Tag

Diagnosis

Sep 25
9

Going South: NESCA Announces New Hingham, MA Location

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is excited to announce that it is opening a Hingham location to serve clients on the South Shore of Massachusetts. NESCA is currently booking appointments now for Neuropsychological and Psychological Evaluation Services commencing on November 1, 2023. Learn more about what is being offered by our Hingham-based staff from my interview with Hingham Director; Pediatric Neuropsychologist Moira Creedon, Ph.D.

What prompted NESCA’s expansion to the South Shore or Massachusetts, and how can clients benefit from our Hingham location’s services?
NESCA is expanding our in-person services to Hingham on the South Shore to widen the breadth of neuropsychological and educational evaluation and consulting services offered within the state. We know that families have options as they partner with neuropsychologists, and we want to be in close proximity to communities we hope to serve. This is an exciting opportunity to support students in elementary, middle, and high school as well as young adults, as they navigate the complexities of their daily lives. It is our priority to continue providing detailed, client-centered, thorough evaluations that highlight a client’s areas of strength and vulnerability. I am also excited to strengthen relationships with local care providers and schools, and to build new relationships as a new clinician within the South Shore community.

What services do you offer?
At this time, NESCA’s South Shore-based practice will offer Neuropsychological Evaluations and Projective Assessments. The goal of these services is to build a complete picture of a client’s functioning, including their intellectual, academic, and social-emotional profile. Team members are also available to participate in team meetings at school (IEP meetings), conduct school observations, and offer consultation to parents and team members. Sometimes, a child has already participated in evaluations in other settings (schools, hospitals), and a family needs help to review these documents and make meaning of the findings.

What types of clients will NESCA serve in its South Shore location?
NESCA’s South Shore-based practice is similar to our other locations and will serve children, teens, and young adults with a range of presenting issues. The focus is in working with students in elementary, middle, and high school as well as young adults. I can see clients with diagnostic questions, including Autism Spectrum Disorder (ASD), Learning Disorders (e.g., dyslexia, dysgraphia), Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety, depression, and complex psychiatric diagnoses.

A specialty we have at NESCA – including in Hingham – is working with clients who have multiple diagnoses or who don’t fit neatly into a singular diagnostic box. I also see clients who are high functioning and curious about their learning style, how to improve their study skills, and how to plan for their academic future based on their unique profile.

Where are you on the South Shore? Are services in-person or remote?
We are practicing in person in an office at 99 Derby Street, Suite 200, in Hingham, MA. Hingham is uniquely positioned to serve the South Shore/Southcoast, and the Cape and Islands. For those traveling for appointments, most clients schedule testing in two longer (2.5 hour) blocks of time so the commute is reduced for families. I am also available to participate in IEP team meetings and conduct student observations in person on the South Shore, which is an exciting way to collaborate and build strong relationships with families, schools, and organizations.

What is different about what NESCA offers on the South Shore compared to other organizations or services available locally?
NESCA is highly respected in the community for providing detailed, comprehensive evaluations of students that speak to their strengths as well as their needs. Compared to some practices, your child or teen will be assessed directly by a neuropsychologist rather than a technician. You can depend on your neuropsychologist to bring their own expertise as well as the “village” of NESCA, as I am always collaborating with NESCA’s team of innovative neuropsychologists, transition specialists, educational consultants, speech and language pathologists, occupational therapists, and therapists. We work routinely with special education attorneys, advocates, therapists, and school personnel in collaborative relationships to support children and teens. At NESCA, we live our core values everyday: being creative problem solvers, being collaborative and building lasting relationships, and caring deeply for students, their families, and the community.

Does insurance cover your services in Hingham?
Several NESCA providers take both Blue Cross Blue Shield and private pay for services. I am paneled with BCBS. Some families are able to obtain some coverage or reimbursement through other insurance agencies, and we can provide those families with brief billing information to submit to their insurance company. We can never guarantee insurance reimbursement, so it is important that families check with their insurance plan regarding covered services.

