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NESCA Notes 2019

Music and the Mind – Musicianship Impacting Executive Functions

By | NESCA Notes 2019

By: Zachary Cottrell, Psy.D., LMHC

Pediatric Neuropsychology Fellow, NESCA

At NESCA, we work with many children with ADHD and issues with executive functions. Fortunately, there is a wide variety of interventions that can be used to aid executive function development, such as martial arts, aerobics, yoga, mindfulness and cognitive-behavioral therapy. However, another option to keep in mind is learning a musical instrument. Most children are naturally drawn to music, and recent research suggests that musical training can positively influence the development of executive functions.

In 2014, Dr. Nadine Gaab at Boston Children’s Hospital found that adult musicians had stronger working memory, greater cognitive flexibility and verbal fluency than non-musicians. Child musicians showed better verbal fluency and faster processing speed than non-musicians. fMRI scans showed that child musicians have more activation in the frontal regions of the brain – the home of executive functions – than non-musicians. Dr. Gaab’s study concludes that children who study music have stronger executive function skills and that studying music may build those skills. For the full details and results of the study, a link is provided below.

In another 2014 study, Dr. James Hudziak at the University of Vermont found that playing a musical instrument was associated with more rapid cortical thickness maturation within the areas of motor planning and coordination, visuo-spatial ability, and emotion and impulse regulation, the latter being correlated with increased executive functions. For the full details and results of the study, a link is provided below.

So, what do these studies really show us? Basically, learning a musical instrument can improve and strengthen our executive functions, such as planning and organizing, working memory, processing speed, task management and initiation as a whole. Musical performance requires a high level of active engagement, which leads to less off-task behaviors. While engaging in music, the individual is more likely to be practicing such skills as attending, inhibiting and shifting. Additionally, musical training involves significant demands on working memory for processing auditory, visual and tactile cues simultaneously. Working memory is required for learning any complex activity, such as understanding language. There are plenty of research studies that show correlating executive skills in musicians and bilinguals.

In my experience as a therapist and when teaching music, these skills are highly translatable to other forms of learning. Music is not only rewarding and fun, but is also effective in developing and improving executive functions. Below are some links for further reading and exploration.

 

 

Book:

This Is Your Brain on Music: The Science of a Human Obsession, by Daniel J. Levitin

Articles:

Investigating the impact of a musical intervention on preschool children’s executive function (Bowmer, et al., 2018)

References:

Behavioral and neural correlates of executive functioning in musicians and non-musicians (Dr. Nadine Gaad, et al., 2014)

Cortical thickness maturation and duration of music training: health-promoting activities shape brain development (Dr. James Hudziak, et al., 2014)

 

About the Author: 

Formerly a therapist, Dr. Cottrell has extensive experience working with children, adolescents and emerging adults as a therapist, behavioral health consultant and evaluator in community, college, private practice and hospital settings. At NESCA, he provides thorough and in-depth neuropsychological evaluations to support youth to not only develop, but also to maximize, their potential. Dr. Cottrell is a graduate of William James College, participating in the Doctorate of Psychology in Clinical Psychology Program. Dr. Cottrell also has 25 years of experience with the guitar, performing and teaching music. 

Dr. Cottrell recently completed a 2 year APA internship placement at North Shore Medical Center (Salem, Mass.) where he was immersed in the world of neuropsychological, personality, psychological and educational testing at the Neuropsychological Assessment Center at MassGeneral for Children. While there, Dr. Cottrell’s work predominantly involved providing evaluation and consultation to children, adolescents and adults with ADHD, ASD, learning disabilities and other neurocognitive developmental and behavioral concerns in addition to providing psychological evaluations to adult patients considering bariatric surgical procedures.

 

To book an evaluation with Zachary Cottrell one of our expert neuropsychologists, complete NESCA’s online intake form

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

8 Tips You Need to Know about SAT and ACT

By | NESCA Notes 2019

 

By: Dina Karlon, M.A.
Transition Specialist, NESCA

Starting to think about the college admissions/testing process? It can be costly and confusing, so we’ve compiled some tips to help you navigate the testing landscape.

Tip 1 – SAT or ACT – Which test should a student take? Most colleges will take either, but there are differences to the tests. SATs, which were revamped a few years ago, has Reading, Math and Writing, while the ACT adds a Science section. SAT questions assess problem-solving abilities, while ACT questions are more fact-based, similar to school testing. Typically, SATs use much higher-level vocabulary than the ACT. The ACT tests math concepts through trigonometry, while SATs stop at geometry. SAT divides its scores into two areas – Reading/Writing and Math, with a perfect score of 1600 (800 for each). ACT scoring is based on 4 sections that are averaged into a composite, with a perfect score of 36. While SAT is more well-known by many New Englanders, the ACT is taken slightly more often, having gained popularity in the past 5 to 10 years. A student may prefer one test over the other if the individual:

Still not sure which one to take? Visit the tests’ websites to take/score a practice test. See which one may be better through this conversion chart: https://www.studypoint.com/ed/sat-act-concordance/.

Tip 2 – SAT Subject Tests – In addition to the general SAT, students can register for tests in specific subject areas. There are 20 specialized tests, and an individual would usually only take 2, if any. Most colleges do not require them, although a student may take them to demonstrate a strong interest or aptitude in a subject or area of passion. For example, a bilingual student could demonstrate proficiency in a language. Subject tests could be a way for students to strengthen their application among similar candidates. If a student wants to major in a science, a strong score on a science subject test could set that person apart from others.

Tip 3 – Apply Early – Standardized testing is pricey, and hidden costs can creep up. Register early to avoid late or waiting list fees. Doing so also allows students to reserve a slot at their own school (if offered there). Whether students are neuro-typical or not, there is comfort in taking tests in one’s own school. For students with anxiety, it is very important, as familiarity with their environment can reduce anxiety.

