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ANXIETY

Low Motivation-based Procrastination: Tips for getting over the hurdle

By | NESCA Notes 2022

By: Lyndsay Wood, OTD, OTR/L
NESCA Transition Specialist & Occupational Therapist

Procrastination is affecting a lot of us these days. There is a wide variety of reasons that people put things off until the last minute. In a previous blog, I discussed tips for anxiety-based procrastination which you can read here. Today I would like to talk about procrastination related to low motivation.

Have you ever had a day where you cannot get off the couch, and you want to keep binge watching your favorite show? Or, maybe you have noticed your child cannot seem to get off TikTok to do their homework. These are all examples of procrastination as a result of low motivation.

It can be extremely challenging to find the motivation to do things we don’t want to, especially when it means transitioning away from the things that bring us joy. You may have noticed this getting worse as the weather turns colder and the sun sets earlier each day. Many people find that their mood and motivation hit a low during these fall and winter months. So, how do you overcome this feeling?

Here are five strategies to get over the procrastination hurdle when motivation is low.

1. Momentum Stairs – Do you remember learning about Newton’s Laws of Motion? The Law of Inertia says an object at rest will stay at rest, and an object in motion will stay in motion. Makes sense, right? If you have been sitting still and engaging in an activity you enjoy (I’m looking at you, Netflix), it can be extremely difficult to transition to the task you have been putting off.

Sometimes, the best thing to do is to start with an activity that is more enjoyable just so you can get moving. For example, if you need to write a paper, but you can’t get off the couch, build your momentum by making yourself a cup of tea. That gets you off the couch and away from the TV, and once you are up, maybe you complete a small chore that isn’t too difficult (watering your house plants, wiping the counter, etc.) then you can move on to start writing your paper.

To initiate that movement, it is easiest to start with something easy and work your way toward the task that you have been procrastinating. Some folks find it helpful to picture a set of stairs; the activity they enjoy is at the top and the uninteresting task is at the bottom. You must take small steps down the stairs to build momentum toward the activity at the bottom of the stairs.

2. Habit Stacking – Habit stacking is a great strategy to help build routines out of existing habits and overcome low motivation. Once a routine is in place, it takes a lot less energy and motivation to complete those regular activities since they have become automatic.

The principle behind this strategy is that you slowly add to existing habits until you have formed a routine. For example, let’s say you eat breakfast every morning, but have not been good about taking your vitamins. By habit stacking, you could start taking your vitamins every day as soon as you finish breakfast, thereby accomplishing two things much more easily than having to remember to take your vitamins separately later in the day.

It may be helpful to place your vitamins in your pantry so there is always a visual reminder when you are making breakfast. Stacking habits in this way can make it much easier to form new routines that help you get past low motivation and accomplish bigger goals.

3. Reduce Barriers – Another helpful strategy for low motivation is to reduce the barriers needed to start the activity. Sometimes it can feel overwhelming to think about cooking that homemade meal you have been wanting to try, or to deep clean an area of your house that you can never get to. That results in low motivation, and the best way to overcome it is to reduce any barriers to initiating the activity.

One suggestion is to take all the materials you will need to complete the task out the day or night before. That can help reduce the barriers to getting started when you are feeling tired later in the day. You could also create checklists for yourself to reduce the cognitive load for certain chores. For example, a house cleaning checklist. Follow this checklist each time you have to clean so that you do not need to use as much brain power. When you can reduce the barriers to starting an activity, it will be so much easier to get up the motivation to complete it.

4. Pairing – Try pairing an activity you must do with something you enjoy doing. When motivation is low, sometimes the only way we can get ourselves up and moving is by combining the activity we have been putting off with something enjoyable. The key to making an effective and lasting pair is to ensure you only engage in the specific fun activity while completing the unpreferred task.

For example, if one of your goals it to take a daily walk to improve your health, but you cannot find the motivation to do it each day, it might help to pair it with a new audiobook that you are really excited about. Only allow yourself to listen when you are walking because that will transform the walk itself into a reward, and you will likely stop dreading it.

5. Five-minute Max – The five-minute max strategy is excellent for low motivation – and it’s easy to accomplish. Set a five-minute timer and start the activity you have been putting off. Tell yourself that you can stop the activity after five minutes. More than likely, once you start, you will be able to keep going, but you have the option to stop after just five minutes. Knowing that you only have to work for five minutes can help when motivation is low and make a task seem a lot less exhausting.

There is no perfect strategy that works for everyone in every situation, but adding these strategies to your toolbox can help you experiment with which methods work best for you. See if you can find just one tool to help you in those moments when low motivation is impacting your ability to get moving.

 

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

 

To book coaching and transition services at NESCA, 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Pediatric Neuropsychologist Ferne Pinard, Ph.D., Joins NESCA

By | NESCA Notes 2022

By: Jane Hauser
Director of Marketing & Outreach

I recently had the opportunity to learn more about Pediatric Neuropsychologist Ferne Pinard, Ph.D., who joined NESCA in this August. We are thrilled to have her on board and hope you learn more about her background and specialty areas in today’s blog interview.

How did you choose pediatric neuropsychology as a profession?

I’ve had an interesting journey to get to where I am today professionally. I started working with adolescents in the West Indies as a high school teacher. There I quickly learned that meant not just teaching to the curriculum, but also looking at each student as a whole person – often along with their parents – providing counseling to them and additional academic support as needed to meet their needs. That sparked my initial interest in working to support children.

That spark turned into a deep interest in psychology. In college I decided to major in psychology. I became involved in research examining various aspects of child development and learned about statistical methods.

