Resilience, Covid and College Admissions

By | NESCA Notes 2021

By: Tabitha Monahan, M.A., CRC
NESCA Transition Specialist/Counselor

It’s been a year since schools across the nation closed their doors and moved education to the world wide web. Teachers, many of whom have never received training to teach in a virtual format, were now providing lessons remotely. The challenges of teaching remotely highlighted many of the disparities that affect our students. Students did not always have the technology or literal bandwidth to learn from home. Students with learning differences and disabilities faced even more challenges in receiving their support in a format not conducive to their needs. However, there were some silver linings. Students had more opportunities to practice executive function skills and become more familiar with software programs outside of video games, social media and YouTube videos.

As students – and, well, all of us – adjusted to the pandemic and what that meant for our daily lives, mental health concerns increased. Faced with uncertainty, constant changes and fear, anxiety, stress and depression increased among students. In response, they built coping skills.  Not all coping mechanisms are positive, but our kids survived this past year. As we work our way back to some semblance of normalcy, what does that mean for our students who were planning to move on to postsecondary education? Extracurricular activities are considered a relatively important part of the admissions process, but those weren’t available last spring and are barely available now. What should colleges use instead to find students that would be a good fit?


Resilience, the ability to adjust and adapt to changes and adversity, is an important factor necessary to reach goals, especially once a person faces a challenge. We encourage students to build resilience by setting high expectations of them and assisting them in creating challenging goals. We help students process what to do when they reach a roadblock. As students build coping skills and learning strategies, they are building resilience. How does resilience help in college? College is a different environment than high school. Many students experience challenges as they adjust to their newfound freedom and responsibilities. Students now find themselves responsible for scheduling their classes, getting to those classes and figuring out how to manage their schedules.

As colleges receive applications in a year unlike any in recent history, students may want to consider how they can show the colleges how they persevered. Matthew Pietrafetta of Academic Approach suggests students use the college admission essay as an opportunity to present the college with their stories that demonstrate how they became more resilient. Recommendations may also provide another factor for colleges to consider. Teachers and counselors understand the challenges that the student experienced and can share how they overcame adversity. Our students have already overcome additional challenges than many of their general education peers have not. Their past successes are the reason colleges should consider their admission. Test scores and grades are only one part of the picture. The next generation of college students has already built the resilience that will help them succeed. The past year has only exemplified this point further. Our students have proven that they can adapt and meet whatever challenges come their way. What a better way to prove to the colleges that they have what it takes?



About the Author

Tabitha Monahan, M.A., CRC, is an experienced transition evaluator and vocational counselor. While she is well-versed in supporting a wide range of transition-aged youth, she is especially passionate and knowledgeable in helping clients and their families navigate the complex systems of adult services and benefits as well as medical and mental health systems. She is further adept in working individually with students of all abilities to empower self-advocacy and goal achievement.


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 or call 617-658-9800.


Autism Awareness Month

By | NESCA Notes 2021

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

So what? What does it really mean to have an awareness month and a designated day? April is Autism Awareness month, and this year April 2 was World Autism Awareness Day, established by the United Nations (UN) in 2008. In general, these designations are meant to bring awareness to ”causes.” You will see a lot of blue in April as blue is the color of autism spectrum disorder (ASD) awareness. There will likely be many federal, state and local municipal buildings, private homes, as well as national and international monuments bathed in blue lights. People will wear blue, there will be blue autism products to buy, and our air waves will be flooded with autism awareness commercials. In a typical year, many commemorative and educational events would be held. It is usually a time of celebration for people with autism as well as their families and friends everywhere. For instance, in pre-pandemic years, sports teams, movie theatres, museums, Broadway and other venues would host ASD-friendly days. Autism Speaks has its “Light it Up Blue” initiative and is celebrating this year specifically with its #LightUpWithKindness campaign. The United Nations (UN) has a different theme every year, and this year’s theme is The Transition to Adulthood.

When the United Nations established April 2 as Autism Awareness Day, it had high hopes.

In 2008, the Convention on the Rights of Persons with Disabilities entered into force, reaffirming the fundamental principle of universal human rights for all. Its purpose is to promote, protect and ensure the full and equal enjoyment of all human rights and fundamental freedoms by all persons with disabilities, and to promote respect for their inherent dignity. It is a vital tool to foster an inclusive and caring society for all and to ensure that all children and adults with autism can lead full and meaningful lives.”

Well said…but far from the reality of many individuals with autism and their families. If only our schools, communities and societies were as inclusive, respectful and welcoming as this statement. If it were today’s reality, many people diagnosed with ASD and their families wouldn’t have to struggle as much as they do on a day to day basis with stigmatization, discrimination and a lack of respect and inclusive opportunities.

