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A few years ago I met a seven year old, recently moved from Guatemala, who was referred for ADHD testing because he was restless, spoke out of turn, and struggled to copy sentences. In the clinic, he froze when asked to repeat strings of numbers in English but laughed and sailed through the same task in Spanish. His teacher ratings screamed hyperactivity. His mother, who had navigated a dangerous trip and long-term uncertainty, described a child who slept lightly and clung

Telehealth pulled ADHD assessment out of the clinic and into kitchens and parked cars. Some of those changes improved access and did not harm accuracy. Others created blind spots that can mislabel everyday stress as a disorder, or miss a serious one hiding in plain sight. After hundreds of remote and hybrid evaluations across age groups, here’s a grounded view of what holds up at a distance, what tends to fall apart, and how to build an assessment that parents, adults, and

Specific phobias take many forms, but the pattern is familiar to anyone who treats anxiety every week. The person knows the fear is outsized, yet their body acts as if danger is imminent. They rearrange life around the problem by avoiding bridges, dogs, injections, elevators, airplanes, or whatever carries the threat. Avoidance brings quick relief, and that short reward quietly teaches the brain to avoid again next time. Exposure therapy interrupts that loop. When done thou

The first panic attack rarely announces itself politely. A client once told me his showed up in the cereal aisle on a Tuesday morning, heart ricocheting, left arm numb, certain he was dying. Paramedics found perfectly normal vitals. He felt foolish, then terrified it would happen again. Over the next month he stopped driving on highways, kept water bottles everywhere, and learned the locations of every urgent care between home and work. That is how panic disorder takes shap

Families rarely arrive at an autism evaluation as a first stop. More often, they have been managing language delays since preschool, sitting through conferences about attention or behavior, riding out meltdowns that seem to arrive without warning, and wondering why morning routines feel like tactical missions. When Autism testing is finally on the calendar, the stakes feel high. The right assessment can open doors to therapies, school supports, and a way of understanding a

Trauma sits in the body as much as it lives in thought. Clients tell me they understand, rationally, that the car they drive today is safe, or that the abusive partner is long gone, yet their chest still tightens at a yellow light or a slammed door. This split between knowing and feeling is why integration matters. EMDR therapy moves stuck sensory memory. Cognitive behavioral therapy (CBT) reshapes meanings and habits. Mindfulness steadies attention so a client can meet wav

Anxiety does not wait for a quiet hour. It shows up in the grocery store line, in the car on the way to daycare pickup, at 2 a.m. When the ceiling takes on an unhelpful level of importance. Over the years, sitting with clients in those exact moments, I have seen what travels well outside the therapy room and what does not. The techniques that matter are the ones you can remember when your heart is racing and your thoughts are sprinting laps. They are simple, portable, and g

Families often come to an autism evaluation with one pressing question: will we finally understand why communication and social interactions feel harder for this child than for their peers? Good testing does more than confirm or rule out a diagnosis. It paints a detailed picture of how someone reads social cues, uses language in context, manages back and forth conversation, and copes with the stress that social situations create. That picture, the social communication profi