Summer Reflections and Growth: A Director’s Update

By | NESCA Notes 2019

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

The final months of the school year always feel intense at NESCA as the clinical staff works diligently to get reports out on shorter timelines, squeeze in extra meetings and school observations, and ride the waves of joy and disappointment with parents who are seeking different educational placements for their child in the fall.  And somehow, every year, it all gets done, and then I can feel everyone let their breath out.  The halls of NESCA are a bit quieter now with staff taking well-deserved time off to be with their families and friends, relaxing and renewing in their favorite places.  I’ve just come back from a week of hiking in Norway, feeling rejuvenated by the time in nature and physical challenge—something we all need.

Even with the quieter summer months upon us, we continue to improve and expand NESCA’s services to meet the needs of the children and families we serve.

  • NESCA is very fortunate to have Dot Lucci, M.Ed., CAGS, join us as the Director of Consultation and Psychoeducational Services. I have worked with Dot many times over the last 30 years and am thrilled to have her as part of our team. She now brings her vast experience with the meaningful inclusion of children with special needs and her exceptional ability to work with school systems effectively to our NESCA families.
  • We also recently welcomed a new pediatric neuropsychologist, Dr. Yvonne Asher, who is splitting her time between the Newton and Londonderry offices. While she sees a wide range of children, Dr. Asher specializes in the evaluation of preschoolers and children with Autism Spectrum Disorder.
  • We are sad to be saying farewell to Holly Pelletier, our acupuncturist, who will be practicing full time in Maine, but welcome Meghan Meade, who will be taking her place starting today, today, July 15.
  • In September, Dr. Sophie Bellenis, OTD, OTR/L, will be joining us full time as a member of the Transition Planning Team under the leadership of Kelley Challen, Ed.M., CAS.

I hope you and your children enjoy the different pace and energy of the summer months and that this is a time of growth as well as reflection for all of you.

 

About the Author: 

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

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

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

 

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists, complete NESCA’s online intake form

 

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

 

 

Epigenetics—Redefining Nature and Nurture

By | NESCA Notes 2019

 

By:  Stephanie Monaghan-Blout, Psy.D.
Pediatric Neuropsychologist

Parents often wonder why their children are contending with learning problems or attentional issues, or suffer from emotional difficulties, and if they could have done something different in their parenting to have spared their child. Alternatively, they assume their own genes are condemning their child to these difficulties and challenges. This is the nature-nurture debate, but beyond contributing to parental sleepless nights, this either-or construction is overly simplistic—and overly deterministic. A  better way to think about this problem is provided by the study of epigenetics, or the  interaction between genetics and environment (genetics x environment).

The word “epigenetic” refers to  any process that alters gene activity (“turning on“ or “turning off” genes) without changing the underlying DNA sequence. These changes are sometimes referred to as “mutations.”  Some of these mutations will be “reset” in the next generation, but some continue to influence gene expression for several generations. Nessa Carey, author of “Epigenetics Revolution,”  uses the analogy of a movie to help understand this process. If a person’s life were a movie, their DNA would be the script, and certain blocks of the DNA sequence (genes) would instruct key actions or events to take place. The concept of genetics could be compared to screen writing, while epigenetics  would be like directing. The script may stay the same, but the director can choose to eliminate or accentuate certain scenes or dialogues, thus changing the course of the story.

Epigenetic effects may occur anytime throughout the life span, from within the womb to old age. Epigenetic influences include what you eat, how you sleep, who you interact with and whether you exercise. They also include environmental factors, such as the quality of the air you breathe and how safe you feel in your home and in your community. For instance, children whose pregnancies occurred during the Dutch famine of 1944-45 have been found to have increased rates of coronary heart disease, obesity and schizophrenia in comparison to the children of mothers who were not exposed to famine.  Other research has shown that children who had experienced stressful events during the pregnancy or during childhood were more likely to experience depression if they have mutations on a small number of genes, including those affecting neurotransmitter serotonin.

The really exciting element of the new research on epigenetics involves the  possibility that lifestyle factors can reverse or mitigate the negative elements of gene mutations. For instance, there is intense interest in the impact of diet on ADHD symptoms. At this point, the findings from the analysis of a large number of studies indicate that Omega-3 (fish oil) can have a small but measurable effect in reducing symptoms, and food additives and allergens can cause or worsen  symptoms in children who are sensitive to these triggers. Exercise has been proven to improve cognition and brain plasticity, the effects of which can be felt for a long time. We are just at the beginning of these investigations, with more exciting findings to come.

References and Resources:

Neurosci Biobehav Rev. Author manuscript; available in PMC 2018 Sep 1.

Published in final edited form as: Neurosci Biobehav Rev. 2017 Sep; 80: 443–456. Published online 2017 Jun 27. doi: 10.1016/j.neubiorev.2017.06

Weinhold, Bob. Epigenetices: The Science of Change. Environmental Perspectives 2006 Mar: 114 (3): 160-167

A Super Brief and Basic Explanation of Epigenetics for Total Beginner: Epigenetics Simplified. https://www.whatis epigenetics.com/what-is-epigenetics

Epigenetics: Fundamentals: Epigenetics Simplified. https://www.whatis epigenetics.com/what-is-epigenetics

Nigg, Joel (2017) Getting Ahead of ADHD. New York. Guilford Press

 

About the Author:

Formerly an adolescent and family therapist, Dr. Stephanie Monaghan-Blout is a senior clinician who joined NESCA at its inception in 2007. Dr. Monaghan-Blout specializes in the assessment of clients with complex learning and emotional issues. She is proficient in the administration of psychological (projective) tests, as well as in neuropsychological testing. Her responsibilities at NESCA also include acting as Clinical Coordinator, overseeing psycho-educational and therapeutic services. She has a particular interest in working with adopted children and their families, as well as those impacted by traumatic experiences. She is a member of the Trauma and Learning Policy Initiative (TLPI) associated with Massachusetts Advocates for Children and the Harvard Law Clinic, and is working with that group on an interdisciplinary guide to trauma sensitive evaluations.

