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NESCA Notes 2020

Why “Find something to do” Doesn’t Work – Teaching Independent Play Skills during Quarantine

By | NESCA Notes 2020 | No Comments

By: Angela Currie, Ph.D.
Pediatric Neuropsychologist, NESCA
Director of Training and New Hampshire Operations

Nowadays, children’s schedules tend to be highly regimented. For many, free play has been replaced by extracurricular activities, sports and planned playdates. Recess hours have also been reduced in favor of structured learning activities. The reduction in free play throughout the day can delay or interfere with the development of independent play and time management skills. Unfortunately, with schools and childcare centers now closed, our children may not know how to use all of the extra time they now have.

I have two young children – a preschooler who is generally an expert at independent play, and a first grader who needs a lot of structure, support and attention to fill his time. Unfortunately, with much of our attention turning toward working from home and remote learning, even my formerly-skilled independent player is now overwhelmed with the amount of unstructured time he has, resulting in some new and not-so-fun attention-seeking behaviors.

Sound familiar? I am guessing this is the experience many families are facing. Both parents and children are trying to navigate life without any clear time boundaries (What day is it, anyway??), and this is stressful. When kids are stressed, they look to their caregiver to help them regulate – “attention seeking” behavior is their way of saying “I’m stressed out and don’t know what to do with myself – help!” The question is, how do we help them play independently (buying us time to get things done) while still supporting their emotional needs?

The experience of navigating the stress of unstructured time and teaching independent play is addressed in Kate Rope’s recent New York Times article titled “Now’s a Good Time to Teach Your Kids to Play on Their Own.” In the article, Rope discusses ways to embrace this new opportunity to teach independent play – a skill that encourages time management, executive function and self-regulation skills. Some of the strategies she outlines are similar to those that we have attempted at my house in the past few weeks. Here are some that have worked for us:

  • Get outside: My kids’ capacity to play on their own is markedly better when outdoors. Allow them to dig in the dirt, explore the woods (with supervision), build a fort and roll down the hill. This will not only keep them occupied, but the physical activity and fresh air will make them better-focused once inside.
  • Make an activities menu: Kids often have so many toys that they do not know what to pick. Slightly structure “free choice” by making a single-page picture “menu” of activities, reducing the amount of time they aimlessly roam around looking for something to do.
  • Start in their play: Children often do not know how to get started. After they pick an activity, say “I have 15 minutes to play,” set a timer, and give them your undivided attention. Comment on what they do and encourage their imagination, rather than making up the play for them. When the timer beeps, say you had fun playing but need to go do something. Hopefully, your child will continue their play without you.
  • Show your interest: Saying “find something to do” is way too vague and not particularly helpful (I’m very guilty of this). Instead, give a “challenge” and convey your interest in it. For example, say “Why don’t you go get the blocks and build the tallest tower you can. Come get me when you’re ready for me to see it. I can’t wait!”
  • Set up new ways to use toys: The same old toys can get boring, so mix things up a bit. Find a spare storage bin, bucket or large container. Each day create a new, multisensory “set-up” for some toys. For example, construction trucks can dig in dried beans; baby dolls can take a bath in soapy water; dinosaurs can play in water beads; or kids can build fine motor skills by just cutting up a bin of scrap paper.
  • Be patient and loosen up: Let your kids guide the play, take some risks and make mistakes. The more you guide them, the more they will need you later. Also, messy kids are happy kids. Use messy activities as a way to teach daily living and self-care skills (e.g. how to use the broom to sweep up beans; how to get mud out of your finger nails; etc.).
  • Make remote learning fun: The more fun your child has with you during instruction, the less attention they will seek from you later. Find way to use your child’s interests to aid teaching. For example, we used my son’s love of hockey to reinforce long A spelling skills – hit the puck into one net if the word was spelled with /ai/ and another for those with /ay/. Because he viewed this as special one-on-one time, he was able to continue playing hockey by himself afterward.

