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Thematic Instruction in Speech-Language Therapy

By | NESCA Notes 2021 | No Comments

By Olivia Rogers, MA, CF-SLP
Speech-Language Pathologist, NESCA

What exactly is a theme and why would we use them in speech therapy? A theme can be defined as the creation of various meaningful activities planned around a central topic or idea. For example, using activities that are all about the ocean, sports, or winter. Themed activities can be great for working on speech and language skills.

Here are some benefits of using thematic instruction (Hadley et al., 2018; Wallach, 2014):

  • Thematic instruction is a meaningful and motivating method of learning concepts.
  • Knowledge on different themes and categories supports a child in making connections between various concepts. It also provides the opportunity to teach and practice new skills by building on a child’s existing knowledge of the topic.
  • Teaching words linked in thematic groups allows for a deeper understanding of functions, categories, and features. Thematic instruction can improve vocabulary and increases a child’s understanding and use of synonyms and antonyms.
  • Activating prior knowledge and engaging students in prior knowledge activities increases the comprehension and retention of information. This, in turn, supports story retelling skills, as well as ability to answer “WH” questions – who, what, where, when and why.
  • Themes are relevant to a child’s real-life experiences; therefore, thematic instruction improves a child’s ability to make inferences and predictions. Children can make better inferences and predictions about situations they may encounter on a daily basis with this knowledge of various themes and categories.
  • Thematic instruction promotes generalization outside the therapy room.

Thematic instruction can result in improvements in overall language skills. Additionally, using themes can keep speech-language therapy interesting and help increase engagement. This is key, as it’s been shown that when a child receives eight more minutes of engaging therapy, there is significantly greater improvement than with regular therapy (Schmitt, 2020).

What can you do at home?

Fortunately, thematic instruction can be easily incorporated into daily life or special occasions at home – and can be adapted for any age. October is one of my favorite months as it is packed with themes. I like to dedicate the first part of October to autumn and leaves, as well as fire safety and occupations. Then it’s time to dive into all things Halloween! Here are some Halloween-themed activities you can do at home to support your child’s language development:

  • Read different Halloween stories while increasing the understanding of Halloween-associated vocabulary (e.g., pumpkin, leaves, haunt, eerie, costume, cauldron, ghost, broomstick, etc.) and Halloween lingo (e.g., “trick or treat,” “boo,” “hair-raising,” “if you dare,” “pumpkin carving,” etc. Some great books to help you with these words and phrases are:
    1. Room on the Broom by Julia Donaldson
    2. There was an Old Lady Who Swallowed a Bat by Lucille Colandro
    3. Goodnight Goon by Michael Rex
  • Encourage your child to recall details and retell the stories you read. Have them:
    1. Describe the setting of the story.
    2. Tell you about one story character.
    3. Identify their favorite part of the story.
    4. Say what happened at the end of the book.
  • Encourage the use of Halloween-associated vocabulary by going on a neighborhood walk and playing I Spy with your child (e.g., “I spy something orange, that you can carve during Halloween,” or “I spy something that changes colors then falls from trees,” etc.).
  • Discuss the history of Halloween and where it originated.
    1. Make predictions regarding this upcoming Halloween and Halloweens to follow.
    2. Compare and contrast Halloween traditions over the years.
  • Create a hands-on activity (e.g., carving pumpkins, drawing a haunted house, collecting leaves for a craft, etc.) where your child/children follow directions to cooperatively complete the project. This encourages problem solving, reasoning and use of appropriate social skills.
  • Engage in a pretend play scenario about Halloween using all the information your child has learned throughout your thematic intervention.

Resources:

Hadley, E. B., Dickinson, D. K., Hirsch-Pasek, K., & Golinkoff, R. M. (2018). Building semantic networks: The impact of a vocabulary intervention on preschoolers’ depth of word knowledge. Reading Research Quarterly.

Schmitt, M. (2020). Children’s active engagement in public school language therapy relates to greater gains. American Journal of Speech-Language Pathologyhttps://doi.org/10.1044/2020_AJSLP-19-00157

 

About the Author

Olivia Rogers received her Master of Arts in Speech-Language Pathology from the University of Maine, after graduating with a Bachelor of Arts in Communication Sciences and Disorders and concentrations in Childhood Development and Disability Studies.

Ms. Rogers has experience working both in the pediatric clinic setting as well as in public schools, evaluating and treating children 2-18 years of age presenting with a wide range of diagnoses (e.g., language delays and disorders, speech sound disorders, childhood apraxia of speech, autism spectrum disorder, social communication disorder, and Down syndrome). Ms. Rogers enjoys making sure therapy is fun and tailored to each client’s interests.

In her free time, she enjoys listening to podcasts and spending times with friends and families.

 

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 Olivia Rogers, please complete our Intake Form today. For more information about NESCA, please email info@nesca-newton.com or call 617-658-9800.

