NESCA’s Newton, MA location has immediate availability for neuropsychological evaluations. Our MA clinicians specialize in the following evaluations: Neuropsychological; Autism; and Emotional and Psychological, as well as Academic Achievement and Learning Disability Testing.

Visit www.nesca-newton.com/intake for more information or to book an evaluation.

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Student trying to write despite hidden language demands

The Hidden Language Demands of Upper Elementary and Middle School

By | NESCA Notes 2022, NESCA Notes 2025

Student trying to write despite hidden language demandsBy Olivia Rogers, MA, CCC-SLP
Speech-Language Pathologist, NESCA

By upper elementary school, learning shifts dramatically. Students are no longer learning foundational skills; they are expected to apply them flexibly, independently, and across subjects. The academic language load increases quietly but significantly.

What Changes in Grades 4 to 7?

  • Students are reading to learn
  • Texts become denser and more abstract
  • Vocabulary shifts from concrete to conceptual
  • Sentence structures become longer and more syntactically complex
  • Students are expected to compare, analyze, justify, and synthesize
  • Writing moves from short responses to multi-paragraph compositions

The Cognitive Load Increases
Students must now hold multiple ideas in working memory, track shifting perspectives in texts, interpret figurative language, and integrate background knowledge – often simultaneously. These demands require strong executive functioning and well-developed language networks.

The Invisible Language Skills Required

  • Understanding complex sentences with embedded clauses
  • Interpreting nuanced vocabulary and morphology
  • Making inferences beyond literal meaning
  • Organizing ideas cohesively in speech and writing
  • Explaining reasoning using precise academic language

Common Signs of Strain

  • Strong verbal knowledge but weak written output
  • Short, underdeveloped written responses
  • Difficulty summarizing or explaining key ideas
  • Avoidance of reading-heavy assignments
  • Homework taking significantly longer than expected
  • Increased anxiety or shutdown around school tasks

Why This Stage Matters
Upper elementary and early middle school are pivotal years for our students. If language organization, executive functioning, and literacy systems are strengthened during this window, students often transition into higher grades with greater confidence and independence. When gaps remain unaddressed, demands compound year after year.

If This Sounds Familiar…
If your child is bright but suddenly struggling with writing, comprehension, or workload, it may not be motivation. It may be due to the increased language load. Strong academic performance is not just about effort. It’s about systems of learning. When language, executive functioning, and literacy are strengthened together, students gain not only skill, but confidence.

 

At NESCA, we view communication holistically. Our therapists use a comprehensive approach to treat the systems of learning as integrative, helping students develop valuable skills they can use in and out of the classroom! If you’re curious whether this integrative approach would benefit your child, I welcome the opportunity to connect to identify what targeted support may make the greatest difference. For more information on Speech and Language Therapy, Literacy, and Executive Functioning Support at NESCA, please complete our online Intake Form or email me directly at orogers@nesca-newton.com.

 

 

About the AuthorOlivia Rogers

Olivia Rogers is a licensed speech-language pathologist with experience in pediatric clinics and public schools, working with children from age 2 through young adulthood across a range of communication challenges. With a special interest in the connection between oral language and literacy, Ms. Rogers is trained in the Orton-Gillingham method and the Brain Frames program, supporting students in language comprehension, expression, and written organization. She is dedicated to making therapy engaging and personalized for each child.

 

To learn more about NESCA’s Speech and Language Services or schedule appointments, complete our online Intake Form or email orogers@nesca-newton.com.

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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SLP working with a student on a summer intensive program focused on speech

Seven Signs Your Child Would Benefit from a Summer Writing Intensive

By | NESCA Notes 2022, NESCA Notes 2025

SLP working with a student on a summer intensive program focused on speechBy Olivia Rogers, MA, CCC-SLP
Speech-Language Pathologist, NESCA

Summer is often seen as a break from academics, but for many students, it’s also the most powerful window for growth. If writing has been a source of stress, avoidance, or frustration during the school year, a structured summer writing intensive program can make a meaningful difference before fall. Here are the most common signs that a student may benefit from targeted, language-based writing support.

  1. They Have Strong Ideas. . . But Difficulty Getting Them Onto Paper
    Your child may speak clearly and express complex ideas verbally, yet struggle to translate those thoughts into written form. Pages remain blank, sentences feel short or incomplete, and written work does not reflect their true ability.
  2. Writing Takes a Long Time
    Assignments that should take 20 minutes stretch into an hour or more. Slow writing can signal challenges with planning, organization, working memory, or executive functioning fatigue.
  3. Paragraphs Lack Structure
    You may notice missing topic sentences, disconnected details, weak transitions, or repetitive ideas. These patterns often reflect underlying language organization challenges rather than simple grammar issues.
  4. Writing Causes Emotional Stress
    Avoidance, frustration, or shutdown at the mention of writing or during the writing process are common signs. When writing feels overwhelming, students often lack internal planning systems to guide them.
  5. Teacher Feedback Highlights Organization or Elaboration Concerns
    Comments such as, “needs more detail,” “ideas are unclear,” or “work lacks organization” often indicate that both language development and executive functioning need targeted support.
  6. ADHD or Executive Functioning Challenges
    Writing requires planning, working memory, inhibition, flexibility, and self-monitoring. Students with executive functioning weaknesses often benefit from explicit writing routines that reduce cognitive load.
  7. Transitioning to a New School Level
    Rising 3rd, 6th, or 9th graders face increased writing demands. Strengthening foundational systems before expectations rise can dramatically improve confidence and performance.

