Leesa Lacey considers her profession personal.
Founder and CEO of Integrated Brain Health, Lacey’s path to helping children and their families better understand how their brains work began with a brain injury of her own. An infection led to the injury, and then Lacey spent time in a coma. Afterward, she found herself on a path to obtaining a graduate degree and becoming a licensed professional counselor.
At the age of 40, Lacey discovered she had attention deficit and hyperactivity disorder. Her then-20-year-old daughter, who had been struggling for years, also received an ADHD diagnosis. Lacey began reflecting on all the things she wished she’d done differently for her daughter and realized she wanted to dedicate her career to keeping other parents from experiencing the same regrets.
The prevalence of ADHD
A meta-analysis of 175 research studies worldwide showed ADHD prevalence in about 7 percent of children ages 18 and younger, according to national ADHD resource Children and Adults with Attention Deficit/Hyperactivity Disorder (CHADD). The organization applied this to population estimates in 2013 to determine an estimated 129 million children had ADHD around the world.
In the United States, CHADD cited data from the 2016 National Survey of Children’s Health that showed 6.1 million children had been diagnosed with ADHD, including about 388,000 ages 2-5; 2.4 million ages 6-11; and 3.3 million ages 12-17.
During ADHD Awareness Month in October, groups like CHADD work to emphasize efforts to clarify information surrounding ADHD, help people understand what it is and what resources can help people with ADHD reach their potential.
Lacey started her company 12 years ago as a counseling agency under a different name, but after performing further evaluations of children coming in for counseling, she realized many had contributing factors that needed addressing. The trouble seemed to come from disconnects between the different providers treating these children.
“Unfortunately, professionals have a tendency to stay in their lanes,” said Lacey, who specializes in evaluating and treating ADHD. “But when it comes to the brain, there is no one lane. If we want to really understand what’s going on and help our clients, we have to be able to look across multiple domains of the brain.”
Evaluating overall brain health
Lacey pivoted the company from counseling to a more holistic approach addressing children’s brain health and renamed the organization Integrated Brain Health. The scope of IBH’s work extends beyond ADHD, incorporating elements like an autism program and occupational therapy to provide a comprehensive approach to improving brain health. Assessment begins with the Integrated Brain Health Multidimensional Assessment Tool, a process IBH refined that helps identify the spectrum of factors impacting the brain’s health. With this tool, Lacey and her team gain a more holistic understanding of their clients’ brains, and they can treat them more effectively with customized, integrated plans for each child.
“When we tell parents about our Assessment Tool, the buy-in is usually instantaneous,” Lacey said. “They’ve been bounced around to different providers for years in some cases, without seeing any real improvement. They are frustrated because they don’t have answers and they’ve tried everything they know to do. They feel alone. The Assessment Tool helps give everyone clarity and a better understanding of how and why things are the way they are. And, of course, it’s really encouraging for everyone when we can then outline a treatment plan that’s going to address what really needs addressing so their child’s brain health can actually improve … and so can theirs.”
The Assessment Tool evaluates not just the behaviors that led to a referral to IBH but also other contributing factors in the child’s environment and experiences to help understand the “why” behind the behavior. It can also help identify other complicating neurodiverse factors that may be working to exacerbate each other.
For example, in children ages 2 to 17 diagnosed with ADHD, 63.8 percent had at least one co-occurring condition, according to data from CHADD. A little more than half of all children had behavioral or conduct problems, 32.7 percent had anxiety, 16.8 percent showed signs of depression, 13.7 percent showed autism spectrum disorders, 1.2 percent had Tourette syndrome and 1 percent had a substance abuse disorder.
“Every child is unique,” Lacey said. “Some may have memory issues. Some may have sensory issues. Some may [have] auditory processing issues. We have to look at exactly how and what all is impacting that child’s brain in order to treat them effectively.”
In some cases, the team at IBH works with families whose children have been incorrectly diagnosed and who have navigated years of frustration.
Laurie Patterson’s teenage daughter was previously diagnosed with ADHD, but the Assessment Tool determined ADHD was not what was plaguing the teen. Instead, she was diagnosed with an anxiety disorder, performance anxiety and depression.
