While school may be wrapping up, Summer is an ideal time to embark on transition assessment and services to ensure that your child’s IEP process is preparing them for learning, living, and working after their public education. The ultimate goal of transition assessment is to identify the necessary skills and services to ready a student age 13-21 for transitioning from high school to the next phase of life. To book an intake and consultation appointment, visit: www.nesca-newton.com/intake. Not sure if you need an assessment? You can schedule a one-hour parent/caregiver intake and consultation.

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ASD

Welcoming Renee Cutiongco Folsom, Ph.D., Pediatric Neuropsychologist

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA recently welcomed Pediatric Neuropsychologist Renee Cutiongco Folsom, Ph.D. to its clinical staff. Dr. Cutiongco Folsom brings a wealth of experiences and vast knowledge in assessing and diagnosing autism spectrum disorders (ASD) as well as conducting international evaluations. Take a moment to learn more about Dr. Cutiongco Folsom from my interview with her. 

Tell us about your background and how you got to NESCA.

I grew up in the Philippines. I started my career as a preschool teacher there for two years. At that point, I knew I wanted to work with children. I eventually got my master’s degree in psychology and took a neuropsychology class with a professor who was trained at Boston Children’s Hospital. I immediately fell in love with neuropsychology. I then came to the U.S. to pursue my Ph.D. and did my fellowship in neuropsychology at UCLA. I planned to go back to the Philippines but met my husband here in the U.S. and decided to stay here.

Since I did not go back to the Philippines, I was interested in practicing neuropsychology internationally, which I was able to do in Baltimore at Johns Hopkins. I was interested in the work NESCA has been doing internationally. The opportunity to work with a talented team at NESCA and the ability to do international evaluations was the right move for me.

What do you mean by looking beyond the data when conducting neuropsychological evaluations?

I refer to employing the “Boston Process Approach” in my evaluations and assessments because my mentor in the Philippines was trained in this approach when she did her postdoctoral work at Boston Children’s Hospital. She tried to ingrain this methodology in her trainees. What it means is that when we look at the data, we do not just look at a score. There is so much more to a child’s story than a number. As neuropsychologists, we are always looking at how the child comes up with an answer to a test. It is possible for a child to get a low score on a test of reproducing designs using blocks, for example, because the child threw or even ate the blocks! We must decipher what is behind the process by which the child produced the answer. This critical information falls outside of the data or what a score is. It tells us how the child learns, and what will help them at school, at home, and in their day-to-day life. This is the approach I take when I work with a child. I take a LOT of notes! I look to see what the child says and does, whether he or she is paying attention, and note other behaviors throughout the evaluation process. Then, I analyze all the data and look for patterns and discrepancies across various tests and measures.

When we see the data associated with the performance on a test, we must ask why, for instance, they achieved a low score. What other factors are at play? Is it anxiety or a visual-motor issue? What we observe throughout the evaluation can guide us to administer some tests that may not have been initially scheduled. Our knowledge, experiences, and careful observations help us to tease apart where a score came from and what it is telling us. We end up with a fuller picture of both the strengths and vulnerabilities of a child or adolescent.

What kind of international work were you doing previously?

After I completed my fellowship in neuropsychology at UCLA, my first job was with the Kennedy Krieger Institute at Johns Hopkins. Because so many families go there from other countries seeking answers, the organization assembled interdisciplinary teams to serve international patients. We conducted week-long intensive and comprehensive evaluations involving a neurologist, neuropsychologist, occupational therapist, speech-language pathologist, and social worker who could help them access resources in their home country. At the end of the week of intense evaluation, we came together as a team to make a diagnosis, if warranted, and provide recommendations for interventions. It was a challenging and intense program because we needed to develop our impressions immediately. And we often saw some of the most difficult and complex cases because the families had already exhausted all the resources available to them in their home countries before traveling overseas.

What do you find most rewarding about being a pediatric neuropsychologist?

I have been practicing neuropsychology for a long time. I chose to work in pediatric neuropsychology vs. adult because we can do so much more with children. We have a particularly good chance of making a bigger impact on their lives at such an early age.

What I find most rewarding is to have patients come back for a follow-up evaluation, and I can see how the child has progressed. Their parents often thank me for providing them with a diagnosis and helping them to access resources and attest how far their child has come. Working alongside families to change the trajectory of a child’s life is very powerful.

 You specialize in autism spectrum disorders (ASD). How do you make a diagnosis and differentiate ASD from its related challenges?

You rely on years of training, your knowledge and expertise, trust your clinical judgment, and factor in the wisdom of colleagues when needed. This is how you make meaningful conclusions and diagnoses that impact a child’s life.

What do you feel makes NESCA a unique environment and practice?

