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Kelley Challen

More Than An Inkblot: Measuring Problem-Solving and Critical Thinking Skills with Projective Tests

By | NESCA Notes 2019

Image Cred: 2019

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

What might this be? A saxophone player? A woman’s face? A bunch of black and white paint? Or is it something else entirely? This classic optical illusion engages the parts of the brain responsible for perception, critical thinking, and problem-solving so that humans can “make sense” of a somewhat ambiguous picture. We know that everyone perceives and experiences the world differently. In order to best support a child’s growth and development, parents, educators, and professionals need to understand a child’s “lens” or “brain habits” that guide how they think, how they feel and how they behave. Projective testing assesses these “brain habits” and sheds light on a child’s problem-solving style.

If you google or look up “projective test” in the dictionary, an array of definitions pop up. The general theme is: a projective test is a test designed with ambiguous stimuli upon which a person presumably “projects” hidden, unconscious emotions and conflicts. Yes, a person’s internal thoughts, feelings, and assumptions sometimes outside of conscious awareness do influence your response to projective tests and your behavior in everyday life. However, projection is only one piece of the puzzle. A broader, more accurate definition is:

A projective test is a “performance-based” test that requires the respondent to perform a task that has little structure, direction or guidanceThese tasks might, for example, involve completing a sentence, telling a story, or describing inkblots (i.e. the famous Rorschach Inkblot Test).

So why do we care about assessing a child or teen’s ability to make sense of an unstructured, ambiguous task? In addition to measuring a child’s concrete knowledge and skills (e.g. academics, intellectual functions, memory capacity etc.), it is oftentimes crucial to understand how a child problem-solves a situation “in action” – when they must rely on themselves to formulate a solution. This is particularly true for children who have difficulties managing their emotions, children who have trouble making reasonable decisions, and children who can’t seem to make or keep friends. For youth with these challenges, understanding how “in the moment” problem-solving and critical thinking skills work or don’t work gives parents, educators, and professionals insight into learning style, challenges and strengths, and most importantly, guides individualized therapeutic interventions.

A growing number of business and education leaders have begun to recognize the importance of performance-based assessments to evaluate student learning in the classroom and the workplace. Creativity, ingenuity, “thinking on your feet” and the capacity for critical thinking and analysis are clearly key skills in today’s innovative world. Therefore, to set kids up for success, it is understandably helpful to evaluate a child’s thinking and feeling “brain habits” that affect their choices, behaviors, and aspirations. As assessors, teachers, professionals, and parents, we want to better understand how each child applies knowledge to solve problems they face now and in the future – social problems, work problems, emotional problems and beyond. Projective testing provides not only a current evaluation of a child’s capacity to problem solve “on their feet” but provides a direction for how those “brain habits” might pose a strength or a challenge for that child as they grow.

Are you thinking about referring a child, teen, or young adult for projective testing? Here are 5 “fast facts” to guide you:

  1. Projective (also known as performance-based) tests are powerful diagnostic tools when administered and interpreted in conjunction with observation and other standardized test results by a skilled, experienced practitioner. It is important to ask a potential evaluator about their training in projective testing and how they utilize the results.
  2. Projective testing is helpful for children and teens with various complex, social and emotional challenges. Common referrals include questions related to: thinking problems/emerging psychosis, trauma, attachment-related concerns, depression, anxiety, bipolar disorder, developing personality traits and disorders, high-risk behaviors such as suicidal or homicidal thoughts and actions, substance abuse, poor emotion regulation, and self-injury.
  3. Projective testing provides information about a child’s thinking patterns, how they experience emotions, self-esteem, and their habits of interacting with others. For example, is a child more likely to “keep everything inside” and avoid or do they dysregulate and “explode” when they experience anxiety? Are a child’s difficulties making and keeping friends because they get “stuck” on the details of a situation, is it because they “miss the big picture”, or are they in a constant state of worrying that others will let them down? Answering these questions results in a more individualized intervention plan for therapy, at home and at school.
  4. Projective testing is not for everyone. There is little research on the use of projective testing with children and adolescents with low visual acuity, below average verbal and/or non-verbal IQs, impairments in visual-spatial processing, social-communication challenges, or language disorders. Be cautious of practitioners who do not inquire and evaluate these important aspects of a child’s functioning, as they are crucial components to determine the appropriateness of a projective evaluation.
  5. Projective testing sheds light on not only a child’s areas of difficulty, but can also provide an individualized analysis of a child’s strengths. For example, projective testing can identify capacity for insight into choices and behaviors, ability to engage effectively in a therapeutic relationship, capacity for empathy and perspective-taking, as well as a child’s inclination towards imagination, creativity, and ingenuity.

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment, and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills, and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate, and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT), and family (solution-focused, structural) modalities. Her school, home, and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel, and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence, and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form.




Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, MA, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


Just What the Doctor Ordered: A Director’s Update on Personal and Social Coaching (PSC)

By | NESCA Notes 2019

By: Ann Helmus, Ph.D.
NESCA Founder/Director

So many wonderful things have happened at NESCA in the past year including our recruitment of many talented interns, post-doctoral fellows, and staff members, the opening of an office in the Foxborough/Plainville Area, and the promotion of several staff. As Founder and Director, I continue to be both proud and humbled by the incredibly talented staff I go to work with each day and the community of families and professionals who allow us the privilege of being part of their lives.

As the New Year often brings about health resolutions, including the desire to increase one’s physical and mental fitness, I am taking this opportunity to spotlight one of our most exciting new staff and services at NESCA: Certified Personal Trainer and Autism Fit Instructor Billy Demiri who leads our Personal and Social Coaching (PSC) Program.