 

To book an evaluation with Dr. Monaghan-Blout or one of our many other expert neuropsychologists and transition specialists, complete NESCA’s online intake form.

 

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

 

School to Summer Transitions

By | NESCA Notes 2019

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

For many children and adults, the end of the school year and the start of summer is an eagerly awaited transition. In schools the days are counted down, final assignments handed in, lockers cleaned out and yearbooks signed. Kids imagine the freedom of more sleep and play, and a reduction in work and stress. During the school year, kids operate under routines and schedules that dictate many aspects of their life. What time to rest and what time to rise, predictability with where they will be each day, who they might encounter, and what their afternoons and evenings will entail. Kids of all ages feel safe and secure when they have clear routines and expectations. With some simple tips, families can help kids of all ages have an enjoyable summer and a smooth transition between school and summer and back into the school.

  1. Reflection: With my NESCA clients and school students, I work towards building and strengthening children and teens’ ability to self-reflect. Self-awareness and curiosity are crucial skills to manage life’s ups and downs and be our best selves. Encourage your child to look back over their year and think about something they enjoyed, learned, worked hard on, or experienced. Have them think about issues that were difficult but are no longer triggers for them (such as a friendship struggle or challenging assignment). This can be a verbal discussion, journal writing, drawing, family share or even acted out. Helping kids look back over their successes and struggles, and talking about what occurred, and could have been done differently allows reflection during a safer, less charged time. It also subtly practices executive function skills such as working memory, problem solving, cognitive flexibility, perspective taking, emotional regulation, and holding and shifting focus.
  2. Setting Goals: The longer, sunny days of summer allow different opportunities for goal setting. It may be swimming out to the dock, adding to a sea glass collection, making a new level in a game, getting through a favorite book series or teaching the dog a new trick. This discussion could also explore ways to break down that goal into achievable steps over time, or what the back-up plan may be if there are unforeseen road blocks (e.g. collecting white rocks if no sea glass is found or conducting research on where to find sea glass) and when the goal will be reviewed or if there will be some family competition involved. Optional: talk out loud about these being brain-strengthening practices of building executive function skills in the areas of action, focus and effort.
  3. Routine: While summer is a time to relax many routines, routines are stabilizing and comforting for children. If your family has Taco Tuesdays, FaceTiming with grandparents on Sundays or soccer practice on Thursday, creatively incorporate these familiar routines to help smooth the start and end of summer. Maybe it’s Tacos Tuesdays on the family vacation week, or a family soccer scrimmage or watching World Cup highlights on Thursdays. You might just find a summer routine that could be added to the school year as well (Sundae Sundays anyone?).

 

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.

 

If you are interested in therapeutic yoga with Ms. McCowan,  please complete NESCA’s intake form today and indicate interest in “Yoga”

 

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, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Exercise Before Medication: How consistent workouts can change your life

By | NESCA Notes 2019

By Billy Demiri, CPT
Certified Personal Trainer

Recently I came across an article that highlights what I have believed to be true since I first started exercising regularly myself…a healthy body will foster a healthy mind. The study shows that “lifting weights helps lift depression; cardiovascular activities reduce the effects of anxiety; and any type of movement improves mental health.” Throughout the study, patients were led in a structured exercise program for 60 minutes four times a week. An astounding 95 percent reported feeling better, and 91.8 percent were very pleased with their bodies during each session. With those kinds of results, exercise should be at the forefront of treating mental health issues before psychiatric drugs.

When I started working as a personal trainer and coach, I saw the positive effects that consistent exercise had on all of my clients. Here at NESCA, I have the privilege of working with some amazing kids and young adults—all dealing with different disabilities/mental illness from Autism Spectrum Disorder (ASD), Anxiety, Depression, Obsessive-Compulsive Disorder (OCD), Muscular Dystrophy, and Attention Deficit Disorder (ADD) or Attention-Deficit Hyperactivity Disorder (ADHD). My goal has always been to make exercise fun and challenging, while also trying to identify goals that drive each individual to want to make exercise a regular part of their lifestyle.

Using a variety of equipment, we work on agility, conditioning, strength, coordination and overall better movement mechanics. After six years of being a personal trainer, and working at NESCA the past year, I couldn’t agree more with the findings of the article. I continue to see firsthand that consistent exercise can unlock everyone’s full potential and, in turn, create a lot of joy and self-worth.

