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158

Executive Function: Skill Building and Maintenance over the Summer

By | NESCA Notes 2022

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

With summer right around the corner, many students are thinking of warm evenings outside, days at the beach, pool or park, summer camps, and summer jobs. For parents, summer can sometimes feel like both a time of fun and a time of struggling to keep up with skills mastered and learned throughout the past school year, all while acclimating to a completely new summer routine. While some students receive summer services to keep up with important academic and executive function skills, there are absolutely ways for us to help support children and adolescents at home. Consider these three ways to incorporate executive function skill building into your child’s summer.

  1. Plan and Complete a Project – Work with your child to brainstorm a project that they would like to complete this summer. Some examples include having a lemonade stand, building a tree fort, doing a full bedroom makeover, or raising money for a cause they care about. Help your child figure out how to put together a plan to complete their goal. This will likely include a timeline complete with a comprehensive “To Do List,” a list of materials or supplies, and a list of people they may need to ask for help. The more intentional the planning of these steps is, the more a child will internalize the level of planning and prioritization that goes into accomplishing such a goal. You may need to jump in to help, but take every opportunity to defer to them and let them actively think things through before making suggestions or solving problems for them. Planning and executing a personal summer project helps to build organization, planning and prioritizing, flexible thinking, working memory, and task initiation.
  2. Organize a Family Outing – Summer can absolutely be a whirlwind, but reserve a day in the calendar for your child to plan a family outing or activity. This could be as big as a full day at the beach or as simple as a trip to lunch at their favorite restaurant. Help them think through everything that will be needed. What time will we leave? How long will it take to get there? How can you find that information? Should we check Google Maps together? How will we pay for the meal? By guiding your child through all of the steps before these activities, you help them recognize the level of planning and forethought that is necessary. For older children or adolescents, consider giving them a budget and asking them to plan a family outing independently, taking into account each family member’s preferences and schedules.
  3. Add a Weekly Task – During the school year, parents often do not have time to add chores or anything new at all to their child’s calendar. Dinners are often prepared and eaten on the fly between rehearsals, appointments, practices, and homework, and laundry gets done when someone has a free moment. Summer can be a great time of the year to add in an expectation for students who have been a bit overloaded with homework or other distractions. Consider adding a weekly task that student both need to complete and figuring out a way to remember (often a digital reminder!). One of my favorite options is to have a student cook a meal for the family one night per week. Have them set an alarm for 12pm that day, or even the day before, that prompts them to “figure out the plan for dinner.” This may look drastically different at various ages. An eight-year-old may be very proud of themselves for serving boxed macaroni and cheese (made with supervision), while a high school student may be up for trying to recreate a family recipe. The goal is not a gourmet Tuesday night meal, but practice with prior planning, sequencing, following directions, and building time management skills.

Incorporating children and adolescents into the planning, hard work, and many executive function tasks that go in to making a summer run smoothly allows them to build skills naturally. By handing down responsibility and increasing expectations bit by bit, we can allow our students to build their skills slowly and confidently. It’s important that students realize all of these many steps before they are expected to do everything on their own. Often, allowing children to feel this level of control and responsibility leads them to feel quite accomplished and proud of themselves! If you feel that facilitating this may be tricky, consider reaching out about executive function coaching, as all of these strategies can be practiced one-on-one with a coach!

 

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 Executive Function Coaching 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.

 

5

Pediatric Neuropsychologist Maggie Rodriguez, Psy.D., Joins NESCA

By | NESCA Notes 2022

By: Jane Hauser
Director of Marketing & Outreach

In today’s blog, I have the pleasure of introducing you to NESCA Pediatric Neuropsychologist Maggie Rodriguez, Psy.D., who recently joined our team of expert clinicians.

How did you discover your interest in neuropsychology?

It was a long and winding road! I went into college, interested in a wide range of subject areas, including medicine. Eventually, I realized my area of interest was truly in psychology. I discovered that I really enjoyed neuropsychological evaluations, since they combined my interests in psychology, neuroscience, working with medical providers, educators, as well as writing and the creativity involved in making a child come alive in a report.

