NESCA’s Newton, MA location has immediate availability for neuropsychological evaluations. Our MA clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing.

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

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NESCA Notes 2026

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Image of a student being testing in school

When School-based Testing Is Not Enough

By | NESCA Notes 2026

Image of a student being testing in schoolBy: Sean Hyde O’Brien, Psy.D., ABPdN 
Pediatric Neuropsychologist, NESCA

Often when a child is struggling at school — whether related to academic, behavioral, or social-emotional functioning — they may be referred for testing by a member of their educational team (often at the parents’ request). Such testing can include psychological, educational, speech-language, occupational, and physical therapy assessments conducted by qualified school personnel, as well as more specialized transition, functional/adaptive behavioral, and autism-related assessments. These evaluations are generally conducted to determine a student’s eligibility for special education services, identify appropriate supports, and establish goals to monitor progress.

In many cases, school-based testing is sufficient to meet the needs of the student and family by facilitating access to services and supports. However, there are situations in which school-based testing may not be sufficient on its own:

Need for a Clinical Diagnosis
School evaluations are designed to determine eligibility for special education services under educational categories (e.g., “Health Impairment,” “Specific Learning Disability,” or “Sensory Impairment”), rather than to establish diagnoses for medical or treatment purposes. When a formal diagnosis is needed to guide treatment, medication decisions, or access to private insurance-based services, a neuropsychological evaluation may be necessary.

Complex or Co-occurring Issues
Neuropsychological evaluations are designed to integrate information across multiple domains, offering a more comprehensive understanding of the student as a whole.

Disagreement with School Findings
If parents have concerns about the conclusions or recommendations from a school evaluation, they may pursue an Independent Educational Evaluation (IEE) or seek private testing with a neuropsychologist to obtain an additional perspective.

Evaluation of Non-academic Concerns
Concerns such as anxiety, depression, trauma, or family stressors — which can significantly affect learning — may fall outside the primary scope of school-based testing and may be more fully explored through a comprehensive neuropsychological evaluation.

Legal or Eligibility Requirements
Certain services, accommodations, or agencies (such as Social Security Disability benefits, specific therapies, or independent schools) may require documentation or diagnoses from a licensed clinical provider. Neuropsychologists are licensed psychologists with specialized doctoral and post-doctoral training in brain-behavior relationships who can provide this type of documentation when needed.

In summary, school-based testing is often a valuable and important first step in understanding a child’s needs within the educational setting. In some cases, however, a comprehensive neuropsychological evaluation can provide additional insight into a student’s profile as well as medical documentation needed to access a variety of services.

 

About the Author

Dr. Sean O’Brien has been providing comprehensive neuropsychological evaluations in the GreaterSean Hyde O'Brien Boston area since 2006. He specializes in the assessment of children and adolescents who present with a wide range of developmental conditions, such as  Attention-Deficit/Hyperactivity Disorder, Specific Learning Disorder (reading, writing, math), Intellectual Disability, and Autism Spectrum Disorder; as well as children whose cognitive functioning has been impacted by medical, psychiatric, and genetic conditions. He also has extensive experience working with children who were adopted both domestically and internationally.

To schedule an appointment with one of NESCA’s neuropsychologists, please complete our 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 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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Unbiased Does Not Mean Uninformed

By | NESCA Notes 2026

By Angela Currie, Ph.D.

NH Clinical and Operational Director; Pediatric Neuropsychologist; PSYPACT-authorized

Families often come to NESCA after a long journey through previous evaluations, diagnoses, and educational plans, sometimes feeling frustrated or misunderstood. When seeking a new neuropsychological evaluation, it is common for parents to hope for a “clean slate.” Understandably, some request that we not review prior reports, IEPs, or teacher input, worrying that this information will bias our perspective or simply repeat what’s been said before.

This desire for objectivity is completely valid. If you disagreed with a previous diagnosis or felt that earlier testing missed the mark, it’s natural to want the new evaluator to approach your child or teen without any preconceived notions. However, it is important to understand that unbiased does not mean uninformed¸ and, in fact, review of previous documents and school input is a critical component of a fresh perspective and comprehensive evaluation.

