Category

NESCA Notes 2018

Blog Update: Increased Access to Publicly Funded Independent Educational Evaluations (IEEs)

By | NESCA Notes 2018

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

In the last blog post about increased access to independent evaluations, we cited some provisions that were in the original bill, filed by State Senator Barbara L’Italien and State Representative Jim O’Day, which ultimately did not pass. The increase in rates for IEEs were made by a regulation from the agency, the Executive Office of Health and Human Services (EOHHS), not legislative action. A corrected version of the article is reprinted below. We remain excited about these changes and thankful for the hard work of our friends at MAC, the Ed Law Project, and the many advocates, parents, and psychologists who helped advocate for these changes.

As an independent group practice, not allied with any one school district, medical or advocacy group, neuropsychologists at NESCA are often called upon to perform independent evaluations for parents who are seeking an unbiased expert opinion related to their child’s developmental and educational needs. In some cases, this is the first evaluation a family is seeking for their child. In others, the family is in disagreement with the progression or conclusions of a school-based evaluation process. In Massachusetts, parents may seek private evaluation of their child at their own expense at any time and their educational team must meet to consider the results and recommendations of that evaluation. State and federal laws also provide parents with a procedure for requesting that a school district fund an Independent Educational Evaluation (IEE) if they believe that the school’s evaluation is not adequate or comprehensive enough. It is often helpful for parents who are interested in this important resource to consult with an educational advocate to see if they have a legitimate reason to request public funding for an IEE.

Unfortunately, in the past, the ability of families to access a publicly funded IEE has been limited by the low rates that school districts were required to pay to the independent evaluator, as set by state regulations. The maximum allowable rates were, until recently, $74.94 per hour with an allowed range of 8-12 hours, for a total of $899.28. Very few practicing evaluators are able or willing to accept less than $900 to perform what, by definition, needs to be a comprehensive evaluation in the context of what is often a complex situation centering on a disagreement between a family and a school district. These rates had not been raised since 2007, more than ten years ago. Thus, even when a school district agreed to fund an IEE, the school and family often had trouble finding an expert evaluator willing and able to perform it for the state rate.

This situation has changed, thanks in large part to the committed lobbying efforts of our friends at Mass Advocates for Children (MAC), a group of dedicated lawyers, advocates, parents and others who work tirelessly to ensure that all children in the state have equal access to educational and life opportunities. They focus particularly on those children who have disabilities, are low income and/or are racially, culturally, or linguistically diverse.  Thanks to MAC’s leadership in lobbying for this new change, the Executive Office of Health and Human Services (EOHHS) passed new regulations, effective April 1, 2018, which allow a maximum rate of $88.43 per hour, and the range of hours has increased to 9-20, bringing the maximum total rate to $1,768.60. This means more families, particularly those of limited means, should be able to access IEEs if they are needed.

We thank our friends at MAC for their dedicated work on this and other efforts that benefit the most vulnerable children in the Commonwealth. MAC also gives grateful credit to the Ed Law Project and other advocates, parents, and psychologists who helped advocate for this bill, as well as Lead Sponsors of the bill: State Senator Barbara L’Italien and State Representative Jim O’Day.

Please visit the MAC website to appreciate the scope of their many efforts.  https://massadvocates.org/

For more information about the Independent Educational Evaluation process in MA, check out these resources:

NESCA is proud to continue to provide evaluations funded both privately and publicly. While our rates are higher than the state’s standard rate, we are thankful that this increased funding is available to defray costs for families in need.

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, 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.

Increased Access to Publicly Funded Independent Educational Evaluations (IEEs)

By | NESCA Notes 2018

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

As an independent group practice, not allied with any one school district, medical or advocacy group, neuropsychologists at NESCA are often called upon to perform independent evaluations for parents who are seeking an unbiased expert opinion related to their child’s developmental and educational needs. In some cases, this is the first evaluation a family is seeking for their child. In others, the family is in disagreement with the progression or conclusions of a school-based evaluation process. In Massachusetts, parents may seek private evaluation of their child at their own expense at any time and their educational team must meet to consider the results and recommendations of that evaluation. State and federal laws also provide parents with a procedure for requesting that a school district fund an Independent Educational Evaluation (IEE) if they believe that the school’s evaluation is not adequate or comprehensive enough. It is often helpful for parents who are interested in this important resource to consult with an educational advocate to see if they have a legitimate reason to request public funding for an IEE.

