Tag

Londonderry

Mar 27
5

Getting to Know NESCA Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach

I recently spoke with J. Michael Abrams, Ph.D., pediatric neuropsychologist practicing in NESCA’s Londonderry, New Hampshire office. Dr. Abrams joined NESCA last fall. Take a few minutes to learn more about him in today’s blog interview. 

How did you became interested in neuropsychology?

Back in the mid-80s, I worked at McLean Hospital, in the Child & Adolescent Inpatient program. They had an educational program set up for the kids that was run by psychologists who were embedded in the classrooms. There was a fair amount of test development going on at that time that used a lot of materials to build executive function and cognitive skills among the students. I was always interested in education and special education, but it was this experience that changed my career mindset toward psychology. So, I went back to school to study psychology.

Tell us about your career journey.

I always wanted to work with children and adolescents. That desire stemmed from my initial interest in special education and education in general, and I was on that path. I spent about seven and a half years at McLean, with the first couple of years working on an inpatient unit. Then I transferred to the psychologist-run education program, where I was a classroom educator.

After switching to psychology, my original clinical interest was with children who had experienced abuse and neglect and those who were involved in children’s eyewitness testimony. The focus was on how the experiences they had been through affected their memory, attention, and cognitive development. The more I worked with children and adolescents, the more I recognized how these neuropsychological factors impacted all aspects of their lives. It became much more than what I saw in the context of a legal case; instead, I saw how their experiences affected the management of themselves, their image of themselves, their hopes and aspirations, etc. I became really interested in how their neuropsychology intersected with their opportunities and experiences.

What segment of children and adolescents do you primarily work with? What is your specialty area?

I am particularly interested in working with children from age eight through 14, when their cognitive development is really taking off and they are trying to master this whole new set of skills. This time is filled with questions and challenges concerning self-esteem, mood, relationships, family relationships, etc. It’s a time when they are asking themselves what they are good at, where they struggle, and what those strengths and challenges say about them as a person. There is a great opportunity to have a big impact on kids in this age range. It’s such a gift to allow them to see themselves as successful and have that lead to future success.

What do you find most rewarding and most challenging about your profession?

The rewarding part is two-fold. The first is the interpersonal emotional piece. On a personal level, it’s rewarding to be able to contribute to other peoples’ success, whether it’s the clients, the practice, or the field overall. The second piece is more personal and intellectual. It’s intellectually stimulating to be able to integrate all of the information we gather or identify about a person, and to be able to communicate those findings or revelations to a child and their parents or caregivers. The intellectual reward lies in the ability to effectively communicate a child’s cognitive complexity in a way that they understand and can use to help reach their goals.

The challenging part has to do with the mental health landscape overall. As someone who is involved in neuropsychological assessments, it can feel like operating within a silo in the overall landscape. So many of the systems, such as insurance and education, are not set up for seamless collaboration with psychology practices or other areas of behavioral health. Unfortunately, this can make getting the appropriate mental health care or educational/therapeutic interventions a cumbersome, sometimes adversarial process. It’s the frustration that accompanies the much larger, more overarching need to develop a genuine collaboration among all the pieces within the health and mental health care settings.

What interested you about NESCA?

I was drawn to the opportunity NESCA provides to interact with other psychologists and affiliated clinicians on an ongoing basis. Professionally, I am not operating in a silo. At NESCA, there is more regular consultation and collaboration on how to put together a comprehensive and coherent plan for these kids. I was very excited to have a team of highly qualified, very experienced professionals, within the same organization, who can provide a range of supports and services for the kids we work with. Having this as a resource is a great opportunity for our clients and our staff, alike.

 

About Pediatric Neuropsychologist J. Michael Abrams, Ph.D.

Dr. J. Michael Abrams has over 30 years of experience in psychological, educational, and neuropsychological assessment and psychotherapy in various settings. A significant aspect of Dr. Abrams’ continuing interest and experience also includes the psychological care and treatment of children, adolescents, and young adults with a broad variety of emotional and interpersonal problems, beyond those that arise in the context of developmental differences or learning-related difficulties.

 

To book a neuropsychological evaluation with Dr. Abrams in Londonderry, NH, or to book with another expert NESCA neuropsychologist, 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, Londonderry, New Hampshire, and Burlington, Vermont, serving clients from preschool through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Jul 11
6

Why Kids Need to Outdoor Free Play

By | NESCA Notes 2020

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

One of the best ways to make the most of your summer is to get outside and engage in lots of outdoor play. We live in a society where we tend to over-schedule ourselves and our children. Particularly during the school year, this makes it very difficult for children to get the amount of free play that they require. With this, I’m going to tell you five great reasons why you should throw away your schedule, put down the tablet, and get outside.