When I arrived to check on how things were going with his first training session,  I heard Liam (not his real name) say, “I make muscular dystrophy look easy!”  This proclamation from a 10 year old boy who had, just hours before, during his evaluation, protested loudly that he would “never work with a coach, no matter what!”    Following his diagnosis of muscular dystrophy, a progressive, degenerative disorder, Liam had become clinically depressed.  Over the past few years, he was often irritable, oppositional, volatile, and completely sedentary.  While a specialized school placement, psychopharmacological intervention and therapy had all been helpful, Liam was still struggling.  His mother and I both viewed physical activity as being an important intervention for him, for medical and psychological reasons.

They were scheduled to have their intake session with Billy Demiri, who heads NESCA’s PSC program, after lunch on the day of Liam’s testing.    Clearly, getting Liam to “sign on” was going to be a challenge.    So, I hatched a plan that I explained to Billy and to Liam’s mother.  Liam’s mother was to tell him that he didn’t have to work with the coach but that she herself wanted to talk with him.  I suggested that Billy focus only on talking with Liam’s mother and not give any attention to Liam.  While Billy and Liam’s mother chatted, Liam was reading a book but regularly glancing over at them, clearly interested.  Eventually, he couldn’t resist joining the conversation.  Billy invited Liam’s mother to look at the exercise room and Liam indicated that he wanted to go too.  Liam succumbed to Billy’s gentle encouragement and was soon navigating an obstacle course and doing hurdle steps…with a huge smile on his face, a smile that I had not seen in the course of our evaluation.  His mother’s smile was even wider.

Liam came back eagerly the following week for his training session.  When he and Billy took a break, Liam told Billy, “I like this!  I can use the stuff that we’re doing, like when I’m feeling mad or upset, to make me feel better.”  He then shared with Billy how hard it’s been for him to know that he has muscular dystrophy and to be depressed.

Billy is not a psychotherapist but he is warm and an empathic listener, a young man who children and adolescents like, respect and trust.  He has done a remarkable job forging a strong connection with each of his clients and skillfully uses that relationship as the basis for getting them to take risks, move out of their comfort zone, and persist in the face of challenge, which are all ingredients in developing “grit.”  Billy’s clients make impressive progress not only physically but also emotionally.  Many of Billy’s clients struggle with self-esteem and the concrete, measurable improvements that they see on a regular basis in their physical capabilities is a huge self-esteem booster.    In addition, through the Physical and Social Coaching program, his clients reduce their level of anxiety, increase coping skills and learn about setting and achieving goals.

NESCA takes a highly integrative approach to the delivery of therapeutic services.  In the case of PSC, Billy coordinates care with the neuropsychologists who have evaluated his clients or the psychotherapists who are treating them so that he understands the underlying social-emotional concerns to be addressed in his sessions.  After an initial assessment of movement patterns, he develops an individualized physical training program that will result in improved physical well-being and serve as a vehicle for social-emotional growth for the client. As NESCA’s Founder and Director (and also a client of Billy’s!), I am tremendously proud to be able to offer this unique and ground-breaking service to our clients.


About the Author: 

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.


Want to learn more about PSC? PSC will initially available for clients who are part of the NESCA family and have already participated in testing, consultation, or therapy at one of our Massachusetts or New Hampshire offices. To learn more about services, please email Or, to book an intake with Billy, please complete NESCA’s Intake Form at and select “Personal and Social Coaching (PSC)” as your reason for referral.


To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists, complete NESCA’s online intake form.





Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville/Foxbourough, Massachusetts as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.



Smart and Slow: What is a processing speed deficit? How can evaluation help?

By | NESCA Notes 2019

By Jessica Geragosian, Psy.D.
Pediatric Neuropsychologist

Emilia is in the 7th grade. Teachers have always found her to be an intelligent and academically motivated child; however, she has historically been quite slow in completing classwork and tests. Homework, particularly now in middle school, has been a highly laborious process, taking her far longer than her peers. Emilia’s parents were also concerned when receiving her SSAT results, as the scores did not seem to reflect the capabilities of their smart kid. But what is most concerning to Emilia’s parents is that Emilia has recently been coming home saying she is “dumb” and hates school.

Processing speed is the rate at which an individual can process information and produce an output. Although it is measured as part of many standard intelligence tests, it has nothing to do with how “smart” an individual is. Processing speed challenges can be visual, oral, and graphomotor in nature. They do not have to be related to a learning disability or ADHD, though they can be. Also, processing speed can be easily impacted by many things. For example, while an individual may not have a primary processing speed deficit, depression and anxiety can temporarily cause deficits in processing speed.

It is not uncommon for children to have strengths and weaknesses in their cognitive profile. Weaknesses in processing speed, however, can be particularly frustrating, especially when children are very bright. This is because these children may have many ideas, but cannot produce them efficiently or effectively. Children with processing speed deficits tend to experience a high level of frustration, as they are not able to demonstrate their knowledge and keep up with their peers in the classroom. Sometimes, processing speed deficits do not become apparent until middle or high school when work demands ramp up, or the student begins taking standardized exams with strict time limits.

For students like Emilia, who experience increased academic challenges as they progress in school, neuropsychological evaluation can be extremely useful and effective. In this case, the purpose of neuropsychological testing aims to better understand the nature of the processing speed challenges, the impact on the child, and how to utilize strengths to overcome challenges. Students with processing speed deficits are often entitled to academic accommodations and can be quite successful with such supports in place. Testing can also be important for ruling in, or out, emerging mental health issues.

For Emilia, the following recommendations were particularly important to address in her educational planning:

-extra time on tests (including standardized exams such as the SSAT)

-the use of a computer to minimize graphomotor output demand (and access to voice-to-text software)

-help with notetaking in the classroom (copy of teacher’s notes)

-learning tools to circumvent processing speed challenges (i.e. use of a Livescribe pen which records audio as she is taking her own notes)

-putting value on quality rather than quantity of school work (e.g., when given a homework assignment in math, Emilia was required to complete every other item)

However, the most effective approach, and one of the most important outcomes made possible by neuropsychological evaluation, was explicitly teaching Emilia about her unique strengths and challenges. Children (especially middle schoolers) tend to be black and white—if they finish their test last, then they must be “dumb.” When Emilia was able to see that this was a challenge that could be overcome, especially in the context of her very impressive intellectual abilities, she was able to re-engage in school without frustration. Moreover, parents and teachers were able to better understand and address her academic challenges in a thoughtful and effective way.


