MENTAL HEALTH Archives

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High school student image who is struggling with the overwhelm of school pressures

When High School Feels Overwhelming: How Neuropsychology Can Help Students Thrive

By | NESCA Notes 2025

By: Moira Creedon, Ph.D.
NESCA Hingham Director & Pediatric Neuropsychologist

I frequently meet high school students and families who are feeling the weight of academic expectations, especially at this point in the school year. Maybe your child recently finished midterms and the results weren’t what you hoped for. Maybe the daily stress of managing coursework of AP classes, standardized test preparation, extracurriculars, and college research feels like too much. The pressure to keep up can buckle even a strong student, and small vulnerabilities can suddenly be amplified in this context. If this sounds familiar, there are steps to take to support the daily midwinter stress.

Why Are So Many Students Struggling?

The challenges of high school are not limited to academics alone. It is a time of rapid growth in physical size, independence, academic demands, social environment, and emotional development. For some students, it is a time to shine with increased independence and responsibility. For others, the demands quickly exceed their skill set. The minor organizational and study challenges of middle school are amplified with more content and the burden to juggle simultaneous demands. Put simply, the executive functioning system gets put to the test in high school. These struggles do not mean you have a student who is not capable or intelligent. It may mean they need support for their unique learning profile.

What are Some Warning Signs of the Mid-year Slump?

Warning signs can include trouble keeping track of deadlines or assignments. It can be studying for hours for a test with a lackluster performance that doesn’t match the effort. It can come in the form of increased procrastination, trouble finishing tasks, and poor follow-through. It can also come in the form of increased fatigue, a sense of “burn out,” anxiety, or overall perception of stress. For some students, it can feel like their plate is too full but without a great plan for how to prioritize to make life manageable.

What Can Help?

Consider a Neuropsychological Evaluation

A neuropsychological evaluation is a comprehensive assessment that looks at how a student learns with an eye toward their unique pattern of strengths and weaknesses. A neuropsychological examination can help clarify a diagnosis or diagnoses (ADHD, anxiety, or a learning disability, to name a few), but it can also provide a detailed understanding of the overall process of learning. Bright students who feel overloaded can learn valuable information about their approach to learning so they can figure out how to study smarter, not longer. These evaluations can also include tailored recommendations for how to approach the stress, with suggestions for where and how to seek the appropriate help.

Explore Executive Functioning Coaching

Executive functioning coaches work with students to develop practical strategies for organization, time management, and study skills. Unlike a tutor in a specific subject domain, executive functioning coaches work across subject areas. Coaching sessions are individualized and can help students learn how to break down large assignments, create effective study schedules, prioritize tasks, and manage distractions. In addition to improvement in your academic performance, coaching can help students build independence and confidence.

Seek Support at School

Start with your academic advisor, adjustment counselor, or favorite teacher. Let them know your student is struggling to manage all the demands of their academic life. Many students pursue learning supports or accommodations at school via special education. Your school will need to review evaluations to determine if your child qualifies for a 504 Plan or Individualized Education Program (IEP) as these formalized supports require a diagnosis of a disability. Outside of these more formal support avenues, many schools offer peer tutoring or after-school homework support. Your student does not have to hide their struggles from their teachers!

Take Care of Yourself

With all of the growth in high school, it is important to remember to prioritize emotional health. Your academic success cannot last if it comes at the expense of your mental health. I encourage students to prioritize the basics – to get enough sleep, eat nutritious foods, exercise or move daily, and leave time for fun. If you sit down to create a calendar or task list with your child, keep these items on the list. A rested and restored brain is far more effective at learning.

We Can All Be in This Together

It is normal for your teen to feel a little overwhelmed at times in high school. Instead of viewing this as an opportunity for panic, let’s see it as an opportunity for growth. It does not have to be a journey you and your child take alone. With the right supports, your high schooler can manage their workload, develop more effective study habits, and build resilience to handle future stress. Neuropsychologists at NESCA are happy to support you in this journey through evaluations, consultation, and to connect you to executive functioning and school resources.

About the Author

Dr. Creedon offers her expertise in evaluating children and teens with a variety of presenting issues. She Moira Creedon headshot is interested in uncovering an individual’s unique pattern of strengths and weaknesses to best formulate a plan for intervention and success. She tailors each assessment to address a range of referral questions, such as developmental disabilities, including Autism Spectrum Disorder, learning disabilities, attention challenges, executive functioning deficits, and social-emotional struggles. She also evaluates college-/grad school-age/adult individuals with developmental issues, such as ASD and ADHD, particularly when there is a diagnostic clarity or accommodation question.

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 and related services practice with offices in Newton, Plainville, and Hingham, Massachusetts; Londonderry, New Hampshire; and Coral Gables, Florida, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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How Executive Function Coaching and Therapy Complement One Another-Part 2

By | NESCA Notes 2025

By Jasmine Badamo, MA
Educational Counselor; Executive Function Coach

Last week I wrote a blog about the complementary nature of executive function coaching and therapy. I discussed the ways in which each service is distinct, as well as where there are overlaps. Today I’d like to share examples of how each service can support the other. If you find the examples helpful, feel free to download the pdf version from our Resources page!

