How We Diagnose & Treat ADHD

With over 35 years of experience, Dr. Neal understands how exceedingly difficult it is to find the right professionals. The medical and psychological community is highly compartmentalized, with little coordination among the various kinds of providers.  Navigating the system can be terrible and overwhelming. His desire is to have you experience a seamless, peaceful treatment plan.

Dr. Neal has spent years building relationships with professionals in the community, who team with him to complete his comprehensive assessment or offer the next steps of treatment. He works in communication with assessment professionals to help rule out other issues that can mimic ADHD symptoms. He works with professionals who will assess for academic issues such as learning disabilities, or sensory integration processing disorder, behavioral vision issues, central auditory processing issues, or allergies.

Once a clear diagnosis has been established, he can refer you to a highly experienced educational coordinator. She assesses learning styles for children and adults, and will attend school meetings with you so you will not be alone in the process of navigating the school system.

He works closely with an ADHD coach, who provides the practical strategies for work that are essential for the adult or young adult with ADHD who needs practical tools at work or home.  She is also experienced in working with the parents of children with ADHD.

Dr. Neal is highly experienced at working with families and marriages that have been impacted by ADHD. Having raised a child with ADHD, he is intimately acquainted with the journey in helping a parent equip their child to be successful in school, home, or work life. He has practical wisdom in helping adults affected by ADHD in their marriage or work life.

Weekly Case Management

Weekly case management is what makes Dr. Neal stand apart from most other private counseling practices.

He gets together weekly to discuss, exchange ideas, generate options and lean into the experience of another experienced professional in his practice. They have seen a lot of what works and does not work when it comes to helping people. They also have the advantage of each other’s eyes and thoughts on your case.

The ADHD Assessment

It takes 4 to 5 appointments to accurately assess and diagnose ADHD. The average cost is approximately $920 to $1300, which most insurance companies cover.

ADHD assessments elsewhere can cost anywhere from $1400 to $3000, and do not necessarily include a plan for treatment. Dr. Neal’s approach is not to diagnose you or your child and send you on your way; he works with you, in coordination with coaches, doctors, and educational specialists, to make sure you are fully supported in your journey.

Here is a breakdown of the assessment process and approximate costs. For insurance codes, go to Rates & Policies.

 

ADHD Assessment Cost

For the person who has no prior diagnosis a total of 3-5 appointments may be needed


Appointments

Individual, or with Parents/Spouse

Comprehensive Intake (Part I)
A comprehensive intake includes 14 different assessments and a comprehensive review of the client’s school, home, and work history.

 

$210

 

Comprehensive Intake (Part II)
(2 to 3 sessions, 53 minutes each)
Depending on the complexity of the case, age of client, prior diagnosis, and other factors, it may take 2 to 3 additional sessions to complete the comprehensive intake.

$190

 

Quotient ADHD Computer Test
Evaluation for inattention, impulsivity and hyperactivity

$330

Feedback and Diagnosis

A diagnosis is made based on all the data collected in the previous sessions.

Your next step for treatment options will be discussed in this session or in a follow-up session, if needed.

$190

 

TOTALS

$920 - $1300


If you have already been diagnosed with ADHD, you may not need as many sessions. Or, if your situation may be more complex, you may require more sessions.

Sometimes when assessing teenagers, we find it necessary to include a separate session one-on-one with the teen, without parents present.

Sometimes when evaluating for ADHD, it is determined that the individual does not have ADHD but rather another psychological or medical condition. Some may have ADHD plus a co-occurring disorder, such as depression, anxiety, OCD, bi-polar, etc.  In either case, this may take less or more time to evaluate.  Dr. Neal will inform you if he needs additional sessions to complete his assessment.

When you first call to schedule an assessment with Dr. Neal, we will immediately schedule three appointments. But if fewer appointments are needed, we will cancel appointments at no charge.