In graduate school, I worked with my mentor on research projects that involved administration of neuropsychological tests and examining how performance on these tests were related to various outcomes (e.g., academic performance, externalizing behaviors). I enjoyed doing assessment as part of the research project and other training experiences. Although I toyed with the idea of becoming a therapist – as I was trained to provide therapy and conduct assessment – I decided to further my knowledge in the brain/behavior relationship

How have your previous work experiences prepared you to be a neuropsychologist with NESCA?

I spent the last 11 years at Boston Children’s Hospital, first as a post-doctorate fellow and later as an attending neuropsychologist.

As a fellow at Boston Children’s, I had the opportunity to work in various specialty clinics, gaining exposure to patients with a range of medical and genetic conditions, including neurofibromatosis, cancer, etc.

Later, I went on to gain specialty experience in the Pediatric Neuro-immunology and Learning Disabilities programs. As an attending neuropsychologist, I worked with, trained, and supervised pre-doctorate psychology interns and post-doctoral fellows.

As part of the neuroimmunology program, you assisted with research on the impact of post-acute sequelae of COVID-19 (PASC) – also known as Long Haul Covid – on children and their education. Tell us about that.

Yes, I had the opportunity to provide consultation to a previous colleague examining the cognitive impact of Long Covid. I also conducted a few assessments of adolescent struggling with persistent symptoms after being diagnosed with Covid. Difficulties with attention, mood, executive functioning (e.g., working memory and slow processing speed), and fatigue are commonly reported among individuals with Long Covid. These students also experienced disruption in school due to their illness then ongoing symptoms and understandably find it difficult to keep up and meet academic expectations. So many young people were sadder and more anxious throughout Covid…layer Long Haul Covid on top of that, and it’s a huge problem.

How do you see your previous work experiences translating to the families we work with at NESCA?

I bring a lot of knowledge and evaluation experience to NESCA, but most importantly, I bring expertise and compassion in working with families – creating and maintaining relationships with them. The greatest thing I can do for a family is to listen to their concerns, let them feel heard, and allow them to express their feelings about what they and their child are going through. This helps the parents and the child’s school gain a better understanding of the child.

How do you tailor your evaluations for different children, say an anxious child?

Patience and validation are key. I think it is also important to include the child and their caregiver in the discussion. Perhaps I add additional structure to the evaluation (e.g., use of a checklist, breaks at predetermined times), integrate strategies to reduce anxiety (e.g., deep breathing, use of fidgets), or modify the evaluation to take place over three sessions instead of two. Sometimes, the child is allowed to have the parent in the room with them throughout the evaluation. There are different approaches that can be taken based on each individual, and it’s my role to work with the child and caregiver to identify what would work best for the child.

You’ve had a lot of experience evaluating medically complex children and children who are dealing with medical conditions that many think only affect adults. Tell us about that.

It’s true. I’ve worked closely with children who have gone through cancer treatments, including chemotherapy, radiation, and surgery. These are always very touching experiences. These children have been through so much medically that sometimes the medical experiences lead to mental health challenges. They may have gotten through the cancer itself, but there can be residual and sometimes long-term fears of a reoccurrence. Often, there is an intensely emotional component to these assessments because of what the children and their families have endured. I’ve heard the fear in the voices of both the children and their parents’ voices. It’s my job to listen and provide them with a safe space.

Some of the children seen may not be able to maintain engagement for a typical evaluation due to fatigue related to their medical condition and treatment, for example. In these cases, the evaluation will need to be carefully tailored to address the referral question (s). And again, the approach to the evaluation would have to be modified to meet the child where they are.

I’ve also worked with children who have been diagnosed with Multiple Sclerosis and other autoimmune conditions. With these children, I always factor in the amount of stress they are experiencing in life and school as well as the fears they have about how MS may impact them later in life. The stress they feel, whether at school or based on their diagnosis, can have a negative impact on their symptoms. There’s a cascading effect from the brain and all of its thoughts and worries, and that is what we help them deal with. I am always eager to advocate for these children who bear such a heavy load.

What is the most rewarding part of your job as a neuropsychologist?

I feel that I have added value to a child’s life, when I can provide them and their families with a meaningful and comprehensive understanding of their profile—one that includes strengths, not just a focus on weaknesses. I think this is essential as it enables the family and child to advocate for their needs.

Why did you want to be part of NESCA’s team?

Initially, I was really drawn to the integrative approach to care for the children who are with NESCA. Coordination of care, whenever possible, and consultation among professionals involved in a child’s care leads to better outcomes. I was also excited to work with the professionals who specialize in different areas than I am accustomed to working with, such as postsecondary transition. The team here is very willing to collaborate so we can all teach and learn from each other. While I know I will gain great knowledge from the group, it really best serves the families with whom we work.

 

About Pediatric Neuropsychologist Ferne Pinard, Ph.D.

Dr. Pinard provides comprehensive evaluation services for children, adolescents, and young adults with learning disabilities, attention deficit/hyperactivity disorders (ADHD), and psychiatric disorders as well as complex medical histories and neurological conditions. She has expertise in assessing children and adolescents with childhood cancer as well as neuro-immunological disorders, including opsoclonus-myoclonus-ataxia syndrome (“dancing eyes syndrome”), central nervous system vasculitis, Hashimoto’s encephalopathy, lupus, auto-immune encephalitis, multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), and acute transverse myelitis (ATM), and optic neuritis.