Finding the balance between providing support and teaching independence is not an easy one, but these are some ways to start. If you need guidance on how to create structure and manage your child’s needs at home, NESCA has providers available for remote consultations. Email info@nesca-newton.com for more information.

 

About the Author:

Dr. Angela Currie is a pediatric neuropsychologist at NESCA. She conducts neuropsychological and psychological evaluations out of our Londonderry, NH office. She specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

 

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

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Londonderry, NH, Plainville, MA, and Newton, MA serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call (603) 818-8526.

Skill Highlight: Touch Typing!

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

As you are sitting at home with your child and working to find a reasonable balance of academics, physical movement, chores, social time and relaxation, one specific skill to consider targeting is touch typing or keyboarding. As we move further and further into the digital age and, more recently, an unprecedented era of remote learning, the ability to successfully type and get ideas onto the screen is paramount. We often joke that our children are more technologically adept that we are, as they easily navigate between iPad apps and turn on anything with a screen. While this is, in many ways, true, two things I constantly observe in students are the propensity to type with just their pointer fingers (hunt and peck method) and that they initially learn about a keyboard for games rather than academics.

As their fingers fly around the keyboard, I am often asked, “Why does it matter if they can use all ten fingers? Who cares if they are typing with two fingers if they are getting the information out of their head?” These are all great questions, and I hope to answer and provide clarity around the ones I hear most frequently.

Why does ten-finger, touch-typing matter?

Massachusetts State Guidelines recommend that a student should be typing at a speed of 5 times their grade level with 80-95% accuracy. For example, a third grader should be typing at 15 words per minute (3 x 5), and a seventh grader should be typing at about 35 words per minute (7 x 5). Following this formula, by graduation, a senior in high school should type with a speed of at least 60 words per minute, a functional speed for an adult in most professions.

While it is likely that some third grade students can use two fingers and type at a rate of 15 words per minute, as these students get older and the demand increases, it is unlikely they will be able to keep up with these guidelines if they have not been taught a functional typing approach.

That may be true for some students, but I promise my child is able to type quickly! Can I just let her teach herself?

While children may be able to type quickly using their own typing method, ten-finger typing uses almost of all of the intrinsic hand muscles to complete the task. This means that children are much less likely to feel fine motor fatigue than if they were using two or three fingers. While this may not matter for a young student typing a paragraph, it will absolutely affect a high school student who is working on a 10- or 15-page paper. Teaching the correct approach will set young students up for future success.

Is it okay to start later in elementary school? My student is still working on handwriting.

There are some mixed opinions on the best time to start teaching keyboarding. I personally recommend first or second grade as an appropriate starting point. At this level, most students can identify their letters and are used to using computers to some extent. As with most motor tasks, practice makes perfect, and the more time our children spend using all ten fingers to type, the better at it they will be. It is perfectly fine to learn handwriting and keyboarding simultaneously.

How much time do you recommend my child spends practicing?

I recommend students practice for about 20-30 minutes at a time. This allows time for direct practice, as well as time for playing games that promote correct finger placement. If a student can do this practice two to three times a week, they will absolutely start to develop the motor patterns necessary and commit them to muscle memory.

What are your thoughts on speech-to-text software?

Speech-to-text software programs are excellent tools when they are used with the right student. They increase accessibility, help students get information on the page and can increase the speed at which a student completes their work. I am hesitant to introduce these tools too early or with the wrong student.  The need to type will not go away and not all programs can support a speech-to-text option. Additionally, in an academic setting, using a speech-to-text option requires a student to have extra testing accommodations, such as a separate room for testing and 1:1 test administration. For some of our students, this is exactly what they need for success, but for others these accommodations are not reasonable or necessary.

Can I leave my child to practice on their own?

Children quickly slip back into old habits. I recommend keeping a watchful eye to ensure that a ten-finger approach is truly being practiced.

Is there anything else I should consider?