The beauty of a practice like NESCA is that we get a broad spectrum of clients who present with different challenges or diagnoses. We get to see a range of ages and draw clients from all over the New England region as well as internationally. That variety enriches your perspective and gives more insight into your clinical work.

I have been at NESCA for about a month, and they take collaboration to heart. My colleagues at NESCA are a giving group of professionals when it comes to sharing experiences and knowledge. The clinicians are humble, candid, open, and eager to help children, adolescents, and young adults. As a pediatric neuropsychologist, I also get to collaborate with transition specialists, educational consultants, OTs, SLPs, and more. The multidisciplinary approach, learning from other perspectives, is a refreshing addition to my work experience.

 

About the Author

Dr. Renee Cutiongco Folsom, Ph.D. has been working with families in the greater Boston area since 2015. Prior to this, she was on staff at Johns Hopkins University and trained at the University of California, Los Angeles (UCLA). She provides comprehensive neuropsychological evaluations of children, adolescents, and young adults who have learning, behavioral, and socio-emotional challenges. Her areas of expertise include Autism Spectrum Disorder and other conditions that usually co-occur with this diagnosis; Attention-Deficit/Hyperactivity Disorder; Dyslexia and other Specific Learning Disabilities; and Anxiety/Depression. She thinks that the best part of being a pediatric neuropsychologist is helping change the trajectory of children’s lives.

To schedule an appointment with one of NESCA’s pediatric neuropsychologists, please complete our online intake form

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, Londonderry, New Hampshire, and the greater Burlington, Vermont area, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

Shouldn’t We All Get Neuropsychological Evaluations, Then?

By | Nesca Notes 2023

By: Yvonne Asher, Ph.D.
NESCA Pediatric Neuropsychologist

One frequent question I have been asked by parents following a neuropsychological evaluation is, “Wouldn’t this process be helpful for everyone?” This tends to come up around the issue of disclosing results of an evaluation to children and teenagers and helping them better understand “how their brain works.” Many families with whom I have had the privilege of working come back months or years later with siblings of an initial client, noting that the process was so valuable the first time, they are hoping for a similar experience for their other child or children.

So, should we all get neuropsychological evaluations? Largely, I think this question is motivated by parents who are eager to help their children understand their own strengths and weaknesses. This is a wonderful goal, as self-understanding is one of the most valuable and lifelong gifts we can give our children.

In my experience, many people come to this kind of self-understanding naturally, over time, through experiences in adolescence and young adulthood. In particular, experiences that involve more independence in living and learning promote this kind of understanding. During childhood, we may learn our relative skill among family members (“I’m good at soccer, and my sibling is good at piano”), but these relative differences may not hold once we leave our family of origin. Many people venture out into the world and find that, compared to their peers, they are actually quite skilled at getting groups of friends together, doing everyday math, putting their thoughts down in writing, or staying organized. These real-world strengths often reflect the strengths that could be found through formal evaluation. As we gain self-understanding, we may be prompted to enter certain professions, take on particular hobbies, or pursue friends and partners with specific traits.

A neuropsychological evaluation can “speed up” the process of self-understanding, giving some young people a head start on the identity formation process that naturally occurs during adolescence. For some, this head start is vital – their brains are structured in ways that present clear, observable differences between them and their peers. This may be the case with diagnoses like autism spectrum disorder, a learning disability, or ADHD. For these individuals, the feedback from a neuropsychological evaluation can (under the best of circumstances) stave off feelings of inadequacy, negative self-esteem, and shame, helping a young person to recognize the deeply important strengths that are present alongside their more observable challenges. In these cases, a neuropsychological evaluation is not only for self-understanding, but also for self-compassion. Our goal as neuropsychologists in these cases is not just to help the child or teen understand themselves, but also to be gentle and kind with how they view their difficulties. Our hope is that, when these individuals venture out of their families and into the broader world, they are able to show resiliency in the face of the obstacles that will almost certainly be present.

 

About the Author

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

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

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

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

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton and Plainville, Massachusetts, Londonderry, New Hampshire, and Burlington, Vermont, 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. Yvonne Asher or another NESCA clinician, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Getting to Know NESCA Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach

I recently spoke with J. Michael Abrams, Ph.D., pediatric neuropsychologist practicing in NESCA’s Londonderry, New Hampshire office. Dr. Abrams joined NESCA last fall. Take a few minutes to learn more about him in today’s blog interview. 

How did you became interested in neuropsychology?

Back in the mid-80s, I worked at McLean Hospital, in the Child & Adolescent Inpatient program. They had an educational program set up for the kids that was run by psychologists who were embedded in the classrooms. There was a fair amount of test development going on at that time that used a lot of materials to build executive function and cognitive skills among the students. I was always interested in education and special education, but it was this experience that changed my career mindset toward psychology. So, I went back to school to study psychology.

