To accommodate requests for neuropsychological evaluations after the start of the new school year, NESCA has added evaluation dates in its Newton, MA office. Immediate openings are now available for scheduling. Please complete our Inquiry/Intake Form for more information or to start the scheduling process.

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NESCA Notes 2026

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Headshot of Dr. James Lynch and a quote from him about joining NESCA

NESCA Welcomes James Lynch, Ph.D., to its Pediatric Neuropsychology Team

By | NESCA Notes 2026

Headshot of Dr. James Lynch and a quote from him about joining NESCABy: Jane Hauser
Director of Marketing & Outreach, NESCA

I recently had the opportunity to learn more about NESCA’s latest addition to its Pediatric Neuropsychology staff, Dr. James Lynch. We are thrilled to have Dr. Lynch on our team at NESCA! I hope you enjoy getting to learn more about him here as well.

What are your areas of expertise in pediatric neuropsychology?
I have worked with many individuals with a wide range of ages and ability areas from my previous educational and professional experiences. Most of my experience is with children and adolescents who show signs of Attention-Deficit/Hyperactivity Disorder (ADHD), autism spectrum disorders (ASD), learning disorders, developmental delays, and intellectual disabilities, as well as the interventions that are used to support those students.

How did you get your start in pediatric neuropsychology?
I started in clinical psychology by training in evaluating children and adolescents with concerns for ADHD and/or autism. While that is my area of specialty, I was also doing a lot of evaluations during my fellowship at Boston Children’s Hospital with complex presentations in children who were often considered “difficult to test” for many reasons, whether due to behavioral challenges, language abilities, or other factors.

What is your approach in evaluating children and young people?
I try to optimize the performance of the evaluations for the students with whom I work. I like to focus specifically on what I am trying to measure and whether I am getting the information that will help me identify the root cause of the challenges the individual is experiencing. I try to look for the patterns of skills – whether they are strong or need support to find out what we are looking for.

What kind of guidance do you offer to parents and caregivers about going through the evaluation process for their child?
It can be scary for families. I try to help parents and caregivers understand that we know how to work with kids and that we understand that the challenges they and their child are experiencing can be very difficult. I explain that our aim is to help them better understand what is causing those struggles and recommend a treatment plan that is targeted specifically to their child. I assure them that while their child’s challenges may be new to them, we are very used to working with kids with similar presentations and that they are not alone.

You have a lot of research experience. Can you tell us more about that?
I’ve done a lot of research into neuropsychological functioning – and how that may help explain differences in real-world outcomes. For example, kids with ADHD tend to have executive functioning (EF) challenges, but there is so much variability in this… so how can we use this variability to make predictions about real-world outcomes. For example, I’ve conducted research examining whether children with ADHD are more susceptible to EF challenges or post-concussive symptoms after a season of high school football or soccer. I’ve also done a study on whether EF can predict which teenagers with ADHD are more or less likely to have automobile crashes or near-crashes when they begin to drive. I’ve also conducted research examining whether differences in reinforcement processing and temperament predict which kids are more likely to respond to an external reward system or develop future anxiety or mood symptoms.

I have also been involved in a lot of caregiver-focused research, such as whether the outcomes for autistic children were better when families participated in an adapted Applied Behavior Analysis (ABA)-based program and if participating had downstream impacts on other services for the child or the wellness of parents of kids with autism.

You join NESCA from Boston Children’s Hospital. What did that experience give you and how will that support you in your work at NESCA?
Working at Children’s for two years allowed me to see a wide range of kids with highly complex challenges, including those with ADHD and ASD, as well as those who were also experiencing GI, genetic, and neurological complexities. We also frequently worked with children whose symptoms made it difficult to tease apart exactly what the underlying issues were.

Children’s also gave me the training on and regular opportunity to make decisions on the fly. This has been extremely beneficial in being able to select the individualized battery of tests we use in our evaluations. Based on behavioral observations mid-testing, I have learned to easily pivot, incorporating additional tests that will allow me to better identify cognitive challenges, which helps to home in on an accurate diagnosis. It’s those in-the-moment choices that I’ve become very accustomed to that are so helpful in getting to the bottom of what’s actually going on with a child.

