Real-life Skills Coaching Alert!

NESCA now has two Occupational Therapists offering in-person, community-based Real-life Skills Coaching in the Newton area. To learn more or book sessions, complete our Inquiry/Intake Form.

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Dr. Luisa Hernandez Medellin evaluating a child

NESCA’s Heading South to Care for Children and Empower Families

By | NESCA Notes 2025

Dr. Luisa Hernandez Medellin evaluating a childBy Jane Hauser
Director of Marketing & Outreach, NESCA

Dr. Luisa Hernandez Medellin Discusses NESCA’s Miami Launch

NESCA recently opened its latest pediatric neuropsychology office in Coral Gables/Miami, Florida, headed up by Dr. Luisa Hernandez Medellin. I had the opportunity to speak with Dr. Luisa Hernandez Medellin to get to know more about her background, the current evaluation landscape in South Florida, Latin America, and the Caribbean, and to hear from her what unmet needs NESCA addresses in bringing its expertise to that region.

Tell us about your background and how you chose to become a pediatric neuropsychologist.
I was born and raised in Mexico City in a family that valued service and helping others. As a teen, I considered becoming a missionary nun because I wanted to travel to deliver services and support to children in need. During those years, I spent time in Cuba, Nicaragua, Guatemala, and Costa Rica, where I witnessed numerous disparities in the way people lived. That experience shaped my commitment to serving children and families.

When I returned to Mexico, I explored different careers, including teaching and medicine, as my father was a doctor, and eventually landed in psychology almost by chance—but it felt like home as soon as I discovered it. Later, when I moved to Miami, I completed my bachelor’s degree and entered a doctoral program in child psychology. During my training, I discovered neuropsychology, and it was a perfect fit: a way to combine psychology with the medical world, caring for both the mind and the body of an individual.

I trained at Jackson Memorial Hospital, where I fell in love with pediatric neuropsychology, working with children with neurodevelopmental disorders in both inpatient and outpatient settings. That experience set the foundation for my career. Since then, I’ve worked in hospitals, private practice, and now with NESCA, where I get to provide high-quality evaluations in a compassionate way that will help children and their families have a path to move forward on.

What is your philosophy when working with children and families?
I treat every child as I would my own. I’m a mother of three, all neurodivergent in different ways, so I understand how hard it can be to navigate the challenges of having children with disabilities while also loving them so deeply. My role is to get to know each child who comes in for an evaluation—what makes them unique, what’s important to them—and to help uncover what’s happening so they can flourish.

How do you feel neuropsychological evaluations benefit individuals and families?
Evaluations give us a deeper, objective understanding of a child’s strengths and challenges. Parents often come to me worried that they’ve done something wrong that caused their child’s struggles. I reassure them that no one is at fault. The goal is not to find problems or identify something or someone to blame; rather, it’s to identify the root cause of a child’s challenges while also highlighting each child’s strengths. It’s about finding the “lights AND the shadows.” For example, if a child struggles in math but loves music, we lean into music as a source of joy and growth for the child while knowing how to  properly provide support in areas like math, that may be more stressful.

How do you approach parents or caregivers who are resistant to the evaluation process or the possibility of their child receiving a diagnosis from it?
In Miami, many families are hesitant about their child receiving a diagnosis(es). I take the time during the intake process to listen to their concerns and gently plant seeds about the types of issues we may be seeing. That way, parents aren’t shocked during the feedback session where they learn the findings from the evaluation, which may include one or more diagnosis(es). It helps them process the information and reduces their fears. I emphasize that neurodivergence isn’t caused by parenting choices or styles, screen time, or the Covid experience. It’s just how a child is wired. My focus is on supporting families and children and building hope with new information from the evaluation.

How did you connect with NESCA, and what excites you about bringing NESCA to Miami?
While considering a move to Boston, I met NESCA’s founder and director, Dr. Ann Helmus, and our conversation felt like meeting a kindred spirit. She reminded me of my attending supervisor from Jackson Memorial Hospital in that they both expect very high quality evaluations, really care about their patients, and truly value the quality of the training provided to their trainees. That’s not always the way with providers, so that was very important to me.

She shared that NESCA was planning to open a Miami office, which felt like the perfect match. Now, I get to help NESCA bring its 30 years of expertise to our region, while I’m also contributing my own 20 years of experience right here in Miami. Together, we’re offering high-quality, culturally-sensitive evaluations in both Spanish and English.

Why does Miami need a practice like NESCA?
The system here in South Florida often creates delays in the identification of developmental, emotional, or learning disabilities. Pediatricians sometimes use a “wait and see” approach; bilingualism is sometimes mistaken for a speech delay when it’s really a sign of autism; and schools often face huge, lengthy backlogs for testing students.

It can be tricky to find the right resource or professional to help identify challenges early on. Neurologists tend to be trained in the brain as “hardware,” whereas we examine the brain’s operating system and how it functions when there is a brain injury, a developmental disorder, or other issue. More often, they look to scans and imaging for answers, where we look at the child’s wellbeing and growth, especially when there is a more complex presentation that may lead to several diagnoses, like ADHD, autism, and anxiety, all co-occurring. And due to productivity pressures in large Miami hospitals, they are only able to see patients for 15 minutes or so and often via telehealth.

