Behind the…jargon?

1. Comprehensive Psychoeducational Assessments are utilized to guide and support school-aged child/adolescent development through an educational perspective. Think of them as a roadmap or a blueprint of your child’s abilities. These assessments include formal and informal methods (tests and tools!) used to examine intelligence, memory, communication, attention, as well as standardized tools focusing on learning components needed for school success (reading, writing, math, etc.). Comprehensive Psychoeducational Assessments seek to assess your child’s cognitive skills (what the brain can do) and academic achievement (how the brain works with core school content) to develop a comprehensive understanding of your child’s learning style. They also guide the development of strength based educational recommendations. Many families utilize Comprehensive Psychoeducational Evaluations, in collaboration with their child’s school, to determine appropriateness or eligibility for special education services or gifted placement.

2. Psychodiagnostic, Psychological, or Developmental Assessments are targeted assessments to determine whether an individual meets criteria for a psychological diagnosis or other developmental concern outlined in the Diagnostic and Statistical Manual, Fifth Edition (DSM-V). Behind the Behavior Psychology offers targeted assessments, that are often referred in our field by many names, including psychodiagnostic, psychological, or Neurodevelopmental assessments. These types of assessments utilize a range of evidence-based or standardized measures, in addition to informal measures to assess a child’s symptoms and determine whether they meet criteria for a specific diagnosis, such as Attention Deficit Disorder or Autism Spectrum Disorder.

3. Neurodevelopmental Disorders are a group of disorders that occur within the early developmental period and typically recognized before or as a child enters school. They are characterized as deficits in areas of the brain that produce impairment in development, including behavioral, social, emotional, and academic functioning. Impairments and outcomes depend on the type of disorder. Examples of Neurodevelopmental Disorders include Attention-Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), Intellectual Disability, Language Disorder, or Specific Learning Disorders.

4. The Individualized Education Program (IEP) is a legal, written plan that is covered under special education law and outlines the specific details regarding a student’s special education supports in school. IEP’s are developed and agreed upon by a school team, which includes a student’s family, teachers, school administrators, a school psychologist, and other providers. An IEP is individualized to the specific strengths and needs of the student, and outlines goals and objective ways to track progress. An IEP is a lengthy, yet incredibly important document to help support your student’s success and development in school.

5. A 504 Plan or Section 504 is a broader plan compared to an IEP and in contrast, is covered under civil rights law that prohibits discrimination of children on the basis of a disabling condition. A 504 plan supports students with a documented physical, mental, and/or medical condition that substantially limits one or more major life activities (e.g., paying attention in school, sitting for long periods of time, walking without specialized equipment, needing a nurse to manage insulin). 504 plans outline the supports a child needs in school to have equal access to their education, such as a student with Diabetes having access to the nurse when blood sugars are low or children with ADHD being allowed to take movement breaks during long instructional periods.

6. Behavioral Parent Training (BPT) is a research supported and effective treatment used to improve your young child’s behavior, regulation, self-esteem, and overall skills. It is a form of behavioral therapy that supports the parents, therefore increasing it’s effectiveness at improving your child’s behavior. With individualized support from the psychologist, parents are trained with skills to navigate a range of challenging behaviors to help improve child skills and confidence in school, home, and in important relationships. BPT may also be referred to as Parent Training in Behavior Management or Behavioral Therapy and is most effective for children under the age of 6 and is a first line of treatment recommended by health care professionals, prior to or paired with medication management for children with behavioral challenges (such as those with ADHD). Psychologists trained in BPT help parents understand what their child’s behavior may be communicating, incrementally master parenting skills, and get real-time feedback.

7. Cognitive Behavioral Therapy (CBT) is an evidenced-based (backed by research) therapy that focuses on the link between feelings, thoughts, and actions to help individuals understand and address maladaptive concerns and symptoms. Trained psychologists or professionals utilize CBT to help individuals recognize and confront concerns, as well as modify the thought and behavior patterns that interfere with functioning or that make symptoms, such as anxiety, worse.