In graduate school, I was fortunate to learn from a number of extremely talented neuropsychologists in a variety of settings. While completing a placement at Children’s Hospital Boston, I remember hearing my very wise supervisor say that, “one year in the correct school placement is worth two years of therapy.” As I continued on with my coursework and clinical training, I repeatedly saw the truth in that statement. I witnessed the value of nuanced neuropsychological assessment in allowing students to receive accurate diagnoses and, in turn, the correct academic accommodations and interventions. I wanted to be part of that, not only to help children and teens succeed academically but to prevent the secondary effects that undiagnosed and untreated learning disorders, neurodevelopmental disorders, and cognitive challenges can have on emotional health, self-esteem, and social functioning.

On the personal side, my interest in neuropsychology was sparked again when I had my own child evaluated. It was surprisingly powerful to go through the process on the parent side, and after taking some time off to have a family, I knew that I wanted to get back into neuropsychology again!

Why did you choose to come to NESCA when re-entering your professional career?

There were several reasons that I looked into NESCA and ultimately opted to join its team. I learned about NESCA while researching neuropsychologists for my child’s evaluation and was impressed with what I saw. Additionally, one of my former testing supervisors told me NESCA is among the best in the business. Having that kind of endorsement from such a trusted source provided me with great confidence being part of NESCA.

I also was really drawn in by NESCA’s emphasis on the continued growth and learning for its clinicians. It was obvious that NESCA is comprised of a highly invested and collaborative team. Every one of us has a lot to learn still, and I valued the opportunity for not just a job, but the continued learning.

NESCA also offers a great work/life balance. Having a family of my own and parents who are approaching the stage where they also require care is a lot to balance. NESCA’s emphasis on supporting its staff in balancing work and life has made it very rewarding. I’ve seen several examples of how the culture of understanding is very much active.

On a very practical level, having clear protocols for handling day-to-day Covid strategies, like masking, cleaning, etc., has been comforting. Returning to clinical work in the midst of a pandemic has been a big transition, and knowing NESCA has put in place measures for keeping staff and clients safe is tremendously important to me. Seeing the creativity and agility in the way the team here tackled the larger challenges—evaluating clients safely and in-person—during Covid was inspiring and told me a lot about the team and culture. Learning that NESCA adapted its methods of testing via the two-office model demonstrated to me that they, as a practice, they are able to roll with those kinds of challenges. That was also very reassuring.

Finally, the interview process provided me with the chance to speak with a number of NESCA’s clinical staff. I was able to get a great feel for the culture and high standards the practice has, which made me confident that this was the right fit for me.

What kinds of concerns do you evaluate or enjoy the most?

I really enjoy working with kids of varying ages, but I do have a keen interest in working with families and children who are just hitting the adolescent years. I get the opportunity to help them understand how all the, sometimes confusing, pieces fit together.

I really enjoy working with kids who may be deemed as “complicated,” where things may have previously been overlooked. Maybe things were going fine for them until they hit a wall academically. Perhaps they got to middle school or high school or even college and began to wonder why things seemed to be falling apart for them. I enjoy the challenge of working with kids who are experiencing executive function deficits, social communication issues, kids whose disability or disabilities are not as straightforward. I like to tease apart whether there are executive function (EF) issues, Attention-Deficit/Hyperactivity Disorder (ADHD), or sensory integration challenges…or perhaps explore whether it could be something else altogether. Is a child’s rigidity due to anxiety, an Autism Spectrum Disorder (ASD), Obsessive-Compulsive Disorder (OCD), cognitive issues or a combination of overlapping challenges? I love teasing all of these things apart. I also work with children whose families have concerns about potential language-based learning disabilities (LBLD), communication issues and challenges with social pragmatics.

It’s incredibly rewarding when you are able to help families understand answers to these kinds of questions that they may have been grappling with for a long time.

 

About Pediatric Neuropsychologist Maggie Rodriguez, Psy.D. 

