Tag

FAILURE TO LAUNCH

Mar 18
1

The Use of Adaptive Behavior Rating Scales in Neuropsychological Assessment

By | NESCA Notes 2019

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

In my work as a neuropsychologist, much of my practice involves assessment geared toward transition planning – the move from high school to college or from high school to the working world. For these cases, I find the use of measures of adaptive behavior skills – day-to-day skills associated with self-care, communication, community navigation, home living, socialization, use of leisure time, and functional academics – to be a critical part of the neuropsychological testing battery.

Historically, adaptive behavior rating scales were developed and primarily used for assessment of intellectual disability. While adaptive behavior has taken rightful prominence in the assessment and diagnosis of intellectual disability – overtaking the importance of intelligence testing – the use of adaptive rating measures also proves quite important to help with transition planning for individuals with a wide range of psychiatric and neurodevelopmental presentations, including those with exceptionally strong cognitive skills.

These measures (e.g., Adaptive Behavior Assessment System – Third Edition; Vineland Adaptive Behavior Scales – Third Edition), which take the form of parent/caregiver or teacher questionnaires/structured interviews, yield detailed information about an adolescent’s readiness for their upcoming transition out of their family’s home. Particularly for bright adolescents with strong academic skills who might, say, present with attention and executive function challenges but have largely been successful in school, an assessment of adaptive behavior skills is often overlooked. However, over the course of my career, I have heard multiple stories of students who have seemed “college-ready” in the traditional sense of the word (i.e., strong academic and cognitive skills) but have suffered “failure to launch” experiences, as they had not learned to take their prescribed medications consistently, never learned to self-regulate their sleep schedule, or were well behind in their capacity to strike a balance between work and leisure activities.

Although the scores obtained on these measures can be a helpful guide, I find that a closer look at the specific components that may point to a need for additional skill development can help generate a sort of “to-do” list for transition planning work. Thus, while at times simply confirming an adolescent’s suspected transition readiness, the administration of an adaptive measure often proves to be a valuable tool to help determine what skill areas need to be targeted prior to the transition and/or supported during the transition.

 

About the Author:

McCormick

Dr. Jason McCormick is a senior clinician at NESCA, sees children, adolescents and young adults with a variety of presenting issues, including Attention Deficit Hyperactivity Disorder (AD/HD), dyslexia and non-verbal learning disability. He has expertise in Asperger’s Disorder and has volunteered at the Asperger’s Association of New England (AANE). Dr. McCormick mainly sees individuals ranging from age 10 through the college years, and he has a particular interest in the often difficult transition between high school and college. As part of his work with older students, Dr. McCormick is very familiar with the documentation requirements of standardized testing boards. He also holds an advisory and consultative role with a prestigious local university, assisting in the provision of appropriate academic accommodations to their students with learning disabilities and other issues complicating their education.

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

 

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

 

Nov 20
0

Community-Based Skills Coaching: What is it? Is it the right intervention for my child?

By | NESCA Notes 2017

By Kathleen Pignone, M.Ed., CRC

Transition Specialist

What is Community-Based Skills Coaching?

Community-Based Skills Coaching is an individualized service delivered by seasoned professionals to support the needs of transition-aged youth and young adults. It is an intensive 1:1 coaching model provided in the young person’s community. It can include any area of need and is tailored to the young person’s age and stage of development.

Community-Based Skills Coaching is empowering to the young person because the coach meets them where they are at emotionally, socially and developmentally. It allows the individual to learn practical living skills across multiple real-life environments. The first step in Community-Based Skills Coaching is an evaluation period where the young person works with the coach to identify strengths and areas for improvement. Through a collaborative process, the coach and young person tailor each session to allow for direct in-vivo teaching. This can include, but is not limited to, independent living skills, career planning and work readiness skills, financial literacy skills, travel skills, social pragmatic skills and self-advocacy skills.

Coaches meet with individuals in their home communities in order to determine how to best problem solve around any barriers or obstacles that the young person may encounter. It allows for the individual to develop and generalize learned and new skills across settings and in real-time. With frequent opportunities to practice skills in authentic environments, the individual begins to develop a level of confidence and automaticity that can only be learned outside of a classroom or office.

Many transition-aged young adults are at a developmental stage of individuating away from parental support. Community-Based Skills Coaching provides an experienced and trained adult to serve as a coach and mentor in order to guide the young person. This coach becomes an important “expert” and a qualified and trusted team member who can support the individual through the lengthy process of transitioning from high school to post-secondary adult life including learning, working, daily living, and community-based leisure activities.

How do I know if this is the right support for my teen, young adult, or myself?