Finally, the interdisciplinary experience Children’s provided has also been extremely helpful in understanding a child as a whole during evaluations so I can create a targeted treatment plan that will support them once the evaluation is concluded.

What drew you to NESCA?
I was drawn to the focus on helping families in areas that other neuropsychology practices may not focus on, mainly how we can support children with their education based on our evaluation findings. I really wanted to move my career forward in a place where I could make an impact on a child’s everyday life, whether behaviorally, developmentally, or helping them thrive academically.

I also really appreciate the efforts that NESCA makes in keeping its clinical staff trained and current on evidence-based treatments, school-based interventions, among other areas from internal and external experts. The case conference and seminar trainings were very familiar to me from the hospital setting, and I greatly appreciate that I can continue to further my education in this manner.

Finally, I saw first-hand in the interview process and throughout my onboarding at NESCA how closely connected NESCA clinicians are with the kids and families they work with. That is something deeply important to me.

 

About Dr. James Lynch

Headshot of James Lynch, Ph.D.Pediatric Neuropsychologist Dr. James Lynch, Ph.D., conducts comprehensive evaluations of toddlers, preschoolers, school-aged children, and adolescents with developmental concerns. These include challenges with cognitive functioning, behavior and emotion regulation, communication skills, and academics. He has expertise in the evaluation of neurodevelopmental disorders such as ADHD, autism, developmental delays, intellectual disabilities, and learning disorders.

To book a consultation or evaluation with 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 student having a hard time initiating homework. Quote from a NESCA clinician.

Understanding LBLD and Executive Functioning: Securing the Right IEP or 504 Support

By | NESCA Notes 2026

Image of a student having a hard time initiating homework. Quote from a NESCA clinician.By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

When a student struggles to start writing, loses track of directions, or takes hours to complete homework, the immediate assumption is often: “This is an attention or ADHD issue.” While ADHD and executive functioning (EF) challenges frequently co-occur with learning differences, there is often a deeper, misunderstood culprit: Language-Based Learning Disability (LBLD).

For parents, advocates, and educators, understanding the relationship between language processing and EF is critical. Without this insight, schools risk implementing accommodations that merely bypass the problem, rather than providing the specialized instruction a student needs to build independence.

What are LBLD and Executive Functioning?

An LBLD is a neurodevelopmental spectrum of difficulties affecting how individuals process, understand, and use spoken and written language. It is a processing difference entirely unrelated to intelligence, motivation, or instructional quality. LBLD typically impacts:

  • Reading (Dyslexia): Decoding, phonics, and comprehension.
  • Written Expression (Dysgraphia): Mechanics, spelling, and organizing thoughts.
  • Spoken Language: Receptive (understanding instructions) and expressive (word retrieval) language.
  • Organization & Memory: Working memory deficits and difficulty planning multi-step tasks.

Executive Functioning is the brain’s “management system” – housed in the prefrontal cortex – enabling individuals to plan, focus, remember instructions, regulate emotions, and prioritize tasks.

The Intersection: How Language Weaknesses Disrupt EF

To support these students, we must distinguish between primary ADHD and LBLD-driven executive dysfunction:

  • Primary ADHD: Driven by global deficits in behavioral inhibition and executive control.
  • LBLD: Executive dysfunction is a secondary consequence of the high cognitive load of language processing.

When a student expends immense energy decoding words, retrieving vocabulary, or analyzing syntax, it rapidly drains their cognitive battery. This cognitive fatigue manifests as apparent executive dysfunction (task avoidance, distractibility, or poor initiation). Treating this solely as an attention issue misses the opportunity to provide necessary language-based instruction.

This breakdown occurs in three key areas:

  1. Working Memory Overload: Weaknesses in word meaning require so much conscious effort to decode that the student’s working memory overflows, causing them to lose track of multi-step directions.
  2. The Processing “Bottleneck”: Translating auditory language into an internal concept, and then into a written response, takes longer. This delay acts as a bottleneck when trying to get ideas onto paper.
  3. The Absence of “Internal Language”: Cognitive flexibility and task initiation rely on “internal language” (self-talk used to plan and organize). Students with LBLD lack strong internal language, resulting in task initiation paralysis.

