Tag

MENTAL HEALTH

The Next Pandemic: Mental Health Issues

By | NESCA Notes 2020

By: Ann Helmus, Ph.D.
NESCA Founder/Director

The return to school, whether remotely or in person, will be a transition that is bound to be stressful for many children and adolescents as well as their parents and teachers. Coming on the heels of five stressful months of lockdown, remote learning, loss of social contact and so many other changes,  children will be meeting this challenge with depleted resources for coping with stress and may show new signs of anxiety or mood issues. This will be particularly true for children and adolescents who have underlying issues with mental health, attention or learning. Prioritizing the mental health of students and focusing on providing emotional support will be key to helping children manage the transition back to school. “When children feel connected, they’re going to learn better, do better, stay on track,” commented Dr. Nadine Kaslow, professor of psychiatry at Emory School of Medicine and past president of the American Psychological Association, in this article. She emphasized that “loving warm interactions need to take precedence” over struggling with them about behavior or about schoolwork.”   Remembering that undesirable behaviors are often driven by emotional distress and are a form of communication can be helpful for parents in responding in a positive and supportive manner. As we continue through this period of unprecedented levels of stress and change, children need to feel connected to and supported by their parents even more than is usual; maintaining this connection is far more important than any academic goals, no matter how far behind parents fear their child is as a result of the interruption to regular schooling.

If you have concerns about your child’s mental health, clinicians at NESCA are available for expert consultation or evaluation of your child’s emotional functioning so that the appropriate supports can be put in place. This work can be done either through teletherapy or in-person through contactless evaluations in all three of our locations (Newton and Plainville, MA and Londonderry, NH). NESCA has several suites in which there is a large plexiglass panel in the shared wall between two offices so that the child/parent and evaluator/therapist are in separate offices but have the benefit of full visibility and communication through headphones. For more information, please view, “Testing in the Age of COVID-19” on our Video Resources page.

If you have questions about your child’s mental health and would like professional help, please reach out to Dot Lucci, M.Ed., CAGS: dlucci@nesca-newton.com for an intake and screening.

 

About the Author: 

NESCA Founder/Director Ann Helmus, Ph.D. is a licensed clinical neuropsychologist who has been practicing for almost 20 years. In 1996, she jointly founded the  Children’s Evaluation Center (CEC) in Newton, Massachusetts, serving as co-director there for almost ten years. During that time, CEC emerged as a leading regional center for the diagnosis and remediation of both learning disabilities and Autism Spectrum Disorders.

In September of 2007, Dr. Helmus established NESCA (Neuropsychology & Education Services for Children & Adolescents), a client and family-centered group of seasoned neuropsychologists and allied staff, many of whom she trained, striving to create and refine innovative clinical protocols and dedicated to setting new standards of care in the field.

Dr. Helmus specializes in the evaluation of children with learning disabilities, attention and executive function deficits and primary neurological disorders. In addition to assessing children, she also provides consultation and training to both public and private school systems. She frequently makes presentations to groups of parents, particularly on the topics of non-verbal learning disability and executive functioning.

To book an evaluation with Dr. Helmus, NESCA Founder and Director, or one of our many other expert neuropsychologists or therapists, 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.

Strong Mental Health is So Important During a Pandemic

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

In March, 2020, a poll conducted by the American Psychiatric Association found that more than a third of all Americans (36%) stated that Covid-19 is having a serious impact on their mental health; 59% said it is a having a major impact on their daily lives; 48% are anxious about contracting Covid-19; 62% are anxious about a loved one becoming ill; and 68% feel it will have a serious impact on our economy. Needless to say, we are living in an unprecedented time due to Covid-19, and it will have a serious impact on people’s mental and physical health both now and for some time. It has created stress, anxiety and depression even as we are learning to cope and adjust to this current new normal.

Given these numbers, many adults, teens and children are struggling with a myriad of challenges, stressors and losses during this pandemic (i.e. missing graduations, births, food insecurity and financial insecurities, including job losses, etc.). Deciding how to alleviate the pain and suffering can be daunting. Psychological, medical/psychopharmacological, complementary (i.e. acupuncture), behavioral and educational treatments are possible choices and can assist in alleviating some pain and suffering. What better time than now to get yourself and your loved ones some mental health support?

