Interview with Reva Tankle, NESCA Pediatric Neuropsychologist

By | NESCA Notes 2018

 

 

By:
Ashlee Cooper
NESCA Marketing and Outreach Coordinator

 

What made you become interested in being a neuropsychologist?

I first became interested in neuropsychology when I was in graduate school.  I was pursuing a Masters Degree in Developmental Psychology and I worked on a research project looking at brain organization in children with autism.  This sparked my interest in how the brain works and how differences in brain organization relate to different neurodevelopmental disorders. My doctoral research focused on differences in how right and left-handers processed information.  I had planned to make a career within the research field of neuropsychology and my first job was in the Neurology department of a medical school. However, after a short time, I found this to be rather unsatisfying as I did not feel that the work, I was doing was having any direct impact on individuals’ lives.  It was at that time that I took a job in Boston at a rehabilitation center working with adults with traumatic brain injury. I found working with the patients and their families to be very meaningful and satisfying.

What brought you to NESCA?

After working for many years in the field of adult brain injury, I found myself having to navigate the special education world. My family and I were assisted by a wonderful Special Education advocate and from that experience I found my next “calling.”  I did the advocate training through the Federation for Children with Special Needs and over the next 7 years, I had the opportunity to work with hundreds of families and help guide them through the process. I was fortunate to meet Dr. Ann Helmus, Director of NESCA, and she invited me to join NESCA; first, to expand my training as a neuropsychologist and then as a staff clinician.  I have been able to bring my experience of working with many wonderful families and dedicated school personnel and connect it to a deep understanding of the neuropsychological underpinnings of the learning and emotional challenges our children face.

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

I evaluate students age 6 years to young adulthood.  I see a wide range of children and young adults including those with language-based learning disabilities, attentional issues, brain injury, and other neurodevelopmental disorders.  I often do school observations and attend Team meetings. I provide recommendations that are individualized for that student and relevant for both school and home-based interventions.

What do you like about your job?

First and foremost, I love spending time with and evaluating children.  One very bright child asked me “Is this boring for you?” I told him “No, I am always thinking about what the child is doing and trying to figure out what else I need to do to best understand his or her thinking and learning.  And that is not boring.” And I try hard to have “fun” and make it an enjoyable experience for the child. No one is going to be a pediatric neuropsychologist and not find kids fun to be with. I also like my job because I can have an impact on the life of that child, their family and their school.  When we work effectively as a Team, we can really make the life of that child so much better and make their school experience more positive.

Why should parents bring their child to NESCA for evaluation?

The evaluations we provide at NESCA are individualized and comprehensive so that we can answer the referral questions being asked by either the family or the school district.  We have no time constraints; so, if a child needs a third or even a fourth session to get through the necessary testing, the clinician is encouraged to do so. This allows us to fully evaluate the child and develop a deep understanding of the cognitive, learning and/or emotional factors that are making school and life in general, hard for this child.

I would also like to point out that NESCA clinicians are provided with extended opportunities for continuing education and consultation with colleagues.  The NESCA clinicians meet several times a month for continuing education seminars provided at NESCA to further both clinical knowledge and information about resources in the community.  In addition, NESCA clinicians gather weekly for a “Case Conference” where colleagues can consult with each other to ensure that our evaluations and recommendations include the broad-based expertise of our many clinicians.

What advice do you have for parents who are not sure if a neuropsychological evaluation is needed for their child?

When I teach at the Parent Consultant Training course for the Federation for Children with Special Needs, I tell them that an evaluation should be recommended when parents have concerns about their child’s development, particularly cognitive or academic.  Parents might start out with a school evaluation, but, a more comprehensive neuropsychological assessment should be considered if the school evaluation does not provide a deep enough understanding of the child’s learning needs or if the child is not making meaningful progress.  There are great benefits to intervening early when a child is struggling. A neuropsychological evaluation can provide a better understanding of the child’s learning profile and offer recommendations for the interventions that can avoid longer-term negative consequences on learning and emotional well-being.

NESCA has opened up a 3rd location in Plainville, Massachusetts which is where you will be primarily seeing clients. Can you tell us more about your decision to work in Plainville?

Well, I have to admit that moving to Plainville will result in a significantly shorter commute for me.  I have loved being a part of the daily excitement in the Newton office but, I have struggled with the commute.  I am excited to extend this easier commute to families on the South Shore, MetroWest and even Central MA who will find it easier to get to our new office.  I don’t want to make our Newton colleagues jealous, but even parking will be easier.

