Tag

alissa talamo

Sep 28
5

Encouraging Your Child to Read

By | NESCA Notes 2020

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

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

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

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

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

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

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

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

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

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

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

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

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

 

This blog was previously published in NESCA Notes. 

 

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 info@nesca-newton.com or call 617-658-9800.

Jul 20
5

There Is No Wrong Decision

By | NESCA Notes 2020

By:  Alissa Talamo, Ph.D.
Pediatric Neuropsychologist

We are living in an unprecedented time. As such, parents are faced with decisions that they have never faced before. For example, families are facing the challenging decision about whether or not to send their children back to school for in-person classes in the middle of the COVID-19 pandemic. Parents have to wrestle with the idea that, on the one hand, sending children to school could increase the risk of COVID-19 among children and family members; while on the other hand, children who don’t return to in-person school may experience disruptions in their education and may miss out on the social interaction and community feeling within the school building. In addition, some families simply don’t have a choice because they need to go to work or a family member at home is immunocompromised.

What is most important is to recognize is that whether or not to send a child to school in the fall means something different to everybody. It is imperative that, as parents, you give yourself permission to feel whatever it is that you are feeling, and that you do what feels right for you and your family. It may be difficult to accept, but we have little control over much of what is happening around us right now. While it is important to acknowledge how you are feeling, it is equally important to remember that, in fact, any reactions are normal under the current circumstances.

How you respond to stress during the COVID-19 pandemic can depend on your background, your financial situation, your health and emotional background, your social support system, the community you live in and many other factors. When it comes to parenting, every day can be a challenge, and the coronavirus has made an already scary world feel even more menacing.  Remember to “ignore the noise” and give yourself credit for taking care of yourself and your family.

 

 

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 info@nesca-newton.com or call 617-658-9800.

Jan 20
5

Why We Should Weed Out Lawnmower Parenting

By | NESCA Notes 2019

By:  Alissa Talamo, Ph.D.
Pediatric Neuropsychologist

There are many parenting styles and trends…helicopter parents, attachment parents, free range parents, and now…the lawnmower parent. All of these parenting styles come from loving, well-meaning parents who want to do what is best for their children and protect them from harm. However, the lawnmower parent, the newest iteration of such approaches, often prevents a child from gaining necessary lifelong skills.

If a helicopter parent is a parent who hovers over their child and jumps in to solve a problem that a child could actually resolve on their own, a lawnmower parent (also referred to as a snowplow parent or bulldozing parent) is a parent who goes out of their way to remove every obstacle for their child; trying to anticipate their child’s every need and solve the problem before the child even experiences it. Lawnmower parent behaviors include everything from choosing a young child’s activities to directly calling a child’s college professor to ask for an extension on an assignment, and—as recently seen play out in the news—the college admissions scandal. One college professor (as shared on the Pittsburgh Moms blog) described lawnmower parenting as ‘Curling Parents,’ “given the similarity to the Olympic athletes who scurry ahead of the gently thrown stone, frantically brushing a smooth path and guiding the stone towards an exact pre-determined location.”

A negative side effect of the lawnmower parent approach is that it suggests to the child they are not able to handle any situation on their own, and possibly the idea that their parents believe they will fail rather than succeed unless the parent clears the way. How can a child develop a sense of self, and confidence to know they can make mistakes and still be ok, unless they are allowed to experience both success and failure? Children need to develop their own problem-solving skills, at a developmentally appropriate level, to know they can solve bigger problems. While it is ok to help your child (or friend, spouse, sibling) out of a difficult situation at times, everyone needs to learn to self-advocate, develop problem-solving skills and feel that sense of accomplishment that doing so yields.

References:

https://grownandflown.com/college-professor-warns-lawnmower-parent/

https://pittsburgh.citymomsblog.com/

https://www.goodhousekeeping.com/life/parenting

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 info@nesca-newton.com or call 617-658-9800.

