Strong Mental Health is So Important During a Pandemic

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

In March, 2020, a poll conducted by the American Psychiatric Association found that more than a third of all Americans (36%) stated that Covid-19 is having a serious impact on their mental health; 59% said it is a having a major impact on their daily lives; 48% are anxious about contracting Covid-19; 62% are anxious about a loved one becoming ill; and 68% feel it will have a serious impact on our economy. Needless to say, we are living in an unprecedented time due to Covid-19, and it will have a serious impact on people’s mental and physical health both now and for some time. It has created stress, anxiety and depression even as we are learning to cope and adjust to this current new normal.

Given these numbers, many adults, teens and children are struggling with a myriad of challenges, stressors and losses during this pandemic (i.e. missing graduations, births, food insecurity and financial insecurities, including job losses, etc.). Deciding how to alleviate the pain and suffering can be daunting. Psychological, medical/psychopharmacological, complementary (i.e. acupuncture), behavioral and educational treatments are possible choices and can assist in alleviating some pain and suffering. What better time than now to get yourself and your loved ones some mental health support?

This blog will review a variety of treatment approaches which are now being offered through telehealth. There are many HIPAA-protected platforms that clinicians are using to meet their client’s needs as well as some “wearables” to assist in treatment. Wearables transmit your biophysiological data to your clinician so s/he may use it in conjunction with and/or inform treatment.

Mental health treatments include many different types: psychotherapy (also known as “talk therapy” or “insight-based therapy”), psychoeducational, biofeedback, social training, mindfulness/relaxation and so many more. Approaches to psychological treatment may include individual, group, family or couples work, and there is no one single approach that works for everyone. Psychological treatment is typically provided by a licensed psychologist, social worker, mental health counselor, expressive therapist, psychiatrist and/or psychiatric nurse.  Many factors go into making psychological treatment decisions, but when it comes to therapy it is most important to have “goodness of fit” between the clinician and the client. The client needs to “get along with” and feel valued, supported and understood by their practitioner. This enhances the effectiveness of whatever treatment approach or method is utilized.

Reviewing the differences between treatment approaches may help you in your decision- making process beyond “the goodness of fit.” Psychotherapy involves talking with a clinician to address emotional, psychological and behavioral challenges that can be both conscious and unconscious. The client’s past experiences, perceptions and history play an important role in psychotherapy. The client “tells their story,” which helps the clinician understand their life experiences through their eyes, which allows treatment to be tailored to their experiences. By working through one’s thoughts, past experiences and stressors with a caring clinician, the client is able to gain insight, perspective and strategies to alleviate pain and suffering and manage unhealthy thought patterns and behaviors. The aim is to help the client understand their past and to recognize its influence on their current situation. Often psychotherapy is long- term and involves good communication/language skills as well as higher level thinking and insight capacity. However, psychotherapy can also be short-term and specifically focused on the thoughts, feelings and behaviors associated with Covid-19 and its impact on a person’s life.

Psychoeducational treatment is somewhat different than psychotherapy. Psychoeducational treatment can be provided to individuals, groups, family member, couples, employers and others. Education is central to treatment, and it is a more directive approach. It can have very specific goals and may be short-term. The past is not actively addressed; the purpose is to educate the client to acknowledge, accept and understand their disability and/or mental health condition and provide ways to support growth, change and meet goals. Psychoeducational treatment may include informative reading material, video analysis, homework, data collection, biofeedback, journal writing and much more.

Some of the goals of both treatment approaches are to connect how thoughts, feelings and behavior are connected, improve coping and problem solving to better deal with life stressors, increase positive self-regard, and to recognize and better deal with strong emotions. Many clinicians have training in specific techniques and use a combination of approaches in their practice. Yet, sometimes a specific approach may be the best method of choice given a specific condition or specific goal of treatment. For example, Covid-19 is having a mental health impact on many people, and seeking short-term treatment may be warranted.