Following diagnosis, the next steps may include:

ADHD COACHING

(Referral)

LEARNING STYLE INVENTORY

(Referral)

COUNSELING - Individual (45 to 53 mintues)

$130-$190

COUNSELING - Marriage/Family (45 to 53 minutes)

$155-$190

MEDICATION REVIEW (15 to 30 minutes)

$85

MEDICATION REVIEW (45 to 53 mintues)

$130-$190

QUOTIENT RE-TEST (45 minutes)

$330

504/IEP PLANNING (45 to 53 mintues)

(Referral)

TUTORING

(Referral)

 

What to expect during these appointments

Comprehensive Intake

During the assessment, Dr. Neal will explain ADHD from a neurobiological behavioral perspective, viewing it primarily as an executive functioning and self-regulation impairment and how it can present in seven different subtypes of ADHD, each with very different symptoms. He will:

  • Ask about your symptoms (current and past), including severity, duration, and how they affect your life, school, or work performance.
  • Ask your spouse/partner or family members about they view your current and past symptoms.
  • Review your school records to find out about symptoms you may have had as a child.
  • Ask if you have a family history of ADHD.
  • Ask if you have a current or past history of sleep disturbance or mental-health problems (e.g., depression, anxiety, bipolar disorder, etc.) to rule out other possible causes of your symptoms, or to determine if these conditions are in addition to a diagnosis of ADHD
  • Screen for auditory and visual processing disorder, sensory integration disorder, or learning disabilities.

Computer and Supplemental Testing

During this appointment, you will take a 15 to 20 minute Quotient ADHD computer test. 

Other tests that Dr. Neal may refer out for include Stroop Test (for visual processing disorder), Scan III Test (for auditory processing disorder), WRAT (for learning disabilities), and TDS (for dyslexia).

Feedback and Diagnosis

Dr. Neal will review the results of computer test and other possible screenings and tests, and will integrate the results with clinical information collected. Usually a diagnosis for ADHD or other condition can be determined at this point. If there are more complex issues then additional sessions may be required.

If additional diagnostic assessment is needed, then a referral will be made to one of our local medical professionals. We maintain a carefully researched referral list. We only refer to those whom we can entrust our clients to, and they must be willing to work together in determining your diagnosis and treatment needs.

Medication or other treatment options will be discussed in this appointment. If medication is decided upon, we have a list of medical doctors who can prescribe the medication, who are willing to collaborate closely with Dr. Neal. He will take the time to communicate with the doctors or other medical professionals you are working with.  Our desire is that you experience a seamless, peaceful treatment plan.

Dr. Neal also works with other local professionals who use alternative methods to treating ADHD. If a non-medication approach is desired, Dr. Neal will discuss with you various options. Today’s research is demonstrating that supplements and Neurofeedback therapy can be of benefit for some people with ADHD.

Quotient ADHD Computer Re-test

The quotient ADHD computer re-test is essential to determining whether your medication is optimized. No more waiting days or weeks, losing precious time in the classroom or at work and relying only on rating scales from the teacher or family member. This test helps to ensure that a person is not over or under medicated. Contrary to the prevailing mindset, most people are actually under medicated, which is why many stop taking the medication after awhile.

Since every person responds differently to medications, given the benefit or side effects, sometimes it takes multiple tries on different dosages or trying another medication till you have the desired response. 

We whole-heartedly believe that if a medication changes a person’s innate personality or “makes them a zombie,” they should stop that particular medication. We want the medication to clear away the distraction so that the person’s real gifts and skills can rise to the surface of their lives and shine. There are many medications, both stimulants and non-stimulants, which have been used effectively for treating ADHD. Dr. Neal tells his clients that he will not give up until he can find a medication that works.

Since medication alone does not address every aspect of ADHD, ADHD coaching is essential for a person to accomplish the type of success they desire.

ADHD Coaching Session or Consult

Living with ADHD successfully is not just about getting a good grade, going to college, or doing well in your career. Thriving with ADHD also means that your relationships are free from the chaos and stress that comes with having ADHD.

Dr. Neal believes that coaching is essential to success with ADHD. Even with an accurate diagnosis, correct medication, supplements, or Neurofeedback therapy, the missing ingredient is someone who will “hold it all together,” who offers accountability and practical steps to managing life with ADHD.

Studies show that the majority of people quit medications within months after starting, not because the medications are ineffective, but because they did not take the next step and get an ADHD coach to walk aside them at school or work. Clients tell us that they cannot imagine how they would have been able to excel at work, school, or home life without coaching.