Moving Beyond Accommodations to Specialized Instruction

Schools often default to accommodations, such as providing extra time, pre-filled graphic organizers, or reduced assignments. While these accommodations act as a passive bypass – altering the environment or format to circumvent a deficit – they do not teach skills. By bypassing the weakness without remediating it, accommodations can create prompt-dependency, where the student relies on an adult or a tool to do the cognitive heavy lifting.

In contrast, specialized instruction serves as active remediation by explicitly and systematically teaching cognitive and linguistic strategies. For example, instead of simply handing a student a graphic organizer, specialized instruction teaches the metacognitive process of how and when to use it. This approach targets the deficit directly, transforming the student from a passive recipient of support into an active, self-regulating learner.

To foster independence, students must learn to internalize strategies through:

  • Explicit Strategy Instruction: Teaching how to identify and map the relationship between main ideas and details.
  • Self-Monitoring Training: Teaching students to use self-talk checklists (e.g., “Stop, Review Prompt, Check”) to monitor their own progress.
  • Working Memory Strategies: Instructing students in verbal rehearsal, visualization, and chunking.

Drafting Measurable EF/LBLD Goals for IEPs and 504s

IEP goals must shift from passive task completion to active skill acquisition by targeting the underlying cognitive-linguistic process, not just the final academic product.

Goal Comparison

  • Weak Goal (Product-Oriented): “Student will use an organizer to complete writing assignments with 80% accuracy.”
    • Why it fails: Focuses on worksheet completion (the product), not the planning skill. It does not define independence level or the specific strategy used.
  • Strong Goal (Skill- & Strategy-Oriented): “Given a multi-step writing prompt, the student will independently apply a 3-step planning strategy (brainstorm, categorize, sequence) to initiate writing within 5 minutes, in 4 out of 5 opportunities.”
    • Why it works: Targets the executive functions of planning and initiation, defines the exact strategy, and measures independence to build internal language.

Three Essential Elements of an EF/LBLD Goal

When advocating for IEP goals, ensure these three elements are explicitly defined:

  1. The Specific Strategy (The “How”): Name the exact cognitive tool (e.g., verbal rehearsal, a 3-step planning strategy, a self-monitoring checklist).
  2. The Level of Independence (Prompt Fading): Quantify the support required using precise, observable terms (e.g., independently, given no more than one verbal prompt), avoiding vague terms like “with minimal assistance.”
  3. Measurement of the EF Skill: Directly measure the executive function deficit (e.g., task initiation latency, planning time) rather than curriculum accuracy.

By shifting the focus of IEPs and 504 plans from passive accommodations to explicit, strategy-based specialized instruction, we can help students with LBLD build the internal language and executive functioning skills they need to navigate school – and life – independently.

 

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 daughter.

To book a consultation or evaluation with 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 showing college students studying together and a quote by a NESCA OT and Executive Function Coach

College Freshman and Executive Function: The Often Unexpected Demands

By | NESCA Notes 2026

Image showing college students studying together and a quote by a NESCA OT and Executive Function CoachBy Sophie Zeif, OTD, OTR/L
Occupational Therapist; Executive Function & Real-life Skills Coach

It is no surprise that the experience of a high school student is vastly different than that of a college student. This transition is seen as a pivotal step towards independence as we send students off to learn, grow, and explore in an often substantially less supported and less controlled environment. The hope is that after 13 years of K-12 education, our students have developed the academic, communication, and organization skills needed for success in school. They know the tricks of the trade. They have systems to employ and even more systems to fall back on if needed. They have become experts at learning, and they know the drill. But what happens when students get to college and everything, from the style of instruction to the flow of coursework, all the way to the demands outside of learning, are just…a little bit different? For some students, this is a welcome opportunity to rise to the challenge, but for others, this is a daunting, overwhelming, and seemingly impossible ask.