 

Reva Tankle, Ph.D.
Pediatric Neuropsychologist

Combining her experience and training in both pediatric neuropsychology and educational advocacy, Dr. Reva Tankle has particular expertise in working with families who are navigating the IEP process. Having participated in numerous team meetings over the years, Dr. Tankle is especially knowledgeable about the many ways that schools can support and accommodate students with special learning needs, information that she clearly communicates in her evaluation reports and in team meetings, if needed. She also has a great deal of experience in articulating the reasons that a student may need a program outside of the public school.

Dr. Tankle evaluates students with ADHD, learning disabilities, high functioning autism spectrum disorders, and neurological conditions, as well as children with complex profiles that are not easily captured by a single diagnostic category.

 

NESCA’s new satellite office, opening December 1st,  is located at 60 Man Mar Drive, Suite 8, Plainville, MA 02762.  To schedule an appointment with Dr. Reva Tankle in Plainville, please complete our online intake form

 

 

 

 

 

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

 

How Chinese Medicine Can Help You Stay Healthy This Fall

By | NESCA Notes 2018

 

 

By Holly Pelletier, L.Ac.
Licensed Acupuncturist

Although no one can argue with the beauty of the changing leaves around us, this time of the year can be hard on people in a multitude of ways. Reason being? For most people, fall merely marks the downward spiral into winter–a season of short days, chilly nights, and colorless, dreary skies. It is a time where we are forced to say goodbye to our sunny, warm days and begin to look ahead to the depths of winter.

As physicists have explained time and time again, everything is energy. Energy makes up our bodies, the world around us, the food we eat, the air we breathe–everything about life and matter. The seasons, therefore, have their own energies as well. Traditional Chinese Medicine (TCM), which is very rooted in the principle of energy, sees summer as the most Yang (vibrant, hot, excited, active) time of the year, while winter is seen as the most Yin (cool, calm, dark, heavy). Fall is a hinge, a transition period out of the Yang and into the Yin. We see this in the physical changes marked by the season: the leaves changing color and falling off the trees, the animals collecting and storing food for the winter, how we start wearing extra layers and perhaps going to bed a little earlier. We and nature are preparing for the cold, the winter, the most Yin time of the year. This transition can be seen and felt as a preparation for loss, a time of letting go of the warmth and sunshine and turning more towards a time of stillness, waiting, and introspection.

TCM connects each of the seasons to specific meridian/channel systems in the body. Autumn correlates with the Lungs and the Large Intestine meridians. Today we’ll focus primarily on the Lung meridian system because it is incredibly vulnerable this time of year.

In TCM, the Lungs are known as the “delicate organ.” They are substantially affected by cold and dry temperatures, wind, fluctuating seasonal changes, and sadness/grief–all things that transpire in the fall. When the hours of daylight shorten, the leaves and other plants begin to die, and the temperatures get cooler, is it a very common thing for people’s moods to also drop–many people even have this diagnosed as seasonal affective disorder (SAD).

Basically, fall creates the perfect storm against the Lungs, and they become very easily damaged. This, in turn, causes more sadness, colds and flus, seasonal allergies, shortness of breath, difficulty exercising or walking upstairs, abnormal sweating, and even a chronically hunched over posture that the body adapts in order to protect the lungs–often leading to upper back and neck tightness. If these ailments continue long enough and cause enough imbalance in the body, then urinary issues, asthma, and long-standing depression can develop, which can then offset other symptoms and imbalances connected with other meridian systems. So what’s the takeaway? Take extra good care of your Lungs this time of year!

 

 

Following are 3 of the simplest ways you can ensure you make it through this transition period with an uplifted spirit and a healthy set of lungs.

1. Breathe Deep

One of the easiest and most effective ways to take care of your Lungs is to breathe deeply. Sounds simple, right? Well, when anxiety and stress set in, one of the quickest things to go is our attention to the breath. We begin to hold our breath or take really shallow gulps of air–oftentimes through our mouths, which can contribute to the anxious feelings. To ensure deep and steady breath, begin by taking really conscious breaths throughout the day, inhale through your nose, and exhale through your nose. Fill up your lungs all the way to the top and then exhale every ounce of air out. If you find yourself in a stressful situation, start counting your breath and make your exhales slightly longer than your inhales–this doesn’t have to be substantial to make a difference, even a slight elongation of the exhale can help. Lengthening out your exhales will calm your sympathetic nervous system and instantly have a calming effect on the mind and the body.

2. Do Yoga

Do some yoga poses to help open up the Lung meridian. The Lung meridian runs along the inside of your chest, across your pectoral muscles. This is one of the first areas to tighten when the lungs are affected, and as mentioned above, this can set off a domino effect and create a tremendous amount of pain and tension in your upper back and neck. You can work to gradually open this area every day to ensure this doesn’t happen by doing the following 3 simple poses. Go deeper into each one until you begin to feel an opening or a stretch but you do not lose control and depth of your breath. Your breathing should not suffer as you go deeper into the pose. Keep your inhales and exhales long and steady. If you are unfamiliar with the pose mentioned, click on the link below to bring you to a step by step instruction guide.

