We provide treatment for children, adolescents and adults with autism spectrum disorder. This includes testing and diagnosis.
In addition to services for children and adolescents with Autism Spectrum Disorder I am one of the few providers in BC with extensive experience working with adults with autism spectrum disorder (ASD) or what was previously called “Asperger’s Disorder or Syndrome.” As a matter of fact, over the past twenty years more and more of my practice has focused on working with adults, their families, social, school or work-place issues. Services include diagnostic testing, social coaching, work-place evaluations, intervention planning and family consultations. I also see couples where one or both members have or suspect they have ASD.
If you have a child who is approved for ministry funding you are able to use the funding for services I provide. I am a member of the approved service providers list- the RASP. You need to to arrange for the funding approval prior to seeing me. Please CLICK HERE to obtain the form necessary to list me as a service provider. Here is the information you need to complete my part of the form:
Service Provider Name : Dr. James Roche
Check “service provider” not “agency”
Address: 501-3292 Production Way, Burnaby, BC V5A 4R4
Phone number: 778.998.7975
Types of Services: Behavioural Therapy and Family Consultation. This allows me to see your child, and you, for family consultations
Start and Finish Dates: Start wth the date you expect to see me, and you can set an end date of your choosing
Fee: $200 per hour
Total Amount: This is the amount you expect to use over a period of time. It could be a total of 3 sessions, or ten. It’s up to you, and you may change this at any time. You are also able to do this through the Ministry’s website. The Ministry provides training sessions on setting up and changing your billing.
Services for Autism and Asperger's Disorder / Syndrome
Assessment and Diagnostic Services (autism, Asperger’s, ADHD and related disorders). Assessments for Asperger's and high-functioning autism spectrum disorder (ASD) cost a maximum of $2,400. Forensic assessment, those involving legal or workplace issues, are billed on an individual basis. Sometimes colleges or universities also require a psychoeducational assessment. Contact them first to see what they expect.
Workplace consultations and site-based education programs
Educational / Social coaching for young adults in the workplace, college, and similar settings
Social coaching for adults with high-functioning (Level 1) autism (Asperger's Disorder / Syndrome)
Couples counselling for couples dealing with adult autism, adult Asperger's Disorder / Syndrome
Do You See Women Who Suspect They Have Autism?
I see a number of women about autism spectrum disorder. I know a lot of individuals worry about doctors being able to “see” and diagnose autism in women, but I feel confident in the structured and normed-based test procedures we use. Problems in the diagnostic process seem to come from situations in which appropriate tests were not used, and the diagnosis was based upon little more than a short clinical interview to circumvent a full assessment. Many times signs and symptoms of ASD are simply not apparent until we do a full assessment. If you feel the need to take a screener, here is one that comes recommended far more often than others: https://autismcanada.org/about-autism/diagnosis/screening-tools/adult/
What are These Assessments Used For?
Adult autism assessments are often used for disability tax credits, qualifying for different types of disability support programs, or qualifying for accommodations and support services in school, university or the workplace. The individuals I see range greatly in their abilities, ranging from heads of corporations, heads of government agencies, police officers, college instructors to university students and individuals who are in need of comprehensive care plans and 24 hr support. We make sure our assessment for autism meet the same standards that are required of the ministry for students in British Columbia obtaining support services. We help you with the necessary forms and backup documentation you might need as well.
We provide assessments for children over 6 years old as well.
Is a referral necessary?
While a referral isn’t necessary, often a short note from your doctor helps clarify what their concerns are, and that other medical issues have already been ruled out. If you have been seen by other doctors who have provided a different diagnosis, I need to have those records available to me. These can usually be obtained simply by asking your medical provider and providing a release form. Most of the time I will request you see a medical doctor to rule out other plausible symptoms for your concerns.
OTHER Frequently Asked Questions (FAQs):
What is Your Background for Providing Treatment for Adults with Asperger's and High Functioning Autism?
My background for working with adults starts with my three decades of experience with children and adolescents as a teacher, school psychologist, behaviour management specialist and provincial consultant for autism and related disorders. I have been an autism consultant through the province. Understanding adult ASD symptoms requires being familiar with the developmental issues of Asperger's and high-functioning (Level 1) autism.
