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complex profiles

4

What’s Up, Postdocs?

By | NESCA Notes 2019

NESCA currently enjoys having three pediatric neuropsychology fellows on its roster: Caroline Kleeman, Psy.M., Miriam Dreyer, Ph.D., and Zachary Cottrell, Psy.D, LMHC. NESCA’s postdoctoral positions are two-year engagements allowing clinicians who have completed or are finalizing their doctoral degrees to advance their training and acquire/hone their skills in preparation for their long-term careers.

We recently sat down with two of our fellows to learn more about their postdoctoral experiences now that they have almost reached the one-year mark in their time at NESCA.

By Jane Hauser
Director of Marketing & Outreach

Tell us about your postdoctoral experience at NESCA so far.

Both: As postdocs, we sit in on every phase of an evaluation – from the intake session to the administering and scoring of the tests, interpretation of the results, feedback session with parents, and writing of the report.

We are always working with a supervising clinician during evaluations, and we participate in a training seminar led by NESCA’s Director of Training Dr. Angela Currie. We get feedback from our supervising clinicians throughout every stage in the testing process.

Caroline: I was fortunate to have worked at NESCA as a practicum student in 2016-2017. It’s been great to be back here in a different role. I’ve had the chance to work closely with Dr. Alissa Talamo during my fellowship.

Miriam: I’ve been on board here at NESCA since September 2018, so almost a year now. I worked closely with Dr. Amity Kulis, and now I am working with Drs. Nancy Roosa and Stephanie Monaghan-Blout.

Based on your experiences at NESCA, have you identified a specialty you would like to focus on?

Caroline: Autism has been and remains my area of interest. I also really enjoy working with children with learning disabilities and collaborating with schools to get the right plans in place for the kids we work with. I’ve really enjoyed and benefited from attending school observations and sitting in on Team meetings.

Miriam: Before I went to graduate school, I was a teacher. My area of interest is the intersection of emotional and learning challenges, including executive functioning difficulties and attentional disorders.  In graduate school, my research and therapy training focused on trauma. So, my goal is to combine my clinical and educational experiences to support families in understanding how emotional experiences impact learning in children and adolescents.

 Why did you choose to do your postdoctoral work at NESCA?

Caroline: As I mentioned, this is my second time being a part of the NESCA team. I came back to NESCA for my postdoc work because I valued the collegial environment. I also felt I could benefit from the different clinical staff and their various areas of expertise. It’s such a great experience to work in a practice where someone always knows the answer to my most challenging questions. I really appreciate the model of teaching at NESCA. Because of the apprenticeship model, there’s so much in-the-moment teaching with our clinical supervisors that I benefit from.

Miriam: I was really Interested in the apprenticeship model of training at NESCA as well. It’s a unique arrangement in that postdocs are with a supervising clinician every step of the of the evaluation process. We receive a lot of mentoring here, which is very important to me. I also value the integrated nature of the reports NESCA produces, which portray the sometimes complex kids we see in a nuanced way. Again, this is very important to me in my continued learning.

Both: We get to work with different people here who do different things. It’s given us exposure to so many new areas of neuropsychology that we may not have seen elsewhere. There are a lot of experts here to learn from.

What makes NESCA different? What did you find most beneficial?

Miriam: The structure of NESCA’s training program and the emphasis on continued learning throughout the organization are both so valuable. We frequently have seminars where third-party speakers come in to educate our staff on new areas of psychology and treatments so we all stay current with the latest evidence-based approaches. We also have a weekly case conference where all of our clinicians gather to discuss complex cases and to share resources, knowledge, and experiences to benefit the case at hand. There is a heavy emphasis on learning within the practice, so I am constantly getting exposed to new ideas. I think that’s a valuable and unique asset of NESCA.

Caroline: I absolutely agree with the fact that we are really benefiting from the heavy emphasis on learning and the years of experience our clinicians have. Their willingness to share the knowledge they’ve gained with each other and us is a great benefit to our clients and to my own education. I have also learned so much from our clinicians who attend and bring back such good information from conferences as well as the conferences I’ve had the opportunity to attend.

What’s been your favorite and your most challenging experience so far at NESCA?

Miriam: Each case is unique, so I’ve had lots of exposure to new areas of neuropsychology. Every person who walks in the door presents new opportunities for learning. While this is one of my favorite aspects of NESCA, it is also challenging. With the unique caseloads we take on, there is a lot to learn about the different profiles. As fellows, we do not yet specialize in one area, so we are getting a broad education across domains of neuropsychology. For every new case, there are unique recommendations tailored to that individual that require research, which is an important part of our training.

