While school may be wrapping up, Summer is an ideal time to embark on transition assessment and services to ensure that your child’s IEP process is preparing them for learning, living, and working after their public education. The ultimate goal of transition assessment is to identify the necessary skills and services to ready a student age 13-21 for transitioning from high school to the next phase of life. To book an intake and consultation appointment, visit: www.nesca-newton.com/intake. Not sure if you need an assessment? You can schedule a one-hour parent/caregiver intake and consultation.



The Impacts of Handwriting Challenges

By | Nesca Notes 2023

By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

After recently participating in the virtual conference of the International Dyslexia Association, two presentations that particularly sparked my interest were, “How Handwriting Impacts Literacy Development,” presented by Carol Armann OTR/L and Kathleen S. Wright of The Handwriting Collaborative LLC, and, “Dysgraphia – Recognize, Diagnose, and Remediate,” by Debi Buchanan, Ed.D. and Sheryl Frierson, M.D., M.Ed.

Within those webinars, research was presented that demonstrated the importance of handwriting and fine motor skills development, as those skills resulted in not only improved literacy skills, such as letter writing, but also kindergarten math performance, and these skills are associated with ongoing reading and math achievement as late as 5th grade (Dinehart et al 2013). Additionally, identifying early handwriting challenges and providing systematic handwriting instruction can reduce the number of children who ultimately will require special education services (Beringer, V& Wolf, B 2016).

Some fine motor skills necessary for the development of handwriting include in-hand manipulation (e.g., precisely picking up, manipulating, and releasing objects), graphomotor (e.g., handwriting strokes, lines used in forming letters), and visual-motor integration. Dysgraphia is an impairment in handwriting, characterized by deficits in legibility and/or fluency. However, it is not exclusively a motor impairment, but is a disruption in the coordination of the mental image (e.g., which letter, which way does it go? Where does it go in the word?) and motor output (e.g., motor sequencing, motor planning) that are required for legible and fluent handwriting.

As students move through the grades, handwriting becomes an essential component in gaining reading and writing skills. Handwriting fluency is particularly important as non-proficient hand writers cannot keep up with their ideas (Graham, 2010). While, positively, there are programs that can help students with graphomotor output challenges, such as speech-to-text programs, teaching early writing skills is essential to building literacy skills, as effective handwriting instruction has been linked to improved letter recognition, letter formation, spelling, and written composition (Berringer et al 2002, Graham Harris, &Herbert, 2011).

Depending on your child’s age, you can encourage fine motor skills development through fun activities. As examples, some good resources are https://napacenter.org/fine-motor-activities/ and https://www.understood.org/en/articles/6-fine-motor-activities-for-young-kids. If you are concerned that your child is not reaching outlined milestones in their development of the underlying skills necessary for writing accuracy and efficiency, consider asking Early Intervention (for children under 3 years of age) or your school district for an occupational therapy evaluation to determine if your child would benefit from specialized supports. For school age children, an occupational therapy evaluation to determine the functional level of your child’s writing skills would also be appropriate.


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 college-aged daughter.


To book a consultation with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, 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.

Handwriting vs. Typing: Where do we draw the line?

By | NESCA Notes 2021

By: Sophie Bellenis, OTD, OTR/L
Occupational Therapist; Real-life Skills Program Manager and Coach, NESCA

For many of our students with dysgraphia, or those who struggle with the fine motor precision and the skills necessary for written output, digital tools and accommodations that promote the use of tech and keyboarding in the academic setting are immensely helpful. These tools allow our students to show their knowledge, demonstrate their written abilities, and fully access their curriculum.  When implemented correctly, these accommodations can have a huge impact on a student’s academic career. While all of this is true, it is worth discussing whether fully taking away the need to produce and practice handwritten work is leaving some of our students at a disadvantage.

When working with adolescents and young adults to help figure out future career or education plans, I am consistently reminded of the fact that despite our continuing transition toward a more and more digitally-based world, the need for handwriting has not disappeared. While we absolutely do not need to be handwriting essays, papers, or long letters sent via snail mail, there are aspects of almost every profession and daily life that require the skill. Here are a few common issues that I am seeing pop up that speak to the need for some continued practice –

  1. Job or rental applications. While some of this has moved over to an online format, many of these still need to be filled out appropriately and legibly by an applicant.
  2. Jotting down notes. The importance of this skill should not be diminished. Whether taking a phone message, making a grocery list, or writing down a phone number, most young adults are expected to be able to read their own handwriting at a later date, or leave a message for someone else who will need to be able to read it.
  3. Vocational responsibilities. Many of our students with disabilities choose to forgo the traditional college path and find a more suitable career field to pursue. Many of my clients have become successful carpenters, mechanics, or other tradespeople. These fields all require vast skill and talent, and often require employees to mark down measurements or make quick notations.
  4. Signing documents. Many banks, institutions, and legal documents require a handwritten signature and initials on any paperwork.

While I am not advocating that we take away accommodations from our students who do not have the foundational skills to write long paragraphs or essays, I am advocating that we stop fully eliminating the demand. By expecting some quick, consistent practice of handwriting, we are building a skill that will be needed multiple times throughout life. I would suggest that students who are being given a keyboarding fine motor/visual motor accommodation, also continue to receive instruction or opportunities to practice writing activities that are less fatiguing in order to continue to build the motor planning and skill necessary. It is unfair to equate the inability to use handwriting as a tool for academic output, with an inability to learn handwriting as a useful functional tool for life.


About the Author
Sophie Bellenis is a Licensed Occupational Therapist in Massachusetts, specializing in educational OT and functional life skills development. Bellenis joined NESCA in the fall of 2017 to offer community-based skills coaching services as a part of the Real-life Skills Program within NESCA’s Transition Services team. Bellenis graduated from the MGH Institute of Health Professions with a Doctorate in Occupational Therapy, with a focus on pediatrics and international program evaluation. She is a member of the American Occupational Therapy Association, as well as the World Federation of Occupational Therapists. Having spent years delivering direct services at the elementary, middle school and high school levels, Bellenis has extensive background with school-based occupational therapy services.  She believes that individual sensory needs and visual skills must be taken into account to create comprehensive educational programming.


To book an appointment or to learn more about NESCA’s Occupational Therapy Services, please fill out our online Intake Form, email info@nesca-newton.com or call 617-658-9800.


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.