And again, with our medical system not being optimized, there is a lot of overwhelm among pediatricians who are forced to operate in a factory-like system. Many people here in South Florida don’t actually have a dedicated pediatrician who knows them and their families. It’s more of a walk-in urgent care system, and that means there is no follow-up in six months or even a year to see how a child is progressing or not. No one is tracking them and is dedicated to their developmental well-being. This is another reason for the frequent delays in diagnosis here.

Because of all of these issues, too often, families don’t receive timely or comprehensive evaluations, and diagnoses and services are delayed. NESCA offers an alternative: in-depth, individualized assessments that consider the whole child—what their lives look like and how they do in school, at home, and in the community. NESCA coming to Miami is filling a very large gap in getting families the answers they are looking for and getting children the support they need to thrive.

What do you evaluate at NESCA in Coral Gables?
I focus primarily in pediatric neurodevelopmental disorders, ADHD, Autism Spectrum Disorders, and learning disabilities, providing evaluations and highly tailored recommendations for interventions. I have also been training practicum students in the Miami area, which we will continue to do as part of the NESCA practice in Coral Gables. There are currently only two sites in Miami where doctoral-level students can train at a practicum level in pediatric neuropsychology, and one of them is now NESCA.

What are your plans for working with schools and international families?
International families and private schools are actively seeking support for their students. Many families from Latin America and the Caribbean face limited resources in their home countries. They come to NESCA for specialized, highly personalized evaluations and recommendations on how to support their child or student at home or in school, in their country. NESCA in Miami will provide these families with the guidance and expertise they need—tailored to their cultural context and delivered with compassion.

Any final thoughts?
NESCA offers families in South Florida, Latin America, and the Caribbean the best of both worlds. We’re bringing NESCA’s legacy of excellence from 30 years of practice in New England, along with my decades of experience living and practicing in Miami, to serve families in this diverse, multicultural community. My goal is simple: to help every child be understood, supported, and given the guidance and tools necessary to thrive.

Headshot of NESCA Pediatric Neuropsychologist Dr. Luisa Hernandez MedellinAbout the Author

As a bilingual pediatric neuropsychologist, Dr. Hernandez Medellin conducts comprehensive and culturally sensitive neurodevelopmental and neuropsychological assessments, comprehensive diagnostic evaluations, and effective care plans, providing appropriate recommendations for the client’s school, home, and the community. She specializes in the identification and assessment of neurodevelopmental disorders such as Autism Spectrum Disorders, ADHD, developmental and learning disorders, and their co-occurrence with anxiety and mood disorders. She also works with children and young adults with acquired brain injuries, epilepsy, brain tumors, strokes, general medical conditions, and genetic disorders affecting the nervous system. She is a native Spanish-speaker, passionate about serving the eclectic and vibrant South Florida community, as well as international patients looking for high-quality and compassionate care.

To book evaluation services at NESCA in Coral Gables, Florida, complete NESCA’s online intake form. 

To book a neuropsychological evaluation or other services at NESCA’s New England offices, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Miami/Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Engineered for Excellence

By | NESCA Notes 2025

Image of NESCA clinicians conferring with each other and a quote from Dr. Ann HelmusBy Ann Helmus, Ph.D.
Founder & Director, NESCA

NESCA supports your clinician—so your clinician can support you and your child

When you choose NESCA, you’re not just hiring an individual clinician—you’re accessing an entire organization built to deliver excellence to each family who works with us. From the first intake call to the final report, every step of our process is designed to ensure quality, accuracy, and the best outcomes for your family. Parents invest in this process to resolve complex questions about their child’s learning, development, or emotional well-being—questions that can only be addressed by a thoughtful, thorough evaluation leading to recommendations that will truly make a difference.

At NESCA, we believe that the best way to provide this level of care is to take extraordinary care of our clinicians. Our equation is simple:

Lower Case Volume + High Clinician Support =

Exceptional Evaluations + Better Outcomes

Supporting Clinicians in Doing Their Best Work
In some practices and settings, clinicians face heavy caseloads, which can make it difficult to dedicate as much time to each child as they’d like. With larger caseloads, clinicians are often left with little time for reflection, professional growth, or collaboration. At NESCA, we intentionally structure things differently. We greatly value our clinicians as highly educated professionals with many years of training and provide them with the support, environment, and opportunity to produce their most thorough and careful work.

From the beginning, NESCA was intentionally designed for clinicians to typically work with six or fewer clients each month—a low volume compared to many other practices or settings. This structure ensures that every child’s evaluation receives the time, attention, and individualized analysis it deserves.

We Care for Our Clinicians—So They Are Able to Care for Your Child
Behind the scenes, our clinicians are supported in ways that are uncommon in many private practices:

  • Professional Development: Weekly seminars, ongoing mentorship, and access to senior clinical directors to ensure that every clinician is continually learning and growing.
  • Collaboration: Regular case conferences provide a forum for discussing complex cases and drawing on the expertise of their NESCA colleagues who specialize in multiple disciplines, providing well-rounded and forward-looking perspectives. Your child’s clinician is never working in isolation.
  • Dedicated Support Staff: Psychometricians handle test scoring, and administrative staff manage scheduling and logistics. This frees clinicians to focus entirely on the heart of their work—understanding your child.
  • Quality over Quantity: Because we are not driven by volume, clinicians can invest the time needed to observe your child carefully, analyze test results holistically, speak with educators and providers on your team, and craft thoughtful recommendations.