The first reason is probably the most obvious. Outdoor play provides great benefits to physical development. It improves motor coordination, strength, and balance, and it puts kids in an overall healthier position.

The next reason to play outside is that there are benefits for internal regulation. Not only does it make kids sleep better at night, but there is research to show that it aids attentional control and stress reduction. Being outdoors also provides kids with different sensory experiences – such as feeling the texture of sand and mud, or feeling the wind blow on your face – which will help to build children’s sensory tolerance.

The next reason to get outside is to improve cognitive development. Being outdoors provides a lot of opportunities to make observations, draw conclusions about things, see cause and effect, and be imaginative.

Next, playing outside aids emotional development. When we are over-scheduled, children do not have the opportunity to feel confident in their ability to step outside of their comfort zone or take risks. Experimenting and taking risks during outdoor play can help children understand that they have some control over what they can do within their environment, as well as begin to recognize boundaries.

Finally, the last reason to get outside is that it really bolsters social development. When there is no structure or there are no rules to follow, kids have to learn how to initiate their interactions, engage in conversation with each other, communicate, problem solve, and find ways to along, even when others have different ideas.

With all of the above benefits, outdoor free play is one of the best things you can give to your child. So as the weather is getting nicer and summer is fast approaching, if you are looking for something to do, sometimes it is best to just put down your schedule, get outside, and get dirty.

 

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.

Jun 14
5

Dealing with End of the School Year Uncertainty

By | NESCA Notes 2021

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

The end of the school year can bring a lot of emotions, such as excitement for summer activities, sadness about closing relationships, and anxiety related to change. Often, children are experiencing these mixed emotions without truly understanding them. The end of this particular school year may bring some unique emotions, as it is the second consecutive ending that “looks different,” be it because students were remote for all or some of the year, class parties and field days are not happening, or children cannot give their teacher an end of the year hug. The loss of such traditions may cause kids to feel a lack of closure. Further, this transition is happening at a time when the world is starting to change again. While the loosening of restrictions and return to a semblance of “normal” may be positive for most, children may not know how to cope with all of this simultaneous change.

Here are some tips for things that adults can do to help children cope with what may be a difficult or uncertain end to the current school year:

  • Watch for signs that your child may be struggling with this transition. This may include new sleep difficulties, low frustration tolerance, heightened emotions, meltdowns, reduced appetite, loss of interest, etc.
  • Talk about their feelings related to the end of the year in an open and responsive manner, validating their emotions (e.g., “I can see why that would make you feel sad,” rather than accidentally dismissing them (e.g., “Don’t worry.”).
  • Help provide some closure with their teacher, such as writing a card or letter about what they enjoyed, learned, or overcame together this year.
  • Using artwork or journaling, help your child reflect on their development, accomplishments, and experiences this past year.
  • Create a plan for how they can stay in touch with friends over the summer and schedule some specific playdates or events to reduce worry about losing touch.
  • Maintain your basic schedule, such as morning and bedtime routines.
  • To reduce worry related to uncertainty, provide some age-appropriate opportunities to feel a sense of control, such as allowing your child to design a new daily schedule for “home days,” choose individual or family activities, etc.

The end of any school year provides a great opportunity to teach children about transition and change. We can teach them that it is okay to celebrate their accomplishment while also simultaneously feeling discomfort about what is to come and sadness about saying goodbye. Particularly during a year that has been marked by adversity, learning how to recognize, “sit with,” and manage these mixed emotions will help to build resiliency for the future.

 

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.

May 24
5

Why Kids Need to Outdoor Free Play

By | NESCA Notes 2020

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

One of the best ways to make the most of your summer is to get outside and engage in lots of outdoor play. We live in a society where we tend to over-schedule ourselves and our children. Particularly during the school year, this makes it very difficult for children to get the amount of free play that they require. With this, I’m going to tell you five great reasons why you should throw away your schedule, put down the tablet, and get outside.

The first reason is probably the most obvious. Outdoor play provides great benefits to physical development. It improves motor coordination, strength, and balance, and it puts kids in an overall healthier position.

The next reason to play outside is that there are benefits for internal regulation. Not only does it make kids sleep better at night, but there is research to show that it aids attentional control and stress reduction. Being outdoors also provides kids with different sensory experiences – such as feeling the texture of sand and mud, or feeling the wind blow on your face – which will help to build children’s sensory tolerance.

The next reason to get outside is to improve cognitive development. Being outdoors provides a lot of opportunities to make observations, draw conclusions about things, see cause and effect, and be imaginative.

Next, playing outside aids emotional development. When we are over-scheduled, children do not have the opportunity to feel confident in their ability to step outside of their comfort zone or take risks. Experimenting and taking risks during outdoor play can help children understand that they have some control over what they can do within their environment, as well as begin to recognize boundaries.