As an occupational therapist specializing in executive function, I have spent the last few years directly supporting those college freshman – the ones who look at the new demands and think, “I was never prepared for this, I don’t know if I can do this.” And I don’t blame them for feeling that way! The demands and expectations truly change. Here are a few that stand out:

  • Time management – High school schedules are rigid. Students are expected to arrive at a specific time, follow a block schedule, and make it to each of their classes (generally all in one building). If they forget what period it is, they can ask a friend, teacher, or almost anyone in the hallway. Conversely, every student in college has their own schedule that they are expected to track and manage. On Monday, they may be in class from 10am-2pm, while on Tuesday they are in class from 3pm-5pm on the other side of campus. There is no one to quickly ask or check in with regarding when and where they are supposed to be, and consistency is rare. This trouble is further compounded by the fact that college coursework requires a substantial amount of work to be done outside of the classroom that must be planned for and built into the weekly schedule.
  • Reading a syllabus – While “reading a syllabus” may sound simple, these documents are often over 20 pages long, providing information about course content, course expectations, each professor’s preferred method of communication, grading systems, and a full schedule of what is due and when. Additionally, each of these documents uses a different format and is frequently amended during the semester. High school students are used to an online portal that is consistently used by their teachers and provides built-in reminders and updates. Syllabi are tricky, and many students skim them without absorbing.
  • Assignment tracking – As mentioned above, college portals are nowhere near as comprehensive, up-to-date, or accurate as most ex-high school students expect. Professors may change a due date in class without updating a syllabus or expect students to keep track of a paper that is due more than a month away. Many college students need support putting a system in place to quickly consolidate due dates, set internal deadlines, and track what they need to hand in. This is especially important when breaking down large assignments into manageable chunks or learning to prepare in advance for busy times in the semester, such as midterms or finals week.
  • Communicating with instructors – Many college students need support in pushing themselves to attend office hours, reach out early and often via email if they have questions about classwork or assignments, and even introduce themselves to their professors.
  • Developing healthy habits and routines – On top of academic executive function demands, college students are dealing with an increase in life-based executive function demands. They are managing their own eating habits, morning routines, evening routines, and organizing all of their personal belongings in their own space. Completing all of this while maintaining life balance can be tricky and may require some support.
  • Accessing accommodations – The accommodation process at a college level is vastly different from the IEP or 504 process in high school. While this topic could be a blog on its own, the biggest takeaway for me is the level of responsibility that falls on the students. They are in charge of letting each professor, at the beginning of every semester, know about their accommodations for sitting in classes, taking exams, or turning in assignments. This requires a level of self-advocacy and functional communication that they may not have had to demonstrate in high school. This demand does not disappear throughout the semester, as they often need to remind professors a week before an exam about their needs or independently book a room to take their test.

While this may seem like a lot, the good news is that our students have learned how to learn. Their systems may need updating, and their strategies may need fine tuning, but with guidance, I have found college success to be a truly achievable goal. I often find that once provided with a foundation and tips for how to be successful, my college freshmen do rise to the challenge and eventually build the ability to do all of this independently. If you feel that your student could benefit from some executive function support as they embark on their college journey, please reach out about NESCA’s EF Coaching Program!

 

About the Author

Dr. Sophie Zeif is a licensed and registered Occupational Therapist in Massachusetts, specializing inSophie Zeif headshot educational occupational therapy and functional life skills development. For the past eight years, her work has primarily been split between children and adolescents on the Autism Spectrum in the United States and marginalized children in Tanzania, East Africa.

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

Dr. Zeif has worked for the Northshore Education Consortium and the Salem Public Schools providing occupational therapy services across vastly different educational settings. She also has experience working at the Northeast ARC Spotlight Program using a drama-based method to teach social skills to children, adolescents and young adults with autism, Asperger’s Syndrome and related social cognitive challenges.

Internationally, Dr. Zeif has done extensive work in Tanzania collaborating with fabulous Tanzanian professionals from a few different non-profit organizations. She has spent significant time working with the Tanzanian Children’s Fund, Asali Project and How to Draw a Lion providing educational enrichment and support. She has also spent time working with The Plaster House, a post-surgical, pediatric rehabilitation center, in Ngaramtoni, Tanzania.

Dr. Zeif currently works as part of NESCA’s transition team and offers transition assessment, educational occupational therapy assessment, consultation and virtual executive function coaching. Additionally, she is the program manager for NESCA’s Real-life Skills Program, providing community- and home-based coaching for functional skill development. She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book coaching services, please complete our Intake Form today. 