What This Means for Families
We know that clinicians do their best work when they feel secure, valued, and engaged. That’s why NESCA provides stability, top notch administrative support, and a professional community. When challenges arise, we work with our clinicians to resolve them, offering mentorship and guidance rather than leaving them to struggle and produce work that doesn’t meet NESCA’s high standards.

This culture of care is not just good for our staff—it’s essential to the families we serve. It means that when you come to NESCA, you are working with professionals who are deeply committed, well supported, and fully equipped to provide the highest quality evaluations and recommendations.

We take care of our clinicians so that they can take the best possible care of your child.

 

About the Author

NESCA Founder and Director Ann Helmus, Ph.D., is a licensed clinical neuropsychologist who has beenAnn Helmus headshot practicing neuropsychology for 35 years and has been director of NESCA’s Neuropsychology practice for nearly three decades, continuously training and mentoring  neuropsychologists to meet the highest professional standards.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Miami/Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of an SAT and an ACT exam with a quote from Dr. Erin Gibbons

Don’t Miss Out: Planning Ahead for College Entrance Testing Accommodations

By | NESCA Notes 2025

Image of an SAT and an ACT exam with a quote from Dr. Erin GibbonsBy: Erin Gibbons, Ph.D. 
NESCA MA Clinical Director; Pediatric Neuropsychologist

If you’re the parent of a high schooler with a disability, you might be thinking ahead to college entrance exams like the ACT or SAT. These tests can be stressful for any student, but for those who need accommodations—such as extended time, additional breaks, or accessible testing formats—planning ahead is especially important. One of the most common pitfalls families encounter is missing the deadline to apply for accommodations. Here’s why you should check those deadlines now, and how to get started.

Why Accommodations Matter

Accommodations help level the playing field for students with disabilities, ensuring they have the support they need to demonstrate their potential. Whether your student has ADHD, a learning disability, anxiety, or another disability, the right accommodations can make a significant difference in their performance and confidence.

Deadlines Sneak Up Fast

Exams, such as the ACT, SAT, and Advanced Placement, require students to apply for accommodations well in advance of the test date—sometimes several months ahead. The process involves gathering documentation, working with your child’s school, and waiting for approval. If you miss the deadline, your student may have to take the test without the support they need or wait for the next test date.

Don’t Forget About Updated Evaluations

One important detail to keep in mind: the College Board and similar organizations require current documentation to support accommodation requests. If your student’s last neuropsychological evaluation is more than 2 years old, you will likely need to schedule an updated evaluation this fall.

What You Should Do Now

  • Check the official website for deadlines: https://accommodations.collegeboard.org/
  • Contact your school’s guidance counselor or learning support specialist
  • Gather documentation – most recent neuropsychological evaluation, current IEP or 504 Plan
  • Schedule updated neuropsychological testing if needed
  • Apply early! If the requested accommodations are not approved, you may need to start an appeal process, which can take a good amount of time to gather the required documentation or other materials.

 

About the Author

Since 2011, Dr. Gibbons has been a trusted expert at NESCA where she evaluates children presenting with a range of attentional, learning,Erin Gibbons headshot and developmental disabilities. She has a particular interest in children with autism spectrum disorders, intellectual disabilities, and those with complex medical histories. In addition, she evaluates adults who have concerns about whether they meet criteria for an ASD or ADHD diagnosis.

If you are interested in booking an evaluation with a NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

NESCA is a multidisciplinary practice with offices or staff in Newton, Hingham, and Plainville, Massachusetts; Londonderry, New Hampshire; the Burlington, Vermont region: and Coral Gables/Miami, Florida, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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image of adults observing a school classroom

Why School Observations Matter in a Neuropsychological Assessment

By | NESCA Notes 2025

image of adults observing a school classroomBy Miranda Milana, Psy.D.
Pediatric Neuropsychologist

When families seek a neuropsychological evaluation for their child, it’s usually because they’re looking for a deeper, more comprehensive understanding of their child’s profile—including both strengths and challenges. This kind of evaluation helps answer important questions about how a child learns, thinks, manages emotions, and interacts with others.

By gaining this insight, we can better support a child in all areas of life—at school, at home, with friends, and in community settings. Sometimes, however, the most valuable piece of the puzzle doesn’t come from test scores at all.

In some cases, your neuropsychologist may determine that observing your child in their natural learning environment—a school observation—can provide crucial information that simply can’t be gathered in an office setting.

What Is a School Observation?

A school observation involves a trained professional—usually the neuropsychologist conducting your child’s evaluation—visiting your child’s school to observe them in real time.

This observation might include time spent watching your child:

  • During classroom instruction
  • In social settings like lunch or recess
  • While transitioning between classes
  • In additional services, such as speech/language therapy or occupational therapy

The purpose is to see how your child functions across different settings and situations throughout their school day.

Why Is a School Observation So Valuable?

You might wonder: if the evaluator already has detailed testing results, rating forms from parents and teachers, and information from the intake appointment and outside providers, why observe at school?

Even the best testing environment can’t fully replicate real-world situations. In a quiet, 1:1 testing setting, a child might appear regulated, focused, and engaged—but in a classroom filled with distractions and increased demands, their behavior and overall presentation might look very different. A school observation helps us understand how a child manages in the real-world environments where challenges often arise.

Observations allow us to:

  • Identify situations that may be triggering challenging behaviors (like transitions, group work, or unstructured time)
  • Determine whether a child is well-matched with their peers or may be in the wrong instructional group
  • Notice social dynamics—Are they connecting with peers? Are they withdrawn or overly controlling during play?

