Tag

Jason McCormick

The Enemy of the Good

By | NESCA Notes 2020

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

As a neuropsychologist who has primarily focused on assessment of middle school, high school and college students, I have worked with many children, adolescents and young adults plagued with perfectionism. On the surface level, perfectionism is defined as a refusal to accept any standard short of perfection. Digging deeper, at the roots of perfection are fears of making mistakes, fears of being judged, and, ultimately, fears of being inadequate.

By definition, students with perfectionism hold impossibly high standards, which can severely undermine productivity and can lead to high levels of emotional distress. The adage, perfection is the enemy of the good, “perfectly” describes these students’ challenges. Students with perfectionism often run into “blank-screen syndrome,” presenting with such a harsh self-censor that they shoot down their own good ideas before they have a chance to develop them. Further, with the additional time needed to “gild the lily,” students often end up blowing past paper deadlines, thus undermining their grades.

Complicating treatment, many students – even those with recognition of their impossibly high standards – view a call to work on ameliorating their perfectionism as an intolerable directive to lower their standards or even as an affront to their intelligence and ability levels. Thus, despite the emotional distress and work production challenges perfectionism causes, many students with perfectionism present with insufficient motivation to change.

In response, treatment needs to begin with helping these students appreciate the negative impact perfectionism can have on their mental health, and, from a more mercenary standpoint, on their grades. Further, it will be important for these students to be able to broaden their definition of success beyond mere quality to include a balance of quality and efficiency. An A paper turned in two weeks late might earn a B, C or even (depending on the philosophy of the teacher or professor) a failing grade, due to its tardiness.

After securing some buy-in, work with a therapist or therapeutic tutor, with background in cognitive-behavioral therapy, is often needed to move the needle on perfectionism. More specifically, the use of exposure and response prevention (ERP) can be effective. Typically used to treat obsessive-compulsive disorder (OCD) and phobias, ERP involves exposing an individual to their feared stimulus (e.g., heights, snakes and in this case sub-perfect work) and not allowing for the avoidant response (in this case, over-reviewing/over-thinking behaviors that are used to avoid the possibility of mistakes). For instance, an ERP assignment might involve a student setting a reasonable time limit to complete a given task and having the student pass in that work, no matter what final state it is in. Over time, such work can help a student progress toward their ultimate goal of producing “the good enough paper.”

To be clear, this progress does not happen overnight, and it can feel difficult and mentally painful. However, it is important work, as learning to strike a reasonable balance between quality and efficiency is a critical element of the “hidden curriculum,” needed for success in college and the workforce.

 

About the Author:

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.

 

In Defense of the Lowly Questionnaire

By | NESCA Notes 2019

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

When gleaning information about a child’s areas of strength and challenge, neuropsychologists gather information from multiple sources, including parent and child interviews, conversations with teachers and mental health professionals working with the child, clinical observations, structured testing and questionnaires.

In my work with families, I sometimes hear complaints from parents about the myriad questionnaires that I saddle with them as part of the evaluation process – that some questionnaires might appear to be geared toward more challenged children than their own or that they are unsure how to respond to some of the questions (e.g., Is this behavior exhibited “sometimes” or “often?”).  While those are valid complaints, I find data from questionnaires to be particularly valuable in my work.

For instance, simply relying on clinical observations to glean information about a child’s attention span and degree of distractibility would be often misleading.  While the distraction-reduced, one-to-one, highly-structured testing setting is an ideal context in which to administer standardized assessments, within such a setting, even students with moderate attention disorders can often remain on task to an extent they are not able to demonstrate in less-structured, real-world contexts.

Similarly, children with mild social communication or autism spectrum disorders might be able to demonstrate reasonably-intact social skills within the context of a structured, one-to-one setting with an adult, while they struggle in their interactions with peers in less structured settings.

Conversely, children who might present with moderately high levels of test anxiety might appear so wound-up in a testing setting that, without additional information about their emotional state outside of the testing context, they could mistakenly be diagnosed with a generalized anxiety disorder.

In addition, relying exclusively on results of standardized testing to glean information about a child’s learning profile can be equally misleading.  For instance, children who might well present with executive function challenges can often fare well on specific tests of executive function, as those tests provide a level of structure not present in daily contexts.  Further, the nature of those standardized tests is such that specific executive function skills are measured in isolation (e.g., how well is a child able to brainstorm or switch gears or see the big picture), as opposed to in real life, when a child needs to make use of multiple different executive function skills in concert to complete given tasks.

