NESCA’s Londonderry, NH location has immediate availability for neuropsychological evaluations. Our NH clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing. Our NH clinicians also conduct evaluations for students who are at boarding schools, and two of our NH clinicians have PsyPACT authorization, allowing them to conduct evaluations out-of-state.

Visit www.nesca-newton.com/intake for more information or to book an evaluation.

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NESCA Notes 2021

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12

Media’s Portrayal of our Differences

By | NESCA Notes 2021

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

Media has portrayed all aspects of society’s strengths, as well as its ugliness, the diversities of its peoples and cultures, political topics, events in history and so much more for as long as television and movies have existed. Often, television and movies try to stay within norms, while, at other times, they push boundaries or raise controversial topics.

  • In 1952 on the “I Love Lucy” show, the episode, “Lucy is Enceinte,” aired in which Lucy learned she was pregnant. But the show never uttered the word, “pregnant,” and then she had the first child brought into a family on TV.
  • Prior to 1965, black actors did not have leading roles and were not portrayed favorably, until “I Spy” starred a black actor in a leading part.
  • Interracial relationships did not appear until 1968 when “Star Trek” aired the first interracial kiss.
  • In 1971, “All in the Family” had the first disclaimer for mature audiences due to its content and language.
  • In the 1950-60s, gays were portrayed in films but again not favorably. It wasn’t until after the Stonewall Riots in 1970 where “The Boys in the Band” depicted gay people in a more honest light. In 1997, Ellen DeGeneres announced on her sitcom, “Ellen,” that she was gay, making it the first prime time major TV sitcom with an openly gay lead character.

Did these shows “get it right?” Did they represent the people, cultural mores, times and issues accurately? You can be the judge. We each judge the shows we watch, and many of us have different criteria for what is right, good, funny, truthful, accurate, scary, etc. Media’s representation of society’s peoples is hard-pressed to “get it right” when it comes to portraying social groups, including most marginalized people (i.e., people with disabilities, races, genders, ethnic groups, LGBTQ, etc.). It is hard to get it right as we are not a monolith. So, even after research is done, movie producers, writers, directors, actors and actresses can still not quite get it right. When portraying a member of any of these groups, they often miss the mark by over-generalizing, simplifying, sugar-coating, missing the point or highlighting things that we wouldn’t highlight about ourselves. When weaving these characters into media, many factors play their own role in the plot – political climate, story line, social norms and monetary ratios, etc. Even with the best of intentions, movies and shows still miss the mark and offend.

Media has often portrayed these groups through stereotypical eyes, not capturing the depth and diversity within each group – even with the right due diligence in depicting these characters. So, how do they portray the breadth of us in ways that satisfy all of us with accurate representations – when each one of us is so uniquely different?

In 1990, on the series “Life Goes On,” Chris Burke, who has Down Syndrome, played the character Corky. He was the first person with Down Syndrome in a leading role. In 2018, Samantha Elisofon and Brandon Polansky – both autistic actors – were featured in a full-length feature called “Keep the Change.”

Over the years many actors/actresses have portrayed people whom they are not – it is what actors do as their job. In “Rainman,” Dustin Hoffman played an autistic savant. Did he get it right? Did he miss the mark? Did he act in ways that offended some and not others? The answer to these questions is yes and no. This has been happening for years – as long as TV and movies have existed. They portray gay people when they are straight, abused people when they have not been abused, killers when they are kind and gentle people.

Likewise, portrayals of people with disabilities have changed over the years, just like other aspects of our society. Historically, portrayals have often included characters who are one-dimensional, stereotypical and pity-provoking. Disability rights activists often use phrases like “inspirational-porn,” “super-crip,” or “cripping-up” to describe the attempts at representing them in media. Autism, like most disabilities, is challenging to portray. Over the years, representation has changed, but it may still be perceived as exaggerated, stereotyped or unrealistic (i.e., “Good Doctor,” “Big Bang Theory,” “Rainman,” etc.).