Finally, the last reason to get outside is that it really bolsters social development. When there is no structure or there are no rules to follow, kids have to learn how to initiate their interactions, engage in conversation with each other, communicate, problem solve, and find ways to along, even when others have different ideas.

With all of the above benefits, outdoor free play is one of the best things you can give to your child. So as the weather is getting nicer and summer is fast approaching, if you are looking for something to do, sometimes it is best to just put down your schedule, get outside, and get dirty.

 

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.

Dec 07
5

The Holiday Blues Coupled with Covid

By | NESCA Notes 2020

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

The holidays can be a time of great joy, but they can also be a time of great stress. Celebrations and merriment can be contrasted with pressure to amaze, long to-do lists, financial constraints or reminders of those we have lost. For many, it is a time of mixed emotions or strong internal conflict about why they cannot feel happy during a season that practically dictates it.

Holiday blues have been felt my many people for a long time, but now during a global pandemic, those feelings may be amplified and more prevalent than previous years. Families are trying to provide children with a positive holiday experience during a time of high stress and significant restriction. Family gatherings and holiday traditions are being cancelled, and many families are mourning the loss of loved ones. Adults are not the only ones feeling increased stress as we enter the holiday season. Children likely feel excited about the holiday but sad about not seeing family, not having holiday parties in school, and not being able to attend their traditional holiday events. This holiday season is simply different in ways that can bring great strain.

So, what can we do as adults to emotionally support children this holiday season? Do we allow them to observe our stress or do we keep it to ourselves in an effort to provide them with the happy holiday season that they deserve?

In June 2018, I wrote a blog post titled: “The Struggle is Not only Real, It is Necessary,” which discusses the importance of embracing uncomfortable, unwanted emotions as being necessary for personal growth and resiliency. By acknowledging, accepting and using unwanted feelings in a functional manner, we teach children to be competent and confident in their ability to navigate a stressful world. Of course, when I wrote the article, I could not have imagined the extent or duration of stress or discomfort that we would be facing in 2020. But does that change anything?

To put it simply, no, not really. Entering into the holidays with the expectation that we can protect our children from life’s stress is unrealistic. Attempting to do so will only add pressure while ignoring the mixed emotions that children are likely feeling as well. During this emotionally high-stakes time, acceptance of the struggles we face is even more critical. Adults and children both need “permission” to feel sad, frustrated, lonely or scared while also still allowing themselves to feel excited, thankful, and, yes, even joyful.

Here are some suggestions for how to help your family navigate the holiday blues this unique holiday season:

  • Talk about your feelings – wanted and unwanted ones – throughout the day, modeling and encouraging regular emotional discourse (e.g. “I love giving gifts, but getting all the shopping done is kind of stressful.”).
  • Help children label and interpret the emotions they may be having, as they may not have the right words or language for expressing them (e.g. “It sounds like you’re really disappointed we can’t go to Grandma’s house.”).
  • Be careful to not accidentally dismiss children’s feelings (e.g. “No need to be sad; we will find another fun way to celebrate.”), instead reflecting their emotion (e.g. “I know you’re sad that we can’t have a holiday party; I am, too.”).
  • Normalize the experience of mixed emotions (e.g. It’s okay to be excited for children while also feeling sad that we won’t see our family.).
  • Find new, safe holiday activities or events (e.g. holiday light drive, virtual gift exchange, etc.) and adapt previous traditions when able (e.g. virtual family gatherings).
  • Don’t romanticize the traditions that were lost this year (e.g. avoid such things as, “Our parties were always the most magical part of the holiday.”).
  • Help children understand new holiday plans as an opportunity to “celebrate” or “experience” the holiday, but be careful to not impose emotional expectations (e.g. “Enjoy the holidays!”) that can add pressure.
  • Reassure children that these changes are temporary, and traditions and visits will continue when it is safe to do so.

 

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.

Nov 18
2

Why Sexuality Education For People With Developmental Disabilities Is So Important

By | NESCA Notes 2019

By: Dina DiGregorio Karlon, M.A.
Transition Specialist, NESCA

Sexuality is something that connects all humans throughout the lifespan. We, as parents, want to see our children as forever young and protect them. For many parents it is extremely difficult to consider our children as sexual beings. Add the complexity of having a child with a developmental disability, and it appears even more challenging; yet ironically, it is even more important. Here are some reasons why:

People with developmental disabilities are not children. While many people believe that children with disabilities are childlike and dependent on others, their humanity and independence should be respected. They have desires and needs similar to others. They deserve to have access to information which will help the make good choices and have healthy relationships.

Sexual education should be taught according to one’s biological age, not cognitive age. Most children with disabilities experience physical changes (i.e., puberty) at the same time as their neurotypical peers. Therefore, sexuality education should be given to them at similar times as peers, but the delivery needs to be the different – one which allows them to access the information.

