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COVID-19

Changes in Transitioning from School-based Services to DDS Adult Services during COVID-19

By | NESCA Notes 2021

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

Transitioning from public education to adult human service supports is a complicated process that we have covered in several blogs over the years here at NESCA, including the two recent resources linked below:

As with many aspects of life, the existence of a global pandemic has complicated the transition process even more. In Massachusetts, Chapter 688 referrals (the referrals that help adult agencies to request the appropriate amount of funding from the state for supporting students with disabilities after they turn 22) were down by as much as 75% in September 2020. Additionally, referral processes that often were carried out in 2-4 months are taking much longer. In fact, at a team meeting I attended last week, a special education administrator shared that it had taken approximately 9 months to complete a recent referral to the Department of Developmental Services (DDS) for a student seeking adult autism services.

[For those unfamiliar with DDS, this is the agency that offers services and supports for individuals with intellectual and developmental disabilities including Autism Spectrum Disorder (ASD).]

To better support transitioning families, DDS recently developed an information sheet that highlights some of the potential changes and challenges families may experience when preparing for their transition to DDS adult service supports during COVID-19. In addition to modified referral timelines, the information sheet touches on changes in how families learn about day and residential programs (e.g., virtual tours) and the ways in which programs may have changed their approaches to service delivery as a result of COVID-19 (e.g., changes to community employment, remote and in-person offerings, visitor policies, etc.).

This DDS information sheet is helpful for professionals and families and is available in several languages on the state’s web site: https://www.mass.gov/lists/transition-considerations-during-covid-19.

 

For families who are struggling to navigate the transition from high school to adult service support, to understand available resources and benefits during or after public education, to create an effective plan for their child during a lapse in service delivery, or with any other transition planning issues, NESCA transition consultation and planning services are here to support you. Visit our transition services page and our transition FAQs or fill out an Intake Form to schedule an appointment with one of our expert transition specialists today.

 

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.

The Intention to Thrive

By | NESCA Notes 2021

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

As I reflect on the year that we have all come through, my overwhelming emotion (aside from exhaustion) is pride in the NESCA team for working together in an extraordinary manner under incredibly challenging circumstances. Just before closing the doors at NESCA in mid-March, I wrote to all staff:

NESCA is going to not only survive through this pandemic but we are going to thrive as an organization and show leadership in the special education community. The needs of our clients have not gone away; in fact, they are likely increasing.  School systems are scrambling to meet their obligations for students with special needs. We will continue to do the work we have always done, albeit in a somewhat modified fashion. 

Each of the NESCA staff—clinical and administrative—immediately rose to the occasion to help me realize this vision for navigating the pandemic. We increased the frequency our blog posts and introduced regular webinars, gearing them towards the needs of parents facing the challenges of the pandemic and increased our social media following from 4,000 to more than 40,000 by offering supportive and helpful content. NESCA clinicians offered multiple, free online support groups for parents and professionals related to topics they were now experiencing due to COVID-19. We acknowledged and addressed the unprecedented COVID-19-related concerns and challenges professionals and educators who support those with autism were experiencing through our free Autism Educator Hangouts.

After a great deal of research and discussion about how to conduct evaluations in a manner that ensured the safety of staff and clients while producing valid results, we settled on our “two office model,” renovating our space with plexiglass panes so that clients and clinicians would be able to work together in separate but adjoining offices. We collaborated with Massachusetts Advocates for Children (MAC), Massachusetts Department of Elementary and Secondary Education (DESE), The Federation for Children with Special Needs (FCSN) and the Massachusetts Urban Project, Inc., providing information about assessments and other services during the pandemic.

