NESCA’s Londonderry, NH location has immediate availability for neuropsychological evaluations. Our NH clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing. Our NH clinicians also conduct evaluations for students who are at boarding schools, and two of our NH clinicians have PsyPACT authorization, allowing them to conduct evaluations out-of-state.

Visit www.nesca-newton.com/intake for more information or to book an evaluation.

Tag

adolescents Archives - NESCA

Subscribe to NESCA Notes

12
Image of a stressed out teenager along with a quote from Julie Weieneth, Ph.D..

Is This Stress or Something More?

By | NESCA Notes 2025

Image of a stressed out teenager along with a quote from Julie Weieneth, Ph.D..By: Julie Weieneth, Ph.D.
Pediatric Neuropsychologist, NESCA

Understanding ADHD, Anxiety, Depression, and Typical Adolescent Development

As both a neuropsychologist and a parent, I see firsthand how challenging academic and social pressures can be for teenagers. Like many parents, I sometimes wonder whether my own teen’s struggles are just part of growing up or if they might signal something more serious, such as ADHD, anxiety, or depression. From my clinical perspective, recognizing the difference is crucial. Early intervention not only supports long-term success but can also help prevent more persistent issues in the future.

Why It Can Be Hard to Tell

Many symptoms, such as difficulty concentrating, mood swings, irritability, and sleep problems, are common and often temporary during adolescence. However, these same concerns can sometimes point to underlying conditions. Careful observation, professional support, and sometimes a thorough evaluation are needed to truly understand what’s happening.

Signs of ADHD

  • Ongoing struggles with attention, organization, and time management in different settings
  • Frequently losing items or forgetting important things
  • Trouble staying focused on tasks that require sustained effort
  • Restlessness or fidgeting
  • Symptoms usually begin in childhood (often by age 12) and are consistent, not just a reaction to stress or specific situations

Signs of Anxiety

  • Excessive worry about school, friendships, or the future
  • Physical complaints, such as headaches or stomachaches
  • Avoidance of stressful situations, including tests or social events
  • Perfectionism and fear of making mistakes
  • Symptoms often become more noticeable during times of increased stress

Signs of Depression

  • Persistent sadness or irritability
  • Loss of interest in activities that used to be enjoyable
  • Fatigue and low energy
  • Changes in sleep or eating habits
  • Withdrawal from friends and family
  • Symptoms last for two weeks or longer and can significantly affect motivation and daily functioning

Typical Adolescent Challenges

  • Occasional procrastination or forgetfulness
  • Temporary mood swings or frustration
  • Feeling stressed before exams or social events
  • Desire for more independence and privacy
  • These concerns are usually mild, short-lived, and tend to improve with support, structure, and time

How a Neuropsychological Evaluation Can Help

A neuropsychological assessment can help clarify whether a teen’s symptoms are part of normal development or indicate a clinical concern. This process includes reviewing developmental and academic history, conducting standardized testing, and gathering input from parents, teachers, and the teen.

Ways to Support Teens Based on Their Needs

  • For ADHD, strategies such as organizational (Executive Function – EF) coaching, academic accommodations, behavioral therapy, and sometimes medication may be needed
  • For anxiety, counseling, stress management techniques, a supportive environment, and sometimes medication may be needed
  • For depression, therapy, healthy routines, and sometimes medication can make a significant difference
  • For teens experiencing more than one of these concerns, a combination of strategies and coordinated care is often most effective
  • For typical adolescent challenges, open communication, structure, and encouragement usually work well

If your teen’s difficulties persist or begin to interfere with everyday life, reaching out to a neuropsychologist can provide clarity and guidance. Early understanding and tailored support can help your teen feel better and succeed both now and in the future. If you are unsure whether your teen needs a full neuropsychological evaluation, you can schedule a consultation with a NESCA clinician who will review your concerns and help you decide how best to proceed.

 

About the AuthorJulie Weineth headshot

Dr. Weieneth is a licensed clinical psychologist who has worked with children and families with complex diagnostic and treatment needs for the last twenty years. Her areas of specialty include ADHD, autism spectrum disorders, anxiety, mood disorders, learning disabilities, executive functioning, and school-related challenges. That being said, Dr. Weieneth also understands that not all individuals fit cleanly into diagnostic groups or labels. Her goals for each evaluation are to help families feel comfortable with the process, use all the tools available to best understand each individual’s unique strengths and needs, and to write a clear and comprehensive report that will guide educational and treatment planning.

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

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

14
Image of a couple with disabilities and a quote from Sarah LaFerriere

How We Teach Sexual Health Education at NESCA

By | NESCA Notes 2025

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

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

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

Meeting Students Where They Are

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

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

Using the Elevatus Curriculum

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

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

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

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

What the Curriculum Covers

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

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

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

Collaborating with Families and Schools

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

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

Why It Matters

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

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

About the AuthorHeadshot of Sarah LaFerriere, M.Ed.

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

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

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

12
Image of a child doing an obstacle course and a quote by Julie Weieneth, Ph.D.

Summer Treatment Ideas for Children with ADHD

By | NESCA Notes 2025

Image of a child doing an obstacle course and a quote by Julie Weieneth, Ph.D.By: Julie Weieneth, Ph.D.
Pediatric Neuropsychologist, NESCA

For many families with children who have ADHD, the end of the school year brings both relief and anxiety. While the break is welcome, the sudden loss of routine can be daunting, leading to unstructured days and endless requests for screen time. But what if this summer could be different? The season’s freedom presents a powerful opportunity to build new skills, strengthen family bonds, and explore creative ways to manage ADHD symptoms. To help you begin, we have gathered summer treatment and planning ideas for every age, including preschoolers, elementary schoolers, middle schoolers, and young adults preparing for college. If any of these ideas resonate with you, try one out this summer and let us know how it goes. We would love to share your experiences with other families!