Sexual education is a protective factor. Educating people with disabilities about sexuality is a protective factor for them, because it provides the knowledge they need to protect themselves against sexual crimes, unprotected sex, unwanted pregnancies and unhealthy relationships. Information is power.

Understanding sexuality will not encourage your children to have sex. Giving individuals with developmental disabilities sexuality education will not put the idea to embark on sexual explorations in their heads. Giving them access to sexuality education gives them information and ultimately the power to make educated choices about their bodies.

People with disabilities are significantly more likely to be a victim of a sexual or violent crime than their non-disabled peers. Understanding consent and sexual advocacy empowers people to protect themselves from being the predator or the prey by learning about concepts, such as, “my body, my choice” and “no means no.”

Much of the general population learns about sexuality and relationships from friends. This means that some of the information they receive about sexuality is not always accurate. People with disabilities may not have as many friendships as their peers without disabilities. Those with developmental disabilities tend to be more isolated, so they do not have the opportunity to learn from friends. Often, they learn about sexuality information from parents and television. Another concern is the ease with which the internet provides sexual information. Access to pornography and posting pictures can be confusing to a person with a disability who doesn’t understand the legal, privacy and employment implications, putting them at even greater risk. So, as parents, it’s very important to give accurate information or seek out professionals who can work with your child.

Sexuality education does not teach sexual values. Parents are the ones who should be teaching their children with and without disabilities about their values around sex. Sexuality education focuses on teaching accurate information in a format that students can access and understand. It is then incumbent upon those students to develop their own values.

Because of the nature of some disabilities, picking up on social cues is challenging. So much of relationships is understanding verbal and non-verbal social cues, so many people with disabilities can struggle with identifying healthy relationships. It makes it easier for others to take advantage of them, instead of enjoying a relationship with both partners on equal footing. Therefore, it is important to teach social skills as part of sexuality education.

There are common universal values:

  1. It is important to respect others by treating them well and listening to them.
  2. It is important to get consent from a partner before being sexual with them.
  3. Relationships should be equal and positive without violence or abuse.

When discussing sex with your children, it’s okay not to have all the answers and to ask for a pause, take a break or a deep breath, and return later with more information. There are always plenty of opportunities for teachable moments. We know that people with disabilities can take in a great deal of information, and sexuality education is critical information to have healthy, sexual relationships. So, while we hate to see our children grow up, we all want the same things – to see them be happy and belong in an appropriate and respectful, safe way.

NESCA has personnel trained to provide sexuality education training to parents and to teens and young adults with disabilities. Training can be done one-on-one or in a group. If you are interested in learning more, contact Dina DiGregorio Karlon at (603)818-8526 to set up a consultation.

 

Reference:

Elevatus Training: GULP! Talking with Your Kids About Sexuality Newsletter, Volume 4, Number 1, May 2003

 

About the Author: 

Dina DiGregorio Karlon, M.A., is a seasoned counselor who has worked as both a school counselor and vocational rehabilitation counselor, guiding and coaching students and adults through transitions toward independence in both college and the working world. With NESCA, she offers transition assessment services in Londonderry, New Hampshire as well as transition planning consultation and coaching to students and families throughout New England.

 

To book Transition Services at NESCA or an evaluation with one of our expert neuropsychologists, complete NESCA’s online intake form. To book Transition Services in N.H., ask for Dina Karlon. 

 

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.

Aug 26
1

How High School and College Differ for Students with Disabilities

By | NESCA Notes 2019

By: Dina DiGregorio Karlon, M.A.
Transition Specialist, NESCA

Today, more students with disabilities are opting to attend college. As students plan to pursue college, it’s important for them to understand the increased expectations in college in the areas of academics, independence and social environments. For example, while in high school, the responsibility to get the students the services needed to be successful fell on parents and teachers; however, college students must advocate for themselves in post-secondary education. Below are some important ways in which the college and high school settings differ for students with disabilities, as well as some suggested strategies to prepare them.

Applicable Laws – In high school, students with disabilities are covered under the Individuals with Disabilities Act (IDEA), which mandates a free, appropriate public education for students with a disability (3-22 years of age). Some students in high school are covered under Section 504. In college, schools must comply with the Americans with Disabilities Act (ADA) and Section 504 – both laws are based on civil rights and prevent discrimination for people with disabilities. In short, IDEA is about success; ADA is about access.

Required Documentation – In high school, the school district is responsible for providing an evaluation at no cost to the student; this documentation focuses on whether a student is eligible for services under specific disability categories. Colleges are not responsible for the documentation. Students must get an evaluation at their own expense (if documentation is not current). Most colleges will accept current testing (within three years). This documentation must provide information about how the disability impacts the student and demonstrate the need for accommodations. Colleges will list on their website the type of documentation needed.