When seeking treatment, determining what technique is most appropriate can be accomplished by considering a variety of areas: the reason/goal of treatment, age and diagnosis of the client, the personality, cognitive and language capacity of the client as well as the cultural/family background and personal experiences. There are upwards of 100 different types of psychotherapeutic approaches, so knowing which one to try is an important decision. Many clients at NESCA present with learning differences, anxiety, OCD, depression, trauma, substance abuse and more. The following partial list includes some of the treatment approaches beneficial to and used by many NESCA clients.

Acceptance and Commitment Therapy

Attachment-based Therapy

Animal-assisted Therapy

Biofeedback

Cognitive Behavior Therapy (CBT)

Dialectic Behavior Therapy (DBT)

Exposure & Response Prevention Therapy

Expressive Therapy (Art, music, drama, etc.)

Mindfulness-based Cognitive Therapy

Motivational Interviewing

Parent-Child Interaction Therapy

Play Therapy

Psychoeducational Counseling

Trauma-focused Cognitive Behavioral Therapy

At NESCA, we are currently offering short-term psychological treatment for Covid-19 mental health challenges as well as long-term psychoeducational treatment. If you are interested in learning about these options, visit: https://nesca-newton.com/integrativetherapeutic/.

More information about treatment approaches can be found at: https://www.psychologytoday.com/us/types-of-therapy

 

References:

https://www.nami.org/learn-more/treatment/psychotherapy

https://www.mhanational.org

https://www.mentalhealth.gov

https://www.psychiatry.org/newsroom/news-releases/new-poll-covid-19-impacting-mental-well-being-americans-feeling-anxious-especially-for-loved-ones-older-adults-are-less-anxious

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

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

 

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

 

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

 

Multi-sensory Learning: More than Just a Buzz Word!

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

As teaching methods continue to become more and more creative, and learning is being facilitated through interventions that target all types of students, the term “multi-sensory learning” has started to cement its place in the educational lexicon. You may have seen a line in an evaluation, such as, “This student would benefit from a multi-sensory learning approach,” or “The use of multi-sensory teaching methods will help this student to solidify their learning.” In some ways this phrase is easy to interpret. Multi means many. Sensory refers to the body’s different senses, the tools we use to interpret and experience the environment around us. Reason would tell us that this phrase means using all of these senses to acquire knowledge, information, and skills, and….it does! But what does this look like in practice? How are professionals actually using this method to help our children learn?

If you picture a typical classroom from a few decades ago, there is a teacher standing up at the front of the room providing students with information to copy down into their notebooks. These students are receiving information through the auditory system only. They are being expected to listen, comprehend and retain the lesson using one sense, their hearing.

Now let’s picture the classroom of a teacher using multi-sensory learning techniques. Often, students are clustered in different areas with a teacher checking in at every table to provide each small group with support. Students are looking at images or pictures of the object they are studying, both reading information and hearing it clarified by their teacher, and are likely using manipulatives, or things they can feel to help understand the content. These students are learning through their visual, auditory and tactile systems.

Humans grow, evolve and learn in complex, multi-sensory environments that are constantly targeting all of our senses. Our brains are built to learn through a combination of visual, auditory, tactile and kinesthetic data (Shams & Seitz, 2008). Using visual methods helps children learn through the sense of sight; auditory through the sense of hearing; tactile through the sense of touch; and kinesthetic through body movement. Children display greater performance when learning activities target all of these systems, as opposed to when they are taught using one modality (Broadbent, White, Mareschal, & Kirkham, 2018).

As an example, let’s look at teaching Kindergarten students their letters. A robust multi-sensory approach to teaching the alphabet includes looking at pictures of the letters, saying the sounds out loud as a class, tracing the letters in the air with one finger, making each letter out of playdough, writing the letters in bins of rice, making the student’s bodies into the shape of individual letters, and finally picking up a pencil to attempt to form the letters on the page independently. Students gain a comprehensive understanding of the letters as their brains have been targeted across multiple sensory systems.