Preschool (Ages 3-5)

For the little ones, learning through play and interaction is key.

  1. Parent-Child Interaction Therapy (PCIT): PCIT is a hands-on approach that helps parents build better relationships with their kids using play and clear discipline strategies, with real-time coaching from a therapist. It focuses on boosting positive behaviors and reducing the tough ones to create a happier home life. For more information, check out PCIT.org or reach out to NESCA for provider recommendations.
  2. Occupational Therapy (OT): OT can support young children with ADHD by targeting sensory processing, self-regulation, and fine motor skills.
  3. Academic Readiness through Play: Head to a local craft, school supply, or thrift store, or a learning store, like Lakeshore Learning, to find games and activities that build fine motor skills, counting, sorting, and creativity. Here are some additional fun ideas to try out:
    • Treasure Hunts: Create simple treasure hunts with clues to improve attention, focus, and listening skills.
    • Storytime with Puppets: Use puppets to act out stories, encouraging participation and retelling to boost language skills.
    • Craft Projects: Try out different crafts involving cutting, gluing, and coloring to strengthen fine motor skills and creativity.
    • Obstacle Courses: Set up indoor or outdoor courses to enhance physical coordination and follow instructions. If you have an older sibling, get them involved in setting up and running the obstacle course.
    • Cooking Together: Involve your child in cooking simple recipes to improve focus, following directions, and fine motor skills.
    • Memory Games: Play memory games with cards or objects to boost attention and recall.
    • Building Challenges: Use blocks or LEGO sets to encourage planning and problem-solving.
    • Dance and Movement Games: Play games, like freeze dance or follow-the-leader, to help with self-regulation and listening skills.

Elementary School (Ages 6-10)

Kids in this age group thrive with structured activities that enhance social skills and organization.

  1. Behavioral Therapy: Enroll your child in therapy sessions targeting goals including impulse control and organization.
  2. ADHD Summer Camps and Social Skills Groups: These camps/group programs offer structured environments tailored for kids with ADHD, focusing on social skills, self-esteem, and executive functioning.
  3. Bibliotherapy or Self-Help: Summer is a great time to read books on parenting children with ADHD, like “Taking Charge of ADHD” by Russell A. Barkley. There are also many children’s books, such as “The Secret Superpowers of ADHD” by Jennifer Everly. Explore resources on CHADD and ADDitude for more ideas.

Middle School (Ages 11-13)

As your child enters adolescence, focus on fostering independence and self-awareness.

  1. Cognitive Behavioral Therapy (CBT): CBT helps middle schoolers learn strategies to manage impulsivity and improve attention, with summer sessions focusing on real-life situations, such as managing social conflict and academic stress.
  2. Mindfulness and Relaxation Techniques: Introduce mindfulness practices –  meditation or yoga – to improve focus and reduce stress. Many apps can help integrate these into daily routines.
  3. Volunteer Opportunities: Encourage community service projects to boost self-esteem, teach life skills, and reinforce social skills and early vocational skills.

Young Adults Transitioning to College/Vocational Endeavors (Ages 14-18)

For these young adults, it is all about preparing for college or vocational work, and managing academic, social, and daily living demands more independently.

  1. Executive Function Coaching: Consider hiring a coach to work on time management, organization, and goal setting, which are key skills for college and career success. NESCA offers transition-related assessments and coaching services tailored to transition-age youth. Explore NESCA Transition Services to help determine if college or a different path is right for you, and NESCA Coaching Services to build and practice skills that will be needed for all future paths.
  2. Medication Management: Check in with your healthcare provider to review medications and make any necessary changes before college starts. Learn more about what they are, what they are for, how to refill them, and when a new prescription is needed.
  3. Transition Workshops and College Immersion Programs: Look for workshops or programs that focus on transitioning to college or postsecondary life, covering self-advocacy, stress management, academic strategies, and social problem-solving.
  4. Updated Neuropsychological Evaluation: Ensure updated testing within three years of starting college or work to receive accommodations. If you have relied on accommodations in high school, have a support plan in place before your first college semester in order to ensure your success. Get to know more about on-campus resources to support you. If you are interested in learning about neuropsychological evaluations, please check out our website or contact us by filling out an Intake Form for more information.

We hope that you have a relaxing, fun, and rewarding summer! Feel free to reach out with any questions or concerns, or if you have any additional ideas to share with the NESCA community!

 

About the AuthorJulie Weineth headshot

Dr. Weieneth is a licensed clinical psychologist who has worked with children and families with complex diagnostic and treatment needs for the last twenty years. Her areas of specialty include ADHD, autism spectrum disorders, anxiety, mood disorders, learning disabilities, executive functioning, and school-related challenges. That being said, Dr. Weieneth also understands that not all individuals fit cleanly into diagnostic groups or labels. Her goals for each evaluation are to help families feel comfortable with the process, use all the tools available to best understand each individual’s unique strengths and needs, and to write a clear and comprehensive report that will guide educational and treatment planning.