Why Summer Is So Effective
Without academic pressure and competing demands, students can build writing fluency, strengthen organization systems, and increase independence in a focused and supportive environment. Application can be embedded in students’ areas of interest, for added motivation. The goal of a writing intensive is not simply to be able to create “better essays.” It is reduced anxiety, stronger thinking on paper, increased independence, and systems students can carry into the fall.

 

At NESCA, we offer intensive summer therapy that targets both verbal communication (such as listening comprehension, expressive language, and social communication) and written expression, an area where many students struggle. For more information on summer intensives and written language support at NESCA, please complete our online Intake Form or email me directly at orogers@nesca-newton.com.

 

About the AuthorOlivia Rogers

Olivia Rogers is a licensed speech-language pathologist with experience in pediatric clinics and public schools, working with children from age 2 through young adulthood across a range of communication challenges. With a special interest in the connection between oral language and literacy, Ms. Rogers is trained in the Orton-Gillingham method and the Brain Frames program, supporting students in language comprehension, expression, and written organization. She is dedicated to making therapy engaging and personalized for each child.

 

To learn more about NESCA’s Speech and Language Services or schedule appointments, complete our online Intake Form or email orogers@nesca-newton.com.

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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student writing in a notebook and quote by Olivia Rogers, SLP

Why Speech-Language Pathologists Are Uniquely Equipped to Support Written Language

By | NESCA Notes 2022, NESCA Notes 2025

student writing in a notebook and quote by Olivia Rogers, SLPBy Olivia Rogers, MA, CCC-SLP
Speech-Language Pathologist, NESCA

Written language refers to the system of communication that involves the use of written symbols to represent language, and it encompasses skills such as fluent word recognition, reading comprehension, written spelling, and written expression. It is one of the most complex academic skills students are asked to master. It requires vocabulary, grammar, organization, working memory, attention, reading skills, and the ability to translate ideas into structured sentences and paragraphs.

Because written expression sits at the intersection of language, literacy, and executive functioning, Speech-Language Pathologists (SLPs) are uniquely positioned to support it. At NESCA, speech language pathologists bring specialized training – including EmPOWER, Brain Frames, and The Orton-Gillingham Approach – that allows them to address writing and reading comprehension in a comprehensive, structured, and functional way.

Written Language Is… Language
Writing is not just handwriting or spelling. At its core, writing is language expressed on paper. Students must generate ideas and vocabulary, use grammar and sentence structure, organize thoughts into narratives or explanations, maintain cohesion across sentences, and consider audience and purpose.

Reading is not just decoding words on a page. True, reading happens when a child understands, connects, and makes meaning from what they read. Comprehension – linking new information to background knowledge, vocabulary, and language skills – is what transforms word calling into real literacy.

These are core areas of SLP expertise. SLPs are trained to analyze how language breaks down,  whether at the word, sentence, or discourse level, and to teach skills explicitly and systematically.

The Executive Function Connection
As discussed in last week’s blog, writing and reading are executive functioning tasks. When writing, students must plan what to say, hold ideas in working memory, organize information, initiate writing, and revise and edit. When reading, students exercise their working memory, inhibition, and metacognitive skills.

NESCA SLPs use the EmPOWER and Brain Frames approaches to make these invisible thinking processes visible. EmPOWER supports students in navigating “how” to bring the writing process from start to finish. Brain Frames provide visual scaffolds that help students map ideas before writing, organize paragraphs, and understand the structure of different text types.

Structured Literacy Strengthens Writing
Strong writing depends on strong reading and spelling skills. NESCA SLPs, trained in Orton-Gillingham, also bring a structured literacy lens to written language intervention through explicit teaching of phonology, morphology, and spelling patterns – all while integrating reading and writing instruction systematically.

SLPs Bridge Ideas and Expression
Many students know what they want to say but cannot translate it into written form. SLPs help students expand sentences, develop narrative and expository structure, use academic vocabulary, improve cohesion and clarity, verbalize ideas before writing, and revise language for precision.  Because SLPs focus on communication, written language therapy is functional and meaningful. Intervention often targets classroom assignments, essays and projects, note-taking, digital communication, and self-advocacy writing so that strategies learned transfer directly to school demands. SLPs brings a functional, real-world approach to written language.

Speech-Language Pathologists are not an alternative option for written language support; they are a natural fit. With explicit strategy instruction, visual scaffolding, and structured literacy methods, SLPs help students move from uncertainty to confident, organized expression. When writing is approached through language, thinking, and literacy together, students gain tools that extend far beyond the page.

