The start of a new school year is the perfect time to check in on how your child is learning and adjusting. If challenges with academics, attention, social skills, or behavior persist, a neuropsychological evaluation can offer valuable insight and guide the right supports in place early on. To learn more or schedule an assessment, fill out our Inquiry/Intake Form.

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Child with behavioral challenges is evaluated

Often Overlooked: Recognizing and Supporting Children with Fetal Alcohol Spectrum Disorder

By | NESCA Notes 2025

Child with behavioral challenges is evaluatedBy Leah Weinberg, Ph.D. 
Pediatric Neuropsychologist, NESCA

One of the reasons I joined the NESCA team was for the opportunity to continually learn and grow professionally. NESCA has a well-earned reputation for fostering an environment where clinicians can expand their knowledge and refine their skills in meaningful ways, and a session I was able to attend for our staff earlier this year was a perfect example of that.

I attended an insightful seminar on Fetal Alcohol Spectrum Disorder (FASD), a topic that is often overlooked yet critically important in neuropsychological practice. The presentation provided clinically relevant information and tools to better recognize and address this condition.

One key takeaway was a reminder of how challenging FASD can be to diagnose. While many people associate the condition with characteristic facial abnormalities, these features are present in only a minority of affected children. Additionally, the social stigma around alcohol use during pregnancy means parents may be reluctant to disclose this history. This can make it easy to miss the diagnosis, particularly in children who present with behavioral or learning challenges that could be attributed to other conditions.

Hallmark symptoms of FASD include executive functioning deficits (e.g., working memory), poor impulse control, difficulties with generalization (people, situations, consequences), difficulties with abstraction, perseverations, and diminished adaptive skills within the context of healthy levels of intellect.

The seminar emphasized why making an accurate diagnosis is so critical: It directly informs how we approach treatment, including how we assist families in accessing services, setting realistic expectations for the child, diminishing the risk of the child receiving inappropriate diagnoses (e.g., Oppositional Defiant Disorder), and assisting the child in developing stronger self-awareness and self-advocacy skills. Moreover, it is important for the adults in the child’s life, including parents and educators, to understand that behaviors that are part of the disability are not willful. Behavioral challenges in children with FASD, for example, often do not respond well to traditional behavioral programs. Instead, a trauma-informed approach is typically more effective, as it accounts for the neurodevelopmental impact of prenatal alcohol exposure and addresses the underlying emotional and regulatory difficulties these children face.

Being part of a team that prioritizes professional development, like the one at NESCA, means continually sharpening my skills and expanding my understanding to better serve the children and families we work with. The FASD seminar was not only a great learning experience but also a reminder of the importance of staying open to complex diagnoses and tailoring treatment plans to meet the unique needs of each child.

About the Author

Dr. Weinberg specializes in the assessment of school-aged children and adolescents with a wide range of concerns including development disorders, such as autism spectrum disorder, learning disabilities (e.g. dyslexia, dysgraphia), language-based learning difficulties, AttentionHeadshot of Leah Weinberg, Ph.D. Deficit Hyperactivity Disorder (ADHD), Nonverbal Learning Disability (NVLD), and executive functioning disorders (e.g. slow processing speed). She also has experience in working with individuals with psychiatric difficulties, such as anxiety, mood disorders (e.g. depression), and behavioral disorders. Dr. Weinberg has expertise in working with children with complex profiles or multiple areas of strength and weakness that cannot be encapsulated by a single diagnosis. Dr. Weinberg is passionate about helping families better understand their child’s neuropsychological profile and the impact it may be having on their behavior or functioning in order to best support them in all areas of their life.

To book a neuropsychological evaluation with Dr. Weinberg or another expert neuropsychologist at NESCA, complete NESCA’s online intake form. 

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

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Image of a cell phone with a banned symbol over it; quote from Angela Currie, Ph.D.

Teaching Executive Function Strategies in the Landscape of Cell Phone Ban Policies

By | NESCA Notes 2025

Image of a cell phone with a banned symbol over it; quote from Angela Currie, Ph.D.By Angela Currie, Ph.D.
Pediatric Neuropsychologist; Londonderry, NH Director, NESCA

As students head back to school this fall, many are facing new policies and restrictions around cell phone use in school. For many states and districts, this is defined by a “bell to bell” cell phone ban, which prohibits students from using their phones from the first bell to final dismissal. For many, these policies are long awaited, as there has been growing concern about student distraction, social disengagement, and the negative impact of social media access in schools. By removing access to cell phones, tablets, and smart watches, “bell to bell” policies aim to reduce distractions and foster a more focused, interactive learning environment.