“Music,” a new movie about an autistic girl (not played by an autistic person) was recently released, sparking outrage among many people, especially within the autism community (Full disclosure – I have not seen the movie yet). The criticisms are that the character is one-dimensional, the girl is not played by an autistic person and there is the use of restraint to deal with aberrant behavior. No one movie or TV show can represent the breadth of those who are diagnosed with an autism spectrum disorder. As the saying goes, if you’ve met one person with autism, you’ve met one person with autism. Autism is a spectrum, and a movie character will not be able to hold the diversity of the population; just like a gay character portrayal cannot tell the whole gay experience. Perhaps even if an autistic person played the role, there might still be controversy. Just like when Chris Burke played Corky, there were people who praised the show and others who disliked it because it wasn’t their experience with Down Syndrome.

We have a long way to go in our society regarding equality, acceptance and inclusion of neurodiverse, racial, ethnic, sexual topics and people. So why do we expect movies and TV shows to be different? Our movie and television history demonstrates that we’ve come a long way, change can happen and media does “tackle” issues of the times. Is change slow? Yes, it is. Do we have a long way to go? You bet, especially when it comes to portrayal of people with disabilities and their inclusion in movies as actors and actresses.

I like to approach watching movies about these issues with a wide-angle lens and limited expectations. I view them as being made to inform; enlighten; open the door to others asking questions; promote thinking, awareness, inclusion, acceptance; mirrors to see ourselves in characters – fictional or otherwise; increase understanding and empathy; or share a perspective or different point of view. I also think that the intentions of most directors, actors/actresses, screen writers, etc. are coming from the right place (even if flawed). They are trying to make movies that make a point, share a perspective, increase awareness, promote inclusion, comfort, knowledge, etc. Movies that highlight sensitive topics, controversial topics and marginalized groups are good for us whether we agree with the portrayal or not. If we are outraged and we begin talking and sharing our opinions, especially our first-person opinions, we broaden awareness and knowledge. So even if you strongly dislike a movie, something good may come from it. By my writing this blog and mentioning the movie “Music,” my guess is I have piqued your curiosity if you didn’t know about it. And maybe you might check it out on Google, read the reviews and learn about the controversy. What’s wrong with that? If you do explore it, wherever you land – liking or disliking it – I’m glad you took the time to think about it, asked yourself questions, felt emotions and hopefully will continue to think about how marginalized groups are portrayed in movies.

References


https://www.insider.com/kate-hudson-responds-to-sia-music-movie-casting-criticism-2021-2
https://www.dazeddigital.com/film-tv/article/51253/1/autistic-person-responds-sia-film-music-maddie-ziegler-autism-speaks
https://www.teenvogue.com/story/trailer-for-sias-music-hurts-autistic-girls

 

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.

 

15

Celebrate the Small Wins

By | NESCA Notes 2021

By: Tabitha Monahan, M.A., CRC
NESCA Transition Specialist/Counselor

In the moment, it can be hard to see the change. It can be hard to find the successes. This is true for any improvement we try to do, whether it is trying to have a healthier lifestyle or build the skills needed for postsecondary life. When looking at a student’s vision, it can feel like getting there is an impossible task. Maybe the student is the only one who believes they can get there. Perhaps they don’t understand all the pieces that need to be put in place. When the rest of the IEP team has doubts, those doubts will likely spread to the student. Objectives about SMART Goals might be added to help the student learn how to set realistic goals and build an understanding of setting small goals and determining specific objectives. However, when we look back to where the student was their freshman year or in elementary school, the progress they made may seem massive. Many small wins over time turn into big wins.

What are the small wins? It might be getting a better grade on a test in math. It might be fastening the buttons on a shirt without help. It could be understanding another’s point of view one time.  Maybe it was trying a bite of one new food. Maybe they were able to identify a coping skill that would have helped after having a rough day. By themselves, none of these seems like they will help a person reach success once they leave special education. But small wins build confidence. They build pride. If we celebrate the small wins, not only do we get reminded that progress is possible, but the student knows they accomplished something. An IEP is filled with areas where the student needs help and even at a young age – when the student is getting more help than their peers – they know it. They should know where they are succeeding, too.

So how can we help our student celebrate the small wins?

  • A high five and a “way to go”
  • Help your child create a list of successes and have them add each win to the list
  • Remind them of where they were at the beginning of the year
  • Pick a fun activity as a “reward”
  • Have your child add to one of their favorite hobbies (e.g., a small LEGO set, a new book, trading cards, collectibles, action figures)
  • Frame it! (If it’s not paper, make part of the celebration part art project)

What do you do to celebrate the small wins?