The NESCA Difference
NESCA SLPs combine deep knowledge of language development with specialized training in executive functioning and structured literacy. Our intervention addresses how students think, understand language, read and spell, and express ideas in writing.

 

At NESCA, we use evidence-based strategy to target written language. Our clinicians use a comprehensive approach to treat the systems of learning as integrative, helping students develop valuable skills they can use in and out of the classroom!  For more information on written language support at NESCA, please complete our online Intake Form or email me directly at orogers@nesca-newton.com.

 

About the AuthorOlivia Rogers

Olivia Rogers is a licensed speech-language pathologist with experience in pediatric clinics and public schools, working with children from age 2 through young adulthood across a range of communication challenges. With a special interest in the connection between oral language and literacy, Ms. Rogers is trained in the Orton-Gillingham method and the Brain Frames program, supporting students in language comprehension, expression, and written organization. She is dedicated to making therapy engaging and personalized for each child.

 

To learn more about NESCA’s Speech and Language Services or schedule appointments, complete our online Intake Form or email orogers@nesca-newton.com.

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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image of yarns intertwined representing EF and language skills being intertwined and a quote from Olivia Rogers, SLP at NESCA

Executive Functioning & Language: Intertwined and Recursive Systems of Learning

By | NESCA Notes 2022, NESCA Notes 2025

image of yarns intertwined representing EF and language skills being intertwined and a quote from Olivia Rogers, SLP at NESCA

By Olivia Rogers, MA, CCC-SLP
Speech-Language Pathologist, NESCA

When we think about learning, we often separate skills into categories – language, executive functioning, literacy, academics, just to name some. But in real life, these systems don’t operate independently. They are deeply intertwined and recursive, meaning they continuously influence, shape, and strengthen one another over time.

What Is Executive Functioning?
Executive functioning refers to the brain’s management system. These skills help students plan and organize ideas, initiate tasks, hold information in working memory, monitor understanding, shift between strategies, and manage time and attention.

What Is Language?
Language includes understanding directions, expressing ideas clearly orally and in writing, narrative organization, comprehension of complex oral and written information, academic language use, and internal self-talk.

How Executive Functioning Depends on Language
Students rely on language to talk themselves through steps, plan written responses, explain reasoning, organize narratives, monitor comprehension, and use strategies independently.

How Language Depends on Executive Functioning
Producing and understanding language requires holding ideas in working memory, sequencing information, shifting between topics, inhibiting irrelevant details, revising messages, and planning written expression.

The Recursive Relationship image showing the recursive nature of EF and language skills
Growth in one area supports growth in the other. Stronger language supports clearer thinking, and better executive skills support more organized language.

The Big Picture
Integrated support helps students explain their thinking, plan before speaking or writing, use language as a strategy, monitor understanding, and become more independent learners. Executive functioning and language are overlapping systems that continuously shape each other. Supporting both together makes learning more accessible, meaningful, and transferable.

At NESCA, we view communication holistically. Our speech language pathologists use a comprehensive approach to treat the systems of learning as integrative, helping students develop valuable skills they can use in and out of the classroom! For more information on Speech and Language Therapy at NESCA, please complete our online Intake Form or email me directly at orogers@nesca-newton.com.

 

About the AuthorOlivia Rogers

Olivia Rogers is a licensed speech-language pathologist with experience in pediatric clinics and public schools, working with children from age 2 through young adulthood across a range of communication challenges. With a special interest in the connection between oral language and literacy, Ms. Rogers is trained in the Orton-Gillingham method and the Brain Frames program, supporting students in language comprehension, expression, and written organization. She is dedicated to making therapy engaging and personalized for each child.

 

To learn more about NESCA’s Speech and Language Services or schedule appointments, complete our online Intake Form or email orogers@nesca-newton.com.

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

 

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Image of student walking into middle school with a quote from Dr. Madeline Manning

Navigating the Transition from Elementary to Middle School with ADHD

By | NESCA Notes 2025

Image of student walking into middle school with a quote from Dr. Madeline ManningBy Madeline Manning, Ph.D.
Pediatric Neuropsychologist, NESCA Hingham

The transition from elementary to middle school is a significant developmental milestone, bringing new academic demands, shifting social dynamics, and greater expectations for independence. For students with attention-deficit/hyperactivity disorder (ADHD), who often experience executive function (EF) vulnerabilities, this period can be particularly challenging. Understanding and proactively addressing the academic, social-emotional, and behavioral needs of these students is essential to support their adaptation and long-term success.

Academic Demands and Executive Function

Middle school introduces a significantly more dynamic, fast-paced academic environment, characterized by multiple teachers, changing classrooms, and a heavier workload. Students must manage assignments from various instructors, each with different expectations and communication methods. This environment requires cognitive flexibility and other advanced EF skills, including organization, time management, task initiation, and prioritization. For students with ADHD, these demands can quickly overwhelm existing coping strategies, leading to forgotten assignments, missed deadlines, and difficulty transitioning between classes. This, in turn, can contribute to a reduced sense of self-efficacy as a learner.