The benefits of cell phone policies are clear; however, they also may present unique challenges for some students who have learned to rely on technology as an appropriate tool for executive function. Executive function refers to a set of cognitive and self-management skills that help individuals manage time, stay organized, remember information, and meet goals efficiently. Because cell phones and tablets are readily accessible and have many embedded tools, many students have integrated technology into their daily routines, using features like calendars, alarms, and note-taking apps to stay on top of assignments and deadlines. These digital tools have become a practical way for some students to stay organized and ensure they are meeting expectations.

With “bell to bell” cell phone bans in place, students will no longer have “on demand” access to the apps or other executive function tools that previously kept them organized, possibly raising concern about increased forgetfulness, missed assignments, and heightened stress. Positively, the laws provide exemptions for students whose IEP, 504 plan, or Title IX needs identify specific technology accommodations (e.g., insulin monitoring, assignment log, communication tools, etc.). However, these students may feel hesitant to use their devices during the school day out of concern for standing out or feeling stigmatized. As a result, even students who are permitted to use their devices may choose to find alternative ways to manage their academic demands in order to avoid feeling singled out.

Cell phone policies are being developed for good reasons, but within this landscape, schools and families must start thinking about how to teach executive function strategies that are not technology-based. Children and teens are developing in a technological world, and they may not have the skills for managing demands without these supports. This provides an opportunity for them to learn more independent skills for daily management, but they may not figure this out on their own. To support students, educators and parents can introduce practical strategies, such as using physical planners to track assignments and deadlines, breaking down larger projects into smaller, actionable steps, and organizing materials with color-coded folders or checklists. Teaching time management techniques, encouraging regular routines, and modeling how to prioritize tasks can also help students build the foundational skills they need to succeed both in and out of the classroom, even without the constant aid of technology.

Ultimately, cell phone bans have the potential to create a more focused and engaged learning environment, fostering improved learning and social interactions. However, as access to technology is reduced, it becomes increasingly important for schools to provide explicit instruction in executive function strategies. By offering concrete tools and strategies, educators can help all students develop enduring, life-long skills that will benefit them not only in managing their responsibilities at school, but also in their future personal an

 

About the Author

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

 

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

 

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

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Image of a signpost with the words Wait and See" and "Check It Out" on it and a quote from Dr. Rebecca Dautoff

When In Doubt, Check it Out

By | NESCA Notes 2025

Image of a signpost with the words Wait and See" and "Check It Out" on it and a quote from Dr. Rebecca DautoffBy: Rebecca Dautoff, Psy.D.
Pediatric Neuropsychologist, NESCA

As a child psychologist, I regularly advise parents that our job is not to eliminate their children’s frustration, anxiety, and disappointment. Instead, our goal is to help kids process and tolerate these emotions. In fact, it’s critical that children face obstacles so they can learn to navigate and endure challenges throughout their life. But what happens when a child has a particularly tough time at school or a really difficult year? What are the next steps?

Deciding what to do can be a hard decision for concerned parents. Some parents question whether they should  “do something” to help the child, or to relieve their own anxiety and guilt. Other parents feel that their child’s issues are due to “a bad fit” with a particular teacher or classroom structure. This can be even harder when the school tells parents that everything is okay, or it’s just a phase that they see all the time. In some cases—such as a child grieving or adjusting to a new school—a short observation period (a few weeks) with close monitoring and open communication can be appropriate. However, this should always come with a clear plan to seek help if things don’t improve, because the “wait and see” approach can pose real risks to a child’s development, mental health, and emotional well-being. Here’s why:

First, childhood is full of developmental windows. These are essentially periods of time or opportunity when the brain is especially receptive to learning a specific skill. If a child is struggling in one of these areas and we wait too long, we risk missing this period of optimal learning. Language delays are a clear example. There is a critical period of language development before the age of 3, meaning that intervention for speech and language challenges are most effective before this age.