How executive function coaching can support your therapy work:

An executive function coach can…

Serve as another person to reinforce the concepts you’re learning in therapy and help you make note of everyday and/or academic situations that connect to your therapy goals.
Serve as a source of motivation and accountability to help you implement the recommendations made in therapy, such as improving your sleep hygiene, widening your social circle, or increasing your positive self-talk.
Consult with your therapist to provide examples of your everyday struggles and mindset towards them.
Provide a safe space for metacognitive and self-reflection discussions, which can serve as a stepping stone if you are not yet ready to embark on therapy or are questioning your current style of therapy. These discussions can promote a new openness to trying therapy or exploring new therapy modalities/approaches.

How therapy can support your executive function work:

A therapist can…

Address anxiety, depression, perfectionism, all-or-nothing thinking, or negative self-talk/narratives, all of which can present a significant barrier to coaching because they reduce your motivation and openness to trying new problem-solving strategies.
Provide a big picture, comprehensive understanding of the mental and emotional barriers facing you and guide you (and your executive function coach) in choosing motivation and routine-building strategies that would work best.
Help you to build coping strategies for managing daily life and novel tasks, freeing up energy for taking on new goals and challenges.

Every service provider brings something important to the table, and therapy and executive function coaching are an extra-special support combination that has truly benefited many of our clients at NESCA. It often takes a team to support an individual through challenging aspects of their life, and NESCA’s coaches are happy to be a part of that team!

NESCA offers executive function coaching for students from elementary school through adulthood who are looking to bolster their organization, scheduling, time management, goal setting, and routine building skills. Students work 1-on-1 with occupational therapists and education specialists to identify specific skills that will help them be more organized and in control of their academic and general life tasks. If you have concerns about your child or student’s executive function challenges and want to try our 1-on-1 coaching, please complete our online Intake Form.

About the Author

Jasmine Badamo, MA, is a licensed special educator and seasoned executive function coach. She Jasmine Badamo headshot supports a wide range of clients, ranging from age 7 to adulthood, to develop executive function and independence skills necessary for success with school (including college and graduate school) and in life. She is also uniquely qualified to coach parents and train educators to support EF skill development across settings.

To book executive function coaching with an EF or Real-life Skills Coach at NESCA, complete NESCA’s online intake form.

NESCA is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, Plainville, and Hingham, 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.

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Image of two puzzle pieces fitting together to represent therapy and EF coaching

How Executive Function Coaching and Therapy Complement One Another-Part 1

By | NESCA Notes 2025

By Jasmine Badamo, MA
Educational Counselor; Executive Function Coach

At a recent NESCA case conference, we had a thought-provoking discussion about the relationship between executive function coaching and therapy that inspired me to write this two-part blog series.

Executive function coaching is different from therapy in a few key ways:

Most executive function coaches are not trained mental health professionals.
Therapy is usually positioned to treat mental health concerns, such as anxiety, depression, OCD, and related emotional patterns.
Executive function coaching focuses more directly on improving cognitive skills and strategies (like planning, organizing, prioritizing, time management, focus, and self-regulation) to support clients in reaching their academic, professional, and personal goals.
Executive function coaching is often more practical and solution-oriented, while many therapy approaches focus on exploring past experiences and deepening a client’s understanding of themselves.

But there can also be overlap between the two supports:

Executive functioning and mental health both impact an individual’s self-regulation and ability to cope with daily life.
Executive function coaches and therapists might both implement skill-based activities with clients.
Executive function coaches and therapists both focus on improving an individual’s well-being by identifying challenges, setting goals, developing strategies, and building self-awareness.

The truth is that the work we executive function coaches do with our clients frequently relates to their mental health and emotional struggles. For example, we may help individuals strengthen their ability to regulate impulses; reflect inward to better understand their habits and patterns in behavior; move past low motivation to activate and take action; adapt their behavioral patterns to better meet their needs and goals; implement self-care routines; and tackle the logistical challenges of accessing other services, such as therapy.

Additionally, persistent mental health struggles (as well as a person’s naturally fluctuating emotional states) play a large role in a person’s ability to access their prefrontal cortex or “thinking brain,” where our executive function abilities reside. This is because emotional regulation and executive control are both housed in this part of the brain. When one skill set is taxed, the other suffers. Correspondingly, persistent executive function struggles can contribute to increased mental health struggles, such as anxiety or depression.

Given the connected nature of executive functioning and mental health, we recognize that executive function coaching and therapy are distinct, but are also connected and complementary. The two services not only balance each other, but help to amplify the success and effectiveness of each individual service.

Tune in for our blog next week where I’ll delve into the ways executive function coaching can support your therapy work and vice versa!

NESCA offers executive function coaching for students from elementary school through adulthood who are looking to bolster their organization, scheduling, time management, goal setting, and routine building skills. Students work 1-on-1 with occupational therapists and education specialists to identify specific skills that will help them be more organized and in control of their academic and general life tasks. If you have concerns about your child or student’s executive function challenges and want to try our 1-on-1 coaching, please complete our online Intake Form.

About the Author

Jasmine Badamo, MA, is an educational counselor and executive function coach who works full-time at NESCA supporting students ranging from elementary school through young adulthood. In addition to direct client work, Ms. Badamo provides consultation and support to parents and families in order to help change dynamics within the household and/or support the special education processes for students struggling with executive dysfunction. She also provides expert consultation to educators, special educators and related professionals.