Maggie Rodriguez, Psy.D., provides comprehensive evaluation services for children, adolescents, and young adults with often complex presentations. She particularly enjoys working with individuals who have concerns about attention and executive functioning, language-based learning disorders, and those with overlapping cognitive and social/emotional difficulties.

Prior to joining NESCA, Dr. Rodriguez worked in private practice, where she completed assessments with high-functioning students presenting with complex cognitive profiles whose areas of weakness may have gone previously undiagnosed. Dr. Rodriguez’s experience also includes pre- and post-doctoral training in the Learning Disability Clinic at Boston Children’s Hospital and the Neurodevelopmental Center at MassGeneral for Children/North Shore Medical Center. Dr. Rodriguez has spent significant time working with students in academic settings, including k-12 public and charter school systems and private academic programs, such as the Threshold Program at Lesley University.

Dr. Rodriguez earned her Psy.D. from William James College in 2012, where her coursework and practicum training focused on clinical work with children and adolescents and on assessment. Her doctoral thesis centered on cultural issues related to evaluation.

To book a neuropsychological evaluation with Dr. Rodriguez or another expert neuropsychologist at NESCA, complete NESCA’s online intake form. 

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

5

Anxiety-based Procrastination: Tips for Getting over the Hurdle

By | NESCA Notes 2022

By: Lyndsay Wood, OTD, OTR/L
NESCA Transition Specialist & Occupational Therapist

Despite our best efforts, procrastination happens. There are many reasons that you may be putting off that large paper, important phone call or those dishes that are stacking up. You may not have the motivation, you may be tired, you may have more fun plans, or maybe it makes you feel anxious. In fact, one of the top reasons people procrastinate is anxiety. Anxiety rates have increased since the start of the COVID pandemic in 2020, and tasks that previously felt easy can now be daunting to think about. It is important to both treat yourself with kindness AND build up your toolbox so that you can tackle the day ahead. Below is a list of nine tips on getting over the procrastination hurdle when anxiety is taking over.

  1. Five minute max – For this strategy, set a five-minute timer and start the activity you have been putting off. Tell yourself that you can stop the activity after five minutes. More than likely, once you start, you will be able to keep going, but you have the option to stop after just five minutes. This strategy helps with perfectionism and all-or-none thinking that can stop you from starting your tasks.
  2. Task breakdown – Big tasks can often feel overwhelming, so breaking your big project, chore, etc., into small steps can help you get going. Tell yourself you will complete step one today and move on to step two tomorrow.
  3. Seek help – Take a step back. Do you have the skills to complete this task? Is there someone you could ask for help if needed? Do not be afraid to seek the help of others to get started!
  4. Reduce the standard – Identify one task that you would be less likely to avoid if you make it easier. For example, have you been putting off exercise because you are worried about going to the gym? Start with a 10-minute walk and build up to a longer exercise period once you are ready. This method is especially helpful to combat an all-or-none mindset.
  5. Notice negative predictions – Be aware of your thoughts and how they can impact, or even control, your actions. Are you making a negative predication about the outcome? If so, it can be helpful to go through the following questions in your mind to reframe your thinking:
    1. What is the worst outcome?
    2. What is the best outcome?
    3. What is the most realistic outcome?
    4. What might I learn if I am willing to take a risk?
  6. Recognize your strengths and challenges – If you find initiating, planning or sequencing tasks difficult when compared to your other skills, don’t misattribute procrastination to laziness or poor motivation. Mislabeling yourself as lazy can lead to further procrastination and decrease self-confidence. You may instead decide to seek extra support or tools to develop your executive function skills.
  7. Visualize – Visualize the finished product AND the feeling associated with completing the task. It is easier to start a task if you feel like you have already succeeded at it.
  8. Accomplishment journal – Keep a running list of accomplishments (even small ones) and check back in to boost your self-confidence for the tasks ahead. It is much easier to start a task when you are in a positive head space and see that you are capable of meeting your goals.
  9. Treat yourself with small rewards – Sometimes a small reward can help you get over a big scary hump. Perhaps after scheduling all of the health care appointments you have been putting off, you sit down and watch the movie you have been wanting to see.