Of further importance, I often find that a comparison between a child’s responses on a self-report questionnaire and those of parents or teachers yields critical information.  More specifically, it is often the case that from the parent perspective a child is running into pronounced executive function challenges, while from the child’s perspective they have minimal challenges in that domain of functioning.  That discrepancy can provide useful information about a child’s level of self-awareness or self-acceptance, information that can, in turn, illuminate an important area to address moving forward.

Again, a thorough, comprehensive, integrated neuropsychological evaluation draws on multiple sources of information.  As part of a thorough assessment, questionnaire data is a critical data source, not only in confirming observations made during the testing and results of structured assessments, but also in providing an additional perspective as to how a child might present outside of the structured testing setting.

 

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.

 

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.

 

A Tale of Two Social Styles: Classical and Jazz Socializers (Republished from Nov. 27, 2017)

By | NESCA Notes 2018

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

I work with a number of parents concerned about the quality of their child’s social life.  Lamenting that their child has no true friends, many parents I see note that that their child doesn’t “hang out” with peers.  However, when asked about how their child does spend time with peers, many parents report that their child is involved in several different structured after-school activities, such as a church youth group, scouting, or a gaming club.  In other words, while not getting together with peers in less structured settings, these students often do, despite parent misgivings, have satisfying social lives.

I find it useful to think about socializers as lying in one of two camps: Jazz and Classical.  Jazz socializers are all about improv.  They’ll head downtown with a friend and see where the afternoon takes them, invite a friend over with no particular plan or agenda, or wander the mall in a herd.  They care little about predictability and in fact relish spontaneity and surprise.  Classical socializers, by contrast, are most comfortable with structure.  They crave predictability, wanting to know the specific parameters of a social activity, including the start and end times, the purpose, and the rules of engagement.  Classical socializers, then, tend to do best with organized social activities.

It’s important to note that one type of socializing is not better than the other; it’s about a match.  I say that as many parents of Classical socializing children worry that their children will grow up to be friendless and alone.  To those concerns, I observe that there are plenty of socially-satisfied Classical socializing adults: they have their book club the first Monday of every month, poker night every other Thursday, weekly chorus practice, and bar trivia on Wednesdays.

Thus, rather than trying cram to their Classical socializing child into a Jazz paradigm – which in fact runs the risk of leading to more social isolation due to anxiety stemming from the mismatch – I encourage parents to embrace the kind of socializer that their child is.  For parents of Classical socializers, that means supporting their child’s social satisfaction and growth through the encouragement of their participation in a variety of structured after-school activities (of course without over-scheduling).  In addition to giving their children a chance for a rich and rewarding social life now, participation in such activities serves as an important practice and preparation for adult life, as in college and as adults in the working world, that is how Classical socializers will be most socially satisfied.

 

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, MA, 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.

 

The Importance of Chores

By | NESCA Notes 2018

 

By Jason McCormick, Psy.D.
Pediatric Neuropsychologist

In her excellent piece in the NYT (Happy Children Do Chores, August 18, 2018), reporter KJ Dell’Antonia describes the importance of chores for a child’s development and well-being.  While I will provide a brief summary and add my own reflections, I strongly recommend that the reader read the full article.

In her article, Ms. Dell’Antonia cites several benefits of chores.  Among those, chores can help a child develop a greater sense of responsibility and awareness of the needs of others, and they can also contribute to a child’s emotional well being (no, really), in that they can help a child feel needed.  In addition to her list of benefits, chores are an excellent teacher of life skills.  Knowing how to do laundry, prepare a meal, change a vacuum cleaner bag, or tighten a loose doorknob can help prepare a child for the responsibilities of adulthood.  Meanwhile, more involved tasks like raking leaves or cleaning out the garage can be used as vehicles in the development a child’s problem-solving skills, prompting them (perhaps with parent assistance) to figure out how to tackle the task in the most efficient, most systematic manner, solutions that they may be applied to a host of other life responsibilities.

While most parents recognize the importance of chores, a large survey cited in Ms. Dell’Antonia’s article found that only slightly over half of American parents required their children to do them.  Some reasons given for this disconnect include parent-child conflict surrounding chores and a desire to free up a child’s time so that they can focus on academics or extracurricular activities.

In those last regards, however, while a strong GPA and an application chock-full of extracurricular accomplishments might help a student get into college, it is their work ethic, sense of responsibility, and time management skills that help a student meet success in college.  In fact, a more robust predictor of success in college than grades is whether an adolescent has held a part-time job prior to college, and chores are an excellent teacher of readiness for part-time employment.