NESCA is a pediatric neuropsychology and related services practice in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables/Miami, 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 collage of various extracurricular activities and quote from a NESCA clinician

How to Choose Kids’ Activities Without Overloading Your Family

By | NESCA Notes 2026

A collage of various extracurricular activities and quote from a NESCA clinicianBy Luisa Hernandez Medellin, Psy.D., PMH-C
Pediatric Neuropsychologist, NESCA

A practical guide for finding the right balance between enrichment, rest, and family life

Back-to-school season often comes with a long list of sign-ups: soccer, dance, music, tutoring, art, clubs, and more. As parents, it is easy to feel like we should say yes to everything so our kids do not miss out.

Extracurricular activities can be wonderful. They help children make friends, build confidence, learn new skills, and discover what they enjoy. But when the calendar gets too full, those same activities can start to feel stressful for kids and exhausting for the whole family.

Start With One Simple Question: Why Are We Doing This?

Before signing up, pause and ask yourself: Is my child truly interested? Are we choosing this because everyone else seems to be doing it? Will this activity fit our family’s schedule, budget, and energy level?

There is no perfect answer. Some children need to try a few things before they find what they love. Others may be happier with one activity and plenty of time to play, rest, and just be kids.

Why Activities Can Be Good for Kids

When the fit is right, activities can support a child in many ways. Sports can teach teamwork and patience. Music, art, and dance can give children a way to express themselves. Clubs and volunteer opportunities can help older kids feel connected and responsible.

Activities can also help children build confidence. A child who struggles in one area of life may feel proud and capable when they learn a song, finish a swim lesson, score a goal, or make something with their hands.

But Downtime Matters, Too

Kids need space in their day that is not scheduled, coached, graded, or rushed. Free play helps younger children solve problems, use their imagination, and learn how to manage boredom. Older kids also need quiet time to think, relax, and recover from school demands.

If your child goes from school to homework to practice to bed most days, it may be too much. A busy schedule is not automatically a better schedule.

Signs Your Child May Need a Break

It is normal for kids to have hard days or feel nervous when trying something new. But if the stress keeps showing up, it may be time to pause and reassess, especially if the following behaviors or signs become frequent:

  • Crying, meltdowns, or big resistance before every practice or class
  • Stomachaches, headaches, or complaints about going
  • Trouble sleeping because of pressure or a packed schedule
  • Falling behind on schoolwork
  • Loss of joy in an activity they used to like
  • Constant exhaustion for your child – or for you

Stopping does not always mean quitting forever. Sometimes a child just needs a season off, a shorter class, a different coach, or an activity that better matches their personality.

Choose Activities That Fit Your Child’s Age

Young children usually do best with playful activities that focus on movement, fun, and simple skills, like tumbling, swimming, music, or art. They may not be ready for competition, strict rules, or teamwork in the way adults sometimes expect.

School-age children may enjoy trying team sports, clubs, or lessons, but they still need support with time management and those emotional ups and downs. Older children and tweens may be ready for more focused activities, but fun and balance should still come first over competition.

Think Beyond the Usual Options

Extracurriculars do not have to mean competitive sports or five-days-a-week commitments. A nature club, library program, art workshop, scouting, coding class, animal shelter volunteer opportunity, or adaptive recreation/therapeutic movement program may be a better fit.

For children with developmental, behavioral, or health needs, the right activity can be especially meaningful. Look for programs that are welcoming, flexible, and willing to make supports available when needed. Your child’s pediatrician or therapist may also be able to suggest options that match their developmental level.

A Family-friendly Rule of Thumb

Try starting with one activity at a time, especially during busy school seasons. After a few weeks, ask: Is my child enjoying this? Are we still eating dinner together sometimes? Is there time for homework, sleep, and unstructured play? Are we calmer…or more stressed?

If the activity is helping your child grow and still leaves room for family life, great. If not, it is okay to make a change. Parenting is not about creating THE perfect schedule. It is about noticing what your child and your family need right now.

The Bottom Line

Activities can enrich childhood, but they should not take over childhood. The goal is not to do everything. The goal is to help your child feel supported, confident, curious, and connected – while still protecting time for rest, play, and family.