Sep 09
4

Increasing Reading Success: Early Identification of Reading Challenges

By | NESCA Notes 2019

 

By:  Alissa Talamo, Ph.D.
Pediatric Neuropsychologist

I recently attended the International Dyslexia Association Conference in Atlanta, GA (dyslexiaida.org). Among the conference attendees were researchers, teachers, speech-language pathologists, psychologists, and parents of children with dyslexia. One recurring key point was the importance of early identification of reading difficulties, as early provision of appropriate interventions and services leads to better outcomes.

It is important to remember that unlike seeing, hearing, and eating, reading is not something humans do naturally. Reading must be learned and it is not easy (Maryanne Wolf, Proust and the Squid).

As a parent, your early observations are important as there are many developmental indicators that may signal a risk for reading difficulties such as:

  • Experiencing repeated early ear infections
  • History of speech delay and/or pronunciation problems
  • Slow vocabulary growth, frequent difficulty finding the right word, use of less specific words such as “the thing,” “the stuff,” or “that place.”
  • Your child struggles to recognize words that start with the same sound (e.g., cat and car) or end with the same sound (rhyming).
  • Difficulty learning letter and number symbols when in preschool
  • Family history of reading problems

During first grade, you can watch for these warning signs as you listen to your child read aloud:

  • Does not know the sounds associated with all of the letters
  • Skips words in a sentence and does not stop to self-correct
  • Cannot remember words; sounds out the same word every time it occurs on the page
  • Frequently guesses at unknown words rather than sounding them out
  • If you ask your first grader to read aloud to you and he/she is reluctant and avoidant

Remember: 

Early identification of reading issues is extremely important for outcome. If children who have dyslexia receive effective phonological awareness and phonics training in Kindergarten and 1st grade, they will have significantly fewer problems learning to read at grade level than children who are not identified or helped until 3rd grade.

What should I do if I suspect my child has challenges with reading?
If you suspect your child is struggling to learn to read, have your child receive an independent comprehensive evaluation so that you understand your child’s areas of cognitive and learning strengths and weaknesses. This evaluation should also include specific, tailored recommendations to address your child’s learning difficulties.

To learn more about evaluations and testing services with Dr. Talamo and other clinicians at NESCA, you may find the following links helpful:

What if I am not sure whether my child needs a neuropsychological evaluation?

When determining whether an initial neuropsychological evaluation or updated neuropsychological evaluation is needed, parents often choose to start with a consultation. A neuropsychological consultation begins with a review of the child’s academic records (e.g., report card, progress reports, prior evaluation reports), followed by a parent meeting, during which concerns and questions are discussed about the child’s profile and potential needs. Based on that consultation, the neuropsychologist can offer diagnostic hypotheses and suggestions for next steps, which might include a comprehensive neuropsychological evaluation, work with a transition specialist, or initiation of therapy or tutoring. While a more comprehensive understanding of the child would be gleaned through a full assessment, a consultation is a good place to start when parents need additional help with decision making about first steps.

Sources used for this blog:

 

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 info@nesca-newton.com or call 617-658-9800.

 

This blog was originally published in 2017.

Jul 22
4

Identifying and Supporting Twice-exceptional (2e) Children

By | NESCA Notes 2019

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

  • Rodney gets decent grades and achieves close to or at grade level in all of his district assessments. When concerns about his reading achievement were raised and an evaluation was conducted, it was found that his IQ is well above average, superior in some areas, but his reading decoding scores are below the average range for students his age. He has a combination of some gifted abilities and other areas that require intensive intervention. Rodney is twice-exceptional. (National Education Association, The Twice Exceptional Dilemma).
  •  Because of his behavioral difficulties, James attends a special program within his school for students with emotional and behavioral disorders. His teachers have difficulty seeing him as “gifted” as he is often uncooperative and reluctant to perform academic tasks in class. However, indicators are there. He participates in a weekly community program with students who are not disabled, to design a functioning robot and does so with a tremendous amount of ingenuity. He is also an avid reader outside of school and can offer a very keen oral analysis of the works he has read.  James is twice-exceptional.  (National Education Association, The Twice Exceptional Dilemma).