Tip 4 – Vouchers – Visit SAT and/or ACT sites to determine eligibility for test fees being waived through a voucher. Work with high school counselors to obtain a waiver.

Tip 5 – Costs – There are registration fees for standardized tests. The current fees for the exams are:

There’s good news for New Hampshire residents. A few years ago, the SAT replaced the New England Common Assessment Program (NECAP) as the state test for high school juniors. Therefore, all juniors have the opportunity to take one free SAT. Factor this in for next year, as the deadline to take the test is in March.

Tip 6 – Free Test Scores Sent to Colleges – To lower costs, take advantage of having 4 free test scores sent to colleges. When you register to take both the SAT and ACT, students have the option to send up to 4 tests to 4 colleges at no charge, saving $52 ($13 per test) for the ACT and $48 ($12 per test) for the SAT. Individuals have up to nine days after taking the SAT test to register for score reports. It’s best to sign up for them when you register as it’s easy to forget to do so after. Some students may not opt to do this because they want to see their scores before they are sent to colleges. The benefit of sending them with the SAT is – regardless of your scores – if taken again, a person’s entire history will be sent to colleges where they take the highest score from each section. For example, if a student scores a 400 on English and a 500 on Math in April, then chooses to retake the test in October and scores a 500 on English and a 400 on Math, the school will take the two 500 scores for a total of 1000. If a student is very unhappy with a score on a particular day and they don’t want a college to see that score, students can research whether the schools they are applying to will accept score choice. While this may be an option, it will incur an additional fee. In general, I recommend sending all of the scores and letting the admissions team select the highest. With ACT, score histories are not sent to colleges. Instead students pick a specific test date’s scores to send. Unlike the SAT, if a student gets a higher score in separate sections on various test dates and wants the colleges to see the scores from each test date, they will have to pay for each test date’s score to be sent.

Tip 7 – Accommodations – The process for requesting accommodations and when to apply for them is different for each test. Check the SAT and ACT websites for exact processes for each. Here are some tips:

– Apply early as it can take up to 7 weeks to hear which accommodations are approved. Accommodation request applications may be due at the time one registers for the test – or even before.

– Students should talk with their SAT/ACT school representative about accommodations. While ACT only accepts requests through students’ schools, SAT allows students to apply for accommodations independently. I recommend working with the Accommodations Coordinator at the high school (school counselors will know who this is).

– It is up to SAT and/or ACT if they will allow students accommodations, not the high school.

– Once accommodations are determined for a school year, students can take the test several times (though it’s not recommended to take it several times each year) and not have to reapply for accommodations. SAT accommodations last for one year after high school graduation.

– Lists of accommodations and procedures for requesting them are at: https://www.understood.org/en/school-learning/partnering-with-childs-school/tests-standards/how-to-apply-for-sat-and-act-accommodations.

Tip 8 – Test-optional Schools – Some of us just don’t test well and are terrified of taking such tests. If a student doesn’t feel standardized tests reflect their academic ability and don’t want them considered in their admissions application, consider applying to test-optional schools. These schools review admission materials (transcript, recommendations, etc.) to determine if a student is a good fit for their institution. Here is a list of test-optional schools: https://www.fairtest.org/university/optional.

References

SAT website: Collegeboard.org

ACT website: ACT.org

https://www.understood.org/en/school-learning/partnering-with-childs-school/tests-standards/how-to-apply-for-sat-and-act-accommodations

https://www.understood.org/en/school-learning/choosing-starting-school/leaving-high-school/sat-or-act-how-to-know-which-is-best-for-your-child

https://www.huffpost.com/entry/differences-between-the-s_b_3451049

 

About the Author: 

Dina DiGregorio Karlon, M.A., is a seasoned counselor who has worked as both a school counselor and vocational rehabilitation counselor, guiding and coaching students and adults through transitions toward independence in both college and the working world. With NESCA, she offers transition assessment services in Londonderry, New Hampshire as well as transition planning consultation and coaching to students and families throughout New England.

 

To book an evaluation with one of our expert neuropsychologists, complete NESCA’s online intake form. To book Transition Services in N.H., ask for Dina Karlon. 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Staying Values-driven During Growth: A Director’s Update

By | NESCA Notes 2019

By: Ann Helmus, Ph.D.
NESCA Founder/Director

It’s finally Spring here in New England – and we are seeing signs of growth and emergence from the winter. At NESCA, we’ve had our own exciting growth over the past few months:

  • In Londonderry, N.H., we brought Dina Karlon on full-time as a Transition Specialist, guiding students and young adults to their next life transition – moving from high school to college, taking a gap year, finding the right residential living environment or entering the workforce.
  • We opened a new office in Plainville, Mass. to serve clients in South Eastern Mass. and Rhode Island communities, with Pediatric Neuropsychologists Reva Tankle and Erin Gibbons available to take on evaluations in the region.
  • Dot Lucci joined our practice to direct our Consultation Services to families, schools, school districts, colleges and universities, businesses and community groups and agencies in Mass., R.I., and N. H.

While growth within an organization is exciting, it’s not without its risks. In previous work experiences, I’ve seen once thrilling and uplifting growth changes turn to a loss of values and culture, and confusion about an organization’s vision. With the recent growth NESCA has experienced, it’s led me to pause and reflect on who we are as a team.