Why Background Information Matters

A comprehensive neuropsychological evaluation is much more than a set of test scores – it is a synthesis of data, history, observation, and context. Reviewing previous reports, IEPs, and teacher feedback is not about accepting others’ conclusions at face value. Rather, it allows the evaluator to:

  • Understand the full picture: Seeing how strengths and challenges evolve over time helps identify patterns, progress, and trajectories, rather than isolated moments in time.
  • Spot gaps and inconsistencies: Previous testing may have missed key areas of possible concern or used measures that just scratch the surface. Knowing what was done helps the evaluator focus on what still needs to be explored.
  • Avoid unnecessary repetition: There are many measures that should not be repeated within a given timeframe, so it is important to know what to avoid. Knowing recent scores also allows the evaluator to avoid unnecessary redundancy and dig deeper into other skills.
  • Clarify and explain differences: If a previous diagnosis or past recommendations are not supported, the evaluator can integrate previous information into a bigger picture explanation for why a shift in perspective is supported.
  • Address discrepancies in presentation across settings: Often times disagreements between families and schools can result from the fact that children and teens may present differently across settings. Integrating teacher input is critical for determining if concerns are consistent across settings or if the client is working hard to compensate and “look good.”
  • Support IEP development and special education due process: Evaluations that lack integration of school records and input are much more likely to be rejected by the IEP team, as they do not provide a complete picture of the child’s functioning. They are also more likely to be viewed as lacking in credibility should the family proceed with special education due process.

Building Trust Through Transparency

Our role as neuropsychologists is to provide an assessment that is both thorough and fair. We approach each client with fresh eyes, critically evaluating all available information. Reviewing past reports allows us to be confident in our conclusions and build on what is already known. This allows for greater clarity and better advocacy for the client’s unique needs. By blending past information with new observations and data, we can provide the most accurate, insightful, and actionable recommendations possible.

If you have questions about how background information is used in our evaluations, please reach out. At NESCA, we believe that true objectivity comes from being informed and that every client deserves an evaluation that tells their whole story.

 

About the Author

Dr. Currie specializes in evaluating children, teens, and young adults with complex profiles, working to tease apart the various factors lending to their challenges, such as underlying learning, attentional, social, or emotional difficulties. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed. She also evaluates adults for concerns regarding ASD and ADHD.

 

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

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; greater Burlington, Vermont, 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 procedures manual and a quote from Dr. Angela Currie

Reflecting on Excellence: How NESCA’s Updated Procedures Manual Sets the Standard for Neuropsychology

By | NESCA Notes 2026

Image of a procedures manual and a quote from Dr. Angela CurrieBy Angela Currie, Ph.D.

NH Clinical and Operational Director; Pediatric Neuropsychologist; PSYPACT-authorized

As we undertake our annual update to NESCA’s comprehensive procedures manual, it’s a moment to reflect on what truly sets our practice apart. The level of structure and support can vary widely in private neuropsychological practices. However, at NESCA, we have intentionally built a model that prioritizes a high degree of structure, explicit expectations, and robust support for our neuropsychologists. We believe this approach ensures the highest quality of care for our clients and the greatest professional growth for our clinicians. Our neuropsychology procedure manual is not just a set of rules; it is a living document that embodies our commitment to excellence.

A Culture of Structure and Accountability

Few neuropsychology practices can claim to have an employee procedures manual as comprehensive, and as regularly updated, as NESCA’s. Our manual is reviewed and revised annually to reflect the latest best practices, regulatory changes, and the evolving needs of our clients and staff. This level of procedural clarity is a hallmark of our commitment to excellence.

From the moment a referral is received, every step – intake documentation, insurance, file management, scoring protocols, feedback, and report writing – is governed by clear, detailed procedures. Our clinicians are never left to guess what is expected, as there are explicit expectations and timelines for every stage of the evaluation and reporting process. These standards are tracked and reinforced by clinical directors.

Unmatched Oversight and Training

At NESCA, oversight is about ensuring quality and fostering growth. New staff are onboarded with in-person training and have direct access to clinical directors for case consultation and procedural questions. We not only have real-time clinical support, but we also have a strong administrative team that can troubleshoot anything from an IT issue to ordering supplies. Thanks to the roles clearly defined in the manual, there is never a question about who to go to when these needs arise.

Although many practices see frequent psychometrician turnover, NESCA has had a consistent, strong team of psychometricians who are committed to excellence in scoring. The procedures manual outlines standardized procedures for scoring, data management, and file security, and clinicians are responsible for cross-checking all data. Although rare, errors are addressed through direct feedback, and there is a clear chain of communication for resolving issues that arise. This system of checks and balances helps ensure the accuracy and integrity of our clinical data, allowing clinicians and clients to feel confident in their findings.

