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NESCA Notes 2026

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From Report to Classroom: Translating Your Child’s Evaluation into Real-World School Supports

By | NESCA Notes 2026 | No Comments

Image of parents meeting with educatorsBy Madeline Manning, Ph.D.
Pediatric Neuropsychologist, NESCA Hingham

A comprehensive neuropsychological evaluation offers a clear, objective look at how your child learns, processes information, and navigates their environment. However, receiving the evaluation report is only the first step in the journey to ensuring those findings translate into meaningful, everyday classroom support. The next crucial phase is working alongside educators to transform these clinical insights into real-world, school-based strategies. By understanding how to utilize the recommendations provided within the report, parents are equipped to foster a collaborative relationship with the school team and establish the precise structural and academic supports their child needs to succeed.

Navigating the educational landscape and special education terminology can sometimes feel like learning a foreign language. Bridging the gap between a clinical diagnosis and school-based eligibility requires a structured, team-based approach. By gaining insight into school procedures, clarifying the difference between support frameworks, and using targeted clinical recommendations, parents can confidently advocate for the resources and learning environment their child requires.

Understanding the Frameworks: 504 Plan vs. IEP

The first step in advocacy is understanding the two primary pathways for school-based support. While both provide essential assistance, these public school documents are governed by different federal laws and serve distinct purposes:

  • The 504 Plan (Section 504 of the Rehabilitation Act): This civil rights statute is designed to prevent discrimination by ensuring “equal access” to learning. A 504 Plan provides accommodations, which are changes to how a student learns, without altering the curriculum. Examples include extra time on tests, preferential seating, or sensory breaks. It is appropriate for students who can access the general education curriculum but need environmental adjustments to do so.
  • The Individualized Education Program (IEP; Individuals with Disabilities Education Act): An IEP is a specialized blueprint for students who require specialized instruction. This involves changes to what they are being taught, where they are being taught, or the delivery of direct services (such as speech-language therapy, occupational therapy, or specialized reading instruction). To qualify for an IEP, a student must have a documented disability that directly impacts their ability to make effective progress in school, requiring targeted, specialized instruction.

A comprehensive neuropsychological evaluation is invaluable for both pathways, as it provides the objective, standardized data necessary to document a child’s functional limitations and academic needs. A primary goal of our evaluation report is to clearly connect your child’s profile directly to appropriate recommendations, including practical classroom strategies.

Translating Clinical Findings into Classroom Supports and Placement

A high-quality neuropsychological report does not simply list test scores and diagnoses; it outlines the underlying cognitive, learning, and social-emotional factors driving a student’s classroom challenges. At NESCA, what sets our reports apart is our commitment to understanding the whole child, including the complex, interacting variables that shape their daily experience. This holistic view allows us to provide highly individualized, detailed recommendations rather than generic lists of accommodations. We specify the exact nature of the support your child needs, including the recommended frequency of services, the provider best suited to deliver the intervention, tailored environmental accommodations, and the specific setting where the support should occur.

A comprehensive evaluation can also inform appropriate classroom placement. For some students, making effective progress requires a specialized language-based, co-taught, or therapeutic classroom setting rather than a standard general education environment.

You do not need to be a clinical expert to advocate effectively during this process. A high-quality report does the heavy lifting by reframing classroom struggles into clear, actionable solutions. For instance, a student who appears “disorganized” or “unmotivated” is often actually experiencing executive dysfunction. Thus, the report may reframe this difficulty to advocate for structured scaffolding, like breaking long-term projects into mini-deadlines with daily staff check-ins.

Similarly, a child labeled “inattentive or slow to finish work” may be managing the impact of slow processing speed, meaning they comprehend the material well but require significantly more time and cognitive energy to show what they know. The report can use this insight to justify pacing accommodations, such as reduced homework volume to prioritize concept mastery over repetitive task completion.

Even emotional vulnerabilities, such as presenting as “withdrawn or resistant to participate,” may be reframed within a report through the lens of underlying sensory overload or social fatigue, pointing the school team toward proactive supports like a designated safe space or scheduled sensory breaks throughout the day. Ultimately, by translating complex behaviors into these precise, real-world connections, the evaluation report provides you and the school with a shared, compassionate roadmap towards supporting the student’s success.

Collaborative Advocacy: Partnering with the School Team

Preparing for a multidisciplinary team meeting can be a deeply personal process, and it is completely natural to want to ensure your child’s needs are fully understood. The most productive school meetings are often built on a foundation of partnership, where everyone brings valuable expertise to the table. Successful advocacy relies on uniting two distinct areas of expertise: the school team’s deep knowledge of curriculum and classroom dynamics, and your unmatched understanding of your child’s unique personality, strengths, and history. By uniting these unique perspectives, you and the school team can work together to build the best possible path forward. To foster a collaborative partnership during your next team meeting, consider these strategies:

  1. Share the Report Early to Build a Collaborative Bridge (Preparation): When possible, provide the school’s multidisciplinary team with the neuropsychological report at least two weeks prior to the scheduled meeting. This gives the educators and specialists adequate time to digest the findings and formulate thoughtful, proactive service proposals. To foster a true partnership, consider sending a brief, friendly email along with the report highlighting your top two or three priorities or questions, ensuring your voice is integrated into the meeting agenda from the very start.
  2. Reframe Behavior Through a Clinical Lens (During the Meeting): Use the evaluation findings to identify the root cause of certain behaviors, allowing the team to reframe classroom challenges and guide targeted, proactive interventions. If it is noted that your child is “disengaged” or “refuses to write,” pointing to the objective data showing fine-motor fatigue, language-retrieval deficits, or underlying performance anxiety helps the team view the behavior as a skill deficit rather than a compliance issue. Reframing these challenges empowers the team to focus on teaching coping strategies and providing proactive supports that set your child up for success.
  3. Focus on “Effective Progress” and Accountability (The Goal): Under special education guidelines, eligibility and services hinge on whether a child is making meaningful, “effective progress” in school. Use the standardized, objective data in your report to highlight where your child is struggling, both compared to their peers and relative to their own capabilities. Rather than asking for generalized help, frame your requests around helping them close these specific developmental and academic gaps, and ask the team how the success of any new accommodations or interventions will be actively measured and tracked.