Unfortunately, in the past, the ability of families to access a publicly funded IEE has been limited by the low rates that school districts were required to pay to the independent evaluator, as set by state regulations. The maximum allowable rates were, until recently, $74.94 per hour with an allowed range of 8-12 hours, for a total of $899.28. Very few practicing evaluators are able or willing to accept less than $900 to perform what, by definition, needs to be a comprehensive evaluation in the context of what is often a complex situation centering on a disagreement between a family and a school district. These rates had not been raised since 2007, more than ten years ago. Thus, even when a school district agreed to fund an IEE, the school and family often had trouble finding an expert evaluator willing and able to perform it for the state rate.

This situation has changed, thanks in large part to the committed lobbying efforts of our friends at Mass Advocates for Children (MAC), a group of dedicated lawyers, advocates, parents and others who work tirelessly to ensure that all children in the state have equal access to educational and life opportunities. They focus particularly on those children who have disabilities, are low income and/or are racially, culturally, or linguistically diverse.  Thanks to MAC’s leadership in lobbying for this new change, the Executive Office of Health and Human Services (EOHHS) passed new regulations, effective April 1, 2018, which allow a maximum rate of $88.43 per hour, and the range of hours has increased to 9-20, bringing the maximum total rate to $1,768.60.  In addition, the Bureau of Special Education Appeals will be able to order a higher rate in extraordinary cases. Further, in the rare instances that parents prevail at a hearing and have paid expert fees, the parents would have the right to be reimbursed for these fees by the school district. This means more families, particularly those of limited means, should be able to access IEEs if they are needed.

We thank our friends at MAC for their dedicated work on this and other efforts that benefit the most vulnerable children in the Commonwealth. MAC also gives grateful credit to the Ed Law Project and other advocates, parents, and psychologists who helped advocate for this bill, as well as Lead Sponsors of the bill: State Senator Barbara L’Italien and State Representative Jim O’Day.

Please visit the MAC website to appreciate the scope of their many efforts.  https://massadvocates.org/

For more information about the Independent Educational Evaluation process in MA, check out these resources:

NESCA is proud to continue to provide evaluations funded both privately and publicly. While our rates are higher than the state’s standard rate, we are thankful that this increased funding is available to defray costs for families in need.

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, 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.

Double Rainbow: The Intersectionality of Autism Spectrum Disorders and gender variance

By | NESCA Notes 2018

By: Jacquelyn Reinert, Psy.D., LMHC
Pediatric Neuropsychologist, NESCA

“Transgender and autism, that’s not a thing, is it?” Since joining NESCA last September, I have encountered countless parents, teachers, and professionals who ask this exact question in feedback sessions, case consultations, and team meetings. The conversation that typically follows often calls into question the validity of the intersectionality of Autism Spectrum Disorder (ASD), Asperger Syndrome, and trans-identities and gender variance, as well as that of sexual orientation.

ASD is a neurodevelopmental disorder which impacts an individual’s communication, social interactions, play, interests, and behaviors. ASD presentations vary according to age, gender, and development. While functionally these communication and behavior patterns can assist clinicians to make diagnoses and inform interventions, we recognize that there can also be a stigma attached to diagnostic codes and labels. As such, we embrace an affirming stance, recognizing neurodiversity within the ASD community.

One commonly utilized phrase at NESCA is Stephen Shore’s quote, “If you have met a person with autism, then you have met one person with autism.” The same can be said for an individual who questions or is exploring their gender expression. There is a spectrum of gender diversity, ranging from gender non-conforming to non-binary, to transgender, and so on. The terminology and classifications within the community are fluid and ever-evolving, but for now, key terms are provided below. It is estimated that gender diverse youth may make up 5 to 12% of birth assigned females, and 2 to 6% of birth-assigned males; transgender youth, 0.5% (APA Fact Sheet). Of those, how many are also neurodiverse?

 

Key Terms*:

Courtesy of the Boston Children’s GeMS Clinic and the American Psychological Association

Sex: the biological category or identity that a person belongs to; based upon chromosomes, genetic makeup, and internal/external reproductive organs.

Gender identity: a person’s inner sense of oneself as either a woman (female), a man (male), or other/something different.

Gender expression: refers to the way in which we display our gender identity to other individuals and to the world around us.

Cisgender: a person whose gender identity and/or expression are aligned with the sex/gender that they were assigned at birth.

Non-binary: identifying as a gender other than exclusively female/woman or male/man.