A Commitment to Professional Development

NESCA’s oversight goes hand-in-hand with our commitment to professional development. Not only do we provide regular staff training, our procedures manual includes guidance on matters such as efficient report writing, guidance for legal hearings, insurance requirements, and the latest assessment technologies. We emphasize ongoing education, with recommendations for tracking CEU workshops and maintaining up-to-date curriculum vitae (CVs).

Why This Matters

Neuropsychology is complex, and the stakes are high. Clients come to us seeking answers and guidance for some of life’s greatest challenges. By providing a highly structured, supportive environment, NESCA ensures our clinicians deliver the highest standard of care – consistently, efficiently, and ethically. NESCA emphasizes strong systems and a culture of continuous improvement. This benefits our staff, our clients, our referring partners, and the field as a whole. NESCA leads the way by valuing structure, mentorship, and excellence. We don’t just set the bar – we raise it every year.

And on that note, I better get back to updating that manual – after all, the bar isn’t going to raise itself.

 

About the Author

Dr. Currie specializes in evaluating children, teens, and young adults with complex profiles, working to tease apart the various factors lending to their challenges, such as underlying learning, attentional, social, or emotional difficulties. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed. She also evaluates adults for concerns regarding ASD and ADHD.

 

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

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; greater Burlington, Vermont, 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 struggling to write and a quote from Alissa Talamo, Ph.D.

Why Does My Child Struggle With Writing?

By | NESCA Notes 2026

Image of a student struggling to write and a quote from Alissa Talamo, Ph.D.By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

A concern I often hear from parents is that their child is bright, creative, and articulate—able to express ideas clearly in conversation—but gets “stuck” when asked to put those same thoughts into written form. Instead of demonstrating the full extent of their knowledge, these children often write just enough to complete the assignment, leaving teachers and parents wondering what’s holding them back.

Difficulties with written expression can arise for a variety of reasons. For some children, an expressive language disorder makes it challenging to find the right words and organize their thoughts on paper. Others may have fine motor difficulties, making the physical act of writing laborious and frustrating. Children who struggle with spelling often limit themselves to simple words, even if their spoken vocabulary is much richer. These challenges are relatively straightforward to identify, but there are many children who don’t fit these patterns—children who seem to have all the necessary skills yet still find writing to be an uphill battle.

In these cases, neuropsychological testing often confirms what parents already suspect: the child is intelligent, insightful, and capable of high-level thinking, but something is interfering with their ability to express themselves in writing. One of the most common underlying issues is difficulty with executive functioning. Executive functioning is a set of mental skills that includes planning, organization, time management, working memory, attention control, task initiation, self-monitoring, impulse control, emotional regulation, cognitive flexibility, goal setting, and problem-solving. Writing is a uniquely demanding task because it requires the simultaneous use of many of these skills. To write effectively, a student must generate ideas, organize those ideas, keep track of them in working memory, and attend to mechanics like spelling, punctuation, and grammar—all at the same time. It’s no wonder that writing can feel overwhelming!

The good news is that once a child’s specific areas of weakness are identified, there are many strategies and supports available to help them improve their writing skills. Executive functioning tutoring can be especially beneficial, teaching students how to use graphic organizers (such as compare/contrast charts, part/whole relationships, or cause/effect diagrams) and writing templates to structure their thoughts. Tutors can also help students develop strategies for catching mistakes that result from inattention to detail, such as errors in grammar, spelling, or capitalization. In addition, tailored recommendations can be made for in-class support, allowing the student to build their writing skills in a supportive environment.

Why Neuropsychological Testing Can Make a Difference

If your child is struggling with writing, neuropsychological testing can be an invaluable tool. This comprehensive assessment goes beyond surface-level observations to identify specific strengths and weaknesses in cognitive, language, motor, emotional, and executive functioning skills. By pinpointing the root causes of writing difficulties, neuropsychological testing provides a roadmap for targeted interventions and accommodations. With the right supports in place, children can overcome barriers to written expression, gain confidence in their abilities, and more fully demonstrate their knowledge and creativity—both in school and beyond.

 

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

NESCA is a pediatric neuropsychology practice and related services center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; 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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