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child developement

The Use of Adaptive Behavior Rating Scales in Neuropsychological Assessment

By | NESCA Notes 2019

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

In my work as a neuropsychologist, much of my practice involves assessment geared toward transition planning – the move from high school to college or from high school to the working world. For these cases, I find the use of measures of adaptive behavior skills – day-to-day skills associated with self-care, communication, community navigation, home living, socialization, use of leisure time, and functional academics – to be a critical part of the neuropsychological testing battery.

Historically, adaptive behavior rating scales were developed and primarily used for assessment of intellectual disability. While adaptive behavior has taken rightful prominence in the assessment and diagnosis of intellectual disability – overtaking the importance of intelligence testing – the use of adaptive rating measures also proves quite important to help with transition planning for individuals with a wide range of psychiatric and neurodevelopmental presentations, including those with exceptionally strong cognitive skills.

These measures (e.g., Adaptive Behavior Assessment System – Third Edition; Vineland Adaptive Behavior Scales – Third Edition), which take the form of parent/caregiver or teacher questionnaires/structured interviews, yield detailed information about an adolescent’s readiness for their upcoming transition out of their family’s home. Particularly for bright adolescents with strong academic skills who might, say, present with attention and executive function challenges but have largely been successful in school, an assessment of adaptive behavior skills is often overlooked. However, over the course of my career, I have heard multiple stories of students who have seemed “college-ready” in the traditional sense of the word (i.e., strong academic and cognitive skills) but have suffered “failure to launch” experiences, as they had not learned to take their prescribed medications consistently, never learned to self-regulate their sleep schedule, or were well behind in their capacity to strike a balance between work and leisure activities.

Although the scores obtained on these measures can be a helpful guide, I find that a closer look at the specific components that may point to a need for additional skill development can help generate a sort of “to-do” list for transition planning work. Thus, while at times simply confirming an adolescent’s suspected transition readiness, the administration of an adaptive measure often proves to be a valuable tool to help determine what skill areas need to be targeted prior to the transition and/or supported during the transition.

 

About the Author:

McCormick

Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.

To book a consultation with Dr. McCormick 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.

 

A Tale of Two Social Styles: Classical and Jazz Socializers (Republished from Nov. 27, 2017)

By | NESCA Notes 2018

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

I work with a number of parents concerned about the quality of their child’s social life.  Lamenting that their child has no true friends, many parents I see note that that their child doesn’t “hang out” with peers.  However, when asked about how their child does spend time with peers, many parents report that their child is involved in several different structured after-school activities, such as a church youth group, scouting, or a gaming club.  In other words, while not getting together with peers in less structured settings, these students often do, despite parent misgivings, have satisfying social lives.

I find it useful to think about socializers as lying in one of two camps: Jazz and Classical.  Jazz socializers are all about improv.  They’ll head downtown with a friend and see where the afternoon takes them, invite a friend over with no particular plan or agenda, or wander the mall in a herd.  They care little about predictability and in fact relish spontaneity and surprise.  Classical socializers, by contrast, are most comfortable with structure.  They crave predictability, wanting to know the specific parameters of a social activity, including the start and end times, the purpose, and the rules of engagement.  Classical socializers, then, tend to do best with organized social activities.

It’s important to note that one type of socializing is not better than the other; it’s about a match.  I say that as many parents of Classical socializing children worry that their children will grow up to be friendless and alone.  To those concerns, I observe that there are plenty of socially-satisfied Classical socializing adults: they have their book club the first Monday of every month, poker night every other Thursday, weekly chorus practice, and bar trivia on Wednesdays.

Thus, rather than trying cram to their Classical socializing child into a Jazz paradigm – which in fact runs the risk of leading to more social isolation due to anxiety stemming from the mismatch – I encourage parents to embrace the kind of socializer that their child is.  For parents of Classical socializers, that means supporting their child’s social satisfaction and growth through the encouragement of their participation in a variety of structured after-school activities (of course without over-scheduling).  In addition to giving their children a chance for a rich and rewarding social life now, participation in such activities serves as an important practice and preparation for adult life, as in college and as adults in the working world, that is how Classical socializers will be most socially satisfied.

 

About the Author:

McCormick

Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.

 

To book a consultation with Dr. McCormick 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, MA, 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.

 

Sit Down with Billy Demiri, Certified Personal Trainer and Autism Fit Instructor at NESCA

By | NESCA Notes 2018

Billy Demiri, a Personal Trainer in Boston for the past 5 years, has recently joined NESCA to offer Personal and Social Coaching (PSC) for clients. We recently caught up with him while he was doing agility courses, wall sits and resistance bands with a client.

 

Tell us about your background, training, and certifications:

I grew up in Malden, Massachusetts. After high school, I attended Merrimack College and graduated with my Bachelor of Science in Sports Medicine with a concentration in Physical Therapy. Since then, I have obtained several certifications: I’m NSCA-CPT (National Strength Condition Association – Certified Personal Trainer) certified, Autism Fit Certified, TRX Certified, Kettle Bell Athletics Level One certified, and also pre- and post-natal certified.

I have worked as a personal trainer for 5 years helping a wide range of clients reach their goals. Over the years, I have learned to tailor programs based on client’s specific goals, whether it be fat loss, building muscle, or just moving better in their daily lives.

For those of us who aren’t familiar, what does a personal trainer do?

As a certified personal trainer, I work with people to achieve fitness goals—both short- and long-term. For each client, I create training programs tailored to their specific needs and goals. It’s also important to be able to adjust and modify workouts around people’s preexisting injuries or disabilities.

What do you love about your job?

Believe it or not, I used to be very unfit and uncoordinated. Growing up I played lots of sports and I remember not being able to do jumping jacks properly and being laughed at by my teammates until I finally worked on my fitness and through hard work ended up becoming a captain of the team. The experience made me connect the dots between the importance of being fit and your overall wellbeing.