There is substantial research for using this multi-sensory approach for another foundational academic skill: reading (Walet, 2011). Many of the most well-known phonics and reading programs, such as Orton-Gillingham and the Wilson Reading System, use these strategies to help students who learn differently to master this skill (AOGPE, 2012 & Wilson, 2017). When using some programs students learn to tap out syllables and letters on their fingers as they read, incorporating tactile feedback. Others focus on including books on tape so that students both see and hear each word as it is read aloud.

Other excellent examples of multi-sensory learning in the classroom include:

  • Songs and rhythm to solidify content
  • Base ten cubes as math manipulatives
  • Fieldtrips!
  • Games involving movement, such as flashcard races, Around the World and clapping games
  • Paper with raised or highlighted lines for tactile or visual feedback
  • Video clips to review concepts
  • Real coins and dollars when learning about money
  • Science experiments in a high school lab

While students are currently all at home receiving their lessons and assignments through a digital medium, many are missing out on the creative ways that their fabulous teachers use these strategies in their classrooms. In my next blog, we will discuss some ways to incorporate these strategies in the home!

 

References

Academy of Orton-Gillingham Practitioners and Educators (AOGPE). (2012). The Orton-Gillingham

Broadbent HJ, White H, Mareschal D, Kirkham NZ. Incidental learning in a multisensory environment across childhood. Dev Sci. 2018;21(2):e12554. doi:10.1111/desc.12554

Shams, L., and Seitz, A.R. Benefits of multisensory learning. Trends in Cognitive Sciences, 60, November 2008, pp. 411-17.

Walet, J. (2011). Differentiating for Struggling Readers and Writers: Improving Motivation and Metacognition through Multisensory Methods & Explicit Strategy Instruction. Journal of the American Academy of Special Education Professionals,83-91.

Wilson, B. (2017). Teaching total word structure. Wilson Language Training Corporation.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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.

 

Behavior Happens! But Does It Have To?

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

Recently, I’ve written a few blogs about behavior management and meltdowns and being a behavior detective. I thought I’d end the behavior series with a blog on how to prevent meltdowns from occurring, or at least try to prevent them! Obviously, preventing meltdowns is the best option if at all possible. No one likes to be around a meltdown, and the child doesn’t like it either.

There are many different experts with their own methods and strategies, but most start with common principles. Know yourself, know your child, meet him/her where they are, know what makes them tick and what works for them, as every child is different. It’s the behavior that is unacceptable, not the child. The child is still valued and loved; the behavior isn’t.

Kids will be kids, and they will lose control. Hopefully, over time, they learn self-control and emotional regulation. But the brain’s frontal lobes which control executive function, which includes behavioral control, don’t fully develop until the child I in his or her late 20’s…so buckle up as it’s going to be a long ride! Remember a meltdown is a child’s best attempt in the moment. It is the fight, flight and fright/freeze response. Trying to prevent these from happening are good for the child and the whole family. Life isn’t perfect and meltdowns will occur, but let’s try to lessen their frequency by employing some of the following:

  • Pick your battles—What’s negotiable and what’s non-negotiable? Make sure your kids know the list of “have-to’s” or non-negotiables. Simplify rules and make them realistic to the age of your child. Don’t make a rule/consequence that you cannot be consistent with or follow through with.
  • Keep calm in the eye of the storm.
  • Catch ‘em being good and let them know you saw them behaving well.
  • Tell your child what you want him or her to do, not what you don’t want them to do. Kids do the best they can in the moment.
  • Whenever possible, limit the amount of times you say the word “No.” Leave “No” for safety concerns. Instead, give information, and acknowledge and accept your child’s feelings/opinions. Substitute a “yes” for a “no” and use fantasy talk. “Yes, I wish you could stay up late, too, but we have to get up early tomorrow.”
  • Don’t phrase things so kids can say ‘no’ if the answer “no” isn’t an option. Wording and phrasing matters. Sometimes indirect requests get better results than directives. Explain your reason for non-negotiables (even if they don’t agree or like them). Do some tasks together that are problematic for your child. Shared ownership is better than no ownership.
  • Allow choice and control whenever possible. Don’t get into power struggles you will lose.
  • Having agency and mastery helps all kids grow and learn.
  • Consistency, Structure and Predictability are providers of Stability and Simplicity that enable your child to Anticipate, which is a means to enhance independence.
  • Clear rules, expectations and consequences provide organization, safety, structure and limits while enhancing mastery, self-control and improved self-efficacy.
  • Children don’t have the same sense of time or urgency as adults do, so allow for extra time to complete tasks when possible and use timers to help them organize their time.
  • Use humor and distraction to achieve desired results.
  • Compromise, Flexibility and Negotiation done proactively can go a long way. Work with your child to solve problems before they occur. Be flexible when necessary and make a compromise. Provide your reasoning for the compromise. This is not bribing; rather this approach teaches valuable lessons in win-win solution making, negotiation, compromise, flexibility, fairness and trust. Use this approach next time, and your child will hopefully, over time, learn these valuable lessons/skills.
  • Know your child’s triggers and be prepared. Try to eliminate/lessen them if possible. If they can’t be lessened, teach your child  the necessary tools to cope with them during more calm moments.
  • Know your child’s limits regarding experiences (i.e. downtime, waiting, loosing at games, etc., sensory needs (i.e. hunger, tiredness, sensitivities, etc.) and take these and other areas into consideration. Be prepared and think ahead.

 

Resources to consider:

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

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

 

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

 

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

 

Bolstering Skills This Summer

By | NESCA Notes 2020

By: Becki Lauzon, M.A., CRC
Transition Specialist and Consultant

With the status of ESY (Extended School Year) services still yet to be determined for the upcoming summer, many parents of transition-aged individuals (14 and up) are wondering what life skills can be worked on this summer, especially if virtual learning continues.

When we think of developing transition skills, the first words that tend to come to mind are “hands-on,” “community-based,” “real-world experiences,” etc. Unfortunately, in our current state of social distancing, many of the “normal” learning opportunities are not available at this time. While some business are beginning to open back up, and there is optimism that more businesses will be opening come June—depending on what the safety guidelines are—there still may not be opportunities for needed community-based experiences. While many schools are providing creative and individualized transition services through online platforms and remote learning, many students have greater difficulty accessing instruction that is hands-off. If you are looking to bolster transition skills over the summer, the following are examples and resources of transition-related activities that could be incorporated into an individual’s summer routine.

 

Career-Research Activities:

https://careerkids.com/pages/career-research

https://www.teacherspayteachers.com/Browse/Search:career%20research/Price-Range/Free

https://www.careeronestop.org/Videos/video-library.aspx

 

Online Banking:

https://www.moneyinstructor.com/onlinebanking.asp

https://www.teacherspayteachers.com/Browse/Price-Range/Free/Search:online%20banking

https://www.bankaroo.com/

 

Domestic Skills (i.e. cooking, cleaning, laundry):

https://www.teacherspayteachers.com/Product/DLS-Doing-the-Laundry-Workbook-423396

https://tacanow.org/family-resources/developing-lifeskills-chores/

https://accessiblechef.com/

 

Recreation and Leisure:

http://www.spedchildmass.com/special-needs-recreation-disability-autism-aspergers-massachusetts/

https://www.wtae.com/article/virtual-disney-world-rides/31788233?fbclid=IwAR1-RK5xHwsCMteU7qM8y1oRGisz2Pp1nifGDfY-MaMgYl0Ih6hf9MxKlCM#

https://www.specialolympics.org/

 

Post-secondary Education:

https://www.youvisit.com/collegesearch/

https://campustours.com/

 

About the Author

Becki Lauzon, M.A., CRC, works with teens, young adults and their families out of the Newton, MA and Plainville, MA offices. Lauzon has unparalleled experience as a Transition Specialist, Transition Consultant and Vocational Program Coordinator. Lauzon will be providing transition assessment (including testing, functional evaluations and observations) consultation, case management, training and professional development for schools; and transition planning, consultation and coaching for transition-aged students and their parents.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, 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 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.

 

There’s an App for That!