Yes! Make sure to consider your child’s posture as they sit at the computer. Ideally, ankles, knees, hips and elbows should all be at 90 degrees, while wrists should be “neutral” or flat.

Where can I go to find lessons or tutorials for my child?

Great Question! Fortunately, there are many excellent online options to help teach children how to type. Some free online sites that directly teach and help to practice ten-finger typing include www.typingclub.com and www.typing.com. Other reasonably priced options include Typing Instructor for Kids Platinum, Mavis Beacon Keyboarding Kidz and Mickey’s Typing Adventure. For more entertaining, game-based practice, take a look at www.abcya.com and www.typinggames.zone.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. 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. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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 info@nesca-newton.com or call 617-658-9800.

 

Helping Your Anxious Child through COVID-19

By | NESCA Notes 2020

By Yvonne M. Asher, Ph.D. 

Pediatric Neuropsychologist

A recent New York Times article by Jessica Grose discusses ways to support your child, specifically helping them to feel less anxious, during the COVID-19 situation. Their “top 4” suggestions are great ones – validate their feelings, manage your own anxiety, aim for some kind of predictable routine and try mindfulness or progressive muscle relaxation activities.

The larger consideration in this case is this: anxiety, particularly in the current situation, is normal. We can label it with clinical words, give you our best clinical tools and recommend that you seek help (and please do!). At the same time, if we take a large step back, being anxious right now is exactly how we are meant to feel. We are social beings, designed to live in the community and support one another through face-to-face social interactions. When something threatens our safety, or the safety of our families, it is normal to respond with fear, worry and hypervigilance. Everyday interactions that would typically result in no response, like hearing someone nearby cough or sneeze, all of a sudden have become indicators of a threat. Even having others in close proximity to us is now a threat, meaning that the social communities in which we are supposed to thrive have now become potentially dangerous places. In this new environment, our bodies, well-attuned and primed to handle threats, are doing what they should do – they are putting us on “hyper-alert mode,” keeping us exceedingly sensitive to these threats so that we can avoid them and preserve our safety.

Children are in this mode, too, albeit with far fewer resources to help mitigate their fear and worry. As adults, we have far more lived experience with threats, anxiety, fear and worry, and we can use this experience to manage our responses to this novel situation. For children, this may be the first time they are struggling with persistent worry and fear. Or, they may have struggled to cope with other fears and worries for a long time, and this new stressor has overwhelmed their system. In either case, it is important to normalize fear and anxiety, in addition to the myriad of other emotions that children may be experiencing.

The key is balance. We have to balance validating and normalizing feelings with reinforcing unhealthy habits. What does that look like? One dimension to consider is time – validating and normalizing feelings is a short acknowledgement that the child is heard, understood and believed. On the other hand, repeatedly discussing the same questions or topics, engaging in persistent conversations about the threats and explaining “adult” information to children (especially dire predictions, long-term impacts, etc.) is not healthy. These behaviors may appear to decrease anxiety in the short-term, but over time, can be detrimental.

Another important consideration is space – focusing on what is happening in the present is important to help children process and understand the radical changes that are impacting their day-to-day lives. However, if you find that your conversations linger on the past or the future, try to shift back to the present. Your mind may be filled with regrets from the past (e.g., “I knew we should have stocked up on their favorite snack last time we were at the store”) or fears for the future (e.g., “My parents are elderly and at high risk”), and these thoughts are entirely normal. At the same time, when talking with children, it is important to try as much as possible to focus on the here and now. Of course, it is important to give children the space to express their fears for the future, and we can and should acknowledge and validate these fears. We can also, simultaneously, bring children’s focus back to the present and back to tangible, concrete things that they can do (e.g., “I know you are really worried about grandma, and it’s sad that we can’t see her right now. Everyone is working hard to keep her safe, and we are going to call and talk to her later today”).