Second, children are incredibly perceptive. Kids are highly attuned and hyper aware when they feel like something is harder for them than it is for their friends and classmates. Often, kids internalize their struggles as personal failures. This can lead to frustration, anxiety, withdrawal, or behavioral problems/acting out. These outcomes are even more likely if a child is late to learn a skill. Take reading as an example. If a child is learning to read more slowly than their peers in first or second grade, they are less likely to internalize this as a problem because most of their classmates are also learning to read. It might come more easily to their friends, but they are all learning to read. If we wait to intervene, and a child is still having difficulty with reading in fourth grade, they are more likely to internalize their difficulty as a personal failure because they are no longer surrounded by peers who are also working on the same skill.

Taking a wait and see approach with your child’s mental health can feel like a cautious or hopeful strategy—especially when you’re unsure if something is truly wrong. Unfortunately, mental health conditions are often progressive, and waiting to treat them can allow symptoms to worsen, which makes them harder to treat. Undiagnosed mental health issues can lead to poor academics, social withdrawal, bullying, or acting out. The child may fall behind developmentally or struggle to make or keep friendships, which will impact their self-esteem and exacerbate their mental health issues. In older children and adolescents, we also see untreated mental health issues lead to more dangerous problems, like substance use, self-harm, eating disorders, or suicidal thoughts.

Instead of waiting, parents should proactively communicate with teachers, seek professional help when needed, and consider the child’s overall well-being when making decisions about their education.

What to Do Instead Of “Wait and See”:

  • Talk to your child: Open the door to conversation and let them know you’re there.
  • Keep track of behaviors, moods, or changes.
  • When in doubt, check it out: Even a single consultation with a pediatrician, school counselor, or therapist can provide guidance without committing to long-term treatment. If you suspect there is a deeper learning, emotional, developmental, or behavioral issue, a neuropsychological evaluation can also determine the root cause of the issues and set you and your child on a better path forward.

 

About the Author

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

 

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

 

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

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Image of a teen male feeling frustrated with a therapist and a quote from Dr. Moira Creedon

Bridging the Gap between Neuropsychological Testing and Therapy

By | NESCA Notes 2024

Image of a teen male feeling frustrated with a therapist and a quote from Dr. Moira CreedonBy: Moira Creedon, Ph.D. 
NESCA Hingham Director & Pediatric Neuropsychologist

Sometimes therapy hits a wall. A child or teen may be attending sessions regularly but still seems “stuck.” They might be unable to make progress, reluctant to engage, or struggling in ways that don’t fully add up. Even the most dedicated clients, those who do their therapy “homework” and participate openly, may continue to face challenges outside of the therapy room. This can be both frustrating and confounding for everyone involved. In these situations, neuropsychological testing does not have to be a last resort. It can be a powerful, collaborative tool that helps uncover what might be happening or why certain obstacles keep getting in the way. By clarifying diagnoses, identifying how a child or teen processes information, and highlighting cognitive or emotional patterns, neuropsychological testing offers insight that can shape therapeutic work to offer meaningful change.

There are few key gaps that neuropsychological testing can help to fill that are not a part of the normal course of therapy. First, neuropsychologists tend to get more extensive histories across all domains. Often times, therapists get some history about the presenting symptoms right away, but then they quickly have to dive into supporting a child, building rapport, providing psychoeducation, or practicing new coping strategies.

Neuropsychologists tend to get data across a broader range of developmental patterns for a holistic understanding of how the child has developed. Secondly, neuropsychologists then get concrete, quantifiable data on how a child or teen processes information – what their cognition is, how they encode and store information in their memory, how they tackle a hard problem, how they interpret a social challenge, and how they reflect on their own emotional experience. The focus is on how a person processes information, not just what their current symptoms are.

Why is this important? Take, for example, the case of a recent 16-year-old seen for neuropsychological testing who was in therapy for years due to a general sense of worry. Neuropsychological testing helped to highlight problems with cognitive flexibility, poor working memory, and distractibility. In addition to her anxiety, she was also struggling with ADHD. Lapses in attention were making her more anxious, leading her to long hours studying, blaming herself for her shortcomings. these long study sessions were disorganized and inefficient because of inherent executive functioning problems.

Take another example of a younger child who was 7-years-old. His parents felt frustrated by his dysregulated behaviors at home. He was disengaged in therapy and seemed unable to talk with his parents about what was going on after a big incident. Neuropsychological testing helped to undercover significant problems with language processing. This led to more frustration as he could not explain why he was upset, and traditional “talk therapy” methods had to be adapted so that language was simple and concrete.