This blog will review a variety of treatment approaches which are now being offered through telehealth. There are many HIPAA-protected platforms that clinicians are using to meet their client’s needs as well as some “wearables” to assist in treatment. Wearables transmit your biophysiological data to your clinician so s/he may use it in conjunction with and/or inform treatment.

Mental health treatments include many different types: psychotherapy (also known as “talk therapy” or “insight-based therapy”), psychoeducational, biofeedback, social training, mindfulness/relaxation and so many more. Approaches to psychological treatment may include individual, group, family or couples work, and there is no one single approach that works for everyone. Psychological treatment is typically provided by a licensed psychologist, social worker, mental health counselor, expressive therapist, psychiatrist and/or psychiatric nurse.  Many factors go into making psychological treatment decisions, but when it comes to therapy it is most important to have “goodness of fit” between the clinician and the client. The client needs to “get along with” and feel valued, supported and understood by their practitioner. This enhances the effectiveness of whatever treatment approach or method is utilized.

Reviewing the differences between treatment approaches may help you in your decision- making process beyond “the goodness of fit.” Psychotherapy involves talking with a clinician to address emotional, psychological and behavioral challenges that can be both conscious and unconscious. The client’s past experiences, perceptions and history play an important role in psychotherapy. The client “tells their story,” which helps the clinician understand their life experiences through their eyes, which allows treatment to be tailored to their experiences. By working through one’s thoughts, past experiences and stressors with a caring clinician, the client is able to gain insight, perspective and strategies to alleviate pain and suffering and manage unhealthy thought patterns and behaviors. The aim is to help the client understand their past and to recognize its influence on their current situation. Often psychotherapy is long- term and involves good communication/language skills as well as higher level thinking and insight capacity. However, psychotherapy can also be short-term and specifically focused on the thoughts, feelings and behaviors associated with Covid-19 and its impact on a person’s life.

Psychoeducational treatment is somewhat different than psychotherapy. Psychoeducational treatment can be provided to individuals, groups, family member, couples, employers and others. Education is central to treatment, and it is a more directive approach. It can have very specific goals and may be short-term. The past is not actively addressed; the purpose is to educate the client to acknowledge, accept and understand their disability and/or mental health condition and provide ways to support growth, change and meet goals. Psychoeducational treatment may include informative reading material, video analysis, homework, data collection, biofeedback, journal writing and much more.

Some of the goals of both treatment approaches are to connect how thoughts, feelings and behavior are connected, improve coping and problem solving to better deal with life stressors, increase positive self-regard, and to recognize and better deal with strong emotions. Many clinicians have training in specific techniques and use a combination of approaches in their practice. Yet, sometimes a specific approach may be the best method of choice given a specific condition or specific goal of treatment. For example, Covid-19 is having a mental health impact on many people, and seeking short-term treatment may be warranted.

When seeking treatment, determining what technique is most appropriate can be accomplished by considering a variety of areas: the reason/goal of treatment, age and diagnosis of the client, the personality, cognitive and language capacity of the client as well as the cultural/family background and personal experiences. There are upwards of 100 different types of psychotherapeutic approaches, so knowing which one to try is an important decision. Many clients at NESCA present with learning differences, anxiety, OCD, depression, trauma, substance abuse and more. The following partial list includes some of the treatment approaches beneficial to and used by many NESCA clients.

Acceptance and Commitment Therapy

Attachment-based Therapy

Animal-assisted Therapy

Biofeedback

Cognitive Behavior Therapy (CBT)

Dialectic Behavior Therapy (DBT)

Exposure & Response Prevention Therapy

Expressive Therapy (Art, music, drama, etc.)

Mindfulness-based Cognitive Therapy

Motivational Interviewing

Parent-Child Interaction Therapy

Play Therapy

Psychoeducational Counseling

Trauma-focused Cognitive Behavioral Therapy

At NESCA, we are currently offering short-term psychological treatment for Covid-19 mental health challenges as well as long-term psychoeducational treatment. If you are interested in learning about these options, visit: https://nesca-newton.com/integrativetherapeutic/.

