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nesca newton

Child Feedback Sessions: How and Why We Explain What Testing Means To Kids

By | NESCA Notes 2019

By: Amity Kulis, PsyD
Pediatric Neuropsychologist, NESCA

“Who get’s the results of the testing, me or my parents?” As a neuropsychologist, clients of all ages ask why they are being tested and who is going to get the information from the testing. Sometimes these questions come from a place of nervousness, while others are asking because they have a general curiosity.

Neuropsychological evaluation is an intensive process where students are trying out all sorts of skill sets, some activities that are familiar (e.g., math problems), and some activities that they will only ever do in the context of an evaluation process (e.g., putting pegs in a pegboard, drawing weird rocketship shaped patterns from memory). Even children as young as elementary school are often curious about the results of the assessment (e.g., how did I do? what were you testing? what is the report going to say?). These are such important questions and I am always excited when the children I am working with are curious about what this all means.

At NESCA, a neuropsychology and integrative treatment practice founded in Newton, MA, we conclude our testing with a parent feedback session where results and preliminary recommendations are clearly presented to parents. This is a conversational format so that we can ensure that there is good understanding and a shared picture of what we have learned about the child. Even with a lengthy conversation, parents often question about how to share the findings with their children because it often results in changes for the child like working with new people or getting more/less or different services at school.

Importantly, we offer child/adolescent feedback sessions for children of all ages. These mini-feedback sessions are presented in a developmentally appropriate manner to share the findings of the evaluation. Often with older children and adolescents this conversation includes discussing any diagnosis that came out of the evaluation. For all individuals the conversation always includes a strengths-based approach highlighting the things the child/adolescent did wonderfully using examples from the testing to explain these strengths and how they might show these skills in real life. Then we move on to also talking about some of the activities that were more challenging and how we envision teachers, providers, or other supports helping them to make progress. For example, a child might do extremely well on tasks of visual problem solving such as recreating block designs or on verbal tasks that ask them to define words, but have greater challenges on tasks that assess processing speed. These findings suggest a child is able to think and problem solve at a high level, yet processes information more slowly and might need more time to show off their strengths when they are expected to produce output. This important difference is so essential to explain to even younger children. Children often value speed over all else, and explaining to them that working slow but producing amazing ideas is a real asset. The same type of careful explanation can be taken when explaining learning disabilities, attentional issues, social difficulties and emotional vulnerabilities. There is a calculated effort to include the child/adolescent in a conversation about their own ideas on how to improve areas of need and I feel this really empowers them to work for the change and positive growth. Plus, these sessions are a great way to gain closure over the experience of testing and allow them to understand what was accomplished and learned through all of their hours of hard work.

About the Author:

Dr. Amity Kulis joined NESCA in 2012 after earning her doctoral degree in clinical psychology from the Massachusetts School of Professional Psychology, with a concentration in Children, Adolescents and Families (CAF). She completed post-doctoral training in pediatric neuropsychology with an emphasis on treating children with developmental, intellectual, learning and executive functioning challenges. She also has extensive training psychological (projective) testing and has conducted individual and group therapies for children of all ages. Before joining NESCA, Dr. Kulis worked in private practices, clinics, and schools, conducting comprehensive assessments on children ranging from toddlers through young adults. In addition, Dr. Kulis has had the opportunity to consult with various school systems, conducting observations of programs, and providing in-service trainings for staff. Dr. Kulis currently conducts neuropsychological and psychological (projective) assessments for school-aged children through young adulthood. She regularly participates in transition assessments (focusing on the needs of adolescents as they emerge into adulthood) and has a special interest in working with complex learners that may also struggle with emotional challenges and psychiatric conditions. In addition to administering comprehensive and data-driven evaluations, Dr. Kulis regularly conducts school-based observations and participates in school meetings to help share her findings and consultation with a student’s TEAM.

 

To book an evaluation with Dr. Kulis or one of our many other expert neuropsychologists and transition specialists, 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, 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.