To book a neuropsychological evaluation with Dr. Pinard or another expert neuropsychologist at NESCA, 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

The Importance of SMEDMERTS

By | NESCA Notes 2022

By: Ann Helmus, Ph.D.
NESCA Founder/Director; Clinical Neuropsychologist

While supporting a friend who was recently diagnosed with bipolar disorder, I have come to appreciate how challenging it is for people with this disorder to maintain a stable mood state. One of the most helpful resources I discovered in my search for information to help me support my friend was a TEDx talk by Ellen Forney, an author who has successfully managed her bipolar disorder for two decades by following SMEDMERTS, an acronym for: Sleep, Medication, Eat Well, Doctor/therapy, Mindfulness/Meditation, Exercise, Routine, Tools (coping), and Support System. I was struck that only 25% of the solution for managing her mental illness involves the mental health system: medication and doctor. The bulk of her treatment system relates to lifestyle choices.

While attention to SMEDMERTS is important for all of us, especially in these stressful times, consistent focus on these lifestyle choices is particularly critical for the many children and adolescents who we see at NESCA presenting with anxiety, mood disorders, ADHD, and behavioral issues. Most of us struggle to achieve our daily goals for sleep, diet, meditation, exercise, sticking to a routine, practicing adaptive coping strategies, and nurturing our support system, even though we know how much better we feel and how much better our children function when we are focused on SMEDMERTS in our daily life. While the impact of medications and doctors on functioning is largely outside of our control, we can control our lifestyle choices, which are critical to the success of managing any mental health issue.

How can we help the children in our lives to embrace SMEDMERTS?

  • Modeling it for them. As Robert Fulgham said, “Don’t worry that your children never listen to you; worry that they are always watching you.”
  • Praising their efforts. Offer positive feedback, such as, “Great idea to get up early to go for a run,” or, “I like how you called a friend when you were upset to get some advice.”
  • Enlisting the help of a coach. NESCA offers real-life skills coaching, executive functioning coaching, and health coaching to help children, adolescents, and young adults build and maintain habits to support positive lifestyle choices.

Health coaching is available to parents of NESCA clients who are seeking support in developing positive health habits, such as exercise, diet, stress management, and meditation.

If you are interested in coaching services at NESCA to support your quest for SMEDMERTS, please contact Crystal Jean: cjean@nesca-newton.com or fill out our intake form at www.nesca-newton.com.

 

About the Author
NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

To book an evaluation with one of NESCA’s many 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

When the Homeymoon Period Is Over: Signs of School Refusal

By | NESCA Notes 2021

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

As we reach the end of our first month back to school, many of us may be reaching the end of that glorious honeymoon period – the phase when kids are excited to see friends, optimistic for the school year, and reviewing material they likely already know. For some, the return did not start this rosy; the bloom is falling off the rose and kids are getting tired. You and your child are not alone in this. My goal for today’s blog is to share with you some warning signs that your child may be struggling and ways to get support before they grow to become bigger problems. The biggest problem I want to avoid: school refusal.

Have you heard this yet? – “My tummy hurts. I have to stay home.” Or, “I hate school. Please don’t make me go.” Or, “I’m not going!” Or perhaps these messages are communicated more subtly with covers over their heads in the morning, difficulty getting out the door on time, tantrums or disruptive behaviors in the mornings, missed buses, or the overwhelming frustration of homework that erupts into nightly battles. According to researcher Christopher Kearney, these are signs to pay attention to as they can evolve into what he terms “school refusal behavior.” School refusal is an umbrella term used to describe behaviors that interfere with a child being in school for their expected and scheduled time. This is a problem that can impact anywhere between 28-35% of students! While there are the more extreme cases for children or teens who are out of school for months at a time, my purpose here is to address the smaller, but more likely, problems. When we address smaller problems, we can keep them small.

Risky signs that your child is struggling with school:

  • Consistent statements of hating school, their teacher, or specific peers. A casual mention of a bad day is not cause for alarm. We all have bad days. If the statements keep coming and they get louder and stronger, then parents should pay attention.
  • The outward behaviors are getting bigger in the mornings before school or over homework. Behavior is a way for children to communicate with us how they are feeling. So, explosions over homework or tantrums in the morning that lead to tardiness are warning signs. The occasional homework meltdown or rushed morning is normal; we are all human! But, the problem is in the pattern.
  • Avoidance rears its ugly head. While some kids show on the outside that they are uncomfortable through their explosions, others communicate very clearly through their withdrawal. Some kids and teens struggle to get out of bed, are constantly tired, not completing work, falling asleep in class, or sharing every somatic complaint or symptom available on Google. If medical causes are ruled out, anxiety can be a culprit.
  • Consider the role of a major transition. According to Kearney, the riskiest time for a child to develop a pattern of school refusal is during times of significant transition – like starting kindergarten or changing schools from middle to high school. In addition to the social and emotional jump that these transitions bring, there is also a massive leap in demands for academic independence. It is very common for kids to struggle with the leap initially.

Oh no. So now what?