Notably, many students have not yet been explicitly taught the EF skills needed for this new level of independence. Evidence shows that many students with ADHD require direct instruction, repetition, clear structure, frequent feedback, and opportunities to practice these skills in real contexts. Early identification of EF difficulties and targeted supports, such as executive function coaching, visual organizers, structured routines, and regular teacher check-ins, can ease the transition and build confidence (Giannakopoulos, 2025).

Social Dynamics and Emotional Development

Middle school is also marked by greater complexity in peer interactions. Friendships shift from more convenience-based connections, often formed through proximity and shared activities in elementary school, to deeper emotional bonds, and students face heightened peer pressure and the formation of social cliques. The onset of puberty, elevated emotional sensitivity, emerging interest in romantic relationships, and the influence of social media can further complicate peer dynamics during this developmental stage.

Students with ADHD are already at increased risk of experiencing challenges with impulse control, emotional regulation, and social problem-solving. The reduced adult scaffolding in middle school means students are expected to navigate social situations with more independence, which can be both empowering and challenging. Difficulties in these areas can negatively affect self-esteem and lead to anxiety or withdrawal.

Fostering resilience involves teaching prosocial coping strategies and promoting self-advocacy. This includes encouraging students to seek support from trusted adults when needed and to practice assertive communication skills. Guidance on managing peer pressure, conflict resolution strategies, and building and maintaining healthy friendships is critical for positive social development and emotional well-being in middle school and beyond.

The Adolescent Brain: Developmental Realities

During early adolescence, the brain undergoes significant changes. The prefrontal cortex (responsible for planning, decision-making, and self-control) is still maturing, while the limbic system (a complex set of brain structures governing emotions and reward systems) develops far earlier. This developmental mismatch means that adolescents are more likely to exhibit heightened emotional responses, increased impulsivity, and a greater sensitivity to rewards and peer influence, often before they have fully developed the cognitive skills necessary for effective self-regulation and long-term planning.

These neurodevelopmental factors mean that even typically developing students may struggle with EF tasks and social functioning during middle school. For those with ADHD, whose brains are already wired for greater difficulty with attention and self-regulation, the challenges can be far more pronounced.

Supporting Skill Development

To help students with ADHD navigate this transition, families and educators can collaborate to provide:

  • Explicit instruction in organizational and planning skills
  • Consistent routines and predictable expectations
  • Visual supports (e.g., checklists, planners)
  • Regular feedback and positive reinforcement
  • Opportunities for guided practice and reflection

These supports help students gradually build independence, resilience, and the executive function skills necessary to meet new demands.

A Critical Window for Evaluation and Intervention

The transition from elementary to middle school is a pivotal time to address concerns around academic, social-emotional, and/or behavioral functioning. A comprehensive neuropsychological evaluation can clarify your child’s unique strengths and challenges, guide targeted interventions, and support the development of formal education plans (e.g., IEPs or 504 Plans) to ensure they are receiving the services they require. Early identification and collaboration between home and school are essential for maintaining self-esteem, fostering self-efficacy, and ensuring access to appropriate supports.

If you have questions or concerns regarding your child’s transition to a new school, executive functioning, or any other aspect of their development, please contact NESCA for guidance. Comprehensive evaluation and targeted strategies can make a meaningful difference in your child’s educational journey and overall well-being.

 

About Dr. Madeline Manning

Dr. Madeline Manning is committed to providing comprehensive, collaborative evaluations that helpMadeline Manning, PhD Headshot families better understand their child’s unique neurocognitive, developmental, learning, and social-emotional profiles. She specializes in the assessment of toddlers, school-aged children, adolescents, and young adults. Her expertise involves working with youth exhibiting a diverse range of clinical presentations, including neurodevelopmental disorders, such as autism spectrum disorder, attention and executive functioning deficits, learning disabilities, developmental delays, intellectual disabilities, and associated emotional challenges. Dr. Manning is also trained in the assessment of children with medical complexities, recognizing how health conditions can impact a child’s development and functioning. She partners closely with families to develop practical, personalized recommendations that support each individual’s success and growth at home, in school, and within the community.

To book a neuropsychological evaluation at NESCA, complete NESCA’s online intake form. 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of a person's brain with gears working in sync, representing Executive functioning

Executive Functioning: What is it and how do we address weaknesses?

By | NESCA Notes 2025

Image of a person's brain with gears working in sync, representing Executive functioningBy: Alison Burns, Ph.D.
Pediatric Neuropsychologist, NESCA

Although the concept of executive functioning has existed since the 19th century, it began to gain significant attention in the fields of psychology, education, and neuroscience in the late 1990s and early 2000s. Executive functioning can be thought of as the brain’s “management system.” It enables us to plan ahead, stay organized, remember important information, initiate tasks, control impulses, adapt to changes, and manage our emotions. These skills help us get started on homework or chores, remember what we need to buy at the store, keep track of our schedules, stay calm when upset, switch gears when plans change, and finish tasks without getting distracted. When executive functioning skills are strong, individuals are able to juggle responsibilities, solve problems, and cope effectively with everyday challenges.