By uncovering a child or teen’s unique profile, a family and the therapist can gain a wealth of information about what might be driving the presenting issues. This is one reason it is important to frame a referral for neuropsychological testing as a tool of discovery, not as a last resort or sign that treatment is failing. Diagnostic clarity is not about labeling; it is about understanding. It is a process of giving a complete picture of a child or teen’s functioning, seeking alternative pathways for change, and capitalizing on the client’s strengths.

With new information provided in neuropsychological testing, therapists can collaborate with a neuropsychologist to individualize treatment. Here are some examples for how testing can help therapists:

  • A therapist can slow down their interventions and offer more repetition for children with processing speed troubles.
  • A therapist can use simplified language for a child with cognitive impairments or reduced language skills.
  • A therapist can reduce the “homework” they assign for a teen with weak working memory and executive functioning deficits.
  • A therapist can pull in a new evidence-based treatment when anxiety veers into a pattern of intense obsessions and compulsive behaviors in a teen with OCD.
  • A therapist can support a teen overwhelmed with anxiety when facing a mountain of assignments at school if their executive functioning challenges make it hard for them to break down these tasks into smaller steps.
  • A therapist can explore the opportunity to collaborate with an executive functioning coach, group therapy program, or psychiatrist if a child’s profile suggests this is helpful.

When therapy stalls, it doesn’t mean a child isn’t trying or the treatment isn’t helpful. It might mean we are missing part of the picture. Neuropsychological testing can offer the insight needed to move forward with greater compassion, precision, and effectiveness.

Being “stuck” does not have to be seen as a sign of failure. It can be a turning point or an opportunity to uncover processing patterns that shift the focus from blame to change. When testing and therapy work hand in hand, they offer families not just answers, but a compassionate and informed way forward.

 

About the Author

Dr. Creedon offers her expertise in evaluating children and teens with a variety of presenting issues. SheMoira Creedon headshot is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. She tailors each assessment to address a range of referral questions, such as developmental disabilities, including Autism Spectrum Disorder, learning disabilities, attention challenges, executive functioning deficits, and social-emotional struggles. She also evaluates college-/grad school-age/adult individuals with developmental issues, such as ASD and ADHD, particularly when there is a diagnostic clarity or accommodation question.

 

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

 

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

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How Executive Function Coaching and Therapy Complement One Another-Part 2

By | NESCA Notes 2025

Quote from NESCA and an image of two puxxle pieces fitting together showing how therapy and EF coaching can complement each otherBy Jasmine Badamo, MA
Educational Counselor; Executive Function Coach

Last week I wrote a blog about the complementary nature of executive function coaching and therapy. I discussed the ways in which each service is distinct, as well as where there are overlaps. Today I’d like to share examples of how each service can support the other. If you find the examples helpful, feel free to download the pdf version from our Resources page!

How executive function coaching can support your therapy work:

An executive function coach can…

  • Serve as another person to reinforce the concepts you’re learning in therapy and help you make note of everyday and/or academic situations that connect to your therapy goals.
  • Serve as a source of motivation and accountability to help you implement the recommendations made in therapy, such as improving your sleep hygiene, widening your social circle, or increasing your positive self-talk.
  • Consult with your therapist to provide examples of your everyday struggles and mindset towards them.
  • Provide a safe space for metacognitive and self-reflection discussions, which can serve as a stepping stone if you are not yet ready to embark on therapy or are questioning your current style of therapy. These discussions can promote a new openness to trying therapy or exploring new therapy modalities/approaches.

How therapy can support your executive function work:

A therapist can…

  • Address anxiety, depression, perfectionism, all-or-nothing thinking, or negative self-talk/narratives, all of which can present a significant barrier to coaching because they reduce your motivation and openness to trying new problem-solving strategies.
  • Provide a big picture, comprehensive understanding of the mental and emotional barriers facing you and guide you (and your executive function coach) in choosing motivation and routine-building strategies that would work best.
  • Help you to build coping strategies for managing daily life and novel tasks, freeing up energy for taking on new goals and challenges.

Every service provider brings something important to the table, and therapy and executive function coaching are an extra-special support combination that has truly benefited many of our clients at NESCA. It often takes a team to support an individual through challenging aspects of their life, and NESCA’s coaches are happy to be a part of that team!