About the Author:

Dr. Jessica Geragosian is a Licensed Psychologist in Massachusetts and New Hampshire. She has a wide range of clinical experience – in hospital, school and clinic settings – working with children and adolescents presenting with a wide range of cognitive, learning, social, and psychological challenges.

Dr. Geragosian operates under the primary belief that all children want to, and can be, successful. The primary goal of her work is to identify the child’s innate strengths, and find any underlying vulnerabilities preventing a child from achieving success. Whether the primary problem is an inability to acquire academic skills, maintain friendships, control emotions, or regulate behavior to meet expectations; she takes a holistic approach to understand the complex interplay of developmental, neurological, and psychological factors contributing to a child’s presenting challenges.

Dr. Geragosian earned her doctoral degree from William James University, before completing postgraduate training in pediatric neuropsychology at the Massachusetts General Hospital for Children at North Shore Medical Center, where a focus of her work was neuropsychological assessment of young children with developmental challenges.

To book an evaluation with Dr. Geragosian or one of our many other expert neuropsychologists, complete NESCA’s online intake form.




Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, MA, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


A Tale of Two Social Styles: Classical and Jazz Socializers (Republished from Nov. 27, 2017)

By | NESCA Notes 2018

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

I work with a number of parents concerned about the quality of their child’s social life.  Lamenting that their child has no true friends, many parents I see note that that their child doesn’t “hang out” with peers.  However, when asked about how their child does spend time with peers, many parents report that their child is involved in several different structured after-school activities, such as a church youth group, scouting, or a gaming club.  In other words, while not getting together with peers in less structured settings, these students often do, despite parent misgivings, have satisfying social lives.

I find it useful to think about socializers as lying in one of two camps: Jazz and Classical.  Jazz socializers are all about improv.  They’ll head downtown with a friend and see where the afternoon takes them, invite a friend over with no particular plan or agenda, or wander the mall in a herd.  They care little about predictability and in fact relish spontaneity and surprise.  Classical socializers, by contrast, are most comfortable with structure.  They crave predictability, wanting to know the specific parameters of a social activity, including the start and end times, the purpose, and the rules of engagement.  Classical socializers, then, tend to do best with organized social activities.

It’s important to note that one type of socializing is not better than the other; it’s about a match.  I say that as many parents of Classical socializing children worry that their children will grow up to be friendless and alone.  To those concerns, I observe that there are plenty of socially-satisfied Classical socializing adults: they have their book club the first Monday of every month, poker night every other Thursday, weekly chorus practice, and bar trivia on Wednesdays.

Thus, rather than trying cram to their Classical socializing child into a Jazz paradigm – which in fact runs the risk of leading to more social isolation due to anxiety stemming from the mismatch – I encourage parents to embrace the kind of socializer that their child is.  For parents of Classical socializers, that means supporting their child’s social satisfaction and growth through the encouragement of their participation in a variety of structured after-school activities (of course without over-scheduling).  In addition to giving their children a chance for a rich and rewarding social life now, participation in such activities serves as an important practice and preparation for adult life, as in college and as adults in the working world, that is how Classical socializers will be most socially satisfied.


About the Author:


Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.


To book a consultation with Dr. McCormick or one of our many other expert neuropsychologists, complete NESCA’s online intake form.




Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, MA, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


I’m Too ____ or _____ for Yoga: Yoga Myths Dispelled

By | NESCA Notes 2018


By: Ann-Noelle McCowan, M.S, RYT
Guidance Counselor; Yoga Specialist

As yoga continues to expand its popularity and presence many people still worry that there is something that prohibits their beginning a yoga practice. Yoga increases strength, balance and flexibility while decreasing stress. Yoga increases athletic performance, improves respiration, and promotes better sleep quality. It has been used successfully as a complementary therapy for mood disorders such as anxiety and depression, addiction and chronic pain.  As an “inflexible” yogi who has worked with a broad range of yogis, both as a student and a teacher I have seen that yoga truly is for anyone. May this review of some if the most common misconceptions to yoga reduce the roadblocks and invite you to step onto a mat in 2019.

  1. I’m too inflexible for yoga.  This may be the most common reason many people give, perhaps due to the images of bendy people in yoga poses on social media or in print. But do beginner Spanish speakers say they can’t take Spanish lessons because they don’t speak Spanish? Yoga classes will include multiple props (blocks, straps,  blankets) to help modify for all different bodies and continued practice will build greater flexibility. I love props and continue to use blocks in certain poses because that works for my body.
  2. I don’t have special yoga clothes or the right mat.  Having practiced in studios, homes, and schools you don’t need particular clothes to do yoga, just clothing that allows you to move is sufficient. Many yoga studios or gyms also offer rental mats, or mats to borrow which is the case at NESCA.
  3. I don’t have the right body/ want to lose weight first…  Similar to point 1 yoga is adaptable and designed for anybody. Blocks, blankets, and props are available. There is  a broad range of classes to try from beginner, or Yin to help increase your comfort in a yoga class.  A yoga practice can also help you be more accepting of your body and build healthy habits.
  4. I’m too old/young/ wrong gender to do yoga.   A quick Google search provides instructors of all ages and genders, from Tabay Atkins, an 11-year-old male yoga teacher, to  Tao Porchon- Lynch, at 100-year-old female instructor. There are resources and books designed for people age 1 to 100 and classes where parents can bring their baby to modified classes in chairs or entirely on the floor. My own teacher training there was a wide range of trainees, from their 20’s to grandmothers and they are the examples you may see leading your class. While yoga was originally taught by men to men, the focus has switched and classes now include both men and women.
  5. Yoga is too spiritual/ I don’t want a clash with my beliefs.  Yoga is taught in a broad range of locations and by different teachers. By reading the teacher bios you will get a sense of how they approach yoga. Classes range from a purely physical experience to ones that may include some chanting.  Many students find their yoga practice enhances their own compassion and in focusing on your own breath and experience you can take your practice in the direction you want, and not where you want.

