, Author at NESCA - Page 7 of 40

Images of a neuropsych eval and questionnaires and quote from Sean Hyde O'Brien

Beyond the Scores: The Comprehensive Approach to Neuropsychological Evaluations

By | NESCA Notes 2024

By: Sean Hyde O’Brien, Psy.D., ABPdN
Pediatric Neuropsychologist, NESCA

When parents think of a Neuropsychological Evaluation, they often envision their child completing a series of tests that generate scores. These test scores tell parents how their child is performing compared to a large group of other students their age across a wide range of cognitive and academic domains. While this is accurate, the evaluation process also integrates data from multiple sources beyond quantitative test scores to develop a comprehensive picture of your child. These other sources of data may be less obvious but are highly essential to developing an accurate “diagnostic formulation” of your child’s strengths and weaknesses, as well as interventions specifically tailored to support their individual neuropsychological profile.

Here’s an overview of the types of data typically involved:

Clinical Interview:

Symptoms and Concerns: The individual’s description of their cognitive, behavioral, emotional, and academic symptoms, as well as those reported by family members or caregivers.
Birth, Developmental, and Medical History: Information about the individual’s birth, medical, psychological, and developmental history, including any past or current health conditions, injuries, or psychiatric disorders.
Family History: Information about any family history of neurological or psychological conditions that may help understand potential genetic or hereditary factors.
Academic and Psychosocial History: Insight into the individual’s social relationships, educational background, and occupational history to understand the impact of cognitive or emotional issues on daily functioning.

Standardized Psychological/Neuropsychological Tests:

These are structured tasks designed to measure different aspects of cognitive and academic functioning. They provide objective data that help evaluate brain-behavior relations.

Intelligence Tests (IQ Tests): Assess overall cognitive ability and intellectual functioning. A common test is the Wechsler Intelligence Scale for Children (WISC-V).
Speech-Language Tests: Evaluate expressive, receptive, and pragmatic language skills, including verbal fluency, comprehension, and naming. Examples are the Boston Naming Test and the Clinical Evaluation of Language Fundamentals (CELF-V).
Visual-Spatial Tests: Measure spatial processing, visual memory, and the ability to integrate visual and motor functions. Examples include the Rey-Osterrieth Complex Figure Test and the Block Design subtest from the WISC-V.
Sensory-Motor Tests: Assess motor skills, coordination, and fine motor skills (e.g., the Grooved Pegboard Test).
Memory and Learning Tests: Evaluate short-term, long-term, and working memory. Examples include the Wide Range Assessment of Memory and Learning (WRAML) and the California Verbal Learning Test (CVLT-C).
Attention and Executive Function Tests: Measure selective-sustained attention and cognitive flexibility, such as the Continuous Performance Test (CPT); as well as assess higher-order cognitive functions, such as planning, decision-making, problem-solving, and impulse control. Examples include the Wisconsin Card Sorting Test (WCST) and the Tower of London task.
Academic Tests: Assess reading, writing, and mathematical skills. An example is the Wechsler Individual Achievement Test (WIAT-IV).

Behavioral Observation:

Behavioral Observations During Testing: The examiner notes the individual’s behavior, mood, and engagement during the testing process. This can provide insight into areas, such as attention, motivation, or emotional regulation.
Classroom/Program Observations: This can involve observing a child’s functioning in a “real life” setting and provide insight about their ability to apply the skills noted in their test findings to more complex environments.

Behavioral Rating Scales and Self-Report Questionnaires:

These are used to assess subjective experiences related to mood, behavior, and cognitive functioning.

Broad Band Rating Scales: Provide information about the individual’s functioning across multiple domains, which can be helpful to identifying areas of concern for additional investigation. An example is the Child Behavior Checklist (CBCL).
Targeted/Narrow Band Rating Scales: Provide information about specific domains, such as depression and/or anxiety, which can be helpful for gaining a deeper understanding of an individual’s particular symptom profile. One example is the Beck Depression Inventory (BDI).

Collateral Information:

Reports from Family Members, Teachers, Coaches, and Tutors: Provide insight from those who know the individual well, often providing information about changes in behavior, memory, or mood.
School or Occupational Records: Include academic performance, work-related difficulties, or other performance metrics that may be reviewed to understand the functional impact of cognitive or emotional difficulties.

Neuroimaging and Medical Data (if applicable):

Brain Imaging (e.g., MRI, CT scans, PET scans): Used to identify brain abnormalities, such as lesions, atrophy, or structural damage, which may contribute to cognitive impairments.
EEG or Evoked Potentials: Sometimes used to assess electrical activity in the brain, particularly if seizures or other neurological concerns are present.
Medical Reports: Data on neurological conditions, medications, or surgeries that may impact cognitive or emotional functioning.

By combining these different types of data, a neuropsychologist can create a comprehensive picture of an individual’s cognitive strengths and weaknesses, helping to identify any underlying neurological conditions or psychological factors that are contributing to their difficulties. While test scores are always important, interpreting your child’s performance on neuropsychological tests without the additional data outlined above can lead to misdiagnosis, ineffective treatment, and other unforeseen complications.

About the Author

Dr. Sean O’Brien has been providing comprehensive neuropsychological evaluations in the Greater Sean Hyde O'Brien Boston area since 2006. He specializes in the assessment of children and adolescents who present with a wide range of developmental conditions, such as Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder (reading, writing, math), Intellectual Disability, and Autism Spectrum Disorder; as well as children whose cognitive functioning has been impacted by medical, psychiatric, and genetic conditions. He also has extensive experience working with children who were adopted both domestically and internationally.

To schedule an appointment with one of NESCA’s neuropsychologists, please complete 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; and Brooklyn, NY (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.

Poster stating Disability not a bad word and a quote from Kelley Challen

Disability is Not a Dirty Word—It’s a Legal Term

By | NESCA Notes 2024

By: Kelley Challen, Ed.M., CAS
Director of Transition Services, NESCA

I recently listened to a podcast where the host shared that she avoids using the term “disability” because she doesn’t want her child to feel limited.