What if I am unsure if I should refer my child or client for an evaluation?
Give us a call! Our administrative team is happy to support you in navigating this process. We are also planning some community events to provide information to our community about a variety of topics, including who we are and how to recognize signs that a child or teen may need additional support. There is also a ton of information on our website.

How do people get more information about NESCA’s South Shore services?
You can fill out our online intake form, call 617-658-9800 to speak with an intake coordinator, or reach Hingham-based Pediatric Neuropsychologist Dr. Moira Creedon directly at mcreedon@nesca-newton.com.

 

About the Author

Hingham Director; Pediatric Neuropsychologist Dr. Moira 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. 

 

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

Dec 26
9

What Is Projective Testing and Why Might My Child Need It?

By | NESCA Notes 2022

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

There can be a great deal of confusion about what kind of testing you want for your child. No wonder when we have so many options – neuropsychological testing, psychoeducational testing, speech and language testing, occupational therapy testing, personality testing, and psychological testing. The part that can be incredibly challenging is that these labels often involve overlapping test measures, meaning that the assessor may choose the same specific tasks that might fall into most or all of these categories. Take cognitive assessment using IQ tests which can be used by a psychologist conducting psychological, neuropsychological, or psychoeducational testing. Another layer of confusion is added for parents when one considers that many professionals in schools or medical practices are also confused and interchangeably use these labels. In an effort to demystify the process, I want to tackle a common question: what is projective testing and why might my child need it?

Projective testing provides psychologists with very specific and unique insight about a person’s thinking habits and processing. Unlike cognitive or academic tests, projective tests do not have a “right answer.” So, projective testing is not going to ask a child to solve a math problem or define a word. It is not going to test how quickly they can name vegetables or see how skilled they are at shifting between sets of the rules. The overall goal of projective testing is to figure out how a child, teen, or adult responds to an ambiguous situation. This means, we ask people to project their brain habits (thinking style, way of interpreting the world, way of processing emotions, way of viewing self and others) onto a situation when it is not clear that there is a “right” or “wrong” answer. A person must use their problem-solving and emotion regulation skills in action. Examples of projective tests include the Rorschach inkblot test, story-telling tasks (e.g., the Thematic Apperception Test or the Roberts Apperception Test), drawings, and incomplete sentences. Projective tests take additional time to administer and usually longer to score, so they are scheduled as separate visits at NESCA.

Why might you use a projective test? There are some situations where projective testing is incredibly useful, such as when a diagnosis of a thought disorder (e.g., psychosis) is in question. It is also very useful for questions of trauma, attachment, anxiety, or mood disorder. Projective testing is also incredibly useful when psychiatric symptoms are confusing. Take the example of someone who is a perfectionistic or very guarded about their symptoms. A person with this profile is very likely to read a question that says, “I am very anxious,” and answer no. However, projective testing can see if there are themes of anxiety by considering how a person responds to an ambiguous situation. Take another example of someone who leans in the other direction and reports many symptoms that overlap with many diagnoses. In this case, many symptoms are endorsed as “yes.” Projective testing can help to provide clarity to narrow down the list, especially without an obvious answer. In both of these cases, it is helpful to access a person’s unconscious brain habits as a key to understanding a person’s functioning.

When would you not use projective testing? I do not use projective testing when my referral question does not need it. For example, a question of a learning disability or ADHD does not require projective testing. Using projective measures would be inappropriate, time consuming, and potentially stressful for a person when it is not needed. Similarly, projective testing is not often used in individuals with Autism Spectrum Disorder as there is little research about how neurodivergent populations respond to the ambiguous stimuli. I also do not use projective testing if neuropsychological testing suggests that a person has an intellectual disability or struggles in their visual processing skills (e.g., NVLD) since many of the projective measures (e.g., Rorschach, story-telling, drawings) use a visual stimulus card. In those cases, it would be inappropriate to assume that a response reflects a person’s emotional processing when it would really be about their visual processing.

