal time to prepare for a school day. Maintain this bedtime schedule over the weekends and holidays as much as possible to reduce excessive sleepiness on Mondays. 

Child Anxiety. Anxiety, worry, and apprehension are normal responses to change for everyone.  Anxiety can be greater for children beginning school for the first time, those going to a new school, and those transitioning into middle or high school where the expectations for independence and organization are the highest.  Start with familiarizing your child with the school, the walk to school, and if possible, his or her teacher(s). For middle and high school students, obtain and review their schedule to ensure they understand what materials they will need.  Encourage or arrange to have your child walk to school with friends or neighbors. If your child is new in the neighborhood, introduce him or her to other children in the neighborhood and invite them to walk to school or sit on the bus together. 

What, the Helmet?!
Submitted May 26, 2011 by Dr. Janet Reed

Q. How can I get my child to wear protective head gear when riding his bike?

A. The next time your child or teen complains about wearing a helmet while riding a bicycle, skateboard, scooter, or rollerblading, think twice about giving in. Now that spring and summer are upon us, youngsters are getting out and becoming active. About 70 percent of children in the United States ride bicycles, with only about 41 percent wearing helmets. Wearing a helmet can reduce the risk of a head injury by as much as 85 percent.

Read the full article:

1 in 7 US Children experience a developmental disability
Submitted May 24, 2011 by Dr. Janet Reed

As defined by the Centers for Disease Control, 1 in 7 children experience a developmental disability. Parents were asked if their children had ever been diagnosed with one of the following neurodevelopmental disabilities: attention deficit hyperactivity disorder; intellectual disability; cerebral palsy; autism; seizures; stuttering or stammering; moderate to profound hearing loss; blindness; learning disorders; and/or other developmental delays. Prevalence of any developmental disability increased from 12.84% to 15.04% over 12 years.

The authors of the article point out that the prevalence of autism is debatable depending on the source and method of study, it is clear through my clinical practice  that the increased awareness of autism has brought many children and adolescents to the attention of professionals.  Though they may not have autism, they very often experience some form of neurodevelopmental disability. The earlier the diagnosis, the earlier the intervention and treatment.

Help Find the Gene for Tourette Syndrome
Submitted May 24, 2011 by Dr. Janet Reed

The national Tourette Syndrome Association and the National Institute on Neurological Diseases and Stroke are recruiting study participants to identify the gene associated with Tourette Syndrome. See flyer at:

Evidence-Based Treatment of Autism
Submitted May 24, 2011 by Dr. Janet Reed

The Agency on Healthcare Quality Research commissioned a comprehensive review of the scientific literature on early intervention for autism spectrum disorder.

Overall, review of the literature and the quality of studies conducted reveals low to moderate levels of strength of evidence for a variety of interventions. The most evidence exists for Applied Behavior Analysis, which rather than being subjected to randomized control trials (RCTS; the strongest method of evaluation), are often single-case designs which examine individual behavior over time. This approach uses intensive (hours per day), individual, single trial learning to improve skills (e.g., communication, verbalization, joint attention) and reduce unwanted behaviors (e.g., self-injurious or self-stimulatory behavior).  Below is an excerpt from the summary, which can be found at the URL below (the full report is over 900 pages but is available for download):

"In the behavioral literature, some evidence supports early and intensive behavioral and developmental intervention, including intensive approaches (provided >30 hours per week) and comprehensive approaches (addressing numerous areas of functioning). These included a UCLA/Lovaas-focused approach and developmentally focused ESDM approach.23, 37 Both approaches were associated with greater improvements in cognitive performance, language skills, and adaptive behavior skills compared with broadly defined eclectic treatments in subgroups of children, although the strength of evidence (confidence in the estimate) is low pending replication of the available studies."