Modifications vs. Accommodations – In high school, if necessary, classes and materials may be modified, and the school is responsible for those accommodations and modifications. Some modifications may include reduced assignments or readings, adjusted grading to weigh a student’s daily work equal to semester tests. However, in college, there are no modifications to assignments or the curriculum; there are only accommodations. School is no longer responsible for arranging accommodations; rather students must advocate and arrange accommodations  for themselves.

Self-disclosure and Self-advocacy – In high school, teachers and parents support the student’s needs, with teachers approaching students if they believe assistance is needed. In college, the student is primarily responsible for arranging accommodations and advocating for their own needs. This is a significant shift—not just for the student, but for the parents, too. Parents no longer have access to the student’s records. The high school cannot disclose to a college a student’s disability—only the student can choose to disclose.

Disclose or Not to Disclose…That is the Question – Choosing to disclose that a student has a disability to a college is a deeply personal decision. As discussed, it is up to the student to disclose. If the student decides to disclose a disability, they need to understand not only the name of the disability, but also be able to communicate and describe how the disability impacts them and their learning. This is critical in determining what types of accommodations will be written into their 504 plan. While in high school, the student should be honest and realistic about the types of accommodations actually used and which of those were helpful. Helping your child practice discussing their disability and how it impacts them is very useful in preparing them to meet with the Office of Disability to share their needs. If a student decides not to disclose, they will not receive accommodations. However, all colleges have some type of tutoring and/or writing center to help students improve their academic skills. If a student chooses not to disclose and does not do well, they can still meet with the Office of Disability at any time to look into a 504 plan. However, their 504 plan will not be retroactive for the semester. Instead, accommodations will start from the date of the plan.

What Can Parents Do?

Preparing your child with a disability is critical to helping them be successful. Specifically, they will need self-determination skills. Self-determination is the understanding of one’s strengths and limitations together with a belief in oneself as capable and effective. These skills enable a person to participate in goal-directed, self-regulated, independent behavior. A person with self-determination skills is more likely to be independent and successful in work and training. Some suggested activities to help build self-determination skills include: Teaching your child how to make phone calls to make appointments, write emails with a professional tone and speak directly to people in stores or restaurants. Parents may need to start with a script to help a child practice, then fade support so the child is speaking as independently as possible in various settings. Other activities include having your child plan and prepare a weekly family meal (including making the grocery list, shopping for items, etc.), playing financial literacy games and activities (http://www.practicalmoneyskills.com/play/the_payoff), or talking with your child about how to begin to interact more independently with healthcare providers.

As parents, it is important to know that as your children become more independent, such as going to college, while they are now holding onto the reins, they are likely to need your help with the steering.

While these differences may seem daunting, self-advocacy, executive functioning and independent living skills taught throughout an individual’s transition to adulthood (starting as early as possible) can help to ease the jump to post-secondary education and its accompanying expectations. If you would like to discuss this topic in greater detail as it relates to you/your student, please complete our online intake form and note that your inquiry is for Transition Services.

 

Resources:

Center on Community Living and Careers, Indiana Institute on Disability and Community, Indiana University

National Council on Disability 

Santa Clara University

Think College

Life After IEPs

Financial Education for Everyone: Practical Money Skills

 

 

About the Author: 

Dina DiGregorio Karlon, M.A., is a seasoned counselor who has worked as both a school counselor and vocational rehabilitation counselor, guiding and coaching students and adults through transitions toward independence in both college and the working world. With NESCA, she offers transition assessment services in Londonderry, New Hampshire as well as transition planning consultation and coaching to students and families throughout New England.

 

To book Transition Services at NESCA or an evaluation with one of our expert neuropsychologists, complete NESCA’s online intake form. To book Transition Services in N.H., ask for Dina Karlon. 

 

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.

Jun 10
9

When “Attention Problems” Are Not ADHD

By | NESCA Notes 2019

By Jessica Geragosian, Psy.D.
Pediatric Neuropsychologist

Attention-Deficit Hyperactivity Disorder (ADHD) is a neurological disruption of the arousal system in the brain resulting in difficulties regulating attention and activity levels. ADHD can present with or without hyperactivity. Children with ADHD often have trouble engaging in expected tasks and maintaining appropriate behavioral control due to problems with inattention and lack of self-regulation. This can result in problems in the home, at school, and in peer relationships.

When concerns regarding attention or activity level are raised by parents or teachers, common practice is to consult with the child’s pediatrician. Parents and teachers might fill out rating scales asking questions like: Does your child have problems paying attention? Does your child have a hard time sitting still? Is your child having problems with learning? Is your child having difficulty following directions at home? When the answers to these questions are “yes,” a diagnosis of ADHD may seem appropriate.