 

 

25 Miles of Inspiration

By | NESCA Notes 2018

 

By: Nancy Roosa, PsyD
Pediatric Neuropsychologist, NESCA

Last Saturday, I found myself – as part of Team NESCA- at the starting line for a bike ride, waiting apprehensively for my turn to start, carefully balancing my bike between my legs, stretching my legs and checking my tires.  I was a bit nervous, because I’m not an experienced or competitive bike rider.  But this was not a race: it was the 28th annual Rodman Ride for Kids, one of the most congenial, supportive athletic events you can imagine and my apprehension soon faded among the general high spirits of riders and volunteers around me.  Team NESCA’s turn soon came and we took off, surrounded by about 1,500 other joyful riders.

The joy of the day was primarily because all of us riders had a shared goal – to raise money for programs that benefit at-risk children across Massachusetts.  Team NESCA took to the road to support one of our favorite local nonprofits: Asperger’s/Autism Network (AANE), which provides a wide variety of educational, outreach and supportive programs for individuals and families affected by autism. For more information about AANE please see their website.  https://www.aane.org/.

The Rodman Ride is unique.  Instead of being run by and for one large entity, the Rodman for Kids charity serves as the organizational powerhouse behind the ride, allowing even small nonprofits to participate in a major fundraiser.  About 45 small nonprofits, like AANE, take advantage of the fact that the Rodman for Kids charity does all the organizational legwork: setting up a website for fundraising, identifying and marking the course, and enlisting an army of volunteers to make the race happen.  Any social service agency that supports at-risk children in Massachusetts can participate.  There is no fee; in fact, the Rodman organization adds 3% to any dollars raised. Over the years, the Rodman Ride has raised about $144 million dollars!

 

Stephanie Monaghan-Blout and Nancy Roosa

 

One fun part of the day was reading the jerseys of all the other riders and feeling uplifted just by seeing how many organizations are working to support at-risk children in our state.  At this time, when so much of the daily news is disheartening, it was inspiring to be surrounded by thousands of people who are putting time and energy into supporting vulnerable children.  Beyond the riders, over 500 other companies sponsor the volunteer activities that support the ride.  We rode with a friend who was riding for Trinity Foundation, and were surrounded by many riders from Mass Mentoring and Jewish Big Brothers Big Sisters.  Our cheerful announcer, who kept us all organized at the starting line, introduced various groups and invited them to speak about their efforts.  Did you know there is a nonprofit group called Above the Clouds, which takes children with disabilities on plane rides?  Who knew?

Team NESCA was thrilled to be part of the day; we, along with about 20 other riders for AANE, helped AANE raise over $56,000 to support their programming for the coming year.

And we had fun.  It was a beautiful ride, with perfect weather, through the mostly flat streets around Foxborough and Lake Massapoag.  There were volunteers ringing cowbells and shouting directions and encouragement anytime we had to make a turn.  The water stops had piles of snacks – from bananas to chocolate energy bars – and a DJ pumping out bouncy songs.  There was breakfast and coffee at the beginning and a great barbeque lunch and beer at the end.

All in all, it was so inspiring to join with so many other people who are committed to helping at-risk youth.  I’ll be buying my next car at Rodman Ford.  In the meantime, who’s up for riding with Team NESCA and AANE next year?

 

 

About the Author:
Roosa

Nancy Roosa, PsyD has been engaged in providing neuropsychological evaluations for children since 1997. She enjoys working with a range of children, particularly those with autism spectrum disorders, as well as children with attentional issues, executive function deficits, anxiety disorders, learning disabilities, or other social, emotional or behavioral problems. Dr. Roosa’s evaluations are highly-individualized and comprehensive, integrating data obtained from a wide range of standardized assessment tools with information gained from history, input from parents, teachers and providers, and important observations gleaned from interacting with the child. Her approach to testing is playful and supportive. Her evaluations are particularly useful for children with complex profiles and those whose presentations do not fit neatly into any one diagnostic box.

 

To book a consultation with Dr. Roosa or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate “Consultation” and your preferred clinician 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, 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.