NESCA offers executive function coaching for students from elementary school through adulthood who are looking to bolster their organization, scheduling, time management, goal setting, and routine building skills. Students work 1-on-1 with occupational therapists and education specialists to identify specific skills that will help them be more organized and in control of their academic and general life tasks. If you have concerns about your child or student’s executive function challenges and want to try our 1-on-1 coaching, please complete our online Intake Form. 

 

 

About the Author

Jasmine Badamo, MA, is a licensed special educator and seasoned executive function coach. SheJasmine Badamo headshot supports a wide range of clients, ranging from age 7 to adulthood, to develop executive function and independence skills necessary for success with school (including college and graduate school) and in life. She is also uniquely qualified to coach parents and train educators to support EF skill development across settings.

To book executive function coaching with an EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form. 

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

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Image of two puzzle pieces fitting together to represent therapy and EF coaching

How Executive Function Coaching and Therapy Complement One Another-Part 1

By | NESCA Notes 2025

Image of two puzzle pieces fitting together to represent therapy and EF coachingBy Jasmine Badamo, MA
Educational Counselor; Executive Function Coach

At a recent NESCA case conference, we had a thought-provoking discussion about the relationship between executive function coaching and therapy that inspired me to write this two-part blog series.

Executive function coaching is different from therapy in a few key ways:

  • Most executive function coaches are not trained mental health professionals.
  • Therapy is usually positioned to treat mental health concerns, such as anxiety, depression, OCD, and related emotional patterns.
  • Executive function coaching focuses more directly on improving cognitive skills and strategies (like planning, organizing, prioritizing, time management, focus, and self-regulation) to support clients in reaching their academic, professional, and personal goals.
  • Executive function coaching is often more practical and solution-oriented, while many therapy approaches focus on exploring past experiences and deepening a client’s understanding of themselves.

But there can also be overlap between the two supports:

  • Executive functioning and mental health both impact an individual’s self-regulation and ability to cope with daily life.
  • Executive function coaches and therapists might both implement skill-based activities with clients.
  • Executive function coaches and therapists both focus on improving an individual’s well-being by identifying challenges, setting goals, developing strategies, and building self-awareness.

The truth is that the work we executive function coaches do with our clients frequently relates to their mental health and emotional struggles. For example, we may help individuals strengthen their ability to regulate impulses; reflect inward to better understand their habits and patterns in behavior; move past low motivation to activate and take action; adapt their behavioral patterns to better meet their needs and goals; implement self-care routines; and tackle the logistical challenges of accessing other services, such as therapy.

Additionally, persistent mental health struggles (as well as a person’s naturally fluctuating emotional states) play a large role in a person’s ability to access their prefrontal cortex or “thinking brain,” where our executive function abilities reside. This is because emotional regulation and executive control are both housed in this part of the brain. When one skill set is taxed, the other suffers. Correspondingly, persistent executive function struggles can contribute to increased mental health struggles, such as anxiety or depression.

Given the connected nature of executive functioning and mental health, we recognize that executive function coaching and therapy are distinct, but are also connected and complementary. The two services not only balance each other, but help to amplify the success and effectiveness of each individual service.

Tune in for our blog next week where I’ll delve into the ways executive function coaching can support your therapy work and vice versa!

NESCA offers executive function coaching for students from elementary school through adulthood who are looking to bolster their organization, scheduling, time management, goal setting, and routine building skills. Students work 1-on-1 with occupational therapists and education specialists to identify specific skills that will help them be more organized and in control of their academic and general life tasks. If you have concerns about your child or student’s executive function challenges and want to try our 1-on-1 coaching, please complete our online Intake Form. 

 

About the Author

Jasmine Badamo, MA, is an educational counselor and executive function coach who works full-time at NESCA supporting students ranging from elementary school through young adulthood. In addition to direct client work, Ms. Badamo provides consultation and support to parents and families in order to help change dynamics within the household and/or support the special education processes for students struggling with executive dysfunction. She also provides expert consultation to educators, special educators and related professionals.