This really made me think. The word “disability” can feel heavy and tied to stigma, but it is not synonymous with limitation. In fact, it doesn’t describe anything about a person’s potential or specify what they can or cannot do. It’s simply a term—a legal one—that ensures access to equal rights, accommodations, and opportunities.

Yes, people with disabilities might use tools, supports, or accommodations to learn, work, and navigate the world. But needing those supports isn’t a limitation—it’s about finding ways to thrive and share unique strengths and abilities.

As a parent and professional who does not identify as disabled, I believe it’s essential to reflect on our own feelings and biases about the word “disability.” If we avoid using it because it makes us uncomfortable, how might that impact our children as they grow and learn to advocate for themselves?

When we don’t teach kids to understand and embrace the term “disability,” we might unintentionally limit their access to the tools, rights, and opportunities they deserve to realize their potential. Additionally, if we avoid using the term “disability” or reframe it when we hear it, we implicitly teach our children that it’s a “dirty word” and possibly associate it with shame.

Understanding disability as a legal term is particularly important because many critical services and protections are only available to those who identify as having a disability. These include:

Individualized Education Programs (IEPs) and 504 Plans, which provide accommodations and support in school settings.
Standardized testing accommodations, such as extended time, alternative test formats, or assistive technology for standardized exams like the SAT, ACT, and college entrance tests.
Vocational Rehabilitation Services, which offer career counseling, job training, and workplace accommodations.
Social Security Disability Benefits (SSI/SSDI), which provide financial assistance to eligible individuals with disabilities.
College disability support services, which can include priority registration, note-taking assistance, alternative testing arrangements, and more.
Workplace accommodations under the Americans with Disabilities Act (ADA), such as modified work schedules, assistive technology, or accessible office spaces.
Access to independent living programs and community supports that help individuals with disabilities navigate housing, transportation, and daily living needs.

We can’t break down stigma if we’re afraid to name it. Let’s change the narrative: Disability is just a term, not a measure of someone’s potential.

About the Author
Kelley Challen, Ed.M., CAS, is an expert transition specialist and national speaker with over 20 years of experience supporting youth and Kelley Challen headshot young adults with diverse developmental and learning abilities. Since 2013, she has served as Director of Transition Services at NESCA, offering individualized transition assessments, planning, consultation, coaching, and program development. She specializes in working with students with complex profiles who may not engage with traditional testing tools or programs. Ms. Challen holds a BA in Psychology and a Minor in Hispanic Studies from The College of William and Mary, along with a Master’s and Certificate of Advanced Graduate Study in Risk and Prevention Counseling from the Harvard Graduate School of Education. She is a member of CEC, DCDT, and COPAA, believing it’s vital for all IEP participants to have accurate information about transition planning. Ms. Challen has also been actively involved in the MA DESE IEP Improvement Project, mentored candidates in UMass Boston’s Transition Leadership Program, and co-authored a chapter in Technology Tools for Students with Autism.

To schedule an appointment with one of NESCA’s transition specialists, please complete our online intake form.

Beyond Picky Eating: Understanding ARFID in Children

By | NESCA Notes 2024

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

Feeding children is one of the many aspects of parenting that seems pretty straightforward before you have kids of your own. But most parents will tell you that it can actually be mind-bogglingly difficult. That’s because “picky eating” is very common, so much so that it’s considered a normal developmental phase in early childhood. In fact, almost half of typically developing children go through a phase of “picky eating,” and the prevalence is even higher in children with neurodivergences, such as Autism Spectrum Disorder. The good news is that, as frustrating as picky eating can be, most children naturally outgrow this phase and eventually expand their diets to include more than chicken nuggets and buttered pasta. However, there is a subset of picky eaters for whom their selective food choices are part of a more serious problem that requires intervention.

In some case, highly selective eating may signal the presence of a condition called Avoidant Restrictive Food Intake Disorder or ARFID. A diagnosis of ARFID is made when an individual’s picky or selective eating is severe enough to cause secondary problems, such as nutritional deficiencies, reduced growth or weight loss, and/or social-emotional difficulties.

Unfortunately, little is understood about the underlying causes of ARFID. However, most people with ARFID fall into one or more of these three “subtypes,” each of which derives from different underlying factors.

In some cases, anxiety about choking, vomiting, or allergies drives avoidance of certain foods. This appears to be a factor for up to half of all children with ARFID and may develop after a traumatic experience, such as an illness.
Sensory sensitivities are another underlying factor for some individuals. These people may respond more intensely and/or have aversions to particular textures or flavors. Roughly one out of five of those with ARFID endorse sensitivities to flavors, textures, or smells. Interestingly, “supertasters”—people who have a higher concentration of taste buds—experience flavors much more intensely than is typical. These individuals may be more likely to develop ARFID as they avoid bitter foods.
Additionally, some people simply experience fewer hunger cues and may forget to eat or simply have a low level of interest in and motivation for eating. In these cases, individuals may be willing to eat a broader range of foods but struggle to eat enough.

Importantly, unlike most other eating disorders, ARFID is NOT related to concerns about body image or a desire to lose weight. It’s also important to recognize that ARFID is NOT just extremely picky eating, and individuals with ARFID won’t simply “outgrow” it.

Regardless of the initial triggering factors, limited or restricted intake is maintained by avoidance. That’s why early identification and treatment is important. It is also critical in order to prevent the development of potentially serious health problems related to nutritional issues, which can, in turn, cause difficulties ranging from fatigue and poor concentration to anemia, reduced immune system functioning, stunted growth, and even delayed puberty. Individuals with ARFID are also at risk of experiencing diminished self-esteem, may struggle to take part in social situations that center around food (e.g., meals with others), and develop emotional distress.

Though ARFID can be challenging to address, there are effective treatments. The goals of treatment depend upon individual factors but typically involve restoring weight if necessary, reducing anxiety, and gradually introducing new foods. Specific treatment modalities include family-based treatment, cognitive behavioral therapy, and exposure and response prevention. Treatment may also involve working with a physician and/or dietician.