A coach helps with organization, time management, and motivation deficits that create the most significant problems at home, work and school. A coach helps the client move forward, breaking the glass ceiling on their life and once and for all, removing the labels of lazy, uncaring, and unintelligent. She is passionate about helping her clients and their family members take the next step toward your life goals and dreams.

ADHD coaching, compared to seeing a licensed counselor, is about finding ways to cope with inattention, hyperactivity, distractibility, money management, time and organizational management. It is less about finding the cause of an issue and more about finding the solution and setting a plan in place. After the client has their action plan, the coach sets up ways for the client to check in and show responsibility for taking action.

There are many barriers that ADHD presents that keep a person from achieving their daily goals. One of the primary focuses is how having ADHD impacts the person’s performance at school, work and home responsibilities.  If something isn’t working in the action plan, the coach and client can brainstorm together new or different ideas that work better for that individual situation.

In counseling, the initial goal is to diagnose any other underlying issues that are causing additional problems along with ADHD. Many times, there is also anxiety, depression, bipolar, tics, sensory integration issues, Autism spectrum disorder, eating disorders, substance abuse, marital and family conflict, and many more possible mental health issues. 

These different serious issues involve different treatment management plans and often utilize medication to facilitate the healing process.  Sometimes a person has past trauma or past unresolved issues that are causing current emotional pain. The counselor will employ their understanding of personality development and what drives a person’s emotions and behaviors. Marital and family dynamics are often a significant problematic issue when it comes to having a loved one with ADHD.

In short, counseling is needed to address psychological concerns or disorders that may be present in the person with ADHD; coaching is needed to implement the practical steps of managing ADHD-specific symptoms and challenges.

Learning Style Inventory (referred out)

Depending on whether you are a student or in the workplace, we will identify your preferred learning style. This assessment is essential for building a plan toward a student’s approach to school and social life, an—if it applies—to a student’s 504 Plan or IEP.

As an adult in the workplace, this assessment is essential to setting you up for the greatest success at work for meetings, projects, managing others, etc. It is also helpful for adults who are stay-at-home or work-from-home parents, who are often balancing multiple people’s schedules, managing several projects, and multi-tasking to the max. This assessment will aid in how to strategize and approach your responsibilities.  

A person typically has a predominance of one of four different learning styles: auditory, visual, tactile or kinesthetic. This assessment identifies specific areas that support an individual’s learning styles. Identifying and approaching work, school, or home life tasks within your learning style will help you understand how you process information. Utilizing your learning style preference will increase your effectiveness, accomplishments and successes. When you discover your natural way of learning and processing information, you can lessen some of the difficulties in dealing with everyday life tasks.

504/IEP Academic Accommodations

The educational coordinator we work with provides support for students in IEP and 504 planning, school meetings, and tutoring needs. She works with elementary, high school and college-age individuals. Once the learning style has been identified, the 504 Plan or IEP is built upon that style, so that your student’s accommodations line up comfortably and easily according to the learning style of the student.

There are many different accommodations available to the elementary, high school and college age student. We want to choose the specific ones that will most benefit, but that will also feel natural and be an easy fit for the student. Parents have highly praised her skill and support in working with the schools or colleges. She will attend IEP and 504 meetings to help parents navigate and work successfully with teachers, and to ensure your student receives all the services and accommodations they are entitled to by law. She has an easy, welcoming approach, and teachers have commented they are thankful she was in attendance with the parent and student. She will also facilitate a college student’s needs at their college student resource center.

Family and Marriage Counseling

When someone we love has ADHD, often times our relationship becomes stressed because part of the struggle of ADHD is forgetfulness and time /organizational challenges.  For the non-ADHD person, this creates frustration and they often view the person with ADHD as unreliable and high maintenance.  Whether it is your child or spouse, these issues can create loss and disappointment on both sides of the relationship. Often the person with ADHD feels blamed and misunderstood for something they cannot control. They can sense the frustration and feel poorly about themselves. The spouses, parents and siblings have resentment. This creates conflict and distance from one another.  

It is our goal that you walk away with a hope that with understanding ADHD and its effect on you and the family, developing new patterns of communication and instilling renewed and realistic expectations that you can experience the type of marriage and family life you have dreamed of.

 

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