Wishing you a happy holiday and that 2019 may be the year you add some yoga to your life!


About the Author:

Ann-Noelle provides therapeutic yoga-counseling sessions individually designed for each child. NESCA therapeutic yoga establishes a safe space for a child to face their challenges while nourishing their innate strengths using the threefold combination of yoga movement, yoga breath, and yoga thinking.

Ann-Noelle has worked with children and adolescents since 2001 and practiced yoga and meditation since 2005. Since 2003 she has been employed full time as a school counselor in a local high performing school district, and prior to that was employed in the San Francisco Public Schools. Ann-Noelle received her dual Masters Degree (MS) in Marriage, Family and Child Therapy (MFCC), and School Counseling from San Francisco State University in 2002, her BA from Union College in New York, and her 200 hour-Registered Yoga Credential (RYT) from Shri Yoga. Ann-Noelle completed additional Yoga training including the Kid Asana Program in 2014, Trauma in Children in 2016 and Adaptive yoga for Parkinson’s in 2014.

If you are interested in therapeutic yoga with Ms. McCowan,  please complete NESCA’s intake form today and indicate interest in “Yoga”


For more information on the therapeutic yoga at NESCA, please visit




Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


Preparing for the College Visit – for Juniors and Their Parents

By | NESCA Notes 2018



By: Dina Karlon, M.A.
NESCA Transition Specialist

So often students feel pressure to come up with a plan of what they want to do with their lives; college is expensive and it’s a big decision. I will say to you that while it feels overwhelming, there are things you can do to limit the stress. During the winter holiday season, college is likely one of the last things you want to think about as a junior or parent of a high school junior. But now is a great time to plan your college campus visits!  

While knowing what you want to do (and study) is important, it is not necessary to know that before deciding on a college. If you know you are going to college, you need to make sure it’s a place you can see yourself living at. Therefore, the feeling you get when on a campus is very important. That’s why I am suggesting you spend some time on it.  

Here are some tips for planning your winter and spring college visits: 

  1. School breaks are a perfect time to visit colleges. This is because colleges are in session when high schools have their breaks. You can always visit in the summer, but you will not get the same “feel” of how busy the campus is when the students are not there. 
  2. Register through the school website for the visit. Colleges do keep track of positive contacts from students (i.e., “points of contact”); it will demonstrate to the college that you are interested enough in the school to go and see it. If you just do a drive by or a self-directed visit, it doesn’t count with the college. You want them to know that you were on campus, so register!  
  3. What schools to look at? If you have narrowed your college list, you will know what schools to look at. If you have not, don’t worry. Just getting out there to see schools can help – you will be narrowing your search by visiting campuses as well. Remember, the feeling you get when you are on campus is just as important, probably more important, than anything else. If you are traveling out-of-state for the breaks, visit a college when you are out there. If you are staying home, do some local or in-state colleges – both 2- and/or 4-year schools.
  4. Remember when you go on a visit that they are trying to sell you the school. They should; that is their job! Your job is to be an educated consumer, so do your homework. Do a little bit of research before you go to the school. Treat it like a job interview – have a couple of questions that you want to ask. For example, ask: What kind of tutoring is there for students? Is it free? Who tutors? These are questions that may be of particular importance to you. One of my favorite questions is: How big is your commuter population? You may wonder, why is this important? Well, if it is a high number, that means that most people are not there during the weekend. If you are planning on being there on weekends, you don’t want to be alone. You want other students there. Schools that have a lot of people leave for the weekend are referred to as “suitcase colleges”. They are not as good for people who live on campus on weekends. 
  5. Go off the beaten path if you can. The student ambassadors giving the tour love the school and are likely being paid for the tour. They are often students with lengthy resumes about their involvement with the school (which is awesome but can feel intimidating). So if possible, talk with other students and ask them about their experience. 
  6. Eat in the cafeteria. You will likely be eating there for every meal (at least freshman year), so you want to know what that experience will be like. Are there a lot of options? Is it very busy? 
  7. Don’t schedule more than two visits in a day. Visiting schools can be exhausting and schools can all start to look alike after a while. Here is the itinerary: Visit one in the morning, eat lunch to debrief the first one (keep a notebook or digital notes/pictures), visit the second school in afternoon, and debrief that school during dinner or on the drive home. If you can do one a day, even better. But doing two in one day can be more time effective. Just don’t so more than two; you won’t remember them! 

So you went on a visit and you didn’t like the school. What a waste of time! You would never go there! Congratulations! You just started whittling your list and didn’t waste money going to a school that you wouldn’t be happy at. Also, you know more about what you do want to look for on your next college visit.  

On a personal note, I have two adult children of my own and have survived the college process. One of the college visits that stood out to me the most was one we attended on a cold, rainy, Friday afternoon. It was a college in a different state from where we live, so my daughter would be living there. Many people didn’t show up for the college visit (probably due to the timing and the weather). Because of that, we had our own tour guide. During the visit, the campus was very busy – students were walking around the campus on a late Friday rainy afternoon. It was clear that students were engaged and planning on being there for the weekend. My daughter ended up going there and enjoyed her college experience. There were obviously other factors that helped her with her choice, but that visit had a significant impact on her decision. 