Ms. Badamo is a New York State Certified ENL and Special Education teacher. She has more than 10 years of teaching experience across three countries and has worked with students and clients ranging in age from 7 to adulthood. She earned her bachelor’s degree in Biological Sciences from Cornell University and her master’s degree in TESOL from CUNY Hunter College. She has also participated in graduate coursework focusing on academic strategies and executive function supports for students with LD, ADHD, and autism as part of the Learning Differences and Neurodiversity (LDN) certification at Landmark College’s Institute for Research and Training. In addition to being a native English speaker, Ms. Badamo is also conversationally fluent in verbal and written Spanish.

Having worked in three different New York City public schools, Ms. Badamo has seen firsthand the importance of executive function skills in facilitating student confidence and success. Her coaching and consultation work focuses on creating individualized supports based on the specific needs and strengths of each client and supporting the development of metacognition (thinking about one’s own thought processes and patterns), executive function skills, and independence. She will guide clients to generate their own goals, identify the barriers to their goals, brainstorm potential strategies, advocate for support when needed, and reflect on the effectiveness of their applied strategies.

Ms. Badamo is a highly relational coach. Building an authentic connection with each client is a top priority and allows her to provide the best support possible. Additionally, as a teacher and coach, Ms. Badamo believes in fostering strong collaborations with anyone who supports her clients including service providers, classroom teachers, parents, administrators, and community providers.

To book executive function coaching with Jasmine Badamo or another EF or Real-life Skills Coach at NESCA, complete NESCA’s 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.

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Do You Know Who Your Teen’s Friends Are?

By | NESCA Notes 2025

By Dot Lucci, M.Ed., CAGS
Director of Consultation and Psychoeducational Services, NESCA

Artificial Intelligence (AI) is a part of our lives, and we may even be using it ourselves at work, in our cars, and at home. There has been much press about the pros and cons of AI, and it continues to evolve at a rate that our laws can’t keep up with. AI is here to stay and is present in almost all aspects of our lives whether we want it to be or not, or whether we use it deliberately or not. Sometimes, we aren’t even aware of its infiltration into our lives.

So, you’ve heard of AI, but have you heard of character.ai? Do you have an AI companion that keeps you company by chatting with you, helping you with your mental health issues, or brainstorming ideas with you? At this point you may be thinking what is an AI companion? Well, if you are a parent of a teen or young adult or work with teens or young adults, you might want to read on. Many of our teens and young adults have heard of it, and according to Common Sense, it is trending in teens and young adults with 51% having used it at least once; some using it daily as their sole companion (Common Sense, 2024).

Character.ai is an AI tool where you can digitally create a character/persona (avatar) of famous people, historical figures, athletes, politicians, movie characters, anime, gaming worlds, or anyone who’s in your imagination. This is where your ideal friend and companion comes in! Usually, AI characters are positive, supportive, and caring. There are many different AI apps and tools to pick from, such as character.ai, Talkie, CHAI, Replika AI, to name a few. Character.ai differs from regular AI, which is frequently used in professional settings to help create efficiencies in our daily tasks. These character-based tools, however, are built for entertainment, companionship, role playing, storytelling, to play a game with, practice a foreign language, or get feedback and brainstorm different ideas or topics with, etc. These avatars can even be your mental health counselor. You can have a companion/friend at your fingertips who is there to support you at any given moment 24/7 for entertainment or emotional support. In essence, these apps let you talk in real time with whomever you’ve created, and it can carry on realistic conversations based on how you’ve programmed it to “be.”

Character.ai and other similar apps have been trained on large language learning models (LLM) and natural language processing (NLP) as well as deep machine learning (DML), which allows them to create natural, flowing, and engaging conversations. Like all AI, it has been trained on massive amounts of data, and these applications consider context and can predict responses. These apps are programmed to show and sound emotionally concerned. The characters can respond with different tones, word choice, personality traits, and more – all based on what you’ve built into it. Within the privacy settings, you can also have your character be available to others on the platform, so you can essentially create a “community of companions and friends” to engage with. These Ai companions can even talk amongst themselves with you in a group chat and share differing opinions and ideas for you to think about.

Like all digital platforms and apps, there are disclaimers, safety rules, and community guidelines, etc. These AI apps also include disclaimers addressing risks like exposure to hate speech, sexual harassment, self-harm, etc., in their safety rules. However, like all AI and social media, it is not foolproof and can be overlooked or bypassed. Because it is trained with LLM, NLP, and DML, the person who it interacts with it runs the risk of the potential for harmful and inappropriate content being included in its interactions.

Since our legal system has not yet caught up with the rapid-fire developments of the AI space, legal issues have been emerging about the duty of the technology companies to protect the mental health, and the emotional and psychological wellbeing of its users, especially those who are more vulnerable. For younger-aged users, or youth who are naïve, have mental health challenges, have less access to professional counselors, or may be in countries where mental health is not endorsed, this type of AI can have dire consequences if left unchecked. For instance, a mother in Florida filed a lawsuit against character.ai after her teenage son, who was diagnosed with an autism spectrum disorder, took his own life after getting emotionally attached to his character (World Law Group, 2024).