If you’re concerned that your child’s “picky eating” may be more than a phase, please reach out to a professional who can further assess the situation and provide direction. There are screening tools that may be helpful in providing direction. One such resource can be found here: https://equip.health/arfid-screener. You can also contact the National Eating Disorders Association (NEDA) Helpline at 1-800-931-2237 or by texting NEDA to 741-741.

References/Resources

https://www.chop.edu/news/dos-and-donts-feeding-picky-eaters#:~:text=Do%20remember%20that%20picky%20eating,2%20to%20about%20age%204.

https://equip.health/conditions/arfid

https://www.nationaleatingdisorders.org/avoidant-restrictive-food-intake-disorder-arfid/

About the Author

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

Dr. Rodriguez lives north of Boston with her husband and three young children. She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

To book a consultation with Dr. Rodriguez or one of our many other expert neuropsychologists, 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, NY, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Image of a supportive learning environment at home

Building a Supportive Learning Environment

By | NESCA Notes 2024

By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

Children will do their best when they feel safe and encouraged to try their best. Thus, a structured and supportive learning environment at home is recommended to support the development and well-being of your child. Establishing a structured learning environment involves several key components. Here are some ideas to consider:

Developing a daily schedule with consistent routines helps children understand what to expect, offering them a sense of security and predictability.
Visual aids, such as pictures or timetables, can be used to help children follow these routines.
Breaking tasks into smaller, manageable steps can keep your child from feeling overwhelmed and can promote success, with each accomplishment celebrated to reinforce progress.
Designating a specific area in the home for learning activities is important. This dedicated learning space should be free from distractions and should provide your child with the necessary materials to encourage independent learning.
Engaging your child in multi-sensory activities, such as sensory play and interactive games, can enhance understanding and retention.
Clear, concise instructions supported by visual and auditory prompts help children stay on track and complete tasks effectively.
Setting achievable goals and celebrating small successes to build their confidence and motivation, while emphasizing effort and progress rather than just achievements.
Identifying and encouraging the child’s strengths and interests.
Maintaining open communication with educators and therapists, maximizing the effectiveness of interventions.

Overall, emphasizing effort and progress, providing consistent positive reinforcement, and encouraging strengths and interests, can help create a calm, organized, and predictable environment in the home setting, while collaborating with teachers ensures consistency in strategies between home and school.

By implementing these strategies, parents and caregivers can create a nurturing space where their children can thrive academically, emotionally, and socially. Each child is unique, so it may take time to find the best approach for each. Be patient, flexible, and adaptive, while celebrating progress and all those small victories along the way! For additional resources and support, consider visiting websites, such as childcare.gov, LDA America, and Understood.org.

Resources

https://www.helpguide.org/family/learning-disabilities/helping-children-with-learning-disabilities

https://atriumhealth.org/dailydose/2024/07/26/a-parents-guide-to-empowering-children-with-learning-disabilities

About the Author

With NESCA since its inception in 2007, Dr. Talamo had previously practiced for many years as a child and adolescent clinical psychologist before completing postdoctoral re-training in pediatric neuropsychology at the Children’s Evaluation Center.

After receiving her undergraduate degree from Columbia University, Dr. Talamo earned her doctorate in clinical health psychology from Ferkauf Graduate School of Psychology and the Albert Einstein College of Medicine at Yeshiva University.

She has given a number of presentations, most recently on “How to Recognize a Struggling Reader,” “Supporting Students with Working Memory Limitations,” (with Bonnie Singer, Ph.D., CCC-SLP of Architects for Learning), and “Executive Function in Elementary and Middle School Students.”

Dr. Talamo specializes in working with children and adolescents with language-based learning disabilities including dyslexia, attentional disorders, and emotional issues. She is also interested in working with highly gifted children.

Her professional memberships include MAGE (Massachusetts Association for Gifted Education), IDA (International Dyslexia Association), MABIDA (the Massachusetts division of IDA) and MNS (the Massachusetts Neuropsychological Society).

She is the mother of one college-aged daughter.

To book a consultation with Dr. Talamo or one of our many other expert neuropsychologists, 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.

Approaching Cultural Knowledge and Sensitivity as More Than Just Buzzwords: A Neuropsychologist’s Perspective

By | NESCA Notes 2024

By Leah Weinberg, Ph.D.
Pediatric Neuropsychologist, NESCA

In recent years, the conversation around cultural knowledge and sensitivity has gained significant traction across many fields, including education, healthcare, and psychology. Yet, despite the increasing prevalence of these terms, we must ask ourselves: Are we truly embodying cultural sensitivity, or are we merely paying lip service to it?

As a neuropsychologist, originally from the former Soviet Union (what is now Ukraine), I believe that cultural competence is not just a set of buzzwords we throw around to make ourselves sound aware; it’s a crucial, ongoing practice that demands attention, empathy, and, above all, genuine understanding. Now more than ever, as we witness global conflicts and societal shifts, it’s essential to engage deeply with the cultural and psychological needs of children who are affected by these events. The horrific events of October 7, 2023, in Israel, the subsequent rise in incidents involving anti-Jewish sentiments, and other crises around the world have had a profound impact on vulnerable children. How can we, as mental health professionals, approach these children in a way that truly honors their cultural identities while understanding the potential toll of trauma?

Children who experience trauma often find themselves at the intersection of multiple identities—cultural, familial, national, and personal. In the Jewish community, for example, the devastating events of October 7, 2023, marked a profound moment of collective grief and fear. For some Jewish children, the emotional impact of these events may be compounded by historical trauma, including awareness of past experiences of antisemitism and persecution. These children may be processing not only the immediacy of their own situation but also an ancestral history of violence and oppression. Similarly, Ukrainian children displaced by the ongoing conflict face a complex mix of trauma. These children might not only be mourning the loss of their homes, but also grappling with the disintegration of their sense of safety and national identity. The trauma of war is not just physical; it disrupts the very fabric of who these children are and how they see the world. Their cultural identity, bound up in language, traditions, and the shared history of their people, may suddenly feel threatened or fragmented.