About the Author:

Dina DiGregorio Karlon, M.A.  is a seasoned counselor specialized in transition issues. She has worked over 15 years as a school counselor in public high schools and has additional experience as a GED program coordinator, career center coordinator, and vocational assessment specialist. She has additionally worked for New Hampshire Vocational Rehabilitation as a rehabilitation counselor and also for the New Hampshire Department of Education.

At NESCA, Ms. Karlon offers coaching services as well as transition planning consultation to students, families, and fellow professionals in New Hampshire. In addition to her work at NESCA, Ms. Karlon is a Program Specialist for the New Hampshire Department of Education, specializing in the development of employability skills and job readiness skills for at-risk youth.  

When providing transition services, Ms. Karlon most enjoys the relationships that she is able to create with her clients and/or students and their families. She loves being part of helping them figure out their strengths and challenges and helping them realize their goals and dreams. Ms. Karlon knows that often the path after high school is not traveled from A to B, but rather it is A to E, to C, and then back to A. She works hard to help her clients view each setback as an opportunity for growth rather than a failure, to recognize their own strengths, and to overcome the barriers that may get in the way of setting goals, solving problems, and making progress. She brings extensive experience supporting clients with career and college planning and she is able to shift fluidly with clients along their paths in each of these domains. 


If you are interested in a consultation, pre-college coaching, or transition planning with Ms. Karlon, please complete NESCA’s intake form today and indicate interest in “Transition Consultation and Planning”




Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


Enjoying the Holidays with Sensory Needs

By | NESCA Notes 2018


By: Sophie Bellenis, OTD, OTR/L 
NESCA Occupational Therapist; Community-Based Skills Coach

School vacation! Bright lights! Snow! Holiday cards on the wall! Bells a’ringing!

For many of us, the holiday season is an exciting, family filled occasion that brings people together to celebrate yearly traditions.  However, for some of our children with sensory needs, the season can be over-stimulating, anxiety producing, and difficult to navigate successfully.  Even children who love the spirit of the season can quickly become saturated with the onslaught of visual, auditory, tactile, and olfactory input.  Here are some tips to consider as we head into December!

  1. Make Your Home a Safe Space – Consider reducing decorations, holding off on moving furniture, and choosing a select few holiday cards from friends and family to display. With everything from daily routines to the look of familiar neighborhood streets changing throughout the month, maintaining consistency within a child’s home can help offer a much needed respite from the visual clutter. While these changes may seem minor, visual clutter causes some children’s eyes to continuously scan the room, move from place to place, and constantly work to perceive all of the information. This is exhausting!
  2. Less is often More – For a child who is easily over-stimulated, opening two presents can be much more exciting and rewarding than ten. One hour visiting family can feel easy, while two hours feels impossible. And a small tree can look beautiful, while a huge tree feels intimidating and scary. Set children up for success by keeping activities manageable.
  3. Have a Designated Sensory Retreat – When venturing out to visit family or friends, preparation is always key. Discussing a sensory plan before arriving and having supports in place can catch stressful situations before they develop. A pre-planned hand signal or code word can save a child from having to explain that their body feels dysregulated and they are overwhelmed. Children may want to take breaks in a quiet bedroom, bring a popup tent to hide in, or eat their meal somewhere quiet before a big sit down dinner begins. For adolescents, this sensory retreat may simply be sitting in the car for 10-15 minutes in silence.  Give children permission to take what they need.
  4. Enlist the Help of Teachers – Social stories, modified visual routines, and exposure to holiday sensory input are all strategies that teachers and therapists in the school setting can help to develop and introduce to a child. Previewing the plan for school vacation can make the week off go much more smoothly.

In a household such as mine, that celebrates both Christmas and Hanukah, the month of December is fraught with routine change, decorations, and new smells from rarely cooked, homemade meals.  Allowing our children with sensory processing disorder, autism spectrum disorder, and other sensory needs to prioritize their internal regulation can help make the season fun for everyone!


About the Author:

Sophie Bellenis, OTD, OTR/L  is a Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. For the past five years her work has primarily been split between children and adolescents on the Autism Spectrum in the United States, and marginalized children in Tanzania, East Africa.

Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists.

Dr. Bellenis has worked for the Northshore Education Consortium at the Kevin O’Grady School providing occupational therapy services and also at the Spaulding Cambridge Outpatient Center. She also has extensive experience working at the Northeast ARC Spotlight Program using a drama-based method to teach social skills to children, adolescents, and young adults with autism, Asperger’s Syndrome, and related social cognitive challenges.

Internationally, Dr. Bellenis has done extensive work with the Tanzanian Children’s Fund providing educational enrichment and support. She has also spent time working with The Plaster House, a post-surgical, pediatric rehabilitation center in Ngaramtoni, Tanzania.

Dr. Bellenis currently works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs and visual motor skills must be taken into account to create comprehensive educational programming. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as well as social skills coaching as part of NESCA’s transition team.


If you are interested in a consultation or individualized skill coaching with Dr. Bellenis, please complete NESCA’s online intake form today.




Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


Nearly 1/3 of College Students Drop out or Transfer by the End of Freshman Year: What Can We Do Differently?

By | NESCA Notes 2018



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


As a transition specialist with a guidance counseling background, I work with many students during the college application process and the transition to managing life on a college campus. I help students and their families determine whether the student is ready to make the transition, whether an “in between” step such as a postgraduate or transitional year is needed, and how to shore up necessary skills for managing the enormous step between structured life at home and high school where adults constantly tell you what is expected and independently managing the freedoms, responsibilities, and unspoken expectations of being an adult on a college campus. Furthermore, I support young adults after a transition home from college participation, whether successful or unsuccessful, as they figure out the next steps in their life journey.