Gender nonconforming, gender variant, or gender diverse: an individual who has a gender identity and/or gender expression that does not conform to the gender they were assigned at birth. They may prefer clothing, accessories, hair length/styles, and activities that are not expected in the culture based on their sex assigned at birth.

Transgender: individuals who typically consistently, persistently, and insistently express a cross-gender identity and feel that their gender is different from their assigned sex.

Gender dysphoria (GD): the distress an individual experiences when their assigned gender does not match their gender identity.

* In April, NESCA had the opportunity to meet with Dr. Kerry McGregor, Attending Psychologist at Boston Children’s Hospital in the Division of Endocrinology and Gender Management Service (GeMS) to learn more about the intersectionality of ASD and gender dysphoria and ways in which NESCA clinicians can provide gender affirmative care.

 

Emerging research suggests that indeed there is a relationship between gender variance and autism, although not without reservation and mixed approval. Researchers exploring the link between these spectrums suggest that gender variance is present in 5 to 7% of adolescents with ASD (Van Der Miesen, Hurley, & De Vries, 2016). Opponents suggest that the co-occurrence is merely a manifestation of restrictive, repetitive behavior, interests, and or activities, a hallmark symptom of ASD. Further, they suggest that due to the inherently negative experiences gender variant adolescents face, these individuals are more likely to demonstrate behaviors consistent with social impairments rather than a primary diagnosis of ASD (Turban & van Schalkwyk, 2018).

Regardless of whether a link is clearly identified at this point in time, individuals, families, clinicians, and communities are faced with navigating the complexities of the intersectionality of gender variance and ASD. Further, they face the complex dilemma of who to seek out should a child, adolescent, or family need support, guidance or targeted intervention to address gender dysphoria and other co-occurring challenges, such as anxiety and depression.

Where to start and what can families do to help?

  1. This is a marathon, not a sprint, and the race begins with balanced acceptance. Validating an individual’s disclosure with empathy and understanding is the first step in providing children and adolescents the space to begin exploration. Parents and caregivers should try to avoid either quick dismissal or accelerated enthusiasm. For many adolescents (gender variant, neurodiverse, or not), self-exploration is an essential part of growing up and being allowed a space with which to question and explore in a safe way is key.
  2. Be an advocate for your child or adolescent; ask questions and be curious. If adolescents are disclosing, be willing to have an open conversation. When you are unsure of what a term is, ask permission to clarify. Promoting a culture of acceptance and validation is essential.
  3. Not all challenges are central to either gender exploration or ASD. Navigating adolescence is difficult and although neurodiverse adolescents exploring gender expression may struggle, these concerns may be attributed to other emerging challenges. Parsing out typical adolescence and emerging mental health difficulties should be done in partnership with knowledgeable professionals who can thoroughly explore the issues.
  4. Be kind to yourselves and know that you will not have all the answers immediately. Parents and caregivers can often experience elevations in stress, particularly when outcomes are vague and without the opportunity to truly digest information. Resources provided below are initial starting points to learn more about gender variance, as well as the intersectionality with the neurodiverse community.
  5. Seek support for yourself. Parents and caregivers can benefit from working through concerns and worries, such as how other family members may react to an adolescent’s gender exploration. Working with an individual therapist or in a support group can be highly beneficial in providing the space for adults to process outside of the relationship with your child.
  6. Seek support for the child or adolescent. If your child is currently working with a mental health provider, working with an existing person in tandem with a gender specialist can be highly beneficial. One excellent area resource is Boston Children’s Gender Management Service (GeMS) Program which provides physical and psychological evaluations which inform individualized treatment plans for children. With a comprehensive plan, GeMS multi-disciplinary team can coordinate with existing providers (e.g., clinicians, primary care physicians) and can make referrals as needed. NESCA also has clinicians who provide a variety of services including individual therapy and neuropsychological and psychological evaluations and who are highly versed in the literature surrounding the intersectionality of neurodiversity and gender.

Resources

Books:
Gender Born, Gender Made by Diane Ehrensaft, Ph.D.

The Gender Creative Child: Pathways for Nurturing and Supporting Children by Diane Ehrensaft, Ph.D.

