By Ann Helmus, Ph.D.
Founder & Director, NESCA
I recently attended a continuing education course on the treatment of sleep problems. The instructor shared something not altogether surprising, but genuinely thought-provoking: simply giving people a list of “sleep hygiene” recommendations has not been shown to be particularly effective.
Most of us have heard these recommendations before:
- Turn off screens before bed
- Keep the room cool and dark
- Avoid caffeine late in the day
- Maintain a consistent sleep schedule
The problem isn’t that these recommendations are wrong. The problem is that they are often delivered as a generic list. So, what does work? A personalized approach to a plan.
For example, instead of handing someone a list of 10 recommendations, an effective approach by a clinician might be to say: “Let’s focus on one thing this week – moving your afternoon coffee a little earlier in the day. We’ll see how that goes, what obstacles come up, and whether it makes a difference before we add anything else.”
Here, the recommendations are tailored to the individual, prioritized based on what is most likely to help, and then followed up on to determine what is working and what needs adjustment.
The same can be said about the recommendations that are provided after a neuropsychological evaluation. After an assessment, families receive evaluation reports that often contain pages of recommendations. While many of those suggestions may be reasonable, a long list can leave parents wondering where to start, which recommendation matters the most, or which recommendation will make the biggest difference for my child right now. It can be overwhelming.
At NESCA, our goal is not simply to generate recommendations. Our goal is to develop a treatment plan.
A treatment plan factors in the full understanding of the child’s unique strengths and challenges, identifies the issues that are having the greatest impact on daily functioning, and prioritizes the interventions that are most likely to improve quality of life and long-term improvement.
For one child, improving sleep may be the most important first step. For another, it may be anxiety management, executive functioning support, social skills coaching, speech-language intervention, or school accommodations. The recommendations may look similar on paper, but the strategy is very different.
A thoughtful evaluation should answer not only what to do, but why, when, and in what order.
Most importantly, meaningful change rarely comes from a report sitting on a shelf. It comes from partnership, implementation, progress monitoring, and adjustments as needed.
Just as effective treatment for sleep difficulties involves more than a list of sleep hygiene tips, effective support for a child involves more than an exhaustive list of recommendations.
It requires a roadmap. At NESCA, our goal is to help families build one.
About the Author
NESCA Founder and Director Ann Helmus, Ph.D., is a licensed clinical neuropsychologist who has been
practicing neuropsychology for 35 years and has been director of NESCA’s Neuropsychology practice for nearly three decades, continuously training and mentoring neuropsychologists to meet the highest professional standards.
To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form.
NESCA is a pediatric neuropsychology and related services group practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.