Two weeks ago, the New York Times (see link below) featured an article by Dr. William Stixrud and Ned Johnson emphasizing the hard reality that initial college transitions are unsuccessful for nearly one-third of young people.  The article further added that college is not actually a four-year endeavor for the majority of students who enroll (only 20% of the students who enroll in four-year college finish a bachelor’s degree in four years, and only 57% of students graduate within six years). The cited statistics are numbers that I have often mentioned in my own work with families and schools. I believe we need to be talking about, and normalizing these experiences. But, while many high schools track and publicize college admissions statistics, long-term graduate outcomes are less often known or shared. For students, parents, and teachers, being accepted into a college is frequently thought of as a final achievement for a successful high school student, rather than a small step in the context of a larger life plan.

Cue the transition specialist! Postsecondary transition planning is a process by which a young person is supported in the setting of goals and expectations for themselves and in building the skills and resources that will enable them to reach those goals. This should be a completely individualized process. However, in working with a large number of clients in Massachusetts and New Hampshire, I have observed that most middle and high school students have the same postsecondary vision: College. There is a strong consensus that college is the only goal to reach after high school, rather than an important step that leads to gainful employment in an area of strength, interest, or aptitude. Students with and without disabilities often know that they want to go to college (or that they are expected to go to college) but they have no career goals or sense about whether a college degree will actually benefit them in finding employment related to their aptitudes. Despite the data, most young people (and their parents) simply take as fact that college is what you do after high school.

But, as Stixrud and Johnson point out, thirty percent of students leave college by the end of their freshman year, and “the wheels can start to fall off as early as Thanksgiving.” Students find themselves back at home, no longer a student, but with no other sense of plan or identity. The authors cite two primary issues faced during this transition to college: the highly dysregulated environment that college provides (e.g., inconsistent sleep and diet patterns, lack of structure, and substance abuse including stimulant overuse, binge-drinking, and pot-smoking), and the late transition of managing daily life from parents to students. While I see students transfer or leave colleges for many reasons (e.g., difficulty managing social relationships without support, burnout, technology overuse, underusing needed/available support services, disciplinary issues, etc.), I certainly agree that the identified issues are often at the heart of college difficulties.

So how do we help students to better manage the transition process? First and foremost, we need to start discussing career development earlier and help our youth to understand the wide range of postsecondary options available to them. A bachelor’s degree is one academic pursuit that has a place for many students, but for a great number of students, it is not the best immediate option available after high school. There are many other options worth exploring such as two-year college programs, vocational or certificate programs, apprenticeships, military, employment, and gap year programs (see Without understanding the concept of career development, and the alternative paths available, students often do not know that they can make another choice besides (or on the way to) college. We also need to acknowledge that four-year college degrees are not a reality for the majority of people. To be truly informed decision-makers, students need to know that enrolling in college is likely to be a 5 or 6-year process.

In addition to helping students make informed decisions, we must begin planning for a transition of power and responsibility much earlier. Transition planning starts at a young age with things like sleep training, taking the school bus, learning to brush one’s own teeth, or packing one’s own school lunches. But as parents, we often establish patterns of doing things for our kids in order to save time and to cram in more activities. However, the net result of this process can end up being a high school student who has a long resume of extracurricular activities but no idea how to get out of bed in the morning or independently manage a schedule of schoolwork, athletics, and clubs. For students who actually need more time to plan and organize independently, they can also end up feeling like failures for not being able to manage this type of busy (and unrealistic) schedule on their own. As pointed out by Stixrud and Johnson, many college students have been used to their parents managing their daily lives and making decisions for them. When faced with a lack of structure and the opportunity to make an unlimited number of poor choices on a daily basis, new college students are frequently unable to navigate the landscape and manage their responsibilities.

“It takes time, practice and some failure to learn how to run a life.” This is probably my favorite quote from the article as it is very similar to a phrase I learned from my colleague Kathleen Pignone; for every transition-aged client at NESCA, we talk with parents about the importance of allowing the young person to have “the dignity to fail.” This is easiest to do when kids are young and consequences are less (e.g., letting them wear pajamas to third grade when they dawdle with their morning routine). However, the reality is that allowing a high school student to oversleep and be late, or to not turn in an assignment, is a much lower risk activity than waiting for them to fail an expensive class in college or binge drink themselves into a hospital bed. Picking and choosing opportunities to allow our children to be “in charge” and to experience the natural consequences of their actions is critical for helping them to develop planning, organization, and coping skills. Also, letting students advocate for themselves with classmates, teachers, and authority figures is vital since they will be expected to do this for themselves after high school. (You may need to plan a script together initially.)

Work experience is briefly mentioned as an alternative to college, but I see employment as much more than an alternative. Early work experience is something that we should be striving to help all youth attain as part of the process of transferring power and responsibility. There are many recent articles (e.g., J. Selingo., 2015; Gowans, H., 2018) highlighting that the number of teenagers who have a paid job while in high school has dropped from nearly 40% in 1990 to somewhere between 16-17%, an all-time low. While the causes for a decline in teen employment are not clear, I have anecdotally observed that summer academic participation, travel, and extracurricular activities (e.g., athletics) are often prioritized above work experience. Sometimes this is in the name of bolstering a college admissions packet which is unfortunate because colleges are often more eager to accept applications from high school students with work experience. Work experience is exactly the way that a young person can learn to manage a schedule, be on time, complete a task list, budget personal money, and generally be accountable for one’s actions. Having employment during high school has long been a predictor of success in college as well as success in attaining employment later in life. Work experience also helps students to start thinking about work they might like to have, or not have, in their adult lives and to begin to think about the concept of a career path.

But, what if you are reading this blog and your child is already at the end of their high school experience? Certainly, some of the alternatives mentioned by Stixrud and Johnson (e.g., employment, gap year) are important options to consider for building maturity. Another transition plan not mentioned, but often essential for students who struggle with executive dysfunction, social, or emotional difficulties, is to continue living at home and start with community college. This type of slower transition reduces the number of skills that the student has to independently learn to manage at the outset. If your child and you really want to give four-year college a try, the authors note that it is important to strike a balance between supporting student autonomy and extending some parental oversight to college. For example, parents who are contributing to college tuition might require that students give them access to on-line grades and/or that students sign a grade release. I often suggest that parents require that students are engaged in at least one or two student organizations or activities on campus to enable social and emotional success. Also, parents can schedule regular phone times, lunches, or dinners in order to more closely monitor the transition. While you don’t want to hover, it is likely that your child would jump at the chance for a free off-campus dinner once a month, especially if they can bring a few friends.