Another critical area we assess during school observations is whether the learning environment is a good fit for your child:

  • Is the classroom appropriately structured?
  • Are staff using the tools and supports outlined in the IEP?
  • Does your child respond well to the strategies, like visual schedules or token boards, being used?

Observing how a child responds to the classroom setup and supports can help determine whether their current environment is truly meeting their needs—or if changes are required to allow them to access the curriculum.

When Is a School Observation Recommended?

Not every evaluation requires a school observation, but there are several situations where it can provide especially meaningful insight. Examples include:

  • A child who struggles with behaviors at school that aren’t seen at home or during testing
  • A child who performs well on standardized tests but is reported to be having a hard time keeping up in class
  • Uncertainty about whether the child’s current classroom or program is the right fit for their learning profile
  • Questions about whether the child would benefit from a different instructional approach, such as a language-based classroom or one using ABA methods

At NESCA, our clinicians are trained to determine when a school observation would add helpful information to the evaluation process. We view it as one of many tools to build the most accurate picture of your child’s needs.

What to Expect During the Observation

If you and your evaluator decide that a school observation would be helpful, we’ll coordinate the visit with your child’s school—with full permission from you and the school team.

On the day of the observation:

  • The evaluator typically sits in the back of the classroom, making every effort not to disrupt the flow of the day.
  • The goal is to blend in and observe naturally occurring interactions and behaviors.
  • Observations are done in a respectful, non-intrusive manner with the sole purpose of helping your child.

Afterward, the evaluator will include a summary of the observation in the written report, and the insights gained will be integrated into the diagnostic impressions and recommendations.

A school observation is about understanding your child in the context of their daily environment. When paired with testing, rating scales, and interviews, this real-world view helps ensure that recommendations are not only accurate, but truly actionable.

If you have any questions about the school observation process—or want to know whether it might be helpful for your child—don’t hesitate to reach out to your evaluator. We’re always here to help guide you through the process and help your child get the support they need to succeed.

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children and adolescents with a wide range of concerns, includingMiranda Milana PsyD headshot attention deficit disorders, communication disorders, intellectual disabilities, and learning disabilities. She particularly enjoys working with children and their families who have concerns regarding an autism spectrum disorder. Dr. Milana has received specialized training on the administration of the Autism Diagnostic Observation Schedule (ADOS).

Dr. Milana places great emphasis on adapting her approach to a child’s developmental level and providing a testing environment that is approachable and comfortable for them. She also values collaboration with families and outside providers to facilitate supports and services that are tailored to a child’s specific needs.

Before joining NESCA, Dr. Milana completed a two-year postdoctoral fellowship at Boston Children’s Hospital in the Developmental Medicine department, where she received extensive training in the administration of psychological and neuropsychological testing. She has also received assessment training from Beacon Assessment Center and The Brenner Center. Dr. Milana graduated with her B.A. from the University of New England and went on to receive her doctorate from William James College (WJC). She was a part of the Children and Families of Adversity and Resilience (CFAR) program while at WJC. Her doctoral training also included therapeutic services across a variety of settings, including an elementary school, the Family Health Center of Worcester and at Roger Williams University.

Dr. Milana grew up in Maine and enjoys trips back home to see her family throughout the year. She currently resides in Wrentham, Massachusetts, with her husband and two golden retrievers. She also enjoys spending time with family and friends, reading, and cheering on the Patriots, Bruins, Red Sox, and Celtics.​

To book an appointment with Dr. Miranda Milana or another expert NESCA neuropsychologist, please complete our Intake Form today. 

NESCA is a multidisciplinary pediatric neuropsychology practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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Child with behavioral challenges is evaluated

Often Overlooked: Recognizing and Supporting Children with Fetal Alcohol Spectrum Disorder

By | NESCA Notes 2025

Child with behavioral challenges is evaluatedBy Leah Weinberg, Ph.D. 
Pediatric Neuropsychologist, NESCA

One of the reasons I joined the NESCA team was for the opportunity to continually learn and grow professionally. NESCA has a well-earned reputation for fostering an environment where clinicians can expand their knowledge and refine their skills in meaningful ways, and a session I was able to attend for our staff earlier this year was a perfect example of that.

I attended an insightful seminar on Fetal Alcohol Spectrum Disorder (FASD), a topic that is often overlooked yet critically important in neuropsychological practice. The presentation provided clinically relevant information and tools to better recognize and address this condition.

One key takeaway was a reminder of how challenging FASD can be to diagnose. While many people associate the condition with characteristic facial abnormalities, these features are present in only a minority of affected children. Additionally, the social stigma around alcohol use during pregnancy means parents may be reluctant to disclose this history. This can make it easy to miss the diagnosis, particularly in children who present with behavioral or learning challenges that could be attributed to other conditions.

Hallmark symptoms of FASD include executive functioning deficits (e.g., working memory), poor impulse control, difficulties with generalization (people, situations, consequences), difficulties with abstraction, perseverations, and diminished adaptive skills within the context of healthy levels of intellect.