Autism is a lifelong neurological condition that originates in childhood, and its presentation changes over time. Autism is a spectrum with social, communication, sensory and behavioral differences manifested uniquely in each individual. While we have come a long way in understanding autism, recognizing the breadth and diversity of those with it; embracing their talents, unique abilities and strengths; and addressing the day to day challenges that autistic people face. The UN’s vision is still far from a reality, and there is still much work to do.

It is my hope that during Autism Awareness Month, you become more aware. If you support the “cause” and buy a shirt, bracelet or puzzle piece and shine a blue light on your porch, that’s great – spread the word.  Take the Autism Speaks #LightUpWithKindness” campaign to heart do something to create a world that is kinder, gentler, more respectful and inclusive of autistic people with autism. Watch a movie about ASD, read a book by an autistic author, take the time to educate yourself and your children. If your child has autism, educate your child’s classmates, neighbors, family members and community members. If a child with autism is in your child’s class or school, connect with them and their parents. You are modeling for your own kids and those around you, so spread kindness, acceptance and inclusiveness. If you are an employer, connect with your local school district and offer to partner with them to provide internships for transition-aged youth with autism and maybe even hire them as employees! While this is a financially challenging time for so many, if you do have the means, donate and give to an ASD agency (whether it be locally-, nationally-, medically- or research-based, etc.) – whatever brings you joy. Donate your time at an autism support center.  There are so many ways to recognize Autism Awareness Month that go beyond the color blue – choose something that resonates with you and be the light! Be the light that goes beyond Autism Awareness to Autism Action, Autism Acceptance, Autism Access and Autism Advancement.


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 or call 617-658-9800.


Mind the Gap: Why You Should Consider Summer OT and Speech Services at NESCA

By | NESCA Notes 2021

By: Julie Robinson, OT
Director of Clinical Services; Occupational Therapist, NESCA

It has been a challenging school year, with ever-changing schedules, routines, and unfortunately with a good deal of inconsistency in the provision of therapeutic services through the schools, due to the many impacts of COVID. Parents, caregivers and students have all experienced differing levels of anxiety about what progress has been and is being made, with many children experiencing some level of regression with regard to behavior, self-regulation, motor skills or language development. In anticipation of many of our children returning to school in-person in April, parents have expressed concerns that their children may be lagging behind or that they have not had ample support throughout the earlier parts of their school year to ensure they can keep up with the other children in their class. Over the months of April, May and June, we will all get to see firsthand where the gaps might arise. And then when school is over, many of us might be concerned that the gains of just a few short months will be lost again over summer. This is why those of us at NESCA perceive that the benefits of summer services will be an important part of ensuring progress and the ability to jump right back into learning – as we hope all school will be in-person again in the fall.

NESCA is available to provide summer services, as we do consistently for our weekly patients. In addition, we are offering short-term services to those children who may not qualify for them through their school systems, or for those families who would simply like to supplement what their children are receiving in-district to give them a boost before school begins again in the fall.

Our occupational therapists (OTs) can work on the following areas of focus with your child:

  • self-regulation and coping skills
  • how best to transition from the quiet of home to the multiple stimuli of a classroom full of children
  • how to cope with longer hours of wearing a mask
  • how to follow social distancing requirements, when they long for a closer physical connection with their peers

We can also help to ease the anxiety some children may have about becoming sick or how NOT to feel fearful of getting back into the classroom when sensory processing issues push them to feel uneasy. Our OTs can continue work on handwriting and motor development work started throughout the school year to ensure there is no regression or to improve the speed and automaticity of written expression and legibility. We can teach organizational and executive functioning skills to encourage kids to be independent, prioritize assignments and manage their time. OTs can address self-care skills of dressing, shoe tying, feeding and hygiene, which are likely to require more independence with social distancing requirements. While it’s summer, we help build outdoor skills, such as bike riding and greater self-confidence on the playground to elicit more social connections with peers. Our OTs are providing services in-person in our Newton and Plainville, Massachusetts clinics, by teletherapy or outdoors in the community as appropriate.

Our speech therapists at NESCA can also help to continue and supplement the hard work children have been putting in throughout the school year. They can work on social pragmatics and help with the skills needed to transition from so much time alone, to being in groups with their peers once again. NESCA’s speech therapists can support children on how to:

  • initiate play
  • find shared interests
  • be flexible thinkers
  • communicate with kindness and an appropriate level of voice
  • read gestures and non-verbal communication (especially while wearing masks, which can impede the ability to properly read another person’s mood, reactions or emotions)

We can continue to work on the established goals from school, regarding both expressive and receptive communication, language articulation and language as it pertains to written communication. Our speech therapists are currently providing all services via teletherapy while we work on a transition back to in-person therapy.