It’s essential to recognize that cultural knowledge is not simply about understanding “facts” about a group’s history or customs. It’s about recognizing the psychological and emotional realities of that culture in the present moment, particularly when faced with trauma. When working with children from these communities, it’s important to begin by listening. Listen not only to their words, but also to the silence in between, to their body language, and to the nuances of how they express their grief and fear. Children from these communities may not always have the language to articulate their feelings, particularly when these feelings are wrapped up in both current trauma and long-standing cultural narratives. For instance, a Jewish child might not immediately say, “I’m scared because of antisemitism.” Instead, they may exhibit anxiety in social settings, avoidance of certain situations, or a sense of hypervigilance. It’s essential to recognize these subtler expressions of distress. Furthermore, cultural sensitivity means appreciating how culture influences coping mechanisms. For Jewish children, faith, community rituals, and family structures often play a significant role in both day-to-day life and in how they process adversity. These rituals, whether it’s a prayer or a specific practice for remembering the dead, can provide crucial emotional support, and understanding their importance can help guide effective interventions. Similarly, Ukrainian children may draw strength from their deep cultural connection to the land and their national identity. Understanding these cultural touchstones allows us to better support their emotional recovery.

To effectively support children affected by trauma, it is important to approach care from a framework that integrates both cultural sensitivity and trauma-informed practice. Children need to feel understood, and this means recognizing their cultural identity as an integral part of their experience. Safe spaces where children can express themselves without fear of judgment are paramount. It is important for clinicians not only to appreciate the current crisis but also the cumulative effect of historical events that have shaped the children’s cultures. As a clinician, this means being aware of the historical context and acknowledging the weight of collective memory. This helps to build trust and validates the child’s emotional experience. Working with families and community leaders helps ensure that interventions are not only culturally relevant but also supported by the broader social structure. This collaborative approach fosters resilience and provides ongoing emotional support.

Cultural competence is not a static goal, but rather a lifelong learning process. As clinicians, we must constantly engage with the evolving cultural, social, and political landscapes to ensure our approach remains relevant and respectful. This includes continuing education and being open to adjusting our practices based on new insights. Ultimately, cultural sensitivity is not about checking off a list of “do’s and don’ts.” It’s about recognizing and understanding that culture shapes how children experience and process the world. This empathetic approach allows us to meet children where they are—emotionally, psychologically, and culturally—and to support them as needed. As we move forward, let us take cultural sensitivity beyond a buzzword and make it a true cornerstone of our practice. In times of crisis, the need for empathy, understanding, and culturally informed care has never been greater.

NESCA has a long-standing commitment to working with internationally based clients, families, and schools through neuropsychological evaluation, consultation, coaching, and transition services. For more information on NESCA’s international work, visit: https://nesca-newton.com/international/.

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, Attention Headshot 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 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.

Image of two people studying together or Body doubling

The Power of Body Doubling

By | NESCA Notes 2024

By Jasmine Badamo, MA
Educational Counselor; Executive Function Coach

Have you heard of body doubling before? Body doubling is when two (or more) people lend each other their presence while doing individual work. You can think of it as a “buddy system” for productivity. Having another person with us while we work can increase our motivation to start a task, boost our focus, and even have a calming effect. In fact, the sheer act of scheduling a body doubling session with someone helps hold us accountable to our to-do list.

Body doubling is a powerful accountability strategy that I use with my clients as well as with friends and family. If you think about it, it’s likely that you have used this strategy, too. Have you ever silently studied in a group, with a friend, or in a public space such as a library or cafe? That was body doubling! What about calling up a friend and scheduling a time to go to the gym together? Body doubling! Do you ever chat with a friend while you cook, fold laundry, or grocery shop? Once again, body doubling! (It doesn’t always have to be silent.)

Body doubling is a foundational strategy that I explore with many clients – first explaining the concept and benefits of it, and then providing them with opportunities to practice it. We may start by body doubling during our video calls, testing out if it’s more effective to keep cameras on or off, mics muted or not, screens shared or not. We’ll experiment with duration to see what’s enough time to get work done, but not too much time to get distracted. Our goal is to find the sweet spot where body doubling is supportive, but not distracting. We also implement structures to make body doubling time as productive as possible. This may look like using a prep checklist to make sure my client has all the materials they need to work; establishing a work plan that includes a goal and the first steps to take; or determining checkpoints when they want me to interrupt with prompts or reminders.

This structured practice is particularly effective because we have fostered a safe and collaborative coaching relationship that is centered on getting work done. With this guided practice, my clients can dip their toes into the world of body doubling and prepare to utilize this strategy on their own – with a natural resource (a person or group of people who is available in their everyday life).

As my clients build independence, we discuss creative ways for them to incorporate this strategy into their everyday lives. We’ll go through the list of people in their lives and think through who would make good body-doubling partners, and who would make socializing too big a temptation to resist. We might remove the temptation to talk altogether and body double with a pet dog or rabbit. I’ve even worked with clients to create “asynchronous” body doubling where they listen to audio messages from friends while they get house chores done.

As body doubling has become more popular, people have found ways to incorporate technology and social media. The YouTube channel @MerveStudyCorner has videos of various lengths showing a person studying in different locations. The Dubbii App by @adhd_love_provides body doubling videos specifically for individuals with ADHD. The FLOWN app offers “coworking” drop-in or power sessions. And some people are hosting TikTok Live while doing chores or working on homework so you can tune in and join. Very clever!

Body doubling is an adaptable and powerful strategy that can help anyone boost productivity, focus, and accountability. Whether you’re experimenting with silent study sessions, enlisting a friend to tackle errands, or exploring innovative tech tools, there’s no shortage of ways to make this strategy work for you. So, why not give it a try? If you need help getting started, reach out to NESCA to work with one of our expert real-life skills and executive function coaches by completing our Intake Form at: www.nesca-newton.com/intake.