Coaches work with young people aged 12-26 with varying skill levels. Coaches most often work with transition-aged youth who have a diagnosed learning, emotional, and/or developmental disability and transition related skill development needs. However, our coaches are also experienced in working with young people who are struggling with forward progress unrelated to a specific learning or medical diagnosis. Coaching utilizes a strength-based approach and supports youth and young adults to learn about themselves while experiencing life outside of school and home.

The student or young adult drives the process by choosing an area of interest and need. The coach provides guidance and immediate feedback and support to practice and improve upon skill areas. The coach builds rapport with the individual and is able to re-frame and teach in the moment. An inquiry based approach is used to allow the young person autonomy over the mastery of the skill. The coaching can occur weekly or more often, if necessary. Feedback to parents and designated team members typically occurs on a weekly or monthly basis, often beginning with student input.

To learn more about our Community Coaching at NESCA, please feel free to contact Kathleen Pignone, M.Ed., CRC at (617) 658-9800 or email at kpignone@nesca-newton.com

Who provides coaching at NESCA?

Kathleen Pigone, M.Ed., CRC, brings a wealth of knowledge and experience to her role as a Transition Specialist at NESCA. She received her undergraduate degree in Sociology from Boston College and her master of education in Rehabilitation Counseling from the University of Massachusetts Boston.

Ms. Pignone was the Career Development Director at Bay Cove Academy for 15 years, providing students with classroom and real-world employment skills training, community job placement and on the job employment-training. She supervised the Career Development Program, developed individualized transition plans for students, created innovative programming for tracking and assessing long-term employability and career success for students. She also trained staff in the areas of career development and transition services.

Ms. Pignone joined NESCA in March 2016, bringing her unique expertise supporting vocational assessment and employment planning for adolescents and young adults as well as local school programs. In addition to supporting NESCA’s premier transition assessment services, Ms. Pignone engages in person-centered planning with teens and young adults, consultation and training for parents, providers and schools, and community-based skills coaching.

Dina Karlon, M.A., is a seasoned counselor specialized in transition issues. She has worked in public schools as a guidance counselor, GED program coordinator, career center coordinator, vocational assessment specialist, and school counselor. At NESCA, She offers community-based skills coaching services in New Hampshire as well as postsecondary planning consultation to students and families throughout New England.

In addition to her work at NESCA, Ms. Karlon is a Program Specialist for the New Hampshire Department of Education, specializing in development of employability skills and job readiness skills for at risk youth. She has recent experience as a Rehabilitation Counselor for New Hampshire Voc Rehab, working with students and adults with a range of developmental, learning, and social-emotional disabilities and helping to guide and coach them through transitions toward independence in both college and the working world. Prior to that, Ms. Karlon worked for more than two decades as a school counselor in local high schools.

She has provided transition services including personal, career, and college counseling to hundreds of students and their families and has also worked as an adjunct professor at Nashua Community College teaching both traditional and online classes for nearly 20 years. Ms. Karlon brings extensive experience supporting clients with career and college planning and she is able to shift fluidly with clients along their paths in each of these domains.

Sophie Bellenis, OTD, OTR/L, is Licensed Occupational Therapist in Massachusetts, specializing in pediatrics and occupational therapy in the developing world. For the past five years her work has primarily been split between children and adolescents with ASD and related profiles in the United States, and marginalized youth in Tanzania, East Africa.

Dr. 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.

Dr. Bellenis works as a school-based occupational therapist for the city of Salem Public Schools and believes that individual sensory needs, and visual motor skills must be taken into account to create comprehensive educational programming. She is joining NESCA in order to offer community-based skills coaching services as well as social skills coaching to students and young adults.

Kelley Challen, Ed.M., CAS, is Director of Transition Services at NESCA and oversees Community-Based Skills Coaching as well as transition assessment, planning, consultation, case management, program development, college supports, trainings, and professional development offerings.

Ms. Challen received her Master’s Degree and Certificate of Advanced Graduate Study in Risk and Prevention Counseling from the Harvard University Graduate School of Education. Initially trained as a school guidance counselor, she completed her practicum work at Boston Latin School focusing on competitive college counseling. She began facilitating social, life, and career skill development programs for transition-aged youth in 2004.

Prior to joining NESCA, Ms. Challen founded an array of programs for teens and young adults at MGH Aspire, and spent time as Program Director of the Northeast Arc’s Spotlight Program, where she often collaborated with schools to develop in-district social skill and transition programming. She is also co-author of the chapter “Technologies to Support Interventions for Social-Emotional Intelligence, Self-Awareness, Personal Style, and Self-Regulation” for the book Technology Tools for Students with Autism.

While Ms. Challen has special expertise in working with students with Asperger’s Syndrome and related profiles, she provides transition assessment, consultation, planning, and programming support for individuals with a wide range of learning and developmental needs.