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

In this time of “telehealth” and “remote learning” adults, teens and children are being bombarded with virtual platforms such as Zoom, Microsoft Teams, Google Hangouts/Meets and more.  Some teachers and students are being asked to use Google Classroom, Blackboard and other classroom-based platforms for the first time. I am of the mindset that this virtual learning and health management approach will be with us even when this pandemic subsides and we “go back to normal.” I’m also afraid that the normal we knew won’t be the normal of the future.

With this in mind I began to think that with all the time some of us have on our hands, wouldn’t it be interesting to “assess” or evaluate the variety of apps that are out there now (and there are tons!)? A middle schooler could do the research with some guidance from parents, teachers, IT professionals or others from their schools. In many middle schools, students are being taught how to critically analyze social media and news reports; why not extend this critical eye to apps? For instance, have your middle schooler research apps that address a variety of topics, such as executive functioning areas (i.e. time management, distraction, organization, etc.), social-emotional well-being and so on. With some guiding questions, help from adults and a way to tally or track data, they could decide which app they think would help them best and why. A sample list of questions may include:

  • What problem am I trying to solve?
  • What need am I trying to fill?
  • When was the app created?
  • Who created it?
  • Who was it created for?
  • How many positive reviews?
  • How many negative reviews?
  • What platform does it use?
  • How much does it cost?
  • What features does it have? Do they solve my problem?
  • How easy is it to operate initially and once I get it set up?
  • Will it work with the other programs I have running?

There are many other questions that one could ask to “evaluate” an app to help solve a specific problem. Your child and you can generate your own questions to add to this list then download and try your top choice. Try it for at least a couple of weeks and create a rating scale to evaluate its helpfulness in solving the problem. If you are satisfied, then no need to try another one. If not, download another one and repeat the procedure.

Here’s a list of various apps that address EF needs. There are many more, and these are in no particular order.

 

Scheduling/Calendar/To Do/Reminders

Pocket Informant

Forgetful

Built-in Calendar App on your smartphone

MemoCal Lite

Visual Schedule Planner

Choice Works

Pocket Picture Planner

Can Plan

30/30

Toodledo

Jot Free

My Homework

 

Time

Time Timer

Giant Timer

Time Meter Time Tracker

 

Social-emotional

Calm

Breathe2Relax

Sosh

Smiling Mind

The Social Express

Stop. Breathe. Think

Hidden Curriculum

Middle School Confidential

Model Me

Take A Chill

emotionary

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

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

 

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

 

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

 

Visual Motor Integration Deep Dive – Part 2

By | NESCA Notes 2020

 

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

Last week’s blog taught us the nuts and bolts of Visual Motor Integration. Let’s jump into the what VMI really means for students who struggle with VMI.

Research has shown a statistically significant correlation between performance on visual motor integration assessments and teachers’ assessments of early elementary school students’ reading, mathematics, writing and spelling ability (Optometry and Vision Science, 1999; Pereira, D., Araujo, R., & Braccialli, L., 2011). Now that we understand what visual motor integration is as a concept and that it is a foundational skill for academics, let’s look at some areas of education that may be difficult for children with visual motor dysfunction.

  • Written Output – Beginning in preschool, children start to learn how to draw vertical, horizontal and diagonal lines. They practice circles, squares, crosses and drawing an X. All of these are considered pre-handwriting practice. As a child moves along in their academic career, they start incorporating these movements into letters and eventually words. Children who struggle with VMI have particular difficulty recreating the images that they see. This often manifests itself in letter reversals, illegible written output and inability to judge whether their copy looks like the model or not. As children get into later grades, visual motor dysfunction may include difficulty copying information from a whiteboard, trouble staying on the line or within the space provided, and a simple lack of fluidity when writing. Tasks, such as filling out graphic organizers and brainstorming, feel tedious and tiring, as opposed to helpful.
  • Math – While math is not typically thought of as a motor-based task, substantial portions of current math curriculums rely on visual motor integration. For younger students, drawing shapes, writing equations and recognizing patterns may be particularly tough. As students get older, geometry requires them to write out proofs and draw shapes, while calculus requires graphing and drawing lines based on complex equations. Building on VMI helps students to access more than simple written output.
  • Using Classroom Tools – While this may not seem as academically focused as the other areas that are affected by VMI, classroom tools are frequently used throughout the school day. Scissors, a stapler, a hole puncher and a mouse/keyboard all require some level of visual motor function.