At our core, we are a neuropsychological and educational services organization whose clinicians and practitioners are passionately driven both individually and as the NESCA team to do their best to help children, adolescents, young adults and their families get the information and support they need to be their best. We hire truly committed and dedicated neuropsychologists who want to live, eat and sleep neuropsychology. We take the time to work with families and individuals to unravel stories, dig into their concerns or struggles and identify the correct diagnosis/es (if warranted). Each clinician takes the time to develop relationships with individuals, often through multiple evaluation meetings, school or community observations and talking to stakeholders in the individual’s life to get a complete picture of each and every individual we evaluate. We aren’t about churning out reports or handing off evaluations to less experienced clinicians. Yes, we get reports out in a timely and expected manner, but not at the expense of doing what’s right and being thorough.

We value continued education and strive to stay up on the latest evidence-based treatments. We frequently invite professionals in to meet with our team and present on new resources, treatments, etc. We are always learning through formal continued education courses, the speakers we host, and most importantly, our own NESCA team.

The NESCA team is comprised of dedicated professionals who have grown their networks over the course of many years, both in discipline and geography, and use these connections to benefit our clients. If one of our clinicians is challenged with identifying the right camp, therapist, or other resource for a client, chances are very good that one of our clinicians has built – not just a knowledge base of referrals to recommend – but relationships there as well. If there is a particularly challenging case, our clients benefit from our entire team of experienced clinicians’ insights, ideas, recommendations, perspectives, experiences and resources to help. In fact, we meet on a weekly basis as a team to discuss these cases and come to the best conclusions and recommendations as a cohesive team. That’s why we can take on the difficult, complex cases and come out with the right diagnosis/es and recommended next steps and strategies.

We’ve carefully built and nurtured a work environment where we all feel supported by each other and by the company. NESCA’s staff knows that they aren’t being pushed to rush through neuropsychological evaluations to get the next client in the door. That would only be penny-wise and pound-foolish and would completely fly in the face of our values-based principles that guide our work daily.

Our staff – both new to NESCA and those who have been with us for years, if not from our inception – know they have my full support to conduct the best, most thorough and comprehensive evaluations. This is how we get to know, develop and foster relationships with our clients for years, all the while helping them succeed academically and in life. I’m proud to say that many of our staff clinicians and clients have been with NESCA for many years. As we grow, we will continue to evaluate the efforts we are putting forth to not just maintain but enhance who we are and what we do here at NESCA.

 

About the Author: 

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

 

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists, complete NESCA’s online intake form. To book an evaluation in Plainville, ask for Reva Tankle on the intake form. To book Consultation Services, ask for Dot Lucci. To book Transition Services in N.H., ask for Dina Karlon. 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

 

What is Working Memory and How Can We Address It?

By | NESCA Notes 2019

By: Nancy Roosa, Psy.D.
Pediatric Neuropsychologist, NESCA

Melanie is a sweet, hard-working 11-year-old girl whose parents brought her to NESCA for an evaluation to try to understand why she was struggling in school. Melanie was a cheerful, vivacious girl who seemed intelligent, curious and articulate. But she was barely getting by in fifth grade, putting in hours on homework every night on assignments her teachers thought should take 30 minutes. Her parents were concerned about how she was going to manage middle school next year.

During the evaluation, Melanie did quite well on most tests. Her intelligence measured in the “Above Average” range, and her academic skills were solid. She worked hard and even did well on a test of sustained attention. So, it was clear she did not have a classic case of attentional dysregulation.

Upon further analysis, a few striking results emerged. Melanie had a good ability to remember information or work on structured tasks, but got confused on multistep tasks. One important result: she was able to remember and repeat back long strings of digits when repeating them verbatim, but she really struggled when she had to repeat them in reverse. The mental manipulations involved flummoxed her.

This is working memory: the ability to hold multiple bits of information in memory banks while there is another, distracting bit of information processing going on. Working memory is the “working” part of memory, as it holds information long enough for us to use it or store it away in longer-term memory banks. Analogies can be made to computer storage, where current information is held while processing occurs; or a mental chalkboard, where we jot down our ideas while working out a problem. For some children, like Melanie, that computer storage or chalkboard space is quite limited, causing difficulty with many aspects of learning. As a first grader, Melanie easily learned the sounds of letters, but it was harder for her to remember and apply that knowledge while reading words. Similarly, she easily learned math facts, but got stymied on multistep math problems. Finally, she had trouble with multistep directions. When her parents or teachers told her three things to do, her response was typically, “Wait, what?”.

Melanie’s parents were right to be concerned about middle school, since this is when students are presented with more complex assignments, such as lengthy reading and writing assignments, PowerPoint presentations and many other multistep projects, which were going to be hard for her.

Working memory deficits are related to other cognitive processes. Children with attentional regulation deficits or learning disabilities often – but not always – have working memory deficits. However, every child is unique, with an individual set of strengths and weaknesses. Therefore, a comprehensive and well-done evaluation is essential to clarify a child’s specific profile – a vital first step in crafting an appropriate plan for support and treatment.

Now that we identified Melanie’s difficulties as primarily due to working memory deficits, how do we help her?

My recommendations centered first on the types of accommodations Melanie would need in school to manage an uptick in demands.

  • Any complex or multistep assignment needed to be presented in writing so Melanie can refer back to the directions. She should be shown completed models and provided with scoring rubrics.
  • Melanie might need support from a learning specialist to manage complex tasks, by dividing them into component parts, then completing each part and integrating the whole.
  • Melanie should not be expected to take notes while simultaneously listening to a teacher’s instruction. She should be provided with notes or given an outline of the teacher’s talk that she could fill in.
  • Melanie’s pace of work was slow, given the need to frequently check back and remind herself what she was doing. Therefore, teachers should consider giving her shorter homework assignments that focus on quality not quantity, and extra time to complete tests and assignments.

We also discussed the strategies that Melanie would need to learn to compensate for working memory deficits. She was already using some important strategies, likely based on coaching from some talented teachers in her past. She knew she needed to write things down to remember them, so she had become good at creating outlines before she started writing and drawing pictures of math problems. However, as assignments got longer, Melanie was going to need additional strategies. For example, for lengthy reading assignments, Melanie might need to jot down sticky notes on pages or develop an ongoing “story board” to keep track of main character descriptions or plot points.