Want to do more reading on body doubling? Check out these articles:

Additional Information

Body doubling can also be done outside the context of productivity, often referred to as “parallel play.” Sitting next to a trusted human and allowing yourself to get lost in a preferred task or hobby can be a truly enjoyable experience, deepening your relationship without even talking! For individuals who find talking tiring or for those who have an easily-drained social battery, this is an accessible way to engage and RESIST isolation.

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.

Why Sexual Education is Crucial

By | NESCA Notes 2024

By: Sarah LaFerriere, M.Ed.
Transition Specialist & Special Educator, NESCA

Empowering Students with Disabilities Through Comprehensive Sexual Education

Sexual education is more than a curriculum; it’s a vital tool for personal empowerment, safety, and self-advocacy. For students with disabilities, access to meaningful sexual education can address unique challenges while fostering independence, confidence, and dignity. Here’s why this education is critical and how it can change lives.

Sexual education is not about encouraging students to have sex. It is about equipping them with the knowledge to make informed choices, understand healthy relationships, respect boundaries, and advocate for themselves. While some parents and educators worry that discussing these topics might “give students ideas about sex,” the reality is that comprehensive sexual education empowers students with the tools they need to stay safe and navigate their lives with confidence.

Addressing Sexual Health Disparities

Research has shown that students with developmental disabilities face disproportionate risks in sexual health outcomes. These include higher rates of unplanned pregnancies, sexually transmitted infections (STIs), and sexual abuse. For instance, young women with cognitive impairments are significantly more likely to experience early pregnancy and STIs compared to their peers without disabilities.

These disparities stem in part from barriers to education and healthcare access, as well as stigmatization and misconceptions about the sexuality of individuals with disabilities. By integrating tailored sexual education into their learning experience, we can close these gaps and provide tools for informed decision-making.

Reducing Vulnerability to Abuse

One of the concerning issues is the heightened vulnerability of individuals with disabilities to sexual abuse. Studies indicate that people with developmental disabilities are up to four times more likely to experience sexual assault than their peers. A lack of understanding about healthy boundaries, consent, and their rights can leave these individuals at greater risk.

Comprehensive sexual education teaches students to recognize inappropriate behavior, understand consent, and advocate for their rights. Lessons on distinguishing between public and private spaces, understanding healthy relationships, and asserting boundaries equip students to protect themselves and seek help when needed.

Fostering Healthy Relationships and Self-Advocacy

Everyone has the right to form relationships based on respect, trust, and mutual understanding. For students with disabilities, sexual education can provide a framework to navigate these connections safely. It’s not just about teaching anatomy and reproduction, it’s about addressing intimacy, connection, and communication.

Self-advocates emphasize the importance of this knowledge, stating they want to learn how to make informed choices, build lasting relationships, and advocate for their desires and boundaries. Teaching sexual self-advocacy encourages independence and fosters a sense of agency.

Combating Stigma and Promoting Inclusion

Historically, people with disabilities have been desexualized or unfairly stereotyped. These harmful narratives contribute to exclusion and limit access to essential education. Providing comprehensive sexual education helps dismantle these misconceptions and affirms that individuals with disabilities are entitled to the same rights, relationships, and respect as anyone else.

Building a Safer, More Inclusive Future

Sexual education for students with disabilities isn’t just about reducing risks—it’s about empowerment. It’s about teaching young people to take ownership of their choices, advocate for themselves, and lead fulfilling lives. When we provide these students with the knowledge and necessary tools, we’re investing in their safety, dignity, and future.

As a special education teacher and advocate trained in sexual education for students with disabilities, I’ve witnessed firsthand the transformative impact of these lessons. Let’s continue to advocate for inclusive, comprehensive sexual education for all students and schools, ensuring that no student is left behind.

NESCA’s Sarah LaFerriere is trained in providing sexual education coaching to groups and schools. For more information, please visit our page about our Sexual Health Education Services complete our Intake Form.

If you are eager to learn more about Sexual Health Education, please register for our upcoming webinar on this topic at: https://nesca-newton.zoom.us/webinar/register/WN_XQN-heyzR8iS2_Kp8ZQLNQ

About the Author

Sarah LaFerriere, M.Ed., is a transition specialist and special educator who has nearly a decade of experience working with transition aged students in public schools, college, and home-based settings. She provides transition assessment, consultation, and coaching services to a wide range of clients, and specializes in supporting students with autism, intellectual disabilities, developmental disabilities, mental health conditions, and medical conditions.

To book a consultation with Sarah LaFerriere or one of our many other expert transition specialists, neuropsychologists, or other clinicians, 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.

Occupational Therapist Leah Bridge, MSOT, OTR, Joins NESCA’s Coaching Team

By | NESCA Notes 2024

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA welcomed Occupational Therapist Leah Bridge, MSOT, OTR, as a per diem Real-life Skills and Executive Function Coach this past fall. Learn more about Leah and what she brings to her clients from our recent interview.

How did you become interested in occupational therapy?
As a younger student, I was diagnosed with a learning disability and was exposed to other students with various challenges in my classes and while receiving services. Through that experience, mostly in high school, I became interested in helping other friends and students engage with their work. That kickstarted my desire to work in an area where I was able to support the specialized needs population engage more in their everyday lives.

When I started my undergraduate degree, I actually didn’t know about occupational therapy at all. After ruling out other career paths and with the help of my advisor, I realized that OT was exactly the path I wanted to go down. It encompassed so much of what I love to do.

Once I started my occupational therapy graduate program, I learned about the mental health side of OT, which I hadn’t really known about before. That was very interesting to me, so I did a clinical placement at a behavioral health hospital, which set me on the path to becoming a mental health occupational therapist. From there, I ended up working at Cambridge Health Alliance for the past two years in the inpatient pediatrics, adolescents, and neurodevelopmental unit. Since these are acute settings, the patients mainly come in after a mental health crisis, and my job was to help stabilize them and work with them on self-regulation and coping skills.

Why are you a NESCA Real-Life Skills and Executive Function Coach?
I wanted to work with clients from start to finish, showing them the necessary skills for life. I came on board at NESCA as a per diem coach and quickly learned just how amazing it is to help people build skills. I love working with people, watching them progress, become more resilient, and build skills.