The seminar emphasized why making an accurate diagnosis is so critical: It directly informs how we approach treatment, including how we assist families in accessing services, setting realistic expectations for the child, diminishing the risk of the child receiving inappropriate diagnoses (e.g., Oppositional Defiant Disorder), and assisting the child in developing stronger self-awareness and self-advocacy skills. Moreover, it is important for the adults in the child’s life, including parents and educators, to understand that behaviors that are part of the disability are not willful. Behavioral challenges in children with FASD, for example, often do not respond well to traditional behavioral programs. Instead, a trauma-informed approach is typically more effective, as it accounts for the neurodevelopmental impact of prenatal alcohol exposure and addresses the underlying emotional and regulatory difficulties these children face.

Being part of a team that prioritizes professional development, like the one at NESCA, means continually sharpening my skills and expanding my understanding to better serve the children and families we work with. The FASD seminar was not only a great learning experience but also a reminder of the importance of staying open to complex diagnoses and tailoring treatment plans to meet the unique needs of each child.

About the Author

Dr. Weinberg specializes in the assessment of school-aged children and adolescents with a wide range of concerns including development disorders, such as autism spectrum disorder, learning disabilities (e.g. dyslexia, dysgraphia), language-based learning difficulties, AttentionHeadshot of Leah Weinberg, Ph.D. Deficit Hyperactivity Disorder (ADHD), Nonverbal Learning Disability (NVLD), and executive functioning disorders (e.g. slow processing speed). She also has experience in working with individuals with psychiatric difficulties, such as anxiety, mood disorders (e.g. depression), and behavioral disorders. Dr. Weinberg has expertise in working with children with complex profiles or multiple areas of strength and weakness that cannot be encapsulated by a single diagnosis. Dr. Weinberg is passionate about helping families better understand their child’s neuropsychological profile and the impact it may be having on their behavior or functioning in order to best support them in all areas of their life.

To book a neuropsychological evaluation with Dr. Weinberg or another expert neuropsychologist at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of a cell phone with a banned symbol over it; quote from Angela Currie, Ph.D.

Teaching Executive Function Strategies in the Landscape of Cell Phone Ban Policies

By | NESCA Notes 2025

Image of a cell phone with a banned symbol over it; quote from Angela Currie, Ph.D.By Angela Currie, Ph.D.
Pediatric Neuropsychologist; Londonderry, NH Director, NESCA

As students head back to school this fall, many are facing new policies and restrictions around cell phone use in school. For many states and districts, this is defined by a “bell to bell” cell phone ban, which prohibits students from using their phones from the first bell to final dismissal. For many, these policies are long awaited, as there has been growing concern about student distraction, social disengagement, and the negative impact of social media access in schools. By removing access to cell phones, tablets, and smart watches, “bell to bell” policies aim to reduce distractions and foster a more focused, interactive learning environment.

The benefits of cell phone policies are clear; however, they also may present unique challenges for some students who have learned to rely on technology as an appropriate tool for executive function. Executive function refers to a set of cognitive and self-management skills that help individuals manage time, stay organized, remember information, and meet goals efficiently. Because cell phones and tablets are readily accessible and have many embedded tools, many students have integrated technology into their daily routines, using features like calendars, alarms, and note-taking apps to stay on top of assignments and deadlines. These digital tools have become a practical way for some students to stay organized and ensure they are meeting expectations.

With “bell to bell” cell phone bans in place, students will no longer have “on demand” access to the apps or other executive function tools that previously kept them organized, possibly raising concern about increased forgetfulness, missed assignments, and heightened stress. Positively, the laws provide exemptions for students whose IEP, 504 plan, or Title IX needs identify specific technology accommodations (e.g., insulin monitoring, assignment log, communication tools, etc.). However, these students may feel hesitant to use their devices during the school day out of concern for standing out or feeling stigmatized. As a result, even students who are permitted to use their devices may choose to find alternative ways to manage their academic demands in order to avoid feeling singled out.

Cell phone policies are being developed for good reasons, but within this landscape, schools and families must start thinking about how to teach executive function strategies that are not technology-based. Children and teens are developing in a technological world, and they may not have the skills for managing demands without these supports. This provides an opportunity for them to learn more independent skills for daily management, but they may not figure this out on their own. To support students, educators and parents can introduce practical strategies, such as using physical planners to track assignments and deadlines, breaking down larger projects into smaller, actionable steps, and organizing materials with color-coded folders or checklists. Teaching time management techniques, encouraging regular routines, and modeling how to prioritize tasks can also help students build the foundational skills they need to succeed both in and out of the classroom, even without the constant aid of technology.

Ultimately, cell phone bans have the potential to create a more focused and engaged learning environment, fostering improved learning and social interactions. However, as access to technology is reduced, it becomes increasingly important for schools to provide explicit instruction in executive function strategies. By offering concrete tools and strategies, educators can help all students develop enduring, life-long skills that will benefit them not only in managing their responsibilities at school, but also in their future personal an

 

About the Author

Dr. Currie specializes in evaluating children, teens, and young adults with complex profiles, working to tease apart the various factors lending to their challenges, such as underlying learning, attentional, social, or emotional difficulties. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

 

To book an evaluation with Dr. Currie or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician in the referral line.

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and staff in greater Burlington, Vermont, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of a signpost with the words Wait and See" and "Check It Out" on it and a quote from Dr. Rebecca Dautoff

When In Doubt, Check it Out

By | NESCA Notes 2025

Image of a signpost with the words Wait and See" and "Check It Out" on it and a quote from Dr. Rebecca DautoffBy: Rebecca Dautoff, Psy.D.
Pediatric Neuropsychologist, NESCA

As a child psychologist, I regularly advise parents that our job is not to eliminate their children’s frustration, anxiety, and disappointment. Instead, our goal is to help kids process and tolerate these emotions. In fact, it’s critical that children face obstacles so they can learn to navigate and endure challenges throughout their life. But what happens when a child has a particularly tough time at school or a really difficult year? What are the next steps?