Once the family brought this information to Melanie’s educational team, they were able to meet and establish important accommodations, including time to work with a learning specialist several times weekly. The team also agreed to continue to monitor her ability to manage future challenges.

Beyond accommodating working memory deficits, there is ongoing research into programs that could actually improve an individual’s working memory. The hope is that by targeted practice, one could strengthen one’s working memory the way we strengthen muscles by working out at the gym. Despite a great deal of research, the preponderance of evidence does not indicate that these kinds of training programs are effective in improving working memory, except on the specific tasks used in the training program itself. At NESCA, we remain optimistic that further research and refinements will eventually yield more promising treatments.

Finally, one of the most important outcomes of the evaluation was a feedback session with Melanie herself, where I explained her learning profile to her in age-appropriate terms. My goal was to help her appreciate her many strengths and understand that her learning challenge was relatively small and specific. She might have to work harder in certain ways, but would be able to be successful in school and life.

At NESCA, we find that when a child is old enough to process this information about their profile, it is vital to provide it. We find that many children, even teenagers and young adults, tend to be black-and-white thinkers. When they struggle in school in any way, they conclude they are “stupid.” It is obviously vital to prevent this kind of global, negative self-concept from developing. Rather, we hope to give the child the self-awareness and confidence to develop and use compensatory strategies, no matter the area of weakness. We need Melanie and children like her to be confident enough to ask a teacher, college professor or even a job supervisor to provide written instructions to a task or go over directions more than once. Our goal is to arm her with enough self-awareness and confidence that she can go into any new situation, as a student or adult, and be successful while not letting her challenges define or limit her.

 

About the Author: 
Roosa

Dr. Roosa has been engaged in providing neuropsychological evaluations for children since 1997. She enjoys working with a range of children, particularly those with autism spectrum disorders, as well as children with attentional issues, executive function deficits, anxiety disorders, learning disabilities, or other social, emotional or behavioral problems. Her evaluations are particularly appropriate for children with complex profiles and those whose presentations do not fit neatly into any one diagnostic box. As part of this process, Dr. Roosa is frequently engaged in school visits, IEP Team Meetings, home observations and phone consultations with collateral providers. Dr. Roosa has also consulted with several area schools, either about individual children or about programmatic concerns. She speaks to parent or school groups, upon request.

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Improving Life Outcomes through Self-awareness, Stress Management and Social Competency

By | NESCA Notes 2019

By Dot Lucci, M.Ed., CAGS

Currently many school districts have social-emotional learning (SEL) goals as part of their mission. They include goals, such as students will: think critically and solve problems; communicate and collaborate effectively; attend to physical, social and emotional health; contribute to and care about their community and world; and, recognize the uniqueness and dignity of individuals of differing religions, classes, ethnicities, sexual orientations, learning abilities and more. These goals are part of what is expected in our workforce and as citizens in general. If children and adults could attain these goals, our world would be a more tolerant and compassionate place.

Given the neurological, psychological, behavioral or cognitive challenges many students diagnosed with Autism Spectrum Disorder (ASD), Attention Deficit Hyperactivity Disorder (ADHD), nonverbal learning disorder (NLD), intellectual disability (ID), anxiety, depression, etc. may have, they will often experience difficulty attaining these goals. Direct teaching as well as embedded instruction of Mindsets, Essential Skills & Habits (MESH) and SEL is imperative for these students to succeed in school, relationships, work and in their own quality of life. In fact, MESH and SEL can help all students with or without special needs. Students of today become the adults of tomorrow. With SEL and MESH instruction, they become mindful, compassionate and socially competent adults – and potentially leaders!

In our consultation work with schools, NESCA focuses on three primary areas that we call the 3-Ss: self-awareness, social competency and stress management. Many adults with learning or developmental challenges have not yet reached their potential because they struggle in one or more of these areas. They do not know who they are and “what makes them tick,” or understand that stress is a part of life that we all deal with. They may struggle to recognize that getting along with and being kind and respectful to others is a necessary part of life, even when we do not agree with others. Some of these adults have advanced degrees but sadly cannot get or keep a job or a relationship. By directly addressing the 3-Ss, we help individuals develop life-long skills to be the best they can be.

Self-awareness

Self-awareness is the ability to recognize one’s strengths/challenges, interests, likes/dislikes, learning style, personality and more. It allows us to self-reflect and accurately identify emotions and thoughts and how they influence our behavior. Being optimistic when dealing with life’s setbacks is also central to self-awareness. As we mature, the ability to make responsible decisions – constructive and respectful choices about personal behaviors based on safety concerns, ethical standards and social norms – also falls under self-awareness.

The earlier we begin to help children develop self-awareness, the better off they are in the long run. Teaching them about their personalities earlier allows them to understand themselves better and themselves in relation to others. Through consultation, we normalize the neurodiversity of learners in a classroom. For example, we may have everyone (teachers and students) complete a learning style checklist and discuss the variety of learning profiles in a class. This makes self-awareness more concrete and accessible to all students.

Social Competency

Social competency allows self-awareness to be applied in relationships with others. Social competency is the ability to establish and maintain healthy and rewarding relationships with others in one’s family, school, community and work. It is what allows us to demonstrate perspective-taking and empathy with others of diverse backgrounds and cultures. It includes knowing the social and cultural norms of behavior and also understanding why demonstrating those matters and helps us to communicate clearly, listen actively, negotiate conflicts, cooperate with others, and ask for help when needed. It can also include nonverbal cues and communication when sharing space with others, which is what makes it possible to ride on public transportation, wait in line, ride in an elevator, watch a movie at a theatre, etc. – all in accordance with unwritten, hidden, yet expected social norms. It is critical to work on social competency from preschool through middle and high school and beyond as the expectations and challenges change throughout our lives – and as we change, too.