NESCA grew by adding new staff and service offerings this past year. We welcomed Dr. Moira Creedon to our pediatric neuropsychology staff. Tabitha Monahan, M.A., CRC, and Becki Lauzon, M.A., CRC, both joined NESCA’s Transition Services team. Julie Robinson, OT, joined NESCA in September with three occupational therapists to offer insurance-based, sensory-motor therapy. Abigael Gray, MS, CCC-SLP, also joined at that time to offer insurance-based speech/language and feeding therapy at NESCA. These staff have been incredibly innovative in their use of teletherapy to continue providing services to clients remotely.  And, they and their clients have experienced some surprising benefits stemming from the delivery of services via telehealth. 2020 also saw the introduction of NESCA’s ASD Diagnostic Clinic, helping families to diagnose children with Autism Spectrum Disorder as early as possible so they may gain access to critically important interventions.

Over the last decade, NESCA has had a strong commitment to international work, seeing clients for evaluation and consultation in the NESCA offices as well as abroad. With travel severely limited by the pandemic, we have instituted teletherapy for international work and are pleased to continue to assist  families abroad. NESCA was honored to be a Gold Sponsor for the annual SENIA conference (Special Education Network & Inclusion Association) that was held virtually. I was pleased to present about the differences between testing and assessment with professionals from schools all over Asia.

In the midst of the global pandemic, we continued to do the work that we have always done. We continued to support each other and became even more closely bonded as a team. We contributed to the community. No matter how challenging it has been, we are motivated by the knowledge that children with special needs and their parents need our support now more than ever.

 

About the Author: 

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

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

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

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists or therapists, complete NESCA’s online intake form

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

The Holiday Blues Coupled with Covid

By | NESCA Notes 2020

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

The holidays can be a time of great joy, but they can also be a time of great stress. Celebrations and merriment can be contrasted with pressure to amaze, long to-do lists, financial constraints or reminders of those we have lost. For many, it is a time of mixed emotions or strong internal conflict about why they cannot feel happy during a season that practically dictates it.

Holiday blues have been felt my many people for a long time, but now during a global pandemic, those feelings may be amplified and more prevalent than previous years. Families are trying to provide children with a positive holiday experience during a time of high stress and significant restriction. Family gatherings and holiday traditions are being cancelled, and many families are mourning the loss of loved ones. Adults are not the only ones feeling increased stress as we enter the holiday season. Children likely feel excited about the holiday but sad about not seeing family, not having holiday parties in school, and not being able to attend their traditional holiday events. This holiday season is simply different in ways that can bring great strain.

So, what can we do as adults to emotionally support children this holiday season? Do we allow them to observe our stress or do we keep it to ourselves in an effort to provide them with the happy holiday season that they deserve?

In June 2018, I wrote a blog post titled: “The Struggle is Not only Real, It is Necessary,” which discusses the importance of embracing uncomfortable, unwanted emotions as being necessary for personal growth and resiliency. By acknowledging, accepting and using unwanted feelings in a functional manner, we teach children to be competent and confident in their ability to navigate a stressful world. Of course, when I wrote the article, I could not have imagined the extent or duration of stress or discomfort that we would be facing in 2020. But does that change anything?

To put it simply, no, not really. Entering into the holidays with the expectation that we can protect our children from life’s stress is unrealistic. Attempting to do so will only add pressure while ignoring the mixed emotions that children are likely feeling as well. During this emotionally high-stakes time, acceptance of the struggles we face is even more critical. Adults and children both need “permission” to feel sad, frustrated, lonely or scared while also still allowing themselves to feel excited, thankful, and, yes, even joyful.