Tell us about your career journey.

I always wanted to work with children and adolescents. That desire stemmed from my initial interest in special education and education in general, and I was on that path. I spent about seven and a half years at McLean, with the first couple of years working on an inpatient unit. Then I transferred to the psychologist-run education program, where I was a classroom educator.

After switching to psychology, my original clinical interest was with children who had experienced abuse and neglect and those who were involved in children’s eyewitness testimony. The focus was on how the experiences they had been through affected their memory, attention, and cognitive development. The more I worked with children and adolescents, the more I recognized how these neuropsychological factors impacted all aspects of their lives. It became much more than what I saw in the context of a legal case; instead, I saw how their experiences affected the management of themselves, their image of themselves, their hopes and aspirations, etc. I became really interested in how their neuropsychology intersected with their opportunities and experiences.

What segment of children and adolescents do you primarily work with? What is your specialty area?

I am particularly interested in working with children from age eight through 14, when their cognitive development is really taking off and they are trying to master this whole new set of skills. This time is filled with questions and challenges concerning self-esteem, mood, relationships, family relationships, etc. It’s a time when they are asking themselves what they are good at, where they struggle, and what those strengths and challenges say about them as a person. There is a great opportunity to have a big impact on kids in this age range. It’s such a gift to allow them to see themselves as successful and have that lead to future success.

What do you find most rewarding and most challenging about your profession?

The rewarding part is two-fold. The first is the interpersonal emotional piece. On a personal level, it’s rewarding to be able to contribute to other peoples’ success, whether it’s the clients, the practice, or the field overall. The second piece is more personal and intellectual. It’s intellectually stimulating to be able to integrate all of the information we gather or identify about a person, and to be able to communicate those findings or revelations to a child and their parents or caregivers. The intellectual reward lies in the ability to effectively communicate a child’s cognitive complexity in a way that they understand and can use to help reach their goals.

The challenging part has to do with the mental health landscape overall. As someone who is involved in neuropsychological assessments, it can feel like operating within a silo in the overall landscape. So many of the systems, such as insurance and education, are not set up for seamless collaboration with psychology practices or other areas of behavioral health. Unfortunately, this can make getting the appropriate mental health care or educational/therapeutic interventions a cumbersome, sometimes adversarial process. It’s the frustration that accompanies the much larger, more overarching need to develop a genuine collaboration among all the pieces within the health and mental health care settings.

What interested you about NESCA?

I was drawn to the opportunity NESCA provides to interact with other psychologists and affiliated clinicians on an ongoing basis. Professionally, I am not operating in a silo. At NESCA, there is more regular consultation and collaboration on how to put together a comprehensive and coherent plan for these kids. I was very excited to have a team of highly qualified, very experienced professionals, within the same organization, who can provide a range of supports and services for the kids we work with. Having this as a resource is a great opportunity for our clients and our staff, alike.

 

About Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

Dr. J. Michael Abrams has over 30 years of experience in psychological, educational, and neuropsychological assessment and psychotherapy in various settings. A significant aspect of Dr. Abrams’ continuing interest and experience also includes the psychological care and treatment of children, adolescents, and young adults with a broad variety of emotional and interpersonal problems, beyond those that arise in the context of developmental differences or learning-related difficulties.

 

To book a neuropsychological evaluation with Dr. Abrams in Londonderry, NH, or to book with another expert NESCA neuropsychologist, 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, Londonderry, New Hampshire, and Burlington, Vermont, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

How Can a Neuropsychological Evaluation Help?

By | Nesca Notes 2023

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

Recently I met with a family seeking a neuropsychological evaluation for their daughter. After talking about their reasons for pursuing testing, the parents asked me, “So…do you think this will help? Is this type of testing what our child needs?” It’s an important question and one I’m sure many families wonder about but don’t always ask. A comprehensive neuropsychological evaluation can be of tremendous value, but the process requires time and energy as well as a financial investment, so it makes sense to consider this question carefully.

Though it may be surprising to hear this coming from a neuropsychologist, the answer to the question of whether to have a child evaluated is not always clear-cut. For instance, parents sometimes wonder if there is practical benefit to seeking testing when a child or adolescent already has a diagnosis but there are questions about its accuracy. Consider the following scenario as an example. A child with issues regulating attention and with weaknesses in social skills has a diagnosis of Attention-Deficit/Hyperactivity Disorder (ADHD). Her therapist has raised the question of whether a diagnosis of Autism Spectrum Disorder (ASD) might better explain the issues the child is facing. Inattention can be present in both ADHD and ASD, and both conditions can result in social difficulties. Especially if a child is already receiving appropriate services, does the diagnostic label matter, and is it worth pursuing formal assessment?

