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Dr. Lauren Tobing-Puente’s private practice provides the following services:
- Psychological Evaluations: including those for the purposes of diagnosing autism-spectrum disorders and for assessment of intellectual and adaptive functioning. Dr. Tobing-Puente is trained to use the Autism Diagnostic Observation Schedule (ADOS), a leading, highly reliable assessment tool for individuals suspected of having an autism-spectrum disorder.
- Developmental Evaluations: to assess a child’s level of overall development (including their cognitive, speech/language, motor, adaptive, and social-emotional development).
- Floortime: individual therapy for children with autism-spectrum and related disorders, including parent, caregiver, and therapist coaching. See below for more information on Floortime.
- Child counseling: including play therapy and psychotherapy with children with a variety of challenges, including autism-spectrum disorders and general delays in social-emotional development, as well as for siblings of children on the autism-spectrum
- Social Skills Groups: for children with difficulties in the areas of relating and communicating, including those diagnosed with an autism-spectrum disorder.
- Parent/Caregiver Training and Support: for parents/caregivers of children with a variety of challenges in order to learn skills that will facilitate their child’s development in generalized settings, to have a place to share and process their experiences, and to learn stress management.
- Parent/Caregiver Groups: twice monthly (1st and 3rd Mondays of the month) including topic-focused groups aimed to provide pertinent information related to their child and family, and supportive groups in which parents/caregivers benefit from interacting with others and sharing experiences related to their children with similar challenges.
- Sibling Support Groups: provide a supportive social environment for siblings of children with autism-spectrum disorders.
About Childhood Development and Social-Emotional Development
Parents and caregivers often have questions about their children’s development and wonder whether certain behaviors are appropriate at various ages. There are also increasing concerns about behaviors and difficulties that may be indicative of autism. Children are expected to develop skills across areas of development (cognition, speech/language, motor, adaptive, and social-emotional) during specific time periods. There are tools to assess such difficulties that give parents the answers they need to pave the way for obtaining any necessary interventions. The traditional “wait and see” approach is no longer the norm, as children’s needs should be addressed before they worsen or further impact their own and their families’ lives. Psychologists are specifically trained to assess and treat such difficulties in order to support children and their families in their daily lives.
Caregivers who suspect that their child is not achieving skills in one or more areas of development are encouraged to seek a developmental screening or developmental evaluation in order to formally assess the child’s skill levels. Dr. Tobing-Puente is highly skilled at using many of the leading developmental assessment tools available for young children. Her many years of clinical experience have led to a highly informed clinical opinion. For more information regarding developmental milestones, refer to the Centers for Disease Control: http://www.cdc.gov/ncbddd/autism/actearly/.
About Autism-Spectrum Disorders
Autism is a neurobiological disorder characterized by significant difficulties in the areas of socialization and relating, communication, and oftentimes, sensory processing. According to the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV), autism is one of the five Pervasive Developmental Disorders (PDDs). In recent years, autism, Asperger’s Disorder, and PDD-NOS (Pervasive Developmental Disorder-Not otherwise specified) have been conceptualized as being on the “autism spectrum.” Asperger’s Disorder is considered to be part of the higher functioning end of the autism spectrum and is characterized by significant difficulties in socialization and difficulties with social communication, with generally typical cognitive development. A diagnosis of PDD-NOS is appropriate for individuals who do not meet the full criteria for autism but display difficulties in the areas of relating and communicating.
Diagnosis of autism-spectrum disorders has markedly risen over the past 10-15 years, with current estimates of 1 out of every 150 children receiving a diagnosis, according to the Centers for Disease Control (CDC). Diagnoses are 4 times more likely in boys than girls.
There are several “red flags” for autism spectrum disorders in children:
- Inconsistently responding to one’s name
- Inconsistently making or sustaining eye contact
- Delayed verbal and nonverbal language development
- Stereotyped and repetitive behaviors (including: hand-flapping, rocking)
- Displaying a limited range of interests
- Limited play skills, including using toys and objects in unusual ways
For more information on the signs and symptoms of autism spectrum disorders, see: http://www.autismspeaks.org/ and http://www.firstsigns.org/.
Evaluation of Autism-Spectrum Disorders
There is no medical test for autism-spectrum disorders. An accurate diagnosis entails a comprehensive observation of an individual’s social interaction skills, communication skills, and behaviors, as well as a detailed report from the individual’s caregivers or others that interact with him/her on a daily basis. Dr. Tobing-Puente has been trained to use the Autism Diagnostic Observation Schedule, and has used this leading, highly reliable test for autism for several years.
Treatment of Autism-Spectrum Disorders
Treatment for autism spectrum disorders typically involves highly supportive, intensive, and individualized programs that address developing the child’s areas of difficulty. Oftentimes, a combination of approaches is used for children on the autism spectrum. There currently is no cure for autism spectrum disorders.
- Floortime is a treatment approached developed for children with autism and related disorders of communicating and relating, which was developed by Dr. Stanley Greenspan and Dr. Serena Wieder based on their Developmental, Individual Differences, and Relationship-based (DIR) Model. Floortime seeks to build upon a child’s capacities using a developmental framework, while acknowledging their individual differences (e.g., sensory processing, visual-motor capacities, etc.). Using this child-directed approach, therapists and parents aim to join with the child using his/her interests in order to build upon longer and more enhanced interactions. For more information on Floortime, see http://www.floortime.org/.
About Dr. Tobing-Puente
Lauren Tobing-Puente is a NYS Licensed Psychologist with over 13 years of clinical experience with children and families. She received her PhD in Clinical Psychology from Fordham University, where she specialized in child and family therapy. Her expertise in diagnosing and treating autism-spectrum disorders stems from working in a variety of treatment settings, using the DIR/Floortime and ABA approaches. She has assessed and treated a variety of clinical populations across an array of settings, including homes, schools, hospitals, and community-based clinics.
Dr. Tobing-Puente’s current position as a psychologist for the Rebecca School (a DIR/Floortime school for children with autism-spectrum and related disorders ranging from 4 to 16 years of age) includes Floortime therapy, play therapy, psychotherapy, and psychological testing, parent support and education, sibling support groups, supervision of externs, classroom consultations, and research on the Floortime model. Dr. Tobing-Puente also currently provides counseling to children through the Committee on Preschool Special Education (CPSE). She serves as a consultant to Early Intervention program and preschool centers, where she conducts staff trainings, screens children for social-emotional and other developmental delays, and provides classroom and parent support.
The experiences of parents of children with autism-spectrum disorders have been the focus of Dr. Tobing-Puente’s research studies, which have been presented at national conferences and published by reputable scientific journals, while paving the way for subsequent research studies on this topic. She currently serves as a consultant and reader for graduate-level research through Fordham University and New York University.
Dr. Tobing-Puente is a member of the American Psychological Association (APA), of APA’s Division 53 (Society of Clinical Child and Adolescent Psychology) of the New York State Psychological Association (NYSPA), and of the Association of Early Childhood and Infant Psychologists (AECIP).
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