 

About the Author

Tabitha Monahan, M.A., CRC, is an experienced transition evaluator and vocational counselor. While she is well-versed in supporting a wide range of transition-aged youth, she is especially passionate and knowledgeable in helping clients and their families navigate the complex systems of adult services and benefits as well as medical and mental health systems. She is further adept in working individually with students of all abilities to empower self-advocacy and goal achievement.

 

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.

 

2

School Stressors in a Pandemic

By | NESCA Notes 2021

By: Amity Kulis, PsyD
Pediatric Neuropsychologist, NESCA

A recent article published by NBC News highlights the multiple stressors facing school-aged children and their families during this pandemic, with a more specific focus on the differing stress levels between remote and in-person learners. It is becoming clearer that during this time, learners and their families are facing higher rates of depression and anxiety, and there are concerns that students who are attending school remotely are learning less, particularly children with disabilities and those from low-income families.

A recent study from NBC News and Challenge Success, a nonprofit affiliated with Stanford Graduate School of Education, compared the differences between students who have been learning exclusively online and those who have been able to attend at least partially in-person. The study involved more than 10,000 students in 12 U.S. high schools who completed a self-questionnaire provided by the research study. The high schools were reported to come from multiple locations around the country (Arizona, Texas, New York and Midwest) and were descried as “demographically similar to the nation in terms of student family income,” though this was not true of being matched for race and likely other factors not discussed in the article. This also does not appear to be a peer-reviewed study, which suggests limitations to predictive power of the outcomes. Nevertheless, findings suggested that students who spent time in the classroom self-reported lower rates of stress and worry than students who were fully remote. An alarming finding was that half of all students, regardless of how they were attending school at the time of the study, reported they were more stressed by school than they had been during the previous year. Students reported exhaustion, headaches, insomnia or other stress-related ailments at high levels – regardless of whether they were in-person or not – with the highest rates being for remote learners: 84 percent fully remote learners; 82 percent hybrid students; and 78 percent fully in-person.

The article suggested that additional stressors found for remote students included on average more homework and that these remote students were also less likely to feel they had an adult they could go to with a personal problem. Anecdotally, one teacher commented, “In the room, you get more eye contact.” The teacher added, “On the screen, oftentimes the kid could be sitting in front of a window. You can’t see them, so it’s hard to make sure they’re attentive.”

While there are limitations to this study, it is clear that students and their families are currently experiencing a high level of stress. Many schools have been aware of this problem and have taken steps to embed extra programming into their students’ weeks. We need to continue to prioritize community connection and wellness for students attending school in-person and online. It is important to ensure that students know who they can reach out to and how, particularly those learners who are not stepping foot into a school building this year. It is also important to build in opportunities for stress management, as well as instruction in healthy habits, such as exercise, sleep hygiene and healthy eating. Clearly both children and their caregivers could benefit from this type of support right now. If you or a loved one is experiencing heightened emotional stress, it is important to reach out for help. This can include alerting your child’s school to their increasing stress, as well as bringing concerns to your child’s doctor. A referral to a psychologist or licensed mental health professional may be in order to help you and your child through this difficult time.

Source: Remote Students Are More Stressed Than Their Peers In The Classroom, Study Shows by Erin Einhorn, 2/15/2021 published by NBC News.

 

About the Author
Dr. Amity Kulis joined NESCA in 2012 after earning her doctoral degree in clinical psychology from the Massachusetts School of Professional Psychology, with a concentration in Children, Adolescents and Families (CAF). She completed post-doctoral training in pediatric neuropsychology with an emphasis on treating children with developmental, intellectual, learning and executive functioning challenges. She also has extensive training psychological (projective) testing and has conducted individual and group therapies for children of all ages. Before joining NESCA, Dr. Kulis worked in private practices, clinics, and schools, conducting comprehensive assessments on children ranging from toddlers through young adults. In addition, Dr. Kulis has had the opportunity to consult with various school systems, conducting observations of programs, and providing in-service trainings for staff. Dr. Kulis currently conducts neuropsychological and psychological (projective) assessments for school-aged children through young adulthood. She regularly participates in transition assessments (focusing on the needs of adolescents as they emerge into adulthood) and has a special interest in working with complex learners that may also struggle with emotional challenges and psychiatric conditions. In addition to administering comprehensive and data-driven evaluations, Dr. Kulis regularly conducts school-based observations and participates in school meetings to help share her findings and consultation with a student’s TEAM.