Three other important skills/experiences also come into play in working with adults with Asperger's Disorder or high-functioning autism. First, I have several years of experience working as a neuropsychological consultant with Rehab Without Walls in California which provided me with a background in working with workplace related issues.
Second, many adults come to me with concerns about their relationships, including couple relations and relations as a parent. Before becoming a registered psychologist I was a licensed and Registered Marriage and Family Therapist and have worked as a couple and family therapist for over 30 years. This includes advanced training in the Gottman Couple's Therapy technique.
Third, one of the most commonly used individual therapy techniques when working with adults with Asperger's or High Functioning Autism is Cognitive Behavioural Therapy or CBT. I hold an advanced certificate in CBT from the Albert Ellis Institute in New York City. My original training in psychology was in behaviour therapy, which is often a critical knowledge base when teaching individuals specific compensatory skills.
What are some of the aims of therapy for adults with Asperger's or high functioning autism?
to provide basic knowledge and understanding of autism spectrum disorder
to teach new cognitive and behavioral skills that were never learned
to teach compensatory strategies for deficits that cannot be changed
to facilitate self-acceptance
to teach strategies to decrease or prevent symptoms of co-morbid mental health problems, such as anxiety disorders and depression
Most importantly, I try to help you discover ways to make life easier, how to reach your goals, and try to help you be as happy and fulfilled in life as you want to be.
Do you work with ADHD (Attention-Deficit/Hyperactivity Disorder) and Executive Dysfunction?
ADHD is now often diagnosed along with Asperger's Disorder of High Functioning Autism, so much of my work with children, adolescents and adults focuses on ADHD and deficits of executive function. Executive function is the concept referring to the cognitive processes required to plan and direct activities, including what we refer to as task-initiation and follow-through, working memory, sustained attention, performance monitoring, inhibition of impulses, and goal-directed persistence. It also affects an individual's ability to control and modulate their emotions.
Many individuals I see have deficits in executive functioning which prevents them from having the necessary skills to perform well in school, work or in social settings. With these clients we often need to make diagnostic decisions through testing and assessment, and then develop an individualized treatment plan addressing school, home and work. This might involve individual behavioural therapy, school or work consultation, referral to medical professionals, and psychoeducation.
I often provide reading material, training videos and demonstrate and practice specific intervention techniques with clients. Much of the work we do in the area of ADHD is based upon the research and treatment programs developed by Dr. Russell Barkley. You can learn more about him by clicking here: Russell Barkley
What about Anxiety, Depression or Family Issues?
Adolescents and adults are seen for both diagnostic assessments and treatment of depression, anxiety and behaviour problems that might arise out of environmental or interpersonal situations. These individuals might take part in cognitive based therapy or counselling, or they might be provided with more traditional supportive therapy. Anxiety and depression are frequent co-morbid disorders for adults with Asperger's Disorder or high-functioning autism and need to be addressed in treatment.
How Do I Make an Appointment and is there a Waiting List?
You may phone my office at 778.998.7975 or email me to begin setting up an appointment. I always start by meeting for an initial session to gather a developmental history, hear about your current issues, and to develop a plan of where to go from here. An assessment may or may not be the best choice, and you should fully understand what your options are before proceeding. Fees for initial and ongoing sessions are $200 per hour and may be paid by cash, check, eTransfer or through PayPal. So I will admit it is sometimes difficult to reach us. We receive many emails a day, as well as numerous phone calls. We cannot reply to everyone so I suggest in the subject heading of your email you clearly state what you are writing about. If you do not hear from us in two weeks, email or call again. Our waiting list is kept short. I know other doctors have waiting lists that extend for several months. These are always problematic as emergencies come up, and people are bumped down the waiting list. Once we contact you we usually are able to see you within 10 days. (Excluding vacations and times I am away for training or teaching workshops.) Once we agree on an assessment we usually have it completed in a couple weeks. More time is then needed to complete a comprehensive written report. We try to focus our practice on those who are the least served, that means adults with autism spectrum disorder, adolescents with autism spectrum disorder, and then learning disabilities and ADHD assessments. We appreciate your being patient.