8. Telemental Health, Telepsychology, or Telehealth are terms you have likely come across over the past year throughout the Covid-19 pandemic. Telehealth is the umbrella term that includes telemental health or telepsychology, although all generally refer to the same process of providing a health service through use of technology. Over the last several years, technologies have become much more sophisticated and research has been conducted to support that many of the skills needed for competent telehealth practice are the same as those provided in traditional office settings. Telepsychology allows families access to psychology services from the comfort of their home and can aid in generalization of skills to the setting where behavior is most likely to occur.

9. Executive Functioning is an all encompassing term capturing the parts of the brain that are necessary for mental control and self-regulation. You can think of executive functions as the main control and command center of the brain that helps manage your thoughts, behaviors, and emotions. Individuals who struggle with executive functioning, may include children with Neurodevelopmental Disorders, such as ADHD.

10. Processing Speed represents the ability to maintain speed and accuracy on simple tasks, which requires sustained attention for a period of time. Essentially, it is your ability to complete simple tasks efficiently.

11. Memory is comprised of many different processes in the brain, all of which are important to an individual’s daily functioning. When reading your child’s psychoeducational evaluation, you are likely to see information about their Short-Term Working Memory, which is the ability to attend to select information, briefly hold it in their mind, and work with it. This type of memory is important for following multiple step directions or completing complex math problems. You may also see information about their Long Term Retrieval, which is the ability to store and retrieve previously learned information. This is important for recalling previously learned information on a test. Short Term Working Memory and Long Term Retrieval are utilized and important for success with many school tasks and behaviors.

12. Reading, Writing, or Math Fluency is important for school success as it provides a connection between a student’s ability to recognize and complete basic skills (e.g., reading vocabulary, basic addition computations, writing words) with automaticity and accuracy. Student’s with adequate or high rates of fluency skills are able to recognize words, facts, or write sentences efficiently, which allows more time to focus on the content or learning of materials, rather than more intentional efforts to break down tasks.

13. Reading Comprehension is a student’s ability to comprehend information during or after the process of reading. Reading comprehension can include answering direct questions from the passage, which comes straight from the text with minimal interpretation (e.g., color of character’s clothing) or inferential questions, which requires a student to interpret information read from the text (e.g., given the information provided, what might this person do next?).

Common Questions:

• What is the difference between psychotherapy and counseling?

  • Psychotherapy and Counseling are commonly interchangeable terms, although there are some distinct differences. Typically, counseling can be done by individuals trained in psychology or a mental health field, although it is a more general term for any sort of “advice giving” or brief goal based approach. Counseling is typically utilized for brief, current concerns, and goal seeking behavior (e.g., high school students engaged in academic counseling for college). Psychotherapy is short for Psychological Therapy. While those who do psychotherapy, may also counsel, psychotherapy is conducted by trained mental health professionals, typically those with an advanced or specialized degree as a psychologist or psychiatrist, and is based on treating chronic or maladaptive behavioral or cognitive patterns that are impacting functioning through use of evidence-based approaches. Psychotherapy aims towards examining patterns (from past or present), how they may present as symptoms, and how they impact current and future behavior. Some examples of psychotherapy are Cognitive Behavioral Therapy or Dialectical Behavioral Therapy.

• Where is Dr. Bobal licensed to practice?

  • Dr. Bobal is a licensed psychologist in North Carolina (#5935) and South Carolina (#1692). She can conduct psychological testing and therapy services in these states in both telehealth and in-person formats. Dr. Bobal, as approved by the Association of State and Provincial Psychology Boards (ASPPB) and the PSYPACT Commission, can also practice telehealth in select states outside of the Carolinas due to her training and qualifications. As of 2022, these states include: Alabama, Arizona, Arkansas, Colorado, Delaware, District of Columbia, Georgie, Idaho, Illinois, Indiana, Kansas, Kentucky, Maine, Maryland, Minnesota, Missouri, Nebraska, Nevada, New Hampshire, New Jersey, North Carolina, Ohio, Oklahoma, Pennsylvania, Tennessee, Texas, Utah, Virginia, West Virginia, Washington, and Wisconsin. For additional information about PSYPACT, eligible states, and how it can support you or someone you know, click here.