Executive functioning difficulties can arise from a variety of causes. Neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD), Autism Spectrum Disorder, and learning disabilities frequently involve challenges with executive skills. Neurological conditions – including brain injury or stroke, particularly those affecting the frontal lobes – can impair executive functioning. Mental health disorders such as depression, anxiety, bipolar disorder, and schizophrenia may also impact these skills, making it harder to plan, organize, or regulate emotions. Environmental factors, including chronic stress, lack of sleep, poor nutrition, or substance use (alcohol or drugs), can temporarily or permanently weaken executive functioning. Additionally, some individuals may have a genetic predisposition to weaker executive functioning, and developmental delays due to prematurity, or early childhood adversity can further contribute to difficulties in these areas.

Fortunately, executive functioning weaknesses can be improved through targeted interventions. Direct interventions may include cognitive-behavioral therapy to enhance skills such as self-regulation, cognitive flexibility, and self-monitoring. Executive function coaching can also be beneficial, focusing on skills like planning, organization, and time management by identifying barriers and providing practical strategies for implementation.

In addition to direct intervention, accommodations can be provided to help individuals compensate for areas of challenge. Accommodations should be matched to an individual’s specific executive functioning weaknesses. Below are examples of accommodations for specific areas of challenge. This is not meant to be an exhaustive list, but rather to provide examples of the types of accommodations that may be recommended depending on an individual’s specific profile.

Planning & Organization

  • Use a paper planner, wall calendar, or smartphone app to record assignments, appointments, and deadlines. Review these tools daily to clearly see what needs to be done and when.
  • Divide complex assignments or larger projects into smaller, more manageable tasks, and set individual deadlines for each one. This approach will make the overall project less overwhelming and easier to tackle.
  • Use visual tools such as graphic organizers, outlines, or flow charts to organize ideas and information before beginning an assignment or task.
  • Use folders, color-coding, and binders to organize physical belongings. Use trial and error to identify what works best and take time every day to maintain organizational systems (i.e., put it away before it piles up and feels overwhelming).

Working Memory (the brain’s “scratch pad” where we hold and manipulate information)

  • Use detailed checklists for tasks that require memory of several steps to reduce the burden on working memory. Check off each step when completed. Apply this strategy to recurring tasks, such as morning or bedtime routines, but also schoolwork or chores that have multiple steps or components.
  • Give the individual verbal instructions more than once and ask them to repeat the instructions back to ensure they understand what needs to be done. Instructions should be provided in in small chunks, rather than all at once, so the individual can focus on one step before moving to the next.
  • Permit individuals to use audio recorders or AI technology to capture information during lectures or meetings, so they can replay and review content as needed.

Task Initiation

  • Define the first action required for a task, such as “open your book to page 10,” so it is clear exactly how to begin.
  • Sentence starters or example problems can be helpful in clarifying task expectations, and, in turn, improving task initiation.
  • Establish regular routines and schedules, such as starting homework at the same time each day, to make it easier to get started on tasks.

Inhibition (Impulse Control)

  • Have a teacher, supervisor, or caregiver nearby to provide quick feedback or reminders when impulsive behaviors occur.
  • Provide items like fidget spinners, putty, or doodling pads to give individuals a safe way to channel their energy and reduce impulsive actions. Allow individuals to take short movement breaks to help manage restlessness or impulsivity.
  • Provide praise or rewards when individuals demonstrate restraint or appropriate behavior, encouraging them to continue using impulse control strategies.

Cognitive Flexibility

  • Inform individuals ahead of time about changes in plans or schedules so they can mentally prepare and reduce stress. Give warnings ahead of transitions (e.g., “You have five minutes to finish up that essay) to assist in the transition from one activity to the next, particularly when shifting from a preferred to non-preferred task.
  • Using written or visual stories that describe upcoming events and expected behaviors will help individuals anticipate and cope with new experiences.
  • Teachers or supervisors should preview any partner and group work ahead of time, including carefully outlining roles and expectations.

Emotional Regulation

  • Offer designated quiet areas or allow breaks for individuals to calm down when feeling overwhelmed or upset.
  • Use charts, cards, or other visual tools to help individuals recognize and communicate their emotions.
  • Allow individuals a few minutes to reflect or calm down after an emotional incident before discussing their behavior or asking them to resume work or activities.

Self-Monitoring

  • Provide tools that allow individuals to evaluate their own work against specific criteria and track their progress over time. For example, an editing checklist for a writing assignment should include specifics such as a review of content, spelling, punctuation/capitalization, and grammar/run-ons. This would help shift the vague task of “check your work” into a more actionable task with greater success of being beneficial.
  • Schedule frequent reviews and provide constructive feedback to help individuals stay on track and make adjustments as needed.
  • Allow individuals extra time to double-check their work for errors or improvements before turning it in or finishing a task.

This vast network of skills, collectively referred to as executive functioning, plays a critical role in an individual’s ability to function in daily life. Comprehensive neuropsychological evaluations can provide valuable insight into specific areas of weakness and how they impact an individual’s functioning. This understanding allows for tailored, targeted recommendations that are more likely to be effective than implementing broad, non-specific executive functioning supports.