Over the past year, it has been spectacular to see each person progress from session to session—not just physically but mentally. One of my clients was struggling with staying on task and had a hard time completing one exercise at a time before he got frustrated and needed a break. Each session we kept on progressing, and one exercise turned into two, then three, until we built up to doing four-move circuits. Yes, he built up strength and endurance over time, but more Importantly, he gained confidence in himself. He learned that what he originally thought was daunting was actually easy and very doable. Then  he went one step further and wanted to make it even harder. It was amazing seeing his mood change from not wanting to do any exercise to smiling and celebrating after beating his previous time in a four-move circuit. By staying consistent with exercise and seeing himself improve each week, I could see noticeable changes in his self-esteem, on-task behavior and overall mood during workouts—not to mention that he also developed better movement patterns and gained strength, endurance and overall better health.

Based on my experiences, prescribing exercise before medication is a worthwhile approach to continue to look at. Each person needs to be looked at individually, and more research needs to be done to ensure the safety of the patient and others without medication, however it’s clear through research and my own experiences that exercise has positive impact on our overall well-being. It will take some time to change the norm of prescribing patterns, but we are heading in the right direction.

 

Related Links for Additional Reading:

https://bigthink.com/surprising-science/exercise-mental-health?fbclid=IwAR3bUtp7SQmpI4w6kITG0RVbVrS_XfE9K1eOIoa018iUpTds9WJrxAganL4

https://journals.sagepub.com/doi/full/10.1177/2164956119848657

https://nesca-newton.com/billydemiri/

 

About the Author:

Certified Personal Trainer Billy Demiri offers Personal and Social Coaching (PSC) at NESCA. Billy has several fitness certifications including: NSCA-CPT (National Strength Condition Association- Certified Personal Trainer) Certified and Autism Fit Certified.

 

To book sessions with Billy Demiri, complete NESCA’s online intake form and note that you are interested in Personal & Social Coaching.

 

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

 

Taking parents to SPACE! A groundbreaking treatment for parents of children with anxiety

By | NESCA Notes 2019

By: Ryan Ruth Conway, PsyD
Clinical Psychologist

As a child and adolescent psychologist who specializes in treating anxiety, it is very rare that I work solely with the individual. More commonly, in working with anxious youth, I engage the caregivers in treatment as well, as they serve a unique role in helping children better manage their symptoms. Sometimes I even meet with parents without ever seeing their anxious child, usually in situations where children are either very young or having difficulty participating in treatment.

Anxiety is a universal emotion that we all experience, and it can be quite helpful in alerting us to danger. However, some people experience heightened anxiety related to things or situations that do not actually pose a real threat, even though it truly feels that way. There are three parts of anxiety that impact each other – 1) cognitions (worrisome thoughts), 2) feelings (emotions and physiological sensations e.g., racing heart, stomachaches), and 3) behaviors (fight/flight/freeze response e.g., having tantrums, avoidance of anxiety-provoking stimuli).

Children will go to great lengths to find relief from anxiety. One of the typical ways they do so is by avoiding things they find scary. For instance, a child with separation anxiety may decline invitations for sleepovers and/or refuse to go to school. As their “go to” for support, children oftentimes manage anxiety by eliciting their parents to make them feel better. For a child with social anxiety, parents might step in and speak for the child when confronting strangers. When a teenager is facing persistent and obsessive thoughts about germs and cleanliness, parents might wash and re-wash the child’s clothing. For the individual who worries about a bunch of different things, parents might find themselves providing reassurance by answering a lot of their child’s questions or responding to repeated text messages ensuring the parents’ safety.

Anxiety has an interesting way of entangling family members into its “worry web,” and families fall victim to its demands to maintain peace in the household, largely without even realizing they are doing so! We call this parent accommodation, or any actions caregivers take or deliberately do not take because of their child’s anxiety. Accommodation is incredibly common and understandable. Parents will do anything and everything to protect their children and make them feel better. While accommodation might alleviate anxiety symptoms quickly and reduce anxiety in the short-term, unfortunately it is unhelpful in the long-term. Anxiety is tricky – the more parents accommodate, the more the worry web continues to grow, and children end up relying on their parents to bring relief as opposed to learning to manage anxiety on their own.

Last month I had the pleasure of attending a training for the SPACE (Supportive Parenting for Anxious Childhood Emotions) program, an innovative, short-term intervention developed at Yale University’s Child Study Center under the leadership of Dr. Eli Lebowitz, a prominent child therapist, researcher and author. As an empirically-supported treatment, SPACE has been well researched and, in a recent study, shown to be just as effective as individual cognitive-behavioral therapy (CBT) in treating child and adolescent anxiety (Click here).

SPACE is unique in that the treatment is delivered only to parents. In considering the interpersonal nature of anxiety and different reactions parents can have to their child’s symptoms, it brings caregivers together to send consistent, supportive messages. The aim of SPACE is two-fold. One goal is to help parents respond effectively to their child, in a way that both validates the child’s experience of anxiety and also shows confidence in the child’s ability to tolerate discomfort. Parents also work collaboratively with the therapist to develop a clear plan to take small, gradual steps in reducing accommodations. In addition, parents receive guidance on how to respond to their child’s reactions to these changes. Parents are not viewed as the problem, but rather as part of the solution. The result is a child or teen who can better self-regulate and cope with anxiety independently.

The interested reader can access additional articles about the SPACE program here:

https://www.jaacap.org/article/S0890-8567(19)30173-X/pdf

https://www.sciencedirect.com/science/article/pii/S1077722913000977?via%3Dihub

Dr. Conway offers SPACE to parents at NESCA’s Newton location. For caregivers who would like to participate in this treatment or have any questions, feel free to contact Dr. Conway at rconway@nesca-newton.com or 617-658-9831.