There are valid arguments to be made in favor of seeking an evaluation in this type of situation and valid arguments to support choosing not to invest in an assessment.  In such a scenario, I would encourage a family to consider the following questions:

  • Will diagnostic clarification address unanswered questions that previous diagnoses have not fully addressed?

Sometimes an established diagnosis partially explains a child’s issues but there are lingering questions about other aspects of a child’s presentation. If a different or additional diagnosis could fill in the gaps, it may be worth assessing.

  • Could testing help identify your child’s unique pattern of strengths and weaknesses?

Especially when an existing diagnosis has been made without testing (for instance by a therapist or physician), there may be important aspects of a child’s neuropsychological profile that have not yet been identified. For instance, individuals with Autism Spectrum Disorder share certain key features, but they also differ in significant ways. A diagnosis alone cannot capture the nuances of an individual child’s strengths and weaknesses, while a full neuropsychological evaluation can more fully describe a child on an individual level.

  • Will understanding the root of the problem help guide recommendations?

NESCA’s clinic director compares a child’s observable difficulties to the “tip of an iceberg.” There are inevitably hidden underlying factors, and discerning these can be important in determining how to address the issues that are visible on the surface. For example, problems with social interactions can arise from deficits in social communication (e.g., difficulty interpreting facial expressions), as seen in Autism. Alternatively, a child with ADHD may encounter social challenges because they have trouble paying attention to relevant social cues or because impulsivity leads them to behave inappropriately. Someone with social phobia may have few relationships because their anxiety drives them to avoid social interactions. Effective intervention in each of these cases requires a nuanced approach that targets not just the surface issue but the factors underlying it.

  • Will establishing a particular diagnosis open up opportunities for additional support and resources that may be important?

In some cases, there are specific resources that are available to individuals with particular diagnoses. For instance, in Massachusetts, individuals with a diagnosis of Autism Spectrum Disorder or Intellectual Disability may be eligible to receive services through the Department of Developmental Services. If qualifying for such services could be beneficial, diagnostic clarification may be important.

More broadly, the internet and social media have allowed people with shared diagnoses to connect in new ways. The opportunity to connect with others experiencing similar difficulties can be invaluable, and online communities can provide a sense of support, educational information, and practical resources for children and parents alike.

The answers to these questions and to the bigger question of whether to seek neuropsychological evaluation will be different for different families. There are many factors to weigh in making the decision to seek testing. If you are considering an assessment for your child and need additional information to make an informed decision, answers to frequently asked questions about neuropsychological evaluation can be found on NESCA’s website.

 

About the Author

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.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

 

To book a consultation with Dr. Rodriguez 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 and Plainville, Massachusetts, Londonderry, New Hampshire, and staff in greater Burlington, Vermont, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Meet Jasmine Badamo, MA, NESCA Executive Function Coach

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach

This week, I had the pleasure of talking with Jasmine Badamo, MA, an Educational Counselor and Executive Function Tutor here at NESCA. While Jasmine has been with NESCA for quite a while on a per diem basis, she officially joined our team on a full-time basis within the past few months. Our clients and staff have enjoyed getting to know her, so we’d like to introduce you to her as well.

What brought you to the education field?

In college, I majored in science, but took a different turn when it came to my career path. After I graduated from college, I took a job teaching English abroad. During that time, I realized that I was far more interested in—and better at—teaching than I was in science. This experience solidified for me that education was really where I wanted to take my career. When I was back in the U.S., I earned my Master’s in TESOL (teaching English to speakers of other languages) at CUNY Hunter College. While in the TESOL program, I also became very interested in special education.

How did you learn about the need for Executive Functioning (EF) tutoring or coaching?

During my time in the TESOL program, I noticed there was a lot of overlap among students in the TESOL program and those in special education—there was a need for individualization among both sets of students. During this time, I learned how to modify a curriculum to be appropriate for each unique learner. I went on to work in a school-based special education setting for three years. Here is where I realized that a lot of the underlying needs of students in special education stemmed from their EF challenges.

When I was studying for my special education license, Executive Functioning wasn’t really even a thing yet; there was a concept, but no real name for it. Once it was given a name and there was more of an understanding about it, everything clicked for me. When I learned that I could make EF the focus of a job, I got really excited. I dove in headfirst and immediately started expanding my coursework in that area.

Executive Function covers a lot of territory. Where did you start?

While I was working toward my professional certificate with Landmark College, I was also working as a 4th grade special education teacher. When Covid hit, we all immediately saw the need for putting those EF coaching skills to really good and frequent use in helping our students to transition to remote education. We were able to help our students find functional, realistic, manageable tools to make their life less stressful while learning from home.