Twice exceptional—or “2e”—students are those who possess outstanding gifts or talents and are capable of high performance, but who also have a disability that affects some aspect of learning (Brody & Mills, 1997).  The largest group of twice exceptional children are those students who are academically gifted but who also have a disability (e.g., learning, physical, social/emotional or behavioral).

Some common characteristics of gifted students who also have a disability include:

  • Demonstrates a high verbal ability, but displays extreme difficulties in written language (reading, written expression)
  • Has strong observation skills but difficulty with memory skills
  • Shows attention deficit problems, even though they demonstrate special talents that consume their attention
  • Understands concepts at a high level, but struggles with basic skills (e.g., reading decoding, math fact fluency).

As a result, these students are at risk of facing challenges, such as:

  • Asynchronous development (the child is far ahead intellectually, but far behind socially and emotionally)
  • Underperforming academically
  • Frustration
  • Argumentative personality
  • Sensitivity to criticism
  • Poor study habits and organizational skills
  • Difficulty in social situations
  • Because they are clearly bright but performing poorly, they may be perceived as “lazy,” which, in turn, puts them at risk for criticism that can negatively impact self-esteem, which can also put them  at risk for depression.

Unfortunately, in the states of Massachusetts and New Hampshire, there is currently no gifted education legislation. As a result, schools are not required to identify gifted students.  Even if a specific school system does choose to identify these students, there is no mandate to create a program for those identified, and there is no gifted funding.  Massachusetts and New Hampshire are two of only eight U.S. states that do not have a gifted and talented mandate. And while Rhode Island has mandated identification of gifted students and requires programs to serve those students, it does not provide the schools with any government funding.

Since Massachusetts and New Hampshire are not yet mandating screenings for giftedness, nor mandating programs for these students (although some schools do so independent of the lack of mandate), it is important for parents to be informed of their child’s learning profile to advocate for needed services as well as to encourage their child’s areas of strengths and interests. The best way to determine if a child meets criteria for twice exceptionality is through a neuropsychological evaluation. A thorough neuropsychological evaluation will help a parent and school understand a child’s cognitive, academic and social/emotional strengths and weaknesses, helping to identify what supports or programming that specific child truly needs.

In addition, there are supports out there, as many giftedness programs and extra-curricular opportunities exist. Some helpful websites include:

  • davidsongifted.org – along with a strong (and easily searchable) database, the Davidson Institute and Davidson Academy are dedicated to supporting profoundly gifted students in the United States, including summer programs, scholarships and an accredited online school.
  • massgifted.org – The Massachusetts Association for Gifted Education’s (MAGE) mission is to support and advance the understanding of high potential/gifted children and their special needs, to promote the establishment of programs, services and opportunities for high ability/gifted students, and to encourage the exchange of information pertaining to gifted individuals among educators, parents, policy-makers and students on the national, state and local levels.

Additional sources used for this article:

childmind.org/article/twice-exceptional kids both gifted and challenged

www.nea.org/assets/docs/twiceexceptional.pdf

www.understood.org/myths about twice exceptional 2e students

https://www.givingcompass.org/article/schools-struggle-to-serve-gifted-students-with-disabilities

 

 

About the Author:
Talamo

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 StudentsDr. 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.

 

To book a neuropsychological evaluation or consultation  with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate that you would like to see “Dr. Talamo” in the referral line.

 

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

Mar 04
4

What is executive functioning? – Part 2 – How can adolescents develop these important skills?

By | NESCA Notes 2019

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

Cody is a 17-year-old young man participating in 11th grade. He is a talented runner with a good sense of humor and he has achieved mostly Bs in his college preparatory and advanced college preparatory high school classes. However, Cody’s mother describes him as the kind of kid whose “head would fall off if it was not attached.” Cody has an English tutor who has helped him to organize his thoughts and writing throughout high school. He seems to run out of time with everything—homework, tests, showers, video games—unless his parents and teachers provide him with several reminders. He also has trouble starting and finishing tasks, even things that are important to him. For example, he wanted to apply for a job at Market Basket. His mother has emailed him the online application link three times, but he still had not completed it after two months. Cody wants to go to college and is hoping to be recruited by a men’s cross country team. So, his parents took him to see a neuropsychologist to see if he could qualify for extra time on the SAT. They had heard the term executive functioning and knew that this was an area where Cody struggled, but they did not realize how significant his challenges were until the neuropsychologist shared his test results. Cody and his parents were grateful to have a better understanding of Cody’s learning strengths and challenges and also to learn that executive functioning skills can be remediated throughout the lifespan.