The Transgender Teen: A Handbook for Parents and Professionals Supporting Transgender and Non-Binary Teens by Stephanie Brill and Lisa Kenney

Support Groups:
AANE Gender Identity and the Autism Spectrum Support Group for Transgender Adults on the Spectrum (link: https://www.aane.org/event/gender-identity-autism-spectrum-support-group-transgender-adults-spectrum-13/)

Online Resources:
ASAN, NCTE, and LGBTQ Task Force Joint Statement on the Rights of Transgender and Gender Non-Conforming Autistic People (link: http://www.thetaskforce.org/wp-content/uploads/2016/06/joint_statement_trans_autistic_GNC_people.pdf)

Family Acceptance Project (link: http://familyproject.sfsu.edu/publications) Spectrum News – Living Between Genders (Link: https://www.spectrumnews.org/features/deep-dive/living-between-genders/)

Boston Children’s Gender Management Services (GeMS) Program (link: http://www.childrenshospital.org/centers-and-services/programs/a-_-e/disorders-of-sexual-development-dsd-and-gender-management-service-program

Sexual Orientation, Gender Identity, and Asperger/Autism by Jamie Freed, MSW for AANE
(link: https://www.aane.org/sexual-orientation-gender-identity-aspergerautism/)

 

About the Author: 

Dr. Reinert is a Pediatric Neuropsychology Postdoctoral Fellow who joined NESCA in September 2017. Dr. Reinert assists with neuropsychological and psychological (projective) assessments in the Newton office and in the Londonderry office. In addition to assisting with neuropsychological evaluations, Dr. Reinert co-facilitates parent-child groups and provides clinical consultation. Before joining NESCA Dr. Reinert worked in a variety of clinical settings, including therapeutic schools, residential treatment programs and in community mental health. She has comprehensive training in psychological assessment, conducting testing with children, adolescents, and transitional-aged adults with complex trauma. Dr. Reinert is particularly interested in researching the intersectionality of ASD and gender exploration.

Reach out if you would like to work with Dr. Reinert:  Email jreinert@nesca-newton.com

 

 

 

 

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.

PCIT: Improving Child Behavior, Transforming Parent-Child Relationships

By | NESCA Notes 2018

photo from pcit.org

 

By: Ryan Ruth Conway, Psy.D.
Clinical Psychologist, NESCA

First developed in the 1970’s by Sheila M. Eyberg, Ph.D., Parent-Child Interaction Therapy (PCIT) is a scientifically proven treatment program for young children (ages 2-7) who display challenging behaviors (e.g., noncompliance, defiance, temper tantrums, aggression) and difficulty regulating their emotions. PCIT therapists work with both the child and the parent together. Goals of treatment are to develop warmth and positivity in the parent-child relationship and teach parents how to effectively deal with behavioral problems both at home and publicly. While this efficacious treatment has been around for almost 50 years and is practiced both nationally and internationally, it is not widely known amongst parents and professionals in Massachusetts.

 

The video above provides brief illustrations of the treatment in action at the University of Miami’s PCIT program. Watching the video, you will see clips of a PCIT therapist “coaching” the parent through a one-way mirror, as the parent listens to the therapist’s instructions about interacting with his or her child through an earpiece while they play. PCIT is unique in that it is “in vivo,” or in real time, which helps the therapist directly observe parent-child interactions and also greatly enhances the caregiver’s learning of new skills that promote positive behaviors in children.

The video depicts the first phase of PCIT treatment called Child-Directed Interaction (CDI), which is the relationship enhancement phase. In CDI, parents follow the child’s lead in play while practicing specialized parenting skills. One of the skills applied by the parents in the video is praise. But not just any praise – this is labeled praise (e.g., “Great job playing gently with the toys”). Labeled praise communicates to the child specifically what it is that they did well, which increases the likelihood that this behavior will happen again, bolsters the child’s self-esteem and also promotes positive feelings between the parent and child. Praise feels good to give and to receive! Another skill practiced in CDI is reflection, or repeating what the child says during the play (e.g., Child says “The kangaroo is jumping”; Parent says “He is jumping very high!”) Reflections show that the parent is listening to the child, that the parent approves of what the child is doing and has also been shown to improve speech. Labeled praise and reflections are just two of the many skills taught to parents in CDI.

While positive behaviors are reinforced in CDI, inappropriate behaviors (e.g., whining, crying, talking back) are intentionally ignored to reduce their occurrence. While ignoring disruptive behaviors, parents are coached to use distraction and redirection skills. CDI then sets the foundation for the next phase of PCIT, called Parent-Directed Interaction (PDI), which continues to encourage appropriate play while also focusing on a structured and consistent approach to discipline.