However, there are many cases where inattention and/or impulsive behavior present as a symptom of another underlying problem and are not attributable to a primary attention disorder (ADHD).

The 5 most common misattributions I have seen in my clinical practice as a pediatric neuropsychologist in New Hampshire and Massachusetts are:

  1. Anxiety—When an individual is in a state of “fight or flight,” the brain lacks appreciation for information from the external environment that isn’t critical. When an individual is in a generalized state of anxiety, it is extremely difficult to remain focused and engaged in expected tasks.
  2. Learning disability—A student may have a disability in a core academic area. For example, a teacher may observe a child as being inattentive, when, in fact, they are several grade levels behind in reading. Thus, they cannot access the materials being distributed to the class.
  3. Communication disorder—If a child’s primary deficit is in the way they process language, you can be sure they look inattentive (e.g., not responding accurately to questions, inability to follow directions, etc.)
  4. Autism spectrum disorder (ASD)—Some children on the autism spectrum appear quite inattentive. In my experience, many children with ASD are often more tuned in to their internal environment (i.e., their thoughts and interests) at the expense of the external/social environment (i.e., parent, classroom and social expectations). While this can look similar to ADHD, the treatment approach is quite different.
  5. Other neurocognitive disorder (e.g., Processing speed deficit)—Other cognitive deficits can also make a student appear inattentive. If a student has slow processing speed, for example, the individual may not be able to keep up with the pace of instruction, resulting in an inability to absorb all of the lesson.

Other less common issues can also present as inattention, including trauma, absence seizures, hearing impairment, hallucinations, Tourette’s syndrome, among others. Because the root cause of inattention can sometimes be something very specific and complex, it is important to get a thorough evaluation.

It is also not uncommon for ADHD to present alongside the challenges identified above. In this case, effective intervention requires a simultaneous treatment plan addressing all challenges concurrently.

It is important to get a big picture—and accurate—understanding of a child’s neuropsychological profile in planning effective interventions. Our brains are complex, and one symptom can be common to many different origins. Getting the correct diagnosis the first time helps to put the right treatments in place.

 

About the Author:

Dr. Jessica Geragosian is a Licensed Psychologist in Massachusetts and New Hampshire. She has a wide range of clinical experience – in hospital, school and clinic settings – working with children and adolescents presenting with a wide range of cognitive, learning, social and psychological challenges.

Dr. Geragosian operates under the primary belief that all children want to, and can be, successful. The primary goal of her work is to identify the child’s innate strengths and find any underlying vulnerabilities preventing a child from achieving success. Whether the primary problem is an inability to acquire academic skills, maintain friendships, control emotions, or regulate behavior to meet expectations; she takes a holistic approach to understand the complex interplay of developmental, neurological and psychological factors contributing to a child’s presenting challenges.

Dr. Geragosian earned her doctoral degree from William James University, before completing postgraduate training in pediatric neuropsychology at the Massachusetts General Hospital for Children at North Shore Medical Center, where a focus of her work was neuropsychological assessment of young children with developmental challenges.

 

To book an evaluation with Dr. Geragosian 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.

 

Apr 15
1

8 Tips You Need to Know about SAT and ACT

By | NESCA Notes 2019

 

By: Dina Karlon, M.A.
Transition Specialist, NESCA

Starting to think about the college admissions/testing process? It can be costly and confusing, so we’ve compiled some tips to help you navigate the testing landscape.

Tip 1 – SAT or ACT – Which test should a student take? Most colleges will take either, but there are differences to the tests. SATs, which were revamped a few years ago, has Reading, Math and Writing, while the ACT adds a Science section. SAT questions assess problem-solving abilities, while ACT questions are more fact-based, similar to school testing. Typically, SATs use much higher-level vocabulary than the ACT. The ACT tests math concepts through trigonometry, while SATs stop at geometry. SAT divides its scores into two areas – Reading/Writing and Math, with a perfect score of 1600 (800 for each). ACT scoring is based on 4 sections that are averaged into a composite, with a perfect score of 36. While SAT is more well-known by many New Englanders, the ACT is taken slightly more often, having gained popularity in the past 5 to 10 years. A student may prefer one test over the other if the individual:

Still not sure which one to take? Visit the tests’ websites to take/score a practice test. See which one may be better through this conversion chart: https://www.studypoint.com/ed/sat-act-concordance/.

Tip 2 – SAT Subject Tests – In addition to the general SAT, students can register for tests in specific subject areas. There are 20 specialized tests, and an individual would usually only take 2, if any. Most colleges do not require them, although a student may take them to demonstrate a strong interest or aptitude in a subject or area of passion. For example, a bilingual student could demonstrate proficiency in a language. Subject tests could be a way for students to strengthen their application among similar candidates. If a student wants to major in a science, a strong score on a science subject test could set that person apart from others.