What is executive functioning?

Part 1 of this blog defined executive functioning as the “conductor” of all cognitive skills and identified three main components:

  • Working memory (the ability to hold and manipulate information in your mind),
  • Inhibitory control (inhibiting impulsivity, to pause and think before reacting),
  • Cognitive flexibility (the ability to adjust to changing demands).

Part 2 of this blog post highlights activities suggested to enhance the development of executive functioning and self-regulation skills during adolescence (taken from developingchild.harvard.edu booklet titled “Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence.”). The full guide is available for download and describes many additional activities and games that provide ways for adults to support various aspects of executive functioning and self-regulation in adolescents (Center on the Developing Child at Harvard University, 2014). While neuropsychological evaluation can be extremely important for understanding an adolescent’s executive functioning profile and planning for postsecondary education, there are a number of activities that young people can work on at home in order to build their executive functioning skills.

Here are some examples of activities suggested for adolescents:

  • Goal setting, planning and monitoring
    • Help the adolescent identify short and long-term goals and think about what has to be done to achieve them.
    • Help adolescents be mindful of interruptions (particularly from electronic communication such as email and cell phones).
  • Activities
    • Sports — The focused attention and skill development inherent in competitive sports improve the ability to monitor one’s own and others’ actions, make quick decisions, and respond flexibly.
    • Yoga and meditation — Activities that support a state of mindfulness may help teens develop sustained attention, reduce stress, and promote less reactive, more reflective decision-making and behavior.
    • Strategy games and logic puzzles — Classic games like chess exercise aspects of working memory, planning, and attention.
  • Study skills
    • Break a project down into manageable pieces.
    • Identify reasonable plans (with timelines) for completing each piece.
    • Self-monitor while working
    • When you don’t understand, what might be the problem? Do you know what the directions are? Is there someone you can ask for help?
    • Think about what was learned from an assignment that was not completed well. Was this due to a lack of information, a need to improve certain skills, bad time management, etc.?
    • Keep a calendar of project deadlines and steps needed to complete along the way
    • Identify ways to reduce distractions (e.g., turn off electronics, find a quiet room).

Are you concerned your adolescent’s trouble with getting organized, starting tasks, or keeping his/her emotions in check could be related to executive functioning issues?

There are many things you can do to get the answers you need to best help your adolescent. The most comprehensive way to assess a child’s executive functioning difficulties and determine a cause is a neuropsychological evaluation. A comprehensive neuropsychological evaluation is made up of a set of tests, questionnaires, interviews, and observations that a clinician will use to gain a good understanding of a young person’s strengths and weaknesses, along with learning how the individual processes information and completes tasks. At NESCA, we offer comprehensive evaluations that can look for potential learning disabilities, attentional difficulties, and other challenges that can negatively impact a child’s executive functioning development. In addition, a NESCA evaluation will include explicit recommendations to address challenges that have been identified.

Also, if you want to learn strategies for helping a teenager or young adult develop executive functioning skills, read Part 1 of this blog!

About the Author:
Talamo

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 StudentsDr. 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.

 

 

 

To book a neuropsychological evaluation or consultation  with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate that you would like to see “Dr. Talamo” in the referral line.