Ms. Badamo is a New York State Certified ENL and Special Education teacher. She has more than 10 years of teaching experience across three countries and has worked with students and clients ranging in age from 7 to adulthood. She earned her bachelor’s degree in Biological Sciences from Cornell University and her master’s degree in TESOL from CUNY Hunter College. She has also participated in graduate coursework focusing on academic strategies and executive function supports for students with LD, ADHD, and autism as part of the Learning Differences and Neurodiversity (LDN) certification at Landmark College’s Institute for Research and Training. In addition to being a native English speaker, Ms. Badamo is also conversationally fluent in verbal and written Spanish.

Having worked in three different New York City public schools, Ms. Badamo has seen firsthand the importance of executive function skills in facilitating student confidence and success. Her coaching and consultation work focuses on creating individualized supports based on the specific needs and strengths of each client and supporting the development of metacognition (thinking about one’s own thought processes and patterns), executive function skills, and independence. She will guide clients to generate their own goals, identify the barriers to their goals, brainstorm potential strategies, advocate for support when needed, and reflect on the effectiveness of their applied strategies.

Ms. Badamo is a highly relational coach. Building an authentic connection with each client is a top priority and allows her to provide the best support possible. Additionally, as a teacher and coach, Ms. Badamo believes in fostering strong collaborations with anyone who supports her clients including service providers, classroom teachers, parents, administrators, and community providers.

To book executive function coaching with Jasmine Badamo or another EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form. 

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

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image of adoption papers and a quote from Sean Hyde O'Brien

Myth vs. Reality: Adoption, Development, and the Role of Neuropsychology

By | NESCA Notes 2024

image of adoption papers and a quote from Sean Hyde O'BrienBy: Sean Hyde O’Brien, Psy.D., ABPdN 
Pediatric Neuropsychologist, NESCA

Adoption is a wonderful way to create family. I say this both as a psychologist who has extensive research and clinical experience working with this population, as well as a person who was adopted. However, my experience working with children and families in the “adoption triad” over the past 20 years has made me aware of the negative stereotypes that are perpetuated by well-meaning professionals that are simply not based in fact and can, in fact, have a deleterious impact on the health and development of those children whom they are trying to serve.

In simplest terms, there is nothing inherently pathological about the process of adoption or individuals who were adopted. Yes, there can be particular family dynamics and developmental issues unique to the adoptive experience (for an interesting perspective on child development through an adoptive lens, see Dr. Joyce Pavao’s “The Family of Adoption”). However, these can be thought of much like other demographic factors that contribute to our development but do not define who we are in totality, such as ethnicity, gender, sexual orientation, or socioeconomic status.

So, if adoptive status is not a causal factor for later psychopathology, why do some children who were adopted display emotional, behavioral, and learning challenges? This is where neuropsychology comes into play. Research suggests that children adopted at older ages, from foster care, or from institutional settings have a higher risk for certain psychological challenges compared to non-adopted peers. However, this increased risk is not due to adoption itself but rather to neurobiological factors that are known to result in developmental challenges regardless of adoptive status. These can include sensory, cognitive, and social deprivation; chronic early stress; attachment disruptions; and teratogenic exposure (e.g., factors that can cause developmental abnormalities in a fetus); all factors that are known to impact the developing brain.

For example, a child who has been separated from their primary caregiver during an early sensitive period of development may show delays in social cognition, understanding others’ emotions, and their ability to form peer relationships. While this child could have been adopted after living in an orphanage, they may also be a non-adoptive child who was separated from their birth parent secondary to an injury/illness and subsequent hospitalization or had a birth parent who was not consistently available due to their own medical or mental health issues. The adoptive status of the child is not the issue at hand, rather the specific experiences of the individual, and for a professional to simply label a child’s challenges as a result of their adoptive status is overly simplistic and possibly unethical.

Thus, as with all children, it is important to understand the “whys” (e.g., why are they having this particular problem) to figure out the “hows” (e.g., how do parents and professionals best address it) when working with children who were adopted. This often requires a comprehensive evaluation of neuropsychological functioning that goes beyond the label of “adopted child” and helps to identify both the risk and protective factors unique to that individual that will impact their health and development.

 

About the Author

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

To schedule an appointment with one of NESCA’s neuropsychologists, please complete our online intake form. 