Stress Management

No matter how self-aware someone is, stress happens and we need to learn to cope or we will suffer both physically and psychologically. Stress is neither good nor bad – it just is. Therefore, stress management is critical to living a life that is as healthy and satisfying as possible. Stress management is the ability to identify one’s emotions, thoughts, feelings and behaviors, and to regulate them effectively – identifying internal and external triggers, controlling impulses, motivating oneself and developing a toolbox to cope with stress. By teaching stress management skills early on, we help children identify how stress feels in their bodies and how our bodies and emotions are linked. All too often, we tell children to “calm down” without teaching them how and what that actually means. If we teach children and adolescents a variety of ways to calm themselves (breathing, progressive muscle relaxation, mindfulness, exercise, problem solving, etc.), and we offer regular opportunities to practice these skills in a range of settings and activities, our hope is that they will gravitate to those techniques and eventually use them independently and successfully. Teaching children about resilience and optimism is key so they can cope when adversity happens – as we know it will.

By highlighting the 3-Ss in our work, we have witnessed significant growth and a positive impact on students’ learning and ultimately their lives. By directly modeling and teaching these MESH skills, students diagnosed with disabilities improve their understanding of self, others and their ability to manage stress and cope with adversity. We are fostering the development of the adults of tomorrow.

To learn more about NESCA and its consultation services, visit: https://nesca-newton.com/.

To learn more about SEL and MESH, visit:

 

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 Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

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

 

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

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

The Use of Adaptive Behavior Rating Scales in Neuropsychological Assessment

By | NESCA Notes 2019

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

In my work as a neuropsychologist, much of my practice involves assessment geared toward transition planning – the move from high school to college or from high school to the working world. For these cases, I find the use of measures of adaptive behavior skills – day-to-day skills associated with self-care, communication, community navigation, home living, socialization, use of leisure time, and functional academics – to be a critical part of the neuropsychological testing battery.

Historically, adaptive behavior rating scales were developed and primarily used for assessment of intellectual disability. While adaptive behavior has taken rightful prominence in the assessment and diagnosis of intellectual disability – overtaking the importance of intelligence testing – the use of adaptive rating measures also proves quite important to help with transition planning for individuals with a wide range of psychiatric and neurodevelopmental presentations, including those with exceptionally strong cognitive skills.

These measures (e.g., Adaptive Behavior Assessment System – Third Edition; Vineland Adaptive Behavior Scales – Third Edition), which take the form of parent/caregiver or teacher questionnaires/structured interviews, yield detailed information about an adolescent’s readiness for their upcoming transition out of their family’s home. Particularly for bright adolescents with strong academic skills who might, say, present with attention and executive function challenges but have largely been successful in school, an assessment of adaptive behavior skills is often overlooked. However, over the course of my career, I have heard multiple stories of students who have seemed “college-ready” in the traditional sense of the word (i.e., strong academic and cognitive skills) but have suffered “failure to launch” experiences, as they had not learned to take their prescribed medications consistently, never learned to self-regulate their sleep schedule, or were well behind in their capacity to strike a balance between work and leisure activities.

Although the scores obtained on these measures can be a helpful guide, I find that a closer look at the specific components that may point to a need for additional skill development can help generate a sort of “to-do” list for transition planning work. Thus, while at times simply confirming an adolescent’s suspected transition readiness, the administration of an adaptive measure often proves to be a valuable tool to help determine what skill areas need to be targeted prior to the transition and/or supported during the transition.

 

About the Author:

McCormick

Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.

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

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

State Dyslexia Laws – What do they aim to do and how can we aid their success?

By | NESCA Notes 2019

 

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

While in 2013 there were only 22 states that had laws regarding dyslexia, as of March 2018, 42 states have dyslexia-specific laws, and as discussed in the article Dyslexia Laws in the USA: A 2018 Update by Martha Youman and Nancy Mather, 33 legislative bills related to dyslexia were introduced between January and March 2018 alone. These dyslexia laws address such things as dyslexia awareness, teacher training, early screening of risk factors, interventions and accommodations, and rights of individuals with dyslexia. In addition to identifying the need to address these matters, at least 10 states have developed dyslexia handbooks, and New Hampshire (where I practice as an evaluator and consultant) has developed a dyslexia resource guide. With Governor Charlie Baker’s signing of S2607 on October 19, 2018, Massachusetts now joins the list of states with dyslexia training, screening, and intervention mandates.

To see such progress in the identification and intervention of dyslexia is exciting for everyone who is connected to this community. As a pediatric neuropsychologist, I have worked with individuals with dyslexia and related disorders for many years, and in 2017 I had the pleasure of being one of the many professionals involved in the development of the NH dyslexia resource guide. Since that time, it has been encouraging to see a number of school districts embrace training opportunities and develop early screening efforts. While that is so, across the nation several states still do not have dyslexia-specific laws, and most states that do have them continue to experience uncertainty about how to implement said laws. Based on my personal experience and observations, there appear to be some basic steps or efforts that may improve the effectiveness of these efforts:

  • Use the term “Dyslexia.” Historically, the term “dyslexia” has been rejected or discouraged by most schools, instead preferring to label the associated learning profile as a Specific Learning Disability in reading; however, dyslexia specialists and advocates have long argued that this latter term is problematic because it fails to acknowledge the neurobiology of dyslexia and it does not inform interventions, accommodations, and related services with the level of specificity that is dictated by the defined diagnosed label. To address this concern, in 2015 the U.S. Department of Education issued a formal letter clarifying that “there is nothing in the IDEA or [the] implementing regulations that would prohibit IEP Teams from referencing or using dyslexia, dyscalculia, or dysgraphia in a child’s IEP.” Until schools are willing to routinely use the term “dyslexia,” the potential success of dyslexia laws is significantly challenged.
  • Educate families about universal screening and differentiated instruction. The screening and intervention requirements outlined in most dyslexia laws fall within the purview of general education, aiming to identify children with risk factors for learning disabilities and support their needs through multi-tiered systems of support, such as Response to Intervention (RTI). As such, there are not as many defined requirements regarding progress monitoring and reporting, or the coordination of the child’s “team” (i.e. parents, teachers, and other pertinent school personnel), as there would be within special education procedures. Families need to be educated about these universal screening procedures and methods of differentiating instruction within the general education curriculum so that they can understand their child’s challenges and monitor progress in a more informed manner.
  • Coordinate general education and special education screening and evaluation procedures. While the screening and intervention procedures discussed in dyslexia laws are generally within general education, a child should be referred for special education consideration if he or she is not making progress with the increased levels of RTI support. To optimize the utility and impact of the early screenings and to ease the referral process, the criterion that is measured within the general education setting should map onto the criterion for special education eligibility as much as possible; however, should a child require referral for special education consideration, it will also be critical to conduct a comprehensive evaluation of why the child is not progressing, allowing for more individualized and appropriate interventions.
  • Ensure the dissemination of dyslexia handbooks or resource guides. While the dyslexia community is enthused by state dyslexia laws, many teachers and school personnel are not aware of these mandates or the associated resources. These resources are a treasure trove of information about how to delivery differentiated instruction and integrate instructional methods and accommodations that are likely to be helpful for all students.
  • Continue raising awareness. Parents, teachers, and school personnel should all be educated about learning profiles, early warning signs, screening procedures, and interventions. School districts should take advantage of the resources provided by their state, which often includes the availability of a state-appointed reading specialist who can provide training or aid the dissemination of information or development of screening and intervention procedures.

There has been great progress in the recognition, identification, and remediation of dyslexia within American schools; however, this work is only just beginning. At the core of this issue is the need to recognize dyslexia as a defined, neurologically-based learning disability that can be identified at an early age and can be effectively remediated through targeted, evidence-based interventions.

Through our evaluations with students in New Hampshire and Massachusetts, clinicians at NESCA aim to identify and define learning profiles such as these and provide recommendations for targeted instruction as well as systemic support and training. Please visit our website at www.nesca-newton.com for more information.

 

About the Author:

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

 

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

 

 

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

What is executive functioning? – Part 2 – How can adolescents develop these important skills?

By | NESCA Notes 2019

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

Cody is a 17-year-old young man participating in 11th grade. He is a talented runner with a good sense of humor and he has achieved mostly Bs in his college preparatory and advanced college preparatory high school classes. However, Cody’s mother describes him as the kind of kid whose “head would fall off if it was not attached.” Cody has an English tutor who has helped him to organize his thoughts and writing throughout high school. He seems to run out of time with everything—homework, tests, showers, video games—unless his parents and teachers provide him with several reminders. He also has trouble starting and finishing tasks, even things that are important to him. For example, he wanted to apply for a job at Market Basket. His mother has emailed him the online application link three times, but he still had not completed it after two months. Cody wants to go to college and is hoping to be recruited by a men’s cross country team. So, his parents took him to see a neuropsychologist to see if he could qualify for extra time on the SAT. They had heard the term executive functioning and knew that this was an area where Cody struggled, but they did not realize how significant his challenges were until the neuropsychologist shared his test results. Cody and his parents were grateful to have a better understanding of Cody’s learning strengths and challenges and also to learn that executive functioning skills can be remediated throughout the lifespan.

What is executive functioning?

Part 1 of this blog defined executive functioning as the “conductor” of all cognitive skills and identified three main components:

  • Working memory (the ability to hold and manipulate information in your mind),
  • Inhibitory control (inhibiting impulsivity, to pause and think before reacting),
  • Cognitive flexibility (the ability to adjust to changing demands).

Part 2 of this blog post highlights activities suggested to enhance the development of executive functioning and self-regulation skills during adolescence (taken from developingchild.harvard.edu booklet titled “Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence.”). The full guide is available for download and describes many additional activities and games that provide ways for adults to support various aspects of executive functioning and self-regulation in adolescents (Center on the Developing Child at Harvard University, 2014). While neuropsychological evaluation can be extremely important for understanding an adolescent’s executive functioning profile and planning for postsecondary education, there are a number of activities that young people can work on at home in order to build their executive functioning skills.

Here are some examples of activities suggested for adolescents:

  • Goal setting, planning and monitoring
    • Help the adolescent identify short and long-term goals and think about what has to be done to achieve them.
    • Help adolescents be mindful of interruptions (particularly from electronic communication such as email and cell phones).
  • Activities
    • Sports — The focused attention and skill development inherent in competitive sports improve the ability to monitor one’s own and others’ actions, make quick decisions, and respond flexibly.
    • Yoga and meditation — Activities that support a state of mindfulness may help teens develop sustained attention, reduce stress, and promote less reactive, more reflective decision-making and behavior.
    • Strategy games and logic puzzles — Classic games like chess exercise aspects of working memory, planning, and attention.
  • Study skills
    • Break a project down into manageable pieces.
    • Identify reasonable plans (with timelines) for completing each piece.
    • Self-monitor while working
    • When you don’t understand, what might be the problem? Do you know what the directions are? Is there someone you can ask for help?
    • Think about what was learned from an assignment that was not completed well. Was this due to a lack of information, a need to improve certain skills, bad time management, etc.?
    • Keep a calendar of project deadlines and steps needed to complete along the way
    • Identify ways to reduce distractions (e.g., turn off electronics, find a quiet room).