Translating a neuropsychological evaluation into a school-based plan is a journey that requires patience, clarity, and persistence. Ultimately, your child’s report is far more than a diagnostic document; it is a powerful roadmap designed to align parents and educators around a shared vision. By using objective clinical data to guide the conversation, you can ensure your child receives the precise, individualized support required to build academic self-efficacy, emotional resilience, and the foundation they need to thrive.

School Meeting Support

Are you preparing to navigate an upcoming multidisciplinary school meeting to discuss an IEP or 504 plan for your child? To bridge the gap between our clinical findings and your child’s classroom, neuropsychologists at NESCA are available to attend school team meetings. In these meetings, our role is to succinctly present the objective evaluation findings directly to the school team, illustrate how your child’s unique profile impacts their classroom learning, and walk educators through our tailored recommendations.

Please note that school meeting attendance is a distinct clinical service and is not included in the core evaluation and report process. Clinicians participate strictly in an advisory, clinical capacity rather than as educational advocates. To inquire about your clinician’s availability and the rates for this service, please reach out to our intake team at NESCA.

 

About Dr. Madeline Manning

Dr. Madeline Manning is committed to providing comprehensive, collaborative evaluations that helpMadeline Manning, PhD Headshot families better understand their child’s unique neurocognitive, developmental, learning, and social-emotional profiles. She specializes in the assessment of toddlers, school-aged children, adolescents, and young adults. Her expertise involves working with youth exhibiting a diverse range of clinical presentations, including neurodevelopmental disorders, such as autism spectrum disorder, attention and executive functioning deficits, learning disabilities, developmental delays, intellectual disabilities, and associated emotional challenges. Dr. Manning is also trained in the assessment of children with medical complexities, recognizing how health conditions can impact a child’s development and functioning. She partners closely with families to develop practical, personalized recommendations that support each individual’s success and growth at home, in school, and within the community.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of teen participating in art therapy and a quote explaining why some individuals may need different forms of therapies.

What If My Child Is Not Ready For Traditional Therapy?

By | NESCA Notes 2026

Image of teen participating in art therapy and a quote explaining why some individuals may need different forms of therapies.By: Jessica Greene, Psy.D.
Postdoctoral Fellow, NESCA

When parents receive a recommendation that their child begin therapy, it can feel overwhelming. Many people are familiar with traditional “talk therapy,” but some may not realize there are many different therapeutic approaches designed to meet children where they are at developmentally or emotionally. After receiving a recommendation for therapy, many parents immediately ask, “Do you recommend anyone?” While that is an important question, it can be just as helpful to first ask, “What type of therapy is the best fit for my child?” Not all children and adolescents are ready to sit down with a therapist and talk about their thoughts and feelings in a traditional therapy setting. Younger children, children with developmental differences, those who have experienced trauma, or children who become overwhelmed by emotions may benefit from therapies that allow them to communicate in other ways.

Fortunately, there are several therapeutic approaches that may be a better fit.

Play-based Therapy

In play-based therapy, children use play to work through challenging feelings, day-to-day stressors, and/or difficult experiences. Rather than relying on conversation, the play allows the child to express themselves in the way that comes most naturally to them. Through the child’s play, the therapist may gain insight into how the child understands experiences, relationships, or emotions. For example, a child may use toy cars to make sense of a car accident, replaying the accident as they work toward understanding and processing the experience.

It is important to know that registered play therapy is different from simply playing games with a child during a therapy session. In play therapy, play itself is the therapeutic language, and the therapist has specialized training in using play to support assessment and treatment. It is okay to ask a potential therapist about their approach.

Find a Registered Play-based Therapist: https://www.a4pt.org/search/custom.asp?id=3571

Music Therapy, Dance/Movement Therapy, and Art Therapy

Music, dance/movement, and art therapy use creative expression as the primary way children explore emotions, build coping skills, strengthen self-awareness, and process difficult experiences. For some children, creating art, moving their bodies, or making music feels safer and more natural than talking. What they may not be able to say in words, they may be able to demonstrate through one of these other forms. These therapies naturally offer rhythmic, patterned, repetitive movements that can support internal regulation while giving children an alternative avenue to express themselves.

Find a Music Therapist: https://my.cbmt.org/cbmtssa/f?p=CRTSSA:17800:1865299384:::17800::

Find an Art Therapist: https://arttherapy.org/art-therapist-locator/

Find a Dance/Movement Therapist: https://www.adta.org/find-a-dmt#/

Occupational Therapy

Occupational Therapy is another alternative that may be a better entry point for some children who are not quite ready for the above-listed therapies. Although occupational therapy is often associated with fine motor skills or handwriting, many occupational therapists also specialize in sensory processing and emotional regulation. Through movement, sensory experiences, and structured activities, children learn what helps their bodies feel calm, organized, and ready to participate in everyday activities. As children engage with swings, climbing equipment, crash pads, sensory tools, and other therapeutic activities, they begin to recognize what helps them feel better regulated. As occupational therapists can provide support for many different needs, seek an occupational therapist that focuses on sensory processing and/or emotion regulation.

To learn more about NESCA’s Occupational Therapy services, visit: https://nesca-newton.com/educational-occupational-therapy-services/

Sensory Motor Arousal Regulation Treatment (SMART)

SMART is a trauma-informed therapy that combines sensory experiences with movement, while also focusing on the importance of the caregiver/child relationship to help children feel safer and more regulated. If your child has experienced trauma, SMART therapy may be an appropriate place to begin. Similar to occupational therapy, the SMART room provides various types of therapeutic equipment to help a child regulate their body throughout the session. Sessions may include crashing into crash pads, throwing a ball back and forth, or jumping on a trampoline to help the client increase or decrease their level of arousal, depending on their needs. Caregivers are an important part of the therapeutic process, helping strengthen attachment, during sessions, while learning to recognize what supports their child’s regulation. The process also encourages caregivers to better understand their own emotional responses and how these can influence their child’s ability to feel safe and regulated.

