Julie Scorah is a neuropsychologist specializing in neurodevelopmental conditions such as autism, ADHD and Fetal Alcohol Spectrum Disorder.
She is the Associate Director of the Azrieli Centre for Autism Research (ACAR) Clinic, and has over 16 years of experience in various tertiary care centres in the assessment and diagnosis of neurodevelopmental conditions.
We spoke to Julie about her day-to-day work, her hopes for the future, and how the pandemic has changed clinical autism care.
"Dr. Scorah's calming and reassuring voice during the appointments for my son's diagnosis made my experience very pleasant. Her expertise is phenomenal and I look forward to my meetings with her. She's an angel doctor!”
– Grace Allanah, parent
What sparked your interest in working in the field of neurodevelopment?
I have always been interested in neurodevelopment and how biological and environmental factors affect brain function.
Through various professional experiences, I started working more closely with children with neurodevelopmental conditions, particularly autism, and decided that this was where I wanted to focus my career.
I really felt at home working with neurodiverse individuals and their families. I also saw first-hand how many of them were lacking appropriate services and supports and how few professionals specialized in this area. I felt that I could have a positive impact if I focused my efforts within this community.
The ACAR Clinic is an integrated autism research clinic that offers personalized services from childhood (at its satellite site at the Montreal Children’s Hospital) through to adulthood (at The Neuro).
What drives your work?
I am driven by the desire to help people reach their potential.
I see so much promise in my patients and I learned a long time ago never to underestimate anyone, especially if they receive the right kind of support at the right times. I strongly believe in providing quality and personalized care that meets the unique needs of patients and their families.
We want to stay away from the old "one size fits all" process and continue to grow a network of specialized clinicians that are accessible to our patients for all of their various needs.
Through my work at the ACAR Clinic, I hope to help fill some of the gaps in clinical care for autistic individuals and to change the way that autism services are delivered.
We start by finding out what their needs are and going from there to decide how best to support them. This is a key focus of our navigation service, where the entire goal is to respond to families’ needs and connect them with information or resources that could help them.
“My basic motivation is that I want to be the kind of clinician that I would want for my child or family member, and that's what makes me want to do my best for our patients.”
– Julie Scorah, Associate Director, ACAR Clinic
Your work at the ACAR Clinic is integrated with research. How does this help improve the lives of autistic individuals and families?
Much of the work that has been done in the field of autism research has focused on characterizing the symptoms or impairments that exist in this condition and understanding how these develop.
While this has been important, I think autism research should also focus on better characterizing the strengths and talents that autistic people have and better understanding their ways of thinking and viewing the world. This is essential if we want to figure out how to truly help and support people in reaching their potential.
"Our work at the ACAR Clinic helps to advance research and inform our patients’ clinical care in a personalized way."
Above all, my work focuses on trying to better understand strengths as well as weaknesses, and how to adapt and work with each individual's profile; tailoring their care to their skills and needs and what will work for them and their families.
What does a typical day look like for you, given the realities of the pandemic?
The pandemic changed what a typical day in the clinic looks like. It gave us an opportunity to rethink how we carry out our diagnostic evaluations in a very short time.
We developed a remote evaluation process to tailor our assessments to the circumstances of each patient.
We now employ a hybrid model so that patients can have virtual appointments and only come to the clinic if we need to see them in person.
More about remote assessments
The virtual process we developed involves clinical observation of the patient at home using video conferencing software, and online questionnaires to evaluate things like adaptive functioning and other behavioural symptoms.
We choose from a predetermined set of tasks depending on the patient's age and language level that allow us to observe, alone or with a caregiver or sibling, how the patient is behaving, communicating and socializing.
We do not require patients or families to have any fancy equipment. We email them a set of instructions before the assessment, with ideas of the types of materials to gather (like common household items that we’d like to see them engaging with), and how to set up the space and camera.
Doing these observations virtually, we can watch our patients in a more natural environment, interacting with people and in a space that they are already familiar with. We can get a much better sense of what individuals are like and how they communicate and socialize in their most comfortable setting.
Prior to the pandemic, we had already been thinking about ways to ease some bottlenecks – especially for us in in Quebec – in terms of reaching more communities that are rural and engaging with people who have accessibility issues, or for whom travel to a big hospital centre was difficult. For example, a single mother who has to bring her toddler and a newborn on public transit to the clinic.
We also have remote Indigenous populations that are in the northern part of the province that usually have to fly to our hospital in Montreal. And that's just not necessarily the greatest solution.
Do you foresee using the Clinic’s remote assessment tool in the future?
Yes, absolutely. Moving forward, I can see our remote methods improving access to specialized care overall, allowing us to reach families across the province in their own homes, schools and communities.
This is important because receiving an autism diagnosis is key to unlocking services and supports that help individuals reach their potential.
It is also the foundation of our partnership with patients and their families throughout their life journeys.
"The philosophy at the heart of everything we do at the ACAR Clinic is simply to ‘do good.’ Whether this means doing our best for our patients, engaging in high quality research or providing specialized training to other clinicians; we strive to do whatever good we can to help improve the lives of the people we serve.”