Are you concerned your adolescent’s trouble with getting organized, starting tasks, or keeping his/her emotions in check could be related to executive functioning issues?

There are many things you can do to get the answers you need to best help your adolescent. The most comprehensive way to assess a child’s executive functioning difficulties and determine a cause is a neuropsychological evaluation. A comprehensive neuropsychological evaluation is made up of a set of tests, questionnaires, interviews, and observations that a clinician will use to gain a good understanding of a young person’s strengths and weaknesses, along with learning how the individual processes information and completes tasks. At NESCA, we offer comprehensive evaluations that can look for potential learning disabilities, attentional difficulties, and other challenges that can negatively impact a child’s executive functioning development. In addition, a NESCA evaluation will include explicit recommendations to address challenges that have been identified.

Also, if you want to learn strategies for helping a teenager or young adult develop executive functioning skills, read Part 1 of this blog!

About the Author:
Talamo

With 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 StudentsDr. 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.

 

 

 

To book a neuropsychological evaluation or consultation  with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate that you would like to see “Dr. Talamo” in the referral line.

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

What is executive functioning? How do I help my child develop these important skills? – Part 1

By | NESCA Notes 2019

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

Alexis is a 5-year-old girl midway through kindergarten. She is well-liked, social, and has a strong vocabulary for her age. But her kindergarten teacher has noticed that Alexis has some difficulties in the classroom. Alexis raises her hand often during circle time, but when she is called on she  usually freezes or contributes something unrelated to the class discussion. Alexis also frustrates easily. When her first attempt at an art project doesn’t look like the example, she will throw it away or ask to do something else. And when she is given a multi-step direction to put her work away and get on her coat to go outside, she usually stops working but doesn’t move until she sees what her peers are doing, then she will follow along. Alexis’ parents have always noticed similar challenges at home such as giving up on difficult activities, forgetting where she has left her toys, and freezing when given too many choices or directions. But until her kindergarten teacher mentioned these classroom challenges, and they took her to see a neuropsychologist to better understand her classroom struggles, they did not realize that there was a name for her difficulties: Alexis is struggling with executive functioning.

What is executive functioning?

Executive functioning can be considered the “conductor” of all cognitive skills. Research has shown that executive function and self-regulation skills are critical for learning and development and help a person manage life tasks of all types.  While humans are not born with executive function skills, we are born with the potential to develop them. Moreover, studies show that we can continue developing the skills throughout our lifespans.

Executive function and self-regulation skills include three key components:

  • Working memory (the ability to hold and manipulate information in your mind),
  • Inhibitory control (inhibiting impulsivity, to pause and think before reacting),
  • Cognitive flexibility (the ability to adjust to changing demands).

While neuropsychological evaluation can be a critical step in learning about a child’s executive functioning skills and gaining recommendations for helping to remediate executive functioning challenges, there are a number of activities that parents can initiate to develop executive functioning skills at home.

Part 1 of this blog post highlights activities suggested to enhance the development of executive functioning and self-regulation skills from infancy through age 12 (taken from developingchild.harvard.edu booklet titled “Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence.”). The full guide is available for download and describes many additional activities and games that provide ways for adults to support various aspects of executive functioning and self-regulation in children (Center on the Developing Child at Harvard University, 2014).

Here are some examples of activities suggested for children of different ages.

Ages 6-18 months old

  • Peekaboo —this activity exercises working memory, challenging the baby to remember who is hiding, and also introduces basic self-control skills as the baby waits for the adult to be revealed.
  • Pat-a-Cake — Predictable rhymes that end with a stimulating yet expected surprise. Infants exercise working memory, becoming familiar with the rhyme and anticipating a surprise.
  • Songs or chants with simple hand motions help develop working memory and language. Infants can learn to copy the movements to a song and, with practice, will remember the sequence (e.g., Eensy Weensy Spider; Open, Shut Them).

Ages 18-36 months old

  • Older toddlers can enjoy simple imitation games (e.g., Follow the Leader) which can help develop working memory as well as attention and inhibition.
  • Song games with many movements are also fun (The Hokey Pokey; Head, Shoulders, Knees, and Toes). These require children to attend to the song’s words and hold them in working memory, using the song to guide their actions.

Ages 3-5 years old

  • Encourage children to tell you stories while you write them down. Also, have the children act out stories they have written. The story provides a structure that guides children’s actions and requires them to attend to the story, while inhibiting their impulse to create a new plot.
  • Play matching and sorting activities that promote cognitive flexibility. Children can first sort or match by one rule (such as by color), and then immediately be asked to switch to a new rule (such as by shape).

Ages 5-7 years old

  • Games that require players to remember the location of particular cards are great at exercising working memory (e.g., Concentration).
  • Games in which the child can match playing cards, either by suit or number, are also good to help strengthen cognitive flexibility (e.g., Crazy Eights, Uno).
  • Games that require attention and quick responses help children practice attention and inhibition (e.g., for younger children – Red Light, Green Light or Duck, Duck, Goose; for older children – Simon Says, Mother May I?).

Ages 7-12 years old

  • Games that require monitoring and fast responses are great for challenging attention and quick decision-making in children at this age (e.g., Spit)
  • Physical activities/games help develop a child’s ability to hold complicated rules and strategies in mind, monitor their own and others’ actions, make quick decisions and respond flexibly.
  • Brain teasers (e.g., Sudoku, Rubik’s Cube) require children to be mentally flexible and consider spatial information.

Are you concerned your child’s trouble keeping his/her emotions in check, answering questions in vague or off-topic ways, managing their belongings, or forgetting what comes next could be related to executive functioning issues?

