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medically complex

Meet Pediatric Neuropsychologist Lauren Halladay, Ph.D.

By | NESCA Notes 2022

By: Jane  Hauser

Director of Marketing & Outreach, NESCA

I recently had the opportunity to learn more about Pediatric Neuropsychologist Lauren Halladay, Ph.D., who joins NESCA in September. Learn more about her background and specialties in today’s blog interview.

How did you choose pediatric neuropsychology as a profession?

My interest was originally piqued when I was younger, as early as my high school years. I volunteered at a therapeutic riding program for kids with disabilities. That’s what initially sparked my desire to work with kids, and those with disabilities, in particular. My mother was a third grade teacher, which also imparted the desire to work with kids and help them overcome their challenges at school.

I went on to major in psychology and had a strong interest in pediatrics for the reasons I mentioned previously. Based on some of the work I did in graduate school, I learned that I really enjoyed the assessment piece, especially with the younger kids, helping them in life by identifying the right diagnosis (when applicable) and helping to put the right interventions in place for them to build skills that will equip them for the future.

How have your previous work experiences prepared you to be a neuropsychologist?

I’ve had a wide breadth of work experiences where I was supervised by neuropsychologists, whether it be in satellite health systems, the hospital setting, etc. While in those clinics, I had the opportunity to work with a variety of populations and presentations, including those who have experienced trauma, or have developmental or learning disabilities.

Having worked in several states throughout the country, including Oregon, Ohio, New York and Massachusetts, I’ve had the pleasure of working closely with a variety of families who present with unique backgrounds, experiences, and cultural values, which I always consider when making diagnostic decisions and developing recommendations.

What areas of neuropsychology have you most enjoyed to date? What would you consider your specialty area?

There are several areas that I am very passionate about. I really enjoy working with young kids, those under the ages of five or six. I also have a great interest in working with families who have concerns about their child potentially having an autism spectrum disorder or an intellectual or developmental disability. In addition, I find it incredibly rewarding to work with and help families whose children are medically complex or have moderate to severe cognitive impairments.

Regardless of how the child or student presents or what challenges they may have, I always individualize my approach so that I can meet the needs of each child. This is especially true in cases where families have had a hard time getting assessments done in the school setting or even privately in the past.

What is the most rewarding experience in neuropsychology that you’ve had to date?

I find it rewarding to hear from families when the strategies I’ve recommended are or are not working for them. For example, hearing that parents achieve success in implementing behavior management strategies, accessing support in the community, and/or learning about their child’s diagnosis and how to create an environment that suits their needs is a wonderful feeling. On the other hand, when the initial recommendations are not as helpful as intended, I enjoy approaching the problem-solving process together and discussing alternate approaches.

I also find it incredibly rewarding to offer parents and caregivers a deeper perspective on a child who has a moderate to severe cognitive impairment or is medically complex. Being able to give them a sense of where their child is developmentally in relation to their peers can be enlightening. Additionally, having more information about a child’s developmental level can help families and school staff establish appropriate, and individualized, expectations that set the child up for success. I strive to make a difference in these cases by developing strong partnerships with families, as well as serving as a trusted resource and advocate as they navigate how to best access supports in the community and in school.

What benefits, having been trained in a school psychology department, do you bring to families at NESCA?

My school psychology background allows me to bring a deep awareness and perspective on how the IEP process works. My experience and knowledge of special education rights allows me to be a true partner to families who are trying to navigate and understand the IEP process. I am able to share that knowledge and better advocate for my clients in Team meetings.

Why did you decide to join the team at NESCA?

I knew that in my next career move, I wanted to be part of a collaborative community that puts an emphasis on work/life balance—I feel that both allow clinicians to produce the highest quality work. At NESCA, I will also have the opportunity to use my school psychology skills and be an active participant in the IEP process on behalf of our clients.

NESCA is known for creating and building long-lasting relationships with the families they work with. I look forward to working with families and their schools/districts for the long-term, helping students to build skills along the way that will help them throughout their lives.

Finally, not being a native Bostonian, I am excited to learn more about and partner with the different school systems on behalf of the families and students we work with at NESCA.

 

About Lauren Halladay, Ph.D.

Dr. Halladay conducts comprehensive evaluations of toddlers, preschoolers, and school-aged children with a wide range of developmental, behavioral, and emotional concerns. She particularly enjoys working with individuals with Autism Spectrum Disorder, Intellectual and Developmental Disabilities, and complex medical conditions. She has experience working in schools, as well as outpatient and inpatient hospital settings. She is passionate about optimizing outcomes for children with neurodevelopmental disabilities by providing evidence-based, family-oriented care.

 

If you are interested in booking an appointment for an evaluation with a NESCA neuropsychologist/clinician, please fill out and submit our 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.

My child is nonverbal. Should I still get a neuropsychological evaluation?

By | NESCA Notes 2022

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

The short answer to this question is YES. As a neuropsychologist, I enjoy evaluating students who have complex profiles, including intellectual/developmental disabilities, genetic conditions, and medical complexities. In many cases, these students have been deemed “untestable” and have never had a comprehensive evaluation.

This is problematic for two major reasons.

  • First, we cannot understand a student’s potential if we have no data or assessments available. Following from this, it is very hard to develop realistic and measurable goals without using the student’s innate potential to guide those goals.
  • Second, lack of testing causes practical and logistical problems later in the student’s life. As a child approaches adulthood at 18, it is necessary to have documentation of their cognitive and adaptive skills as well as diagnoses in order to seek adult services. More specifically, the Department of Developmental Services (DDS) requires documentation of intellectual disabilities prior to age 18.

Having assessed thousands of children and adolescents over the years, I’ve learned that I can ALWAYS gather important information from a neuropsychological evaluation. I have evaluated students who are nonverbal, students with severe intellectual disabilities, students with limited to no motor abilities, students with vision and hearing impairments, students with severely challenging behaviors…. In every case, a neuropsychological evaluation has been meaningful and useful in terms of A) understanding the student’s capabilities, and B) developing educational and treatment goals.

It is important to understand that a neuropsychological evaluation with a more developmentally complex student will look different than an evaluation with a neurotypical student. There are standardized tests that I will not be able to administer based on the student’s language skills, motor abilities, and academic knowledge. Some students can only tolerate 20 or 30 minutes of testing at a time, so the evaluation is broken into 9 or 10 sessions. Some students provide their responses using a communication device. Some students need to be supported by a behavior therapist to help them maintain a safe body.

In some cases, students cannot engage in any standardized tests due to multiple disabilities. However, I still have them come into my office at least once so that I can meet them in person and gather information about their communication skills, social interest, and activity levels. I will then spend time observing the student at their educational program, interviewing school-based staff, and gathering information from the student’s caregivers about their skills at home. With all of these data points, I can then provide a thorough set of recommendations for school-, community-, and home-based goals – even though I might not have “valid” standard scores.

For all of the families who think that a neuropsychological evaluation cannot be done with their child for one reason or another, I urge you to reconsider your perception of the purpose of an evaluation. In these cases, the emphasis of the evaluation is not on test scores, but on developing a better understanding of the student’s strengths and weaknesses. More importantly, the evaluation should be used as a reference to guide treatment goals to help the student achieve the highest level of independence of which they are capable based on their potential.

 

About the Author

Erin Gibbons, Ph.D. is a pediatric neuropsychologist with expertise in neurodevelopmental and neuropsychological assessment of infants,

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

 

If you are interested in booking an appointment for the ASD Diagnostic Clinic or an evaluation with a NESCA neuropsychologist/clinician, please fill out and submit our 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.