 

About the Author: 
Conway

Ryan Ruth Conway, PsyD, 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 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.

 

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

When “Attention Problems” Are Not ADHD

By | NESCA Notes 2019

By Jessica Geragosian, Psy.D.
Pediatric Neuropsychologist

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurological disruption of the arousal system in the brain resulting in difficulties regulating attention and activity levels. ADHD can present with or without hyperactivity. Children with ADHD often have trouble engaging in expected tasks and maintaining appropriate behavioral control due to problems with inattention and lack of self-regulation. This can result in problems in the home, at school, and in peer relationships.

When concerns regarding attention or activity level are raised by parents or teachers, common practice is to consult with the child’s pediatrician. Parents and teachers might fill out rating scales asking questions like: Does your child have problems paying attention? Does your child have a hard time sitting still? Is your child having problems with learning? Is your child having difficulty following directions at home? When the answers to these questions are “yes,” a diagnosis of ADHD may seem appropriate.

However, there are many cases where inattention and/or impulsive behavior present as a symptom of another underlying problem and are not attributable to a primary attention disorder (ADHD).

The 5 most common misattributions I have seen in my clinical practice as a pediatric neuropsychologist in New Hampshire and Massachusetts are:

  1. Anxiety—When an individual is in a state of “fight or flight,” the brain lacks appreciation for information from the external environment that isn’t critical. When an individual is in a generalized state of anxiety, it is extremely difficult to remain focused and engaged in expected tasks.
  2. Learning disability—A student may have a disability in a core academic area. For example, a teacher may observe a child as being inattentive, when, in fact, they are several grade levels behind in reading. Thus, they cannot access the materials being distributed to the class.
  3. Communication disorder—If a child’s primary deficit is in the way they process language, you can be sure they look inattentive (e.g., not responding accurately to questions, inability to follow directions, etc.)
  4. Autism spectrum disorder (ASD)—Some children on the autism spectrum appear quite inattentive. In my experience, many children with ASD are often more tuned in to their internal environment (i.e., their thoughts and interests) at the expense of the external/social environment (i.e., parent, classroom and social expectations). While this can look similar to ADHD, the treatment approach is quite different.
  5. Other neurocognitive disorder (e.g., Processing speed deficit)—Other cognitive deficits can also make a student appear inattentive. If a student has slow processing speed, for example, the individual may not be able to keep up with the pace of instruction, resulting in an inability to absorb all of the lesson.

Other less common issues can also present as inattention, including trauma, absence seizures, hearing impairment, hallucinations, Tourette’s syndrome, among others. Because the root cause of inattention can sometimes be something very specific and complex, it is important to get a thorough evaluation.

It is also not uncommon for ADHD to present alongside the challenges identified above. In this case, effective intervention requires a simultaneous treatment plan addressing all challenges concurrently.

It is important to get a big picture—and accurate—understanding of a child’s neuropsychological profile in planning effective interventions. Our brains are complex, and one symptom can be common to many different origins. Getting the correct diagnosis the first time helps to put the right treatments in place.

 

About the Author:

Dr. Jessica Geragosian is a Licensed Psychologist in Massachusetts and New Hampshire. She has a wide range of clinical experience – in hospital, school and clinic settings – working with children and adolescents presenting with a wide range of cognitive, learning, social and psychological challenges.

Dr. Geragosian operates under the primary belief that all children want to, and can be, successful. The primary goal of her work is to identify the child’s innate strengths and find any underlying vulnerabilities preventing a child from achieving success. Whether the primary problem is an inability to acquire academic skills, maintain friendships, control emotions, or regulate behavior to meet expectations; she takes a holistic approach to understand the complex interplay of developmental, neurological and psychological factors contributing to a child’s presenting challenges.

Dr. Geragosian earned her doctoral degree from William James University, before completing postgraduate training in pediatric neuropsychology at the Massachusetts General Hospital for Children at North Shore Medical Center, where a focus of her work was neuropsychological assessment of young children with developmental challenges.

 

To book an evaluation with Dr. Geragosian or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

 

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

 

What’s Up, Postdocs?

By | NESCA Notes 2019

NESCA currently enjoys having three pediatric neuropsychology fellows on its roster: Caroline Kleeman, Psy.M., Miriam Dreyer, Ph.D., and Zachary Cottrell, Psy.D, LMHC. NESCA’s postdoctoral positions are two-year engagements allowing clinicians who have completed or are finalizing their doctoral degrees to advance their training and acquire/hone their skills in preparation for their long-term careers.

We recently sat down with two of our fellows to learn more about their postdoctoral experiences now that they have almost reached the one-year mark in their time at NESCA.

By Jane Hauser
Director of Marketing & Outreach

Tell us about your postdoctoral experience at NESCA so far.

Both: As postdocs, we sit in on every phase of an evaluation – from the intake session to the administering and scoring of the tests, interpretation of the results, feedback session with parents, and writing of the report.

We are always working with a supervising clinician during evaluations, and we participate in a training seminar led by NESCA’s Director of Training Dr. Angela Currie. We get feedback from our supervising clinicians throughout every stage in the testing process.

Caroline: I was fortunate to have worked at NESCA as a practicum student in 2016-2017. It’s been great to be back here in a different role. I’ve had the chance to work closely with Dr. Alissa Talamo during my fellowship.