  • First and foremost, keep calm. It is far easier to keep small problems small when we have a clear-headed approach. Pull in anxiety management techniques like deep breathing, sleep, and exercise to support your own anxiety as a parent.
  • Reach out to your child’s teacher or school psychologist. Let them know your child is struggling with homework or coming to school. This is a great chance to gather information on what is going on in your child’s day and put your child on their teacher’s radar. This is critical as the only effective approach to remedy a problem with school refusal is a team approach.
  • Talk to your child honestly about what is going on. This has to include a chance for kids to talk about what might be happening to make them feel stressed or why they dislike school. Don’t shortcut this step. If your child has trouble explaining what is going on (which can be especially true for younger kids), try this approach: you and your child are both going to be detectives to learn together what is making school feel hard. We can’t solve a problem until we understand it. By joining with your child in gathering information, you are demonstrating great empathy and validating that their feelings are real.
  • Be careful of your language and conversation about school. It can be tempting to go too far in validating a child to give the message that the assignment really is stupid or their teacher really is unreasonable and mean. It’s best to stick to the feeling (“that must feel so frustrating”) without reinforcing negative messages about school.
  • Hold the line. As you gather more information, it is really important to maintain the message that it is your child’s job to go to school. It might feel conflicting to both validate the feelings of hating school and give the message to attend school. It might feel something like this: It’s either “I love and support my child OR I’m going to force them to go to school even when it’s hard.” Let’s change that OR to AND. Reframe the thought to: “I love and support my child AND they have to go to school AND they can do hard things.”

For more information, please check out:

Kearney, C.A. (2007). Getting your child to say “yes” to school: A guide for parents of youth with school refusal behavior. New York: Oxford University Press.

 

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

 

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.

Why Delay a Diagnosis?

By | NESCA Notes 2022

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

As part of NESCA’s ongoing blog series addressing some of the most frequently asked questions about neuropsychological testing, today we are addressing why neuropsychologists may choose to delay a diagnosis.

At NESCA, I often supervise neuropsychology trainees, and one of the first questions I asked them is: “What is the goal of a neuropsychological evaluation?” I often hear answers, such as “to identify strengths and weaknesses” or “to determine appropriate diagnosis.” These answers are not wrong, per se – they are what we are taught in graduate school. However, I often explain that while these may be part of our goal, the primary goal is to tell a client’s story and help them understand a path for moving forward. While this may sound a bit aspirational, it is the approach that best appreciates developmental, systemic, and individual factors that may come into play. As addressed by Dr. Moira Creedon in the first blog within this series, this is also one of the reasons why neuropsychologists want to review all prior evaluations and documentation, as this helps to elucidate the developmental timeline.

When a neuropsychologist is approaching an evaluation through the above developmental lens, it is not always possible to land on a specific diagnosis. This may sometimes be referenced as a “deferred diagnosis” or “differential diagnosis,” meaning there is evidence to possibly support the diagnosis, but not enough evidence at this time to decide for certain. Another term that may be used is “provisional diagnosis.” This indicates that there is enough evidence to support the diagnosis at this time, and there is clinical utility to diagnosing (e.g., informs intervention, qualifies for services, etc.); however, more information or monitoring may be needed to be completely confident, so future reassessment is warranted.

There are several reasons why a diagnosis may be deferred or deemed provisional. First, children are constantly developing, and sometimes the challenges they are demonstrating may be developmental in nature. This may be particularly so when evaluating young children. For example, if a young child has significant language delays, it may be difficult to assess whether they are also on the autism spectrum or have early signs of a learning disability, as their observed weaknesses in these areas may be accounted for by their language. Often times these are children who may “catch up” in skills once provided intervention, meaning their difficulties were related to delayed acquisition, rather than an being an issue of innate impairment.

Similarly, another reason diagnosis may be deferred is if a child’s self-regulation challenges interfere with their ability to engage in typical daily demands. For example, for a child who has significant anxiety or behavioral dysregulation that interferes with their ability to engage in school, it may be difficult to determine if academic delays are related to a learning disability or are a secondary consequence to their dysregulation. While provision of targeted instruction may still be necessary in order to help the child regulate and close gaps in skills, a full understanding of their innate learning profile may not be possible until such supports are in place.

Deferred diagnosis is quite common when more significant psychiatric diagnoses are in question, such as whether a child or adolescent is presenting with a mood or thought disorder, such as bipolar or emerging psychosis. There are many other conditions that may “look like” these disorders, including trauma or co-occurring anxiety and ADHD. When diagnosing more significant, often life-course disorders, it is important to ensure that all other potential explanations are identified and addressed. This is important for informing the appropriate treatments while also allowing the evaluator to outline some of the “red flags” that should be monitored by the client, their parents, and their care team over time.

Another reason why a diagnosis may be deferred is that there may be systemic factors at play. In other words, there may be things going on within the child’s home, peer setting, school, or other surroundings that interfere with the evaluator’s ability to understand the child in isolation. This is a particular issue when evaluating a client with a trauma history. Developmental trauma can often “mimic” other symptom profiles, and so it may be important to first address issues within the system before providing a diagnosis for the individual.

There are other less common situations in which diagnosis may be deferred, but they warrant mention. One is when the neuropsychologist is concerned about possible malingering, which is when certain symptoms are being falsified or exaggerated for personal gain (e.g., a child with learning disability exaggerating mood symptoms to avoid school). Another less common situation is when prescribed medication or recreational drugs may be inadvertently causing the symptoms of concern (e.g., depression occurring as a side effect).

A final reason why a diagnosis may be deferred is simply that things can sometimes be messy. We often evaluate children and teens who have several presenting concerns, and sometimes it takes time to peel away the layers of the onion. In any of the above scenarios, we start with “what we know” and then describe “what is possible.” Regardless of whether or not a diagnosis is certain, as neuropsychologists, we are still able to tell the client’s story, describing how they “got here” and how to move forward. This developmentally-sensitive approach allows us to make recommendations based on their need, not just their diagnostic label. We are then able to assess how their profile and symptoms change as they access intervention. It is for this reason that we enjoy the opportunity to develop long-term relationships with our clients, helping to monitor growth over time. Children do not develop in one finite time point, and the neuropsychological evaluation process sometimes has to be patient and continue to develop alongside them.