I believe that being fit makes a difference in mental health as well as physical wellbeing. As a personal trainer, I get to work with people, help them progress, and make positive changes in their lives.

What brought you to NESCA?

I met Ann (Helmus, Founder/Director of NESCA) at Equinox. She jokes that I was one of the first people who could help her make sense of some of the exercises and equipment. Ann felt that many of the strengths I had in working with her-–patience, how to motivate, adjust workouts, make fun—could be a good fit for the kids at NESCA. Fitness had such a big impact on me as a kid; When Ann mentioned Autism Fit Certification, I was immediately interested. I learned so much at that training and I love being able to help vulnerable kids to develop confidence and skills.

What types of clients are you planning to work with and when are you available for sessions?

I started working at NESCA three months ago and have had a lot of success with one 12-year-old boy. I am planning to expand to additional male clients ages 8-18. With my Autism Fit Certification, I will be working with many clients who have autism or related learning disabilities. I am currently available on Tuesdays and Fridays after 2pm or on Saturdays from 8am-2pm.

 

 

How will you start working with clients? What is your intake process like?

First, I meet with parents to discuss needs and goals. This is about 30 minutes. Then, I will take the child through an evaluation process to assess motivation and a physical workout. The whole intake process will take 60-90min.

What exercise equipment will you be using and how will you protect clients from injury?

I use lots of different equipment including Hurdle Steps, Agility Ladder, TRX, SandBell, Bands, Medicine Balls, and Cones. Protecting clients from injury starts with good initial training. I will monitor their form and teach them proper technique and how to move their bodies properly so they can control their movement and avoid injury.

How can children or teens with social-cognitive challenges like autism benefit from fitness activities?

Exercise is one of the most effective instant happiness boosters of all time. For kids who often struggle with low muscle tone, poor motor planning, and proprioception difficulties, fitness activities help to increase strength, stability, and motor planning for all daily activities, not just working out. But also, more importantly, participating in regular fitness like Personal and Social Coaching (PSC) at NESCA, provides an opportunity for kids to have repetitive successful physical experiences. PSC will help create a new foundation for socialization and communication by introducing the conceptual framework for play. As kids gain more confidence in their physical abilities, they will want to participate and socialize in more activities. Also, when kids are more active and confident, the regular movement decreases anxiety and potentially even depression symptoms. Regular practice with fitness will also help decrease off-task behavior because kids practice and are able to focus on one exercise at a time.

What other goals might you work on with clients?

Other goals we can work on can be sport specific goals, including coordination, strength, and weight loss. With some clients, we may even work on community-specific goals like using a local rock climbing gym. Also, we work with staying on task and building confidence in their abilities so they can have fun and socialize when they play physically.

What do you enjoy doing outside of NESCA?

I enjoy hiking with my dog, playing sports, cooking, riding my motorcycle, Jiu- Jitsu, and obviously working out!

 

Video-What one 12-year-old client has to say about Billy!

Ready to get fit with Billy?

Billy will be initially working with clients who are part of the NESCA family and have already participated in testing, consultation, or therapy at one of our Massachusetts or New Hampshire offices. To learn more about his services, please email bdemiri@nesca-newton.com. Or, to book an intake with Billy, please complete NESCA’s Intake Form at https://nesca-newton.com/intake-form/ and select “Personal and Social Coaching (PSC)” as your reason for referral.

As a certified personal trainer and autism fit instructor at NESCA, Billy will not be giving medical advice, physical therapy advice or attempt to make a medical diagnosis for any client. He also will not serve as a therapist or psychological counselor to clients.

 

 

 

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

 

The Importance of Chores

By | NESCA Notes 2018

 

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

In her excellent piece in the NYT (Happy Children Do Chores, August 18, 2018), reporter KJ Dell’Antonia describes the importance of chores for a child’s development and well-being.  While I will provide a brief summary and add my own reflections, I strongly recommend that the reader read the full article.

In her article, Ms. Dell’Antonia cites several benefits of chores.  Among those, chores can help a child develop a greater sense of responsibility and awareness of the needs of others, and they can also contribute to a child’s emotional well being (no, really), in that they can help a child feel needed.  In addition to her list of benefits, chores are an excellent teacher of life skills.  Knowing how to do laundry, prepare a meal, change a vacuum cleaner bag, or tighten a loose doorknob can help prepare a child for the responsibilities of adulthood.  Meanwhile, more involved tasks like raking leaves or cleaning out the garage can be used as vehicles in the development a child’s problem-solving skills, prompting them (perhaps with parent assistance) to figure out how to tackle the task in the most efficient, most systematic manner, solutions that they may be applied to a host of other life responsibilities.

While most parents recognize the importance of chores, a large survey cited in Ms. Dell’Antonia’s article found that only slightly over half of American parents required their children to do them.  Some reasons given for this disconnect include parent-child conflict surrounding chores and a desire to free up a child’s time so that they can focus on academics or extracurricular activities.

In those last regards, however, while a strong GPA and an application chock-full of extracurricular accomplishments might help a student get into college, it is their work ethic, sense of responsibility, and time management skills that help a student meet success in college.  In fact, a more robust predictor of success in college than grades is whether an adolescent has held a part-time job prior to college, and chores are an excellent teacher of readiness for part-time employment.

Ms. Dell’Antonia concludes her article with advice that is, unfortunately, easier said than done, which is that helping to establish a chore routine at home requires perseverance.  Sometimes that means that it will take longer to convince the child to attend to the chore than it would take for the parent to do it themselves.  No easy answers, I guess.

 

 

About the Author:

McCormick

Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.

 

To book a consultation with Dr. McCormick 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, 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.