It’s difficult to briefly sum up all of the ways that students are incorporating their visual motor integration skills into a typical school day, or realistically a day in general. They use these skills without even realizing it, which means they unintentionally practice them all day. VMI is something that can continue to develop all through the lifespan. Artists pick up new tools and build mastery, adult calligraphy classes have become a new fad as people learn to modify and improve their handwriting, and even Tom Brady continues to work on perfecting that spiral. Targeted intervention can help children build on their foundation and find confidence in their abilities. If you feel that VMI might be affecting your child’s education, reach out to an occupational therapist and see if they can help you better understand your child’s individual profile.

 

References

Optometry and Vision Science: March 1999 – p 159-163. Retrieved from https://journals.lww.com/optvissci/Abstract/1999/03000/Relationship_between_Visual_Motor_Integration.15.aspx

Pereira, D., Araujo, R., & Braccialli, L. (2011) Relationship between visual-motor integration ability and academic performance. Journal of Human Growth and Development, 21(3), 808-817. Retrieved_from https://www.researchgate.net/publication/317462934_Relationship_analysis_between_visual-motor_integration_ability_and_academic_performance

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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.

 

Becoming a Behavior Detective

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

Behavior = Communication

Behavior is everywhere you look. All behavior is adaptive and purposeful whether “appropriate or inappropriate,” “expected or unexpected,” or “regulated or not.” Have you ever heard of the phrase, “Behavior = Communication?” It is often used to help us think about behavior as a meaningful and purposeful means of communication, even when it is maladaptive.

Behavior is multifaceted and can be internally- and externally-driven. Every behavior that any one of us does can be interpreted as communicative and as having meaning. When a mom says to load the dishwasher and a child doesn’t respond, the child may not have heard her or may have actually heard the direction and chosen to ignore her. Ignoring her and not responding is actually responding – the is escaping a demand or that direction. If a child asks for a toy at the store and the parent says, “No,” and the child cries and stomps their feet in displeasure, the child is definitely expressing feelings. If the parent gives in to the tantrum and agrees to buy the toy to quiet the child down, the parent is reinforcing the inappropriate behavior/tantrum. This pattern often repeats itself, leaving parents and kids in a vicious cycle. The child learns that crying and stomping gets what he/she wants.

Becoming a Behavior Detective

In the current COVID-19/stay at home landscape, being a behavior detective could serve parents and caregivers well! Parents and children are feeling stressed and anxious, even if they don’t appear so. This is a communal feeling given the current situation, and parents may need to pick and choose their battles wisely. Otherwise, they may spend hours of each day dealing with many unpleasant moments. Being “cooped up” with each other may present an opportunity for parents to become behavior detectives to figure out what their kids are trying to communicate. If the children are older, parents may want share this with them so both parent and child become detectives together; maybe even of each other!

Conjunction, Junction, What’s the Function?

Maladaptive behavior is communicating something, and if we want to change that we need to know what the communicative function of the behavior is. By knowing the function behind the behavior (what they are trying to accomplish by the behavior), we can then think about prevention, intervention and post-intervention—thus being able to intervene at three different times before a behavior actually occurs, during the behavior or after the behavior occurs.

Communicative functions of behavior include:

  • Escape/Avoidance of a task
  • Access to something/someone desirable
  • To make a request or a comment
  • Negations/refusal
  • Self-non-interactive—communicating with ourselves or self-talk/actions
  • Attention-seeking
  • Expression of feelings
  • Expression of sensory needs

Given our current environment, it may be important to think about the communicative function of a child’s “maladaptive behaviors.” This provides a way to intervene with a hypothesis of function and consistency of prevention, intervention or response. Given parents’ own mental, emotional or psychological state, they have the option to escalate or deescalate any situation. Be honest with your kids if you are tired, stressed or overloaded; let them know that you may have less patience when appropriate. Remind them that they have a role in helping to make the house and family a kind, happy and compassionate place. Honest communication, kindness and gentleness with one another (even when we lose control) goes a long way to help during these trying times.