There have been numerous studies documenting the effectiveness of PCIT (http://www.pcit.org/literature.html). Results have shown improvements in child behavior as well as reduced stress and increased confidence amongst caregivers. In addition to these outcomes, we see a stronger, happier parent-child bond!

NESCA is thrilled to announce that we are now offering PCIT! If you or someone you know might be interested in this treatment, please contact Dr. Ryan Ruth Conway at rconway@nesca-newton.com or (617) 658-9831.

To learn more about PCIT, visit http://www.pcit.org/

 

About the Author: 
Conway

Ryan Ruth Conway, Psy.D., is a licensed clinical psychologist who specializes in Cognitive Behavioral Therapy (CBT), behavioral interventions, and other evidence-based treatments for children, adolescents and young adults who struggle with mood and anxiety disorders as well as behavioral challenges. She also has extensive experience conducting parent training with caregivers of children who present with disruptive behaviors and Attention-Deficit/Hyperactivity Disorder. Dr. Conway has been trained in a variety of evidence-based treatments, including Parent-Child Interaction Therapy (PCIT), Dialectical Behavior Therapy (DBT), and Exposure with Response Prevention (ERP). Dr. Conway conducts individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal.

Reach out if you would like to work with Ryan: Email rconway@nesca-newton.com

 

 

 

 

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.

Social Creativity and ASD – Challenging the assumption that autistic people are not social

By | NESCA Notes 2018

Photo from the documentary, Autism: The Musical (2007)

By: Rebecca Girard, LICSW, CAS
Licensed Clinical Social Worker

The New York Times recently published an opinion piece titled, How to Meet Autistic People Halfway, an article that challenges the common belief that people on the autism spectrum are avoidant of social interaction and do not desire social connections. The authors, Vikram K. Jaswal and Nameera Akhtar are psychologists and researchers who study the social lives of people on the autism spectrum. They assert that while core deficits of autism may make social interaction more challenging, it does not mean people on the spectrum do not desire meaningful social connection. For years, many in the ASD community and their allies in the neurodiversity rights movement have attempted to combat this anti-social stereotype, but the notion stubbornly persists. Counter-narratives of the autistic social experience often reflect autistic people as extremely emotionally sensitive, hyper-aware of the feeling states of others, and indeed motivated to experience social success in the form of friendships and social acceptance. Additionally, an increasing number of people believe those on the spectrum may actually display more creative and interesting ways to connect and choose to describe autistic individuals as “socially creative” rather than having “social deficits”.

If we then acknowledge the desire to connect is present, how can we best facilitate social learning and promote social success? First, we can acknowledge that a person on the spectrum will have a myriad of ASD-related challenges that will likely make socializing difficult. These include trouble reading and interpreting social cues (eye contact, body language, facial expressions), attending to and managing sensory challenges during interaction, and repetitive and inflexible thinking (getting “stuck”, echolalia), all of which can lead to preemptive social rejection by peers and a lack of social opportunities to practice and improve upon their social interaction skills. These challenges require multi-disciplinary supports, including (but not limited to) occupational therapy, speech therapy, and cognitive-behavioral therapy. Second, we can provide positive social learning interventions that address and ameliorate the impact of these factors, while providing opportunities to explore and understand the social world.

A popular method of intervention is that of “social knowledge”, or didactic social skills training. This entails imparting concrete social skills, in the effort to explicitly teach what a person may not know about socializing. Think – programming a social computer with many algorithms; if a person does A, you do B. While this may be great at teaching the basics, it often does not adequately prepare ASD individuals for the unpredictability and fluidity of everyday interactions. Another approach is that of “social performance”, a dynamic method of encouraging social pragmatic development by providing semi-structured socialization opportunities in small group settings with immediate, in vivo feedback on what’s working or not. Think – flexing a social muscle. Drama-based social pragmatic groups are gaining in popularity as a method for not only promoting social connections but as a fun way to create an encouraging and supportive space to finds one’s own intrinsically motivating social style.