Here are some suggestions for how to help your family navigate the holiday blues this unique holiday season:

  • Talk about your feelings – wanted and unwanted ones – throughout the day, modeling and encouraging regular emotional discourse (e.g. “I love giving gifts, but getting all the shopping done is kind of stressful.”).
  • Help children label and interpret the emotions they may be having, as they may not have the right words or language for expressing them (e.g. “It sounds like you’re really disappointed we can’t go to Grandma’s house.”).
  • Be careful to not accidentally dismiss children’s feelings (e.g. “No need to be sad; we will find another fun way to celebrate.”), instead reflecting their emotion (e.g. “I know you’re sad that we can’t have a holiday party; I am, too.”).
  • Normalize the experience of mixed emotions (e.g. It’s okay to be excited for children while also feeling sad that we won’t see our family.).
  • Find new, safe holiday activities or events (e.g. holiday light drive, virtual gift exchange, etc.) and adapt previous traditions when able (e.g. virtual family gatherings).
  • Don’t romanticize the traditions that were lost this year (e.g. avoid such things as, “Our parties were always the most magical part of the holiday.”).
  • Help children understand new holiday plans as an opportunity to “celebrate” or “experience” the holiday, but be careful to not impose emotional expectations (e.g. “Enjoy the holidays!”) that can add pressure.
  • Reassure children that these changes are temporary, and traditions and visits will continue when it is safe to do so.

 

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.

Good Night, Sleep Tight: What if I Can’t Sleep Right?

By | NESCA Notes 2020

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

The American Psychological Association recently issued a press release about the impact of the COVID-19 pandemic on our dreaming. Not surprisingly, the information in four published articles indicates that people are having more anxious dreams now. This seems obvious given the emotional toll and high levels of stress as everyone juggles work, virtual school, health and safety, and family needs in a pandemic. We have an overflowing plate of stress on our hands with distant notions of when this stress will end. While these articles describe the anxious dreaming and sleep of adults, it’s not a stretch to consider that children and teens may have disrupted sleep right now. Their plates are overflowing, too, as they manage virtual and hybrid learning, confusing social demands, less movement and exercise than usual, and less contact with both adults and kids.

We cannot underestimate the importance of sleep to our system. Sleep is when our body restores itself, builds important immune functions and consolidates memories and learning. When children do not get enough sleep, we can see a whole host of problems, including issues with attention, concentration, learning, irritability, poor emotion regulation and risky behaviors in addition to the physical health outcomes.

What do we do to help our kids and teens get more and better sleep? It’s time to get sleep hygiene back on track. It’s possible to do even if the pandemic has caused the norm to drastically shift. Here are some tips for promoting sleep for children and teens:

Establish a consistent schedule. I cannot emphasize this one enough. Establish consistent times for settling down for bed and waking up that are the same every day of the week. Try to stick to this schedule whether your child is having an in-person learning day or remote, whether it is a weekend or weekday. This can be tricky with teenagers who tend to sleep in on weekend days. Try to stick within an hour, if possible, to get your body on a more consistent schedule. Avoid naps during the day if you can, even if there has been a rough night of sleep (or limit naps to less than 30 minutes). Daytime napping can interrupt night sleep patterns.

Develop a routine to settle for bed. Children and teens need to settle down for bed gradually. We can’t go from wide awake to peaceful slumber in a few moments. Limit screen time 30 minutes before bed as the light that is given off by televisions, phones or other devices confuses our systems and causes delays in releasing melatonin (the magic sleep hormone). Choose the same relaxing activity each night. Children and teens can read (or listen to a story read aloud by a parent), listen to an audiobook, color in special coloring book, listen to music or a podcast, or take a warm bath or shower. Include your child or teen in conversations about what relaxing activity to try before bed. Keep the same activity for several weeks before trying other ones. The brain does not want variety when you are trying to settle for bed, or it can become more alert in the face of a novel activity. The routine promotes relaxation.

Schedule talk time. Children and teens tend to think about their day as they are laying down. This can lead to “just one more thing” that kids have to tell us or one more question. They can also anticipate what is happening next, which can lead to an increase in anxiety. Schedule a “talk time” with your child or teen to discuss the day and think ahead to tomorrow. Do this at least 30 minutes before bedtime (ideally closer to dinnertime) to avoid a lengthy conversation that can activate anxiety. Use this time to validate feelings and model problem-solving about any issues coming up.