For some children, advanced intellectual abilities may allow them to understand (at least, in some sense) a great deal of the information that is portrayed on the television and news media. However, it is important to remember that, while their cognitive abilities are years ahead of their peers, their emotional development is not. It may be necessary to closely monitor their online activity, as they may be seeking out information (which is a normal response to fears, especially fear of the unknown) without having the critical thinking abilities to understand the source or potential biases in the way the information is presented. On the other hand, some children may struggle to understand the situation, either because of their young age, learning disability or other developmental delays. If this describes your child, consider putting together a story, with pictures and words, to help them understand some basic information (e.g., why we can’t go to school right now, why we can’t go play with friends). This is often referred to as a “social story,” and clinicians at NESCA can help you create one specifically for your child.

Last, and most certainly not least, seek help and support for yourself, your child or anyone in your family who is struggling. While experiencing anxiety during these times is normal, when these thoughts and feelings are taking over your child’s daily life (or your own), it may be time to look for assistance. Many clinicians, including here at NESCA, are available via phone or videoconferencing, and we can assist with a range of concerns. Whether you want a brief consultation to help you respond to persistent questions from your child or whether your child has a pre-existing anxiety disorder that is exacerbated by these challenging times, we are here to help.

 

About Pediatric Neuropsychologist Dr. Yvonne Asher:

Dr. Yvonne M. Asher enjoys working with a wide range of children and teens, including those with autism spectrum disorder, developmental delays, learning disabilities, attention difficulties and executive functioning challenges. She often works with children whose complex profiles are not easily captured by a single label or diagnosis. She particularly enjoys working with young children and helping parents through their “first touch” with mental health care or developmental concerns.

Dr. Asher’s approach to assessment is gentle and supportive, and recognizes the importance of building rapport and trust. When working with young children, Dr. Asher incorporates play and “games” that allow children to complete standardized assessments in a fun and engaging environment.

Dr. Asher has extensive experience working in public, charter and religious schools, both as a classroom teacher and psychologist. She holds a master’s degree in education and continues to love working with educators. As a psychologist working in public schools, she gained invaluable experience with the IEP process from start to finish. She incorporates both her educational and psychological training when formulating recommendations to school teams.

Dr. Asher attended Swarthmore College and the Jewish Theological Seminary. She completed her doctoral degree at Suffolk University, where her dissertation looked at the impact of starting middle school on children’s social and emotional wellbeing. After graduating, she completed an intensive fellowship at the MGH Lurie Center for Autism, where she worked with a wide range of children, adolescents and young adults with autism and related disorders.

 

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 info@nesca-newton.com or call 617-658-9800.

 

To book an appointment with Dr. Yvonne Asher, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Tips for Structuring Schedules with Transition Activities

By | NESCA Notes 2020

By: Becki Lauzon, M.A., CRC
Transition Specialist and Consultant

There are lots of helpful resources, including articles, blogs, charts, etc. being shared about how to structure your time while you are at home and continue to work on maintaining transition skills. While much of the information is helpful and informative, it can also become overwhelming. Many people have asked how to organize all of the information and make it manageable for both themselves and the transition-aged individual they are supporting.

Below are some samples of schedules and lists that may be helpful establishing routine into this uncertain time.

 

 

About the Author

Becki Lauzon, M.A., CRC, works with teens, young adults and their families out of the Newton, MA and Plainville, MA offices. Lauzon has unparalleled experience as a Transition Specialist, Transition Consultant and Vocational Program Coordinator. Lauzon will be providing transition assessment (including testing, functional evaluations and observations) consultation, case management, training and professional development for schools; and transition planning, consultation and coaching for transition-aged students and their parents.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, 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 and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Resilience during COVID-19: Collective Efficacy

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

There is an array of research-proven factors shown to increase psychological and physiological resilience or “bounce-back” from stressful experiences, such as maintaining a social network and practicing healthy coping skills when in distress.