 

About the Author

Dr. Angela Currie is a pediatric neuropsychologist at NESCA. She conducts neuropsychological and psychological evaluations out of our Londonderry, NH office. She specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

 

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

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Londonderry, NH, Plainville, MA, and Newton, MA serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call (603) 818-8526.

Coping Strategies for Anxiety and Panic

By | NESCA Notes 2022

By: Lyndsay Wood, OTD, OTR/L
NESCA Transition Specialist & Occupational Therapist

Do you, your child or your loved one deal with frequent anxiety? Stress? Panic? Sometimes it may feel like you are spinning out of control. With so much going on in the world, in our own lives, and in our own head, it can feel like an impossible task to quiet the mind and calm the body. However, there are things we can do to regulate the nervous system, thereby relaxing the body and reducing the effects of anxiety. Below is a list of these strategies, but they are not one-size-fits all. Try each of them and see what works best for you or your loved one.

  • 5, 4, 3, 2, 1 Grounding Technique: This technique is helpful to ground yourself in the present moment. Often, we can get stuck in our own head, and our worries and fears spiral out of control. This strategy is helpful to pull yourself out of those thoughts and into the present moment. The procedure is as follows:
    • Identify five things you can see. Feel free to describe them. What color are they? What are their shapes?
    • Identify four things you can touch. Get up and actually touch them! How do they feel? Are they soft? Hard? Squishy? Wet?
    • Identify three things you can hear. Is there a car driving by? Are the noises loud or soft?
    • Name two things you can smell. Are the smells pleasant? Neutral? Familiar?
    • Finally, name one thing you can taste. Can you taste the remnants of dinner on your tongue? Perhaps you have a piece of candy nearby you want to put in your mouth and describe.

Hopefully, completing this technique helps break the anxiety spiral. Feel free to repeat it as many times as you need. You can try to identify new items and sensations each time.

    • Weighted blanket or deep pressure: Deep pressure activates the parasympathetic nervous system, which is responsible for relaxing your body. Therefore, if you are feeling anxious, try sitting with a weighted blanket. Alternatively, if you have a pet, put them on your lap. Both the pressure of their body and the act of petting them is great for relaxing. You could also try giving yourself a hand massage or tight hug.
    • Box breathing: This is a breathing technique that also activates the parasympathetic nervous system and relaxes the body. The steps of this technique are as follows:
      • Take a slow breath in through your nose (if possible) for four seconds
      • Hold that breath for four seconds
      • Slowly breathe out for four seconds
      • Hold your breath again for four seconds
      • Repeat this cycle three or four times
    • Funny videos: Sometimes it can be helpful to distract the mind with a funny video. Animal videos can be great! Or perhaps you have a favorite comedian that will always make you laugh.
  • Progressive Muscle Relaxation: This technique involves tightening different muscle groups and then letting them go. It helps to relax the body and reduce tension. You can find a guided YouTube video to walk you through the process, or you can also try it on your own by moving from head to toe, tightening different muscle groups. You may start by tightening all of the muscles in your face for 5-to-10 seconds as you inhale and relaxing the face muscles as you exhale. Give yourself 10-to-20 seconds to relax before moving on to the next muscle group.

 

About the Author

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

 

To book coaching and transition services at NESCA, 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Pediatric Neuropsychologist Maggie Rodriguez, Psy.D., Joins NESCA

By | NESCA Notes 2022

By: Jane Hauser
Director of Marketing & Outreach

In today’s blog, I have the pleasure of introducing you to NESCA Pediatric Neuropsychologist Maggie Rodriguez, Psy.D., who recently joined our team of expert clinicians.

How did you discover your interest in neuropsychology?

It was a long and winding road! I went into college, interested in a wide range of subject areas, including medicine. Eventually, I realized my area of interest was truly in psychology. I discovered that I really enjoyed neuropsychological evaluations, since they combined my interests in psychology, neuroscience, working with medical providers, educators, as well as writing and the creativity involved in making a child come alive in a report.

In graduate school, I was fortunate to learn from a number of extremely talented neuropsychologists in a variety of settings. While completing a placement at Children’s Hospital Boston, I remember hearing my very wise supervisor say that, “one year in the correct school placement is worth two years of therapy.” As I continued on with my coursework and clinical training, I repeatedly saw the truth in that statement. I witnessed the value of nuanced neuropsychological assessment in allowing students to receive accurate diagnoses and, in turn, the correct academic accommodations and interventions. I wanted to be part of that, not only to help children and teens succeed academically but to prevent the secondary effects that undiagnosed and untreated learning disorders, neurodevelopmental disorders, and cognitive challenges can have on emotional health, self-esteem, and social functioning.

On the personal side, my interest in neuropsychology was sparked again when I had my own child evaluated. It was surprisingly powerful to go through the process on the parent side, and after taking some time off to have a family, I knew that I wanted to get back into neuropsychology again!

Why did you choose to come to NESCA when re-entering your professional career?

There were several reasons that I looked into NESCA and ultimately opted to join its team. I learned about NESCA while researching neuropsychologists for my child’s evaluation and was impressed with what I saw. Additionally, one of my former testing supervisors told me NESCA is among the best in the business. Having that kind of endorsement from such a trusted source provided me with great confidence being part of NESCA.

I also was really drawn in by NESCA’s emphasis on the continued growth and learning for its clinicians. It was obvious that NESCA is comprised of a highly invested and collaborative team. Every one of us has a lot to learn still, and I valued the opportunity for not just a job, but the continued learning.