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

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

10
Map of Hingham, MA and quote by Dr. Moira Creedon

Strengthening the South Shore Community: Supporting Our Children, Teens, and Adults

By | NESCA Notes 2024

Map of Hingham, MA and quote by Dr. Moira CreedonBy: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

It was an exciting dream realized when our NESCA South Shore office in Hingham opened in November 2023. As a resident of the South Shore, I was looking forward to connecting to my community closer to home. I was expecting to enjoy a shorter commute and great location. Pausing to reflect after 16 months with our doors open in Hingham, I realize that it is so much more.

I am grateful for how quickly we were welcomed by pediatricians, therapists, psychiatrists, tutors and executive functioning coaches, attorneys, advocates, and public and private schools. We have all quickly aligned on the needs of our communities. There are many children, teens, and adults struggling with gaps in learning, trouble with social connections, high anxiety, depressed mood, and behavioral troubles. Many of these collaborations have also communicated the frustration and sense of burnout facing families who feel like they have been working hard and trying to make changes. Teachers feel discouraged when they have dedicated their hearts and minds to support students, and yet students continue to struggle. Adults are also going through this in record numbers. The experience in our community is universal – it’s so hard to watch our kids, teens, young adults, and our contemporaries struggle.

This can leave many wondering if neuropsychological testing is just one more “hoop” to jump through. Within the trenches of the daily struggle, it can be hard to see how testing might help – especially when change is so slow. I do all that I can to explain why neuropsychological testing is way more than a hoop; it can be a roadmap. How?

  1. Even if you or your child has had “evaluations before,” neuropsychological testing is a chance at an integrated and comprehensive evaluation. What does that mean? It means that if you have had pieces of testing before, you still have a pile of pieces – an educational evaluation from school, a private OT evaluation, an early speech evaluation, a diagnostic interview with a therapist, etc. My goal is to take all of those pieces, plus the new ones I add, and put them together into one cohesive puzzle demonstrating how a child or teen thinks and learns.  This is one of the reasons NESCA does academic testing as part of its testing batteries, because these pieces are essential for diagnostic clarity, to see how the profile impacts a person’s real life skills/functioning, and because being a student is a kid or teen’s full time job. It’s not a piece to be overlooked.
  2. Neuropsychological testing can be a chance to understand the “why” when there are many complicated layers. When an individual is struggling, we often start in the middle of the process. Often, parents and/or schools want to try to solve the problem with school support, or interventions such as a referral to a therapist or connection to a social skills group. When those efforts stall, the impulse is to try a different solution.  Neuropsychological testing lets us step back, learn about a larger profile or picture of all aspects of a child’s learning or thinking to make meaning of what is happening. Then, we can choose a path for intervention that has the best chance of success. When a child is struggling, trying to see what works in a way that’s not fully informed or that addresses the child as a whole, is often not the best use of time and resources. The same goes for adults who seem to be missing a piece of their own puzzle.
  3. Neuropsychological testing uses the data collected from the testing to outline the steps for what to do next. Any good plan needs a detailed understanding of a problem. Oftentimes, it’s a combination of services that are needed – in the community, at home, and/or at school. It can be hard to figure out how to prioritize the steps, and it’s important to consider what is realistic and feasible. Neuropsychological evaluation can help make those steps clearer.
  4. Neuropsychological testing can give us a good baseline and measure of progress. Caretakers know their children best, so they can often spot subtle issues before they bloom into the bigger issues. Neuropsychological testing can be proactive, and it can help to track how a student responds to interventions. We can also use neuropsychological testing to maximize potential, including how students find their strengths, build their “academic diet” of courses in high school and college, and build stronger study skills along the way.
  5. At NESCA, neuropsychological testing involves important collaboration, perspective, and insight. The reason I mention the community that I’ve met through our South Shore office is because collaboration is key. The observations and insight offered by anyone who comes in contact with a child or teen is invaluable. Standardized test measures are a critical piece of the puzzle, but it’s one part of the critical triad of history, observations, and testing. These collaborations are also helpful to keep the neuropsychological test report “alive” as the community putting the recommendations into action works best through communication.

In the upcoming year, we set many goals for NESCA as a leader in our field. I want to pledge to my community that we will continue to provide the highest quality care and to respect and value our clients and families.  We will continue to build connections to our community members to join the efforts in supporting children, teens, and young adults. I am thrilled for upcoming opportunities to learn and grow alongside you all.  I am deeply grateful to be part of the South Shore community supporting children, teens, and young adults.

 

About the Author

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

 

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

 

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

13
Couple with disabilities

Why Sexual Education is Crucial

By | NESCA Notes 2024

Couple with disabilitiesBy: Sarah LaFerriere, M.Ed.
Transition Specialist & Special Educator, NESCA

Empowering Students with Disabilities Through Comprehensive Sexual Education

Sexual education is more than a curriculum; it’s a vital tool for personal empowerment, safety, and self-advocacy. For students with disabilities, access to meaningful sexual education can address unique challenges while fostering independence, confidence, and dignity. Here’s why this education is critical and how it can change lives.

Sexual education is not about encouraging students to have sex. It is about equipping them with the knowledge to make informed choices, understand healthy relationships, respect boundaries, and advocate for themselves. While some parents and educators worry that discussing these topics might “give students ideas about sex,” the reality is that comprehensive sexual education empowers students with the tools they need to stay safe and navigate their lives with confidence.

Addressing Sexual Health Disparities

Research has shown that students with developmental disabilities face disproportionate risks in sexual health outcomes. These include higher rates of unplanned pregnancies, sexually transmitted infections (STIs), and sexual abuse. For instance, young women with cognitive impairments are significantly more likely to experience early pregnancy and STIs compared to their peers without disabilities​.