 

Interest Inventories

By | NESCA Notes 2021

By: Tabitha Monahan, M.A., CRC
Transition Specialist/Counselor

In the last Transition Thursday blog, Kelley Challen, Director of Transition Services at NESCA, discussed vocational assessments and aptitude testing. As Kelley stated, vocational assessments should be the start of the career exploration process, not the end. When most people think of vocational assessment, interest inventories and surveys are the first things that may come to mind. While each inventory asks and reports information differently, inventories generally ask individuals to rank how much they like the concept of a job or activity. Individuals are not supposed to consider whether they can do a task (such as in aptitude testing or skill inventories), but if completing the task seems enjoyable or of interest. Results are frequently displayed as occupational themes that help individuals have a starting point on a wide variety of jobs that may be worth exploring. The most well-known of which is based on the work of John Holland. Holland Codes are used as the basis of many well-known interest inventories (including the O*NET Interest Profiler). Other inventories that utilize different occupational themes may also loosely relate to Holland Codes. Thus, the information from multiple inventories may provide clarification of a person’s interest. As many of the shorter inventories have a limited number of activities per career cluster, it can be helpful to take more than one inventory to establish areas of interest. If a person has the same code (or sets of codes) in multiple inventories, it further indicates strong areas of interest. Frequently, however, results may indicate a different career code, indicating many areas of interest and the need for broader career exploration in order to develop a better sense of their working selves.

Most inventories indicate a career code of a person’s top 3 career clusters, e.g., RIC. What does that mean? It means that the individual identified that they would likely most enjoy careers that include interests in the Realistic, Investigative, and Conventual career themes. Examples of such jobs could include dental laboratory technicians, RV service technicians, computer support specialists, electricians, model makers, and many others (www.onetonline.org). The types of work and preferences for the different themes include:

Realistic – Individuals interested in this area like to work with things, use tools and machines and prefer physical, outdoors, and mechanical work.  They are doers and often described as persistent and practical.  They prefer a structured work environment.  Workers with high realistic interest are found in construction and skilled trades, production and manufacturing, agriculture, transportation, hospitality and recreation, food service, and natural resources.

Investigative – Individuals interested in this area like to work with ideas and data and prefer figuring out problems mentally.  They are thinkers and often described as curious, intellectual, and independent.  They favor jobs that require abstract thinking, research, and analysis.  Workers with high investigative interest are found in the life and physical sciences, health and behavioral sciences, applied technologies, academics, research and development, mathematics, and engineering.

Artistic – Individuals inter5ested in this area like to work with forms, designs, and patterns and prefer creative and self-expressive work.  Artistic individuals are creators and often described as imaginative and original.  They favor flexible and less predictable work environments.  Workers with high artistic interest are found in design, applied arts, architecture, culinary arts, performing arts, fine arts, education, communication and media, and fashion.

Social – Individuals interested in this area usually like to work with people and prefer helping, teaching, and healing work.  Social individuals are helpers and often described as supportive, understanding, patient, and generous.  They favor jobs that require listening, comforting, serving others, and advising.  Workers with high social interest are found in education, health and human services, recreation and fitness, safety and service, and religious vocations.

Enterprising – Individuals interested in this area alike to work with start-up ideas and new projects and prefer leading.  Enterprising individuals are persuaders and often described as confident, ambitious, and energetic.  They generally favor jobs that involve selling and achieving set goals.  Workers with high enterprising interest are often found in business and administration, marketing, finance and insurance, sales, regional planning, and law.

Conventional – Individuals interested in this area usually like to work with set procedures, data, and details and prefer clerical and computational work.  Conventional individuals are organizers and often described as organized, efficient, and careful.  They generally favor jobs that involve routine work with numbers, machines, and computers to meet required goals.  Workers with high conventional interest are found in accounting, banking, office work, and computer applications.

Definitions provided by/taken from the PICS-3 Administrator’s Guide 2020[i].

Knowing the types of careers which may be of interest is just the first step. An individual’s preferred work setting can make the difference in a person’s success. Having a preferred setting is also likely to increase work satisfaction. A great way to take an extensive and potentially overwhelming list of career options is to determine the most critical factors for that person. These aspects can be explored through informal conversations and worksheets or even more formal assessment measures. Basics, such as whether a person wants to spend most of their time standing or sitting, being inside or outside, or having a consistent schedule, can help the individual more easily decide which career options are worth a deeper look. From there, options, such as beginning salary, needed education and training, and career outlook, are important to consider. Research, including finding videos showing a typical day and tasks, informational interviewing, job shadowing, and internships, helps provide individuals with an extensive understanding of their career choices and determine the skills they need to build to meet their vocational goals. Be sure to check out the next Transition Thursday blog in our vocational assessment and career exploration series as it will go into more detail about these later career exploration activities.

[i] Picture Interest Career Survey-Third Edition.  Administrator’s Guide Robert P. Brady, EdD.  Published 2020 by JUST Publishing, Inc.