Find a SMART-trained Therapist: https://smartmovespartners.com/find-a-smart-therapy-therapist/

Regardless of the type of therapy, one factor consistently predicts better outcomes: the relationship between the child and therapist. Children are most likely to make progress when they feel safe, understood, and connected to the person supporting them. If your child does not seem comfortable with a therapist after an appropriate adjustment period, it is okay to ask questions or explore whether another provider may be a better fit.

 

About the Author

Dr. Jessica Greene is a licensed clinical psychologist who has worked After working with Dr. Angela Currie in NESCA’s Londonderry, N.H. office from 2023-2024 as a practicum student, Dr. Jessica Greene re-joins NESCA to complete her postdoctoral fellowship in pediatric neuropsychological assessment. Dr. Greene has a particular interest in understanding clients’ strengths as well as differences, integrating a therapeutic assessment approach, when appropriate.

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

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of a student going back to school along with a quote from a NESCA clinician

Helping Children with Social and Emotional Needs Navigate the Back-to-School Transition

By | NESCA Notes 2026

Image of a student going back to school along with a quote from a NESCA clinicianBy: Julie Weieneth, Ph.D.
Pediatric Neuropsychologist, NESCA

As summer winds down, many families begin shifting their focus to the upcoming school year. We start to notice store shelves filled with backpacks and notebooks. We update our calendars with orientation events and fall sports schedules. Parents also start thinking about new teachers, changing routines, and everything their children will need for a successful start.

For many children and families, the return to school brings a mix of excitement and nervousness. However, for children with diverse social, emotional, or neurodevelopmental needs – such as anxiety, ADHD, or Autism Spectrum Disorder (ASD) – this transition can be especially challenging. Sudden shifts in routines, expectations, sensory environments, and social dynamics can trigger significant stress, even when the changes are positive.

Fortunately, with proactive planning and preparation, families can make the transition smoother and reduce anticipatory anxiety before the first day of school arrives.

Why the Back-to-School Transition Can Be Difficult

Children with anxiety, ADHD, or ASD often rely on predictability, structure, and familiar environments to feel secure and regulated:

  • For children with anxiety, the unknown can trigger a cycle of worry. This may include apprehension about academic performance, social acceptance, or simply not knowing the daily schedule.
  • For children with ADHD, the transition from the relatively relaxed pace of summer to the high executive functioning demands of the classroom – which requires sustained attention, organization, and self-regulation – can feel overwhelming.
  • For children with ASD, differences in social communication and a strong preference for sameness mean that new teachers, different peer groups, and novel sensory environments require significantly more cognitive effort to manage.

Helping children understand exactly what to expect before these changes occur builds confidence and makes unfamiliar situations feel manageable. Below are some practical steps that families can take to help reduce this stress:

  1. Visit the School Before Classes Begin

One of the most effective ways to reduce first-day anxiety is to make the new environment feel physically familiar. This sensory and spatial familiarity benefits anxious, hyperactive, and sensory-sensitive children alike. Replacing uncertainty with physical familiarity significantly lowers anxiety on the first day of school.

If possible, arrange a visit to the school before classes officially start. Many schools host orientation days or can accommodate a brief walk-through during teacher preparation week. During the visit, your child can:

  • Meet their new teacher to establish an early, positive connection.
  • Locate their classroom, desk, and cubby or locker.
  • Walk the routes to key locations like the cafeteria, gym, library, and bathrooms.
  • Identify a “safe space” or a designated staff member they can access if they feel overwhelmed during the day.
  1. Use Social Narratives and Visual Schedules

Social narratives are personalized, step-by-step stories that help children understand what to expect in specific situations and outline helpful coping strategies. While originally developed for children with autism, these narratives are highly effective for children with ADHD and anxiety, as they clarify expectations and reduce executive functioning demands.

Using photos taken during your school visit can make the story even more meaningful. For example:

Tomorrow is my first day of fifth grade. I will walk into my classroom and see my teacher, Mrs. Smith. I will put my backpack in my cubby and find my desk. The classroom might be loud, or I might feel nervous, and that is okay. I can take deep breaths or ask to use my sensory tool. At the end of the day, I will take the bus home, and my family will be waiting for me.

Reading this narrative together several times before school starts allows children to mentally rehearse the day, reducing anxiety and boosting their sense of control.

  1. Utilize Video Modeling and Visual Walkthroughs

Many neurodivergent children are strong visual learners who process information more effectively through images and video than through verbal explanations alone.

Before school begins, consider recording a brief video on your phone during your school visit. Narrate the steps as you walk through the building: entering the front doors, finding the classroom, opening a locker, or navigating the cafeteria. Watching this video repeatedly at home allows your child to familiarize themselves with the sights and sounds of the school layout from the safety of a comfortable environment.

If you cannot visit the school in person to record, check the school’s website or reach out to the principal – many schools now host virtual tours or welcome videos recorded by staff that you can watch together at home. Video modeling is a highly versatile tool; it can also be used to prepare children for other transitions, such as medical appointments, family gatherings, or community outings.

  1. Gradually Shift Routines Before Day One

The transition from the relaxed schedule of summer to the highly structured routine of the school year can be a shock to a child’s internal clock. For children with ADHD and ASD, sleep disruption directly impacts daytime attention and emotional regulation.

About two weeks before school starts, begin incrementally shifting bedtimes and wake-up times by 15 minutes each day. Additionally, start practicing the morning routine – waking up, getting dressed, and having breakfast in the same sequence they will on school mornings. This gradual shift prevents first-week sleep deprivation and makes the first real school morning feel like a routine they have already mastered.

  1. Share a “One-Page Profile” with the New Teacher

Teachers receive a significant amount of paperwork at the start of the year, but a brief, personalized “One-Page Profile” (or “About Me” sheet) can be incredibly helpful. Before the first day, email a simple, bulleted summary to your child’s teacher. Consider including:

  • My Strengths: What your child loves and what motivates them (e.g., “loves space science,” “highly creative”).
  • What Helps Me: Strategies that work well (e.g., “needs a visual timer,” “benefits from sitting near the front”).
  • What I Struggle With: Early warning signs of distress (e.g., “fidgets when overwhelmed,” “may shut down if confused”).