 

 

Encourage Your Children to Read

By | NESCA Notes 2018

By: Alissa Talamo, PhD
Clinical Neuropsychologist, NESCA

According to Sally Shaywitz M.D., (Audrey G. Ratner Professor of Pediatrics-Neurology; Co-Director, Yale Center for Dyslexia & Creativity), dyslexia is highly prevalent, affecting one in five people, and it represents over 80% of all learning disabilities.

Even when a child does not meet the criteria for dyslexia, they may be a reluctant reader. Children who do not practice reading perform poorly on reading tests relative to children who do read on a regular basis. In addition, reduced reading time results in exposure to fewer words. In general, people use limited vocabulary during conversation compared to the language one is exposed to while reading. As such, a reluctant reader is at risk to have poorly developed vocabulary knowledge compared to same-age peers. They are also less likely to improve their reading skills over time. In her book, Overcoming Dyslexia (2003), Dr. Shaywitz shared the following information:

Through reading, a child is introduced to new concepts and information. In addition, the more a child is exposed to literature, the more likely reading will become an integral part of their daily life. However, how does a parent encourage a reluctant reader?  Here are some ideas:

1.  Read a story to your child. Then ask them to talk about their favorite parts of the story.

2. Be ready to read or listen to books over and over again – this is how children learn. FYI- Did you know you can listen to the audio version of Mrs. Piggle-Wiggle (a series of children’s books by Betty MacDonald originally published in 1947)  four times in a row on a drive from Boston to Maryland and four times in a row on the way back?  I did this with my daughter when she was 4-years-old (she is now 16) and I do believe that, to this day, I can still quote parts of the book!

3.  Surround your children with reading material – this can be comprised of books, graphic novels, or magazines, anything that is of interest to your child.

4.  Let your child take out their own library card and go with you to the library to pick out their own reading material. Allowing a child to read for pleasure is the best way to create a more engaged reader. However, it is also important to make sure the child is choosing an age-appropriate book. A librarian can be very helpful in providing recommendations based on a child’s age and areas of interest.

 5.  Have your children practice reading whenever possible. Baking a cake? Ask them to help you read the instructions (perhaps your hands are too messy to turn the page!). At a restaurant? Let them read the menu aloud to a younger sibling.

6. Use technology to your advantage. For example, I worked with a 14-year old boy with dyslexia who was intimidated by the size of the first Harry Potter book. However, I mentioned to him that, on the I-pad, the book is no bigger than the I-pad itself. He was more willing to carry an I-pad around and read at his own pace. Another advantage is that with an e-reader the child can place as much or as little text on a page as they wish, another way to reduce reading stress.

 7. Take advantage of audiobooks. This technology is a huge benefit for students who struggle to access books that are written for children their age but beyond their current independent reading level. The child can simply listen along, or they can hold the book and follow along with the text while listening. There are several ways to access audiobooks, including downloading them from your library for free!

8. Finally, model good reading habits. If your child never sees you reading, but you insist that they read, they will see reading as a chore rather than a pleasure. If you are not a strong reader, that is ok, you too can listen to audiobooks!

While these recommendations will hopefully help your child experience increased reading pleasure and exposure to literature, it is still important to find out the reason why your child is struggling to read. If your child has not had a thorough reading evaluation, you can ask your child’s school to complete such an assessment. In addition, you may wish to have your child evaluated by an independent evaluator.

To book a consultation with Dr. Talamo or one of our many other expert neuropsychologists, complete NESCA’s online intake form. Indicate “Consultation” and your preferred clinician in the referral line.

About the Author:

With NESCA since its inception in 2007,  Dr. Talamo had previously practiced for many years as a child and adolescent clinical psychologist before completing postdoctoral re-training in pediatric neuropsychology at the Children’s Evaluation Center.

After receiving her undergraduate degree from Columbia University, Dr. Talamo earned her doctorate in clinical health psychology from Ferkauf Graduate School of Psychology and the Albert Einstein College of Medicine at Yeshiva University.

Dr. Talamo specializes in working with children and adolescents with language-based learning disabilities including dyslexia, attentional disorders and emotional issues. She is also interested in working with highly gifted children.

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, 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.