What approaches do you take in working with our coaching clients when they are so unique from one another?
I want my clients to feel like I’m easygoing and approachable. I use a very warm, empathetic approach and a lot of humor to make connections with them. I also like to see where individuals are at and follow their lead – never pushing someone too quickly and meeting their comfort level throughout the process. Once we have a foundational relationship, I can see where to challenge them.

What skills do you work on in Real-life Skills Coaching?
It can be a whole range of things. So far, I’ve worked on behavioral activation, meal prepping, note taking, folding laundry, taking out the trash, placing things into the dishwasher – generally helping people to take more of an independent approach to their daily tasks.

In the community, it could be anything from going into a store and feeling comfortable interacting with different employees in that store. I may take an individual into a store and practice some of the different types of jobs we are working on, like organizing a shelf in Target that was a bit disheveled and putting items back in their places. It’s a more interactive way to work on the organizational skills we may be building. We may also just walk around a crowded grocery store or mall where we can determine different self-regulation techniques that work in these overstimulating and overwhelming moments. It helps individuals be confident that, in the future, they may be able to go to these places alone and feel completely comfortable there.

What is the profile of some of the students that you’ve worked with?
I like working with people of all ages, and I love the differences among all of the patients, students, and clients I’ve seen. I’ve worked with a whole wide variety. At Cambridge Health, I worked with kids who are struggling from depression, anxiety, or a mood disorder, like bipolar, borderline personality disorder or psychosis. In the neurodevelopmental unit, I worked with a lot of different kids with autism, have an intellectual disability, or a traumatic brain injury. While there, I worked with kids who are both very resistant to working together as well as those who are incredibly self-motivated and really want to do the work.

At NESCA, I’ve also seen a variety of clients who are really fun to work with. We do things like work towards building skills they can use when they go off to college, helping them to be more independent and live on campus more confidently. I’ve also worked with students who are taking some time off from college or graduate school to rebuild their confidence and mental health before going back into the school setting. We’re working on a lot of daily tasks to help them feel more regulated and less overwhelmed, and on strategies to help in those difficult moments and remember that they can do this.

How do you gain buy-in from the individuals you work with?
Meeting coaching students where they’re at is so important. I go in with an open attitude and determine where they are at in each session, adjusting my plan from there. I never force anything, but rather go at their pace. I find I’m more successful when we just take time to get to know each other, build trust and understanding, and then the buy-in comes.

Most people are more willing to participate when they know why they are engaging in an activity or some type of coaching. When they learn that I am trying to teach them skills to help them advocate for themselves, they feel more empowered – not just that their parents are making them do this. It’s been very helpful to show them that they have a say in the process and a voice that helps them get to that place of independence.

How does NESCA’s collaborative approach help you in your coaching practice?
It offers amazing value. As an example, I may be thinking of an approach to use in a session, and then I hear from or consult with someone from another discipline within the practice about how they may approach it. It opens your eyes to a whole other way of looking at something. I’m also someone who is very eager to learn and improve my own skills, so I love getting input from other people and delving into the resources they suggest. I always want what’s best for my clients and my patients, so I am always happy to collaborate with everyone to be able to get that for them.

What’s your approach to designing a program or curriculum for someone?
I start off with doing some assessments to determine the areas that are within the domains of OT, such as activities of daily living, leisure activities, work/school activities, and also looking at what skills the individual can already do on their own, and ranking their performance level within each of those along the way. Some clients are able to complete these assessments independently, and some require input from their parents or caregivers. From there, we choose what areas we want to start with and set goals, mainly based on what the greatest areas of need are. We typically work in increments of eight-week sessions. Near the end of the eight weeks, we reevaluate and see if we want to do more.

What are some of the goals your students are working on?
A person may have the goal to go to a grocery store and pick out items from a shopping list. We may not start with going to the grocery store right away. Instead, we may sit down and look at a map of the grocery store and get a feel for what each aisle looks like and what we can find in each one. We may do this kind of work for the first four sessions and then spend the next four sessions going to different places where we can look at how different stores are set up, and how we can find items when the aisles look different from store to store. If we can’t find the items, we work on how to approach someone and ask where we can find them.

What is your take on using different technology tools or apps?
I’m someone who loves learning all about new approaches, including technology, to see what may work. I’m open to exploring new technology and introducing it to students if I think it is something that will support them in reaching their goals. There are some great ones available for anxiety, which may help them engage in our sessions together. There are others for banking, scheduling, and calendaring. If a student prefers using Google Sheets or Excel to help organize their day, I am definitely willing to work with them using those as long as they are a support.

Is there anything else that you would like people to know about you?
I love working with individuals who are going through mental health challenges, whether short-term or chronic. But it’s not the only area I am interested in. I’m someone who feels I can offer a lot and am willing to do the work to really learn and feel as though I can provide the best care to those with whom I work. So, for me, there’s really nothing that I feel I want to avoid. I’m a very open person in that sense that I really just want to help as many people as I can.

About Leah Bridge, MSOT, OTR

Leah Bridge, MSOT, OTR, is a licensed occupational therapist with a passion for helping individuals develop the skills needed to Headshot of Leah Bridge meaningfully engage in their daily lives. With a Master’s degree in Occupational Therapy from Regis College and a Bachelor’s degree in Kinesiology from the University of Massachusetts Amherst, Leah brings a well-rounded educational background to her practice. She is currently licensed to practice in Massachusetts.

Throughout her career, Leah has specialized in mental health-based occupational therapy across various settings, including inpatient units, partial hospitalization programs, and schools. She has worked closely with individuals aged 4 to 26, addressing critical areas such as activities of daily living (ADLs), self-regulation techniques, executive functioning, and routine development. Her experience spans a wide range of diagnoses, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), traumatic brain injury (TBI), and mental health conditions such as depression, generalized anxiety disorder (GAD), and bipolar disorder.

Leah’s therapeutic approach is client-centered and holistic, adapting her interventions to suit the unique needs of each individual and their environment. Whether facilitating community engagement with adolescents in schools, providing vocational consults and life skills groups at partial programs, or teaching coping and self-regulation techniques in inpatient settings, Leah is committed to tailoring her strategies to each client’s specific goals.