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

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Image of a feedback session with a parent and neuropsychologist along with a quote from Dr. Rodriguez

Beyond a Label: The Value of Neuropsychological Evaluation Even When There’s No Clear Diagnosis

By | NESCA Notes 2024

Image of a feedback session with a parent and neuropsychologist along with a quote from Dr. RodriguezBy: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

Why Diagnosis Matters

Most parents seek out a neuropsychological evaluation because they’re looking for answers. Often, someone in the child’s life—whether a parent, teacher, or caregiver—has noticed something that doesn’t quite add up. Pursuing testing is a wise and proactive step toward understanding the root of a child’s challenges. In many cases, families hope to find a diagnosis that explains what’s going on. To borrow a phrase from psychiatrist and author Dan Siegel, “You have to name it to tame it.” Having a name for a child’s difficulties is often the first step toward effective support and intervention. Many parents describe feeling validated and relieved when a professional can identify and explain what their child is experiencing. Knowing there is an understandable reason behind their child’s struggles can be both reassuring and empowering.

Why A Clear Diagnosis Isn’t Always Possible

Despite everyone’s best efforts, sometimes a child’s challenges don’t fit neatly into a single diagnostic label. There are several reasons for this:

  • Human complexity: Diagnoses can be helpful frameworks, but they don’t always capture the full picture. Children are wonderfully complex, and their unique mix of strengths and challenges often doesn’t align perfectly with one specific category.
  • Overlap between conditions: Diagnoses are often presented as distinct “boxes,” but in real life, there is a lot of overlap between conditions. It’s often more accurate to picture diagnoses as overlapping circles in a Venn diagram, with many children’s experiences falling in the spaces where these circles intersect. It’s not always possible—or even helpful—to fully separate features into distinct diagnoses.
  • Gradual emergence of symptoms: Some conditions develop slowly and may not be fully recognizable until later in life. For example, mild Autism Spectrum Disorder can be subtle and hard to identify, especially in gender-conforming girls and women. Social challenges may not be obvious in early childhood but can become clearer as social demands increase in adolescence, delaying a clear diagnosis.
  • Lack of formal diagnostic labels: There are profiles commonly seen in clinical settings that don’t yet have formal diagnostic labels. For instance, significant executive functioning weaknesses can greatly impact daily life and academics, but there is no official diagnosis for this. Similarly, while we may use the term “Non-Verbal Learning Disorder” to describe certain patterns of difficulty with visual-spatial skills, organization, social cues, or motor abilities, this label isn’t formally recognized in current diagnostic systems.

What To Do Next

Receiving an evaluation without a clear diagnosis can be disappointing and even anxiety-provoking for parents; however, a neuropsychological assessment still offers significant value. The true strength of a thorough evaluation lies in its ability to provide a detailed understanding of your child’s unique strengths and challenges, and to clearly outline the supports and interventions that will be most helpful. Even among children who share a diagnosis, there can be important differences in how their difficulties present. A high-quality assessment goes beyond simply assigning a label; rather, it paints a comprehensive picture of your child as an individual. Ultimately, the most effective recommendations are those tailored specifically to your child’s needs, regardless of whether they meet criteria for a particular diagnosis.

If you find yourself in this situation, allow yourself space for your feelings. It’s natural to crave clear answers, and it can be difficult to live with uncertainty. Yet, there are concrete steps you can take:

  • Recognize challenges independently of diagnosis: Throughout history, people have faced real and significant difficulties long before science could provide official explanations. For example, prior to advanced imaging, vision problems caused by multiple sclerosis were often mislabeled as “hysterical blindness” until CT scans revealed nervous system lesions. Similarly, before HIV was identified as the cause of AIDS, individuals suffered and died from the illness without a clear diagnosis. Sometimes, it takes time for science to catch up. In the same way, your child’s needs are real and valid, regardless of whether a formal diagnosis has been made.
  • Advocate for your unique child: Similarly, focus on addressing their specific areas of need, rather than waiting for a label.
  • Seek appropriate support services: There’s no need to wait for a formal diagnosis to pursue executive function coaching, psychotherapy, occupational or speech therapy, or specialized academic support. In some cases, early intervention may even help prevent a difficulty from becoming a full-blown diagnosis.
  • Try to be patient and stay open to change:  Remember that your child is still developing in very significant ways. Consider re-evaluation in a few years, as more information may become clear over time.