Projective testing is incredibly informative and, like other neuropsychological tools, should only be utilized by professionals who are trained to administer and interpret these tests. Since it is not as simple as a correct single answer on an answer key, it is critical that these procedures are administered by psychologists with the advanced training to use and interpret the information. And, like all of our measures, the results gathered using projective measures are data points that are combined with other data points. The performance on one test or demand does not dictate the entire conclusion. A strong and comprehensive assessment will use projective test data as part of a larger understanding of your child. Information gathered in projective testing can highlight important strengths for your child and contribute helpful information to drive treatment.

NESCA has several clinicians who are highly trained and skilled at administering projective testing. If you have questions about projective testing and whether your child needs it, let us know by filling out our online Intake Form.

 

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.

Aug 08
1

Why Delay a Diagnosis?

By | NESCA Notes 2022

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

As part of NESCA’s ongoing blog series addressing some of the most frequently asked questions about neuropsychological testing, today we are addressing why neuropsychologists may choose to delay a diagnosis.

At NESCA, I often supervise neuropsychology trainees, and one of the first questions I asked them is: “What is the goal of a neuropsychological evaluation?” I often hear answers, such as “to identify strengths and weaknesses” or “to determine appropriate diagnosis.” These answers are not wrong, per se – they are what we are taught in graduate school. However, I often explain that while these may be part of our goal, the primary goal is to tell a client’s story and help them understand a path for moving forward. While this may sound a bit aspirational, it is the approach that best appreciates developmental, systemic, and individual factors that may come into play. As addressed by Dr. Moira Creedon in the first blog within this series, this is also one of the reasons why neuropsychologists want to review all prior evaluations and documentation, as this helps to elucidate the developmental timeline.

When a neuropsychologist is approaching an evaluation through the above developmental lens, it is not always possible to land on a specific diagnosis. This may sometimes be referenced as a “deferred diagnosis” or “differential diagnosis,” meaning there is evidence to possibly support the diagnosis, but not enough evidence at this time to decide for certain. Another term that may be used is “provisional diagnosis.” This indicates that there is enough evidence to support the diagnosis at this time, and there is clinical utility to diagnosing (e.g., informs intervention, qualifies for services, etc.); however, more information or monitoring may be needed to be completely confident, so future reassessment is warranted.

There are several reasons why a diagnosis may be deferred or deemed provisional. First, children are constantly developing, and sometimes the challenges they are demonstrating may be developmental in nature. This may be particularly so when evaluating young children. For example, if a young child has significant language delays, it may be difficult to assess whether they are also on the autism spectrum or have early signs of a learning disability, as their observed weaknesses in these areas may be accounted for by their language. Often times these are children who may “catch up” in skills once provided intervention, meaning their difficulties were related to delayed acquisition, rather than an being an issue of innate impairment.

Similarly, another reason diagnosis may be deferred is if a child’s self-regulation challenges interfere with their ability to engage in typical daily demands. For example, for a child who has significant anxiety or behavioral dysregulation that interferes with their ability to engage in school, it may be difficult to determine if academic delays are related to a learning disability or are a secondary consequence to their dysregulation. While provision of targeted instruction may still be necessary in order to help the child regulate and close gaps in skills, a full understanding of their innate learning profile may not be possible until such supports are in place.

Deferred diagnosis is quite common when more significant psychiatric diagnoses are in question, such as whether a child or adolescent is presenting with a mood or thought disorder, such as bipolar or emerging psychosis. There are many other conditions that may “look like” these disorders, including trauma or co-occurring anxiety and ADHD. When diagnosing more significant, often life-course disorders, it is important to ensure that all other potential explanations are identified and addressed. This is important for informing the appropriate treatments while also allowing the evaluator to outline some of the “red flags” that should be monitored by the client, their parents, and their care team over time.

Another reason why a diagnosis may be deferred is that there may be systemic factors at play. In other words, there may be things going on within the child’s home, peer setting, school, or other surroundings that interfere with the evaluator’s ability to understand the child in isolation. This is a particular issue when evaluating a client with a trauma history. Developmental trauma can often “mimic” other symptom profiles, and so it may be important to first address issues within the system before providing a diagnosis for the individual.