One important factor is self-efficacy. Self-efficacy is distinct from self-esteem. Self-esteem is a judgement of self-worth whereas self-efficacy is a judgement of personal capability. People with a strong sense of self-efficacy:

  • View challenging problems as tasks to be mastered;
  • Develop deeper interest in the activities in which they participate;
  • Form a stronger sense of commitment to their interests and activities; and
  • Recover quickly from setbacks and disappointments (Bandura, 1995).

The COVID-19 crisis has cultivated a closely related and critical construct, collective efficacy. Collective efficacy is a group’s shared belief in its capability to organize and execute actions required to achieve goals (Bandura, 1995). In other words, members of a community look out for each other, support each other in solving problems, and, in effect, improve their lives through combined efforts.

Collective self-efficacy is everywhere amidst this crisis. Social distancing is in itself a collective efficacy measure. Thousands of communities across the world continue to show everyday kindness for those in need and solidarity for those on the front lines. A few local Massachusetts examples are:

Collective efficacy is proven to increase resilience at a family level and at a community level. Collective efficacy is critical for navigating through, tolerating and “bouncing back” from this crisis. Collective self-efficacy can be cultivated and grown at home through small, meaningful and intentional acts.

Here are three research-proven “collective self-efficacy” enhancers to practice while you’re home with your family during COVID-19:

  1. Stay active in a cause for kindness and connection: Make art or compliment cards for first responders. Record a video and send to a local nursing home. Participate in an organized trip to the grocery store for vulnerable members of your community.
  2. Create collective mastery experiences: Mastery experiences are experiences we gain when we take on a challenge and succeed. Identify a “home project” such as organizing a closet together. Creatively problem solve how to cook a snack or meal with four ingredients already in your kitchen. Organize a family “work-out” exercise challenge.
  3. Encourage reflection and communication: Identify a small, realistic goal for each family member to accomplish each morning. Have each family member name a “take away” and “throw away” from their day in the evening. Share a “strength story” to reflect on a strength you and/or your family member showed that week. Consider using specific value-driven language to identify this strength (see examples from the VIA character strengths research studies below).

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 and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

An OT’s Guide to Home Learning: Board Games and Puzzles

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

As social distancing recommendations, stay-at-home orders and shelter-in-place mandates continue to keep families confined to the home, parents are quickly being asked to take on the roles of teacher, therapist, warden, work-from-home professional, best friend and more. For parents of children with special needs and learning differences, this can feel extra daunting. There are countless online resources providing specific in-home activities, recommendations, and suggestions for working on targeted skills (e.g., literacy, fine motor, sensory integration, gross motor, etc.) in the home. It’s easy to get quickly overwhelmed by the onslaught of information.

While I believe there are many useful and creative free resources available online (I’ve written some of them!), our “new normal” includes many barriers to easy implementation including time, expertise, resources and confidence. Today, I want to share how some fun activities involving board games that you may already have in your home could make the task of keeping children engaged, interested and learning a little bit easier. Our game makers are getting increasingly creative and aware of their role in helping children build their skills, and the games listed below are just a few of the many options available.

5 Board Games for Development of Visual Perception

  • Connect 4 – Playing Connect 4 with the traditional rules requires kids to track horizontally, vertically and diagonally with their eyes. They need to visualize where their checker will land and place it in the correct spot at the top. Additionally, children need to monitor two colors at a time to ensure that they do not need to block their opponent on their next turn. For younger children, consider using the board to practice patterns or make shapes out of one color.
  • Quirkle – Quirkle combines colors, shapes and a grid pattern to create an interactive game for children to play with their parents. It promotes form perception, visual discrimination, tracking and matching.
  • Dominoes – There are many different games that can be played with Dominoes, making it easy to scaffold the activity for all different ages. Dominoes works on many of the same skills as Quirkle, but really allows children to practice visual figure ground. Figure ground is the ability to distinguish relevant information from a busy or overwhelming background. Dominoes have lots of different colored little dots in different patterns and alignments allowing children to practice this skill. Notably, Dominoes often have a tactile aspect allowing children to both see and feel the dots.
  • Spot it! / Spot it Jr! – Spot it! has quickly become a favorite game of occupational therapists, speech language pathologists and school psychologists alike. It practices a multitude of important skills. In terms of visual perception, Spot it! focuses on visual discrimination, hand-eye coordination, attention to detail, figure ground and more. Due to its popularity, Spot it! has provided us with an excellent variety of specific versions, such as Alphabet, NFL, Gone Camping, Animals, as well as substantial Spot it Jr.! options.
  • Memory – Unsurprisingly, the game Memory works on increasing visual memory! Children have to remember which cards they have picked, where they are on a grid and where the matches are. There are lots of options to order online, but this can absolutely be played used playing cards or DIY pictures drawn on pieces of paper. Children are also able to practice pronation/supination by flipping over the cards and placing them back down on the table.