 

 

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

Feb 25
5

What is executive functioning? How do I help my child develop these important skills? – Part 1

By | NESCA Notes 2019

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

Alexis is a 5-year-old girl midway through kindergarten. She is well-liked, social, and has a strong vocabulary for her age. But her kindergarten teacher has noticed that Alexis has some difficulties in the classroom. Alexis raises her hand often during circle time, but when she is called on she  usually freezes or contributes something unrelated to the class discussion. Alexis also frustrates easily. When her first attempt at an art project doesn’t look like the example, she will throw it away or ask to do something else. And when she is given a multi-step direction to put her work away and get on her coat to go outside, she usually stops working but doesn’t move until she sees what her peers are doing, then she will follow along. Alexis’ parents have always noticed similar challenges at home such as giving up on difficult activities, forgetting where she has left her toys, and freezing when given too many choices or directions. But until her kindergarten teacher mentioned these classroom challenges, and they took her to see a neuropsychologist to better understand her classroom struggles, they did not realize that there was a name for her difficulties: Alexis is struggling with executive functioning.

What is executive functioning?

Executive functioning can be considered the “conductor” of all cognitive skills. Research has shown that executive function and self-regulation skills are critical for learning and development and help a person manage life tasks of all types.  While humans are not born with executive function skills, we are born with the potential to develop them. Moreover, studies show that we can continue developing the skills throughout our lifespans.

Executive function and self-regulation skills include three key components:

  • Working memory (the ability to hold and manipulate information in your mind),
  • Inhibitory control (inhibiting impulsivity, to pause and think before reacting),
  • Cognitive flexibility (the ability to adjust to changing demands).

While neuropsychological evaluation can be a critical step in learning about a child’s executive functioning skills and gaining recommendations for helping to remediate executive functioning challenges, there are a number of activities that parents can initiate to develop executive functioning skills at home.

Part 1 of this blog post highlights activities suggested to enhance the development of executive functioning and self-regulation skills from infancy through age 12 (taken from developingchild.harvard.edu booklet titled “Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence.”). The full guide is available for download and describes many additional activities and games that provide ways for adults to support various aspects of executive functioning and self-regulation in children (Center on the Developing Child at Harvard University, 2014).

Here are some examples of activities suggested for children of different ages.

Ages 6-18 months old

  • Peekaboo —this activity exercises working memory, challenging the baby to remember who is hiding, and also introduces basic self-control skills as the baby waits for the adult to be revealed.
  • Pat-a-Cake — Predictable rhymes that end with a stimulating yet expected surprise. Infants exercise working memory, becoming familiar with the rhyme and anticipating a surprise.
  • Songs or chants with simple hand motions help develop working memory and language. Infants can learn to copy the movements to a song and, with practice, will remember the sequence (e.g., Eensy Weensy Spider; Open, Shut Them).

Ages 18-36 months old

  • Older toddlers can enjoy simple imitation games (e.g., Follow the Leader) which can help develop working memory as well as attention and inhibition.
  • Song games with many movements are also fun (The Hokey Pokey; Head, Shoulders, Knees, and Toes). These require children to attend to the song’s words and hold them in working memory, using the song to guide their actions.

Ages 3-5 years old

  • Encourage children to tell you stories while you write them down. Also, have the children act out stories they have written. The story provides a structure that guides children’s actions and requires them to attend to the story, while inhibiting their impulse to create a new plot.
  • Play matching and sorting activities that promote cognitive flexibility. Children can first sort or match by one rule (such as by color), and then immediately be asked to switch to a new rule (such as by shape).

Ages 5-7 years old

  • Games that require players to remember the location of particular cards are great at exercising working memory (e.g., Concentration).
  • Games in which the child can match playing cards, either by suit or number, are also good to help strengthen cognitive flexibility (e.g., Crazy Eights, Uno).
  • Games that require attention and quick responses help children practice attention and inhibition (e.g., for younger children – Red Light, Green Light or Duck, Duck, Goose; for older children – Simon Says, Mother May I?).

Ages 7-12 years old

  • Games that require monitoring and fast responses are great for challenging attention and quick decision-making in children at this age (e.g., Spit)
  • Physical activities/games help develop a child’s ability to hold complicated rules and strategies in mind, monitor their own and others’ actions, make quick decisions and respond flexibly.
  • Brain teasers (e.g., Sudoku, Rubik’s Cube) require children to be mentally flexible and consider spatial information.