3. Get outside.

Yes, the Lungs are vulnerable to the cooler temperatures, but there is nothing better for them than breathing deep in the great outdoors. Take short walks and make an effort to spend time in nature daily–just ensure that you are dressing “seasonably.” A great thing to start adding to your fall attire is a scarf around the neck.  Who knows? Maybe you could even get a little wild and connect all 3 suggestions–take a walk outside with your yoga mat, and set up to do some deep breathing and some lung opening yoga poses all at the same time!

There is so much more to Chinese medicine than just the acupuncture piece. Incorporating mindfulness activities such as the ones mentioned here and others including meditation, journaling, and pranayama (breathwork) can be monumental in the healing process.

 

 

About the Author:

Holly Pelletier, licensed acupuncturist, has been working with children, adolescents and young adults, in many different capacities since 2004. Prior to treating youth with acupuncture, she worked as a teacher, coach and mentor. She especially enjoys working with young people and acupuncture because of their speedy response time and genuine excitement about this form of medicine.  For more information about acupuncture at NESCA and our new ‘Acupuncture & Mindfulness’ program for teens, please email Holly Pelletier at hpelletier@nesca-newton.comFor more blog posts by Holly check out her personal blog: www.holisticallyinspired.org.

 

 

 

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

 

Sit Down with Billy Demiri, Certified Personal Trainer and Autism Fit Instructor at NESCA

By | NESCA Notes 2018

Billy Demiri, a Personal Trainer in Boston for the past 5 years, has recently joined NESCA to offer Personal and Social Coaching (PSC) for clients. We recently caught up with him while he was doing agility courses, wall sits and resistance bands with a client.

 

Tell us about your background, training, and certifications:

I grew up in Malden, Massachusetts. After high school, I attended Merrimack College and graduated with my Bachelor of Science in Sports Medicine with a concentration in Physical Therapy. Since then, I have obtained several certifications: I’m NSCA-CPT (National Strength Condition Association – Certified Personal Trainer) certified, Autism Fit Certified, TRX Certified, Kettle Bell Athletics Level One certified, and also pre- and post-natal certified.

I have worked as a personal trainer for 5 years helping a wide range of clients reach their goals. Over the years, I have learned to tailor programs based on client’s specific goals, whether it be fat loss, building muscle, or just moving better in their daily lives.

For those of us who aren’t familiar, what does a personal trainer do?

As a certified personal trainer, I work with people to achieve fitness goals—both short- and long-term. For each client, I create training programs tailored to their specific needs and goals. It’s also important to be able to adjust and modify workouts around people’s preexisting injuries or disabilities.

What do you love about your job?

Believe it or not, I used to be very unfit and uncoordinated. Growing up I played lots of sports and I remember not being able to do jumping jacks properly and being laughed at by my teammates until I finally worked on my fitness and through hard work ended up becoming a captain of the team. The experience made me connect the dots between the importance of being fit and your overall wellbeing.

I believe that being fit makes a difference in mental health as well as physical wellbeing. As a personal trainer, I get to work with people, help them progress, and make positive changes in their lives.

What brought you to NESCA?

I met Ann (Helmus, Founder/Director of NESCA) at Equinox. She jokes that I was one of the first people who could help her make sense of some of the exercises and equipment. Ann felt that many of the strengths I had in working with her-–patience, how to motivate, adjust workouts, make fun—could be a good fit for the kids at NESCA. Fitness had such a big impact on me as a kid; When Ann mentioned Autism Fit Certification, I was immediately interested. I learned so much at that training and I love being able to help vulnerable kids to develop confidence and skills.

What types of clients are you planning to work with and when are you available for sessions?

I started working at NESCA three months ago and have had a lot of success with one 12-year-old boy. I am planning to expand to additional male clients ages 8-18. With my Autism Fit Certification, I will be working with many clients who have autism or related learning disabilities. I am currently available on Tuesdays and Fridays after 2pm or on Saturdays from 8am-2pm.

 

 

How will you start working with clients? What is your intake process like?

First, I meet with parents to discuss needs and goals. This is about 30 minutes. Then, I will take the child through an evaluation process to assess motivation and a physical workout. The whole intake process will take 60-90min.

What exercise equipment will you be using and how will you protect clients from injury?

I use lots of different equipment including Hurdle Steps, Agility Ladder, TRX, SandBell, Bands, Medicine Balls, and Cones. Protecting clients from injury starts with good initial training. I will monitor their form and teach them proper technique and how to move their bodies properly so they can control their movement and avoid injury.

How can children or teens with social-cognitive challenges like autism benefit from fitness activities?