Provide comfort after dreams. We can expect that everyone may wake up at some point after an anxiety dream. If we can predict it, it can make it feel less overwhelming. Teach children and teens what to do when they wake up feeling anxious, including seeking the support of their parent for the very upsetting ones. Offer comfort and a tuck back into bed. Encourage your child to talk about how to resolve the frightening dream in a way that is silly, funny or triumphant to shift the focus away from what felt upsetting. Have a scary dream about a monster? Imagine him having to perform a ballet while balancing hot sauce on his head. Have an anxiety dream about a teacher yelling at you for forgetting your homework? Imagine turning it in and your teacher leading the rest of class in a celebratory song. You can also encourage children or teens to think of their favorite movie or book, and ask them to close their eyes and replay the movie or book to refocus the mind.

Practice breathing. To soothe our overactive anxiety systems, practice taking deep breaths. Imagine your breath filling up the back of your lungs and visualize the air going through your body. Practice circle breathing where air comes in one nostril and out the other (of course it comes in and goes out both!).  With younger kids, a little modeling helps. You can also encourage kids and teens to tense different parts of their body, hold for a count of 10, and then release to feel more relaxed.

Reach out for help. If your child or teen has persistent trouble with sleep, contact your pediatrician. It may be time for a more thorough evaluation to rule out sleep disorders, medical causes or behavioral patterns that signal a bigger sleep problem.

 

For more information, please check out these resources:

American Psychological Association (APA) press release related to dreaming:  https://www.apa.org/news/press/releases/2020/09/upsetting-dreams-covid-19

Fantastic APA resource on sleep: https://www.apa.org/monitor/2020/07/ce-corner-sleep

What To Do When You Dread Your Bed: A Kid’s Guide to Overcoming Problems with Sleep (2008) by Dawn Huebner, Ph.D.

 

About the Author: 

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

If you are interested in booking an evaluation with Dr. Creedon or another NESCA neuropsychologist, please fill out and submit our online intake form

 

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

Positive Coping Strategies for Stress, Anxiety and Trauma During Times of Crisis

By | NESCA Notes 2020

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Amidst the global pandemic, children, their caregivers, their teachers and therapists are naturally experiencing heightened stress and anxiety. We are more likely to be sent into “fight, flight, freeze, mode” – the body and brain’s critical survival strategy to prepare and deal with perceived threat. For example, when you see a Grizzly Bear on your hiking trail, you instinctually run, fight back or hide.

However, we can become “stuck” or more sensitive to this instinctual urge, which is not adaptive and can negatively impact physical, emotional and social health. For example, chronic deployment of the “flight, flight, freeze” response occurs for individuals who experience post-traumatic stress disorder. Chronic deployment of “fight, flight, freeze” responses is also more likely amidst a global pandemic, such as COVID-19. Importantly, chronic deployment of “fight, flight, freeze” responses also occurs for individuals and communities who experience chronic racial injustice and oppression.

Under chronic experiences of stress and threat, our body remains activated and hyper-aroused, even when deploying this response is not helpful. For example, children may shut down or dysregulate when faced with even small stressors – making an error on a math worksheet or even accidentally spilling something on the table. Children and teens may be more irritable, defiant or isolative. Overall, chronic deployment of the “fight, flight, freeze” response heightens anxiety, stress and general feelings of malaise.

So, what can we do? What can we do to “turn off” or lessen this stress response? What are some ways to positively cope during these difficult times?

