NESCA is currently accepting Therapy and Executive Function Coaching clients from middle school-age through adulthood with Therapist/Executive Function Coach/Parent Coach Carly Loureiro, MSW, LCSW. Carly specializes in the ASD population and also sees individuals who are highly anxious, depressed, or suffer with low self-esteem. She also offers parent coaching and family sessions when needed. For more information or to schedule appointments, please complete our Intake Form.

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Massachusetts

Image of the MA State House with quote from the blog

Access to Mental Health Care in Massachusetts: Challenges and Opportunities

By | NESCA Notes 2024

Image of the MA State House with quote from the blogBy: Rebecca Dautoff, Psy.D.
Pediatric Neuropsychologist, NESCA

Access to mental health care is an increasingly critical issue across the United States, and Massachusetts is no exception. While the state is often lauded for its comprehensive healthcare system and progressive policies, barriers to mental health care still persist. In this blog post, we will explore the current landscape of mental health services in Massachusetts, the challenges faced by individuals seeking care, and the initiatives being implemented to improve access.

The State of Mental Health Care in Massachusetts
Massachusetts has made significant strides in mental health care over the years. The state boasts some of the country’s leading hospitals, research institutions, and mental health professionals. Organizations such as the Massachusetts Department of Mental Health (DMH) and the Massachusetts Behavioral Health Partnership (MBHP) work to ensure that residents have access to necessary services, yet many still find it difficult to access care. There are also continuing racial inequities in medical and mental health care and a significant shortage of mental health providers of color.

Types of Services Available
Massachusetts offers a range of mental health services, including:

  • Inpatient Treatment: Hospitals provide acute care for individuals in crisis.
  • Outpatient Services: Clinics and private practices offer therapy and counseling sessions.
  • Community Support: Programs that focus on recovery and support that are community-based.
  • Telehealth Services: An increasingly popular option, especially since the COVID-19 pandemic, allows individuals to access care remotely.

Despite this variety of resources available, the gap between those in need and those receiving care remains significant.

Barriers to Accessing Mental Health Care

  1. Stigma and Misunderstanding

Stigma surrounding mental health issues is a significant barrier. Many individuals hesitate to seek help due to fear of judgment or misunderstanding by others. This stigma can come from family, friends, or even within professional environments. Education and awareness campaigns are essential to reducing stigma and encouraging individuals to seek the care they need.

  1. Insurance Limitations

While Massachusetts has implemented laws requiring insurance companies to provide equal coverage for mental and physical health services, discrepancies still exist. Many individuals find that their insurance plans have high deductibles, limited provider networks, or caps on the number of therapy sessions covered.

  1. Workforce Shortages

There is a notable shortage of mental health professionals in Massachusetts, particularly in rural areas. While urban centers like Boston have many providers, individuals in more remote locations often face long wait times or a lack of available services altogether. The distribution of resources is uneven, exacerbating access issues.

  1. Financial Barriers

Even with insurance, the cost of mental health care can be prohibitive. Copays, deductibles, and uncovered services can add up quickly, making it difficult for individuals to afford the care they need. Paying privately often leads to shorter wait times but is more expensive. Often families find themselves caught in a cycle where they need help but cannot afford it.

Current Initiatives and Improvements
To address these challenges, Massachusetts is taking steps to improve access to mental health care. Various initiatives are being implemented across the Commonwealth.

  1. Legislative Efforts

The Massachusetts State Legislature has been active in introducing bills aimed at improving access to mental health care. The “Mental Health Parity” law ensures that mental health care is treated on par with physical health care in terms of coverage. Advocacy groups continue to push for reforms that address loopholes and improve enforcement.

  1. Telehealth Expansion

The COVID-19 pandemic accelerated the adoption of telehealth services, which have proven to be a valuable tool for increasing access to mental health care. Telehealth allows individuals to connect with therapists and psychiatrists from the comfort of their homes, reducing barriers related to transportation, location, and time constraints.

  1. Community-based Programs

Community-based mental health programs are essential in providing support and resources. Initiatives, like the Massachusetts Community Behavioral Health Center (CBHC) program, aim to create a network of services that meet the diverse needs of communities. These centers offer a variety of services, including crisis intervention and case management.