NESCA also offers a great work/life balance. Having a family of my own and parents who are approaching the stage where they also require care is a lot to balance. NESCA’s emphasis on supporting its staff in balancing work and life has made it very rewarding. I’ve seen several examples of how the culture of understanding is very much active.

On a very practical level, having clear protocols for handling day-to-day Covid strategies, like masking, cleaning, etc., has been comforting. Returning to clinical work in the midst of a pandemic has been a big transition, and knowing NESCA has put in place measures for keeping staff and clients safe is tremendously important to me. Seeing the creativity and agility in the way the team here tackled the larger challenges—evaluating clients safely and in-person—during Covid was inspiring and told me a lot about the team and culture. Learning that NESCA adapted its methods of testing via the two-office model demonstrated to me that they, as a practice, they are able to roll with those kinds of challenges. That was also very reassuring.

Finally, the interview process provided me with the chance to speak with a number of NESCA’s clinical staff. I was able to get a great feel for the culture and high standards the practice has, which made me confident that this was the right fit for me.

What kinds of concerns do you evaluate or enjoy the most?

I really enjoy working with kids of varying ages, but I do have a keen interest in working with families and children who are just hitting the adolescent years. I get the opportunity to help them understand how all the, sometimes confusing, pieces fit together.

I really enjoy working with kids who may be deemed as “complicated,” where things may have previously been overlooked. Maybe things were going fine for them until they hit a wall academically. Perhaps they got to middle school or high school or even college and began to wonder why things seemed to be falling apart for them. I enjoy the challenge of working with kids who are experiencing executive function deficits, social communication issues, kids whose disability or disabilities are not as straightforward. I like to tease apart whether there are executive function (EF) issues, Attention-Deficit/Hyperactivity Disorder (ADHD), or sensory integration challenges…or perhaps explore whether it could be something else altogether. Is a child’s rigidity due to anxiety, an Autism Spectrum Disorder (ASD), Obsessive-Compulsive Disorder (OCD), cognitive issues or a combination of overlapping challenges? I love teasing all of these things apart. I also work with children whose families have concerns about potential language-based learning disabilities (LBLD), communication issues and challenges with social pragmatics.

It’s incredibly rewarding when you are able to help families understand answers to these kinds of questions that they may have been grappling with for a long time.

 

About Pediatric Neuropsychologist Maggie Rodriguez, Psy.D. 

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

To book a neuropsychological evaluation with Dr. Rodriguez or another expert neuropsychologist at NESCA, 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Risk Factors & Warning Signs of Substance Use

By | NESCA Notes 2022

By Miranda Milana, Psy.D.
Pediatric Neuropsychologist

It is estimated that approximately one third of adults in the United States have met criteria for an alcohol use disorder at some point in their lives, while approximately 10% have met criteria for another substance use disorder. While these numbers are staggering, what is even more astonishing is the fact that consuming substances before the age of 14 increases the likelihood of abusing substances later in life by 400%. In fact, The National Child Traumatic Stress Network reports that 9 out of 10 individuals who abuse substances began using these substances before the age of 18. So, what are the risk factors and early signs to watch out for? What can you do to help?

Risk Factors:

  • Family history—if you have a family history of addiction, it is important to talk about this with your children just as you would have a conversation about a family history of cancer, diabetes, or any other mental illness. Determine when and how to approach this conversation by talking with your pediatrician.
  • Comorbid diagnoses—having an existing mental health diagnosis (e.g., ADHD, depression, anxiety) increases the chances that one will use and abuse substances later in life. Many individuals start using substances as a method of self-medicating if their mental health symptoms are not well managed.
  • Exposure—having easy access to substances, being exposed to peer groups or family members who use substances, or being exposed to media messages encouraging substance use can also increase the risk of substance use and abuse.
  • Additional risk factors include poor coping skills, academic failure, chaotic home or peer environments, as well as impulsivity and risk taking behaviors.

Warning Signs to Watch for:

  • Unexplained and/or extreme mood swings
  • Dilated pupils/bloodshot eyes
  • Changes in appetite
  • Change in sleep patterns or levels of fatigue
  • Changes in friends
  • Loss of interest in previously preferred hobbies
  • Being secretive about friends and activities
  • Withdrawing from family members and loved ones
  • Not respecting curfew or breaking other house rules
  • Running away from home or sneaking out
  • Stealing or having unexplained amounts of money
  • Increased absences from school
  • Decline in grades
  • Increase in behavioral problems

How to Help:

  • Start the conversation when it is appropriate. Talking to your pre-teen or teen about the effects of substances and alcohol/drug laws is essential in keeping the lines of communication open. Ask them first about their level understanding and what they have already learned or heard about.
  • Increase coping skills—having appropriate communication skills, positive social-emotional connections, strong self-esteem, and confidence in dealing with peer pressure are all extremely beneficial in helping children and teens navigate adolescence. If your child struggles in one or more of these areas, it is important to target these vulnerabilities early on through the appropriate therapeutic supports (i.e., psychotherapy, social skills groups, school counseling, occupational therapy, executive function coaching).
  • If you are concerned your child is using substances, you may contact their pediatrician or find support through SAMHSA’s national helpline (call 1-800-662-HELP or text HELP4U to 435748 to receive information on local treatment facilities, support groups, and local community organizations).