If you need help in being a behavior detective, NESCA is providing virtual parent coaching and consultation. Complete our online Intake Form for more information.

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

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

 

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

 

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

 

Visual Motor Integration Deep Dive – Part 1

By | NESCA Notes 2020

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach

If your child is currently receiving occupational therapy services in either a sensory clinic or a school-based setting, it is likely that you have heard the phrase “visual motor integration (VMI).” It has possibly been described as the ability to “see something and then recreate it with a pencil,” or “coordination between the eyes and the hands to create an intended outcome.” While these phrases or simple definitions do give some insight into the skill, there are layers to understanding the intricacies of VMI and how it may affect someone in a classroom setting. Why is visual motor integration important? Why does this skill affect a child’s ability to successfully access their curriculum? And really, why do occupational therapists seem to be so focused on this foundational skill?

Let’s start by dissecting the phrase visual motor integration, as each word truly highlights an important aspect.

Visual.

In this sense, “visual” refers to the functional visual skills and visual perception. Functional visual skills include being able to follow along a horizontal, vertical or diagonal line with one’s eyes, as well as being able to account for depth by focusing on objects that are both close to the face (a book) and far away (the whiteboard). Clinically, these skills are referred to as visual tracking and convergence respectively. Visual perception is the brain’s ability to interpret the data that the eyes are seeing and turn it into meaningful information. This is not simply the ability to clearly see something, a skill that is often assessed by school nurses or optometrist. It is the ability to understand it. Visual perception is complex in its own right, but the specific details are for another time, or potentially another blog.

Motor.

Similar to visual skills, “motor” refers to one’s overall motor skills. This includes:

  • Fine motor control – the ability to use the small muscles in the hands to make coordinated movements;
  • Gross motor – the ability to use the large muscles in the body; and
  • Postural stability – the ability to create a supported foundation when sitting or standing; a child’s postural stability is hugely affected by their core muscles and their position when sitting.

Integration.

Some students have visual motor dysfunction because of a deficit in either their visual skills or their motor skills. They find using these two skills together difficult simply because one foundational piece is already affected. Conversely, some students have trouble with VMI simply because of this integration piece. Being able to use these two skills in conjunction with intention and coordination is a skill within itself. Through standardized assessment and clinical observation, occupational therapists should be able to determine the root cause of a child’s VMI dysfunction. This helps to guide appropriate intervention and accommodation. In some ways, visual motor integration is similar to hand-eye coordination.  Being able to recreate something that a child sees, such as a square, the letter “A” or a horizontal line is truly using VMI skills.

Next week, we’ll dive further into VMI and how it serves as a foundational skill for academics, its impact on learning and the output students produce.

 

About the Author

Dr. Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Dr. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Dr. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Dr. Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.

 

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.

 

Meltdown Analysis — Part 2

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

As discussed in last week’s blog, Meltdowns Happen, all children meltdown. Adults meltdown, too. Losing control can take many forms. It is a part of human nature unless we deliberately work on “controlling the beast” that’s lurking inside of us when our system gets taxed. When children are very young, we expect them to lose control because they are learning how to identify and express their emotions. A three-year-old who tantrums is not that uncommon; however, by the time that child is six and then 10, we want them to have developed more and more control as they mature.  But, many children don’t always develop the control that we’d like, and those diagnosed with learning differences sometimes have even more difficulty controlling their emotions.