If you are interested in seeking out summer services at NESCA, or any of our assessments and services, please contact NESCA’s Director of Clinical Services Julie A. Robinson. She can be reached at and will conduct a phone intake with you to help you best determine your needs.


About the Author

Julie Robinson is an occupational therapist with over 25 years of experience as a clinician. The work Julie does is integral to human development, wellness and a solid family unit. She particularly enjoys supporting families through the process of adoption and in working with children who are victims of trauma. Julie has extensive experience working with children diagnosed with an Autism Spectrum Disorder (ASD), or who have learning or emotional disabilities. She provides services that address Sensory Processing Disorder (SPD) and self-regulation challenges, as well as development of motor and executive functioning skills.

To book an appointment or to learn more about NESCA’s Occupational Therapy Services or other clinical therapies, please fill out our online Intake Form, email 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 or call 617-658-9800.


Facilitating Language Growth at Home

By | NESCA Notes 2021

By: Abigael Gray, MS, CCC-SLP
NESCA Speech-Language Pathologist

I recently got to spend time with my 18-month-old nephew, after not having seen him in a year and a half due to the pandemic. It got me thinking about practical ways to help facilitate language throughout the day without feeling like you’re doing anything extra. Play and routines are great times to build language, and you can often find opportunities that are motivating for your child. Motivation and interest are key, because children are much more likely to participate and communicate. Below, I discuss tips to incorporate into your daily routine at home.

Five ways to facilitate language growth at home:

  1. Play!
    • Play the way your child is playing and imitate what they’re doing.
    • Even if you had a plan, don’t be afraid to change it to focus on their interests (i.e., follow their lead, as explained below).
    • Use fun sounds, words and gestures to go with what you’re doing (e.g., “beep beep” when playing with cars, “pop” when popping bubbles, “yummy/mmm” and rubbing your stomach when pretending to eat play food).
  2. Follow your child’s lead
    • Observe what they’re interested in, wait until they initiate or continue interaction, and listen to their words and sounds.
    • Get on their level so they know you are joining in.
    • If they are doing something unsafe, explain why it’s unsafe in simple terms and redirect them to a safe activity.
  3. Get silly
    • Repeat actions they think are funny.
    • Switch up routines in a silly way (e.g., “forget” their favorite bath toy, give them a fork with their yogurt). This encourages language when your child notices and wants to tell you something is different or missing.
    • Change song lyrics or words in stories to be about your child, their interests and/or what is happening around you in the moment.
  4. Pause
    • Slowly sing familiar nursery rhymes and songs and then pause at key words to encourage them to fill in a word or gesture.
    • Pause a familiar activity, such as pushing the swing, and wait for them to ask you to continue using words or gestures (e.g., “more,” “again,” “go”).
    • When looking for a response, stop talking, lean forward and look at them expectantly. You can count slowly to 10 silently, which gives your child time to respond.
  5. Expand
    • When your child uses one to two words, turn it into a short sentence. For example, if they say “up” wanting you to pick them up, you could say, “Ok, I’ll pick you up.”
    • Be sure to use correct grammar when expanding their message, even if your child is still using immature grammar.
    • Use a variety of words (e.g., describing words, action words, words for feelings, location words, etc.). Start with words your child would want to say to talk about the things they are interested in.

Many of these ideas are things you may already be doing throughout the day, but it is good to think about how doing so helps your child learn to understand and use language. If you feel that your child may be behind in their language understanding or production, it is helpful to schedule an evaluation with a speech-language pathologist. If therapy is warranted, your speech-language pathologist can make recommendations specific to your child and family and show you how to best encourage language growth in the home environment.

Weitzman, E. (2017). It takes two to talk: A practical guide for parents of children with language delays (5th ed.). Toronto: Hanen Centre.


About the Author

Abigael Gray has over six years of experience in assessment and treatment of a variety of disorders, including dysphagia, childhood apraxia of speech, speech sound disorder, receptive and expressive language disorder, autism spectrum disorder and attention deficit hyperactivity disorder. She has a special interest and experience in working with children with feeding and swallowing disorders, including transitioning infants to solid foods, weaning from tube feeding, improving sensory tolerance, developing chewing skills, increasing variety and volume of nutritional intake and reducing avoidance behaviors during mealtimes.