Many users of character.ai and tools with AI chatbots/avatars, allow the characters or avatars to become and serve as their sole friend. Users can develop a strong emotional attachment to their character, which can lead to a dependence and over-reliance on the character. The danger is that some characters may provide inaccurate, harmful, dangerous, or misleading advice, depending on their database, if they are not monitored properly (which many are not), as in the case of the Florida teen. These avatars are only as good as their training, and they are not humans. Needless to say, they are not fully able to understand the complexities of human interactions (and the nuances that come with them) and relationships, particularly in the contexts in which they occur. Becoming more reliant on an AI character can lead to isolation and a decrease in real life social interaction with family and friends. (Science Digest, 2024)

As with all technology, there are advantages and disadvantages to character AI avatars. For many, AI avatars/chatbots can also have positive benefits. For instance, they offer immediate accessibility to a listening ear, a non-judgmental friend, mental health support, and more – all which can quickly turn into cons. They can also be an outlet for creativity, imagination, working out the anxieties of connecting with a person in real life, and helping them practice and try on different ways of interacting.

In the broader context, character AI tools can be used for educational purposes, such as personalizing learning, simulating real-world scenarios, training individuals in various skills, using scientific figures to teach concepts, and more. If used properly, the story-telling and role-playing aspects can be harnessed to create interactive formats.

As with all technology usage, adults should be aware of what teens and young adults are engaged in online. As a parent or caregiver, it is important to stay ahead of this trend and its usage, especially if it is being used as a substitute for human companionship and mental health support. For many young people, the benefits of “having a friend, being seen, heard, and valued” by a chatbot/avatar is better than not having a friend, being seen, heard, and valued in real life. Although there are warnings on all of these platforms that the avatar is not real and that the conversation is computer-generated, it may not matter to the user if it feels real, sounds real, and provides real comfort. For them, it is worth it. This real-time friend, who is non-judgmental, supportive and readily available, is powerful for many teens and young adults.

If you notice a person changing their habits regarding engagement in real life activities, connection with family and friends, retreating/isolating to their room, becoming secretive, or only talking about their AI character, these could all be “red flags.”

Guidelines for Usage of Character-based AI

If you know of a teen who is using character AI, begin by checking in about their app use with a conversation. Approach it with curiosity and openness; not blame and punishment. Ask to see their avatars/characters to see if there is anything potentially harmful about their personalities. Assess whether there is anything beyond their maturity level. Teens and many young adults do not have fully-developed frontal lobes, or critical thinking and decision making skills to use character AI and manage potential harmful content and situations.

Schools are teaching teens about social media, internet safety, privacy, etc.; parents and caregivers must build on what is being taught at school in the home by reviewing the privacy and safety features with their teen/young adult and the reasons they are necessary. Review how they can spot harmful content when they see it, report it, and fully understand the app’s community guidelines.

If you feel the user may not be ready to access character-based AI, use parental controls on their devices, in the app store, and on the internet network to restrict character-based AI access. Just like other social media platforms, there are published guidelines for using character-based AI: don’t upload images of themselves, friends, or family members or recordings of their voices.

As teens become more active with AI and character-based AI, set time limits for its use and where they can use character-based AI (i.e., at the kitchen table), and how they will use it by identifying what function will it serve for them (i.e., practice conversational foreign language). Explain why the boundaries are there and how you want to help them make good decisions about AI usage in general, as it is and will continue to be all around them now and as they move on in life, where they will be making these decisions themselves. Set a good foundation early on.

References

About the Author

NESCA’s Director of Consultation and Psychoeducational Services Dot Lucci has been active in the fields of education, psychology, research and academia for over 30 years. She is a national consultant and speaker on program design and the inclusion of children and adolescents with special needs, especially those diagnosed with Autism Spectrum Disorder (ASD). Prior to joining NESCA, Ms. Lucci was the Principal of the Partners Program/EDCO Collaborative and previously the Program Director and Director of Consultation at MGH/Aspire for 13 years, where she built child, teen and young adult programs and established the 3-Ss (self-awareness, social competency and stress management) as the programming backbone. She also served as director of the Autism Support Center. Ms. Lucci was previously an elementary classroom teacher, special educator, researcher, school psychologist, college professor and director of public schools, a private special education school and an education collaborative.

Ms. Lucci directs NESCA’s consultation services to public and private schools, colleges and universities, businesses and community agencies. She also provides psychoeducational counseling directly to students and parents. Ms. Lucci’s clinical interests include mind-body practices, positive psychology, and the use of technology and biofeedback devices in the instruction of social and emotional learning, especially as they apply to neurodiverse individuals.

To book a consultation with Ms. Lucci or one of our many expert clinicians, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant/service in the referral line.

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, NY, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Occupational Therapist Leah Bridge, MSOT, OTR, Joins NESCA’s Coaching Team

By | NESCA Notes 2024

By: Jane Hauser
Director of Marketing & Outreach, NESCA

NESCA welcomed Occupational Therapist Leah Bridge, MSOT, OTR, as a per diem Real-life Skills and Executive Function Coach this past fall. Learn more about Leah and what she brings to her clients from our recent interview.

How did you become interested in occupational therapy?
As a younger student, I was diagnosed with a learning disability and was exposed to other students with various challenges in my classes and while receiving services. Through that experience, mostly in high school, I became interested in helping other friends and students engage with their work. That kickstarted my desire to work in an area where I was able to support the specialized needs population engage more in their everyday lives.

When I started my undergraduate degree, I actually didn’t know about occupational therapy at all. After ruling out other career paths and with the help of my advisor, I realized that OT was exactly the path I wanted to go down. It encompassed so much of what I love to do.