But enhancing individual social skills and providing adequate social opportunities is admittedly a one-sided approach. Equally important is challenging the stigma and bias that plague the ASD community. We need to be allies to this community by promoting greater acceptance of a wide-range of social styles and approaches to social engagement. To honor the neurodiversity mission, which “rejects the idea that autism should be cured, advocating instead for celebrating autistic forms of communication and self-expression, and for promoting support systems that allow autistic people to live as autistic people.” (What is Neurodiversity? [Website]. (2011).  National Symposium on Neurodiversity at Syracuse University)

As a therapist who has worked with ASD individuals across the lifespan since 2004, I know firsthand that autistic people feel the same loneliness and isolation when chronically socially disconnected, and feel the same anxiety and unease when experiencing social rejection. I have also had the pleasure of witnessing individuals find their own distinctive social style and the joy of connecting with others who appreciate what is different as interesting and exceptional, rather than off-putting or strange. The autistic people in my life, both professionally and personally, have challenged me to rethink narrow and strictly defined social expectations, and have made all my relationships richer as a result. Autistic people are often credited with “out of the box” thinking and innovation, which can be applied to their social lives as well, as they are uninhibited by social convention. For example, Asperger’s are Us are the first all-autistic sketch comedy troupe, and their performances reflect their original and offbeat sense of humor, as well as their deep connection to one another as friends. A great example of what is possible.

The New York Times article said it best in its conclusion, “improving the social lives of autistic people will require putting aside assumptions about how social interest is expressed and recognizing that it can be shown in unexpected ways.” As parents, professionals, and allies, let’s commit to challenging this very basic and long-held assumption and appreciate and embrace the unique and creative ways autistic people chose to engage the world around them.

 

About the Author: 

Rebecca Girard, LICSW, CAS is a licensed clinical social worker specializing in neurodivergent issues, sexual trauma, and international social work. She has worked primarily with children, adolescents, adults with Autism Spectrum Disorders and their families for over a decade. Ms. Girard is highly experienced in using Cognitive Behavior Therapy (CBT) as well as Socio-dramatic Affective Relational Intervention (SDARI), in addition to a number of other modalities. She provides enhanced psychotherapy to children with ASD at NESCA as well as to provide therapeutic support to youth with a range of mood, anxiety, social and behavioral challenges. Her approach is child-centered, strengths-based, creative and compassionate.

Reach out if you would like to work with Rebecca: Email rgirard@nesca-newton.com or call 617-658-9825

 

 

 

 

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.

“Vitamin G” Project

By | NESCA Notes 2018

By: Ann-Noelle McCowan, M.S., RYT
Guidance Counselor; Yoga Specialist

Each school year I observe the fluctuations of student and adult stress, and each August the return of relaxed and recharged kids and adults.  For many, summer means a slower pace and longer days filled with activities that bring joy and support our health and happiness. Time with family, friends, and pets bonds us with others. We’re connected with nature through the fullness of trees or the heat of the sun, and our perspectives are turned outward with less time inside on screens and gaming devices.  We’re renewed with less packed schedules, fewer alarms, more sleep, and our bodies are nourished by eating outside, less complicated meals and more fruits and vegetables. So how can summer’s ease and joy build our resilience to handle the natural unavoidable stressors of the school year and seasonal changes? By starting a gratitude practice.

Gratitude practices that amp up “Vitamin G”  have been shown to help people feel better about their lives, experience higher levels of positive emotions and have fewer physical problems or even feel less pain. Vitamin “G” helps us act kinder and more generous towards others, feel less stress and then handle stress better when it shows up, as well as get more exercise, eat healthier and sleep better!  Neuroscientists have said that our brain has a “negativity bias” where our minds respond like velcro for bad thoughts and Teflon (non-stick) for good thoughts. Vitamin “G” to the rescue!  When we are thankful, it helps stop negative thoughts and increases the feel-good chemicals like dopamine and serotonin. Summer naturally provides time and opportunities to teach kids about gratitude, to practice the crucial ability to notice and acknowledge things in their life that bring them pleasure. Now how to begin…

  • Start by thanking your own children and help them learn about appreciation. Don’t worry too much about younger kids who might say they are thankful for a toy, you are building the idea of gratitude. It’s the practice, not perfection. Feel free to connect Vitamin G to other important nutrients or times when you have asked them to thank others.
  • Use age-appropriate language: we are going to learn how to name/ acknowledge/ build an account or recording of things that make us feel happy/ appreciative/ lucky/grateful. Give some examples of the benefits of Vitamin “G”. Explain that deposits to this “bank account” builds a mind that feels happier, less stressed and healthier.
  • Decide how you want to recognize daily gratitude. It could be a journal, a jar, a shared blog, drawings, colleagues, voice or video recordings, or a routine prayer with your child at night. I’ll expand on how to build a gratitude jar but experiment and choose what works for your child and family.
  • Gratitude Jar: Essentials are a writing utensil, slips of paper and a vessel to store your “gratitude slips” in. You could have your child pick one or two shades of colored paper or a special pen for recording, the jar could be decorated with pictures of things they enjoy or a beloved pet or kept blank to view the collection.
  • Cut up a few different sizes of rectangle slips of paper, or print a few prompts if that works for your child. Examples of prompts could be: Today I loved… I’m thankful for….. I appreciate that … I’m grateful for… I liked it when … I felt happy when….I feel good when.
  • Make a commitment to model this on a daily or routine schedule with your child, start recording and watch their account grow.