These disparities stem in part from barriers to education and healthcare access, as well as stigmatization and misconceptions about the sexuality of individuals with disabilities. By integrating tailored sexual education into their learning experience, we can close these gaps and provide tools for informed decision-making.

Reducing Vulnerability to Abuse

One of the concerning issues is the heightened vulnerability of individuals with disabilities to sexual abuse. Studies indicate that people with developmental disabilities are up to four times more likely to experience sexual assault than their peers​​. A lack of understanding about healthy boundaries, consent, and their rights can leave these individuals at greater risk.

Comprehensive sexual education teaches students to recognize inappropriate behavior, understand consent, and advocate for their rights. Lessons on distinguishing between public and private spaces, understanding healthy relationships, and asserting boundaries equip students to protect themselves and seek help when needed.

Fostering Healthy Relationships and Self-Advocacy

Everyone has the right to form relationships based on respect, trust, and mutual understanding. For students with disabilities, sexual education can provide a framework to navigate these connections safely. It’s not just about teaching anatomy and reproduction, it’s about addressing intimacy, connection, and communication​.

Self-advocates emphasize the importance of this knowledge, stating they want to learn how to make informed choices, build lasting relationships, and advocate for their desires and boundaries. Teaching sexual self-advocacy encourages independence and fosters a sense of agency.

Combating Stigma and Promoting Inclusion

Historically, people with disabilities have been desexualized or unfairly stereotyped. These harmful narratives contribute to exclusion and limit access to essential education. Providing comprehensive sexual education helps dismantle these misconceptions and affirms that individuals with disabilities are entitled to the same rights, relationships, and respect as anyone else.

Building a Safer, More Inclusive Future

Sexual education for students with disabilities isn’t just about reducing risks—it’s about empowerment. It’s about teaching young people to take ownership of their choices, advocate for themselves, and lead fulfilling lives. When we provide these students with the knowledge and necessary tools, we’re investing in their safety, dignity, and future.

As a special education teacher and advocate trained in sexual education for students with disabilities, I’ve witnessed firsthand the transformative impact of these lessons. Let’s continue to advocate for inclusive, comprehensive sexual education for all students and schools, ensuring that no student is left behind.

NESCA’s Sarah LaFerriere is trained in providing sexual education coaching to groups and schools. For more information, please visit our page about our Sexual Health Education Services complete our Intake Form.

Sexual Health Education Webinar Registration Page

If you are eager to learn more about Sexual Health Education, please register for our upcoming webinar on this topic at: https://nesca-newton.zoom.us/webinar/register/WN_XQN-heyzR8iS2_Kp8ZQLNQ

About the AuthorHeadshot of Sarah LaFerriere, M.Ed.

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

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

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

12
Julie Weieneth headshot and quote

NESCA Welcomes Julie Weieneth, Ph.D., to its Team

By | NESCA Notes 2025

Julie Weieneth headshot and quoteBy: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is excited to welcome Pediatric Neuropsychologist Julie Weieneth, Ph.D., to its Newton, Massachusetts location! Read more about Dr. Weieneth’s past experience, areas of specialization, and what brought her to NESCA as a pediatric neuropsychologist.

 

What drew you to neuropsychology?

Part of what interested me is that I’ve always done and have always enjoyed testing. I did my post-doc at the Developmental Medicine Center at Children’s Hospital Boston and did plenty of testing there. Then, with each subsequent role I was in – whether at a therapeutic school or in a group practice – I was conducting evaluations.

Neuropsychology is a really helpful way to integrate school-based evaluations. If we’re looking at diagnostic clarification, which is one of my areas of interest, that’s what a neuropsychological evaluation and subsequent report can do.

What settings have you worked in previously?

A lot of my background has been as a staff psychologist in therapeutic school settings, including the Manville School and New England Academy for many years, including during Covid.

I then moved on to a group neuropsychology practice so I could better balance my work and life schedules. My own kids were transitioning back to in-person school, and I wanted more flexibility in my schedule to support them as well as the students I evaluate.

What are your specialty areas?

My years in the therapeutic school setting gave me a good understanding of the various challenges students have as well as the complex educational needs that come with supporting them through those challenges.

Taking a step back, my dissertation was on the early development of ADHD, so that is an area that I am very familiar with and still really interested in. I also enjoy working with students with complex presentations, helping to provide diagnostic clarification as well as the kind of supports the individual and family will need to foster their education and development. In addition, I’d say I am also a bit of a generalist, able to work with most children and adolescents who are struggling.

What were you looking for in a new environment?

I am really excited about NESCA being a multidisciplinary practice. I’m looking forward to being part of a team made up of providers from different specialty areas. It will be great to refer children and students to people and providers in-house who I trust for executive function coaching, real-life skills coaching, transition planning, therapy, consultation, and more.

What do you find most rewarding as a neuropsychologist who works with children and adolescents?

I find it particularly rewarding when a student who has struggled with school refusal, meaning they are not actively attending school, is fully back in school and thriving. It’s a great feeling to be part of the team that helps figure out what is  happening for them, and helps direct them to the right resources so they can get back into school. I recently heard from a parent of a student I evaluated, who was really struggling and not engaging in any aspects of their schooling or life overall. They let me know that their child sought out and stuck to the interventions we recommended, and their child is back in school and doing well. That’s what our job is all about.

What do you think are the benefits of working in a group practice?

Sometimes the children we work with have a really hard time during the evaluation process, and we can’t finish all of the testing in the first session. I like having the ability to be flexible with them and bring them back in for another session if necessary. If we rush or force the testing, we will not get accurate results. Being in a group practice – rather than a hospital setting where the flexibility in schedules just isn’t there – allows me, as a neuropsychologist, to meet kids where they are at and get the best data and observations that I can.

