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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Adapting Academic Accommodations for Return to Learning

By | NESCA Notes 2020

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

As students with disabilities return to learning, the accommodations provided through their 504 Plan or Individualized Education Program (IEP) may no longer meet their needs within the structure and limitations of remote learning and/or return to school protocols. For example, when remote learning, teachers are not as readily available to provide “in the moment” redirection, check-ins for understanding or modifications to the presentation or length of assignments. When at school, many students are at the same desk all day, for academics, “specials,” snack and lunch, meaning teachers have to identify new ways to provide movement and sensory breaks while maintaining social distancing. For hybrid learners, teachers have to consider how to provide structure and predictability in the face of frequent transition and increased demands on independent work.

Within all return to learning plans, parents and school teams are having to be more creative than ever before, working to quickly and flexibly identify and implement new accommodations to address a range of new challenges. While this is new territory for all, there is fortunately an increasing number of online resources to aid this process, some of which are listed below. Foundational to the success of any COVID-era accommodations plan will be the team’s ability to regularly assess its feasibility and effectiveness, engage in open communication between home and school, and steadfastly and flexibly adapt the accommodation plan as individual needs and/or school instructional plans change.

See the following websites for information about how to implement accommodations during COVID-19:

In IEP Accommodations During Distance Learning, Amanda Morin of www.understood.org presents a list of many standard accommodations for presentation of information, assignment completion and daily management/organization, with ways to adapt each for remote instruction, giving specific consideration of available tools within Microsoft and Google suites.

Socially Distant Sensory and Movement Break Ideas by Katie McKenna, M.S., ORT/L, of The Autism Helper provides a range of creative solutions for meeting regulation needs for a wide range of students.

The State Educational Technology Directors Association (SETDA) eLearning Coalition website provides webinars and a host of information regarding the development and implementation of accessible educational materials during remote learning.

 

About the Author:

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

 

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

 

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

Transition Planning at IEP Team Meetings – The Good, The Fun and The Beautiful

By | NESCA Notes 2019

By: Kelley Challen, Ed.M., CAS
Director of Transition Services; Transition Specialist

Transition planning is a complicated process for schools, families and related service professionals. It is not something that can be done well without key ingredients, such as open minds, collaboration and creative brain power… not to mention time. But when good transition planning happens in the context of a team meeting, it is a really powerful and awesome process – and even, dare I say, fun!

I recently worked with a young woman – let us call her Julie – who had spent four years of high school in a small therapeutic program. It took Julie, with great support from her team, a lot of effort to get through the academic demands of high school while simultaneously managing and remediating social and emotional complexities. As Julie progressed through her senior year, her school team recognized that she had not had the time or opportunities to build some critical life skills, including the self-advocacy and executive function skills she would need to manage post-secondary, real-world activities. Everyone agreed that she needed another year to build and generalize the functional skills that are essential for being a student in a post-secondary learning environment and to be deemed employable. With no option available for Julie to continue in her therapeutic school program, the team agreed to set up a meeting to create a new IEP that focused largely on Julie’s remaining transition-focused needs. Due to time constraints, the team meeting occurred at the start of this school year.

I was fortunate to be invited to consult at this meeting. After introductions, we dug in together to review Julie’s most recent transition evaluation. Julie had a thorough evaluation that had been completed by the school district, which provided a lot of information about her disability-related needs as well as her vision and interests. We talked about the most pressing areas to address in developing the IEP goals and debated options for creatively writing the annual goals in the IEP document (i.e. whether to focus annual goals on life, vocational and college participation skills with objectives related to social, emotional, executive functioning and self-advocacy issues in each arena or whether to employ a more traditional IEP format with seven goal areas).

We discussed objectives that would be most useful in the context of Julie’s long-term goals – attaining a college degree and working as a nutritionist. Julie’s mom had done a great deal of work prior to the team meeting, helping Julie apply to Massachusetts Rehabilitation Commission (MRC) Vocational Rehabilitation (VR) Services, connecting with the local agency contracted to provide Pre-Employment Transition Services (Pre-ETS), and setting up Julie’s first internship experience for the summer. She also helped Julie to sign up for an adaptive driver’s education class to occur on weekends throughout the fall. Julie’s mother had also researched options for college classes that Julie might be able to participate in, even though she had missed the start of many fall classes.