If your child or student can benefit from executive function coaching, complete NESCA’s online inquiry/intake form to receive additional information or book sessions.

 

About the Author

Dr. Burns conducts comprehensive evaluations of school-aged children, adolescents, and young adults with a variety of developmental, learning, and emotional difficulties. She has expertise in the evaluation of individuals following a concussion/mild traumatic brain injury and particularly enjoys working with individuals with attention (ADHD) and executive functioning (EF) difficulties. Dr. Burns is passionate about helping individuals and their families better understand their areas of strength and weakness and provides tailored treatment recommendations based upon that unique profile to make the evaluation most helpful for each client.

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

NESCA is a pediatric neuropsychology practice and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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High school student image who is struggling with the overwhelm of school pressures

When High School Feels Overwhelming: How Neuropsychology Can Help Students Thrive

By | NESCA Notes 2025

High school student image who is struggling with the overwhelm of school pressuresBy: Moira Creedon, Ph.D. 
NESCA Hingham Director & Pediatric Neuropsychologist

I frequently meet high school students and families who are feeling the weight of academic expectations, especially at this point in the school year. Maybe your child recently finished midterms and the results weren’t what you hoped for. Maybe the daily stress of managing coursework of AP classes, standardized test preparation, extracurriculars, and college research feels like too much. The pressure to keep up can buckle even a strong student, and small vulnerabilities can suddenly be amplified in this context. If this sounds familiar, there are steps to take to support the daily midwinter stress.

Why Are So Many Students Struggling?

The challenges of high school are not limited to academics alone. It is a time of rapid growth in physical size, independence, academic demands, social environment, and emotional development. For some students, it is a time to shine with increased independence and responsibility. For others, the demands quickly exceed their skill set. The minor organizational and study challenges of middle school are amplified with more content and the burden to juggle simultaneous demands. Put simply, the executive functioning system gets put to the test in high school. These struggles do not mean you have a student who is not capable or intelligent. It may mean they need support for their unique learning profile.

What are Some Warning Signs of the Mid-year Slump?

Warning signs can include trouble keeping track of deadlines or assignments. It can be studying for hours for a test with a lackluster performance that doesn’t match the effort. It can come in the form of increased procrastination, trouble finishing tasks, and poor follow-through. It can also come in the form of increased fatigue, a sense of “burn out,” anxiety, or overall perception of stress. For some students, it can feel like their plate is too full but without a great plan for how to prioritize to make life manageable.

What Can Help?

  1. Consider a Neuropsychological Evaluation

A neuropsychological evaluation is a comprehensive assessment that looks at how a student learns with an eye toward their unique pattern of strengths and weaknesses. A neuropsychological examination can help clarify a diagnosis or diagnoses (ADHD, anxiety, or a learning disability, to name a few), but it can also provide a detailed understanding of the overall process of learning. Bright students who feel overloaded can learn valuable information about their approach to learning so they can figure out how to study smarter, not longer. These evaluations can also include tailored recommendations for how to approach the stress, with suggestions for where and how to seek the appropriate help.

  1. Explore Executive Functioning Coaching

Executive functioning coaches work with students to develop practical strategies for organization, time management, and study skills. Unlike a tutor in a specific subject domain, executive functioning coaches work across subject areas. Coaching sessions are individualized and can help students learn how to break down large assignments, create effective study schedules, prioritize tasks, and manage distractions. In addition to improvement in your academic performance, coaching can help students build independence and confidence.

  1. Seek Support at School

Start with your academic advisor, adjustment counselor, or favorite teacher. Let them know your student is struggling to manage all the demands of their academic life. Many students pursue learning supports or accommodations at school via special education. Your school will need to review evaluations to determine if your child qualifies for a 504 Plan or Individualized Education Program (IEP) as these formalized supports require a diagnosis of a disability. Outside of these more formal support avenues, many schools offer peer tutoring or after-school homework support. Your student does not have to hide their struggles from their teachers!

  1. Take Care of Yourself

With all of the growth in high school, it is important to remember to prioritize emotional health. Your academic success cannot last if it comes at the expense of your mental health. I encourage students to prioritize the basics – to get enough sleep, eat nutritious foods, exercise or move daily, and leave time for fun. If you sit down to create a calendar or task list with your child, keep these items on the list. A rested and restored brain is far more effective at learning.

We Can All Be in This Together

It is normal for your teen to feel a little overwhelmed at times in high school. Instead of viewing this as an opportunity for panic, let’s see it as an opportunity for growth. It does not have to be a journey you and your child take alone. With the right supports, your high schooler can manage their workload, develop more effective study habits, and build resilience to handle future stress. Neuropsychologists at NESCA are happy to support you in this journey through evaluations, consultation, and to connect you to executive functioning and school resources.

 

About the Author

Dr. Creedon offers her expertise in evaluating children and teens with a variety of presenting issues. SheMoira Creedon headshot is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. She tailors each assessment to address a range of referral questions, such as developmental disabilities, including Autism Spectrum Disorder, learning disabilities, attention challenges, executive functioning deficits, and social-emotional struggles. She also evaluates college-/grad school-age/adult individuals with developmental issues, such as ASD and ADHD, particularly when there is a diagnostic clarity or accommodation question.