  1. Research shows that the #1 resiliency factor is the reliable presence of at least one supportive relationship with an adult. Build connection and community through shared activities and conversations about your experiences. Remember to always take care of yourself before taking care of others – self-care is critical.
  2. Focus on validation first; problem-solving second. Validating, acknowledging and accepting pain, distress, hurt and the like builds communication and naturally decreases tension and stress. Validation is the essential first step prior to action, problem-solving and positive coping.
  3. In order to grow positive coping, it is helpful to build mastery and self-expression. Strategies that can help to both organize and “release” feelings and stressful experiences rather than “bottle them up” include:
  • Use your body to heal your mind: play, do yoga, engage with nature, exercise;
  • Engage in shared action to promote communication and change at a community and systemic level. Volunteer or advocate for a cause of importance. Contact your local legislators and express your concerns;
  • Write or draw about your experience. Use collages, images or videos to express your goals, experiences and fears;
  • Engage in therapeutic movement. Create a music playlist for various emotions. Dance or engage in rhythmic actions (e.g. knitting, pottery);
  • Identify your strengths and what you value in life. Happiness is fleeting – goals and values last longer and support positive coping. For a free strengths and values survey, check out: https://www.viacharacter.org/;
  • Connect with community resources available in your area, such as therapists, mentors, religious organizations, support groups, local-nonprofits, etc.; and
  • Be kind to yourself and practice self-compassion.

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant 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, 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.

 

Kids Want to Do Well and Would If They Could

By | NESCA Notes 2020

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist Fellow and Therapist

Ross Greene, Ph.D., is the author of several books including The Explosive Child, Lost at School, Lost and Found, and his most recent book, Raising Human Beings. He also is the founder of Lives in the Balance, a non-profit dedicated to supporting families with behaviorally challenging children. The foundation of his approach is that all kids want to do well and would if they could. Dr. Greene emphasizes using a collaborative problem-solving approach, which he calls Collaborative and Proactive Solutions (CPS). This model is based on the assertion that challenging behaviors arise when a child is faced with expectations that exceed their capacity to respond adaptively. Thus, adults are encouraged to take a collaborative, proactive approach to managing challenging behavior as opposed to relying on punishment and rewards.

The focus of collaborative problem-solving is not on the child’s challenging behavior, which could range from crying and whining, to hitting and biting, but rather on the expectations the child is having difficulty meeting. Adults work to identify the problematic expectations and the skills the child is lacking to meet the expectations. Dr. Greene refers to unmet expectations as “unsolved problems.” The goal is to solve those problems rather than modify behavior. Dr. Greene describes the CPS model as non-punitive and non-adversarial, and as such, it decreases the likelihood of conflict, enhances relationships and improves communication.

As a result of the pandemic, many parents and children are spending much more time together. For some parents of challenging children, their child’s behavior has been exacerbated by the increase in uncertainty and constantly changing expectations. There are many situations that arise that may lead to power struggles with children. It is important to remember that behavior is communication. Families are encouraged to reconsider their expectations and work collaboratively with their children to solve problems, especially when faced with extraordinary circumstances.

The specifics of collaborative problem-solving are much more detailed than there is space in this blog, and I encourage you to check out the resources listed below. While the consequences of the pandemic are certainly very stressful, they also present a good opportunity for families to enhance communication, uncover unsolved problems, teach skills and foster resilience.

 

Books for families by Dr. Greene:

The Explosive Child

Raising Human Beings

Website – contains educational videos and free resources for families and educators: https://www.livesinthebalance.org/about-cps

There are many YouTube videos available about CPS, but this one is pertinent to our current circumstances

 

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. Currently, Dr. Hess is a second-year post-doctoral fellow in pediatric neuropsychological assessment, working with NESCA Londonderry’s Dr. Angela Currie.

 

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.

 

Supporting Your Child’s Reading Development – Even During a Pandemic

By | NESCA Notes 2020

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

Aside from allowing children to access school instruction, the ability to read provides a child with the opportunity to read for pleasure. Reading for pleasure has been shown to support a child’s cognitive development, improve concentration, increase a child’s vocabulary, expand a child’s level of creativity and imagination, improve empathy and provide the child with a deeper understanding of the world around them.

Here are some ideas to support reading for children of all ages:

Pre-school Years:

  • Develop awareness of different sounds
    • For example, have your child look for things around the home that start with a certain letter sound.
    • Play rhyming games.
    • Sing songs.
  • Read the same book to them daily for several days
    • Point out and talk about different vocabulary words each time.
    • Repetition helps build vocabulary and comprehension.