Teaching children about their emotions, their triggers and how to manage their feelings is the backbone of improving self-awareness, stress management and social competency (3 Ss). If children can label and recognize feelings, notice how their body feels with different emotions and know how to calm themselves when stressed, the better off they will be in life. In a previous role as the program director of Aspire/MGH, we focused on these 3 Ss and utilized a volcano image with our autism spectrum disorder (ASD) participants to teach them about their stress cycle. The volcano image represented a meltdown (see below).

In using this with your child, pick a quiet, calm moment to introduce it to him/her. You might want to start the conversation by reading a book about stress or big emotions. There are many to choose from depending upon the age of your child. You could also just begin a discussion with volcano image to help them understand what they look like and sound like when they are melting down. Discuss with your child what you think s/he looks like as s/he begins to meltdown starting at the bottom of the volcano and working all the way to the top (5) and then what s/he looks like when s/he begins to calm down and recover (moving down the right side of the volcano). If your child has not learned stress management strategies, this is a good time to practice. If your child has learned some techniques, you can also create a list of strategies that s/he can do at each step to help gain control so s/he doesn’t continue to escalate to the next stage. For instance, at a 3, you may be able to use humor to help redirect, but when s/he is at a 4 or 5, using humor may increase distress. I hope this image helps with understanding and reducing the meltdowns that are occurring every day in everyone’s home.

If you’d like assistance in creating your child’s personal meltdown plan, self-awareness plan or behavior plan, NESCA’s parent coaching services can assist you in the journey.

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

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

 

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

 

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

 

Preparing for the Transition from Special Education to Adult Services

By | NESCA Notes 2020

By: Becki Lauzon, M.A., CRC
Transition Specialist and Consultant

As many parents, educators and young adults know, the transition from special education services to adult services is an overwhelming and scary time. I recently gave a presentation about breaking down the referral process for adult services, as well as highlighting many types of services that are available once a student turns 22 or graduates from high school. From community-based day supports, to job coaching, accessing travel options and managing the day-to-day tasks of living as independently as possible, there are a handful of resources available within Massachusetts. Below you will find some helpful links to begin educating yourself on what some of those services could look like, answers to commonly asked questions, as well as a breakdown of helpful timelines for when the planning process should begin.

Commonly Asked Questions:

  • What are the adult agencies?
    • Massachusetts Rehabilitation Commission (MRC); Massachusetts Department of Developmental Services (DDS); Massachusetts Department of Mental Health (DMH); Massachusetts Commission for the Blind (MCB); and Massachusetts Commission for the Deaf and Hard of Hearing (MCDHH)
  • What is a 688 referral?
    • A 688 referral can only be completed by school systems for students who may be eligible for adult services. This should be discussed at a student’s IEP meeting AT LEAST two years before the student is expected to graduate or turn 22. It should also be documented in the student’s IEP that it was discussed at the meeting.
    • It is important that the 688 referral is done at least two years before the student is supposed to leave the school system, as this provides enough planning time to determine eligibility for adult services and for the student to be included in the anticipated cost of services for the state.
    • The 688 referral must be signed by the parent or legal guardian, unless the student is over 18 and their own guardian. In this case, the student needs to sign it. There are different agencies (DDS, DMH, MRC, MCB, etc.), and the appropriate one will be discussed and then determined.
  • How do I fill out a self-referral?
    • For the Department of Developmental Services (DDS)
    • For the Department of Mental Health (DMH)
    • For Massachusetts Rehabilitation Commission (MRC): Students, family members and/or school staff can begin the referral process with a phone call or a visit to the local MRC Area Office. There may also be a Vocational Rehabilitation Counselor assigned to the student’s high school who can assist with the direct referral process. The MRC direct referral process can begin as early as age 14 or at least two years prior to graduation from high school.

Helpful Links:

 

About the Author

Becki Lauzon, M.A., CRC, works with teens, young adults and their families out of the Newton, MA and Plainville, MA offices. Lauzon has unparalleled experience as a Transition Specialist, Transition Consultant and Vocational Program Coordinator. Lauzon will be providing transition assessment (including testing, functional evaluations and observations) consultation, case management, training and professional development for schools; and transition planning, consultation and coaching for transition-aged students and their parents.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, 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 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.