 

To book an evaluation with Dr. Kulis or one of our many other expert neuropsychologists and transition specialists, 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, 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.

 

 

151

Executive Function Tools: The Calendar

By | NESCA Notes 2021

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

When working with young adults and adolescents to build up executive function skills, my main goal is to find systems and strategies that are truly helpful, easily accessed and that will eventually be used independently. While there are many fabulous apps that have been developed to target specific organizational skills, such as medication management, creating to-do lists and taking notes, I would argue that the number one, most important tool is an accurate, up-to-date calendar. The format of a digital calendar provides three hugely important supports.

  1. Visual Map of Time – Time management is tricky, and for many of our students, the concept of time itself is quite abstract. A calendar that has chunks of time visually blocked out helps to concretize an abstract concept. Additionally, having a calendar can help students plan their work. If a student has five different assignments to work on in a given week, looking at a calendar to find available segments of time will often help them realize that leaving everything until the last minute will not be possible. Notably, this requires guidance at first. Asking students questions, such as, “how long does an assignment like this generally take you?” or “would that available hour on Tuesday give you enough time for your problem set?” will help them start to internally ask themselves the right questions.
  2. Built-in Notification Systems – Some students use the alarms on their phone as reminders that they need to complete academic or daily living tasks. For example, they may have an alarm at 7:00pm every evening as a prompt to take their medication. Digital calendar apps allow for notifications to be linked to an event or task. Sometimes a simple reminder 10 minutes before a meeting or class is plenty, and our students can arrive on time with that quick prompt. For other appointments, I have students set two separate notifications, one in the morning and one at the time they would need to start getting ready or prepared for an appointment. For example, if a student has a doctor’s appointment two months in the future, a student could benefit from setting a notification eight hours and 1 hour before the appointment. This way, they start their morning with an acute awareness of their responsibility that afternoon and are reminded again when they need to start getting ready to leave.
  3. Constant Access when Synced across Devices – Calendars, such as the Google Calendar, sync seamlessly across digital devices. The same calendar can be accessed from a phone, a tablet, a laptop or a desktop quickly and easily. Students can refer to their phone when they are out and about or their computer if they are focused in class.

Research shows us that building executive function skills requires direct instruction and the opportunity to practice (Semenov & Zelazo, 2019). While using a calendar may seem like a simple skill, many of the systems provided in high schools take away the opportunity for students to practice setting up and maintaining their own calendar. Online portals have calendars that are immediately synced to the teacher’s schedule with assignments and due dates already entered. Additionally, many of our students rely on their parents to keep track of any and all appointments (medical or otherwise), meetings and other scheduled activities. This means that when starting a more independent schedule – whether at a university, vocational program or first job – these students often find themselves overwhelmed by the deadlines and the number of responsibilities that they must track. I urge parents to slowly increase the number of appointment and activities that students are in charge of remembering on their own. Helping a student enter doctor or dentist appointments, vacation details, such as flight or bus times, and deadlines into their personal calendar helps them start to build this habit and provides opportunity for practice. We have the tools to help students make this transition more easily, and with small, intentional changes to expectations of responsibility and independence, we can provide students with tools in their back pockets so they are ready to support (and schedule) themselves!

References

Semenov A, D, Zelazo P, D: Mindful Family Routines and the Cultivation of Executive Function Skills in Childhood. Human Development 2019;63:112-131. doi: 10.1159/000503822

 

About the Author

Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. 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. 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, 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.

 

3

How to Not Worry Alone: Signs Your Teen May Need More Help

By | NESCA Notes 2021

By: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

As we reach nearly a year since children and teens in Massachusetts were sent home from school, many of us are experiencing the sadness and disappointment that comes from chronic stress. Combined with colder weather keeping us indoors and more limited daylight, it’s certainly harder for us to stay positive and upbeat. Children and teens have experienced tremendous and immeasurable loss over the last year – loss of normalcy, of freedom, of rites of passage like graduations, of competition and sport, of friendships, to name a few. Some have lost loved ones to illness and death, and others to separation and distance. They have experienced large doses of social deprivation and far less interaction with the world. And, while most children and teens will weather this storm, there are some whose resilience is very much at risk.