To book an appointment with or to learn more about NESCA’s Speech & Language Therapy, please fill out our online Intake Form, email NESCA’s Director of Clinical Services Julie Robinson 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 or call 617-658-9800.


The Roles of Students, the School and the Family during the Transition Planning Process

By | NESCA Notes 2021

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

The transition process is a complex and ongoing one. Throughout the transition planning process, many individuals often wonder who exactly is responsible for what. While the school system plays a big role during this time, it is also important to make sure that students and their families/guardians have a role in the process as well. Here’s a helpful breakdown of the participants involved in the transition process and what responsibilities fall within each of their roles.

The Role of the School in the Transition Process

  • Provide information on the student’s strengths, past achievements and progress on the current IEP
  • Provide strategies for effectively teaching the student, including appropriate accommodations and/or modifications so the student can successfully access the general curriculum
  • Identify needed related services
  • Coordinate all the people, agencies, services or programs involved in the transition planning
  • Link students and parents to appropriate post-school services, supports or agencies prior to the student leaving high school
  • Suggest courses of interest to the student and educational experiences that relate to the student’s preferences and interests and that provide skills to help the student achieve their desired post-school goals
  • Hold workshops for families on transition planning, post-secondary options, adult service providers, etc.

The Role of the Student in the Transition Process

  • Participate actively in all discussions and decisions (IEP meetings). This could include reading their vision statement, creating a PowerPoint to share at the meeting, etc.
  • Communicate preferences and interests
  • Communicate strengths and areas where help is needed
  • Take part in the IEP development
  • Develop a post-secondary vision statement
  • Identify transition-related skills that can be done in the home environment (i.e., chores)

The Role of the Parent(s)/Guardian in the Transition Process

  • Support the student
  • Reinforce the value of an individualized, appropriate educational program
  • Provide information about the student’s strengths, interests and areas where assistance is needed
  • Provide information about the student’s independent living skills and the help the student may need to achieve the desired post-school goals
  • Be actively engaged as equal partners in all aspects of the IEP planning, discussion and decision-making
  • Work in collaboration with the school to practice transition skills within the home environment

Below are some additional resources on this topic:

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 or call 617-658-9800.


Giftedness – What does it mean, and how do I know if my child is gifted?

By | NESCA Notes 2021

By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

All children have learning strengths and weaknesses, and as parents we are proud of all our children. However, there are some children who are precocious and seem to learn many skills early and with ease. According to the National Association of Gifted Children, there are certain characteristics that parents will often notice and wonder if their child is gifted. Some of these characteristics include:

  • Unusual alertness, even in infancy
  • advanced vocabulary
  • heightened sensitivity
  • remarkable memory
  • rapid and constant learning from their environment
  • seeming to know things without the effort required to learn it
  • longer attention spans and intense concentration skills; yet at the same time they can become preoccupied with their own thoughts, often being labeled as “daydreamers”
  • demonstrate a wide range of interests
  • display a highly developed level of curiosity and ask probing questions
  • vivid imaginations (often including imaginary playmates during pre-school years)

However, there are also some challenges for gifted children as they tend to be highly sensitive, and they feel things deeply and respond with intense feelings and reactions. When a child demonstrates advanced cognitive abilities, that does not mean that they are emotionally mature enough to manage the information they are able to access. For example, a young child who can read at an advanced level is not necessarily mature enough to read books intended for older children, as the content is beyond their ability to process emotionally. This discrepancy is referred to as asynchronous development. Often highly gifted children will be advanced in many academic areas but may lag behind their peers in their development of social skills. They can also demonstrate perfectionism and anxiety, often as a result of their asynchronous development.

Unfortunately, at this time, Massachusetts does not have a definition of giftedness and does not collect data on gifted students. However, if you believe that your child is gifted, there are many things you can do to support them. For example,

  • allow them to dive deeply into subjects of interest to them
  • encourage them to take risks and make mistakes, as this will allow them to develop coping strategies as well as improved problem-solving skills
  • provide opportunities outside of school, such as enrichment programs in their areas of interest
  • consider participating in opportunities for activities that occur with like-minded peers, that teach in depth, encourage creative problem-solving and are fun (e.g., those provided by the Massachusetts Association for Gifted Education, MAGE)

Finally, early identification improves the likelihood that a child’s gifts will develop into talents. If you suspect that your child is gifted, consider both objective testing (e.g., IQ testing, academic achievement tests) as well as collecting subjective information (e.g., teacher observation and rating forms, parent reports, examples of child’s work).