Julie’s Special Education Director had worked equally hard in looking into resources within the school district and community that could provide Julie with meaningful activities and experiences and assist her in making progress with the skills outlined in the transition assessment. One such resource identified by Julie’s Special Education Director was a non-profit social skills group. Another resource was a coach who could provide hands-on support on a college campus and was already in place as part of a postgraduate program run through a nearby district. The Director also identified several staff withing the school district who were experienced in supporting transition-age students – the school social worker and lead teacher within the school’s therapeutic program – who could work with Julie.

We gathered in a room together not to talk about a program that already existed, but to design the individualized, unique transition program that Julie required. We brainstormed options for shoring up her writing skills with such approaches as drafting an independent research paper on being a nutritionist and participating in a dual enrollment college writing class. We thought of ways to build money management skills through an online personal finance class with school support and real-life practice by visiting her local bank and several ATMs with her school’s occupational therapist.

When we left the meeting, we had designed a brand new program for Julie that would satisfy her needs in the areas of social, emotional, self-advocacy, executive functioning, adaptive and vocational skills development through a combination of school-, community- and home-based activities, with defined support from the school district, community agencies and her family. Everyone left the meeting ready to carry out the next steps of planning for Julie, with roles and responsibilities clearly outlined to initiate the activities that would hopefully propel Julie toward greater independence and satisfaction in her adult life.

This is just one example of a great team meeting that I have been a part of this school year. Over the years, I’ve been fortunate to have had the opportunity to contribute to many of these meetings as well as some of the more challenging ones. After this meeting, I drove all the way home smiling about how much can be accomplished in a 75-minute team meeting when everyone comes to the table thinking about the student, willing to brainstorm, interested in collaborative problem-solving, thinking outside the box, and eager to share responsibility in supporting the student.

Certainly, there are many times when a school district or local collaborative already has a great program and peer group that will work for a student’s post-12th-grade needs, but, as a Transition Specialist, it is truly a lot of fun when everyone is ready to roll their sleeves up and pitch in to create a new tailored individualized education program that taps into the internal resources available to the student and school, while adding community supports and services as appropriate.

In thinking about what makes transition planning at IEP team meetings, such as Julie’s, notably successful, the following “ingredients” stand out:

  • The meeting focuses on the student, with the student’s vision presented at the start of the meeting (ideally by the student), and the team is in agreement about supporting that vision;
  • Team members come to the table eager to work with one another, willing to problem-solve, ask questions, listen to feedback and build on one another’s ideas;
  • There is good assessment data to inform the team process, whereby the team has a good sense of the student’s strengths, preferences and needs, and works together to prioritize what has to be addressed through the IEP; and
  • Team members come to the table knowing what resources exist inside and outside of the school program, with parents and educators having researched and reached out to invite new team members who may know about internal and external resources.

If you are interested in working with a transition specialist at NESCA for consultation, planning or evaluation, please complete our online intake form: https://nesca-newton.com/intake-form/.

About the Author:

Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

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.

Addressing Anxiety through the IEP Process

By | NESCA Notes 2019

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

Anxiety disorders are becoming more and more common among children and adolescents. Recent data from the National Institute of Mental Health (NIMH) reported that 31.9% of adolescents between 13-19 have an identified anxiety disorder. Although fewer statistics are available, it is clear that students who have a developmental, learning, or attention disorder are at high risk for developing clinically significant anxiety in light of their struggles with academics, learning, and/or social development. Given the rising numbers of affected children and adolescents, it has become increasingly important that a student’s emotional health is addressed both at home through private counseling, as well as through the provision of school-based services. When students experience a high level of unmitigated anxiety throughout the day, they are less able to learn and meet their potential.

When parents are seeking services for anxiety through their school system, there are different levels of support. First, teachers can provide classroom supports and address emotional health with all students, whether or not they have an identified anxiety disorder. Some examples of useful classroom strategies include:

  • Create predictable routines and clear expectations.
  • Provide warnings about upcoming transitions.
  • Have a “cool down space” available in the classroom or another room in the school.
  • Incorporate movement into lessons throughout the day.

There are also programs designed to address emotional regulation that can be used throughout the school or district. For example:

If these supports are not sufficient to meet a student’s needs, then it is necessary to develop goals through the IEP process. In order to make needed progress, it is important that the goals and benchmarks in the IEP are specific. For example, a benchmark might state: “Johnny will show better emotional regulation in stressful situations.” A more specific benchmark might state: “When Johnny starts to shut down or refuse to participate during a math class, he will identify his current emotion(s) in 4 out of 5 opportunities.”