Do you provide social/relational interventions?
One of autism’s “core deficits” is a lack of social and communication skills. Many children with autism and Asperger’s Syndrome or Aspergers Syndrome need help in building the skills they need to hold a conversation, connect with a new friend, or even navigate the playground. Social skills therapy can help out setting up and facilitating peer-based social interactions. We often use books and programs developed by Michelle Garcia Winner such as her “Social Behaviour Mapping” to address these issues.
Do you provide play therapy?
Children with autism and Asperger’s Disorder often need help learning to play, and play can also serve as a tool for building speech, communication, and social skills. I provide consultation and parent training in using play therapy techniques in your home, including therapeutic techniques such as Floortime.
What about behaviour therapy for problematic behaviours
Children and adolescents with autism and Asperger’s Disorder are often frustrated. They are misunderstood, have a tough time communicating their needs, suffer from hyper-sensitivities to sound, light and touch and constant anxiety. Using Functional Behaviour Analysis (FBA) we will help you figure out just what lies behind negative behaviours, and recommend both changes to the environment and routines to improve behavior as well as what specific new skills are needed to address the function of the behaviour (called a Functionally Equivalent Replacement Behaviour or FERB). Behaviour interventions are developed for use in the home, school or community.
Can you help us with School Problems?
School academic and behaviour problems are a major part of my practice. We can help you understand what the problem is through diagnostic assessments, and then develop a school based intervention plan that will work in conjunction with your home interventions. This usually means completing an assessment for learning disabilities that will help you get accommodations and an individualized education plan (IEP) at school. This starts with a psychoeducational evaluation. These tests are administered by myself and two psychometrists who are fully certified school psychologists. We provide you with a full diagnostic report with educational recommendations that meet the requirements of the Ministry of Education. Psychoeducational evaluations cost $2,400.
Are there any on-line screening tools that are useful?
(Information from AutismCanada’s website)
I don’t like on-line screening tools for autism, depression, ADHD or any other disorder. My reasoning is very simple: A diagnosis of any disorder is complex. Much of what goes on in a diagnosis is about “ruling out” other possible causes for the symptoms or behaviours. ADHD can look just like autism, or depression, and autism and several language disorders are very difficult to distinguish. Still, I know parents and adults are looking these tools up. So here is some information from the AutismCanada website:
There are a number of screening tools available for autism spectrum disorder, however most are available only to professionals as part of a large testing kit. These include:
Ages and Stages Questionnaires (ASQ)
Communication and Symbolic Behavior Scales (CSBS)
Parent’s Evaluation of Development Status (PEDS)
Modified Checklist for Autism in Toddlers (M-CHAT)
Screening Tool for Autism in Toddlers and Young Children (STAT)
Observation tools such as the Autism Diagnostic Observation Schedule (ADOS-G)
The Childhood Autism Rating Scale (CARS)
The Autism Diagnostic Interview – Revised (ADI-R)
For Children and Toddlers
Of all of the on-line tools that are available for young children-toddlers I would suggest the M-CHAT-R. The Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R™) is a scientifically validated screening tool for children between 16 and 30 months of age that assesses risk for Autism Spectrum Disorder (ASD).
The American Academy of Pediatrics (AAP) recommends that all children receive an autism screening at 18 and 24 months of age.
Autism Speaks is an international advocacy organization "dedicated to advancing research into causes and better treatments for autism spectrum disorders and related conditions both through direct funding and collaboration; increasing understanding and acceptance of autism spectrum disorders; and working toward solutions for the needs of individuals with autism and their families across the spectrum and lifespan through advocacy and support." [Website]
For full text or more information
Autism Screening Tool for Children ages 3-11
For children ages 3-11, I would suggest The Childhood Autism Spectrum Test (CAST) Here is a link to an on-line version:
Autism Screening Tool for Teens ages 12-15
For teens I would suggest The Adolescent Autism Spectrum Quotient (AQ). Here is a link to an on-line version:
Autism Screening Tool for Adults Ages 16+
For adults I would suggest the The Adult Autism Spectrum Quotient (AQ)