Your Vitamin G  project will hold beautiful recollections of summer as well as teach your child an important habit of mind and useful stress buster tool. Starting a gratitude practice will build resilience and empower them to find moments of happiness and goodness even when summer ends. Enjoy and have fun!

 

About the Author: 

Ann-Noelle provides therapeutic yoga-counseling sessions individually designed for each child. NESCA therapeutic yoga establishes a safe space for a child to face their challenges while nourishing their innate strengths using the threefold combination of yoga movement, yoga breath, and yoga thinking.

Ann-Noelle has worked with children and adolescents since 2001 and practiced yoga and meditation since 2005. Since 2003 she has been employed full time as a school counselor in a local high performing school district, and prior to that was employed in the San Francisco Public Schools. Ann-Noelle received her dual Masters Degree (MS) in Marriage, Family and Child Therapy (MFCC), and School Counseling from San Francisco State University in 2002, her BA from Union College in New York, and her 200 hour-Registered Yoga Credential (RYT) from Shri Yoga. Ann-Noelle completed additional Yoga training including the Kid Asana Program in 2014, Trauma in Children in 2016 and Adaptive yoga for Parkinson’s in 2014.

For more information on the therapeutic yoga at NESCA, please visit  https://nesca-newton.com/yoga/

 

 

 

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.

Acupuncture for Mental and Emotional Spectrum

By | NESCA Notes 2018

 

By: Holly Pelletier, L.Ac.
Licensed Acupuncturist

Acupuncture is a gentle approach to health care that utilizes energy meridians in the body to help facilitate and unblock areas of stagnation and congestion. There are many different ways to perform an acupuncture treatment, some don’t even require the use of needles. Because acupuncture works to restore balance in the body, it can literally work for anything. In fact, some of my favorite things to work with lie on the mental-emotional spectrum; it works wonders for anxiety, depression, stress, obsessions/compulsions, and ADHD. It can also treat everything from digestive disorders to insomnia.

Acupuncture is a great preventative medicine, so you do not need some big serious main complaint to get treated. In fact, I recommend seeking treatment before anything arises, and even after your symptoms clear! I strongly encourage patients to continue treatments as a preventative and maintenance approach to their health.

For more information or to set up a consult and/or treatment please feel free to email me at hpelletier@nesca-newton.com.

 

About the Author: 

Holly Pelletier has been working with children of varying ages, in many different capacities since 2004. Prior to treating kids with acupuncture, she worked as a teacher, coach, and mentor. She especially enjoys working with children and acupuncture because of their speedy response time and genuine excitement about this form of medicine. Acupuncture is a wonderful healing modality because children’s bodies are very adaptable, and, being so young and not yet deeply affected by the stresses of life, children generally show signs of response to acupuncture quickly.

Holly has a very gentle technique and has specific training in non-insertive acupuncture styles, which does not require needling directly into the skin. Acupuncture is great for many different concerns because it’s focus is that of bringing balance back to a body where this has been disrupted. Therefore, basically any form of imbalance can be helped with acupuncture. Common imbalances kids seek treatment for, are stress, anxiety, digestive issues, headaches, low energy/motivation, and fluctuations in mood.

Holly is licensed by the Massachusetts Board of Medicine and by the National Certification Commission for Acupuncture and Oriental Medicine. She graduated from the New England School of Acupuncture at MCPHS University in Newton, MA where she studied Japanese and Chinese acupuncture styles, along with Chinese herbology.

For more written by Holly, check out her personal blog, www.holisticallyinspired.org

 

 

 

 

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.

My (Second) Favorite Day of the Week

By | NESCA Notes 2018

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

It’s hard to beat Saturday, but Tuesday comes close!  Tuesdays at NESCA are all about learning, collaborating, and eating, three of my favorite activities.