NESCA’s comprehensive neuropsychological evaluations provide a highly-detailed description of an individual’s developmental status, thinking patterns and learning style based upon a very careful integration of findings from developmental history, observations by parents, teachers and clinician(s), and data from NESCA’s own testing. These evaluations, which seek to paint a recognizable portrait of the whole person, assess the underlying reasons they may be struggling academically, socially or emotionally and offer parents and teachers a set of tools for supporting the individual’s development.

If you are interested in learning more about NESCA’s Neuropsychological Evaluations, email: or complete our online intake form.



Davidson Institute – (
National Association for Gifted Children (


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.

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

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

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

She is the mother of one teenage girl.

To book a consultation with Dr. Talamo 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, Plainville, Massachusetts, and Londonderry, New Hampshire, serving clients from preschool through young adulthood and their families. For more information, please email or call 617-658-9800.

Appreciating and Responding to The New York Times article, For Some Teens, It’s Been a Year of Anxiety and Trips to the E.R. by Benedict Carey

By | NESCA Notes 2021

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

As an occupational therapist working almost exclusively with teenagers and young adults over the past year, the title of Benedict Carey’s article jumped out at me like a tired and worn flag, waving frantically for acknowledgement. Our teens are anxious, tired, and dealing with living through the proverbial “unprecedented times” without the developmental capabilities needed to quickly adapt in this era of remote learning, remote social interaction, and remote extracurriculars. Remote everything!

It is important for me to note that I really enjoy working with teenagers. I find myself in constant awe of their resiliency, their willingness to confront hard truths that many of us shy away from, and their ability to push forward despite having huge questions about who they truly are. All of these things are tough and require immense emotional fortitude, but this year many of these challenges feel impossible.

Carey has taken the time to gather perspectives from multiple stakeholders. He provides a platform for parents, educators, professors, therapists, pediatricians, and directors of hospital programs to explain the struggles of supporting these kids without adequate resources. Parents describe the fear of supporting their children as they struggle with mental health. Doctors discuss the frustration of having inadequate resources and support in emergency rooms around the country. Carey highlights that, according to the Centers for Disease Control and Prevention (CDC), the proportion of adolescent emergency admissions for mental problems, like panic and anxiety, is up 31 percent. Some of my clients add to this statistic and are navigating their own path through chaotic hospitalizations and overwhelmed support systems. Carey’s article is absolutely worth taking the time to read, if only to see the ubiquity of these issues and how they are happening all around our country. Simply put, we have a clear problem. Less clear, is the solution.

When meeting with adolescents and young adults themselves, I hear three main fears popping up week after week. Here are a few thoughts and suggestions on how to support these specific fears or feelings.

  1. “I can’t get this done, (and therefore) I am going to completely ruin my future.”

When looking at future success through a transition lens, we consider the areas of independent living, community participation, post-secondary education, and employment. In the school setting, most students’ curricula are focused solely on academic success. Sometimes, we do a poor job of teaching students about multiple intelligences or emphasizing the importance of hard work. While grades are important, they are not everything, and while standardized testing is returning to students’ schedules, they should not serve as students’ measure of self-worth. We know this, but do they? We have to teach our children that if they are hardworking, kind, and truly doing their best, the threat of “ruining their future” is much less likely than they fear. Let’s highlight the undeniably true narrative that everyone’s path can look different and still lead to success.

  1. “I’m so tired. All of the time.”

Many of my clients tell me they are not sleeping. If they are sleeping, they fall asleep late with a phone in their hand, constantly refreshing apps or trying to maintain communication with their peers. In our current remote world, the phone can feel like a lifeline. Sleep is a foundational need for mental and physical health. Students who are 15 or 16 years old often have a limited understanding of how holistic the effects of decreased sleep can be. Sleep is not their priority. Recently, I have seen parents disable the internet or have their teenagers put their phones into a lockbox from midnight until 6:00am. This new boundary is often met with anger or frustration at the beginning, but then these students start to sleep. They are better able to manage their emotions. They have more energy. They start to see the benefits despite their skepticism. If a tech break doesn’t feel quite right for your family, it is still worth opening up a conversation about the need for strong sleep hygiene and modeling a routine that promotes calming down by limiting screens before bed, which can have hugely positive effects.

  1. “This is never going to end.”

In many ways, a year feels much longer to a 17 year-old than it does to an older adult. Working at a job for four years never feels as long or as formative as the four years of high school. And objectively, a year to a 17 year-old is over five percent of their life, while it’s only two percent of 50 year old’s life. Let’s acknowledge that. Let’s verbalize the fact that teenage years are also full of milestones that have been constantly cancelled or changed to fit social distancing recommendations and safety precautions. There is a sense of loss and grief surrounding many events that these students have been looking forward to since elementary school. Encourage students to do their own research into what the next six months may look like as we start to open back up. Help them to understand the vaccine rollout and the pitfalls and successes that we have had as a nation tackling a novel disease.