 

Headshot of NESCA Pediatric Neuropsychologist Dr. Luisa Hernandez MedellinAbout the Author

As a bilingual pediatric neuropsychologist, Dr. Hernandez Medellin conducts comprehensive and culturally sensitive neurodevelopmental and neuropsychological assessments, comprehensive diagnostic evaluations, and effective care plans, providing appropriate recommendations for the client’s school, home, and the community. She specializes in the identification and assessment of neurodevelopmental disorders such as Autism Spectrum Disorders, ADHD, developmental and learning disorders, and their co-occurrence with anxiety and mood disorders. She also works with children and young adults with acquired brain injuries, epilepsy, brain tumors, strokes, general medical conditions, and genetic disorders affecting the nervous system. She is a native Spanish-speaker, passionate about serving the eclectic and vibrant South Florida community, as well as international patients looking for high-quality and compassionate care.

To book evaluation services at NESCA in Coral Gables, Florida, complete NESCA’s online intake form. 

To book a neuropsychological evaluation or other services at NESCA’s New England offices, 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; the greater Burlington, Vermont region; and Miami/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 putting forth effort on an exam and a quote from a NESCA clinician

The Right Praise Leads to Grit – Part 2

By | NESCA Notes 2026

Image of a student putting forth effort on an exam and a quote from a NESCA clinicianBy Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

In my last blog, I discussed why the right kind of praise matters for students. In Part 2 of my blog series about Praise, I’m going to discuss how the right kind of praise leads to students having grit or perseverance. Grit or perseverance is often understood as sustained effort toward a achieving a goal. Research links grit, self-regulated learning, and resilience with students’ engagement and persistence in challenging academic tasks as the ability persist through challenges, setbacks, and failures.

In Part 1, I discussed Carol Dweck’s research that distinguished praising intelligence versus praising effort. When students are told they are “smart,” their identity gets “locked in” on being/appearing smart, so they avoid difficult tasks that could expose them to failure or being perceived as “dumb or not smart.” Therefore, praising effort encourages a “growth mindset,” which is the belief that abilities can develop through learning, practice, and persistence.

This idea connects directly to grit. Praising effort naturally encourages grit. It teaches that productive failure is part of the learning process and prepares students for setting long-term goals or assignments that are challenging. It prepares them for life! Failure should be viewed as a part of life and learning, and not associated with shame or a permanent label. Failure can be used as a jumping off point to explore where the breakdown happened. This is why we praise “productive failure.” It encourages students to ask questions about what happened and move forward with curiosity. Grades should not be ignored, but they should not be the sole object of praise. Instead, use good grades as a recognition of mastery of content, study habits, effort, perseverance, practicing the hardest problems, asking for help when needed, and revising mistakes, etc.

Teachers and parents should praise actions instead of results or identity labels. Instead of saying, “You’re such a math whiz,” try saying, “You stuck with those confusing word problems and kept trying a different approach, that’s great.” Or instead of, “You failed the test,” one can offer, “This test score shows me that you didn’t really understand this concept or study in a way that allowed you to master the content.” These types of phrases show students that failure and setbacks are temporary and actionable – not permanent.

A growth mindset allows students to approach life with an openness that allows them to fail, make mistakes, and be/feel okay about themselves. It does not define who they are as a person! Praise about the process they took or the effort they put forth helps students develop intrinsic motivation, resilience, and greater challenge-seeking behaviors. They don’t see themselves as a failure and won’t give up as easily. Remind them that failure is part of learning, and building grit will carry them forward in future endeavors. Praising effective strategies, improvement, and sustained effort can help students develop resilience. Ultimately, praise that emphasizes the process of learning can strengthen the mindset that supports grit, helping individuals persist because they understand that effort can lead to growth.

As we send students back to school for the new academic year, remember the impact that giving the right kind of praise can make in the short- and long-term in helping them to build both a growth mindset and grit in their school life and life in general.

 

Resources:

“How to Encourage Academic Grit and a Growth Mindset in Your Students”
By Princy Quadros-Mennella, PhD, Associate Professor of Psychology, Director of the Neuroscience Program, Bay Path University and Thomas Mennella, PhD, Associate Professor of Biology Director of the M.S. in Applied Laboratory Science and Operations Program, Bay Path University
https://www.academicimpressions.com/how-to-encourage-academic-grit-and-a-growth-mindset-in-your-students/

Psychologist Angela Duckworth’s research about grit:
https://www.angeladuckworth.com

https://americanradioworks.publicradio.org/features/tomorrows-college/grit/angela-duckworth-grit.html

 

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 clinicians, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant/service in the referral line.