More information about treatment approaches can be found at: https://www.psychologytoday.com/us/types-of-therapy

 

References:

https://www.nami.org/learn-more/treatment/psychotherapy

https://www.mhanational.org

https://www.mentalhealth.gov

https://www.psychiatry.org/newsroom/news-releases/new-poll-covid-19-impacting-mental-well-being-americans-feeling-anxious-especially-for-loved-ones-older-adults-are-less-anxious

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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

 

There’s an App for That!

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

In this time of “telehealth” and “remote learning” adults, teens and children are being bombarded with virtual platforms such as Zoom, Microsoft Teams, Google Hangouts/Meets and more.  Some teachers and students are being asked to use Google Classroom, Blackboard and other classroom-based platforms for the first time. I am of the mindset that this virtual learning and health management approach will be with us even when this pandemic subsides and we “go back to normal.” I’m also afraid that the normal we knew won’t be the normal of the future.

With this in mind I began to think that with all the time some of us have on our hands, wouldn’t it be interesting to “assess” or evaluate the variety of apps that are out there now (and there are tons!)? A middle schooler could do the research with some guidance from parents, teachers, IT professionals or others from their schools. In many middle schools, students are being taught how to critically analyze social media and news reports; why not extend this critical eye to apps? For instance, have your middle schooler research apps that address a variety of topics, such as executive functioning areas (i.e. time management, distraction, organization, etc.), social-emotional well-being and so on. With some guiding questions, help from adults and a way to tally or track data, they could decide which app they think would help them best and why. A sample list of questions may include:

  • What problem am I trying to solve?
  • What need am I trying to fill?
  • When was the app created?
  • Who created it?
  • Who was it created for?
  • How many positive reviews?
  • How many negative reviews?
  • What platform does it use?
  • How much does it cost?
  • What features does it have? Do they solve my problem?
  • How easy is it to operate initially and once I get it set up?
  • Will it work with the other programs I have running?

There are many other questions that one could ask to “evaluate” an app to help solve a specific problem. Your child and you can generate your own questions to add to this list then download and try your top choice. Try it for at least a couple of weeks and create a rating scale to evaluate its helpfulness in solving the problem. If you are satisfied, then no need to try another one. If not, download another one and repeat the procedure.

Here’s a list of various apps that address EF needs. There are many more, and these are in no particular order.

 

Scheduling/Calendar/To Do/Reminders

Pocket Informant

Forgetful

Built-in Calendar App on your smartphone

MemoCal Lite

Visual Schedule Planner

Choice Works

Pocket Picture Planner

Can Plan

30/30

Toodledo

Jot Free

My Homework

 

Time

Time Timer

Giant Timer

Time Meter Time Tracker

 

Social-emotional

Calm

Breathe2Relax

Sosh

Smiling Mind

The Social Express

Stop. Breathe. Think

Hidden Curriculum

Middle School Confidential

Model Me

Take A Chill

emotionary

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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

 

Becoming a Behavior Detective

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

Behavior = Communication

Behavior is everywhere you look. All behavior is adaptive and purposeful whether “appropriate or inappropriate,” “expected or unexpected,” or “regulated or not.” Have you ever heard of the phrase, “Behavior = Communication?” It is often used to help us think about behavior as a meaningful and purposeful means of communication, even when it is maladaptive.

Behavior is multifaceted and can be internally- and externally-driven. Every behavior that any one of us does can be interpreted as communicative and as having meaning. When a mom says to load the dishwasher and a child doesn’t respond, the child may not have heard her or may have actually heard the direction and chosen to ignore her. Ignoring her and not responding is actually responding – the is escaping a demand or that direction. If a child asks for a toy at the store and the parent says, “No,” and the child cries and stomps their feet in displeasure, the child is definitely expressing feelings. If the parent gives in to the tantrum and agrees to buy the toy to quiet the child down, the parent is reinforcing the inappropriate behavior/tantrum. This pattern often repeats itself, leaving parents and kids in a vicious cycle. The child learns that crying and stomping gets what he/she wants.

Becoming a Behavior Detective

In the current COVID-19/stay at home landscape, being a behavior detective could serve parents and caregivers well! Parents and children are feeling stressed and anxious, even if they don’t appear so. This is a communal feeling given the current situation, and parents may need to pick and choose their battles wisely. Otherwise, they may spend hours of each day dealing with many unpleasant moments. Being “cooped up” with each other may present an opportunity for parents to become behavior detectives to figure out what their kids are trying to communicate. If the children are older, parents may want share this with them so both parent and child become detectives together; maybe even of each other!