This quick-reference guide helps the teacher understand your child’s unique profile from day one, fostering a collaborative home-school partnership.

  1. Plan for the “After-School Letdown”

For children with diverse needs, holding it together during a highly structured school day requires immense cognitive and emotional effort. When they finally return to their safe haven at home, it is incredibly common for them to release that built-up tension. This often looks like sudden irritability, meltdowns, or extreme fatigue right after school – a very normal reaction often referred to as the “after-school letdown” or decompression.

To help your child gently decompress at the end of the day:

  • Keep the transition quiet: Avoid immediately asking, “How was your day?” as they get in the car or walk through the door. Give them time to transition in comfortable silence.
  • Provide a comforting snack: Have a favorite snack ready immediately to address any hunger-related irritability.
  • Schedule quiet downtime: Allow for 30 to 60 minutes of unstructured, low-demand time (like quiet play, outdoor movement, or relaxing screen time) before starting homework or chores.

Small Steps Make a Big Difference

Transitions naturally involve uncertainty, which can fuel anxiety and behavioral challenges. Providing opportunities to preview and practice what lies ahead helps children feel more secure and confident.

Whether it is visiting the school, reading a personalized narrative, watching a video walkthrough, or gradually adjusting routines, these proactive strategies can help children with diverse needs approach the new school year with greater ease. While every child’s profile is unique, thoughtful preparation can make the transition back to school a more positive experience for the entire family.

Wishing you and your family a smooth transition back to school. Please feel free to reach out with any questions, or to share your own transition strategies with the NESCA community!

 

About the AuthorJulie Weineth headshot

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

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

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of student walking into middle school with a quote from Dr. Madeline Manning

Navigating the Transition from Elementary to Middle School with ADHD

By | NESCA Notes 2026

Image of student walking into middle school with a quote from Dr. Madeline ManningBy Madeline Manning, Ph.D.
Pediatric Neuropsychologist, NESCA Hingham

The transition from elementary to middle school is a significant developmental milestone, bringing new academic demands, shifting social dynamics, and greater expectations for independence. For students with attention-deficit/hyperactivity disorder (ADHD), who often experience executive function (EF) vulnerabilities, this period can be particularly challenging. Understanding and proactively addressing the academic, social-emotional, and behavioral needs of these students is essential to support their adaptation and long-term success.

Academic Demands and Executive Function

Middle school introduces a significantly more dynamic, fast-paced academic environment, characterized by multiple teachers, changing classrooms, and a heavier workload. Students must manage assignments from various instructors, each with different expectations and communication methods. This environment requires cognitive flexibility and other advanced EF skills, including organization, time management, task initiation, and prioritization. For students with ADHD, these demands can quickly overwhelm existing coping strategies, leading to forgotten assignments, missed deadlines, and difficulty transitioning between classes. This, in turn, can contribute to a reduced sense of self-efficacy as a learner.

Notably, many students have not yet been explicitly taught the EF skills needed for this new level of independence. Evidence shows that many students with ADHD require direct instruction, repetition, clear structure, frequent feedback, and opportunities to practice these skills in real contexts. Early identification of EF difficulties and targeted supports, such as executive function coaching, visual organizers, structured routines, and regular teacher check-ins, can ease the transition and build confidence (Giannakopoulos, 2025).

Social Dynamics and Emotional Development

Middle school is also marked by greater complexity in peer interactions. Friendships shift from more convenience-based connections, often formed through proximity and shared activities in elementary school, to deeper emotional bonds, and students face heightened peer pressure and the formation of social cliques. The onset of puberty, elevated emotional sensitivity, emerging interest in romantic relationships, and the influence of social media can further complicate peer dynamics during this developmental stage.

Students with ADHD are already at increased risk of experiencing challenges with impulse control, emotional regulation, and social problem-solving. The reduced adult scaffolding in middle school means students are expected to navigate social situations with more independence, which can be both empowering and challenging. Difficulties in these areas can negatively affect self-esteem and lead to anxiety or withdrawal.

Fostering resilience involves teaching prosocial coping strategies and promoting self-advocacy. This includes encouraging students to seek support from trusted adults when needed and to practice assertive communication skills. Guidance on managing peer pressure, conflict resolution strategies, and building and maintaining healthy friendships is critical for positive social development and emotional well-being in middle school and beyond.

The Adolescent Brain: Developmental Realities

During early adolescence, the brain undergoes significant changes. The prefrontal cortex (responsible for planning, decision-making, and self-control) is still maturing, while the limbic system (a complex set of brain structures governing emotions and reward systems) develops far earlier. This developmental mismatch means that adolescents are more likely to exhibit heightened emotional responses, increased impulsivity, and a greater sensitivity to rewards and peer influence, often before they have fully developed the cognitive skills necessary for effective self-regulation and long-term planning.

These neurodevelopmental factors mean that even typically developing students may struggle with EF tasks and social functioning during middle school. For those with ADHD, whose brains are already wired for greater difficulty with attention and self-regulation, the challenges can be far more pronounced.

Supporting Skill Development

To help students with ADHD navigate this transition, families and educators can collaborate to provide:

  • Explicit instruction in organizational and planning skills
  • Consistent routines and predictable expectations
  • Visual supports (e.g., checklists, planners)
  • Regular feedback and positive reinforcement
  • Opportunities for guided practice and reflection

These supports help students gradually build independence, resilience, and the executive function skills necessary to meet new demands.

A Critical Window for Evaluation and Intervention

The transition from elementary to middle school is a pivotal time to address concerns around academic, social-emotional, and/or behavioral functioning. A comprehensive neuropsychological evaluation can clarify your child’s unique strengths and challenges, guide targeted interventions, and support the development of formal education plans (e.g., IEPs or 504 Plans) to ensure they are receiving the services they require. Early identification and collaboration between home and school are essential for maintaining self-esteem, fostering self-efficacy, and ensuring access to appropriate supports.