 

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 and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of a student struggling to write and a quote from Alissa Talamo, Ph.D.

Why Does My Child Struggle With Writing?

By | NESCA Notes 2025

Image of a student struggling to write and a quote from Alissa Talamo, Ph.D.By: Alissa Talamo, PhD
Pediatric Neuropsychologist, NESCA

A concern I often hear from parents is that their child is bright, creative, and articulate—able to express ideas clearly in conversation—but gets “stuck” when asked to put those same thoughts into written form. Instead of demonstrating the full extent of their knowledge, these children often write just enough to complete the assignment, leaving teachers and parents wondering what’s holding them back.

Difficulties with written expression can arise for a variety of reasons. For some children, an expressive language disorder makes it challenging to find the right words and organize their thoughts on paper. Others may have fine motor difficulties, making the physical act of writing laborious and frustrating. Children who struggle with spelling often limit themselves to simple words, even if their spoken vocabulary is much richer. These challenges are relatively straightforward to identify, but there are many children who don’t fit these patterns—children who seem to have all the necessary skills yet still find writing to be an uphill battle.

In these cases, neuropsychological testing often confirms what parents already suspect: the child is intelligent, insightful, and capable of high-level thinking, but something is interfering with their ability to express themselves in writing. One of the most common underlying issues is difficulty with executive functioning. Executive functioning is a set of mental skills that includes planning, organization, time management, working memory, attention control, task initiation, self-monitoring, impulse control, emotional regulation, cognitive flexibility, goal setting, and problem-solving. Writing is a uniquely demanding task because it requires the simultaneous use of many of these skills. To write effectively, a student must generate ideas, organize those ideas, keep track of them in working memory, and attend to mechanics like spelling, punctuation, and grammar—all at the same time. It’s no wonder that writing can feel overwhelming!

The good news is that once a child’s specific areas of weakness are identified, there are many strategies and supports available to help them improve their writing skills. Executive functioning tutoring can be especially beneficial, teaching students how to use graphic organizers (such as compare/contrast charts, part/whole relationships, or cause/effect diagrams) and writing templates to structure their thoughts. Tutors can also help students develop strategies for catching mistakes that result from inattention to detail, such as errors in grammar, spelling, or capitalization. In addition, tailored recommendations can be made for in-class support, allowing the student to build their writing skills in a supportive environment.

Why Neuropsychological Testing Can Make a Difference

If your child is struggling with writing, neuropsychological testing can be an invaluable tool. This comprehensive assessment goes beyond surface-level observations to identify specific strengths and weaknesses in cognitive, language, motor, emotional, and executive functioning skills. By pinpointing the root causes of writing difficulties, neuropsychological testing provides a roadmap for targeted interventions and accommodations. With the right supports in place, children can overcome barriers to written expression, gain confidence in their abilities, and more fully demonstrate their knowledge and creativity—both in school and beyond.

 

About the Author

Alissa Talamo headshotWith 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 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 related services center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Image of kids helping to cook in the kitchen and a quote from Dr. Yvonne Asher

Kids in the Kitchen

By | NESCA Notes 2025

Image of kids helping to cook in the kitchen and a quote from Dr. Yvonne AsherBy: Yvonne Asher, Ph.D.
NESCA Pediatric Neuropsychologist

Cooking Thanksgiving dinner usually takes me about 8 hours by myself. With help, it’s closer to 12. But my kids LOVE to help. They always want to mix and pour and measure and dump ingredients hour after hour, standing beside me on a wobbly kitchen chair. I’ll leave the question of safety – you know your child best in that respect – except to say that the heavily marketed “Montessori style” kitchen tools are pretty great. Instead, I want to talk about the neurocognitive benefits of helping with cooking. There are other, wonderful benefits – bonding, sharing memories and family stories, creating traditions – but those probably do not require a neuropsychologist to opine on.

First and foremost, cooking is science and math. Actually, a ton of math. Addition, subtraction, multiplication, division, fractions, and more. Having company? We probably need to double our usual brownie recipe. Only Aunt Sue and Jimmy like cranberry sauce? Let’s halve that one. We need one and a half cups of flour for this pie crust, but only the one-quarter cup measure is clean. How many quarter-cups will we need? For science, we have states of matter, heat transfer, and chemical reactions. Why do carrots turn green in carrot cake? How do baking soda and vinegar get a chocolate cake to rise? What makes those dinner rolls so fluffy? The age of your child is (almost) irrelevant – younger children are intrigued by more basic concepts, and older ones can understand more complex and nuanced ideas. When I was a preschool teacher (long before my current career), I can still remember the wide eyes of my barely 3-year-old pupils when watching heavy cream turn into butter, yeasted dough turn into bread, and disparate ingredients turn into delicious cookies.