What about NESCA did you find attractive?

I was looking to focus a little more on EF outside of the elementary school setting. I found NESCA through a connection I made at Landmark. With NESCA’s EF and Real-life Skills Coaching Program, I was able to offer tutoring to a more diverse population among a wider range of ages, which was exciting to me. Being a part of NESCA’s coaching program also allowed me to really focus in on teaching EF skills, which is where my true interest lies.

How would you describe what you do to those who may not know much about EF?

I initially say that I am kind of like a special education tutor who helps people with study skills and life skills. I work closely with individuals who struggle with organization, time management, and focus to build skills in those areas to make things easier for them to do on their own. I often work with people who have characteristics of Attention-deficit/hyperactivity disorder (ADHD), Autism spectrum disorder (ASD), or a learning disability.

How do you do tutor students in EF?  

It all comes down to individualization. I spend a good amount of time focusing on getting to know a person in the beginning. I try to identify the biggest stress point or disconnect in their life. Together, we develop strategies to tackle those stressors in a way that works for them. We may come up with a bunch of potential strategies, but finding the ones that are realistic for them to maintain independently is the key to success. Once we identify and practice those, we remove the scaffolding bit by bit, giving them the independence they desire.

What is the favorite part of your job?

I love to figure out something that will have a positive impact on a student…that moment when we crack the code! It’s amazing to be able to use my knowledge in a way that can be directly meaningful to someone else in their life.

What do you find most challenging?

The fact that everything I do with each student is totally individualized can be challenging. There’s no script to go off of, and it takes a lot of trial and error to find what you’re looking for. You so desperately want to help the person and ease their struggles. Even if you find the right way to build an EF skill, it still takes a lot of time and patience. Teaching the student to also be patient with themselves during this time can be a challenge. But it’s so worth it!

Are there other areas of EF you’d like to focus on?

A lot of the strategies that can be used with students who struggle with EF are designed for neurotypical people. Often the tier one interventions that work for neurotypical individuals are not really tailored for them. That means we have to find creative ways to support these students while still honoring who they are. We can’t change the world for them, but they need to be able to navigate through it. And yet, we don’t want them to have to change the person who they are. It can be difficult, so I’d love to work on identifying more strategies and tools that may be good options for my specific students. I’d like to help them to find a better balance between the way the world works and the way their brain works.

Tell us what you’ve found rewarding about your work at NESCA so far.

I truly love getting positive feedback from my students’ parents. I am so validated by how appreciative they are that I “get” their kid. Sometimes my students tell me, but more often than not, I hear this feedback from their parents.

Unfortunately, a lot of kids with EF struggles are on the periphery with friends or academics. It’s great to be able to tell them there’s nothing wrong with them and guide them to having more self-compassion and self-empowerment. I strive to let my students know that we all have EF struggles. Life is one giant EF demand on us, and it’s a good thing to seek out support to help manage those demands. We put so much pressure on ourselves to manage it all, but it’s okay to get guidance, support, or a boost from someone else.

 

About Educational Counselor & Executive Function Tutor Jasmine Badamo, MA

Jasmine Badamo, MA is an educational counselor and executive function coach who works full-time at NESCA supporting students ranging from elementary school through young adulthood. In addition to direct client work, Ms. Badamo provides consultation and support to parents and families in order to help change dynamics within the household and/or support the special education processes for students struggling with executive dysfunction. She also provides expert consultation to educators, special educators and related professionals.

Ms. Badamo is a New York State Certified ENL and Special Education teacher. She has more than 10 years of teaching experience across three countries and has worked with students and clients ranging in age from 7 to adulthood. She earned her bachelor’s degree in Biological Sciences from Cornell University and her master’s degree in TESOL from CUNY Hunter College. She has also participated in graduate coursework focusing on academic strategies and executive function supports for students with LD, ADHD, and autism as part of the Learning Differences and Neurodiversity (LDN) certification at Landmark College’s Institute for Research and Training. In addition to being a native English speaker, Ms. Badamo is also conversationally fluent in verbal and written Spanish.

Having worked in three different New York City public schools, Ms. Badamo has seen firsthand the importance of executive function skills in facilitating student confidence and success. Her coaching and consultation work focuses on creating individualized supports based on the specific needs and strengths of each client and supporting the development of metacognition (thinking about one’s own thought processes and patterns), executive function skills, and independence. She will guide clients to generate their own goals, identify the barriers to their goals, brainstorm potential strategies, advocate for support when needed, and reflect on the effectiveness of their applied strategies.

Ms. Badamo is a highly relational coach. Building an authentic connection with each client is a top priority and allows her to provide the best support possible. Additionally, as a teacher and coach, Ms. Badamo believes in fostering strong collaborations with anyone who supports her clients including service providers, classroom teachers, parents, administrators, and community providers.