NESCA is a pediatric neuropsychology practice and related services center 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 parent praising a student with a high five and a quote from a NESCA provider.

The Right Type of Praise Matters – Part 1

By | NESCA Notes 2026

Image of a parent praising a student with a high five and a quote from a NESCA provider.By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

I just returned from consulting to a couple of schools in Honduras. While there, I met with teachers, parents, and students, and provided workshops to the teachers there. I have been honored and excited to consult to these schools and to witness the teachers implementing the lessons gained from our workshops, showing how they have positively shifted their habits and practices as they have welcomed students back for their new school year.

On the first day of school at one of the schools, the graduating seniors lead a pep rally for the whole school, and it was exhilarating. Watching this assembly then witnessing all of the students – not just the seniors – go to their classes with enthusiasm, excitement, and optimism was palatable.  The whole experience energized the entire student body and faculty alike. My goal in all my school consults is to help teachers keep this spirit and enthusiasm alive within their students throughout the whole school year.

One of the workshops I gave was on how to keep students’ motivation, optimism, and positive self-worth alive. Most students start off the year with a positive attitude and hope for the future, but as the school year progresses these feelings tend to shift and wane. Sometimes this shift is influenced by how the adults in the student’s life provide feedback. Teachers, parents, and caregivers can sometimes provide feedback that turns the student off to working harder and trying difficult tasks. When we say things like, “You’re so smart,” “You got an A,” or “You’re a great creative writer,” we are praising a person’s worth on achievement, talent, results, and intelligence. Grade-, intelligence-, and achievement-based praise, or results-driven praise places a student’s worth on the final result. Praise that encourages effort, grit, and perseverance activates the brain to keep going with an attitude of, “I can do it,” “I’ll try even if it is hard,” or “I’m good enough even if I make a mistake.” It fosters the mindset that their self-worth isn’t tied up in getting the good grade or isn’t attached to being intelligent.

Psychologist Carol Dweck’s research on the growth mindset highlights how powerful this difference is when students are confronted with difficult work or failure. Dweck’s growth mindset research contrasts the belief that intelligence is fixed with the belief that ability can develop through practice, effective strategies, feedback, and help from others. When teachers, parents, and caregivers repeatedly praise grades, intelligence, or talent alone, students then infer that they have to be smart, successful, and can’t make mistakes to be loved (by parents) and valued and respected (by teachers). Thus, when a student gets a disappointing grade, it feels like evidence that they are not good enough or smart enough, which often leads to feelings of unworthiness and a lack of risk-taking behavior related to academic challenge. Studies conducted by Carol Dweck and fellow Stanford psychologist and research director Claudia Mueller showed that students who were praised for their intelligence after achieving a good grade were more likely to choose easier tasks afterward and showed weaker performance following failure than students who were praised for their effort. In contrast, the effort-praised students demonstrated greater persistence, enjoyment, and post-failure performance, choosing a more difficult test to complete than their counterparts. For more on this, watch this YouTube video: Carol Dweck – A Study on Praise and Mindsets – https://www.youtube.com/watch?v=NWv1VdDeoRY.

Adults should use praise to their advantage to help students keep their beginning-of-the-school-year optimism, excitement, and positive attitude alive all year long. Praise should communicate that students are more than their grades and that they are enough! By honoring solid effort, thoughtful strategies and attempts, perseverance, and learning from mistakes, teachers and parents help students develop the confidence to attempt difficult things and the resilience to continue even when success does not come naturally.

 

Resources:

Carol Dweck – Praising Intelligence: Costs to Children’s Self-Esteem and Motivation
https://bingschool.stanford.edu/news/carol-dweck-praising-intelligence-costs-childrens-self-esteem-and-motivation

Claudia Mueller and Carol Dweck – Praise for intelligence can undermine children’s motivation and performance.
https://psycnet.apa.org/record/1998-04530-003

 

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 clinicians, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant/service in the referral line.

NESCA is a pediatric neuropsychology practice and related services center 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 parents meeting with educators

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

By | NESCA Notes 2026

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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