• What is the difference between Behavioral Therapy and Cognitive Behavioral Therapy?

  • The names say it all. Behavioral Therapy focuses on changing or improving behavior by changing the environment, and evidence supports it use with a range of different presenting concerns or populations. Behavioral Parent Training is a type of Behavioral Therapy because it focusses on improving parent skill in order to change or improve the behavior of a young child. Cognitive Behavioral Therapy is also a widely used therapeutic approach and it extends beyond Behavioral Therapy by focusing on one’s thoughts (cognitions) and how they may impact behavior and environment and vice versa.

• What does Behavioral Parent Training rely on?

  • Behavioral Parent Training (BPT) relies on the collaborative efforts between the psychologist or specialist (trained in BPT), the caregiver, and the child. As a parent, you will experience a developmental and tailored sequence of learning the basics about 1.) How your child’s brain works, 2.) How to use this information to re-examine your child’s behavior and parent/child interactions, 3.) How to learn skills to manage, support, and respond to your child’s behavior, 4.) Observe the psychologist utilizing those skills, and 5.) Practice those skills in real time, in real settings, with real behavior.

• Is Behavioral Parent Training helpful for children with ADHD?

  • Yes. Research supports the use of behavioral therapy for children age 6 or younger, particularly parent training in behavior management for children with ADHD. Other recommended treatments include medication, behavior therapy (in school settings) and psychosocial interventions. Behavioral Parent Training is typically recommended as the first line of intervention prior to medication for children with ADHD as it helps children and parents learn skills to manage symptoms, rather than solely relying on medication, which may only improve symptoms while the child is taking the medication. Overall, research shows that the combination of medication (symptom reduction) and behavioral therapy (learning lifelong skills) is beneficial, although it is important to consult with your child’s pediatrician or psychiatrist regarding whether medication is appropriate.

• What is the difference between behavioral parent training, individual child therapy, and family therapy?

  • Behavioral Parent Training (BPT) helps parents learn basic behavior management skills and how to tailor those skills to improve their child’s behavior, development, self-esteem, and improve the parent/child relationship. BPT is effective for children with the developmental age of 1-5 years. Individual child therapy is beneficial for children to have a 1:1 therapeutic experience with a trained mental health professional to learn about and explore emotions, navigate concerns, and improve coping in a confidential and safe space. While parents and caregivers are a necessary and important aspect of individual therapy, the focus of support is on the individual work with the child, rather than the parent, compared to BPT. Family therapy, as it sounds, involves working with the family unit as a whole and can be beneficial for improving family communication and relationships, coping with unexpected or expected change, or developing co-parenting plans.

• How do I know if Behind the Behavior Psychology, PLLC is a good fit?

  • While evidence-based methods are necessary for effective treatment, research also emphasizes the importance of a positive therapeutic relationship. At BTB, we are only as successful as the partnership we have with you. The culture at BTB is about collaboration. BTB brings the clinical expertise in child behavior and you bring the expertise of what it’s like to be the parent. Your initial time at BTB is about determining whether we are a good fit for you and your child’s needs and whether other (or additional) supports are needed or preferred.

• Do psychologists prescribe medication?

  • Licensed psychologists are highly trained, with a doctoral degree and intensive clinical training in diagnosing and treating a range of mental health and behavioral disorders. Some treatment involves the combination of therapy and medication management of symptoms. However, psychologists do not prescribe medication in the majority of states, including North and South Carolina. With that being said, licensed psychologists are important members of a treatment team, as the medically trained providers that prescribe medications (including a pediatrician or family physician) seek collaboration from psychologists to determine appropriateness for a child or teen’s medication management. In some states, appropriately trained psychologists may be granted the right to prescribe some medications.

• What questions should I ask my insurance provider before scheduling an appointment with a psychologist or mental health provider?

  • What are my mental or behavioral health benefits for in-network providers? Out of network providers?

  • Are there dollar limits, visit limits, or other coverage limits?