Tip 3 – Apply Early – Standardized testing is pricey, and hidden costs can creep up. Register early to avoid late or waiting list fees. Doing so also allows students to reserve a slot at their own school (if offered there). Whether students are neuro-typical or not, there is comfort in taking tests in one’s own school. For students with anxiety, it is very important, as familiarity with their environment can reduce anxiety.

Tip 4 – Vouchers – Visit SAT and/or ACT sites to determine eligibility for test fees being waived through a voucher. Work with high school counselors to obtain a waiver.

Tip 5 – Costs – There are registration fees for standardized tests. The current fees for the exams are:

There’s good news for New Hampshire residents. A few years ago, the SAT replaced the New England Common Assessment Program (NECAP) as the state test for high school juniors. Therefore, all juniors have the opportunity to take one free SAT. Factor this in for next year, as the deadline to take the test is in March.

Tip 6 – Free Test Scores Sent to Colleges – To lower costs, take advantage of having 4 free test scores sent to colleges. When you register to take both the SAT and ACT, students have the option to send up to 4 tests to 4 colleges at no charge, saving $52 ($13 per test) for the ACT and $48 ($12 per test) for the SAT. Individuals have up to nine days after taking the SAT test to register for score reports. It’s best to sign up for them when you register as it’s easy to forget to do so after. Some students may not opt to do this because they want to see their scores before they are sent to colleges. The benefit of sending them with the SAT is – regardless of your scores – if taken again, a person’s entire history will be sent to colleges where they take the highest score from each section. For example, if a student scores a 400 on English and a 500 on Math in April, then chooses to retake the test in October and scores a 500 on English and a 400 on Math, the school will take the two 500 scores for a total of 1000. If a student is very unhappy with a score on a particular day and they don’t want a college to see that score, students can research whether the schools they are applying to will accept score choice. While this may be an option, it will incur an additional fee. In general, I recommend sending all of the scores and letting the admissions team select the highest. With ACT, score histories are not sent to colleges. Instead students pick a specific test date’s scores to send. Unlike the SAT, if a student gets a higher score in separate sections on various test dates and wants the colleges to see the scores from each test date, they will have to pay for each test date’s score to be sent.

Tip 7 – Accommodations – The process for requesting accommodations and when to apply for them is different for each test. Check the SAT and ACT websites for exact processes for each. Here are some tips:

– Apply early as it can take up to 7 weeks to hear which accommodations are approved. Accommodation request applications may be due at the time one registers for the test – or even before.

– Students should talk with their SAT/ACT school representative about accommodations. While ACT only accepts requests through students’ schools, SAT allows students to apply for accommodations independently. I recommend working with the Accommodations Coordinator at the high school (school counselors will know who this is).

– It is up to SAT and/or ACT if they will allow students accommodations, not the high school.

– Once accommodations are determined for a school year, students can take the test several times (though it’s not recommended to take it several times each year) and not have to reapply for accommodations. SAT accommodations last for one year after high school graduation.

– Lists of accommodations and procedures for requesting them are at: https://www.understood.org/en/school-learning/partnering-with-childs-school/tests-standards/how-to-apply-for-sat-and-act-accommodations.

Tip 8 – Test-optional Schools – Some of us just don’t test well and are terrified of taking such tests. If a student doesn’t feel standardized tests reflect their academic ability and don’t want them considered in their admissions application, consider applying to test-optional schools. These schools review admission materials (transcript, recommendations, etc.) to determine if a student is a good fit for their institution. Here is a list of test-optional schools: https://www.fairtest.org/university/optional.

References

SAT website: Collegeboard.org

ACT website: ACT.org

https://www.understood.org/en/school-learning/partnering-with-childs-school/tests-standards/how-to-apply-for-sat-and-act-accommodations

https://www.understood.org/en/school-learning/choosing-starting-school/leaving-high-school/sat-or-act-how-to-know-which-is-best-for-your-child

https://www.huffpost.com/entry/differences-between-the-s_b_3451049

 

About the Author: 

Dina DiGregorio Karlon, M.A., is a seasoned counselor who has worked as both a school counselor and vocational rehabilitation counselor, guiding and coaching students and adults through transitions toward independence in both college and the working world. With NESCA, she offers transition assessment services in Londonderry, New Hampshire as well as transition planning consultation and coaching to students and families throughout New England.

 

To book an evaluation with one of our expert neuropsychologists, complete NESCA’s online intake form. To book Transition Services in N.H., ask for Dina Karlon. 

 

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.

Feb 18
0

Interview with Dina DiGregorio Karlon, NESCA North Transition Specialist

By | NESCA Notes 2019

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

 

What are Transition Services?