The evidence strongly suggests that there are increased rates of depression, anxiety, substance use and suicidal ideation in children and teens. Some changes in your child or teen since the “good old days” pre-pandemic are expected, just as ebbs and flows in our mood throughout the day or week are. So how is one to know when the situation is going from “normal adjustment” to the completely abnormal pandemic to a more dire and urgent need for help?  Here are few signs to keep alert to:

  • If you see your child withdrawing from activities they enjoy – even those around the house – pay attention. This might mean that a teen has stopped showing interest in baking projects, in connecting with friends over gaming, in watching movies with the family, etc. The shift from limited social interactions to total isolation is important.
  • If you see your child persistently struggling with daily living activities that used to be somewhat easy, keep a close eye on sleep and hygiene. Depressed children and teens tend to sleep much more or even much less than their peers with a sense of being tired and lethargic. Be alert for newer changes in hygiene and bathing that may have not been an issue before.
  • If you are noticing a persistent low or sad mood, pay attention to how your child talks about the future. A sense of hopelessness or difficulty articulating anything they look forward to about the future (for a family trip, for a chance to see a friend again, for a new season of a favorite show) is a sign that emotional health is precarious.
  • If you notice behavioral outbursts that happen more often and seem to grow more intense, your child or teen may be showing the irritability and anger that is common in depression in children and teens.
  • If your child had signs of anxiety or depression before the pandemic, the increased stress is likely to hit harder.

If a child or teen’s low mood seems to be persistent (around all the time) and pervasive (no matter what they are doing), it’s time to reach out for help. If you have noticed these struggles, who do you call?

  • Start with your child’s pediatrician. Many clinics have social workers on staff who can help to locate service agencies in your area. You can call and request a list of referral agencies or therapists. It may also help to ensure that there are not physical illnesses that are underlying the emotional problem.
  • Contact your child’s school. It’s worthwhile to check out how your child’s teacher perceives their engagement with school since a decline in academic functioning and even motivation to do any school work can be an important sign of a problem. Contact the guidance counselor, school psychologist, or social worker to ask for support. If the staff are unable to arrange therapy at school, they can provide names of therapists in the community.
  • Contact your insurance company either by calling or reviewing information on their website. Most providers are using telehealth platforms to interact with clients. Insurance companies regularly contact providers who are paneled to take insurance to see if they are accepting new patients for telehealth.
  • Ask friends or family for any providers they may have worked with in the past.

Asking for help for your struggling child or teen is a brave and powerful message. It shows your child that you do not ever need to worry alone.

 

For additional resources, please see:

The American Psychological Association at https://www.apa.org/monitor/2020/06/covid-suicide.

The Centers for Disease Control and Prevention at https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/stress-coping/young-adults.html

National Suicide Prevention Lifeline at 1-800-273-TALK.

 

About the Author

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

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

22

Anxiety Reducers for Children and Teens with ASD

By | NESCA Notes 2021

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Research indicates that children and teens with Autism Spectrum Disorders (ASD) are more sensitive to heightened physiological sympathetic arousal (the “fight or flight” response), including increased heart rate, breathing rate, feeling “on edge” and body-based tenseness. Heightened physiological arousal is neurologically connected to sensory processing and emotional responses. This is why some children with ASD have “high startle responses” or sensitivities to specific sensations, such as touch or sounds. This is also why some children and teens with ASD are vulnerable to feelings of anxiety, particularly within social situations and settings.

There is growing research focusing on possible strategies and interventions that reduce anxiety and “buffer” the “fight or flight” response that can be activated for many children and teens with ASD.

5 Research-driven Anxiety Reducers:

Animals: Include companion or therapy animals in social groups or social outings (particularly new social events). In one study, children with ASD showed a 43% decrease in skin conductance responses during free play with peers in the presence of animals, as compared to toys (O’Haire, McKenzie, Beck, & Slaughter, 2015).