Are you concerned your child’s trouble keeping his/her emotions in check, answering questions in vague or off-topic ways, managing their belongings, or forgetting what comes next could be related to executive functioning issues?

There are many things you can do to get the answers you need to best help your child. The most comprehensive way to assess a child’s executive functioning difficulties and determine a cause is a neuropsychological evaluation. A comprehensive neuropsychological evaluation is made up of a set of tests, questionnaires, interviews, and observations that a clinician will use to gain a good understanding of a child’s strengths and weaknesses, along with learning how a child processes information and completes tasks. At NESCA, we offer comprehensive evaluations that can look for potential learning disabilities, attentional difficulties, and other challenges that can negatively impact a child’s executive functioning development. In addition, a NESCA evaluation will include explicit recommendations to address challenges that have been identified.

Also, if you want to learn strategies for helping a teenager or young adult develop executive functioning skills, stay tuned for next week’s edition of NESCA Notes!

About the Author:
Talamo

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 StudentsDr. 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.

 

 

 

To book a neuropsychological evaluation or consultation  with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate that you would like to see “Dr. Talamo” in the referral line.

 

 

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

Sep 24
0

Encourage Your Children to Read

By | NESCA Notes 2018

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

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

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

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

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

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

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

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

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

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

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

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

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

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

About the Author:

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

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

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

 

 

 

 

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

 

 

May 14
4

How Language Difficulties Impact Math Development

By | NESCA Notes 2018

 

By:  Alissa Talamo, Ph.D.
Pediatric Neuropsychologist

Did you know research shows that 43-65% of students diagnosed with Dyslexia also struggle with math at a level that meets criteria for a Specific Learning Disability in Math? This is in comparison to the general population, where 5-7 % of the population meet criteria for a Specific Math Disability (Dyscalculia – difficulties with number sense, number facts, or calculations).

I recently attended a lecture given by Dr. Joanna A. Christodoulou, assistant professor in the Department of Communication Sciences and Disorders at Massachusetts General Hospital and leader of the Brain, Education, and Mind (BEAM) Team in the Center for Health and Rehabilitation Research at MGH. The topic of discussion? How language difficulties can negatively impact math development.

How do language difficulties impact math development?

When asked to learn math, a student with language problems may: 

  • Have difficulty with the vocabulary of math
  • Be confused by language word problems
  • Not know when irrelevant information is included or when information is given out of sequence
  • Have difficulty understanding directions
  • Have difficulty explaining and communicating about math including asking and answering  questions
  • Have difficulty reading texts to direct their own learning
  • Have difficulty remembering assigned values or definitions in specific problems

It is helpful to have an understanding of typical math development in children. With this information, a parent can monitor their child’s development relative to grade level expectations.

Math difficulties often looks different at different ages. It becomes more apparent as children get older but symptoms can be observed as early as preschool. Here are some things to look for:

Preschool: 

  • Has trouble learning to count
  • Skips over numbers long after kids the same age can remember numbers in the right order
  • Struggles to recognize patterns, such as smallest to largest or tallest to shortest
  • Has trouble recognizing number symbols (knowing that “7” means seven)
  • Unable to demonstrate the meaning of counting. For example, when asked to give you 6 crayons, the child provides a handful, rather than counting out the crayons

In grades One to Three, a child should: 

  • Begin to perform simple addition and subtraction computations efficiently
  • Master basic math facts (such as 2+3=5)
  • Recognize and respond accurately to mathematical signs
  • Begin to grasp multiplication (grade 3)
  • Understand the concept of measurement and be able to apply this understanding
  • Improve their concept of time and money

Clearly, as a child continues through school, demands to understanding abstract math concepts increases. For example, in middle school, a child will be expected to understand concepts such as place value and changing fractions to percentiles, and when in high school, a child will be expected to understand increasingly complex formulas as well as be able to find different approaches to solve the same math problem.

What should I do if I suspect my child has challenges with math?

If you suspect your child is struggling to gain math skills, have your child receive an independent comprehensive evaluation so that you understand your child’s areas of cognitive and learning strengths and weaknesses. This evaluation should also include specific, tailored recommendations to address your child’s learning difficulties.