Adolescent mental health is going to be an on-going challenge that we tackle as a community. As we slowly forge out of isolation, let’s center our conversations around the mental health of our teens and honestly acknowledge the unique position that they have found themselves in.


Carey, B. (2021, February 23). For some teens, it’s been a year of anxiety and trips to the e.r. The New York Times.

Leeb, R.T., Radhakrishnan, L., Martinez, P., Njaj, R., Holland, K.M. (2020, October 27). Mental health-related emergency department visits among children aged <18 during the covid-19 pandemic. MMWR Morbidity and Mortality Weekly Report 2020:1675-1680. DOI:


About the Author

Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. 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. 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, 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 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 or call 617-658-9800.


The Uncertainty, Stress and Anxiety About What School Will Look Like

By | NESCA Notes 2020

*This blog post was originally published prior to the start of in-person school last fall for some. While many students have returned to their school buildings, many others are just now returning or will be in the coming weeks. 

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist Fellow and Therapist

Much of adjusting to the world in the midst of a global pandemic has been learning to live with nearly constant uncertainty. Undoubtedly, this pandemic and ensuing uncertainty has caused significant stress for youth and their families. The experience of persistent stress can result in increased vulnerability to anxiety and depression. Symptoms may become magnified in those who already faced mental health challenges. There is little doubt that there will be increases in mental and behavior health problems for children and families both in anticipating the re-opening of schools, and when schools reopen their physical buildings.

We all wonder what school will look like in the fall. The anticipation of returning to school can be especially stressful, and will likely be so for most youth. Given that students will not have been in schools with their peers for several months, it can be anticipated that they might feel a heighted sense of insecurity and uncertainty. Even in “normal times,” returning to the complex social and educational environment of school can be worrisome for many children and adolescents.

Each individual child will have had their own experiences while schools were closed. Some children and/or staff members may have been impacted by COVID-19 and some families and/or staff may be experiencing financial hardship due to parental unemployment or loss of household income. It is important to realize that regardless of their experience, each individual will have a unique response. It is helpful to recognize the signs of stress and help children learn positive ways of coping with it.

Signs of stress in preschool children include, but are not limited to, anger, nervousness, eating and sleeping problems (including nightmares), fear of being alone, irritability and uncontrollable crying.

In elementary age children, stress may manifest as increased complaining of headaches and stomachaches, feeling insecure, reduced appetite and difficulty sleeping, withdrawal and worrying about the future.

Signs of stress in pre-teens and teens may include anger, disillusionment, distrust of the world, low self-esteem, stomachaches and headaches, panic attacks and rebellious behavior.

As each person works through this very challenging situation, it is more important than ever to adopt a position of acceptance, as we never truly know what another person is experiencing or has experienced. The following are offered as suggestions on how to help children and teens cope with stress.

  • Help them identify how they are feeling and acknowledge and validate those feelings.
  • Encourage them to talk about what is bothering them.
  • Share strategies you use to cope with stress.
  • Talk openly and, as appropriate, share stories about stress in your day.
  • Find a physical activity and/or hobby that they enjoy and encourage them to participate.
  • Encourage them to eat healthy foods and emphasize the importance of a healthy lifestyle, especially as it relates to stress.
  • Make sure they get plenty of sleep.
  • Set clear expectations, without being overly rigid, and allow for “down” time.
  • Spend time outdoors, encourage them to do something they love – read a book, ride their bike, bake, etc.
  • Learn and teach your children relaxation skills, such as breathing exercises, muscle relaxation exercises, meditating, yoga, drawing or writing.

Our world will have changed by the time children re-enter their classrooms. No matter what happens in the fall, when it is time for school to start, it will inevitably be stressful. Learning to cope with and manage stress is important for physical and emotional health. However, if you are concerned about your child or are struggling yourself, seek help and support for yourself, your child or anyone in your family who is struggling.

Below are some helpful resources:


About the Author

Dr. Cynthia Hess recently graduated from Rivier University with a PsyD in Counseling and School Psychology. Previously, she earned an M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations. Currently, Dr. Hess is a second-year post-doctoral fellow in pediatric neuropsychological assessment, working with NESCA Londonderry’s Dr. Angela Currie.


To schedule an appointment with one of NESCA’s expert 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 or call 617-658-9800.