Working as part of a group practice allows us to share insights, perspectives, connections, and experiences of the entire team. The cases that we all see are complicated, and sometimes, it’s really helpful to take all the information we have available and consult with those around us. To me, it’s a best practice to consult on cases with others. You gain the perspectives and experiences of others in the practice, and it also helps to develop solid recommendations with specific referrals from other experts in the practice to help a family move forward.

As neuropsychologists, we’ve all had different training and previous work experiences, and this is particularly important when cases are complicated. I’m open to hearing information and feedback from others, especially if I think it’s going to help the family move forward. When you work with a team of experts, it makes our reports so much more meaningful for the families we serve.

What are some of the strategies you employ when you are evaluating a child or adolescent who is struggling during the assessment?

Oh, there are so many. Sometimes, I will use Collaborative Problem Solving techniques. I’ve also had sessions where I have waited children out, offered them rewards, provided lots of nurturing and praise – again just meeting them where they are at. I also involve the parent or caregiver in the sessions if the child needs that support.

I’ve learned through the years how to be comfortable in most situations or settings, and I’m not easily thrown by emotional intensity. I always try to end on a positive note, whether the evaluation was smooth or challenging. If they struggled and needed an extra session, I involve the child in the decision to come back the next day and praise them for everything they accomplished in the initial session. They worked hard and should be positively reinforced for that.

Parents and caregivers come to NESCA for answers. How do you help guide parents and caregivers through the evaluation process?

Just like with children and adolescents, I meet the parents and caregivers where they’re at. And everyone is so different in their own experience when they are exploring or seeking out a neuropsychological evaluation. It may be their first time, and they are afraid, or it could be the sixth neuropsychological evaluation their child has had, and they know the drill. No matter where they are at, you do your best to explain what the process is and inform them about what to expect. I let them know that the whole process is designed to understand an individual’s learning strengths and challenges. I let them know that when I develop the report,  I will write highly personalized recommendations that build on their child’s strengths and how they can help to understand and work through their challenges.

People often say that I have a “matter of fact” way about me. I approach things practically, and I like to share input, feedback, and guidance with parents, caregivers, and students in that way. While I am practical, I am also empathetic and understanding of everyone’s stories.

How important do you think observation of the individual being evaluated is? What can you tell from the observations?

I was trained to pay attention to the observations. What’s behind the numbers is super important. I would never write a report without a lot of behavioral observations and interpretations around what things mean, because that is so critical.

Behavioral observations can provide insight into what comes easy to the students. And even if they have an average score in a particular area, it’s critical to look at how they approached that task. This can be really meaningful in an evaluation and in providing recommendations.

When you are working with students who are complicated, their struggles emerge in many ways beyond what the typical data show. If you just looked at the numbers, you might not see any struggle. Because the tasks are administered in a 1:1 setting, you see how they approach a task, how they complete it, or whether they can complete it. It informs us about things like their working memory and processing speed, and how that may impact them in real-life or educational settings. Children with high variability in their scores can “fall through the cracks” in school. They may appear like they are doing just fine from their grades and other test scores, but they are often dealing with an internal struggle or an uneven profile. The risk in saying they are doing fine is that, as they progress through their education, the struggle often just gets worse.

What have you noticed in the students you’ve evaluated since Covid?

I see a lot more school refusal among students, meaning the students who are not able to attend school or those who may be in school but need to arrive late or leave early on a consistent basis.

In addition, there has been a lot of anxiety, depression, isolation, and those sorts of things. Everything seems to be far more complex than it had been before Covid. And that’s a lot, considering it was already getting more complex before, with social media other stressors.

I’ve also noticed that there’s a lot of anxiety among adults. The parents and caregivers seem to have a heightened sense of anxiety and uncertainty.

How did you work through Covid?

It certainly was challenging, but there were two important silver linings that emerged from that experience. I learned to meditate and get more interested in mindfulness throughout that time. It has been really helpful to me.

Professionally, Covid actually helped me grow and transition from the therapeutic school setting to a group neuropsychology practice. While I loved my roles within schools, I was looking to delve deeper into diagnostic assessment. Doing so also provided me with more flexibility to balance things between my professional and personal lives. So, there were at least two positives that came out of the experience.

 

About the AuthorJulie Weineth headshot

Dr. Weieneth is a licensed clinical psychologist who has worked with children and families with complex diagnostic and treatment needs for the last twenty years. Her areas of specialty include ADHD, autism spectrum disorders, anxiety, mood disorders, learning disabilities, executive functioning, and school-related challenges. That being said, Dr. Weieneth also understands that not all individuals fit cleanly into diagnostic groups or labels. Her goals for each evaluation are to help families feel comfortable with the process, use all the tools available to best understand each individual’s unique strengths and needs, and to write a clear and comprehensive report that will guide educational and treatment planning.

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

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

13
Sean O'Brien headshot and quote

Introducing Pediatric Neuropsychologist Sean Hyde O’Brien, Psy.D., ABPdN

By | NESCA Notes 2024

Sean O'Brien headshot and quoteBy: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is excited to welcome Sean Hyde O’Brien, Psy.D., ABPdN, to our team, conducting evaluations in the Newton, Massachusetts office! My interview with Dr. O’Brien offers an opportunity for readers to get to know him, his professional background, experiences and expertise, and his approach to working with children, adolescents, and young adults as a pediatric neuropsychologist.

