FAQ

What does a typical client of yours look like?
People who are struggling with lower level (attention, motivation, emotions) and higher level (planning, preparation, problem solving, flexibility, self-monitoring) cognitive skills. The clinical name for these issues is executive function deficit (EFD) which are typically found in individuals with attention deficit disorder (ADD/ADHD), Asperger syndrome (AS), Nonverbal Learning Disorder (NLD) and even oppositional defiant disorder (ODD). Individuals may suffer from EFD even if they do not have a diagnosis of ADD/ADHD, AS, etc.

Clients are both male and female and vary in age from as young as 5-years-old to 70+.

Do only those diagnosed with ADD/ADHD, Asperger Syndrome, etc, benefit from your services?
No, a diagnosis is not necessary. Anyone struggling with lower level or higher level cognitive skills can benefit from learning if they have EFD and, if so, following an individualized plan to address it.
What exactly are executive functions?

Executive function (EF) is a name given to the cognitive skills that are closely involved in bringing organization and order to our thoughts and behavior. Someone who has a deficit in executive function has the knowledge of what to do but lacks the ability to act on that knowledge properly (or consistently or effectively).

Taking EF a step further, we can break it down into two categories—thinking and doing. Thinking skills (higher level skills) involve planning, organizing, time management, working memory and metacognition. Doing skills (lower level skills) involve response inhibition, emotional control, sustained attention, task initiation, flexibility and goal-directed persistence. Together, we refer to these as Executive Skills.

The front part of the brain (prefrontal cortex) retrieves and flexibly applies these skills. Over time we gradually develop these cognitive skills from early childhood throughout young adulthood. The good news is that the brain continues to mature and develop connections well into adulthood. A person’s executive skills are shaped by both physical changes in the brain and through life experiences. CogniBuilders focuses on improving executive skills for children, teenagers and adults. We do this the same way you’d improve any skill—by practicing.

How does what you do differ from others?
One of the key differences is that CogniBuilders utilizes assessments that focus specifically on executive function versus an overall general assessment of cognitive abilities. As an example: An individual has been diagnosed with ADHD and is able to manage the core symptoms, with the help of medication, but is unable to perform as expected at school or work. It’s not that they don’t know what to do. Rather, they have a faulty connection from the part of the brain that houses the knowledge to the part of the brain that puts that knowledge into action. This is known as executive function disorder (EFD).

In addition, most ADHD assessments are self/parent/teacher rating scales which are prone to bias and can lead to a misdiagnosis. Research estimates that overall in the US, the misdiagnosis rate is about 1 in 5, that is around 900,000 of the 4.5 million children currently diagnosed with ADHD have been misdiagnosed [link] . This is why CogniBuilders uses a comprehensive assessment of executive functions beyond rating scales.

What's included in the comprehensive assessment?
The first stage of the comprehensive assessment involves a review of developmental history along with a review of other pertinent information which may include educational records, assessments/diagnoses, etc. This is combined with a formal interview with Dr. Miller. The second stage is a formal indirect method which involves a ratings scale that the client and someone else that knows the client (parent, teacher, significant other) fills out. The third stage is a direct formal assessment of executive function which varies in length based upon age and responses. After these stages, the data is analyzed and by Dr. Miller who will present you with a comprehensive report and answer questions you may have. Based upon the report, an Individualized Training & Development Plan will be created to address the appropriate deficits identified in the report.
How long does a comprehensive assessment take?
A comprehensive assessment takes, on average, about four hours to complete. However, the length of an evaluation varies from person to person. The comprehensive assessment is done at different stages and at different times versus a solid four hour block of time.
What is cognitive skills training?
Cognitive skills, just like any other skill such as shooting a basketball or riding a bike, can be improved through repetition and consistent practice. Once an assessment has been made an individualized training plan is developed for the cognitive skills that need improvement.
Do you diagnose ADD/ADHD, Asperger Syndrome, etc?
No, we do not conduct nor provide medical or psychological diagnoses. We specialize in the assessment, training & development of executive skills. Much of what is considered executive function disorder goes beyond the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for ADD/ADHD and/or Asperger Syndrome. As such, there is a lack of specialized providers like CogniBuilders.
Do you take insurance?
Cognibuilders is not a medical provider so we do not take insurance. We accept cash and all major credit cards as forms of payment.

 

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