Tag

collaboration

Aug 23
4

The Value of Mulligans

By | NESCA Notes 2021

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

Let’s face it – a lot of parenting involves socializing children whose brains are in the process of being built. This means:

  1. They do not yet have the cognitive capacity to understand the moral principles behind such behaviors as “sharing, “being nice” and “using our words.”
  2. They are in the process of learning how to inhibit the impulse to grab, say whatever one thinks and using physical force to get what one wants.

Behavioral reinforcement strategies (rewarding desirable behavior) can be quite effective as a socialization technique – but only if the strategy is keyed to both an understanding of the level of the child’s cognitive/moral development and their capacity for impulse control. All too often, the parent’s efforts to shape their child’s behavior run aground because of problems in assessing either (or both) of these areas. The concept of a “mulligan” can be a very useful in compensating for either child or parent error.

The term “mulligan” comes from the game of golf where it means getting an extra stroke after a poor shot. There are several stories about the origin of the term, but most involve a player named Mulligan who had been so rattled by a variety of events that he made a very poor shot on his first effort and claimed a “correction” – basically a do-over. This fits well with the dilemma presented to parents when a child has not been able to stick to an agreement, like “if you boys can work out your differences without verbal or physical fighting this morning, we will get some ice cream this afternoon.”

The first step in taking a mulligan, or correction do-over, always involves giving everybody involved some time to calm down, thus restoring the capacity for flexible thinking and problem solving. Once this is achieved, it is time to figure out where things broke down: was it overestimating the child’s capacity for controlling their impulses over time, in certain situations, or with certain people? Or was it because the child did not know how or why to take certain actions? If the problem involves impulse control, it will be up to the parent to restructure the situation in order to make it more realistically doable for the child or children – in other words, the parent takes a mulligan. For instance, s/he might say, “Look, this is not working out. I’m going to take a mulligan. Every 15 minutes that you guys can get along and work out your differences, I will give you a point. If you can get 3 points this morning, we will go for ice cream this afternoon.” Notice that this directive leaves some room for inevitable error, but still imposes reasonable expectations.

When the problem falls in the “how” or “why” category, parents also need to consider the child’s developmental status before engaging in problem solving. It is really important to appreciate that a child’s understanding of common conventions, like “sharing” and “fair.” In the egocentric and preconventional thinking of young children, “sharing” is too abstract of a concept and “fair” means “I get my way.” To speak about “taking turns,” make more sense to them. In the more conventional thinking of elementary school children, the key element in sharing is “fairness,” or, is the exchange equal? (In high school or college, some students will begin to struggle with the concept of equity, or how to allocate resources and opportunities in order to ensure an equal outcome, but this is a foreign thought to most children when it applies to their own resources, like candy or access to video games). Once the parent is clear about how the child is viewing the problem and where their strategies broke down, they can offer a chance for a mulligan while teaching more effective strategies than brute force or crying. Concrete aids, such as wind-up timers that show minutes, can help children understand the passing of time. Whimsical strategies, such as “shooting fingers” or “Rock, Paper, Scissors” are fun ways of determining who goes first or who gets to choose the video that also teach tenets of compromise and collaboration.

 

Resources:

https://www.golfdigest.com/story/did-you-know-where-did-the-term-mulligan-originate

 

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 Dr. Monaghan-Blout or one of our many other 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.

Jan 27
11

Transition Planning at IEP Team Meetings – The Good, The Fun and The Beautiful

By | NESCA Notes 2019

By: Kelley Challen, Ed.M., CAS
Director of Transition Services; Transition Specialist

Transition planning is a complicated process for schools, families and related service professionals. It is not something that can be done well without key ingredients, such as open minds, collaboration and creative brain power… not to mention time. But when good transition planning happens in the context of a team meeting, it is a really powerful and awesome process – and even, dare I say, fun!

I recently worked with a young woman – let us call her Julie – who had spent four years of high school in a small therapeutic program. It took Julie, with great support from her team, a lot of effort to get through the academic demands of high school while simultaneously managing and remediating social and emotional complexities. As Julie progressed through her senior year, her school team recognized that she had not had the time or opportunities to build some critical life skills, including the self-advocacy and executive function skills she would need to manage post-secondary, real-world activities. Everyone agreed that she needed another year to build and generalize the functional skills that are essential for being a student in a post-secondary learning environment and to be deemed employable. With no option available for Julie to continue in her therapeutic school program, the team agreed to set up a meeting to create a new IEP that focused largely on Julie’s remaining transition-focused needs. Due to time constraints, the team meeting occurred at the start of this school year.

I was fortunate to be invited to consult at this meeting. After introductions, we dug in together to review Julie’s most recent transition evaluation. Julie had a thorough evaluation that had been completed by the school district, which provided a lot of information about her disability-related needs as well as her vision and interests. We talked about the most pressing areas to address in developing the IEP goals and debated options for creatively writing the annual goals in the IEP document (i.e. whether to focus annual goals on life, vocational and college participation skills with objectives related to social, emotional, executive functioning and self-advocacy issues in each arena or whether to employ a more traditional IEP format with seven goal areas).