Remember, your child is more than a label. The insights from a neuropsychological evaluation can guide you in supporting their growth and well-being, even when there isn’t a specific diagnostic term to describe their unique profile. If you have questions or want to discuss whether a neuropsychological evaluation might be helpful, our team is here to support you.

 

About the Author

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

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

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

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

How to Encourage Summer Reading with Your Child

By | NESCA Notes 2025

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

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

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

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

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

Helpful Resources and Tools

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

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

Other Resources:

Conclusion

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

 

References:

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

 

About the Author

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

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

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

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

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

She is the mother of one college-aged daughter.

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

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

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Image of a couple with disabilities and a quote from Sarah LaFerriere

How We Teach Sexual Health Education at NESCA

By | NESCA Notes 2025

Image of a couple with disabilities and a quote from Sarah LaFerriereBy: Sarah LaFerriere, M.Ed.
Transition Specialist & Special Educator, NESCA

Sexual health education is often overlooked when it comes to students with disabilities—but it’s one of the most important subjects we can offer. In my last blog post, “Why Sexual Education is Crucial,” I explored the reasons why this kind of instruction is essential for adolescents and young adults with learning, developmental, and emotional challenges.

Today, I want to take that conversation further by sharing what sexual health instruction looks like in practice and how NESCA is helping students gain the knowledge, skills, and confidence they need to navigate relationships and their own well-being.

Meeting Students Where They Are

Sexual health education isn’t “one-size-fits-all,” especially for students with disabilities. Many of the individuals I work with have had limited or no access to comprehensive sexual health instruction. Some have received fragmented or confusing messages about consent, safety, or their own bodies. Others are at a developmental stage where typical school-based programming doesn’t match their learning profile.

At NESCA, our goal is to meet each student exactly where they are intellectually, socially, and emotionally. That’s why our sexual health instruction is individualized, paced appropriately, and rooted in respect and inclusion.

Using the Elevatus Curriculum

At NESCA, we use the Elevatus curriculum, a nationally respected sexual health education program designed specifically for individuals with disabilities. The curriculum offers two levels of instruction:

  • One for students with moderate support needs
  • Another for students with high support needs

This allows us to tailor content to the cognitive and communication levels of each learner. The curriculum emphasizes concrete language, repetition, and visual supports, making it accessible and meaningful for a wide range of students.

Instruction is available in-person or virtually, and we can modify both format and pacing to fit your student’s specific needs. Whether your child thrives in one-on-one sessions or small groups, we’ll work with you to design a program that supports learning and comfort.

What the Curriculum Covers

The Elevatus curriculum spans 22 lessons and includes topics such as:

  • Anatomy and puberty
  • Consent and personal boundaries
  • Healthy vs. unhealthy relationships
  • Online safety and media literacy
  • Understanding feelings and attraction
  • Decision-making and communication

Lessons are engaging and interactive, using visuals, stories, discussions, and role-play activities. We also incorporate functional goals, like understanding personal space on public transportation or recognizing signs of coercion in online messages.

Collaborating with Families and Schools

Sexual health instruction doesn’t exist in a vacuum; it works best when it’s integrated into a student’s broader learning and transition planning. At NESCA, we collaborate with families, educators, and support staff to align lessons with IEP goals, social-emotional supports, and the student’s overall educational plan.

We also guide families on how to reinforce learning at home, answer questions in developmentally appropriate ways, and create an open, respectful dialogue.

Why It Matters

At the core of sexual health education is empowerment. When students understand their bodies, their rights, and their choices, they’re safer, more confident, and more connected to others. This kind of instruction isn’t just about preventing risk it’s about promoting dignity, autonomy, and well-being.

If you’re interested in learning more about our sexual health instruction services, or want to explore whether it’s a fit for your child or student, please reach out to us here at NESCA via our Inquiry/Intake Form and visit our page about our Sexual Health Education Services.

About the AuthorHeadshot of Sarah LaFerriere, M.Ed.

Sarah LaFerriere, M.Ed., is a transition specialist and special educator who has nearly a decade of experience working with transition aged students in public schools, college, and home-based settings. She provides transition assessment, consultation, and coaching services to a wide range of clients, and specializes in supporting students with autism, intellectual disabilities, developmental disabilities, mental health conditions, and medical conditions.

To book a consultation with Sarah LaFerriere or one of our many other expert transition specialists, neuropsychologists, or other clinicians, complete NESCA’s online intake form.

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

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