Exercise is one of the most effective instant happiness boosters of all time. For kids who often struggle with low muscle tone, poor motor planning, and proprioception difficulties, fitness activities help to increase strength, stability, and motor planning for all daily activities, not just working out. But also, more importantly, participating in regular fitness like Personal and Social Coaching (PSC) at NESCA, provides an opportunity for kids to have repetitive successful physical experiences. PSC will help create a new foundation for socialization and communication by introducing the conceptual framework for play. As kids gain more confidence in their physical abilities, they will want to participate and socialize in more activities. Also, when kids are more active and confident, the regular movement decreases anxiety and potentially even depression symptoms. Regular practice with fitness will also help decrease off-task behavior because kids practice and are able to focus on one exercise at a time.

What other goals might you work on with clients?

Other goals we can work on can be sport specific goals, including coordination, strength, and weight loss. With some clients, we may even work on community-specific goals like using a local rock climbing gym. Also, we work with staying on task and building confidence in their abilities so they can have fun and socialize when they play physically.

What do you enjoy doing outside of NESCA?

I enjoy hiking with my dog, playing sports, cooking, riding my motorcycle, Jiu- Jitsu, and obviously working out!

 

Video-What one 12-year-old client has to say about Billy!

Ready to get fit with Billy?

Billy will be initially working with clients who are part of the NESCA family and have already participated in testing, consultation, or therapy at one of our Massachusetts or New Hampshire offices. To learn more about his services, please email bdemiri@nesca-newton.com. Or, to book an intake with Billy, please complete NESCA’s Intake Form at https://nesca-newton.com/intake-form/ and select “Personal and Social Coaching (PSC)” as your reason for referral.

As a certified personal trainer and autism fit instructor at NESCA, Billy will not be giving medical advice, physical therapy advice or attempt to make a medical diagnosis for any client. He also will not serve as a therapist or psychological counselor to clients.

 

 

 

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

 

The Importance of Chores

By | NESCA Notes 2018

 

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

In her excellent piece in the NYT (Happy Children Do Chores, August 18, 2018), reporter KJ Dell’Antonia describes the importance of chores for a child’s development and well-being.  While I will provide a brief summary and add my own reflections, I strongly recommend that the reader read the full article.

In her article, Ms. Dell’Antonia cites several benefits of chores.  Among those, chores can help a child develop a greater sense of responsibility and awareness of the needs of others, and they can also contribute to a child’s emotional well being (no, really), in that they can help a child feel needed.  In addition to her list of benefits, chores are an excellent teacher of life skills.  Knowing how to do laundry, prepare a meal, change a vacuum cleaner bag, or tighten a loose doorknob can help prepare a child for the responsibilities of adulthood.  Meanwhile, more involved tasks like raking leaves or cleaning out the garage can be used as vehicles in the development a child’s problem-solving skills, prompting them (perhaps with parent assistance) to figure out how to tackle the task in the most efficient, most systematic manner, solutions that they may be applied to a host of other life responsibilities.

While most parents recognize the importance of chores, a large survey cited in Ms. Dell’Antonia’s article found that only slightly over half of American parents required their children to do them.  Some reasons given for this disconnect include parent-child conflict surrounding chores and a desire to free up a child’s time so that they can focus on academics or extracurricular activities.

In those last regards, however, while a strong GPA and an application chock-full of extracurricular accomplishments might help a student get into college, it is their work ethic, sense of responsibility, and time management skills that help a student meet success in college.  In fact, a more robust predictor of success in college than grades is whether an adolescent has held a part-time job prior to college, and chores are an excellent teacher of readiness for part-time employment.

Ms. Dell’Antonia concludes her article with advice that is, unfortunately, easier said than done, which is that helping to establish a chore routine at home requires perseverance.  Sometimes that means that it will take longer to convince the child to attend to the chore than it would take for the parent to do it themselves.  No easy answers, I guess.

 

 

About the Author:

McCormick

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

 

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

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Massachusetts, 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.

 

Everyone Has Something to Offer

By | NESCA Notes 2018

 

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

It feels like every day is a National soup or sandwich day or Taco Tuesday. So much that national recognition months are getting lost in the shuffle. National Disability Employment Awareness Month was declared in 1988 by the United States Congress for October to raise awareness of the employment needs and contributions of individuals with all types of disabilities. The purpose of National Disability Employment Awareness Month is to educate about disability employment issues and celebrate the many and varied contributions of America’s workers with disabilities. This year’s theme is “America’s Workforce: Empowering All”

“Americans of all abilities must have access to good, safe jobs,” said U.S. Secretary of Labor Alexander Acosta. “Smart employers know that including different perspectives in problem-solving situations leads to better solutions. Hiring employees with diverse abilities strengthens their business, increases competition and drives innovation.”