What if I am not sure whether my child needs a neuropsychological evaluation?

When determining whether an initial neuropsychological evaluation or updated neuropsychological evaluation is needed, parents often choose to start with a consultation. A neuropsychological consultation begins with a review of the child’s academic records (e.g., report card, progress reports, prior evaluation reports), followed by a parent meeting, during which concerns and questions are discussed about the child’s profile and potential needs. Based on that consultation, the neuropsychologist can offer diagnostic hypotheses and suggestions for next steps, which might include a comprehensive neuropsychological evaluation, work with a transition specialist, or initiation of therapy or tutoring. While a more comprehensive understanding of the child would be gleaned through a full assessment, a consultation is a good place to start when parents need additional help with decision making about first steps.

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

Sources used for this blog:
– Dr. Joanna A. Christodoulou
– www.understood.org

 

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 info@nesca-newton.com or call 617-658-9800.

 

Dec 18
4

Increasing Reading Success: Early Identification of Reading Challenges

By | NESCA Notes 2017

 

By:  Alissa Talamo, Ph.D.
Pediatric Neuropsychologist

I recently attended the International Dyslexia Association Conference in Atlanta, GA (dyslexiaida.org). Among the conference attendees were researchers, teachers, speech-language pathologists, psychologists, and parents of children with dyslexia. One recurring key point was the importance of early identification of reading difficulties, as early provision of appropriate interventions and services leads to better outcomes.

It is important to remember that unlike seeing, hearing, and eating, reading is not something humans do naturally. Reading must be learned and it is not easy (Maryanne Wolf, Proust and the Squid).

As a parent, your early observations are important as there are many developmental indicators that may signal a risk for reading difficulties such as:

  • Experiencing repeated early ear infections
  • History of speech delay and/or pronunciation problems
  • Slow vocabulary growth, frequent difficulty finding the right word, use of less specific words such as “the thing,” “the stuff,” or “that place.”
  • Your child struggles to recognize words that start with the same sound (e.g., cat and car) or end with the same sound (rhyming).
  • Difficulty learning letter and number symbols when in preschool
  • Family history of reading problems

During first grade, you can watch for these warning signs as you listen to your child read aloud:

  • Does not know the sounds associated with all of the letters
  • Skips words in a sentence and does not stop to self-correct
  • Cannot remember words; sounds out the same word every time it occurs on the page
  • Frequently guesses at unknown words rather than sounding them out
  • If you ask your first grader to read aloud to you and he/she is reluctant and avoidant

Remember: 

Early identification of reading issues is extremely important for outcome. If children who have dyslexia receive effective phonological awareness and phonics training in Kindergarten and 1st grade, they will have significantly fewer problems learning to read at grade level than children who are not identified or helped until 3rd grade.

What should I do if I suspect my child has challenges with reading?
If you suspect your child is struggling to learn to read, have your child receive an independent comprehensive evaluation so that you understand your child’s areas of cognitive and learning strengths and weaknesses. This evaluation should also include specific, tailored recommendations to address your child’s learning difficulties.

To learn more about evaluations and testing services with Dr. Talamo and other clinicians at NESCA, you may find the following links helpful:

What if I am not sure whether my child needs a neuropsychological evaluation?

When determining whether an initial neuropsychological evaluation or updated neuropsychological evaluation is needed, parents often choose to start with a consultation. A neuropsychological consultation begins with a review of the child’s academic records (e.g., report card, progress reports, prior evaluation reports), followed by a parent meeting, during which concerns and questions are discussed about the child’s profile and potential needs. Based on that consultation, the neuropsychologist can offer diagnostic hypotheses and suggestions for next steps, which might include a comprehensive neuropsychological evaluation, work with a transition specialist, or initiation of therapy or tutoring. While a more comprehensive understanding of the child would be gleaned through a full assessment, a consultation is a good place to start when parents need additional help with decision making about first steps.

Sources used for this blog:

 

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 info@nesca-newton.com or call 617-658-9800.