If you have questions or concerns regarding your child’s transition to a new school, executive functioning, or any other aspect of their development, please contact NESCA for guidance. Comprehensive evaluation and targeted strategies can make a meaningful difference in your child’s educational journey and overall well-being.

 

About Dr. Madeline Manning

Dr. Madeline Manning is committed to providing comprehensive, collaborative evaluations that helpMadeline Manning, PhD Headshot families better understand their child’s unique neurocognitive, developmental, learning, and social-emotional profiles. She specializes in the assessment of toddlers, school-aged children, adolescents, and young adults. Her expertise involves working with youth exhibiting a diverse range of clinical presentations, including neurodevelopmental disorders, such as autism spectrum disorder, attention and executive functioning deficits, learning disabilities, developmental delays, intellectual disabilities, and associated emotional challenges. Dr. Manning is also trained in the assessment of children with medical complexities, recognizing how health conditions can impact a child’s development and functioning. She partners closely with families to develop practical, personalized recommendations that support each individual’s success and growth at home, in school, and within the community.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of a reward chart and quote from NESCA

“I’ve tried a sticker/reward chart, and it does not work!” – Strategies to Make Incentive Plans Actually Work

By | NESCA Notes 2026

Image of a reward chart and quote from NESCABy: Alison Burns, Ph.D.
Pediatric Neuropsychologist, NESCA

Behind the simple sticker chart or reward chart is decades of solid science. Psychologists and brain researchers have found that these charts work because they tap into how the human brain naturally learns and stays motivated. When a child gets a sticker or a point towards a reward immediately after doing a good job, their brain releases a tiny splash of dopamine, the “feel-good” chemical that helps us focus and feel successful. Decades of research, especially with kids who have ADHD, shows that rewards make boring or difficult tasks feel achievable. By focusing on positive rewards rather than nagging or punishment, these charts help shape behavior through slowly motivating changes which become habits or routines.

Incentive charts are highly versatile tools. While most commonly associated with young children, they are effective for anyone, including elementary-aged students and teenagers, who need help changing behaviors, building new habits, or staying motivated.

Despite these benefits, many parents I work with share the same frustration: “I’ve tried a sticker/reward chart, and it just didn’t work.”

When I dig a little deeper, I usually find that the incentive system wasn’t set up in a way that allowed the child, and the family, to succeed. I provide the following guidance to make their incentive plans more effective:

  1. Pick Your Battles: Focus on just 2 to 3 goals at a time (or even just one for very young kids). Ask yourself: What is the most pressing behavior change we need right now? Is it brushing teeth without an argument? Getting out the door on time for school? Stopping hitting or food-throwing? Trying to change too many things at once is a major reason why these charts fail. Think of it like New Year’s resolutions: when we try to overhaul our diet, go to sleep early, start a daily workout routine, complete a gratitude journal, and read a book a week all at the same time, we quickly burn out. It is simply too hard to maintain that much change long enough for new habits to stick. The same is true for your child. Keep it simple. Once your child masters one specific goal, you can “graduate” them from that goal and introduce a new one.
  2. State Goals Clearly and Positively: Tell your child exactly what you want them to do, rather than what you want them to stop doing. Instead of “Don’t be late for school,” phrase the goal as “Be ready with your shoes on and backpack packed by 7:20 AM.”
  3. Start with “Easy Wins”: Incentive plans often fail when parents set the bar too high right away; if a child goes several days without earning a reward, they will lose motivation and give up. Instead, start with an easy, highly achievable version of your goal and slowly raise the bar. For example, if your ultimate goal is for your child to have their shoes on and backpack packed by 7:20 AM, start by rewarding them just for having their shoes on by 7:20. Once that becomes a habit, you can raise the bar to include the backpack. Slowly shaping the behavior in these small, manageable steps keeps your child winning, building the momentum they need to succeed rather than setting the bar out of reach and causing them to throw in the towel.
  4. Reward the Behavior Immediately: Timing is everything. To help your child’s brain connect the good behavior with the reward, hand over the incentive right away. For timed tasks (like being ready by 7:20 AM), give the sticker, token, or point the second they finish. For all-day goals (like keeping hands to themselves), have a set time every day (like right after dinner) to hand out the reward. Connect the dots for them by saying: “Because you kept your hands to yourself today, you earned your sticker!” The more immediate or consistent the reward process is, the more likely the incentive system will be a success.
  5. Let Your Child Choose the Rewards: Children are far more motivated by rewards they actually care about. Sit down together and make a list of prizes. Remember, rewards do not have to be toys or cost money. Kids are highly motivated by quality time and special privileges, such as an extra bedtime story, 10 minutes of one-on-one time with a parent, choosing what’s for dinner, or picking the movie for family night.
  6. Make the “Exchange Rate” Clear: Make sure your child knows exactly what their stickers/points can buy. For young kids: Keep it simple. Placing the sticker on the chart might be enough, or they can “cash in” 3 stickers for a reward (like 10 minutes of screen time). For older kids, let them save up. They can earn points daily, but saving up 5 points might earn them a larger weekend reward (like a trip to get ice cream).
  7. Never Take Stickers Away: This is the golden rule of incentive charts. Once a sticker or point is earned, it is locked in. If your child has a great morning and earns a sticker/point, but has a meltdown in the afternoon, do not peel the morning sticker off or take away a point. Taking away earned rewards feels unfair to kids and ruins their motivation to keep trying. If they have a tough afternoon, simply say: “You didn’t earn your sticker/point for this afternoon, but you can try again tomorrow.”

Why Summer is the Perfect Time to Start

Summer is a fantastic time to introduce an incentive plan because it provides a light, predictable structure to those otherwise unstructured summer days. Furthermore, behavior change can be easier to accomplish when kids are relaxed and free from the daily stress of the school year. Making small, positive changes over the summer months can pay large dividends and set your family up for a smooth transition back to school in the fall. Not only will your child be accustomed to using a reward system by then, but they will also have already established several positive habits that will make the start of the school year much easier for everyone!