Deciding what to do can be a hard decision for concerned parents. Some parents question whether they should  “do something” to help the child, or to relieve their own anxiety and guilt. Other parents feel that their child’s issues are due to “a bad fit” with a particular teacher or classroom structure. This can be even harder when the school tells parents that everything is okay, or it’s just a phase that they see all the time. In some cases—such as a child grieving or adjusting to a new school—a short observation period (a few weeks) with close monitoring and open communication can be appropriate. However, this should always come with a clear plan to seek help if things don’t improve, because the “wait and see” approach can pose real risks to a child’s development, mental health, and emotional well-being. Here’s why:

First, childhood is full of developmental windows. These are essentially periods of time or opportunity when the brain is especially receptive to learning a specific skill. If a child is struggling in one of these areas and we wait too long, we risk missing this period of optimal learning. Language delays are a clear example. There is a critical period of language development before the age of 3, meaning that intervention for speech and language challenges are most effective before this age.

Second, children are incredibly perceptive. Kids are highly attuned and hyper aware when they feel like something is harder for them than it is for their friends and classmates. Often, kids internalize their struggles as personal failures. This can lead to frustration, anxiety, withdrawal, or behavioral problems/acting out. These outcomes are even more likely if a child is late to learn a skill. Take reading as an example. If a child is learning to read more slowly than their peers in first or second grade, they are less likely to internalize this as a problem because most of their classmates are also learning to read. It might come more easily to their friends, but they are all learning to read. If we wait to intervene, and a child is still having difficulty with reading in fourth grade, they are more likely to internalize their difficulty as a personal failure because they are no longer surrounded by peers who are also working on the same skill.

Taking a wait and see approach with your child’s mental health can feel like a cautious or hopeful strategy—especially when you’re unsure if something is truly wrong. Unfortunately, mental health conditions are often progressive, and waiting to treat them can allow symptoms to worsen, which makes them harder to treat. Undiagnosed mental health issues can lead to poor academics, social withdrawal, bullying, or acting out. The child may fall behind developmentally or struggle to make or keep friendships, which will impact their self-esteem and exacerbate their mental health issues. In older children and adolescents, we also see untreated mental health issues lead to more dangerous problems, like substance use, self-harm, eating disorders, or suicidal thoughts.

Instead of waiting, parents should proactively communicate with teachers, seek professional help when needed, and consider the child’s overall well-being when making decisions about their education.

What to Do Instead Of “Wait and See”:

  • Talk to your child: Open the door to conversation and let them know you’re there.
  • Keep track of behaviors, moods, or changes.
  • When in doubt, check it out: Even a single consultation with a pediatrician, school counselor, or therapist can provide guidance without committing to long-term treatment. If you suspect there is a deeper learning, emotional, developmental, or behavioral issue, a neuropsychological evaluation can also determine the root cause of the issues and set you and your child on a better path forward.

 

About the Author

Dr. Rebecca Dautoff provides comprehensive neuropsychological and psychological (projective) evaluation services for children, adolescents,Headshot of Rebecca Dautoff, Psy.D. and young adults who have complex presentations with a wide range of concerns, including attention deficit disorders, psychiatric disorders, intellectual disabilities, and autism spectrum disorders (ASD). She also values collaboration with families and outside providers to facilitate supports and services that are tailored to each child’s specific needs.

 

If you are interested in booking an appointment for an evaluation with Dr. Dautoff or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of a teen male feeling frustrated with a therapist and a quote from Dr. Moira Creedon

Bridging the Gap between Neuropsychological Testing and Therapy

By | NESCA Notes 2024

Image of a teen male feeling frustrated with a therapist and a quote from Dr. Moira CreedonBy: Moira Creedon, Ph.D. 
NESCA Hingham Director & Pediatric Neuropsychologist

Sometimes therapy hits a wall. A child or teen may be attending sessions regularly but still seems “stuck.” They might be unable to make progress, reluctant to engage, or struggling in ways that don’t fully add up. Even the most dedicated clients, those who do their therapy “homework” and participate openly, may continue to face challenges outside of the therapy room. This can be both frustrating and confounding for everyone involved. In these situations, neuropsychological testing does not have to be a last resort. It can be a powerful, collaborative tool that helps uncover what might be happening or why certain obstacles keep getting in the way. By clarifying diagnoses, identifying how a child or teen processes information, and highlighting cognitive or emotional patterns, neuropsychological testing offers insight that can shape therapeutic work to offer meaningful change.

There are few key gaps that neuropsychological testing can help to fill that are not a part of the normal course of therapy. First, neuropsychologists tend to get more extensive histories across all domains. Often times, therapists get some history about the presenting symptoms right away, but then they quickly have to dive into supporting a child, building rapport, providing psychoeducation, or practicing new coping strategies.

Neuropsychologists tend to get data across a broader range of developmental patterns for a holistic understanding of how the child has developed. Secondly, neuropsychologists then get concrete, quantifiable data on how a child or teen processes information – what their cognition is, how they encode and store information in their memory, how they tackle a hard problem, how they interpret a social challenge, and how they reflect on their own emotional experience. The focus is on how a person processes information, not just what their current symptoms are.