Leah’s work is deeply collaborative, and she frequently partners with families and with other professionals such as social workers, psychiatrists, nurses, and psychologists to ensure comprehensive care. Her ability to foster strong therapeutic relationships, combined with her humor and validation techniques, helps clients feel comfortable and supported throughout their therapy journey.

To schedule an appointment with one of NESCA’s coaches, please complete our online intake form.

Finding the Right Therapist for Individuals with ASD

By | NESCA Notes 2024

Therapy session image By: Carly Loureiro, MSW, LICSW
Therapist, Executive Function Coach, Parent Coach

Finding the right therapist for individuals diagnosed with Autism Spectrum Disorder (ASD) can be challenging to come by. Finding an appropriate fit has more to do with the therapist’s background, style, and experience than it does with their license type (LICSW, PhD, LMHC, or LPC). As a therapist who specializes in ASD with a background in special education, I have developed a list of general guidelines when searching for an appropriate mental health provider.

Their ASD specialty should be visible on their website or profile: Websites or profiles on databases like Psychology Today and Zencare should highlight whether or not a clinician specializes in working with individuals with ASD. Not all, but some of these providers may have the letters CAS (Certified Autism Specialist) next to their name as well. A CAS is a professional who has obtained a certification that demonstrates specialized knowledge and training in working with individuals with ASD. Though this certification isn’t necessary, now you’ll know what it represents if you see it.
Schedule a free consultation if offered: If you see an ASD specialty or focus, schedule that introduction call or consultation! Ask the provider about their experience and approach with the population, and see if what is explained resonates with your needs.
They emphasize the importance of rapport building: Individuals diagnosed with ASD may struggle to communicate things like their preferences, needs, feelings, emotions, opinions, interests, and humor. An ideal therapist for this population will take the time to learn these unique attributes through a variety of different approaches and integrate them into treatment. This won’t be achieved in the intake or even within a specific number of sessions, but when the client is ready and able to share and open up.
They offer a strengths-based approach rooted in self-determination and self-empowerment: Often working with specialists all their lives, folks with ASD are more likely to have low self-esteem due to the amount of professionals who have been working to help them. Therapy should feel completely different from any other service. It should be a safe space where the individual feels in control, practicing self-advocacy as they learn new skills and strategies.
There is a family/caregiver component: If the client lives with a caregiver, partner, or other family members, it will be important for the provider to offer family work, if deemed necessary. Oftentimes, communication challenges exist in families and households where one or more members are diagnosed with ASD. By identifying and working through these challenges with a trained professional, life at home can get a whole lot easier.
They display flexibility and patience: Timelines and therapeutic frameworks should be approached gently and with curiosity, with an understanding that no two people with ASD are alike. Given this, a provider with a “one size fits all” approach or therapy framework will not be successful with this population. When you book an introduction call, make sure to explore this with the provider to check for flexibility regarding what a treatment plan may look like.

About the Author

Carly Loureiro is a Licensed Independent Clinical Social Worker practicing in Massachusetts and Rhode Island. Having worked both in private practice and schools, she has extensive experience supporting students, families and educational teams to make positive changes. Mrs. Loureiro provides executive function coaching and psychotherapy to clients ranging from middle school through adulthood, as well as to parents/caregivers. She also offers consultation to schools and families in order to support her clients across home and community environments.

To schedule an appointment with one of NESCA’s counselors, coaches, or other experts, please complete 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 staff in the greater Burlington, Vermont region and Brooklyn, New York, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

NESCA Welcomes Julie Weieneth, Ph.D., to its Team

By | NESCA Notes 2025

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is excited to welcome Pediatric Neuropsychologist Julie Weieneth, Ph.D., to its Newton, Massachusetts location! Read more about Dr. Weieneth’s past experience, areas of specialization, and what brought her to NESCA as a pediatric neuropsychologist.

What drew you to neuropsychology?

Part of what interested me is that I’ve always done and have always enjoyed testing. I did my post-doc at the Developmental Medicine Center at Children’s Hospital Boston and did plenty of testing there. Then, with each subsequent role I was in – whether at a therapeutic school or in a group practice – I was conducting evaluations.

Neuropsychology is a really helpful way to integrate school-based evaluations. If we’re looking at diagnostic clarification, which is one of my areas of interest, that’s what a neuropsychological evaluation and subsequent report can do.

What settings have you worked in previously?

A lot of my background has been as a staff psychologist in therapeutic school settings, including the Manville School and New England Academy for many years, including during Covid.

I then moved on to a group neuropsychology practice so I could better balance my work and life schedules. My own kids were transitioning back to in-person school, and I wanted more flexibility in my schedule to support them as well as the students I evaluate.

What are your specialty areas?

My years in the therapeutic school setting gave me a good understanding of the various challenges students have as well as the complex educational needs that come with supporting them through those challenges.

Taking a step back, my dissertation was on the early development of ADHD, so that is an area that I am very familiar with and still really interested in. I also enjoy working with students with complex presentations, helping to provide diagnostic clarification as well as the kind of supports the individual and family will need to foster their education and development. In addition, I’d say I am also a bit of a generalist, able to work with most children and adolescents who are struggling.

What were you looking for in a new environment?

I am really excited about NESCA being a multidisciplinary practice. I’m looking forward to being part of a team made up of providers from different specialty areas. It will be great to refer children and students to people and providers in-house who I trust for executive function coaching, real-life skills coaching, transition planning, therapy, consultation, and more.

What do you find most rewarding as a neuropsychologist who works with children and adolescents?

I find it particularly rewarding when a student who has struggled with school refusal, meaning they are not actively attending school, is fully back in school and thriving. It’s a great feeling to be part of the team that helps figure out what is happening for them, and helps direct them to the right resources so they can get back into school. I recently heard from a parent of a student I evaluated, who was really struggling and not engaging in any aspects of their schooling or life overall. They let me know that their child sought out and stuck to the interventions we recommended, and their child is back in school and doing well. That’s what our job is all about.