When parents seek supports for their child’s anxiety through the IEP, they should consider whether their child needs accommodations, specialized instruction or both.

Examples of accommodations for anxiety include:

  • Extra time in testing situations.
  • Opportunities to take tests in a quiet setting.
  • Access to breaks as needed.
  • Access to the school counselor as needed.
  • Student does not need to sign out of class to use the bathroom.
  • Student is prompted to take breaks when showing signs of distress.
  • Student has modified homework.
  • Teacher will check in with student before independent work blocks.
  • Specialized instruction can be provided in the classroom (push-in) or in a different setting (pull-out).

Push-in services might include:

  • Provision of an instructional aide to support emotion identification and regulation.
  • The school counselor/psychologist works with the entire class once or twice a month to discuss emotional health.

Pull-out services might include:

  • Regular sessions with the school counselor/psychologist.
  • Social skills groups.

Consultation services are also important, especially if a student participates in private therapy outside of school. Parents should consider giving permission for the private therapist to speak with the school counselor to discuss common treatment goals and ways in which the student’s coping skills can be supported and reinforced in school.

About the Author:

GibbonsErin Gibbons, Ph.D. is a pediatric neuropsychologist with expertise in neurodevelopmental and neuropsychological assessment of infants, children, and adolescents presenting with developmental disabilities including autism spectrum disorders, Down syndrome, intellectual disabilities, learning disabilities, and attention deficit disorders. She has a particular interest in assessing students with complex medical histories and/or neurological impairments, including those who are cognitively delayed, nonverbal, or physically disabled. Dr. Gibbons joined NESCA in 2011 after completing a two-year post-doctoral fellowship in the Developmental Medicine Center at Boston Children’s Hospital. She particularly enjoys working with young children, especially those who are transitioning from Early Intervention into preschool. Having been trained in administration of the Autism Diagnostic Observation Schedule (ADOS), Dr. Gibbons has experience diagnosing autism spectrum disorders in children aged 12 months and above.

Dr. Gibbons recently began serving clients in NESCA’s newest location in Plainville/Foxborough, MA. She is thrilled to bring her expertise in evaluating and supporting children with a wide range of abilities to this area of the state.

 

To book an evaluation with Dr. Gibbons or one of our many other expert neuropsychologists and transition specialists, 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.

 

Transition Planning: Let’s Talk about Graduation Dates for Students on IEPs

By | NESCA Notes 2018

 

By: Kelley Challen, Ed.M., CAS
Director of Transition Services; Transition Specialist

On March 26, the Massachusetts Department of Elementary and Secondary Education (DESE) sent out an important administrative advisory regarding transition services and graduating with a high school diploma (Administrative Advisory SPED 2018-2: Secondary Transition Services and Graduation with a High School Diploma). This much-needed advisory clarifies when and how students with IEP’s should be issued a high school diploma and also touches on best practices for planning both student graduation and appropriate secondary transition services.

As a transition specialist who is often contracted by schools and families, it is not uncommon to be asked to help determine whether a student is ready to graduate. The challenge in answering this particular question is that there is no universal set of skills or level of knowledge that deems a student on an IEP “ready” to graduate. In fact, students on IEP’s, just as with mainstream students, graduate all the time without being ready for many adult activities (e.g. apartment hunting, changing jobs, applying for a bank loan, comparing health insurance plans).

The truth is, there are a number of skills that we need for “adulting,” but do not need in order to graduate with a high school diploma. As this important advisory points out, the special education process is not simply about completing local graduation requirements. It is also about transition planning and services that uniquely equip a student for reaching their goals after leaving public education. Therefore, we need to rethink the question, “Is my child/student ready to graduate?” And instead, the critical question to ask when a student approaches the end of 12th grade is, “Has the child/student received a free and appropriate public education (FAPE)?”

As I discussed in a previous blog (Transition Planning: The Missing Link Between Special Education and Successful Adulthood), FAPE as guaranteed by the Individuals with Disabilities Education Act of 2004 (IDEA 2004) includes transition planning and services. Under IDEA 2004, a federal law, transition planning must start by the time a student turns 16. Here in Massachusetts, we have even stronger regulations, and secondary transition services may begin “no later than the age of 14.” This means that the IEP has to be carefully constructed to help students build skills “in a stepwise and cumulative manner” toward completing their high school program while also making progress toward their desired post-secondary learning, working, and independent living activities including community engagement.