Exercise: Make a plan to engage in a “warm up” body-based activity right before a social event when anxiety levels are increasing (e.g., jumping jacks, burpees, squats). Research indicates that exercise calms the amygdala and decreases physiological arousal.

Relax or Distract: Practice progressive muscle relaxation (PMR). Recent research has indicated that regular and routine engagement in PMR sessions can be a useful strategy for individuals with ASD. Distract yourself from the anxiety-producing situation for the short term (e.g., count by 3s, name three things you can see and hear in the room, repeat words from your favorite song in your head).

Plan to Take a Break: Children and teens can benefit from having a healthy “escape plan” to take a break from socially-demanding and sensory-demanding settings (e.g., a large event like a play or concert, a college lecture, an interview for a job). Research indicates that “rest breaks” during mentally demanding tasks result in increased alertness, decreased fatigue and heightened relaxation.

Social Stories: Social stories provide the opportunity to practice and prepare for stressful situations, decreasing “fight or flight” responses. Read more about examples and applications of social stories in my colleague, Dr. Erin Gibbons’ previous blog post.

 

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. Click here to learn more about NESCA’s ASD Diagnostic Clinic.

 

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.

 

152

The Benefits of Sensory-based Play

By | NESCA Notes 2021

By: Madelyn (Maddie) Girardi, OTD, OTR/L
Occupational Therapist, NESCA

The importance of play for child development

Play is considered an essential aspect of child development as it contributes to cognitive, physical, social and emotional well-being. As a pediatric occupational therapist, play is an integral part of my job. When children have opportunities to play, this allows them to build their creativity and imagination, resolve conflicts and learn self-advocacy skills. Through play, children develop new abilities that lead to enhanced confidence and resiliency, skills crucial for navigating day to day challenges. Play allows kids to practice decision-making skills, discover areas of interest and engage in passions. (Ginsburg, 2007).

 What is sensory-based play?

Sensory play can be described as any play activity that stimulates an individual’s sensory system. The sensory system includes touch (tactile), smell (olfactory), taste (gustatory), sight (visual), hearing (auditory), balance (vestibular) and movement (proprioception). Common examples include sensory bin or sandbox play, play with shaving cream, finger paint and/or food, use of a balance beam, ball pit, and/or swings, sound tubes, and so much more!

Why is sensory play beneficial?

While we know that play is a critical part of child development, incorporating a multi-sensory approach into play activities can be particularly beneficial. When activities are fun and meaningful – our senses are engaged – we learn best!

  • Promotes learning – children who engage multiple senses to accomplish a task are better able to remember and recall learned information.
  • Facilitates exploration, creativity and curiosity in children who may be seeking, or avoiding, certain types of stimuli.
  • Allows for strengthening of the brain pathways and connections that allow for efficient sensory integration.
  • Promotes self-regulation by allowing for interaction with different mediums that may be calming for the child (Educational Playcare, 2016).

What kinds of OT skills can be targeted through sensory play?

  • Sensory processing skills
  • Fine motor skills
  • Gross motor skills
  • Feeding skills
  • Body awareness
  • Motor planning
  • Visual perceptual skills
  • Communication and play skills
  • Self-regulation and coping skills

References:

Educational Playcare. (2016, October 27). Why Sensory Play is Important for Development.
https://www.educationalplaycare.com/blog/sensory-play-important-development/#:~:text=Sensory%20play%20includes%20any%20activity,%2C%20create%2C%20investigate%20and%20explore

Ginsburg, K. R. (2007). The importance of play in promoting healthy child development and
maintaining strong parent-child bonds. Pediatrics, 119(1), 182-191.

To learn more about Maddie Girardi, watch this video interview between NESCA Occupational Therapists Sophie Bellenis, OTD, OTR/L, and Maddie Girardi, OTD, OTR/L.

About the Author
Madelyn (Maddie) Girardi is a Licensed Occupational Therapist in Massachusetts with experience in both school-based and outpatient pediatric settings. Maddie received her undergraduate degree in Exercise Science/Kinesiology at The College of Charleston in South Carolina and  earned her Doctorate degree in Occupational Therapy from The MGH Institute of Health Professions in Boston.

Maddie is a passionate therapist with professional interest in working with young children with neurodevelopmental disorders, fine and gross motor delays and Autism Spectrum Disorder (ASD).