College Transition – Important Considerations for Students with Disabilities who are Making a Final Decision

By | NESCA Notes 2021

By: Kelley Challen, Ed.M., CAS
Director of Transition Services; Assistant Director, NESCA

May 1st is often referred to as “College Decision Day,” the deadline by which students must submit their deposit and commit to enrolling at the college of their choice. Given that students are applying to an increasing number of colleges, with multiple “safety schools” on their application lists, students are often still comparing and contrasting several prospective college choices during the winter and spring months of their senior year. Moreover, this year, due to the pandemic students may be choosing among colleges they have never visited or making first-time visits to colleges during spring vacation weeks.

There are some common variables that students learn to compare when researching and visiting colleges:

  • Location
  • Cost
  • Scholarships and Financial Aid
  • Size (campus size, number of undergraduate students, class sizes, etc.)
  • Strength and Availability of Majors
  • Retention and Graduation Rates
  • Internships
  • Gut feelings

But, for students with disabilities, there is often additional information that can be useful in making a decision to commit to a particular college. Here are five tips that can be helpful when researching, communicating with, and visiting colleges in order to make a final selection, if not earlier in the college application process:

  • Book an appointment with Disability Support Services (often called Student Accessibility Services). While it is important to ask questions about accommodations offered to students, the process of qualifying for accommodations and/or assistive technology devices/services on campus, it is also important to think about how accessible the services will be for you. Where is the office located on campus? Do you feel comfortable talking with the director and staff? Is the website easy to find and navigate? How easy was it to book the appointment in the first place?
  • Research foreign language requirements. Having a foreign language waiver in high school does not mean that you will qualify for a waiver in college. In fact, having any accommodation or service in high school will not automatically qualify a student for the same support in college. As such, it is important to understand the foreign language requirements of the college and to ask whether the college will allow course substitutions or other accommodations (e.g., pass/fail grading, adjustments to the class participation requirement, etc.). It is important to realize that even colleges that allow substitutions may not be able to do so if the language is central to the student’s chosen major/course of study. If substitutions are not allowed, it is useful to ask about foreign language faculty on campus and to look for foreign languages that may be easier to learn, such as Latin or Greek, which are not spoken.
  • Contact the Office of Residential Life. Not all dorm life is created equal, especially for students with disabilities who require accommodations in college. Ask questions about the leadership structure within the dorms, the training/qualifications for residential directors and residential assistants in the freshman housing, how social relationships are fostered and facilitated within the dorm environment, and how dorm conflicts are resolved. For students who require a medical single (e.g., a single dorm room on the basis of documented social or emotional difficulties, allergies, etc.), elevator access, or a service/support animal, make sure that you confirm not only that these accommodations are available, but also where that housing is available on campus. For instance, single dorm rooms are sometimes only available within dorms or housing complexes that are traditionally reserved for upperclass students, reducing the opportunity for freshman bonding.
  • Research student clubs and organizations. Student participation in clubs and campus activities is known to contribute to the student’s retention, persistence, and success in college. Therefore, researching student groups should be an important aspect of the college selection process for every college student. However, for students with social, emotional, or other disabilities that impact communication and connection with others, participation in student clubs and organizations can also provide exactly the structure needed to assist the student in forging both initial and lasting relationships in college. Therefore, it’s important to research ahead of time and ensure that there are structured groups on campus you can see yourself being part of.
  • Research the college’s Covid-19 plan from this year and for next. For students with disabilities, understanding the impact of Covid-19 on the academics – as well as the social and daily life of the college – is particularly important. How did the college respond when the pandemic first hit? What proportion of classes were they able to offer in person this school year, and what safety precautions were put in place? What was the structure (e.g., synchronous, asynchronous, reverse classroom, etc.) and size of remote classes? Is the college planning to continue offering courses remotely in the fall? If so, what proportion of classes and for which students (e.g., Freshmen? Certain majors?)? Has the college retained most or all of its staff, or has there been a substantial amount of turnover? How available are professors when they are not on campus? Has the college added any additional counseling or mental health supports for students?

Certainly, the college search and selection processes are different for each student, both with and without disabilities. But my hope is that this list of considerations helps to make this difficult decision-making process easier. At the end of the day, it is important to remember that there is not just one perfect school for a student. There are lots of places where you can be successful and happy, and your job is just to make the best decision you can for yourself.


About the Author:

Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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 or call 617-658-9800.