  • Are there specific diagnoses that are covered?

  • How much does my plan pay for an out of network provider?

  • How do I submit for reimbursement if I use an out of network provider?

  • Do I need pre-authorization, referral, or approval from my family physician or child’s pediatrician?

• What is ADHD?

  • Attention-Deficit /Hyperactivity Disorder (ADHD) is one of the most common Neurodevelopmental Disorders and is typically first diagnosed in school-aged children, with symptoms continuing to impact aspects of functioning into adulthood. Children with ADHD likely have trouble paying attention or regulating behaviors necessary to function effectively or consistently across school, home, and community settings. Currently, there are three types of ADHD, including Predominantly Inattentive Presentation, Predominantly Hyperactive-Impulsive Presentation, and Combined Presentation. Talk with your child’s pediatrician or a psychologist to determine whether your child’s behaviors are typical for their development or indicative of other underlying concerns.

• What is the difference between ADHD predominately inattentive and hyperactive/impulsive subtypes?

  • Predominately Inattentive (ADHD-I), formerly known and still commonly referred to as “ADD”, and Predominately Hyperactive (ADHD-H) subtypes are 2/3 subtypes of an Attention-Deficit/Hyperactivity Disorder diagnosis (the third subtype, ADHD-C is a combination of both symptoms). ADHD subtypes are diagnosed by a psychologist, psychiatrist, or physician based upon the observed or reported behavioral and cognitive symptoms present. Depending on the amount and type of symptoms, a child can be diagnosed with primarily inattentive versus primarily hyperactive, or combined symptoms. While these examples are not all encompassing or exclusive, a child with ADHD-I exhibits mostly inattentive features and may have difficulties sustaining attention on academic tasks, conversations, and/or play, may not appear to be listening (or dazed) when spoken to directly, may be forgetful or lose things, or may have difficulties with organizing tasks. Children with ADHD-H exhibit more stereotypical hyperactive/impulsive behaviors such as frequent fidgeting, difficulties remaining seated, running, climbing, or bumping into things, prone to accidents, described as frequently “on the go,” or excessively talking/interrupting others.

• What is the difference between ADD and ADHD?

  • ADHD is the up to date and appropriate psychological or medical term used when referencing Attention-Deficit/ Hyperactivity Disorder. When diagnosed, your provider will clarify the subtype of ADHD. Attention Deficit Disorder (ADD) is an outdated term still occasionally used by individuals or physicians who are referring to ADHD-Inattentive Presentations.

• How do I know if my child’s developmental milestones are delayed?

  • All caregivers look forward to their child’s “firsts.” First smiles, first words, first steps… developmental milestones are things most children can do within a certain age range. Children reach a range of milestones through active exploration of and interactions within their environment. There is no rush for children to reach milestones and many children, even those within the same family, will reach certain milestones when they are ready. With that being said, families and caregivers are children’s earliest and most important teachers. Combining your expertise and knowledge of your child with the guidance and expertise of child development experts, developmental screenings are necessary to ensure your child is making progress in important areas, such as cognitive skills, language development, motor skills, and socio-emotional functioning. If you have any concerns or questions about your child’s development, talk with a child development specialist, such as a psychologist, or a developmental pediatrician.

• What is the difference between a psychological or diagnostic assessment and a comprehensive psychoeducational evaluation?

  • Psychoeducational evaluations are typically performed by school psychologists or psychologists with specific training and experience assessing children struggling to perform in the school setting. When compared to psychological or diagnostic evaluations, psychoeducational evaluations are utilized to guide and support child development through an educational perspective. Psychoeducational evaluations seek to assess a child’s cognitive skills and academic achievement to seek a comprehensive understand of a child’s learning style and guide the development of strength based educational accommodations. Psychological evaluations tend to be more diagnostic in nature and typically focus on guiding diagnosis and treatment outside of the school setting. Whereas a psychoeducational evaluation evaluates cognitive and academic functioning, amongst other domains, psychological or diagnostic assessments are more targeted in nature and focus on assessing specific symptoms. Want to learn more on this topic? Click here.