 5 Board Games for Development of Fine Motor Skills

  • Trouble – Trouble allows children to work on building hand strength as they push down the pop-o-matic die roller. Try to ensure that children are using the muscles in their hands and fingers to push down, and limit the amount of body weight they use to help them push down. Additionally, children practice a pincer grasp as they pinch their pegs to move them around the board.
  • Hi-Ho! Cherry-O! – This game includes little plastic fruit that need to be placed in a basket to promote a pincer grasp and a spinner board that helps teach kids to flick or push a spinner.
  • BedBugs – Tongs and tweezers are part of an OT’s go-to toolbox as they promote fine motor precision, keeping an open webspace, and hand strength and coordination. This game is for children age 4 and up and provides each player with their own tongs to try and catch little bouncy bugs on a bed. Add a layer of complexity by having kids each try to catch one color!
  • Avalanche Fruit Stand – Another game that incorporates tweezers, Avalanche Fruit Stand promotes grip strength, pincer grasp and problem-solving as children need to balance different fruits on a stand. There is also a spinner to add in another element.
  • Hungry Hungry Hippos – Use this game to practice finger isolation and increase finger/hand strength. Encourage your children to use one finger at a time to depress the lever and make their hippo eat the marbles. Try switching fingers for each round.

*Bonus!* While many of these games work on more than one skill at a time, one age-old recreational activity that targets visual perception, visual motor integration and fine motor skill is simply completing a puzzle. Focus on teaching strategy and problem-solving by having your children start with the edge pieces, organize by color or choose one figure or character in the puzzle to build independently.

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. 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. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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 info@nesca-newton.com or call 617-658-9800.

 

But First, Settle into the New Normal

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

Let’s face it, parents have a big job to do when life is “normal,” never mind when we are living in this new normal. Parents are being bombarded with information from every corner of your life—even all of us at NESCA are blogging every day to help parents with information. Packets of educational information are being sent home, online learning classes are being arranged, etc. Talk about information overload. Are you feeling overwhelmed or saturated yet? Do you need a break from it all, even though we are only in week two of this pandemic in the United States?  Some parents are worried about their child’s education and, perhaps, their special education services. I get it. Many federal and state agencies as well as local school districts are trying to figure this out as we speak. This is a time to exercise patience with yourself, your leaders and your family members as we figure this new normal out.

Many of you are not teachers and, even if you are a teacher, teaching your own child is different than teaching your class. To your son/daughter, you are mom/dad—not their teacher.  So, trying on this new role isn’t going to be easy. If you aren’t a teacher, you may feel ill-equipped or may not even not know where to begin in doing these new educational tasks with your children. Even in the best of circumstances, children may “regress” or not learn new content during this time period. It is what it is. They can learn new and different things that aren’t in this realm—something we’ll continue to elaborate on in future blogs.

In the midst of this new normal, you are also home trying to figure out your own new rhythm of working from home or being unemployed, etc. Take the next few weeks to settle into this new normal. We are creating new rhythms as we are all at home trying to work, play, live and love each other. Most importantly during this time, don’t forget to enjoy each other, love each other and have some fun. Given all the tasks being asked of you, be realistic. Ask yourself what you are capable of doing given your circumstances and life realities. Don’t set your expectations too high, or you will be disappointed. Try to create structure out of chaos before you even begin to “be your child’s teacher.”