 

To book executive function coaching with Jasmine Badamo or another EF or Real-life Skills Coach 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, Londonderry, New Hampshire, and Burlington, Vermont, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Paying Proper Attention to Inattention

By | NESCA Notes 2022

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

One of the most common referral questions I see in my work as a neuropsychologist is, “Does my child have ADHD?” When a child has trouble focusing, Attention-Deficit/Hyperactivity Disorder, or ADHD, is one of the first things that comes to mind, and for good reason. However, ADHD is only one potential underlying cause of inattention. In fact, there are many cases in which attentional difficulties are present as part of another underlying issue. Some of these include:

  1. Anxiety—On a physiological level, anxiety involves activation of the “fight or flight” response. This adaptive process is designed to alter attention in order to prioritize survival. When the brain senses a threat, it tunes out everything else so it can focus on dealing with the danger at hand. This is extremely useful when the threat is something like a wild animal chasing you. In that case, you need to momentarily shift all of your attention to survival. It’s the worst possible time to be distracted by anything that could divert your attention from escaping a dangerous situation. But when students are anxious, especially for extended periods of time, the same process can make it difficult to focus on day-to-day tasks, including learning.
  2. Learning Disorder—Students who lack the academic skills to engage with the curriculum can appear to be simply not paying attention. If a student’s reading skills, for instance, are several grade levels below expectations, they won’t be able to actively engage with written assignments or materials in class.
  3. Communication Disorder—Deficits in receptive and/or expressive language often manifest in ways that mimic inattention. If a child cannot grasp what is being communicated, they will have significant difficulty following verbal instructions, answering questions, and retaining important information. This can easily be misinterpreted as a sign of an attentional issue when, in reality, the underlying problem has to do with communication.
  4. Autism Spectrum Disorders (ASD)—Many individuals on the Autism spectrum tend to be more attuned and focused on internal experiences (e.g., their own thoughts and specific interests) than to the external environment. As a result, they can miss important information, ranging from social cues to expectations communicated at home or within the classroom.
  5. Other neurocognitive disorders—Weaknesses in other cognitive functions, particularly those we refer to as “cognitive proficiency” skills (e.g., processing speed) and executive functions (e.g., working memory, organization) can also result in apparent inattention. Students who cannot process information quickly are sometimes unable to keep up with the pace of instruction, which causes a diminished ability to comprehend and retain information. Similarly, students who cannot hold information in working memory or organize ideas and concepts can demonstrate reduced comprehension.

There is a range of other issues that can contribute to children or adolescents appearing inattentive. Some of these include trauma, absence seizures, hearing impairments, thought disorders and/or hallucinations, and Tourette’s Syndrome. It is important to thoroughly evaluate the potential causes of inattention and to consider an individual’s full history and presentation.  Because different underlying issues will necessitate different treatment approaches, getting to the root of the issue can be tremendously important.

 

About the Author

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.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

 

To book a consultation with Dr. Rodriguez 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.

IEP or 504: What Do They Mean and How Can They Apply to My Child?

By | NESCA Notes 2022

By Miranda Milana, Psy.D.
Pediatric Neuropsychologist

If your child has ever undergone an evaluation through their school system or received an outside neuropsychological evaluation, chances are you have heard the terms “504 plan” or “IEP” thrown around. Given that it can be difficult to understand the differences between the two, we will break down what both of these terms mean and how they might apply to your child.

What is an IEP?

IEP stands for Individualized Education Program and provides specialized instruction, program modification, and accommodations through the public school system based on a student’s disability and how it impacts access to the curriculum. IEPs must include:

  • Annual goals that are measurable via benchmarks
  • Progress reports of the student’s current performance
  • Descriptions of how services will be provided
  • Outlined transition services as the child ages

In addition, IEPs must detail what academic environment would be the least restrictive, and therefore, most suitable for the student to appropriately access the educational curriculum.

Who is eligible for an IEP?

In order to qualify for an IEP, students must receive an evaluation either through the school system or through an outside provider that outlines the student’s disability status and how it negatively impacts accessing the educational curriculum. Importantly, a diagnosed disability is not enough to quality for an IEP on its own. Instead, the disability must be impacting the student’s ability to make effective progress in the general education program, which includes both academic and non-academic offerings of the district. Some examples of qualifying diagnoses include (but are not limited to):

  • Autism
  • Emotional Disturbance
  • Intellectual Disability
  • Specific Learning Disability

A parent or caregiver may ask what happens if  their child has a diagnosed disability but does not require special education services? Instead, the team may determine, through the eligibility process, that the student only requires accommodations, such as extended time on tests.