What do you think are the benefits of working in a group practice?

Sometimes the children we work with have a really hard time during the evaluation process, and we can’t finish all of the testing in the first session. I like having the ability to be flexible with them and bring them back in for another session if necessary. If we rush or force the testing, we will not get accurate results. Being in a group practice – rather than a hospital setting where the flexibility in schedules just isn’t there – allows me, as a neuropsychologist, to meet kids where they are at and get the best data and observations that I can.

Working as part of a group practice allows us to share insights, perspectives, connections, and experiences of the entire team. The cases that we all see are complicated, and sometimes, it’s really helpful to take all the information we have available and consult with those around us. To me, it’s a best practice to consult on cases with others. You gain the perspectives and experiences of others in the practice, and it also helps to develop solid recommendations with specific referrals from other experts in the practice to help a family move forward.

As neuropsychologists, we’ve all had different training and previous work experiences, and this is particularly important when cases are complicated. I’m open to hearing information and feedback from others, especially if I think it’s going to help the family move forward. When you work with a team of experts, it makes our reports so much more meaningful for the families we serve.

What are some of the strategies you employ when you are evaluating a child or adolescent who is struggling during the assessment?

Oh, there are so many. Sometimes, I will use Collaborative Problem Solving techniques. I’ve also had sessions where I have waited children out, offered them rewards, provided lots of nurturing and praise – again just meeting them where they are at. I also involve the parent or caregiver in the sessions if the child needs that support.

I’ve learned through the years how to be comfortable in most situations or settings, and I’m not easily thrown by emotional intensity. I always try to end on a positive note, whether the evaluation was smooth or challenging. If they struggled and needed an extra session, I involve the child in the decision to come back the next day and praise them for everything they accomplished in the initial session. They worked hard and should be positively reinforced for that.

Parents and caregivers come to NESCA for answers. How do you help guide parents and caregivers through the evaluation process?

Just like with children and adolescents, I meet the parents and caregivers where they’re at. And everyone is so different in their own experience when they are exploring or seeking out a neuropsychological evaluation. It may be their first time, and they are afraid, or it could be the sixth neuropsychological evaluation their child has had, and they know the drill. No matter where they are at, you do your best to explain what the process is and inform them about what to expect. I let them know that the whole process is designed to understand an individual’s learning strengths and challenges. I let them know that when I develop the report, I will write highly personalized recommendations that build on their child’s strengths and how they can help to understand and work through their challenges.

People often say that I have a “matter of fact” way about me. I approach things practically, and I like to share input, feedback, and guidance with parents, caregivers, and students in that way. While I am practical, I am also empathetic and understanding of everyone’s stories.

How important do you think observation of the individual being evaluated is? What can you tell from the observations?

I was trained to pay attention to the observations. What’s behind the numbers is super important. I would never write a report without a lot of behavioral observations and interpretations around what things mean, because that is so critical.

Behavioral observations can provide insight into what comes easy to the students. And even if they have an average score in a particular area, it’s critical to look at how they approached that task. This can be really meaningful in an evaluation and in providing recommendations.

When you are working with students who are complicated, their struggles emerge in many ways beyond what the typical data show. If you just looked at the numbers, you might not see any struggle. Because the tasks are administered in a 1:1 setting, you see how they approach a task, how they complete it, or whether they can complete it. It informs us about things like their working memory and processing speed, and how that may impact them in real-life or educational settings. Children with high variability in their scores can “fall through the cracks” in school. They may appear like they are doing just fine from their grades and other test scores, but they are often dealing with an internal struggle or an uneven profile. The risk in saying they are doing fine is that, as they progress through their education, the struggle often just gets worse.

What have you noticed in the students you’ve evaluated since Covid?

I see a lot more school refusal among students, meaning the students who are not able to attend school or those who may be in school but need to arrive late or leave early on a consistent basis.

In addition, there has been a lot of anxiety, depression, isolation, and those sorts of things. Everything seems to be far more complex than it had been before Covid. And that’s a lot, considering it was already getting more complex before, with social media other stressors.

I’ve also noticed that there’s a lot of anxiety among adults. The parents and caregivers seem to have a heightened sense of anxiety and uncertainty.

How did you work through Covid?

It certainly was challenging, but there were two important silver linings that emerged from that experience. I learned to meditate and get more interested in mindfulness throughout that time. It has been really helpful to me.

Professionally, Covid actually helped me grow and transition from the therapeutic school setting to a group neuropsychology practice. While I loved my roles within schools, I was looking to delve deeper into diagnostic assessment. Doing so also provided me with more flexibility to balance things between my professional and personal lives. So, there were at least two positives that came out of the experience.

About the Author

Dr. Weieneth is a licensed clinical psychologist who has worked with children and families with complex diagnostic and treatment needs for the last twenty years. Her areas of specialty include ADHD, autism spectrum disorders, anxiety, mood disorders, learning disabilities, executive functioning, and school-related challenges. That being said, Dr. Weieneth also understands that not all individuals fit cleanly into diagnostic groups or labels. Her goals for each evaluation are to help families feel comfortable with the process, use all the tools available to best understand each individual’s unique strengths and needs, and to write a clear and comprehensive report that will guide educational and treatment planning.

To book a consultation with Dr. Weieneth or one of our many other expert neuropsychologists or other clinicians, 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.

Beyond the Scores: The Comprehensive Approach to Neuropsychological Evaluations

Disability is Not a Dirty Word—It’s a Legal Term

Beyond Picky Eating: Understanding ARFID in Children

Building a Supportive Learning Environment

Approaching Cultural Knowledge and Sensitivity as More Than Just Buzzwords: A Neuropsychologist’s Perspective

The Power of Body Doubling

Why Sexual Education is Crucial

Occupational Therapist Leah Bridge, MSOT, OTR, Joins NESCA’s Coaching Team

Finding the Right Therapist for Individuals with ASD

NESCA Welcomes Julie Weieneth, Ph.D., to its Team

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