Why is this important? Take, for example, the case of a recent 16-year-old seen for neuropsychological testing who was in therapy for years due to a general sense of worry. Neuropsychological testing helped to highlight problems with cognitive flexibility, poor working memory, and distractibility. In addition to her anxiety, she was also struggling with ADHD. Lapses in attention were making her more anxious, leading her to long hours studying, blaming herself for her shortcomings. these long study sessions were disorganized and inefficient because of inherent executive functioning problems.

Take another example of a younger child who was 7-years-old. His parents felt frustrated by his dysregulated behaviors at home. He was disengaged in therapy and seemed unable to talk with his parents about what was going on after a big incident. Neuropsychological testing helped to undercover significant problems with language processing. This led to more frustration as he could not explain why he was upset, and traditional “talk therapy” methods had to be adapted so that language was simple and concrete.

By uncovering a child or teen’s unique profile, a family and the therapist can gain a wealth of information about what might be driving the presenting issues. This is one reason it is important to frame a referral for neuropsychological testing as a tool of discovery, not as a last resort or sign that treatment is failing. Diagnostic clarity is not about labeling; it is about understanding. It is a process of giving a complete picture of a child or teen’s functioning, seeking alternative pathways for change, and capitalizing on the client’s strengths.

With new information provided in neuropsychological testing, therapists can collaborate with a neuropsychologist to individualize treatment. Here are some examples for how testing can help therapists:

  • A therapist can slow down their interventions and offer more repetition for children with processing speed troubles.
  • A therapist can use simplified language for a child with cognitive impairments or reduced language skills.
  • A therapist can reduce the “homework” they assign for a teen with weak working memory and executive functioning deficits.
  • A therapist can pull in a new evidence-based treatment when anxiety veers into a pattern of intense obsessions and compulsive behaviors in a teen with OCD.
  • A therapist can support a teen overwhelmed with anxiety when facing a mountain of assignments at school if their executive functioning challenges make it hard for them to break down these tasks into smaller steps.
  • A therapist can explore the opportunity to collaborate with an executive functioning coach, group therapy program, or psychiatrist if a child’s profile suggests this is helpful.

When therapy stalls, it doesn’t mean a child isn’t trying or the treatment isn’t helpful. It might mean we are missing part of the picture. Neuropsychological testing can offer the insight needed to move forward with greater compassion, precision, and effectiveness.

Being “stuck” does not have to be seen as a sign of failure. It can be a turning point or an opportunity to uncover processing patterns that shift the focus from blame to change. When testing and therapy work hand in hand, they offer families not just answers, but a compassionate and informed way forward.

 

About the Author

Dr. Creedon offers her expertise in evaluating children and teens with a variety of presenting issues. SheMoira Creedon headshot is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. She tailors each assessment to address a range of referral questions, such as developmental disabilities, including Autism Spectrum Disorder, learning disabilities, attention challenges, executive functioning deficits, and social-emotional struggles. She also evaluates college-/grad school-age/adult individuals with developmental issues, such as ASD and ADHD, particularly when there is a diagnostic clarity or accommodation question.

 

If you are interested in booking an evaluation with Dr. Creedon or another NESCA neuropsychologist, please fill out and submit our online intake form. 

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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How Executive Function Coaching and Therapy Complement One Another-Part 2

By | NESCA Notes 2025

Quote from NESCA and an image of two puxxle pieces fitting together showing how therapy and EF coaching can complement each otherBy Jasmine Badamo, MA
Educational Counselor; Executive Function Coach

Last week I wrote a blog about the complementary nature of executive function coaching and therapy. I discussed the ways in which each service is distinct, as well as where there are overlaps. Today I’d like to share examples of how each service can support the other. If you find the examples helpful, feel free to download the pdf version from our Resources page!

How executive function coaching can support your therapy work:

An executive function coach can…

  • Serve as another person to reinforce the concepts you’re learning in therapy and help you make note of everyday and/or academic situations that connect to your therapy goals.
  • Serve as a source of motivation and accountability to help you implement the recommendations made in therapy, such as improving your sleep hygiene, widening your social circle, or increasing your positive self-talk.
  • Consult with your therapist to provide examples of your everyday struggles and mindset towards them.
  • Provide a safe space for metacognitive and self-reflection discussions, which can serve as a stepping stone if you are not yet ready to embark on therapy or are questioning your current style of therapy. These discussions can promote a new openness to trying therapy or exploring new therapy modalities/approaches.

How therapy can support your executive function work:

A therapist can…

  • Address anxiety, depression, perfectionism, all-or-nothing thinking, or negative self-talk/narratives, all of which can present a significant barrier to coaching because they reduce your motivation and openness to trying new problem-solving strategies.
  • Provide a big picture, comprehensive understanding of the mental and emotional barriers facing you and guide you (and your executive function coach) in choosing motivation and routine-building strategies that would work best.
  • Help you to build coping strategies for managing daily life and novel tasks, freeing up energy for taking on new goals and challenges.

Every service provider brings something important to the table, and therapy and executive function coaching are an extra-special support combination that has truly benefited many of our clients at NESCA. It often takes a team to support an individual through challenging aspects of their life, and NESCA’s coaches are happy to be a part of that team!