There is no perfect strategy that works for everyone in every situation, but add these strategies to your toolbox and test them out. See if you can find just one tool to help you in those moments when anxiety is impacting your ability to get moving. You’ve got this!

 

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

 

To book coaching and transition services at NESCA, complete NESCA’s online intake form. 

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

158

Executive Function and Goal Setting

By | NESCA Notes 2022

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

Personal, professional, and academic goals are a large part of what drives us as we transition from one stage of life to the next. They also provide direction as we choose and maintain the habits and routines that we feel are important to daily life. Determining what our goals are is a big step, one that students are often working on with their families, school supports, and friends as they start to figure out their next steps in life. But once these goals are solidified, what’s next? How  do we get there? As an executive function coach working with high school and college students, I can attest that this can unexpectedly be the most difficult step in the process. Let’s talk about some ways that we can support students in these endeavors.

  1. Break down goals into manageable chunks. Many goals tend to be large or long-term and can feel daunting and amorphous. For example, a common goal for high school seniors might be, “I will apply to five colleges by their application deadlines.” We can help students by breaking a goal like this down and creating step by step lists, such as: put together a list of preferences for my ideal school, research schools that fit these preferences, meet with guidance counselor to review my research, finalize list of five schools, ask teachers for letters of recommendations, fill out each section of the Common App, write personal essay, have English teacher or other support person review personal essay and give feedback, etc. This list is not comprehensive, but it does show how much goes into the seemingly simple initial goal.
  2. Help them prioritize. Once students have created a comprehensive list of steps, help them to understand what steps need to be attended to right away and which can wait. Continuing with the example of applying to college, figure out what steps need to happen before the Thanksgiving or winter break! It may also be helpful to figure out which steps seem difficult for your specific student. For some, this may be writing the personal essay; for others, it may be building up the courage to ask a favorite teacher to write them a recommendation. Busy students who are already taking multiple classes may have trouble figuring out how to add the steps needed to reach another goal into their schedule.
  3. Put together a plan. Set a timeline. Put internal deadlines into a calendar. Figure out specific times to work towards the goal. Find people who can be solid supports and help to make things happen.
  4. Check in on them. Offer to check in along the way. Some students will love having a partner to track their progress with, while others simply need help setting the foundation.

While this example is very concrete and includes working towards a specific predetermined deadline, not all goals need to be. Whether your student’s goal is to find a summer job they enjoy, get an average of a B in all of their classes, or find a new hobby that makes them happy, using these strategies can help to make a goal feel more manageable.

Finally, you might notice that these steps are quite similar to some of the strategies for completing specific academic tasks, and you would be right! Take, for example, writing a research paper. We want students to break that task down into smaller pieces, such as finding sources, creating an outline, writing a rough draft, and developing a final draft. We then help them to prioritize which steps will need more time to complete and eventually put together a plan so they dedicate sufficient time to each section and submit a final draft on time. Many of the academic executive function tasks that we learn in school create processes and roadmaps for how to tackle life skills that require similar executive function skills. However, not all students can transfer these skills to setting goals without some direct support or help seeing the similarities in the process.

 

To learn more about Executive Function from Dr. Bellenis, join her along with Dan Levine from Engaging Minds, for a free webinar, “Executive Function in the Covid Era: Managing School and Life (Kindergarten through High School),” on March 8 at 7:00PM ET.

Register now: https://engagingmindsonline.zoom.us/webinar/register/WN_vWNlilZkS36imBqvr4IMZQ

 

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.

 

4

Meet NESCA Transition Specialist & Occupational Therapist Lyndsay Wood, OTD, OTR/L

By | NESCA Notes 2022

By: Jane Hauser
Director of Marketing & Outreach

NESCA is thrilled to have welcomed a new Occupational Therapist who is serving as a Transition Specialist on the Transition Services Team. Learn more about Lyndsay Wood, OTD, OTR/L, in my interview with her below.

How did you become interested in Occupational Therapy, specifically for transition-aged students?