Why does it matter? Why recognize a small group of the population? Because they are a valuable resource. Because they deserve a reframe from being disenfranchised to being seen as an asset. In 2017, 18.7 percent of persons with a disability were employed, the U.S. Bureau of Labor Statistics reported today. In contrast, the employment-population ratio for those without a disability was 65.7 percent. The employment-population ratios for both persons with and without a disability increased from 2016 to 2017.

The Office of Disability Employment Policy under the US Department of Labor offers so many resources for employers and employees. They offer free curriculum on teaching soft skills so all young people regardless of ability can not only get jobs, but keep jobs. They offer public service campaigns that promote the benefits of employing those who regardless of disability or diagnosis offer something to an employer. They propose the question, “What can YOU do?” They give examples of what employees with disabilities can do!

“I can solve difficult problems for a Fortune 500 company.” Says Bob an executive from Google who has bipolar disorder.

“I can manage your home improvements.” Says Michael a landscaper and carpenter who has an intellectual disability.

“I can run a successful business.” Says Patty who co-owns and manages a grocery store and has paraplegia.

These are just a few examples of the valuable contributions that many people with disabilities can offer.

As each day passes and it is National Dessert Day and you want to roll your eyes and minimize a special day or month. Please pause and remember that some of these national recognitions may be a valuable opportunity to celebrate pride and difference in a positive way.

If you are interested in supporting National Disability awareness month please feel free to visit the ODEP website and find several ways to positively support those who are capable and desiring employment, but may be overlooked.

 

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.

 

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

 

Lessons from My Children: Always Ask “Why?”

By | January 2018, NESCA Notes 2018

 

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

There is a lot that we can learn from our children. They are not as burdened as we, and they approach life with more vigor, wonder, and confidence. With this, they do a lot of important things that we adults have forgotten to do.

Right now, both of my boys are at ages when they are constantly asking, “Why?” For my two year old, it may sound something like this:

Me: “It’s time to put on our shoes.”
Him: “Why?”
Me: “Because we have to go to school.”
Him: “Why?”
Me: “Because we leave at 7:45.”
Him: “Why?”
Me: “Because I have to be at work at 8:15.”
Him: “Why?”

I think you can see where that one is going…

For my five year old, the questioning is a little more sophisticated:

“Why can’t we feel the earth moving?”
“Why do the teens always start with number one?”
“Why is ‘W’ an upside down ‘M’?”

While sometimes the incessant questioning can make a parent’s head spin, asking “why” is how children learn about the world. Questioning is one of the primary tools aiding children’s cognitive development. But in spite of the importance of questioning early on, as we get older, we increasingly forget to make such inquiries. While this may be for understandable reasons – life is busy, we are set in our routines, we have learned to trust the expertise and opinions of others, etc. – such lack of questioning can often interfere with our ability to effectively solve life’s dilemmas, and effectively help our children.

At NESCA, families and caregivers seek out our evaluations for a range of concerns: reading interventions were tried, but they did not work; a child’s behavior is out of control, but they are not responding to the behavioral plan; a teenager is not motivated to do their schoolwork, and they are failing; or conversely, in spite of spending five hours per night on homework, the teen is still failing.

What is most often happening in these situations is that there is not a sufficient understanding of why the child is struggling, and so well-intentioned attempts at helping are rendered fruitless.

Things are not always as they seem. Behavior, be it academic difficulties or noncompliance, is a symptom of an underlying issue. So while some children struggle to read because they are delayed in the acquisition of phonological skills and other foundations of reading, other children may struggle to read because of deficits in things like visual scanning and processing, attention, and/or auditory processing. For the out of control child, if their noncompliance is based in underlying anxiety and their need to avoid anxiety triggers and feared situations, then behavioral plans that are not paired with anxiety-focused therapeutic interventions will be ineffective.

It is because of the need to know “why” that NESCA’s neuropsychologists always conduct the most comprehensive neuropsychological evaluations. Unless we know the underlying reasons for a client’s challenges, we cannot create the well-informed recommendations and roadmap for how to help them make progress. Through in-depth inquiry and investigation, we get a detailed understanding of a client’s strengths and challenges. We find the reason “why.”

So, while I may sometimes get tired of answering my children’s near-constant questioning, they may have this one right. It is only with ongoing contemplation and inquiry that we can be confident in our understanding of the world, and of our children.

 

About the Author:

Dr. Angela Currie conducts neuropsychological and psychological (projective) assessments out of NESCA’s Londonderry, NH and Newton, MA offices, seeing individuals with a wide range of concerns. She enjoys working with stressed-out children and teens, working to tease apart the various factors that may be lending to their stress, including assessment of possible underlying learning challenges (such as dyslexia or nonverbal learning disability), attentional deficit, or executive function weakness. She also often conducts evaluations with children confronting more primary emotional and anxiety-related challenges, such as generalized anxiety, obsessive compulsive disorder, or depression. Dr. Currie 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 or consultation 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.