Helping Your Anxious Child through COVID-19

By | NESCA Notes 2020


Almost a year into Covid-19, many of us can use this blog as a reminder when our children exhibit signs of anxiety from learning of new developments with the pandemic; friends, family or others testing positive for Covid-19; or returning to school. The guidance shared in this blog still holds true, nearly one year since many of us went into lockdown and schools shuttered. 


By Yvonne M. Asher, Ph.D. 
Pediatric Neuropsychologist

A recent New York Times article by Jessica Grose discusses ways to support your child, specifically helping them to feel less anxious, during the COVID-19 situation. Their “top 4” suggestions are great ones – validate their feelings, manage your own anxiety, aim for some kind of predictable routine and try mindfulness or progressive muscle relaxation activities.

The larger consideration in this case is this: anxiety, particularly in the current situation, is normal. We can label it with clinical words, give you our best clinical tools and recommend that you seek help (and please do!). At the same time, if we take a large step back, being anxious right now is exactly how we are meant to feel. We are social beings, designed to live in the community and support one another through face-to-face social interactions. When something threatens our safety, or the safety of our families, it is normal to respond with fear, worry and hypervigilance. Everyday interactions that would typically result in no response, like hearing someone nearby cough or sneeze, all of a sudden have become indicators of a threat. Even having others in close proximity to us is now a threat, meaning that the social communities in which we are supposed to thrive have now become potentially dangerous places. In this new environment, our bodies, well-attuned and primed to handle threats, are doing what they should do – they are putting us on “hyper-alert mode,” keeping us exceedingly sensitive to these threats so that we can avoid them and preserve our safety.

Children are in this mode, too, albeit with far fewer resources to help mitigate their fear and worry. As adults, we have far more lived experience with threats, anxiety, fear and worry, and we can use this experience to manage our responses to this novel situation. For children, this may be the first time they are struggling with persistent worry and fear. Or, they may have struggled to cope with other fears and worries for a long time, and this new stressor has overwhelmed their system. In either case, it is important to normalize fear and anxiety, in addition to the myriad of other emotions that children may be experiencing.

The key is balance. We have to balance validating and normalizing feelings with reinforcing unhealthy habits. What does that look like? One dimension to consider is time – validating and normalizing feelings is a short acknowledgement that the child is heard, understood and believed. On the other hand, repeatedly discussing the same questions or topics, engaging in persistent conversations about the threats and explaining “adult” information to children (especially dire predictions, long-term impacts, etc.) is not healthy. These behaviors may appear to decrease anxiety in the short-term, but over time, can be detrimental.

Another important consideration is space – focusing on what is happening in the present is important to help children process and understand the radical changes that are impacting their day-to-day lives. However, if you find that your conversations linger on the past or the future, try to shift back to the present. Your mind may be filled with regrets from the past (e.g., “I knew we should have stocked up on their favorite snack last time we were at the store”) or fears for the future (e.g., “My parents are elderly and at high risk”), and these thoughts are entirely normal. At the same time, when talking with children, it is important to try as much as possible to focus on the here and now. Of course, it is important to give children the space to express their fears for the future, and we can and should acknowledge and validate these fears. We can also, simultaneously, bring children’s focus back to the present and back to tangible, concrete things that they can do (e.g., “I know you are really worried about grandma, and it’s sad that we can’t see her right now. Everyone is working hard to keep her safe, and we are going to call and talk to her later today”).

For some children, advanced intellectual abilities may allow them to understand (at least, in some sense) a great deal of the information that is portrayed on the television and news media. However, it is important to remember that, while their cognitive abilities are years ahead of their peers, their emotional development is not. It may be necessary to closely monitor their online activity, as they may be seeking out information (which is a normal response to fears, especially fear of the unknown) without having the critical thinking abilities to understand the source or potential biases in the way the information is presented. On the other hand, some children may struggle to understand the situation, either because of their young age, learning disability or other developmental delays. If this describes your child, consider putting together a story, with pictures and words, to help them understand some basic information (e.g., why we can’t go to school right now, why we can’t go play with friends). This is often referred to as a “social story,” and clinicians at NESCA can help you create one specifically for your child.

Last, and most certainly not least, seek help and support for yourself, your child or anyone in your family who is struggling. While experiencing anxiety during these times is normal, when these thoughts and feelings are taking over your child’s daily life (or your own), it may be time to look for assistance. Many clinicians, including here at NESCA, are available via phone or videoconferencing, and we can assist with a range of concerns. Whether you want a brief consultation to help you respond to persistent questions from your child or whether your child has a pre-existing anxiety disorder that is exacerbated by these challenging times, we are here to help.


About Pediatric Neuropsychologist Dr. Yvonne Asher:

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

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

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

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


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


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