Conjunction, Junction, What’s the Function?

Maladaptive behavior is communicating something, and if we want to change that we need to know what the communicative function of the behavior is. By knowing the function behind the behavior (what they are trying to accomplish by the behavior), we can then think about prevention, intervention and post-intervention—thus being able to intervene at three different times before a behavior actually occurs, during the behavior or after the behavior occurs.

Communicative functions of behavior include:

  • Escape/Avoidance of a task
  • Access to something/someone desirable
  • To make a request or a comment
  • Negations/refusal
  • Self-non-interactive—communicating with ourselves or self-talk/actions
  • Attention-seeking
  • Expression of feelings
  • Expression of sensory needs

Given our current environment, it may be important to think about the communicative function of a child’s “maladaptive behaviors.” This provides a way to intervene with a hypothesis of function and consistency of prevention, intervention or response. Given parents’ own mental, emotional or psychological state, they have the option to escalate or deescalate any situation. Be honest with your kids if you are tired, stressed or overloaded; let them know that you may have less patience when appropriate. Remind them that they have a role in helping to make the house and family a kind, happy and compassionate place. Honest communication, kindness and gentleness with one another (even when we lose control) goes a long way to help during these trying times.

If you need help in being a behavior detective, NESCA is providing virtual parent coaching and consultation. Complete our online Intake Form for more information.

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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

 

Meltdown Analysis — Part 2

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

As discussed in last week’s blog, Meltdowns Happen, all children meltdown. Adults meltdown, too. Losing control can take many forms. It is a part of human nature unless we deliberately work on “controlling the beast” that’s lurking inside of us when our system gets taxed. When children are very young, we expect them to lose control because they are learning how to identify and express their emotions. A three-year-old who tantrums is not that uncommon; however, by the time that child is six and then 10, we want them to have developed more and more control as they mature.  But, many children don’t always develop the control that we’d like, and those diagnosed with learning differences sometimes have even more difficulty controlling their emotions.

Teaching children about their emotions, their triggers and how to manage their feelings is the backbone of improving self-awareness, stress management and social competency (3 Ss). If children can label and recognize feelings, notice how their body feels with different emotions and know how to calm themselves when stressed, the better off they will be in life. In a previous role as the program director of Aspire/MGH, we focused on these 3 Ss and utilized a volcano image with our autism spectrum disorder (ASD) participants to teach them about their stress cycle. The volcano image represented a meltdown (see below).

In using this with your child, pick a quiet, calm moment to introduce it to him/her. You might want to start the conversation by reading a book about stress or big emotions. There are many to choose from depending upon the age of your child. You could also just begin a discussion with volcano image to help them understand what they look like and sound like when they are melting down. Discuss with your child what you think s/he looks like as s/he begins to meltdown starting at the bottom of the volcano and working all the way to the top (5) and then what s/he looks like when s/he begins to calm down and recover (moving down the right side of the volcano). If your child has not learned stress management strategies, this is a good time to practice. If your child has learned some techniques, you can also create a list of strategies that s/he can do at each step to help gain control so s/he doesn’t continue to escalate to the next stage. For instance, at a 3, you may be able to use humor to help redirect, but when s/he is at a 4 or 5, using humor may increase distress. I hope this image helps with understanding and reducing the meltdowns that are occurring every day in everyone’s home.

If you’d like assistance in creating your child’s personal meltdown plan, self-awareness plan or behavior plan, NESCA’s parent coaching services can assist you in the journey.

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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

 

Meltdowns Happen

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

When we think of the word meltdown, we may think of the economy or stock market, glaciers, nuclear meltdowns or even volcanoes erupting. These are all examples of things collapsing from being over-stressed, overheating, a major disruption to a system or an internal collapse. Using the word meltdown to describe people is similar. In homes across America, even as we settle into quarantine, slow down our lives and find ways to enjoy our time together, there may be more meltdowns happening that are filled with tears, screams and lots of “No, I don’t want to!” Adults and children are becoming overheated, over-stressed, and our systems are over-burdened. And when a system can no longer take it, it melts down, boils over, erupts, or crashes and burns. In these moments, it is the only way of coping – to let loose, let off of steam, erupt – or just plain melt down. Sometimes it’s hard to believe, but each of us is doing the best we can to cope with a difficult environment. We’re trying to do the best we can, because our biological system is in a meltdown. We are not responding; instead we are reacting from our “downstairs” brain and not our “upstairs” brain.