Finally, there is enormous value in talking about the reality that students who finish high school can “try” college and that it may not be completely successful the first time around or they may not like it at all. Students may figure out that they have picked the wrong school, don’t actually like lecture learning, would rather live at home, or don’t want to participate in a general studies program because they don’t want to take another math class, ever.  We need to be clear that the requisites for getting into college are not the same as those for getting out. College failure is a reality for a high percentage of students and good transition planning requires that teens and young adults make informed decisions, understand the risks, and have the skills for coping with the realities. As part of transition planning, we need to be emotionally and financially planning for much more than a four-year college experience and we need to be thoughtful about the timing of college participation and how the experience fits or doesn’t fit, into a longer and larger plan for our children. Thank you to Dr. Stixrud, Mr. Johnson, and the editors at The New York Times for shining a light on something we need to talk more about!


Stixrud, W., and Johnson, N. (November 19, 2018). When a College Student Comes Home to Stay. The New York Times. Retrieved from

Selingo, J. (November 25, 2015). Why more teenagers and college students need to work while in school. The Washington Post. Retrieved from

Gowins, H. (May 25, 2018). Fewer high schoolers are working. This is not good. Crain’s Chicago Business. Retrieved from


About the Author:


Kelley Challen, EdM, CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training, and program development services. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles.  She also worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities including students with complex medical needs. She is also co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism.


To book a consultation or evaluation with one of NESCA’s expert transition specialists, please complete NESCA’s online intake form today.




Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


Dr. Ryan Conway on Parent-Child Interaction Therapy

By | NESCA Notes 2018


Ashlee Cooper
NESCA Marketing and Outreach Coordinator


PCIT was first developed in the 1970’s. How did you become interested in this treatment?  

My first exposure to PCIT was in graduate school, in a course through my doctoral program that covered evidence-based therapies for childhood externalizing disorders, including ADHD and disruptive behaviors. I was immediately intrigued by the methodology given my interest in providing behavior therapy to young children and supporting parents.

What training is involved for a therapist who wants to provide PCIT?

PCIT training for therapists is highly structured and time intensive. It includes in-person training and live practice with PCIT Master Trainers, as well as ongoing consultation to ensure treatment is being delivered effectively.

Who is the target audience for this treatment?

PCIT is for young children, ages 2-7, along with their caregivers. It is an empirically supported therapy for children who demonstrate emotional challenges and behavioral problems (e.g., noncompliance, aggression). Some children might have a diagnosis of Attention Deficit Hyperactivity Disorder (ADHD) and/or Oppositional Defiant Disorder (ODD), although it is not necessary to have a formal diagnosis in order to participate in treatment and get help!

How does PCIT work?

PCIT is a dyadic treatment, in which parents and children participate together. It is delivered in weekly 60-minute sessions that progress through two treatment phases. In PCIT, parents learn specialized techniques to improve interactions with their children and effectively manage their behaviors at home. What is unique about PCIT is that the therapist coaches parents in real time, where the therapist is able to observe certain behaviors and interactions while offering immediate feedback, which is then continuously practiced at home in between sessions.

Video Link: Dr. Conway explains PCIT


Can you speak more to the two phases of PCIT? Why is it important to complete the first phase before moving on to the second?

As mentioned in the video above, PCIT has two phases. The first phase is called Child Directed Interaction (CDI), in which caregivers learn and practice new parenting techniques in the context of playing with their child. However, even while playing, parents are practicing essential behavioral techniques for children who tend to have self-regulation challenges, such as giving lots of attention to positive behaviors and learning to ignore negative behaviors. CDI helps to promote positivity in parent-child interactions, which then sets the foundation for the second phase, called Parent Directed Interaction (PDI). The focus of PDI is teaching parents how to give effective commands and learning specific techniques to increase child compliance at home and in public settings.

What are some of the program goals? How long does it take to complete treatment?

Goals of PCIT include reducing challenging child behaviors, increasing child social skills and cooperation, improving the parent-child relationship and decreasing parental stress.

PCIT is time-unlimited, meaning that families remain in treatment until caregivers have mastered certain skills and child behaviors fall in the more typical range of development. While treatment length varies, given its structured, skill-based and targeted design, families typically graduate from treatment in about 12 to 20 sessions. Keep in mind that the length of treatment depends on each family’s specific needs, as well as other factors (e.g., regular attendance, completion of home practice in between sessions, and the intensity of the child’s behaviors at the onset of treatment).

When talking about PCIT, I have heard you say that parents are “not the problem, but part of the solution.” What do you mean by this?

Yes, I heard this once from a PCIT Master Trainer and it has stuck with me ever since! In PCIT, parents essentially are the agent of change in improving their child’s behavior. By promoting warmth in the parent-child relationship, learning new ways of relating to their child and employing both a consistent and predictable approach, parents are able to get back to enjoying their child again.

What advice do you have for families who may be considering this treatment?

There are many behavioral parent training programs out there, so it can be helpful to speak to a professional to determine which might be best for your family. While many parenting programs teach similar skills, PCIT is so effective because it emphasizes in session learning and practicing of skills through coaching, as opposed to separating learning in session and practicing at home. This process enables caregivers to feel increasingly equipped and confident in their parenting, after sometimes feeling defeated about ongoing behavioral challenges dealt with at home.

Are there any additional references to learn more about PCIT?