Early School Years:

  • Practice rhyming
    • Say a word and have your child see how many real or made-up words they can say that rhyme with that word.
  • Practice reading
    • Have your child read a page of a “just right” book aloud. Be sure it’s a page they can read with fewer than two or three reading mistakes.
    • Have your student use their finger to ensure they stop and look at every word rather than guess or skip words.
    • Another goal may be to pause whenever they see a period, since many struggling readers miss punctuation.

For All School Grades/Ages:

  • Read books of interest aloud to your child that they may not yet be able to read independently. This will allow your child to enjoy more sophisticated stories and increase their exposure to complex syntax and new vocabulary.
  • Continue to introduce a wide range of books.
  • Let your child’s areas of interest(s) help determine the books you choose.
  • Provide your child with experiences that help increase their background knowledge before reading about a topic, as this will then help with reading comprehension.
  • Ask your child questions about what you’re reading as you go. For younger children, this may involve them retelling the story. Ask older students to identify the key points in the text.

Finally, here is a list of apps and websites that can provide activities and books for you to enjoy as a family.

 

If you suspect your child may have reading challenges, join Dr. Talamo for a webinar on how to spot those early signs on October 15, 2020, from 2:00-3:00 PM ET.

Register in advance for this webinar: https://nesca-newton.zoom.us/…/WN_4XOoaw4IS-e8xEkHt6ev_A

References

https://www.childrensmn.org/2020/05/13/help-kids-keep-reading-stay-home-order-distance-learning/

https://www.eschoolnews.com/2020/06/30/how-to-effectively-support-struggling-readers-during-distance-learning

https://hr.uw.edu/coronavirus/caring-for-self-and-family/child-care/at-home-learning-resources/

www.commonsensemedia.org/lists/reading-apps-games-and-websites

 

About the Author:

With NESCA since its inception in 2007, Dr. Talamo had previously practiced for many years as a child and adolescent clinical psychologist before completing postdoctoral re-training in pediatric neuropsychology at the Children’s Evaluation Center.

After receiving her undergraduate degree from Columbia University, Dr. Talamo earned her doctorate in clinical health psychology from Ferkauf Graduate School of Psychology and the Albert Einstein College of Medicine at Yeshiva University.

She has given a number of presentations, most recently on “How to Recognize a Struggling Reader,” “Supporting Students with Working Memory Limitations,” (with Bonnie Singer, Ph.D., CCC-SLP of Architects for Learning), and “Executive Function in Elementary and Middle School Students.”

Dr. Talamo specializes in working with children and adolescents with language-based learning disabilities including dyslexia, attentional disorders, and emotional issues. She is also interested in working with highly gifted children.

Her professional memberships include MAGE (Massachusetts Association for Gifted Education), IDA (International Dyslexia Association), MABIDA (the Massachusetts division of IDA) and MNS (the Massachusetts Neuropsychological Society).

She is the mother of one teenage girl.

 

To book a consultation with Dr. Talamo 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.

Adapting Academic Accommodations for Return to Learning

By | NESCA Notes 2020

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

As students with disabilities return to learning, the accommodations provided through their 504 Plan or Individualized Education Program (IEP) may no longer meet their needs within the structure and limitations of remote learning and/or return to school protocols. For example, when remote learning, teachers are not as readily available to provide “in the moment” redirection, check-ins for understanding or modifications to the presentation or length of assignments. When at school, many students are at the same desk all day, for academics, “specials,” snack and lunch, meaning teachers have to identify new ways to provide movement and sensory breaks while maintaining social distancing. For hybrid learners, teachers have to consider how to provide structure and predictability in the face of frequent transition and increased demands on independent work.