 

About the Author

Tabitha Monahan, M.A., CRC, is an experienced transition evaluator and vocational counselor. While she is well-versed in supporting a wide range of transition-aged youth, she is especially passionate and knowledgeable in helping clients and their families navigate the complex systems of adult services and benefits as well as medical and mental health systems. She is further adept in working individually with students of all abilities to empower self-advocacy and goal achievement.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, please complete our online intake form

 

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

 

Myth Busters: Bilingualism and Language Delays in Young Children

By | NESCA Notes 2021

By Renée Marchant, Psy.D.
Pediatric Neuropsychologist

Bilingual and multilingual children are often diagnosed with both language disorders and autism spectrum disorders later in development than monolingual children. There are a variety of reasons for later diagnosis, such as disparities in service access or structural inequities in society which limit diagnostic or treatment services for bilingual and multilingual families as well as disparities in the availability of providers and experts capable of diagnosing communication disabilities and language delays in bilingual and multilingual children. Another main factor I often see in practice as a neuropsychologist is a “myth” related to language development in bilingual/multilingual children. The myth is that “bilingualism or multilingualism causes language delay.” This is not accurate and not concordant with the scientific research. This is not accurate and not concordant with the scientific research. If a parent, educator, pediatrician, or therapist raises concern about a bilingual or multilingual child’s language development, do not delay an evaluation to consider the presence of a language delay, communication disability, autism spectrum disorder, or a neurological or cognitive disability. It is likewise critical to not delay access to helpful interventions for language development (e.g., speech/language therapy, early literacy/phonics interventions, social skills/play interventions). Early detection of language delays improves outcomes for monolingual and bilingual/multilingual children.

Here are important key facts about language delay and bilingual/multilingual children which can be helpful for parents, educators, therapists, and other professionals:

  • While there are some differences in bilingual and multilingual language development from monolingual development in the brain, those differences do not produce speech delays.
  • Bilingual/multilingual children and monolingual children develop expressive language skills and reach early speech and language milestones at similar times in early development. For example, single-word vocabulary size of bilingual/multilingual children is equitable to vocabulary size of monolingual children.
  • Language regression (a “red flag” for autism spectrum disorders) occurs regardless of language status and is not dependent on a child’s monolingual or multilingual abilities.
  • There is much scientific research indicating that bilingualism/multilingualism enhances social communication skills (including children with autism spectrum disorders). Likewise, bilingualism/multilingualism does not in itself produce or explain social communication challenges for children.

Additional Resources

If you want to learn more about bilingualism and language delay, Dr. Brenda Gorman, Associate Professor in Communication Sciences and Disorders at Elmhurst College, and Dr. Alejandro Brice, Professor in the Department of Education at the University of Florida at St. Petersburg offer an informative YouTube video for parents and clinicians regarding bilingualism, “late talkers,” and language delay: https://www.youtube.com/watch?v=zT0x-EqanGg

This scientific article is also a helpful resource for parents and professionals: “Bilingualism in the Early Years: What the Science Says” (Byers-Heinlein and Lew-Williams, 2013): https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6168212/

 

About the Author:

Dr. Renée Marchant provides neuropsychological and psychological (projective) assessments for youth who present with a variety of complex, inter-related needs, with a particular emphasis on identifying co-occurring neurodevelopmental and psychiatric challenges. She specializes in the evaluation of developmental disabilities including autism spectrum disorder and social-emotional difficulties stemming from mood, anxiety, attachment and trauma-related diagnoses. She often assesses children who have “unique learning styles” that can underlie deficits in problem-solving, emotion regulation, social skills and self-esteem.

Dr. Marchant’s assessments prioritize the “whole picture,” particularly how systemic factors, such as culture, family life, school climate and broader systems impact diagnoses and treatment needs. She frequently observes children at school and participates in IEP meetings.

Dr. Marchant brings a wealth of clinical experience to her evaluations. In addition to her expertise in assessment, she has extensive experience providing evidence-based therapy to children in individual (TF-CBT, insight-oriented), group (DBT) and family (solution-focused, structural) modalities. Her school, home and treatment recommendations integrate practice-informed interventions that are tailored to the child’s unique needs.

Dr. Marchant received her B.A. from Boston College with a major in Clinical Psychology and her Psy.D. from William James College in Massachusetts. She completed her internship at the University of Utah’s Neuropsychiatric Institute and her postdoctoral fellowship at Cambridge Health Alliance, a Harvard Medical School teaching hospital, where she deepened her expertise in providing therapy and conducting assessments for children with neurodevelopmental disorders as well as youth who present with high-risk behaviors (e.g. psychosis, self-injury, aggression, suicidal ideation).

Dr. Marchant provides workshops and consultations to parents, school personnel and treatment professionals on ways to cultivate resilience and self-efficacy in the face of adversity, trauma, interpersonal violence and bullying. She is an expert on the interpretation of the Rorschach Inkblot Test and provides teaching and supervision on the usefulness of projective/performance-based measures in assessment. Dr. Marchant is also a member of the American Family Therapy Academy (AFTA) and continues to conduct research on the effectiveness of family therapy for high-risk, hospitalized patients.

 

To book an evaluation with Dr. Marchant or one of our many other expert neuropsychologists, complete NESCA’s online intake form.

 

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

 

The Power of a List

By | NESCA Notes 2021

By Yvonne M. Asher, Ph.D. 
Pediatric Neuropsychologist

For so many children, adolescents, and young adults, I find myself recommending something that seems too simple to be of much use – a list. The power of lists has been identified and described in depth by several experts, such as Atul Gawande (The Checklist Manifesto – an excellent read). These books often discuss efficiency in the workplace, health and safety practices, and maintaining consistency in products or services. As adults, these are the things we often care about – ensuring that we are efficient, consistent, and getting things done.

