private practice

Day 1 and Day 905

New year, new office!

This morning I welcomed my first patients into the new office at 610 Pittsford Victor Road.

This reminded me of when I first started blogging in anticipation of starting private practice.

In the spring and summer of 2016, I put a countdown in a blog post titled “Final Countdown.”

Feeling nostalgic and wondering if time stood still on this post, I took a look. That countdown clock has continued ticking ever since and here we are in a new forever home 905 days later.

Getting the space ready for today has been an all-hands-on-deck labor-of-love for the Harrison family. This included holiday visits from different sides of the family to pitch in with everything from childcare to switching out door knobs, major trash removal to interior decorating counsel.

We rung in the New Year at the new office working on important finishing touches such as…

Organizing toys in the waiting room.

Organizing toys in the waiting room.

Testing out Mario Kart in my new therapy space.

Testing out Mario Kart in my new therapy space.

Thank you to everyone who has helped to make this dream come true. The trust and support of so many people has helped grow this practice into a place where more people can find help. Something that I know I can do no justice to is highlighting the role My Better Half has played in all of this. I intend to devote a full post to describing how my wife and best friend has built my dreams and given me the opportunity to live out my life’s calling. Can you guess when this post will appear? Until then, you’ll just have to remember that she even thought of the Keurig!

Coffee (and tea and hot cocoa) for everyone!

Coffee (and tea and hot cocoa) for everyone!

One of the greatest features of this new office is more space to expand!

For those of you that have reached out since I first announced my move, thank you. Thank you for your interest. Thank you for your patience. Now with this additional space, I will work with other providers to meet the needs of families, both the ones I currently see and those waiting patiently for services. You will be the first to know!

Day 1 in the new forever home.

Day 1 in the new forever home.

Autism Evaluation Process

April is National Autism Awareness Month, so I wanted to post about topics that relate to the autism aspects of my professional training and practice. One piece that is often not discussed is what actually goes into an autism diagnostic evaluation - for patient and practitioner alike.

I take the process of conducting an autism diagnostic evaluation very seriously. I try to give as much of myself as I can intellectually and emotionally in order to provide patients and families with guidance. My goal is to offer an evaluation that is compassionate, informative, and useful.

These are the measures I routinely use as part of an autism diagnostic evaluation:

  • Autism Diagnostic Observation Schedule - Second Edition (ADOS-2) - clinician-administered
  • Social Communication Questionnaire (SCQ) - caregiver report
  • Social Responsiveness Scale - Second Edition (SRS-2) - caregiver & self-report
  • Detailed Developmental History - caregiver report
  • Chart Review - pediatric medical records and educational services & assessment history

As outlined above, the diagnostic evaluation is not just me and the patient taking a prescribed set of tests. It is often what I learn in the life narrative that gives me the confidence to proceed with a clear diagnosis and treatment plan. In order to get this information and an accurate health history, I need to talk to caregivers and review pediatric records. This is true for my adult patients seeking a diagnosis as well. While it may seem like a long time ago, childhood behaviors as reported by caregivers give me a fuller picture of the patient's life. 

Beyond the ADOS, I provide anxiety, ADHD, and mood screening Instruments when applicable. An evaluation is so much more than a "Yes" or "No" stamp for a single diagnosis, as it represents a person and a plan to improve their lives based on the challenges they have had and face today.

The inspiration for my wanting to be Ever Better at conducting autism diagnostic evaluations comes from the families I've met along the way. Those who've talked with me about what went well and what they wished could've been different on the day they learned the diagnosis.

I've also found new inspiration and room for growth in working with adults who are seeking a diagnosis later in life. The feelings and dynamics of obtaining a first diagnosis as an adult are something I am learning to navigate with my clients, and I am honored to learn with them.

I am starting to get into a rhythm with scheduling diagnostic evaluations, and I hope to keep receiving referrals for individuals across the lifespan who wonder if they're on the spectrum. In private practice, I am afforded more flexibility in scheduling and administering tests. What this has meant is that patients can get an appointment more quickly and often during "outside of typical office hours" so they can get the answers and help they are seeking more smoothly. 

This April, I'm providing autism diagnostic evaluations on Saturday mornings. So far, I have enjoyed serving new patients in a timely manner - it is very fulfilling for me to get a call from a new referral and be able to serve them within a week or two of their inquiry. Providing answers and helping families better understand their loved ones is one of the most satisfying parts of my work, and I am grateful for the opportunity to serve patients and families in this way.

I'm a guest blogger... again!

Some folks may have noticed that I've been a bit quiet on the blogging front lately.  

There are three main reasons for this: 

  1. Private Practice is really taking off! Thank you to everyone who has made the time to make an appointment with me, those who have made referrals, and those who have recommended me to your family, friends and colleagues. I cannot do this without you!
     