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.

 

5

Teens Online: Participation vs. Observation

By | NESCA Notes 2021

By Yvonne M. Asher, Ph.D. 
Pediatric Neuropsychologist

As we enter the beginning of 2021, the COVID-19 pandemic continues to shape our world. More and more, events, activities and interactions are pushed online – onto videoconferencing apps, social media and academic learning  platforms. Online social interactions are not new, and they won’t disappear anytime soon. With this, how do we, as adults, understand and navigate these oddly draining electronically-mediated gatherings, and how do we help our teens do the same?

One unique characteristic of online interaction is the ability to be present without being visible. In traditional social settings, to be present with the group is to be seen and, often times, noticed. Joining a Zoom or Google Meet offers one the ability to listen, watch and take the information presented without offering anything of yourself – no one has to see you, hear you, know where you are or know what you are doing. As many adults have noticed, this gives incredible freedom to the multi-taskers – listen to your meetings while getting the dishes done or the laundry folded.

For some adolescents, though, this is an opportunity to bypass many of the core tasks of social development, while still engaging with the material needed to accomplish one’s academic goals. A high schooler, acutely aware of how they are perceived and what others think of them, can sit silently, invisibly in social studies class. They can hone in on the economic impacts of World War I without the crushing anxiety of worrying about being teased or ostracized. However, that same high schooler may never have to confront the developmentally-expected challenges of venturing out of their “comfort zone” socially. They may not learn to ask someone out on a date, explore a new friendship or show up to the first meeting of a club.

How can we help our teens learn to take the best from online interactions while also pushing them to fully engage with others? There is no one, clear-cut answer – no “10 things…” or similar checklist. In any situation, we must look holistically at the teen, the context and the goals, and, from there, determine the best path forward. Sometimes, the anonymity of the online world is a welcome respite for teens looking to explore a new facet of their identity. Other times, it undercuts the core tasks of adolescence – building deep bonds with peers, taking responsibility for one’s social relationships and developing independence. Having direct, open conversations with our teens helps them understand and begin to own the challenges of the online world. If cameras are always off and microphones are always on mute, maybe it is time for a chat about participation versus observation.

 

About the Author

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.

 

20

Changes in Transitioning from School-based Services to DDS Adult Services during COVID-19

By | NESCA Notes 2021

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

Transitioning from public education to adult human service supports is a complicated process that we have covered in several blogs over the years here at NESCA, including the two recent resources linked below:

As with many aspects of life, the existence of a global pandemic has complicated the transition process even more. In Massachusetts, Chapter 688 referrals (the referrals that help adult agencies to request the appropriate amount of funding from the state for supporting students with disabilities after they turn 22) were down by as much as 75% in September 2020. Additionally, referral processes that often were carried out in 2-4 months are taking much longer. In fact, at a team meeting I attended last week, a special education administrator shared that it had taken approximately 9 months to complete a recent referral to the Department of Developmental Services (DDS) for a student seeking adult autism services.

[For those unfamiliar with DDS, this is the agency that offers services and supports for individuals with intellectual and developmental disabilities including Autism Spectrum Disorder (ASD).]

To better support transitioning families, DDS recently developed an information sheet that highlights some of the potential changes and challenges families may experience when preparing for their transition to DDS adult service supports during COVID-19. In addition to modified referral timelines, the information sheet touches on changes in how families learn about day and residential programs (e.g., virtual tours) and the ways in which programs may have changed their approaches to service delivery as a result of COVID-19 (e.g., changes to community employment, remote and in-person offerings, visitor policies, etc.).

This DDS information sheet is helpful for professionals and families and is available in several languages on the state’s web site: https://www.mass.gov/lists/transition-considerations-during-covid-19.

 

For families who are struggling to navigate the transition from high school to adult service support, to understand available resources and benefits during or after public education, to create an effective plan for their child during a lapse in service delivery, or with any other transition planning issues, NESCA transition consultation and planning services are here to support you. Visit our transition services page and our transition FAQs or fill out an Intake Form to schedule an appointment with one of our expert transition specialists today.

 

About the Author:

Kelley Challen, Ed.M., 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 additionally 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. Ms. Challen is 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. She is also a proud mother of two energetic boys, ages six and three. 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.