In my practice, I recommend lists for different reasons. I recommend lists to teach executive functioning skills, such as planning, task initiation, organization, and task monitoring. Lists are also incredibly helpful for children who struggle to hold on to information. These children often miss information that is stated aloud, such as a parent giving directions or a teacher explaining instructions. Their brains often struggle to “keep up” with the pace of information presented in the world. Having the information written down in an organized manner, such a list, can help them access the information without time constraints.

Here is a quick example:

On a typical weekday morning, parents alternate checking on their 8-year-old as he gets ready for school. They give reminders of all the things left to do – “Brush your teeth!” “Get dressed!” “Put your homework in your backpack!” Time before the bus becomes shorter and shorter, as does everyone’s patience. Parents think, “We do the same things every single morning! Why is it so hard for him to remember?” Child thinks, “Why can’t they just leave me alone!” Voice volumes increase, tone shifts, and before anyone knows it or means to, there is a shouting match as the bus is pulling up.

Of course, a list won’t stop hurt feelings or eliminate frustration. However, if the child’s “morning routine” is posted somewhere easy to see, he may need far fewer reminders from his parents of all the tasks he has left to do. Frustration may be reduced, and the child can feel successful completing tasks with greater independence.

A list may be steps in a routine, as illustrated above. A list could also be of materials the child needs for baseball practice, the chores that should be done each week, or the limits and expectations around “screen time.” I often spend time with parents discussing the contents of a list, where the list should be placed, and the format it might take. For example, do you want checkboxes next to each item? Do you want the steps to be numbered? Maybe you love arts and crafts, and you want to laminate the list and have Velcro tabs with a “checkmark” that can be placed next to each completed task. The format and purpose vary, but lists are infinitely useful.

For many children, practice using lists is not only helping them to build skills in the moment, but is excellent practice for later life. Developing comfort with the tools and strategies that work best for you is an invaluable aspect of raising our children to become independent adults who can achieve their goals.

 

About the Author

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.

 

Vocational Assessment and Transition Planning

By | NESCA Notes 2021

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

Transition planning is a complex process centered around helping students, typically who receive special education services, to set goals for their postsecondary adult lives and to engage in learning, services, and experiences that will help them to ultimately reach those goals. Assessment is a critical aspect of this process, both as a means for collecting baseline information about the student and measuring progress throughout the planning process. While transition planning focuses on outcomes in several key areas (e.g., further education and training, employment, independent living, community engagement, adult service involvement), many families who seek transition assessment and planning help are specifically concerned about employment. What can my child do? What career path is best for my daughter? Will my son be able to support himself? For these families, vocational assessment is a critical piece of the transition planning process. Yet, many families do not have a good understanding of what a vocational evaluation includes and the types of results and recommendations that can come from such evaluation.

Vocational assessment has a relatively simple definition. It is the process of gathering information about a student’s interests, abilities, and aptitudes as they relate to the student’s work potential.[i] However, there is not one universal test or process used to collect this information. In fact, any of the following types of tests might be part of vocational assessment:

  • Record review
  • Informal interview with the student
  • Informal interview with parents, teachers, or other professionals who know the student well
  • Observation of student in current familiar environments
  • Interest inventories (informal or formal)
  • Learning style inventories
  • Self-reported skill, ability and achievement inventories
  • Work preference and motivation assessments
  • Work-related behavior inventories
  • Employability/Life skills assessment
  • Formal aptitude assessment
  • Situational assessment of a student in a controlled work environment
  • Work samples
  • Functional assessment of simulated or real job tasks

Importantly, most students do not need to participate in all of the above types of assessments. In fact, a lot of the best information comes from the first few informal steps of the process, record review (which often includes rich data about a student’s cognitive skills, sensory and motor skills, perceptual skills, and learning style) and interviews with the student and adults familiar with the student. Ultimately, the purpose of vocational assessment is to develop a profile of the student’s interests, skills, and aptitudes and formulate measurable short- and long-term career goals. However, it is important to remember that participation in vocational assessment typically does not, and should not, result in identification of one specific career to pursue. That’s not how any of the tests, or the overall process, is designed. Instead, results of vocational assessment will suggest a variety of careers or career families that a student may be interested in exploring more in depth. It is an important starting point of career exploration, especially for students who are unsure about their career goals. Results can also be helpful for identifying where there is alignment in a student’s aptitudes and interests or where more exposure and instruction may be needed to support a student’s career development. The information that comes out of vocational assessment is an invaluable part of comprehensive transition assessment and planning for students with and without disabilities.

For more information about vocation assessment and transition assessment at NESCA, visit our transition services page and our transition FAQs.

Also, stay tuned for more blogs about vocational assessment this fall as my colleague Tabitha Monahan and I will be specifically breaking down some of the above types of testing in greater detail.

[i] Instructional Materials Laboratory. (1998).  Vocational assessment for students with special needs. Columbia, MO: Author.

 

About the Author
Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

 

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, call 617-658-9800 or complete our online Intake Form.