You covered a broad swath of academic, emotional, and developmental challenges in your career as a pediatric neuropsychologist. Tell us more about that.

I think I’m a good generalist as far as pediatric neuropsychology goes, covering a lot of the high-incidence disorders, like ADHD, autism spectrum disorder, and learning disorders, but there are a couple groups that I really like working with.

What are the groups of children or students you find the most interesting?

I really like kids that are on the high functioning end of the autism spectrum, so I did one of my post-doctoral years at McLean at the Center for Neurointegrative Services, which is a DOE-approved special education school for kids who used to have what was called Asperger’s Disorder, which is now part of the ASD diagnosis. I got to spend a lot of time honing my assessment skills, but also spending quality time getting to know this group of students. They have a special place in my heart.

Another area I enjoy is working with children who came from other countries and may have moved because of war, famine, or simply for better opportunities for their families. They often come to this new country, perhaps not with the best English skills, and a lot of complex developmental and psychiatric challenges. Teasing all of those components apart and helping them acclimate to a new school, culture, and world has been interesting to me.

It takes a lot of thinking on your feet from an assessment standpoint to work with this population. For example, when you evaluate a child who speaks Russian and has only been learning English for six months, you’re not going to be able to do your standard battery of tests to figure out what their cognitive functioning is like. You have to think creatively and find ways to work slightly outside the domain of standard evaluation procedures. I’ve learned so much being with them, watching, and observing them in different settings, and, of course, getting the information from multiple sources, like teachers and parents. Those kids along with those who come from other countries through adoption are the most challenging, but also probably the most rewarding to me.

My wife and I were both adopted, so I come from a family of people who know and are part of the adoption community. I did a lot of research and clinical work involving international adoption. I love working with children who are coming from China, India, Korea, or domestically and their adoptive parents who are trying to figure out how to best support them with the range of strengths and weaknesses that they might have. These are also some of the kids who stick out to me.

Why did you come to NESCA?

I was looking for a change. I’ve been a partner in a private practice that we built from scratch for about 15 years, handling all of the many aspects of running a small business and evaluating students. I felt that the operational and clinical duties became too time-consuming to have a healthy work-life balance. I decided that it was time for a recalibration that would allow me to continue to evaluate children, but not have to stress over all of the other time-consuming operational details.

Throughout my career, I’ve had many NESCA reports come across my desk. They were very well done, and the practice has an incredible reputation. I met with NESCA’s founder and I knew it was the right place. She values the same things that I value – collegiality, warmth, and child-centric care. I was looking for a place where I could do good work and do it in a way that feels good at the end of the day. I found that in NESCA.

What do you feel you can contribute to NESCA families and staff?

The feedback I received over the years is that my ability to connect with children makes me an ally to them, especially those who may be a little resistant to the process. Some kids come in and are scared or angry that they have to be there for an evaluation. I always find a way to let them know this is in their best interest. I will explain what an evaluation will do for them in the end and that I want to work with them to figure out their “operating system” to make life work better for them. Families feel that I’m warm, approachable, and just a nice guy. I make sure that the individuals I evaluate don’t see me as Dr. O’Brien – I’m just Sean, and I’m a “learning detective,” of sorts, who helps figure out what’s going on with them.

I’ve had a number of students who I’ve seen three or so times over the course of the past 15 years. They may have come to me as a struggling six- or seven-year-old and are now in college. It’s the long-term relationships and knowing that the work I did, or that we did together, changed their developmental trajectory and helped them start to feel better about themselves as a learner and/or a person. That’s the piece that keeps me loving the work that I do and feeling young, fresh, and energized. I couldn’t ask for a better job.

What are your thoughts on the field of neuropsychology overall?

We’re a field that is a mixture of art and science. We are students of the brain; not experts, and we are all still learning about how the brain works. That is continuously being questioned, refuted, and remodeled. Since I first started studying neuroanatomy, we have come so far and yet we still know so little.

We can’t become rigid or complacent in the evaluation of children, adolescents, or adults, because that will be the biggest disservice we can give to our clients. We have to always be learning and evolving. Using antiquated models, not being open to new tests or new ways of thinking about things will not help anyone. I have the feeling I will learn a lot of new, creative, proven approaches while I am at NESCA, and that is very exciting to me.

I don’t think you get that kind of ongoing learning and exposure to innovative ways of doing things in many places. Often, neuropsychologists have to go outside of their practices to get that kind of knowledge from colleagues. Having that built in here at NESCA is something I am excited about.

 

About the AuthorHeadshot of Sean Hyde O'Brien

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

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

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

11
Image of the words Fading Prompts fading out

Helping Students Become Independent: The Role of Fading Prompts

By | NESCA Notes 2024

Image of the words Fading Prompts fading outBy: Sarah LaFerriere, M.Ed.
Transition Specialist & Special Educator, NESCA

Supporting students with disabilities is an experience filled with opportunities to help them grow and succeed. One key area to focus on is promoting independence, which involves carefully managing the use of prompts. If not handled well, prompt dependence can become a significant barrier, especially as students move toward transition age.

What is Prompt Dependence?
Prompt dependence happens when students become overly reliant on external cues, like verbal or written instructions or physical guidance – from teachers, therapists, or caregivers. While prompts are a helpful tool in teaching, over time, too much reliance on them can make it difficult for students to act independently. This can become a bigger issue as they get older and need to function more independently in real-world situations, such as in jobs or community settings.

