30-Minute Session: Dr. Chris Tysiaczny

For this 30-Minute Session feature, we sat down with Dr. Chris Tysiaczny of Red Ladder Optimized Learning.

Chris completed his Ph.D. in Clinical Psychology at the University of Manitoba and is a Registered Psychologist.

He provides a variety of psychological services to children, adolescents, and adults, including psychological and psycho-educational assessment and psychological treatment for difficulties with anxiety, mood, learning disorders, ADHD, Autism Spectrum Disorders, FASD, and various health-related concerns.

---

Hey Chris! Thanks for doing this with us today. To start off, do you want to maybe just explain what exactly a psychoeducational assessment is?

The aim of a psychoeducational assessment is to kind of get an understanding of a child’s development. So getting a sense of things that might be personal areas of strength for them, and areas and things that might be tougher for them which might be contributing to some of the difficulties they might be having in a variety of different areas of their life.

It could be their home life – social, emotional, behavioural –  it could be school life; academically, peer relationships, things like that. So what we do is we provide a comprehensive look at how they’re developing in a number of different areas, and then we share that information with the families and give them some guidance on how best they can support them going forward; at home, at school, sometimes through different services like tutoring, things like that that might be helpful for them.

In the assessment that we do together, we do things like some psychological testing which looks at things like how somebody’s brain is developing in a number of ways so looking at things like their language development, reasoning abilities, memory. We look at their academic development and take an in depth look into different areas like their reading abilities, their math abilities, their writing. We collect information through parent interviews, teachers (through questionnaires). And we put all of that together and get a good sense of how they’re developing, why some of the challenges they’re having are happening, and then what we do is we make some recommendations for supporting them going forward.

So what does an assessment actually look like for an individual?

It depends on what the concerns are.

Oftentimes we’ll see somebody for an intake meeting, and we’ll usually spend about an hour for them. Just sort of getting a sense of what is bringing them in for the assessment, what are their concerns, and then we’d also be collecting some background information from them; so getting a sense of early life experiences, early educational experiences, a bit of a social history, a bit of a mental health history as well. And within that hour we’d sort of get a sense of what we want to do for the assessment.

Then they’d come in for the assessment, and oftentimes we can see them just in one appointment. Sometimes people have difficulties doing a lot of things over a long period of time, like two or three hours, which is often the amount of time that we need. So sometimes we need to break that up for people into shorter chunks.

Then we’d spend some time putting together the actual assessment report for them, and we’d do a feedback meeting with them, which is usually about an hour. We talk about what we did during the assessment, what it all means, share the findings of the assessment. If there’s a diagnosis, we’d help explain what that is, and then we’d help explain the recommendations we have for supporting themselves going forward.

We hear frustration from a lot of parents after their child has been diagnosed with a learning disability or ADHD that they felt like they didn’t receive much – or any – guidance on what to do with that diagnosis. Is that something you try to be cognizant of in your practice?

That’s a big part of what we want to do.

We’ve talked about this as a practice a lot; people don’t want to know only what’s going on, they’re really coming here to know, “What do I do about this?” That’s what we aim to do with the services we provide, to help give somebody a good understanding of what’s going on, and, y’know, if someone has a diagnosis of ADHD or a learning disability, we really want to explain what that is and what that means, why we made the diagnosis, what it means for them going forward.

But then the next part is how can you support yourself, and that’s really what we aim to do in the assessment report. So we’ll make recommendations around accommodations and supports at school that will be needed into the future, we may make recommendations around specific tutoring requirements depending on what’s needed, we may make recommendations around medical requirements like going to see a physician and talking about medications. And then we give people an opportunity to ask the questions that they have, not only at the meetings that they have with us, but oftentimes people follow up with me for periods of time – even years in the future – asking me questions or things that come up and asking for guidance on issues.

How has the COVID-19 pandemic affected things at Red Ladder? Have you seen an influx of people seeking diagnoses and supports?

I think the pandemic has been tough on many people, and exactly what you said is exactly what we’ve noticed as well. The more interactions families are having with their kids around their learning, the more they’re able to recognize things that are challenges for their kids.