Miriam: I’ve been on board here at NESCA since September 2018, so almost a year now. I worked closely with Dr. Amity Kulis, and now I am working with Drs. Nancy Roosa and Stephanie Monaghan-Blout.

Based on your experiences at NESCA, have you identified a specialty you would like to focus on?

Caroline: Autism has been and remains my area of interest. I also really enjoy working with children with learning disabilities and collaborating with schools to get the right plans in place for the kids we work with. I’ve really enjoyed and benefited from attending school observations and sitting in on Team meetings.

Miriam: Before I went to graduate school, I was a teacher. My area of interest is the intersection of emotional and learning challenges, including executive functioning difficulties and attentional disorders.  In graduate school, my research and therapy training focused on trauma. So, my goal is to combine my clinical and educational experiences to support families in understanding how emotional experiences impact learning in children and adolescents.

 Why did you choose to do your postdoctoral work at NESCA?

Caroline: As I mentioned, this is my second time being a part of the NESCA team. I came back to NESCA for my postdoc work because I valued the collegial environment. I also felt I could benefit from the different clinical staff and their various areas of expertise. It’s such a great experience to work in a practice where someone always knows the answer to my most challenging questions. I really appreciate the model of teaching at NESCA. Because of the apprenticeship model, there’s so much in-the-moment teaching with our clinical supervisors that I benefit from.

Miriam: I was really Interested in the apprenticeship model of training at NESCA as well. It’s a unique arrangement in that postdocs are with a supervising clinician every step of the of the evaluation process. We receive a lot of mentoring here, which is very important to me. I also value the integrated nature of the reports NESCA produces, which portray the sometimes complex kids we see in a nuanced way. Again, this is very important to me in my continued learning.

Both: We get to work with different people here who do different things. It’s given us exposure to so many new areas of neuropsychology that we may not have seen elsewhere. There are a lot of experts here to learn from.

What makes NESCA different? What did you find most beneficial?

Miriam: The structure of NESCA’s training program and the emphasis on continued learning throughout the organization are both so valuable. We frequently have seminars where third-party speakers come in to educate our staff on new areas of psychology and treatments so we all stay current with the latest evidence-based approaches. We also have a weekly case conference where all of our clinicians gather to discuss complex cases and to share resources, knowledge, and experiences to benefit the case at hand. There is a heavy emphasis on learning within the practice, so I am constantly getting exposed to new ideas. I think that’s a valuable and unique asset of NESCA.

Caroline: I absolutely agree with the fact that we are really benefiting from the heavy emphasis on learning and the years of experience our clinicians have. Their willingness to share the knowledge they’ve gained with each other and us is a great benefit to our clients and to my own education. I have also learned so much from our clinicians who attend and bring back such good information from conferences as well as the conferences I’ve had the opportunity to attend.

What’s been your favorite and your most challenging experience so far at NESCA?

Miriam: Each case is unique, so I’ve had lots of exposure to new areas of neuropsychology. Every person who walks in the door presents new opportunities for learning. While this is one of my favorite aspects of NESCA, it is also challenging. With the unique caseloads we take on, there is a lot to learn about the different profiles. As fellows, we do not yet specialize in one area, so we are getting a broad education across domains of neuropsychology. For every new case, there are unique recommendations tailored to that individual that require research, which is an important part of our training.

Caroline: Seeing each child who comes to NESCA as a unique individual is probably my most rewarding and challenging part of being in this practice. Getting to work with some of the more complex profiles out there is exciting to me, but is obviously a challenge, too. There’s always a lot to be learned about each child, and that can take some time to do.

What advice can you share with others looking into this field or who are looking for the right place for their postdoc experience?

Miriam: It’s a great opportunity to be here. My advice is to visit NESCA for an interview, see what it’s like here and learn about the different specializations of the practice’s clinicians. In your search, look for a postdoc position where you get varied training and exposure to a lot of different cases, even if they aren’t in your specific area of interest.

Caroline: Neuropsychology is a very fulfilling career. Every day and every child are different, so it never gets boring. Of course, it can also be frustrating in that there are sometimes barriers to kids getting what they need, whether in school or with community resources not being available. In those moments, you have to be creative and problem-solve. That said, the rewards far outweigh the challenges.

 

About Pediatric Neuropsychologist Fellow Miriam Dreyer, Ph.D.:

Dr. Dreyer enjoys working with children, adolescents and families who come to her office with a wide range of questions about learning, social and emotional functioning. She is passionate about helping children and parents understand the different, often complex, factors that may be contributing to a presenting problem and providing recommendations that will help break impasses – whether they be academic, therapeutic, social or familial.

Dr. Dreyer joins NESCA after completing her Doctorate in Clinical Psychology at the City University of New York.  She most recently provided psychological assessments and comprehensive evaluations at the Cambridge Health Alliance/Harvard Medical School for children and families with a wide range of presenting problems including trauma, anxiety, psychosis, and depression.  During her training in New York, she conducted neuropsychological and psychological testing for children and adolescents presenting with a variety of learning disabilities, as well as attentional and executive functioning challenges.  Her research focused on developmental/complex trauma, as well as the etiology of ADHD.

Dr. Dreyer’s experience providing therapy to children, adolescents and adults in a variety of modalities (individual, group, psychodynamic, CBT) and for a wide range of presenting problems including complex trauma/PTSD, anxiety, depression, ADHD, and eating disorders informs her ability to provide a safe space for individuals to share their concerns, as well as to provide tailored recommendations regarding therapeutic needs.