Right after college, I worked in an assisted living center in an administrative role. I got to know the Occupational Therapist (OT) there, who was amazing at what she did. She helped people with the skills they needed to do on a daily basis. I asked to shadow her so I could learn more about the profession and what kind of skills she was teaching the residents to do. Energized by what I learned, I then became a Teaching Assistant (TA) in the CASE Collaborative’s high school program. This is where I started to learn about the needs of transition-aged students and how Occupational Therapy played a role in that area. Again, I was fortunate to learn so much from another talented OT, particularly around the importance of transition, with our students who are often underserved on that front. Moving into adulthood is so challenging, and it’s even harder when coupled with a disability. I found that the environments these students encountered every day just aren’t set up for them to succeed. I was able to help them move into adulthood and practice skills they would need to achieve their goals within these environments.

What made you realize that you wanted to work as a Transition Specialist?

I had already developed a passion for working with transition-aged students in the school setting both during my time as a TA and as an occupational therapist at The League School of Greater Boston. I loved working with the students on life skills, emotional regulation, and executive functioning. I found that I most enjoyed working with the students on hands-on, real-life learning. It seemed to be the most important and most effective way that, as an OT, I could help young adults and teens become more self-determined and thrive. They were able to see what they were able to do, and that was exciting!

Why did you join NESCA?

I loved working with students, but I wanted the opportunity to work with transition-aged youth out in the community. It’s often really difficult for this group to generalize what they learn in the school setting to the experiences they face in the community or even at home. I wanted to help them do just that.

I was thrilled to learn that NESCA offers Transition and Coaching services since I didn’t know anything like that existed outside of an academic setting. I initially joined NESCA as an Occupational Therapist; Executive Function and Real-life Skills Coach on a per diem basis during the summer of 2021. I got to take the skills our teens and young adults learn in school and tailor them to be put into place in the community in a hands-on way. We’re able to teach clients skills like grocery shopping, using the subway or Uber to get to where they need to go, making a deposit at the bank and any other skills they may need to succeed in real life. Having recently moved into a full-time Occupational Therapist; Transition Specialist position here, I look forward to doing much more of these kinds of activities!

What is the most rewarding part of what you do?

The most rewarding aspect of what I do is when I actually get to see the client perform the skill(s) that they have had a hard time with and that they have been working toward for so long. Watching them accomplish their goal is so gratifying. When you see that success, it’s a wonderful feeling!

I also love that I am able to do what I do – not only within the walls of a classroom or school – but in the outside world. I always wanted my students to practice the skills that we were working on in the school environment out in the real world so I knew they would be prepared for experiences they were likely to face in their daily lives. This could be anything from placing an order at Starbucks, riding the bus or refilling a prescription. I get to do that with them here at NESCA…and so much more.

What’s your specialty area? Who do you most enjoy working with?

My passion is working with those who are on their way to adulthood. I am definitely where I want to be with the transition-aged youth and young adults! When working with teens, you get to see them prosper and make monumental changes that can help them build a high quality of life, allowing them to be successful and happy for a greater portion of their lifespan.

I really enjoy working with a wide population of clients, including those with mental health challenges, Autism Spectrum Disorders (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD). I especially find it rewarding to work with young adults with mental health issues, such as anxiety or depression, to help manage those challenges and lead a fulfilling life.

Tell us a little about yourself. What do you like to do in your spare time?

I grew up in Acton, Massachusetts, and I’m a big outdoors person. I like to spend most weekends in Vermont or New Hampshire, exploring new places to hike. I also enjoy skiing, kayaking and most other outdoor activities. I also like to read, play weekly board games and dance when I get the chance!

 

About Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completely her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored the client’s goals and interests.

 

To book coaching and transition services at NESCA, complete NESCA’s online intake form. 

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

10

The Power of a List

By | NESCA Notes 2021

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

For so many children, adolescents, and young adults, I find myself recommending something that seems too simple to be of much use – a list. The power of lists has been identified and described in depth by several experts, such as Atul Gawande (The Checklist Manifesto – an excellent read). These books often discuss efficiency in the workplace, health and safety practices, and maintaining consistency in products or services. As adults, these are the things we often care about – ensuring that we are efficient, consistent, and getting things done.