  2. I'm preparing for a few speaking engagements this fall.  Stay tuned to this blog for exact dates and times. I am honored and excited to partner with local not-for-profits and organizations that serve families in our Rochester community.
     
  3. I was asked to write another blog for The Scientific Parent. This time my topic is Developmental Milestones and Delays: When to Seek Help

Like in my previous blog entry for The Scientific ParentWhat is Autism & When Should Parents Seek a Diagnosis?, this time I wanted to provide some concrete information and additional perspective for parents and caregivers. In this recent post, I focused on giving caregivers guidance about whether their children are meeting their developmental milestones on time. This is a worry most parents confront at some point in time, as they watch their child's behaviors around same-ages peers at the play ground, in child care settings, or within the family. Writing this article gave me a great opportunity to address some of the concerns that impact perceptions, such as comparing the child's progress to peers, siblings, family, even the parent's own childhood development timelines. I was also able to tackle the concept of a milestone being continuous, componential, and variable in onset. Read on to learn what I mean. 

So what does it mean to meet a developmental milestone? We tend to view the meeting of a milestone as a binary event: Either they’ve done it or they haven’t. Milestones are rarely all-or-none in the final analysis. Remember the time you spent repeating “dada” or “mama” over and over to your baby as they studied your lips and tongue to try and mimic the sound. There were likely many attempts that came out as “ada” and “da” before they were able to finally say “dada” or “mama.”

First Week Follow Up

I had an amazing first week in private practice. I met with 13 different families at both of my office locations and learned about their children who ranged in age from 4- to 22-years-old. The diversity of strengths and interests of each child, adolescent, and young adult gives me a great deal of hope and excitement about the weeks ahead as we forge a therapeutic relationship. Their families are incredibly engaged and motivated to help their loved ones flourish.

I am excited, too, that I have another 10 new clients scheduled for next week and a few additional new clients scheduled for my third week of practice. I really can’t thank my colleagues and friends enough for “getting the word out” about my practice and helping to build my schedule with wonderful new people. Rest assured, there is still plenty of space left, and I am eager to welcome more new clients in the coming weeks.


I’ve had folks from a few different organizations reach out to me asking if I have a flyer to share with them that they can hand out to families. I did not have a flyer, and I think it is a fabulous idea. I developed a first edition flyer to view, share, and download here

Please feel free to share it with others who may be interested. You can offer feedback on the flyer by reaching out to me directly, or in the comments section of this blog post. 

Thank you!

My first day of Private Practice

You know how parents take pictures of their kids on the first day of school? 

Well my wife likes to do this to me on my ‘first day’ of new positions like internship and post-doc. The first day of private practice is no exception. However, this time when I protested, she snapped all of those lovely moments, too.  That’s how my first day of private practice started!

Day 1: Monday, July 11 – Clinton Crossing

Mondays and Fridays I will be at  Elmwood Pediatric   Group  in Clinton Crossing, Building A, Suite 105.

Mondays and Fridays I will be at Elmwood Pediatric Group in Clinton Crossing, Building A, Suite 105.

My first day at Elmwood Pediatrics office went really well. I felt incredibly supported and welcomed by the providers, technicians, and staff at the 919 Westfall location. There may have been some happy squealing by certain providers when they saw me arrive. I really appreciate being able to stay connected with medical providers as part of my psychology practice and value being able to collaborate with them to help patients.

I saw three patients on my first day at Elmwood Pediatrics, and I was honored to meet each of them and their families. It also meant a great deal to hear from these families that I came recommended by my colleagues at Kirch Developmental Services Center. My first day consisted of intake appointments to learn about presenting concerns and select an appropriate “first step” that fits with what families are looking for and need right now.

Day 2: Tuesday, July 12 – East Avenue Towers

Tuesdays, Wednesdays, and Thursdays I will be at the Psychology Office in East Avenue Towers. The entrance is around the back of the building, Suite 108.

Tuesdays, Wednesdays, and Thursdays I will be at the Psychology Office in East Avenue Towers. The entrance is around the back of the building, Suite 108.

My first day at East Avenue was a smooth one filled with four intake appointments. It was really nice to work closely with my psychology colleagues in this private practice setting and to dialogue more directly with the administrative team who schedules my patients.

I am amazed by the strength and love caregivers clearly show for their children when meeting with me for the first time. I think it takes a lot to seek out help, especially when we think about time and effort involved with committing to therapy. I realized today, too, that I am well positioned as part of my training with Tristram Smith, PhD and Laura Silverman, PhD to provide behavioral, evidenced-based supports for caregivers whose children present with developmental differences and behavior concerns.

Day 3, 4, & 5: We will see!

I am really looking forward to finishing out my first week. Today and Thursday I will be at East Avenue and Friday I rejoin my friends at Elmwood Pediatrics. I am excited to have two offices and two sets of professional colleagues to work with everyday. Wish me luck for the rest of the week to be as awesome as the beginning was!