A meltdown may be an explosion and look like crying, throwing things, yelling, aggressing, breaking things, etc. Or it may be more like an implosion – a withdrawal from the family, hiding, sleeping more, lethargy, etc. Both are the same in many ways biologically; the system is in fight, fright or freeze. A meltdown should be viewed as a “neurological storm.” This fight, flight or freeze response is not a child being “bad” or disrespectful, but rather is “bad behavior” that needs to be changed. Remember, it is their best attempt to cope, not a deliberate, willful, defiant act towards you. It is your child saying, “Help me – I can’t help myself! I’ve lost it!” This is not a time to teach, reason with, or win a battle. It is a fire to be put out, and you as the parent or caretaker is the firefighter. It’s a crisis to be managed, and you become your child’s “upstairs brain” or frontal lobe (even though you may want to react from your “downstairs brain,” because you may also be losing it.

Everyone wants to have a good day. Remember, when it’s going in a different direction, you are the adult. You can take a breath and even walk away (if you can) for a few seconds to compose yourself. This allows you to respond versus react. It is your job to manage the situation and take the emotional high road (often easier said than done). In these moments, it is really only about a few things.

  1. Safety and dignity
  2. Keep calm and reduce/simplify your language
  3. Keep calm and know this too shall pass
  4. Don’t get pulled off topic by all the things your child is saying or doing – this is a rabbit hole that you won’t emerge from
  5. Mention what you want to have happen, rather than what you want to stop (“Bang your pillow” instead of “Stop banging the wall”)
  6. Establish connection – right brain to right brain. Remember the mantra, “Name it to tame it.” (i.e. I know this is hard; I know you don’t want to do it; I wouldn’t want to either; or I know you don’t like it, etc.)

Resources:

https://www.drdansiegel.com/books/the_whole_brain_child/

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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

 

Good Ideas for Dogs are Good for People, Too

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

  • Play Every Day! — Play can promote calmness and reduce anxiety. This is true for adults and kids.
  • Play Is Learning — Reflect after play by creating and asking questions. Did you learn anything new? What surprised you? How did you feel before you played? How you feel now?
  • Walk, Walk, Walk! — Walking helps dogs stay engaged with the world and brains stimulated. Yup, works for humans, too.
  • Be Present While Walking — Go for walks with or without a dog. Feel the air blowing, smell the flowers, hear the birds singing, feel the rain on your face. Learn the bird calls, bring binoculars and look closely at the birds. Be present as you walk, laugh, sing, splash in puddles….
  • Game Play — Playing games can help satisfy natural instincts. Play old games, teach your children games you played as a child, learn new games. Any games will do – board, card, dice, movement, etc. Play skill games, games of chance or luck games, silly games, etc.
  • Feed Relationships Through Play and Exercise — Bond with each other (a child, a dog or both!) through playing or getting some exercise together. Be active together…teach new tricks, kick a ball around, play catch, take a yoga or Zumba class, watch GoNoodle as long as it’s together.
  • Be in gratitude that you are experiencing this time together to slow down and reconnect with each other. Laugh, play, sing and dance together. Love and care for each other. Enjoy each other.

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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

 

Daily Journaling While Social Distancing

By | NESCA Notes 2020

By Dot Lucci, M.Ed., CAGS

Director of Consultation and Psychoeducational Services, NESCA

This is such a unique time that we are living in, but one day it will be a distant memory. Get a special journal book, make it from scratch or create one online. It will give you something to look back on and remember how you achieved something every day, smiled and made it through a very surreal time in history. Keep your journal to share with future generations. While we are practicing social distancing or being asked to stay home, challenge yourself to do something out of every category below on a daily basis. Do something for your brain, your mental health, your body, your home, your community, your creativity, your family, the environment and your friends/neighbors. Adults and kids can do this.

 

While Physically Distancing, Do Something For:

Your Brain

❏     Do a puzzle

❏     Listen to a podcast

❏     Tour a Virtual Museum

❏     READ

❏     Challenge yourself with a game, crossword puzzle, Sudoku, etc.