The foundation for this process is an individualized and coordinated transition assessment process that carefully evaluates a student’s needs, strengths, preferences, and interests beginning before the age of 14. Just as with all IEP goals and services, assessment informs the team’s discussion and decision-making; it helps the team to know how to plan for the long-term, prioritize for the coming school year, and to track progress.

In each annual meeting for a transition-aged student, the IEP team needs to explicitly discuss whether the student is progressing towards their measurable postsecondary goals and whether the educational program and related transition services are calibrated in such a way that the student will continue to make progress. Anticipated graduation date (listed on the top of the Transition Planning Form and recorded in the Additional Information section of the IEP) is a critical part of this discussion each year. When a student, parent, teacher, or other team member is uncertain about a student’s ability to complete local requirements and receive appropriate transition services “on time,” this needs to be discussed directly.

If there is confusion or disagreement about the graduation date, additional assessment may be needed to clarify the student’s needs. However, if the team starts the transition planning process when a student is 14, and carefully plans out the instruction, community experiences, and employment related activities necessary for progressing toward the student’s post-high school goals, and closely tracks the student’s progress, then students, parents and educators will rarely need to ask whether the student is “ready to graduate.” Instead, they will know if the student has received FAPE because the student’s IEP has included well-calculated transition services and there will be clear measures of the student’s progress with annual goals and transition-related services indicating whether this particular student requires support beyond the traditional 12 years of education.

I am grateful for the recent administrative advisory from DESE and have found each of their advisories on the topic of transition to be tremendously helpful in supporting a shared understanding of the transition planning process among families, schools, and the professionals supporting them. At NESCA, we have seen great progress in the delivery of individualized transition services across the state of Massachusetts since the Massachusetts Legislature approved the amendment to the Massachusetts special education statute in 2008 to require transition planning services “beginning age 14 or sooner” and DESE put out Technical Assistance Advisory SPED 2009-1: Transition Planning to Begin at Age 14. With the recent advisory, I am certain that we will continue to see more teams embrace the transition planning process early. Students, families, and districts will experience less confusion and distress as a student approaches the end of 12th grade, because there will be a clear plan for exiting or continuing special education based on effective transition planning and a collaborative and communicative team process.

Transition Resources and Advisories from MA Department of Elementary and Secondary Education 
· MA DESE Secondary Transition Page – http://www.doe.mass.edu/sped/secondary-transition/default.html
· Administrative Advisory SPED 2018-2:Secondary Transition Services and Graduation with a High School Diploma – http://www.doe.mass.edu/sped/advisories/2018-2.html
· Technical Assistance Advisory SPED 2017-1: Characteristics of High Quality Secondary Transition Services – http://www.doe.mass.edu/sped/advisories/2017-1ta.pdf
· Technical Assistance Advisory SPED 2016-2: Promoting Student Self-Determination to Improve Student Outcomes – http://www.doe.mass.edu/sped/advisories/2016-2ta.pdf
· Technical Assistance Advisory SPED 2014-4: Transition Assessment in the Secondary Transition Planning Process – http://www.doe.mass.edu/sped/advisories/2014-4ta.html
· Technical Assistance Advisory SPED 2013-1: Postsecondary Goals and Annual IEP Goals in the Transition Planning Process – http://www.doe.mass.edu/sped/advisories/13_1ta.html
· Technical Assistance Advisory SPED 2009-1: Transition Planning to Begin at Age 14 – http://www.doe.mass.edu/sped/advisories/09_1ta.html

While this blog includes some specific content that applies only to families of students in IEPs in Massachusetts, the requirement of transition services for students on IEPs is a federal mandate. For families living in New Hampshire, guidance from the New Hampshire Department of Education can be found athttps://www.education.nh.gov/instruction/special_ed/sec_trans.htmThe NH DOE has additionally helped develop a website with resources for increasing the college and career readiness of NH Students that can be found ahttps://nextsteps-nh.org.

 

If you are interested in working with a transition specialist at NESCA for consultation, planning, or evaluation, please complete our online intake form: https://nesca-newton.com/intake-form/.

 

About the Author:

Kelley Challen, EdM, CAS, is NESCA’s Director of Transition Services, overseeing planning,  consultation, evaluation, coaching, case management, training and program development services.  She began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She also worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities including students with complex medical needs. She is also co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism.

 

 

 

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.

 

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