NESCA offers executive function coaching for students from elementary school through adulthood who are looking to bolster their organization, scheduling, time management, goal setting, and routine building skills. Students work 1-on-1 with occupational therapists and education specialists to identify specific skills that will help them be more organized and in control of their academic and general life tasks. If you have concerns about your child or student’s executive function challenges and want to try our 1-on-1 coaching, please complete our online Intake Form. 

 

 

About the Author

Jasmine Badamo, MA, is a licensed special educator and seasoned executive function coach. SheJasmine Badamo headshot supports a wide range of clients, ranging from age 7 to adulthood, to develop executive function and independence skills necessary for success with school (including college and graduate school) and in life. She is also uniquely qualified to coach parents and train educators to support EF skill development across settings.

To book executive function coaching with an EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of two puzzle pieces fitting together to represent therapy and EF coaching

How Executive Function Coaching and Therapy Complement One Another-Part 1

By | NESCA Notes 2025

Image of two puzzle pieces fitting together to represent therapy and EF coachingBy Jasmine Badamo, MA
Educational Counselor; Executive Function Coach

At a recent NESCA case conference, we had a thought-provoking discussion about the relationship between executive function coaching and therapy that inspired me to write this two-part blog series.

Executive function coaching is different from therapy in a few key ways:

  • Most executive function coaches are not trained mental health professionals.
  • Therapy is usually positioned to treat mental health concerns, such as anxiety, depression, OCD, and related emotional patterns.
  • Executive function coaching focuses more directly on improving cognitive skills and strategies (like planning, organizing, prioritizing, time management, focus, and self-regulation) to support clients in reaching their academic, professional, and personal goals.
  • Executive function coaching is often more practical and solution-oriented, while many therapy approaches focus on exploring past experiences and deepening a client’s understanding of themselves.

But there can also be overlap between the two supports:

  • Executive functioning and mental health both impact an individual’s self-regulation and ability to cope with daily life.
  • Executive function coaches and therapists might both implement skill-based activities with clients.
  • Executive function coaches and therapists both focus on improving an individual’s well-being by identifying challenges, setting goals, developing strategies, and building self-awareness.

The truth is that the work we executive function coaches do with our clients frequently relates to their mental health and emotional struggles. For example, we may help individuals strengthen their ability to regulate impulses; reflect inward to better understand their habits and patterns in behavior; move past low motivation to activate and take action; adapt their behavioral patterns to better meet their needs and goals; implement self-care routines; and tackle the logistical challenges of accessing other services, such as therapy.

Additionally, persistent mental health struggles (as well as a person’s naturally fluctuating emotional states) play a large role in a person’s ability to access their prefrontal cortex or “thinking brain,” where our executive function abilities reside. This is because emotional regulation and executive control are both housed in this part of the brain. When one skill set is taxed, the other suffers. Correspondingly, persistent executive function struggles can contribute to increased mental health struggles, such as anxiety or depression.

Given the connected nature of executive functioning and mental health, we recognize that executive function coaching and therapy are distinct, but are also connected and complementary. The two services not only balance each other, but help to amplify the success and effectiveness of each individual service.

Tune in for our blog next week where I’ll delve into the ways executive function coaching can support your therapy work and vice versa!

NESCA offers executive function coaching for students from elementary school through adulthood who are looking to bolster their organization, scheduling, time management, goal setting, and routine building skills. Students work 1-on-1 with occupational therapists and education specialists to identify specific skills that will help them be more organized and in control of their academic and general life tasks. If you have concerns about your child or student’s executive function challenges and want to try our 1-on-1 coaching, please complete our online Intake Form. 

 

About the Author

Jasmine Badamo, MA, is an educational counselor and executive function coach who works full-time at NESCA supporting students ranging from elementary school through young adulthood. In addition to direct client work, Ms. Badamo provides consultation and support to parents and families in order to help change dynamics within the household and/or support the special education processes for students struggling with executive dysfunction. She also provides expert consultation to educators, special educators and related professionals.

Ms. Badamo is a New York State Certified ENL and Special Education teacher. She has more than 10 years of teaching experience across three countries and has worked with students and clients ranging in age from 7 to adulthood. She earned her bachelor’s degree in Biological Sciences from Cornell University and her master’s degree in TESOL from CUNY Hunter College. She has also participated in graduate coursework focusing on academic strategies and executive function supports for students with LD, ADHD, and autism as part of the Learning Differences and Neurodiversity (LDN) certification at Landmark College’s Institute for Research and Training. In addition to being a native English speaker, Ms. Badamo is also conversationally fluent in verbal and written Spanish.

Having worked in three different New York City public schools, Ms. Badamo has seen firsthand the importance of executive function skills in facilitating student confidence and success. Her coaching and consultation work focuses on creating individualized supports based on the specific needs and strengths of each client and supporting the development of metacognition (thinking about one’s own thought processes and patterns), executive function skills, and independence. She will guide clients to generate their own goals, identify the barriers to their goals, brainstorm potential strategies, advocate for support when needed, and reflect on the effectiveness of their applied strategies.

Ms. Badamo is a highly relational coach. Building an authentic connection with each client is a top priority and allows her to provide the best support possible. Additionally, as a teacher and coach, Ms. Badamo believes in fostering strong collaborations with anyone who supports her clients including service providers, classroom teachers, parents, administrators, and community providers.

To book executive function coaching with Jasmine Badamo or another EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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