Your Mental Health

❏     Try a meditation app, like “stop, breathe, think” or www.calm.com

❏     Find an example of someone giving back or helping others

❏     Laugh out loud at least twice a day, tell a joke, watch a funny movie

❏     Turn off the news

❏     Record how you are feeling using the Yale Mood Meter

Your Body

❏     Take a walk, go for a run, ride a bike

❏     Create a dance play list and dance, dance, dance – We Are Family!

❏     GoNoodle Indoor Recess

❏     YouTube: workouts, yoga or dance

Your Home

❏     Do a chore – vacuum, dishes, laundry

❏     Clean your room

❏     Put your things away

Your Creativity

❏     Learn something new

❏     Draw/paint

❏     Build with LEGO

❏     Learn Calligraphy or Hand Lettering

❏     Play an instrument

❏     Search Pinterest for “DIY” or “upcycle”

Your Community

❏     Follow CDC Guidelines – stay home and wash your hands

❏     Go through clothing and toys to donate

❏     Check out your community website for what is needed

❏     Make cards to send to a local nursing home, nurses, doctors

The Earth

❏     Go for walks and enjoy nature

❏     Plant something

❏     Pick up litter – wear gloves

❏     Find another use for something before you recycle it

Family, Friends, Neighbors

❏     Stay in touch with each other

❏     Connect on FaceTime calls

❏     Have dinners together over FaceTime, Skype, Zoom

❏     Call people instead of text, write a letter, draw a picture

❏     Make a photo book of memories with a service like shutterfly

❏     Cook something for your family, neighbors

❏     Ask if someone needs help

 

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 neuropsychologists, complete NESCA’s online intake form. Indicate whether you are seeking an “evaluation” or “consultation” and your preferred clinician/consultant in the referral line.

 

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

 

Helping Your Anxious Child through COVID-19

By | NESCA Notes 2020

By Yvonne M. Asher, Ph.D. 

Pediatric Neuropsychologist

A recent New York Times article by Jessica Grose discusses ways to support your child, specifically helping them to feel less anxious, during the COVID-19 situation. Their “top 4” suggestions are great ones – validate their feelings, manage your own anxiety, aim for some kind of predictable routine and try mindfulness or progressive muscle relaxation activities.

The larger consideration in this case is this: anxiety, particularly in the current situation, is normal. We can label it with clinical words, give you our best clinical tools and recommend that you seek help (and please do!). At the same time, if we take a large step back, being anxious right now is exactly how we are meant to feel. We are social beings, designed to live in the community and support one another through face-to-face social interactions. When something threatens our safety, or the safety of our families, it is normal to respond with fear, worry and hypervigilance. Everyday interactions that would typically result in no response, like hearing someone nearby cough or sneeze, all of a sudden have become indicators of a threat. Even having others in close proximity to us is now a threat, meaning that the social communities in which we are supposed to thrive have now become potentially dangerous places. In this new environment, our bodies, well-attuned and primed to handle threats, are doing what they should do – they are putting us on “hyper-alert mode,” keeping us exceedingly sensitive to these threats so that we can avoid them and preserve our safety.

Children are in this mode, too, albeit with far fewer resources to help mitigate their fear and worry. As adults, we have far more lived experience with threats, anxiety, fear and worry, and we can use this experience to manage our responses to this novel situation. For children, this may be the first time they are struggling with persistent worry and fear. Or, they may have struggled to cope with other fears and worries for a long time, and this new stressor has overwhelmed their system. In either case, it is important to normalize fear and anxiety, in addition to the myriad of other emotions that children may be experiencing.

The key is balance. We have to balance validating and normalizing feelings with reinforcing unhealthy habits. What does that look like? One dimension to consider is time – validating and normalizing feelings is a short acknowledgement that the child is heard, understood and believed. On the other hand, repeatedly discussing the same questions or topics, engaging in persistent conversations about the threats and explaining “adult” information to children (especially dire predictions, long-term impacts, etc.) is not healthy. These behaviors may appear to decrease anxiety in the short-term, but over time, can be detrimental.