  1. Educational Campaigns

Efforts to combat stigma and raise awareness about mental health are crucial. Organizations like the National Alliance on Mental Illness (NAMI) Massachusetts work tirelessly to educate the public about mental health issues, promote resources, and advocate for policy changes. These campaigns foster understanding and encourage individuals to seek help.

Looking Ahead: The Future of Mental Health Care in Massachusetts
The landscape of mental health care in Massachusetts is continually evolving. While significant challenges remain, the state is committed to addressing these issues through comprehensive reforms and community-based approaches.

  1. Continued Advocacy

Ongoing advocacy at both the grassroots and legislative levels is essential in pushing for systemic changes. By uniting voices and sharing personal stories, advocates can influence policies that prioritize access to mental health care.

  1. Innovative Solutions

As technology continues to advance, innovative solutions, such as mobile apps for mental health monitoring, digital therapy platforms, and AI-driven resources, could enhance accessibility.

Conclusion
Access to mental health care in Massachusetts is a multifaceted issue that requires ongoing attention and action. While challenges persist, the State legislature is committed to improving access to community programs and public awareness campaigns. By addressing stigma, financial barriers, and workforce shortages, Massachusetts can move closer to a system where mental health care is truly accessible for all. This journey continues. With continued advocacy and innovation, a brighter future for mental health care in the state is on the horizon.

How to Access Care
If you are or someone you love or care for is experiencing a mental health issue, you need to know how and where to find services. First, contact your primary care doctor or pediatrician. For parents or caregivers, the next contact should be someone at the child’s school. It could be an administrator, a teacher, or a mental health professional. Seek out additional information about what school personnel have observed about the child and find out about available resources at the school. This is an important part of treatment for a child.

 If you or the person you’re seeking to assist requires a crisis response to meet immediate safety needs, call 911, go to your local emergency room, or find your local Emergency Service Program by calling 877-382-1609.

Call or text the Massachusetts Behavioral Health Help Line (MBHHL) at 833-773-2445 for free, confidential support 24/7. Live chat is available at: https://www.masshelpline.com/. This helpline is useful even if you’re not sure what kind of help you need. Interpretation in over 200 languages is available in real time. Deaf or hard of hearing individuals can contact MassRelay at 711.

NAMI Compass is the information and referral helpline at NAMI Massachusetts. They provide resources and support to help people navigate the complex mental health system and problem solve in challenging situations. The COMPASS helpline is available Monday through Friday, 9 AM – 5 PM. Call the helpline at 617-704-6264 or 1-800-370-9085, or email them at compass@namimass.org.

SAMHSA’s National Helpline1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) or TTY: 1-800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations.

The Massachusetts Substance Use Helpline is a good resource for finding substance use treatment and recovery services. Helpline services are free and confidential. Call 1-800-327-5050.

The William James INTERFACE Referral Service aims to increase access to mental health and wellness services for individuals. Call the helpline at 888-244-6843 or 617-332-3666 from 9 AM- 5 PM on Monday, Wednesday and Friday, and 8 AM- 6 PM on Tuesday and Thursday, to work with a Resource and Referral Counselor who will help you navigate the challenges of finding mental health services. Communities served can be found on their website, https://interface.williamjames.edu/communities.

 

About the Author

Dr. Rebecca Dautoff provides comprehensive neuropsychological and psychological (projective) evaluation services for children, adolescents,Headshot of Rebecca Dautoff, Psy.D. and young adults who have complex presentations with a wide range of concerns, including attention deficit disorders, psychiatric disorders, intellectual disabilities, and autism spectrum disorders (ASD). She also values collaboration with families and outside providers to facilitate supports and services that are tailored to each child’s specific needs.

 

If you are interested in booking an appointment for an evaluation with Dr. Dautoff or another NESCA neuropsychologist/clinician, please fill out and submit our online intake form

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; the greater Burlington, Vermont region; and Brooklyn, New York (coaching services only) serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Going South: NESCA Announces New Hingham, MA Location

By | Nesca Notes 2023

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA is excited to announce that it is opening a Hingham location to serve clients on the South Shore of Massachusetts. NESCA is currently booking appointments now for Neuropsychological and Psychological Evaluation Services commencing on November 1, 2023. Learn more about what is being offered by our Hingham-based staff from my interview with Hingham Director; Pediatric Neuropsychologist Moira Creedon, Ph.D.