In my practice, I recommend lists for different reasons. I recommend lists to teach executive functioning skills, such as planning, task initiation, organization, and task monitoring. Lists are also incredibly helpful for children who struggle to hold on to information. These children often miss information that is stated aloud, such as a parent giving directions or a teacher explaining instructions. Their brains often struggle to “keep up” with the pace of information presented in the world. Having the information written down in an organized manner, such a list, can help them access the information without time constraints.

Here is a quick example:

On a typical weekday morning, parents alternate checking on their 8-year-old as he gets ready for school. They give reminders of all the things left to do – “Brush your teeth!” “Get dressed!” “Put your homework in your backpack!” Time before the bus becomes shorter and shorter, as does everyone’s patience. Parents think, “We do the same things every single morning! Why is it so hard for him to remember?” Child thinks, “Why can’t they just leave me alone!” Voice volumes increase, tone shifts, and before anyone knows it or means to, there is a shouting match as the bus is pulling up.

Of course, a list won’t stop hurt feelings or eliminate frustration. However, if the child’s “morning routine” is posted somewhere easy to see, he may need far fewer reminders from his parents of all the tasks he has left to do. Frustration may be reduced, and the child can feel successful completing tasks with greater independence.

A list may be steps in a routine, as illustrated above. A list could also be of materials the child needs for baseball practice, the chores that should be done each week, or the limits and expectations around “screen time.” I often spend time with parents discussing the contents of a list, where the list should be placed, and the format it might take. For example, do you want checkboxes next to each item? Do you want the steps to be numbered? Maybe you love arts and crafts, and you want to laminate the list and have Velcro tabs with a “checkmark” that can be placed next to each completed task. The format and purpose vary, but lists are infinitely useful.

For many children, practice using lists is not only helping them to build skills in the moment, but is excellent practice for later life. Developing comfort with the tools and strategies that work best for you is an invaluable aspect of raising our children to become independent adults who can achieve their goals.

 

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.

 

157

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.

 

23

Executive Function Skills in the Outdoors

By | NESCA Notes 2021

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Executive functioning skills are a “family” of skills that operate in a “top-down” process, controlling and regulating brain regions associated with attention, impulse control, emotion regulation, and meta-cognition or “thinking about thinking.” For more information about executive function skills, please refer to my previous NESCA blog “Teenage Stress and Executive Functioning.” As an evaluator, I often emphasize two key points about executive function skills: (1) Developing executive function skills is a combination of brain development and life experience; and (2) These skills are built through interactions (with others and our world) and practice.

Now with more access to New England summer weather, there are plenty of opportunities for children and teens to grow executive function skills in interaction with the natural world. I recommend a “must-download” if you want to review practical, science-based activities and games for children from the ages of six months old through adolescence, “Enhancing and Practicing Executive Function Skills with Children from Infancy to Adolescence.” This is a wonderful resource that provides a clear list and description of practical activities to strengthen executive function skills based on a child’s age. This resource was developed by The Center on the Developing Child at Harvard University, a multidisciplinary team supporting research, policy, and practice for childhood development. Their website also provides excellent free resources for parents, clinicians, and educators related to topics such as stress, resiliency, play, and brain structure/development.

Here is a short list of outdoor summer executive function activities based on your child’s developmental age:

  1. 6-18 months-old: Peekaboo and Patty-Cake on the grass and other textures, such as dirt, mud, water, or wood (a multi-sensory experience), encourage joint attention and object focus by naming, pointing, and sustaining focus on natural objects at the beach or in the woods.
  2. 18-36 months-old: Match/sort natural objects, such as placing rocks in one bucket and flowers in another bucket, blow bubbles with a variety of wand shapes, pretend play as fishermen, construction workers, or farmers/gardeners.
  3. 3-5 years-old: Pretend to be an outdoor superhero in an obstacle course or race (e.g., running through Hula Hoops or around traffic cones), assist with cooking/preparing an outdoor picnic, or make a nature bracelet.
  4. 5-7 years-old: Play the I-Spy game and participate in scavenger hunts, use strategy board games (e.g., Uno, Concentration) on land or maybe even in the water, go on a sensory walk (name something you see, hear, smell, taste, and touch).
  5. 7-12 years-old: Star-gaze and find/name constellations, create a bird house or other wood structure through woodworking activities, garden one or more plants, play with a super soaker toy or laser/flashlight tag.
  6. Adolescents: Maintain a summer sketching and drawing journal of natural objects, participate in sunrise or sunset yoga or dance classes, outdoor animal-assistant yoga (e.g., Goat Yoga), or sports-oriented camps and activities.