When Gaming Is No Longer A Game

By | NESCA Notes 2021

By: Cynthia Hess, PsyD
Pediatric Neuropsychologist and Therapist

Many parents are wrestling with how much time their children are engaging with screens, and finding themselves wondering how much is too much. Children who experience difficulty related to symptoms of ADHD are especially drawn to the stimulation of screens. And children with ADHD tend to require frequent and immediate rewards, making them especially drawn to screen-time activities. While a specific cause for ADHD has not been identified, there is some consensus that a shortage of dopamine could be to blame. Dopamine not only plays a role in how we feel pleasure, it is also significant in the uniquely human ability to think and plan.

Part of the allure of gaming – and social media – is that each new level reached and each new “like,” instantly releases a small dose of dopamine directly into the brain’s reward center. If you have ever had to fight with your child to get off technology, this is likely why. A deficit in dopamine is easily fed by screen-time activities, leading children to want more. This has led to a demand for content, resulting in tens of millions of dollars having been made by YouTubers whose entire platform is gaming, and children love watching them. They are entertaining, and kids learn tips for improving their own gaming.

Children worship gaming YouTubers, and many strive to be one someday. It is challenging for parents to keep up with the content their children are accessing largely because YouTube has created an algorithm in the system that suggests what to watch next based on frequent views or recent searches. YouTube’s recommendation system is specifically engineered to maximize watch time and often “up next” videos play automatically. In fact, this feature is responsible for more than 70 percent of all time spent on the site, indicating that children, and others, are consistently and reliably exploring recommended “up next” content. It is important for parents to do their research and know who their children are watching and following on YouTube, as they may be drawn into content that could be highly influential and contrary to family values. While many YouTubers are harmless, there are those who include brief, perhaps undetectable messages (e.g., PewDiePie) that influence what shows up next. Children are curious, and YouTube’s goal is to keep them engaged, which can turn into the perfect storm.

YouTube consists of a business model that rewards provocative videos with large sums of money. They strive to attract viewers by leading them down paths meant to keep people engaged. While much of the content may seem innocuous, there are reasons to be cautious as things aren’t always as innocent as they seem. Provocative content creates intrigue. It piques interest and may be especially attractive to older children and adolescents. As individuals strive to create the next viral video, putting forth extreme beliefs and violent content may be their pathway to becoming a celebrity. For these reasons, and as technology becomes increasingly embedded in children’s lives, it is important for parents to do their research and stay informed.

Some helpful resources include:

https://www.pewresearch.org/internet/2020/07/28/parenting-children-in-the-age-of-screens/

https://chadd.org/wp-content/uploads/2018/06/ATTN_06_15_TooMuchScreenTime.pdf

https://childmind.org/article/healthy-limits-on-video-games/

 

About the Author

Dr. Cynthia Hess recently graduated from Rivier University with a PsyD in Counseling and School Psychology. Previously, she earned an M.A. from Antioch New England in Applied Psychology. She also worked as an elementary school counselor and school psychologist for 15 years before embarking on her doctorate. During her doctorate, she did her pre-doctoral internship with RIT in Rochester, N.Y. where she worked with youth ages 5-17 who had experienced complex developmental trauma. Dr. Hess’s first post-doctoral fellowship was with The Counseling Center of New England where she provided psychotherapy and family therapy to children ages 5-18, their families and young adults. She also trained part-time with a pediatric neuropsychologist conducting neuropsychological evaluations.

 

To schedule an appointment with one of NESCA’s expert neuropsychologists, please complete our online intake form

 

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

 

Voting Support in Local Elections

By | NESCA Notes 2021

By: Tabitha Monahan, M.A., CRC
Transition Specialist/Counselor

It’s after Labor Day, and the signs for local elections will increase significantly over the next two months. Non-presidential election years see a drastic drop in participation in the voting process. This drop extends even more for years where there are only local elections. However, it is our local elections that have the most significant impact on our day-to-day lives. Whether it is the town selectman, city council, zoning board, or school committee, voting for these candidates can make a big difference in the priorities and projects that become the focus of your community.

So how can we help our young people with disabilities exercise their right to vote? Even individuals with guardianship maintain their right to vote in Massachusetts unless the court documents specifically state otherwise. There are many ways to support individuals, but it starts with helping them register. Massachusetts residents can register to vote online when obtaining or renewing a driver’s license or state ID or at the local registrar of voters’ office. Notices from MassHealth and the DTA also include voter registration forms.

Our young people may need more guidance in understanding the importance of voting in local elections and the purpose of those positions. Below are some great resources to support our young people in voting. This article by Rock the Vote explains more about the importance of voting in local elections. Reach out to your local election official to determine what positions will be on the ballot and if there is a local primary election before the November election. Be prepared to explain the role of the positions to youth who may not have had experience dealing with the department.

While there has been less news this year about Absentee/mail-in ballots, and the COVID-19 vaccine is available to all persons of voting age, Absentee/mail-in ballots have long been an excellent strategy for individuals with disabilities who would have difficulty voting in person. Absentee ballots are a great option for individuals who may have difficulty navigating the multiple steps in person or have a lower processing speed.

All citizens are also allowed to bring a person to help them while they are at the polls. Encourage your young person by educating them that many people require assistance at the polls, and it is completely normal to have the help available if they need it. Each polling location should also have at least one AutoMARK Voter Assist Terminal, which helps individuals with visual impairments vote independently.