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.

152

Literacy-based Speech Therapy: Winter Edition

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP

NESCA Speech-Language Pathologist

Books are a great speech-language therapy tool. They can be used to target many different goals for a variety of ages and profiles. With books, children are given context for learning vocabulary, concepts and important story elements. Literacy-based therapy is not only more fun, but research also supports its use in teaching children with speech and language disorders:

  • Teaching story elements has been shown to improve oral language production and reading comprehension.
  • Teaching within a narrative context can make language learning less demanding, more meaningful and more authentic.
  • Students’ comprehension and story retelling/generation skills improved more with contextualized (literacy-based) intervention than decontextualized intervention.

Books can easily be incorporated into life at home, if they are not already a part of the daily routine. Just grab your or your child’s favorite book, or find a YouTube read aloud of it, and have your child help you read it! Be sure to pause throughout the book to talk about the pictures, make inferences about why events are happening and ask a few questions. Don’t be afraid to change the words to match your child’s level of understanding or interests.

My top three favorite winter books to use in speech-language therapy are:

  1. Sneezy the Snowman by Maureen Wright

A story about a cold and sneezy snowman who melts several times while trying to get warm. His human friends help him by rebuilding him and sharing their winter clothes.

Amazon: https://www.amazon.com/Sneezy-Snowman-Maureen-Wright/dp/1477810544

YouTube Read Aloud: https://youtu.be/iUsHnKSyDH0

Skills that I target and can be incorporated into shared book reading at home:

  • Producing subject-verb-object or complex sentences to talk about what is happening.
  • Predicting what will happen before and throughout reading (e.g., “Sneezy is drinking hot chocolate, what do you think will happen?”).
  • Answering detail (what, where, who, when) and inferential (why) questions.
  • Discussing story parts (e.g., characters, setting, problem, solution) and retelling the story.
  • Writing using different prompts, such as “My snowman melted because…” or “When I’m cold, I…”.
  1. The Mitten by Jan Brett

A traditional story about a boy whose grandmother knits him new mittens. He loses one mitten when he is outside playing, and many different animals climb inside to stay warm.

Amazon: https://www.amazon.com/Mitten-Jan-Brett/dp/0399231099

YouTube Read Aloud: https://youtu.be/duhj0Op_slo

Skills that I target and can be incorporated into shared book reading at home:

  • Sequencing events by talking about the order of animals that climbed into the mitten.
  • Creating a craft by printing a mitten and animals, coloring the animals and putting them inside the mitten as you retell the story.
  • Watching a different rendition of The Mitten on Vooks.com and comparing and contrasting the two stories using a Venn diagram.
  • Producing past tense verbs to describe what happened.
  • Making inferences about characters’ emotions and motivations.
  1. The Snowy Day by Ezra Jack Keats

A Caldecott Medal-winning book about a boy’s adventures in the snow when he puts on his snowsuit and goes outside to play.

Amazon: https://www.amazon.com/Snowy-Day-Board-Book/dp/0670867330

YouTube Read Aloud: https://youtu.be/FmZCQfeWjeQ

Skills that I target and can be incorporated into shared book reading at home:

  • Telling an original story together by covering up the words on the pages.
  • Finding words that contain the child’s target speech sound (i.e., if your child is working on producing the “R” sound, find all the words that contain “R” and practice those).
  • Describing character traits of Peter, the main character.
  • Discussing cause and effect (e.g., cause: Peter smacked a snow-covered tree, effect: snow fell on Peter’s head).
  • Writing using different prompts, such as “On a snowy day, I like to…” or “I can save a snowball by…”.

 

References:

Davies, P., Shanks, B., & Davies, K. (2004). Improving narrative skills in young children with delayed language development. Educational Review, 56, 271 – 286.

Gillam, S. L., Gillam, R. B., & Reece, K. (2012). Language outcomes of contextualized and decontextualized language intervention: results of an early efficacy study. Language, speech, and hearing services in schools, 43(3), 276–291. https://doi.org/10.1044/0161-1461(2011/11-0022)

Tomasello, M. (2003). Constructing a language. A usage-based theory of language acquisition. Cambridge, MA: Harvard University Press

 

About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.

 

 

 

To book an appointment or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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.

 

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