Before becoming a psychologist, Dr. Dreyer taught elementary and middle school students for nine years in Brooklyn, NY.  She also had an individual tutoring practice and specialized in working with children with executive functioning challenges, as well as providing support in writing, reading and math.  Her experience in education informs both her understanding of learning challenges, as well as her capacity to make specific and well-informed recommendations.

She received her Masters in Early Childhood Education from Bank Street College, and her B.A. in International Studies from the University of Chicago.

About Pediatric Neuropsychologist Fellow Caroline Kleeman, Psy.M.:

Caroline Kleeman comes to NESCA with experience providing evaluations for children with a range of neurodevelopmental profiles.  She has focused on assessing children with autism spectrum disorder, including those presentations accompanied by cognitive delays, language impairments, or genetic disorders.  She also enjoys evaluating children with academic difficulties stemming from learning disorders or attention/executive function disorders.

Ms. Kleeman’s approach to testing recognizes that children are so much more than a list of scores.  Combining her own careful observations with input provided by parents and teachers, Ms. Kleeman strives to differentiate between skill deficits or performance deficits, while also identifying unique strengths.  Additionally, drawing on her applied behavior analysis (ABA) background, Ms. Kleeman looks beyond the individual to identify helping and hindering features of the surrounding environment.  The result is meaningful, highly individualized educational and therapeutic recommendations.

Ms. Kleeman received her Sc.B. with honors from Brown University, where she studied cognitive science.  Focusing on early childhood, she conducted research on the role of sleep (especially naps!) in cognitive development.  After college, Ms. Kleeman worked as a therapist at Nashoba Learning Group, using the tenets of ABA to provide instruction across educational, vocational, behavioral, and adaptive domains.

Bridging between psychology and education, Ms. Kleeman is finalizing her doctorate in school psychology at Rutgers University Graduate School of Applied and Professional Psychology.  Her dissertation is investigating the role that Sesame Street’s autistic muppet, Julia, could play in early childhood social and emotional learning (SEL) programs.  She completed her pre-doctoral internship at the Center for Children with Special Needs in Connecticut, where, in addition to psychoeducational evaluations, she provided ABA therapy and ABA-based reading intervention for children across the autism spectrum.

 

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

 

To book an appointment with one of our expert neuropsychologists, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

When the Worry Bug Makes You Mad: Understanding the Importance of Positive Behavior Plans for Anxious Kids

By | NESCA Notes 2019

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

“Don’t Feed the Worry Bug,” by Andi Green is a wonderful book for children who are anxious or experience a lot of worrisome thoughts. The story is about a monster who constantly feeds his WorryBug, only to find that as he worries more and more, the WorryBug continues to grow until the monster is totally overwhelmed by the emotion. Eventually, he learns to control it. In my practice, I evaluate a number of children with lots of worries…but they don’t actually look worried. Instead, children may appear defiant, hyperactive and aggressive. Why do children overwhelmed with anxiety sometimes become frustrated and angry or have poor behavioral control at home and in the classroom?

Children with anxiety “on the surface” may appear angry, oppositional and defiant to adults. However, these behaviors oftentimes reflect secondary responses to an underlying cause: anxiety. Responses to anxiety can be categorized as “fight, flight or freeze.” As a classic example, if you run into a grizzly bear on a hike, your body’s natural physiological response is to fight, flee or freeze. Your anxiety about the demands of a situation send your body and brain into a state of “threat alert.” Similarly, when a child is worrying about something, is socially anxious, or is feeling nervous about their ability to handle a task, this “threat alert” system is activated and the child’s ability to make well-thought out decisions is impaired. The child may be labeled a “behavior problem” because of the impulsivity, defiance, disruptiveness or aggression (fight mode). Or the child may appear distractible, silly and immature, or avoidant of challenging tasks (flight mode). An anxious child may also show difficulties shifting gears/transitioning, problems letting go of events, or seem unmotivated or apathetic (freeze mode). It is also not uncommon for children with anxiety to have challenges demonstrating appropriate social skills, such as problems with insight into how their behaviors may affect others. They may also experience challenges reading the nonverbal and verbal cues in their environment because their brain is “soaked” with high arousal, immobilizing their capacity to apply logic to everyday situations. How do we help children manage their anxiety and the resulting behavioral challenges from that anxiety?

A neuropsychological evaluation can provide insights into your child’s behavioral challenges to determine if there may be an “underlying cause,” such as anxiety, (or other causes such as learning disabilities, depression or poor information processing) which are driving weak emotional and behavior control. Once identified, a neuropsychologist can provide guidance on the most effective interventions for a child at school and at home.

In my experience, one of the most important interventions for a child who experiences anxiety and secondary behavioral challenges is the development of a Positive Behavior Plan at school, which can then be included in a child’s IEP. However, many children with anxiety do not respond well to traditional behavioral reward systems that solely focus on increasing or decreasing behaviors (e.g. follow directions, sit calmly, keep your body safe, etc.), as these systems do not teach the child the self-regulation skills necessary for controlling emotional and behavioral responses. Instead, an effective Positive Behavior Plan for a child with anxiety includes behavioral targets or “goals” that focus on the attempt at coping strategy application. Importantly, a child with anxiety should be rewarded for trying to use a coping strategy, as it will take time, practice and reinforcement before a child develops the capacity to apply coping strategies consistently and successfully.