No one wants their vote not to be counted due to errors filling out their ballot. People can request a sample ballot in advance from their local registrar of voters (the Secretary of State’s website can give you the address and phone number of your local registrar). Practicing filling out ballots in advance (even ballots from previous elections) can help a new voter become comfortable with the form and is great fine motor skill practice for those who may need it!

While typically not applicable to local elections, it is important to remember that the Massachusetts Secretary of State also creates a voter information booklet for each election regarding the ballot initiatives. These red booklets can be found at many community locations and frequently include the local library, post office, and city/town hall. These booklets offer information on what a yay or nay vote would mean and have information from each initiative’s proponents and opponents. Use that sample ballot as a starting point for the different types of elected positions.

Help your young adult find out what the different boards do and why there is an election for things such as town selectman or zoning board. Help your young adult find the websites for candidates running for office and review the candidates’ stances on issues. Ask what issues they want to learn more about and are important to them.

Most importantly, remind them that their voice counts. As many disability rights activists have said, “nothing about us without us.” Individuals with disabilities are greatly affected by the policy decisions that occur in government at all levels. Individuals with disabilities have frequently experienced disenfranchisement, and many groups are working tirelessly to lessen and remove these barriers. How have you helped your young adult exercise their right to vote?

 

About the Author

Tabitha Monahan, M.A., CRC, is an experienced transition evaluator and vocational counselor. While she is well-versed in supporting a wide range of transition-aged youth, she is especially passionate and knowledgeable in helping clients and their families navigate the complex systems of adult services and benefits as well as medical and mental health systems. She is further adept in working individually with students of all abilities to empower self-advocacy and goal achievement.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, please complete our online intake form

 

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

 

Going with the Flow

By | NESCA Notes 2021

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

It’s September, and a new school year has already begun for most children. We had hoped that Covid would be behind us and the start of this school year would begin with a greater semblance of the old normal. Sigh…it has not. We are still wearing masks, keeping our distance and washing hands amongst other health considerations. Many students are eager to get back to school and in-person learning even though they have to wear masks. Many are accustomed to it, and it is no big deal. However, there are those students who preferred virtual learning and have grown more and more anxious at the thought of going back to in-person learning.

Back at the start of the pandemic, I wrote a blog about going with the flow, and it seemed appropriate to reintroduce the topic again as we start another school year still with so much uncertainty. Will there be outbreaks of the new variants at school? Will there be quarantines happening again? Will someone in my family, class, school get sick and how serious will it be?  We don’t know the answers to these questions, and worrying about them doesn’t help us be in the moment. In Bostonia’s current cover piece, “The kids are stressed, anxious, lonely, struggling, learning, grateful, adapting, alright,” Eric Moskowitz summed it up accurately. What researchers found is that children who were at a disadvantage before the pandemic suffered the most – which is not surprising – yet overall kids are resilient.

In  Angela Currie’s recent blog, “Helping Students Transition Back to School,” she covers the essentials of establishing bed time/morning routines, connecting with teachers, mask wearing routines and many more. I would like to add to her list with the psychological, social and emotional routines and ways of being that will also make the transition smoother.

Education Week offers a few social-emotional checklists that are good to review to help you set your student off on the right foot as they start this school year.

  • First check in with yourself and your own emotions/feelings. If you are feeling anxious, do something to help calm your emotions and gain some centeredness. Take care of yourself so you can take care of others.
  • Establish those all so important sleep, eating and exercise routines.
  • Establish a calming routine that the family can do together for a few minutes (i.e., yoga, mindful minute, deep breathing, etc.).
  • Acknowledge the breadth of feelings your child may have and how rapidly they may change. Point this out to him/her when they are calm. Introduce the realization that thoughts are connected to feelings, and they can change their thoughts to help their feelings change. Be understanding, supportive and empathetic yet also encourage your student to use their “past data” to support their progress forward through their feelings.
  • As Angela said, establish routines and predictability at home but also model and help your child know that things don’t always go as planned. Have routines yet be flexible, adaptable and a “go with the flow” mindset will be essential as s/he enters this school year. There are always Plans B, C, and D when Plan A doesn’t work. For instance, you may insist your child wear a mask and another child in his class, or afterschool activity/sport, may not. Preview this possible scenario so your child can adept and accept. Or, a student starts the year in-person, but then hybrid (hopefully not) happens…again. You get the idea about teaching flexibility.
  • Stay positive even in the midst of uncertainty, as this helps create the right biochemical mix that allows you to think more clearly.
  • Be aware of your thoughts and help your child be aware of their thoughts. Thoughts influence our mood, feelings and behavior, and we can exert control over them.
  • Be grateful (end the night with a gratitude moment).
  • Be supportive. Acknowledge the efforts, tasks, feelings, etc. that your kids are taking on and experiencing. It helps them develop self-confidence, self-esteem, self-efficacy, pride and a sense of competence.
  • Be hopeful. Yesterday is history (don’t dwell there), tomorrow is a mystery (don’t worry about it) and today is a gift (even if you don’t feel like it is). Be present and allow whatever feelings come up (positive or negative) to flow through you so you can make way for new feelings.

Wishing everyone a smooth start to the 2021-2022 school year, and may the force be with us as we continue to combat Covid.