There are other less common situations in which diagnosis may be deferred, but they warrant mention. One is when the neuropsychologist is concerned about possible malingering, which is when certain symptoms are being falsified or exaggerated for personal gain (e.g., a child with learning disability exaggerating mood symptoms to avoid school). Another less common situation is when prescribed medication or recreational drugs may be inadvertently causing the symptoms of concern (e.g., depression occurring as a side effect).

A final reason why a diagnosis may be deferred is simply that things can sometimes be messy. We often evaluate children and teens who have several presenting concerns, and sometimes it takes time to peel away the layers of the onion. In any of the above scenarios, we start with “what we know” and then describe “what is possible.” Regardless of whether or not a diagnosis is certain, as neuropsychologists, we are still able to tell the client’s story, describing how they “got here” and how to move forward. This developmentally-sensitive approach allows us to make recommendations based on their need, not just their diagnostic label. We are then able to assess how their profile and symptoms change as they access intervention. It is for this reason that we enjoy the opportunity to develop long-term relationships with our clients, helping to monitor growth over time. Children do not develop in one finite time point, and the neuropsychological evaluation process sometimes has to be patient and continue to develop alongside them.

 

About the Author

Dr. Angela Currie is a pediatric neuropsychologist at NESCA. She conducts neuropsychological and psychological evaluations out of our Londonderry, NH office. She specializes in the evaluation of anxious children and teens, working to tease apart the various factors lending to their stress, such as underlying learning, attentional, or emotional challenges. She particularly enjoys working with the seemingly “unmotivated” child, as well as children who have “flown under the radar” for years due to their desire to succeed.

 

To book an evaluation with Dr. Currie or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician in the referral line.

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Londonderry, NH, Plainville, MA, and Newton, MA serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call (603) 818-8526.

Aug 01
9

Are We Working With a Full Deck of Cards? Why Neuropsychologists Want Results from Previous Evaluations

By | NESCA Notes 2022

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

Neuropsychological testing is a tremendous undertaking in time and effort for a family. It involves intake documents, questionnaires, financial paperwork, insurance information, teacher forms, and the list goes on. I promise this paperwork is meaningful and helpful, a way to get the most out of the time and investment in a neuropsychological evaluation. Over the next few weeks, several of NESCA’s neuropsychologists will tackle a few common questions that we face that will help you prepare for neuropsychological testing.

The first topic to tackle relates to the need for previous records. It can feel time consuming to track down documents from years ago, particularly if your child has grown and changed over time. There are many reasons why it is critical to provide these records so your provider has the full deck of cards as they build an individualized evaluation for your child. I’ll tackle the three most important reasons to me:

First, pediatric neuropsychologists want to understand the development of your child over time. For example, if we are evaluating learning problems, I want to know what it was like in kindergarten and early elementary school when your child learned to read. I want to know when the attention problems started or problems interacting with peers were first noticeable to those around them. As we build a developmental timeline, it can help to conceptualize where it all began to help us get at the magical “root cause” that parents often seek. Understanding development over time also helps us to build a better treatment plan. For example, if I can see that a child struggled to develop early reading skills and then years later is extremely anxious about attending school, it helps guide recommendations in both domains.

Secondly, records are critical so we do not risk “practice effects.” “Practice effects” refer to the improvement in scores that happens simply from being exposed to the task before. While guidelines are not as set in stone as some may think, it is generally advised not to repeat many neuropsychological measures within a year of testing. There may be reasons to speed up this timeline that are client-specific, but we cannot make that determination unless we see the documents. Research says practice effects diminish over a few months to a year. We want to eliminate any interfering factors that would make it harder to draw conclusions about the data in the current evaluation. With the time and investment you make in testing as a parent, I can only imagine how frustrating it would feel to hear that something we can manage interfered with the process. Access to records helps us to choose the right measures for the right moment.

Thirdly, providing previous records also allows us to track skill development over time. This is particularly important if we want to see if an intervention (e.g., reading instruction, therapy, attending social skill groups) is working to build the skills. Put simply, it tells us if a problem is getting better or getting worse. Even if you do not agree with the final conclusions drawn by the previous professional, the scores still provide critical data points in development. For more information on seeking a second opinion when you disagree with results, sit tight – that blog post is coming!