25 Miles of Inspiration

By | NESCA Notes 2018

 

By: Nancy Roosa, PsyD
Pediatric Neuropsychologist, NESCA

Last Saturday, I found myself – as part of Team NESCA- at the starting line for a bike ride, waiting apprehensively for my turn to start, carefully balancing my bike between my legs, stretching my legs and checking my tires.  I was a bit nervous, because I’m not an experienced or competitive bike rider.  But this was not a race: it was the 28th annual Rodman Ride for Kids, one of the most congenial, supportive athletic events you can imagine and my apprehension soon faded among the general high spirits of riders and volunteers around me.  Team NESCA’s turn soon came and we took off, surrounded by about 1,500 other joyful riders.

The joy of the day was primarily because all of us riders had a shared goal – to raise money for programs that benefit at-risk children across Massachusetts.  Team NESCA took to the road to support one of our favorite local nonprofits: Asperger’s/Autism Network (AANE), which provides a wide variety of educational, outreach and supportive programs for individuals and families affected by autism. For more information about AANE please see their website.  https://www.aane.org/.

The Rodman Ride is unique.  Instead of being run by and for one large entity, the Rodman for Kids charity serves as the organizational powerhouse behind the ride, allowing even small nonprofits to participate in a major fundraiser.  About 45 small nonprofits, like AANE, take advantage of the fact that the Rodman for Kids charity does all the organizational legwork: setting up a website for fundraising, identifying and marking the course, and enlisting an army of volunteers to make the race happen.  Any social service agency that supports at-risk children in Massachusetts can participate.  There is no fee; in fact, the Rodman organization adds 3% to any dollars raised. Over the years, the Rodman Ride has raised about $144 million dollars!

 

Stephanie Monaghan-Blout and Nancy Roosa

 

One fun part of the day was reading the jerseys of all the other riders and feeling uplifted just by seeing how many organizations are working to support at-risk children in our state.  At this time, when so much of the daily news is disheartening, it was inspiring to be surrounded by thousands of people who are putting time and energy into supporting vulnerable children.  Beyond the riders, over 500 other companies sponsor the volunteer activities that support the ride.  We rode with a friend who was riding for Trinity Foundation, and were surrounded by many riders from Mass Mentoring and Jewish Big Brothers Big Sisters.  Our cheerful announcer, who kept us all organized at the starting line, introduced various groups and invited them to speak about their efforts.  Did you know there is a nonprofit group called Above the Clouds, which takes children with disabilities on plane rides?  Who knew?

Team NESCA was thrilled to be part of the day; we, along with about 20 other riders for AANE, helped AANE raise over $56,000 to support their programming for the coming year.

And we had fun.  It was a beautiful ride, with perfect weather, through the mostly flat streets around Foxborough and Lake Massapoag.  There were volunteers ringing cowbells and shouting directions and encouragement anytime we had to make a turn.  The water stops had piles of snacks – from bananas to chocolate energy bars – and a DJ pumping out bouncy songs.  There was breakfast and coffee at the beginning and a great barbeque lunch and beer at the end.

All in all, it was so inspiring to join with so many other people who are committed to helping at-risk youth.  I’ll be buying my next car at Rodman Ford.  In the meantime, who’s up for riding with Team NESCA and AANE next year?

 

 

About the Author:
Roosa

Nancy Roosa, PsyD has been engaged in providing neuropsychological evaluations for children since 1997. She enjoys working with a range of children, particularly those with autism spectrum disorders, as well as children with attentional issues, executive function deficits, anxiety disorders, learning disabilities, or other social, emotional or behavioral problems. Dr. Roosa’s evaluations are highly-individualized and comprehensive, integrating data obtained from a wide range of standardized assessment tools with information gained from history, input from parents, teachers and providers, and important observations gleaned from interacting with the child. Her approach to testing is playful and supportive. Her evaluations are particularly useful for children with complex profiles and those whose presentations do not fit neatly into any one diagnostic box.

 

To book a consultation with Dr. Roosa or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate “Consultation” and your preferred clinician in the referral line.

 

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

 

 

Encourage Your Children to Read

By | NESCA Notes 2018

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

According to Sally Shaywitz M.D., (Audrey G. Ratner Professor of Pediatrics-Neurology; Co-Director, Yale Center for Dyslexia & Creativity), dyslexia is highly prevalent, affecting one in five people, and it represents over 80% of all learning disabilities.