Ms. Dell’Antonia concludes her article with advice that is, unfortunately, easier said than done, which is that helping to establish a chore routine at home requires perseverance.  Sometimes that means that it will take longer to convince the child to attend to the chore than it would take for the parent to do it themselves.  No easy answers, I guess.

 

 

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, 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.

 

When it Comes to the College Transition, Sweat (some of) the Small Stuff

By | NESCA Notes 2018

 

By:  Jason McCormick, Psy.D.
NESCA Pediatric Neuropsychologist

As a neuropsychologist who specializes in working with adolescents and young adults, I have had many years of experience assessing students who are gearing up for the college transition. Having also the vantage point of working regularly with college students, I see up close what kinds of skills help students make a smooth landing and, conversely, what types of skill deficits throw a monkey wrench in this transition.

In assessing readiness for a four-year college, it is of course important to consider a student’s cognitive profile, academic functioning, executive functioning, and information processing skills. However, in addition to those important areas of functioning, it is also critical to consider a student’s degree of independence with life skills.

With multiple priorities in a student’s high school career, the development of independence with life skills is one area that often gets shuttled to the side. Among those skills are the abilities to self-regulate sleep schedules, set alarms to wake up without parental assistance, do laundry, and take prescribed medication consistently and with full independence (including monitoring when medicines are running low and taking care of prescription refills).

A common refrain when I bring up these issues to parents in testing feedback sessions is that those are skills that their student will be able to figure out when they get to college. Whether or not that is the case, the important question here is not just if a student has the cognitive and executive function capacities to figure out these tasks, but have they done those tasks enough that they are habits, thus allowing the student to follow through on them with automaticity.

Even under the best of circumstances, the college transition brings with it a number of stressors, including navigating roommate issues, branching out socially, managing academic demands, and making effective use of the large swaths of unscheduled time without the built-in oversight and structure of living at home.

Understanding that this is a major life transition, the more needed skills a student can master before that transition, the easier that transition will be. In this regard, I like to think about this topic in terms of conservation of energy. If, for instance, a student not only has the ability to do their own laundry, but the ability to take care of that chore on autopilot, they will be more likely to follow through on that (socially-important) task when they are stressed, fatigued, or under the weather.

Thus, while in many cases I endorse the adage, “Don’t sweat the small stuff,” in this regard sweating the small stuff makes the bigger stuff more manageable.

 

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.

 

A Tale of Two Social Styles: Classical and Jazz Socializers

By | NESCA Notes 2017

 

By:  Jason McCormick, Psy.D.
NESCA Pediatric Neuropsychologist

I work with a number of parents concerned about the quality of their child’s social life.  Lamenting that their child has no true friends, many parents I see note that that their child doesn’t “hang out” with peers.  However, when asked about how their child does spend time with peers, many parents report that their child is involved in several different structured after-school activities, such as a church youth group, scouting, or a gaming club.  In other words, while not getting together with peers in less structured settings, these students often do, despite parent misgivings, have satisfying social lives.

I find it useful to think about socializers as lying in one of two camps: Jazz and Classical.  Jazz socializers are all about improv.  They’ll head downtown with a friend and see where the afternoon takes them, invite a friend over with no particular plan or agenda, or wander the mall in a herd.  They care little about predictability and in fact relish spontaneity and surprise.  Classical socializers, by contrast, are most comfortable with structure.  They crave predictability, wanting to know the specific parameters of a social activity, including the start and end times, the purpose, and the rules of engagement.  Classical socializers, then, tend to do best with organized social activities.

It’s important to note that one type of socializing is not better than the other; it’s about match.  I say that as many parents of Classical socializing children worry that their children will grow up to be friendless and alone.  To those concerns, I observe that there are plenty of socially-satisfied Classical socializing adults: they have their book club the first Monday of every month, poker night every other Thursday, weekly chorus practice, and bar trivia on Wednesdays.

Thus, rather than trying cram to their Classical socializing child into a Jazz paradigm – which in fact runs the risk of leading to more social isolation due to anxiety stemming from the mismatch – I encourage parents to embrace the kind of socializer that their child is.  For parents of Classical socializers, that means supporting their child’s social satisfaction and growth through encouragement of their participation in a variety of structured after school activities (of course without over-scheduling).  In addition to giving their children a chance for a rich and rewarding social life now, participation in such activities serves as important practice and preparation for adult life, as in college and as adults in the working world, that is how Classical socializers will be most socially satisfied.

 

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.