Words of advice:

  • Smile each day upon waking – make the best of the day
  • Live in the moment – one day at a time
  • Have fun and laugh every day – create moments of laughter and joy, as these are the moments that will be remembered
  • Breathe, and do it deliberately – use a reminder on your smart watch, fitness tracker or phone
  • Communicate honestly with each other
  • Be flexible – know there will be curveballs thrown your way
  • Be kind and gentle with yourself and your family members

These helpful hints will hopefully make each day go a little smoother! We are all in this together.

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

 

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

 

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 info@nesca-newton.com or call 617-658-9800.

 

Maintaining Transition Skills at Home

By | NESCA Notes 2020

By: Becki Lauzon, M.A., CRC
Transition Specialist and Consultant

Transition skills are vital for many students, especially those who are close to turning 22 and aging out of the public education system or in their senior year of high school. Below are some free tools and suggestions, based on DESE’s secondary-transition model, regarding how students can continue to work on developing and maintaining a variety of skills while out of school.

Education and Training

  • If you are thinking about taking a college class, spend time researching different colleges online. Make a list of what you like about each school and what you don’t like. Write down what services/accommodations each college has to offer.  
  • Watch virtual tours of college campuses.
  • If you are thinking about going into a training program, research what programs are out there. Are the programs online or in-person and how long do they take to complete, what is the cost, etc.?
  • If you want to finish your MCAS or work on your GED, download study guides online and take practice tests.

Employment

  • Create a free account with teacherspayteachers.com and download free practice job applications and job interview questions.
  • Complete a free online career interest inventory at: www.mynextmove.org and www.careeronestop.org.
  • Research different careers and make a job journal. The job journal can include the following: education needed, work environment (i.e. inside or outside, many people or few people, standing all day or sitting all day, salary, job tasks, etc.). O*Net is a great resource for this.
  • If you have been considering a part time job this summer, start researching places that are easy for you to get to. You can even fill out online applications.
  • Research places in your community that need volunteers. Email them or make a list of whom to contact.

Independent Living

  • Create a free account with teacherspayteachers.com and download free financial literacy activities around banking and budgeting.
  • If you are thinking of getting your Driver’s License, many websites offer free practice online tests.
  • Use Pinterest for recipe ideas and make a meal each day for you or your family.
  • Create a recipe book of foods you can make.
  • Practice different independent living skills for household management (i.e. laundry, cleaning, organizing, folding clothes, sorting clothes by size and color, etc.).
  • If you are thinking about making some extra money when the weather gets nicer, go through items and start making a yard sale pile!

Community Participation

  • Research what adult service agencies have to offer (i.e. MRC, DDS, DMH, Centers for Independent Living, etc.).
  • Register to vote.
  • Research fun places close to where you live and make a list of things you want to do when the weather is nice.

 

About the Author

Becki Lauzon, M.A., CRC, works with teens, young adults and their families out of the Newton, MA and Plainville, MA offices. Lauzon has unparalleled experience as a Transition Specialist, Transition Consultant and Vocational Program Coordinator. Lauzon will be providing transition assessment (including testing, functional evaluations and observations) consultation, case management, training and professional development for schools; and transition planning, consultation and coaching for transition-aged students and their parents.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, 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 and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Now is a Great Time to Practice Self-compassion

By | NESCA Notes 2020

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist Fellow

In this new era of social distancing, and where homeschooling has gone from being an exception to a new way of life, many are feeling confused, overwhelmed and wondering what to do next. Many parents have found themselves adrift in a sea of uncertainty without a compass. In her New York Times article titled, I Refuse to Run a Coronavirus Home School, Dr. Jennie Weiner discusses the perils of comparing ourselves with other parents on social media and of setting unrealistic expectations that we are going to navigate this wild period of uncertainty perfectly and with grace. Parents who are working at home may be feeling as though they are unable to meet the demands of parenting, teaching, and performing at their jobs, leading to feelings of inadequacy. About her own family’s experience, she states, “We love each other, we yell, we apologize, we laugh, [her kids] punch each other, we yell some more, we make up. We live, we try to be compassionate and we hope this will all be a memory soon. And when it’s over, the schoolwork will be there.”