Resources

https://www.bu.edu/bostonia/

https://www.edweek.org/leadership/preparing-for-in-person-learning-a-covid-19-checklist-for-parents/2021/08?utm_source=nl&utm_medium=eml&utm_campaign=eu&M=63136722&U=1970318&UUID=f2e19d19dbb5bd4e92068a32311b141c

 

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.

 

Transition Training in Today’s Environment

By | NESCA Notes 2021

By: Becki Lauzon, M.A., CRC
Transition Specialist and Consultant

As we head back to school and continue to live with COVID in our lives, it has become apparent that transition services must include training our students to live in this “new normal.” When I sat down to write about back to school tips and suggestions, I was reminded of the blog post that I wrote last summer in preparation of our return to the classrooms. I never would have thought that we would be returning to masks in the fall of 2021, but here we are! Below are some basic ideas from my blog last summer about how to continue developing transition skills if community-based options are not fully available.

Independent Living
Practice using Peapod or other online grocery delivery services
Cooking within the school building
Research how to order prescriptions online or over the phone
Practice mock phone calls to order food, make a medical appointment, etc.
Review public transportation schedules and research how long it takes to get from one place to another

Vocational
Folding clothes or stocking shelves in the school store
Learning how to use Microsoft Word, Excel, PowerPoint, etc.
Practice mock interviews
Use free online resources to watch short career videos and start a binder of likes and dislikes about each job
Identify places you might like to work (MANY places are hiring due to a shortage of workers)

Functional Academics
Access your bank account online and see where you spend your money
Use mock online banking resources to understand the do’s and don’ts
Practice ordering at a restaurant by using an online menu

Helpful Resources

In addition to the above suggestions, there are many other resources that parents, educators, and individuals may find helpful.

“Coping With COVID” Anxiety Worksheets
https://www.teacherspayteachers.com/Product/Coping-with-Covid-19-Anxiety-19-Worksheets-for-Teens-Google-Slides-option-5763713?st=16ac0d9101b4f377d4a58d35e2284100

Vaccine Lesson
https://www.teacherspayteachers.com/Product/COVID-19Coronavirus-mRNA-vaccines-Pfizer-vs-Moderna-6573582?st=16ac0d9101b4f377d4a58d35e2284100

Updated DDS guidance (8/11/21)
https://www.mass.gov/news/coronavirus-update-from-dds-commissioner-jane-ryder

 

About the Author

Becki Lauzon, M.A., CRC, works with teens, young adults and their families out of the Newton, MA and Plainville, MA offices. Lauzon has unparalleled experience as a Transition Specialist, Transition Consultant and Vocational Program Coordinator. Lauzon will be providing transition assessment (including testing, functional evaluations and observations) consultation, case management, training and professional development for schools; and transition planning, consultation and coaching for transition-aged students and their parents.

 

To schedule an appointment with one of NESCA’s expert transition specialists or neuropsychologists, please complete our online intake form

 

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

 

Student Involvement in IEPs: Ten Tips to Help Middle School Students Get Started – Part 2

By | NESCA Notes 2021

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

As discussed in my previous blog, federal law requires that students with Individual Education Programs (IEPs) be invited to attend their transition IEP meetings. In Massachusetts, this means that students approaching the age of 14, often 8th graders, should be invited to attend their IEP meetings to start the process of transition planning if this has not already begun. However, many students are not invited to their team meetings until high school, if at all. Additionally, research has indicated that when students do attend team meetings, they have the lowest level of satisfaction about their IEP meeting of any team member and they feel the least comfortable sharing their thoughts and suggestions in the meeting.[i] Nevertheless, studies across the country have shown that students can learn skills to actively participate in their IEP meetings, especially when they are directly taught terminology, roles, and how to participate, and when team members expect student participation.[ii] In the first part of this blog series, I provided five tips for helping students to become involved in their IEP process: Explicitly learn about the IEP document and process; Talk about strengths; Talk about challenges; Complete interest and preference inventories; and, Talk about the student’s goals for after high school. Today, I am adding five more tips aimed at truly helping the student to be an instrumental part of their team meeting. After all, the student’s voice and their vision are the most important aspects of transition planning and special education.