Sample coping strategies that a child should be taught by a special educator, counselor or other specialist include “taking deep breaths, jumping jacks, taking a break, using words to say how I feel,” or other self-regulation tools. When the goals of a Positive Behavior Plan focus on using a coping strategy before or during moments of distress rather than a plan that is tied to increasing or decreasing specific behaviors after they occur, a child builds independent capacity to appraise and react appropriately to physical and emotional responses in the classroom and the community. Children learn the signs (e.g. in their body, mind and in their environment) that the WorryBug is approaching, and feel better equipped, confident and more in control of their emotions and behaviors. For more information on how to appropriately develop Positive Behavior Plans for children with anxiety, “The Behavior Code” by Jessica Minahan and Nancy Rappaport is an excellent resource for parents and educators.

When the “WorryBug” or anxiety makes kids mad, mean and aggressive, a comprehensive and thorough neuropsychological evaluation can determine how to best tackle the anxiety “beneath the surface” through therapeutic and educational interventions. A neuropsychological evaluation can also direct the development of strategic Positive Behavior Plans that are individualized and appropriate for the child’s home and school environment.

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

 

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

 

Got Complicated? NESCA’s Newest Pediatric Neuropsychologist Wants to Test Your Child. Find Out Why!

By | NESCA Notes 2019

Pediatric Neuropsychologist Yvonne Asher, Ph.D., joins NESCA on June 3, servicing clients in the Londonderry, New Hampshire and Newton, Massachusetts offices, and is scheduling new clients now. We sat down with Yvonne to learn more about her, what her passions in neuropsychology are and why she joined NESCA.

 

By Jane Hauser
Director of Marketing & Outreach

NESCA has 15 neuropsychologists who test a wide range of individuals. Tell us about your past professional experience and the types of clients you most enjoy serving.

I love working with children with complex profiles where challenges and diagnoses aren’t easily made or identified. This is the group of kids I worked with most often when I was with Mass General Hospital’s Lurie Center for Autism. It’s also incredibly rewarding to work with kids who aren’t able to communicate in a traditional manner—they may be too young, too impaired or potentially non-verbal. Many people think these individuals are too difficult to work with in testing. Using data to better understand their strengths and weaknesses is my passion, and I love to help them tell their stories through the assessment process.

It sounds like you enjoy working with complex kids. Can kids who have limited verbal skills and/or behavior challenges be tested?

Yes! Sometimes these children can be labeled in a punitive or negative way, such as being “uncooperative” or “untestable.” I don’t believe that anyone benefits from these kind of labels. It’s my job as the psychologist to be creative so that we can get the necessary data to understand them. I try to ease parents’ minds by reassuring them that I’ve seen many of these children before. And, if I haven’t frequently seen a particular complex profile, I’m lucky to have wonderful colleagues and resources to collaborate with on such cases.

For example, I worked with one very sweet, four-year-old child who had severe communication issues.  The parents and his pediatrician questioned whether he had autism. Since he had incredibly limited verbal skills, we altered all of the assessment tasks, using some non-verbal assessments and creatively modifying others to complete the testing. We noted that everything in the assessments—aside from his language—was on track developmentally. Prior to testing, everyone was pointing toward autism as the diagnosis, but he actually had a severe expressive/receptive language delay. His parents had figured out some tricks to communicate with him, but the world was a very scary place to him. He didn’t understand what was going on and primarily used gestures and facial expressions to communicate. That, unfortunately, only got him so far. As you can imagine, these challenges and frustrations led to a very stressful environment for the entire family. We recommended intensive speech therapy to help develop his communication skills, providing the family with a clear path forward.

You were a teacher before becoming a neuropsychologist. How do you feel your past experience as an educator enhances your work as a pediatric neuropsychologist?

I have a lot of experience working in public and charter schools. I was also a preschool teacher before graduate school, where I found the children to be endlessly funny, creative and just awesome! This experience is, in part, what fuels my desire to work with younger children who are experiencing challenges.

Having that educational experience is so valuable for the families at NESCA. I’ve been in special education and can help parents understand the process and landscape every step of the way—from an initial concern and assessment to getting an IEP and to thinking about high school placement and transition to adulthood.

The school experience also helps me to relate to the teachers, since I’ve been one and know how to partner with them to help students. We always help our families and push for what’s needed, but it’s helpful to also understand the constraints of the school setting. Knowing the constraints won’t change our recommendations, but it’s helpful in providing recommendations that will be implemented.

Why did you opt to move from the school setting to neuropsychology?

While I loved working in the school setting, I found that I didn’t get the chance to work as closely with families as I wanted. While families were there for school meetings, I’m looking to work with and serve the whole family system. I enjoy taking a close look at why children are having particular challenges, whether there’s a diagnosis that can be identified, and determining what school or path best fits a child and their family. I like taking the time to talk with parents and educators, giving each of them the chance to talk about the child, and to ask questions and make a plan for the child and their family. With really young kids, this is often just a first step, and I am excited to work with families long-term and help them through future hurdles.

What is so special about working with young children and their families?

Being a family’s first introduction to mental health is so meaningful. I tend to work with families who may be noticing that some milestones or behaviors are a bit off, or when they may first be considering a neuropsychological evaluation or other assessments. I like to find those parents who are asking, “What do you think it could be?” I truly enjoy giving these parents insight into their child, and providing exposure to and help along their path in mental healthcare.