Another important consideration is space – focusing on what is happening in the present is important to help children process and understand the radical changes that are impacting their day-to-day lives. However, if you find that your conversations linger on the past or the future, try to shift back to the present. Your mind may be filled with regrets from the past (e.g., “I knew we should have stocked up on their favorite snack last time we were at the store”) or fears for the future (e.g., “My parents are elderly and at high risk”), and these thoughts are entirely normal. At the same time, when talking with children, it is important to try as much as possible to focus on the here and now. Of course, it is important to give children the space to express their fears for the future, and we can and should acknowledge and validate these fears. We can also, simultaneously, bring children’s focus back to the present and back to tangible, concrete things that they can do (e.g., “I know you are really worried about grandma, and it’s sad that we can’t see her right now. Everyone is working hard to keep her safe, and we are going to call and talk to her later today”).

For some children, advanced intellectual abilities may allow them to understand (at least, in some sense) a great deal of the information that is portrayed on the television and news media. However, it is important to remember that, while their cognitive abilities are years ahead of their peers, their emotional development is not. It may be necessary to closely monitor their online activity, as they may be seeking out information (which is a normal response to fears, especially fear of the unknown) without having the critical thinking abilities to understand the source or potential biases in the way the information is presented. On the other hand, some children may struggle to understand the situation, either because of their young age, learning disability or other developmental delays. If this describes your child, consider putting together a story, with pictures and words, to help them understand some basic information (e.g., why we can’t go to school right now, why we can’t go play with friends). This is often referred to as a “social story,” and clinicians at NESCA can help you create one specifically for your child.

Last, and most certainly not least, seek help and support for yourself, your child or anyone in your family who is struggling. While experiencing anxiety during these times is normal, when these thoughts and feelings are taking over your child’s daily life (or your own), it may be time to look for assistance. Many clinicians, including here at NESCA, are available via phone or videoconferencing, and we can assist with a range of concerns. Whether you want a brief consultation to help you respond to persistent questions from your child or whether your child has a pre-existing anxiety disorder that is exacerbated by these challenging times, we are here to help.

 

About Pediatric Neuropsychologist Dr. Yvonne Asher:

Dr. Yvonne M. Asher enjoys working with a wide range of children and teens, including those with autism spectrum disorder, developmental delays, learning disabilities, attention difficulties and executive functioning challenges. She often works with children whose complex profiles are not easily captured by a single label or diagnosis. She particularly enjoys working with young children and helping parents through their “first touch” with mental health care or developmental concerns.

Dr. Asher’s approach to assessment is gentle and supportive, and recognizes the importance of building rapport and trust. When working with young children, Dr. Asher incorporates play and “games” that allow children to complete standardized assessments in a fun and engaging environment.

Dr. Asher has extensive experience working in public, charter and religious schools, both as a classroom teacher and psychologist. She holds a master’s degree in education and continues to love working with educators. As a psychologist working in public schools, she gained invaluable experience with the IEP process from start to finish. She incorporates both her educational and psychological training when formulating recommendations to school teams.

Dr. Asher attended Swarthmore College and the Jewish Theological Seminary. She completed her doctoral degree at Suffolk University, where her dissertation looked at the impact of starting middle school on children’s social and emotional wellbeing. After graduating, she completed an intensive fellowship at the MGH Lurie Center for Autism, where she worked with a wide range of children, adolescents and young adults with autism and related disorders.

 

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

 

To book an appointment with Dr. Yvonne Asher, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

When Parents and Kids Have BIG Emotions

By | NESCA Notes 2020

By Miriam Dreyer, Ph.D.

Pediatric Neuropsychologist Fellow

Brianna Sharpe’s recent essay for the New York Times – Parenting section titled, “I’d Like to Melt Down When My Kids Do,” captures an essential challenge of parenting – managing one’s own emotions when your child is having big and difficult feelings. Ms. Sharpe writes about her own extensive training as a mental health professional and how even with lots of experience working with children, she was not prepared for the emotional demands of parenting. She writes, “. . . like all preschoolers, my son needs an anchor when the waters get rough. But just when he needed me most, I found myself being pulled under by my own emotions. Although I never called him names or outright accused him of being at fault, I would yell in anger when hurt. My irrational response was often, ‘Why would you do that?!’ Once the red haze faded, I knew he was doing just what preschoolers are designed to do – but I had a hard time reconnecting with him.”