Why Fading Prompts Matters and How to Do It
Fading prompts is a technique used to gradually decrease the level of support given to students, helping them gain the skills they need to act independently. The goal is to provide enough support initially so that students can learn, and then slowly reduce that support as they become more capable on their own. This isn’t about suddenly withdrawing help but rather about making a gradual shift that encourages students to rely on their own skills.

  1. Start Early—Addressing prompt dependence early on is crucial. When introducing prompts, consider how you’ll gradually reduce them. For younger students, this could mean starting with more hands-on assistance and gradually moving to less direct forms of support, such as verbal or visual cues.
  2. Reduce Support Gradually—Fading prompts involves a step-by-step reduction of assistance. Begin with more direct prompts and, as the student improves, shift to more subtle forms of support. It’s important to pace this reduction based on the student’s progress, ensuring they have enough opportunity to practice and succeed before making further changes.
  3. Promote Self-awareness—Encouraging students to recognize when they need help and how to seek it can be very effective. By developing self-monitoring skills, students can learn to manage their own needs and understand when they are capable of performing tasks on their own.
  4. Be Consistent and Patient—Consistency among all those involved in a student’s education is key. This means that teachers, therapists, and family members should use the same approach and follow the same plan for reducing prompts. Patience is also important, as progress can be gradual and may require repeated practice.
  5. Customize Approaches—Every student is different, and so their path to independence will be unique. Tailoring the approach to each student’s specific needs can make a big difference. This might involve adjusting how quickly prompts are faded or choosing the types of support that work best for the student. Regularly reviewing and adjusting the plan ensures that students are receiving the right level of support.

Involving Families and Service Providers
Families and service providers are essential in this process. Good communication and teamwork between educators, therapists, and families help create a consistent approach to fading prompts. Families can support the skills being taught in various settings, and service providers can offer valuable insights and guidance.

Preparing for the Future
As students reach transition age, being able to act independently becomes even more important. By addressing prompt dependence early and using effective fading techniques, we can help students develop the skills and confidence they need for adult life. This preparation not only aids students but also benefits their families and communities by fostering a more inclusive environment.

In summary, fading prompts is a crucial practice in helping students with disabilities become more independent. By understanding and applying strategies to reduce prompt dependence, we can better prepare students for a future where they can navigate the world with confidence and self-sufficiency. This not only supports the students but also contributes to a more supportive and inclusive community.

 

About the AuthorHeadshot of Sarah LaFerriere, M.Ed.

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

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

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

8
Child in bed suffering from a concussion, holding their head in pain

What School Supports Does My Child Need After A Concussion?

By | NESCA Notes 2024

Child in bed suffering from a concussion, holding their head in painBy: Alison Burns, Ph.D.
Pediatric Neuropsychologist, NESCA

Unfortunately, every year, many children and adolescents experience concussions. A concussion is a mild traumatic brain injury that occurs when an individual sustains a blow to the head or body that results in the brain moving rapidly back and forth. This causes the brain to stretch and strain, resulting in a vast array of possible symptoms. Symptoms of a concussion include:

list of physical, cognitive, emotional, and sleep concussion symptoms

Recent studies have shown that while it is important to rest for the initial few days after an injury, slowly reengaging in cognitive activities at a tolerable level helps to promote recovery. This period of rest followed by a slow increase in cognitive activity means that children are often out of school/slowly transitioning back to school for an unspecified period after injury. As such, many children will benefit from support and accommodation at school during the recovery period. Parents are encouraged to talk to their child’s academic team and school personnel to discuss the need for these supports. As children and adolescents experience differing sets of symptoms after an injury, the accommodations and supports should be tailored to the individual’s unique symptom profile.

Physical Symptoms: Students who experience headaches or fatigue may benefit from rest breaks or even a nap during the school day. Dizziness, balance problems, or nausea may necessitate the need for an elevator pass and it may be helpful for the student to transition to class before the bell rings when there are less people to navigate around in the hallway. Light and noise sensitivity can be particularly hard within the school setting. Students may need to wear sunglasses or a hat, be seated away from the window, and may need teacher notes as looking at a smartboard may be painful. In addition, computer-based work may need to be printed during the recovery period for light sensitive students. Students with noise sensitivity may need to wear ear plugs, avoid crowded and noisy areas, such as the lunchroom, assemblies, or music class, and they may need to transition to the next class before the bell rings and the hallway becomes noisy.

Cognitive Symptoms: A concussion can temporarily impact an individual’s attention, executive functioning skills, and processing speed. Therefore, it may be necessary to reduce a child’s workload (e.g., odd/even problems only, outline a paper instead of writing it fully, reduce homework load) and assign only essential work (i.e., waive non-essential assignments, quizzes, and tests). In addition, it may be helpful to break down tasks into smaller “chunks,” repeat information or instructions, and allow for extended time to complete essential classwork, quizzes, and tests. They may need access to teacher notes if they are unable to keep up with the pace of the instruction to take proper notes, and they may need information presented in a slower manner or repeated to ensure comprehension. Teachers should consider alternative ways to ensure mastery of information (e.g., oral discussion, multiple choice instead of open-ended questions) as students may not be able to demonstrate their true knowledge in standard ways while recovering from a concussion. Tests and quizzes should only be given if symptoms do not interfere, and the student is adequately prepared.

Emotional Symptoms: Emotional symptoms following concussion are often overlooked as they are not a commonly known symptom of concussion. Some children and adolescents may become overwhelmed about missing school and the accumulating workload, and they may feel isolated from their friends. This would also suggest the need to reduce a child’s workload for a short period of time, including waiving non-essential assignments, quizzes, or tests. Students should also be allowed to socialize with their peers as tolerated (e.g., quiet lunch setting with a few close friends).