 

About the Author:

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

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

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

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

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

 

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form. 

 

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

 

14

Summer is Here, but There are Still Chores to Do – The Importance of Chores in a Child’s Development

By | NESCA Notes 2021

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

What a year it’s been! Hopefully with the pandemic restrictions lifted and the start of summer, we are all breathing a sigh of relief. I’m certainly looking forward to traveling, seeing relatives and getting out without masks. The pandemic upturned our lives in so many ways, but now that there is a “sense of normalcy” returning, we may be tempted to kick back and really relax this summer. However, I would caution that in kicking back and relaxing, there are still chores that need to be done. So, why not include your children in taking ownership and helping out around the house? There is research that states that toddlers who are taught to “help out” around the house continue to help out as they age. Many children in indigenous communities grow up asking to help or just help out because it is needed. Wouldn’t it be nice if that were the case in the United States?

Jim Fay, co-founder of the Love and Logic parenting website, says that all of us need to feel needed and know we are making a contribution to those around us or to our world at large – even kids. In many families, chores are a tradition, but in others they have fallen by the wayside. Many upper and middle class families have hired household help, so the need to do chores isn’t as great, and fighting with children to do chores doesn’t seem worth it. Let’s face it, no one likes to do chores, but they have to get done. Psychologist Roger McIntire, author of Raising Good Kids in Tough Times, says, “A child has to have some responsibilities.” The family is a community, and everyone should chip in and help out. Helping out with family responsibilities and doing one’s own personal responsibilities are useful and necessary skills for a child’s development. The American Academy of Child and Adolescent Psychiatry states that, “there are benefits to including chores in a child’s routine as early as age 3. Children who do chores may exhibit higher self-esteem, be more responsible, and be better equipped to deal with frustration, adversity, and delayed gratification. These skills can lead to greater success in school, work, and relationships.” Research also shows that children who grow up contributing to the family responsibilities grow up to be adults who work well in collaborative groups and have a “can-do” attitude.

Helping kids learn that they have to do chores and that they are a part of life teaches them that it’s not just about me and what I need at this moment, but that I’m part of a system. I’m part of a family (I set the table). I’m part of my class at school (I clean up after an art project). I’m part of my sports team (I carry the bat/ball bag). I’m part of the workplace (I do my part). Humans crave a sense of belonging and connection, and helping others out and doing work for the good of the whole helps us understand why connection is important. The more we can do to foster this in our kids, the better off they will be as adults. Chores are a form of selflessness and help children develop a sense of responsibility and awareness of the needs of others. They begin to recognize that when they pick up, they can find their toys and they are grateful for the small things. Parents show gratitude when children do chores. Praise is good! Children feel appreciated and connected, and gratitude helps wire our brains to notice more things to feel thankful for, leading us to feel better overall.

Chores are powerful teachers. They help a child develop a greater sense of responsibility and awareness of the needs of others, and they also contribute to a child’s social and emotional well-being. Chores help children believe that they are competent and capable and help them develop greater self-esteem. Doing chores can also help children learn problem solving skills as well as the consequences of not doing their chores (i.e., not putting your baseball shirt in the laundry so it’s dirty for the next game). Chores are an excellent teacher of life skills. Knowing how to set the table, walk the dog, pick up toys, do laundry, prepare a meal, sweep/vacuum the floor, change a vacuum cleaner bag, etc., all help prepare a child for the responsibilities of adulthood. More involved tasks (i.e., cleaning out the garage) can be used in the development a child’s executive functioning skills, prompting them (perhaps with parent assistance) to figure out how to tackle the task in the most efficient, most systematic manner. And they learn about solutions that may be applied to a host of other life responsibilities.