Within the context of uncertainty and inevitable change, there are opportunities to help kids develop important life skills. While reading and math are certainly an important part of a child’s education, there are many “soft skills” that lead to healthy outcomes in life. At school these softer skills are nurtured when children are asked to wait patiently in line; whether it’s for gym class, lunch or a turn on the swing. In the classroom they are expected to listen to others, raise their hand or wait to be called on by their teacher. Navigating these tasks requires children to monitor their behavior, plan for when it’s their turn, direct their attention to their goals and be respectful. Many of these soft skills are already practiced at home and in the course of everyday life. Children are learning while waiting for their turn to play a game or watch a show. They are also learning while waiting for a parent to play a game, watch a show or read a book with them. Times like these can be very challenging for children and their parents, but learning to manage the often-inevitable frustration, anger and/or disappointment, helps children become more resilient and self-reliant – skills that are not always overtly taught, but are important as children continue to grow into adulthood. Be gentle with yourself knowing that at any given moment you are doing your best, and that is good enough.

As we all head down this path of uncertainty, Dr. Weiner suggests that we meet this new challenge head on, holding our breath, crossing our fingers and accepting that it’s going to be messy and that is okay. At the end of the day, tell yourself gently: “I love you. You did the best you could today, and even if you didn’t accomplish all you had planned, I love you anyway.”

To read Dr. Weiner’s article:

https://www.nytimes.com/2020/03/19/opinion/coronavirus-home-school.html?referringSource=articleShare

 

About the Author

Dr. Cynthia Hess recently graduated from Rivier University with a PsyD in Counseling and School Psychology. Previously, she earned an M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations. Currently, Dr. Hess is a second-year post-doctoral fellow in pediatric neuropsychological assessment, working with NESCA Londonderry’s Dr. Angela Currie and Dr. Jessica Geragosian.

 

To schedule an appointment with one of NESCA’s expert neuropsychologists, 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 and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Five Tips for Promoting Fine Motor Development in the Home!

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

  • Writing on a vertical surface is a great way to promote proper hand/wrist positioning and fine motor growth – try taping paper to an easel or to the wall and allowing them to try writing on this plane.
  • Skip the fat pencils for our little learners. While specific adapted writing utensils for children with fine motor needs can be best assessed by an occupational therapist, for the majority of our young learners, the rule “the object promotes the grasp!” is applicable. If we want our learners to be building strength and learning proper hand positioning, I suggest trying either a standard number 2 pencil or a mini golf pencil.
  • Let your children peel off and stick on their own stickers! In reality this could end up with some ripped stickers or extra time spent on a project, but peeling off stickers promotes a pincer grasp, bilateral coordination and visual motor integration. If your child is too young to find the edge and begin to peel, consider starting the sticker and then letting them finish peeling it off independently.
  • Use scissors to cut anything and everything! While supplies of construction paper and worksheets sent home from school may be dwindling, consider letting your children cut up junk mail (make sure it’s sanitized), old magazines, newspapers and scraps of old cloth. Some of our kids will want to use these scraps to create a collage or other art projects, while others will simply enjoy the act of shredding. You can make this activity accessible for really young kids by simply having them tear the paper with both hands.
  • Bring out the tool box! Twisting a bolt onto a screw, using a wrench to tighten a hex-nut and using a hammer to pull nails out of a block of wood all help with fine motor and increasing strength. For more of a visual perception task, considering mixing all of the screws, nails and bolts together and having your child sort them into different bowls or containers.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. 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. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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 info@nesca-newton.com or call 617-658-9800.