Why did you opt to work in a group practice, like NESCA?

During my postdoctoral work, I really came to value the consultation with and supervision from other psychologists. I thought about going back into the school setting, but school psychologists are typically the only ones in that role at their school, or even their district. I appreciate the ability to put heads and knowledge together as colleagues. Doing so, on behalf of our clients, can help us to frame a case or intervention in a different way. Being able to bounce ideas or recommendations off of each other and using the combined experiences, knowledge and referral resources of other neuropsychologists brings so much to clients, families and individuals with challenges. NESCA, in particular, offers a very supportive environment in which to work. That can be felt by co-workers as well as the families we serve.

 

About Pediatric Neuropsychologist Dr. Yvonne Asher:

Dr. Yvonne M. Asher enjoys working with a wide range of children and teens, including those with autism spectrum disorder, developmental delays, learning disabilities, attention difficulties and executive functioning challenges. She often works with children whose complex profiles are not easily captured by a single label or diagnosis. She particularly enjoys working with young children and helping parents through their “first touch” with mental health care or developmental concerns.

Dr. Asher’s approach to assessment is gentle and supportive, and recognizes the importance of building rapport and trust. When working with young children, Dr. Asher incorporates play and “games” that allow children to complete standardized assessments in a fun and engaging environment.

Dr. Asher has extensive experience working in public, charter and religious schools, both as a classroom teacher and psychologist. She holds a master’s degree in education and continues to love working with educators. As a psychologist working in public schools, she gained invaluable experience with the IEP process from start to finish. She incorporates both her educational and psychological training when formulating recommendations to school teams.

Dr. Asher attended Swarthmore College and the Jewish Theological Seminary. She completed her doctoral degree at Suffolk University, where her dissertation looked at the impact of starting middle school on children’s social and emotional wellbeing. After graduating, she completed an intensive fellowship at the MGH Lurie Center for Autism, where she worked with a wide range of children, adolescents and young adults with autism and related disorders.

 

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

 

To book an appointment with Dr. Yvonne Asher, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Why are they called “Soft” Skills?

By | NESCA Notes 2019

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

If they are soft, why are they so crucial in this hard, cruel world? As a transition specialist, I meet with young adults and their parents on a daily basis. All parents want to know what is that missing piece for child to really succeed after high school? What should my priorities be? Is the right college more important than the right internship or vise versa? I often hear the saying, “I remember in my day, you just dusted yourself off and kept going. Why is this new generation struggling?”

While I don’t have an answer to those profound questions, I can offer some go-to skills that will support our young adults as they transition from high school to college, the world of work and the great beyond…soft skills—those intangible, hard-to-pin-down skills that we all know we need to succeed, but are so hard to teach. As a wise practitioner once told me, “Just because it is simple, it doesn’t make it easy.” While it’s critical to teach, prepare and equip our students with the necessary skills for academic success, soft skills can be just as important in many instances. Young adults need a balance of academic, executive functioning, communication and soft skills to set themselves up for success in their multi-faceted life after high school. These soft skills can make the difference between candidates competing for college acceptance and job opportunities.

I also like to refer to these skills as the job keeping and high achieving skills. Strong foundational academic, planning and team-building skills are necessary for success, but these soft skills are the subtle differences observed in the student chosen for that internship by the professor and recognized in the entry-level employee who quickly advances to the mentor employee.

In my practice, I am witness to amazing, capable, energizing and unique young adults, who are unaware of the many talents and strengths they already possess. I work to coach, teach and persuade them that these soft skills are in there, but are struggling to make an appearance. The key is identifying them and knowing when to call on them in stressful times. As a transition specialist, I offer the young people I meet with the opportunities to name and own these skills within themselves. For example, when a teenager is struggling with school, but shows up every day, I introduce them to their “grit,” their get-up- and-go and “try again” skill.  By identifying skills that may just be lying dormant or unrecognized, I offer them a chance to see that they have an innate strength that has both a name and a purpose. These skills are not only necessary, but are transferable to all aspects of their future lives. Their internal grit pushes them to go to class when their roommate is sleeping in and go to work even though they have a cold and could call out sick.

By definition, students ready to transition from high school are at an age and stage of curiosity, exploration, hope and optimism. But they may easily miss out on identifying these characteristics as strengths and skills, if we do not point it out and celebrate it with them. When they are resisting rules and boundaries, they are employing their skills of curiosity and exploration. When they want to protest against inequity in this unfair world and are perceived as naive and inexperienced, I praise their hope and optimism. We talk about how these soft skills are integral to their success as an adult and will serve them as they continue to grow and learn.

Young adults in our current society have no other option than to be flexible and adaptable. Technology is constantly updating and changing, forcing them to move forward or be left behind. Their resilience in handling all that social media exposes them to on a daily basis is admirable. I wouldn’t have stood as tall and strong as they do with such public scrutiny.

As we prepare our young adults for life after high school, let us always take the time to see, name and recognize the strengths and soft skills they show us. We have the opportunity to observe and learn from them and value these skills so that they may offer themselves as resources to their community. The balance necessary to teach young people how to manage an interdependent world as an adult is complicated. It is exciting and energizing to witness young people find these strengths within themselves, helping them to conquer that great big world.

 

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, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

To book a transition assessment or consultation with Kathleen, please complete NESCA’s online intake form