References:

Grant BF, Goldstein RB, Saha TD, et al. Epidemiology of DSM-5 Alcohol Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry. 2015;72(8):757–766. doi:10.1001/jamapsychiatry.2015.0584

Grant BF, Saha TD, Ruan WJ, et al. Epidemiology of DSM-5 Drug Use Disorder: Results From the National Epidemiologic Survey on Alcohol and Related Conditions–III. JAMA Psychiatry. 2016;73(1):39–47. doi:10.1001/jamapsychiatry.2015.2132

 

About the Author

Dr. Miranda Milana provides comprehensive evaluation services for children and adolescents with a wide range of concerns, including attention deficit disorders, communication disorders, intellectual disabilities, and learning disabilities. She particularly enjoys working with children and their families who have concerns regarding an autism spectrum disorder. Dr. Milana has received specialized training on the administration of the Autism Diagnostic Observation Schedule (ADOS).

Dr. Milana places great emphasis on adapting her approach to a child’s developmental level and providing a testing environment that is approachable and comfortable for them. She also values collaboration with families and outside providers to facilitate supports and services that are tailored to a child’s specific needs.

Before joining NESCA, Dr. Milana completed a two-year postdoctoral fellowship at Boston Children’s Hospital in the Developmental Medicine department, where she received extensive training in the administration of psychological and neuropsychological testing. She has also received assessment training from Beacon Assessment Center and The Brenner Center. Dr. Milana graduated with her B.A. from the University of New England and went on to receive her doctorate from William James College (WJC). She was a part of the Children and Families of Adversity and Resilience (CFAR) program while at WJC. Her doctoral training also included therapeutic services across a variety of settings, including an elementary school, the Family Health Center of Worcester and at Roger Williams University.

Dr. Milana grew up in Maine and enjoys trips back home to see her family throughout the year. She currently resides in Wrentham, Massachusetts, with her husband and two golden retrievers. She also enjoys spending time with family and friends, reading, and cheering on the Patriots, Bruins, Red Sox, and Celtics.​

 

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.

 

To book an appointment with Dr. Miranda Milana, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Anxiety-based Procrastination: Tips for Getting over the Hurdle

By | NESCA Notes 2022

By: Lyndsay Wood, OTD, OTR/L
NESCA Transition Specialist & Occupational Therapist

Despite our best efforts, procrastination happens. There are many reasons that you may be putting off that large paper, important phone call or those dishes that are stacking up. You may not have the motivation, you may be tired, you may have more fun plans, or maybe it makes you feel anxious. In fact, one of the top reasons people procrastinate is anxiety. Anxiety rates have increased since the start of the COVID pandemic in 2020, and tasks that previously felt easy can now be daunting to think about. It is important to both treat yourself with kindness AND build up your toolbox so that you can tackle the day ahead. Below is a list of nine tips on getting over the procrastination hurdle when anxiety is taking over.

  1. Five minute max – For this strategy, set a five-minute timer and start the activity you have been putting off. Tell yourself that you can stop the activity after five minutes. More than likely, once you start, you will be able to keep going, but you have the option to stop after just five minutes. This strategy helps with perfectionism and all-or-none thinking that can stop you from starting your tasks.
  2. Task breakdown – Big tasks can often feel overwhelming, so breaking your big project, chore, etc., into small steps can help you get going. Tell yourself you will complete step one today and move on to step two tomorrow.
  3. Seek help – Take a step back. Do you have the skills to complete this task? Is there someone you could ask for help if needed? Do not be afraid to seek the help of others to get started!
  4. Reduce the standard – Identify one task that you would be less likely to avoid if you make it easier. For example, have you been putting off exercise because you are worried about going to the gym? Start with a 10-minute walk and build up to a longer exercise period once you are ready. This method is especially helpful to combat an all-or-none mindset.
  5. Notice negative predictions – Be aware of your thoughts and how they can impact, or even control, your actions. Are you making a negative predication about the outcome? If so, it can be helpful to go through the following questions in your mind to reframe your thinking:
    1. What is the worst outcome?
    2. What is the best outcome?
    3. What is the most realistic outcome?
    4. What might I learn if I am willing to take a risk?
  6. Recognize your strengths and challenges – If you find initiating, planning or sequencing tasks difficult when compared to your other skills, don’t misattribute procrastination to laziness or poor motivation. Mislabeling yourself as lazy can lead to further procrastination and decrease self-confidence. You may instead decide to seek extra support or tools to develop your executive function skills.
  7. Visualize – Visualize the finished product AND the feeling associated with completing the task. It is easier to start a task if you feel like you have already succeeded at it.
  8. Accomplishment journal – Keep a running list of accomplishments (even small ones) and check back in to boost your self-confidence for the tasks ahead. It is much easier to start a task when you are in a positive head space and see that you are capable of meeting your goals.
  9. Treat yourself with small rewards – Sometimes a small reward can help you get over a big scary hump. Perhaps after scheduling all of the health care appointments you have been putting off, you sit down and watch the movie you have been wanting to see.

There is no perfect strategy that works for everyone in every situation, but add these strategies to your toolbox and test them out. See if you can find just one tool to help you in those moments when anxiety is impacting your ability to get moving. You’ve got this!

 

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

 

To book coaching and transition services at NESCA, 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 and Plainville, Massachusetts, as well as Londonderry, New Hampshire. NESCA serves clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Yoga Therapy for Children and Adolescents

By | NESCA Notes 2022

By:  Stephanie Monaghan-Blout, Psy.D.
Pediatric Neuropsychologist

As a pediatric neuropsychologist, I often recommend yoga therapy for children with anxiety, impulse control, and/or motor/coordination/sensory issues, as well as issues that alienate them from their body (e.g., eating disorders and trauma). Another group for which a body-focused therapy like yoga would be helpful is children with language challenges who are not equipped to manage the challenge of “talking” therapy.