There are many things you can do to get the answers you need to best help your child. The most comprehensive way to assess a child’s executive functioning difficulties and determine a cause is a neuropsychological evaluation. A comprehensive neuropsychological evaluation is made up of a set of tests, questionnaires, interviews, and observations that a clinician will use to gain a good understanding of a child’s strengths and weaknesses, along with learning how a child processes information and completes tasks. At NESCA, we offer comprehensive evaluations that can look for potential learning disabilities, attentional difficulties, and other challenges that can negatively impact a child’s executive functioning development. In addition, a NESCA evaluation will include explicit recommendations to address challenges that have been identified.

Also, if you want to learn strategies for helping a teenager or young adult develop executive functioning skills, stay tuned for next week’s edition of NESCA Notes!

About the Author:
Talamo

With 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 StudentsDr. 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.

 

 

 

To book a neuropsychological evaluation or consultation  with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate that you would like to see “Dr. Talamo” in the referral line.

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Interview with Dina DiGregorio Karlon, NESCA North Transition Specialist

By | NESCA Notes 2019

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

 

What are Transition Services?

Transition means the process of moving from one life stage to another. In context to NESCA, we are referring to the transition from high school to post-secondary life, and we specialize in working with nontraditional students who often have had accommodations or special education services. While the prospect of leaving high school is exciting, it can be overwhelming as well. The prospect of figuring out what you want to do with your life causes some level of anxiety in all of us; transition services helps to relieve this anxiety by working with individuals in setting short and long term goals and participating in guidance and psychoeducation related to college and/or employment.

How did you get interested in this field?

Helping people understand their strengths and weaknesses while exploring their vision for adulthood is my passion. Upon reflection, I believe that I have always been a transition specialist, long before there was a name for this work. Having worked with adolescents and young adults for more than 25 years, I understand the demands and expectations placed on them and how that can be daunting. Helping people to recognize that their path may be different than they expected is very rewarding, and I do not take that responsibility lightly.

What do you like about your job?

I particularly enjoy working with adolescents and families through the college process; while the process is not difficult to understand, it is time-consuming and can often feel overwhelming. I enjoy assisting students and helping them to accomplish new tasks. I love to help people identify their strengths and use those to minimize and overcome their challenges. Being able to assist people in setting their own personal goals and achieve them is very gratifying to me. Getting to know new people, teaching important skills, presenting a different perspective, piecing together a plan; these are all things I love about the work I do.

Do you have a specialty? What do you specialize in?

I specialize in both college and career counseling. I am experienced in working with high school students as well as young adults.

What do you enjoy about your job?

I particularly enjoy working with adolescents and families through the college process; while the process is not difficult to understand, it is time-consuming and can often feel overwhelming. I enjoy assisting students and helping them to accomplish new tasks. I love to help people identify their strengths and use those to minimize and overcome their challenges. Being able to assist people in setting their own personal goals and achieve them is very gratifying to me. Getting to know new people, teaching important skills, presenting a different perspective, piecing together a plan; these are all things I love about the work I do.

What brought you to NESCA?

My experience as a school counselor and a vocational rehabilitation counselor have given me a unique skill set and provide me with the experience needed to do transition planning for students who are college bound and also students or adults who are seeking employment or support with career exploration. My passion for working with adolescents and helping them maneuver the challenges of early adulthood matches the philosophy of NESCA and I am eager to work as part of a team of specialists providing this support to young people.

What are you most looking forward to about working full-time at NESCA?

I am excited to work with adolescents to help them with the journey into adulthood. The variety of clients and their needs at NESCA is a real draw for me. Whether my work takes me to teaching a teenager how to do laundry, practicing interviewing for a first job or new school, or identifying a college list, it all sounds challenging and rewarding to me.

Who are your favorite students/clients to work with?

I have a lot of expertise in working with all kinds of students. I have worked with students who have been identified with Autism Spectrum Disorders, ADD/ADHD, mental health disorders, and other profiles. With the myriad of clients I worked with at Vocational Rehabilitation, I have developed a solid understanding of many diagnoses and disabilities and how clients’ lives are impacted by the related challenges. I have often worked with students who face multiple barriers; seeing those students work through their challenges and develop resiliency is professionally rewarding.

What advice do you have for parents or young adults who are not sure if they need a transition specialist?

Working with a transition specialist can be very helpful for parents to understand what their children’s strengths and weaknesses are in relation to adult-readiness. Are they ready for a 4-year college? Do they need a gap year? What would that look like? Do they know how to interview for a job? Do they need help getting a job? Do they know what kind of job fits their skills? Do they know to self-advocate? Do they know how to access resources?

Teenagers will often not work with their parents to do goal setting and transition planning, so having a transition expert to work with can often help. Working with a transition specialist can also be a great step toward a student taking ownership of their future planning and a parent releasing some control and responsibility. Most teenagers or young adults would benefit from doing transition planning; but it is a highly personal family decision as to whether to work with a transition specialist.

If you are not sure if you need a transition specialist, you can always come in for a consultation appointment. This is a one-hour meeting that helps a family determine if this is the right time to work with a transition specialist and what type of transition service may be best. For example, does the family need assessment and a report for an IEP process or just help with appropriate college planning? Talking things through with a transition expert can be extremely helpful for knowing what is needed and when.

We are very excited to announce that as of February 1, 2019, Ms. Karlon is working as a full-time staff member delivering assessment services in the state of New Hampshire and college and career coaching services to clients throughout New England! NESCA is thrilled to be able to offer these expanded transition services in our New Hampshire Office in addition to the services we already offer in Newton, MA.

To schedule an appointment with Dina DiGregorio Karlon in Londonderry, please complete our online intake form: https://nesca-newton.com/intake-form/  The address of NESCA-North is 75 Gilcreast Rd #305, Londonderry, NH 03053.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.