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. Children with mild ASD may be incorrectly labeled as having ADHD, oppositional/defiant disorder, anxiety/fearfulness or simply seen by parents and teachers as being ‘strong-willed’ or ‘stubborn’. The earlier we are able to identify ASD in children, the greater gains we can make in maximizing their developmental potential. 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 child’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 your child’s growth.
ADHD
Attention Deficit Hyperactivity Disorder (ADHD) is a common condition which manifests prior to the age of 7. ADHD 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. Fortunately, there are very effective treatments for ADHD once a solid diagnosis is made. Children who do not receive proper treatment for ADHD are at risk for a variety of issues in school, friendships, family life and mental health.
School – Academics and Social/Emotional
Starting school is a major transition in a child’s life. And the first several years of school are an early window into academic issues that—left unaddressed—can become major stumbling blocks with repercussions in all areas of life. Common preschool concerns include separation anxiety and behavioral problems, both of which can disrupt academic progress. During the first few years of school, early issues may manifest, giving us the first and best opportunity to intervene with critical support for cognitive, social/emotional and physical development, fine motor skills, behavior and self-direction. In addition, all of these factors and others play into selecting a “best-fit” school for your child.
In addition to addressing these common concerns, we help many children who are experiencing developmental delays or “lags” with respect to milestones such as speech/language development, motor development, potty training, and more.
Anger and Emotion
Learning to tolerate and regulate one’s negative emotions (e.g., frustration, anger, etc.) is a developmental skill that often takes time and practice to master. If your child is exhibiting significant anger outbursts, or appears to “go from 0 to 60” when frustrated, he or she may benefit from learning more sophisticated self-regulation strategies.
Anxiety
Many children struggle with anxiety. Extreme fear, worry, and anticipatory anxiety can lead children to begin to avoid situations and greatly limit their activities. Anxiety that is left unaddressed can also lead to poor self-esteem, poor self-confidence, and can put a child at greater risk for developing depression in the future. Fortunately, anxiety is one of the most well researched mental health concerns. There are extremely effective short term-treatments, such as Cognitive-Behavioral Therapy. This therapy helps the child to change thoughts, beliefs, and ideas about the feared situation. And it creates gradual, systemic changes in behavior to allow the child to better manage the fear.
Certainly, treatments that take into consideration the child’s individual strengths, environment (e.g., family relationships, peer relationships, school setting), temperament, level of insight, motivation, and other factors (e.g., health or other concerns) will be the most effective. In addition, anxiety that is situational or due to a major change in a child’s life (e.g., parental divorce, loss of a family member, transitioning to middle/high school, peer difficulties, coping with medical health issues) will require a less structured approach in order to tailor the therapy to the child’s individual circumstances.
Trauma
Many children experience trauma—both acute, single-event trauma as well as chronic trauma. A traumatic event is one that threatens injury, death, or the physical integrity of self or others and also causes horror, terror, or helplessness at the time it occurs. Almost all children who have experienced trauma experience short-term distress, but can return to normal levels of functioning if they receive proper treatment and support. The quality of the relationships a child has with therapists, family and others in their support networks is fundamental to their recovery.
Our menu of services for trauma includes EMDR, a powerful technique for accessing and processing past traumatic events, bringing those events to a healthy resolution. Few practices include a certified EMDR practitioner, but our own Kim Brownell, LCSW, is certified to provide this effective treatment option.
Eating Disorders
Although more frequently recognized in adolescents and young adults, eating disorders frequently begin in childhood, but go unrecognized, undiagnosed and untreated. Eating disorders include not only anorexia and bulimia, but also many other, lesser known varieties. Disturbed eating behavior can be associated with concerns about weight and shape, but also by disinterest in food, phobic avoidance or avoidance due to the sensations of eating. Effective treatment includes both psychological and dietary components—dietary approaches alone are far less effective.
Family Issues
Children experience and react to any issues within their family. Sometimes the effects go unnoticed until they become more severe and obvious. Sometimes the effects are dramatic and immediately recognized. Sometimes children are seen as bystanders to disruptions in family dynamics, and other times they are seen as the source of the disruptions. But all of these situations point to the fact that children are interconnected with all the members of the family; they experience and participate in all its dynamics. Seemingly disconnected issues or problems experienced by a child are very frequently connected to—and exacerbated by—larger issues within the family. In therapy, the goal is not to assign blame, but to recognize unhelpful patterns of behavior, and replace them with patterns that support the wellbeing of all the members of the 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.
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.
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.