Caroline: Seeing each child who comes to NESCA as a unique individual is probably my most rewarding and challenging part of being in this practice. Getting to work with some of the more complex profiles out there is exciting to me, but is obviously a challenge, too. There’s always a lot to be learned about each child, and that can take some time to do.

What advice can you share with others looking into this field or who are looking for the right place for their postdoc experience?

Miriam: It’s a great opportunity to be here. My advice is to visit NESCA for an interview, see what it’s like here and learn about the different specializations of the practice’s clinicians. In your search, look for a postdoc position where you get varied training and exposure to a lot of different cases, even if they aren’t in your specific area of interest.

Caroline: Neuropsychology is a very fulfilling career. Every day and every child are different, so it never gets boring. Of course, it can also be frustrating in that there are sometimes barriers to kids getting what they need, whether in school or with community resources not being available. In those moments, you have to be creative and problem-solve. That said, the rewards far outweigh the challenges.

 

About Pediatric Neuropsychologist Fellow Miriam Dreyer, Ph.D.:

Dr. Dreyer enjoys working with children, adolescents and families who come to her office with a wide range of questions about learning, social and emotional functioning. She is passionate about helping children and parents understand the different, often complex, factors that may be contributing to a presenting problem and providing recommendations that will help break impasses – whether they be academic, therapeutic, social or familial.

Dr. Dreyer joins NESCA after completing her Doctorate in Clinical Psychology at the City University of New York.  She most recently provided psychological assessments and comprehensive evaluations at the Cambridge Health Alliance/Harvard Medical School for children and families with a wide range of presenting problems including trauma, anxiety, psychosis, and depression.  During her training in New York, she conducted neuropsychological and psychological testing for children and adolescents presenting with a variety of learning disabilities, as well as attentional and executive functioning challenges.  Her research focused on developmental/complex trauma, as well as the etiology of ADHD.

Dr. Dreyer’s experience providing therapy to children, adolescents and adults in a variety of modalities (individual, group, psychodynamic, CBT) and for a wide range of presenting problems including complex trauma/PTSD, anxiety, depression, ADHD, and eating disorders informs her ability to provide a safe space for individuals to share their concerns, as well as to provide tailored recommendations regarding therapeutic needs.

Before becoming a psychologist, Dr. Dreyer taught elementary and middle school students for nine years in Brooklyn, NY.  She also had an individual tutoring practice and specialized in working with children with executive functioning challenges, as well as providing support in writing, reading and math.  Her experience in education informs both her understanding of learning challenges, as well as her capacity to make specific and well-informed recommendations.

She received her Masters in Early Childhood Education from Bank Street College, and her B.A. in International Studies from the University of Chicago.

About Pediatric Neuropsychologist Fellow Caroline Kleeman, Psy.M.:

Caroline Kleeman comes to NESCA with experience providing evaluations for children with a range of neurodevelopmental profiles.  She has focused on assessing children with autism spectrum disorder, including those presentations accompanied by cognitive delays, language impairments, or genetic disorders.  She also enjoys evaluating children with academic difficulties stemming from learning disorders or attention/executive function disorders.

Ms. Kleeman’s approach to testing recognizes that children are so much more than a list of scores.  Combining her own careful observations with input provided by parents and teachers, Ms. Kleeman strives to differentiate between skill deficits or performance deficits, while also identifying unique strengths.  Additionally, drawing on her applied behavior analysis (ABA) background, Ms. Kleeman looks beyond the individual to identify helping and hindering features of the surrounding environment.  The result is meaningful, highly individualized educational and therapeutic recommendations.

Ms. Kleeman received her Sc.B. with honors from Brown University, where she studied cognitive science.  Focusing on early childhood, she conducted research on the role of sleep (especially naps!) in cognitive development.  After college, Ms. Kleeman worked as a therapist at Nashoba Learning Group, using the tenets of ABA to provide instruction across educational, vocational, behavioral, and adaptive domains.

Bridging between psychology and education, Ms. Kleeman is finalizing her doctorate in school psychology at Rutgers University Graduate School of Applied and Professional Psychology.  Her dissertation is investigating the role that Sesame Street’s autistic muppet, Julia, could play in early childhood social and emotional learning (SEL) programs.  She completed her pre-doctoral internship at the Center for Children with Special Needs in Connecticut, where, in addition to psychoeducational evaluations, she provided ABA therapy and ABA-based reading intervention for children across the autism spectrum.

 

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 one of our expert neuropsychologists, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

3

Got Complicated? NESCA’s Newest Pediatric Neuropsychologist Wants to Test Your Child. Find Out Why!

By | NESCA Notes 2019

Pediatric Neuropsychologist Yvonne Asher, Ph.D., joins NESCA on June 3, servicing clients in the Londonderry, New Hampshire and Newton, Massachusetts offices, and is scheduling new clients now. We sat down with Yvonne to learn more about her, what her passions in neuropsychology are and why she joined NESCA.