 

 

School Observations

By | NESCA Notes 2018

By: Amity Kulis, PsyD
Pediatric Neuropsychologist, NESCA

One of my favorite activities as a neuropsychologist is getting to conduct school observations. Many parents ask why would I need a school observation? And the answer is simple, they provide a wealth of information about your child and their everyday experience at school. For so many, understanding the comings and goings of a child’s day at school is something most parents do not have the opportunity to explore. You ask your child, “how was your day?” and for many, all you get is a “fine” or “okay” with no elaboration of what actually happened. Understanding a child’s experience of the school day is important for all families, but especially important if your child is having difficulties at school such as learning, social or emotional stressors.

After conducting a neuropsychological assessment of a child, I am able to get a good understanding of the child’s learning profile and a good grasp of the child’s strengths and needs. With this information, I am able to conduct school observations with a lens towards what the children I am seeing might need and how they interact with their environment. For the majority of the children I observe at school they are already getting specialized services and for one reason or another, their parents are concerned.

During the observation, I am able to gain a better understanding of a child’s social functioning within the context of their peers at school. I often purposefully schedule observations during a combination of structured class time as well as less structured time such as art or gym, and finally during an unstructured time such as lunch or recess. This combination of environments allows me to see the child interact with peers in a variety of settings. I am able to answer questions about where a child does best and what types of environments might be more challenging. Are they a rock star during group lessons or are they leading a group of peers across the playground? For other children they may fade into the background, refusing to participate during large group instruction but become more animated during one-on-one time with their teacher. Or maybe they are a child that cannot handle the unstructured recess time and hide in the corner isolating themselves. Gaining a better understanding of a child’s social successes and then relating that information to their neuropsychological profile can help to explain why a child is struggling and how best to support them.

Beyond looking at a child’s social functioning during the school day, I am also able to observe the delivery of instruction and how the child responds. I am always watching how a teacher deliveries information to the class and then seeing how the child is able to respond. Does the child follow the direction the first time they are heard or do they need them repeated and modeled by watching other students begin the activity first? I also look at how a child interacts during whole group instruction or discussion versus a small group or more individual work. I also love the opportunity to speak with teachers during the observation to understand what curriculums they are using as well as answering questions about how they see the child interacting in the classroom. If a child is on an education plan I am also paying close attention to how accommodations and supports are being integrated into and across the child’s school day.

In addition to being a fun and engaging part of my job, observations also provide such valuable information from which I can create very specific and targeted recommendations for a child based on their own school environment. There is definitely not a one-size-fits-all recipe for helping a child with a particular profile because an environment is so influential on a child’s successes and challenges. An amazing relationship with one teacher can go a long way toward helping a child take chances and make progress, just as the opposite is true. With a school observation, there is the opportunity to gain more clarity into a child’s everyday school life to help foster their strengths and support their vulnerabilities.

About the Author:

Dr. Amity Kulis joined NESCA in 2012 after earning her doctoral degree in clinical psychology from the Massachusetts School of Professional Psychology, with a concentration in Children, Adolescents and Families (CAF). She completed post-doctoral training in pediatric neuropsychology with an emphasis on treating children with developmental, intellectual, learning and executive functioning challenges. She also has extensive training psychological (projective) testing and has conducted individual and group therapies for children of all ages. Before joining NESCA, Dr. Kulis worked in private practices, clinics, and schools, conducting comprehensive assessments on children ranging from toddlers through young adults. In addition, Dr. Kulis has had the opportunity to consult with various school systems, conducting observations of programs, and providing in-service trainings for staff. Dr. Kulis currently conducts neuropsychological and psychological (projective) assessments for school-aged children through young adulthood. She regularly participates in transition assessments (focusing on the needs of adolescents as they emerge into adulthood) and has a special interest in working with complex learners that may also struggle with emotional challenges and psychiatric conditions. In addition to administering comprehensive and data-driven evaluations, Dr. Kulis regularly conducts school-based observations and participates in school meetings to help share her findings and consultation with a student’s TEAM.

 

 

 

 

Neuropsychology & Education Services for Children & Adolescents (NESCA) is a pediatric neuropsychology practice and integrative treatment center with offices in Newton, 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.