What prompted NESCA’s expansion to the South Shore or Massachusetts, and how can clients benefit from our Hingham location’s services?
NESCA is expanding our in-person services to Hingham on the South Shore to widen the breadth of neuropsychological and educational evaluation and consulting services offered within the state. We know that families have options as they partner with neuropsychologists, and we want to be in close proximity to communities we hope to serve. This is an exciting opportunity to support students in elementary, middle, and high school as well as young adults, as they navigate the complexities of their daily lives. It is our priority to continue providing detailed, client-centered, thorough evaluations that highlight a client’s areas of strength and vulnerability. I am also excited to strengthen relationships with local care providers and schools, and to build new relationships as a new clinician within the South Shore community.

What services do you offer?
At this time, NESCA’s South Shore-based practice will offer Neuropsychological Evaluations and Projective Assessments. The goal of these services is to build a complete picture of a client’s functioning, including their intellectual, academic, and social-emotional profile. Team members are also available to participate in team meetings at school (IEP meetings), conduct school observations, and offer consultation to parents and team members. Sometimes, a child has already participated in evaluations in other settings (schools, hospitals), and a family needs help to review these documents and make meaning of the findings.

What types of clients will NESCA serve in its South Shore location?
NESCA’s South Shore-based practice is similar to our other locations and will serve children, teens, and young adults with a range of presenting issues. The focus is in working with students in elementary, middle, and high school as well as young adults. I can see clients with diagnostic questions, including Autism Spectrum Disorder (ASD), Learning Disorders (e.g., dyslexia, dysgraphia), Attention-Deficit/Hyperactivity Disorder (ADHD), anxiety, depression, and complex psychiatric diagnoses.

A specialty we have at NESCA – including in Hingham – is working with clients who have multiple diagnoses or who don’t fit neatly into a singular diagnostic box. I also see clients who are high functioning and curious about their learning style, how to improve their study skills, and how to plan for their academic future based on their unique profile.

Where are you on the South Shore? Are services in-person or remote?
We are practicing in person in an office at 99 Derby Street, Suite 200, in Hingham, MA. Hingham is uniquely positioned to serve the South Shore/Southcoast, and the Cape and Islands. For those traveling for appointments, most clients schedule testing in two longer (2.5 hour) blocks of time so the commute is reduced for families. I am also available to participate in IEP team meetings and conduct student observations in person on the South Shore, which is an exciting way to collaborate and build strong relationships with families, schools, and organizations.

What is different about what NESCA offers on the South Shore compared to other organizations or services available locally?
NESCA is highly respected in the community for providing detailed, comprehensive evaluations of students that speak to their strengths as well as their needs. Compared to some practices, your child or teen will be assessed directly by a neuropsychologist rather than a technician. You can depend on your neuropsychologist to bring their own expertise as well as the “village” of NESCA, as I am always collaborating with NESCA’s team of innovative neuropsychologists, transition specialists, educational consultants, speech and language pathologists, occupational therapists, and therapists. We work routinely with special education attorneys, advocates, therapists, and school personnel in collaborative relationships to support children and teens. At NESCA, we live our core values everyday: being creative problem solvers, being collaborative and building lasting relationships, and caring deeply for students, their families, and the community.

Does insurance cover your services in Hingham?
Several NESCA providers take both Blue Cross Blue Shield and private pay for services. I am paneled with BCBS. Some families are able to obtain some coverage or reimbursement through other insurance agencies, and we can provide those families with brief billing information to submit to their insurance company. We can never guarantee insurance reimbursement, so it is important that families check with their insurance plan regarding covered services.

What if I am unsure if I should refer my child or client for an evaluation?
Give us a call! Our administrative team is happy to support you in navigating this process. We are also planning some community events to provide information to our community about a variety of topics, including who we are and how to recognize signs that a child or teen may need additional support. There is also a ton of information on our website.

How do people get more information about NESCA’s South Shore services?
You can fill out our online intake form, call 617-658-9800 to speak with an intake coordinator, or reach Hingham-based Pediatric Neuropsychologist Dr. Moira Creedon directly at mcreedon@nesca-newton.com.

 

About the Author

Hingham Director; Pediatric Neuropsychologist Dr. Moira Creedon has expertise in evaluating children and teens with a variety of presenting issues. She is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. With experiences providing therapy and assessments, Dr. Creedon bridges the gap between testing data and therapeutic services to develop a clear roadmap for change and deeper of understanding of individual needs.