We start the day with seminar over continental breakfast.  Professionals are invited to NESCA to share their work with us, mostly focused on intervention services for children with special needs so that NESCA clinicians continue to build and refine our knowledge of treatment options.  Meeting with service providers in person gives us the opportunity to more deeply understand their philosophy and approach, enhancing our ability to make effective recommendations for our clients.

Mid-day we are back together for case conference and international luncheon cuisine.  Clinicians present challenging cases to our whole group of about 15 professionals and we hash out complex diagnostic issues, debate interventions, and synthesize our best ideas into a treatment plan.  Witnessing a group of highly skilled clinicians, each contributing his/her own expertise to the cause of helping a child is truly a joy.  Research is clear that groups formulate better solutions than individuals.  I am grateful to be part of a group of such intelligent, thoughtful, and compassionate clinicians.  While the purpose of case conference is clinical care, it is also an incredible opportunity for learning and building the bonds among our staff.

People working together, learning together and helping kids: that’s the essence of my vision for NESCA when I set it up more than a decade ago.  And, since its inception, Tuesday has always been a special day at NESCA.

About the Author: 

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who hasbeen 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.

 

 

 

 

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.

 

 

Why Work Works

By | NESCA Notes 2018

By: Kathleen Pignone, M.Ed., CRC
Transition Specialist, NESCA

Summer is here. The weather is mostly sunny, we are in New England after all, and many of us are looking forward to our teenagers being out of school and hanging around in the basement playing video games on line with their friends, asking for rides to the mall and wondering why there is no food in the fridge.

Wait! Whoa! It’s summer! Don’t teenagers work anymore? Many young adults are spending summers preparing for travel sports teams, drama clubs and exploring post-secondary options. As a transition specialist I work with parents and young adults every day who are trying to plan for life after high school. There are so many areas to consider: post-secondary education/training, independent living skills, leisure and recreation, transportation skills and EMPLOYMENT!

Researchers have studied and debated the benefits and drawbacks of teens and part-time jobs for more than 2 decades. Many researchers, including those on government panels like the National Commission on Youth, praise part-time work and say it contributes to the transition from youth to adulthood.

Top 10 Reasons why Work Works!

  1. As an employee, young adults gain a new identity outside of being a student. They have a role and a purpose that cannot be replicated in any other setting. When they arrive at work, their employer is so grateful for their presence there because without them the job doesn’t get done or someone else needs to stop their productivity to get it done.
  2. Teamwork! You can’t be employed in any entry-level job without learning the basics of collaboration and negotiation.
  3. Responsibility and Accountability are the easiest skills to teach on the job. Every employee is expected to fulfill their role and add to the greater good. These two skills are crucial for success in college and in all relationships.
  4. Time management. Young adults learn how to balance free time and productive time. This is a crucial skill for success in the unstructured time shift from high school to college life. Also, employment gives teens less time to engage in risky behaviors.
  5. Learn important executive functioning skills. Young adults learn how to juggle their schedules and plan ahead so they can fit in leisure and extracurricular activities around their work schedules.
  6. Money management skills. Young adults learn how to effectively manage finances. Even if the teen is simply using their earnings to pay for their own expenses, they will learn to budget between clothes, movies, and car expenses.
  7. Career Development. Young adults gain practical experience in a field of interest helping to further college major and career choices
  8. Skills! Young adults gain useful, marketable skills such as improving their communication, instilling new confidence, learning how to handle difficult people, developing interview skills and filling out job applications.
  9. Community! Their world becomes bigger. Young adults learn to navigate transportation options, gain networking possibilities and set a young adult on a rewarding lifetime career path.
  10. Fun! Work is fun!!

 

About the Author:

Kathleen Pignone, M.Ed. CRC is a deeply knowledgeable and experienced transition specialist. Prior to her tenure at NESCA, Ms. Pignone was the Career Development Director at Bay Cove Academy for 15 years, providing students with classroom and real-world employment skills training, community job placement and on the job employment-training. She has also worked at Massachusetts Department of Secondary and Elementary Education and privately as a vocational rehabilitation consultant. As a certified rehabilitation counselor, Ms. Pignone brings unique expertise carrying out vocational assessment and employment planning for adolescents and young adults as well as supporting local school programs. In addition to fortifying NESCA’s premier transition assessment services, Ms. Pignone engages in person-centered planning with teens and young adults, consultation and training for parents, providers and schools, and community-based coaching services.

 

 

 

 

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.