So when families were doing home schooling at the beginning of the pandemic and everything was shut down, I’d say you were in the majority if your child accomplished very little during the day. Many parents found, “I’m having a really, really tough time getting my child to stay on task, to do the requirements, and I’m also trying to do my own job.” So I’d say the majority of families had an enormous amount of difficulties with that. And through that, I think they also noticed some of the difficulties that their kids were having with reading, writing, math, or even just focusing and attention.

So the pandemic ended up leading to a lot more referrals to our practice, specifically because of parents seeing the challenges that their kids were having up close.

And what about adults, did you also see a lot more adults coming in for assessments?

Yep. I would say probably for the same reasons as well; people being at home, working from home, and having a lot more demands on needing to organize themselves, manage their time, manage the distractions that are around and in their environment, those kinds of things have been much more challenging for a lot of people.

One of the stigmas ADHD often wrestles with is that it’s an over-diagnosed condition. Do you think it is?

No. The truth is that ADHD isn’t over-diagnosed, and, in fact, it probably is underdiagnosed.

Particularly for females, it’s an incredibly underdiagnosed condition. Because it presents a bit differently in females, and females may have different personality traits or approaches to how they present themselves that just don’t, “stand out” as ADHD to teachers. So it’s one of the more underdiagnosed conditions, I think, in the female population.

Wait times are something that we see is one of the biggest barriers to individuals getting the support they need, when they need it. What are your thoughts on this issue?

Yeah, definitely. With the pandemic and the increased referrals, it’s increased the wait time to a point where we’re not happy with our own wait time, and we’re doing what we can to reduce that as much as possible. We were aiming at one point for it to be a couple months at most to see somebody, but now it can take even up to five or six months sometimes for somebody to be seen. That’s something that we’re working hard to reduce, and we recognize that as being a barrier just as our clients do.

In your opinion, what is one of the most misunderstood things about ADHD?

Well, I think with ADHD, one thing that people often think is that ADHD means that somebody just struggles with attention, or just struggles with not being able to sit still and is constantly moving or running around the room. And I think that sometimes when teachers, parents, even some family doctors, when they see a child and they’re sitting, they’re not standing, they’re not moving, and they’re looking at them while they’re talking to them, they might think, “Well this can’t be ADHD.” And ADHD is a lot more than that, as I’m sure you know.

One of the biggest things that’s challenges for someone with ADHD is around executive functioning. So those are some things that you don’t always see just by looking at and observing somebody. They might look attentive and be sitting still, but we don’t see the things that are challenging for them like remembering things, or organizing things, or time management, planning, those kinds of things. Those are going to be challenging for somebody and they aren’t observable things.

So the idea that ADHD is going to be a very visible condition, that’s probably something that’s quite misunderstood.

Last question, Chris; what is something that you hope looks different about the way learning disabilities and ADHD are handled or regarded, years down the road from now?

Oh, that’s an easy answer for me.

What I would say is that a lot of the kids that I see with ADHD or a learning disorder, who are beyond those elementary school years, are struggling incredibly with self-confidence. I see them, I do testing with them, I know how bright they are. I know how capable they are. But because of the types of difficulties that they’ve had, they’ve really felt that I’m not as good as other people around me.

They can see their peers are reading at a higher level than them, or writing at a higher level, they see themselves getting supports and accommodations and they feel bad about that. They wonder, “Why do I need this and other people don’t?”

People with ADHD often get a lot of negative comments; even their name can become aversive to somebody with ADHD, just hearing, “Chris! Chris! Chris!” all the time.

One of the things I tell parents at the end of the meeting, I share a whole bunch of recommendations with them about teaching, tutoring, supports, things like that, but I say if there’s one thing or if the only thing that comes out of what we do going forward, it’s to help their self confidence and to improve their self-esteem, because we want your child to know that they’re smart and capable.

They learn a little bit differently, but with the right kind of supports, they’re going to be able to do anything they want to do.