Within all return to learning plans, parents and school teams are having to be more creative than ever before, working to quickly and flexibly identify and implement new accommodations to address a range of new challenges. While this is new territory for all, there is fortunately an increasing number of online resources to aid this process, some of which are listed below. Foundational to the success of any COVID-era accommodations plan will be the team’s ability to regularly assess its feasibility and effectiveness, engage in open communication between home and school, and steadfastly and flexibly adapt the accommodation plan as individual needs and/or school instructional plans change.

See the following websites for information about how to implement accommodations during COVID-19:

In IEP Accommodations During Distance Learning, Amanda Morin of www.understood.org presents a list of many standard accommodations for presentation of information, assignment completion and daily management/organization, with ways to adapt each for remote instruction, giving specific consideration of available tools within Microsoft and Google suites.

Socially Distant Sensory and Movement Break Ideas by Katie McKenna, M.S., ORT/L, of The Autism Helper provides a range of creative solutions for meeting regulation needs for a wide range of students.

The State Educational Technology Directors Association (SETDA) eLearning Coalition website provides webinars and a host of information regarding the development and implementation of accessible educational materials during remote learning.

 

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.

Simple Executive Functioning Strategies When The World Is Anything But Simple

By | NESCA Notes 2020

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

Whether your children have returned to school full-time, on a hybrid model or fully virtual learning, we are all juggling. Juggling work demands, family demands, household demands and educational demands in a time of remarkable uncertainty. The start of the school year typically brings the smell of fresh school supplies and our best organizational efforts, but many of us may feel hesitant to use organizing strategies to manage our lives. Why? Because our lives are unpredictable and anything but typical these days. If you’re hesitating to use pen on a calendar, I hear you!

The ability to plan and employ organizational strategies is a key task of our executive functioning system. It’s what allows us to coordinate multiple schedules, dance and sports practices, projects at work, PTO bake sale reminders, and get out the door each day on time. I have been hesitant to adopt routines because I recall vividly how all those plans imploded in March when the world stood still. I hear the buzz about how school will end up fully remote so “put it all down in pencil before it all changes.”  Maybe that will prove true, but in the meantime, let’s consider the ways that we can rally our executive systems to do what they do best: plan, organize and regulate. Some suggestions for how to do this now while the world is unpredictable:

  1. Adopt the Sunday Game Plan. Put information in a family or personal calendar once a week. Spend a few moments on Sunday night catching up on plans for the coming week. Even if we end up transitioning from “hybrid” to “remote” (or all remote), this planning routine can still be adopted. Conclude your Sunday Game Plan by previewing what may be coming the week after in the event of long-term projects. While the content of your game plan may change, the structure can remain consistent.
  2. Keep a consistent schedule for sleep for the family. When we were all in school and work, we had set times to wake up in the morning. We should adopt more consistent bed times at least from Sunday through Thursday nights. Engage kids and teens in a conversation about the plan for sleep. If there are days when children are not waking up to physically attend school, try to keep wake up times no more than an hour off to allow for more consistency in our overall sleep regulation.
  3. As part of your weekly plan, set aside time for exercise. This is particularly important for children who will have reduced physical education activities. Research about the positive impact of exercise on mood, anxiety and attention underscores how important movement is in the day.
  4. Work together with your child to identify a consistent work space. Needing a work space at home is not suddenly and dramatically forced on all of us like it was in the spring. Take the time to arrange a space that is as distraction-free as you can make it. It’s not necessary to run out and buy things as minimal distractions can allow your child to focus on their school work. Keep the supplies nearby in their own bin, basket or box top.
  5. Help your child to create visual schedules or checklists for the day. Include times for virtual school, times for completing assignments and steps to submit the work either electronically or packed for the next day in school. Keep checklists consistent throughout the week when possible.
  6. Plan and schedule breaks. For young kids, try to plan breaks from tasks for every 15-20 minutes. Incorporate movement or stretching when possible to improve focus. For older students, try to plan breaks every 30 minutes of sustained effort. Try to take a full break from screens rather than replacing a tablet/computer screen with a phone or video game.