 

If you are interested in booking an evaluation with Dr. Creedon or another NESCA neuropsychologist, please fill out and submit our online intake form

 

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham (coming soon), Massachusetts; Londonderry, New Hampshire; and the greater Burlington, Vermont region, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

Low Motivation-based Procrastination: Tips for getting over the hurdle

By | NESCA Notes 2022

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

Procrastination is affecting a lot of us these days. There is a wide variety of reasons that people put things off until the last minute. In a previous blog, I discussed tips for anxiety-based procrastination which you can read here. Today I would like to talk about procrastination related to low motivation.

Have you ever had a day where you cannot get off the couch, and you want to keep binge watching your favorite show? Or, maybe you have noticed your child cannot seem to get off TikTok to do their homework. These are all examples of procrastination as a result of low motivation.

It can be extremely challenging to find the motivation to do things we don’t want to, especially when it means transitioning away from the things that bring us joy. You may have noticed this getting worse as the weather turns colder and the sun sets earlier each day. Many people find that their mood and motivation hit a low during these fall and winter months. So, how do you overcome this feeling?

Here are five strategies to get over the procrastination hurdle when motivation is low.

1. Momentum Stairs – Do you remember learning about Newton’s Laws of Motion? The Law of Inertia says an object at rest will stay at rest, and an object in motion will stay in motion. Makes sense, right? If you have been sitting still and engaging in an activity you enjoy (I’m looking at you, Netflix), it can be extremely difficult to transition to the task you have been putting off.

Sometimes, the best thing to do is to start with an activity that is more enjoyable just so you can get moving. For example, if you need to write a paper, but you can’t get off the couch, build your momentum by making yourself a cup of tea. That gets you off the couch and away from the TV, and once you are up, maybe you complete a small chore that isn’t too difficult (watering your house plants, wiping the counter, etc.) then you can move on to start writing your paper.

To initiate that movement, it is easiest to start with something easy and work your way toward the task that you have been procrastinating. Some folks find it helpful to picture a set of stairs; the activity they enjoy is at the top and the uninteresting task is at the bottom. You must take small steps down the stairs to build momentum toward the activity at the bottom of the stairs.

2. Habit Stacking – Habit stacking is a great strategy to help build routines out of existing habits and overcome low motivation. Once a routine is in place, it takes a lot less energy and motivation to complete those regular activities since they have become automatic.

The principle behind this strategy is that you slowly add to existing habits until you have formed a routine. For example, let’s say you eat breakfast every morning, but have not been good about taking your vitamins. By habit stacking, you could start taking your vitamins every day as soon as you finish breakfast, thereby accomplishing two things much more easily than having to remember to take your vitamins separately later in the day.

It may be helpful to place your vitamins in your pantry so there is always a visual reminder when you are making breakfast. Stacking habits in this way can make it much easier to form new routines that help you get past low motivation and accomplish bigger goals.

3. Reduce Barriers – Another helpful strategy for low motivation is to reduce the barriers needed to start the activity. Sometimes it can feel overwhelming to think about cooking that homemade meal you have been wanting to try, or to deep clean an area of your house that you can never get to. That results in low motivation, and the best way to overcome it is to reduce any barriers to initiating the activity.

One suggestion is to take all the materials you will need to complete the task out the day or night before. That can help reduce the barriers to getting started when you are feeling tired later in the day. You could also create checklists for yourself to reduce the cognitive load for certain chores. For example, a house cleaning checklist. Follow this checklist each time you have to clean so that you do not need to use as much brain power. When you can reduce the barriers to starting an activity, it will be so much easier to get up the motivation to complete it.

4. Pairing – Try pairing an activity you must do with something you enjoy doing. When motivation is low, sometimes the only way we can get ourselves up and moving is by combining the activity we have been putting off with something enjoyable. The key to making an effective and lasting pair is to ensure you only engage in the specific fun activity while completing the unpreferred task.

For example, if one of your goals it to take a daily walk to improve your health, but you cannot find the motivation to do it each day, it might help to pair it with a new audiobook that you are really excited about. Only allow yourself to listen when you are walking because that will transform the walk itself into a reward, and you will likely stop dreading it.