We discussed objectives that would be most useful in the context of Julie’s long-term goals – attaining a college degree and working as a nutritionist. Julie’s mom had done a great deal of work prior to the team meeting, helping Julie apply to Massachusetts Rehabilitation Commission (MRC) Vocational Rehabilitation (VR) Services, connecting with the local agency contracted to provide Pre-Employment Transition Services (Pre-ETS), and setting up Julie’s first internship experience for the summer. She also helped Julie to sign up for an adaptive driver’s education class to occur on weekends throughout the fall. Julie’s mother had also researched options for college classes that Julie might be able to participate in, even though she had missed the start of many fall classes.

Julie’s Special Education Director had worked equally hard in looking into resources within the school district and community that could provide Julie with meaningful activities and experiences and assist her in making progress with the skills outlined in the transition assessment. One such resource identified by Julie’s Special Education Director was a non-profit social skills group. Another resource was a coach who could provide hands-on support on a college campus and was already in place as part of a postgraduate program run through a nearby district. The Director also identified several staff withing the school district who were experienced in supporting transition-age students – the school social worker and lead teacher within the school’s therapeutic program – who could work with Julie.

We gathered in a room together not to talk about a program that already existed, but to design the individualized, unique transition program that Julie required. We brainstormed options for shoring up her writing skills with such approaches as drafting an independent research paper on being a nutritionist and participating in a dual enrollment college writing class. We thought of ways to build money management skills through an online personal finance class with school support and real-life practice by visiting her local bank and several ATMs with her school’s occupational therapist.

When we left the meeting, we had designed a brand new program for Julie that would satisfy her needs in the areas of social, emotional, self-advocacy, executive functioning, adaptive and vocational skills development through a combination of school-, community- and home-based activities, with defined support from the school district, community agencies and her family. Everyone left the meeting ready to carry out the next steps of planning for Julie, with roles and responsibilities clearly outlined to initiate the activities that would hopefully propel Julie toward greater independence and satisfaction in her adult life.

This is just one example of a great team meeting that I have been a part of this school year. Over the years, I’ve been fortunate to have had the opportunity to contribute to many of these meetings as well as some of the more challenging ones. After this meeting, I drove all the way home smiling about how much can be accomplished in a 75-minute team meeting when everyone comes to the table thinking about the student, willing to brainstorm, interested in collaborative problem-solving, thinking outside the box, and eager to share responsibility in supporting the student.

Certainly, there are many times when a school district or local collaborative already has a great program and peer group that will work for a student’s post-12th-grade needs, but, as a Transition Specialist, it is truly a lot of fun when everyone is ready to roll their sleeves up and pitch in to create a new tailored individualized education program that taps into the internal resources available to the student and school, while adding community supports and services as appropriate.

In thinking about what makes transition planning at IEP team meetings, such as Julie’s, notably successful, the following “ingredients” stand out:

  • The meeting focuses on the student, with the student’s vision presented at the start of the meeting (ideally by the student), and the team is in agreement about supporting that vision;
  • Team members come to the table eager to work with one another, willing to problem-solve, ask questions, listen to feedback and build on one another’s ideas;
  • There is good assessment data to inform the team process, whereby the team has a good sense of the student’s strengths, preferences and needs, and works together to prioritize what has to be addressed through the IEP; and
  • Team members come to the table knowing what resources exist inside and outside of the school program, with parents and educators having researched and reached out to invite new team members who may know about internal and external resources.

If you are interested in working with a transition specialist at NESCA for consultation, planning or evaluation, please complete our online intake form: https://nesca-newton.com/intake-form/.

About the Author:

Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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.

Jun 25
0

My (Second) Favorite Day of the Week

By | NESCA Notes 2018

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

It’s hard to beat Saturday, but Tuesday comes close!  Tuesdays at NESCA are all about learning, collaborating, and eating, three of my favorite activities.

We start the day with seminar over continental breakfast.  Professionals are invited to NESCA to share their work with us, mostly focused on intervention services for children with special needs so that NESCA clinicians continue to build and refine our knowledge of treatment options.  Meeting with service providers in person gives us the opportunity to more deeply understand their philosophy and approach, enhancing our ability to make effective recommendations for our clients.

Mid-day we are back together for case conference and international luncheon cuisine.  Clinicians present challenging cases to our whole group of about 15 professionals and we hash out complex diagnostic issues, debate interventions, and synthesize our best ideas into a treatment plan.  Witnessing a group of highly skilled clinicians, each contributing his/her own expertise to the cause of helping a child is truly a joy.  Research is clear that groups formulate better solutions than individuals.  I am grateful to be part of a group of such intelligent, thoughtful, and compassionate clinicians.  While the purpose of case conference is clinical care, it is also an incredible opportunity for learning and building the bonds among our staff.

People working together, learning together and helping kids: that’s the essence of my vision for NESCA when I set it up more than a decade ago.  And, since its inception, Tuesday has always been a special day at NESCA.

About the Author: 

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who hasbeen 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.

 

 

 

 

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.