Children and teens develop their executive functioning skills over time. Keep this in mind as you set up routines and expectations for your whole family as what is expected for a second grader should and will differ from a seventh grader. Again, the content can differ but the structure of using a checklist, planning a break, or working at a desk or table is the same.

Please remember: the pandemic has depleted our executive functioning systems, so it’s important that we are gentle and kind to ourselves. Think about simple and reasonable systems to organize yourself and your family.  And be flexible when we have to go back to the drawing board.

 

Resources:

Positive impact of exercise:

https://www.sciencedirect.com/science/article/abs/pii/S0022347612009948

Executive Functioning tips and sample schedules:

https://www.smartbutscatteredkids.com/

 

About the Author: 

Dr. Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

If you are interested in booking an evaluation with Dr. Creedon or another NESCA neuropsychologist, please fill out and submit our online intake form

 

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

How Do I Prepare My Child for a Neuropsychological Evaluation?

By | NESCA Notes 2020

By: Erin Gibbons, Ph.D.
Pediatric Neuropsychologist, NESCA

Parents often ask us what they should tell their child about their upcoming neuropsychological evaluation, especially when it is their first experience with testing. I advise parents to refer to the neuropsychologist using his or her first name, as the term “doctor” can be scary and raise fears about medical exams. I might also add that the visit will not involve any shots! In order to describe the evaluation itself; here is some helpful language:

  • They are going to ask you questions, and you just need to do your best to answer.
  • They might ask you to do some drawing or writing.
  • Some activities might feel like you’re in school; for example, reading stories or doing math problems.

It may also be helpful to create a simple social story prior to the evaluation to help preview what to expect for your child.

To explain the reasons for doing the evaluation, some key phrases to use with your child include:

  • We want to understand how you learn, because everybody learns differently.
  • We are going to be “brain detectives” and figure out how your brain works!
  • This will help us identify your strengths and areas that we need to work on. That way, we can help you with things that are harder for you.
  • This will help your teachers understand your learning style so they can help you better at school.
  • Just try your best!

Testing in the age of Covid-19 is different. It can be harder to help children feel at ease when everyone is wearing masks, and we can’t offer a high five for good work. But as we are all learning, children are often more resilient than adults. Prior to coming in for an evaluation, you might want to remind your child to wear their mask, wash their hands and not approach people too closely.

It is also important to understand that a neuropsychological evaluation is a lot of work for your child! Finding a way to reward them for their effort will go a long way in helping them stay motivated and positive. This could be as simple as swinging by the drive-thru for a donut or something more extravagant, like a new video game. Whatever you choose to do, create a plan with your child and let the neuropsychologist know. When I have a child in my office who is starting to fatigue, it’s always a great motivator to remind them of the special prize they’ll get at the end of the visit!

 

About the Author: 

Erin Gibbons, Ph.D. is a pediatric neuropsychologist with expertise in neurodevelopmental and neuropsychological assessment of infants,

children, and adolescents presenting with developmental disabilities including autism spectrum disorders, Down syndrome, intellectual disabilities, learning disabilities, and attention deficit disorders. She has a particular interest in assessing students with complex medical histories and/or neurological impairments, including those who are cognitively delayed, nonverbal, or physically disabled. Dr. Gibbons joined NESCA in 2011 after completing a two-year post-doctoral fellowship in the Developmental Medicine Center at Boston Children’s Hospital. She particularly enjoys working with young children, especially those who are transitioning from Early Intervention into preschool. Having been trained in administration of the Autism Diagnostic Observation Schedule (ADOS), Dr. Gibbons has experience diagnosing autism spectrum disorders in children aged 12 months and above.

 

If you are interested in booking an evaluation with Dr. Gibbons or another NESCA neuropsychologist, please fill out and submit our online intake form

 

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