Yoga is a 4,000-year-old practice that originated in what is now known as India. The word means “yoke” or “union,” and the practice of yoga aims to quiet the mind in order to find the unity within ourselves and with the world around us. This ancient practice was developed to facilitate development and integration of the human body, mind, and breath to produce a strong and flexible body free of pain, a balanced autonomic nervous system with all physiological systems functioning optimally, and a calm, clear, and tranquil mind (1). As we make this transformation in ourselves, we hope to affect the larger world. This is done through a variety of elements, but the western world tends to focus on movement (asanas), breathwork (pranayamas), and meditation (dhyanas).

Yoga was introduced to the west in the 19th century and has become a popular form of physical fitness and injury rehabilitation. More recently, we have begun to investigate its impact on physiological function, specifically the autonomic nervous system which controls vital life functions and regulates our stress response and return to equilibrium. Research has shown that chronic activation of the stress response (“fight/flight/freeze”) is strongly associated with increased risk of cardiovascular problems and autoimmune disorders (including diabetes), as well as psychiatric conditions, such as anxiety and depression. Yoga has been found to be effective in damping the stress response and allowing the body to return to equilibrium (“rest and digest”), resulting in lower heart rate and blood pressure, improved hormone regulation and gastrointestinal processes, lowered levels of anxiety, and better emotional and behavioral control. It is now included in cardiac rehabilitation programs, chronic pain programs, and psychotherapeutic treatment modalities.

Recently, I became curious with what exactly happens in yoga therapy and decided to talk with the new yoga therapist at NESCA, Danielle Sugrue, M.S. An athlete throughout high school and college, Danielle became involved with yoga about 15 years ago because she was looking for something that “would get me back into movement.” She quickly fell in love with yoga and completed her 200-hour Yoga Teacher Training. In the meantime, she also completed her master’s degree in Marriage and Family Studies at Salem State University. With this combination of expertise, she is able to help children and adolescents become more in touch with their bodies and find their words through movement, breathing, and relaxation.

I asked Danielle what a yoga therapy session with a child would look like. She quickly assured me that interventions with young children hold little resemblance to adult yoga classes. Danielle described her sessions with children as a playful movement exercise to learn to come to their breathing when things get challenging. If a child becomes dysregulated, she helps them tap into their senses to ground them and begin to put words on the feelings. A session may start by spreading cards with animals doing various poses out on the floor and asking the child to pick the card that looks like how s/he is feeling. Based on the cards selected, Danielle may develop a flow of postures based on those selections. The poses and concepts are taught through stories and games using mythical characters, like Ganesh, the Hindu elephant god who clears obstacles and paves the way for us to move forward in life.

The sessions for adolescents tend to take a more direct approach to the issues of concern as described by the teenager. Learning breathing techniques tends to be a key element; because of body issues, many teenage girls don’t breathe deeply (belly breathing) because it makes their stomach stick out. This kind of shallow breathing activates the stress response, making the person feel more anxious, while deep breathing “turns on” the rest and relax function. Moving freely without self-consciousness is another big challenge for teens—and developing a flow that allows them to feel themselves moving with ease but also makes them feel capable of holding a pose just a little longer than they thought they could—helps with developing self-confidence. Directly addressing mindset (self-love and self-compassion) also tends to be an important focus of work with teens and may involve activities such as a mirror challenge of looking at oneself and identifying what s/he likes about themselves.

Yoga therapy usually involves purchasing a 10-session package of once weekly meetings of an hour’s length. If you are interested in having your child work with Danielle, please contact her directly at: dsugrue@nesca-newton.com or complete an online Intake Form at: https://hipaa.jotform.com/220393954666062.

In addition to her work at NESCA, Danielle also teaches yoga at Power Yoga Evolution in North Andover. Dr. Monaghan-Blout is in the process of completing her own 200-hour yoga teacher training.

  1. Kayley-Isley, L., Peterson , J, Fischer, C, and Peterson, E. Yoga as a Complementary Therapy for Children and Adolescents, Psychiatry 2010; 7(8): 20-32.
  2. Nourollahimoghadam, E., Gorji, S., Ghadiri M., Therapeutic Role of Yoga in Neuropsychological Disorders., World Journal of Psychiatry 2021, October 19; 11 (10): 754-773
  3. Permission to Unplug: the Health Benefits of Yoga for Kids. https://www.healthychildren.org, the American Academy of Pediatrics
  4. Barkataki, Susanna. Embrace Yoga’s Roots; Courageous Ways to Deepen Your Yoga Practice 2020, Orlando, FLA, Ignite Yoga and Wellness Institute

 

About the Author:

Formerly an adolescent and family therapist, Dr. Stephanie Monaghan-Blout is a senior clinician who joined NESCA at its inception in 2007. Dr. Monaghan-Blout specializes in the assessment of clients with complex learning and emotional issues. She is proficient in the administration of psychological (projective) tests, as well as in neuropsychological testing. Her responsibilities at NESCA also include acting as Clinical Coordinator, overseeing psycho-educational and therapeutic services. She has a particular interest in working with adopted children and their families, as well as those impacted by traumatic experiences. She is a member of the Trauma and Learning Policy Initiative (TLPI) associated with Massachusetts Advocates for Children and the Harvard Law Clinic, and is working with that group on an interdisciplinary guide to trauma sensitive evaluations.

To book an evaluation with one of our many expert neuropsychologists and transition specialists, 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.