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Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a developmental disorder associated with impairments in social functioning, communication and by restricted and/or repetitive behaviors. Although children as young as three may be diagnosed with ASD, sometimes the symptoms of ASD don’t become pronounced until adolescence, often in connection with the social pressures of middle and high school. Relationship and communication issues, repetitive behaviors, intense interests and sensory sensitivities are hallmark symptoms. By the teenage years, these core issues may also have contributed to a host of other emotional or behavioral difficulties. A thorough and accurate evaluation incorporating testing, information from parents and teachers, school observations (when appropriate) and in-office assessment is crucial in making a diagnostic determination. Creating an individualized developmental profile of your teen’s strengths as well as their weaknesses is much more important than the label itself, as it will enable us to provide you with a tailored action plan that truly promotes growth.

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Attention Deficit Hyperactivity Disorder (ADHD) is a common condition which involves a deficiency in the part of the brain that helps us to sustain focus, concentrate, filter out extraneous information, organize, plan, understand others’ actions, and inhibit impulses. There is currently no established “test” which can conclusively diagnose ADHD, and symptoms of ADHD overlap with those of dozens of other conditions. So, diagnosing ADHD requires a very comprehensive approach. ADHD therefore often goes undiagnosed until the increased academic and social rigors of adolescence bring the symptoms to a crisis point. Fortunately, there are very effective treatments for ADHD once a solid diagnosis is made. Teens who do not receive proper treatment for ADHD are at risk for a variety of issues in school, friendships, family life and mental health.

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School – Academics

From childhood to adolescence, academics become more demanding, draw on a greater set of skills and are associated with higher stakes. It’s no surprise that children who excelled or at least “got by” during the earlier school years can experience difficulties in middle and high school. These difficulties are frequently associated with gaps in core study and organizational skills, which then compound into gaps in specific subject areas. Left unaddressed, academic difficulties can complicate social and family dynamics, often in dramatic ways. Finding and supporting gaps early is key not only to academic progress and self-esteem, but can head off a wide variety of larger problems.

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School – Social

Anyone who has been a teen knows how challenging it can be to navigate the social landscape during those years. Adolescence itself makes things difficult enough. The structure and rhythms of school life add enormous pressure and complication. So, it’s tough, before even considering family dynamics or the burdens of any other issues the teen may be enduring. Effective support and therapy respects all this complexity, understands that the quality of relationships is fundamental, and focuses on the teen’s existing strengths as a starting point for progress.

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Mood and Emotion

Adolescence is a fertile time for the development of mood and emotional issues. To some extent, mood swings themselves are normal: cognitive development lags behind emotional development during these years, and the start of high school marks a major transition, so difficulty coping with emotions is par for the course. But these same factors can also contribute to greater volatility in the symptoms of mood and emotional disorders. When symptoms are particularly severe, when they fail to stabilize over time and despite calm, open support from family and friends, professional assistance is a good idea. 

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Anxiety disorders are common, and very frequently grow pronounced during adolescence. Symptoms of an anxiety disorder can appear suddenly, or emerge gradually. Very often, teens who have an anxiety disorder are unable to understand or articulate a definite cause for their fears, worries, emotions and related physical symptoms.  Although anxiety is a normal—even healthy—ingredient of life, when it occurs too frequently, is too strong, and affects a person’s daily life and happiness, it is time to seek professional support.

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Eating Disorders

Eating disorders are serious conditions that can wreak havoc on teens, and are especially common among girls. There are many eating disorders, but all feature persistent eating behaviors that adversely impact health, emotions and the ability to function. Certain factors appear to put teens at risk of developing eating disorders, including social pressures, involvement in activities that value leanness, genetics, and personality traits like perfectionism, anxiety or rigidity. Teens may go to great lengths to hide eating disorder behaviors, so parents need to be educated and alert about common “red flags” and patterns that may signal a problem. Frequently, recognizing and dealing effectively with an eating disorder in a teen is complicated by family issues. Because of the high potential consequences of these disorders, taking them seriously and seeking professional assistance are critical.

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Many teens experience acute or chronic trauma, and others experience symptoms in their teens of trauma that occurred in childhood. Trauma can be associated with any event that threatens injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Teens may be less likely than children to openly share traumatic experiences with parents or friends, making it more difficult to promptly recognize and treat their trauma. And symptoms of trauma can contribute to problems within family communication and relationships. Parents may not understand the cause of trauma-related behaviors in their teens, or may feel “locked out” from discussing the trauma. 

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Family Issues

Conflict is a normal part of family life, and it is particularly common with teens, who are exploring independence for the first time. Disagreements, communication issues and changes in the family all increase the likelihood and severity of these conflicts. Teens can respond to family conflict in many ways, including aggression, defiance, withdrawal, depression, anxiety and self-medication with drugs or alcohol.  With effective professional support, teens and their families can use the conflict as on opportunity to build important communication and life skills that not only help to resolve the current situation, but countless others in the future. It is imperative to address family issues that involve teens promptly, prior to the onset of aggressive, violent or self-destructive behaviors. 

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Are you ready for help? We’re ready to start you on your journey to maximize the developmental, social, emotional, behavioral, and academic potential of your child, teen, and/or family.


What Others Say About Us

I am a general pediatrician with a special interest in ADHD, spending about 20% of my clinical time caring for ADHD patients. I have known Dr Pontillo since 2005 and have an enormous respect for her clinical skills and insights. She is my “go to” psychologist for more complicated developmental issues and for diagnosis of subtle high functioning disabilities. Dr. Pontillo’s interest in her patients and her ability to clearly delineate developmental problems allows parents to move forward with establishing a treatment plan. She is an invaluable resource to the San Diego Pediatric community.

Nicholas Levy, MD, Medical Director, El Camino Pediatrics, V. Asst Clinical Professor, School of Medicine, UCSD

Dr. Pontillo is an exceptional, and one-of-a-kind child psychologist. I have referred many children of my patients to Dr. Pontillo and she has always given them the best care and attention. Referring a patient to another professional is a big responsibility. I always look for a colleague who is efficient, professional, experienced and one who is able to come up with a clear diagnosis. I keep referring to Dr. Pontillo because of her expertise, efficiency and especially her warm and caring personality that is extremely necessary when dealing with children. I very highly recommend Deborah Pontillo, Ph.D as a child diagnostician, developmental and behavioral specialist, and therapist.

David Kravetz, M.D., Professor of Clinical Medicine, School of Medicine, UCSD

I’ve been referring my patients to Dr. Pontillo for the past several years with the utmost confidence that she will care and understand their developmental needs. Dr. Pontillo always provided them with a balanced and age appropriate intervention to help not only the child but the family as a whole.

Chrystal de Freitas M.D., Pediatrician Carmel Valley Pediatrics