  1. If testing is being discussed, make sure that an adult talks about the testing with the student BEFORE the IEP meeting—The ability to use assessment information to develop goals is one of the most important skills a student needs in order to be an active participant in their transition planning process. This means that students need to have access to, and an understanding of, assessment information just like every other member of the team. Professionals and parents all have the right to access evaluation results ahead of a team meeting and traditionally come to the meeting having read the evaluations, often more than once. Moreover, they have typically seen the same tests or similar tests beforehand and usually already have some sense of the student’s learning profile, strengths, and challenges. When the student has undergone evaluations that will inform IEP development, it is critical for the evaluator or another adult who understands the testing well to sit with the student and explain the findings and recommendations from the evaluations in a developmentally appropriate manner. The student needs to know what areas were evaluated, and to have a general sense of the strengths, challenges, interests, and preferences that were highlighted within the testing, in order to be able to participate in a meaningful discussion about their short- and long-term goals and the services that they need. Moreover, they need to have time to process this information, with support, before they are expected to participate in a discussion about what to do with the information.
  2. Give the student options as to how they would like to participate—Just like any other activity, an IEP meeting can be broken down through a task analysis process, and participation in the IEP meeting can be scaffolded, rather than taking an all or nothing approach. There are many actions and “micro-actions” that a student can take to be involved in their team meeting in a way that feels comfortable and satisfying to the student. Certainly, there are the preparatory activities described in my previous blog (e.g., participating in assessment, learning about the IEP, completing a one-pager, etc.). But there are also administrative tasks that the student can participate in, like photocopying materials or sending out invitations or reminders to participants. Students may also want to prepare a script, PowerPoint, video, work portfolio or other materials they can share with the team during the meeting. Also, they may want to share their experience at the meeting with peers afterward or present highlights of the meeting to a staff member or family member who could not attend. There are many examples of ways to participate before, during, and after the team meeting in this great brochure from the I’m Determined project (https://www.imdetermined.org/wp-content/uploads/2017/10/iep_participation_brochure.pdf). Some students may choose to take a more passive role, but it is important that the student has the opportunity to prepare and to make an informed choice regarding their participation. Over time, students should be building their skills for IEP participation so that they can ultimately lead one or more of their transition IEP meetings (http://www.ciclt.net/ul/mgresa/2.HowtoHelpStudentsLeadIEP.pdf).
  3. Practice!—This tip may seem obvious, but I am taking time to state it because it is often something that is forgotten. Participating in an IEP meeting, especially as the student, is not a normal activity. Sitting in tight quarters with your parents, general educators, special educators, therapists, counselors, and any number of other professionals, who are all talking about you and your challenges is inherently uncomfortable—especially if you have difficulties with language, social cues, anxiety, etc. One way to make the experience “less weird” is to practice. Generally, students will be asked questions about their concerns, strengths, accomplishments, challenges, and goals for the future. It helps to practice answering questions about these areas outside of the IEP meeting and to not be answering these types of questions for the first time in the meeting. An even more useful practice activity is to have a mock IEP meeting. There are plenty of scripts online that follow the typical format of an IEP meeting, such as introductions and attendance, questions and concerns, reports of current performance, transition planning, and IEP development. It is particularly important for the student to be aware of times in the meeting when they will be specifically asked for their contribution (e.g., introductions, student concerns, vision statement, etc.).
  4. Invite preferred staff—Scheduling team meetings is a logistical puzzle, and often not all staff can be present for the whole meeting, if at all. Ask the student who they feel knows them best and who they really want on their team. If you know which teachers are the most motivating for the student, make sure that they are invited. Moreover, when there is a choice related to staff participation, prioritize having the meeting at a time when staff who the student likes and feels comfortable with can be part of the meeting. For student’s who have 1:1 paraprofessional support, it is really important for the paraprofessional to be at the meeting so that the student can have the same level of assistance (and feel the same sense of safety and support) that they do throughout their school day. The student is the most important member of their IEP team, and they will feel most included if they look around the room and see familiar faces of people they know are on their side.
  5. Expect the student to participate!—The  most important thing that adults can do to assist students in participating in their IEP meetings is to make the time and space for the student to participate in the meeting. This may mean requesting a longer meeting than usual so that adults in the meeting can slow down or rephrase language in terms that are accessible for the student and so that the student has time to formulate their thoughts and language in order to participate in the meeting. Whatever accommodations a student needs to participate actively in a classroom discussion should be considered and put in place if they are needed for a student to participate actively in the team meeting discussion. Adults need to be respectful of the student’s voice and to not speak for the student, interrupt the student, talk over the student, or disregard the student’s input. The student’s participation needs to be expected, empowered, and applauded, because, after all, it is their IEP meeting, their education, and their life.

[i] http://www2.ku.edu/~tccop/files/Martins_Perspective.pdf

[ii] http://www2.ku.edu/~tccop/files/Martins_Perspective.pdf

 

About the Author
Kelley Challen, Ed.M., CAS, is NESCA’s Director of Transition Services, overseeing planning, consultation, evaluation, coaching, case management, training and program development services. Ms. Challen also provides expert witness testimony in legal proceedings related to special education. She is also the Assistant Director of NESCA, working under Dr. Ann Helmus to support day-to-day operations of the practice. Ms. Challen began facilitating programs for children and adolescents with special needs in 2004. After receiving her Master’s Degree and Certificate of Advanced Study in Risk and Prevention Counseling from Harvard Graduate School of Education, Ms. Challen spent several years at the MGH Aspire Program where she founded an array of social, life and career skill development programs for teens and young adults with Asperger’s Syndrome and related profiles. She additionally worked at the Northeast Arc as Program Director for the Spotlight Program, a drama-based social pragmatics program, serving youth with a wide range of diagnoses and collaborating with several school districts to design in-house social skills and transition programs. Ms. Challen is co-author of the chapter “Technologies to Support Interventions for Social- Emotional Intelligence, Self-Awareness, Personality Style, and Self-Regulation” for the book Technology Tools for Students with Autism. She is also a proud mother of two energetic boys, ages six and three. While Ms. Challen has special expertise in supporting students with Autism Spectrum Disorders, she provides support to individuals with a wide range of developmental and learning abilities, including students with complex medical needs.

 

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, call 617-658-9800 or complete our online Intake Form.