Osika & Scarano Psychological Services, P.C.

Our Services

Providing Mental & Behavioral Health Services
to Adults and Children

Screening, Evaluation and/or Treatment for Children:
ADHD
Autism Spectrum Disorder

Learning Disabilities
Intellectual Developmental Disorders
Oppositional Defiant Disorder and Conduct Disorders
Explosive Anger/Defiance
Therapeutic Visits with Offending Parents

For Both Children and Adults:
Depressed, Angry, and Anxious Mood Disorders
Impulse Control Disorders (self-harm, gambling, sex and electronics addictions)
Suicidal Thinking and Cutting Behavior
Survivors of Domestic Violence

Substance Abuse
Binge Eating and Obesity
PTSD
Sexual Assault

Personality Disorders

Treatment Modalities:
 Brief Psychotherapy
Cognitive Behavioral Therapy

Dialectical Behavioral Therapy

Family Therapy
Applied Behavioral Analysis
Marital and Conjoint Therapy
Co-Parenting with Divorced Parents

Telemedicine at VSee.com

Procedures for Neuro-Behavioral Evaluations

Neuro-behavioral evaluations are a very useful service to provide for children, especially those presenting with emotional, behavioral, or academic struggles. The question we try to answer is “to what degree are the academic struggles due to Autism, poor effort (a behavioral problem), poor concentration due to depression or anxiety, ADHD, or a learning disability?” Accurately diagnosing a child can have a tremendously powerful impact on a child’s future happiness and academic success.

Some children are taking medications which yield minimal improvement. This is especially true of children with ADHD. Our neuro-behavioral evaluations can answer questions regarding to what extent are the medications helping or hurting the child’s ability to concentrate.

Autism is a diagnosis which directly impacts a child’s emotional and academic success. Unfortunately, there are many misconceptions about Autism, especially on the internet. Our providers are prepared to answer any questions you may have about how we diagnose Autism.

All of these are complex issues which require the use of sound procedures grounded in behavioral and neuro-psychological science. Our neuro-behavioral evaluations require in depth interviews of the child and parents, a review of records from collateral sources, and administration of cognitive testing and/or behavioral inventories. Parents will be able to observe their child during the procedures, and ask questions at the end of each session. This serves to empower parents as the complexities are unraveled and the science is explained. In the end, our goal is for parents to obtain a greater understanding of their child and why they struggle the way they do.

Session #1
Session #1 is a diagnostic exam in which we interview the child and parents to determine if there exists any emotional or behavioral diagnosis requiring treatment. Behaviors which can confound the diagnosis of a neurocognitive disorder include (but are not limited to) poor effort on homework, disrespect to teachers, defiance, and poor sleep. We make treatment recommendations for behavioral concerns first, before launching a neuro-behavioral assessment. Problematic behaviors will be targeted on the treatment plan which will be generated at Session #1.

At the first session parents are required to sign a Release of Information to gather collateral information from the child’s school and any other practitioner that has previously done testing on the child. Copies of IEP’s, previous psychological evaluations, and behavioral reports from teachers are critical to properly diagnosing your child. Requests for such records will be faxed to collateral sources before the second session. Conveying collateral information via phone is discouraged for liability reasons.

Sessions 2-4
In most cases testing can begin at the second session. To maximize your child’s performance and ability to focus, we administer only 10-20 minutes of testing at each session. This allows your provider to explain the results of each testing “cluster” and how it relates to your child’s study habits, adaptive life skills and academic achievement. Your provider will suggest ways in which to improve learning and retention if an area of weakness is identified.

De-Briefing Session
After testing is completed, a full report will be written which summarizes test results, diagnosis, and treatment recommendations. Unless your insurance is Medicaid, this will require some out-of-pocket expenses described below. During the de-briefing session, parents meet with the provider to review the written report. During this session the task is to review the report for accuracy, errors and spelling errors. Also discussed is the treatment plan, especially if ADHD, Autism, or any emotional or behavioral diagnosis is made.

Therapeutic Visitations to Repair Parental Alienation

Therapeutic visitations are a very delicate and slow process. If they are done well, it's most likely not going to be quick, but the end result can be life-changing for both the child and the alienated parent. There are two primary ways these visits can happen.

For children, this process can be terribly scary and confusing, so we prefer to identify the children as the patient of the practice. This ensures that the child's best interest is the primary concern. Treatment goals will include reducing anxiety about contact with the other parent and reducing any emotional or behavioral distress that arises (from the visitations). In order for insurance to pay, however, a child cannot be in therapy elsewhere. This option also requires that a release of information be signed by the custodial parent, allowing the alienated parent to receive progress notes from each session. Each parent will then have the opportunity to suggest edits or changes to the progress note within 24 hours of the appointment. If the custodial parent refuses to sign a release of information, there is no other choice but to proceed to option number two. If the child never (at least) has phone contact with the alienated parent, the therapeutic visits will be considered as "failed", and we would proceed to option number two.

Option number two involves the alienated parent as a patient of the practice. A requirement of this is that the alienated parent sign a release of information allowing the custodial parent to review only progress notes from each session in which the child is present. The custodial parent will have no rights to other private health information in the alienated patients medical chart.

Here are a few other major highlights: 1) If at any point there is an (already) open CPS investigation, the therapeutic visitation process cannot even begin. 2) When the child's anxiety or confusion is severe, then we typically start with phone or Zoom contact, which is far less intrusive than face-to-face contact. 3) At the very least, a successful case results in both parents being able to co-parent and communicate about the child.

HIPPA Mandates for the Release of Court Ordered Material
As a side note, please remember that (similar to individual forensic and psychological evaluations), even if these visitations are court ordered, unless a release of information is signed, members of the court, honorable judges and attorneys are prohibited from receiving medical documents from this practice. As stated above, parents will be given copies of progress notes, which they are free to disseminate to members of the court. Another option is that it can be stated directly in the court order that each parent "sign all requested releases of information". The only circumstance that a release of information is not required (for the release of court-ordered requests) is if the court order actually states "All required parties will waive their right to keep private health information confidential and private".

Video chat with us via Zoom, a HIPAA-compliant Telemedicine Platform!

Zoom is a free download, and is available on Windows and Mac, as well as iOS and Android devices.

If you are on a desktop computer, go to www.zoom.us/download and download the Zoom Desktop Client. If you are on a handheld device, go to your device's app store and enter "Zoom" for search text. Download the app called "Zoom - One Platform to Connect."
Run the application, and either sign in with an existing account, or click on "sign up" to create one.
The app may send a one-time verification code to your email address. Retrieve this from your email, and enter the requested numbers into the application.
Once you're logged in, you're ready to go! Usually your provider will email or text you connection information just before your scheduled appointment. Just click on the link provided at that time, and you should be able to enter your session.