Once I started my occupational therapy graduate program, I learned about the mental health side of OT, which I hadn’t really known about before. That was very interesting to me, so I did a clinical placement at a behavioral health hospital, which set me on the path to becoming a mental health occupational therapist. From there, I ended up working at Cambridge Health Alliance for the past two years in the inpatient pediatrics, adolescents, and neurodevelopmental unit. Since these are acute settings, the patients mainly come in after a mental health crisis, and my job was to help stabilize them and work with them on self-regulation and coping skills.

Why are you a NESCA Real-Life Skills and Executive Function Coach?
I wanted to work with clients from start to finish, showing them the necessary skills for life. I came on board at NESCA as a per diem coach and quickly learned just how amazing it is to help people build skills. I love working with people, watching them progress, become more resilient, and build skills.

What approaches do you take in working with our coaching clients when they are so unique from one another?
I want my clients to feel like I’m easygoing and approachable. I use a very warm, empathetic approach and a lot of humor to make connections with them. I also like to see where individuals are at and follow their lead – never pushing someone too quickly and meeting their comfort level throughout the process. Once we have a foundational relationship, I can see where to challenge them.

What skills do you work on in Real-life Skills Coaching?
It can be a whole range of things. So far, I’ve worked on behavioral activation, meal prepping, note taking, folding laundry, taking out the trash, placing things into the dishwasher – generally helping people to take more of an independent approach to their daily tasks.

In the community, it could be anything from going into a store and feeling comfortable interacting with different employees in that store. I may take an individual into a store and practice some of the different types of jobs we are working on, like organizing a shelf in Target that was a bit disheveled and putting items back in their places. It’s a more interactive way to work on the organizational skills we may be building. We may also just walk around a crowded grocery store or mall where we can determine different self-regulation techniques that work in these overstimulating and overwhelming moments. It helps individuals be confident that, in the future, they may be able to go to these places alone and feel completely comfortable there.

What is the profile of some of the students that you’ve worked with?
I like working with people of all ages, and I love the differences among all of the patients, students, and clients I’ve seen. I’ve worked with a whole wide variety. At Cambridge Health, I worked with kids who are struggling from depression, anxiety, or a mood disorder, like bipolar, borderline personality disorder or psychosis. In the neurodevelopmental unit, I worked with a lot of different kids with autism, have an intellectual disability, or a traumatic brain injury. While there, I worked with kids who are both very resistant to working together as well as those who are incredibly self-motivated and really want to do the work.

At NESCA, I’ve also seen a variety of clients who are really fun to work with. We do things like work towards building skills they can use when they go off to college, helping them to be more independent and live on campus more confidently. I’ve also worked with students who are taking some time off from college or graduate school to rebuild their confidence and mental health before going back into the school setting. We’re working on a lot of daily tasks to help them feel more regulated and less overwhelmed, and on strategies to help in those difficult moments and remember that they can do this.

How do you gain buy-in from the individuals you work with?
Meeting coaching students where they’re at is so important. I go in with an open attitude and determine where they are at in each session, adjusting my plan from there. I never force anything, but rather go at their pace. I find I’m more successful when we just take time to get to know each other, build trust and understanding, and then the buy-in comes.

Most people are more willing to participate when they know why they are engaging in an activity or some type of coaching. When they learn that I am trying to teach them skills to help them advocate for themselves, they feel more empowered – not just that their parents are making them do this. It’s been very helpful to show them that they have a say in the process and a voice that helps them get to that place of independence.

How does NESCA’s collaborative approach help you in your coaching practice?
It offers amazing value. As an example, I may be thinking of an approach to use in a session, and then I hear from or consult with someone from another discipline within the practice about how they may approach it. It opens your eyes to a whole other way of looking at something. I’m also someone who is very eager to learn and improve my own skills, so I love getting input from other people and delving into the resources they suggest. I always want what’s best for my clients and my patients, so I am always happy to collaborate with everyone to be able to get that for them.

What’s your approach to designing a program or curriculum for someone?
I start off with doing some assessments to determine the areas that are within the domains of OT, such as activities of daily living, leisure activities, work/school activities, and also looking at what skills the individual can already do on their own, and ranking their performance level within each of those along the way. Some clients are able to complete these assessments independently, and some require input from their parents or caregivers. From there, we choose what areas we want to start with and set goals, mainly based on what the greatest areas of need are. We typically work in increments of eight-week sessions. Near the end of the eight weeks, we reevaluate and see if we want to do more.

What are some of the goals your students are working on?
A person may have the goal to go to a grocery store and pick out items from a shopping list. We may not start with going to the grocery store right away. Instead, we may sit down and look at a map of the grocery store and get a feel for what each aisle looks like and what we can find in each one. We may do this kind of work for the first four sessions and then spend the next four sessions going to different places where we can look at how different stores are set up, and how we can find items when the aisles look different from store to store. If we can’t find the items, we work on how to approach someone and ask where we can find them.

What is your take on using different technology tools or apps?
I’m someone who loves learning all about new approaches, including technology, to see what may work. I’m open to exploring new technology and introducing it to students if I think it is something that will support them in reaching their goals. There are some great ones available for anxiety, which may help them engage in our sessions together. There are others for banking, scheduling, and calendaring. If a student prefers using Google Sheets or Excel to help organize their day, I am definitely willing to work with them using those as long as they are a support.

Is there anything else that you would like people to know about you?
I love working with individuals who are going through mental health challenges, whether short-term or chronic. But it’s not the only area I am interested in. I’m someone who feels I can offer a lot and am willing to do the work to really learn and feel as though I can provide the best care to those with whom I work. So, for me, there’s really nothing that I feel I want to avoid. I’m a very open person in that sense that I really just want to help as many people as I can.