 

About the Author

Dr. Burns conducts comprehensive evaluations of school-aged children, adolescents, and young adults with a variety of developmental, learning, and emotional difficulties. She has expertise in the evaluation of individuals following a concussion/mild traumatic brain injury and particularly enjoys working with individuals with attention (ADHD) and executive functioning (EF) difficulties. Dr. Burns is passionate about helping individuals and their families better understand their areas of strength and weakness and provides tailored treatment recommendations based upon that unique profile to make the evaluation most helpful for each client.

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

NESCA is a pediatric neuropsychology practice and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image showing a father with two daughters, one of whom has special needs, A quote also follows.

Supporting Sibling Relationships in Families with Special Needs

By | NESCA Notes 2026

Image showing a father with two daughters, one of whom has special needs, A quote also follows.By: Erin Gibbons, Ph.D. 
NESCA MA Clinical Director; Pediatric Neuropsychologist

I am a parent of two amazing children, one of whom is neurotypical and one of whom is neurodiverse. Finding the balance between supporting my neurodiverse child while also giving my other child enough attention can feel like walking a tightrope. Siblings of children with developmental or learning challenges often experience a unique family dynamic.

  • To foster healthy sibling relationships, it’s crucial to promote open communication. Creating a safe and open environment for discussions helps them understand the situation and feel heard.
  • Providing age-appropriate information about the sibling’s disability can help demystify behaviors and challenges, fostering empathy and reducing misconceptions or frustrations.
  • Recognizing and validating the emotions of siblings, whether positive or negative, is also important. It’s natural for them to have mixed feelings, and acknowledging these emotions helps them process and cope effectively.
  • Encourage siblings to pursue their own interests, reinforcing their identity outside of the family role.
  • Try to dedicate individual time with each child to strengthen personal bonds and make them feel special and attended to.
  • Encourage siblings to support each other and work as a team.

If you find that sibling dynamics are causing family discord, it might be helpful to connect with sibling support groups where children can meet others in similar situations. Consulting a family therapist or counselor can also be helpful and provide tailored strategies to facilitate improved family interactions.

 

About the Author

Since 2011, Dr. Gibbons has been a trusted expert at NESCA where she evaluates children presenting with a range of attentional, learning,Erin Gibbons headshot and developmental disabilities. She has a particular interest in children with autism spectrum disorders, intellectual disabilities, and those with complex medical histories. In addition, she evaluates adults who have concerns about whether they meet criteria for an ASD or ADHD diagnosis.

If you are interested in booking an evaluation with a NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Hingham, and Plainville, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, 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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Image of teo children reading outside on the grass with a quote from NESCA Pediatric Neuropsychologist Alissa Talamo, Ph.D.

How to Encourage Summer Reading with Your Child

By | NESCA Notes 2026

Image of teo children reading outside on the grass with a quote from NESCA Pediatric Neuropsychologist Alissa Talamo, Ph.D.By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

Summer is an important time for children to relax and recharge, but it also provides a valuable opportunity to make reading enjoyable. Research consistently shows that students who do not read over the summer are at risk for the “summer slide,” which is a decline in reading skills acquired during the school year. In contrast, children who continue to read during the summer not only maintain but can even improve their literacy abilities.

The benefits of summer reading extend well beyond academics. Regular reading helps expand general knowledge, improve vocabulary and spelling, and strengthen focus and attention. According to Dr. Sally Shaywitz, author of Overcoming Dyslexia, children who read for just 20 minutes a day are exposed to approximately 1.8 million words each year, compared to only 8,000 words for those who read just a few minutes daily. This increased exposure to language supports both language development and writing skills.

Reading for just 20 minutes each day offers numerous advantages. Children experience significant vocabulary growth, encounter diverse perspectives that foster empathy, and develop stronger critical thinking skills as they engage with stories and information. Additionally, reading can be a relaxing activity, particularly before bedtime, helping children unwind after a busy day.

Despite these benefits, some children may be reluctant to read due to reading difficulties, uncertainty about their interests, or a preference for other activities. To encourage reading, it is important to let children choose books that interest them, set aside time to read together, and create a cozy reading environment at home. Pairing reading with interactive activities, such as visiting a museum, landmark, or travel destination related to a book’s topic, characters, or setting, can also make reading more appealing. Regular library visits, audiobooks, and a variety of reading materials—including magazines, comics, and graphic novels—can also help sustain interest. Introducing children to book series and modeling your own enjoyment of reading are additional strategies to foster a positive reading culture.

Helpful Resources and Tools

There are many excellent websites and apps that can support your child’s reading journey. Here are some sites to consider:

  • Unite for Literacy: A collection of audio/picture books read aloud to your child.
  • Reading Rockets—Reading Adventure Packs: Downloadable guides with book suggestions and activities.
  • Starfall.com: Early literacy games and books, ideal for young children.
  • Talking is Teaching: Encourages parents to talk, read, and sing with children to boost early brain and vocabulary development.

Other Resources:

Conclusion

Encouraging your child to read over the summer—and throughout the year—can have lasting benefits for their academic, social, and emotional development. By making reading enjoyable and accessible, and by supporting their individual interests and needs, you can help your child build a lifelong love of reading.

 

References:

  • Sally Shaywitz, MD, Overcoming Dyslexia (2020 Edition): Second Edition, January 4, 2005
  • https://specialedresource.com/benefits-of-reading-20-minutes-a-day
  • https://www.k12reader.com/why-read-20-minutes-a-day/
  • https://www.understood.org/articles/en/14-ways-to-encourage-your-grade-schooler-to-read

 

About the Author

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

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

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

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

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

She is the mother of one college-aged daughter.

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

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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image of a child receiving summer services

Why Summer Is the Perfect Time to Start Services for Your Child

By | NESCA Notes 2026

image of a child receiving summer servicesBy: Rebecca Dautoff, Psy.D.
Pediatric Neuropsychologist, NESCA

For many families, summer is a welcome break from the busy routines of the school year. Without homework, early morning schedules, and packed extracurricular calendars, children often have more flexibility and downtime. While summer is commonly viewed as a season for relaxation and fun, it can also be an ideal time to begin therapeutic, educational, or developmental services.