In addition to providing the Patterson family with an accurate diagnosis for their daughter and effective tools to support her, the team at IBH provided holistic care and helped them assess and improve their communication with each other.
“She helped my husband and I have both perspective and hope,” said Patterson of working with Lacey. “IBH goes well beyond traditional therapy [to] look at nutrition, exercise, screen time, sleep hygiene and family dynamics.”
With the 18-page, 250-question Assessment Tool, IBH can provide recommendations for evidence-based treatments and can bridge the gap between standard psychotherapy intake assessments and often more expensive full-psychological assessments, which typically have months-long waiting periods for treatment to begin, said Lacey. She developed the Assessment Tool over the years of her counseling career leading to the formation of IBH. The team at IBH – which provides its integrated services in a 28,000 square-foot clinic – can then implement treatment plans in-house to reduce the need for families to bounce from specialist to specialist to get the services they need.
Supplementing medication received from medical providers, IBH develops treatment plans that address a wide variety of everyday factors that can make a difference in helping neurodiverse children, including exercise, motor function, language skills, sleep hygiene, extracurricular activities, technology habits and nutrition, Lacey said. Another major piece of the puzzle is educating parents. For example, when parents understand that a child’s behavior is rooted in an attempt to recreate a dopamine response that’s comparable to someone struggling with addiction, they have a better understanding of their child’s behavior and how to respond and parent more effectively.
“Treatment for ADHD requires more than medication alone,” Lacey said. “Medication is like one leg of a six-legged table. There’s no one-size-fits-all. In psychoeducation with the parents, the most important thing is that parents gain an understanding of how to best support their child and implement necessary changes in their daily lives.”
The parental education was as vital to Molli Grove as the treatment her son received through IBH.
“To say he was on a collision course with life and the law, is an understatement,” said Grove of her son, who was diagnosed with ADHD and ODD. “He could not control his impulsivity or his compulsions. I did not have any idea how to support him. My very passive approach was creating more chaos, and my hyper sensitivity was not helpful.”
Instead of sitting during therapy sessions, Lacey took Grove’s son outdoors so he could move while they talked. From the team at IBH, Grove gained vital insight on the importance of nutrition, sleep and monitoring her son’s screen time, and she gained a firmer understanding of the importance of rewards and discipline. Grove also appreciated the holistic support her family received during her son’s IEP meetings, with the hospital intake team when her son became suicidal and with her son’s psychiatrist to ensure her son’s needs were met and that everyone was working toward the same end goals.
“My son is a different person,” said Grove of his transformation. “He is med free today, thriving, preparing for his next chapter.”
The power of neurodiversity
When encouraging the child to understand how their own brain works, Lacey uses a variety of tools to help them see and understand brain health instead of just viewing it as a component of mental health. She may have them interact with a physical model of a brain to show how different areas work or help them visualize their role via a poster depicting a green fish swimming among a school of goldfish.
“I tell them ‘I’m just like you,’” Lacey said. “‘We’re green fish. We can swim around with the goldfish, but we’re different. We’re super cool, super smart, but no one understands how we work.’ It gives the child permission to be proud of how unique they are.”
In addition to giving kids confidence, Lacey has also seen parents develop a sense of relief after understanding the underlying causes and seeing a path to improving their children’s brain health. The Assessment Tool can also help determine if the child’s behavior is simply attention-seeking or related to a different diagnosis that may put them years behind their peers in maturity, especially with a child who has ADHD.
Even if the Assessment Tool does not reveal a specific diagnosis, it may help identify other neurodiverse factors that parents could address to help their child make the most of how their brain works, Lacey said.
Though the team cannot practice across state lines, IBH is working to make the Diagnostic Assessment Tool available across the country so parents anywhere can access and use it to coordinate with their local providers in getting the most effective treatment for their child. The Diagnostic Assessment Tool should be available by the end of 2022.
“The Multidimensional Diagnostic Assessment Tool is based on DSM criteria as well as other assessments utilized by speech pathologists and occupational therapists to drive appropriate treatment,” Lacey said. “Having the results of this assessment in their hands gives parents peace of mind and empowers them with a way forward for their child. I never want a parent to not have that information … as I didn’t before my daughter was diagnosed.
For more information, visit IBHealth.co or call (405) 702-9032.