About Leah Bridge, MSOT, OTR

Leah Bridge, MSOT, OTR, is a licensed occupational therapist with a passion for helping individuals develop the skills needed to Headshot of Leah Bridge meaningfully engage in their daily lives. With a Master’s degree in Occupational Therapy from Regis College and a Bachelor’s degree in Kinesiology from the University of Massachusetts Amherst, Leah brings a well-rounded educational background to her practice. She is currently licensed to practice in Massachusetts.

Throughout her career, Leah has specialized in mental health-based occupational therapy across various settings, including inpatient units, partial hospitalization programs, and schools. She has worked closely with individuals aged 4 to 26, addressing critical areas such as activities of daily living (ADLs), self-regulation techniques, executive functioning, and routine development. Her experience spans a wide range of diagnoses, including autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), traumatic brain injury (TBI), and mental health conditions such as depression, generalized anxiety disorder (GAD), and bipolar disorder.

Leah’s therapeutic approach is client-centered and holistic, adapting her interventions to suit the unique needs of each individual and their environment. Whether facilitating community engagement with adolescents in schools, providing vocational consults and life skills groups at partial programs, or teaching coping and self-regulation techniques in inpatient settings, Leah is committed to tailoring her strategies to each client’s specific goals.

Leah’s work is deeply collaborative, and she frequently partners with families and with other professionals such as social workers, psychiatrists, nurses, and psychologists to ensure comprehensive care. Her ability to foster strong therapeutic relationships, combined with her humor and validation techniques, helps clients feel comfortable and supported throughout their therapy journey.

To schedule an appointment with one of NESCA’s coaches, please complete 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, NY (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.

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Pediatric & Adult Neuropsychologist Rebecca Dautoff, Psy.D., Joins NESCA

By | NESCA Notes 2024

By: Jane Hauser
Director of Marketing & Outreach, NESCA

You adapt your approach with neuropsychological evaluations for each individual based on their developmental stage. Tell us about that.

With younger kids, it’s a much more interactive experience. Their attention spans are shorter, so they often need a warmer environment that feels less intimidating. Sometimes it’s getting on the ground and playing with them, other times it is starting testing under a table until the individual feels confident enough to sit at a table. I try to make it feel like a collaborative process.

It ultimately comes down to how you connect with someone. I connect very differently with a four-year-old than I do with a 14-year-old or a 20-year-old.

How do you get older adolescents, who may not be eager to be evaluated, to buy-in on engaging in evaluations?

This can be tricky. Usually, we can find a reason that they are comfortable sharing about why they are being evaluated, and I use that to explain what an evaluation can do to help them with that reason or issue. I try to understand what they want to get out of an evaluation and what it will help clear up for them.

Sometimes parents and adolescents are not aligned. Maybe a parent wants their child evaluated because they think that they have ADHD. The individual being evaluated may agree that they are neurodivergent, but may feel like their symptoms align better with Autism than ADHD. We can work with whatever that individual is feeling, even if it’s different from their parents’ concerns. We take the information and feelings from both the parents and adolescents – as well as input from educators and professional providers – and combine that history with the testing data, our observations during the evaluation, and synthesize it all to identify a diagnosis (when applicable). Then we develop highly personalized recommendations for interventions and hope to partner with the family along the way to support both parents and the adolescent.

You conduct neuropsychological evaluations and also projective testing here at NESCA. What is your approach to projective, or psychological testing?

If you’re questioning major psychiatric diagnoses that often feel very scary and are hard to talk about, projective testing can be very useful. It gives us a way to look at someone’s inner world or emotions, especially when they’re unwilling or unable to talk about it directly.

Describe the most challenging but rewarding individuals you’ve evaluated.

I enjoy working with the kids who think differently from their parents. It can be really rewarding to validate their feelings, explain their concerns to their parents and do some psychoeducation for their parents to get the adolescent or young adult and the parents back on the same page. Getting members of a family to understand each other’s perspectives is a really rewarding experience.

I also enjoy working with families who have gone through some kind of really hard experience, perhaps for a long time – whether that’s a traumatic experience or an adoption. And again, the part that I like so much is the feeling of bringing people back together and giving them some hope for the future.

Finally, I like incredibly complicated cases where there isn’t a clear answer – the ones where it’s a bit of a struggle to figure out or, in some instances, you work with a family as part of a longer-term partnership to gradually see a path forward. It’s not always clear-cut. When you can’t immediately clarify all of the pieces, you need to find a path forward for the family to start out on, revisit that path and potentially change or enhance that path. I like knowing that I can be part of someone’s team for the long term, like I’m joining the family and other providers, who are all working for that child. I’m talking about the ones that aren’t one-offs, rather the ones where we can build lasting relationships on behalf of a child.

You’ve worked in private and public schools and at a clinical treatment center. What brought you to NESCA, and how do you feel your past experiences impact your work with NESCA families?

Having lots of different experiences at different places and settings makes it easier for me to connect with a huge variety of people. I’m very rarely uncomfortable or fazed by the families or individuals I work with, their comments, or experiences, because I feel like I’ve heard so much from so many different people throughout my career.

I enjoy working with adolescents and young adults. Since they spend so much time in school, it has been beneficial for me as a clinician to have spent years working in the school setting. You have that perspective on schools – where they spend more waking hours than even at home. I have a good understanding of how schools work and the social dynamics for adolescents in schools. That has been especially useful in my work as a neuropsychologist.