As a psychologist, I often hear parents wonder whether they should wait until the fall to start services. In most cases, my recommendation is simple: if a child would benefit from support, summer is one of the best times to begin. Schedules are more open, and you may even be able to meet more often and make as much progress in the summer as you would over the course of an entire semester. I personally have two children getting services this summer, and here is why:

Reduced Academic Demands Create More Capacity for Growth
During the school year, children are balancing academics, social expectations, extracurricular activities, and family responsibilities. Adding a new service can sometimes feel overwhelming for both children and parents. Summer offers a different environment. With fewer academic pressures and more flexible schedules, children often have greater emotional and cognitive bandwidth to engage in learning new skills, and parents may have more bandwidth to take on the scheduling of yet another thing. Whether they are working on emotional regulation, social communication, executive functioning, speech and language development, or motor skills, children may be more receptive to intervention when they are not simultaneously managing the demands of a full school day.

Time to Build Relationships Before School Starts
One of the most important factors in successful intervention is the relationship between the child and the provider. Trust and comfort take time to develop. Starting services during the summer allows children to establish rapport with therapists, specialists, or support providers before the school year begins. By the time fall arrives, many children feel more comfortable, confident, and familiar with the therapeutic process, allowing them to make more meaningful progress when academic demands increase.

Opportunities to Practice Skills in Real-Life Settings
Summer often provides more opportunities for children to practice new skills in everyday situations. Family outings, camps, playdates, vacations, and community activities create natural opportunities to apply what they are learning.

For example:

  • Children working on social skills can practice initiating conversations and maintaining friendships.
  • Children receiving counseling can use coping strategies during new experiences and transitions.
  • Children developing executive functioning skills can practice planning, organization, and independence.
  • Children receiving speech or occupational therapy can apply newly learned skills across a variety of environments.

This real-world practice helps strengthen learning and promotes generalization of skills beyond the therapy setting.

Preventing the “Wait and See” Delay
Parents sometimes hope that a challenge will improve on its own over time. While development naturally occurs as children grow, delaying support can sometimes mean missing valuable opportunities for intervention. Summer provides a proactive window to address concerns before they potentially become more significant during the school year. Beginning services early allows professionals to assess needs, develop goals, and implement strategies that can help children start the school year with greater confidence and support.

Easing School-Year Transitions
Transitions can be challenging for many children. Starting a new school year often brings changes in routines, teachers, expectations, and social dynamics. When children begin services during the summer, they can enter the school year with established supports already in place. They may have stronger coping skills, increased confidence, and a clearer understanding of their strengths and challenges. This foundation can make the transition back to school smoother and less stressful for both children and parents.

More Opportunities to Participate
Parent involvement is one of the strongest predictors of successful outcomes in many therapeutic and educational interventions. The school year in our house often feels hectic. With two working parents and three kids in school, our day-to-day is fast-paced and complicated, to say the least. During the summer, families like ours often have more flexibility to attend appointments, participate in consultations, and implement recommended strategies at home. This increased bandwidth and collaboration allows providers and families to work together more effectively, creating consistency between sessions and daily life.

Progress Before the Next School Year Begins
Perhaps one of the greatest advantages of starting services during the summer is the opportunity to make meaningful progress before school resumes. A few months of targeted support can help children develop new skills, increase confidence, and establish positive routines. Rather than beginning services while already managing the demands of a new school year, children can start the fall with momentum and a stronger foundation for success.

 

About the Author

Dr. Rebecca Dautoff provides comprehensive neuropsychological and psychological (projective) evaluation services for children, adolescents,Headshot of Rebecca Dautoff, Psy.D. and young adults who have complex presentations with a wide range of concerns, including attention deficit disorders, psychiatric disorders, intellectual disabilities, and autism spectrum disorders (ASD). She also values collaboration with families and outside providers to facilitate supports and services that are tailored to each child’s specific needs.

 

If you are interested in booking an appointment for an evaluation with Dr. Dautoff or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form. 

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and the Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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images showing what In-person or Teletherapy Speech Services look like and a quote from Olivia Rogers, CCC-SLP

Teletherapy vs. In-Person Therapy: What Families Should Know

By | NESCA Notes 2026

images showing what In-person or Teletherapy Speech Services look like and a quote from Olivia Rogers, CCC-SLPBy Olivia Rogers, MA, CCC-SLP
Speech-Language Pathologist, NESCA

Speech-language therapy has evolved significantly over the past several years, giving families more options than ever before. While in-person therapy has long been the traditional model, teletherapy has emerged as an effective, flexible, and research-supported way to deliver high-quality services.

Both approaches can support meaningful progress, but they offer different advantages depending on a student’s needs, learning style, and family schedule.

What is In-Person Therapy?
In-person therapy takes place face-to-face in a clinic, school, or home setting. Sessions often include hands-on materials, physical movement, and direct interaction with the clinician in the same space.

Benefits of In-Person Therapy

  • Natural opportunities for play-based learning
  • Physical prompts and hands-on support
  • Easier for very young children who need frequent redirection
  • Helpful when targeting feeding, articulation placement, or sensory-motor skills

For some students – particularly younger children or those needing physical cueing – in-person therapy can be an important option.

What is Teletherapy?
Teletherapy delivers speech, language, and coaching services through a secure video platform. Sessions remain interactive, individualized, and structured and use digital materials, shared screens, real-time coaching, and collaborative activities. Teletherapy is not “less than” in-person therapy. In many cases, it offers unique advantages that directly support academic and functional skill development.

The Benefits of Teletherapy

  1. Therapy Happens in the Student’s Real Learning Environment

Students often join sessions from home or school, allowing strategies to be applied immediately to real assignments, writing tasks, and classroom demands. This is especially powerful for:

  • Academic language
  • Writing
  • Executive functioning
  • Organization and study skills

Skills transfer more naturally because therapy is embedded in everyday routines.