Even when a child does not meet the criteria for dyslexia, they may be a reluctant reader. Children who do not practice reading perform poorly on reading tests relative to children who do read on a regular basis. In addition, reduced reading time results in exposure to fewer words. In general, people use limited vocabulary during conversation compared to the language one is exposed to while reading. As such, a reluctant reader is at risk to have poorly developed vocabulary knowledge compared to same-age peers. They are also less likely to improve their reading skills over time. In her book, Overcoming Dyslexia (2003), Dr. Shaywitz shared the following information:

Through reading, a child is introduced to new concepts and information. In addition, the more a child is exposed to literature, the more likely reading will become an integral part of their daily life. However, how does a parent encourage a reluctant reader?  Here are some ideas:

1.  Read a story to your child. Then ask them to talk about their favorite parts of the story.

2. Be ready to read or listen to books over and over again – this is how children learn. FYI- Did you know you can listen to the audio version of Mrs. Piggle-Wiggle (a series of children’s books by Betty MacDonald originally published in 1947)  four times in a row on a drive from Boston to Maryland and four times in a row on the way back?  I did this with my daughter when she was 4-years-old (she is now 16) and I do believe that, to this day, I can still quote parts of the book!

3.  Surround your children with reading material – this can be comprised of books, graphic novels, or magazines, anything that is of interest to your child.

4.  Let your child take out their own library card and go with you to the library to pick out their own reading material. Allowing a child to read for pleasure is the best way to create a more engaged reader. However, it is also important to make sure the child is choosing an age-appropriate book. A librarian can be very helpful in providing recommendations based on a child’s age and areas of interest.

 5.  Have your children practice reading whenever possible. Baking a cake? Ask them to help you read the instructions (perhaps your hands are too messy to turn the page!). At a restaurant? Let them read the menu aloud to a younger sibling.

6. Use technology to your advantage. For example, I worked with a 14-year old boy with dyslexia who was intimidated by the size of the first Harry Potter book. However, I mentioned to him that, on the I-pad, the book is no bigger than the I-pad itself. He was more willing to carry an I-pad around and read at his own pace. Another advantage is that with an e-reader the child can place as much or as little text on a page as they wish, another way to reduce reading stress.

 7. Take advantage of audiobooks. This technology is a huge benefit for students who struggle to access books that are written for children their age but beyond their current independent reading level. The child can simply listen along, or they can hold the book and follow along with the text while listening. There are several ways to access audiobooks, including downloading them from your library for free!

8. Finally, model good reading habits. If your child never sees you reading, but you insist that they read, they will see reading as a chore rather than a pleasure. If you are not a strong reader, that is ok, you too can listen to audiobooks!

While these recommendations will hopefully help your child experience increased reading pleasure and exposure to literature, it is still important to find out the reason why your child is struggling to read. If your child has not had a thorough reading evaluation, you can ask your child’s school to complete such an assessment. In addition, you may wish to have your child evaluated by an independent evaluator.

To book a consultation with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate “Consultation” and your preferred clinician in the referral line.

About the Author:

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

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

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.

 

 

 

 

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

 

 

School Observations

By | NESCA Notes 2018

By: Amity Kulis, PsyD
Pediatric Neuropsychologist, NESCA

One of my favorite activities as a neuropsychologist is getting to conduct school observations. Many parents ask why would I need a school observation? And the answer is simple, they provide a wealth of information about your child and their everyday experience at school. For so many, understanding the comings and goings of a child’s day at school is something most parents do not have the opportunity to explore. You ask your child, “how was your day?” and for many, all you get is a “fine” or “okay” with no elaboration of what actually happened. Understanding a child’s experience of the school day is important for all families, but especially important if your child is having difficulties at school such as learning, social or emotional stressors.

After conducting a neuropsychological assessment of a child, I am able to get a good understanding of the child’s learning profile and a good grasp of the child’s strengths and needs. With this information, I am able to conduct school observations with a lens towards what the children I am seeing might need and how they interact with their environment. For the majority of the children I observe at school they are already getting specialized services and for one reason or another, their parents are concerned.

During the observation, I am able to gain a better understanding of a child’s social functioning within the context of their peers at school. I often purposefully schedule observations during a combination of structured class time as well as less structured time such as art or gym, and finally during an unstructured time such as lunch or recess. This combination of environments allows me to see the child interact with peers in a variety of settings. I am able to answer questions about where a child does best and what types of environments might be more challenging. Are they a rock star during group lessons or are they leading a group of peers across the playground? For other children they may fade into the background, refusing to participate during large group instruction but become more animated during one-on-one time with their teacher. Or maybe they are a child that cannot handle the unstructured recess time and hide in the corner isolating themselves. Gaining a better understanding of a child’s social successes and then relating that information to their neuropsychological profile can help to explain why a child is struggling and how best to support them.