What brought you to NESCA and why?

In my last position, I was in a mostly administrative role, doing a lot of supervision and teaching, which I really liked, but I missed the clinical work.

I was also looking for more exposure to different ways of doing things.

Since NESCA’s Founder and Director Dr. Ann Helmus is such a phenomenal clinician and is so well-known and respected, it felt like a great opportunity to learn from her. I had also trained as an intern with Dr. Miranda Milana, who is in NESCA’s Plainville office, and she talked a lot about the culture, the people, and how great everyone was. She was right! It’s a very supportive environment.

What I’ve found in the several months that I’ve been with NESCA is that the people are very smart here. I remember coming to one of NESCA’s weekly Case Conferences before I had agreed to join and thinking, “Wow, these people certainly know what they’re doing!” I learned something new in that Case Conference that I hadn’t thought about before, even though I had been practicing for years. I thought that was really powerful. NESCA is a group of professionals who truly love what they do and are so passionate about it. It is impressive to see so many people who have different perspectives and experiences come together to be so skilled at what we do. To be quite frank, I have learned a ton since being here and it hasn’t even been that long!

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.

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Hands reaching out to each other for help

Busting a Common Therapy Myth

By | NESCA Notes 2024

Hands reaching out to each other for help By: Carly Loureiro, MSW, LICSW
Therapist, Executive Function Coach, Parent Coach

Despite the many benefits of therapy, many people still hesitate to seek it out or see it through when things are seemingly going well. This hesitation can stem from a variety of factors, including societal attitudes, personal beliefs, and misconceptions about therapy. Going to therapy even when you’re not facing a specific problem can be incredibly beneficial for several reasons. Here are some key points to consider:

1. Preventative Mental Health Care

Just like regular physical check-ups help maintain your overall health, therapy can act as a preventative measure for your mental well-being. It provides an opportunity to address smaller concerns before they grow into bigger issues. Regular therapy sessions can help you develop strategies to manage stress, improve emotional regulation, and build resilience. Mental health doesn’t have a “finish line”—it’s an ongoing process.

2. Self-Exploration and Personal Growth

Therapy isn’t just for when you’re struggling—it’s also a space for self-exploration and personal development. For example, your therapist can help you find ways to reignite the creative side of yourself that took a back seat while you worked towards that promotion at work. This kind of introspection can help you lead a more intentional, fulfilling life and deepen your understanding of yourself and others.

3. Building Emotional Tools and Resilience

Therapists can help you build a toolkit for managing a wide range of emotions, from anxiety and anger to sadness and joy. Even if you’re not currently facing any challenges, strengthening these skills can help you navigate life’s ups and downs with greater ease.

4. Improving Relationships

Therapy can also support relationship health. You might not be experiencing conflict, but therapy can help you understand your communication patterns, your needs in relationships, and how to foster stronger, more supportive connections with others.

5. Managing Stress and Building Coping Strategies

Life doesn’t stop being stressful, even if there’s no crisis. Learning how to effectively manage stress, anxiety, or pressure in healthy ways can improve your overall quality of life. Therapy can help you develop coping mechanisms and mindfulness practices that make handling stress more manageable.

6. Increasing Self-Awareness

Therapy can help you become more self-aware by reflecting on your thoughts, feelings, and behaviors. This awareness can help you break old patterns or negative cycles you may not even realize you’re in. It’s a proactive way to improve your mental health before things escalate.

8. Learning to Manage “Normal” Life Struggles

Everyone experiences day-to-day challenges—work stress, relationship dynamics, feeling stuck, or uncertainty about the future. Therapy can help you address these common struggles in healthy ways, equipping you with problem-solving and coping strategies that you can use long-term.

________________________________________________________________________________________________

Even if you’re not facing an immediate crisis, therapy can be a helpful tool for maintaining a strong, healthy mind and enhancing your quality of life. It’s about building the emotional and mental muscle that allows you to better handle whatever comes your way—big or small.

If you are interested in exploring therapy for your teen, young adult, or yourself, let us know by filling out our Intake Form.

About the Author

Carly Loureiro is a Licensed Independent Clinical Social Worker practicing in Massachusetts and Rhode Island. Having worked both in private practice and schools, she has extensive experience supporting students, families and educational teams to make positive changes. Mrs. Loureiro provides executive function coaching and psychotherapy to clients ranging from middle school through adulthood, as well as to parents/caregivers. She also offers consultation to schools and families in order to support her clients across home and community environments.

To schedule an appointment with one of NESCA’s counselors, coaches, or other experts, please complete 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; and staff in the greater Burlington, Vermont region and Brooklyn, New York, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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Pile of tangled holiday lights representing holiday stress

Coping over the Holidays

By | NESCA Notes 2024

Pile of tangled holiday lights representing holiday stress By: Carly Loureiro, MSW, LICSW
Therapist, Executive Function Coach, Parent Coach

Home for the holidays isn’t always as it appears in a Hallmark movie. For many NESCA families, the holidays bring considerable anxiety and a fear of the unknown. Whether you have a family member returning home from a residential program or have a child coming home for school/college winter break, changes in environment, schedule, and routine can bring significant unpredictability. Below are some suggestions to feel more prepared as you enter this busy holiday season.