  1. Increased Engagement for Older Students

Many school-age students and adolescents are highly responsive to digital learning. Interactive slides, collaborative documents, and visual supports can increase participation and independence. Teletherapy often feels:

  • Less intimidating
  • More conversational
  • Provides more room for independence
  • More aligned with how students already learn

This can lead to stronger buy-in and carryover.

  1. Greater Family Involvement

Caregivers can easily observe sessions, ask questions, and learn strategies without travel. Due to the ease of meeting, consultation time can easily be built into teletherapy sessions or added on as a monthly service. This improves consistency between therapy and daily life – one of the biggest predictors of progress.

  1. Flexible Scheduling and Reduced Barriers

Teletherapy eliminates commuting, waiting rooms, and geographic limitations. Families can access specialized services that may not exist locally. This flexibility is particularly helpful for:

  • Busy families
  • Students with extracurricular schedules
  • Students who fatigue easily
  • Families planning transitions or moves
  1. Strong Fit for Language, Literacy, and Executive Functioning

Many higher-level communication skills naturally occur on screens, such as reading passages, writing responses, organizing ideas, and managing tasks. Middle and High School students now type essays, rather than handwriting. Teletherapy allows clinicians to:

  • Model writing in real time
  • Scaffold comprehension strategies
  • Practice planning and organization
  • Teach digital learning skills students already need

For these goals, the teletherapy environment can actually mirror classroom expectations more closely than a clinic setting.

When One Approach May Be Better Than the Other
In-person therapy may be preferred when:

  • Physical cueing is essential
  • Attention regulation is extremely challenging
  • Sensory-motor or feeding work is a primary goal

Teletherapy may be ideal when:

  • Goals are academic or language-based
  • Students benefit from visual/digital supports
  • Families need scheduling flexibility
  • Collaboration with caregivers or teachers is important

Often, the best approach is individualized, and some students benefit from a combination over time.

Final Thoughts
Teletherapy has expanded what is possible in speech-language support. For many students, particularly those working on language, literacy, and executive functioning, it provides a flexible, effective, and highly relevant model of care.

Rather than replacing in-person therapy, teletherapy offers another pathway for families to access specialized support and help students build skills that extend beyond the therapy session.

At NESCA, we know that the research shows that outcomes depend less on location and more on the clinician’s expertise, individualized goals, consistency of sessions, and strategy carryover into daily life. Whether sessions occur in-person or online, meaningful progress happens when therapy is functional, engaging, and connected to a student’s real-world demands. For more information on Speech and Language Therapy and services at NESCA, please complete our online Inquiry/Intake Form or email me directly at orogers@nesca-newton.com.

 

About the AuthorOlivia Rogers

Olivia Rogers is a licensed speech-language pathologist with experience in pediatric clinics and public schools, working with children from age 2 through young adulthood across a range of communication challenges. With a special interest in the connection between oral language and literacy, Ms. Rogers is trained in the Orton-Gillingham method and the Brain Frames program, supporting students in language comprehension, expression, and written organization. She is dedicated to making therapy engaging and personalized for each child.

To learn more about NESCA’s Speech and Language Services or schedule appointments, complete our online Intake Form or email orogers@nesca-newton.com.

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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a roadmap wirh a treatment plan sign showing the way; quote from Dr. Ann Helmus

Beyond Recommendations: Creating a Roadmap for Change

By | NESCA Notes 2026

a roadmap wirh a treatment plan sign showing the way; quote from Dr. Ann HelmusBy Ann Helmus, Ph.D.
Founder & Director, NESCA

I recently attended a continuing education course on the treatment of sleep problems. The instructor shared something not altogether surprising, but genuinely thought-provoking: simply giving people a list of “sleep hygiene” recommendations has not been shown to be particularly effective.

Most of us have heard these recommendations before:

  • Turn off screens before bed
  • Keep the room cool and dark
  • Avoid caffeine late in the day
  • Maintain a consistent sleep schedule

The problem isn’t that these recommendations are wrong. The problem is that they are often delivered as a generic list. So, what does work? A personalized approach to a plan.

For example, instead of handing someone a list of 10 recommendations, an effective approach by a clinician might be to say: “Let’s focus on one thing this week – moving your afternoon coffee a little earlier in the day. We’ll see how that goes, what obstacles come up, and whether it makes a difference before we add anything else.”

Here, the recommendations are tailored to the individual, prioritized based on what is most likely to help, and then followed up on to determine what is working and what needs adjustment.

The same can be said about the recommendations that are provided after a neuropsychological evaluation. After an assessment, families receive evaluation reports that often contain pages of recommendations. While many of those suggestions may be reasonable, a long list can leave parents wondering where to start, which recommendation matters the most, or which recommendation will make the biggest difference for my child right now. It can be overwhelming.

At NESCA, our goal is not simply to generate recommendations. Our goal is to develop a treatment plan.

A treatment plan factors in the full understanding of the child’s unique strengths and challenges, identifies the issues that are having the greatest impact on daily functioning, and prioritizes the interventions that are most likely to improve quality of life and long-term improvement.

For one child, improving sleep may be the most important first step. For another, it may be anxiety management, executive functioning support, social skills coaching, speech-language intervention, or school accommodations. The recommendations may look similar on paper, but the strategy is very different.

A thoughtful evaluation should answer not only what to do, but why, when, and in what order.

Most importantly, meaningful change rarely comes from a report sitting on a shelf. It comes from partnership, implementation, progress monitoring, and adjustments as needed.

Just as effective treatment for sleep difficulties involves more than a list of sleep hygiene tips, effective support for a child involves more than an exhaustive list of recommendations.

It requires a roadmap. At NESCA, our goal is to help families build one.

 

About the Author

NESCA Founder and Director Ann Helmus, Ph.D., is a licensed clinical neuropsychologist who has beenAnn Helmus headshot practicing neuropsychology for 35 years and has been director of NESCA’s Neuropsychology practice for nearly three decades, continuously training and mentoring  neuropsychologists to meet the highest professional standards.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology and related services group practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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