I often use the metaphor with kids and families that neuropsychological testing can help us to develop a type of “instructional manual” for how their brain works. With younger kids, I tell them that I am writing the LEGO instructional manual for which steps to take in what order and with what pieces. Without the prior records, I’m missing a bag of pieces. That is almost as frustrating as stepping on the actual LEGOs!

Please come back over the next several weeks to hear more from my colleagues about how to make the most of your child’s neuropsychological evaluation!

 

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.

Mar 21
2

Managing Stress while Navigating the Initial IEP Referral Process

By | NESCA Notes 2022

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

The special education process is naturally stressful, particularly when submitting a first request for eligibility. It is difficult to watch your child struggle in school, and while the IEP process may bring hope for things improving, there are complex procedures and timelines, as well as feelings of anxiety and uncertainty, that must first be navigated. Luckily, there are some things that families can do to help manage the stress that comes with the IEP eligibility process:

  • Acknowledge from the onset that the process will be stressful and that stress is okay. Stress is telling you that something is important and requires your attention. Try to accept stress as part of the process and use that to help prepare yourself.
  • Build a team. Allow yourself to just be the caregiver, and find professionals who can take on other duties. This may include hiring an educational advocate or attorney who can help you understand special education laws as well as advocate for your child’s needs at meetings. This may also include seeking a private evaluation to obtain an expert opinion on your child’s needs and inviting this individual to participate in the meeting. The goal is to divide responsibilities, focus on your child, and speak to your concerns as the caregiver.
  • If you had an evaluation and are working through a new diagnosis, take in information at a pace that you can handle. Ask your evaluator for clarifying information when needed, and try to reduce your Googling and online research. Do not get yourself stuck in a rabbit hole of online information that may or may not pertain to your child. If you feel uncertain about things, use your team and ask questions.
  • Maintain effective communication with your IEP team. Know your goal for each meeting and plan your input ahead of time. Be concise but include observations or history to support your point, and state your specific goals for each meeting.
  • Manage your expectations. Concerns and requests may not be entirely resolved within one meeting, and there may be many steps you have to go through before a plan is in place.
  • For children who “fly under the radar” at school, take some basic notes of what you observe at home, such as difficulty with homework, “meltdowns” after school, etc., which you can share with the team. That said, only take these notes for a manageable time frame (e.g., two weeks), allowing you to maintain your sanity.
  • Lastly, engage in self-care. While this may sound cliché, it is indeed important to take time to yourself and do activities that bring you some peace and enjoyment while navigating through these stressful procedures.

 

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.

Jul 12
10

Rating Scales/Questionnaires – Why Do We Give Them and Why Do They Matter?

By | NESCA Notes 2021

By Yvonne M. Asher, Ph.D. 
Pediatric Neuropsychologist

When you request a neuropsychological evaluation, you are undoubtably inundated with paperwork. Consent forms, confidentiality forms, COVID forms, and credit card forms. Then, to your surprise, you bring your child to their first appointment, and the neuropsychologist hands you…more forms! Why? What are these forms for, and what will you do with the information? These are great questions, and always feel free to ask your neuropsychologist. Here are some answers I give when I am asked:

Why do you need so many forms?

Our goal in completing a neuropsychological evaluation is to have as comprehensive picture of a child as possible. This means gathering information from many sources, including what you and/or others are noticing that is raising concerns (what we discuss in the intake appointment), prior evaluations and documentation (e.g., their IEP, testing done at school), your child’s performance on our assessment measures (what they do when they come to the office), and important people’s perceptions of your child’s functioning in daily settings – this is what we assess through the rating scales (also called questionnaires). The parent/teacher rating scales are an important source of information because they not only capture your concerns, but also show us how your concerns may be similar to or different from parents (or teachers) of same-age children. For example, concerns with “attention and focus” are common for us to hear. Attentional skills develop gradually over time, and having a standardized rating scale that evaluates your concerns (or your child’s teacher’s concerns) with attention helps us understand how far off your child’s skills are from what is expected for their age.