This is a perfect example of when a student might not qualify for an IEP and would instead be considered for a 504 plan. Simply put, IEPs and 504 plans both provide accommodations; however, 504 plans do NOT provide for specialized instruction or program modifications.

 What is a 504 plan?

A 504 plan is referred to as such because it is covered under Section 504 of a federal civil rights law called the Rehabilitation Act. This law works to ensure that students receive appropriate supports and accommodations within the academic setting. 504 plans outline accommodations for students which can include some of the following (but again, accommodations are not limited to the following):

  • Preferential seating
  • Extended time on tests and quizzes
  • Reduced distraction testing environments
  • Access to class notes
  • The use of a calculator during exams

As you can see, none of these accommodations is modifying the curriculum or providing a student with educational services as would be the case with an IEP.

Who is eligible for a 504 plan?

Any student with a disability impairing functioning in one or more areas is eligible for a 504 plan. One common example would be a student with diagnosed Attention Deficit Hyperactivity Disorder (ADHD) who requires distraction-reduced testing environments and/or other associated accommodations but does NOT require specialized academic instruction.

Another example is a parent of a child with an autism spectrum diagnosis may find that their child was found to be ineligible for an IEP through the special education eligibility determination process. Shouldn’t the student qualify for an IEP based on the autism disability?

The answer is not necessarily. If a student has a diagnosis of autism but is showing no signs of impairment within the academic setting (i.e., making appropriate academic progress, showing no signs of emotional distress, doing well with their peers, etc.), an IEP would not be warranted. Instead, a 504 plan would likely be considered (but again, is not guaranteed if academic functioning is not impaired).

If you feel your child requires a 504 plan or IEP and you are not sure where to start, contact your child’s special education program at their school. You may also wish to consult with an educational advocate or attorney who has a thorough understanding of special education laws.

References:

Massachusetts Department of Elementary and Secondary Education. (2018, June 29). Education Laws and Regulations. 603 CMR 28.00: Special Education – Education Laws and Regulations. Retrieved August, 2022, from https://www.doe.mass.edu/lawsregs/603cmr28.html?section=05

Massachusetts Department of Elementary and Secondary Education. (2014, July 14). Section 504 and the Americans with disabilities act. Section 504 – Special Education. Retrieved August, 2022, from https://www.doe.mass.edu/sped/links/sec504.html

 

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.

 

Private Neuropsychological Evaluation vs. School Evaluation

By | NESCA Notes 2022

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist

While both a school evaluation and a private neuropsychological evaluation often provide valuable information, there are some considerable differences. The primary purpose of a school evaluation is to determine whether or not a student presents with a disability that impairs their ability to access the curriculum and fully participate in the academic and social life of the school. Once a student has been referred for special education, the special education team convenes to determine if, when, and how the student should be evaluated. They decide which instruments will be used for the assessment and who will be responsible for administering them. For example, if a student is referred for a suspected disability, a school psychologist conducts a cognitive evaluation, and a special education teacher will administer an academic assessment. A speech and language, physical therapy, functional behavior, or occupational therapy evaluation may be requested as well. After testing, each specialist writes their report and presents their results individually.

When a student participates in a private neuropsychological evaluation, the parents and student work closely with the evaluator through the entire process, from the intake to feedback and beyond. While there are certainly very comprehensive school evaluations, the information obtained by the evaluators is rarely integrated and instead presented as separate evaluations. This does not allow for a complete understanding of how deficits (or strengths) impact functioning across domains, especially when the child has complex challenges. A comprehensive neuropsychological evaluation is comprised of many elements. Most evaluations consist of a detailed developmental and family history, cognitive, academic, learning and memory (auditory and visual) assessment, visual-spatial and graphical motor skills, and attention and executive function. Depending on the referral question, the evaluation may include reviews of social skills and adaptive functioning or specific measures to assist with making a differential diagnosis. Generally, the assessment is conducted by a single evaluator. The data, including data from prior testing, is synthesized into a detailed report with specific recommendations for school, home, and community life when appropriate.

There are undeniably circumstances when a thorough school evaluation is beneficial. School evaluators have opportunities to observe students at school and consult with their teachers, which can be advantageous (although observations may be requested or necessary to complete a thorough private evaluation, too). School team members also have many opportunities to collaborate when evaluating and working with students. However, school personnel are limited in their ability to integrate data across disciplines, provide diagnoses, and directly assess medical conditions, such as attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and complex challenges, such as dyslexia and nonverbal learning disability (NLD). Additionally, while some parents establish a good working relationship with members of the special education team, they do not have the opportunity to develop a long-term, collaborative relationship with the evaluator as they would when a private evaluation is obtained.