Transition means the process of moving from one life stage to another. In context to NESCA, we are referring to the transition from high school to post-secondary life, and we specialize in working with nontraditional students who often have had accommodations or special education services. While the prospect of leaving high school is exciting, it can be overwhelming as well. The prospect of figuring out what you want to do with your life causes some level of anxiety in all of us; transition services helps to relieve this anxiety by working with individuals in setting short and long term goals and participating in guidance and psychoeducation related to college and/or employment.

How did you get interested in this field?

Helping people understand their strengths and weaknesses while exploring their vision for adulthood is my passion. Upon reflection, I believe that I have always been a transition specialist, long before there was a name for this work. Having worked with adolescents and young adults for more than 25 years, I understand the demands and expectations placed on them and how that can be daunting. Helping people to recognize that their path may be different than they expected is very rewarding, and I do not take that responsibility lightly.

What do you like about your job?

I particularly enjoy working with adolescents and families through the college process; while the process is not difficult to understand, it is time-consuming and can often feel overwhelming. I enjoy assisting students and helping them to accomplish new tasks. I love to help people identify their strengths and use those to minimize and overcome their challenges. Being able to assist people in setting their own personal goals and achieve them is very gratifying to me. Getting to know new people, teaching important skills, presenting a different perspective, piecing together a plan; these are all things I love about the work I do.

Do you have a specialty? What do you specialize in?

I specialize in both college and career counseling. I am experienced in working with high school students as well as young adults.

What do you enjoy about your job?

I particularly enjoy working with adolescents and families through the college process; while the process is not difficult to understand, it is time-consuming and can often feel overwhelming. I enjoy assisting students and helping them to accomplish new tasks. I love to help people identify their strengths and use those to minimize and overcome their challenges. Being able to assist people in setting their own personal goals and achieve them is very gratifying to me. Getting to know new people, teaching important skills, presenting a different perspective, piecing together a plan; these are all things I love about the work I do.

What brought you to NESCA?

My experience as a school counselor and a vocational rehabilitation counselor have given me a unique skill set and provide me with the experience needed to do transition planning for students who are college bound and also students or adults who are seeking employment or support with career exploration. My passion for working with adolescents and helping them maneuver the challenges of early adulthood matches the philosophy of NESCA and I am eager to work as part of a team of specialists providing this support to young people.

What are you most looking forward to about working full-time at NESCA?

I am excited to work with adolescents to help them with the journey into adulthood. The variety of clients and their needs at NESCA is a real draw for me. Whether my work takes me to teaching a teenager how to do laundry, practicing interviewing for a first job or new school, or identifying a college list, it all sounds challenging and rewarding to me.

Who are your favorite students/clients to work with?

I have a lot of expertise in working with all kinds of students. I have worked with students who have been identified with Autism Spectrum Disorders, ADD/ADHD, mental health disorders, and other profiles. With the myriad of clients I worked with at Vocational Rehabilitation, I have developed a solid understanding of many diagnoses and disabilities and how clients’ lives are impacted by the related challenges. I have often worked with students who face multiple barriers; seeing those students work through their challenges and develop resiliency is professionally rewarding.

What advice do you have for parents or young adults who are not sure if they need a transition specialist?

Working with a transition specialist can be very helpful for parents to understand what their children’s strengths and weaknesses are in relation to adult-readiness. Are they ready for a 4-year college? Do they need a gap year? What would that look like? Do they know how to interview for a job? Do they need help getting a job? Do they know what kind of job fits their skills? Do they know to self-advocate? Do they know how to access resources?

Teenagers will often not work with their parents to do goal setting and transition planning, so having a transition expert to work with can often help. Working with a transition specialist can also be a great step toward a student taking ownership of their future planning and a parent releasing some control and responsibility. Most teenagers or young adults would benefit from doing transition planning; but it is a highly personal family decision as to whether to work with a transition specialist.

If you are not sure if you need a transition specialist, you can always come in for a consultation appointment. This is a one-hour meeting that helps a family determine if this is the right time to work with a transition specialist and what type of transition service may be best. For example, does the family need assessment and a report for an IEP process or just help with appropriate college planning? Talking things through with a transition expert can be extremely helpful for knowing what is needed and when.

We are very excited to announce that as of February 1, 2019, Ms. Karlon is working as a full-time staff member delivering assessment services in the state of New Hampshire and college and career coaching services to clients throughout New England! NESCA is thrilled to be able to offer these expanded transition services in our New Hampshire Office in addition to the services we already offer in Newton, MA.

To schedule an appointment with Dina DiGregorio Karlon in Londonderry, please complete our online intake form: https://nesca-newton.com/intake-form/  The address of NESCA-North is 75 Gilcreast Rd #305, Londonderry, NH 03053.

 

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.