What do the forms ask about?

This depends on why your child is being referred for a neuropsychological evaluation. For example, if your child is referred for a question around autism, you will likely be given forms that ask about their social functioning, such as how they do at playdates, birthday parties, the playground, or other community spaces with peers. Your child’s teacher would also likely be given forms to evaluate how your child interacts with peers at school, such as how they do during lunch, snack, and recess; how well they work in groups; and if they have been successful in forming strong friendships. If the concerns are more related to mental health, you may be given forms that ask about their symptoms of anxiety, depression, etc.

What will you do with the forms?

We will take your ratings (or your child’s teacher’s ratings) and compare them to normative data. This is a fancy way of saying “we will see how your child compares to kids their age.” Then, we will take that information to help us form a more comprehensive picture of your child’s profile and our recommendations for how to best help and support them. For example, something I see often is a concern with kids following directions, remembering what they are told to do, and finishing all the steps necessary for a task or project (e.g., getting ready for school or bed). This can be (though certainly isn’t always) a difficulty with working memory or, holding information in mind. We assess working memory in many ways during testing. However, we can’t always see the deficits that parents and teachers see, because testing is inherently different from “real life.” So, rating scales serve as an important source of information in understanding what is going on day-to-day, which helps us to make more comprehensive recommendations.

How do I fill these out?

Please, please, please – read the directions carefully! Each form is meant to evaluate something different. For example, some ask you about your child’s emotional state “in general,” others ask about how they have been behaving over the last two weeks, and others ask about how well they can complete tasks independently (i.e., without any help or guidance). Do your best to complete each question – skipping questions that seem “irrelevant” or “inappropriate” may impact how well we can use the information later on. We realize that not every question will apply to every child – we are using the best tools we have, and some are designed to assess a wide range of children. If you have questions about the wording or phrasing, please ask your neuropsychologist – we really don’t mind!

I have a teenager. Why don’t you just ask them about how they are feeling?

If your child is old enough, we will absolutely talk to them about their perceptions of what is going on, what their concerns are, and what has been helpful for them. Many rating scales have a “child” or “self-report” version, and we may have them complete those, in addition to talking more conversationally about how they are doing.

 

About the Author

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

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

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

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

 

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.

 

Nov 30
2

Early Detection of Autism: NESCA’s New ASD Diagnostic Clinic

By | NESCA Notes 2020

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

Children with autism spectrum disorder (ASD) vary widely in terms of the intensity of their symptoms as well as the age at which symptoms emerge. In some cases, signs of autism are apparent during infancy. For other children, concerns about autism might not arise until toddlerhood or even early childhood.

As neuropsychologists, we have become increasingly adept at detecting and diagnosing ASD using a combination of developmental history, clinical observation and standardized assessments. We are constantly learning more about ASD and fine-tuning the tools we have available to us to make a diagnosis.

One of the most important things we have learned through longitudinal research over the past 10 years is that early detection of ASD is a crucial part of a child’s prognosis. Young children who receive intensive services are much more likely to develop language, play and social skills. Because their brains are still in a state of rapid development, they are much quicker to acquire new skills and make progress in the areas where they are struggling. Children who receive early intervention for ASD are typically better able to participate in inclusion settings with same-age peers once they enter elementary school.

Unfortunately, many parents are told to “wait and see” when they express concerns about their child’s development – especially with children who are not yet in preschool. This is a risky and sometimes harmful approach as it leads to children with developmental disabilities not receiving the services they need.

In light of our understanding about the importance of early detection of ASD, NESCA is proud to introduce its ASD Diagnostic Clinic. The clinic offers testing that is targeted specifically at identifying ASD in children between the ages of 2 and 5. For children who do receive a diagnosis of ASD, the report will allow parents to start accessing services immediately. As with all of our families, we hope to establish a lifelong relationship and will be available for follow-up consults and additional evaluations at any time.

 

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 appointment for the ASD Diagnostic Clinic or an evaluation with a NESCA neuropsychologist/clinician, 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.