Stick to a schedule: make a loose and casual itinerary so all family members are aware of what can be expected over the holiday stretch. Preview plans and activities with family members to ensure everyone can process what is on the agenda.
Prioritize self-care: Schedule time for downtime & relaxation, exercise, healthy eating, and activities you enjoy, even if it’s just a short break during the day. Some family members may require assistance with coming up with ideas on what downtime looks like for them. Block self-care time and activities in your calendar so you don’t neglect the time needed to recharge.
Say no when needed: Boundaries, boundaries, boundaries! Don’t be afraid to decline external invitations or commitments that will overwhelm you and your family. Or, if it’s decided that one or two family members are best staying back home while others attend these commitments, that is okay too. Do what is best for you.
Manage your time: Don’t bite off more than you can chew! Create a plan for holiday tasks like shopping, cooking, and socializing to avoid feeling rushed. Schedule these plans and tasks in your calendar so that you don’t overbook yourself with other commitments.
Limit social media: Reduce exposure to unrealistic holiday portrayals on social media to prevent comparisons and stress. Let’s not forget that social media is a “highlight reel” of someone’s best moments. No one wants to show the depths of what actually goes on.
Communicate openly:
Talk to family and friends about your needs and expectations during the holidays. Identifying one or two people you can confide in about how you’re feeling will help ease some of that tension that can be hard to carry.
Practice mindfulness:
Engage in meditation or deep breathing exercises to manage stress and stay present. There are great options available on YouTube. Some of my favorite accounts for guided meditation and visualization are The Honest Guys and Dr. Jennifer Andrews.

Lastly, we at NESCA are here for you. If you need support with implementing any of the above, please do not hesitate to reach out and fill out an intake form. It’s never too late or too early to get started!

About the Author

Carly Loureiro is a Licensed Independent Clinical Social Worker practicing in Massachusetts and Rhode Island. Having worked both in private practice and schools, she has extensive experience supporting students, families and educational teams to make positive changes. Mrs. Loureiro provides executive function coaching and psychotherapy to clients ranging from middle school through adulthood, as well as to parents/caregivers. She also offers consultation to schools and families in order to support her clients across home and community environments.

To schedule an appointment with one of NESCA’s counselors, coaches, or other experts, please complete 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; and staff in the greater Burlington, Vermont region and Brooklyn, New York, serving clients from infancy through young adulthood and their families. For more information, please email info@nesca-newton.com or call 617-658-9800.

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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

By: 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

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 Helpline, 1-800-662-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.

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Image of flowers coming out of a person's head, symbolizing various mental health disorders/diagnoses

Understanding Diagnostic Labels

By | NESCA Notes 2024

By: Lauren Halladay, Ph.D.
Pediatric Neuropsychologist, NESCA

Throughout the evaluation process, many families express concern about the potential negative impacts of placing diagnostic labels on a child. Unfortunately, parental worries associated with stigmatization, as well as others making incorrect assumptions and placing inappropriate expectations on their child are common and valid. As such, it is reasonable to ask, “where does diagnostic labeling come from?”

In 1952, the first version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) was developed by the American Psychological Association (APA) as the standard classification of mental disorders used by mental health professionals in the United States. Since that time, several iterations of the DSM have been developed. Most recently, the DSM-IV- Text Revision (TR) was published (2022), in which sections of text describing diagnostic categories and associated features were revised based on new research. Hundreds of international experts in all aspects of mental health contributed to the development of the DSM, as well as adjustments to subsequent versions.

There are certainly benefits and drawbacks for making specific diagnoses, a few of which are detailed below:

Pros	Cons
Provides a common language in an effort to help mental health and medical professionals communicate effectively. May provide some relief to clients who come to find their symptoms are associated with a disorder that others also experience. Helps guide providers in recommending appropriate treatment options based on diagnostic presentation.	May not fully account for contextual influences, such as ethnicity and culture on the development of psychopathology. Potential for disagreements related to interpreting diagnostic criteria when trying to make diagnostic decisions. Places individuals into “boxes,” which can lead to stigmatization.

Broadly, much of the neuropsychological evaluation process focuses on identifying how a child’s behavioral, emotional, and/or social functioning may be discrepant from that of their peers for the purpose of identifying appropriate treatment and educational services to support the child. Of equal importance is highlighting the child’s strengths, as well as understanding individual family values and cultural factors that may be contributing to a child’s presentation.

As neuropsychologists at NESCA, we take a holistic view of your child and consider multiple sources of information when answering referral questions, including information from parents, teachers, providers with whom the child has developed strong rapport, as well as our observations throughout the evaluation process. While we do refer to the DSM when making diagnoses, we pride ourselves on taking an incredibly individualized approach and high level of care when working with clients. Our goal is not to simply put your child in a “box” and send you on your way. We seek to understand your child’s symptoms and how they impact functioning across environments. We consider initial evaluations as the first step in your journey to fully understanding your child, treating the aspects of their presentation that you’d like to prioritize, and ultimately promoting their overall well-being and success.

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 Dr. Halladay 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.

MENTAL HEALTH Archives - NESCA

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How Executive Function Coaching and Therapy Complement One Another-Part 2

How Executive Function Coaching and Therapy Complement One Another-Part 1

Do You Know Who Your Teen’s Friends Are?

Occupational Therapist Leah Bridge, MSOT, OTR, Joins NESCA’s Coaching Team

Pediatric & Adult Neuropsychologist Rebecca Dautoff, Psy.D., Joins NESCA