 

By Jane Hauser
Director of Marketing & Outreach

NESCA has 15 neuropsychologists who test a wide range of individuals. Tell us about your past professional experience and the types of clients you most enjoy serving.

I love working with children with complex profiles where challenges and diagnoses aren’t easily made or identified. This is the group of kids I worked with most often when I was with Mass General Hospital’s Lurie Center for Autism. It’s also incredibly rewarding to work with kids who aren’t able to communicate in a traditional manner—they may be too young, too impaired or potentially non-verbal. Many people think these individuals are too difficult to work with in testing. Using data to better understand their strengths and weaknesses is my passion, and I love to help them tell their stories through the assessment process.

It sounds like you enjoy working with complex kids. Can kids who have limited verbal skills and/or behavior challenges be tested?

Yes! Sometimes these children can be labeled in a punitive or negative way, such as being “uncooperative” or “untestable.” I don’t believe that anyone benefits from these kind of labels. It’s my job as the psychologist to be creative so that we can get the necessary data to understand them. I try to ease parents’ minds by reassuring them that I’ve seen many of these children before. And, if I haven’t frequently seen a particular complex profile, I’m lucky to have wonderful colleagues and resources to collaborate with on such cases.

For example, I worked with one very sweet, four-year-old child who had severe communication issues.  The parents and his pediatrician questioned whether he had autism. Since he had incredibly limited verbal skills, we altered all of the assessment tasks, using some non-verbal assessments and creatively modifying others to complete the testing. We noted that everything in the assessments—aside from his language—was on track developmentally. Prior to testing, everyone was pointing toward autism as the diagnosis, but he actually had a severe expressive/receptive language delay. His parents had figured out some tricks to communicate with him, but the world was a very scary place to him. He didn’t understand what was going on and primarily used gestures and facial expressions to communicate. That, unfortunately, only got him so far. As you can imagine, these challenges and frustrations led to a very stressful environment for the entire family. We recommended intensive speech therapy to help develop his communication skills, providing the family with a clear path forward.

You were a teacher before becoming a neuropsychologist. How do you feel your past experience as an educator enhances your work as a pediatric neuropsychologist?

I have a lot of experience working in public and charter schools. I was also a preschool teacher before graduate school, where I found the children to be endlessly funny, creative and just awesome! This experience is, in part, what fuels my desire to work with younger children who are experiencing challenges.

Having that educational experience is so valuable for the families at NESCA. I’ve been in special education and can help parents understand the process and landscape every step of the way—from an initial concern and assessment to getting an IEP and to thinking about high school placement and transition to adulthood.

The school experience also helps me to relate to the teachers, since I’ve been one and know how to partner with them to help students. We always help our families and push for what’s needed, but it’s helpful to also understand the constraints of the school setting. Knowing the constraints won’t change our recommendations, but it’s helpful in providing recommendations that will be implemented.

Why did you opt to move from the school setting to neuropsychology?

While I loved working in the school setting, I found that I didn’t get the chance to work as closely with families as I wanted. While families were there for school meetings, I’m looking to work with and serve the whole family system. I enjoy taking a close look at why children are having particular challenges, whether there’s a diagnosis that can be identified, and determining what school or path best fits a child and their family. I like taking the time to talk with parents and educators, giving each of them the chance to talk about the child, and to ask questions and make a plan for the child and their family. With really young kids, this is often just a first step, and I am excited to work with families long-term and help them through future hurdles.

What is so special about working with young children and their families?

Being a family’s first introduction to mental health is so meaningful. I tend to work with families who may be noticing that some milestones or behaviors are a bit off, or when they may first be considering a neuropsychological evaluation or other assessments. I like to find those parents who are asking, “What do you think it could be?” I truly enjoy giving these parents insight into their child, and providing exposure to and help along their path in mental healthcare.

Why did you opt to work in a group practice, like NESCA?

During my postdoctoral work, I really came to value the consultation with and supervision from other psychologists. I thought about going back into the school setting, but school psychologists are typically the only ones in that role at their school, or even their district. I appreciate the ability to put heads and knowledge together as colleagues. Doing so, on behalf of our clients, can help us to frame a case or intervention in a different way. Being able to bounce ideas or recommendations off of each other and using the combined experiences, knowledge and referral resources of other neuropsychologists brings so much to clients, families and individuals with challenges. NESCA, in particular, offers a very supportive environment in which to work. That can be felt by co-workers as well as the families we serve.

 

About Pediatric Neuropsychologist Dr. Yvonne Asher:

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.

 

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. Yvonne Asher, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.