Being a part of a family and taking responsibility for oneself and contributing to the family by doing chores is a powerful gift to give to children, even if they may not do the chores perfectly, may need to be reminded to do them, or grumble while they are doing them. It’s okay. Over time, these will lessen. Stay with it and help your child recognize and understand that life is work, and they have to be a part of the work of life.

If you aren’t having your child do chores now, consider it while the summer is here. It will help them out in many ways in the long run, helping them to be better functioning and more capable adults. If you need help figuring out which chores are age-appropriate, there are many lists online offering ideas and ways to assist in helping children do chores without too much complaining!

References

https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Chores_and_Children-125.aspx

https://www.loveandlogic.com

https://www.nytimes.com/2018/08/18/opinion/sunday/children-chores-parenting.html

 

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

 

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

 

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.

 

158

Put Me In, Coach!

By | NESCA Notes 2021

 

Coaching Services at NESCA

For students and young adults with social, emotional, organizational and/or learning differences, hands-on instruction in real-world environments is a critical means of developing skills for postsecondary living, learning and working. NESCA is pleased to offer individualized home-, community-,and office-based coaching services as well as remote coaching services, delivered by a team of seasoned Occupational Therapists (OTs), Vocational Counselors and Transition Specialists to support the needs of transition-age youth.

 

Meet the Coaches

 

Sophie Bellenis, OTD, OTR/L

Dr. Sophie Bellenis is Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy, including school-based service delivery. Dr. Bellenis has expertise in working with tweens, teens, and young adults with a wide range of social, emotional, and developmental needs. She joined NESCA full-time in the fall of 2019 in order to oversee the Real-life Skills Coaching program as well as to carry out transition assessment, occupational therapy assessment and treatment services. One of the keys to Dr. Bellenis’ success coaching students and young adults is her ability to form a meaningful relationship with each client and use that relationship to motivate lasting change.

 

 

 

 

Aubrey Matthews, OTD, OTR/L

Aubrey Matthews, OTD, OTR/L, is an occupational therapist who has focused most of her career on mental health and skill building for adolescents and young adults. She currently works full-time at a behavioral health hospital, splitting her time between the inpatient adolescent unit and the young adult intensive outpatient program. Aubrey tends to focus on building emotional regulation, executive function, and social skills through occupation-based strategies. Aubrey’s doctoral research at the MGH Institute of Health Professions focused on using LEGO therapy to build social skills at a pro-bono pediatric program, and she uses many of these creative strategies to increase client motivation and success.

 

 

 

 

Jasmine Badamo, MA

Jasmine is an executive function coach, and a New York State Certified ENL and Special Education teacher. She earned her bachelor’s degree in Biological Sciences from Cornell University and her masters degree in TESOL from CUNY Hunter College. She has over 10 years of teaching experience across three countries, and has worked with students ranging in age from 7 years to adults.
Her work focuses on creating individualized supports based on the specific needs and strengths of each client, and supporting the development of metacognition, executive function skills, and independence. Building an authentic connection with clients is a top priority, as this allows her to provide the best supports possible.

 

 

 

 

Lyndsay Wood, OTD, OTR/L

Lyndsay Wood, OTD, OTR/L, is an occupational therapist who focuses on helping students and young adults with disabilities to build meaningful skills in order to reach their goals. She has spent the majority of her career working in a private school for students with ASD and related social, emotional and executive functioning challenges. She has also spent some time working in an inpatient mental health setting. Lyndsay uses occupation-based interventions and strategies to develop life skills, executive functioning, and emotional regulation. While completing her doctoral degree at MGH Institute of Health Professions, Lyndsay worked with the Boston Center for Independent Living to evaluate transition-age services. She uses the results from her research to deliver services in a way that is most beneficial for clients. Specifically, she focuses on hands-on, occupation-based learning that is tailored to the client’s goals and interests.

 

 

 

Visit our website for more information about NESCA’s Coaching Services or complete our online Intake Form. 

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