There is also a tremendous amount of executive functioning in cooking and food preparation. As anyone who has hosted a meal or, frankly, just tried to get dinner on the table before 9pm, will know, planning is crucial. Holding information in mind (working memory), organizing, setting smaller goals in the service of larger ones, tracking progress through multiple tasks, and checking one’s work are all vital to ending up with a special meal (did you remember to put the butter in the mashed potatoes???). If anyone in your crowd has particular eating requirements (babies learning solids, allergies, vegan/gluten-free diets, etc.), the executive functioning demands are ratcheted up by a lot. And, if you are the kind of person who sets an elaborate table with décor and such (my kids are lucky if I remember to grab a tablecloth), you have even more planning, organizing, and task management to do.

Last, but most certainly not least, learning to plan menus, shop, prepare food, cook, and bake are phenomenal life skills. Life skills are vital for everyone, but especially for individuals with developmental disabilities. Strong, confident mastery of life skills is critical for adolescents and young adults to achieve independence. I’m still patiently awaiting the day that one of my kids can cook dinner all by themselves, but I will be immeasurably pleased and proud when they do.

It is a commitment to have kids help in the kitchen. They make unbelievable messes (I never knew how many places powdered sugar could end up), ruin dishes with expensive ingredients, and most certainly introduce germs into food (even with the best of handwashing practices and “DON’T TOUCH YOUR FACE” admonishments). But this is the space between ideal and real that we can inhabit in service of teaching. Yes, it will take longer. Yes, things you envisioned may absolutely not happen (or not happen the way you hoped). Yes, it will be a crazy amount of work for you. Yes, you may need an extra grown up to actually help while your child “helps.” (You can, of course, designate certain dishes or elements of dishes as appropriate for “help” and others “just for grownups.”) But this is an incredible opportunity to help your kids learn math, science, executive functioning, and life skills in ways that are meaningful, filled with love, and built in to the fabric of their lives.

 

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.

 

NESCA is a pediatric neuropsychology and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; Coral Gables, Florida; and staff in 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.

 

To book an appointment with a NESCA clinician, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

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Image of a cell phone with a banned symbol over it; quote from Angela Currie, Ph.D.

Teaching Executive Function Strategies in the Landscape of Cell Phone Ban Policies

By | NESCA Notes 2025

Image of a cell phone with a banned symbol over it; quote from Angela Currie, Ph.D.By Angela Currie, Ph.D.
Pediatric Neuropsychologist; Londonderry, NH Director, NESCA

As students head back to school this fall, many are facing new policies and restrictions around cell phone use in school. For many states and districts, this is defined by a “bell to bell” cell phone ban, which prohibits students from using their phones from the first bell to final dismissal. For many, these policies are long awaited, as there has been growing concern about student distraction, social disengagement, and the negative impact of social media access in schools. By removing access to cell phones, tablets, and smart watches, “bell to bell” policies aim to reduce distractions and foster a more focused, interactive learning environment.

The benefits of cell phone policies are clear; however, they also may present unique challenges for some students who have learned to rely on technology as an appropriate tool for executive function. Executive function refers to a set of cognitive and self-management skills that help individuals manage time, stay organized, remember information, and meet goals efficiently. Because cell phones and tablets are readily accessible and have many embedded tools, many students have integrated technology into their daily routines, using features like calendars, alarms, and note-taking apps to stay on top of assignments and deadlines. These digital tools have become a practical way for some students to stay organized and ensure they are meeting expectations.

With “bell to bell” cell phone bans in place, students will no longer have “on demand” access to the apps or other executive function tools that previously kept them organized, possibly raising concern about increased forgetfulness, missed assignments, and heightened stress. Positively, the laws provide exemptions for students whose IEP, 504 plan, or Title IX needs identify specific technology accommodations (e.g., insulin monitoring, assignment log, communication tools, etc.). However, these students may feel hesitant to use their devices during the school day out of concern for standing out or feeling stigmatized. As a result, even students who are permitted to use their devices may choose to find alternative ways to manage their academic demands in order to avoid feeling singled out.

Cell phone policies are being developed for good reasons, but within this landscape, schools and families must start thinking about how to teach executive function strategies that are not technology-based. Children and teens are developing in a technological world, and they may not have the skills for managing demands without these supports. This provides an opportunity for them to learn more independent skills for daily management, but they may not figure this out on their own. To support students, educators and parents can introduce practical strategies, such as using physical planners to track assignments and deadlines, breaking down larger projects into smaller, actionable steps, and organizing materials with color-coded folders or checklists. Teaching time management techniques, encouraging regular routines, and modeling how to prioritize tasks can also help students build the foundational skills they need to succeed both in and out of the classroom, even without the constant aid of technology.

Ultimately, cell phone bans have the potential to create a more focused and engaged learning environment, fostering improved learning and social interactions. However, as access to technology is reduced, it becomes increasingly important for schools to provide explicit instruction in executive function strategies. By offering concrete tools and strategies, educators can help all students develop enduring, life-long skills that will benefit them not only in managing their responsibilities at school, but also in their future personal an

 

About the Author

Dr. Currie specializes in evaluating children, teens, and young adults with complex profiles, working to tease apart the various factors lending to their challenges, such as underlying learning, attentional, social, or emotional difficulties. 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.

 

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

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