Beyond looking at a child’s social functioning during the school day, I am also able to observe the delivery of instruction and how the child responds. I am always watching how a teacher deliveries information to the class and then seeing how the child is able to respond. Does the child follow the direction the first time they are heard or do they need them repeated and modeled by watching other students begin the activity first? I also look at how a child interacts during whole group instruction or discussion versus a small group or more individual work. I also love the opportunity to speak with teachers during the observation to understand what curriculums they are using as well as answering questions about how they see the child interacting in the classroom. If a child is on an education plan I am also paying close attention to how accommodations and supports are being integrated into and across the child’s school day.

In addition to being a fun and engaging part of my job, observations also provide such valuable information from which I can create very specific and targeted recommendations for a child based on their own school environment. There is definitely not a one-size-fits-all recipe for helping a child with a particular profile because an environment is so influential on a child’s successes and challenges. An amazing relationship with one teacher can go a long way toward helping a child take chances and make progress, just as the opposite is true. With a school observation, there is the opportunity to gain more clarity into a child’s everyday school life to help foster their strengths and support their vulnerabilities.

About the Author:

Dr. Amity Kulis joined NESCA in 2012 after earning her doctoral degree in clinical psychology from the Massachusetts School of Professional Psychology, with a concentration in Children, Adolescents and Families (CAF). She completed post-doctoral training in pediatric neuropsychology with an emphasis on treating children with developmental, intellectual, learning and executive functioning challenges. She also has extensive training psychological (projective) testing and has conducted individual and group therapies for children of all ages. Before joining NESCA, Dr. Kulis worked in private practices, clinics, and schools, conducting comprehensive assessments on children ranging from toddlers through young adults. In addition, Dr. Kulis has had the opportunity to consult with various school systems, conducting observations of programs, and providing in-service trainings for staff. Dr. Kulis currently conducts neuropsychological and psychological (projective) assessments for school-aged children through young adulthood. She regularly participates in transition assessments (focusing on the needs of adolescents as they emerge into adulthood) and has a special interest in working with complex learners that may also struggle with emotional challenges and psychiatric conditions. In addition to administering comprehensive and data-driven evaluations, Dr. Kulis regularly conducts school-based observations and participates in school meetings to help share her findings and consultation with a student’s TEAM.

 

 

 

 

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

 

 

Blog Update: Intensive Therapy

By | NESCA Notes 2018

By: Ryan Ruth Conway, PsyD
Clinical Psychologist, NESCA

Earlier this month, the New York Times published an article about intensive therapy, a type of treatment that is more accelerated and condensed than traditional once weekly therapy. The author described a “new wave” of therapy programs popping up around the country designed to help clients with all types of anxiety experience relief more quickly. The article cited new research to explain the growing popularity of concentrated treatment, which shows that the approach is generally just as effective, and in some ways more effective, than longer-term care for both children and adults. Also noteworthy is that fewer clients dropped out of the intensive treatment, which suggests that clients are more likely to “stick with” therapy when it is delivered in a shortened, consistent format.

In short-term therapies, clients have the opportunity to practice using newly learned skills to face their fears in all different situations and environments that elicit anxiety. For instance, a client with social fears might be instructed to order for himself at a restaurant, ask a stranger for directions or purposely do something embarrassing in public. By practicing daily in session and also for homework, you see a lot of carryover from day to day and faster acquisition of skills, which is a huge confidence booster! Exposure and Response Prevention (ERP), a technique often used in Cognitive Behavioral Therapy (CBT), helps clients approach anxiety-provoking situations and learn that anxiety eventually habituates, or dissipates, on its own over time, and those other behaviors they have been using to manage their fears (e.g., excessive washing, checking, seeking reassurance from parents or avoidance) are neither helpful nor necessary.

NESCA offers intensive CBT “boot camps” for children and adolescents with anxiety, including (but not limited to) social anxiety, phobias, OCD and generalized anxiety. NESCA clinicians thoroughly enjoyed helping clients build coping skills and feel better through intensive treatments this past summer, and received a positive response from children and their families! Our treatment programs are individually tailored for each client and also include parent sessions in order to teach caregivers the tools they need to best support their child. Summer or school breaks can be the perfect time to focus on mental health without the distractions of the academic year or other extracurricular activities.

To learn more about intensive therapy and NESCA’s program visit: http://www.nesca-news.com/2018/03/intensive-cognitive-behavioral-therapy.html

For any questions about NESCA’s intensive treatment program or to sign up please contact Ryan Ruth Conway, PsyD 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 individual and group therapy at NESCA utilizing an individualized approach and tailoring treatments to meet each client’s unique needs and goals. Dr. Conway has a passion for working collaboratively with families and other professionals. She is available for school consultations and provides a collaborative approach for students who engage in school refusal.

 

 

 

 

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