Ms. Sharpe beautifully depicts the intricate link between a child and a parent’s emotions. As parents, one of our essential roles throughout our children’s lives is to help them regulate. From birth, our job is to love, soothe, feed, attend and help our kids make sense of their feelings. This is a hard job, made even more complicated by the nuances and complexities of our own emotional lives.

Emotion regulation is a multifaceted process. As defined by Gross (1998), emotion regulation involves conscious and unconscious processes that operate both before an emotional response is generated and after it occurs. He writes that emotion regulation consists of “processes by which individuals influence which emotions they have, when they have them, and how they experience and express these emotions.” Challenges with emotion regulation are a component of many of the presenting problems we see at our center. Children with ADHD can struggle with emotional impulsivity, shifting and modulating emotional responses. Individuals with depression and anxiety face challenges balancing positive and negative feelings, as well as controlling irrational thoughts and worries. Difficulties with emotion regulation for individuals on the Autism spectrum are also common and intersect with social/emotional and behavioral problems that can arise with symptoms related to rigidity, self-direction and repetitive, self-soothing behaviors.  Symptoms associated with traumatic stress, such as dissociation, mood lability and alexithymia, all interfere with one’s ability to regulate emotionally. Even challenges like communication disorders and other learning disabilities are related to emotion regulation since they generate anxiety and can impede expressing oneself using language, which is a key regulatory process. In fact, theorists are now conceptualizing emotion regulation as a possible unifying, underlying component across psychological disorders (Aldao, Nolen-Hoeksema, & Schweizer, 2010).

What are we, as parents, to do then in the face of our children’s and our own stormy emotions?  How do those of us caring for children who are struggling help them while attending to our own complicated emotional processes? A helpful framework for considering these questions comes from researchers who focus on attachment relationships in parenting, mentalization, as well as the mindfulness and self-compassion literature. 

  • Cultivate self-compassion. Parenting is hard, as is childhood. A stance of self-compassion which acknowledges challenges and encourages kindness to oneself helps move out of cycles of self-blame and anger.
  • Encourage curiosity about your own and your child’s emotions. Developing awareness of our own and our children’s emotional lives helps create a buffer in moments of heightened emotional arousal and can shed light on challenging patterns and interactive cycles.
  • Take a pause. Try breathing and mindfulness exercises to regain calm in difficult moments.
  • Consult with a therapist for parent guidance. There are many different types of parenting programs and support that can help tailor strategies and target complicated dynamics within family systems.

 

References

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical psychology review30(2), 217-237.

Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of general psychology2(3), 271-299.

Sharpe, B. (2019, June 21). I’d like to melt down when my kids do.  The New York Times.

 

About the Author

Dr. Dreyer enjoys working with children, adolescents and families who come to her office with a wide range of questions about learning, social and emotional functioning. She is passionate about helping children and parents understand the different, often complex, factors that may be contributing to a presenting problem and providing recommendations that will help break impasses – whether they be academic, therapeutic, social or familial.

Dr. Dreyer joins NESCA after completing her Doctorate in Clinical Psychology at the City University of New York.  She most recently provided psychological assessments and comprehensive evaluations at the Cambridge Health Alliance/Harvard Medical School for children and families with a wide range of presenting problems including trauma, anxiety, psychosis, and depression.  During her training in New York, she conducted neuropsychological and psychological testing for children and adolescents presenting with a variety of learning disabilities, as well as attentional and executive functioning challenges.  Her research focused on developmental/complex trauma, as well as the etiology of ADHD.

Dr. Dreyer’s experience providing therapy to children, adolescents and adults in a variety of modalities (individual, group, psychodynamic, CBT) and for a wide range of presenting problems including complex trauma/PTSD, anxiety, depression, ADHD, and eating disorders informs her ability to provide a safe space for individuals to share their concerns, as well as to provide tailored recommendations regarding therapeutic needs.

Before becoming a psychologist, Dr. Dreyer taught elementary and middle school students for nine years in Brooklyn, NY.  She also had an individual tutoring practice and specialized in working with children with executive functioning challenges, as well as providing support in writing, reading and math.  Her experience in education informs both her understanding of learning challenges, as well as her capacity to make specific and well-informed recommendations.

She received her Masters in Early Childhood Education from Bank Street College, and her B.A. in International Studies from the University of Chicago.

 

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

 

To book an appointment with one of our expert neuropsychologists, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.