Yes, absolutely! Please check out my prior blog post about PCIT here: You can also visit PCIT International’s website ( for additional information.

If parents or guardians would like to speak to you more about PCIT, how can they reach you?

I would be happy to speak with any caregivers who are interested in PCIT and/or wondering if the treatment would be a helpful next step. I can be reached at or (617) 658-9831.


Ryan Ruth Conway, PsyD
Clinical Psychologist

Ryan Ruth Conway, Psy.D., is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal.












Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.


Interview with Reva Tankle, NESCA Pediatric Neuropsychologist

By | NESCA Notes 2018



Ashlee Cooper
NESCA Marketing and Outreach Coordinator


What made you become interested in being a neuropsychologist?

I first became interested in neuropsychology when I was in graduate school.  I was pursuing a Masters Degree in Developmental Psychology and I worked on a research project looking at brain organization in children with autism.  This sparked my interest in how the brain works and how differences in brain organization relate to different neurodevelopmental disorders. My doctoral research focused on differences in how right and left-handers processed information.  I had planned to make a career within the research field of neuropsychology and my first job was in the Neurology department of a medical school. However, after a short time, I found this to be rather unsatisfying as I did not feel that the work, I was doing was having any direct impact on individuals’ lives.  It was at that time that I took a job in Boston at a rehabilitation center working with adults with traumatic brain injury. I found working with the patients and their families to be very meaningful and satisfying.

What brought you to NESCA?

After working for many years in the field of adult brain injury, I found myself having to navigate the special education world. My family and I were assisted by a wonderful Special Education advocate and from that experience I found my next “calling.”  I did the advocate training through the Federation for Children with Special Needs and over the next 7 years, I had the opportunity to work with hundreds of families and help guide them through the process. I was fortunate to meet Dr. Ann Helmus, Director of NESCA, and she invited me to join NESCA; first, to expand my training as a neuropsychologist and then as a staff clinician.  I have been able to bring my experience of working with many wonderful families and dedicated school personnel and connect it to a deep understanding of the neuropsychological underpinnings of the learning and emotional challenges our children face.

Do you have a specialty? What do you specialize in?

I evaluate students age 6 years to young adulthood.  I see a wide range of children and young adults including those with language-based learning disabilities, attentional issues, brain injury, and other neurodevelopmental disorders.  I often do school observations and attend Team meetings. I provide recommendations that are individualized for that student and relevant for both school and home-based interventions.

What do you like about your job?

First and foremost, I love spending time with and evaluating children.  One very bright child asked me “Is this boring for you?” I told him “No, I am always thinking about what the child is doing and trying to figure out what else I need to do to best understand his or her thinking and learning.  And that is not boring.” And I try hard to have “fun” and make it an enjoyable experience for the child. No one is going to be a pediatric neuropsychologist and not find kids fun to be with. I also like my job because I can have an impact on the life of that child, their family and their school.  When we work effectively as a Team, we can really make the life of that child so much better and make their school experience more positive.

Why should parents bring their child to NESCA for evaluation?

The evaluations we provide at NESCA are individualized and comprehensive so that we can answer the referral questions being asked by either the family or the school district.  We have no time constraints; so, if a child needs a third or even a fourth session to get through the necessary testing, the clinician is encouraged to do so. This allows us to fully evaluate the child and develop a deep understanding of the cognitive, learning and/or emotional factors that are making school and life in general, hard for this child.

I would also like to point out that NESCA clinicians are provided with extended opportunities for continuing education and consultation with colleagues.  The NESCA clinicians meet several times a month for continuing education seminars provided at NESCA to further both clinical knowledge and information about resources in the community.  In addition, NESCA clinicians gather weekly for a “Case Conference” where colleagues can consult with each other to ensure that our evaluations and recommendations include the broad-based expertise of our many clinicians.

What advice do you have for parents who are not sure if a neuropsychological evaluation is needed for their child?

When I teach at the Parent Consultant Training course for the Federation for Children with Special Needs, I tell them that an evaluation should be recommended when parents have concerns about their child’s development, particularly cognitive or academic.  Parents might start out with a school evaluation, but, a more comprehensive neuropsychological assessment should be considered if the school evaluation does not provide a deep enough understanding of the child’s learning needs or if the child is not making meaningful progress.  There are great benefits to intervening early when a child is struggling. A neuropsychological evaluation can provide a better understanding of the child’s learning profile and offer recommendations for the interventions that can avoid longer-term negative consequences on learning and emotional well-being.

NESCA has opened up a 3rd location in Plainville, Massachusetts which is where you will be primarily seeing clients. Can you tell us more about your decision to work in Plainville?

Well, I have to admit that moving to Plainville will result in a significantly shorter commute for me.  I have loved being a part of the daily excitement in the Newton office but, I have struggled with the commute.  I am excited to extend this easier commute to families on the South Shore, MetroWest and even Central MA who will find it easier to get to our new office.  I don’t want to make our Newton colleagues jealous, but even parking will be easier.


Reva Tankle, Ph.D.
Pediatric Neuropsychologist

Combining her experience and training in both pediatric neuropsychology and educational advocacy, Dr. Reva Tankle has particular expertise in working with families who are navigating the IEP process. Having participated in numerous team meetings over the years, Dr. Tankle is especially knowledgeable about the many ways that schools can support and accommodate students with special learning needs, information that she clearly communicates in her evaluation reports and in team meetings, if needed. She also has a great deal of experience in articulating the reasons that a student may need a program outside of the public school.

Dr. Tankle evaluates students with ADHD, learning disabilities, high functioning autism spectrum disorders, and neurological conditions, as well as children with complex profiles that are not easily captured by a single diagnostic category.


NESCA’s new satellite office, opening December 1st,  is located at 60 Man Mar Drive, Suite 8, Plainville, MA 02762.  To schedule an appointment with Dr. Reva Tankle in Plainville, please complete our online intake form






Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.