Sleep Symptoms: A child or adolescent experiencing sleep difficulties as a result of their concussion may not have the energy to complete a full day of school. They may need a later start time or only be able to complete a half day of school. Some students with disrupted sleep may be able to complete a full school day, but they may require a nap in the nurse’s office.

In sum, a concussion presents in many ways and often has a significant impact on the day-to-day functioning of a child or adolescent. In particular, school is often disrupted after a concussion, even for children and adolescents who have a short recovery. School supports and accommodations should be tailored to the child’s individual profile of symptoms to best support them throughout their recovery.

 

About the Author

Dr. Burns conducts comprehensive evaluations of school-aged children, adolescents, and young adults with a variety of developmental, learning, and emotional difficulties. She has expertise in the evaluation of individuals following a concussion/mild traumatic brain injury and particularly enjoys working with individuals with attention (ADHD) and executive functioning (EF) difficulties. Dr. Burns is passionate about helping individuals and their families better understand their areas of strength and weakness and provides tailored treatment recommendations based upon that unique profile to make the evaluation most helpful for each client.

 

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

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

10

Supporting Teens: Helping Them Engage in Treatment

By | NESCA Notes 2024

By: Moira Creedon, Ph.D. 
Pediatric Neuropsychologist, NESCA

I was fortunate to join my colleague, Kelley Challen, Ed.M., CAS, in a recent presentation about fostering self-advocacy and self-determination for young adults. The focus of our conversation was around encouraging teens to participate in the special education process as active members of their IEP team. It got me thinking: what are other ways that teens should be included in decision making? How do we ensure that teens are included in vital treatment decisions? And what do we do about those teens who are reluctant to engage?

There is a robust body of empirical evidence to suggest that the combination of medications and therapy is most effective at reducing symptom severity for emotional health disorders including anxiety and mood disorders. While adults on a treatment team may be well aware of this evidence, teens may look elsewhere to gather information – turning to the less than reliable sources of anecdotal conversations and social media. If we want teens to participate in the treatment planning process armed with greater information, there are a few steps we can follow to support their treatment engagement.

First, when the question relates to medications, I always encourage teens to have very open discussions with their parents and providers about the risks and side effects of medications. It’s incredibly helpful to open conversations by asking teens what they already know or what they have already heard or read about different types of medications. This helps to eliminate any confusion or misperceptions, either about negative side effects or about their unrealistic expectations that things will be “magically cured” in a very short period of time. It is important for teens to understand how long medications may work in their system, how long they need to take the medication to reach the therapeutic dosing, and the risks of not taking it or experimenting with other substances which may interfere with the mechanisms of action. For anxious kids who may not feel comfortable speaking up within an appointment, I encourage families to make a list of their teen’s questions and a plan for who will read the list of questions in the appointment. There are valuable supports that can help with the executive functioning demands needed to remember medications (e.g., daily pill boxes, setting alarms, or reminders on their phone, etc.).

When it comes to therapy, it is relatively common for me to hear a parent state that a child is reluctant or unwilling to attend therapy. There may be many very valid reasons why a teen may feel this way, and it is a sign that they are engaging in the developmental task of individuation when they push back on this recommendation. We don’t need to fear this struggle, and we can use it as an opportunity to invite a conversation. For teens who struggle to explain why they are reluctant about treatment, I might share a few common explanations to see if they resonate with the teen: “Some teens think it’s boring, or it’s too hard, or it’s a waste of time. Some worry their parents will know each thing they say, or feel like they are not in control of the treatment goals.” It may also be as simple as finding virtual sessions to be frustrating and impersonal, or finding the commute to an office for an in-person session to be time consuming. Many of these logistic concerns can be addressed with scheduling. It is also important for teens to know that therapy is not “one size fits all.” There are different forms of therapeutic treatment, and it is important to find a provider with experience delivering evidence-based treatments for the specific diagnosis that your teen carries.

One of the most important factors in treatment adherence is a trusting therapeutic relationship. Those relationships take time to build. If a teen is not feeling well connected to their therapeutic provider, I encourage them to have a discussion either directly with their provider about this or to explore other treatment providers. The same way someone may not wish to be friends with every person they meet, there are certain connections that just “feel right.” Skilled providers also use techniques, such as Motivational Interviewing, to encourage teens to develop their own goals for treatment. This can help to diffuse the argument that a teen is only engaging in a treatment to appease their parent or caregiver. These powerful tactics include important elements of empathy, highlighting discrepancies in thinking (or in conflicting actions and behaviors), accepting (and even expecting) resistance, and promoting self-efficacy.

In helping teens to find their own voice in the treatment process, a power struggle or a demand for engagement from a parent is unlikely to get us very far. Bringing in the support of other trusted people in a teen’s life (e.g., teacher, school counselor, coach, uncle or aunt, older cousin) may also be a useful way to open the discussion about why therapy feels stressful. While teens may wish for things to get better on their own, ignored or avoided struggles do not just go away magically. Treatment can be hard as it does involve facing anxiety-provoking material. However, teens will be facing this content with a trusted adult and armed with new tools to master these triggers. It is important to acknowledge that therapy can be hard work, and they will not be doing it alone. Engaging in special self-care routines after a therapy session, particularly if parents can acknowledge and create space for these, can be a powerful way to encourage commitment to treatment. When teens feel more control in engaging with their treatment, they are far more likely to persist.

For more information on enhancing motivation for treatment engagement, consider the following resources:

 

About the Author

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

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

 

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

Skip to content