5. Five-minute Max – The five-minute max strategy is excellent for low motivation – and it’s easy to accomplish. Set a five-minute timer and start the activity you have been putting off. Tell yourself that you can stop the activity after five minutes. More than likely, once you start, you will be able to keep going, but you have the option to stop after just five minutes. Knowing that you only have to work for five minutes can help when motivation is low and make a task seem a lot less exhausting.

There is no perfect strategy that works for everyone in every situation, but adding these strategies to your toolbox can help you experiment with which methods work best for you. See if you can find just one tool to help you in those moments when low motivation is impacting your ability to get moving.

 

About Lyndsay Wood, OTD, OTR/L

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

 

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

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

Coping Strategies for Anxiety and Panic

By | NESCA Notes 2022

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

Do you, your child or your loved one deal with frequent anxiety? Stress? Panic? Sometimes it may feel like you are spinning out of control. With so much going on in the world, in our own lives, and in our own head, it can feel like an impossible task to quiet the mind and calm the body. However, there are things we can do to regulate the nervous system, thereby relaxing the body and reducing the effects of anxiety. Below is a list of these strategies, but they are not one-size-fits all. Try each of them and see what works best for you or your loved one.

  • 5, 4, 3, 2, 1 Grounding Technique: This technique is helpful to ground yourself in the present moment. Often, we can get stuck in our own head, and our worries and fears spiral out of control. This strategy is helpful to pull yourself out of those thoughts and into the present moment. The procedure is as follows:
    • Identify five things you can see. Feel free to describe them. What color are they? What are their shapes?
    • Identify four things you can touch. Get up and actually touch them! How do they feel? Are they soft? Hard? Squishy? Wet?
    • Identify three things you can hear. Is there a car driving by? Are the noises loud or soft?
    • Name two things you can smell. Are the smells pleasant? Neutral? Familiar?
    • Finally, name one thing you can taste. Can you taste the remnants of dinner on your tongue? Perhaps you have a piece of candy nearby you want to put in your mouth and describe.

Hopefully, completing this technique helps break the anxiety spiral. Feel free to repeat it as many times as you need. You can try to identify new items and sensations each time.

    • Weighted blanket or deep pressure: Deep pressure activates the parasympathetic nervous system, which is responsible for relaxing your body. Therefore, if you are feeling anxious, try sitting with a weighted blanket. Alternatively, if you have a pet, put them on your lap. Both the pressure of their body and the act of petting them is great for relaxing. You could also try giving yourself a hand massage or tight hug.
    • Box breathing: This is a breathing technique that also activates the parasympathetic nervous system and relaxes the body. The steps of this technique are as follows:
      • Take a slow breath in through your nose (if possible) for four seconds
      • Hold that breath for four seconds
      • Slowly breathe out for four seconds
      • Hold your breath again for four seconds
      • Repeat this cycle three or four times
    • Funny videos: Sometimes it can be helpful to distract the mind with a funny video. Animal videos can be great! Or perhaps you have a favorite comedian that will always make you laugh.
  • Progressive Muscle Relaxation: This technique involves tightening different muscle groups and then letting them go. It helps to relax the body and reduce tension. You can find a guided YouTube video to walk you through the process, or you can also try it on your own by moving from head to toe, tightening different muscle groups. You may start by tightening all of the muscles in your face for 5-to-10 seconds as you inhale and relaxing the face muscles as you exhale. Give yourself 10-to-20 seconds to relax before moving on to the next muscle group.

 

About the Author

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

 

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

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

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

By | NESCA Notes 2022

By: Jane Hauser
Director of Marketing & Outreach

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

How did you discover your interest in neuropsychology?

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

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

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

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

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

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

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

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

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

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

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

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

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

 

About Pediatric Neuropsychologist Maggie Rodriguez, Psy.D. 

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

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

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

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

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

Anxiety-based Procrastination: Tips for Getting over the Hurdle

By | NESCA Notes 2022

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

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

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

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

 

About Lyndsay Wood, OTD, OTR/L

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

 

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

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

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

By | NESCA Notes 2022

By: Jane Hauser
Director of Marketing & Outreach

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

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

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

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

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

Why did you join NESCA?

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

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

What is the most rewarding part of what you do?

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

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

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

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

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

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

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

 

About Lyndsay Wood, OTD, OTR/L

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

 

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

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