 

About the Author

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

 

To schedule an appointment with one of NESCA’s expert neuropsychologists, please complete our online intake form

 

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

ADHD & Social Skills

By | NESCA Notes 2022

By: Maggie Rodriguez, Psy.D.
Pediatric Neuropsychologist, NESCA

When most of us hear the term “ADHD (attention deficit hyperactivity disorder),” we think of the little boy who can’t sit still at his desk or the girl gazing out the window lost in her own thoughts during class. While difficulties with hyperactivity and/or attention are core features of ADHD–embedded directly in the diagnostic label–there are often co-occurring features that are less obvious. Moreover, even the central aspects of ADHD can have far-reaching impacts beyond the classroom. One of the most frequently misunderstood and overlooked facets of ADHD is its potential impact on social functioning.

In clinical practice, parents of children with ADHD are often confused by the unexpected and indirect ways that attentional and executive functioning deficits can affect social functioning. They sometimes wonder if their children have an additional challenge, such as autism spectrum disorder. Most often, that’s not the case. Rather, it’s more likely that one or more of the following is at play:

  • Kids with ADHD can have difficulty selectively attending to relevant social cues
    • Imagine looking through a camera with a broken zoom lens. At first everything is in frame at once; it’s too much information. Then you try to zoom in, but when you do, sometimes the lens focuses on unimportant things (like the random details in the background), leaving out what’s most relevant (like the person you’re trying to capture in your photo). Children with ADHD have difficulty figuring out what details to focus on and struggle to effectively “zoom in” on those elements. In social settings, which are often unstructured, kids with ADHD are even more prone to “zoom in” on unimportant things and miss the more salient information. They can also become easily distracted and fail to register important information in the moment. To others, this can come across as lack of interest (for instance, the child who seems not to be listening or is distracted by sounds, sights, or other sensory information in the moment). It can also lead children with ADHD to overlook contextual cues about what’s expected in a given social setting, which can lead to inappropriate behavior.
  • Children with ADHD often struggle with nuance, making inferences, and reading between the lines
    • Social situations are much more complex than we often realize. Successfully navigating social interactions requires paying attention, not just to surface level information but to the often subtle, implied meaning embedded in things like figures of speech, tone of voice, and body language. For many with ADHD, it’s already a challenge to maintain focus at the surface level; the task of trying to simultaneously attend to and interpret subtext is too much. Individuals with ADHD may focus on what another person says (the content of their speech) but fail to notice the eye roll or sarcastic tone of voice that goes along with it.
  • Impulsivity can lead to social faux pas
    • Impulsivity is a central feature of ADHD in many cases. In social settings, difficulty inhibiting impulses can take many forms. For some, it may simply present as rapid-fire speech, leaving little room for others to respond in conversation. It can also look like interrupting, cutting others in line, or expressing ideas and opinions in a way that can be hurtful or seem rude. Especially in younger children, impulsive behavior can lead to difficulty sharing, physical aggression towards others, and trouble with turn taking. Children who have more difficulty slowing down and inhibiting impulses are more likely to inadvertently offend others or to engage in behavior that their peers may view as odd or inappropriate; in turn, this can lead to trouble developing and sustaining friendships and other positive relationships.
  • Hyperactivity makes participating appropriately in some social settings difficult
    • There are some social contexts in which an abundance of energy is a very good thing. For this reason, many ADHD kids can excel in activities like sports, into which they can channel their high energy. But other social situations demand a different set of skills. For kids with hyperactivity as part of their ADHD, sitting still and maintaining quiet can be a challenge. They may struggle with activities like going to the library, watching a movie in a theater, attending church or religious ceremonies, or sitting at the table in order to have family dinner.

The good news is that there are ways to manage these social challenges. If your child with ADHD has difficulty with any aspects of social functioning, it may help to seek out social skills training with a therapist or through a structured social skills training program. Interventions often include a combination of explicit instruction, modeling, role playing, and feedback. Parents can also help by implementing simple, consistent ground rules for behavior and providing gentle but clear reminders as needed. Additionally, parents can facilitate play dates with peers, during which the parents take an active role in helping children utilize social skills and engage with each other appropriately.

Finally, though ADHD can present challenges in the social domain, kids with ADHD often possess many strengths that can help actually them succeed socially. Children with ADHD can be highly engaging, curious, energetic, creative, and open-minded. When these strengths are reinforced, kids with ADHD can often utilize them to create fun, rewarding social interactions and to develop rich, dynamic relationships.

 

About the Author

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.

Dr. Rodriguez lives north of Boston with her husband and three young children.  She enjoys spending time outdoors hiking and bike riding with her family, practicing yoga, and reading.

To book a consultation with Dr. Rodriguez 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.